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Sample records for cumulative risk index

  1. Cumulative risk assessment of phthalate exposure of Danish children and adolescents using the hazard index approach

    DEFF Research Database (Denmark)

    Søeborg, T; Frederiksen, H; Andersson, Anna-Maria

    2012-01-01

    and adolescents and resulting estimated daily intakes of four different phthalates. These daily intake estimates are used for a cumulative risk assessment with anti-androgenic effects as the endpoint using Tolerable Daily Intake (TDI) values determined by the European Food Safety Authorities (EFSA) or Reference...... endpoint for the phthalates included in this article. Using the EFSA TDI values, 12 children exceeded the hazard quotient for the sum of di-n-butyl phthalate and di-iso-butyl phthalate (∑DBP((i+n)) ) and one child exceeded the hazard quotient for di-(2-ethylhexyl)phthalate (DEHP). Nineteen children...... exceeded the cumulated hazard index for three phthalates. Using the RfD AA values, one child exceeded the hazard quotient for DEHP and the same child exceeded the cumulated hazard index for four phthalates. The EFSA TDI approach thus is more restrictive and identifies ∑DBP((i+n)) as the compound...

  2. Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach.

    Science.gov (United States)

    Chang, J W; Chen, C Y; Yan, B R; Chang, M H; Tseng, S H; Kao, Y M; Chen, J C; Lee, C C

    2014-06-01

    Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP(i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP(i + n) in 0-6-yr-old children accounted for 91% (79-107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0-3-yr-old children and 4-6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods.

  3. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study.

    Science.gov (United States)

    Zhang, Ming; Wang, Bingyuan; Liu, Yu; Sun, Xizhuo; Luo, Xinping; Wang, Chongjian; Li, Linlin; Zhang, Lu; Ren, Yongcheng; Zhao, Yang; Zhou, Junmei; Han, Chengyi; Zhao, Jingzhi; Hu, Dongsheng

    2017-03-01

    Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China. We included data from 5706 people with normal body mass index (BMI) (18.5-23.9 kg/m(2)) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure-response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2]. Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20-5.11], 3.77 [1.83-7.79], and 5.30 [2.21-12.71], P trend Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22-6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index. Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.

  4. A new family of cumulative indexes for measuring scientific performance.

    Directory of Open Access Journals (Sweden)

    Marcin Kozak

    Full Text Available In this paper we propose a new family of cumulative indexes for measuring scientific performance which can be applied to many metrics, including h index and its variants (here we apply it to the h index, h(2 index and Google Scholar's i10 index. These indexes follow the general principle of repeating the index calculation for the same publication set. Using bibliometric data and reviewer scores for accepted and rejected fellowship applicants we examine how valid the cumulative variant is compared to the original variant. These analyses showed that the cumulative indexes result in higher correlations with the reviewer scores than their original variants. Thus, the cumulative indexes better reflect the assessments by peers than the original variants and are useful extensions of the original indexes. In contrast to many other measures of scientific performance proposed up to now, the cumulative indexes seem not only to be effective, but they are also easy to understand and calculate.

  5. Cumulative index 1981-1985, Volumes 138-157.

    Science.gov (United States)

    1985-01-01

    This cumulative index also includes listings of all major papers from the American Journal of Neuroradiology, American Journal of Roentgenology, Clinics in Diagnostic Ultrasound, Journal of Computer Assisted Tomography, Journal of Ultrasound in Medicine, RadioGraphics, Radiologic Clinics of North America, Seminars in Nuclear Medicine, Seminars in Roentgenology, and Seminars in Ultrasound, CT and MR.

  6. Cumulative index 1981-1985, Volumes 138-157

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    This cumulative index also includes listings of all major papers from the American Journal of Neuroradiology, American Journal of Roentgenology, Clinics in Diagnostic Ultrasound, Journal of Computer Assisted Tomography, Journal of Ultrasound in Medicine, RadioGraphics, Radiologic Clinics of North America, Seminars in Nuclear Medicine, Seminars in Roentgenology, and Seminars in Ultrasound, CT and MR.

  7. EPA Workshop on Epigenetics and Cumulative Risk ...

    Science.gov (United States)

    Agenda Download the Workshop Agenda (PDF) The workshop included presentations and discussions by scientific experts pertaining to three topics (i.e., epigenetic changes associated with diverse stressors, key science considerations in understanding epigenetic changes, and practical application of epigenetic tools to address cumulative risks from environmental stressors), to address several questions under each topic, and included an opportunity for attendees to participate in break-out groups, provide comments and ask questions. Workshop Goals The workshop seeks to examine the opportunity for use of aggregate epigenetic change as an indicator in cumulative risk assessment for populations exposed to multiple stressors that affect epigenetic status. Epigenetic changes are specific molecular changes around DNA that alter expression of genes. Epigenetic changes include DNA methylation, formation of histone adducts, and changes in micro RNAs. Research today indicates that epigenetic changes are involved in many chronic diseases (cancer, cardiovascular disease, obesity, diabetes, mental health disorders, and asthma). Research has also linked a wide range of stressors including pollution and social factors with occurrence of epigenetic alterations. Epigenetic changes have the potential to reflect impacts of risk factors across multiple stages of life. Only recently receiving attention is the nexus between the factors of cumulative exposure to environmental

  8. Cumulative risks of foster care placement for Danish children

    National Research Council Canada - National Science Library

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster...

  9. Cumulative Risks of Foster Care Placement for Danish Children

    DEFF Research Database (Denmark)

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster care placement in other countries, which makes it difficult to gauge the degree to which factor...... is for Danish children. Results suggest that at the beginning of the study period (in 1998) the cumulative risk of foster care placement for Danish children was roughly in line with the risk for American children. Yet, by the end of the study period (2010), the risk had declined to half the risk for American...... foster care placement is salient in other contexts. In this article, we provide companion estimates to those provided in recent work on the US by using Danish registry data and synthetic cohort life tables to show how high and unequally distributed the cumulative risk of foster care placement...

  10. Childhood Cumulative Risk Exposure and Adult Amygdala Volume and Function.

    Science.gov (United States)

    Evans, Gary W; Swain, James E; King, Anthony P; Wang, Xin; Javanbakht, Arash; Ho, S Shaun; Angstadt, Michael; Phan, K Luan; Xie, Hong; Liberzon, Israel

    2016-06-01

    Considerable work indicates that early cumulative risk exposure is aversive to human development, but very little research has examined the neurological underpinnings of these robust findings. This study investigates amygdala volume and reactivity to facial stimuli among adults (mean 23.7 years of age, n = 54) as a function of cumulative risk exposure during childhood (9 and 13 years of age). In addition, we test to determine whether expected cumulative risk elevations in amygdala volume would mediate functional reactivity of the amygdala during socioemotional processing. Risks included substandard housing quality, noise, crowding, family turmoil, child separation from family, and violence. Total and left hemisphere adult amygdala volumes were positively related to cumulative risk exposure during childhood. The links between childhood cumulative risk exposure and elevated amygdala responses to emotionally neutral facial stimuli in adulthood were mediated by the corresponding amygdala volumes. Cumulative risk exposure in later adolescence (17 years of age), however, was unrelated to subsequent adult amygdala volume or function. Physical and socioemotional risk exposures early in life appear to alter amygdala development, rendering adults more reactive to ambiguous stimuli such as neutral faces. These stress-related differences in childhood amygdala development might contribute to the well-documented psychological distress as a function of early risk exposure.

  11. Cumulative risks of foster care placement for Danish children.

    Science.gov (United States)

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster care placement in other countries, which makes it difficult to gauge the degree to which factor foster care placement is salient in other contexts. In this article, we provide companion estimates to those provided in recent work on the US by using Danish registry data and synthetic cohort life tables to show how high and unequally distributed the cumulative risk of foster care placement is for Danish children. Results suggest that at the beginning of the study period (in 1998) the cumulative risk of foster care placement for Danish children was roughly in line with the risk for American children. Yet, by the end of the study period (2010), the risk had declined to half the risk for American children. Our results also show some variations by parental ethnicity and sex, but these differences are small. Indeed, they appear quite muted relative to racial/ethnic differences in these risks in the United States. Last, though cumulative risks are similar between Danish and American children (especially at the beginning of the study period), the age-specific risk profiles are markedly different, with higher risks for older Danish children than for older American children.

  12. Aerospace Medicine and Biology: A cumulative index to the 1980 issues

    Science.gov (United States)

    1981-01-01

    A cumulative index to the abstracts contained in the Supplements 203 through 214 of Aerospace Medicine and Biology: A Continuing Bibliography is presented. It includes three indexes--subject, personal author, and corporate source.

  13. Cumulative Risk and Teacher Well-Being in the Democratic Republic of the Congo

    Science.gov (United States)

    Wolf, Sharon; Torrente, Catalina; McCoy, Marissa; Rasheed, Damira; Aber, J. Lawrence

    2015-01-01

    Remarkably little systematic research has examined the living and working conditions for teachers in sub-Saharan Africa and how such conditions predict teacher well-being. This study assesses how various risks across several domains of teachers' lives--measured as a "cumulative risk index"--predict motivation, burnout, and job…

  14. Cumulative Effect of Depression on Dementia Risk

    Directory of Open Access Journals (Sweden)

    J. Olazarán

    2013-01-01

    Full Text Available Objective. To analyze a potential cumulative effect of life-time depression on dementia and Alzheimer’s disease (AD, with control of vascular factors (VFs. Methods. This study was a subanalysis of the Neurological Disorders in Central Spain (NEDICES study. Past and present depression, VFs, dementia status, and dementia due to AD were documented at study inception. Dementia status was also documented after three years. Four groups were created according to baseline data: never depression (nD, past depression (pD, present depression (prD, and present and past depression (prpD. Logistic regression was used. Results. Data of 1,807 subjects were investigated at baseline (mean age 74.3, 59.3% women, and 1,376 (81.6% subjects were evaluated after three years. The prevalence of dementia at baseline was 6.7%, and dementia incidence was 6.3%. An effect of depression was observed on dementia prevalence (OR [CI 95%] 1.84 [1.01–3.35] for prD and 2.73 [1.08–6.87] for prpD, and on dementia due to AD (OR 1.98 [0.98–3.99] for prD and OR 3.98 [1.48–10.71] for prpD (fully adjusted models, nD as reference. Depression did not influence dementia incidence. Conclusions. Present depression and, particularly, present and past depression are associated with dementia at old age. Multiple mechanisms, including toxic effect of depression on hippocampal neurons, plausibly explain these associations.

  15. The impact of cumulative family risks on various levels of food insecurity.

    Science.gov (United States)

    Hernandez, Daphne C

    2015-03-01

    The study uses the Fragile Families and Child Well-being Study (N=2025) to examine the relationship between four cumulative family risk indices and refined measures of food hardship: marginal food security, low food security, and very low food security. Regression analyses indicate that cumulative family risk indices are useful in differentiating various levels of food insecurity. Specifically, the maternal poor health and risky health behaviors index is pertinent for distinguishing (1) food insecure from marginal food secure households and (2) very low food secure from low food secure households. In addition, the financial strain index is pertinent for differentiating between marginal food secure families from food secure families among non-poor households. Connecting food assistance programs with established social services may decrease the negative impact that cumulative family-level risk factors have on families' varying levels of food insecurity.

  16. Childhood Cumulative Risk and Later Allostatic Load

    DEFF Research Database (Denmark)

    Doan, Stacey N; Dich, Nadya; Evans, Gary W

    2014-01-01

    Objective: The present study investigated the long-term impact of exposure to poverty-related stressors during childhood on allostatic load, an index of physiological dysregulation, and the potential mediating role of substance use. Method: Participants (n = 162) were rural children from New York...... in health across the life span and of the mechanisms by which adverse childhood environments impact health as children emerge into early adulthood. This knowledge will have implications for early intervention efforts. (PsycINFO Database Record (c) 2013 APA, all rights reserved)....

  17. Cumulative risk hypothesis: Predicting and preventing child maltreatment recidivism.

    Science.gov (United States)

    Solomon, David; Åsberg, Kia; Peer, Samuel; Prince, Gwendolyn

    2016-08-01

    Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism.

  18. The proportional odds cumulative incidence model for competing risks

    DEFF Research Database (Denmark)

    Eriksson, Frank; Li, Jianing; Scheike, Thomas

    2015-01-01

    We suggest an estimator for the proportional odds cumulative incidence model for competing risks data. The key advantage of this model is that the regression parameters have the simple and useful odds ratio interpretation. The model has been considered by many authors, but it is rarely used in pr...

  19. Cumulative Risk Assessment Toolbox: Methods and Approaches for the Practitioner

    Directory of Open Access Journals (Sweden)

    Margaret M. MacDonell

    2013-01-01

    Full Text Available The historical approach to assessing health risks of environmental chemicals has been to evaluate them one at a time. In fact, we are exposed every day to a wide variety of chemicals and are increasingly aware of potential health implications. Although considerable progress has been made in the science underlying risk assessments for real-world exposures, implementation has lagged because many practitioners are unaware of methods and tools available to support these analyses. To address this issue, the US Environmental Protection Agency developed a toolbox of cumulative risk resources for contaminated sites, as part of a resource document that was published in 2007. This paper highlights information for nearly 80 resources from the toolbox and provides selected updates, with practical notes for cumulative risk applications. Resources are organized according to the main elements of the assessment process: (1 planning, scoping, and problem formulation; (2 environmental fate and transport; (3 exposure analysis extending to human factors; (4 toxicity analysis; and (5 risk and uncertainty characterization, including presentation of results. In addition to providing online access, plans for the toolbox include addressing nonchemical stressors and applications beyond contaminated sites and further strengthening resource accessibility to support evolving analyses for cumulative risk and sustainable communities.

  20. Cumulative Risk Assessment Toolbox: Methods and Approaches for the Practitioner

    Science.gov (United States)

    MacDonell, Margaret M.; Haroun, Lynne A.; Teuschler, Linda K.; Rice, Glenn E.; Hertzberg, Richard C.; Butler, James P.; Chang, Young-Soo; Clark, Shanna L.; Johns, Alan P.; Perry, Camarie S.; Garcia, Shannon S.; Jacobi, John H.; Scofield, Marcienne A.

    2013-01-01

    The historical approach to assessing health risks of environmental chemicals has been to evaluate them one at a time. In fact, we are exposed every day to a wide variety of chemicals and are increasingly aware of potential health implications. Although considerable progress has been made in the science underlying risk assessments for real-world exposures, implementation has lagged because many practitioners are unaware of methods and tools available to support these analyses. To address this issue, the US Environmental Protection Agency developed a toolbox of cumulative risk resources for contaminated sites, as part of a resource document that was published in 2007. This paper highlights information for nearly 80 resources from the toolbox and provides selected updates, with practical notes for cumulative risk applications. Resources are organized according to the main elements of the assessment process: (1) planning, scoping, and problem formulation; (2) environmental fate and transport; (3) exposure analysis extending to human factors; (4) toxicity analysis; and (5) risk and uncertainty characterization, including presentation of results. In addition to providing online access, plans for the toolbox include addressing nonchemical stressors and applications beyond contaminated sites and further strengthening resource accessibility to support evolving analyses for cumulative risk and sustainable communities. PMID:23762048

  1. Cumulative risk: toxicity and interactions of physical and chemical stressors.

    Science.gov (United States)

    Rider, Cynthia V; Boekelheide, Kim; Catlin, Natasha; Gordon, Christopher J; Morata, Thais; Selgrade, Maryjane K; Sexton, Kenneth; Simmons, Jane Ellen

    2014-01-01

    Recent efforts to update cumulative risk assessment procedures to incorporate nonchemical stressors ranging from physical to psychosocial reflect increased interest in consideration of the totality of variables affecting human health and the growing desire to develop community-based risk assessment methods. A key roadblock is the uncertainty as to how nonchemical stressors behave in relationship to chemical stressors. Physical stressors offer a reasonable starting place for measuring the effects of nonchemical stressors and their modulation of chemical effects (and vice versa), as they clearly differ from chemical stressors; and "doses" of many physical stressors are more easily quantifiable than those of psychosocial stressors. There is a commonly held belief that virtually nothing is known about the impact of nonchemical stressors on chemically mediated toxicity or the joint impact of coexposure to chemical and nonchemical stressors. Although this is generally true, there are several instances where a substantial body of evidence exists. A workshop titled "Cumulative Risk: Toxicity and Interactions of Physical and Chemical Stressors" held at the 2013 Society of Toxicology Annual Meeting provided a forum for discussion of research addressing the toxicity of physical stressors and what is known about their interactions with chemical stressors, both in terms of exposure and effects. Physical stressors including sunlight, heat, radiation, infectious disease, and noise were discussed in reference to identifying pathways of interaction with chemical stressors, data gaps, and suggestions for future incorporation into cumulative risk assessments.

  2. Childhood poverty and health: cumulative risk exposure and stress dysregulation.

    Science.gov (United States)

    Evans, Gary W; Kim, Pilyoung

    2007-11-01

    A massive literature documents the inverse association between poverty or low socioeconomic status and health, but little is known about the mechanisms underlying this robust relation. We examined longitudinal relations between duration of poverty exposure since birth, cumulative risk exposure, and physiological stress in two hundred seven 13-year-olds. Chronic stress was assessed by basal blood pressure and overnight cortisol levels; stress regulation was assessed by cardiovascular reactivity to a standard acute stressor and recovery after exposure to this stressor. Cumulative risk exposure was measured by multiple physical (e.g., substandard housing) and social (e.g., family turmoil) risk factors. The greater the number of years spent living in poverty, the more elevated was overnight cortisol and the more dysregulated was the cardiovascular response (i.e., muted reactivity). Cardiovascular recovery was not affected by duration of poverty exposure. Unlike the duration of poverty exposure, concurrent poverty (i.e., during adolescence) did not affect these physiological stress outcomes. The effects of childhood poverty on stress dysregulation are largely explained by cumulative risk exposure accompanying childhood poverty.

  3. Predicting Academic Achievement from Cumulative Home Risk: The Mediating Roles of Effortful Control, Academic Relationships, and School Avoidance

    Science.gov (United States)

    Swanson, Jodi; Valiente, Carlos; Lemery-Chalfant, Kathryn

    2012-01-01

    Components of the home environment are associated with children's academic functioning. The accumulation of risks in the home are expected to prove more detrimental to achievement than any one risk alone, but the processes accounting for this relation are unclear. Using an index of cumulative home risk (CHR) inclusive of protective factors, as…

  4. The cumulative effect of risk compensation on infection preventive measures.

    Science.gov (United States)

    Maxin, Daniel; Sega, Laurentiu; Eaton, Lisa

    2016-12-01

    We study several epidemic models (with and without gender structure) that incorporate risk compensation behavior in response to a lower chance of acquiring the infection as a result of preventive measures that are only partially effective. We show that the cumulative risk compensation that occurs between a high risk susceptible and infectious individual may play an important role in whether the implementation of these measures is successful in lowering the epidemic reproductive number. In addition, we show that certain levels of risk compensation may cancel the benefit of the low infection risk practiced by diagnosed infectious individuals when the goal is a reduction of the epidemic reproductive number. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Chicano Periodical Index: A Cumulative Index to Selected Chicano Periodicals Between 1967 and 1978.

    Science.gov (United States)

    Chabran, Richard; Garcia, Francisco

    The Index provides comprehensive access to 18 Chicano periodicals which were retrospectively indexed through October 1978. All material within the periodicals was indexed except photographs and advertisements. Periodicals were selected from academic journals, general consumption magazines, and humanities journals. The Index consists of three main…

  6. Use of a Cumulative Risk Scale to Predict Poor Intellectual and Academic Outcomes in Childhood Epilepsy.

    Science.gov (United States)

    Kavanaugh, Brian C; Scarborough, Vanessa Ramos; Salorio, Cynthia F

    2016-06-01

    Discrete risk factors for poor outcomes in childhood epilepsy have been identified, but it is unclear whether the combined effect of several risk factors better predicts outcome. The Epilepsy Cumulative Risk Scale was developed to quantify cumulative risk for poor outcomes in childhood epilepsy. Participants included 156 clinic-referred children with epilepsy. The Epilepsy Cumulative Risk Scale was developed using variables previously associated with functional outcomes. Scale utility was examined through its association with intellectual and academic functioning. All Epilepsy Cumulative Risk Scale variables were significantly associated with functioning. The Total Score (ie, cumulative effect) was most strongly correlated with cognition and academic skills. A Total Score ≥ 5 had the best sensitivity and specificity for differentiating those at high risk for poor outcomes. The Epilepsy Cumulative Risk Scale shows promise as a practical, data-driven tool for quantification of cumulative risk for poor outcomes in childhood epilepsy and may be helpful in detecting those needing referral for additional services.

  7. 75 FR 69662 - Workshop: Cumulative Mixtures Risk of Six Selected Phthalates in Support of Summary Information...

    Science.gov (United States)

    2010-11-15

    ... AGENCY Workshop: Cumulative Mixtures Risk of Six Selected Phthalates in Support of Summary Information on...: Notice of Peer Consultation Workshop on the Cumulative Mixtures Risk of Six Selected Phthalates; Request... phthalates as set forth in the National Academies of Science (NAS) report ``Phthalates and Cumulative...

  8. Cumulative Incidence Association Models for Bivariate Competing Risks Data.

    Science.gov (United States)

    Cheng, Yu; Fine, Jason P

    2012-03-01

    Association models, like frailty and copula models, are frequently used to analyze clustered survival data and evaluate within-cluster associations. The assumption of noninformative censoring is commonly applied to these models, though it may not be true in many situations. In this paper, we consider bivariate competing risk data and focus on association models specified for the bivariate cumulative incidence function (CIF), a nonparametrically identifiable quantity. Copula models are proposed which relate the bivariate CIF to its corresponding univariate CIFs, similarly to independently right censored data, and accommodate frailty models for the bivariate CIF. Two estimating equations are developed to estimate the association parameter, permitting the univariate CIFs to be estimated either parametrically or nonparametrically. Goodness-of-fit tests are presented for formally evaluating the parametric models. Both estimators perform well with moderate sample sizes in simulation studies. The practical use of the methodology is illustrated in an analysis of dementia associations.

  9. Chemical evolution and the origin of life: cumulative keyword subject index 1970-1986

    Science.gov (United States)

    Roy, A. C.; Powers, J. V.; Rummel, J. D. (Principal Investigator)

    1990-01-01

    This cumulative subject index encompasses the subject indexes of the bibliographies on Chemical Evolution and the Origin of Life that were first published in 1970 and have continued through publication of the 1986 bibliography supplement. Early bibliographies focused on experimental and theoretical material dealing directly with the concepts of chemical evolution and the origin of life, excluding the broader areas of exobiology, biological evolution, and geochemistry. In recent years, these broader subject areas have also been incorporated as they appear in literature searches relating to chemical evolution and the origin of life, although direct attempts have not been made to compile all of the citations in these broad areas. The keyword subject indexes have also undergone an analogous change in scope. Compilers of earlier bibliographies used the most specific term available in producing the subject index. Compilers of recent bibliographies have used a number of broad terms relating to the overall subject content of each citation and specific terms where appropriate. The subject indexes of these 17 bibliographies have, in general, been cumulatively compiled exactly as they originally appeared. However, some changes have been made in an attempt to correct errors, combine terms, and provide more meaningful terms.

  10. Cumulative oxytocin dose during induction of labor according to maternal body mass index.

    Science.gov (United States)

    Roloff, Kristina; Peng, Sheppard; Sanchez-Ramos, Luis; Valenzuela, Guillermo J

    2015-10-01

    To determine the cumulative oxytocin dose needed to achieve vaginal delivery among obese and non-obese women. A retrospective study was undertaken of women with singleton, term (≥37 weeks) pregnancies who delivered at an institution in California, USA, between May 1 and July 31, 2012. Women were deemed to be obese when their body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) was 30 or above. Cumulative oxytocin doses were calculated for women who achieved vaginal delivery. Overall, 413 women were included. Among 357 women for whom BMI data were available, 204 (57.1%) were obese. Vaginal delivery was achieved in 379 women. Among women who received augmentation after spontaneous labor onset, obese women trended towards more cumulative oxytocin (minimum: 24.7 ± 100.5 mU among women with a BMI of 18.50-24.99; maximum: 1580.5 ± 2530.5 mU among women with a BMI of 35.00-39.99; P=0.086). Women who underwent induction of labor required significantly more oxytocin with increasing BMI class (Plabor. Obese women required a larger cumulative oxytocin dose to achieve vaginal birth during labor induction, but not during augmentation of labor. The physiology of spontaneous labor could supersede or influence the metabolic derangement facing obese patients undergoing induction of labor. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. The Composite Strain Index (COSI) and Cumulative Strain Index (CUSI): methodologies for quantifying biomechanical stressors for complex tasks and job rotation using the Revised Strain Index.

    Science.gov (United States)

    Garg, Arun; Moore, J Steven; Kapellusch, Jay M

    2016-11-04

    The Composite Strain Index (COSI) quantifies biomechanical stressors for complex tasks consisting of exertions at different force levels and/or with different exertion times. The Cumulative Strain Index (CUSI) further integrates biomechanical stressors from different tasks to quantify exposure for the entire work shift. The paper provides methodologies to compute COSI and CUSI along with examples. Complex task simulation produced 169,214 distinct tasks. Use of average, time-weighted average (TWA) and peak force and COSI classified 66.9, 28.2, 100 and 38.9% of tasks as hazardous, respectively. For job rotation the simulation produced 10,920 distinct jobs. TWA COSI, peak task COSI and CUSI classified 36.5, 78.1 and 66.6% jobs as hazardous, respectively. The results suggest that the TWA approach systematically underestimates the biomechanical stressors and peak approach overestimates biomechanical stressors, both at the task and job level. It is believed that the COSI and CUSI partially address these underestimations and overestimations of biomechanical stressors. Practitioner Summary: COSI quantifies exposure when applied hand force and/or duration of that force changes during a task cycle. CUSI integrates physical exposures from job rotation. These should be valuable tools for designing and analysing tasks and job rotation to determine risk of musculoskeletal injuries.

  12. Cumulative family risks across income levels predict deterioration of children's general health during childhood and adolescence.

    Science.gov (United States)

    Lin, Yi-Ching; Seo, Dong-Chul

    2017-01-01

    Family is considered an important agent in the health development of children. This process is significant but quite complex because the prevalence of potential risk factors in the family can hinder children's health. This study examined if multiple family risks might have cumulative effect on children and youth's health across various levels of household income. The data in this study were drawn from the 2011-2012 U.S. National Survey of Children's Health (N = 79,601). A cumulative family risk (CFR) index was developed, which included such constructs as single-parenthood, unstable employment, large family, parenting stress, poor maternal education, poor maternal general health and poor maternal mental health. Multiple logistic regression analyses showed that CFR level was significantly related to children and youth's poor health outcome (p families than on those from poor families. Overall there was a consistent pattern of trend in the point estimate as well as confidence limits as levels of affluence and numbers of family risk increased although some of the confidence intervals overlapped. Living in disadvantaged families might serve as a protective factor against CFRs possibly through repeated exposure to hardships and subsequent formation of resilience among some of the disadvantaged children.

  13. Assessing cumulative pressures and impacts in a regional scale: HELCOM Baltic Sea Impact Index

    DEFF Research Database (Denmark)

    Korpinen, S.; Meski, L.; Andersen, Jesper;

    of identifying hot spots needs to be replaced by spatial high-resolution maps associated with estimated impacts on key ecosystem components. The Baltic Sea Marine Environment Protection Commission (HELCOM) took a first step towards an initial regional assessment of anthropogenic pressures in the Initial Holistic...... of macrozoobenthic communities in some Baltic sub-basins and the results have suggested that more specific selection of pressures is needed in order to assess anthropogenic impacts on benthic habitats. Such an adaptation of the tool has already been tested to assess the sea-floor integrity under the MSFD qualitative...... Assessment of the Baltic Sea by producing the Baltic Sea Pressure Index (BSPI) and the Baltic Sea Impact Index (BSII). The BSPI visualizes cumulative anthropogenic pressures in the Baltic Sea scale, whereas the BSII consists of potential impacts of anthropogenic pressures on key ecosystem components...

  14. The effects of antipoverty programs on children's cumulative level of poverty-related risk.

    Science.gov (United States)

    Gassman-Pines, Anna; Yoshikawa, Hirokazu

    2006-11-01

    The authors examined the effects of antipoverty programs on children's cumulative poverty-related risk and the relationship between cumulative poverty-related risk and child outcomes among low-income families. Samples included 419 children ages 3-10 years in the New Hope program and 759 children ages 2-9 years in the Minnesota Family Investment Program (MFIP), which tested 2 program approaches. Nine poverty-related risks made up the measure of cumulative risk. Both MFIP program approaches reduced cumulative poverty-related risk. New Hope reduced cumulative poverty-related risk among long-term welfare recipients. In both New Hope and MFIP, significant linear relationships between cumulative poverty-related risk and parent-reported behavior problems and school achievement were found. Cumulative poverty-related risk partially mediated the impacts of the MFIP programs on children's behavior problems. Among long-term welfare recipients, cumulative poverty-related risk partially mediated New Hope's impact on parent-reported school achievement.

  15. Cumulative Index to the Sixteenth through the Twentieth Semiannual Reports of the Commission to the Congress. January 1954 - June 1956

    Energy Technology Data Exchange (ETDEWEB)

    Strauss, Lewis L.

    1956-07-30

    The sixteenth through the twentieth semiannual reports of the United States Atomic Energy Commission to Congress are covered in this cumulative index, which included both a name and subject index as aids to finding information in the full reports.. The full semiannual reports themselves cover the major unclassified activities of the Commission from January 1954 through June 1956.

  16. Cumulative risk and asthma outcomes in inner-city African-American youth.

    Science.gov (United States)

    Josie, Katherine Leigh; Greenley, Rachel Neff; Drotar, Dennis

    2007-09-01

    A cumulative risk framework was used to examine the impact of the presence of multiple risk factors on key asthma outcomes (i.e., health-related quality of life [HRQoL], severity) for a sample of 149 inner-city African-American youth with asthma. The presence of a greater number of risk factors was associated with lower HRQoL and greater severity, regardless of age or gender. Cumulative risk methodology, in combination with selection of risk factors based on theoretical and empirical work, is a viable option for researchers and clinicians who are interested in examining the impact of multiple risk factors on disease functioning and status.

  17. Low Fruit/Vegetable Consumption in the Home: Cumulative Risk Factors in Early Childhood

    Science.gov (United States)

    Ward, Wendy L.; Swindle, Taren M.; Kyzer, Angela L.; Whiteside-Mansell, Leanne

    2015-01-01

    Cumulative risk theory suggests that a variety of social risk factors would have an additive effect on obesity risk. Multiple studies have suggested that obesity is related to basic resources such as transportation and financial resources. Additional research points to parental engagement and parental monitoring as additional sources of risk. This…

  18. Statistical Methods for Estimating the Cumulative Risk of Screening Mammography Outcomes

    NARCIS (Netherlands)

    Hubbard, R.A.; Ripping, T.M.; Chubak, J.; Broeders, M.J.; Miglioretti, D.L.

    2016-01-01

    BACKGROUND: This study illustrates alternative statistical methods for estimating cumulative risk of screening mammography outcomes in longitudinal studies. METHODS: Data from the US Breast Cancer Surveillance Consortium (BCSC) and the Nijmegen Breast Cancer Screening Program in the Netherlands were

  19. Cumulative Impact Evaluation in Central Part of Liepaja with Comulative Pollution Index Method and Air Pollution Dispersion Modelling

    Directory of Open Access Journals (Sweden)

    Kalniņš Viesturs

    2015-07-01

    Full Text Available Cumulative impact evaluation is one of the most actual problems in air quality monitoring. At the same time, it is also the most problematic factor to evaluate due to lack of appropriate methodology. The aim of this study was to assess the opportunity to use a new method – Cumulative Pollution Index (CPI in cumulative impact calculation from two different sets of data – bioindication survey with Index of Atmospheric Purity method and air pollution dispersion modelling. Results show that the usage of modelling data, instead of measurements, in cumulative impact evaluation can be quite difficult due to the fact that dispersion models not always give sufficiently accurate data. Despite the issues with modelling specifics, the use of dispersion modelling in CPI calculation shows that the use of this approach not only gives plausible data – obtained values correlate with pollution level and forming strong clustering in spatial distribution, but also reveals new facts about cumulative impact – demonstrates the city microclimate importance in forming of cumulative effect due to geometry of street canyons.

  20. CUMEX: a cumulative hazard index for assessing limiting exposures to environmental pollutants

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, P.J.; Killough, G.G.; Parzyck, D.C.; Rohwer, P.S.; Rupp, e.M.; Whitfield, B.L.; Booth, R.S.; Raridon, R.J.

    1977-04-01

    A hazard index methodology called CUMEX has been developed for limiting human exposure to environmental pollutants. Hazard index is defined as Q/Q/sub L/ where Q is exposure or dose to total-body, organ or tissue from all environmental pathways and Q/sub L/ is a limit which should not be exceeded because of health risk to humans. Mathematical formulations for hazard indices are developed for each sampling medium corresponding to each effluent type. These hazard indices are accumulated into composite indices such that total human intake or dose would not exceed the health risk limit. Mathematical formulation for composite hazard indices or CUMEX indices for multiple pollutants are presented. An example CUMEX application to cadmium release from a smelter complex in East Helena, Montana demonstrates details of the methodology for a single pollutant where human intake occurs through inhalation and ingestion.

  1. When Dread Risks Are More Dreadful than Continuous Risks: Comparing Cumulative Population Losses over Time.

    Directory of Open Access Journals (Sweden)

    Nicolai Bodemer

    Full Text Available People show higher sensitivity to dread risks, rare events that kill many people at once, compared with continuous risks, relatively frequent events that kill many people over a longer period of time. The different reaction to dread risks is often considered a bias: If the continuous risk causes the same number of fatalities, it should not be perceived as less dreadful. We test the hypothesis that a dread risk may have a stronger negative impact on the cumulative population size over time in comparison with a continuous risk causing the same number of fatalities. This difference should be particularly strong when the risky event affects children and young adults who would have produced future offspring if they had survived longer. We conducted a series of simulations, with varying assumptions about population size, population growth, age group affected by risky event, and the underlying demographic model. Results show that dread risks affect the population more severely over time than continuous risks that cause the same number of fatalities, suggesting that fearing a dread risk more than a continuous risk is an ecologically rational strategy.

  2. Cumulative Index to the First Fifteen Semiannual Reports of the Commission to the Congress. January 1947 - 1953

    Energy Technology Data Exchange (ETDEWEB)

    Dean, Gordon

    1954-01-31

    The first fifteen semiannual reports of the United States Atomic Energy Commission to Congress cover the major unclassified activities of the Commission from January 1947 through December 1953. This cumulative name and subject index provides a guide to the information published in these reports.

  3. Probabilistic cumulative risk assessment of anti-androgenic pesticides in food

    DEFF Research Database (Denmark)

    Müller, Anne Kirstine; Nielsen, Elsa

    2008-01-01

    A cumulative risk assessment of three anti-androgenic pesticides vinclozolin, procymidone and prochloraz in combination has been carried out using an Integrated Probabilistic Risk Assessment (IPRA) model. In the model, variability in both exposure and sensitivity between individuals were combined...

  4. Cumulative Family Risk Predicts Increases in Adjustment Difficulties across Early Adolescence

    Science.gov (United States)

    Buehler, Cheryl; Gerard, Jean M.

    2013-01-01

    Family is an important socialization context for youth as they move through early adolescence. A significant feature of this complex socialization context is the accumulation of potential family risk factors that may compromise youth adjustment. This study examined cumulative family risk and adolescents' adjustment difficulties in 416 two-parent…

  5. Probabilistic cumulative risk assessment of anti-androgenic pesticides in food.

    NARCIS (Netherlands)

    Müller, A.K.; Bosgra, S.; Boon, P.E.; van der Voet, H.; Nielsen, E.; Ladefoged, O.

    2009-01-01

    In this paper, we present a cumulative risk assessment of three anti-androgenic pesticides (vinclozolin, procymidone and prochloraz) using the relative potency factor (RPF) approach and an integrated probabilistic risk assessment (IPRA) model. RPFs for each substance were estimated for three reprodu

  6. Probabilistic cumulative risk assessment of anti-androgenic pesticides in food

    NARCIS (Netherlands)

    Muller, A.K.; Bosgra, S.; Boon, P.E.; Voet, van der H.; Nielsen, E.; Ladefoged, O.

    2009-01-01

    In this paper, we present a cumulative risk assessment of three anti-androgenic pesticides (vinclozolin, procymidone and prochloraz) using the relative potency factor (RPF) approach and an integrated probabilistic risk assessment (IPRA) model. RPFs for each substance were estimated for three reprodu

  7. Cumulative family risk predicts increases in adjustment difficulties across early adolescence.

    Science.gov (United States)

    Buehler, Cheryl; Gerard, Jean M

    2013-06-01

    Family is an important socialization context for youth as they move through early adolescence. A significant feature of this complex socialization context is the accumulation of potential family risk factors that may compromise youth adjustment. This study examined cumulative family risk and adolescents' adjustment difficulties in 416 two-parent families using four waves of annual longitudinal data (51% female youth). Risk factors in four family domains were examined: socioeconomic, parents' psychological realm, marital, and parenting. Cumulative family risk experienced while in 6th grade was associated concurrently with daughters' higher internalizing problems and with increased internalizing problems during early adolescence. Cumulative family risk was associated concurrently with sons' higher externalizing problems and with daughters' increased externalizing problems over time. Cumulative family risk was associated concurrently with lower grades and with declining grades over time for both daughters and sons. The number of risk domains also was associated with youths' adjustment difficulties during early adolescence, providing evidence that risk in two-parent families involves more than ineffective parenting. These findings suggest a critical need to provide strong support for families in reducing a variety of stressors across multiple family domains as their children traverse early adolescence.

  8. Investigation of hydrological drought using Cumulative Standardized Precipitation Index (SPI 30) in the eastern Mediterranean region (Damascus, Syria)

    Science.gov (United States)

    Zakhem, Boulos Abou; Kattaa, Bassam

    2016-07-01

    The Eastern Mediterranean region has been exposed to drought episodes, which have been occurring more frequently during the last decades. The objective of the present paper is to study the precipitation regime of the Damascus (Mazzeh) meteoric station by analysing drought characteristics using the Standardized Precipitation Index (SPI) and comparing this with the drought in Cyprus. The cumulative drought conceptis proposed to characterize long-term hydrologic drought, which affects the shallow groundwater productivity in terms of quantity and quality. Gamma probability distribution was fitted to the long-term annual precipitation in Damascus from 1918-1919 to 2007-2008 ( n = 90 years). Generally, a decreasing trend of 17% to the mean annual rainfall of Damascus and 13% to the mean annual rainfall of Cyprus was estimated between 1970 and 2000. The SPI identifies three major extended drought periods: (1) 9 years of severe drought (1954-1963) with an average 20% precipitation deficit per year compared to the mean. (2) 8 years of severe drought (1983-1991) with a 27% deficit per year on average. (3) 9 years of extreme drought (1993-2002) with a 31% deficit per year on average. The cumulative standardized precipitation index (SPI 30) demonstrates positive values for the first period and is indicative of having no effect on the global water balance. SPI 30 exhibits sensitive equilibrium with near zero values / a near zero value (±1.5) for the second period. For the third period, however, the SPI 30 decreases below -10 indicating an extreme hydrological drought that has negative consequences on the recent groundwater recharge. It is required to develop and implement a sustainable groundwater management strategy to reduce long-terms drought risks. Generally, the SPI 30 in Cyprus is parallel to that in Damascus with a 3-5 year delay. Thus, the central zone of the Eastern Mediterranean region is facing big challenges and has been suffering from three decades of moderate to

  9. Investigation of hydrological drought using Cumulative Standardized Precipitation Index (SPI 30) in the eastern Mediterranean region (Damascus, Syria)

    Indian Academy of Sciences (India)

    Boulos Abou Zakhem; Bassam Kattaa

    2016-07-01

    The Eastern Mediterranean region has been exposed to drought episodes, which have been occurring morefrequently during the last decades. The objective of the present paper is to study the precipitation regimeof the Damascus (Mazzeh) meteoric station by analysing drought characteristics using the StandardizedPrecipitation Index (SPI) and comparing this with the drought in Cyprus. The cumulative droughtconcept is proposed to characterize long-term hydrologic drought, which affects the shallow groundwaterproductivity in terms of quantity and quality. Gamma probability distribution was fitted to the long-termannual precipitation in Damascus from 1918–1919 to 2007–2008 (n = 90 years). Generally, a decreasingtrend of 17% to the mean annual rainfall of Damascus and 13% to the mean annual rainfall of Cypruswas estimated between 1970 and 2000. The SPI identifies three major extended drought periods: (1)9 years of severe drought (1954–1963) with an average 20% precipitation deficit per year compared tothe mean. (2) 8 years of severe drought (1983–1991) with a 27% deficit per year on average. (3) 9 yearsof extreme drought (1993–2002) with a 31% deficit per year on average. The cumulative standardizedprecipitation index (SPI 30) demonstrates positive values for the first period and is indicative of havingno effect on the global water balance. SPI 30 exhibits sensitive equilibrium with near zero values / a nearzero value (±1.5) for the second period. For the third period, however, the SPI 30 decreases below −10indicating an extreme hydrological drought that has negative consequences on the recent groundwaterrecharge. It is required to develop and implement a sustainable groundwater management strategy toreduce long-terms drought risks. Generally, the SPI 30 in Cyprus is parallel to that in Damascus witha 3–5 year delay. Thus, the central zone of the Eastern Mediterranean region is facing big challengesand has been suffering from three decades of moderate to

  10. Childhood poverty and young adults' allostatic load: the mediating role of childhood cumulative risk exposure.

    Science.gov (United States)

    Evans, Gary W; Kim, Pilyoung

    2012-09-01

    Childhood poverty is linked to a host of physical and psychological disorders during childhood and later in life. In the study reported here, we showed that the proportion of childhood spent in poverty from birth to age 9 was linked to elevated allostatic load, a marker of chronic physiological stress, in 17-year-olds. Furthermore, this prospective longitudinal relationship was mediated by cumulative risk exposure at age 13. The greater the duration of early life spent in poverty, the greater the exposure to cumulative risk. This, in turn, leads to elevated allostatic load. Multiple psychological, biological, and neurological pathways likely account for the social patterning of psychological and physical disease.

  11. Cumulative risk effects in the bullying of children and young people with autism spectrum conditions.

    Science.gov (United States)

    Hebron, Judith; Oldfield, Jeremy; Humphrey, Neil

    2017-04-01

    Students with autism are more likely to be bullied than their typically developing peers. However, several studies have shown that their likelihood of being bullied increases in the context of exposure to certain risk factors (e.g. behaviour difficulties and poor peer relationships). This study explores vulnerability to bullying from a cumulative risk perspective, where the number of risks rather than their nature is considered. A total of 722 teachers and 119 parents of young people with autism spectrum conditions participated in the study. Established risk factors were summed to form a cumulative risk score in teacher and parent models. There was evidence of a cumulative risk effect in both models, suggesting that as the number of risks increased, so did exposure to bullying. A quadratic effect was found in the teacher model, indicating that there was a disproportionate increase in the likelihood of being bullied in relation to the number of risk factors to which a young person was exposed. In light of these findings, it is proposed that more attention needs to be given to the number of risks to which children and young people with autism spectrum conditions are exposed when planning interventions and providing a suitable educational environment.

  12. Cumulative risk assessment of the intake of organophosphorus and carbamate pesticides in the Danish diet

    DEFF Research Database (Denmark)

    Jensen, A. F.; Petersen, Annette; Granby, Kit

    2003-01-01

    The aim of the study is to evaluate the potential cumulative effects of organophosphorus and carbamate pesticides that act through a common mechanism of toxicity, and to assess the long- and short-term risks for the Danish population. The intake estimates are based on dietary intake data collected...... in the Danish nation-wide food consumption survey in 1995. The pesticide data are based on the Danish pesticide residue-monitoring programme from 1996-2001. The amount of 35 organophosphorus pesticides and carbamates were included in the cumulative risk assessment. Processing factors, such as reduction...... of pesticide levels by rinsing and peeling, were applied in the exposure assessment. The "Toxicity Equivalence Factor" (TEF) approach was used to normalise the toxicity of the different organophosphorus and carbamate pesticides. Cumulative chronic exposure of organophosphorus and carbamates pesticides via...

  13. Cumulative Index to Twenty Five Semiannual Reports of the Commission to the Congress. January 1947 - January 1959

    Energy Technology Data Exchange (ETDEWEB)

    McCone, John A.

    1960-01-31

    The first twenty five semiannual reports of the United States Atomic Energy Commission to Congress cover the major unclassified activities of the Commission from January 1947 through January 1959. In addition to the semiannual summaries, a series of special reports on important atomic energy programs were included in many of the semiannual reports. This cumulative name and subject index provides a guide to the information published in these reports. Beginning in 1960, the Commission will be issuing annual reports, each separately indexed, ceasing the semiannual reporting.

  14. New approaches to uncertainty analysis for use in aggregate and cumulative risk assessment of pesticides

    NARCIS (Netherlands)

    Kennedy, M.C.; Voet, van der H.; Roelofs, V.J.; Roelofs, W.; Glass, C.R.; Boer, de W.J.; Kruisselbrink, J.W.; Hart, A.D.M.

    2015-01-01

    Risk assessments for human exposures to plant protection products (PPPs) have traditionally focussed on single routes of exposure and single compounds. Extensions to estimate aggregate (multi-source) and cumulative (multi-compound) exposure from PPPs present many new challenges and additional uncert

  15. Associations between parenting, media use, cumulative risk, and children’s executive functioning

    NARCIS (Netherlands)

    Linebarger, D.L.; Barr, R.; Lapierre, M.A.; Piotrowski, J.

    2014-01-01

    Objective: This study was designed to examine how parenting style, media exposure, and cumulative risk were associated with executive functioning (EF) during early childhood. Methods: A nationally representative group of US parents/caregivers (N = 1156) with 1 child between 2 and 8 years

  16. Effects of Cumulative Family Risk Factors on American Students' Academic Performance

    Science.gov (United States)

    Dunst, Carl J.; Hamby, Deborah W.

    2016-01-01

    The relationships between cumulative family risk factors and American students' academic performance were examined in all 50 States and the District of Columbia. Data from the 2007 "American Community Survey" were used to ascertain the percent of birth to 18 year old children in the United States who experienced three or more risk…

  17. 76 FR 82296 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Extension of Comment Period

    Science.gov (United States)

    2011-12-30

    ... AGENCY Pyrethrins/Pyrethroid Cumulative Risk Assessment; Extension of Comment Period AGENCY: Environmental Protection Agency (EPA). ACTION: Notice; extension of comment period. SUMMARY: EPA issued a notice... called ``the pyrethroids'') and opened a public comment period on this document and other supporting...

  18. Parenting intervention and the caregiving environment : cumulative risk and process evaluation

    NARCIS (Netherlands)

    Stolk, Mirjam Neeltje

    2007-01-01

    The objective of the research described in this thesis was to study single and cumulative family risk in relation to early childhood externalizing problems and the effectiveness of a parenting intervention program. The Video-feedback Intervention to promote Positive Parenting and Sensitive Disciplin

  19. Associations between parenting, media use, cumulative risk, and children’s executive functioning

    NARCIS (Netherlands)

    D.L. Linebarger; R. Barr; M.A. Lapierre; J. Piotrowski

    2014-01-01

    Objective: This study was designed to examine how parenting style, media exposure, and cumulative risk were associated with executive functioning (EF) during early childhood. Methods: A nationally representative group of US parents/caregivers (N = 1156) with 1 child between 2 and 8 years participate

  20. Cumulative health risk assessment of 17 perfluoroalkylated and polyfluoroalkylated substances (PFASs) in the Swedish population.

    Science.gov (United States)

    Borg, Daniel; Lund, Bert-Ove; Lindquist, Nils-Gunnar; Håkansson, Helen

    2013-09-01

    Humans are simultaneously exposed to a multitude of chemicals. Human health risk assessment of chemicals is, however, normally performed on single substances, which may underestimate the total risk, thus bringing a need for reliable methods to assess the risk of combined exposure to multiple chemicals. Per- and polyfluoroalkylated substances (PFASs) is a large group of chemicals that has emerged as global environmental contaminants. In the Swedish population, 17 PFASs have been measured, of which the vast majority lacks human health risk assessment information. The objective of this study was to for the first time perform a cumulative health risk assessment of the 17 PFASs measured in the Swedish population, individually and in combination, using the Hazard Index (HI) approach. Swedish biomonitoring data (blood/serum concentrations of PFASs) were used and two study populations identified: 1) the general population exposed indirectly via the environment and 2) occupationally exposed professional ski waxers. Hazard data used were publicly available toxicity data for hepatotoxicity and reproductive toxicity as well as other more sensitive toxic effects. The results showed that PFASs concentrations were in the low ng/ml serum range in the general population, reaching high ng/ml and low μg/ml serum concentrations in the occupationally exposed. For those congeners lacking toxicity data with regard to hepatotoxicity and reproductive toxicity read-across extrapolations was performed. Other effects at lower dose levels were observed for some well-studied congeners. The risk characterization showed no concern for hepatotoxicity or reproductive toxicity in the general population except in a subpopulation eating PFOS-contaminated fish, illustrating that high local exposure may be of concern. For the occupationally exposed there was concern for hepatotoxicity by PFOA and all congeners in combination as well as for reproductive toxicity by all congeners in combination, thus a

  1. Risk management of stock index futures

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The Hong Kong Hang Seng index futures is taken as a study object and a method of empirical analysis is adopted in order to verify the validity of the application of the value-at-risk (VaR) method in the risk measurement of the stock index futures market. The results suggest that under normal market conditions it is feasible to apply the VaR method in the measurement of the market risks of stock index futures. The daily VaR value of the stock index futures provides a foreseeable profit and loss of the stock ...

  2. Lifetime cumulative risk factors predict cardiovascular disease mortality in a 50-year follow-up study in Finland.

    Science.gov (United States)

    Reinikainen, Jaakko; Laatikainen, Tiina; Karvanen, Juha; Tolonen, Hanna

    2015-02-01

    Systolic blood pressure, total cholesterol and smoking are known predictors of cardiovascular disease (CVD) mortality. Less is known about the effect of lifetime accumulation and changes of risk factors over time as predictors of CVD mortality, especially in very long follow-up studies. Data from the Finnish cohorts of the Seven Countries Study were used. The baseline examination was in 1959 and seven re-examinations were carried out at approximately 5-year intervals. Cohorts were followed up for mortality until the end of 2011. Time-dependent Cox models with regular time-updated risk factors, time-dependent averages of risk factors and latest changes in risk factors, using smoothing splines to discover nonlinear effects, were used to analyse the predictive effect of risk factors for CVD mortality. A model using cumulative risk factors, modelled as the individual-level averages of several risk factor measurements over time, predicted CVD mortality better than a model using the most recent measurement information. This difference seemed to be most prominent for systolic blood pressure. U-shaped effects of the original predictors can be explained by partitioning a risk factor effect between the recent level and the change trajectory. The change in body mass index predicted the risk although body mass index itself did not. The lifetime accumulation of risk factors and the observed changes in risk factor levels over time are strong predictors of CVD mortality. It is important to investigate different ways of using the longitudinal risk factor measurements to take full advantage of them. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  3. Blood lead levels and cumulative blood lead index (CBLI) as predictors of late neurodevelopment in lead poisoned children

    Science.gov (United States)

    Nie, Linda H.; Wright, Robert O.; Bellinger, David C.; Hussain, Javed; Amarasiriwardena, Chitra; Chettle, David R.; Pejović-Milić, Ana; woolf, Alan; Shannon, Michael

    2011-01-01

    Objective To find the best lead exposure assessment marker for children. Methods We recruited 11 children, calculated a cumulative blood lead index (CBLI) for the children, measured their concurrent BLL, assessed their development, and measured their bone lead level. Results Nine of 11 children had clinically significant neurodevelopment problems. CBLI and current blood lead level, but not the peak lead level, were significantly or marginally negatively associated with the full-scale IQ score. Conclusion Lead exposure at younger age significantly impacts a child’s later neurodevelopment. CBLI may be a better predictor of neurodevelopment than are current or peak blood lead levels. PMID:21827276

  4. Cumulative Risk Assessment: An Overview of Methodological Approaches for Evaluating Combined Health Effects from Exposure to Multiple Environmental Stressors

    Science.gov (United States)

    Sexton, Ken

    2012-01-01

    Systematic evaluation of cumulative health risks from the combined effects of multiple environmental stressors is becoming a vital component of risk-based decisions aimed at protecting human populations and communities. This article briefly examines the historical development of cumulative risk assessment as an analytical tool, and discusses current approaches for evaluating cumulative health effects from exposure to both chemical mixtures and combinations of chemical and nonchemical stressors. A comparison of stressor-based and effects-based assessment methods is presented, and the potential value of focusing on viable risk management options to limit the scope of cumulative evaluations is discussed. The ultimate goal of cumulative risk assessment is to provide answers to decision-relevant questions based on organized scientific analysis; even if the answers, at least for the time being, are inexact and uncertain. PMID:22470298

  5. Modelling the cumulative risk of a false-positive screening test.

    Science.gov (United States)

    Hubbard, Rebecca A; Miglioretti, Diana L; Smith, Robert A

    2010-10-01

    The goal of a screening test is to reduce morbidity and mortality through the early detection of disease; but the benefits of screening must be weighed against potential harms, such as false-positive (FP) results, which may lead to increased healthcare costs, patient anxiety, and other adverse outcomes associated with diagnostic follow-up procedures. Accurate estimation of the cumulative risk of an FP test after multiple screening rounds is important for program evaluation and goal setting, as well as informing individuals undergoing screening what they should expect from testing over time. Estimation of the cumulative FP risk is complicated by the existence of censoring and possible dependence of the censoring time on the event history. Current statistical methods for estimating the cumulative FP risk from censored data follow two distinct approaches, either conditioning on the number of screening tests observed or marginalizing over this random variable. We review these current methods, identify their limitations and possibly unrealistic assumptions, and propose simple extensions to address some of these limitations. We discuss areas where additional extensions may be useful. We illustrate methods for estimating the cumulative FP recall risk of screening mammography and investigate the appropriateness of modelling assumptions using 13 years of data collected by the Breast Cancer Surveillance Consortium (BCSC). In the BCSC data we found evidence of violations of modelling assumptions of both classes of statistical methods. The estimated risk of an FP recall after 10 screening mammograms varied between 58% and 77% depending on the approach used, with an estimate of 63% based on what we feel are the most reasonable modelling assumptions.

  6. Cumulative Doses of T-Cell Depleting Antibody and Cancer Risk after Kidney Transplantation.

    Directory of Open Access Journals (Sweden)

    Jenny H C Chen

    Full Text Available T-cell depleting antibody is associated with an increased risk of cancer after kidney transplantation, but a dose-dependent relationship has not been established. This study aimed to determine the association between cumulative doses of T-cell depleting antibody and the risk of cancer after kidney transplantation. Using data from the Australian and New Zealand Dialysis and Transplant Registry between 1997-2012, we assessed the risk of incident cancer and cumulative doses of T-cell depleting antibody using adjusted Cox regression models. Of the 503 kidney transplant recipients with 2835 person-years of follow-up, 276 (55%, 209 (41% and 18 (4% patients received T-cell depleting antibody for induction, rejection or induction and rejection respectively. The overall cancer incidence rate was 1,118 cancers per 100,000 patient-years, with 975, 1093 and 1377 cancers per 100,000 patient-years among those who had received 1-5 doses, 6-10 doses and >10 doses, respectively. There was no association between cumulative doses of T cell depleting antibody and risk of incident cancer (1-5: referent, 6-10: adjusted hazard ratio (HR 1.19, 95%CI 0.48-2.95, >10: HR 1.42, 95%CI 0.50-4.02, p = 0.801. This lack of association is contradictory to our hypothesis and is likely attributed to the low event rates resulting in insufficient power to detect significant differences.

  7. Modeling Joint Exposures and Health Outcomes for Cumulative Risk Assessment: The Case of Radon and Smoking

    Directory of Open Access Journals (Sweden)

    Jonathan I. Levy

    2011-09-01

    Full Text Available Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case example, given its large attributable risk, effect modification due to smoking, and significant variability in radon concentrations and smoking patterns. In spite of this fact, no study to date has estimated geographic and sociodemographic patterns of both radon and smoking in a manner that would allow for inclusion of radon in community-based cumulative risk assessment. In this study, we apply multi-level regression models to explain variability in radon based on housing characteristics and geological variables, and construct a regression model predicting housing characteristics using U.S. Census data. Multi-level regression models of smoking based on predictors common to the housing model allow us to link the exposures. We estimate county-average lifetime lung cancer risks from radon ranging from 0.15 to 1.8 in 100, with high-risk clusters in areas and for subpopulations with high predicted radon and smoking rates. Our findings demonstrate the viability of screening-level assessment to characterize patterns of lung cancer risk from radon, with an approach that can be generalized to multiple chemical and non-chemical stressors.

  8. Covariate adjustment of cumulative incidence functions for competing risks data using inverse probability of treatment weighting.

    Science.gov (United States)

    Neumann, Anke; Billionnet, Cécile

    2016-06-01

    In observational studies without random assignment of the treatment, the unadjusted comparison between treatment groups may be misleading due to confounding. One method to adjust for measured confounders is inverse probability of treatment weighting. This method can also be used in the analysis of time to event data with competing risks. Competing risks arise if for some individuals the event of interest is precluded by a different type of event occurring before, or if only the earliest of several times to event, corresponding to different event types, is observed or is of interest. In the presence of competing risks, time to event data are often characterized by cumulative incidence functions, one for each event type of interest. We describe the use of inverse probability of treatment weighting to create adjusted cumulative incidence functions. This method is equivalent to direct standardization when the weight model is saturated. No assumptions about the form of the cumulative incidence functions are required. The method allows studying associations between treatment and the different types of event under study, while focusing on the earliest event only. We present a SAS macro implementing this method and we provide a worked example.

  9. The impact of physical activity on cumulative cardiovascular disease risk factors among Malaysian adults.

    Science.gov (United States)

    Rasiah, Rajah; Thangiah, Govindamal; Yusoff, Khalid; Manikam, Rishya; Chandrasekaran, Sankara Kumar; Mustafa, Rujhan; Bakar, Najmin Binti Abu

    2015-12-16

    Numerous studies have shown the importance of physical activity in reducing the morbidity and mortality rates caused by cardiovascular disease (CVD). However, most of these studies emphasise little on the cumulative effect of CVD risk factors. Hence, this study investigates the association between physical exercise and cumulative CVD risk factors among adults in three different age groups. Using a sample of 7276 respondents drawn from community centers, the REDISCOVER team gathered information on physical activity, CVD risk factors (obesity, diabetes, hypertension, hypercholesterolemia, tobacco use) and socioeconomic and demographic variables in Malaysia. Because the study required medical examination, a convenience sampling frame was preferred in which all volunteers were included in the study. Fasting blood samples and anthropometric (height, weight and more) measurements were collected by trained staffs. Socio-demographic and physical activity variables were recorded through questionnaires. A Chi-square test was performed to identify the bivariate association between the covariates (socioeconomic variables, demographic variables and physical activity) and outcome variable. The association between the main exposure, physical activity, and the outcome variable, cumulative CVD risk factors, was assessed using an ordinal logistic regression model, controlling for socioeconomic status and demographic influences in three different age groups, 35-49, 50-64 and 65 and above. The mean age of participants is 51.8 (SD = 9.4). Respondents in the age groups of 35-49 (aORmoderate = 0.12; 95 % CI: 0.02 - 0.53 ) and 65 and above (aORhigh = 0.58; 95 % CI: 0.24, 0.78) showed a statistically significant inverse relationship between physical activity and cumulative CVD risk factors. However, this relationship was not significant among respondents in the 50-64 age group suggesting the possible influence of other variables, such as stress and environment. The

  10. The Risk Premia Embedded in Index Options

    DEFF Research Database (Denmark)

    Andersen, Torben Gustav; Fusari, Nicola; Todorov, Viktor

    We study the dynamic relation between market risks and risk premia using time series of index option surfaces. We find that priced left tail risk cannot be spanned by market volatility (and its components) and introduce a new tail factor. This tail factor has no incremental predictive power...... for future volatility and jump risks, beyond current and past volatility, but it critical in predicting future market equity and variance risk premia. Our findings suggest a wide wedge between the dynamics of market risks and their compensation, with the latter typically displaying a far more persistent...

  11. Cumulative association of obstructive sleep apnea severity and short sleep duration with the risk for hypertension.

    Directory of Open Access Journals (Sweden)

    Pascaline Priou

    Full Text Available Obstructive sleep apnea (OSA and short sleep duration are individually associated with an increased risk for hypertension (HTN. The aim of this multicenter cross-sectional study was to test the hypothesis of a cumulative association of OSA severity and short sleep duration with the risk for prevalent HTN. Among 1,499 patients undergoing polysomnography for suspected OSA, 410 (27.3% previously diagnosed as hypertensive and taking antihypertensive medication were considered as having HTN. Patients with total sleep time (TST <6 h were considered to be short sleepers. Logistic regression procedures were performed to determine the independent association of HTN with OSA and sleep duration. Considering normal sleepers (TST ≥6 h without OSA as the reference group, the odds ratio (OR (95% confidence intervals for having HTN was 2.51 (1.35-4.68 in normal sleepers with OSA and 4.37 (2.18-8.78 in short sleepers with OSA after adjustment for age, gender, obesity, diabetes, depression, current smoking, use of thyroid hormones, daytime sleepiness, poor sleep complaint, time in bed, sleep architecture and fragmentation, and study site. The risk for HTN appeared to present a cumulative association with OSA severity and short sleep duration (p<0.0001 for linear trend. The higher risk for HTN was observed in short sleepers with severe OSA (AHI ≥30 (OR, 4.29 [2.03-9.07]. In patients investigated for suspected OSA, sleep-disordered breathing severity and short sleep duration have a cumulative association with the risk for prevalent HTN. Further studies are required to determine whether interventions to optimize sleep may contribute to lower BP in patients with OSA.

  12. Modeling the cumulative genetic risk for multiple sclerosis from genome-wide association data.

    Science.gov (United States)

    Wang, Joanne H; Pappas, Derek; De Jager, Philip L; Pelletier, Daniel; de Bakker, Paul Iw; Kappos, Ludwig; Polman, Chris H; Chibnik, Lori B; Hafler, David A; Matthews, Paul M; Hauser, Stephen L; Baranzini, Sergio E; Oksenberg, Jorge R

    2011-01-18

    Multiple sclerosis (MS) is the most common cause of chronic neurologic disability beginning in early to middle adult life. Results from recent genome-wide association studies (GWAS) have substantially lengthened the list of disease loci and provide convincing evidence supporting a multifactorial and polygenic model of inheritance. Nevertheless, the knowledge of MS genetics remains incomplete, with many risk alleles still to be revealed. We used a discovery GWAS dataset (8,844 samples, 2,124 cases and 6,720 controls) and a multi-step logistic regression protocol to identify novel genetic associations. The emerging genetic profile included 350 independent markers and was used to calculate and estimate the cumulative genetic risk in an independent validation dataset (3,606 samples). Analysis of covariance (ANCOVA) was implemented to compare clinical characteristics of individuals with various degrees of genetic risk. Gene ontology and pathway enrichment analysis was done using the DAVID functional annotation tool, the GO Tree Machine, and the Pathway-Express profiling tool. In the discovery dataset, the median cumulative genetic risk (P-Hat) was 0.903 and 0.007 in the case and control groups, respectively, together with 79.9% classification sensitivity and 95.8% specificity. The identified profile shows a significant enrichment of genes involved in the immune response, cell adhesion, cell communication/signaling, nervous system development, and neuronal signaling, including ionotropic glutamate receptors, which have been implicated in the pathological mechanism driving neurodegeneration. In the validation dataset, the median cumulative genetic risk was 0.59 and 0.32 in the case and control groups, respectively, with classification sensitivity 62.3% and specificity 75.9%. No differences in disease progression or T2-lesion volumes were observed among four levels of predicted genetic risk groups (high, medium, low, misclassified). On the other hand, a significant

  13. Third cumulative index for Koedoe: volumes 35/2-44/1

    Directory of Open Access Journals (Sweden)

    J.C. Rautenbach

    2001-08-01

    Full Text Available Index to Koedoe: volumes 35/2 - 44/1 Authors85 Subjects98 Botany 98 Ecology and behaviour 100 Wildlife conservation & techniques 100 Zoology102 Invertebrata 102 Pisces 103 Amphibia 103 Reptilia 103 Aves104 Mammalia 104 Archaeology and History 105 Bibliography 106 Climate 106 Geologyand Pedology 106 Environmental impact on rivers & water quality 106 Check list 107 Issues in conservation 107 Maps 108 Social Science 108 Parks

  14. Phthalates in Commercial Chinese Rice Wines: Concentrations and the Cumulative Risk Assessment to Adult Males in Shanghai.

    Science.gov (United States)

    Huang, Yue; Lu, Wen Wei; Chen, Bo; You, Jie; Wu, Min; Li, Shu Guang

    2014-10-01

    The concentrations of 16 phthalates in 164 commercial Chinese rice wines (CRW) were detected by GC-MS, and consumption data on CRW in different packaging types was investigated from 634 adult males in Shanghai using a food frequency questionnaire. Based on the principles of probabilistic modelling and cumulative risk assessment, the exposure and health risk of phthalates from CRW to adult males in Shanghai was evaluated. DMP, DEP, DIBP, DnBP, BBP, and DEHP were detected in the samples, the range of detection frequency of individual phthalates varied from 6.10% for BBP to 15.24% for DIBP, and the detected concentrations were 51.06-200.34 ng/mL. All the respondents consumed CRW, 90.69% of them consumed CRW 0.01-49.9 mL/d, the minimum value of the average daily intake of CRW was 6.25 mL/d, the median was 13.72 mL/d and the maximum was 300 mL/d. The median exposure level of the 6 detected Phthalates to adult males in Shanghai were 6.58-7.10 ng/(d•kg), and the maximum exposure level were 137.38-540.47 ng/(d•kg). The cumulative exposure health risk index (HI) based on the median and maximum exposure level of the 6 Phthalates (DMP, DEP, DIBP, DnBP, BBP, and DEHP) were 0.001147 and 0.063396, both were far less than 1. In conclusion, CRW were generally consumed by the adult males in Shanghai, although multiple phthalates were detected in commercial CRW, health risk of such exposure levels from commercial CRW to the target adult males in Shanghai was very low.

  15. The collected papers of Albert Einstein. - Vol. 11: Cumulative index, bibliography, list of correspondence, chronology, and errata to volumes 1-10

    NARCIS (Netherlands)

    Kox, A.J.; Sauer, T.; Kormos Buchwald, D.; Hirschmann, R.; Moses, O.; Aronin, B.; Stolper, J.

    2009-01-01

    This index volume provides quick access to the most authoritative compilation of documents and information concerning Einstein's work and correspondence for the first half of his life. It offers readers a Cumulative Index to the first ten volumes of the collected papers, the first complete bibliogra

  16. Long-Term Effects of Prematurity, Cumulative Medical Risk, and Proximal and Distal Social Forces on Individual Differences in Diurnal Cortisol at Young Adulthood.

    Science.gov (United States)

    Winchester, Suzy B; Sullivan, Mary C; Roberts, Mary B; Bryce, Crystal I; Granger, Douglas A

    2017-01-01

    This study examined the effects of prematurity, cumulative medical risk, and proximal and distal social forces on individual differences in the activity of the hypothalamic-pituitary-adrenal (HPA) axis in young adulthood. A prospective sample of 149 infants born healthy preterm (PT; n = 22), sick PT ( n = 93, medical illness, neurological illness, small for gestational age), and full term ( n = 34) was recruited from a Level III neonatal intensive care unit in southern New England between 1985 and 1989 and followed to age 23 years. Cumulative medical risk was indexed across seven assessment waves (spanning 17 years) using medical and neurological health status at birth, toddlerhood (ages 18 and 30 months), childhood (ages 4 and 8 years), and adolescence (ages 12 and 17 years). Distal risk included socioeconomic status (SES) at birth. Proximal social factors were indexed from assessments of the home environment and measures of child vulnerability and maternal self-esteem, involvement, and control style from birth, 4 years, 8 years, and 12 years. At age 23 years, five saliva samples were collected upon awakening, 45 min after waking, 4 hr after waking, 8 hr after waking, and bedtime (later assayed for cortisol). Results reveal effects of cumulative medical risk on the diurnal pattern of HPA axis activity, with moderating effects of SES and proximal social factors. Findings are discussed in terms of implications for contemporary theories related to developmental sensitivity and susceptibility to context and the developmental origins of health and disease theory.

  17. DOSE-RESPONSE MODELING FOR THE ASSESSMENT OF CUMULATIVE RISK DUE TO EXPOSURE TO N-METHYL CARBAMATE PESTICIDES

    Science.gov (United States)

    The US EPAs N-Methyl Carbamate Cumulative Risk Assessment (NMCRA) assesses the effect on acetylcholine esterase (AChE) activity of exposure to 10 N-methyl carbamate (NMC) pesticides through dietary, drinking water, and residential exposures.

  18. Nonparametric Estimation of Cumulative Incidence Functions for Competing Risks Data with Missing Cause of Failure

    DEFF Research Database (Denmark)

    Effraimidis, Georgios; Dahl, Christian Møller

    In this paper, we develop a fully nonparametric approach for the estimation of the cumulative incidence function with Missing At Random right-censored competing risks data. We obtain results on the pointwise asymptotic normality as well as the uniform convergence rate of the proposed nonparametric...... estimator. A simulation study that serves two purposes is provided. First, it illustrates in details how to implement our proposed nonparametric estimator. Secondly, it facilitates a comparison of the nonparametric estimator to a parametric counterpart based on the estimator of Lu and Liang (2008...

  19. Cumulative risk and developmental health: an argument for the importance of a family-wide science.

    Science.gov (United States)

    Browne, Dillon T; Plamondon, Andre; Prime, Heather; Puente-Duran, Sofia; Wade, Mark

    2015-01-01

    A substantial body of research links social disadvantage and developmental health via a cascade running from poverty, to cumulative psychosocial risk, to disrupted family dynamics, to child biological regulatory systems and neurocognitive processing, and finally to morbidity across the lifespan. Most research in this area employs single-dyad or between-family methodology. While informative, there are limitations to this approach. Specifically, it is impossible to determine how risk alters psychosocial environments that are similar for all persons within a household, versus processes that are unique to particular children. This is important in light of literature citing the primacy of child-specific environments in driving developmental health. Methodologically speaking, there are both benefits and challenges to family-wide approaches that differentiate between- and within-family environments. This review describes literature linking cumulative risk and developmental health via family process, while articulating the importance of family-wide approaches. Areas of shortcoming and recommendations for a family-wide science are provided.

  20. A semiparametric censoring bias model for estimating the cumulative risk of a false-positive screening test under dependent censoring.

    Science.gov (United States)

    Hubbard, Rebecca A; Miglioretti, Diana L

    2013-03-01

    False-positive test results are among the most common harms of screening tests and may lead to more invasive and expensive diagnostic testing procedures. Estimating the cumulative risk of a false-positive screening test result after repeat screening rounds is, therefore, important for evaluating potential screening regimens. Existing estimators of the cumulative false-positive risk are limited by strong assumptions about censoring mechanisms and parametric assumptions about variation in risk across screening rounds. To address these limitations, we propose a semiparametric censoring bias model for cumulative false-positive risk that allows for dependent censoring without specifying a fixed functional form for variation in risk across screening rounds. Simulation studies demonstrated that the censoring bias model performs similarly to existing models under independent censoring and can largely eliminate bias under dependent censoring. We used the existing and newly proposed models to estimate the cumulative false-positive risk and variation in risk as a function of baseline age and family history of breast cancer after 10 years of annual screening mammography using data from the Breast Cancer Surveillance Consortium. Ignoring potential dependent censoring in this context leads to underestimation of the cumulative risk of false-positive results. Models that provide accurate estimates under dependent censoring are critical for providing appropriate information for evaluating screening tests.

  1. Prevalence and risk factors of upper extremity cumulative trauma disorder in dental hygienists.

    Science.gov (United States)

    Shenkar, O; Mann, J; Shevach, A; Ever-Hadani, P; Weiss, P L

    1998-01-01

    Cumulative trauma disorder (CTD) refers to a number of conditions arising from overuse of joints or soft tissues. The common risk factors that contribute to the development of these disorders are related to personal and occupational variables. Job analysis of the tasks performed by the dental hygienist have shown that this occupation is particularly at risk. The objectives of this study were to determine the prevalence of CTD symptoms amongst dental hygienists in Israel and to identify which are the factors that are related to CTD. A questionnaire including items concerning demographic data, employment history, professional occupational information, use of instrumentation, and CTD symptomatology was mailed to all 530 registered dental hygienists. Two hundred forty-six hygienists (46%) returned the questionnaire; 63% of the respondents were classified as CTD 'sufferers', Age, year of graduation, hours worked per week, and frequency of changing instruments were found to be significantly related to CTD symptoms. Hygienists at high risk included those aged 50 years or more (Odds ratio, OR = 6), those who graduated before 1986 (OR = 3), those who work more than 34 h per week (OR = 2.5) and those who change two or fewer instruments per patient (OR = 2). The major recommendation resulting from this study is to make dental hygienists aware that they work in a high-risk profession. It is hoped that increased awareness of the risk will spur the hygienist to make appropriate work practice, administrative, and engineering modifications and to seek treatment at the first indication of CTD symptoms.

  2. Potential Health Risks Posed by Plant-Derived Cumulative Neurotoxic Bufadienolides in South Africa

    Directory of Open Access Journals (Sweden)

    Christo Botha

    2016-03-01

    Full Text Available Bufadienolide-type cardiac glycosides have a worldwide distribution and are mainly synthesized by plants, but there are also animal sources. In South Africa, members of three genera of the Crassulaceae (Cotyledon, Tylecodon and Kalanchoe cause a unique chronic form of cardiac glycoside poisoning, predominantly in small stock. This paretic/paralytic condition is referred to as “krimpsiekte”, cotyledonosis or “nenta”. “Krimpsiekte” is a plant poisoning only reported from South Africa and is regarded as the most important plant poisoning of small stock in the semi-arid Little Karoo and southern fringes of the Great Karoo. The toxicosis is caused by cumulative bufadienolides which have neurotoxic properties. Four types of cumulative neurotoxic bufadienolides, namely cotyledoside, and the tyledosides, orbicusides and lanceotoxins, have been isolated. Based on the structure activity relationships and certain toxicokinetic parameters possible reasons for their accumulation are presented. Consumption of edible tissues from animals that have ingested these plants poses a potential risk to humans.

  3. Metals in residential soils and cumulative risk assessment in Yaqui and Mayo agricultural valleys, northern Mexico.

    Science.gov (United States)

    Meza-Montenegro, Maria M; Gandolfi, A Jay; Santana-Alcántar, María Ernestina; Klimecki, Walter T; Aguilar-Apodaca, María Guadalupe; Del Río-Salas, Rafael; De la O-Villanueva, Margarita; Gómez-Alvarez, Agustín; Mendivil-Quijada, Héctor; Valencia, Martín; Meza-Figueroa, Diana

    2012-09-01

    This investigation examines the extent of soil metal pollution associated with the Green Revolution, relative to agricultural activities and associated risks to health in the most important agricultural region of Mexico. Metal contents in bulk soil samples are commonly used to assess contamination, and metal accumulations in soils are usually assumed to increase with decreasing particle size. This study profiled the spatial distribution of metals (Ni, Cr, Pb, Cu, Fe, Cd, V, Hg, Co, P, Se, and Mn) in bulk soil and fine-grained fractions (soil-derived dust) from 22 towns and cities. The contamination of soil was assessed through the use of a geoaccumulation index (Igeo) and pollution index (PI). The results of this study indicated that a number of towns and cities are moderately to highly polluted by soil containing Be, Co, Hg, P, S, V, Zn, Se, Cr, and Pb in both size fractions (coarse and fine). Hazard index in fine fraction (HI(children)=2.1) shows that risk assessment based on Co, Mn, V, and Ni spatially related to power plants, have the potential to pose health risks to local residents, especially children. This study shows that risk assessment based on metal content in bulk soil could be overestimated when compared to fine-grained fraction. Our results provide important information that could be valuable in establishing risk assessment associated with residential soils within agricultural areas, where children can ingest and inhale dust. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Optimization of the cumulative risk assessment of pesticides and biocides using computational techniques: Pilot project

    DEFF Research Database (Denmark)

    Jonsdottir, Svava Osk; Reffstrup, Trine Klein; Petersen, Annette

    This pilot project is intended as the first step in developing a computational strategy to assist in refining methods for higher tier cumulative and aggregate risk assessment of exposure to mixture of pesticides and biocides. For this purpose, physiologically based toxicokinetic (PBTK) models were...... developed for two compounds, tebuconazole and prochloraz, and a binary mixture of these compounds in two species, rat and human. PBTK models can be used to estimate the concentration levels (internal doses) of toxic substances and their metabolites in blood and tissue, by a collection of differential...... the models. Exposure scenarios were constructed based on findings of pesticide residues in food of ordinary consumers, and assessment of dermal exposure of professional workers. PBTK simulations were carried using these scenarios....

  5. When Two Isn't Better than One: Predictors of Early Sexual Activity in Adolescence Using a Cumulative Risk Model

    Science.gov (United States)

    Price, Myeshia N.; Hyde, Janet Shibley

    2009-01-01

    This study explored factors that may be associated with early initiation of sexual activity among adolescents. Using the cumulative risk model, we hypothesized that as exposure to risk factors increases, so does the likelihood of early sexual debut. A sample of 273 (53% girls, 90% European American) adolescents was followed longitudinally from age…

  6. Serious, Minor, and Non-Delinquents in Early Adolescence : The Impact of Cumulative Risk and Promotive Factors. The TRAILS Study

    NARCIS (Netherlands)

    van der Laan, A.M.; Veenstra, R.; Bogaerts, S.; Verhulst, F.C.; Ormel, J.

    2010-01-01

    This study uses a social-ecological approach to the development of delinquency. The authors emphasize that a balance between eliminating risk and enhancing protection across domains is essential in reducing problems and promoting competence. The cumulative risk and promotive effects of temperament,

  7. HIV-Risk Index: Development and Validation of a Brief Risk Index for Hispanic Young People.

    Science.gov (United States)

    Ballester-Arnal, Rafael; Gil-Llario, María Dolores; Castro-Calvo, Jesús; Giménez-García, Cristina

    2016-08-01

    The prevalence of HIV risk behaviors among young people facilitates the spread of HIV, in particular regarding unsafe sex behavior, although this trend is different within this population. For this reason, identifying the riskier young population is required to prevent HIV infection. The main purpose of this study was to develop and validate a risk index to assess the different sexual HIV risk exposure among Hispanic Young people. For this purpose, 9861 Spanish young people were randomly distributed into two groups (derivation and validation group). According to the results, the factor analyses grouped the nine items of the HIV- risk index into two factors (factor 1, direct sexual risk indicators and factor 2, indirect sexual risk indicators) with an equal structure for men and women by a multi-group confirmatory factor analysis. The variance explained was 54.26 %. Moreover, the Cronbach's alpha coefficient revealed high internal reliability (α = .79) and the convergent validity supported its evidence based on different HIV risk indexes. Therefore, the HIV-risk index seem to be a rigorous and valid measure to estimate HIV risk exposure among young people.

  8. Cumulative Cardiovascular Polypharmacy Is Associated With the Risk of Acute Kidney Injury in Elderly Patients.

    Science.gov (United States)

    Chao, Chia-Ter; Tsai, Hung-Bin; Wu, Chia-Yi; Lin, Yu-Feng; Hsu, Nin-Chieh; Chen, Jin-Shin; Hung, Kuan-Yu

    2015-08-01

    Polypharmacy is common in the elderly due to multimorbidity and interventions. However, the temporal association between polypharmacy and renal outcomes is rarely addressed and recognized. We investigated the association between cardiovascular (CV) polypharmacy and the risk of acute kidney injury (AKI) in elderly patients.We used the Taiwan National Health Insurance PharmaCloud system to investigate the relationship between cumulative CV medications in the 3 months before admission and risk of AKI in the elderly at their admission to general medical wards in a single center. Community-dwelling elderly patients (>60 years) were prospectively enrolled and classified according to the number of preadmission CV medications. CV polypharmacy was defined as use of 2 or more CV medications.We enrolled 152 patients, 48% with AKI (based upon Kidney Disease Improving Global Outcomes [KDIGO] classification) and 64% with CV polypharmacy. The incidence of AKI was higher in patients taking more CV medications (0 drugs: 33%; 1 drug: 50%; 2 drugs: 57%; 3 or more drugs: 60%; P = 0.05) before admission. Patients with higher KDIGO grades also took more preadmission CV medications (P = 0.04). Multiple regression analysis showed that patients who used 1 or more CV medications before admission had increased risk of AKI at admission (1 drug: odds ratio [OR] = 1.63, P = 0.2; 2 drugs: OR = 4.74, P = 0.03; 3 or more drugs: OR = 5.92, P = 0.02), and that CV polypharmacy is associated with higher risk of AKI (OR 2.58; P = 0.02). Each additional CV medication increased the risk for AKI by 30%.We found that elderly patients taking more CV medications are associated with risk of adverse renal events. Further study to evaluate whether interventions that reduce polypharmacy could reduce the incidence of geriatric AKI is urgently needed.

  9. Comparison of competing risks models based on cumulative incidence function in analyzing time to cardiovascular diseases.

    Science.gov (United States)

    Dianatkhah, Minoo; Rahgozar, Mehdi; Talaei, Mohammad; Karimloua, Masoud; Sadeghi, Masoumeh; Oveisgharan, Shahram; Sarrafzadegan, Nizal

    2014-01-01

    Competing risks arise when the subject is exposed to more than one cause of failure. Data consists of the time that the subject failed and an indicator of which risk caused the subject to fail. With three approaches consisting of Fine and Gray, binomial, and pseudo-value, all of which are directly based on cumulative incidence function, cardiovascular disease data of the Isfahan Cohort Study were analyzed. Validity of proportionality assumption for these approaches is the basis for selecting appropriate models. Such as for the Fine and Gray model, establishing proportionality assumption is necessary. In the binomial approach, a parametric, non-parametric, or semi-parametric model was offered according to validity of assumption. However, pseudo-value approaches do not need to establish proportionality. Following fitting the models to data, slight differences in parameters and variances estimates were seen among models. This showed that semi-parametric multiplicative model and the two models based on pseudo-value approach could be used for fitting this kind of data. We would recommend considering the use of competing risk models instead of normal survival methods when subjects are exposed to more than one cause of failure.

  10. Cumulative risk effects for the development of behaviour difficulties in children and adolescents with special educational needs and disabilities.

    Science.gov (United States)

    Oldfield, Jeremy; Humphrey, Neil; Hebron, Judith

    2015-01-01

    Research has identified multiple risk factors for the development of behaviour difficulties. What have been less explored are the cumulative effects of exposure to multiple risks on behavioural outcomes, with no study specifically investigating these effects within a population of young people with special educational needs and disabilities (SEND). Furthermore, it is unclear whether a threshold or linear risk model better fits the data for this population. The sample included 2660 children and 1628 adolescents with SEND. Risk factors associated with increases in behaviour difficulties over an 18-month period were summed to create a cumulative risk score, with this explanatory variable being added into a multi-level model. A quadratic term was then added to test the threshold model. There was evidence of a cumulative risk effect, suggesting that exposure to higher numbers of risk factors, regardless of their exact nature, resulted in increased behaviour difficulties. The relationship between risk and behaviour difficulties was non-linear, with exposure to increasing risk having a disproportionate and detrimental impact on behaviour difficulties in child and adolescent models. Interventions aimed at reducing behaviour difficulties need to consider the impact of multiple risk variables. Tailoring interventions towards those exposed to large numbers of risks would be advantageous.

  11. The role of violent media preference in cumulative developmental risk for violence and general aggression.

    Science.gov (United States)

    Boxer, Paul; Huesmann, L Rowell; Bushman, Brad J; O'Brien, Maureen; Moceri, Dominic

    2009-03-01

    The impact of exposure to violence in the media on the long-term development and short-term expression of aggressive behavior has been well documented. However, gaps in this literature remain, and in particular the role of violent media exposure in shaping violent and other serious antisocial behavior has not been investigated. Further, studies of violent media effects typically have not sampled from populations with confirmed histories of violent and/or nonviolent antisocial behavior. In this study, we analyzed data on 820 youth, including 390 juvenile delinquents and 430 high school students, to examine the relation of violent media use to involvement in violence and general aggression. Using criterion scores developed through cross-informant modeling of data from self, parent/guardian, and teacher/staff reports, we observed that childhood and adolescent violent media preferences contributed significantly to the prediction of violence and general aggression from cumulative risk totals. Findings represent a new and important direction for research on the role of violent media use in the broader matrix of risk factors for youth violence.

  12. Probabilistic acute risk assessment of cumulative exposure to organophosphorus and carbamate pesticides from dietary vegetables and fruits in Shanghai populations.

    Science.gov (United States)

    Li, Fan; Yuan, Yaqun; Meng, Pai; Wu, Min; Li, Shuguang; Chen, Bo

    2017-05-01

    Organophosphorus pesticides (OPs) and carbamate pesticides (CPs) are among the most widely used pesticides in China, playing a major role in protecting agricultural commodities. In this study, we determined the cumulative acute exposure to OPs and CPs of Shanghai residents from vegetables and fruits (VFs). The food consumption data were obtained from the Shanghai Food Consumption Survey (SHFCS) of 2012-14 including a total of 1973 participants aged 2-90 years. The pesticide residue data were obtained from the Shanghai monitoring programme during 2008-11 with 34 organophosphates and 11 carbamates analysed in a total of 5335 samples of VFs. A probabilistic approach was performed as recommended by the EFSA, using the optimistic model with non-detects set as zero and with processing factors (PFs) being used and the pessimistic model with non-detects replaced by limit of detection (LOD) and without PFs. We used the relative potency factor (RPF) method to normalise the various pesticides to the index compound (IC) of methamidophos and chlorpyrifos separately. Only in the pessimistic model using methamidophos as the IC was there was small risk of exposure exceeding the ARfD (3 µg kg(-)(1) bw day(-)(1)) in the populations of preschool children (0.029%), school-age children (0.022%) and adults (0.002%). There were no risk of exposure exceeding the ARfD of methamidophos in the optimistic model and of chlorpyrifos (100 µg kg(-)(1) bw day(-)(1)) in both optimistic and pessimistic models in all three populations. Considering the Chinese habits of overwhelmingly eating processed food (vegetables being cooked, and fruits being washed or peeled), we conclude that little acute risk was found for the exposure to VF-sourced OPs and CPs in Shanghai.

  13. Non-chemical stressors and cumulative risk assessment: an overview of current initiatives and potential air pollutant interactions.

    Science.gov (United States)

    Lewis, Ari S; Sax, Sonja N; Wason, Susan C; Campleman, Sharan L

    2011-06-01

    Regulatory agencies are under increased pressure to consider broader public health concerns that extend to multiple pollutant exposures, multiple exposure pathways, and vulnerable populations. Specifically, cumulative risk assessment initiatives have stressed the importance of considering both chemical and non-chemical stressors, such as socioeconomic status (SES) and related psychosocial stress, in evaluating health risks. The integration of non-chemical stressors into a cumulative risk assessment framework has been largely driven by evidence of health disparities across different segments of society that may also bear a disproportionate risk from chemical exposures. This review will discuss current efforts to advance the field of cumulative risk assessment, highlighting some of the major challenges, discussed within the construct of the traditional risk assessment paradigm. Additionally, we present a summary of studies of potential interactions between social stressors and air pollutants on health as an example of current research that supports the incorporation of non-chemical stressors into risk assessment. The results from these studies, while suggestive of possible interactions, are mixed and hindered by inconsistent application of social stress indicators. Overall, while there have been significant advances, further developments across all of the risk assessment stages (i.e., hazard identification, exposure assessment, dose-response, and risk characterization) are necessary to provide a scientific basis for regulatory actions and effective community interventions, particularly when considering non-chemical stressors. A better understanding of the biological underpinnings of social stress on disease and implications for chemical-based dose-response relationships is needed. Furthermore, when considering non-chemical stressors, an appropriate metric, or series of metrics, for risk characterization is also needed. Cumulative risk assessment research will benefit

  14. Oral contraceptive use and impact of cumulative intake of estrogen and progestin on risk of ovarian cancer

    DEFF Research Database (Denmark)

    Faber, M T; Jensen, A; Frederiksen, K

    2013-01-01

    women aged 35–79 years; 554 women with epithelial ovarian cancer and 1,564 age-matched controls were included in the analyses. Data were analyzed in multiple logistic regression models. RESULTS: The use of combined oral contraceptives only and the mixed use of combined and progestin-only pills decreased...... the risk of ovarian cancer, while no association was found with exclusive use of progestin-only pills. No major differences in risk were found for users of combined oral contraceptives with high- and low-potency estrogen and progestin. There was no effect of cumulative progestin intake, but decreased risks......PURPOSE: Oral contraceptive use decreases the risk of ovarian cancer, but no previous studies have assessed the impact of cumulative intake of estrogen and progestin on ovarian cancer risk. METHODS: We used data from a population-based case–control study conducted in Denmark in 1995–1999 among...

  15. A cumulative risk factor model for early identification of academic difficulties in premature and low birth weight infants

    NARCIS (Netherlands)

    Roberts, G.; Bellinger, D.; McCormick, Marie C.

    2007-01-01

    Objectives: Premature and low birth weight children have a high prevalence of academic difficulties. This study examines a model comprised of cumulative risk factors that allows early identification of these difficulties. Methods: This is a secondary analysis of data from a large cohort of premature

  16. Cumulative Risk and Adolescent's Internalizing and Externalizing Problems: The Mediating Roles of Maternal Responsiveness and Self-Regulation

    Science.gov (United States)

    Doan, Stacey N.; Fuller-Rowell, Thomas E.; Evans, Gary W.

    2012-01-01

    The purpose of the present study was to examine longitudinal associations among maternal responsiveness, self-regulation, and behavioral adjustment in adolescents. The authors used structural equation modeling to test a model that demonstrates that the effects of early cumulative risk on behavioral problems is mediated by maternal responsiveness…

  17. Benchmark Dose Analysis from Multiple Datasets: The Cumulative Risk Assessment for the N-Methyl Carbamate Pesticides

    Science.gov (United States)

    The US EPA’s N-Methyl Carbamate (NMC) Cumulative Risk assessment was based on the effect on acetylcholine esterase (AChE) activity of exposure to 10 NMC pesticides through dietary, drinking water, and residential exposures, assuming the effects of joint exposure to NMCs is dose-...

  18. Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis with Contextual and Genetic Protective Factors

    Science.gov (United States)

    Brody, Gene H.; Yu, Tianyi; Chen, Yi-Fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

    2013-01-01

    The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental…

  19. Cumulative biomedical risk and social cognition in the second year of life: prediction and moderation by responsive parenting.

    Science.gov (United States)

    Wade, Mark; Madigan, Sheri; Akbari, Emis; Jenkins, Jennifer M

    2015-01-01

    At 18 months, children show marked variability in their social-cognitive skill development, and the preponderance of past research has focused on constitutional and contextual factors in explaining this variability. Extending this literature, the current study examined whether cumulative biomedical risk represents another source of variability in social cognition at 18 months. Further, we aimed to determine whether responsive parenting moderated the association between biomedical risk and social cognition. A prospective community birth cohort of 501 families was recruited at the time of the child's birth. Cumulative biomedical risk was measured as a count of 10 prenatal/birth complications. Families were followed up at 18 months, at which point social-cognitive data was collected on children's joint attention, empathy, cooperation, and self-recognition using previously validated tasks. Concurrently, responsive maternal behavior was assessed through observational coding of mother-child interactions. After controlling for covariates (e.g., age, gender, child language, socioeconomic variables), both cumulative biomedical risk and maternal responsivity significantly predicted social cognition at 18 months. Above and beyond these main effects, there was also a significant interaction between biomedical risk and maternal responsivity, such that higher biomedical risk was significantly associated with compromised social cognition at 18 months, but only in children who experienced low levels of responsive parenting. For those receiving comparatively high levels of responsive parenting, there was no apparent effect of biomedical risk on social cognition. This study shows that cumulative biomedical risk may be one source of inter-individual variability in social cognition at 18 months. However, positive postnatal experiences, particularly high levels of responsive parenting, may protect children against the deleterious effects of these risks on social cognition.

  20. Cumulative biomedical risk and social cognition in the second year of life: prediction and moderation by responsive parenting

    Directory of Open Access Journals (Sweden)

    Mark eWade

    2015-04-01

    Full Text Available At 18 months, children show marked variability in their social-cognitive skill development, and the preponderance of past research has focused on constitutional and contextual factors in explaining this variability. Extending this literature, the current study examined whether cumulative biomedical risk represents another source of variability in social cognition at 18 months. Further, we aimed to determine whether responsive parenting moderated the association between biomedical risk and social cognition. A prospective community birth cohort of 501 families was recruited at the time of the child’s birth. Cumulative biomedical risk was measured as a count of 10 prenatal/birth complications. Families were followed up at 18 months, at which point social-cognitive data was collected on children’s joint attention, empathy, cooperation, and self-recognition using previously-validated tasks. Concurrently, responsive maternal behavior was assessed through observational coding of mother-child interactions. After controlling for covariates (e.g. age, gender, child language, socioeconomic variables, both cumulative biomedical risk and maternal responsivity significantly predicted social cognition at 18 months. Above and beyond these main effects, there was also a significant interaction between biomedical risk and maternal responsivity, such that higher biomedical risk was significantly associated with compromised social cognition at 18 months, but only in children who experienced low levels of responsive parenting. For those receiving comparatively high levels of responsive parenting, there was no apparent effect of biomedical risk on social cognition. This study shows that cumulative biomedical risk may be one source of inter-individual variability in social cognition at 18 months. However, positive postnatal experiences, particularly high levels of responsive parenting, may protect children against the deleterious effects of these risks on social

  1. Linking turbine collision risks with population models to assess cumulative impacts of multiple wind farms on threatened birds

    Energy Technology Data Exchange (ETDEWEB)

    Smales, Ian; Muir, Stuart; Meredith, Charles; Baird, Robert

    2011-07-01

    Full text: Assessment of the effects on birds of wind turbine collisions has generally been focussed on the number of individuals that might be killed at a particular facility. However, this measure, of itself, may have little relevance to evaluating the potential or real effects on conservation status of threatened species. Determination of the overall effect any such mortality may have on the functioning of these populations will provide a better basis for decisions that have a strong foundation in ecology. For species with sufficient demographic information, we have developed and applied an approach combining collision risk modelling for all wind farms within the range of a threatened species with population modelling. This permits population-level evaluation of potential cumulative impacts of multiple wind farms. In Australia, regulatory authorities are increasingly interested in the cumulative risk to threatened species that may be posed by multiple wind energy facilities within a species. range. The approach outlined here has been applied in the pre-construction approval stage using collision risk modelling, and can be applied to operational facilities using data on actual mortalities. Cumulative modelling of risk posed by multiple wind farms requires different approaches for sedentary and migratory species. For sedentary species the cumulative effect will be the sum of the impact experienced by those parts of the population whose range intersects with wind farms. Cumulative impact is derived for migratory species by assessing the probability of birds surviving encounters with one wind farm after another on the migratory route and is thus the product of their survivorship rates for the relevant wind farms. The collision risk modelling used will be outlined along with the method in which it is integrated with a population model. Case studies for a crane (Brolga Grus rubicundus) and a parrot (orange- bellied parrot Neophema chrysogaster) species will be

  2. Relations of Growth in Effortful Control to Family Income, Cumulative Risk, and Adjustment in Preschool-age Children

    OpenAIRE

    Lengua, Liliana J.; Moran, Lyndsey; Zalewski, Maureen; Ruberry, Erika; Kiff, Cara; Thompson, Stephanie

    2015-01-01

    The study examined growth in effortful control (executive control, delay ability) in relation to income, cumulative risk (aggregate of demographic and psychosocial risk factors), and adjustment in 306 preschool-age children (50% girls, 50% boys) from families representing a range of income (29% at- or near-poverty; 28% lower-income; 25% middle-income; 18% upper-income), with 4 assessments starting at 36–40 mos. Income was directly related to levels of executive control and delay ability. Cumu...

  3. Body Mass Index Genetic Risk Score and Endometrial Cancer Risk.

    Directory of Open Access Journals (Sweden)

    Jennifer Prescott

    Full Text Available Genome-wide association studies (GWAS have identified common variants that predispose individuals to a higher body mass index (BMI, an independent risk factor for endometrial cancer. Composite genotype risk scores (GRS based on the joint effect of published BMI risk loci were used to explore whether endometrial cancer shares a genetic background with obesity. Genotype and risk factor data were available on 3,376 endometrial cancer case and 3,867 control participants of European ancestry from the Epidemiology of Endometrial Cancer Consortium GWAS. A BMI GRS was calculated by summing the number of BMI risk alleles at 97 independent loci. For exploratory analyses, additional GRSs were based on subsets of risk loci within putative etiologic BMI pathways. The BMI GRS was statistically significantly associated with endometrial cancer risk (P = 0.002. For every 10 BMI risk alleles a woman had a 13% increased endometrial cancer risk (95% CI: 4%, 22%. However, after adjusting for BMI, the BMI GRS was no longer associated with risk (per 10 BMI risk alleles OR = 0.99, 95% CI: 0.91, 1.07; P = 0.78. Heterogeneity by BMI did not reach statistical significance (P = 0.06, and no effect modification was noted by age, GWAS Stage, study design or between studies (P≥0.58. In exploratory analyses, the GRS defined by variants at loci containing monogenic obesity syndrome genes was associated with reduced endometrial cancer risk independent of BMI (per BMI risk allele OR = 0.92, 95% CI: 0.88, 0.96; P = 2.1 x 10-5. Possessing a large number of BMI risk alleles does not increase endometrial cancer risk above that conferred by excess body weight among women of European descent. Thus, the GRS based on all current established BMI loci does not provide added value independent of BMI. Future studies are required to validate the unexpected observed relation between monogenic obesity syndrome genetic variants and endometrial cancer risk.

  4. Risk weighted alpha index – analysis of the ASX50 index

    Directory of Open Access Journals (Sweden)

    Nipun Agarwal

    2013-12-01

    Full Text Available Major stock indexes are developed on the market capitalization or price weighted indexation method. The Australian Stock Exchange 50 (ASX50 index is a market capitalization index of the top 50 Australian stocks. Fundamental indexation, equal weighted index and risk weighted index methods have recently been developed as an alternative to the market cap and price indexes. However, empirical studies do not conclusively prove if these alternate methods are more efficient to the existing market cap or price weighted methods. Also, the fundamental index method provides a higher alpha, while the risk weighted index methods focus on risk reduction through diversification. There is a gap to develop another passive indexation method in order to provide the investor a higher return (alpha and lower volatility. This paper re-weights the ASX50 index using the risk weighted alpha method and provides higher weight to stocks that have increasing returns and lower volatility. The empirical study for ASX50 index from 2002-2012 is undertaken and results show that the risk weighted alpha method provides higher return and has lower systematic risk than the ASX50 index.

  5. STORMTOOLS: Coastal Environmental Risk Index (CERI

    Directory of Open Access Journals (Sweden)

    Malcolm L. Spaulding

    2016-08-01

    Full Text Available One of the challenges facing coastal zone managers and municipal planners is the development of an objective, quantitative assessment of the risk to structures, infrastructure, and public safety that coastal communities face from storm surge in the presence of changing climatic conditions, particularly sea level rise and coastal erosion. Here we use state of the art modeling tool (ADCIRC and STWAVE to predict storm surge and wave, combined with shoreline change maps (erosion, and damage functions to construct a Coastal Environmental Risk Index (CERI. Access to the state emergency data base (E-911 provides information on structure characteristics and the ability to perform analyses for individual structures. CERI has been designed as an on line Geographic Information System (GIS based tool, and hence is fully compatible with current flooding maps, including those from FEMA. The basic framework and associated GIS methods can be readily applied to any coastal area. The approach can be used by local and state planners to objectively evaluate different policy options for effectiveness and cost/benefit. In this study, CERI is applied to RI two communities; Charlestown representing a typical coastal barrier system directly exposed to ocean waves and high erosion rates, with predominantly low density single family residences and Warwick located within Narragansett Bay, with more limited wave exposure, lower erosion rates, and higher residential housing density. Results of these applications are highlighted herein.

  6. Relations of growth in effortful control to family income, cumulative risk, and adjustment in preschool-age children.

    Science.gov (United States)

    Lengua, Liliana J; Moran, Lyndsey; Zalewski, Maureen; Ruberry, Erika; Kiff, Cara; Thompson, Stephanie

    2015-05-01

    The study examined growth in effortful control (executive control, delay ability) in relation to income, cumulative risk (aggregate of demographic and psychosocial risk factors), and adjustment in 306 preschool-age children (50 % girls, 50 % boys) from families representing a range of income (29 % at- or near-poverty; 28 % lower-income; 25 % middle-income; 18 % upper-income), with 4 assessments starting at 36-40 month. Income was directly related to levels of executive control and delay ability. Cumulative risk accounted for the effects of income on delay ability but not executive control. Higher initial executive control and slope of executive control and delay ability predicted academic readiness, whereas levels, but not growth, of executive control and delay ability predicted social competence and adjustment problems. Low income is a marker for lower effortful control, which demonstrates additive or mediating effects in the relation of income to children's preschool adjustment.

  7. Cumulative radiation exposure and cancer risk of patients with ischemic heart diseases from diagnostic and therapeutic imaging procedures

    Energy Technology Data Exchange (ETDEWEB)

    Brix, Gunnar, E-mail: gbrix@bfs.de [Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, Ingoldstädter Landstraße 1, D-85764 Oberschleissheim (Germany); Berton, Marc, E-mail: marcberton@web.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Nekolla, Elke, E-mail: enekolla@bfs.de [Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, Ingoldstädter Landstraße 1, D-85764 Oberschleissheim (Germany); Lechel, Ursula, E-mail: ulechel@bfs.de [Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, Ingoldstädter Landstraße 1, D-85764 Oberschleissheim (Germany); Schegerer, Alexander, E-mail: aschegerer@bfs.de [Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, Ingoldstädter Landstraße 1, D-85764 Oberschleissheim (Germany); Süselbeck, Tim, E-mail: Tim.Sueselbeck@umm.de [Department of Cardiology, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Fink, Christian, E-mail: Christian.Fink@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany)

    2013-11-01

    Objectives: To present a detailed analysis of the cumulative radiation exposure and cancer risk of patients with ischemic heart diseases (IHD) from diagnostic and therapeutic imaging. Methods: For 1219 IHD patients, personal and examination data were retrieved from the information systems of a university hospital. For each patient, cumulative organ doses and the corresponding effective dose (E{sup ¯}) resulting from all imaging procedures performed within 3 months before and 12 months after the date of the diagnosis were calculated. The cumulative lifetime attributable risk (LAR{sup ¯}) of the patients to be diseased by radiation-related cancer was estimated using sex-, age-, and organ-specific risk models. Results: Among the 3870 procedures performed in the IHD patients, the most frequent were radiographic examinations (52.4%) followed by coronary catheter angiographies and percutaneous cardiac interventions (41.3%), CT scans (3.9%), and perfusion SPECT (2.3%). 87% of patient exposure resulted from heart catheter procedures. E{sup ¯} and LAR{sup ¯} were significantly higher in males than females (average, 13.3 vs. 10.3 mSv and 0.09 vs. 0.07%, respectively). Contrary to the effective dose, the cancer risk decreased markedly for both sexes with increasing age. Conclusions: Although IHD patients were partially exposed to considerable amounts of radiation, estimated LAR{sup ¯}s were small as compared to their baseline risk to develop cancer in the remaining life.

  8. Cumulative Psychosocial and Medical Risk as Predictors of Early Infant Development and Parenting Stress in an African-American Preterm Sample

    Science.gov (United States)

    Candelaria, Margo A.; O'Connell, Melissa A.; Teti, Douglas M.

    2006-01-01

    The present study examined predictive linkages between cumulative psychosocial and medical risk, assessed neonatally, and infant development and parenting stress at 4 months of infant corrected age. Predominantly low-income, African-American mothers and their preterm infants served as participants. Cumulative psychosocial risk predicted early…

  9. Psychobiology of cumulative trauma: hair cortisol as a risk marker for stress exposure in women.

    Science.gov (United States)

    Morris, Matthew C; Abelson, James L; Mielock, Alyssa S; Rao, Uma

    2017-07-01

    Childhood trauma (CT) is associated with long-lasting alterations of the hypothalamic-pituitary-adrenal (HPA) axis and elevated risk for stress exposure in adulthood. Although HPA alterations are present in the early aftermath of trauma, it remains unclear how initial HPA activity is associated with subsequent stress exposure and whether CT exposure influences the strength and direction of this association. The present study examined prospective associations between hair cortisol content (HCC) and stress exposure from baseline to 3-month follow-up in young adult women with recent (i.e. past 3 months) exposure to interpersonal violence (IPV; i.e. physical or sexual assault) and non-traumatized controls. History of significant CT abuse or neglect was determined based on clinical cutoffs for a self-report CT measure: 12 women had abuse or neglect and recent IPV exposure (CT + IPV); 7 women had abuse or neglect but no IPV exposure (CT); 15 women had no history of trauma (NTC). HCC was computed for 3 cm sections reflecting cortisol secretion during the 3 months preceding the baseline assessment. The interaction of cumulative trauma and HCC predicted stress exposure over 3-month follow-up, controlling for baseline stress exposure and depressive symptoms. Simple slopes analyses revealed that lower baseline HCC predicted greater stress exposure in the CT + IPV group compared to the CT group; HCC was not associated with stress exposure in the NTC group. The present findings highlight the potential utility of HCC as a predictor of stress exposure for women with a history of childhood abuse or neglect, particularly in the context of recent IPV. Lay summary Adults with a history of CT show long-lasting alterations in major stress response systems, including the HPA axis. They are also more likely to experience stressful life events in adulthood. However, it is not clear how altered HPA activity influences risk for stress exposure and whether CT affects their

  10. Development and implementation of a business continuity management risk index.

    Science.gov (United States)

    Kadar, Michael

    This paper will present the building blocks for developing and implementing the BCM risk index; whether it is used as a comprehensive metric for risk or preparedness. This paper introduces the concept of a business continuity management (BCM) risk index--a comprehensive metric that measures and reports the status of the primary 'intended outcome' of the BCM programme to top management. In addition to measuring the primary programme output,;the BCM risk index can be used to demonstrate the overall value of the BCM programme to executive management. This is accomplished because the BCM risk index allows quantitative measurement of current risk levels and their comparison with established risk tolerances. The BCM Risk Index can provide executive management with reports on the risk level of individual business units, departments, subsidiaries or the enterprise in a way that drives both risk management and BCM initiatives. The name 'risk index' can be misleading, however. The BCM risk index concept can also be used to measure preparedness levels. In fact, implementation at DTE Energy has resulted in calling it the 'preparedness index', which is used to measure and report preparedness levels rather than risk levels.

  11. Cumulative Small Effect Genetic Markers and the Risk of Colorectal Cancer in Poland, Estonia, Lithuania, and Latvia

    Directory of Open Access Journals (Sweden)

    Pablo Serrano-Fernandez

    2015-01-01

    Full Text Available The continued identification of new low-penetrance genetic variants for colorectal cancer (CRC raises the question of their potential cumulative effect among compound carriers. We focused on 6 SNPs (rs380284, rs4464148, rs4779584, rs4939827, rs6983267, and rs10795668, already described as risk markers, and tested their possible independent and combined contribution to CRC predisposition. Material and Methods. DNA was collected and genotyped from 2330 unselected consecutive CRC cases and controls from Estonia (166 cases and controls, Latvia (81 cases and controls, Lithuania (123 cases and controls, and Poland (795 cases and controls. Results. Beyond individual effects, the analysis revealed statistically significant linear cumulative effects for these 6 markers for all samples except of the Latvian one (corrected P value = 0.018 for the Estonian, corrected P value = 0.0034 for the Lithuanian, and corrected P value = 0.0076 for the Polish sample. Conclusions. The significant linear cumulative effects demonstrated here support the idea of using sets of low-risk markers for delimiting new groups with high-risk of CRC in clinical practice that are not carriers of the usual CRC high-risk markers.

  12. 1960-69 Cumulative Index of Articles Related to Oceanography and Limnology Education in The Science Teacher.

    Science.gov (United States)

    Cohen, Maxwell

    Indexed are articles relating to oceanography and limnology published in "The Science Teacher" between 1960 and 1969. Articles are indexed under title, author, and topic. Topics include background information, course descriptions, and laboratory equipment and techniques. (EB)

  13. Urinary antibiotics of pregnant women in Eastern China and cumulative health risk assessment.

    Science.gov (United States)

    Wang, Hexing; Wang, Na; Qian, Junhua; Hu, Lingyun; Huang, Peixin; Su, Meifang; Yu, Xin; Fu, Chaowei; Jiang, Feng; Zhao, Qi; Zhou, Ying; Lin, Haijiang; He, Gengsheng; Chen, Yue; Jiang, Qingwu

    2017-02-23

    Exposure to antibiotics during pregnancy can pose a systematic effect on human health. A few bio-monitoring studies have demonstrated an extensive exposure of children to antibiotics, but there is still lack of data for pregnant women. To assess the exposure of pregnant women to antibiotics and potential health risk, we investigated 536 pregnant women aged 16-42 years from two geographically different study sites in Eastern China in 2015. We measured 21 antibiotics of five categories (seven fluoroquinolones, three phenicols, four tetracyclines, three macrolides, and four sulfonamides) in urines by using the isotope dilution ultra-performance liquid chromatography coupled to quadrupole time of-flight mass spectrometry. Hazard index (HI) was calculated based on estimated daily exposure dose and acceptable daily intakes. Sixteen antibiotics were found in urines with detection frequencies between 0.2% and 16.0%. Antibiotics were overall detected in 41.6% of urines, and two or more antibiotics were detected in 13.1% of urines. Ciprofloxacin, ofloxacin, and trimethoprim were most frequently detected in urine with detection frequencies between 10% and 20%. The majority of the antibiotics tested had an estimated daily exposure dose less than 1μg/kg/day and 4.3% of pregnant women had a HI value more than one. These findings indicated that pregnant women were frequently exposed to antibiotics and some individuals were in the potential risk of adverse microbiological effects induced by antibiotics.

  14. High cumulative insulin exposure : a risk factor of atherosclerosis in type 1 diabetes?

    NARCIS (Netherlands)

    Muis, MJ; Bots, ML; Bilo, HJG; Hoogma, RPLM; Hoekstra, JBL; Grobbee, DE; Stolk, RP

    Background: Since insulin therapy might have an atherogenic effect, we studied the relationship between cumulative insulin dose and atherosclerosis in type 1 diabetes. We have focused on patients with type 1 diabetes instead of type 2 diabetes to minimise the effect of insulin resistance as a

  15. Mechanisms and risk of cumulative impacts to coastal ecosystem services: An expert elicitation approach

    KAUST Repository

    Singh, Gerald G.

    2017-05-23

    Coastal environments are some of the most populated on Earth, with greater pressures projected in the future. Managing coastal systems requires the consideration of multiple uses, which both benefit from and threaten multiple ecosystem services. Thus understanding the cumulative impacts of human activities on coastal ecosystem services would seem fundamental to management, yet there is no widely accepted approach for assessing these. This study trials an approach for understanding the cumulative impacts of anthropogenic change, focusing on Tasman and Golden Bays, New Zealand. Using an expert elicitation procedure, we collected information on three aspects of cumulative impacts: the importance and magnitude of impacts by various activities and stressors on ecosystem services, and the causal processes of impact on ecosystem services. We assessed impacts to four ecosystem service benefits — fisheries, shellfish aquaculture, marine recreation and existence value of biodiversity—addressing three main research questions: (1) how severe are cumulative impacts on ecosystem services (correspondingly, what potential is there for restoration)?; (2) are threats evenly distributed across activities and stressors, or do a few threats dominate?; (3) do prominent activities mainly operate through direct stressors, or do they often exacerbate other impacts? We found (1) that despite high uncertainty in the threat posed by individual stressors and impacts, total cumulative impact is consistently severe for all four ecosystem services. (2) A subset of drivers and stressors pose important threats across the ecosystem services explored, including climate change, commercial fishing, sedimentation and pollution. (3) Climate change and commercial fishing contribute to prominent indirect impacts across ecosystem services by exacerbating regional impacts, namely sedimentation and pollution. The prevalence and magnitude of these indirect, networked impacts highlights the need for

  16. Job level risk assessment using task level strain index scores: a pilot study.

    Science.gov (United States)

    Drinkaus, Phillip; Bloswick, Donald S; Sesek, Richard; Mann, Clay; Bernard, Thomas

    2005-01-01

    This paper explores 2 methods of modifying the Strain Index (SI) to assess the ergonomic risk of multi-task jobs. Twenty-eight automotive jobs (15 cases and 13 controls) were studied. The first method is based on the maximum task SI score, and the second method is modeled on the NIOSH Composite Lifting Index (CLI) algorithm, named cumulative assessment of risk to the distal upper extremity (CARD). Significant odds ratios of 11 (CI 1.7-69) and 24 (CI 2.4-240) were obtained using the modified maximum task and CARD, respectively. This indicates that modification of the SI may be useful in determining the risk of distal upper extremity injury associated with a multi-task job.

  17. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    Energy Technology Data Exchange (ETDEWEB)

    Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

    2014-09-15

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  18. The excess risk of major osteoporotic fractures in hypothyroidism is driven by cumulative hyperthyroid as opposed to hypothyroid time

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Jørgensen, Henrik L; Laulund, Anne Sofie

    2015-01-01

    The long-term relationship between hypothyroidism and fracture risk is challenging to dissect because of the modifying influence of subsequent thyroxine replacement with the potential for excessive replacement doses. We studied changes in serum thyrotropin concentration (TSH) over time and associ......The long-term relationship between hypothyroidism and fracture risk is challenging to dissect because of the modifying influence of subsequent thyroxine replacement with the potential for excessive replacement doses. We studied changes in serum thyrotropin concentration (TSH) over time...... as a predictor of fracture risk in postmenopausal women whereas hypothyroid time predicted increased fracture risk in men below age 75 years. In conclusion, among patients who present with an elevated TSH, the long-term risk of hip and other osteoporotic fractures is strongly related to the cumulative duration...

  19. A semi-parametric censoring bias model for estimating the cumulative risk of a false-positive screening test under dependent censoring

    OpenAIRE

    Hubbard, Rebecca A.; Miglioretti, Diana L.

    2013-01-01

    False-positive test results are among the most common harms of screening tests and may lead to more invasive and expensive diagnostic testing procedures. Estimating the cumulative risk of a false-positive screening test result after repeat screening rounds is therefore important for evaluating potential screening regimens. Existing estimators of the cumulative false-positive risk are limited by strong assumptions about censoring mechanisms and parametric assumptions about variation in risk ac...

  20. Cumulative risk on the oxytocin receptor gene (OXTR) underpins empathic communication difficulties at the first stages of romantic love.

    Science.gov (United States)

    Schneiderman, Inna; Kanat-Maymon, Yaniv; Ebstein, Richard P; Feldman, Ruth

    2014-10-01

    Empathic communication between couples plays an important role in relationship quality and individual well-being and research has pointed to the role of oxytocin in providing the neurobiological substrate for pair-bonding and empathy. Here, we examined links between genetic variability on the oxytocin receptor gene (OXTR) and empathic behaviour at the initiation of romantic love. Allelic variations on five OXTR single nucleotide polymorphisms (SNPs) previously associated with susceptibility to disorders of social functioning were genotyped in 120 new lovers: OXTRrs13316193, rs2254298, rs1042778, rs2268494 and rs2268490. Cumulative genetic risk was computed by summing risk alleles on each SNP. Couples were observed in support-giving interaction and behaviour was coded for empathic communication, including affective congruence, maintaining focus on partner, acknowledging partner's distress, reciprocal exchange and non-verbal empathy. Hierarchical linear modelling indicated that individuals with high OXTR risk exhibited difficulties in empathic communication. OXTR risk predicted empathic difficulties above and beyond the couple level, relationship duration, and anxiety and depressive symptoms. Findings underscore the involvement of oxytocin in empathic behaviour during the early stages of social affiliation, and suggest the utility of cumulative risk and plasticity indices on the OXTR as potential biomarkers for research on disorders of social dysfunction and the neurobiology of empathy.

  1. Probabilistic cumulative risk assessment of anti-androgenic pesticides in food

    DEFF Research Database (Denmark)

    Müller, Anne Kirstine; Bosgra, Sieto; Boon, Polly E.;

    2009-01-01

    reproductive endpoints (ano-genital distance, and weights of the seminal vesicles and the musculus levator ani/bulbocavernosus) in male rat foetuses exposed in utero. The cumulative dietary intake was estimated based on consumption data and residue data from the Netherlands. The IPRA model combines variability...... in both exposure and sensitivity between individuals into a distribution of individual margins of exposures (IMoEs) and IMoEs of 1 or less indicate a possible concern. The assessment did not result in IMoEs ≤ 1. The endpoint ‘weight of seminal vesicles’ resulted in the lowest IMoEs (0.1th percentile: 198...

  2. 76 FR 69726 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability

    Science.gov (United States)

    2011-11-09

    ... Business Information (CBI) or other information whose disclosure is restricted by statute. Do not submit information that you consider to be CBI or otherwise protected through regulations.gov or email. The... index available at http://www.regulations.gov . Although listed in the index, some information is not...

  3. Meta-analysis for aggregated survival data with competing risks: a parametric approach using cumulative incidence functions.

    Science.gov (United States)

    Bonofiglio, Federico; Beyersmann, Jan; Schumacher, Martin; Koller, Michael; Schwarzer, Guido

    2016-09-01

    Meta-analysis of a survival endpoint is typically based on the pooling of hazard ratios (HRs). If competing risks occur, the HRs may lose translation into changes of survival probability. The cumulative incidence functions (CIFs), the expected proportion of cause-specific events over time, re-connect the cause-specific hazards (CSHs) to the probability of each event type. We use CIF ratios to measure treatment effect on each event type. To retrieve information on aggregated, typically poorly reported, competing risks data, we assume constant CSHs. Next, we develop methods to pool CIF ratios across studies. The procedure computes pooled HRs alongside and checks the influence of follow-up time on the analysis. We apply the method to a medical example, showing that follow-up duration is relevant both for pooled cause-specific HRs and CIF ratios. Moreover, if all-cause hazard and follow-up time are large enough, CIF ratios may reveal additional information about the effect of treatment on the cumulative probability of each event type. Finally, to improve the usefulness of such analysis, better reporting of competing risks data is needed. Copyright © 2015 John Wiley & Sons, Ltd.

  4. Understanding the Relation of Low Income to HPA-Axis Functioning in Preschool Children: Cumulative Family Risk and Parenting As Pathways to Disruptions in Cortisol

    OpenAIRE

    Zalewski, Maureen; Lengua, Liliana J.; Kiff, Cara J.; Fisher, Philip A.

    2012-01-01

    This study examined the relation of low income and poverty to cortisol levels, and tested potential pathways from low income to disruptions in cortisol through cumulative family risk and parenting. The sample of 306 mothers and their preschool children included 29 % families at or near poverty, 27 % families below the median income, and the remaining families at middle and upper income. Lower income was related to lower morning cortisol levels, and cumulative risk predicted a flatter diurnal ...

  5. Child maltreatment, impulsivity, and antisocial behavior in African American children: Moderation effects from a cumulative dopaminergic gene index.

    Science.gov (United States)

    Thibodeau, Eric L; Cicchetti, Dante; Rogosch, Fred A

    2015-11-01

    A model examining the effects of an increasing number of maltreatment subtypes experienced on antisocial behavior, as mediated by impulsivity and moderated by a polygenic index of dopaminergic genotypes, was investigated. An African American sample of children (N = 1,012, M age = 10.07) with and without maltreatment histories participated. Indicators of aggression, delinquency, and disruptive peer behavior were obtained from peer- and counselor-rated measures to form a latent variable of antisocial behavior; impulsivity was assessed by counselor report. Five genotypes in four dopaminergic genes (dopamine receptors D4, D2, known as DRD4, DRD2; dopamine active transporter 1, known as DAT1; and catechol-O-methyltransferase, known as COMT) conferring heightened environmental sensitivity were combined into one polygenic index. Using structural equation modeling, a first-stage, moderated-mediation model was evaluated. Age and sex were entered as covariates, both as main effects and in interaction with maltreatment and the gene index. The model had excellent fit: χ2 (32, N = 1,012) = 86.51, p impulsivity (β = 0.173, p impulsivity was stronger as children evinced more differentiating genotypes, thereby strengthening the mediational effect of impulsivity on antisocial behavior. These findings elucidate the manner by which maltreated children develop early signs of antisocial behavior, and the genetic mechanisms involved in greater vulnerability for maladaptation in impulse control within the context of child maltreatment.

  6. Child Maltreatment, Impulsivity, and Antisocial Behavior in African-American Children: Moderation Effects from a Cumulative Dopaminergic Gene Index

    Science.gov (United States)

    Thibodeau, Eric L.; Cicchetti, Dante; Rogosch, Fred A.

    2015-01-01

    A model examining the effects of an increasing number of maltreatment subtypes experienced on antisocial behavior, as mediated by impulsivity and moderated by a polygenic index of dopaminergic genotypes, was investigated. An African American sample of children (N = 1012, M age = 10.07) with and without maltreatment histories participated. Indicators of aggression, delinquency, and disruptive peer behavior were obtained from peer and counselor rated measures to form a latent variable of antisocial behavior; impulsivity was assessed by counselor report. Five genotypes in four dopaminergic genes (DRD4, DRD2, DAT1, and COMT) conferring heightened environmental sensitivity were combined into one polygenic index. Using SEM, a first-stage, moderated-mediation model was evaluated. Age and sex were entered as covariates, both as main effects and in interaction with maltreatment and the gene index. The model had excellent fit: χ2(32, N =1012) = 86..51, p<0.001; CFI = 0.982; TLI = 0.977; RMSEA = 0.041; SRMR = 0.022. The effect of maltreatment subtypes on antisocial behavior was partially mediated by impulsivity (β= 0.173, p<0.001), and these relations were moderated by the number of differentiating dopaminergic genotypes. Specifically, a significant GxE interaction (b = 0.016, p = 0.013) indicated that the relation between maltreatment and impulsivity was stronger as children evinced more differentiating genotypes, thereby strengthening the mediational effect of impulsivity on antisocial behavior. These findings elucidate the manner by which maltreated children develop early signs of antisocial behavior, and the genetic mechanisms involved in greater vulnerability for maladaptation in impulse-control within context of child maltreatment. PMID:26535948

  7. Cumulative risk and AIDS-orphanhood: interactions of stigma, bullying and poverty on child mental health in South Africa.

    Science.gov (United States)

    Cluver, Lucie; Orkin, Mark

    2009-10-01

    Research shows that AIDS-orphaned children are more likely to experience clinical-range psychological problems. Little is known about possible interactions between factors mediating these high distress levels. We assessed how food insecurity, bullying, and AIDS-related stigma interacted with each other and with likelihood of experiencing clinical-range disorder. In South Africa, 1025 adolescents completed standardised measures of depression, anxiety and post-traumatic stress. 52 potential mediators were measured, including AIDS-orphanhood status. Logistic regressions and hierarchical log-linear modelling were used to identify interactions among significant risk factors. Food insecurity, stigma and bullying all independently increased likelihood of disorder. Poverty and stigma were found to interact strongly, and with both present, likelihood of disorder rose from 19% to 83%. Similarly, bullying interacted with AIDS-orphanhood status, and with both present, likelihood of disorder rose from 12% to 76%. Approaches to alleviating psychological distress amongst AIDS-affected children must address cumulative risk effects.

  8. Measuring the Combined Risk to Young Children's Cognitive Development: An Alternative to Cumulative Indices

    Science.gov (United States)

    Hall, James E.; Sammons, Pam; Sylva, Kathy; Melhuish, Edward; Taggart, Brenda; Siraj-Blatchford, Iram; Smees, Rebecca

    2010-01-01

    In studies of child development, the combined effect of multiple risks acting in unison has been represented in a variety of ways. This investigation builds upon this preceding work and presents a new procedure for capturing the combined effect of multiple risks. A representative sample of 2,899 British children had their cognitive development…

  9. The use of modelling and probabilistic methods in cumulative risk assessment

    NARCIS (Netherlands)

    Bosgra, S.

    2008-01-01

    This thesis was realized as part of the EU integrated project SAFE FOODS, the overall objective of which was to change the scope of decision-making on food safety from single risks to considering foods as sources of risks, benefits and costs associated with their production and consumption, and taki

  10. Cumulative Risk for Early Sexual Initiation among American Indian Youth: A Discrete-Time Survival Analysis

    Science.gov (United States)

    Mitchell, Christina M.; Whitesell, Nancy Rumbaugh; Spicer, Paul; Beals, Janette; Kaufman, Carol E.

    2007-01-01

    Approximately 3 million teens are diagnosed with a sexually transmitted disease (STD) annually; STDs rates for American Indian young adults are among the highest of any racial/ethnic group. An important risk factor for STDs is early initiation of sex. In this study, we examined risk for early initiation with 474 American Indian youth ages 14-18,…

  11. Cumulative Effects of Mothers' Risk and Promotive Factors on Daughters' Disruptive Behavior

    Science.gov (United States)

    van der Molen, Elsa; Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

    2012-01-01

    Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N = 2043).…

  12. Cumulative years in occupation and the risk of hip or knee osteoarthritis in men and women

    DEFF Research Database (Denmark)

    Andersen, Susan; Thygesen, Lau Caspar; Davidsen, Michael

    2012-01-01

    Occupational workload has been associated with an increased risk of osteoarthritis (OA), but only little research has been conducted among female workers. The objective of this study was to analyse if men and women in farming, construction or healthcare work have increased risk of developing OA...

  13. 78 FR 25440 - Request for Information and Citations on Methods for Cumulative Risk Assessment

    Science.gov (United States)

    2013-05-01

    ..., social sciences, dose response modeling and statistics (among others); and may also include addressing... understanding risk from multiple stressors, and that EPA had begun to address approaches to CRA. The NRC and EPA..., multi-stressor approaches to understanding risks to human health and the environment. For example, in...

  14. The Association between Cumulative Psychosocial Risk and Cervical HPV Infection Among Female Adolescents in a Free Vaccination Program

    Science.gov (United States)

    Linares, Lourdes Oriana; Shankar, Viswanathan; Diaz, Angela; Nucci-Sack, Anne; Strickler, Howard D.; Peake, Ken; Weiss, Jocelyn; Burk, Robert D.; Schlecht, Nicolas F.

    2016-01-01

    Objective This study investigated the association of cervical Human Papillomavirus (HPV) infection with cumulative psychosocial risk reflecting family disadvantage, psychological distress, and unhealthy life style. Methods The sample (N=745) was comprised of sexually-active female adolescent patients (12-19 years), primarily ethnic minorities, enrolled in a free HPV vaccination program. Subjects completed questionnaires and provided cervical swabs for HPV DNA testing. Unweighted and weighted Principal Component Analyses (PCA) for categorical data were used to derive multi-systemic psychosocial risk indices using nine indicators: low socioeconomic status, lack of adult involvement, not attending high-school/college, history of treatment for depression/anxiety, antisocial/delinquent behavior, number of recent sexual partners, use of alcohol, use of drugs, and dependency risk for alcohol/drugs. The association between cervical HPV (any-type, high risk-types, vaccine-types) assayed by polymerase chain reaction and self-reported number of psychosocial risk indicators was estimated using multivariable logistic regression. Results Subjects had a median of three psychosocial risk indicators. Multiple logistic regression analyses showed associations with unweighted and weighted number of psychosocial indicators for HPV any-type (adjusted odds ratio [aOR]=1.1; 95% confidence interval [CI]: 1.0-1.2 ); with the strongest associations between weighted drug/alcohol use, drug/alcohol dependency risk, and antisocial/delinquent behavior and detection of HPV vaccine-types (aOR=1.5; 95%CI: 1.1-2.0) independent of number of recent sexual partners and vaccine dose (0-3). Conclusion Increased HPV infections including HPV vaccine-types were associated with greater number of psychosocial risk indicators even after controlling for demographics, sexual behavior, history of chlamydia, and vaccine dose. PMID:25985216

  15. Childhood body mass index and multiple sclerosis risk

    DEFF Research Database (Denmark)

    Munger, Kassandra L; Bentzen, Joan; Laursen, Bjarne

    2013-01-01

    BACKGROUND: Obesity in late adolescence has been associated with an increased risk of multiple sclerosis (MS); however, it is not known if body size in childhood is associated with MS risk. METHODS: Using a prospective design we examined whether body mass index (BMI) at ages 7-13 years...

  16. Donor risk index and organ patient index as predictors of graft survival after liver transplantation.

    Science.gov (United States)

    Avolio, A W; Siciliano, M; Barbarino, R; Nure, E; Annicchiarico, B E; Gasbarrini, A; Agnes, S; Castagneto, M

    2008-01-01

    In liver transplantation the identification of risk factors and the risk quantification for each single case represent a field of great interest. There are donor-related and recipient-related risk factors. Donor risk index (DRI) was retrospectively calculated in 223 liver transplant cases. We did not include patients with preoperative diagnosis of hepatocarcinoma and retransplants. The cases were stratified into two classes according to the DRI (low risk, DRIor= 1.7). A new index, namely the organ patient index (OPI) was calculated adding the Model for End-stage Liver Disease (MELD) score to the DRI. Patients were stratified into two classes according to the OPI (low risk, OPI 2.85). The cases with low DRI (n=144) showed better survival than the cases with high DRI (n=82; P< .02). The cases with low OPI (n=173) showed better survival than cases with high OPI (n=50; P< .01). The OPI predicted outcomes better than DRI, increasing the gap in the long-term graft survival between the low- and the high-risk class. The inclusion of the MELD in the new index allowed better prediction of graft survival.

  17. Smoking and the risk of systemic lupus erythematosus: an updated systematic review and cumulative meta-analysis.

    Science.gov (United States)

    Jiang, Fan; Li, Suyun; Jia, Chongqi

    2015-11-01

    Published articles reported controversial results about the association of smoking with the risk of systemic lupus erythematosus (SLE). A meta-analysis was performed to assess the aforementioned association and arrive at a more precise estimate of effect. A comprehensive search was performed to identify case-control or cohort studies (from 1990 to 2015) of the aforementioned association. The I (2) statistic was used to examine between-study heterogeneity. Fixed or random effect model was selected based on heterogeneity test among studies. Publication bias was estimated using Egger's regression asymmetry test. A total of 12 published articles with 13 studies were finally included in our meta-analysis. Results showed that the pooled odds ratio (OR) for SLE risk was 1.56 (95% confidence interval (CI) = 1.26-1.95) among current smokers compared with nonsmokers. For ex-smokers versus nonsmokers, the pooled OR for SLE risk was 1.23 (95% CI = 0.93-1.63). Subgroup analysis by geographic location and cumulative meta-analysis were also analyzed. In conclusion, our meta-analysis suggested that smoking increased the risk of SLE. Further studies are needed to confirm this result.

  18. Single-compound and cumulative risk assessment of mycotoxins present in breakfast cereals consumed by children from Lisbon region, Portugal.

    Science.gov (United States)

    Assunção, Ricardo; Vasco, Elsa; Nunes, Baltazar; Loureiro, Susana; Martins, Carla; Alvito, Paula

    2015-12-01

    Humans can be exposed to multiple chemicals, but current risk assessment is usually carried out on one chemical at a time. Mycotoxins are commonly found in a variety of foods including those intended to consumption by children namely breakfast cereals. The present study aims to perform, the risk assessment of single and multiple mycotoxins present in breakfast cereals consumed by children (1-3 years old) from Lisbon region, Portugal. Daily exposure of children to ochratoxin A, fumonisins and trichothecenes showed no health risks to the children population considering individual mycotoxins, while exposure to aflatoxin B1 (AFB1) suggested a potential health concern for the high percentiles of intake (P90, P95 and P99). The combined exposure to fumonisins and trichothecenes are not expected to be of health concern. The combined margin of exposure (MoET) for the aflatoxins group could constitute a potential health concern and AFB1 was the main contributor for MoET. Legal limits and control strategies regarding the presence of multiple mycotoxins in foodstuffs is an urgent need. To the best of our knowledge, this is the first time a cumulative risk assessment was performed on multiple mycotoxins present in breakfast cereals consumed by children.

  19. Tsunami, War, and Cumulative Risk in the Lives of Sri Lankan Schoolchildren

    Science.gov (United States)

    Catani, Claudia; Gewirtz, Abigail H.; Wieling, Elizabeth; Schauer, Elizabeth; Elbert, Thomas; Neuner, Frank

    2010-01-01

    This study examines the impact of children's exposure to natural disaster against the backdrop of exposure to other traumatic events and psychosocial risks. One thousand three hundred ninety-eight Sri Lankan children aged 9-15 years were interviewed in 4 cross-sectional studies about exposure to traumatic life events related to the war, the…

  20. Tsunami, War, and Cumulative Risk in the Lives of Sri Lankan Schoolchildren

    Science.gov (United States)

    Catani, Claudia; Gewirtz, Abigail H.; Wieling, Elizabeth; Schauer, Elizabeth; Elbert, Thomas; Neuner, Frank

    2010-01-01

    This study examines the impact of children's exposure to natural disaster against the backdrop of exposure to other traumatic events and psychosocial risks. One thousand three hundred ninety-eight Sri Lankan children aged 9-15 years were interviewed in 4 cross-sectional studies about exposure to traumatic life events related to the war, the…

  1. Cumulative Risk Effects in the Bullying of Children and Young People with Autism Spectrum Conditions

    Science.gov (United States)

    Hebron, Judith; Oldfield, Jeremy; Humphrey, Neil

    2017-01-01

    Students with autism are more likely to be bullied than their typically developing peers. However, several studies have shown that their likelihood of being bullied increases in the context of exposure to certain risk factors (e.g. behaviour difficulties and poor peer relationships). This study explores vulnerability to bullying from a cumulative…

  2. Multilevel Mediation: Cumulative Contextual Risk, Maternal Differential Treatment, and Children's Behavior within Families

    Science.gov (United States)

    Meunier, Jean Christophe; Boyle, Michael; O'Connor, Thomas G.; Jenkins, Jennifer M.

    2013-01-01

    This study tests the hypothesis that links between contextual risk and children's outcomes are partially explained by differential parenting. Using multi-informant measurement and including up to four children per family (M[subscript age] = 3.51, SD = 2.38) in a sample of 397 families, indirect effects (through maternal differential…

  3. Estimated Daily Intake and Cumulative Risk Assessment of Phthalates in the General Taiwanese after the 2011 DEHP Food Scandal

    Science.gov (United States)

    Chang, Jung-Wei; Lee, Ching-Chang; Pan, Wen-Harn; Chou, Wei-Chun; Huang, Han-Bin; Chiang, Hung-Che; Huang, Po-Chin

    2017-03-01

    A food scandal occurred in Taiwan in 2011 because the DEHP (di-2-ethylhexyl phthalate) had been intentionally used in food products. We assessed the daily intakes (DIs) and cumulative risk of phthalates in Taiwan’s general population after the scandal. The DIs of 6 phthalates, including di-n-butyl phthalate (DnBP), di-iso-butyl phthalate (DiBP), and DEHP, were evaluated using urinary phthalate metabolites. Hazard quotients of phthalates classified as affecting the reproductive (HQrep) and hepatic (HQhep) systems were assessed using cumulative approach. The creatinine-based model showed that the highest DI values in children 7-to 12- years-old were for DEHP (males: median: 4.79 μg/kg bw/d; females: median: 2.62 μg/kg bw/d). The 95th percentile (P95) of HQrep values were all >1 in the 7- to 12-year-old and 18- to 40-year-old male groups. The P95 of HQhep values were all >1 in the 7- to 18- year-old male groups. Most of the HQrep was attributable to the HQs of DnBP and DiBP (53.9–84.7%), and DEHP contributed most to HQhep (83.1–98.6%), which reveals that DnBP, DiBP and DEHP were the main risk of phthalate exposure for Taiwanese. Taiwan’s general population is widely exposed to DnBP, DiBP and DEHP, especially for young children.

  4. Risk of therapy-related leukaemia and preleukaemia after Hodgkin's disease. Relation to age, cumulative dose of alkylating agents, and time from chemotherapy

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, J; Specht, L; Larsen, S O;

    1987-01-01

    391 patients treated intensively for Hodgkin's disease were followed for up to 15 years to evaluate the risk of therapy-related acute non-lymphocytic leukaemia (t-ANLL) and preleukaemia. Only two independent factors, patient age and cumulative dose of alkylating agents, were related to the risk o...

  5. Development of an operational specific CAT risk (SCATR) index

    Science.gov (United States)

    Keller, J. L.; Haines, P. A.; Luers, J. K.

    1983-01-01

    The original formulations of Roach (1970) and Oard (1974) for the calculation of clear air turbulence (CAT) potential from synoptic scale data were extended. An index which gives a measure of the specific risk of encountering CAT - the specific clear air turbulence risk (SCATR) index - was defined. This index takes into account both the locally and advected contributions to the energy necessary for CAT. The advected contribution is associated with the role of atmospheric gravity waves. The SCATR index was calculated for a number of cases where documented encounters with CAT occurred. Of particular interest were those made for cases involving severe CAT. The results for the two severe CAT cases run were quite impressive and elicited considerable interest from operational aviation meteorologists.

  6. A comparison of peak vs cumulative physical work exposure risk factors for the reporting of low back pain in the automotive industry.

    Science.gov (United States)

    Norman, R.; Wells, R.; Neumann, P.; Frank, J.; Shannon, H.; Kerr, M.

    1998-12-01

    OBJECTIVE: To determine the relative importance of modelled peak spine loads, hand loads, trunk kinematics and cumulative spine loads as predictors of reported low back pain (LBP). BACKGROUND: The authors have recently shown that both biomechemical and psychosocial variables are important in the reporting of LBP. In previous studies, peak spinal load risk factors have been identified and while there is in vitro evidence for adverse effects of excessive cumulative load on tissue, there is little epidemiological evidence. METHODS: Physical exposures to peak and cumulative lumbar spine moment, compression and shear forces, trunk kinematics, and forces on hands were analyzed on 130 randomly selected controls and 104 cases. Univariable and multivariable odds ratios of the risk of reporting were calculated from a backwards logistic regression analysis. Interrelationships among variables were examined by factor analysis. RESULTS: Cases showed significantly higher loading on all biomechanical variables. Four independent risk factors were identified: integrated lumbar moment (over a shift), 'usual' hand force, peak shear force at the level of L(4)/L(5) and peak trunk velocity. Substituting lumbar compression or moment for shear did not appreciably alter odds ratios because of high correlations among these variables. CONCLUSIONS: Cumulative biomechanical variables are important risk factors in the reporting of LBP. Spinal tissue loading estimates from a biomechanical model provide information not included in the trunk kinematics and hand force inputs to the model alone. Workers in the top 25% of loading exposure on all risk factors are at about six times the risk of reporting LBP when compared with those in the bottom 25%. RELEVANCE: Primary prevention, treatment, and return to work efforts for individuals reporting LBP all require understanding of risk factors. The results suggest that cumulative loading of the low back is important etiologically and highlight the need for

  7. Assessment of cardiovascular risk in patients with rheumatoid arthritis using the SCORE risk index.

    Science.gov (United States)

    de Campos, Otávio Augusto Martins; Nazário, Nazaré Otília; de Magalhães Souza Fialho, Sônia Cristina; Fialho, Guilherme Loureiro; de Oliveira, Fernando José Savóia; de Castro, Gláucio Ricardo Werner; Pereira, Ivânio Alves

    2016-01-01

    Rheumatoid arthritis is an autoimmune disease that causes systemic involvement and is associated with increased risk of cardiovascular disease. To analyze the prediction index of 10-year risk of a fatal cardiovascular disease event in female RA patients versus controls. Case-control study with analysis of 100 female patients matched for age and gender versus 100 patients in the control group. For the prediction of 10-year risk of a fatal cardiovascular disease event, the SCORE and modified SCORE (mSCORE) risk indexes were used, as suggested by EULAR, in the subgroup with two or more of the following: duration of disease ≥10 years, RF and/or anti-CCP positivity, and extra-articular manifestations. The prevalence of analyzed comorbidities was similar in RA patients compared with the control group (p>0.05). The means of the SCORE risk index in RA patients and in the control group were 1.99 (SD: 1.89) and 1.56 (SD: 1.87) (p=0.06), respectively. The means of mSCORE index in RA patients and in the control group were 2.84 (SD=2.86) and 1.56 (SD=1.87) (p=0.001), respectively. By using the SCORE risk index, 11% of RA patients were classified as of high risk, and with the use of mSCORE risk index, 36% were at high risk (p<0.001). The SCORE risk index is similar in both groups, but with the application of the mSCORE index, we recognized that RA patients have a higher 10-year risk of a fatal cardiovascular disease event, and this reinforces the importance of factors inherent to the disease not measured in the SCORE risk index, but considered in mSCORE risk index. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  8. Cumulative contextual risk, maternal responsivity, and social cognition at 18 months.

    Science.gov (United States)

    Wade, Mark; Moore, Chris; Astington, Janet Wilde; Frampton, Kristen; Jenkins, Jennifer M

    2015-02-01

    By 18 months children demonstrate a range of social-cognitive skills that can be considered important precursors to more advanced forms of social understanding such as theory of mind. Although individual differences in social cognition have been linked to neurocognitive maturation, sociocultural models of development suggest that environmental influences operate in the development of children's social-cognitive outcomes. In the current study of 501 children and their mothers, we tested and found support for a model in which distal environmental risk, assessed when children were newborns, was indirectly associated with children's social-cognitive competency at 18 months through mothers' responsivity at 18 months. Part of this effect also operated through children's concomitant language skills, suggesting both a language-mediated and a language-independent mechanism of social-cognitive development. These findings are discussed with respect to the Vygotskian themes of internalization and semiotic mediation.

  9. Understanding the relation of low income to HPA-axis functioning in preschool children: cumulative family risk and parenting as pathways to disruptions in cortisol.

    Science.gov (United States)

    Zalewski, Maureen; Lengua, Liliana J; Kiff, Cara J; Fisher, Philip A

    2012-12-01

    This study examined the relation of low income and poverty to cortisol levels, and tested potential pathways from low income to disruptions in cortisol through cumulative family risk and parenting. The sample of 306 mothers and their preschool children included 29 % families at or near poverty, 27 % families below the median income, and the remaining families at middle and upper income. Lower income was related to lower morning cortisol levels, and cumulative risk predicted a flatter diurnal slope, with a significant indirect effect through maternal negativity, suggesting that parenting practices might mediate an allostatic effect on stress physiology.

  10. Cumulative impact of common genetic variants and other risk factors on colorectal cancer risk in 42 103 individuals

    NARCIS (Netherlands)

    Dunlop, Malcolm G.; Tenesa, Albert; Farrington, Susan M.; Ballereau, Stephane; Brewster, David H.; Koessler, Thibaud; Pharoah, Paul; Schafmayer, Clemens; Hampe, Jochen; Voelzke, Henry; Chang-Claude, Jenny; Hoffmeister, Michael; Brenner, Hermann; von Holst, Susanna; Picelli, Simone; Lindblom, Annika; Jenkins, Mark A.; Hopper, John L.; Casey, Graham; Duggan, David; Newcomb, Polly A.; Abuli, Anna; Bessa, Xavier; Ruiz-Ponte, Clara; Castellvi-Bel, Sergi; Niittymaeki, Iina; Tuupanen, Sari; Karhu, Auli; Aaltonen, Lauri; Zanke, Brent; Hudson, Tom; Gallinger, Steven; Barclay, Ella; Martin, Lynn; Gorman, Maggie; Carvajal-Carmona, Luis; Walther, Axel; Kerr, David; Lubbe, Steven; Broderick, Peter; Chandler, Ian; Pittman, Alan; Penegar, Steven; Campbell, Harry; Tomlinson, Ian; Houlston, Richard S.

    2013-01-01

    Objective Colorectal cancer (CRC) has a substantial heritable component. Common genetic variation has been shown to contribute to CRC risk. A study was conducted in a large multi-population study to assess the feasibility of CRC risk prediction using common genetic variant data combined with other r

  11. Ergonomic risk exposure and upper-extremity cumulative trauma disorders in a maquiladora medical devices manufacturing plant.

    Science.gov (United States)

    Meservy, D; Suruda, A J; Bloswick, D; Lee, J; Dumas, M

    1997-08-01

    Workers at a Nogales, Mexico, maquiladora plant that assembles medical devices were studied to determine the prevalence of upper-extremity cumulative trauma disorders (CTD). Subjects included production workers employed 6 months or longer; of the 148 eligible workers, 145 (98%) participated. Subjects had a mean age of 24.6 years (SD = 5.2; range, 17 to 45) and the mean length of employment was 3.5 years (SD = 2.5; range, 0.5 to 14). Job tasks were videotaped and analyzed for ergonomic risk factors, using pre-defined criteria. All jobs performed by study subjects were found to involve one or more ergonomic risk factors associated with the development of CTD. A CTD questionnaire and screening physical examination format, similar to that used by the National Institute of Occupational Safety and Health (NIOSH) in a chicken processing plant study, were administered. Period prevalence of CTD within the previous year, as reported on the questionnaire, was 28%. Prevalence of CTD was 17%, using data from the screening physical examination. Point prevalence (current pain data from the questionnaire plus positive symptoms on the screening physical examination) was 15%. CTD was reported more frequently in women than men (46% and 25%, respectively; P < 0.05) and in subjects who had worked at the plant less than one year (50%; P < 0.05). Workforce turnover (3% monthly) may have resulted in those affected by CTD leaving employment, reducing the apparent CTD rate in experienced workers.

  12. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    Science.gov (United States)

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  13. Cumulative traumas and risk thresholds: 12-month PTSD in the World Mental Health (WMH) surveys.

    Science.gov (United States)

    Karam, Elie G; Friedman, Matthew J; Hill, Eric D; Kessler, Ronald C; McLaughlin, Katie A; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C; Bromet, Evelyn J; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E; Haro, Josep Maria; He, Yanling; Karam, Aimee N; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A Oakley; Posada-Villa, José A; Shalev, Arieh Y; Stein, Dan J; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C

    2014-02-01

    Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n = 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyperarousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more "complex" clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. © 2013 Wiley Periodicals, Inc.

  14. The standard international prognostic index for predicting the risk of CNS involvement in DLBCL without specific prophylaxis.

    Science.gov (United States)

    Tomita, Naoto; Yokoyama, Masahiro; Yamamoto, Wataru; Watanabe, Reina; Shimazu, Yutaka; Masaki, Yasufumi; Tsunoda, Saburo; Hashimoto, Chizuko; Murayama, Kayoko; Yano, Takahiro; Okamoto, Rumiko; Kikuchi, Ako; Tamura, Kazuo; Sato, Kazuya; Sunami, Kazutaka; Shibayama, Hirohiko; Takimoto, Rishu; Ohshima, Rika; Takahashi, Hiromichi; Moriuchi, Yukiyoshi; Kinoshita, Tomohiro; Yamamoto, Masahide; Numata, Ayumi; Nakajima, Hideaki; Miura, Ikuo; Takeuchi, Kengo

    2017-06-08

    Central nervous system (CNS) involvement is a serious complication in patients with diffuse large B-cell lymphoma (DLBCL) and evaluating CNS risk is an important issue. Using the standard international prognostic index (IPI) and CNS-IPI, a recently proposed model including IPI risk factors and adrenal/kidney involvement, we assessed CNS risk in 1220 untreated DLBCL patients who received R-CHOP without prophylaxis. According to the standard IPI, the cumulative incidences of CNS involvement at 2 years were 1.3, 4.6, 8.8, and 12.7% in the low-, low-intermediate-, high-intermediate-, and high-risk groups, respectively (p involvement tended to have lower risk according to the standard IPI but showed frequent CNS involvement, similar to patients with testis involvement. The standard IPI is also a useful predictor of CNS involvement. Patients with breast/testis involvement would be candidates for prophylaxis regardless of the standard IPI risk.

  15. Premorbid body mass index and risk of amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    O'Reilly, Eilis J.; Wang, Hao; Weisskopf, Marc G.; Fitzgerald, Kathryn C.; Falcone, Guido; McCullough, Marjorie L.; Thun, Michael; Park, Yikyung; Kolonel, Laurence N.; Ascherio, Alberto

    2013-01-01

    Our objective was to determine if amyotrophic lateral sclerosis (ALS) risk varies according to body mass index (BMI) captured up to three decades earlier. At baseline 537,968 females and 562,942 males in five ongoing cohorts reported height, current weight and weight at age 18/21 years. During 14-28

  16. Premorbid body mass index and risk of amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    O'Reilly, Eilis J.; Wang, Hao; Weisskopf, Marc G.; Fitzgerald, Kathryn C.; Falcone, Guido; McCullough, Marjorie L.; Thun, Michael; Park, Yikyung; Kolonel, Laurence N.; Ascherio, Alberto

    Our objective was to determine if amyotrophic lateral sclerosis (ALS) risk varies according to body mass index (BMI) captured up to three decades earlier. At baseline 537,968 females and 562,942 males in five ongoing cohorts reported height, current weight and weight at age 18/21 years. During 14-28

  17. Solemnity: A Clinical Risk Index for Iron Deficient Infants.

    Science.gov (United States)

    Honig, Alice Sterling; Oski, Frank A.

    1984-01-01

    Studies four groups of infants with iron deficiency but without anemia in an attempt to discover behavioral signs that can be used to index high-risk probability for iron deficiency. Solemnity in well-attached infants is suggested as a clinical sign to indicate the need for biochemical screening for iron deficiency. (AS)

  18. Solemnity: A Clinical Risk Index for Iron Deficient Infants.

    Science.gov (United States)

    Honig, Alice Sterling; Oski, Frank A.

    1984-01-01

    Studies four groups of infants with iron deficiency but without anemia in an attempt to discover behavioral signs that can be used to index high-risk probability for iron deficiency. Solemnity in well-attached infants is suggested as a clinical sign to indicate the need for biochemical screening for iron deficiency. (AS)

  19. Premorbid body mass index and risk of amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    O'Reilly, Eilis J.; Wang, Hao; Weisskopf, Marc G.; Fitzgerald, Kathryn C.; Falcone, Guido; McCullough, Marjorie L.; Thun, Michael; Park, Yikyung; Kolonel, Laurence N.; Ascherio, Alberto

    2013-01-01

    Our objective was to determine if amyotrophic lateral sclerosis (ALS) risk varies according to body mass index (BMI) captured up to three decades earlier. At baseline 537,968 females and 562,942 males in five ongoing cohorts reported height, current weight and weight at age 18/21 years. During 14-28

  20. Hedging with stock index futures: downside risk versus the variance

    NARCIS (Netherlands)

    Brouwer, F.; Nat, van der M.

    1995-01-01

    In this paper we investigate hedging a stock portfolio with stock index futures.Instead of defining the hedge ratio as the minimum variance hedge ratio, we considerseveral measures of downside risk: the semivariance according to Markowitz [ 19591 andthe various lower partial moments according to Fis

  1. The cumulative incidence of conventional risk factors of cardiovascular disease and their population attributable risk in an Iranian population: The Isfahan Cohort Study

    Directory of Open Access Journals (Sweden)

    Masoumeh Sadeghi

    2014-01-01

    Full Text Available Background: Cardiovascular diseases (CVDs are the leading cause of death in Iran. The present study evaluated the 7-year incidence of CVD risk factors among the participants of Isfahan cohort study (ICS. Materials and Methods: ICS was a longitudinal study on adults over 35 years of age from the urban and rural areas in three counties in central Iran. Data on clinical examination and blood measurements were collected in 2001. Subjects were followed and similar data were collected in 2007. Cumulative incidence was calculated through dividing new cases of each risk factor by the population free of that risk factor at baseline. Incidence proportion was determined for major CVD risk factors including hypertension (HTN, hypercholesterolemia (HC, hypertriglyceridemia (HTg, obesity, diabetes mellitus (DM, metabolic syndrome (MetS, and smoking. Results: A total number of 6323 adults free of CVDs were recruited. After 7 years of follow-up, 3283 individuals were re-evaluated in 2007. The participants′ age was 49.2 ± 10.3 years in 2001 (mean ± SD. The 7-year cumulative incidence of HTN, HC, HTg, overweight, obesity, DM, MetS, and smoking was 22.8%, 37.4%, 28.0%, 26.3%, 7.4%, 9.5%, 23.9%, and 5.9% in men and 22.2%, 55.4%, 33.5%, 35.0%, 18.8%, 11.3%, 36.1%, and 0.7% in women, respectively. Among those with overweight or obesity, 14.7% of men and 7.9% of women decreased their weight up to the normal level. Conclusions: The present study revealed a high incidence of CVD risk factors especially dyslipidemia, obesity, MetS and HTN. Therefore, the application of life-style modification interventions seems necessary.

  2. Application of Risk Index to Risk-Based Decision-Making in Vessel Traffic Service System

    Institute of Scientific and Technical Information of China (English)

    GUO Guo-ping; FAN Yao-tian

    2007-01-01

    The applications of risk index to risk estimation, risk acceptability, and cost-benefit analysis for planning vessel traffic service (VTS) system were analyzed. An example of Wuhan Port shows that its application is easily implemented and can be helpful in a comprehensive and scientific decision-making. Especially aiming to the difficult problems with respect to risk prediction, risk acceptability and cost-benefit assessment, this article put forward some new solutions based on risk-index, such as the trendline estimation, ALARP (as low as reasonably practicable) matrix and weighted cost-benefit analysis, with a fairly good operability and comparability.

  3. Reducing Production Basis Risk through Rainfall Intensity Frequency (RIF) Indexes: Global Sensitivity Analysis' Implication on Policy Design

    Science.gov (United States)

    Muneepeerakul, Chitsomanus; Huffaker, Ray; Munoz-Carpena, Rafael

    2016-04-01

    The weather index insurance promises financial resilience to farmers struck by harsh weather conditions with swift compensation at affordable premium thanks to its minimal adverse selection and moral hazard. Despite these advantages, the very nature of indexing causes the presence of "production basis risk" that the selected weather indexes and their thresholds do not correspond to actual damages. To reduce basis risk without additional data collection cost, we propose the use of rain intensity and frequency as indexes as it could offer better protection at the lower premium by avoiding basis risk-strike trade-off inherent in the total rainfall index. We present empirical evidences and modeling results that even under the similar cumulative rainfall and temperature environment, yield can significantly differ especially for drought sensitive crops. We further show that deriving the trigger level and payoff function from regression between historical yield and total rainfall data may pose significant basis risk owing to their non-unique relationship in the insured range of rainfall. Lastly, we discuss the design of index insurance in terms of contract specifications based on the results from global sensitivity analysis.

  4. Genetically Predicted Body Mass Index and Breast Cancer Risk

    DEFF Research Database (Denmark)

    Guo, Yan; Warren Andersen, Shaneda; Shu, Xiao-Ou

    2016-01-01

    BACKGROUND: Observational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic or enviro......BACKGROUND: Observational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic...... or environmental factors. METHODS: We applied Mendelian randomization to evaluate the association between BMI and risk of breast cancer occurrence using data from two large breast cancer consortia. We created a weighted BMI genetic score comprising 84 BMI-associated genetic variants to predicted BMI. We evaluated...... genetically predicted BMI in association with breast cancer risk using individual-level data from the Breast Cancer Association Consortium (BCAC) (cases  =  46,325, controls  =  42,482). We further evaluated the association between genetically predicted BMI and breast cancer risk using summary statistics from...

  5. Risk of therapy-related leukaemia and preleukaemia after Hodgkin's disease. Relation to age, cumulative dose of alkylating agents, and time from chemotherapy

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, J.; Specht, L.; Larsen, S.O.;

    1987-01-01

    .0% (SE 3.0) at 10 years after which time there were no further cases. Calculated from cessation of therapy with alkylating agents, however, the cumulative risk curve increased steeply during the first 1-2 years then gradually levelled out and no new cases were observed beyond 7 years. With a 15-year...

  6. Understanding the Relation of Low Income to HPA-Axis Functioning in Preschool Children: Cumulative Family Risk and Parenting as Pathways to Disruptions in Cortisol

    Science.gov (United States)

    Zalewski, Maureen; Lengua, Liliana J.; Kiff, Cara J.; Fisher, Philip A.

    2012-01-01

    This study examined the relation of low income and poverty to cortisol levels, and tested potential pathways from low income to disruptions in cortisol through cumulative family risk and parenting. The sample of 306 mothers and their preschool children included 29 % families at or near poverty, 27 % families below the median income, and the…

  7. Understanding the Relation of Low Income to HPA-Axis Functioning in Preschool Children: Cumulative Family Risk and Parenting as Pathways to Disruptions in Cortisol

    Science.gov (United States)

    Zalewski, Maureen; Lengua, Liliana J.; Kiff, Cara J.; Fisher, Philip A.

    2012-01-01

    This study examined the relation of low income and poverty to cortisol levels, and tested potential pathways from low income to disruptions in cortisol through cumulative family risk and parenting. The sample of 306 mothers and their preschool children included 29 % families at or near poverty, 27 % families below the median income, and the…

  8. Exploring the risk factors for differences in the cumulative incidence of coeliac disease in two neighboring countries : the prospective DIABIMMUNE study

    NARCIS (Netherlands)

    Simre, Kärt; Uibo, Oivi; Peet, Aleksandr; Tillmann, Vallo; Kool, Pille; Hämäläinen, Anu-Maaria; Härkönen, Taina; Siljander, Heli; Virtanen, Suvi; Ilonen, Jorma; Knip, Mikael; Uibo, Raivo; Harmsen, Hermie J.

    2016-01-01

    BACKGROUND: During the last several decades the prevalence of coeliac disease (CD) has increased worldwide. AIM: To compare the cumulative incidence of CD between Estonian and Finnish children and to identify the risk factors. MATERIALS AND METHODS: Children were recruited as part of the DIABIMMUNE

  9. Body mass index and the risk of injury in adults: a cross-sectional study.

    Science.gov (United States)

    Chassé, M; Fergusson, D A; Chen, Y

    2014-11-01

    To investigate the association between body mass index (BMI) and the risk of nonfatal body injury. We analyzed data from 113,203 adults who participated in the Canadian Community Health Survey conducted in 2009-2010. Log-binomial models were used to estimate crude and adjusted relative risks of the association between BMI and the risk of body injury for men and women. Of 113,203 adult participants, 15,194 had self-reported body injuries during the past 12 months, with a 12-month cumulative incidence of 13.7% (weighted to Canadian population). There was a significant interaction between gender and BMI in relation to the risk of body injury, and therefore, analyses were stratified by gender. For women, we found a significant association between BMI and an increased risk of body injury. Women with an increased BMI had a significant increased risk of body injuries as compared with those with normal weight (adjusted relative risk: 1.13, 95% confidence interval (CI)=1.02-1.25 for BMI 30.0-34.9 kg m(-)(2); 1.17, 95% CI=1.00-1.37 for BMI 35.0-39.9 kg m(-)(2); 1.41, 95% CI=1.16-1.69 for BMI ⩾ 40 kg m(-)(2)). A reduced risk of injury was observed in underweight women. There was no significant association between BMI and the risk of body injury for men. Obese persons of both gender were more likely to suffer injuries to the knee and lower leg, and in less demanding activities such as household chores or using the stairs. We therefore conclude that increased BMI may be a risk factor for body injury in women, but not in men.

  10. Cumulative health risk assessment of co-occurring mycotoxins of deoxynivalenol and its acetyl derivatives in wheat and maize: case study, Shanghai, China.

    Science.gov (United States)

    Han, Zheng; Nie, Dongxia; Ediage, Emmanuel Njumbe; Yang, Xianli; Wang, Jianhua; Chen, Bo; Li, Shuguang; On, Stephen L W; De Saeger, Sarah; Wu, Aibo

    2014-12-01

    Humans are naturally and frequently exposed to a multitude of mycotoxins, but health risk assessments are usually performed on individual mycotoxins, which may underestimate the total risks. In this study, we assessed for the first time the cumulative health risks of concomitant exposure via dietary intake (DI) to multiple mycotoxins, namely deoxynivalenol (DON) and its acetyl derivatives of 3-acetyldeoxynivalenol (3-ADON) and 15-acetyldeoxynivalenol (15-ADON), based on the concentration addition (CA) concept. A cross-sectional study was conducted in seven districts in Shanghai, China with 1269 participants and 330 wheat and maize samples analyzed. After probabilistic analysis using Monte Carlo simulation, the results showed no health risks to the population in Shanghai considering individual mycotoxins. However, if the cumulative health risks were calculated based on the combined consideration of DON with either 3-ADON or 15-ADON or both, the DI values in 95th percentile were up to 1087 ng/kg body weight/day, exceeding the Provisional Maximum Tolerable Daily Intake (PMTDI) of 1000 ng/kg body weight/day and hence representing potential health risks to the population in Shanghai. The integrated study proposed here could be a model strategy for cumulative health risk assessment on the co-occurring hazards in the fields of food safety combined with environmental contaminants.

  11. Novel Threat-risk Index Using Probabilistic Risk Assessment and Human Reliability Analysis - Final Report

    Energy Technology Data Exchange (ETDEWEB)

    George A. Beitel

    2004-02-01

    In support of a national need to improve the current state-of-the-art in alerting decision makers to the risk of terrorist attack, a quantitative approach employing scientific and engineering concepts to develop a threat-risk index was undertaken at the Idaho National Engineering and Environmental Laboratory (INEEL). As a result of this effort, a set of models has been successfully integrated into a single comprehensive model known as Quantitative Threat-Risk Index Model (QTRIM), with the capability of computing a quantitative threat-risk index on a system level, as well as for the major components of the system. Such a threat-risk index could provide a quantitative variant or basis for either prioritizing security upgrades or updating the current qualitative national color-coded terrorist threat alert.

  12. The effect of financial ratios on systematic risk index

    Directory of Open Access Journals (Sweden)

    Ali Faez

    2013-11-01

    Full Text Available This paper investigates the relationship between financial ratios and indicator of systemic risk in the Tehran Stock Exchange. The study selects 73 manufacturing companies of the Tehran Stock Exchange market over the period 2003-2010. The study first calculates the independent variables in the form of financial ratios and then the ratios affecting the systematic risk index are extracted using entropy method. The output of this stage is the introduction of five influential financial indicators as the independent variables of the study. Using t-test and Pearson correlation coefficient the rate of independent variables effect on the systematic risk index is evaluated and finally, using stepwise regression method, the effect of independent variables on the dependent variable is examined. According to results of our survey, the correlation coefficient of such indices as “the ratio of stock price to the profit of each share”, “Current ratio”, “each share profit ratio” and “the stockholders rights return ratio” have respectively the highest correlation with the systematic risk index.

  13. Individual contributions to portfolio risk: risk decomposition for the BET-FI index

    Directory of Open Access Journals (Sweden)

    Marius ACATRINEI

    2015-06-01

    Full Text Available The paper applies Euler formula for decomposing the standard deviation and the Expected Shortfall for the BET-FI equity index. Risk attribution allows the decomposition of the total risk of the portfolio in individual risk units. In this way we can compute the contribution of each company to the overall standard deviation/Expected Shortfall of the portfolio.

  14. Individual contributions to portfolio risk: risk decomposition for the BET-FI index

    OpenAIRE

    Marius ACATRINEI

    2015-01-01

    The paper applies Euler formula for decomposing the standard deviation and the Expected Shortfall for the BET-FI equity index. Risk attribution allows the decomposition of the total risk of the portfolio in individual risk units. In this way we can compute the contribution of each company to the overall standard deviation/Expected Shortfall of the portfolio.

  15. Early introduction and cumulative consumption of sugar-sweetened beverages during the pre-school period and risk of obesity at 8-14 years of age.

    Science.gov (United States)

    Cantoral, A; Téllez-Rojo, M M; Ettinger, A S; Hu, H; Hernández-Ávila, M; Peterson, K

    2016-02-01

    Consumption of sugar-sweetened beverages (SSB) has been associated with risk of obesity, but little evidence exists to evaluate if age of introduction and cumulative SSB consumption increases risk in children. The objective of the study was to estimate the relationship between age of introduction and cumulative SSB consumption with risk of obesity in 227 Mexican children. SSB intake was measured every 6 months; age of introduction and cumulative consumption during the pre-school period were calculated. Height, weight, waist circumference, SSB intake and other relevant variables were measured at age 8-14 years and obesity defined using standard criteria. All participants were introduced to SSB before age 24 months and most (73%) before 12 months. Early SSB introduction (≤12 months) was not significantly associated with increased odds of obesity (odds ratio [OR] = 2.00, 95% confidence interval [CI]: 0.87, 4.59). However, children in the highest tertile of cumulative SSB consumption, compared with the lowest, had almost three times the odds of general (OR = 2.99, 95% CI: 1.27, 7.00) and abdominal (OR = 2.70, 95% CI: 1.03, 7.03) obesity at age 8-14 years. High SSB consumption increased the likelihood of obesity in 8-14-year-old children. Our results suggest that SSB intake should be delayed and excessive SSB consumption in pre-school period should be avoided. © 2015 World Obesity.

  16. Prenatal cocaine exposure: the role of cumulative environmental risk and maternal harshness in the development of child internalizing behavior problems in kindergarten.

    Science.gov (United States)

    Eiden, Rina D; Godleski, Stephanie; Colder, Craig R; Schuetze, Pamela

    2014-01-01

    This study examined the associations between prenatal exposure to cocaine and other substances and child internalizing behavior problems at kindergarten. We investigated whether maternal harshness or cumulative environmental risk mediated or moderated this association. Participants consisted of 216 (116 cocaine exposed, 100 non-cocaine exposed) mother-infant dyads participating in an ongoing longitudinal study of prenatal cocaine exposure. Results indicated that, as hypothesized, maternal harshness moderated the association between prenatal cocaine exposure to child internalizing in kindergarten such that prenatal cocaine exposure increased risk for internalizing problems at high levels of maternal harshness from 7 to 36months and decreased risk at low levels of harshness. Contrary to hypothesis, the association between prenatal cocaine exposure and child internalizing in kindergarten was not mediated by maternal harshness or cumulative environmental risk. However, cumulative environmental risk (from 1month of child age to kindergarten) was predictive of child internalizing behavior problems at kindergarten. Results have implications for parenting interventions that may be targeted toward reducing maternal harshness in high risk samples characterized by maternal substance use in pregnancy.

  17. A prospective study of gynecological cancer risk in relation to adiposity factors: cumulative incidence and association with plasma adipokine levels.

    Directory of Open Access Journals (Sweden)

    Meei-Maan Wu

    Full Text Available BACKGROUND: Associations of obesity and obesity-related metabolic factors (adiposity factors with uterine corpus cancer (UCC and ovarian cancer (OVC risk have been described. Still, a cause-effect relationship and the underlying mediators remain unclear, particularly for low-incidence populations. We aimed to prospectively determine whether adiposity factors could predict the development of UCC and OVC in Taiwanese women. To explore the biological mediators linking adiposity factors to cancer risk, we examined the association of two adipokines, leptin and adiponectin, with the gynecological cancers. METHODS: Totally, 11,258 women, aged 30-65, were recruited into the Community-Based Cancer Screening Program (CBCSP study during 1991-1993, and were followed for UCC and OVC cases until December 31, 2011. Cox proportional hazard models were used to estimate hazard ratios (HRs. Adiposity factors and risk covariates were assessed at recruitment. Newly-developed cancer cases were determined from data in the government's National Cancer Registry and Death Certification System. For adipokienes study, a nested case-control study was conducted within the cohort. Baseline plasma samples of 40 incident gynecological cancer cases and 240 age-menopause-matched controls were assayed for adipokines levels. FINDINGS: There were 38 and 30 incident cases of UCC and OVC, respectively, diagnosed during a median 19.9 years of follow-up. Multivariate analysis showed that alcohol intake (HR = 16.00, 95%  = 4.83-53.00, high triglyceride levels (HR = 2.58, 95% = 1.28-5.17, and years of endogenous estrogen exposure per 5-year increment (HR = 1.91, 95%  = 1.08-3.38 were associated with increased UCC risk. High body mass index (BMI ≥ 27 kg/m(2, HR = 2.90, 95%  = 1.30-6.46 was associated with increased OVC risk. Analysis further showed an independent effect of adipokines on UCC and OVC risk after adjustment of the risk covariates. CONCLUSION: We provided evidence

  18. Childhood body mass index growth trajectories and endometrial cancer risk

    DEFF Research Database (Denmark)

    Aarestrup, Julie; Gamborg, Michael; Tilling, Kate

    2017-01-01

    Previously, we found that excess weight already in childhood has positive associations with endometrial cancer; however, associations with changes in body mass index (BMI) during childhood are not well understood. Therefore, we examined whether growth in childhood BMI is associated with endometri...... cancer risk. We did not identify any sensitive childhood growth period, which suggests that excess gain in BMI during the entire childhood period should be avoided.[on SciFinder (R)]...

  19. Using Physiologically-Based Pharmacokinetic Models to Incorporate Chemical and Non-Chemical Stressors into Cumulative Risk Assessment: A Case Study of Pesticide Exposures

    Directory of Open Access Journals (Sweden)

    Jonathan I. Levy

    2012-05-01

    Full Text Available Cumulative risk assessment has been proposed as an approach to evaluate the health risks associated with simultaneous exposure to multiple chemical and non-chemical stressors. Physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD models can allow for the inclusion and evaluation of multiple stressors, including non-chemical stressors, but studies have not leveraged PBPK/PD models to jointly consider these disparate exposures in a cumulative risk context. In this study, we focused on exposures to organophosphate (OP pesticides for children in urban low-income environments, where these children would be simultaneously exposed to other pesticides (including pyrethroids and non-chemical stressors that may modify the effects of these exposures (including diet. We developed a methodological framework to evaluate chemical and non-chemical stressor impacts on OPs, utilizing an existing PBPK/PD model for chlorpyrifos. We evaluated population-specific stressors that would influence OP doses or acetylcholinesterase (AChE inhibition, the relevant PD outcome. We incorporated the impact of simultaneous exposure to pyrethroids and dietary factors on OP dose through the compartments of metabolism and PD outcome within the PBPK model, and simulated combinations of stressors across multiple exposure ranges and potential body weights. Our analyses demonstrated that both chemical and non-chemical stressors can influence the health implications of OP exposures, with up to 5-fold variability in AChE inhibition across combinations of stressor values for a given OP dose. We demonstrate an approach for modeling OP risks in the presence of other population-specific environmental stressors, providing insight about co-exposures and variability factors that most impact OP health risks and contribute to children’s cumulative health risk from pesticides. More generally, this framework can be used to inform cumulative risk assessment for any compound impacted by

  20. Cumulative Risk Assessment and Environmental Equity in Air Permitting: Interpretation, Methods, Community Participation and Implementation of a Unique Statute

    Directory of Open Access Journals (Sweden)

    Gregory C. Pratt

    2011-11-01

    Full Text Available In 2008, the statute authorizing the Minnesota Pollution Control Agency (MPCA to issue air permits was amended to include a unique requirement to analyze and consider “cumulative levels and effects of past and current environmental pollution from all sources on the environment and residents of the geographic area within which the facility's emissions are likely to be deposited.” Data describing the Statute Area suggest it is challenged by environmental and socioeconomic concerns, i.e., concerns which are often described by the phrase ‘environmental equity’. With input from diverse stakeholders, the MPCA developed a methodology for implementing a cumulative levels and effects analysis when issuing air permits in the designated geographic area. A Process Document was created defining explicit steps a project proposer must complete in the analysis. An accompanying Reference Document compiles all available environmental health data relevant to the Statute Area that could be identified. The final cumulative levels and effects methodology is organized by health endpoint and identifies hazard, exposure and health indices that require further evaluation. The resulting assessment is summarized and presented to decision makers for consideration in the regulatory permitting process. We present a description of the methodology followed by a case study summary of the first air permit processed through the “cumulative levels and effects analysis”.

  1. Cumulative risk assessment and environmental equity in air permitting: interpretation, methods, community participation and implementation of a unique statute.

    Science.gov (United States)

    Ellickson, Kristie M; Sevcik, Sarah M; Burman, Shelley; Pak, Steven; Kohlasch, Frank; Pratt, Gregory C

    2011-11-01

    In 2008, the statute authorizing the Minnesota Pollution Control Agency (MPCA) to issue air permits was amended to include a unique requirement to analyze and consider "cumulative levels and effects of past and current environmental pollution from all sources on the environment and residents of the geographic area within which the facility's emissions are likely to be deposited." Data describing the Statute Area suggest it is challenged by environmental and socioeconomic concerns, i.e., concerns which are often described by the phrase 'environmental equity'. With input from diverse stakeholders, the MPCA developed a methodology for implementing a cumulative levels and effects analysis when issuing air permits in the designated geographic area. A Process Document was created defining explicit steps a project proposer must complete in the analysis. An accompanying Reference Document compiles all available environmental health data relevant to the Statute Area that could be identified. The final cumulative levels and effects methodology is organized by health endpoint and identifies hazard, exposure and health indices that require further evaluation. The resulting assessment is summarized and presented to decision makers for consideration in the regulatory permitting process. We present a description of the methodology followed by a case study summary of the first air permit processed through the "cumulative levels and effects analysis".

  2. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  3. Cardiopulmonary risk index does not predict complications after thoracic surgery.

    Science.gov (United States)

    Melendez, J A; Carlon, V A

    1998-07-01

    The preoperative cardiopulmonary risk index (CPRI) is a multifactorial index intended to predict postoperative outcome after thoracic surgery. It combines cardiac and pulmonary information into one parameter that ranges from 1 to 10, with 10 being the worst. A CPRI > or = 4 has been advocated as an effective predictor of postoperative pulmonary and cardiac complications. This study prospectively evaluates the predictive value of CPRI in a large population of patients undergoing thoracic surgery. We performed prospective calculation of CPRI in patients about to undergo thoracic surgery. Postthoracic surgery occurrence of pneumonia, atelectasis, arrhythmias, congestive heart failure, respiratory failure requiring therapy, or death occurring within 30 days of surgery was compared with preoperative CPRI and its components. One hundred eighty consecutive patients, aged 15 to 87 years, were studied. Operations performed included 114 lobectomies, 35 wedge resections, 19 pneumonectomies, 5 pleurectomies, 5 lymph node dissections, 1 thoracic wall resection, and 1 paravertebral tumor resection. Twenty-seven percent of patients experienced complications. CPRI and its components did not predict complications, deaths, or the number of in-hospital days. We found a CPRI > or = 4 to be a moderate predictor of outcome for patients undergoing pneumonectomy (n = 19). It correctly identified four of nine postpneumonectomy complications. The preoperative CPRI and its components are inadequate predictors of medical complications after thoracic surgery in a general population. In the subgroup of patients undergoing pneumonectomy, the index may be of some value in forecasting outcome.

  4. Glycemic index, glycemic load and thyroid cancer risk.

    Science.gov (United States)

    Randi, G; Ferraroni, M; Talamini, R; Garavello, W; Deandrea, S; Decarli, A; Franceschi, S; La Vecchia, C

    2008-02-01

    Risk of thyroid cancer has already been related to refined cereals and starch food, but the association has not been studied in terms of glycemic index (GI) and glycemic load (GL). We analyzed data from a case-control study conducted in Italy from 1986 to 1992 and including 399 histologically confirmed and incident cases of thyroid cancer and 616 control subjects. Information on dietary habits was derived through a food-frequency questionnaire and multivariate odds ratios (ORs) for GI and GL levels were estimated with adjustment for age, education, sex, area of residence, history of diabetes, body mass index, smoking, alcohol consumption, intake of fruit and vegetables, and noncarbohydrate energy intake. Compared with the lowest tertile, the ORs in subsequent tertiles were 1.68 and 1.73 for GI, and 1.76 and 2.17 for GL. The OR for highest tertile of GI compared with lowest one was 1.70 for papillary and 1.57 for follicular thyroid cancer. The ORs for GL were 2.17 for papillary and 3.33 for follicular thyroid cancer. Our study shows that high dietary levels of GI and GL are associated with thyroid cancer risk.

  5. Risk Assessment Index System of Natural Gas Industrial Chain in China

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    This paper establishes a risk assessment index system for the natural gas industrial chain. China's natural gas industrial chain is entering a stage of rapid growth. In order to guarantee healthy development of the natural gas industrial chain,it is urgent to establish a risk alert system, which is based on a risk assessment index system. First of all, the risks of the natural gas industrial chain are defined in the paper; then the risk factors are analyzed according to the present status of the natural gas industrial chain, and five categories of risk factors are summarized: resource risk, transport risk, marketing risk, risk of unbalanced chain links, and environment risk. The paper presents the principles of the risk assessment index system. The natural gas industrial chain risk assessment index system is established with four levels and forty-six risk indices.

  6. Sleep duration and cancer risk: time to use a "sleep-years" index?

    Science.gov (United States)

    Erren, Thomas C

    2012-09-01

    With a focus on melatonin, a recent paper in the Journal investigated the hypothesis that endometrial cancer might be associated with the duration, and ultimately, amount of sleep. The authors found that "[s]elf-reported sleep duration may not adequately represent melatonin levels." The authors also concluded that there was "weak evidence of an association between sleep duration and endometrial cancer risk." Overall, these are interesting observations because primarily experimental and mechanistic research from many angles supports the study's notion that inappropriate sleep may be a determinant of cancer risk. To find out whether this is so in man, rather than assigning study individuals to fixed or average "baseline sleep categories" i.e., ≤5, 6, 7, 8, ≥9 h of habitual sleep in the present study, the accumulated amount of sleep over decades should be reconstructed in retrospective or constructed in prospective studies. To achieve this end, future epidemiological studies may want to use a sleep-years index [SYI]. This simple exposure parameter promises to be a sensible, feasible, and affordable way to approximate cumulative time spent at sleep in critical time windows over many years which we should expect to be relevant for the development of cancer. The SYI could be tested and used in observational studies which promise to be comparable and can be merged. This commentary provides roots of the index and explains why and how it should be used and how it could be interpreted in rigorous studies of biologically plausible links between sleep, on the one hand, and the development of internal cancers, on the other. This commentary also points out limitations of interpreting the SYI. It is emphasized that, where possible, the SYI should be assessed independently of (a) other sleep facets--such as quality--and of (b) known or suspected cancer risk factors. The respective contribution of (a) and (b) to risk must then be assessed during the analyses. Overall, the

  7. 国内外累积性环境风险评估研究进展%Research Progress of Cumulative Environmental Risk Assessment at Home and Abroad

    Institute of Scientific and Technical Information of China (English)

    袁鹏; 李文秀; 彭剑峰; 宋永会; 许伟宁

    2015-01-01

    随着环境风险评估的重点由单一源、单一传播途径、单受体转向多来源、多传播途径、多受体的评估,累积性环境风险评估逐渐成为当前研究热点。通过概念辨析和文献调研的方法,综述了美国累积性环境风险评估的发展历史、评估流程,并对国内外累积性环境风险评估方法、应用研究进展进行了评述。指出了目前国内开展累积性环境风险评估存在的方法不完善、基础科研工作不足、宏观环境管理政策亟待加强等问题。建议应尽快明确累积性环境风险评估概念与管理要求,制订累积性环境风险评估的流程、框架与技术指南,加强基础数据库建立和实践探索,为长效的环境风险管理提供决策依据。%With the focuses of environmental risk assessment gradually evolving from assessment of single source or stressor, single exposure route and single risk receptor toward integrated assessment involving several sources or stressors, multiple exposure routes and multiple receptors in recent years, the cumulative risk assessment has become a study hot spot.Through concepts discrimination and literatures search, the development history and assessment procedure in the US, and the methods and practices of cumulative risk assessment both at home and abroad were reviewed.It was pointed out that there were several problems in conducting cumulative risk assessment in China, such as lack of assessment methods, lack of basic scientific data and urgent need of reinforcement of macro-environmental management policy and so on.It was suggests that the concept and management requirements of cumulative environmental risk assessment should be defined, the evaluation process, framework and technical guide be formulated, and the construction of foundational databases and practical explorations be reinforced as soon as possible,which can provide the decision support for the long-term effective environmental

  8. Towards personalized screening: Cumulative risk of breast cancer screening outcomes in women with and without a first-degree relative with a history of breast cancer.

    Science.gov (United States)

    Ripping, Theodora Maria; Hubbard, Rebecca A; Otten, Johannes D M; den Heeten, Gerard J; Verbeek, André L M; Broeders, Mireille J M

    2016-04-01

    Several reviews have estimated the balance of benefits and harms of mammographic screening in the general population. The balance may, however, differ between individuals with and without family history. Therefore, our aim is to assess the cumulative risk of screening outcomes; screen-detected breast cancer, interval cancer, and false-positive results, in women screenees aged 50-75 and 40-75, with and without a first-degree relative with a history of breast cancer at the start of screening. Data on screening attendance, recall and breast cancer detection were collected for each woman living in Nijmegen (The Netherlands) since 1975. We used a discrete time survival model to calculate the cumulative probability of each major screening outcome over 19 screening rounds. Women with a family history of breast cancer had a higher risk of all screening outcomes. For women screened from age 50-75, the cumulative risk of screen-detected breast cancer, interval cancer and false-positive results were 9.0, 4.4 and 11.1% for women with a family history and 6.3, 2.7 and 7.3% for women without a family history, respectively. The results for women 40-75 followed the same pattern for women screened 50-75 for cancer outcomes, but were almost doubled for false-positive results. To conclude, women with a first-degree relative with a history of breast cancer are more likely to experience benefits and harms of screening than women without a family history. To complete the balance and provide risk-based screening recommendations, the breast cancer mortality reduction and overdiagnosis should be estimated for family history subgroups.

  9. 基于累积前景理论的出行风险分析%Cumulative Prospect Theory-based Analysis of Travel Risk

    Institute of Scientific and Technical Information of China (English)

    甘佐贤; 陈红; 冯微; 邓亚娟

    2014-01-01

    Cumulative prospect theory-based travel costs ,namely cumulative perceived value (CPV ) made up of travel time cost and arrival time perceived value is proposed in the paper .First ,the pros-pect theory as well as the further developed cumulative prospect theory is introduced ,and the concept of arrival time perceived value (ATPV) is brought in to establish the contact of arrive time and per-ceived value .Second ,a simple parallel network with variable message sign (VMS) set up or not is as an ex-ample to analysis the use of cumulative prospect theory in travel option .The result shows that ,the cumula-tive perceived value based on cumulative prospect theory is good to depict the travel choice risk under different travel environment .The existence of VMS is favorable for traveler to reduce travel cost .%将出行者基于累积前景理论的出行成本---累积感知价值(CPV )看作是由路径出行时间成本和到达目的地后的到达时间感知价值共同组成,对累积前景理论(CPT )进行了介绍,同时引入到达时间感知价值(ATPV)概念建立到达时间与出行感知价值之间的联系,以一个中间节点设置可变信息情报板(VMS)的简单平行网络为例,对累积前景理论在出行决策中的运用进行了分析。结果表明,基于累积前景理论的累积感知价值建模方式较好的刻画了不同出行环境下出行选择风险,VMS的设置有利于降低出行风险。

  10. Geriatric nutritional risk index: A mortality predictor in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Mahnaz Edalat-Nejad

    2015-01-01

    Full Text Available Recently, the Geriatric Nutritional Risk Index (GNRI has been introduced as a valuable tool to assess the nutritional status of hemodialysis (HD patients. To determine the predictive value of the GNRI score for death in HD, we studied 145 chronic HD patients (%53 men, mean age 60 ± 16 years. The GNRI score was estimated by an equation involving serum albumin and individual′s weight and height. According to the highest positive likelihood and risk ratios, the cut-off value of the GNRI for mortality was set at 100. The survival of patients on HD was examined with the Cox proportional hazards model. Mortality was monitored prospectively over an 18-month period, during which 35 patients died. The GNRI (mean 102.6 ± 5.5 was significantly positively correlated with lean body mass, hematocrit, serum lipids and presence of metabolic syndrome. Multivariate Cox proportional hazards analysis demonstrated that the GNRI <100, serum ferritin ≥ 500 μ g/L and age 65 years or older were significant predictors for mortality (hazard ratio 3.691, 95% CI 1.751-7.779, P = 0.001; hazard ratio 3.105, 95% CI 1.536-6.277, P = 0.002; and hazard ratio 2.806, 95% CI 1.297-6.073, P = 0.009, respectively, after adjustment to gender and vintage time. It can be concluded that, in addition to old age, malnutrition (low GNRI and inflammation (high ferritin are identified as significant independent risk factors that predict all-cause mortality in HD patients.

  11. Carcinoma in the Remnant Stomach During Long-Term Follow-up After Distal Gastrectomy for Gastric Cancer: Analysis of Cumulative Incidence and Associated Risk Factors.

    Science.gov (United States)

    Hanyu, Takaaki; Wakai, Atsuhiro; Ishikawa, Takashi; Ichikawa, Hiroshi; Kameyama, Hitoshi; Wakai, Toshifumi

    2017-09-18

    The number of patients with remnant gastric cancer following resection of gastric cancer may increase. The aims of this study were to investigate the development of remnant gastric cancer after distal gastrectomy for gastric cancer and to examine its cumulative incidence, clinicopathological characteristics, and risk factors. We examined 437 patients with relapse-free survival for 5 years or more after distal gastrectomy with Billroth I reconstruction for gastric cancer performed between 1985 and 2005. A total of 17 patients suffered from remnant gastric cancer. The cumulative incidence was 3.7% at 10 years and 5.4% at 20 years. The median time until development of remnant gastric cancer was 79 months (range 30-209 months). The presence of synchronous multiple gastric cancers was a significant independent risk factor for remnant gastric cancer (hazard ratio 4.036; 95% confidence interval 1.478-11.02; P = 0.006). Of the 17 patients, the 13 whose remnant gastric cancer was detected via regular endoscopy showed better prognoses than the patients detected by other means (P gastric cancer was 5.4% at 20 years. In particular, patients who had multiple gastric cancers at initial gastrectomy were at higher risk for remnant gastric cancer. Therefore, long-term endoscopic surveillance is important.

  12. Body Mass Index and Risk of Death in Asian Americans

    Science.gov (United States)

    Wang, Sophia; Kitahara, Cari M.; Moore, Steven C.; Berrington de Gonzalez, Amy; Bernstein, Leslie; Chang, Ellen T.; Flint, Alan J.; Freedman, D. Michal; Gaziano, J. Michael; Hoover, Robert N.; Linet, Martha S.; Purdue, Mark; Robien, Kim; Schairer, Catherine; Sesso, Howard D.; White, Emily; Willcox, Bradley J.; Thun, Michael J.; Hartge, Patricia; Willett, Walter C.

    2014-01-01

    Objectives. We investigated the association between body mass index (BMI) and mortality among Asian Americans. Methods. We pooled data from prospective cohort studies with 20 672 Asian American adults with no baseline cancer or heart disease history. We estimated hazard ratios and 95% confidence intervals (CIs) with Cox proportional hazards models. Results. A high, but not low, BMI was associated with increased risk of total mortality among individuals aged 35 to 69 years. The BMI was not related to total mortality among individuals aged 70 years and older. With a BMI 22.5 to < 25 as the reference category among never-smokers aged 35 to 69 years, the hazard ratios for total mortality were 0.83 (95% CI = 0.47, 1.47) for BMI 15 to < 18.5; 0.91 (95% CI = 0.62, 1.32) for BMI 18.5 to < 20; 1.08 (95% CI = 0.86, 1.36) for BMI 20 to < 22.5; 1.14 (95% CI = 0.90, 1.44) for BMI 25 to < 27.5; 1.13 (95% CI = 0.79, 1.62) for BMI 27.5 to < 30; 1.82 (95% CI = 1.25, 2.64) for BMI 30 to < 35; and 2.09 (95% CI = 1.06, 4.11) for BMI 35 to 50. Higher BMI was also related to increased cardiovascular disease and cancer mortality. Conclusions. High BMI is associated with increased mortality risk among Asian Americans. PMID:24432919

  13. External validation of the paediatric risk of malignancy index.

    Science.gov (United States)

    Hermans, A J; Kluivers, K B; Massuger, L F; Coppus, S F

    2016-02-01

    This study aimed to validate the paediatric risk of malignancy index (PRMI), as previously published. External validation study. Academic hospital: Radboud University Medical Center. Female paediatric patients under the age of 18 years diagnosed with, or treated for, an adnexal mass between January 1999 and October 2013. Information was collected on diagnosis, presenting symptoms, and signs and imaging characteristics. The PRMI was calculated for each patient. Sensitivity, specificity, and positive and negative predictive values were calculated, and the results were visualised using a receiver operating characteristic curve (ROC curve). Histological diagnosis, discriminative performance using the area under the curve (AUC) of the ROC curve and sensitivity and specificity. Seventy-eight patients were included, with a median age of 12 years. A malignant mass was found in 17 patients (21.8%). The PRMI with a cut-off value of 7 resulted in a sensitivity of 70.1% (95% CI 44.1-89.6%) and a specificity of 85.3% (95% CI 73.8-93.0%). The area under the ROC curve was 0.868 (95% CI 0.756-0.980). The PRMI showed less discriminative capacity than originally published, but its performance was still good; however, further prospective validation studies are needed to define whether the model is useful in daily clinical practice. © 2015 Royal College of Obstetricians and Gynaecologists.

  14. Project 6: Cumulative Risk Assessment Methods and Applications: Task 6.3. Applying Genetic and Epigenetic Data to Inform Susceptibility

    Science.gov (United States)

    Susceptibility is defined by the NRC (2009) as the capacity to be affected. A person can be at greater or less risk relative to population median risk because of susceptibility factors such as life stage, sex, genetics, socioeconomic status, prior exposure to chemicals, and non-c...

  15. Exposure to phthalates in 5-6 years old primary school starters in Germany--a human biomonitoring study and a cumulative risk assessment.

    Science.gov (United States)

    Koch, Holger M; Wittassek, Matthias; Brüning, Thomas; Angerer, Jürgen; Heudorf, Ursel

    2011-06-01

    We determined the internal exposure of 111 German primary school starters by analyzing urinary metabolites of six phthalates: butyl benzyl phthalate (BBzP), di-iso-butyl phthalate (DiBP), di-n-butyl phthalate (DnBP), di (2-ethylhexyl) phthalate (DEHP), di-iso-nonyl phthalate (DiNP) and di-iso-decylphthalate (DiDP). From the urinary metabolite levels, we calculated daily intakes and related these values to Tolerable Daily Intake (TDI) values. By introducing the concept of a relative cumulative Tolerable Daily Intake (TDI(cum)) value, we tried to account for the cumulative exposure to several of the above-mentioned phthalates. The TDI(cum) was derived as follows: the daily intake (DI) calculated from the metabolite level was divided by the TDI for each phthalate; this ratio was multiplied by 100% indicating the TDI percentage for which the DI accounted. Finally the % TDIs of the different phthalates were totalled to get the TDI(cum). A TDI(cum) above 100% is a potential cause for concern. We confirmed the ubiquitous exposure of the children to all phthalates investigated. Exposures were within range of levels previously reported for GerES, albeit slightly lower. Regarding daily intakes, two children exceeded the TDI for DnBP, whereas one child closely approached the TDI for DEHP. 24% of the children exceeded the TDI(cum) for the three most critical phthalates: DEHP, DnBP and DiBP. Furthermore, 54% of the children had total exposures that used up more than 50% the TDI(cum). Therefore, the overall exposure to a number of phthalates, and the knowledge that these phthalates (and other anti-androgens) act in a dose-additive manner, urgently warrants a cumulative risk assessment approach.

  16. Comprehensive lipid tetrad index, atherogenic index and lipid peroxidation: Surrogate markers for increased cardiovascular risk in psoriasis

    Directory of Open Access Journals (Sweden)

    S Sunitha

    2015-01-01

    Full Text Available Background and Objectives: Recently, the concept of "psoriatic march" has come to the fore, in which chronic cutaneous inflammation in psoriasis leads to systemic inflammation which, in conjunction with increased oxidative stress, triggers a cascade of events resulting in increased cardiovascular risk in patients with severe psoriasis. We, therefore, decided to study the levels of some biochemical cardiovascular risk markers: lipid peroxidation (malondialdehyde, lipoprotein (a, lipid indices and atherogenic index, in patients with psoriasis and their association with disease severity. Methods: Fortyfive patients with psoriasis and 45 age and gender-matched healthy controls were included in this cross-sectional study. Disease severity was assessed by the Psoriasis Area Severity Index (PASI. Serum malondialdehyde, lipoprotein (a and fasting lipid profile were estimated in all study subjects. Lipoprotein ratios were computed using standard formulae. Atherogenic index was calculated as ratio of lipoprotein (a/high-density lipoprotein. Results: In psoriasis, we observed significantly higher levels of malondialdehyde, total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, lipoprotein (a, lipid ratios, atherogenic index and comprehensive lipid tetrad index, compared to controls. These levels were directly proportional to disease severity. Serum levels of malondialdehyde correlated positively with serum lipoprotein (a, comprehensive lipid tetrad index and atherogenic index. Limitations: Different morphological types of psoriasis were not included and follow-up post-therapy was not done. A larger sample size would have validated the results further. Conclusion: Our results indicate that psoriasis, especially the severe variants, are associated with increased oxidative stress and dyslipidemia, which correlate positively with atherogenic index and hence, an increased cardiovascular risk.

  17. Risk factors and risk index of cardiac events in pregnant women with heart disease

    Institute of Scientific and Technical Information of China (English)

    LIU Hua; HUANG Tao-tao; LIN Jian-hua

    2012-01-01

    Background Pregnant women with heart disease are at high risk.Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes.In this paper,we try to discuss the main risk factors of cardiac events in pregnant women with heart disease and to establish a risk assessment system.Methods A retrospective analysis was carried out for pregnancies in 1741 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and September 2010.A Logistic regression model was used to identify independent risk factors of cardiac events and calculate the risk index in pregnant women with heart disease.Results The composition of heart disease in pregnant women was arrhythmia (n=662,38.00%),congenital heart disease (CHD; n=529,30.40%),cardiomyopathy (n=327,18.80%),rheumatic heart disease (RHD; n=151,8.70%),and cardiopathy induced by pre-eclampsia (n=53,3.00%).Main cardiac events were heart failure (n=110,6.32%),symptomatic arrhythmia needing medication (n=43,2.47%),cardiac arrest (n=2,0.11%),syncope (n=3,0.17%),and maternal death (n=10,0.57%).Six independent risk factors to predict cardiac events in pregnant women with heart disease were cardiac events before pregnancy (heart failure,severe arrhythmia,cardiac shock,etc.,P=0.000),New York Heart Association (NYHA) class >ll (P=0.000),oxygen saturation <90% (P=0.018),pulmonary artery hypertention (PAH)>50 mmHg (P=0.025),cyanotic heart disease without surgical correction (P=0.015),and reduced left ventricular systolic function (ejection fraction <40%,P=0.003).Every risk factor was calculated as 1 score.The incidence of cardiac events in patients with scores 0,1,2,3,and ≥4 was 2.10%,31.61%,61.25%,68.97%,and 100.00% respectively.Conclusions Pregnancy with heart disease could lead to undesirable pregnancy outcomes.The risk of cardiac events in pregnant women with heart disease could be assessed by risk

  18. Impact of individual and cumulative coronary risk factors on coronary flow reserve assessed by dobutamine stress echocardiography.

    Science.gov (United States)

    Ahmari, Saeed A L; Bunch, T Jared; Modesto, Karen; Stussy, Vicky; Dichak, Amy; Seward, James B; Pellikka, Patricia A; Chandrasekaran, Krishnaswamy

    2008-06-15

    Traditional cardiovascular risk factors have been shown to cause microvascular dysfunction. Most studies that have evaluated microcirculation rely on invasive measurement tools. We used dobutamine stress echocardiography, a validated method to measure coronary flow velocity (CFV) and coronary flow reserve (CFR), in a previously unstudied population without known significant coronary artery disease to determine the impact of traditional risk factors on CFR. Consecutive patients who had no evidence of regional wall motion abnormalities at rest or during dobutamine stress echocardiography were studied. Left anterior descending artery CFV was measured at baseline and at peak dobutamine stress and CFR was calculated as the ratio of peak stress CFV to baseline CFV. Fifty-nine consecutive patients (28 men) with mean age of 66.8+/-14.5 years were studied. CFR was lower in patients with diabetes mellitus (DM) compared with those without (1.7+/-0.74 vs 2.48+/-0.98, p50 mm Hg), and obesity with a wide pulse pressure. In a multivariate model, DM, obesity, and wide pulse pressure were significantly associated with variation in CFR (p<0.0008). In conclusion, CFR was abnormal in patients with DM, hypertension, and obesity. CFR impairment is exaggerated as the number of risk factors increases. Despite a negative dobutamine stress echocardiographic result, aggressive risk factor assessment and control should be implemented in patients with coronary risk factors due to an underlying abnormal CFR.

  19. Body adiposity index and cardiovascular health risk factors in Caucasians: a comparison with the body mass index and others.

    Directory of Open Access Journals (Sweden)

    Miquel Bennasar-Veny

    Full Text Available BACKGROUND: Several studies have shown a relation between the adipose tissue accumulation and a higher risk for developing metabolic and cardiovascular diseases. Thus, body fat content and, mainly, the fat distribution or adiposity could be considered as important indicators of health risk. In spite of presenting several limitations, BMI is the most widely used and accepted index for classifying overweight and obesity. The aim of the study was to evaluate the correlations between Body Adiposity Index (BAI, BMI and other adiposity indexes such as WC, WHR and WHtR with cardiovascular and metabolic risk factors. Furthermore, the behavior of BAI and BMI regarding the ability to discriminate overweight or obese individuals was also analyzed. RESEARCH METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was conducted in Spanish Caucasian adult workers. Participants in the study (29.214 men and 21.040 women, aged 20-68 years were systematically selected during their work health periodic examinations. BAI, BMI, WHR, WHtR, body weight, hip and waist circumference (WC as well as systolic and diastolic blood pressure were measured. Serum levels of high density lipoprotein cholesterol (HDL-C, low density lipoprotein cholesterol (LDL-C, triglycerides (TG and glucose were also determined. Results of the study indicated that BAI was less correlated with cardiovascular risk factors and metabolic risk factors than other adiposity indexes (BMI, WC and WHtR. The best correlations were found for WHtR. In addition, the BAI presented lower discriminatory capacity than BMI for diagnosing metabolic syndrome (MS using both IDF and ATP III criteria. A different behavior of the BAI in men and women when considering the ability to discriminate overweight or obese individuals was also observed. CONCLUSIONS: The adiposity indexes that include the waist circumference (WHtR and WC may be better candidates than BAI and BMI to evaluate metabolic and cardiovascular risk in

  20. The Financial Stress Index: Identification of Systemic Risk Conditions

    Directory of Open Access Journals (Sweden)

    Mikhail V. Oet

    2015-09-01

    Full Text Available This paper develops a financial stress measure for the United States, the Cleveland Financial Stress Index (CFSI. The index is based on publicly available data describing a six-market partition of the financial system comprising credit, funding, real estate, securitization, foreign exchange, and equity markets. This paper improves upon existing stress measures by objectively selecting between several index weighting methodologies across a variety of monitoring frequencies through comparison against a volatility-based benchmark series. The resulting measure facilitates the decomposition of stress to identify disruptions in specific markets and provides insight into historical stress regimes.

  1. [Body mass index and the risk of lung cancer incidence in smokers: a prospective cohort study].

    Science.gov (United States)

    Li, F; Xie, S H; Wang, G; Su, K; Feng, X S; Lyu, Z Y; Guo, L W; Chen, S H; Chang, S; Chen, Y H; Ren, J S; Shi, J F; Yang, W J; Cui, H; Wu, S L; Dai, M; Li, N; He, J

    2016-05-01

    To investigate the effect of baseline body mass index (BMI) on the risk of lung cancer incidence in male smokers. All the male employees and retirees of the Kailuan Group were recruited in the Chinese Kailuan Male Cohort Study, and they had been experienced routine physical examinations every two years since May, 2006. Up to 31st December 2011, a total of 3 rounds physical examinations had been completed. A total of 42 718 male smokers candidates from the Chinese Kailuan Male Cohort Study were enrolled in the present study. The date of entering this study was defined as that of taking first check-up, and the date of end-of-observation was defined as that of cancer diagnosis, death or end of follow-up (31 December 2011). Information on demographics, lifestyle such as smoking, alcohol consumption, anthropometries such as height and weight, as well as the information of newly-diagnosed cancer cases, were collected at the baseline investigation. Multivariable Cox proportional hazards regression models were used to investigate the association between levels of the baseline BMI and risk of lung cancer. Of the 42 718 male smokers, there were 181 998.09 person-years of follow-up, taking 4.26 years of average follow-up period. During follow-up, 234 new lung cancer cases were identified among the 42 718 male smokers and the crude incidence density was 128.57/100 000. After the factors adjustment for age, education level, alcohol consumption, physical activity, work environment and cumulative smoking levels (pack-years), compared with subjects of normal BMI group, hazard ratio and 95% confidence intervals of lung cancer for subjects of underweight, overweight, and obesity were 1.63 (0.79-3.37), 0.79 (0.57-1.09) and 0.50 (0.27-0.91), respectively. After the facotors adjustment for age, education level, alcohol consumption, physical activity, work environment and cumulative smoking levels (pack-years), compared with subjects of normal BMI, hazard ratio and 95% confidence

  2. MTHFR gene A1298C polymorphisms are associated with breast cancer risk among Chinese population: evidence based on an updated cumulative meta-analysis

    Science.gov (United States)

    Wang, Yadong; Yang, Haiyan; Duan, Guangcai

    2015-01-01

    Objectives: Published studies on the association between methylenetetrahydrofolate reductase (MTHFR) gene A1298C polymorphisms and breast cancer risk among Chinese population have yielded conflicting results. The purpose of this study was to clarify the association between MTHFR gene A1298C polymorphisms and breast cancer risk among Chinese population. Methods: Systematic searches were performed through the database of Medline/PubMed, Science Direct, Elsevier, CNKI and Wanfang Medical Online. Results: Overall, a significantly increased risk of breast cancer was observed among the subjects carrying MTHFR gene A1298C AC+CC genotype (odds ratio [OR]=1.05 with 95% confidence interval [CI]: 1.01-1.10) as compared to those carrying AA genotype among total Chinese population. We did not observe any significant association between MTHFR gene A1298C polymorphisms and the risk of breast cancer under the additional genetic models of AC vs. AA, CC vs. AA and C-allele vs. A-allele (OR=1.00 with 95% CI: 0.97-1.02, OR=1.01 with 95% CI: 1.00-1.02 and OR=1.00 with 95% CI: 0.99-1.02, respectively). The cumulative meta-analysis showed similar results. In subgroup analysis, we observed subjects carrying AC+CC genotype had an increased breast cancer risk compared with those carrying AA genotype among the studies of sample size less than 1000. We did not observe any significant association between MTHFR gene A1298C polymorphisms and breast cancer risk in additional subgroup analyses. Conclusions: Our results suggest that MTHFR gene A1298C AC+CC genotype may be a risk factor for the development of breast cancer among Chinese population. Well-designed studies with a large sample size are needed to further confirm our findings. PMID:26884927

  3. Cumulative Environmental Risk in Substance Abusing Women: Early Intervention, Parenting Stress, Child Abuse Potential and Child Development.

    Science.gov (United States)

    Kelley, Susan J.

    2003-01-01

    A study of 161 substance-abusing mothers assessed 10 maternal risk factors: maternal depression; domestic violence; nondomestic violence; family size; incarceration; no significant other at home; negative life events; psychiatric problems; homelessness; and drug use severity. Parenting stress and child abuse potential was higher for women with…

  4. Quantifying Chronic Stress Exposure for Cumulative Risk Assessment: Lessons Learned from a Case Study of Allostatic Load

    Science.gov (United States)

    Although multiple methods of quantifying environmental chemical exposures have been validated for use in human health risk assessment, quantifying chronic stress exposure is more challenging. Stress is a consequence of perceiving an “exposure” (e.g., violence, poverty) as more th...

  5. Cumulative Risk, the Mother-Child Relationship, and Social-Emotional Competence in Latino Head Start Children

    Science.gov (United States)

    Martí, Maria; Bonillo, Albert; Jané, Maria Claustre; Fisher, Elisa M.; Duch, Helena

    2016-01-01

    Research Findings: Supportive mother-child interactions promote the development of social-emotional competence. Poverty and other associated psychosocial risk factors have a negative impact on mother-child interaction. In spite of Latino children being disproportionately represented among children living in poverty, research on mother-child…

  6. Cumulative health risk assessment of halogenated and parent polycyclic aromatic hydrocarbons associated with particulate matters in urban air.

    Science.gov (United States)

    Sun, Jian-Lin; Jing, Xin; Chang, Wen-Jing; Chen, Zheng-Xia; Zeng, Hui

    2015-03-01

    Halogenated polycyclic aromatic hydrocarbons (HPAHs) have been reported to occur widely in urban air. Nevertheless, knowledge about the human health risk associated with inhalation exposure to HPAHs is scarce so far. In the present study, nine HPAHs and 16 PAHs were determined in atmospheric particulate matter (PM) collected from Shenzhen, China to address this issue. Concentrations of Σ9HPAHs varied from 0.1 to 1.5 ng/m(3) and from 0.09 to 0.4 ng/m(3) in PM10 and PM2.5 samples, respectively. As for individuals, 9-bromoanthracene, 7-bromobenz(a)anthracene, and 9,10-dibromoanthracene were the dominant congeners. Levels of Σ16PAHs in PM10 and PM2.5 samples ranged from 3.2 to 81 ng/m(3) and from 2.8 to 85 ng/m(3), respectively. Among individual PAHs, chrysene, benzo[b]fluoranthene, and indeno[1,2,3-c,d]pyrene were the main congeners. According to the season, concentrations of HPAHs and PAHs in atmospheric PM10/PM2.5 samples show a similar decreasing trend with an order: winter>autumn>spring>summer. The daily intake (DI) of PM10/PM2.5-bound HPAHs and PAHs were estimated. Our results indicated that children have the highest DI levels via inhalation exposure. The incremental lifetime cancer risk (ILCR) induced by PM10/PM2.5-bound HPAHs and PAHs were calculated. The ILCR values showed a similar decreasing trend with an order: adults>children>seniors>adolescent. Overall, the ILCR values induced by HPAHs and PAHs were far below the priority risk level (10(-4)), indicating no obvious cancer risk. To our knowledge, this is the first study to investigate the human health risk associated with inhalation exposure to PM10/PM2.5-bound HPAHs.

  7. The Soft Cumulative Constraint

    CERN Document Server

    Petit, Thierry

    2009-01-01

    This research report presents an extension of Cumulative of Choco constraint solver, which is useful to encode over-constrained cumulative problems. This new global constraint uses sweep and task interval violation-based algorithms.

  8. Mortality-Indexed Annuities. Managing Longevity Risk via Product Design

    OpenAIRE

    2009-01-01

    Longevity risk has become a major challenge for governments, individuals, and annuity providers in most countries, and especially its aggregate form, i.e. the risk of unsystematic changes to general mortality patterns, bears a large potential for accumulative losses for insurers. As obvious risk management tools such as (re)insurance or hedging are less suited to manage an annuity provider’s exposure to aggregate longevity risk, the current paper proposes a new type of life annuities with ben...

  9. Occupational coke oven emissions exposure and risk of abnormal liver function: modifications of body mass index and hepatitis virus infection

    Energy Technology Data Exchange (ETDEWEB)

    Y. Hu; B. Chen; J. Qian; L. Jin; T. Jin; D. Lu [Fudan University, Shanghai (China). Department of Occupational and Environmental Health

    2010-03-15

    Occupational coke oven emissions (COEs) have been considered an important health issue. However, there are no conclusive data on human hepatic injury due to COE exposure. The association of COE exposure with liver function was explored and the effects of modification of potential non-occupational factors were assessed. 705 coke oven workers and 247 referents were investigated. Individual cumulative COE exposure was quantitatively estimated. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), {gamma}-glutamyl transferase, alkaline phosphatase, hepatitis B surface antigen and anti-hepatitis C antibody were measured. Among those with high COE exposure, the adjusted ORs of abnormal ALT and AST were 5.23 (95% CI 2.66 to 10.27) and 1.95 (95% CI 1.18 to 3.52), respectively. Overweight individuals (body mass index (BMI) {>=}25 kg/m{sup 2}) with high COE exposure had elevated risks of abnormal ALT (adjusted OR 23.93, 95% CI 8.73 to 65.62) and AST (adjusted OR 5.18, 95% CI 2.32 to 11.58). Risk of liver damage in hepatitis B virus- or hepatitis C virus-positive individuals with COE exposure was also elevated. Long-term exposure to COE increases the risk of liver dysfunction, which is more prominent among those with higher BMI and hepatitis virus infection. The risk assessment of liver damage associated with COE exposure should take BMI and hepatitis virus infection into consideration.

  10. Dietary Glycemic Index, Glycemic Load, and Risk of Cancer: A Prospective Cohort Study

    OpenAIRE

    George, Stephanie Materese; Mayne, Susan T.; Leitzmann, Michael F; Park, Yikyung; Schatzkin, Arthur; Flood, Andrew; Hollenbeck, Albert; Subar, Amy F

    2008-01-01

    Previous studies have provided limited evidence for a harmful effect of high glycemic index and dietary glycemic load on cancer. The authors analyzed associations among glycemic index, glycemic load, and risk of cancer in women and men in the National Institutes of Health–AARP Diet and Health Study. Published glycemic index values were assigned to 225 foods/food groups. Glycemic load was calculated by multiplying the glycemic index, carbohydrate content, and intake frequency of individual foo...

  11. Cumulative Risks of Foster Care Placement by Age 18 for U.S. Children, 2000–2011

    Science.gov (United States)

    Wildeman, Christopher; Emanuel, Natalia

    2014-01-01

    Foster care placement is among the most tragic events a child can experience because it more often than not implies that a child has experienced or is at very high risk of experiencing abuse or neglect serious enough to warrant state intervention. Yet it is unclear how many children will experience foster care placement at some point between birth and age 18. Using synthetic cohort life tables and data from the Adoption and Foster Care Analysis and Reporting System (AFCARS), we estimated how many U.S. children were placed in foster care between birth and age 18, finding support for three conclusions. First, up to 5.91% of all U.S. children were ever placed in foster care between their birth and age 18. Second, Native American (up to 15.44%) and Black (up to 11.53%) children were at far higher risk of placement. Foster care is thus quite common in the U.S., especially for historically disadvantaged racial/ethnic groups. Third, differences in foster care placement were minimal between the sexes, indicating that the high risks of foster care placement are shared almost equally by boys and girls. PMID:24671254

  12. Cumulative risks of foster care placement by age 18 for U.S. children, 2000-2011.

    Science.gov (United States)

    Wildeman, Christopher; Emanuel, Natalia

    2014-01-01

    Foster care placement is among the most tragic events a child can experience because it more often than not implies that a child has experienced or is at very high risk of experiencing abuse or neglect serious enough to warrant state intervention. Yet it is unclear how many children will experience foster care placement at some point between birth and age 18. Using synthetic cohort life tables and data from the Adoption and Foster Care Analysis and Reporting System (AFCARS), we estimated how many U.S. children were placed in foster care between birth and age 18, finding support for three conclusions. First, up to 5.91% of all U.S. children were ever placed in foster care between their birth and age 18. Second, Native American (up to 15.44%) and Black (up to 11.53%) children were at far higher risk of placement. Foster care is thus quite common in the U.S., especially for historically disadvantaged racial/ethnic groups. Third, differences in foster care placement were minimal between the sexes, indicating that the high risks of foster care placement are shared almost equally by boys and girls.

  13. Cumulative risks of foster care placement by age 18 for U.S. children, 2000-2011.

    Directory of Open Access Journals (Sweden)

    Christopher Wildeman

    Full Text Available Foster care placement is among the most tragic events a child can experience because it more often than not implies that a child has experienced or is at very high risk of experiencing abuse or neglect serious enough to warrant state intervention. Yet it is unclear how many children will experience foster care placement at some point between birth and age 18. Using synthetic cohort life tables and data from the Adoption and Foster Care Analysis and Reporting System (AFCARS, we estimated how many U.S. children were placed in foster care between birth and age 18, finding support for three conclusions. First, up to 5.91% of all U.S. children were ever placed in foster care between their birth and age 18. Second, Native American (up to 15.44% and Black (up to 11.53% children were at far higher risk of placement. Foster care is thus quite common in the U.S., especially for historically disadvantaged racial/ethnic groups. Third, differences in foster care placement were minimal between the sexes, indicating that the high risks of foster care placement are shared almost equally by boys and girls.

  14. Rationale and Development of a Security Assurance Index with Application toward the Development of a World Risk Index

    Energy Technology Data Exchange (ETDEWEB)

    M. M. Plum; G. A. Beitel, PhD

    2006-06-01

    Assurance categories were previously developed to support the Department of Homeland Security’s efforts in the mitigation of Cyber Control System events. Defined according to the risk of life and economic loss, the minimum range is designated by policy, whereas the maximum limit seems to be constrained only by limits and interdependencies of the event. Use of this life / assets scale has proven to be helpful in managing risk due to the scale's ease of use, communication, and understanding. Suggestions have been made that this scale could be applied to all events of terror, disaster, and calamity of an international scale, with equally good results. This paper presents the history of some existing scales of disaster and assurance, the rationale behind the development of the original Security Assurance Index, and our proposed scale of disaster and calamity as a World Risk Index.

  15. Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents

    Directory of Open Access Journals (Sweden)

    Patrícia Morais de Oliveira

    2016-03-01

    Full Text Available Abstract Objective: To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Methods: Cross-sectional study was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Results: Regarding the nutritional status, 66.5% of the adolescents had normal weight, 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents who had high serum triglycerides, body mass index and waist circumference. Conclusions: Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective.

  16. Body mass index and risk of Parkinson's disease: a prospective cohort study.

    Science.gov (United States)

    Logroscino, Giancarlo; Sesso, Howard D; Paffenbarger, Ralph S; Lee, I-Min

    2007-11-15

    High body mass index has been associated with increased risk of several chronic diseases, including cardiovascular disease, and, recently, Alzheimer's disease. There are few data on the association of body mass index with Parkinson's disease, and results have been inconsistent. The authors conducted a prospective study among 10,812 men in the Harvard Alumni Health Study, followed from 1988 to 1998 (mean age at baseline: 67.7 years), to test the hypothesis that body mass index is associated with Parkinson's disease risk. Among 106 incident cases of Parkinson's disease, body mass index at baseline was not associated with Parkinson's disease risk (for body mass index or =25.0 kg/m2: multivariate relative risks = 1.51 (95% confidence interval: 0.95, 2.40), 1.00 (referent), and 0.86 (95% confidence interval: 0.53, 1.41)). The authors had information on body mass index during late adolescence, when men entered college; this was unrelated to Parkinson's disease risk as well. Subjects who lost at least 0.5 units of body mass index per decade between college entry and 1988 had a significantly increased Parkinson's disease risk, compared with men having stable body mass index (multivariate relative risk = 2.60, 95% confidence interval: 1.10, 6.10). The authors conclude that body mass index is unrelated to Parkinson's disease risk and speculate that the observation of increased risk with body mass index loss since late adolescence may reflect weight loss due to Parkinson's disease that preceded clinical diagnosis.

  17. Idiosyncratic risk in the Dow Jones Eurostoxx50 Index

    Science.gov (United States)

    Daly, Kevin; Vo, Vinh

    2008-07-01

    Recent evidence by Campbell et al. [J.Y. Campbell, M. Lettau B.G. Malkiel, Y. Xu, Have individual stocks become more volatile? An empirical exploration of idiosyncratic risk, The Journal of Finance (February) (2001)] shows an increase in firm-level volatility and a decline of the correlation among stock returns in the US. In relation to the Euro-Area stock markets, we find that both aggregate firm-level volatility and average stock market correlation have trended upwards. We estimate a linear model of the market risk-return relationship nested in an EGARCH(1, 1)-M model for conditional second moments. We then show that traditional estimates of the conditional risk-return relationship, that use ex-post excess-returns as the conditioning information set, lead to joint tests of the theoretical model (usually the ICAPM) and of the Efficient Market Hypothesis in its strong form. To overcome this problem we propose alternative measures of expected market risk based on implied volatility extracted from traded option prices and we discuss the conditions under which implied volatility depends solely on expected risk. We then regress market excess-returns on lagged market implied variance computed from implied market volatility to estimate the relationship between expected market excess-returns and expected market risk.We investigate whether, as predicted by the ICAPM, the expected market risk is the main factor in explaining the market risk premium and the latter is independent of aggregate idiosyncratic risk.

  18. Development of a brief parent-report risk index for children following parental divorce.

    Science.gov (United States)

    Tein, Jenn-Yun; Sandler, Irwin N; Braver, Sanford L; Wolchik, Sharlene A

    2013-12-01

    This article reports on the development of a brief 15-item parent-report risk index (Child Risk Index for Divorced or Separated Families; CRI-DS) to predict problem outcomes of children who have experienced parental divorce. A series of analyses using 3 data sets were conducted that identified and cross-validated a parsimonious set of items representing parent report of child behavior problems and family level risk and protective factors, each of which contributed to the predictive accuracy of the index. The index predicted child behavior outcomes and substance abuse problems up to 6 years later. The index has acceptable levels of sensitivity and specificity as a screening measure to predict problem outcomes up to 1 year later. The use of the index to identify the need for preventive services is discussed, along with limitations of the study.

  19. Could Testosterone Replacement Therapy in Hypogonadal Men Ameliorate Anemia, a Cardiovascular Risk Factor? An Observational, 54-Week Cumulative Registry Study.

    Science.gov (United States)

    Zhang, Li Tao; Shin, Yu Seob; Kim, Ji Yong; Park, Jong Kwan

    2016-04-01

    In this study we investigated if testosterone undecanoate attenuates anemia and the risk of cardiovascular disease in patients with hypogonadism. A registry study consisted of 58 participants with a subnormal total testosterone level (less than 2.35 ng/ml) and at least mild symptoms of testosterone deficiency. All patients received an injection of 1,000 mg testosterone undecanoate at the initial visit, followed by injection at 6, 18, 30, 42 and 54 weeks. Serum hormones, hemoglobin, hematocrit, anemia risk factors, lipid profiles, whole blood viscosity and anthropometry were measured. Total testosterone (from mean ± SD 1.87 ± 1.09 to 5.52 ± 1.92 ng/ml, p testosterone (from 3.04 ± 2.03 to 7.23 ± 2.90 pg/ml, p testosterone undecanoate therapy. Hemoglobin and hematocrit significantly increased after testosterone undecanoate therapy by an average of 2.46 gm/dl (p testosterone undecanoate therapy (p = 0.047). A reduction in total cholesterol (from 165.89 ± 39.16 to 153.80 ± 154.27 mg/dl, p = 0.002), increased whole blood viscosity and increased hematocrit were observed until 54 weeks compared with baseline. However, whole blood viscosity and hematocrit stabilized after 18 weeks. After 54 weeks testosterone undecanoate decreased the prevalence of anemia and components of the metabolic syndrome. A longer duration of testosterone undecanoate therapy of more than 18 weeks may be effective and safe in reducing blood viscosity and improving anemia. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. Applying weather index insurance to agricultural pest and disease risks

    NARCIS (Netherlands)

    Norton, Michael; Sprundel, van Gert Jan; Turvey, Calum G.; Meuwissen, Miranda P.M.

    2016-01-01

    In this paper, we explore the application of weather index insurance to plant pest and disease management strategies using two distinct models: (1) insuring crop loss due to disease incidence (“Crop Insurance”) and (2) insuring the use of pesticides (“Pesticide Insurance”). We find that despite t

  1. Body mass index and risk of autoimmune diseases

    DEFF Research Database (Denmark)

    Harpsøe, Maria C; Basit, Saima; Andersson, Mikael;

    2014-01-01

    .57) and type 1 diabetes mellitus (HR 2.67; 95% CI, 1.71 to 4.17). Risk of dermatitis herpetiformis increased by 14% (95% CI, 1% to 30%) per BMI unit. Conversely, risk of celiac disease and Raynaud's phenomenon decreased by 7% (95% CI, 1% to 13%) and 12% (95% CI, 4% to 19%) per BMI unit, respectively. Further...

  2. Cumulative social disadvantage and child health.

    Science.gov (United States)

    Bauman, Laurie J; Silver, Ellen J; Stein, Ruth E K

    2006-04-01

    Disparities in child health are a major public health concern. However, it is unclear whether these are predominantly the result of low income, race, or other social risk factors that may contribute to their health disadvantage. Although others have examined the effects of the accumulation of risk factors, this methodology has not been applied to child health. We tested 4 social risk factors (poverty, minority race/ethnicity, low parental education, and not living with both biological parents) to assess whether they have cumulative effects on child health and examined whether access to health care reduced health disparities. We analyzed data on 57,553 children low parental education, and single-parent household) were consistently associated with child health. These were summed, generating the Social Disadvantage Index (range: 0-3). A total of 43.6% of children had no social disadvantages, 30.8% had 1, 15.6% had 2, and 10.0% had all 3. Compared with those with no social disadvantages, the odds ratios (ORs) of being in "good, fair, or poor health" (versus "excellent or very good") were 1.95 for 1 risk, 3.22 for 2 risks, and 4.06 for 3 risks. ORs of having a chronic condition increased from 1.25 (1 risk) to 1.60 (2 risks) to 2.11 (3 risks). ORs for activity limitation were 1.51 (1 risk) to 2.14 (2 risks) and 2.88 (3 risks). Controlling for health insurance did not affect these findings. The accumulation of social disadvantage among children was strongly associated with poorer child health and having insurance did not reduce the observed health disparities.

  3. Cumulative Estrogen Exposure and Prospective Memory in Older Women

    Science.gov (United States)

    Hesson, Jacqueline

    2012-01-01

    This study looked at cumulative lifetime estrogen exposure, as estimated with a mathematical index (Index of Cumulative Estrogen Exposure (ICEE)) that included variables (length of time on estrogen therapy, age at menarche and menopause, postmenopausal body mass index, time since menopause, nulliparity and duration of breastfeeding) known to…

  4. Modeling of Ship Collision Risk Index Based on Complex Plane and Its Realization

    Directory of Open Access Journals (Sweden)

    Xiaoqin Xu

    2016-07-01

    Full Text Available Ship collision risk index is the basic and important concept in the domain of ship collision avoidance. In this paper, the advantages and deficiencies of the various calculation methods of ship collision risk index are pointed out. Then the ship collision risk model based on complex plane, which can well make up for the deficiencies of the widely-used evaluation model proposed by Kearon.J and Liu ruru is proposed. On this basis, the calculation method of collision risk index under the encountering situation of multi-ships is constructed, then the three-dimensional image and spatial curve of the risk index are figured out. Finally, single chip microcomputer is used to realize the model. And attaching this single chip microcomputer to ARPA is helpful to the decision-making of the marine navigators.

  5. Cumulative effects of bamboo sawdust addition on pyrolysis of sewage sludge: Biochar properties and environmental risk from metals.

    Science.gov (United States)

    Jin, Junwei; Wang, Minyan; Cao, Yucheng; Wu, Shengchun; Liang, Peng; Li, Yanan; Zhang, Jianyun; Zhang, Jin; Wong, Ming Hung; Shan, Shengdao; Christie, Peter

    2017-03-01

    A novel type of biochar was produced by mixing bamboo sawdust with sewage sludge (1:1, w/w) via a co-pyrolysis process at 400-600°C. Changes in physico-chemical properties and the intrinsic speciation of metals were investigated before and after pyrolysis. Co-pyrolysis resulted in a lower biochar yield but a higher C content in the end product compared with use of sludge alone as the raw material. FT-IR analysis indicates that phosphine derivatives containing PH bonds were formed in the co-pyrolyzed biochars. In addition, co-pyrolysis of sludge with bamboo sawdust transformed the potentially toxic metals in the sludge into more stable fractions, leading to a considerable decrease in their direct toxicity and bioavailability in the co-pyrolyzed biochar. In conclusion, the co-pyrolysis technology provides a feasible method for the safe disposal of metal-contaminated sewage sludge in an attempt to minimize the environmental risk from potentially toxic metals after land application. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Performance assessment of the risk index category for surgical site infection after colorectal surgery.

    Science.gov (United States)

    Watanabe, Masanori; Suzuki, Hideyuki; Nomura, Satoshi; Hanawa, Hidetsugu; Chihara, Naoto; Mizutani, Satoshi; Yoshino, Masanori; Uchida, Eiji

    2015-02-01

    The traditional National Healthcare Safety Network (previously National Nosocomial Infections Surveillance) risk index is used to predict the risk of surgical site infection across many operative procedures. However, this index may be too simple to predict risk in the various procedures performed in colorectal surgery. The aim of this study was to evaluate the usefulness of the risk index by analyzing the impact of the risk index factors on surgical site infection after abdominal colorectal surgery. Using our surgical site infection surveillance database, we analyzed retrospectively 538 consecutive patients who underwent abdominal colorectal surgery between 2005 and 2010. Correlations between surgical site infection and the following risk index factors were analyzed: length of operation, American Society of Anesthesiologists score, wound classification, and use of laparoscopy. The 75th percentile for length of operation was determined separately for open and laparoscopic surgery in the study model. Univariate analyses showed that surgical site infection was more strongly associated with a >75th percentile length of operation in the study model (odds ratio [OR], 2.07) than in the traditional risk index model (OR, 1.64). Multivariable analysis found that surgical site infection was independently associated with a >75th percentile length of operation in the study model (OR, 2.75; 95% confidence interval [CI], 1.66-4.55), American Society of Anesthesiologists score ≥3 (OR, 2.22; 95% CI, 1.10-4.34), wound classification ≥III (OR, 5.29; 95% CI, 2.62-10.69), and open surgery (OR, 2.21; 95% CI, 1.07-5.17). Performance of the risk index category was improved in the study model compared with the traditional model. The risk index category is sufficiently useful for predicting the risk of surgical site infection after abdominal colorectal surgery. However, the 75th percentile length of operation should be set separately for open and laparoscopic surgery.

  7. A Late Life Risk Index for Severe Cognitive Impairment in Mexico.

    Science.gov (United States)

    Downer, Brian; Veeranki, Sreenivas P; Wong, Rebeca

    2016-03-08

    Several dementia risk indices have been developed for older adults in high-income countries. However, no index has been developed for populations in low- or middle-income countries. To create a risk index for predicting severe cognitive impairment among adults aged ≥60 in Mexico and to compare the accuracy of this index to the Dementia Screening Indicator (DSI). This study included 3,002 participants from the Mexican Health and Aging Study (MHAS) interviewed in 2001 and 2012. The MHAS risk index included sociodemographic, health, and functional characteristics collected in 2001. A point value based on the beta coefficients from a multivariable logistic regression model was assigned to each risk factor and the total score was calculated. The MHAS risk index (AUC = 0.74 95% CI = 0.70-0.77) and DSI (AUC = 0.72 95% CI = 0.69-0.77) had similar accuracy for discriminating between participants who developed severe cognitive impairment from those who did not. A score of ≥16 on the MHAS risk index had a sensitivity of 0.69 (95% CI = 0.64-0.70) and specificity of 0.67 (95% CI = 0.66-0.69). A score of ≥23 on the DSI had a sensitivity of 0.56 (95% CI = 0.50-0.63) and specificity of 0.78 (95% CI = 0.76-0.79). The MHAS risk index and DSI have moderate accuracy for predicting severe cognitive impairment among older adults in Mexico. This provides evidence that existing dementia risk indices may be applicable in low- and middle-income countries such as Mexico. Future research should seek to identify additional risk factors that can improve the accuracy of the MHAS risk index.

  8. Cumulative dietary exposure of the population of Denmark to pesticides

    DEFF Research Database (Denmark)

    Jensen, Bodil Hamborg; Petersen, Annette; Nielsen, Elsa

    2015-01-01

    We used the Hazard Index (HI) method to carry out a cumulative risk assessment after chronic dietary exposure to all monitored pesticides in fruit, vegetables and cereals for various consumer groups in Denmark. Residue data for all the pesticides were obtained from the Danish monitoring programme...... that included processing factors and set non-detects to ½ LOR, but limited the correction (Model 3), gave the most realistic exposure estimate. With Model 3 the HI was calculated to be 0.44 for children and 0.18 for adults, indicating that there is no risk of adverse health effects following chronic cumulative...... exposure to the pesticides found in fruit, vegetables and cereals on the Danish market. The HI was below 1 even for consumers who eat more than 550 g of fruit and vegetables per day, corresponding to 1/3 of the population. Choosing Danish-produced commodities whenever possible could reduce the HI...

  9. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  10. Potential Risk Estimation Drowning Index for Children (PREDIC): a pilot study from Matlab, Bangladesh.

    Science.gov (United States)

    Borse, N N; Hyder, A A; Bishai, D; Baker, T; Arifeen, S E

    2011-11-01

    Childhood drowning is a major public health problem that has been neglected in many low- and middle-income countries. In Matlab, rural Bangladesh, more than 40% of child deaths aged 1-4 years are due to drowning. The main objective of this paper was to develop and evaluate a childhood drowning risk prediction index. A literature review was carried out to document risk factors identified for childhood drowning in Bangladesh. The Newacheck model for special health care needs for children was adapted and applied to construct a childhood drowning risk index called "Potential Risk Estimation Drowning Index for Children" (PREDIC). Finally, the proposed PREDIC Index was applied to childhood drowning deaths and compared with the comparison group from children living in Matlab, Bangladesh. This pilot study used t-tests and Receiver Operating Characteristic (ROC) curve to analyze the results. The PREDIC index was applied to 302 drowning deaths and 624 children 0-4 years old living in Matlab. The results of t-test indicate that the drowned children had a statistically (t=-8.58, p=0.0001) significant higher mean PREDIC score (6.01) than those in comparison group (5.26). Drowning cases had a PREDIC score of 6 or more for 68% of the children however, the comparison group had 43% of the children with score of 6 or more which was statistically significant (t=-7.36, p<0.001). The area under the curve for the Receiver Operating Characteristic curve was 0.662. Index score construction was scientifically plausible; and the index is relatively complete, fairly accurate, and practical. The risk index can help identify and target high risk children with drowning prevention programs. PREDIC index needs to be further tested for its accuracy, feasibility and effectiveness in drowning risk reduction in Bangladesh and other countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Draught risk index tool for building energy simulations

    DEFF Research Database (Denmark)

    Vorre, Mette Havgaard; Jensen, Rasmus Lund; Nielsen, Peter V.

    2014-01-01

    Flow elements combined with a building energy simulation tool can be used to indicate areas and periods when there is a risk of draught in a room. The study tests this concept by making a tool for post-processing of data from building energy simulations. The objective is to show indications...

  12. Dietary glycemic load, glycemic index and colorectal cancer risk: Results from the Netherlands Cohort Study

    NARCIS (Netherlands)

    Weijenberg, M.P.; Mullie, P.F.F.; Brants, H.A.M.; Heinen, M.M.; Goldbohm, R.A.; Brandt, P.A. van den

    2008-01-01

    Since hyperinsulinemia is implicated in the development of colorectal cancer, determinants of serum insulin levels, like the glycemic load and the glycemic index of the diet, could influence cancer risk. Our objective was to evaluate whether a diet with a high glycemic load or glycemic index is asso

  13. Associations between Area-Level Unemployment, Body Mass Index, and Risk Factors for Cardiovascular Disease in an Urban Area

    Directory of Open Access Journals (Sweden)

    Lise Gauvin

    2009-12-01

    Full Text Available Introduction: Cardiovascular Disease (CVD has been linked to "neighbourhood" socioeconomic status (nSES, often operationalized as a composite index of aggregate income, occupation and education within predefined administrative boundaries. The role of specific, non-composite socioeconomic markers has not been clearly explained. It is also unclear whether the relationship between nSES and CVD varies according to sex. We sought to determine whether area-level unemployment (ALU was associated with CVD risk, and whether this association differed by sex. Methods: 342 individuals from the Montreal Neighbourhood Survey of Lifestyle and Health provided self-reported behavioural and socioeconomic information. A nurse collected biochemical and anthropometric data. ALU, a weighted average of the proportion of persons 15-years and older available for but without work, was measured using a Geographic Information System for a 250 m buffer centred on individual residence. Generalized Estimating Equations were used to estimate the associations between ALU, body mass index (BMI and a cumulative score for total cardiometabolic risk (TCR. Results: After confounder adjustments, the mean 4th minus 1st quartile difference in BMI was 3.19 kg/m2 (95% CI: 2.39, 3.99, while the prevalence ratio for the 4th relative to 1st quartile for TCR was 2.20 (95 % CI: 1.53, 3.17. Sex interacted with ALU; women relative to men had greater mean 3.97 kg/m2 (95% CI: 2.08, 5.85 BMI and greater mean TCR 1.51 (95% CI: 0.78, 2.90, contrasted at mean ALU. Conclusions: Area-level unemployment is associated with greater CVD risk, and this association is stronger for women.

  14. The effect of elevated body mass index on ischemic heart disease risk

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Palmer, Tom M; Benn, Marianne

    2012-01-01

    Adiposity, assessed as elevated body mass index (BMI), is associated with increased risk of ischemic heart disease (IHD); however, whether this is causal is unknown. We tested the hypothesis that positive observational associations between BMI and IHD are causal.......Adiposity, assessed as elevated body mass index (BMI), is associated with increased risk of ischemic heart disease (IHD); however, whether this is causal is unknown. We tested the hypothesis that positive observational associations between BMI and IHD are causal....

  15. American Society of Anesthesiologists Classification Versus ARISCAT Risk Index: Predicting Pulmonary Complications Following Renal Transplant.

    Science.gov (United States)

    Kupeli, Elif; Er Dedekarginoglu, Balam; Ulubay, Gaye; Oner Eyuboglu, Fusun; Haberal, Mehmet

    2017-02-01

    Patients with chronic renal failure are prone to pulmonary complications. Renal transplant recipients should undergo complete preoperative evaluation to determine risk of postoperative pulmonary complications. The American Society of Anesthesiologists classification and the Assess Respiratory Risk in Surgical Patients in Catalonia risk index correlate well with incidence of postoperative pulmonary complications. Here, we compared their accuracy in predicting pulmonary complications following renal transplant. We retrospectively reviewed medical records of renal transplant recipients between years 2004 and 2015. We collected patient data on Assess Respiratory Risk in Surgical Patients in Catalonia risk index, including demographics, smoking history, comorbidities, preoperative pulmonary risk score, laboratory results, surgery information, history of lower respiratory tract infection 1 month pretransplant, urgency of surgery, American Society of Anesthesiologists classification, and pulmonary complications within 1 month posttransplant. Of 172 patients (123 males; mean age 38.82 y), 22 (12.8%) developed pulmonary complication during the first month posttransplant, including effusion (9 patients), pneumonia (10 patients), respiratory inefficiency (2 patients), and pulmonary embolism (1 patient). Atelectasis was observed in 95.4% of patients with complications. A positive correlation was observed between age and development of complications (r = 0.171; P = .025). Regarding risk score, 75% of patients at high risk and 19.5% at intermediate risk developed pulmonary complications. Patients with low-risk scores had significantly lower complications than intermediate- and high-risk groups (P Catalonia risk index.

  16. The Procedural Index for Mortality Risk (PIMR: an index calculated using administrative data to quantify the independent influence of procedures on risk of hospital death

    Directory of Open Access Journals (Sweden)

    Wong Jenna

    2011-10-01

    Full Text Available Abstract Background Surgeries and other procedures can influence the risk of death in hospital. All published scales that predict post-operative death risk require clinical data and cannot be measured using administrative data alone. This study derived and internally validated an index that can be calculated using administrative data to quantify the independent risk of hospital death after a procedure. Methods For all patients admitted to a single academic centre between 2004 and 2009, we estimated the risk of all-cause death using the Kaiser Permanente Inpatient Risk Adjustment Methodology (KP-IRAM. We determined whether each patient underwent one of 503 commonly performed therapeutic procedures using Canadian Classification of Interventions codes and whether each procedure was emergent or elective. Multivariate logistic regression modeling was used to measure the association of each procedure-urgency combination with death in hospital independent of the KP-IRAM risk of death. The final model was modified into a scoring system to quantify the independent influence each procedure had on the risk of death in hospital. Results 275 460 hospitalizations were included (137,730 derivation, 137,730 validation. In the derivation group, the median expected risk of death was 0.1% (IQR 0.01%-1.4% with 4013 (2.9% dying during the hospitalization. 56 distinct procedure-urgency combinations entered our final model resulting in a Procedural Index for Mortality Rating (PIMR score values ranging from -7 to +11. In the validation group, the PIMR score significantly predicted the risk of death by itself (c-statistic 67.3%, 95% CI 66.6-68.0% and when added to the KP-IRAM model (c-index improved significantly from 0.929 to 0.938. Conclusions We derived and internally validated an index that uses administrative data to quantify the independent association of a broad range of therapeutic procedures with risk of death in hospital. This scale will improve risk

  17. Dietary glycemic index, glycemic load, and risk of cancer: a prospective cohort study.

    Science.gov (United States)

    George, Stephanie Materese; Mayne, Susan T; Leitzmann, Michael F; Park, Yikyung; Schatzkin, Arthur; Flood, Andrew; Hollenbeck, Albert; Subar, Amy F

    2009-02-15

    Previous studies have provided limited evidence for a harmful effect of high glycemic index and dietary glycemic load on cancer. The authors analyzed associations among glycemic index, glycemic load, and risk of cancer in women and men in the National Institutes of Health-AARP Diet and Health Study. Published glycemic index values were assigned to 225 foods/food groups. Glycemic load was calculated by multiplying the glycemic index, carbohydrate content, and intake frequency of individual foods reported on a food frequency questionnaire. From 1995 through 2003, the authors identified 15,215 and 33,203 cancer cases in women and men, respectively. Cox proportional hazards models were used to estimate multivariate relative risks and 95% confidence intervals. For women and men, respectively, the relative risks for total cancer for high versus low glycemic index were 1.03 (P(trend)=0.217) and 1.04 (P(trend)=0.012) and, for glycemic load, were 0.90 (P(trend)=0.024) and 0.93 (P(trend)=0.01). Associations with total cancer held only among the overweight for glycemic index and among those of healthy weight for glycemic load. These findings suggest that glycemic index and glycemic load are not strong predictors of cancer incidence. The direction and small magnitude of associations might be explained by the manner in which high glycemic index and glycemic load track with overall diet and lifestyle patterns.

  18. Improving Sharia Risk Compliance: Proposing Daily Index for Mudharaba Contract in Islamic Banks in Indonesia

    Directory of Open Access Journals (Sweden)

    Laode Hasahu

    2012-01-01

    Full Text Available Objective – The objective of this paper is to analyze the profit distribution method applied in Islamic banks in Indonesia and to propose better method in order to improve sharia risk compliance.Methods – Employing a descriptive quantitative method and literature review. This paper evaluate weaknesses of the current profit distribution method and proposes daily revenue index to solve the problems arising from using current method which is unfairness between bank and customers.Results – By the two current profit distribution methods which use monthly revenue index calculated only at the end of the month, there are potential injustices occur. Therefore, instead of using monthly index, daily index is proposed. There are two steps in calculating profit distribution by using daily revenue index: (1 Accumulating Source of Fund (SoF, Reserve Requirement (RR, and Source of Fund after Reserve Requirement (SoFaRR, and (2 Determining Average Financing (AF, Revenue Index (RI, Cost Index (CI, Revenue Sharing Index (RSI, and Profit Sharing Index (PSI.Conclusion - Daily revenue index will solve the unfairness problems arise from current profit distribution method applied in Islamic banks. Daily revenue index is also applicable if Islamic banks apply profit and loss sharing instead of revenue sharing.

  19. Nutritional risk index is predictor of postoperative complications in operations of digestive system or abdominal wall?

    Science.gov (United States)

    Thieme, Rubia Daniela; Cutchma, Gislaine; Chieferdecker, Maria Eliana Madalozzo; Campos, Antônio Carlos Ligocki

    2013-01-01

    Malnutrition can be considered the most common disease in hospitals due to its high prevalence. To investigate the methods of evaluation of the nutritional status that better correlate with postoperative complications and the length of hospital stay in patients submitted to gastrointestinal or abdominal wall surgeries. This is a retrospective evaluation of 215 nutritional assessment records. All were submitted to traditional anthropometry (weight, height, BMI, arm circumference, triceps skinfold thickness and mid-arm muscle circumference), subjective global assessment, serum albumin and lymphocyte count. Nutritional risk index was also calculated. A total of 125 patients were included. Malnutrition was diagnosed by mid-arm muscle circumference, nutritional risk index and subjective global assessment in 46%, 88% and 66%, respectively. Severe malnutrition was found in 17,6% if considered subjective global assessment and in 42% by the nutritional risk index. Oncologic patients had a worst nutritional status according to this index (5,42 less units). There was a negative correlation between occurrence the noninfectious postoperative complications with the nutritional risk index (p=0,0016). Similarly, lower serum albumin levels were associated with higher non infectious complications (p=0,0015). The length of hospital stay was, in average, 14,24 days less in patients without complications as compared with non infectious postoperative complications (p<0,05). Nutritional risk index and serum albumin are the parameters with the best capacity to predict the occurrence of non infectious postoperative complications and the length of hospital stay was higher to this patients.

  20. UBIQUITOUS POLLUTANTS FROM CUMULATIVE ...

    Science.gov (United States)

    The occurrence of pharmaceuticals and personal care products (PPCPS) as environmental pollutants is a multifaceted issue whose scope continues to become better delineated since the escalation of concerted attention beginning in the 1980s. PPCPs typically occur as trace environmental pollutants (primarily in surface but also in ground waters) as a result of their widespread, continuous, combined usage in a broad range of human and veterinary therapeutic activities and practices. With respect to the risk-assessment paradigm, the growing body of published work has focused primarily on the origin and occurrence of these substances. Comparatively less is known about human and ecological exposure, and even less about the known or even potential hazards associated with exposure to these anthropogenic substances, many of which are highly bioactive. The continually growing, worldwide importance of freshwater resources underscores the need for ensuring that any aggregate or cumulative impacts on water supplies and resultant potential for human or ecological exposure be minimized. This has prompted the more recent investigations on waste treatment processes for one of the major sources of environmental disposition, namely sewage. Despite the paucity of health effects data for long-term, simultaneous exposure to multiple xenobiotics (particularly PPCPS) at low doses (a major toxicological issue that can be described by the

  1. Risk preference or financial literacy? Behavioural experiment on index insurance demand

    NARCIS (Netherlands)

    Awel, Y.; Azomahou, T.T.

    2015-01-01

    We use unique cross-sectional household data from Ethiopia to investigate the effect of risk preference, financial literacy and other socio-economic characteristics on demand for index insurance. We measure risk preference based on survey experiments using lottery choice game with real monetary priz

  2. Childhood body mass index in relation to future risk of oesophageal adenocarcinoma

    DEFF Research Database (Denmark)

    Cook, M B; Freedman, N D; Gamborg, M;

    2015-01-01

    BACKGROUND: Middle-aged obese adults are at substantially elevated risk of oesophageal adenocarcinoma. It is unclear whether this risk originates earlier in life. METHODS: We assessed associations between childhood body mass index (BMI) and height-measured annually between ages 7 and 13-with adul...

  3. Enviromentally sensitive patch index of desertification risk applied to the main habitats of Sicily

    Science.gov (United States)

    Duro, A.; Piccione, V.; Ragusa, M. A.; Rapicavoli, V.; Veneziano, V.

    2017-07-01

    The authors applied the MEDALUS - Mediterranean Desertification and Land Use - procedure to the most representative sicilian habitat by extension, socio-economic and environmental importance, in order to assess the risk of desertification. Thanks to the ESPI, Environmentally Sensitive Patch Index, in this paper the authors estimate the current and future regional levels of desertification risk.

  4. A meta-analysis of the association of fracture risk and body mass index in women

    NARCIS (Netherlands)

    Johansson, Helena; Kanis, John A; Odén, Anders; McCloskey, Eugene; Chapurlat, Roland D; Christiansen, Claus; Cummings, Steve R; Diez-Perez, Adolfo; Eisman, John A; Fujiwara, Saeko; Glüer, Claus-C; Goltzman, David; Hans, Didier; Khaw, Kay-Tee; Krieg, Marc-Antoine; Kröger, Heikki; LaCroix, Andrea Z; Lau, Edith; Leslie, William D; Mellström, Dan; Melton, L Joseph; O'Neill, Terence W; Pasco, Julie A; Prior, Jerilynn C; Reid, David M; Rivadeneira, Fernando; van Staa, Tjerd; Yoshimura, Noriko; Zillikens, M Carola; van Staa, Tjeerd

    2014-01-01

    Several recent studies suggest that obesity may be a risk factor for fracture. The aim of this study was to investigate the association between body mass index (BMI) and future fracture risk at different skeletal sites. In prospective cohorts from more than 25 countries, baseline data on BMI were av

  5. Determinants of the omega-3 index in a Mediterranean population at increased risk for CHD.

    OpenAIRE

    Sala Vila, Aleix; Harris, William S.; Cofán Pujol, Montserrat; Pérez-Heras, Ana Maria; Pintó Sala, Xavier; Lamuela Raventós, Rosa Ma.; Covas Planells, María Isabel; Estruch Riba, Ramon; Ros Rahola, Emilio

    2011-01-01

    The omega-3 index, defined as the sum of EPA and DHA in erythrocyte membranes expressed as a percentage of total fatty acids, has been proposed as both a risk marker and risk factor for CHD death. A major determinant of the omega-3 index is EPA þ DHA intake, but the impact of other dietary fatty acids has not been investigated. In a cross-sectional study on 198 subjects (102 men and 96 women, mean age 66 years) at high cardiovascular risk living in Spain, the country with low rates of cardiac...

  6. Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children☆

    Science.gov (United States)

    Gonçalves, Reginaldo; Szmuchrowski, Leszek Antony; Damasceno, Vinícius Oliveira; de Medeiros, Marcelo Lemos; Couto, Bruno Pena; Lamounier, Joel Alves

    2014-01-01

    Objective: To identify the association between both, body mass index and aerobic fitness, with cardiovascular disease risk factors in children. Methods: Cross-sectional study, carried out in Itaúna-MG, in 2010, with 290 school children ranging from 6 to 10 years-old of both sexes, randomly selected. Children from schools located in the countryside and those with medical restrctions for physical activity were not included. Blood sample was collected after a 12-hour fasting period. Blood pressure, stature and weight were evaluated in accordance with international standards. The following were considered as cardiovascular risk factors: high blood pressure, high total cholesterol, LDL, triglycerides and insulin levels, and low HDL. The statistical analysis included the Spearman's coefficient and the logistic regression, with cardiovascular risk factors as dependent variables. Results: Significant correlations were found, in both sexes, among body mass index and aerobic fitness with most of the cardiovascular risk factors. Children of both sexes with body mass index in the fourth quartile demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Moreover, girls with aerobic fitness in the first quartile also demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Conclusion: The significant associations and the increased chances of having cardiovascular risk factors in children with less aerobic fitness and higher levels of body mass index justify the use of these variables for health monitoring in Pediatrics. PMID:25479851

  7. [Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children].

    Science.gov (United States)

    Gonçalves, Reginaldo; Szmuchrowski, Leszek Antony; Damasceno, Vinícius Oliveira; de Medeiros, Marcelo Lemos; Couto, Bruno Pena; Lamounier, Joel Alves

    2014-09-01

    To identify the association between both, body mass index and aerobic fitness, with cardiovascular disease risk factors in children. Cross-sectional study, carried out in Itaúna-MG, in 2010, with 290 school children ranging from 6 to 10 years-old of both sexes, randomly selected. Children from schools located in the countryside and those with medical restrctions for physical activity were not included. Blood sample was collected after a 12-hour fasting period. Blood pressure, stature and weight were evaluated in accordance with international standards. The following were considered as cardiovascular risk factors: high blood pressure, high total cholesterol, LDL, triglycerides and insulin levels, and low HDL. The statistical analysis included the Spearman's coefficient and the logistic regression, with cardiovascular risk factors as dependent variables. Significant correlations were found, in both sexes, among body mass index and aerobic fitness with most of the cardiovascular risk factors. Children of both sexes with body mass index in the fourth quartile demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Moreover, girls with aerobic fitness in the first quartile also demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. The significant associations and the increased chances of having cardiovascular risk factors in children with less aerobic fitness and higher levels of body mass index justify the use of these variables for health monitoring in Pediatrics. Copyright © 2014 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  8. Association of Pre-Pregnancy Body Mass Index, Pregnancy-Related Weight Changes, and Parity With the Risk of Developing Degenerative Musculoskeletal Conditions

    DEFF Research Database (Denmark)

    Bliddal, Mette; Pottegård, Anton; Kirkegaard, Helene;

    2016-01-01

    Objective To examine how pre-pregnancy body mass index (BMI), parity, and pregnancy-related weight changes are associated with long-term risk of degenerative musculoskeletal conditions. Methods A total of 79,687 mothers with singleton births from the Danish National Birth Cohort were included....... Information on height and weight prior to pregnancy and 6 months postpartum as well as gestational weight gain (GWG) was obtained from telephone interviews, while parity was derived from the Danish Medical Birth Registry. Diagnoses of musculoskeletal conditions, including osteoarthritis, disc disorders, low...... back pain, and soft tissue disorders, were obtained from the Danish National Patient Registry. Hazard ratios (HRs) were estimated using a Cox proportional hazards regression model. Results The cumulative incidence of musculoskeletal conditions during a median follow-up of 12.4 years was 19.7%. The risk...

  9. Childhood Obesity Risk Evaluation based on perinatal factors and family sociodemographic characteristics: CORE index.

    Science.gov (United States)

    Manios, Yannis; Birbilis, Manolis; Moschonis, George; Birbilis, George; Mougios, Vassilis; Lionis, Christos; Chrousos, George P

    2013-04-01

    The aim of this study was to develop an index that estimates late childhood obesity risk based on certain perinatal and family sociodemographic characteristics. The study was cross-sectional with retrospectively collected data from a representative sample of 2,294 primary schoolchildren, aged 9-13 years, in four counties from north, west, central, and south Greece. Mother's prepregnancy weight status, maternal smoking during pregnancy, maternal educational level, and infant weight gain in the first 6 months of life were combined with children's gender for the development of the Childhood Obesity Risk Evaluation (CORE) index. The score of the CORE index ranged from 0 to 11 units and each unit was associated with an obesity risk probability (range, 4-40 %). Cutoff point analysis revealed that a score ≤ 5 units best discriminated obese from non-obese children. On the basis of this cutoff point, the sensitivity of the CORE index was 54 % and the corresponding specificity 65 %. The proposed CORE index and the relevant percent risk probability chart could be used by pediatricians and other health professionals to identify children at high risk for obesity from early life. This simple and inexpensive tool could be useful in assisting early childhood obesity preventing initiatives.

  10. ENSO-Based Index Insurance: Approach and Peru Flood Risk Management Application

    Science.gov (United States)

    Khalil, A. F.; Kwon, H.; Lall, U.; Miranda, M. J.; Skees, J. R.

    2006-12-01

    Index insurance has recently been advocated as a useful risk transfer tool for disaster management situations where rapid fiscal relief is desirable, and where estimating insured losses may be difficult, time consuming, or subject to manipulation and falsification. For climate related hazards, a rainfall or temperature index may be proposed. However, rainfall may be highly spatially variable relative to the gauge network, and in many locations data are inadequate to develop an index due to short time-series and the spatial dispersion of stations. In such cases, it may be helpful to consider a climate proxy index as a regional rainfall index. This is particularly useful if a long record is available for the climate index through an independent source and it is well correlated with the regional rainfall hazard. Here, ENSO related climate indices are explored for use as a proxy to extreme rainfall in one of the departments of Peru -- Piura. The ENSO index insurance product may be purchased by banks or microfinance institutions (MFIs) to aid agricultural damage relief in Peru. Crop losses in the region are highly correlated with floods, but are difficult to assess directly. Beyond agriculture, many other sectors suffer as well. Basic infrastructure is destroyed during the most severe events. This disrupts trade for many micro-enterprises. The reliability and quality of the local rainfall data is variable. Averaging the financial risk across the region is desirable. Some issues with the implementation of the proxy ENSO index are identified and discussed. Specifically, we explore (a) the reliability of the index at different levels of probability of exceedance of maximum seasonal rainfall; (b) the potential for clustering of payoffs; (c) the potential that the index could be predicted with some lead time prior to the flood season; and (d) evidence for climate change or non-stationarity in the flood exceedance probability from the long ENSO record. Finally, prospects for

  11. Money laundering regulatory risk evaluation using Bitmap Index-based Decision Tree

    Directory of Open Access Journals (Sweden)

    Vikas Jayasree

    2017-06-01

    Full Text Available This paper proposes to evaluate the adaptability risk in money laundering using Bitmap Index-based Decision Tree (BIDT technique. Initially, the Bitmap Index-based Decision Tree learning is used to induce the knowledge tree which helps to determine a company’s money laundering risk and improve scalability. A bitmap index in BIDT is used to effectively access large banking databases. In a BIDT bitmap index, account in a table is numbered in sequence with each key value, account number and a bitmap (array of bytes used instead of a list of row ids. Subsequently, BIDT algorithm uses the “select” query performance to apply count and bit-wise logical operations on AND. Query result coincides exactly to build a decision tree and more precisely to evaluate the adaptability risk in the money laundering operation. For the root node, the main account of the decision tree, the population frequencies are obtained by simply counting the total number of “1” in the bitmaps constructed on the attribute to predict money laundering and evaluate the risk factor rate. The experiment is conducted on factors such as regulatory risk rate, false positive rate, and risk identification time.

  12. A comparison of the environmental impact of different AOPs: risk indexes.

    Science.gov (United States)

    Giménez, Jaime; Bayarri, Bernardí; González, Óscar; Malato, Sixto; Peral, José; Esplugas, Santiago

    2014-12-31

    Today, environmental impact associated with pollution treatment is a matter of great concern. A method is proposed for evaluating environmental risk associated with Advanced Oxidation Processes (AOPs) applied to wastewater treatment. The method is based on the type of pollution (wastewater, solids, air or soil) and on materials and energy consumption. An Environmental Risk Index (E), constructed from numerical criteria provided, is presented for environmental comparison of processes and/or operations. The Operation Environmental Risk Index (EOi) for each of the unit operations involved in the process and the Aspects Environmental Risk Index (EAj) for process conditions were also estimated. Relative indexes were calculated to evaluate the risk of each operation (E/NOP) or aspect (E/NAS) involved in the process, and the percentage of the maximum achievable for each operation and aspect was found. A practical application of the method is presented for two AOPs: photo-Fenton and heterogeneous photocatalysis with suspended TiO2 in Solarbox. The results report the environmental risks associated with each process, so that AOPs tested and the operations involved with them can be compared.

  13. A Comparison of the Environmental Impact of Different AOPs: Risk Indexes

    Directory of Open Access Journals (Sweden)

    Jaime Giménez

    2014-12-01

    Full Text Available Today, environmental impact associated with pollution treatment is a matter of great concern. A method is proposed for evaluating environmental risk associated with Advanced Oxidation Processes (AOPs applied to wastewater treatment. The method is based on the type of pollution (wastewater, solids, air or soil and on materials and energy consumption. An Environmental Risk Index (E, constructed from numerical criteria provided, is presented for environmental comparison of processes and/or operations. The Operation Environmental Risk Index (EOi for each of the unit operations involved in the process and the Aspects Environmental Risk Index (EAj for process conditions were also estimated. Relative indexes were calculated to evaluate the risk of each operation (E/NOP or aspect (E/NAS involved in the process, and the percentage of the maximum achievable for each operation and aspect was found. A practical application of the method is presented for two AOPs: photo-Fenton and heterogeneous photocatalysis with suspended TiO2 in Solarbox. The results report the environmental risks associated with each process, so that AOPs tested and the operations involved with them can be compared.

  14. Index models to evaluate the risk of phosphorus and nitrogen loss at catchment scales.

    Science.gov (United States)

    Drewry, J J; Newham, L T H; Greene, R S B

    2011-03-01

    This paper investigates index models as a tool to estimate the risk of N and P source strengths and loss at the catchment scale. The index models assist managers in improving the focus of remediation actions that reduce nutrient delivery to waterbodies. N and P source risk factors (e.g. soil nutrient concentrations) and transport risk factors (e.g. distance-to-streams) are used to determine the overall risk of nutrient loss for a case study in the Tuross River catchment of coastal southeast Australia. In the development of the N index model for Tuross, particulate N was considered important based on the observed event water quality data. In contrast to previous N index models, erosion and contributing distance were therefore included in the Tuross River catchment N index. Event-based water quality monitoring, and soil information, or in data-poor catchments conceptual understanding, are essential to represent catchment-scale processes. The techniques have high applicability in other catchments, and are complementary to other modelling techniques such as process-based semi-distributed modelling. Index models generally provide much more detailed spatial resolution than fully- or semi-distributed conceptual modelling approaches. Semi-distributed models can be used to quantify nutrient loads and provide overall direction to set the broad focus of management. Index models can then be used to refine on-the-ground investigations and investment priorities. In this way semi-distributed models can be combined with index models to provide a set of powerful tools to influence management decisions and outcomes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Glycemic Index, Carbohydrates, Glycemic Load, and the Risk of Pancreatic Cancer in a Prospective Cohort Study

    OpenAIRE

    2009-01-01

    Diets with high glycemic index and glycemic load have been associated with insulin resistance. Insulin resistance has been implicated in the etiology of pancreatic cancer. We prospectively investigated the associations between glycemic index, carbohydrates, glycemic load, and available carbohydrates dietary constituents (starch and simple sugar) intake and the risk of pancreatic cancer. We followed the participants in the NIH-AARP Diet and Health Study from 1995/1996 through December 2003. A ...

  16. Business risk assessment of the companies on the Mexican Stock Exchange’s sustainable index

    Directory of Open Access Journals (Sweden)

    José Antonio Morales Castro

    2014-12-01

    Full Text Available (Received: 2014/10/27 - Accepted: 2014/12/15This work evaluated the business risk change of 20 companies included on the sustainable index of the Mexican Stock Exchange (BMV. The unlevered beta coefficient was used for this analysis. Two periods were compared: the one before, and the one after including the companies on the index. For each of the 20 companies it was used financial information, stocks closing prices and the stock market index value, over a period of 234 weeks. Then, considering the two periods, the statistical difference between the unlevered beta coefficient averages was calculated. Finally, a hypothesis proof was made to evaluate the business risk change. It was found that for 12 out of the 20 companies, the unlevered beta coefficient suffered a reduction. The findings suggest that it is not enough for the companies to certify as sustainable in order to reduce its business risk.

  17. Low ankle-brachial index predicts early risk of recurrent stroke in patients with acute cerebral ischemia.

    Science.gov (United States)

    Tsivgoulis, Georgios; Bogiatzi, Chrysi; Heliopoulos, Ioannis; Vadikolias, Konstantinos; Boutati, Eleni; Tsakaldimi, Soultana; Al-Attas, Omar S; Charalampidis, Paris; Piperidou, Charitomeni; Maltezos, Efstratios; Papanas, Nikolaos

    2012-02-01

    Low ankle-brachial blood pressure index (ABI) identifies patients with symptomatic and asymptomatic peripheral arterial disease (PAD). We sought to investigate the association of low ABI with early risk of stroke recurrence in patients with acute cerebral ischemia (ACI) and without history of symptomatic PAD. Consecutive patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) and no previous history of PAD were prospectively evaluated with ABI measurements. Demographic characteristics, vascular risk factors and secondary prevention therapies were documented. An ABI ≤0.90 in either leg was considered as evidence of asymptomatic PAD, and an ABI >0.90 was considered as normal. Patients with elevated ABI (>1.30) were excluded. The outcome of interest was recurrent stroke during 30-day follow-up. A total of 176 patients with acute cerebral ischemia (mean age 64±14 years, 59.1% men, 76.7% AIS) were evaluated. Asymptomatic PAD was detected in 14.8% (95%CI: 10.2-20.8%) of the studied population. The following factors were independently associated with low ABI on multivariate logistic regression models, after adjustment for potential confounders: coronary artery disease (p=0.008), diabetes mellitus (p=0.017) and increasing age (p=0.042). The cumulative 30-day recurrence rate was higher in patients with low ABI (19.2%; 95%CI: 4.1-34.3) compared to the rest (3.3%; 95%CI: 0.4-6.2%; p=0.001). Atherothrombotic stroke (ASCO grade I; pstroke recurrence on multivariate Cox regression models adjusting for confounders. Low ABI appears to be associated with a higher risk of early recurrent stroke in patients with ACI and no history of symptomatic PAD. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Ecological risks of trace metals in Guanabara Bay, Rio de Janeiro, Brazil: An index analysis approach.

    Science.gov (United States)

    de Carvalho Aguiar, Valquiria Maria; de Lima, Michelle Nunes; Abuchacra, Rodrigo Coutinho; Abuchacra, Paula Ferreira Falheiro; Neto, José Antônio Baptista; Borges, Heloísa Vargas; de Oliveira, Vitor Calôr

    2016-11-01

    Total concentrations of Ni, Cr, Cu, Pb and Zn were determined in surface sediments from 30 stations in Guanabara Bay in 1999 and 2008. An approach using various environmental indices was used to assess contamination status of metals. This approach allowed the comparison with different coastal areas. Background Enrichment Index, Contamination index and Ecological Risk index (Pollution Load Index; Sediment Quality Guideline Quotient and Ecological Risk Index) were calculated for the metals. Results revealed a great load of organic matter and significant increases in Cu and Pb levels between 1999 and 2008. The concentrations of Cr and Zn were of great concern, surpassing the values of Probable Effect Level reference values. In spite of the differences of each index, results effectively revealed the striking contamination in Guanabara Bay concerning trace metals, and also suggested potential risk to local biota. The contamination of the northwest area was notably higher than the rest of the bay. In comparison with some other coastal bays around the world, Guanabara Bay stood out as a remarkably contaminated environment. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Dietary glycemic index and glycemic load, and breast cancer risk: a case-control study.

    Science.gov (United States)

    Augustin, L S; Dal Maso, L; La Vecchia, C; Parpinel, M; Negri, E; Vaccarella, S; Kendall, C W; Jenkins, D J; Francesch, S

    2001-11-01

    Certain types of carbohydrates increase glucose and insulin levels to a greater extent than others. In turn, insulin may raise levels of insulin-like growth factors, which may influence breast cancer risk. We analyzed the effect of type and amount of carbohydrates on breast cancer risk, using the glycemic index and the glycemic load measures in a large case-control study conducted in Italy. Cases were 2,569 women with incident, histologically-confirmed breast cancer interviewed between 1991 and 1994. Controls were 2588 women admitted to the same hospital network for a variety of acute, non-neoplastic conditions. Average daily glycemic index and glycemic load were calculated from a validated 78-item food frequency questionnaire. Direct associations with breast cancer risk emerged for glycemic index (odds ratio, OR for highest vs. lowest quintile = 1.4; P for trend breast cancer (OR = 1.3) while the intake of pasta, a medium glycemic index food, seemed to have no influence (OR = 1.0). Findings were consistent across different strata of menopausal status, alcohol intake, and physical activity level. This study supports the hypothesis of moderate, direct associations between glycemic index or glycemic load and breast cancer risk and, consequently, a possible role of hyperinsulinemia/insulin resistance in breast cancer development.

  20. Body mass index, waist circumference, body adiposity index, and risk for type 2 diabetes in two populations in Brazil: general and Amerindian.

    Directory of Open Access Journals (Sweden)

    Rafael de Oliveira Alvim

    Full Text Available The use of the anthropometric indices of adiposity, especially body mass index and waist circumference in the prediction of diabetes mellitus has been widely explored. Recently, a new body composition index, the body adiposity index was proposed. The aim of this study was to compare the effectiveness of body mass index, waist circumference, and body adiposity index in the risk assessment for type 2 diabetes mellitus.A total of 1,572 individuals from the general population of Vitoria City, Brazil and 620 Amerindians from the Aracruz Indian Reserve, Brazil were randomly selected. BMI, waist circumference, and BAI were determined according to a standard protocol. Type 2 diabetes mellitus was diagnosed by the presence of fasting glucose ≥126 mg/dL or by the use of antidiabetic drugs.The area under the curve was similar for all anthropometric indices tested in the Amerindian population, but with very different sensitivities or specificities. In women from the general population, the area under the curve of waist circumference was significantly higher than that of the body adiposity index. Regarding risk assessment for type 2 diabetes mellitus, the body adiposity index was a better risk predictor than body mass index and waist circumference in the Amerindian population and was the index with highest odds ratio for type 2 diabetes mellitus in men from the general population, while in women from the general population waist circumference was the best risk predictor.Body adiposity index was the best risk predictor for type 2 diabetes mellitus in the Amerindian population and men from the general population. Our data suggest that the body adiposity index is a useful tool for the risk assessment of type 2 diabetes mellitus in admixture populations.

  1. Body mass index and risk of gastric cancer: a meta-analysis.

    Science.gov (United States)

    Lin, Xue-Jun; Wang, Chun-Peng; Liu, Xiao-Dong; Yan, Kang-Kang; Li, Shuang; Bao, Hong-Hong; Zhao, Long-Yu; Liu, Xin

    2014-09-01

    Overweight and obesity, indicated as increased body mass index, are associated with the risk of some cancers. We carried out a meta-analysis on published cohort and case-control studies to assess the strength of association between body mass index and gastric cancer. Relevant studies were identified through PubMed, Web of Science and Medline electronic databases. Adjusted relative risks (odds ratios) with 95% confidence interval were used to assess the strength of association between body mass index and gastric cancer. Sixteen eligible studies were included in this meta-analysis. Overall, obesity (body mass index ≥ 30 kg/m(2)) was associated with an increased risk of gastric cancer (odds ratio = 1.13, 95% confidence interval = 1.03-1.24) compared with normal weight (body mass index = 18.5 to obesity and the increased risk of gastric cancer for males (odds ratio = 1.27, 95% confidence interval = 1.09-1.48), non-Asians (odds ratio = 1.14, 95% confidence interval = 1.02-1.28) and both cohort studies (odds ratio = 1.10, 95% confidence interval = 1.00-1.22) and case-control studies (odds ratio = 1.29, 95% confidence interval = 1.03-1.60). Both overweight (odds ratio = 1.22, 95% confidence interval = 1.05-1.42) and obesity (odds ratio = 1.61, 95% confidence interval = 1.15-2.24) were associated with the increased risk of gastric cardia cancer. The results indicated that obesity was associated with the risk of gastric cancer, especially for males and among non-Asians. Both overweight and obesity were associated with the risk of gastric cardia cancer. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Development of an Objective Autism Risk Index Using Remote Eye Tracking.

    Science.gov (United States)

    Frazier, Thomas W; Klingemier, Eric W; Beukemann, Mary; Speer, Leslie; Markowitz, Leslie; Parikh, Sumit; Wexberg, Steven; Giuliano, Kimberly; Schulte, Elaine; Delahunty, Carol; Ahuja, Veena; Eng, Charis; Manos, Michael J; Hardan, Antonio Y; Youngstrom, Eric A; Strauss, Mark S

    2016-04-01

    Abnormal eye gaze is a hallmark characteristic of autism spectrum disorder (ASD), and numerous studies have identified abnormal attention patterns in ASD. The primary aim of the present study was to create an objective, eye tracking-based autism risk index. In initial and replication studies, children were recruited after referral for comprehensive multidisciplinary evaluation of ASD and subsequently grouped by clinical consensus diagnosis (ASD n = 25/15, non-ASD n = 20/19 for initial/replication samples). Remote eye tracking was blinded to diagnosis and included multiple stimuli. Dwell times were recorded to each a priori-defined region of interest (ROI) and averaged across ROIs to create an autism risk index. Receiver operating characteristic curve analyses examined classification accuracy. Correlations with clinical measures evaluated whether the autism risk index was associated with autism symptom severity independent of language ability. In both samples, the autism risk index had high diagnostic accuracy (area under the curve [AUC] = 0.91 and 0.85, 95% CIs = 0.81-0.98 and 0.71-0.96), was strongly associated with Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) severity scores (r = 0.58 and 0.59, p  .095). The autism risk index may be a useful quantitative and objective measure of risk for autism in at-risk settings. Future research in larger samples is needed to cross-validate these findings. If validated and scaled for clinical use, this measure could inform clinical judgment regarding ASD diagnosis and track symptom improvements. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. Gender disparities among the association between cumulative family-level stress & adolescent weight status.

    Science.gov (United States)

    Hernandez, Daphne C; Pressler, Emily

    2015-04-01

    To investigate precursors to gender-related obesity disparities by examining multiple family-level stress indices. Analyses was based on adolescents born between 1975 and 1991 to women from the 1979 National Longitudinal Study of Youth data set (N=4762). Three types of family-level stressors were captured from birth to age 15: family disruption and conflict, financial strain, and maternal risky health behaviors, along with a total cumulative risk index. Body mass index was constructed on reference criteria for children outlined by the Centers for Disease Control. Multivariate logistic regressions were conducted for the three types of family stressors and for the total cumulative index. The accumulation of family disruption and conflict and financial stress was positively related to female adolescents being overweight/obese. Childhood exposure to maternal risky health behaviors was positively associated with higher weight status for male adolescents. Total cumulative stress was related to overweight/obesity for females, but not males. Different family-level stress indices are associated with the weight status of female and male adolescents. Combining types of family-level stress into one cumulative index appears to mask these differences. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Glycemic load, glycemic index and breast cancer risk in a prospective cohort of Swedish women.

    Science.gov (United States)

    Larsson, Susanna C; Bergkvist, Leif; Wolk, Alicja

    2009-07-01

    High-glycemic load diets have been hypothesized to increase the risk of breast cancer but epidemiologic studies have yielded inconsistent findings. We examined the associations of carbohydrate intake, glycemic index and glycemic load with risk of overall and hormone receptor-defined breast cancer in the Swedish Mammography Cohort, a population-based cohort of 61,433 women who completed a food frequency questionnaire at enrollment in 1987-1990. During a mean follow-up of 17.4 years, we ascertained 2,952 incident cases of invasive breast cancer. Glycemic load but not carbohydrate intake or glycemic index was weakly positively associated with overall breast cancer risk (p for trend = 0.05). In analyses stratified by estrogen receptor (ER) and progesterone receptor (PR) status of the breast tumors, we observed statistically significant positive associations of carbohydrate intake, glycemic index and glycemic load with risk of ER+/PR- breast cancer; the multivariate relative risks comparing extreme quintiles were 1.34 [95% confidence interval (CI) = 0.93-1.94; p for trend = 0.04] for carbohydrate intake, 1.44 (95% CI = 1.06-1.97; p for trend = 0.01) for glycemic index and 1.81 (95% CI = 1.29-2.53; p for trend = 0.0008) for glycemic load. No associations were observed for ER+/PR+ or ER-/PR- breast tumors. These findings suggest that a high carbohydrate intake and diets with high glycemic index and glycemic load may increase the risk of developing ER+/PR- breast cancer.

  5. Innovation in drought risk management: exploring the potential of weather index insurance

    Science.gov (United States)

    Iglesias, E.; Baez, K.

    2012-04-01

    Many family farming and indigenous communities depend on grazing livestock activities and are particularly prone to drought risks. Vulnerability to drought limits the ability of these households to exit poverty and in many cases leads to environmental degradation. It is well known that uninsured exposure exacerbates income inequality in farming systems and eventually results in welfare losses for rural families. The advantages of farmers who have access to financial tools have been widely acknowledged. However, high administrative costs of traditional insurance hinder small farmers' access to risk management tools. One of the main problems in insurance design relates to the lack of quality data to estimate the risk premium. In rural areas where there are no historical records of farm production data on adverse events such as drought. New technologies such as remote sensing help to overcome this problem and generate information from these areas that otherwise would be impossible or too expensive to obtain. In this paper, we use a satellite based vegetation index (NDVI) and develop a stochastic model to analyse the potential of index insurance to address the risk of drought in Chilean grazing lands. Our results suggest that contract design is a key issue to improve the correlation of the index with individual farm losses, thus reducing basis risk. In particular, we find that the definition of homogeneous areas and the selection of the triggering index threshold are critical issues and show the incidence of different contract designs on (i) the probability that the farmer experience losses but does not receive compensation (false negative) and (ii) the probability that the index triggers compensation but the farmer does not experience drought losses (false negative). Both aspects are key issues to offer the farmer an adequate protection against droughts and guarantee the affordability of the risk premium.

  6. Glycemic index, carbohydrates, glycemic load, and the risk of pancreatic cancer in a prospective cohort study.

    Science.gov (United States)

    Jiao, Li; Flood, Andrew; Subar, Amy F; Hollenbeck, Albert R; Schatzkin, Arthur; Stolzenberg-Solomon, Rachael

    2009-04-01

    Diets with high glycemic index and glycemic load have been associated with insulin resistance. Insulin resistance has been implicated in the etiology of pancreatic cancer. We prospectively investigated the associations between glycemic index, carbohydrates, glycemic load, and available carbohydrates dietary constituents (starch and simple sugar) intake and the risk of pancreatic cancer. We followed the participants in the NIH-AARP Diet and Health Study from 1995/1996 through December 2003. A baseline self-administered food frequency questionnaire was used to assess the dietary intake and exposure information. A total of 1,151 exocrine pancreatic cancer cases were identified from 482,362 participants after excluding first-year of follow-up. We used multivariate Cox proportional hazards regression models to calculate relative risks (RR) and 95% confidence intervals (95% CI) for pancreatic cancer. There were no associations between glycemic index, total or available carbohydrates, gycemic load, and pancreatic cancer risk. Participants with high free fructose and glucose intake were at a greater risk of developing pancreatic cancer (highest compared with lowest quintile, RR, 1.29; 95% CI, 1.04-1.59; P trend = 0.004 and RR, 1.35; 95% CI, 1.10-1.67; P trend = 0.005, respectively). There were no statistically significant interactions by body mass index, physical activity, or smoking status. Our results do not support an association between glycemic index, total or available carbohydrate intake, and glycemic load and pancreatic cancer risk. The higher risk associated with high free fructose intake needs further confirmation and elucidation.

  7. [Diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours].

    Science.gov (United States)

    Treviño-Báez, Joaquín Darío; Cantú-Cruz, Javier Alejandro; Medina-Mercado, Javier; Abundis, Alberto

    2016-01-01

    The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200. To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results. A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II ≤ 200 or greater than this. The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266. The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  8. An index of risk as a measure of biodiversity conservation achieved through land reform.

    Science.gov (United States)

    Walker, Susan; Price, Robbie; Stephens, R T Theo

    2008-02-01

    We measured the net progress of land reform in achieving a national policy goal for biodiversity conservation in the context of ongoing clearing of native vegetation and additions of land to a highly nonrepresentative (residual) reserve network, interior South Island, New Zealand. We used systematic conservation-planning approaches to develop a spatially explicit index of risk of biodiversity loss (RBL). The index incorporated information from national data sets that describe New Zealand's remaining indigenous land cover, legal protection, and land environments and modeled risk to biodiversity on the basis of stated assumptions about the effects of past habitat loss and legal protection. The index identified irreplaceable and vulnerable native habitats in lowland environments as the most at risk of biodiversity loss, and risk was correlated with the density of threatened plant records. To measure achievement, we used changes in the index that reflected gains made and opportunity costs incurred by legal protection and privatization. Application of the index to measure the difference made by land reform showed it had caused a net increase in the risk of biodiversity loss because most land vulnerable to habitat modification and rich in threatened plant species was privatized and land at least risk of biodiversity loss was protected. The application revealed that new high-elevation reserves did little to mitigate biodiversity decline, that privatization of low-elevation land further jeopardized the most vulnerable biodiversity in lowland native habitats, and that outcomes of land reform for biodiversity deteriorated over time. Further development of robust achievement measures is needed to encourage more accountable biodiversity conservation decisions.

  9. Predicting complications after pulmonary resection. Preoperative exercise testing vs a multifactorial cardiopulmonary risk index.

    Science.gov (United States)

    Epstein, S K; Faling, L J; Daly, B D; Celli, B R

    1993-09-01

    Recent studies have used preoperative cardiopulmonary exercise testing to improve risk assessment of pulmonary resection for lung cancer. These studies have demonstrated inconsistent correlation between peak oxygen uptake (VO2) and postoperative complications but have not systematically examined other methods of risk stratification. We analyzed the findings in 42 patients who had cardiopulmonary exercise testing prior to lung cancer resection. Preoperative clinical data combining pulmonary factors (obesity, productive cough, wheezing, tobacco use, ratio of the forced expiratory volume in 1 s over the forced vital capacity [FEV1/FVC] 45 mm Hg), and an established cardiac risk index were used to generate a cardiopulmonary risk index (CPRI). When analyzed using the risk index, the incidence of postoperative complications increased with higher CPRI scores. Those with a CPRI of 4 or greater were 22 times more likely to develop a complication, compared to a CPRI of less than 4 (p CPRI of 4 or greater was associated with significant reductions in peak VO2. We conclude that both the peak VO2 during cardiopulmonary exercise testing and a multifactorial CPRI are highly predictive of complications after lung resection. Adding the peak VO2 did not enhance the risk estimation generated by the CPRI. The association between postoperative complications and peak VO2 may be explained by the correlation between identifiable cardiopulmonary disease (CPRI) and reduced oxygen uptake with exercise.

  10. GLOBALISATION AND THE UNPREDICTABILITY OF CRISIS EPISODES: AN EMPIRICAL ANALYSIS OF COUNTRY RISK INDEXES

    Directory of Open Access Journals (Sweden)

    San-Martín-Albizuri, Nerea

    2012-05-01

    Full Text Available The ongoing globalisation process has not put an end to international financial crises. On the contrary, it seems to have contributed to their appearance and to accentuating their degrees of unpredictability. In this context, the main objective of the present study is to establish whether the values of the best-known and most widely used country risk indexes, namely, the Euromoney index and the International Country Risk Group (ICRG, and the values of their representative variables could have forecasted well in advance the crises that took place between 1994 and 2002, a period which is herein termed the ‘globalisation era’. The results show that, although the selected indexes and their representative variables were able to identify certain vulnerabilities, they could not accurately identify the political, economic, and/or financial factors that developed prior to these crisis episodes.

  11. Is risk of degenerative musculoskeletal conditions associated with pre-pregnancy body mass index and parity?

    DEFF Research Database (Denmark)

    Bliddal, Mette; Pottegård, Anton; Kirkegaard, Helene

    Background Obesity among women may influence the risk of degenerative musculoskeletal conditions (MSCs) and contribute to poor quality of life. Parity, which constitutes a sudden natural increase in weight as well it affects long-term body mass index (BMI), may put strain on the musculoskeletal s...

  12. Adult body mass index and risk of ovarian cancer by subtype

    DEFF Research Database (Denmark)

    Dixon, Suzanne C; Nagle, Christina M; Thrift, Aaron P

    2016-01-01

    BACKGROUND: Observational studies have reported a positive association between body mass index (BMI) and ovarian cancer risk. However, questions remain as to whether this represents a causal effect, or holds for all histological subtypes. The lack of association observed for serous cancers may, f...

  13. Generation of a landslide risk index map for Cuba using spatial multi-criteria evaluation

    NARCIS (Netherlands)

    Castellanos Abella, E.A.

    2007-01-01

    his paper explains the procedure for the generation of a landslide risk index map at national level in Cuba, using a semiquantitative model with ten indicator maps and a cell size of 90× 90 m. The model was designed and implemented using spatial multi-criteria evaluation techniques in a GIS system.

  14. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

    NARCIS (Netherlands)

    Buckland, G.; Travier, N.; Huerta, J.M.; Bueno-de-Mesquita, H.B.; Siersema, P.D.; Skeie, G.; Weiderpass, E.; Engeset, D.; Ericson, U.; Ohlsson, B.; Agudo, A.; Romieu, I.; Ferrari, P.; Freisling, H.; Colorado-Yohar, S.; Li, K.; Kaaks, R.; Pala, V.; Cross, A.J.; Riboli, E.; Trichopoulou, A.; Lagiou, P.; Bamia, C.; Boutron-Ruault, M.C.; Fagherazzi, G.; Dartois, L.; May, A.M.; Peeters, P.H.M.; Panico, S.; Johansson, M.; Wallner, B.; Palli, D.; Key, T.J.; Khaw, K.T.; Ardanaz, E.; Overvad, K.; Tjonneland, A.; Dorronsoro, M.; Sanchez, M.J.; Quiros, J.R.; Naccarati, A.; Tumino, R.; Boeing, H.; Gonzalez, C.A.

    2015-01-01

    Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behav

  15. Generation of a landslide risk index map for Cuba using spatial multi-criteria evaluation

    NARCIS (Netherlands)

    Castellanos Abella, E.A.

    2007-01-01

    his paper explains the procedure for the generation of a landslide risk index map at national level in Cuba, using a semiquantitative model with ten indicator maps and a cell size of 90× 90 m. The model was designed and implemented using spatial multi-criteria evaluation techniques in a GIS system.

  16. clinical risk index for babies (crib) ii score as a predictor of neonatal ...

    African Journals Online (AJOL)

    2011-01-01

    Jan 1, 2011 ... Among them is the scoring system Clinical Risk Index for Babies also known as CRIB II score. .... strongly with hospital neonatal mortality, the cost of ... analysis was obtained using standard procedure ... then labelled and transported to the laboratory ... labor, the babies' details – the components of CRIB.

  17. Waist-to-Height Ratio and Body Mass Index as Indicators of Cardiovascular Risk in Youth

    Science.gov (United States)

    Keefer, Daniel J.; Caputo, Jennifer L.; Tseh, Wayland

    2013-01-01

    Background: The purpose of this investigation was to determine if waist-to-height ratio (WHTR) or body mass index (BMI) is the better indicator of cardiovascular disease risk in children and adolescents of varying ages. Methods: Data from children and adolescents (N?=?2300) who were part of the 2003-2004 National Health and Nutrition Examination…

  18. Work Ability Index as Tool to Identify Workers at Risk of Premature Work Exit

    NARCIS (Netherlands)

    Roelen, Corne A. M.; Heymans, Martijn W.; Twisk, Jos W. R.; van der Klink, Jac J. L.; Groothoff, Johan W.; van Rhenen, Willem

    2014-01-01

    Purpose To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Methods Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at

  19. Elevated body mass index as a causal risk factor for symptomatic gallstone disease:

    DEFF Research Database (Denmark)

    Stender, Stefan; Nordestgaard, Børge G; Tybjaerg-Hansen, Anne

    2013-01-01

    Elevated body mass index (BMI) is associated with an increased risk of gallstone disease. Whether this reflects a causal association is unknown. Using a Mendelian randomization approach, we studied 77,679 individuals from the general population. Of these, 4,106 developed symptomatic gallstone...

  20. DEVELOPMENT OF A CRASH RISK PROBABILITY MODEL FOR FREEWAYS BASED ON HAZARD PREDICTION INDEX

    Directory of Open Access Journals (Sweden)

    Md. Mahmud Hasan

    2014-12-01

    Full Text Available This study presents a method for the identification of hazardous situations on the freeways. The hazard identification is done using a crash risk probability model. For this study, about 18 km long section of Eastern Freeway in Melbourne (Australia is selected as a test bed. Two categories of data i.e. traffic and accident record data are used for the analysis and modelling. In developing the crash risk probability model, Hazard Prediction Index is formulated in this study by the differences of traffic parameters with threshold values. Seven different prediction indices are examined and the best one is selected as crash risk probability model based on prediction error minimisation.

  1. Conception of a method for the creation of volcanic risk index maps

    Science.gov (United States)

    Bion, P.; Van Wyk de Vries, B.; Valentine, G.

    2012-04-01

    Risk index maps are a variant of risk maps, having the advantage of containing unique kinds of information - levels of risk spatially represented - and can therefore be a more effective communication tool than traditional risk maps. Nevertheless, despite their apparent simplicity, their achievement is the result of a complex risk analysis, requiring the consideration of multidisciplinary indicators, expressing different parameters of the physical and human dimensions of the environment and their interactions. The risk index is obtained in three main stages: the definition of hazard and vulnerability indicators, the transformation of the indicators into subindices through mathematical processes (formulation, standardization, weighting), and the combination of the subindices into a final index. As of now, only few attempts of risk quantification have been done, related to landslide, flood or seismic hazards, and those linked to volcanic hazards are very incomplete because of the specificities and complexities of these kinds of events and their effects. Volcanic hazards have the particularity of being of different types, moreover all events can combine together or be combined with other external events (e.g. meteorological), and they can reach and therefore affect extensive areas by different phenomena. The methodology developed here assesses risk levels in regions potentially impacted by volcanic hazards. It incorporates volcanic hazard specificities and nuances of "vulnerability" by integrating the diversity of the environmental components. It analyses the natural and human strengths, weaknesses, opportunities and threats, which are located within the areas potentially "at risk". Consequently, it considers negative but also positive indicators (respectively aggravating and improving the potential consequences), which can be internal but also external to the volcanic hazards. The approach also considers a temporal variability of the events and their direct or

  2. Cumulative fatigue damage models

    Science.gov (United States)

    Mcgaw, Michael A.

    1988-01-01

    The problem of calculating expected component life under fatigue loading conditions is complicated by the fact that component loading histories contain, in many cases, cyclic loads of widely varying amplitudes. In such a case a cumulative damage model is required, in addition to a fatigue damage criterion, or life relationship, in order to compute the expected fatigue life. The traditional cumulative damage model used in design is the linear damage rule. This model, while being simple to use, can yield grossly unconservative results under certain loading conditions. Research at the NASA Lewis Research Center has led to the development of a nonlinear cumulative damage model, named the double damage curve approach (DDCA), that has greatly improved predictive capability. This model, which considers the life (or loading) level dependence of damage evolution, was applied successfully to two polycrystalline materials, 316 stainless steel and Haynes 188. The cumulative fatigue behavior of the PWA 1480 single-crystal material is currently being measured to determine the applicability of the DDCA for this material.

  3. A probabilistic method for computing quantitative risk indexes from medical injuries compensation claims.

    Science.gov (United States)

    Dalle Carbonare, S; Folli, F; Patrini, E; Giudici, P; Bellazzi, R

    2013-01-01

    The increasing demand of health care services and the complexity of health care delivery require Health Care Organizations (HCOs) to approach clinical risk management through proper methods and tools. An important aspect of risk management is to exploit the analysis of medical injuries compensation claims in order to reduce adverse events and, at the same time, to optimize the costs of health insurance policies. This work provides a probabilistic method to estimate the risk level of a HCO by computing quantitative risk indexes from medical injury compensation claims. Our method is based on the estimate of a loss probability distribution from compensation claims data through parametric and non-parametric modeling and Monte Carlo simulations. The loss distribution can be estimated both on the whole dataset and, thanks to the application of a Bayesian hierarchical model, on stratified data. The approach allows to quantitatively assessing the risk structure of the HCO by analyzing the loss distribution and deriving its expected value and percentiles. We applied the proposed method to 206 cases of injuries with compensation requests collected from 1999 to the first semester of 2007 by the HCO of Lodi, in the Northern part of Italy. We computed the risk indexes taking into account the different clinical departments and the different hospitals involved. The approach proved to be useful to understand the HCO risk structure in terms of frequency, severity, expected and unexpected loss related to adverse events.

  4. Developing an index model for flood risk assessment in the western coastal region of Mazandaran, Iran

    Directory of Open Access Journals (Sweden)

    Sadeghi-Pouya Alireza

    2017-06-01

    Full Text Available This paper represents an index model developed for the assessment of risk caused by river floods. The main purpose of this model is to evaluate the flood risk in the western coastal region of Mazandaran Province/Iran. The model assesses the risk at triple components, i.e. the flood occurrence probability, vulnerability and consequences, through identification and evaluation of effective criteria categorized into seven indexes (environmental, technical, economic, social, depth, population and sensitivity ones that are involved in all stages of flooding (source, pathway and receptor. The flood risk in the developed model is defined by a dimensionless magnitude called as risk score between 0 and 100 for each zone of the area under assessment by calculating and combining of two newly defined factors: occurrence and vulnerability factor and impact factor. The model was applied in a case study, the Nowshahr flood in 2012. The results showed that: (i the flood risk zoning was compared with observed data for aspect of the damages, and general agreement between them was obtained; (ii for urban zones, which surrounded by two rivers, would easily be in critical condition and rescue operations face difficulties; and (iii it is necessary to review the location of the emergency services, according the flood risk zoning.

  5. Assessment of Cumulative Trauma Disorder (CTD) Risk for 3 Different Tasks Constructing and Repairing Multi-Layer Insulation (MLI) Blankets, Preparing the Dough for a Pizza, and Operating the Becton-Dickinson FACSAria Flow Cytometer

    Science.gov (United States)

    Gentzler, Marc; Kline, Martin; Palmer, Andrew; Terrone, Mark

    2007-01-01

    The Cumulative Trauma Disorder (CTD) risks for three different tasks using McCauley-Bell and Badiru's (1993) formula based on task, personal, and organizational factors were examined. For the Multi-Layer Insulation (MLI) blanket task, the results showed that the task, personal, and organizational risks were at about the same level. The personal risk factors for this task were evaluated using a hypothetical female employee age 52. For the pizza dough task, it was shown that the organizational risk was particularly high, with task related factors also at quite dangerous levels. On the other hand, there was a very low level of personal risk factors, based on a female age 17. The flow cytometer task was assessed with three different participants, a11 of whom had quite disparate levels of personal risk, which slightly affected the overall CTD risk. This reveals how individual difference variables certainly need to be considered. The task and organizational risks for this task were rated at about the same moderate level. The overall CTD risk averaged across the three participants was .335, indicating some risk. Compruing across the tasks revealed that the pizza dough task created the greatest overall CTD risk by far (.568), with the MLI (.325) and flow cytometer task (.335) having some risk associated with them. Future research should look into different tasks for more of a comparison

  6. Carbohydrate intake, glycemic index, glycemic load and risk of gastric cancer.

    Science.gov (United States)

    Lazarević, Konstansa; Nagorni, Aleksandar; Jeremić, Miroslav

    2009-06-01

    The aim of this study was to examine relationship between dietary carbohydrate, glycemic index, glycemic load and gastric cancer risk. This hospital based case-control study was conducted in Nis (Serbia) between 2005 and 2006. Subjects (n=102) with histologically confirmed gastric cancer and controls (n=204) selected from non-cancer patients were interviewed. The structured questionnaire included information on socio-demographic and lifestyle habits. Data from dietary habits were based on Food Frequency Questionnaire (FFQ). We found reductions in gastric cancer risk for diets high in carbohydrate (OR for highest versus the lowest tertile = 0.07, 95% CI: 0.02-0.23) and mono- and disaccharides (OR = 0.03, 95% CI: 0.01-0.09) and increased risk (OR = 4.13, 95% CI: 1.73-9.86) for high polysaccharide intake. Total carbohydrate intake (OR = 0.17, 95% CI: 0.04-0.66) and mono- and disaccharides intake (OR = 0.06, 95% CI: 0.02-0.20) was associated with a reduction in gastric cancer risk, while polysaccharide intake was associated with an increased risk (OR = 4.85, 95% CI: 1.67-14.09) for the diffuse type only. In both histological subtypes, there was not significant association between glycemic index, glycemic load and the risk of gastric cancer. Our results suggest that increased intake of foods rich in carbohydrate, particularly mono- and disaccharides, as well as reduced consumption of food rich in polysaccharides, may lower the risk of diffuse type of gastric cancer. Our data do not support association between glycemic index, glycemic load and the risk of gastric cancer.

  7. Characterization of SNPs associated with prostate cancer in men of Ashkenazic descent from the set of GWAS identified SNPs: impact of cancer family history and cumulative SNP risk prediction.

    Directory of Open Access Journals (Sweden)

    Ilir Agalliu

    Full Text Available BACKGROUND: Genome-wide association studies (GWAS have identified multiple SNPs associated with prostate cancer (PrCa. Population isolates may have different sets of risk alleles for PrCa constituting unique population and individual risk profiles. METHODS: To test this hypothesis, associations between 31 GWAS SNPs of PrCa were examined among 979 PrCa cases and 1,251 controls of Ashkenazic descent using logistic regression. We also investigated risks by age at diagnosis, pathological features of PrCa, and family history of cancer. Moreover, we examined associations between cumulative number of risk alleles and PrCa and assessed the utility of risk alleles in PrCa risk prediction by comparing the area under the curve (AUC for different logistic models. RESULTS: Of the 31 genotyped SNPs, 8 were associated with PrCa at p ≤ 0.002 (corrected p-value threshold with odds ratios (ORs ranging from 1.22 to 1.42 per risk allele. Four SNPs were associated with aggressive PrCa, while three other SNPs showed potential interactions for PrCa by family history of PrCa (rs8102476; 19q13, lung cancer (rs17021918; 4q22, and breast cancer (rs10896449; 11q13. Men in the highest vs. lowest quartile of cumulative number of risk alleles had ORs of 3.70 (95% CI 2.76-4.97; 3.76 (95% CI 2.57-5.50, and 5.20 (95% CI 2.94-9.19 for overall PrCa, aggressive cancer and younger age at diagnosis, respectively. The addition of cumulative risk alleles to the model containing age at diagnosis and family history of PrCa yielded a slightly higher AUC (0.69 vs. 0.64. CONCLUSION: These data define a set of risk alleles associated with PrCa in men of Ashkenazic descent and indicate possible genetic differences for PrCa between populations of European and Ashkenazic ancestry. Use of genetic markers might provide an opportunity to identify men at highest risk for younger age of onset PrCa; however, their clinical utility in identifying men at highest risk for aggressive cancer remains

  8. An index for drought induced financial risk in the mining industry

    Science.gov (United States)

    Bonnafous, L.; Lall, U.; Siegel, J.

    2017-02-01

    Water scarcity has emerged as a potential risk for mining operations. High capital spending for desalination and water conflicts leading to asset stranding have recently occurred. Investors in mining companies are interested in the exposure to such risks across portfolios of mining assets (whether the practical at-site consequences are foregone production, higher OPEX and CAPEX and ensuing lost revenues, or asset-stranding). In this paper, an index of the potential financial exposure of a portfolio is developed and its application is illustrated. Since the likely loss at each mine is hard to estimate a priori, one needs a proxy for potential loss. The index considers drought duration, severity and frequency (defined by a return-level in years) at each mining asset, and provides a measure of financial exposure through weighing of production or Net Asset Value. Changes in human needs are not considered, but are relevant, and could be incorporated if global data on mine and other water use were available at the appropriate resolution. Potential for contemporaneous drought incidence across sites in a portfolio is considered specifically. Through an appropriate choice of drought thresholds, an analyst can customize a scenario to assess potential losses in production value or profits, or whether conflicts could emerge that would lead to stranded assets or capital expenditure to secure alternate water supplies. Global climate data sets that allow a customized development of such an index are identified, and selected mining company portfolios are scored as to the risk associated with one publicly available drought index.

  9. OSTEOPOROSIS RISK AND BODY MASS INDEX COMPARISON AMONG URBAN AND RURAL MENOPAUSAL WOMEN

    Directory of Open Access Journals (Sweden)

    Vita Muniarti Tarawan

    2015-03-01

    Full Text Available Objective: To compare osteoporosis risk factors between urban and rural menopausal women. Methods: This study applied the causal-comparative analysis to compare osteoporosis risk factors between urban and rural menopausal women. The subjects included in this study were 40 urban and 40 rural menopausal women who were randomly recruited. The respondents’ bone mass density was measured using densitometry. This study also examined several aspects, including the respondents’ nutritional status (body mass index calculation and physical fitness (VO2 max. The correlation between osteoporosis risk and either nutritional status or physical fitness among urban and rural menopausal women were tested using Chi square correlation analysis. Results: This study examined several aspects, including age (years 58.7±6.1 (urban and 58.3±6.5 (rural, p=0.815, body mass index (kg/m2 23.7±3.7 (urban and 22.7±3.6 (rural, p=0.221, VO2 max (average 27 (67.5% (urban and 25 (62.5% (rural, p=0.624. The respondents diagnosed as suffering from osteoporosis were statistically measured for the: nutritional status (body mass index (under urban 0%, rural (p=0.789 2.5%, body mass index 7.5% urban, rural (p=0.571 2.5%, physical fitness condition (VO2 max (average urban 7.5%, rural (p=0.850 5%, VO2 max (poor urban 7.5%, rural (p=0.880 5%. Body mass index and bone mass density calculation results described that the nutritional status of urban and rural menopausal women: normal 12 (30% vs (32.5%, osteopenia 8 (20% vs (15%, osteoporosis 3 (7.5% vs (2.5, p=0.571. Conclusions: This study shows that there is no significant difference between osteoporosis risk and nutritional status and physical fitness in urban and rural menopausal women.

  10. Age-specific performance of the revised cardiac risk index for predicting cardiovascular risk in elective noncardiac surgery

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Wissenberg, Mads; Jørgensen, Mads Emil;

    2015-01-01

    BACKGROUND: The revised cardiac risk index (RCRI) holds a central role in preoperative cardiac risk stratification in noncardiac surgery. Its performance in unselected populations, including different age groups, has, however, not been systematically investigated. We assessed the relationship......%, 71%, 64%, 66%, and 67% in patients aged ≤ 55, 56 to 65, 66 to 75, 76 to 85, and >85 years, respectively; the negative predictive values were >98% across all age groups. CONCLUSIONS: In a nationwide unselected cohort, the performance of the RCRI was similar to that of the original cohort. Having ≥ 1...

  11. The Healthy Eating Index 2005 and risk for pancreatic cancer in the NIH-AARP study.

    Science.gov (United States)

    Arem, Hannah; Reedy, Jill; Sampson, Josh; Jiao, Li; Hollenbeck, Albert R; Risch, Harvey; Mayne, Susan T; Stolzenberg-Solomon, Rachael Z

    2013-09-04

    Dietary pattern analyses characterizing combinations of food intakes offer conceptual and statistical advantages over food- and nutrient-based analyses of disease risk. However, few studies have examined dietary patterns and pancreatic cancer risk and none focused on the 2005 Dietary Guidelines for Americans. We used the Healthy Eating Index 2005 (HEI-2005) to estimate the association between meeting those dietary guidelines and pancreatic cancer risk. We calculated the HEI-2005 score for 537 218 men and women in the National Institutes of Health-American Association of Retired Persons Diet and Health Study using responses to food frequency questionnaires returned in 1995 and 1996. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of pancreatic cancer according to HEI-2005 quintiles and explored effect modification by known risk factors. P interaction values were calculated using the Wald test. All statistical tests were two-sided. We identified 2383 incident, exocrine pancreatic cancer cases (median = 10.5 years follow-up). Comparing participants who met the most dietary guidelines (Q5) with those who met the fewest guidelines (Q1), we observed a reduced risk of pancreatic cancer (HR = 0.85, 95% CI = 0.74 to 0.97). Among men there was an interaction by body mass index (P interaction = .03), with a hazard ratio of 0.72 (95% CI = 0.59 to 0.88) comparing Q5 vs Q1 in overweight/obese men (body mass index ≥ 25 kg/m(2)) but no association among normal weight men. Our findings support the hypothesis that consuming a high-quality diet, as scored by the HEI-2005, may reduce the risk of pancreatic cancer.

  12. Weather-Related Flood and Landslide Damage: A Risk Index for Italian Regions.

    Science.gov (United States)

    Messeri, Alessandro; Morabito, Marco; Messeri, Gianni; Brandani, Giada; Petralli, Martina; Natali, Francesca; Grifoni, Daniele; Crisci, Alfonso; Gensini, Gianfranco; Orlandini, Simone

    2015-01-01

    The frequency of natural hazards has been increasing in the last decades in Europe and specifically in Mediterranean regions due to climate change. For example heavy precipitation events can lead to disasters through the interaction with exposed and vulnerable people and natural systems. It is therefore necessary a prevention planning to preserve human health and to reduce economic losses. Prevention should mainly be carried out with more adequate land management, also supported by the development of an appropriate risk prediction tool based on weather forecasts. The main aim of this study is to investigate the relationship between weather types (WTs) and the frequency of floods and landslides that have caused damage to properties, personal injuries, or deaths in the Italian regions over recent decades. In particular, a specific risk index (WT-FLARI) for each WT was developed at national and regional scale. This study has identified a specific risk index associated with each weather type, calibrated for each Italian region and applicable to both annual and seasonal levels. The risk index represents the seasonal and annual vulnerability of each Italian region and indicates that additional preventive actions are necessary for some regions. The results of this study represent a good starting point towards the development of a tool to support policy-makers, local authorities and health agencies in planning actions, mainly in the medium to long term, aimed at the weather damage reduction that represents an important issue of the World Meteorological Organization mission.

  13. Hazard Assessment on Chlorine Distribution Use of Chemical Transportation Risk Index

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Gon [Hanwha Chemical Ulsan Site, Ulsan (Korea, Republic of); Byun, Hun Soo [Chonnam National University, Yeosu (Korea, Republic of)

    2014-12-15

    Chlorine is one of the most produced and most used non-flammable chemical substances in the world even though its toxicity and high reactivity cause the ozone layer depletion. However, in modern life, it is impossible to live a good life without using Chlorine and its derivatives since they are being used as an typical ingredient in more than 40 percent of the manufactured goods including medicines, detergents, deodorant, fungicides, herbicides, insecticides, and plastic, etc. Even if Chlorine has been handled and distributed in various business (small and medium-sized businesses, water purification plants, distribution company, etc.), there have been few researches about its possible health hazard and transportation risks. Accordingly, the purpose of this paper is to make a detailed assessment of Chlorinerelated risks and to model an index of chemicals transportation risks that is adequate for domestic circumstances. The assessment of possible health hazard and transportation risks was made on 13 kinds of hazardous chemicals, including liquid chlorine. This research may be contributed to standardizing the risk assessment of Chlorine and other hazardous chemicals by using an index of transportation risks.

  14. Index-based dietary patterns and colorectal cancer risk: a systematic review.

    Science.gov (United States)

    Steck, Susan E; Guinter, Mark; Zheng, Jiali; Thomson, Cynthia A

    2015-11-01

    Colorectal cancer (CRC) is the third most common cancer in both men and women in the United States. Various a priori dietary patterns that take into account diet complexity have been associated with CRC risk. This systematic review augments the evidence for an association between CRC risk and the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), and provides new evidence for a novel Dietary Inflammatory Index (DII). Human studies published in English after 31 December 2008 were reviewed. Five case-control studies and 7 prospective cohort studies conducted in the United States and Europe were identified. Five of the studies examined the MDS, 4 examined the HEI, and 4 examined the DII. Comparing highest to lowest score groups, higher MDSs were associated with an 8-54% lower CRC risk, and higher HEI scores were associated with a 20-56% lower CRC risk. More proinflammatory diet scores were associated with a 12-65% higher CRC risk compared with more anti-inflammatory diets in studies that used the DII. The results reported by sex suggested similar associations for men and women. This review builds upon the evidence supporting the association between higher overall diet quality and lower risk of CRC. Increasing scores of MDS and HEI and anti-inflammatory DII scores are characterized by high intake of plant-based foods and low intake of animal products. Future studies in more diverse populations and with consistent scoring calculations are recommended.

  15. Managing the financial risk of low water levels in Great Lakes with index-based contracts

    Science.gov (United States)

    Meyer, E.; Characklis, G. W.; Brown, C. M.; Moody, P.

    2014-12-01

    Low water levels in the Great Lakes have recently had significant financial impacts on the region's commercial shipping, responsible for transporting millions of dollars' worth of bulk goods each year. Low lake levels can significantly affect shipping firms, as cargo capacity is a function of draft, or the distance between water level and the ship's bottom. Draft increases with weight, and lower lake levels force ships to reduce cargo to prevent running aground in shallow harbors, directly impacting the finances of shipping companies. Risk transfer instruments may provide adaptable, yet unexplored, alternatives for managing these financial risks, at significantly less expense than more traditional solutions (e.g., dredging). Index-based financial instruments can be particularly attractive as contract payouts are directly linked to well-defined transparent metrics (e.g., lake levels), eliminating the need for subjective adjustors, as well as concerns over moral hazard. In developing such instruments, a major challenge is identifying an index that is well correlated with financial losses, and thus a contract that reliably pays out when losses are experienced (low basis risk). In this work, a relationship between lake levels and shipping revenues is developed, and actuarial analyses of the frequency and magnitude of revenue losses is completed using this relationship and synthetic water level data. This analysis is used to develop several types of index-based contracts. A standardized suite of binary contracts is developed, with each indexed to lake levels and priced according to predefined thresholds. These are combined to form portfolios with different objectives (e.g. options, collars), with optimal portfolio structure and length of coverage determined by limiting basis risk and contract cost, using simulations over the historic dataset. Results suggest that portfolios of these binary contracts can substantially reduce the risk of financial losses during periods of

  16. The spatial distribution characteristics of a comprehensive drought risk index in southwestern China and underlying causes

    Science.gov (United States)

    Han, Lanying; Zhang, Qiang; Ma, Pengli; Jia, Jianying; Wang, Jinsong

    2016-05-01

    Drought is a serious problem in southwestern China, where drought risk exceeds the national average. Climate change is likely to exacerbate the problem, thereby endangering China's food security. In this paper, we used the analytic hierarchy process and meteorological, geographic, soil, and remote-sensing data to develop a drought risk assessment model based on the drought hazard, environmental vulnerability, sensitivity and exposure of the values at risk, and capacity to prevent or mitigate the problem. Using the model, we assessed the drought risk (defined using a comprehensive drought risk index, R) and its spatial distribution in southwestern China and revealed complex zonality. The eastern part of the study area had an extremely high risk, and risk was generally greater in the north than in the south, and increased from southwest to northeast. The comprehensive risk ( R) was lowest in Yunnan province. It was highest in Sichuan Province and Chongqing Municipality. The contribution of the risk factors to R was highest for the capacity for prevention and mitigation, followed by the drought hazard, sensitivity and exposure, and environmental vulnerability.

  17. Cardiovascular risk assessment in rheumatoid arthritis: impact of the EULAR recommendations on a national calibrated score risk index.

    Science.gov (United States)

    Rosales-Alexander, J L; Salvatierra, J; Llorca, J; Magro-Checa, C; González-Gay, M A; Cantero-Hinojosa, J; Raya-Álvarez, E

    2014-01-01

    To evaluate the impact of the application of the EULAR task force recommendations in the cardiovascular (CV) risk assessment of rheumatoid arthritis (RA) patients according to a national calibrated SCORE. Two hundred and one consecutive RA patients seen at the rheumatology outpatient clinics of the University Hospital 'San Cecilio', Granada, Southern Spain, were studied. Information on demographic, classic CV risk factors, history of CV events and disease clinical features were obtained. Both the systematic coronary risk evaluation (SCORE) risk index and the modified SCORE (mSCORE) following the EULAR recommendations were performed. Based on the classic CV risk factors the mean ± standard deviation SCORE was 2.2 ± 2.6 (median 2). Twenty-two (11%) patients were above the threshold of high risk for the Spanish population. Following the EULAR recommendations 52 of the 124 patients (41.93%) initially classified as having intermediate risk were reclassified as having high CV risk. Therefore, the mean mSCORE was 3.3 ± 4 (median 3) and, due to this, 74 (36.8%) patients were above the threshold of high CV risk for the Spanish population. As expected, patients who had experienced CV events were older, had more CV risk factors and higher mSCORE than those without CV events. These observations support the claim that the mSCORE should be specifically adapted to the population to be assessed. However, the use of additional tools should be considered in an attempt to fully identify high-risk RA patients.

  18. Development of a prediction model and estimation of cumulative risk for upper aerodigestive tract cancer on the basis of the aldehyde dehydrogenase 2 genotype and alcohol consumption in a Japanese population

    Science.gov (United States)

    Koyanagi, Yuriko N.; Ito, Hidemi; Oze, Isao; Hosono, Satoyo; Tanaka, Hideo; Abe, Tetsuya; Shimizu, Yasuhiro; Hasegawa, Yasuhisa

    2017-01-01

    Alcohol consumption and the aldehyde dehydrogenase 2 (ALDH2) polymorphism are associated with the risk of upper aerodigestive tract cancer, and a significant gene–environment interaction between the two has been confirmed in a Japanese population. To aid the development of a personalized prevention strategy, we developed a risk-prediction model and estimated absolute risks stratified by a combination of the ALDH2 genotype and alcohol consumption. We carried out two age-matched and sex-matched case–control studies: one (630 cases and 1260 controls) for model derivation and the second (654 cases and 654 controls) for external validation. On the basis of data from the derivation study, a prediction model was developed by fitting a conditional logistic regression model using the following predictors: age, sex, smoking, drinking, and the ALDH2 genotype. The risk model, including a combination of the ALDH2 genotype and alcohol consumption, provided high discriminatory accuracy and good calibration in both the derivation and the validation studies: C statistics were 0.82 (95% confidence interval 0.80–0.84) and 0.83 (95% confidence interval 0.81–0.85), respectively, and the calibration plots of both studies remained close to the ideal calibration line. Cumulative risks were obtained by combining odds ratios estimated from the risk model with the age-specific incidence rate and population size. For heavy drinkers with a heterozygous genotype, the cumulative risk at age 80 was above 20%. In contrast, risk in the other groups was less than 5%. In conclusion, modification of alcohol consumption according to the ALDH2 genotype will have a major impact on upper aerodigestive tract cancer prevention. These findings represent a simple and practical model for personalized cancer prevention. PMID:26862830

  19. Development of prolonged standing strain index to quantify risk levels of standing jobs.

    Science.gov (United States)

    Halim, Isa; Omar, Abdul Rahman

    2012-01-01

    Many occupations in industry such as metal stamping workers, electronics parts assembly operators, automotive industry welders, and lathe operators require working in a standing posture for a long time. Prolonged standing can contribute to discomfort and muscle fatigue particularly in the back and legs. This study developed the prolonged standing strain index (PSSI) to quantify the risk levels caused by standing jobs, and proposed recommendations to minimize the risk levels. Risk factors associated with standing jobs, such as working posture, muscles activity, standing duration, holding time, whole-body vibration, and indoor air quality, were the basis for developing the PSSI. All risk factors were assigned multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness. multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness.

  20. Assessing global exposure and vulnerability towards natural hazards: the Disaster Risk Index

    Directory of Open Access Journals (Sweden)

    P. Peduzzi

    2009-07-01

    Full Text Available This paper presents a model of factors influencing levels of human losses from natural hazards at the global scale, for the period 1980–2000. This model was designed for the United Nations Development Programme as a building stone of the Disaster Risk Index (DRI, which aims at monitoring the evolution of risk. Assessing what countries are most at risk requires considering various types of hazards, such as droughts, floods, cyclones and earthquakes. Before assessing risk, these four hazards were modelled using GIS and overlaid with a model of population distribution in order to extract human exposure. Human vulnerability was measured by crossing exposure with selected socio-economic parameters. The model evaluates to what extent observed past losses are related to population exposure and vulnerability. Results reveal that human vulnerability is mostly linked with country development level and environmental quality. A classification of countries is provided, as well as recommendations on data improvement for future use of the model.

  1. Multivariate market risk evaluation between Malaysian Islamic stock index and sectoral indices

    Directory of Open Access Journals (Sweden)

    Sew Lai Ng

    2017-03-01

    Full Text Available Without an efficient financial risk management, it may cause massive consequences to a financial institution as well as individual. Therefore, developing a methodology which gives precise estimates to reduce the exposure of risk to a minimum is of great importance. This paper uses an asymmetric BEKK-GARCH model to examine the return and volatility linkages between the FTSE Bursa Malaysia Emas Shariah (FBMS index and the sectoral indices under a normal market. The findings suggest that the FBMS plays a leading role in the mean return spillover effect. There is a strong evidence of significant transmission of past shocks, volatilities and leverage effects are observed on the current conditional variance-covariance in all the pair-wise models. These empirical results are helpful in quantifying the cross-market risk evaluation, risk minimizing weight and cross-market hedge ratio for strategizing appropriate portfolio selection.

  2. [Childhood body mass index and the risk of coronary heart disease in adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, L.W.; Sørensen, Thorkild I.A.

    2008-01-01

    The severity of the long term consequences of the current childhood obesity epidemic on coronary heart disease is unknown. Therefore we investigated the association between body mass index (BMI) at ages 7-13 years and heart disease in adulthood among 276,835 Danish schoolchildren. We found...... that higher BMI during this period of childhood is associated with an increased risk of any, non-fatal and fatal heart disease in adulthood. Worldwide, as children are becoming heavier, our findings suggest that greater numbers of children are at risk of having coronary heart disease in adulthood...

  3. Abdominal obesity and cardiovascular disease risk factors within body mass index categories.

    Science.gov (United States)

    Shields, Margot; Tremblay, Mark S; Connor Gorber, Sarah; Janssen, Ian

    2012-06-01

    Several organizations recommend the use of measures of abdominal obesity in conjunction with body mass index (BMI) to assess obesity-related health risk. Recent evidence suggests that waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) are increasing within BMI categories. This shift may have affected the usefulness of abdominal obesity measures. Data are from respondents aged 18 to 79 to the 2007 to 2009 Canadian Health Measures Survey. Using logistic regression, this paper examines cardiovascular disease (CVD) risk factors in relation to WC, WHR and WHtR within BMI health-risk categories. CVD risk factors considered include components of the metabolic syndrome. Among men in the normal and overweight BMI categories, WHR and WHtR were positively associated with having at least two CVD risk factors. All three abdominal obesity measures were associated with increased odds of having at least two CVD risk factors among normal-weight women. Abdominal obesity was not associated with CVD risk factors for people in obese class I. Among men and women in the normal BMI category, measures of abdominal obesity are associated with increased odds of CVD risk factors. This underscores the importance of measuring and monitoring abdominal obesity in normal-weight men and women.

  4. Index of harm: a measure for comparing occupational risk across industries

    Energy Technology Data Exchange (ETDEWEB)

    Solomon, K.A.; Abraham, S.C.

    1979-01-01

    This areport explores the implications of an index-of-harm methodology that compares occupational risks among workers exposed to radiological and nonradiological harms. It extends the work of the International Commission on Radiological Protection (ICRP) by considering American rather than European and Japanese industry groups, by treating the relative importance of various occupational harms as a parameter rather than an arbitrary constant, and by identifying several ways in which both the methodology and the data base could be improved. Unfortunately, the data base is too fragmented, and radiological risk estimates are too imprecise for quantitative comparisons across industries. Inclusion of subjective risk preferences is one way to make policy-relevant judgments based on a limited data base. Our study agrees with known accidental fatality rates by showing the riskiest industries to be mining; agriculture, forestry, and fisheries; construction; transportation; and manufacturing - roughly in that order. Using a factor of five times the ICRP dose/risk parameter suggests that the index of harm for radiological workers exposed to 0.35 Rem/yr is still below that of the five riskiest industries. However, the rankings re altered considerably at the regulatory dose level of 5.0 Rem/yr. At that level, the nuclear industry would be significantly more risky, particularly when upper risk estimates are used. (PCS)

  5. Dietary Carbohydrate, Glycemic Index, Glycemic Load, and Breast Cancer Risk Among Mexican Women.

    Science.gov (United States)

    Amadou, Amina; Degoul, Julie; Hainaut, Pierre; Chajes, Veronique; Biessy, Carine; Torres Mejia, Gabriela; Huybrechts, Inge; Moreno Macia, Hortensia; Ortega, Caro; Angeles-Llerenas, Anjélica; Romieu, Isabelle

    2015-11-01

    Very few studies have focused on the relationship among dietary carbohydrates, glycemic index (GI), glycemic load (GL), and breast cancer risk in Latin American women. Our objective was to assess the associations among dietary carbohydrate, GI, GL, and risk of breast cancer, and to further investigate these associations by levels of overweight/obesity and physical activity. We used data from a Mexican population-based case-control study. We recruited a 1,000 women with incident breast cancer and 1,074 matched control women ages 35 to 69 years between 2004 and 2007. We used conditional logistic regression models and energy-adjusted carbohydrates, GI, and GL using the residual method. Total carbohydrate intake was associated with an increased risk of breast cancer among premenopausal women. The odds ratio in the highest versus the lowest quartile was 1.3 (95% confidence interval = 1.0, 1.7; P trend = 0.03). In stratified analyses by body mass index (BMI), the positive association between carbohydrate and risk of premenopausal breast cancer was only observed among overweight women. The odds ratio comparing the top with the bottom quartile was 1.9 (95% confidence interval = 1.2, 3.0; P trend = 0.01) among women with BMI ≥ 25 kg/m. No association was observed among women with BMI carbohydrate diets are associated with an increased risk of breast cancer among premenopausal Mexican women.

  6. Environmental risk index: A tool to assess the safety of dams for leachate

    Energy Technology Data Exchange (ETDEWEB)

    Colomer Mendoza, Francisco J. [Department of Mechanical Engineering and Construction, Universitat Jaume I, Av. de Vicente Sos Baynat s/n, 12071 Castellon (Spain)], E-mail: fcolomer@emc.uji.es; Gallardo Izquierdo, Antonio [Department of Mechanical Engineering and Construction, Universitat Jaume I, Av. de Vicente Sos Baynat s/n, 12071 Castellon (Spain)

    2009-02-15

    Dams for leachate store very toxic substances that contain a large amount of organic material and, probably, heavy metals; they therefore constitute an important threat to the environment. Existing models of environmental risk assessment for landfills do not take into consideration the specific risk that leachate dams may represent for the environment. In this paper a methodology to improve the environmental safety is presented according to the parameters used in their construction and management. In order to do that, the following characteristics of the dam must be known: (1) geotechnical stability, (2) erosion of downstream slope, (3) type of sealing of the dam, (4) overtopping probability, (5) volume of leachate stored inside the dam and (6) pollution load of leachate. Once these parameters have been calculated, they are transformed by means of rating curves into homogeneous units, so as to make it possible to operate between them. From the study and analysis of these parameters an environmental risk index for a dam for leachate can be calculated. If the environmental risk index exceeds an established value then it involves a dam for leachate with high environmental risk, therefore preventive measures in its design, construction and management would be necessary.

  7. READMIT: a clinical risk index to predict 30-day readmission after discharge from acute psychiatric units.

    Science.gov (United States)

    Vigod, Simone N; Kurdyak, Paul A; Seitz, Dallas; Herrmann, Nathan; Fung, Kinwah; Lin, Elizabeth; Perlman, Christopher; Taylor, Valerie H; Rochon, Paula A; Gruneir, Andrea

    2015-02-01

    Our aim was to create a clinically useful risk index, administered prior to discharge, for determining the probability of psychiatric readmission within 30 days of hospital discharge for general psychiatric inpatients. We used population-level sociodemographic and health administrative data to develop a predictive model for 30-day readmission among adults discharged from an acute psychiatric unit in Ontario, Canada (2008-2011), and converted the final model into a risk index system. We derived the predictive model in one-half of the sample (n = 32,749) and validated it in the other half of the sample (n = 32,750). Variables independently associated with 30-day readmission (forming the mnemonic READMIT) were: (R) Repeat admissions; (E) Emergent admissions (i.e. harm to self/others); (D) Diagnoses (psychosis, bipolar and/or personality disorder), and unplanned Discharge; (M) Medical comorbidity; (I) prior service use Intensity; and (T) Time in hospital. Each 1-point increase in READMIT score (range 0-41) increased the odds of 30-day readmission by 11% (odds ratio 1.11, 95% CI 1.10-1.12). The index had moderate discriminative capacity in both derivation (C-statistic = 0.631) and validation (C-statistic = 0.630) datasets. Determining risk of psychiatric readmission for individual patients is a critical step in efforts to address the potentially avoidable high rate of this negative outcome. The READMIT index provides a framework for identifying patients at high risk of 30-day readmission prior to discharge, and for the development, evaluation and delivery of interventions that can assist with optimizing the transition to community care for patients following psychiatric discharge.

  8. Creating a spatially-explicit index: a method for assessing the global wildfire-water risk

    Science.gov (United States)

    Robinne, François-Nicolas; Parisien, Marc-André; Flannigan, Mike; Miller, Carol; Bladon, Kevin D.

    2017-04-01

    The wildfire-water risk (WWR) has been defined as the potential for wildfires to adversely affect water resources that are important for downstream ecosystems and human water needs for adequate water quantity and quality, therefore compromising the security of their water supply. While tools and methods are numerous for watershed-scale risk analysis, the development of a toolbox for the large-scale evaluation of the wildfire risk to water security has only started recently. In order to provide managers and policy-makers with an adequate tool, we implemented a method for the spatial analysis of the global WWR based on the Driving forces-Pressures-States-Impacts-Responses (DPSIR) framework. This framework relies on the cause-and-effect relationships existing between the five categories of the DPSIR chain. As this approach heavily relies on data, we gathered an extensive set of spatial indicators relevant to fire-induced hydrological hazards and water consumption patterns by human and natural communities. When appropriate, we applied a hydrological routing function to our indicators in order to simulate downstream accumulation of potentially harmful material. Each indicator was then assigned a DPSIR category. We collapsed the information in each category using a principal component analysis in order to extract the most relevant pixel-based information provided by each spatial indicator. Finally, we compiled our five categories using an additive indexation process to produce a spatially-explicit index of the WWR. A thorough sensitivity analysis has been performed in order to understand the relationship between the final risk values and the spatial pattern of each category used during the indexation. For comparison purposes, we aggregated index scores by global hydrological regions, or hydrobelts, to get a sense of regional DPSIR specificities. This rather simple method does not necessitate the use of complex physical models and provides a scalable and efficient tool

  9. Glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases

    OpenAIRE

    Tatiana Uchôa Passos; Helena Alves de Carvalho Sampaio; Maria Olganê Dantas Sabry; Maria Luisa Pereira de Melo; Maria Auristela Magalhães Coelho; José Wellington de Oliveira Lima

    2015-01-01

    The objective was to determine the glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases. Nine fruits were investigated: coconut water (for the purpose of this study, coconut water was classified as a “fruit”), guava, tamarind, passion fruit, custard apple, hog plum, cashew, sapodilla, and soursop. The GI and GL were determined according to the Food and Agriculture Organization protocol. The GL was calculated taking into consideration inta...

  10. Ergonomic issues in ewe cheese production: reliability of the Strain Index and OCRA Checklist risk assessments

    Directory of Open Access Journals (Sweden)

    John Rosecrance

    2013-09-01

    Full Text Available Occupational ergonomists often use a variety of methods to identify jobs that are considered at high risk for the development of work-related musculoskeletal illnesses. The Strain Index (SI and the Occupational Repetitive Actions (OCRA Checklist are two popular upper limb risk assessment tools used in many industries, including the agro-food industry. Both methods are based on similar biomechanical, physiological and epidemiologic principles, but their approach to quantification and estimation of risk factor magnitude is quite different. The purpose of this study was to assess the inter-method reliability of SI and OCRA Checklist. Methods: Twenty-one jobs were video recorded in a Sardinian cheese manufacturing facility. Eight raters were recruited to assess job exposures to physical risk factors using the SI and OCRA Checklist. Inter-method reliability was characterized using proportion of overall agreement, Cohen’s kappa, and Spearman and Pearson correlations. Results: Strain Index and the OCRA Checklist assessments produced generally reliable results, classifying the risk of 35 of 42 (83% job exposures similarly. Conclusions: The OCRA Checklist and SI risk assessments are reliable upper limb measures of physical work exposures. Both measures appear useful for assessing risk of upper limb disorders of work tasks in the agro-food industry. However, the SI is specific to disorders of the distal upper limb and perhaps most useful for assessing risk in work primarily involving the wrist and fingers. Whereas the OCRA Checklist, which includes an assessment of the shoulder, may be more appropriate for evaluating jobs that also require extended periods of reaching and shoulder activity.

  11. Hyperbaric index in the primary prevention of hypertensive complications in high-risk pregnancy.

    Science.gov (United States)

    Otero González, Alfonso; Uribe Moya, Silvia; Arenas Moncaleano, Ivan Gilberto; Borrajo Prol, María Paz; García García, María Jesús; López Sánchez, Luis

    2015-01-01

    Preeclampsia (PE) is a major cause of fetal morbidity and mortality. In the Western World, PE affects 2-7% of pregnancies and is responsible for 50,000 deaths annually. Early detection is a priority as it can change the clinical course, but there are no biomarkers or instrumental methods with high sensitivity and specificity. Only the hyperbaric index has a sensitivity and specificity of 99% for early identification of pregnant women at risk of developing PE, but its use is not widespread. To assess the usefulness of the hyperbaric index in the primary prevention of hypertensive pregnancy complications in a public healthcare area. This is a retrospective study of pregnancies that occurred in our area during the period 2007-2012 (N=11,784). The diagnosis was established by the hyperbaric index and pregnant women at risk were treated with ASA at night. In pregnant patients referred to the nephrology clinic (38.2%), diagnosed as high-risk for PE, and treated with 100mg ASA/night (from week 17), the incidence of PE episodes was reduced by 96.94. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Gingival immunologic defense index: a new indicator for evaluating dental plaque infection risk in allergic children

    Directory of Open Access Journals (Sweden)

    Seno Pradopo

    2008-03-01

    Full Text Available There is a possible relationship between dental plaque and children allergic diseases. According to literatures, gingivitis suffered mostly by allergic children than control. Case reports also revealed that dental plaque control therapy was able to reduce, even eliminate rhinosinusitis and asthmatic symptoms without additional medications. However, the exact method for confirming the gingivitis-related allergy is still uncertain. Allergic diseases have multifactorial etiologies and dental plaque had been proposed as a new trigger of allergic symptoms. Nevertheless, since not every child with gingivitis suffered from allergy or vice versa, this uncertain phenomenon may lead to patients or other clinician disbelief. The objective of the present study was to propose a new method, which involving the Gingival immunologic defense index (GIDI to evaluate the susceptibility to allergic diseases. GIDI is an index that had been developed earlier for evaluating gingival immunologic defense with respect to immunoglobulin A (IgA levels. This index based on the simple count of the inflamed gingival surfaces of a child plus the measurement of salivary IgA content. It provides clinicians with important information about the immunologic defense potential of each subject. Interestingly, most allergic children also had inherited IgA deficiency, thus this concept is likely. Based on literatures, GIDI could be a potential index for evaluating the risk of allergic diseases through gingival health assessment. However, prior investigation to the value of Indonesian GIDI index which related to allergy should be conducted.

  13. Assessment of cardiovascular risk in rheumatoid arthritis: impact of the new EULAR recommendations on the score cardiovascular risk index.

    Science.gov (United States)

    Gómez-Vaquero, Carmen; Robustillo, Montserrat; Narváez, Javier; Rodríguez-Moreno, Jesús; González-Juanatey, Carlos; Llorca, Javier; Nolla, Joan Miquel; González-Gay, Miguel Angel

    2012-01-01

    To assess the impact of the application of the European League against Rheumatism (EULAR) task force recommendations in the cardiovascular (CV) risk of a series of Spanish patients diagnosed with rheumatoid arthritis (RA). Two hundred consecutive RA patients seen at the rheumatology outpatient clinics of Bellvitge Hospital, Barcelona, were studied. Information on clinical features of the disease, classic CV risk factors, and history of CV events was assessed. Both the systematic coronary risk evaluation (SCORE) CV risk index and the modified SCORE (mSCORE) according to the last EULAR recommendations were calculated. Based on the classic CV risk factors, the mean ± standard deviation SCORE was 2.1 ± 2.3% (median, 2; interquartile range [IQR], 1-3). Twenty-three (11%) patients were above the threshold of high CV risk for the Spanish population (≥5%). Following the EULAR recommendations, a change in the score was required in 119 (59%) patients. Therefore, the mean mSCORE was 2.7 ± 2.9% (median, 2; IQR, 1-3) and, due to this, 28 (14%) patients were above the threshold of high CV risk. Nine (5%) had at least one ischemic CV event. Patients with CV events were older and had more CV risk factors and higher SCORE and mSCORE than those without CV events. Although a large proportion of patients from this series fulfilled the criteria for the application of the EULAR recommendations, the final impact on the calculated CV risk was low and clinically significant in only a few patients. However, an association between the mSCORE and the presence of ischemic CV events was observed.

  14. Different body mass index grade on the risk of developing glioma: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Zifeng Dai; Qilin Huang; Haipeng Liu

    2015-01-01

    Background: Previous studies reported conflicting results about the risk of developing glioma and different body mass index.So we decided to execute a meta-analysis to solve the dispute.Methods: Comprehensive literature retrieval was carried in PubMed, MEDLINE, and EMBASE up to September 15, 2014.Hand literature information retrieval was not carried.Six studies were fit for this meta-analysis.Pooled hazard ratio (HR) and 95 % confidence interval (CI) of different body mass index grade were performed by fixed/random-effects models, except for normal weight which was referent.Results: Data of 3726 cases were included.Compared with normal weight (20 kg.m-2 < body mass index (BMI) ≤ 24.9 kg.m-2), the underweight (BMI ≤ 20 kg.m-2) might have lower incidence on the risk of developing glioma (HR =1.08, 95 % CI ranged 0.74 to 1.58, P =0.678).While the overweight (25 kg.m-2 < BMI ≤ 29.9 kg.m-2)and obesity (BMI ≥ 30 kg.m-2) were performed as a risk factor of developing glioma.The pooled HR of overweight group was 1.12 (95 % CI ranged 1.02 to 1.22, P=0.013);the pooled HR of obesity was 1.14 (95 % CI ranged 1.02 to 1.27, P =0.017).Sensitivity analysis approved that our results were stable.There was no publication bias of these studies.Conclusions: Underweight could decrease the risk of developing glioma.Excess BMI was considered as a risk factor to develop glioma.

  15. Dietary carbohydrate intake, glycemic index, and glycemic load and endometrial cancer risk: a prospective cohort study.

    Science.gov (United States)

    Coleman, Helen G; Kitahara, Cari M; Murray, Liam J; Dodd, Kevin W; Black, Amanda; Stolzenberg-Solomon, Rachael Z; Cantwell, Marie M

    2014-01-01

    Endometrial cancer risk has been directly associated with glycemic load. However, few studies have investigated this link, and the etiological role of specific dietary carbohydrate components remains unclear. Our aim was to investigate associations of carbohydrate intake, glycemic index, and glycemic load with endometrial cancer risk in the US Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Recruitment took place in 1993-2001. Over a median of 9.0 years of follow-up through 2009, 386 women developed endometrial cancer among 36,115 considered in the analysis. Dietary intakes were assessed using a 124-item diet history questionnaire. Cox proportional hazards models were applied to calculate hazard ratios and 95% confidence intervals. Significant inverse associations were detected between endometrial cancer risk and total available carbohydrate intake (hazard ratio (HR) = 0.66, 95% confidence interval (CI): 0.49, 0.90), total sugars intake (HR = 0.71, 95% CI: 0.52, 0.96), and glycemic load (HR = 0.63, 95% CI: 0.46, 0.84) when women in the highest quartile of intake were compared with those in the lowest. These inverse associations were strongest among overweight and obese women. No associations with endometrial cancer risk were observed for glycemic index or dietary fiber. Our findings contrast with previous evidence and suggest that high carbohydrate intakes and glycemic loads are protective against endometrial cancer development. Further clarification of these associations is warranted.

  16. Regression coefficient-based scoring system should be used to assign weights to the risk index.

    Science.gov (United States)

    Mehta, Hemalkumar B; Mehta, Vinay; Girman, Cynthia J; Adhikari, Deepak; Johnson, Michael L

    2016-11-01

    Some previously developed risk scores contained a mathematical error in their construction: risk ratios were added to derive weights to construct a summary risk score. This study demonstrates the mathematical error and derived different versions of the Charlson comorbidity score (CCS) using regression coefficient-based and risk ratio-based scoring systems to further demonstrate the effects of incorrect weighting on performance in predicting mortality. This retrospective cohort study included elderly people from the Clinical Practice Research Datalink. Cox proportional hazards regression models were constructed for time to 1-year mortality. Weights were assigned to 17 comorbidities using regression coefficient-based and risk ratio-based scoring systems. Different versions of CCS were compared using Akaike information criteria (AIC), McFadden's adjusted R(2), and net reclassification improvement (NRI). Regression coefficient-based models (Beta, Beta10/integer, Beta/Schneeweiss, Beta/Sullivan) had lower AIC and higher R(2) compared to risk ratio-based models (HR/Charlson, HR/Johnson). Regression coefficient-based CCS reclassified more number of people into the correct strata (NRI range, 9.02-10.04) compared to risk ratio-based CCS (NRI range, 8.14-8.22). Previously developed risk scores contained an error in their construction adding ratios instead of multiplying them. Furthermore, as demonstrated here, adding ratios fail to even work adequately from a practical standpoint. CCS derived using regression coefficients performed slightly better than in fitting the data compared to risk ratio-based scoring systems. Researchers should use a regression coefficient-based scoring system to develop a risk index, which is theoretically correct. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A Novel Ultrasound-Based Carotid Plaque Risk Index Associated with the Presence of Cerebrovascular Symptoms.

    Science.gov (United States)

    Kanber, B; Hartshorne, T C; Horsfield, M A; Naylor, A R; Robinson, T G; Ramnarine, K V

    2015-10-01

    The purpose of this study was to determine the efficacy of a novel ultrasound-based carotid plaque risk index (CPRI) in predicting the presence of cerebrovascular symptoms in patients with carotid artery stenosis. This was a cross-sectional, observational study involving 56 patients (mean age 76.6 years, 62.5 % male). Plaque grayscale median (GSM) and surface irregularity indices (SII) were measured in 82 stenosed carotid arteries (range 10 - 95 %) and combined with the degree of stenosis (DOS) in the form of (DOS*SII)/(1 + GSM). A reduced index DOS/(1 + GSM) not incorporating plaque surface irregularities was also investigated. Receiver operating characteristic curves (ROC) were used to study the diagnostic efficacy of CPRI, comparing against DOS and an equivalent risk index constructed using a conventional logistic regression based method with model parameters optimized to the dataset (CPRIlogistic). There were 42 stenosed carotid arteries with cerebrovascular symptoms, and 40 without symptoms. The presence of symptoms significantly correlated with DOS, GSM and SII (p CPRI of the symptomatic (asymptomatic) groups were 23.2 (9.2) compared with 0.71 (0.30) for CPRIlogistic (p CPRI exceeded that of CPRIlogistic and DOS, and demonstrated a better separation of the symptomatic and asymptomatic groups. Our novel risk index combines quantitative measures of carotid plaque echogenicity and surface irregularities with the degree of stenosis. It is a better predictor of cerebrovascular symptoms than the degree of stenosis and could be valuable in studies and clinical trials aimed at identifying vulnerable carotid artery stenoses. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Cumulative Timers for Microprocessors

    Science.gov (United States)

    Battle, John O.

    2007-01-01

    It has been proposed to equip future microprocessors with electronic cumulative timers, for essentially the same reasons for which land vehicles are equipped with odometers (total-distance-traveled meters) and aircraft are equipped with Hobbs meters (total-engine-operating time meters). Heretofore, there has been no way to determine the amount of use to which a microprocessor (or a product containing a microprocessor) has been subjected. The proposed timers would count all microprocessor clock cycles and could only be read by means of microprocessor instructions but, like odometers and Hobbs meters, could never be reset to zero without physically damaging the chip.

  19. Cumulative Vehicle Routing Problems

    OpenAIRE

    Kara, &#;mdat; Kara, Bahar Yeti&#;; Yeti&#;, M. Kadri

    2008-01-01

    This paper proposes a new objective function and corresponding formulations for the vehicle routing problem. The new cost function defined as the product of the distance of the arc and the flow on that arc. We call a vehicle routing problem with this new objective function as the Cumulative Vehicle Routing Problem (CumVRP). Integer programming formulations with O(n2) binary variables and O(n2) constraints are developed for both collection and delivery cases. We show that the CumVRP is a gener...

  20. A prevalência cumulativa de fatores de risco para doença cardiovascular em adolescentes iranianos: IHHP-HHPC Cumulative prevalence of risk factors for atherosclerotic cardiovascular diseases in Iranian adolescents: IHHP-HHPC

    Directory of Open Access Journals (Sweden)

    Roya Kelishadi

    2005-12-01

    Full Text Available OBJETIVO: Avaliar a prevalência cumulativa dos fatores de risco para a doença cardiovascular aterosclerótica numa amostra de adolescentes iranianos. MÉTODOS: Foi realizado um estudo transversal com 1000 meninas e 1000 meninos, com idade entre 11 e 18 anos, selecionados através de uma amostragem aleatória multietapas à base de conglomerados das áreas urbana e rural de três cidades iranianas. RESULTADOS: As taxas de prevalência de inatividade física, dislipidemia, tabagismo, pressão arterial alta e obesidade (índice de massa corporal >P95 foram 66,6, 23,7, 8,7, 5,7 e 2,2%, respectivamente. Dentre os indivíduos estudados, 79,1% apresentaram pelo menos um e 24,6% tiveram dois fatores de risco para doença cardiovascular. A prevalência de inatividade física foi significativamente menor entre os meninos que entre as meninas [53,9 contra 79,3%, respectivamente, OR IC95%, 0,44 (0,39-0,51]. A prevalência de tabagismo foi maior nos meninos que nas meninas [13,1 contra 4,2%, respectivamente, OR IC95%, 3,4 (2,4-4,9]. CONCLUSÃO: Considerando a alta prevalência de fatores de risco para doença cardiovascular em adolescentes, deve-se garantir intervenções que sejam adequadas à idade e sensíveis a aspectos culturais para que medidas preventivas possam ser tomadas em tempo hábil.OBJECTIVE: To evaluate the cumulative prevalence of atherosclerotic cardiovascular disease risk factors in a representative sample of Iranian adolescents. METHODS: The subjects of this cross-sectional study were 1,000 girls and 1,000 boys, ages 11-18 years, selected by multi stage-random cluster sampling from urban and rural areas of three cities in Iran. RESULTS: The prevalence of physical inactivity, dyslipidemia, smoking, high blood pressure and obesity (body mass index >95th percentile were 66.6, 23.7, 8.7, 5.7 and 2.2%, respectively. Of subjects studied, 79.1% had at least one and 24.6% had two cardiovascular disease risk factors. The prevalence of physical

  1. Childhood body mass index and height and risk of histologic subtypes of endometrial cancer

    DEFF Research Database (Denmark)

    Aarestrup, J.; Gamborg, M.; Ulrich, L. G.

    2016-01-01

    BACKGROUND: Endometrial cancer risk factors include adult obesity and taller stature, but the influence of size earlier in life is incompletely understood. We examined whether childhood body mass index (BMI; kg m(-2)) and height were associated with histologic subtypes of endometrial cancer...... childhood ages. Height at all ages was statistically significant and positively associated with all endometrial cancers, except non-oestrogen-dependent cancers. At 7 years, per ~5.2 cm (1 z-score), the risk of endometrioid adenocarcinoma was 1.18 (95% confidence interval: 1.09-1.28). Among non......-users of unopposed oestrogens, associations between BMI and endometrioid adenocarcinoma strengthened, but no effects on height associations were observed. CONCLUSIONS: Endometrial carcinogenesis is linked to early-life body size, suggesting that childhood BMI and height may be useful indicators for the risk of later...

  2. Ponderal index at birth associates with later risk of gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Crusell, Mie; Damm, Peter; Hansen, Torben

    2017-01-01

    PURPOSE: Low birth weight (BW) and low ponderal index (PI) are associated with increased risk of type 2 diabetes mellitus. This study has two purposes: first to investigate the influence of PI on the risk of gestational diabetes mellitus (GDM); second, to study the association between glucose...... the original midwifery records. BW and PI were stratified into tertiles for analysis. RESULTS: PI in the lower tertiles was associated with an increased risk of GDM [odds ratio 1.59 (95% confidence interval 1.07-2.36, p = 0.021)]. Among women with previous GDM, the area under the curve (AUC) for plasma levels...... metabolism and BW in women with previous GDM. METHODS: GDM cohort: 185 women with GDM in 1978-1996, attending a follow-up study in 2000-2002. Control cohort: 1137 women from a population-based diabetes screening study (Inter99) in a neighbouring county in 1999-2001. BW and birth length were collected from...

  3. SURGICAL RISK INDEX AND SURGICAL SITE INFECTION IN POSTPARTUM WOMEN SUBMITTED TO CESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Luana Machado Chianca

    2015-07-01

    Full Text Available Backgound and Objectives: Considering the use of active surveillance assists in infection identification and the need for studies that use Surgical Risk Index (SRI for assessment of Surgical Site Infection (SSI in cesareans, this study aims to determine the incidence of SSI and analyze the applicability of SRI in the prediction of SSI in women in the postpartum period after being submitted to a cesarean section at a university hospital between April 2012 and March of 2013. Methods: Prospective cohort study. Information notifying SSI by active surveillance was collected daily from the medical records. After hospital discharge, the mothers were contacted through telephone calls to identify infection criteria within 30 days after the cesarean. Descriptive and comparative analyses were performed. The chi-square test was used to compare groups. Results: 737 cesareans were performed. Telephone contact was achieved with 507 (68.8% women up to 30 days postpartum, with loss of follow-up of 230 cases (31.2%. The medical consultation in the post-partum period occurred with 188 (37.08% women, with whom telephone contact was obtained, on average, 17.28 days (SD=8.39 after delivery. It was verified that 21 patients met the criteria for SSI, with a 4.14% rate. A total of 12 cases (57.1% were classified as superficial SSI, 5 (23.8% as deep and 4 (19.1% as infection of organs and cavities. The SRI and its risk variables were not associated with SSI in patients submitted to cesarean sections. Conclusion: The SRI and the risk variables included in this index were not associated to SSI in patients submitted to cesarean sections. KEYWORDS: Cesarean Section; Surgical Wound Infection; Epidemiological Surveillance; Infection Control; Risk Index; Disease Notification.

  4. Performance of the LACE index to identify elderly patients at high risk for hospital readmission in Singapore.

    Science.gov (United States)

    Low, Lian Leng; Liu, Nan; Ong, Marcus Eng Hock; Ng, Eileen Yining; Ho, Andrew Fu Wah; Thumboo, Julian; Lee, Kheng Hock

    2017-05-01

    Unplanned readmissions may be avoided by accurate risk prediction and appropriate resources could be allocated to high risk patients. The Length of stay, Acuity of admission, Charlson comorbidity index, Emergency department visits in past six months (LACE) index was developed to predict hospital readmissions in Canada. In this study, we assessed the performance of the LACE index in a Singaporean cohort by identifying elderly patients at high risk of 30-day readmissions. We further investigated the use of additional risk factors in improving readmission prediction performance.Data were extracted from the hospital's electronic health records (EHR) for all elderly patients ≥ 65 years, with alive-discharge episodes from Singapore General Hospital in 2014. In addition to LACE, we also collected patients' data during the index admission, including demographics, medical history, laboratory results, and previous medical utilization.Among the 17,006 patients analyzed, 2051 or 12.1% of them were observed 30-day readmissions. The final predictive model was better than the LACE index in terms of discriminative ability; c-statistic of LACE index and final logistic regression model was 0.595 and 0.628, respectively.The LACE index had poor discriminative ability in identifying elderly patients at high risk of 30-day readmission, even if it was augmented with additional risk factors. Further studies should be conducted to discover additional factors that may enable more accurate and timely identification of patients at elevated risk of readmissions, so that necessary preventive actions can be taken.

  5. Air quality trends and potential health effects - Development of an aggregate risk index

    Science.gov (United States)

    Sicard, Pierre; Lesne, Olivia; Alexandre, Nicolas; Mangin, Antoine; Collomp, Rémy

    2011-02-01

    The "Provence Alpes Côte d'Azur" (PACA) region, in the South East of France, is one of Europe's regions most influenced by the atmospheric pollution. During the last 15 years, the industrial emissions decrease caused an evolution of the atmospheric pollution nature. Nowadays, atmospheric pollution is more and more influenced by the road traffic, the dominating pollution source in urban zones for the PACA region. Combined with this intense road traffic, the strong hot season of the Mediterranean climate contributes to the region bad air quality; it is known to be one of the worse in Europe. The recognized air pollution effects over public health include increased risk of hospital admissions and mortality by respiratory or cardiovascular diseases. The combination of these serious pollution related health hazards with senior and children vulnerabilities leads to serious sanitary concerns. Over the 1990-2005 period, we obtained, using the non-parametric Mann-Kendall test from annual mortality dataset (CépiDC), decreasing trends for Asthma (-5.00% year -1), Cardiovascular (-0.73% year -1), Ischemic (-0.69% year -1) and cerebrovascular diseases (-3.10% year -1). However, for "Other heart diseases" (+0.10% year -1) and "Respiratory" (+0.10% year -1) an increase was observed. The development of an adequate tool to understand impacts of pollution levels is of utmost importance. Different pollutants have different health endpoints, information may be lost through the use of a single index consequently, in this study we present the modified formula of air quality index, based on Cairncross's concept the Aggregate Risk Index (ARI). ARI is based on the relative risk of the well-established increased daily mortality, or morbidity, enabling an assessment of additive effects of short-term exposure to the main air pollutants: PM 2.5, PM 10, SO 2, O 3 and NO 2 in order to account for the reality of the multiple exposures impacts of chemical agents. The ARI, developed per pathology

  6. Body mass index and risk of subtypes of head-neck cancer: the Netherlands Cohort Study

    Science.gov (United States)

    Maasland, Denise H. E.; Brandt, Piet A. van den; Kremer, Bernd; Schouten, Leo J.

    2015-01-01

    Low body mass index (BMI) has been associated with risk of head-neck cancer (HNC), but prospective data are scarce. We investigated the association between BMI, BMI at age 20 years and change in BMI during adulthood with risk of HNC and HNC subtypes. 120,852 participants completed a questionnaire on diet and other cancer risk factors, including anthropometric measurements, at baseline in 1986. After 20.3 years of follow-up, 411 HNC (127 oral cavity cancer (OCC), 84 oro-/hypopharyngeal cancer (OHPC), and 197 laryngeal cancer (LC)) cases and 3,980 subcohort members were available for case-cohort analysis using Cox proportional hazards models. BMI at baseline was inversely associated with risk of HNC overall, with a multivariate rate ratio of 3.31 (95% CI 1.40–7.82) for subjects with a BMI < 18.5 kg/m2, compared to participants with a BMI of 18.5 to 25 kg/m2. Among HNC subtypes, this association was strongest for OCC and OHPC. The association between BMI at age 20 and HNC risk appeared to be positive. In this large prospective cohort study, we found an inverse association between BMI at baseline and HNC risk. For BMI at age 20, however, a positive rather than inverse association was found. PMID:26634678

  7. Body mass index and risk of subtypes of head-neck cancer: the Netherlands Cohort Study.

    Science.gov (United States)

    Maasland, Denise H E; van den Brandt, Piet A; Kremer, Bernd; Schouten, Leo J

    2015-12-04

    Low body mass index (BMI) has been associated with risk of head-neck cancer (HNC), but prospective data are scarce. We investigated the association between BMI, BMI at age 20 years and change in BMI during adulthood with risk of HNC and HNC subtypes. 120,852 participants completed a questionnaire on diet and other cancer risk factors, including anthropometric measurements, at baseline in 1986. After 20.3 years of follow-up, 411 HNC (127 oral cavity cancer (OCC), 84 oro-/hypopharyngeal cancer (OHPC), and 197 laryngeal cancer (LC)) cases and 3,980 subcohort members were available for case-cohort analysis using Cox proportional hazards models. BMI at baseline was inversely associated with risk of HNC overall, with a multivariate rate ratio of 3.31 (95% CI 1.40-7.82) for subjects with a BMI risk appeared to be positive. In this large prospective cohort study, we found an inverse association between BMI at baseline and HNC risk. For BMI at age 20, however, a positive rather than inverse association was found.

  8. The Relationship between Native American Ancestry, Body Mass Index and Diabetes Risk among Mexican-Americans.

    Science.gov (United States)

    Hu, Hao; Huff, Chad D; Yamamura, Yuko; Wu, Xifeng; Strom, Sara S

    2015-01-01

    Higher body mass index (BMI) is a well-established risk factor for type 2 diabetes, and rates of obesity and type 2 diabetes are substantially higher among Mexican-Americans relative to non-Hispanic European Americans. Mexican-Americans are genetically diverse, with a highly variable distribution of Native American, European, and African ancestries. Here, we evaluate the role of Native American ancestry on BMI and diabetes risk in a well-defined Mexican-American population. Participants were randomly selected among individuals residing in the Houston area who are enrolled in the Mexican-American Cohort study. Using a custom Illumina GoldenGate Panel, we genotyped DNA from 4,662 cohort participants for 87 Ancestry-Informative Markers. On average, the participants were of 50.2% Native American ancestry, 42.7% European ancestry and 7.1% African ancestry. Using multivariate linear regression, we found BMI and Native American ancestry were inversely correlated; individuals with 80% Native American ancestry. Furthermore, we demonstrated an interaction between BMI and Native American ancestry in diabetes risk among women; Native American ancestry was a strong risk factor for diabetes only among overweight and obese women (OR = 1.190 for each 10% increase in Native American ancestry). This study offers new insight into the complex relationship between obesity, genetic ancestry, and their respective effects on diabetes risk. Findings from this study may improve the diabetes risk prediction among Mexican-American individuals thereby facilitating targeted prevention strategies.

  9. Association of Body Mass Index with Chromosome Damage Levels and Lung Cancer Risk among Males

    Science.gov (United States)

    Li, Xiaoliang; Bai, Yansen; Wang, Suhan; Nyamathira, Samuel Mwangi; Zhang, Xiao; Zhang, Wangzhen; Wang, Tian; Deng, Qifei; He, Meian; Zhang, Xiaomin; Wu, Tangchun; Guo, Huan

    2015-01-01

    Epidemiological studies have shown an etiological link between body mass index (BMI) and cancer risk, but evidence supporting these observations is limited. This study aimed to investigate potential associations of BMI with chromosome damage levels and lung cancer risk. First, we recruited 1333 male workers from a coke-oven plant to examine their chromosome damage levels; and then, a cohort study of 12 052 males was used to investigate the association of BMI with lung cancer incidence. We further carried out a meta-analysis for BMI and male lung cancer risk based on cohort studies. We found that men workers with excess body weight (BMI ≥ 25 kg/m2) had lower levels of MN frequencies than men with normal-weight (BMI: 18.5–24.9). Our cohort study indicated that, the relative risk (RR) for men with BMI ≥ 25 to develop lung cancer was 35% lower than RR for normal-weight men. Further meta-analysis showed that, compared to normal-weight men, men with BMI ≥ 25 had decreased risk of lung cancer among both the East-Asians and others populations. These results indicate that men with excess body weight had significant decreased chromosome damage levels and lower risk of lung cancer than those with normal-weight. However, further biological researches were needed to validate these associations. PMID:25820198

  10. Mendelian randomization study of body mass index and colorectal cancer risk

    Science.gov (United States)

    Thrift, Aaron P.; Gong, Jian; Peters, Ulrike; Chang-Claude, Jenny; Rudolph, Anja; Slattery, Martha L.; Chan, Andrew T.; Locke, Adam E.; Kahali, Bratati; Justice, Anne E.; Pers, Tune H.; Gallinger, Steven; Hayes, Richard B; Baron, John A.; Caan, Bette J.; Ogino, Shuji; Berndt, Sonja I.; Chanock, Stephen J.; Casey, Graham; Haile, Robert W.; Du, Mengmeng; Harrison, Tabitha A.; Thornquist, Mark; Duggan, David J.; Le Marchand, Loïc; Lindor, Noralane M.; Seminara, Daniela; Song, Mingyang; Wu, Kana; Thibodeau, Stephen N.; Cotterchio, Michelle; Win, Aung Ko; Jenkins, Mark A.; Hopper, John L.; Ulrich, Cornelia M.; Potter, John D.; Newcomb, Polly A.; Hoffmeister, Michael; Brenner, Hermann; White, Emily; Hsu, Li; Campbell, Peter T.

    2015-01-01

    Background High body mass index (BMI) is consistently linked to increased risk of colorectal cancer (CRC) for men, whereas the association is less clear for women. As risk estimates from observational studies may be biased and/or confounded, we conducted a Mendelian randomization study to estimate the causal association between BMI and CRC. Methods We used data from 10,226 CRC cases and 10,286 controls of European ancestry. The Mendelian randomization analysis used a weighted genetic risk score, derived from 77 genome-wide association study identified variants associated with higher BMI, as an instrumental variable (IV). We compared the IV odds ratio (IV-OR) with the OR obtained using a conventional covariate-adjusted analysis. Results Individuals carrying greater numbers of BMI-increasing alleles had higher CRC risk (per weighted allele OR, 1.31; 95% confidence interval [CI], 1.10–1.57). Our IV estimation results support the hypothesis that genetically influenced BMI is directly associated with risk for CRC (IV-OR per 5 kg/m2, 1.50; 95% CI, 1.13–2.01). In the sex-specific IV analyses higher BMI was associated with higher risk of CRC among women (IV-OR per 5 kg/m2, 1.82; 95% CI, 1.26–2.61). For men, genetically influenced BMI was not associated with CRC (IV-OR per 5 kg/m2, 1.18; 95% CI, 0.73–1.92). Conclusions High BMI was associated with increased CRC risk for women. Whether abdominal obesity, rather than overall obesity, is a more important risk factor for men requires further investigation. Impact Overall, conventional epidemiologic and Mendelian randomization studies suggest a strong association between obesity and the risk of CRC. PMID:25976416

  11. Dietary glycemic load and glycemic index and risk of cerebrovascular disease in the EPICOR cohort.

    Directory of Open Access Journals (Sweden)

    Sabina Sieri

    Full Text Available BACKGROUND: Studies on the association of stroke risk to dietary glycemic index (GI and glycemic load (GL have produced contrasting results. OBJECTIVE: To investigate the relation of dietary GI and GL to stroke risk in the large EPIC-Italy cohort (EPICOR recruited from widely dispersed geographic areas of Italy. DESIGN: We studied 44099 participants (13,646 men and 30,453 women who completed a dietary questionnaire. Multivariable Cox modeling estimated adjusted hazard ratios (HRs of stroke with 95% confidence intervals (95%CI. Over 11 years of follow-up, 355 stroke cases (195 ischemic and 83 hemorrhagic were identified. RESULTS: Increasing carbohydrate intake was associated with increasing stroke risk (HR = 2.01, 95%CI = 1.04-3.86 highest vs. lowest quintile; p for trend 0.025. Increasing carbohydrate intake from high-GI foods was also significantly associated with increasing stroke risk (HR 1.87, 95%CI = 1.16-3.02 highest vs. lowest, p trend 0.008, while increasing carbohydrate intake from low-GI foods was not. Increasing GL was associated with significantly increasing stroke risk (HR 2.21, 95%CI = 1.16-4.20, highest vs. lowest; p trend 0.015. Dietary carbohydrate from high GI foods was associated with increased both ischemic stroke risk (highest vs. lowest HR 1.92, 95%CI = 1.01-3.66 and hemorrhagic stroke risk (highest vs. lowest HR 3.14, 95%CI = 1.09-9.04. GL was associated with increased both ischemic and hemorrhagic stroke risk (HR 1.44, 95%CI = 1.09-1.92 and HR 1.56, 95%CI = 1.01-2.41 respectively, continuous variable. CONCLUSIONS: In this Italian cohort, high dietary GL and carbohydrate from high GI foods consumption increase overall risk of stroke.

  12. Body mass index cut-points to identify cardiometabolic risk in black South Africans.

    Science.gov (United States)

    Kruger, H Salome; Schutte, Aletta E; Walsh, Corinna M; Kruger, Annamarie; Rennie, Kirsten L

    2017-02-01

    To determine optimal body mass index (BMI) cut-points for the identification of cardiometabolic risk in black South African adults. We performed a cross-sectional study of a weighted sample of healthy black South Africans aged 25-65 years (721 men, 1386 women) from the North West and Free State Provinces. Demographic, lifestyle and anthropometric measures were taken, and blood pressure, fasting serum triglycerides, high-density lipoprotein (HDL) cholesterol and blood glucose were measured. We defined elevated cardiometabolic risk as having three or more risk factors according to international metabolic syndrome criteria. Receiver operating characteristic curves were applied to identify an optimal BMI cut-point for men and women. BMI had good diagnostic performance to identify clustering of three or more risk factors, as well as individual risk factors: low HDL-cholesterol, elevated fasting glucose and triglycerides, with areas under the curve >.6, but not for high blood pressure. Optimal BMI cut-points averaged 22 kg/m(2) for men and 28 kg/m(2) for women, respectively, with better sensitivity in men (44.0-71.9 %), and in women (60.6-69.8 %), compared to a BMI of 30 kg/m(2) (17-19.1, 53-61.4 %, respectively). Men and women with a BMI >22 and >28 kg/m(2), respectively, had significantly increased probability of elevated cardiometabolic risk after adjustment for age, alcohol use and smoking. In black South African men, a BMI cut-point of 22 kg/m(2) identifies those at cardiometabolic risk, whereas a BMI of 30 kg/m(2) underestimates risk. In women, a cut-point of 28 kg/m(2), approaching the WHO obesity cut-point, identifies those at risk.

  13. A Risk-Free Protection Index Model for Portfolio Selection with Entropy Constraint under an Uncertainty Framework

    Directory of Open Access Journals (Sweden)

    Jianwei Gao

    2017-02-01

    Full Text Available This paper aims to develop a risk-free protection index model for portfolio selection based on the uncertain theory. First, the returns of risk assets are assumed as uncertain variables and subject to reputable experts’ evaluations. Second, under this assumption, combining with the risk-free interest rate we define a risk-free protection index (RFPI, which can measure the protection degree when the loss of risk assets happens. Third, note that the proportion entropy serves as a complementary means to reduce the risk by the preset diversification requirement. We put forward a risk-free protection index model with an entropy constraint under an uncertainty framework by applying the RFPI, Huang’s risk index model (RIM, and mean-variance-entropy model (MVEM. Furthermore, to solve our portfolio model, an algorithm is given to estimate the uncertain expected return and standard deviation of different risk assets by applying the Delphi method. Finally, an example is provided to show that the risk-free protection index model performs better than the traditional MVEM and RIM.

  14. Cumulative dietary exposure of the population of Denmark to pesticides.

    Science.gov (United States)

    Jensen, Bodil Hamborg; Petersen, Annette; Nielsen, Elsa; Christensen, Tue; Poulsen, Mette Erecius; Andersen, Jens Hinge

    2015-09-01

    We used the Hazard Index (HI) method to carry out a cumulative risk assessment after chronic dietary exposure to all monitored pesticides in fruit, vegetables and cereals for various consumer groups in Denmark. Residue data for all the pesticides were obtained from the Danish monitoring programme during the period 2004-2011. Food consumption data were obtained from DANSDA (the DAnish National Survey of Diet and physical Activity) for the period 2005-2008. The calculations were made using three different models to cope with residues below the limit of reporting (LOR). We concluded that a model that included processing factors and set non-detects to ½ LOR, but limited the correction (Model 3), gave the most realistic exposure estimate. With Model 3 the HI was calculated to be 0.44 for children and 0.18 for adults, indicating that there is no risk of adverse health effects following chronic cumulative exposure to the pesticides found in fruit, vegetables and cereals on the Danish market. The HI was below 1 even for consumers who eat more than 550 g of fruit and vegetables per day, corresponding to 1/3 of the population. Choosing Danish-produced commodities whenever possible could reduce the HI by a factor of 2.

  15. Body mass index and risk of pneumonia: a systematic review and meta-analysis.

    Science.gov (United States)

    Phung, D T; Wang, Z; Rutherford, S; Huang, C; Chu, C

    2013-10-01

    The aims of our meta-analysis were to examine the pattern and gender's influence on body mass index (BMI) - pneumonia relationship. Published studies were searched from PubMed, Web of Science, Cochrane Library databases using keywords of pneumonia, BMI and epidemiologic studies. Random-effects analysis was applied to estimate pooled effect sizes from individual studies. The Cochrane Q-test and index of heterogeneity (I(2) ) were used to evaluate heterogeneity, and Egger's test was used to evaluate publication bias. Random-effects meta-regression was applied to examine the pattern and gender's influence on BMI-pneumonia relationship. A total of 1,531 studies were initially identified, and 25 studies finally were included. The pooled relative risk (RR) and meta-regression model revealed a J-shaped relationship between BMI and risk of community-acquired pneumonia (underweight, RR 1.8, 95% confidence interval [CI], 1.4-2.2, P pneumonia (underweight, RR 1.9, 95% CI, 1.2-3, P pneumonia was found across the BMI groups. Gender difference did not make significant contribution in modifying BMI-pneumonia risk relationship.

  16. Dietary glycemic index, glycemic load, and cardiovascular disease risk factors: Tehran Lipid and Glucose Study.

    Science.gov (United States)

    Hosseinpour-Niazi, Somayeh; Sohrab, Golbon; Asghari, Golaleh; Mirmiran, Parvin; Moslehi, Nazanin; Azizi, Fereidoun

    2013-07-01

    Data available on the effect of quality (glycemic index [GI]) and quantity (glycemic load [GL]) of carbohydrates on the risk factors of cardiovascular disease (CVD) are inconsistent. The objective of this study was to examine the association between dietary GI, GL, and CVD risk factors among Tehranian adults, the participants of the Tehran Lipid and Glucose Study. This population- based cross-sectional study was conducted on 2457 subjects (46% men and 54% women), aged 19 to 84 years. Dietary GI and GL were measured using a validated 168- item semiquantitative food frequency questionnaire. Anthropometrics, blood pressure, fasting blood glucose, and lipid profiles were measured. The mean intakes of GI and GL were 68.3 and 244.8, respectively. Rice (26.6%) and bread (19.0%) were the major contributors to dietary GI and GL, respectively. Higher dietary GI and GL were associated with high intakes of carbohydrate, fiber, refined grain, fruits, simple sugar, snack, and desserts. After adjustment for lifestyle and dietary variables, a higher dietary GI was positively associated with triglycerides and high-density lipoprotein (HDL) cholesterol concentrations among obese subjects. Dietary GL was positively associated with fasting and 2-h blood glucose among nonobese subjects, after adjustment for confounders.   Dietary GI and GL were associated with a few CVD risk factors, and body mass index levels may modulate these associations.

  17. Correlation between body mass index and the risk factors and severity of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Jing LI

    2011-04-01

    Full Text Available Objective To assess the correlation between body mass index and the risk factors and severity of coronary artery disease.Methods Five thousand two hundred and ninety-four patients with suspected coronary artery disease,who underwent coronary angiography from Jan.2001 to Mar.2007 at 20 medical centers in China,were enrolled in the present study.The patients were divided into normal,overweight and obesity group,and body mass index(BMI,blood pressure(BP,blood glucose,serum total cholesterol(TC,triglyceride(TG,low-density lipoprotein cholesterol(LDL-C and high-density lipoprotein cholesterol(HDL-C were measured.The correlation between BMI and the risk factors and severity of coronary artery disease(CAD was analyzed.And the correlation between gender in different BMI group and CAD rick factors was also evaluated.Results The BMI was correlated with BP,TC,blood glucose,age and HDL-C(P 0.05 in male group.The BMI was correlated with BP,TC,TG,LDL-C and high blood glucose(P 0.05 in female group.Logistic regression analysis showed that hypertension was a prominent predictor of overweight and obesity(OR=2.102,95%CI 1.762~2.509.Conclusion BMI is significantly correlated with blood glucose,BP,TG,TC,LDL-C and HDL-C,but it is not an independent risk factor for CAD.

  18. Body mass index and risk for mental stress induced ischemia in coronary artery disease.

    Science.gov (United States)

    Soufer, Robert; Fernandez, Antonio B; Meadows, Judith; Collins, Dorothea; Burg, Matthew M

    2016-05-19

    Acute emotionally reactive mental stress (MS) can provoke prognostically relevant deficits in cardiac function and myocardial perfusion, and chronic inflammation increases risk for this ischemic phenomenon. We have described parasympathetic withdrawal and generation of inflammatory factors in MS. Adiposity is also associated with elevated markers of chronic inflammation. High body mass index (BMI) is frequently used as a surrogate for assessment of excess adiposity, and associated with traditional CAD risk factors, and CAD mortality. BMI is also associated with autonomic dysregulation, adipose tissue derived proinflammatory cytokines, which are also attendant to emotion provoked myocardial ischemia. Thus, we sought to determine if body mass index (BMI) contributes to risk of developing myocardial ischemia provoked by mental stress. We performed a prospective interventional study in a cohort of 161 patients with stable CAD. They completed an assessment of myocardial blood flow with single photon emission computed tomography (SPECT) simultaneously during 2 conditions: laboratory mental stress and at rest. Multivariate logistic regression determined the independent contribution of BMI to the occurrence of mental-stress induced ischemia. Mean age was 65.6±9.0 years; 87.0% had a history of hypertension, and 28.6% had diabetes. Mean BMI was 30.4±4.7. Prevalence of mental stress ischemia was 39.8%. BMI was an independent predictor of mental stress ischemia, OR=1.10, 95% CI [1.01-1.18] for one-point increase in BMI and OR=1.53, 95% CI [1.06-2.21] for a 4.7 point increase in BMI (one standard deviation beyond the cohort BMI mean), p=0.025 for all. These data suggest that BMI may serve as an independent risk marker for mental stress ischemia. The factors attendant with greater BMI, which include autonomic dysregulation and inflammation, may represent pathways by which high BMI contribute to this risk and serve as a conceptual construct to replicate these findings in larger

  19. The Aftershock Risk Index - quantification of aftershock impacts during ongoing strong-seismic sequences

    Science.gov (United States)

    Schaefer, Andreas; Daniell, James; Khazai, Bijan; Wenzel, Friedemann

    2016-04-01

    The occurrence and impact of strong earthquakes often triggers the long-lasting impact of a seismic sequence. Strong earthquakes are generally followed by many aftershocks or even strong subsequently triggered ruptures. The Nepal 2015 earthquake sequence is one of the most recent examples where aftershocks significantly contributed to human and economic losses. In addition, rumours about upcoming mega-earthquakes, false predictions and on-going cycles of aftershocks induced a psychological burden on the society, which caused panic, additional casualties and prevented people from returning to normal life. This study shows the current phase of development of an operationalised aftershock intensity index, which will contribute to the mitigation of aftershock hazard. Hereby, various methods of earthquake forecasting and seismic risk assessments are utilised and an integration of the inherent aftershock intensity is performed. A spatio-temporal analysis of past earthquake clustering provides first-hand data about the nature of aftershock occurrence. Epidemic methods can additionally provide time-dependent variation indices of the cascading effects of aftershock generation. The aftershock hazard is often combined with the potential for significant losses through the vulnerability of structural systems and population. A historical database of aftershock socioeconomic effects from CATDAT has been used in order to calibrate the index based on observed impacts of historical events and their aftershocks. In addition, analytical analysis of cyclic behaviour and fragility functions of various building typologies are explored. The integration of many different probabilistic computation methods will provide a combined index parameter which can then be transformed into an easy-to-read spatio-temporal intensity index. The index provides daily updated information about the probability of the inherent seismic risk of aftershocks by providing a scalable scheme fordifferent aftershock

  20. A risk index for multicriterial selection of a logging system with low environmental impact

    Energy Technology Data Exchange (ETDEWEB)

    Horodnic, Sergiu Andrei, E-mail: horodnic@usv.ro

    2015-02-15

    Setting up the working stages in forest operations is conditioned by environmental protection and forest health requirements. This paper exposes a method for improving the decision-making process by choosing the most environmentally effective logging systems according to terrain configuration and stand characteristics. Such a methodology for selecting machines or logging systems accounting for environment, safety as well as economics, becomes mandatory in the context of sustainable management of forest with multiple functions. Based on analytic hierarchy process analysis the following classification of the environmental performance for four considered alternatives was obtained: skyline system (42.43%), forwarder system (20.22%), skidder system (19.92%) and horse logging system (17.43%). Further, an environmental risk matrix for the most important 28 risk factors specific to any work equipment used in forest operations was produced. In the end, a multicriterial analysis generated a risk index RI ranging between 1.0 and 3.5, which could help choosing the optimal combination of logging system and logging equipment with low environmental impact. In order to demonstrate the usefulness of the proposed approach, a simple application in specific conditions of a harvesting site is presented. - Highlights: • We propose a decision-making algorithm to select eco-friendly logging systems. • Analytic hierarchy process was applied for ranking 4 types of logging systems. • An environmental risk matrix with 28 risk factors in forest operations was made up.

  1. Utilization of kidneys with similar kidney donor risk index values from standard versus expanded criteria donors.

    Science.gov (United States)

    Woodside, K J; Merion, R M; Leichtman, A B; de los Santos, R; Arrington, C J; Rao, P S; Sung, R S

    2012-08-01

    With the shortage of standard criteria donor (SCD) kidneys, efficient expanded criteria donor (ECD) kidney utilization has become more vital. We investigated the effects of the ECD label on kidney recovery, utilization and outcomes. Using data from the Scientific Registry of Transplant Recipients from November 2002 to May 2010, we determined recovery and transplant rates, and modeled discard risk, for kidneys within a range of kidney donor risk index (KDRI) 1.4-2.1 that included both SCD and ECD kidneys. To further compare similar quality kidneys, these kidneys were again divided into three KDRI intervals. Overall, ECD kidneys had higher recovery rates, but lower transplant rates. However, within each KDRI interval, SCD and ECD kidneys were transplanted at similar rates. Overall, there was increased risk for discard for biopsied kidneys. SCD kidneys in the lower two KDRI intervals had the highest risk of discard if biopsied. Pumped kidneys had a lower risk of discard, which was modulated by KDRI for SCD kidneys but not ECD kidneys. Although overall ECD graft survival was worse than SCD, there were no differences within individual KDRI intervals. Thus, ECD designation adversely affects neither utilization nor outcomes beyond that predicted by KDRI.

  2. Maternal Body Mass Index and Risk of Autism Spectrum Disorders in Offspring: A Meta-analysis

    Science.gov (United States)

    Wang, Ying; Tang, Shiming; Xu, Shunsheng; Weng, Shenhong; Liu, Zhongchun

    2016-01-01

    Controversial results of the association between maternal body mass index (BMI) and risk of autism spectrum disorder (ASD) in offspring were reported among several studies. This meta-analysis was conducted to estimate the overall association between maternal BMI and risk of ASD in offspring. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched until January 2016. Cohort and case-control studies addressing the association between maternal BMI and risk of ASD in offspring were included. We used random-effect models to estimate the summary relative risks (RRs), we also performed a dose-response meta-analysis to estimate the trend from the correlated log RR estimates across levels of BMI quantitatively. Totally, 6 cohort studies and 1 case-control study involving 8,403 cases and 509,167 participants were included for analysis. The summary RR (95% confidence interval) for ASD in offspring in relation to maternal underweight, overweight, and obesity vs. normal weight during pre-pregnancy or pregnancy, was 1.07 (0.93, 1.23), 1.28 (1.19, 1.36) and 1.36 (1.03, 1.78), respectively. A linear dose-response relationship was found, with a pooled RR of 1.16 (1.01, 1.33) for each 5 kg/m2. increment in maternal BMI. The present study suggests that excessive maternal BMI is associated with increased ASD risk in offspring. PMID:27687989

  3. Predicting dyslexia at age 11 from a risk index questionnaire at age 5.

    Science.gov (United States)

    Helland, Turid; Plante, Elena; Hugdahl, Kenneth

    2011-08-01

    This study focused on predicting dyslexia in children ahead of formal literacy training. Because dyslexia is a constitutional impairment, risk factors should be seen in preschool. It was hypothesized that data gathered at age 5 using questions targeting the dyslexia endophenotype should be reliable and valid predictors of dyslexia at age 11. A questionnaire was given to caretakers of 120 5-year-old children, and a risk index score was calculated based on questions regarding health, laterality, motor skills, language, special needs education and heredity. An at-risk group (n = 25) and matched controls (n = 24) were followed until age 11, when a similar questionnaire and literacy tests were administered to the children who participated in the follow-up study (22 at risk and 20 control). Half of the at-risk children and two of the control children at age 5 were identified as having dyslexia at age 11 (8 girls and 5 boys). It is concluded that it is possible to identify children at the age of 5 who will have dyslexia at the age of 11 through a questionnaire approach.

  4. Association between prostatic resistive index and cardiovascular risk factors in patients with benign prostatic hyperplasia.

    Science.gov (United States)

    Baykam, Mehmet Murat; Aktas, Binhan Kagan; Bulut, Suleyman; Ozden, Cuneyt; Deren, Tagmac; Tagci, Suleyman; Gokkaya, Cevdet Serkan; Memis, Ali

    2015-04-01

    We evaluated the relationship between prostatic resistive index (RI) and cardiovascular system (CVS) risk factors in patients with benign prostatic hyperplasia. The study included 120 patients who were attending our outpatient clinic with lower urinary tract symptoms related to benign prostatic hyperplasia. The clinical, laboratory, anthropometric data, and CVS risk factors (hypertension, diabetes mellitus, metabolic syndrome, history of CVS events, and smoking) of the patients were evaluated regarding the association between prostate RI level by regression analyses. The prostatic RI levels of the patients were measured using power Doppler imaging. In univariate regression analysis, there were statistically significant relationships between prostatic RI levels and the patients' age, International Prostate Symptom Score, hip circumference, fasting blood glucose, prostate specific antigen, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total prostate volume, uroflowmetric maximal flow rate, and all investigated CVS risk factors (p prostatic RI levels were found to be associated with fasting blood glucose and total prostate volume, and also with CVS risk factors including only metabolic syndrome and cigarette smoking in the multivariate regression analysis. Our results showed that prostatic RI level is significantly related to metabolic syndrome and smoking among the investigated CVS risk factors.

  5. Glycemic load, glycemic index, and the risk of breast cancer among Mexican women.

    Science.gov (United States)

    Lajous, Martin; Willett, Walter; Lazcano-Ponce, Eduardo; Sanchez-Zamorano, Luisa Maria; Hernandez-Avila, Mauricio; Romieu, Isabelle

    2005-12-01

    The amount and composition of dietary carbohydrates is a major determinant of postprandial blood glucose and insulin, and risk of breast cancer has been positively associated with plasma levels of insulin and insulin-like growth factor 1. We sought to evaluate dietary glycemic load (GL) and overall glycemic index (GI) in relation to breast cancer risk in Mexican women. We examined dietary GL and overall GI and breast cancer risk among 475 women with histologically-confirmed breast cancer and a random sample of 1391 women from Mexico City households. Diet was assessed using a food frequency questionnaire adapted to the Mexican population. The multivariate adjusted or for all women comparing the highest quartile of dietary GL with the lowest quartile was 1.62 (95% CI 1.13-2.32; p-test for trend = 0.02) with a significant trend. In postmenopausal women, the multivariate adjusted or comparing the extreme quartiles was 2.18 (95% CI 1.34-3.55; p-test for trend=0.005). Overall GI was not significantly associated with risk of breast cancer. High intake of rapidly absorbed carbohydrate appears to play an important role in the risk of breast cancer in Mexican women.

  6. Risk Level Assessment in Construction Projects Using the Schedule Performance Index

    Directory of Open Access Journals (Sweden)

    Roberto Barbosa dos Santos

    2016-01-01

    Full Text Available Construction projects are risky in both physical implementation and management. The characteristics of the risk reinforce the necessity of efficient management to increase the chances of success without commitment to its goals. This study explores the correlation of delay and the schedule performance index (SPI to evaluate the risk of a construction project completed with time overruns. The hypothesis that the SPI of projects with a delay is distinct from those projects without a delay is assumed. A database with 19 elements was used to test this hypothesis and to calculate limit values to the SPI. Therefore, the risk of delay will be small when the observed SPI is greater than the superior limit and large when the SPI is below the inferior limit. The simplicity involved in the calculation of these values showed an advantage in comparison with other methods of risk evaluation. Another strong point observed is that any company can determine the value of risk by considering its own history and support decisions like doing corrective actions.

  7. Cumulative environmental effects. Summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    This report presents a compilation of knowledge about the state of the environment and human activity in the Norwegian part of the North Sea and Skagerrak. The report gives an overview of pressures and impacts on the environment from normal activity and in the event of accidents. This is used to assess the cumulative environmental effects, which factors have most impact and where the impacts are greatest, and to indicate which problems are expected to be most serious in the future. The report is intended to provide relevant information that can be used in the management of the marine area in the future. It also provides input for the identification of environmental targets and management measures for the North Sea and Skagerrak.(Author)

  8. Relation of body mass index to risk of stent thrombosis after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Schmiegelow, Michelle; Torp-Pedersen, Christian; Gislason, Gunnar H;

    2012-01-01

    [CI] 0.86 to 0.97) for each increase in kilograms per square meter of BMI. There was no significant interaction between stent type and BMI (p = 0.48). Hazard ratios for probable stent thrombosis and possible stent thrombosis adjusted for numbers of stents at the index PCI were 1.01 (CI 0.99 to 1.......03) and 0.99 (CI 0.98 to 1.01) for each increase in kilograms per square meter of BMI, respectively. In conclusion, BMI was inversely correlated with risk of definite stent thrombosis after PCI irrespective of stent type....

  9. Overall glycaemic index and glycaemic load of habitual diet and risk of heart disease

    DEFF Research Database (Denmark)

    Grau, Katrine; Tetens, Inge; Bjørnsbo, Kirsten S

    2011-01-01

    Objective To test the hypothesis that diets with high glycaemic index (GI) and glycaemic load (GL) increase the risk of heart disease. Design Overall GI and GL were assessed from 7 d diet records or diet history interviews. Setting Information on hospitalization and death due to CVD and CHD...... with either outcome. In women no clear association between overall GI and heart disease was found, whereas positive non-linear associations were found for GL: at very high levels of GL, increase in GL was associated with increasing CVD and CHD morbidity. Conclusions In men low-GI diets were associated...

  10. Childhood body mass index and height and risk of histologic subtypes of endometrial cancer

    DEFF Research Database (Denmark)

    Aarestrup, J.; Gamborg, M.; Ulrich, L. G.;

    2016-01-01

    . METHODS: From the Copenhagen School Health Records Register, 155 505 girls born 1930-1989 with measured weights and heights from 7 to 13 years were linked to health registers. BMI and height were transformed to age-specific z-scores. Hazard ratios (HRs) and 95% confidence intervals were estimated by Cox......BACKGROUND: Endometrial cancer risk factors include adult obesity and taller stature, but the influence of size earlier in life is incompletely understood. We examined whether childhood body mass index (BMI; kg m(-2)) and height were associated with histologic subtypes of endometrial cancer...

  11. Association Between Lateral Posterior Tibial Slope, Body Mass Index, and ACL Injury Risk

    Science.gov (United States)

    Bojicic, Katherine M.; Beaulieu, Mélanie L.; Imaizumi Krieger, Daniel Y.; Ashton-Miller, James A.; Wojtys, Edward M.

    2017-01-01

    Background: While body mass index (BMI), a modifiable parameter, and knee morphology, a nonmodifiable parameter, have been identified as risk factors for anterior cruciate ligament (ACL) rupture, the interaction between them remains unknown. An understanding of this interaction is important because greater compressive axial force (perhaps due to greater BMI) applied to a knee that is already at an increased risk because of its geometry, such as a steep lateral posterior tibial slope, could further increase the probability of ACL injury. Purpose: To quantify the relationship between BMI and select knee morphological parameters as potential risk factors for ACL injury. Study Design: Case-control study; Level of evidence, 3. Methods: Sagittal knee magnetic resonance imaging (MRI) files from 76 ACL-injured and 42 uninjured subjects were gathered from the University of Michigan Health System’s archive. The posterior tibial slope (PTS), middle cartilage slope (MCS), posterior meniscus height (PMH), and posterior meniscus bone angle (MBA) in the lateral compartment were measured using MRI. BMI was calculated from demographic data. The association between the knee structural factors, BMI, and ACL injury risk was explored using univariate and multivariate logistic regression. Results: PTS (P = .043) and MCS (P = .037) significantly predicted ACL injury risk. As PTS and MCS increased by 1°, odds of sustaining an ACL injury increased by 12% and 13%, respectively. The multivariate logistic regression analysis, which included PTS, BMI centered around the mean (cBMI), and their interaction, showed that this interaction predicted the odds of ACL rupture (P = .050; odds ratio, 1.03). For every 1-unit increase in BMI from the average that is combined with a 1° increase in PTS, the odds of an ACL tear increased by 15%. Conclusion: An increase in BMI was associated with increased risk of ACL tear in the presence of increased lateral posterior tibial slope. Larger values of PTS or

  12. Glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases

    Directory of Open Access Journals (Sweden)

    Tatiana Uchôa Passos

    2015-03-01

    Full Text Available The objective was to determine the glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases. Nine fruits were investigated: coconut water (for the purpose of this study, coconut water was classified as a “fruit”, guava, tamarind, passion fruit, custard apple, hog plum, cashew, sapodilla, and soursop. The GI and GL were determined according to the Food and Agriculture Organization protocol. The GL was calculated taking into consideration intake recommendation guidelines; 77.8% of the fruits had low GI although significant oscillations were observed in some graphs, which may indicate potential risks of disease. Coconut water and custard apple had a moderate GI, and all fruits had low GL. The fruits evaluated are healthy and can be consumed following the daily recommended amount. However, caution is recommended with fruits causing early glycemic peak and the fruits with moderated GI (coconut water and custard apple.

  13. Height, weight and body mass index in early adulthood and risk of schizophrenia

    DEFF Research Database (Denmark)

    2006-01-01

    status when the cohort members were 1 year old, birth weight, birth length, and maternal pre-pregnancy BMI. RESULTS: Forty-five cases of schizophrenia had a lower young adult mean body weight and BMI than controls. A significant inverse relationship between BMI and risk of later schizophrenia was found....... No significant differences between cases and controls were observed with respect to adult height. CONCLUSION: Independent of several possible confounders, an inverse relationship between young adult BMI and risk of later development of schizophrenia was demonstrated in this all-male sample.......OBJECTIVE: To illuminate the possible associations between height, weight, and body mass index (BMI) during early adulthood and the development of schizophrenia. METHOD: This prospective study is based on an all-male sample of 3210 individuals from the Copenhagen Perinatal Cohort, comprising...

  14. Project 6: Cumulative Risk Assessment Methods and ApplicationsTask 6.3: Applying Genetic and Epigenetic Data to Inform Susceptibility

    Science.gov (United States)

    Susceptibility is defined as the capacity to be affected; an individual can be at greater or less risk relative to population median risk because of susceptibility factors such as life stage, sex, genetics, socioeconomic status, prior exposure to chemicals, and non-chemical stres...

  15. The Relationship between Native American Ancestry, Body Mass Index and Diabetes Risk among Mexican-Americans: e0141260

    National Research Council Canada - National Science Library

    Hao Hu; Chad D Huff; Yuko Yamamura; Xifeng Wu; Sara S Strom

    2015-01-01

      Higher body mass index (BMI) is a well-established risk factor for type 2 diabetes, and rates of obesity and type 2 diabetes are substantially higher among Mexican-Americans relative to non-Hispanic European Americans...

  16. Determination of the health of Lunyangwa wetland using Wetland Classification and Risk Assessment Index

    Science.gov (United States)

    Wanda, Elijah M. M.; Mamba, Bhekie B.; Msagati, Titus A. M.; Msilimba, Golden

    2016-04-01

    Wetlands are major sources of various ecological goods and services including storage and distribution of water in space and time which help in ensuring the availability of surface and groundwater throughout the year. However, there still remains a poor understanding of the range of values of water quality parameters that occur in wetlands either in its impacted state or under natural conditions. It was thus imperative to determine the health of Lunyangwa wetland in Mzuzu City in Malawi in order to classify and determine its state. This study used the Escom's Wetland Classification and Risk Assessment Index Field Guide to determine the overall characteristics of Lunyangwa wetland and to calculate its combined Wetland Index Score. Data on site information, field measurements (i.e. EC, pH, temperature and DO) and physical characteristics of Lunyangwa wetland were collected from March, 2013 to February, 2014. Results indicate that Lunyangwa wetland is a largely open water zone which is dominated by free-floating plants on the water surface, beneath surface and emergent in substrate. Furthermore, the wetland can be classified as of a C ecological category (score = 60-80%), which has been moderately modified with moderate risks of the losses and changes occurring in the natural habitat and biota in the wetland. It was observed that the moderate modification and risk were largely because of industrial, agricultural, urban/social catchment stressors on the wetland. This study recommends an integrated and sustainable management approach coupled with continuous monitoring and evaluation of the health of the wetland for all stakeholders in Mzuzu City. This would help to maintain the health of Lunyangwa wetland which is currently at risk of being further modified due to the identified catchment stressors.

  17. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  18. Dietary Carbohydrate, Glycemic Index, and Glycemic Load in Relation to Colorectal Cancer Risk in the Women’s Health Initiative

    OpenAIRE

    2008-01-01

    Evidence implicating hyperinsulinemia and insulin resistance in the etiology of colorectal cancer suggests that a diet characterized by a high glycemic index and load may increase the risk of this disease, but previous studies have yielded inconsistent results. We assessed the association between intake of total carbohydrates, sugars, fiber, and the glycemic index (GI) and glycemic load (GL) of individual diets, and risk of developing colorectal cancer among 158,800 participants in the Women’...

  19. Risks, Returns, and Portfolio Diversification Benefits of Country Index Funds in Bear and Bull Markets

    Directory of Open Access Journals (Sweden)

    Ilhan Meric,

    2011-01-01

    Full Text Available In this paper, we study the risk-return performance of 23 Ishares country index funds in the U.S. during the May 19, 2008-March 9, 2009 bear market and the March 9, 2009-January 19, 2010 bull market. Our findings with the Sharpe and Treynor portfolio performance measures indicate that the Malaysia, Japan, U.S., and Switzerland country index funds had the best performance in both markets. The statistics indicate that, in terms of loss recovery from the bear market to the bull market, the Malaysia, Singapore, South Africa, and Australia funds had the best performance and the Belgium, Austria, Italy, and Germany funds had the worst performance. Exchange-traded country index funds make it easy for investors to achieve global diversification. Our findings with the PCA (Principal Components Analysis methodology indicate that investors had more global diversification opportunities in the March 9, 2009-January 19, 2010 bull market than in the May 19, 2008-March 9, 2009 bear market.

  20. Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.

    Directory of Open Access Journals (Sweden)

    Miguel A Martínez-González

    Full Text Available Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality.We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR, waist circumference (WC, body mass index (BMI and height with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years and 57% were women (60 to 80 years. All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009.After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70 were 1.02 (0.78-1.34, 1.30 (0.97-1.75 and 1.55 (1.06-2.26. When we used WC (cut-off points: 100, 105 and 110 cm, the multivariable adjusted Hazard Ratios (HRs for mortality were 1.18 (0.88-1.59, 1.02 (0.74-1.41 and 1.57 (1.19-2.08. In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial.Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality.Controlled-Trials.com ISRCTN35739639.

  1. Obesity Indexes and Total Mortality among Elderly Subjects at High Cardiovascular Risk: The PREDIMED Study

    Science.gov (United States)

    Martínez-González, Miguel A.; García-Arellano, Ana; Toledo, Estefanía; Bes-Rastrollo, Maira; Bulló, Mónica; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Lamuela-Raventós, Rosa Maria; Rekondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Santos-Lozano, Jose Manuel; Serra-Majem, Lluis; Martínez, J. Alfredo; Eguaras, Sonia; Sáez-Tormo, Guillermo; Pintó, Xavier; Estruch, Ramon

    2014-01-01

    Background Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. Methods We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. Results After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78–1.34), 1.30 (0.97–1.75) and 1.55 (1.06–2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88–1.59), 1.02 (0.74–1.41) and 1.57 (1.19–2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. Conclusions Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality. Trial

  2. Increased Dietary Inflammatory Index (DII) Is Associated With Increased Risk of Prostate Cancer in Jamaican Men

    Science.gov (United States)

    Shivappa, Nitin; Jackson, Maria D.; Bennett, Franklyn; Hébert, James R.

    2015-01-01

    Purpose Prostate cancer is the most common non-skin malignancy; and it accounts for the most cancer deaths among Jamaican males. Diet has been implicated in the etiology of prostate cancer, including through its effects on inflammation. Method We examined the association between a newly developed dietary inflammatory index (DII) and prostate cancer in a case-control study of 40-80 year-old Jamaican males. A total of 229 incident cases and 250 controls attended the same urology out-patient clinics at 2 major hospitals and private practitioners in the Kingston, Jamaica Metropolitan area between March 2005 and July 2007. The DII was computed based on dietary intake assessed using a previously validated food frequency questionnaire (FFQ) that was expanded to assess diet and cancer in this Jamaican population. Multivariable logistic regression was used to estimate odds ratios, with DII as continuous and expressed as quartiles. Logistic regression analysis adjusted for age, total energy intake, education, body mass index (BMI), smoking status, physical activity and family history of prostate cancer. Results Men in the highest quartile of the DII were at higher risk of prostate cancer [odds ratio (OR) = 2.39; 95% confidence interval (CI) =1.14–5.04 (Ptrend = 0.08)] compared to men in the lowest DII quartile. Conclusion These data suggest a pro-inflammatory diet, as indicated by increasing DII score, may be a risk factor for prostate cancer in Jamaican men. PMID:26226289

  3. Dietary glycemic index and glycemic load and their relationship to cardiovascular risk factors in Chinese children.

    Science.gov (United States)

    Zhang, Xinyu; Zhu, Yanna; Cai, Li; Ma, Lu; Jing, Jin; Guo, Li; Jin, Yu; Ma, Yinghua; Chen, Yajun

    2016-04-01

    The purpose of this study was to examine the cross-sectional associations between dietary glycemic index (GI) and glycemic load (GL) and cardiovascular disease (CVD) risk factors in Chinese children. A total of 234 Chinese schoolchildren aged 8-11 years in Guangdong participated in the study. Dietary intake was assessed via a 3-day dietary record. Seven established cardiovascular indicators were analyzed in this study: fasting plasma glucose (FPG), fasting triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure. Higher dietary GI was significantly associated with higher TG levels (P = 0.037) and lower HDL-C levels (P = 0.005) after adjusting for age, sex, nutritional intake, physical activity, and body mass index z score. LDL-C was found to differ across tertiles of dietary GL. The middle tertile tended to show the highest level of LDL-C. TC, FPG, and blood pressure were independent of both dietary GI and GL. Our findings suggest that higher dietary GI is differentially associated with some CVD risk factors, including lower HDL-C and higher TG, in school-aged children from south China.

  4. Percent body fat is a better predictor of cardiovascular risk factors than body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Qiang; Dong, Sheng-Yong; Sun, Xiao-Nan; Xie, Jing; Cui, Yi [International Medical Center, Chinese PLA General Hospital, Beijing (China)

    2012-04-20

    The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor.

  5. Dietary carbohydrate intake, glycaemic load, glycaemic index and ovarian cancer risk in African-American women.

    Science.gov (United States)

    Qin, Bo; Moorman, Patricia G; Alberg, Anthony J; Barnholtz-Sloan, Jill S; Bondy, Melissa; Cote, Michele L; Funkhouser, Ellen; Peters, Edward S; Schwartz, Ann G; Terry, Paul; Schildkraut, Joellen M; Bandera, Elisa V

    2016-02-28

    Epidemiological evidence regarding the association between carbohydrate intake, glycaemic load (GL) and glycaemic index (GI) and risk of ovarian cancer has been mixed. Little is known about their impact on ovarian cancer risk in African-American women. Associations between carbohydrate quantity and quality and ovarian cancer risk were investigated among 406 cases and 609 controls using data from the African American Cancer Epidemiology Study (AACES). AACES is an ongoing population-based case-control study of ovarian cancer in African-Americans in the USA. Cases were identified through rapid case ascertainment and age- and site-matched controls were identified by random-digit dialling. Dietary information over the year preceding diagnosis or the reference date was obtained using a FFQ. Multivariable logistic regression models were used to estimate odds ratios and 95% CI adjusted for covariates. The OR comparing the highest quartile of total carbohydrate intake and total sugar intake v. the lowest quartile were 1·57 (95% CI 1·08, 2·28; P trend=0·03) and 1·61 (95% CI 1·12, 2·30; P trendcancer (OR 1·18 for each 10 units/4184 kJ (1000 kcal); 95% CI 1·04, 1·33). No associations were observed for starch or GI. Our findings suggest that high intake of total sugars and GL are associated with greater risk of ovarian cancer in African-American women.

  6. Dietary glycemic index and glycemic load and the risk of type 2 diabetes in older adults.

    Science.gov (United States)

    Sahyoun, Nadine R; Anderson, Amy L; Tylavsky, Frances A; Lee, Jung Sun; Sellmeyer, Deborah E; Harris, Tamara B

    2008-01-01

    It is unclear whether immediate dietary effects on blood glucose influence the risk of developing type 2 diabetes. The objective of this study was to examine whether the dietary glycemic index (GI) and glycemic load (GL) were associated with the risk of type 2 diabetes in older adults. The Health, Aging, and Body Composition Study is a prospective cohort study of 3075 adults who were 70-79 y old at baseline (n=1898 for this analysis). The intakes of specific nutrients and food groups and the risk of type 2 diabetes over a 4-y period were examined according to dietary GI and GL. Dietary GI was positively associated with dietary carbohydrate and negatively associated with the intakes of protein, total fat, saturated fat, alcohol, vegetables, and fruit. Dietary GL was positively associated with dietary carbohydrate, fruit, and fiber and negatively associated with the intakes of protein, total fat, saturated fat, and alcohol. Persons in the higher quintiles of dietary GI or GL did not have a significantly greater incidence of type 2 diabetes. These findings do not support a relation between dietary GI or GL and the risk of type 2 diabetes in older adults. Because dietary GI and GL show strong nutritional correlates, the overall dietary pattern should be considered.

  7. Body mass index and myocardium at risk in patients with acute coronary syndrome.

    Science.gov (United States)

    Arrebola-Moreno, A L; Marfil-Alvarez, R; Catena, A; García-Retamero, R; Arrebola, J P; Melgares-Moreno, R; Ramirez-Hernández, J A; Kaski, J C

    2014-04-01

    Whilst traditional studies have shown that obese individuals are at a higher risk of cardiovascular events compared to lean subjects, recent studies in patients with acute myocardial infarction (AMI) have suggested that obesity may exert protective effects (the "obesity paradox"). We sought to assess the relationship between body mass index (BMI) and the BARI score (BARIsc), a validated tool used to assess myocardium at risk, in patients with acute coronary syndrome. Participants were 116 consecutive patients (mean age, 60.6 years; 97 men) with AMI (68 ST elevated myocardial infarction, STEMI; 48 non-ST elevated myocardial infarction, NSTEMI). Demographics, BMI, risk factors, biochemistry data, left ventricular function, angiographic data and the BARIsc were assessed in every patient. Multiple linear regression analyses showed that BMI significantly correlated with BARIsc; β=.23, p<0.02. This was found only in the overweight/obese patients, β=.27, p<0.01, but not in patients with normal BMIs, β=0.08, p=0.71. An increased body weight is associated with an increased area of myocardium at risk in patients with ACS. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  8. Interactive Effects of Physical Fitness and Body Mass Index on the Risk of Hypertension.

    Science.gov (United States)

    Crump, Casey; Sundquist, Jan; Winkleby, Marilyn A; Sundquist, Kristina

    2016-02-01

    High body mass index (BMI) and low physical fitness are risk factors for hypertension, but their interactive effects are unknown. Elucidation of interactions between these modifiable risk factors may help inform more effective interventions in susceptible subgroups. To determine the interactive effects of BMI and physical fitness on the risk of hypertension in a large national cohort. This cohort study included all 1,547,189 military conscripts in Sweden from January 1, 1969, through December 31, 1997 (97%-98% of all 18-year-old men nationwide each year), who were followed up through December 31, 2012 (maximum age, 62 years). Data analysis was conducted August 1 through August 15, 2015. Standardized aerobic capacity, muscular strength, and BMI measurements obtained at a military conscription examination. Hypertension identified from outpatient and inpatient diagnoses. A total of 93,035 men (6.0%) were diagnosed with hypertension in 39.7 million person-years of follow-up. High BMI and low aerobic capacity (but not muscular strength) were associated with increased risk of hypertension, independent of family history and socioeconomic factors (BMI, overweight or obese vs normal: incidence rate ratio, 2.51; 95% CI, 2.46-2.55; P fitness, even among persons with normal BMI.

  9. Low ankle-brachial index predicts cardiovascular risk after acute ischemic stroke or transient ischemic attack.

    Science.gov (United States)

    Busch, Markus A; Lutz, Katrin; Röhl, Jens-Eric; Neuner, Bruno; Masuhr, Florian

    2009-12-01

    A low ankle-brachial blood pressure index (ABI) is an established risk marker for cardiovascular disease and mortality in the general population, but little is known about its prognostic value in individuals with acute ischemic stroke or transient ischemic attack (TIA). An inception cohort of 204 patients with acute ischemic stroke or TIA was followed up for a mean of 2.3 years. At baseline, patients underwent ABI measurement and were assessed for risk factors, cardiovascular comorbidities, and cervical or intracranial artery stenosis. The association between low ABI (stroke, myocardial infarction, or death was examined by Kaplan-Meier and Cox regression analyses. A low ABI was found in 63 patients (31%) and was associated with older age, current smoking, hypertension, peripheral arterial disease, and cervical or intracranial stenosis. During a total of 453.0 person-years of follow-up, 37 patients experienced outcome events (8.2% per person-year), with a higher outcome rate per person-year in patients with low ABI (12.8% vs 6.3%, P=0.03). In survival analysis adjusted for age and stroke etiology, patients with a low ABI had a 2 times higher risk of stroke, myocardial infarction, or death than those with a normal ABI (hazard ratio=2.2; 95% CI, 1.1 to 4.5). Additional adjustment for risk factors and cardiovascular comorbidities did not attenuate the association. A low ABI independently predicted subsequent cardiovascular risk and mortality in patients with acute stroke or TIA. ABI measurement may help to identify high-risk patients for targeted secondary stroke prevention.

  10. Fatty Acid Synthase Polymorphisms, Tumor Expression, Body Mass Index, Prostate Cancer Risk, and Survival

    Science.gov (United States)

    Nguyen, Paul L.; Ma, Jing; Chavarro, Jorge E.; Freedman, Matthew L.; Lis, Rosina; Fedele, Giuseppe; Fiore, Christopher; Qiu, Weiliang; Fiorentino, Michelangelo; Finn, Stephen; Penney, Kathryn L.; Eisenstein, Anna; Schumacher, Fredrick R.; Mucci, Lorelei A.; Stampfer, Meir J.; Giovannucci, Edward; Loda, Massimo

    2010-01-01

    Purpose Fatty acid synthase (FASN) regulates de novo lipogenesis, body weight, and tumor growth. We examined whether common germline single nucleotide polymorphisms (SNPs) in the FASN gene affect prostate cancer (PCa) risk or PCa-specific mortality and whether these effects vary by body mass index (BMI). Methods In a prospective nested case-control study of 1,331 white patients with PCa and 1,267 age-matched controls, we examined associations of five common SNPs within FASN (and 5 kb upstream/downstream, R2 > 0.8) with PCa incidence and, among patients, PCa-specific death and tested for an interaction with BMI. Survival analyses were repeated for tumor FASN expression (n = 909). Results Four of the five SNPs were associated with lethal PCa. SNP rs1127678 was significantly related to higher BMI and interacted with BMI for both PCa risk (Pinteraction = .004) and PCa mortality (Pinteraction = .056). Among overweight men (BMI ≥ 25 kg/m2), but not leaner men, the homozygous variant allele carried a relative risk of advanced PCa of 2.49 (95% CI, 1.00 to 6.23) compared with lean men with the wild type. Overweight patients carrying the variant allele had a 2.04 (95% CI, 1.31 to 3.17) times higher risk of PCa mortality. Similarly, overweight patients with elevated tumor FASN expression had a 2.73 (95% CI, 1.05 to 7.08) times higher risk of lethal PCa (Pinteraction = .02). Conclusion FASN germline polymorphisms were significantly associated with risk of lethal PCa. Significant interactions of BMI with FASN polymorphisms and FASN tumor expression suggest FASN as a potential link between obesity and poor PCa outcome and raise the possibility that FASN inhibition could reduce PCa-specific mortality, particularly in overweight men. PMID:20679621

  11. Work Ability Index as tool to identify workers at risk of premature work exit.

    Science.gov (United States)

    Roelen, Corné A M; Heymans, Martijn W; Twisk, Jos W R; van der Klink, Jac J L; Groothoff, Johan W; van Rhenen, Willem

    2014-12-01

    To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at baseline and reported their work status (employed, unemployed, disability pension, or retired) after mean 2.3 years of follow-up. Associations between WAI scores and work status were investigated by multinomial logistic regression analysis. The ability of the WAI to discriminate between workers at high and low risk of premature work exit was analyzed by the area (AUC) under the receiver operating characteristic curve. 9,530 (83 %) construction workers had complete data for analysis. At follow-up, 336 (4 %) workers reported disability pension, 125 (1 %) unemployment, and 255 (3 %) retirement. WAI scores were prospectively associated with the risk of disability pension at follow-up, but not with the risk of unemployment and early retirement. The WAI showed fair discrimination to identify workers at risk of disability pension [AUC = 0.74; 95 % confidence interval (CI) 0.70-0.77]. The discriminative ability decreased with age from AUC = 0.78 in workers aged 30-39 years to AUC = 0.69 in workers ≥50 years of age. Discrimination failed for unemployment (AUC = 0.51; 95 % CI 0.47-0.55) and early retirement (AUC = 0.58; 95 % CI 0.53-0.61). The WAI can be used to identify construction workers risk of disability pension and invite them for preventive interventions.

  12. An improved risk of malignancy index in diagnosis of adnexal mass

    Institute of Scientific and Technical Information of China (English)

    WANG Li-ming; SONG Hao; SONG Xiao; ZHOU Xiao-bin

    2012-01-01

    Background With the advent of color Doppler flow imaging (CDFI) and technological development of detection of serum tumor markers,new opportunities are presented to the improved risk of malignancy index (RMI) based on Jacobs'research for predicting ovarian malignancy in patients with adnexal masses.Methods One hundred and eighty women with an adnexal mass admitted for primary laparotomy were studied.Tumor specific growth factor (TSGF) adjusted ultrasound scores and the results of Doppler blood flow analysis were obtained before the operation.Based on the parameters which had been studied in Jacobs' research,TSGF levels and the findings of color Doppler flow imaging,the risk of malignancy model was redesigned using a binary Logistic regression model.The diagnostic efficacy of the improved risk of malignancy index (improved RMI) was compared with the Jacobs'model RMI by receiver operator characteristic (ROC) curve.Results The ROC curve showed a higher sensitivity (Mcnamer's test,P <0.05) in the discrimination between benign and malignant adnexal masses for the improved RMI than the RMI.Compared with the RMI,the improved RMI had an advantage in prediction of ovarian germ cell tumors and granular cell tumor (28.57% vs.71.43%,P <0.05) and the early stage tumors and borderline tumors (33.33% vs.66.67%,P<0.05).Conclusion The predictability of the improved RMI is better than the classic Jacobs' model,especially in diagnosis of the ovarian germ cell tumors and granular cell tumor and other early stage adnexal tumors.

  13. Climate Risk and Production Shocks: Using Index Insurance to Link Climate Science to Policy for Sustainable Development

    Science.gov (United States)

    McCarney, G. R.; Osgood, D. E.

    2011-12-01

    Smallholder farmers in developing countries are often severely impacted by droughts and other climate related events. However, agricultural insurance programs are largely unavailable in lower-income countries because of limitations in traditional loss-based indemnity insurance. As a result, it is often the case that farmers who are the most vulnerable to climate shocks lack access to the insurance tools that could help to reduce their production risk. Index insurance, a recent financial innovation, has the potential to increase access to insurance for smallholder farmers (Barrett et al. 2007). Index insurance allows farmers to insure their production risk based on a weather index (such as total seasonal rainfall) rather than on crop yields. The use of a weather index addresses many of the perverse incentive problems found in traditional crop insurance, and greatly reduces the costs of insuring smallholder farmers. The trade-off in index insurance, however, is limited accuracy in calibrating payouts to actual losses, a phenomenon commonly known as basis risk. While index insurance has promise as a risk-smoothing instrument, many argue it has greater promise as a mechanism for improving access to credit for smallholder farmers in developing countries (e.g. Barnett, Barrett & Skees 2008). In these areas, farmers are often fully exposed to climate shocks, which greatly affect their willingness to borrow. By smoothing the uncertainty in climate shocks, insurance may allow farmers to take credit for productive risks. There has been much discussion as to the optimal strategy for combining index insurance with credit, specifically if the financial institutions or the individual farmers themselves should hold the insurance policy. Many existing insurance implementations insure the farmer directly. However, since a weather index is a proxy for yield loss based on regional data, there is basis risk due to uninsured idiosyncratic differences between farmers. As a response to

  14. Design of satisfaction output feedback controls for stochastic nonlinear systems under quadratic tracking risk-sensitive index

    Institute of Scientific and Technical Information of China (English)

    刘允刚; 张纪峰; 潘子刚

    2003-01-01

    In this paper, the design problem of satisfaction output feedback controls for stochastic nonlinear systems in strict feedback form under long-term tracking risk-sensitive index is investigated.The index function adopted here is of quadratic form usually encountered in practice, rather than of quartic one used to beg the essential difficulty on controller design and performance analysis of the closed-loop systems. For any given risk-sensitive parameter and desired index value, by using the integrator backstepping method, an output feedback control is constructively designed so that the closed-loop system is bounded in probability and the risk-sensitive index is upper bounded by the desired value.

  15. Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer.

    Science.gov (United States)

    Green, Andrew R; Soria, D; Powe, D G; Nolan, C C; Aleskandarany, M; Szász, M A; Tőkés, A M; Ball, G R; Garibaldi, J M; Rakha, E A; Kulka, J; Ellis, I O

    2016-05-01

    The Nottingham prognostic index plus (NPI+) is based on the assessment of biological class combined with established clinicopathologic prognostic variables providing improved patient outcome stratification for breast cancer superior to the traditional NPI. This study aimed to determine prognostic capability of the NPI+ in predicting risk of development of distant disease. A well-characterised series of 1073 primary early-stage BC cases treated in Nottingham and 251 cases from Budapest were immunohistochemically assessed for cytokeratin (Ck)5/6, Ck18, EGFR, oestrogen receptor (ER), progesterone receptor, HER2, HER3, HER4, Mucin 1 and p53 expression. NPI+ biological class and prognostic scores were assigned using individual algorithms for each biological class incorporating clinicopathologic parameters and investigated in terms of prediction of distant metastases-free survival (MFS). The NPI+ identified distinct prognostic groups (PG) within each molecular class which were predictive of MFS providing improved patient outcome stratification superior to the traditional NPI. NPI+ PGs, between series, were comparable in predicting patient outcome between series in luminal A, basal p53 altered and HER2+/ER+ (p > 0.01) tumours. The low-risk groups were similarly validated in luminal B, luminal N, basal p53 normal tumours (p > 0.01). Due to small patient numbers the remaining PGs could not be validated. NPI+ was additionally able to predict a higher risk of metastases at certain distant sites. This study may indicate the NPI+ as a useful tool in predicting the risk of metastases. The NPI+ provides accurate risk stratification allowing improved individualised clinical decision making for breast cancer.

  16. Interleukin-6-related genotypes, body mass index, and risk of multiple myeloma and plasmacytoma.

    Science.gov (United States)

    Cozen, Wendy; Gebregziabher, Mulugeta; Conti, David V; Van Den Berg, David J; Coetzee, Gerhard A; Wang, Sophia S; Rothman, Nathaniel; Bernstein, Leslie; Hartge, Patricia; Morhbacher, Ann; Coetzee, Simon G; Salam, Muhammad T; Wang, Wei; Zadnick, John; Ingles, Sue A

    2006-11-01

    Interleukin-6 (IL-6) promotes normal plasma cell development and proliferation of myeloma cells in culture. We evaluated IL-6 genotypes and body mass index (BMI) in a case-control study of multiple myeloma and plasmacytoma. DNA samples and questionnaires were obtained from incident cases of multiple myeloma (n = 134) and plasmacytoma (n = 16; plasma cell neoplasms) ascertained from the Los Angeles County population-based cancer registry and from siblings or cousins of cases (family controls, n = 112) and population controls (n = 126). Genotypes evaluated included IL-6 promoter gene single nucleotide polymorphisms (SNP) at positions -174, -572, and -597; one variable number of tandem repeats (-373 A(n)T(n)); and one SNP in the IL-6 receptor (IL-6ralpha) gene at position -358. The variant allele of the IL-6 promoter SNP -572 was associated with a roughly 2-fold increased risk of plasma cell neoplasms when cases were compared with family [odds ratio (OR), 1.8; 95% confidence interval (95% CI), 0.7-4.7] or population controls (OR, 2.4; 95% CI, 1.2-4.7). The -373 9A/9A genotype was associated with a decreased risk compared with the most common genotype (OR for cases versus family controls, 0.4; 95% CI, 0.1-1.7; OR for cases versus population controls, 0.3; 95% CI, 0.1-0.9). No other SNPs were associated with risk. Obesity (BMI >or= 30 kg/m(2)) increased risk nonsignificantly by 40% and 80% when cases were compared with family controls or population controls, respectively, relative to persons with a BMI of <25 kg/m(2). These results suggest that IL-6 promoter genotypes may be associated with increased risk of plasma cell neoplasms.

  17. Agriculture Drought Risk Management Using Standardized Precipitation Index and AEZ Model

    Directory of Open Access Journals (Sweden)

    M. H. Nazarifar

    2014-01-01

    Full Text Available The objective of this study was to assess the drought risk management in the region under study. The SPI method was adopted for drought monitoring in Hamadan Province, Iran. The temporal and spatial extent of the area vulnerable to drought was delineated using AEZ model, GIS and other softwares. Five zones were recognized based on the drought severity index. Selection of compatible crops with respect to climate and land production capability of a region specially in drought condition is one of the effective elements to increase the water productivity in agriculture, based on Agro-ecological Zoning(AEZ model, developed by FAO, suitable spatial extension of wheat cultivation, which is the main crop in Hamadan Province, were delineated. According to this study the most suitable lands potentially available for wheat production are located in the north-east region and a part of the central region, where as, least suitable ones can be observed in the north-east and the south – east regions. The results of the risk analysis study show that south-east, north and central regions are susceptible to longest duration intense droughts where as long duration droughts are intensive in north, west and south-east regions. The overlaid and integrated maps of risks with the maps obtained after applying the AEZ model resulted into the map of spatial suitability of potential crop production for each class of risk (longest duration and most intensive durations. This enables the decision makers to define spatial priority of crop cultivation and manage various potential regions susceptible to drought risks.

  18. A meta-analysis of the association of fracture risk and body mass index in women.

    Science.gov (United States)

    Johansson, Helena; Kanis, John A; Odén, Anders; McCloskey, Eugene; Chapurlat, Roland D; Christiansen, Claus; Cummings, Steve R; Diez-Perez, Adolfo; Eisman, John A; Fujiwara, Saeko; Glüer, Claus-C; Goltzman, David; Hans, Didier; Khaw, Kay-Tee; Krieg, Marc-Antoine; Kröger, Heikki; LaCroix, Andrea Z; Lau, Edith; Leslie, William D; Mellström, Dan; Melton, L Joseph; O'Neill, Terence W; Pasco, Julie A; Prior, Jerilynn C; Reid, David M; Rivadeneira, Fernando; van Staa, Tjerd; Yoshimura, Noriko; Zillikens, M Carola

    2014-01-01

    Several recent studies suggest that obesity may be a risk factor for fracture. The aim of this study was to investigate the association between body mass index (BMI) and future fracture risk at different skeletal sites. In prospective cohorts from more than 25 countries, baseline data on BMI were available in 398,610 women with an average age of 63 (range, 20-105) years and follow up of 2.2 million person-years during which 30,280 osteoporotic fractures (6457 hip fractures) occurred. Femoral neck BMD was measured in 108,267 of these women. Obesity (BMI ≥ 30 kg/m(2) ) was present in 22%. A majority of osteoporotic fractures (81%) and hip fractures (87%) arose in non-obese women. Compared to a BMI of 25 kg/m(2) , the hazard ratio (HR) for osteoporotic fracture at a BMI of 35 kg/m(2) was 0.87 (95% confidence interval [CI], 0.85-0.90). When adjusted for bone mineral density (BMD), however, the same comparison showed that the HR for osteoporotic fracture was increased (HR, 1.16; 95% CI, 1.09-1.23). Low BMI is a risk factor for hip and all osteoporotic fracture, but is a protective factor for lower leg fracture, whereas high BMI is a risk factor for upper arm (humerus and elbow) fracture. When adjusted for BMD, low BMI remained a risk factor for hip fracture but was protective for osteoporotic fracture, tibia and fibula fracture, distal forearm fracture, and upper arm fracture. When adjusted for BMD, high BMI remained a risk factor for upper arm fracture but was also a risk factor for all osteoporotic fractures. The association between BMI and fracture risk is complex, differs across skeletal sites, and is modified by the interaction between BMI and BMD. At a population level, high BMI remains a protective factor for most sites of fragility fracture. The contribution of increasing population rates of obesity to apparent decreases in fracture rates should be explored.

  19. A GOOD ANTHROPOMETRIC INDEX FOR PREDICTI NG THE RISK OF TYPE 2 DIABETES: WAIST TO HIP RATIO

    OpenAIRE

    Ramadevi,; Padmini; Kali Vara Prasad

    2015-01-01

    An increasing trend of type2 Diabetes mellitus is seen with age . Visceral or central obesity is a very common risk factor for developing type 2 diabetes Mellitus. Hence any index which reliably measures obesity can be us ed as a tool to predict the risk of Diabetes. We have attempted to correlate waist to hip ratio (WHR) ...

  20. Birth weight, childhood body mass index and risk of coronary heart disease in adults: combined historical cohort studies

    DEFF Research Database (Denmark)

    Andersen, Lise Geisler; Ängquist, Lars Henrik; Eriksson, Johan G

    2010-01-01

    Low birth weight and high childhood body mass index (BMI) is each associated with an increased risk of coronary heart disease (CHD) in adult life. We studied individual and combined associations of birth weight and childhood BMI with the risk of CHD in adulthood....

  1. Interaction between smoking and body mass index and risk of oral clefts

    DEFF Research Database (Denmark)

    Wehby, George L; Uribe, Lina M Moreno; Wilcox, Allen J

    2017-01-01

    PURPOSE: To examine maternal smoking and body mass index (BMI) interactions in contributing to risk of oral clefts. METHODS: We studied 4935 cases and 10,557 controls from six population-based studies and estimated a pooled logistic regression of individual-level data, controlling for study fixed...... effects and individual-level risk factors. RESULTS: We found a significant negative smoking-BMI interaction, with cleft risk with smoking generally declining with higher BMI. For all clefts combined, the odds ratio for smoking was 1.61 (95% confidence interval [CI]: 1.39-1.86) at BMI 17 (underweight), 1.......47 (95% CI: 1.34-1.62) at BMI 22 (normal weight), 1.35 (95% CI: 1.22-1.48) at BMI 27 (overweight), 1.21 (95% CI: 1.04-1.41) at BMI 33 (obese), and 1.13 (95% CI: 0.92-1.38) at BMI 37 (very obese). A negative interaction was also observed for isolated clefts and across cleft types but was more pronounced...

  2. Tools and Techniques - Statistical. Estimating cumulative incidences in the presence of right-censoring and competing risks : an introduction with illustrations from the COACH study

    NARCIS (Netherlands)

    Postmus, Douwe; Demissei, Biniyam G; Hillege, Hans L

    2016-01-01

    In cardiovascular studies, it is common to assess the association between the risk of experiencing an event, such as death or hospitalisation, and one or more exposure variables, such as different treatment regimens when the study under consideration is an intervention study. A frequently applied

  3. Improving index-based drought insurance in varying topography: evaluating basis risk based on perceptions of Nicaraguan hillside farmers.

    Science.gov (United States)

    Kost, André; Läderach, Peter; Fisher, Myles; Cook, Simon; Gómez, Lorena

    2012-01-01

    This paper discusses a methodology to model precipitation indices and premium prices for index-based drought insurance for smallholders. Spatial basis risk, which is borne by the insured, is a problem, especially in variable topography. Also, site-specific drought risk needs to be estimated accurately in order to offer effective insurance cover and ensure financial sustainability of the insurance scheme. We explore farmers' perceptions on drought and spatial climate variability and draw conclusions concerning basis risk with regards to the proposed methodology. There are technically many options to represent natural heterogeneity in index insurance contracts while serving the customer adequately and keeping transaction costs low.

  4. Body mass index and risk of lung cancer among never, former, and current smokers.

    Science.gov (United States)

    Smith, Llewellyn; Brinton, Louise A; Spitz, Margaret R; Lam, Tram Kim; Park, Yikyung; Hollenbeck, Albert R; Freedman, Neal D; Gierach, Gretchen L

    2012-05-16

    Although obesity has been directly linked to the development of many cancers, many epidemiological studies have found that body mass index (BMI)--a surrogate marker of obesity--is inversely associated with the risk of lung cancer. These studies are difficult to interpret because of potential confounding by cigarette smoking, a major risk factor for lung cancer that is associated with lower BMI. We prospectively examined the association between BMI and the risk of lung cancer among 448 732 men and women aged 50-71 years who were recruited during 1995-1996 for the National Institutes of Health-AARP Diet and Health Study. BMI was calculated based on the participant's self-reported height and weight on the baseline questionnaire. We identified 9437 incident lung carcinomas (including 415 in never smokers) during a mean follow-up of 9.7 years through 2006. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment for lung cancer risk factors, including smoking status. To address potential bias due to preexisting undiagnosed disease, we excluded potentially unhealthy participants in sensitivity analyses. All statistical tests were two-sided. The crude incidence rate of lung cancer over the study follow-up period was 233 per 100 000 person-years among men and 192 per 100 000 person-years among women. BMI was inversely associated with the risk of lung cancer among both men and women (BMI ≥35 vs 22.5-24.99 kg/m(2): HR = 0.81, 95% CI = 0.70 to 0.94 and HR = 0.73, 95% CI = 0.61 to 0.87, respectively). The inverse association was restricted to current and former smokers and was stronger after adjustment for smoking. Among smokers, the inverse association persisted even after finely stratifying on smoking status, time since quitting smoking, and number of cigarettes smoked per day. Sensitivity analyses did not support the possibility that the inverse association was due to

  5. Body mass index and obesity- and diabetes-associated genotypes and risk for pancreatic cancer.

    Science.gov (United States)

    Tang, Hongwei; Dong, Xiaoqun; Hassan, Manal; Abbruzzese, James L; Li, Donghui

    2011-05-01

    The genetic factors predisposing individuals with obesity or diabetes to pancreatic cancer have not been identified. To investigate the hypothesis that obesity- and diabetes-related genes modify the risk of pancreatic cancer. We genotyped 15 single nucleotide polymorphisms of fat mass and obesity-associated (FTO), peroxisome proliferators-activated receptor gamma (PPARγ), nuclear receptor family 5 member 2 (NR5A2), AMPK, and ADIPOQ genes in 1,070 patients with pancreatic cancer and 1,175 cancer-free controls. Information on risk factors was collected by personal interview. Adjusted ORs (AOR) and 95% CIs were calculated using unconditional logistic regression. The PPARγ P12A GG genotype was inversely associated with risk of pancreatic cancer (AOR, 0.21; 95% CI, 0.07-0.62). Three NR5A2 variants that were previously identified in a genome-wide association study were significantly associated with reduced risk of pancreatic cancer, AORs ranging from 0.57 to 0.79. Two FTO gene variants and one ADIPOQ variant were differentially associated with pancreatic cancer according to levels of body mass index (BMI; P(interaction) = 0.0001, 0.0015, and 0.03). For example, the AOR (95% CI) for FTO IVS1-2777AC/AA genotype was 0.72 (0.55-0.96) and 1.54 (1.14-2.09) in participants with a BMI of less than 25 or 25 kg/m(2) or more, respectively. We observed no significant association between AMPK genotype and pancreatic cancer and no genotype interactions with diabetes or smoking. Our findings suggest the PPARγ P12A GG genotype and NR5A2 variants may reduce the risk for pancreatic cancer. A positive association of FTO and ADIPOQ gene variants with pancreatic cancer may be limited to persons who are overweight. The discovery of genetic factors modifying the risk of pancreatic cancer may help to identify high-risk individuals for prevention efforts. ©2011 AACR.

  6. Height, weight and body mass index in early adulthood and risk of schizophrenia

    DEFF Research Database (Denmark)

    Sørensen, Holger Jelling; Mortensen, E L; Reinisch, J M;

    2006-01-01

    individuals born between 1959 and 1961. In 1999, cases of schizophrenia were identified in the Danish Psychiatric Central Register, and the cases were compared with the cohort pool of controls with respect to height, weight, and BMI from draft records. The effect of low BMI was adjusted for parental social......OBJECTIVE: To illuminate the possible associations between height, weight, and body mass index (BMI) during early adulthood and the development of schizophrenia. METHOD: This prospective study is based on an all-male sample of 3210 individuals from the Copenhagen Perinatal Cohort, comprising...... status when the cohort members were 1 year old, birth weight, birth length, and maternal pre-pregnancy BMI. RESULTS: Forty-five cases of schizophrenia had a lower young adult mean body weight and BMI than controls. A significant inverse relationship between BMI and risk of later schizophrenia was found...

  7. Risk of asthma in adult twins with type 2 diabetes and increased body mass index

    DEFF Research Database (Denmark)

    Thomsen, S F; Duffy, D L; Kyvik, K O

    2011-01-01

    AIM: To examine the relationship between asthma, type 2 diabetes and increased body mass index (BMI) in adult twins. METHODS: We performed record linkage between questionnaire-defined asthma and BMI, and hospital discharge diagnoses of type 2 diabetes in 34,782 Danish twins, 20-71 years of age....... RESULTS: The risk of asthma was increased in subjects with type 2 diabetes relative to nondiabetic subjects both in men (13.5%vs 7.5%), P = 0.001 and in women (16.6%vs 9.6%), P = 0.001. The result remained significant after adjustment for age, BMI, smoking, symptoms of chronic bronchitis, marital status...... and zygosity, men: OR = 1.70 (1.07-2.70), P = 0.026; women: OR = 1.88 (1.24-2.85), P = 0.003. In this analysis, BMI remained a highly significant predictor for asthma independently of diabetes status in women, P

  8. Re: Could Testosterone Replacement Therapy in Hypogonadal Men Ameliorate Anemia, a Cardiovascular Risk Factor? An Observational, 54-week Cumulative Registry Study

    Directory of Open Access Journals (Sweden)

    Emre Bakırcıoğlu

    2016-09-01

    Full Text Available Testosterone deficiency syndrome may associate with erectile dysfunction, increased abdominal fat and reduced muscle mass. Low serum testosterone is also related with anemia, metabolic syndrome and cardiovascular disease. In this study, the authors investigated if testosterone undecanoate (TU reduces anemia and the risk of cardiovascular disease in patients with hypogonadism A total of 58 participants with a total testosterone level of less than 2.35 ng/ml received an injection of 1.000 mg TU 6 times; at initial visit, 6, 18, 30, 42 and 54 weeks. They observed that total testosterone and free testosterone levels were restored by TU. Hemoglobin and hematocrit levels significantly increased while anemia and total cholesterol levels significantly reduced. Although there are some limitations of this study e.g. it is not a randomized controlled and a long-term study, TU treatment in hypogonadal men decreased the prevalence of anemia, improved lipid profiles and lowered the risk of cardiovascular disease.

  9. From infancy to pregnancy: birth weight, body mass index, and the risk of gestational diabetes.

    Science.gov (United States)

    Lagerros, Ylva Trolle; Cnattingius, Sven; Granath, Fredrik; Hanson, Ulf; Wikström, Anna-Karin

    2012-10-01

    Obesity is a risk factor for gestational diabetes, whereas the role of the mother's birth weight is more uncertain. We aimed to investigate the combined effect of mothers' birth-weight-for-gestational-age and early pregnancy Body Mass Index (BMI) in relation to risk of gestational diabetes. Between 1973 and 2006, we identified a cohort of 323,083 women included in the Swedish Medical Birth Register both as infants and as mothers. Main exposures were mothers' birth-weight-for-gestational-age (categorized into five groups according to deviation from national mean birth weight) and early pregnancy BMI (classified according to WHO). Rates of gestational diabetes increased with adult BMI, independently of birth-weight-for-gestational-age. However, compared to women with appropriate birth-weight-for-gestational-age [appropriate-for-gestational age (AGA); -1 to +1 SD] and BMI (born small-for-gestational-age [small for gestational age (SGA); born large-for-gestational-age [large-for-gestational-age (LGA); >2SD], and OR = 10.4 (95 % CI 8.4-13.0) if born AGA. Risk of gestational diabetes is not only increased among obese women, but also among women born SGA and LGA. Severely obese women born with a low or a high birth-weight-for-gestational-age seem more vulnerable to the development of gestational diabetes compared to normal weight women. Normal pre-pregnancy BMI diminishes the increased risk birth size may confer in terms of gestational diabetes. Therefore, the importance of keeping a healthy weight cannot be overemphasized.

  10. Operative Risk for Major Lung Resection Increases at Extremes of Body Mass Index.

    Science.gov (United States)

    Williams, Trevor; Gulack, Brian C; Kim, Sunghee; Fernandez, Felix G; Ferguson, Mark K

    2017-01-01

    Although body mass index (BMI) has been used in risk stratification for lung resection, many models only take obesity into account. Recent studies have demonstrated that underweight patients also experience increased postoperative complications. We explored the relationship of extremes of BMI to outcomes after lung resection for non-small cell cancer. Patients in the Society of Thoracic Surgeons General Thoracic Surgery Database (2009 to 2014) undergoing elective lung resection for cancer were evaluated. Multivariable logistic regression was used to adjust for potential confounders including functional status and spirometry. We evaluated 41,446 patients (median 68 years of age; 53% female) grouped by BMI: underweight (obese I (30 to 34.9 kg/m(2); 18.1%), obese II (35 to 39.9 kg/m(2); 6.4%), and obese III (≥40 kg/m(2); 3.6%). Pulmonary complication rates were higher in underweight and obese III patients compared to normal BMI patients (p Obese III patients had an increased risk of any major postoperative complication (adjusted OR: 1.18, 95% CI: 1.02 to 1.36). Overweight and obese class I to II patients had a lower risk of pulmonary complications and any postoperative event. BMI is associated with postoperative complications after lung resection for cancer. Being underweight or severely overweight is associated with an increased risk of complications, whereas being overweight or moderately obese appears to have a protective effect. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Physical activity and body mass index as predictors of prostate cancer risk.

    Science.gov (United States)

    Grotta, Alessandra; Bottai, Matteo; Adami, Hans-Olov; Adams, Swann Arp; Akre, Olof; Blair, Steven Noel; Mariosa, Daniela; Nyrén, Olof; Ye, Weimin; Stattin, Pär; Bellocco, Rino; Trolle Lagerros, Ylva

    2015-10-01

    Physical activity and body mass index (BMI) are involved in prostate cancer etiology; possible biologic mechanisms include their effects on hormonal levels. Our aim was to investigate the relationship between physical activity, obesity, and prostate cancer. We followed a cohort of 13,109 Swedish men for 13 years and investigated the association of self-reported physical activity and BMI at baseline with prostate cancer incidence. We further analyzed whether BMI could modulate effects of physical activity. Occupational, recreational, and total physical activity were analyzed in relation to overall, localized, and advanced prostate cancer. During the study follow-up, we observed a total of 904 cases of prostate cancer (429 localized, 407 advanced, and 68 unclassified). High levels of occupational physical activity were associated with a nonsignificantly decreased risk of overall (HR 0.81, 95 % CI 0.61-1.07), localized (HR 0.75, 95 % CI 0.51-1.12), and advanced (HR 0.85, 95 % CI 0.55-1.31) prostate cancer. We found no association between high BMI and risk of prostate cancer incidence: We observed, however, a significant interaction between BMI and leisure physical activity. No association was confirmed between total physical activity and localized or advanced prostate cancer. The highest, relative to the lowest, level of occupational physical activity tended to be linked to a lower risk of prostate cancer, with a suggested dose-response relationship. We found no association between high BMI and risk of prostate cancer incidence; however, our analyses suggested an interaction between BMI and physical activity during recreational time that merits further investigation in future studies.

  12. Influence of glycemic index and glycemic load of the diet on the risk of overweight and adiposity in childhood

    Directory of Open Access Journals (Sweden)

    Kellen Cristine Silva

    Full Text Available Abstract Objective: To investigate the association between the glycemic index and the glycemic load of the diet with the risk of overweight and high adiposity in children with 5 years of age. Methods: Cross-sectional study nested in a cohort of 232 children born and living in Diamantina (MG, Brazil. Parents and/or guardians provided the food intake data, using a semiquantitative food frequency questionnaire, past history and socioeconomic conditions. Anthropometric and fatness data were collected from the children. The dietary glycemic index and the glycemic load were calculated from the food intake. The glycemic index and glycemic load effect on overweight and adiposity in children was assessed by the Poisson regression (p<0.05. Results: The prevalence of overweight by body mass index was 17.3%, and high adiposity was observed in 3.4% and 6.9% by triceps skinfold and subscapular skinfold, respectively. No difference was reported between the mean body mass index, triceps skinfold and subscapular skinfold according to the glycemic index and glycemic load tertiles; however, the overweight group presented a higher carbohydrate intake (p=0.04. No association was found between glycemic index and glycemic load with overweight and adiposity among the children assessed. Conclusions: The glycemic index and glycemic load of the diet were not identified as risk factors for overweight and adiposity in this cross-sectional study.

  13. Influence of glycemic index and glycemic load of the diet on the risk of overweight and adiposity in childhood.

    Science.gov (United States)

    Silva, Kellen Cristine; Neri Nobre, Luciana; Emanuelle de Castro Ferreira Vicente, Sofia; Lopes Moreira, Lidiane; do Carmo Lessa, Angelina; Alves Lamounier, Joel

    2016-09-01

    To investigate the association between the glycemic index and the glycemic load of the diet with the risk of overweight and high adiposity in children with 5 years of age. Cross-sectional study nested in a cohort of 232 children born and living in Diamantina (MG, Brazil). Parents and/or guardians provided the food intake data, using a semiquantitative food frequency questionnaire, past history and socioeconomic conditions. Anthropometric and fatness data were collected from the children. The dietary glycemic index and the glycemic load were calculated from the food intake. The glycemic index and glycemic load effect on overweight and adiposity in children was assessed by the Poisson regression (p<0.05). The prevalence of overweight by body mass index was 17.3%, and high adiposity was observed in 3.4% and 6.9% by triceps skinfold and subscapular skinfold, respectively. No difference was reported between the mean body mass index, triceps skinfold and subscapular skinfold according to the glycemic index and glycemic load tertiles; however, the overweight group presented a higher carbohydrate intake (p=0.04). No association was found between glycemic index and glycemic load with overweight and adiposity among the children assessed. The glycemic index and glycemic load of the diet were not identified as risk factors for overweight and adiposity in this cross-sectional study. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  14. [Value of cardiopulmonary risk index in predicting postoperative short-term prognosis in patients with lung cancer].

    Science.gov (United States)

    Gu, Yueqing; Gao, Chengxin; Bai, Hao; Liao, Meilin

    2002-06-20

    To determine the value of preoperative cardiopulmonary risk index (CPRI) in predicting the short-term prognosis after lung resection in patients with lung cancer. Preoperative clinical data were used to generate a cardiac risk index (CRI) and a pulmonary risk index (PRI). And the value of cardiopulmonary risk index (CPRI) consisting of CRI and PRI in predicting postoperative prognosis was estimated in patients who underwent lung resection at Shanghai Chest Hospital in 1999. A total of 625 consecutive patients were studied. Postoperative complications occurred in 49 patients (7.8%), including 8 deaths within 30 days of operation. In the total group, CRI, PRI and CPRI scores ranged from 1 to 3, 0 to 5 and 1 to 7, respectively. There were 489 patients with CPRI CPRI≥4. Using CPRI≥4 as a threshold for predicting postoperative complications, the sensitivity, specificity and accuracy rate were 75.5%, 82.8% and 82.2% respectively. The preoperative CPRI is one of the important indexes in predicting the short-term postoperative prognosis for patients with lung cancer. However, it can not completely predict all of postoperative risks, and should be used together with other factors.

  15. Classification of high-risk with cardiac troponin and shock index in normotensive patients with pulmonary embolism.

    Science.gov (United States)

    Ozsu, Savas; Erbay, Muge; Durmuş, Zerrin Gürel; Ozlu, Tevfik

    2017-02-01

    Accurate risk stratification of normotensive patients with acute pulmonary embolism (PE) require further investigation. We aimed to develop a simple model using clinical (shock index) and laboratory findings (cardiac Troponin, echocardiography) to assess the risk of 30-day mortality in normotensive patients with acute PE. In this retrospective study, 489 normotensive patients with acute PE diagnosed objectively. The primary end-point was defined as a all cause 30-day mortality. Shock index was calculated on admission. The primary end-point occurred in 67 (13.7%, 95% CI 10.7-16.8) patients with acute PE. Predictors of complications included elevated cardiac troponin (OR 1.7, 95% CI 1.3-2.2) and shock index (OR 1.3, 95% CI 1.1-1.5) by multivariable analysis. Risk index point was created based on OR. The model identified stages (stage I: 0-1 point, stage II: 2 points and stage III: 3 point) with 30-day mortality rates of 4.3, 19 and 38.6 %, respectively. The shock index and cardiac troponin can be safely used in combination to determine intermediate risk in patients with PE in emergency departmant. The study provided observations that will require prospective validation before the proposed risk score is adopted in clinical practice.

  16. Is there a role for body mass index in the assessment of prostate cancer risk on biopsy?

    Science.gov (United States)

    Liang, Yuanyuan; Ketchum, Norma S; Goodman, Phyllis J; Klein, Eric A; Thompson, Ian M

    2014-10-01

    We examine the role of body mass index in the assessment of prostate cancer risk. A total of 3,258 participants who underwent biopsy (including 1,902 men with a diagnosis of prostate cancer) were identified from the Selenium and Vitamin E Cancer Prevention Trial. The associations of body mass index with prostate cancer and high grade prostate cancer were examined using logistic regression, adjusting for age, race, body mass index adjusted prostate specific antigen, digital rectal examination, family history of prostate cancer, biopsy history, prostate specific antigen velocity, and time between study entry and the last biopsy. The prediction models were compared with our previously developed body mass index adjusted Prostate Cancer Prevention Trial prostate cancer risk calculator. Of the study subjects 49.1% were overweight and 29.3% were obese. After adjustment, among men without a known family history of prostate cancer, increased body mass index was not associated with a higher risk of prostate cancer (per one-unit increase in logBMI OR 0.83, p=0.54) but was significantly associated with a higher risk of high grade prostate cancer (ie Gleason score 7 or greater prostate cancer) (OR 2.31, p=0.03). For men with a known family history of prostate cancer the risks of prostate cancer and high grade prostate cancer increased rapidly as body mass index increased (prostate cancer OR 3.73, p=0.02; high grade prostate cancer OR 7.95, p=0.002). The previously developed risk calculator generally underestimated the risks of prostate cancer and high grade prostate cancer. Body mass index provided independently predictive information regarding the risks of prostate cancer and high grade prostate cancer after adjusting for other risk factors. Body mass index, especially in men with a known family history of prostate cancer, should be considered for inclusion in any clinical assessment of prostate cancer risk and recommendations regarding prostate biopsy. Copyright © 2014

  17. Nutritional risk index as a predictor of postoperative wound complications after gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Cheong Ah Oh; Dae Hoon Kim; Seung Jong Oh; Min Gew Choi; Jae Hyung Noh; Tae Sung Sohn; Jae Moon Bae; Sung Kim

    2012-01-01

    AIM:To investigate the correlation between the nutritional risk index (NRI) and postoperative wound complications.METHODS:From January 2008 through June 2008,669 patients who underwent curative gastrectomy for gastric cancer were included in a retrospective study.Medical records of consecutive patients were collected and analyzed to determine postoperative wound complication rates.The NRI was assessed on the fifth postoperative day and other possible risk factors for the incidence of wound complications were analyzed to identify the factors affecting postoperative wound complications.Patients with other postoperative complications were excluded from the study.RESULTS:On the 5th postoperative day,the NRI showed a malnutrition rate of 84.6% among postoperative patients.However,postoperative wound complications occurred in only 66/669 (9.86%) patients.Of the patients with wound complications,62/66 (94%)belonged to the malnourished group (NRI < 97.5),and 4/66 (6%) patients to the non-malnourished group (NRI ≥ 97.5).The only factor correlated with wound complications was the NRI on the 5th postoperative day (odds ratio of NRI ≥ 97.5 vs NRI < 97.5:0.653; 95%confidence interval:0.326-0.974; P =0.014) according to univariate analysis as well as multivariate analysis.CONCLUSION:This study suggests that malnutrition immediately after surgery may play a significant role in the development of wound complications.

  18. Ankle-Brachial Index: Nurses Strategy To Cardiovascular Disease Risk Factors Identification

    Directory of Open Access Journals (Sweden)

    Daniela Luisa Maggi

    2014-04-01

    Full Text Available Elevated risk of fatal and non-fatal cardiovascular events is associated with high prevalence of peripheral arterial disease, with assessment through the ankle-brachial index (ABI. This study aimed to demonstrate that the ABI and the Edinburgh Claudication Questionnaire are tools to be used by nurses in prevention and/or treatment of CVD (cardiovascular disease. A cross-sectional study was carried out with patients from a cardiovascular clinic. The Edinburgh Claudication Questionnaire was applied and the ABI was measured with the formula (ABI= Blood Pressure Ankle/Blood Pressure Brachial. A total of 115 patients were included, most were females (57.4%, aged 60.6 ± 12.5 years. The most prevalent risk factors were hypertension (64.3%, physical inactivity (48.7% and family history (58.3%. The study showed that abnormal ABI was frequently found and 42.6% of the patients with abnormal ABI showed intermittent claudication. The method to evaluate the ABI associated to the Edinburg Claudication Questionnaire, can be easily used by nurses in the clinical evaluation of asymptomatic and symptomatic CVD patients.

  19. Assessing the environmental risks associated with contaminated sites: Definition of an Ecotoxicological Classification index for landfill areas (ECRIS).

    Science.gov (United States)

    Senese, V; Boriani, E; Baderna, D; Mariani, A; Lodi, M; Finizio, A; Testa, S; Benfenati, E

    2010-06-01

    Assessing ecological risk in quantitative terms is a site-specific complex procedure requiring evaluation of all possible pathways taken by the chemicals from the contamination source to the targets to be protected. Unfortunately, too many cases lack of physico-chemical and ecotoxicological data makes impossible to quantify the ecological risk. We present the Ecotoxicological Classification Risk Index for Soil (ECRIS), a new classification system specific for soil risk assessment, which gives a comparative indication of the risk linked to environmental contamination by any chemical. The tool we propose is based on the integration of a data set characterizing the ecotoxicological and exposure profile of chemicals. ECRIS is a simple approach specifically set up for the landfill scenario. This index draws on the huge amount of data from our many years of leachate analysis. ECRIS is useful for a first screening of probably contaminated soil. A case study based on some Italian landfills is proposed. 2010 Elsevier Ltd. All rights reserved.

  20. Body mass index, serum total cholesterol, and risk of gastric high-grade dysplasia

    Science.gov (United States)

    Huang, Ya-Kai; Kang, Wei-Ming; Ma, Zhi-Qiang; Liu, Yu-Qin; Zhou, Li; Yu, Jian-Chun

    2016-01-01

    Abstract Obesity is related to an increased risk of gastric cardia cancer. However, the influences of excess body weight and serum total cholesterol on the risk of gastric high-grade dysplasia have not been fully characterized. A case–control study was conducted to explore the relationships between body mass index (BMI), serum total cholesterol level, and the risk of gastric high-grade dysplasia in Chinese adults. A total of 893 consecutive patients with gastric high-grade dysplasia (537 men and 356 women) and 902 controls (543 men and 359 women) were enrolled from January 2000 to October 2015. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated, and a multivariate analysis was conducted. After adjusting for age, alcohol consumption, smoking status, family history of gastric cancer or esophageal cancer, and serum total cholesterol level, a BMI ranging from 27.5 to 29.9 was significantly related to an increased risk of gastric high-grade dysplasia in both men (adjusted OR = 1.87, 95% CI = 1.24–2.81) and women (adjusted OR = 2.72, 95% CI = 1.44–5.16). The 2 highest BMI categories (27.5–29.9 and ≥30.0) were identified as risk factors for gastric cardia high-grade dysplasia in both men (BMI = 27.5–29.9: adjusted OR = 1.78, 95% CI = 1.02–3.10; BMI ≥ 30.0: adjusted OR = 2.54, 95% CI = 1.27–5.08) and women (BMI = 27.5–29.9: adjusted OR = 2.88, 95% CI = 1.27–6.55; BMI ≥ 30.0: adjusted OR = 2.77, 95% CI = 1.36–5.64), whereas only a BMI ranging from 27.5 to 29.9 was a risk factor for gastric noncardia high-grade dysplasia in both men (adjusted OR = 1.98, 95% CI = 1.25–3.14) and women (adjusted OR = 2.88, 95% CI = 1.43–5.81). In addition, higher serum total cholesterol was associated with an increased risk of gastric noncardia high-grade dysplasia (adjusted OR = 1.83, 95% CI = 1.25–2.69) in women. Increased BMI was associated with an increased risk

  1. Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity.

    Science.gov (United States)

    Gómez-Ambrosi, J; Silva, C; Galofré, J C; Escalada, J; Santos, S; Millán, D; Vila, N; Ibañez, P; Gil, M J; Valentí, V; Rotellar, F; Ramírez, B; Salvador, J; Frühbeck, G

    2012-02-01

    Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat. We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI-classified subjects with similar BF%. We performed a cross-sectional study. A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years. BMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured. We found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3 ± 9.2, women 4.9 ± 19.5 mg l(-1)) as well as in obese BMI-classified individuals (men 4.2 ± 5.5, women 5.1 ± 13.2 mg l(-1)) compared with lean volunteers with normal body fat amounts (men 0.9 ± 0.5, women 2.1 ± 2.6 mg l(-1); Pbody fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable.

  2. Cumulative Alendronate Dose and the Long-Term Absolute Risk of Subtrochanteric and Diaphyseal Femur Fractures: A Register-Based National Cohort Analysis

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Eiken, Pia Agnete; Eastell, Richard

    2010-01-01

    are currently the subject of a U.S. Food and Drug Administration review. Objective: Our objective was to examine the risk of subtrochanteric/diaphyseal femur fractures in long term users of alendronate. Design: We conducted an age- and gender-matched cohort study using national healthcare data. Patients...... fractures occurred at a rate of 13 per 10,000 patient-years in untreated women and 31 per 10,000 patient-years in women receiving alendronate [adjusted hazard ratio (HR) = 1.88; 95% confidence interval (CI) = 1.62-2.17]. Rates for men were six and 31 per 10,000 patient-years, respectively (HR = 3.98; 95% CI...

  3. Cumulative glycemia and microangiopathy in subjects with impaired glucose regulation in the Inter99 study

    DEFF Research Database (Denmark)

    Munch, Inger Christine; Larsen, Michael; Kessel, Line

    2011-01-01

    participants. RESULTS: Lens fluorescence, a quantitative index of life-long cumulative glycemia, was increased by 7.5% (CI(95) 0.37-15.1%) in subjects with impaired fasting glucose, by 13.0% (CI(95) 5.5-21%) in subjects with combined impaired fasting glucose and impaired glucose tolerance (IFG+IGT), and by 11......AIMS: To assess cumulative glycemia, microvascular characteristics, and associated risk factors for diabetes in subjects with impaired glucose regulation. METHODS: Cross-sectional, population-based study comprising systemic characteristics in 6487 participants and ocular characteristics in 970.......8% (CI(95) 6.8-17.1%) in subjects with screen-detected diabetes compared to normoglycemic subjects, adjusted for age, sex, and smoking. The prevalences of microalbuminuria and retinopathy were significantly increased in subjects with screen-detected diabetes after adjusting for age, sex and systolic...

  4. Operative Risk for Major Lung Resection Increases at Extremes of Body Mass Index

    Science.gov (United States)

    Williams, Trevor; Gulack, Brian C.; Kim, Sunghee; Fernandez, Felix G.; Ferguson, Mark K.

    2016-01-01

    Background Although body mass index (BMI) has been used in risk stratification for lung resection, many models only take obesity into account. Recent studies have demonstrated that underweight patients also experience increased postoperative complications. We explored the relationship of extremes of BMI to outcomes after lung resection for non-small cell cancer. Methods Patients in the Society of Thoracic Surgeons General Thoracic Surgery Database (2009 to 2014) undergoing elective lung resection for cancer were evaluated. Multivariable logistic regression was used to adjust for potential confounders including functional status and spirometry. Results We evaluated 41,446 patients (median 68 years of age; 53% female) grouped by BMI: underweight (<18.5 kg/m2; 3.0%), normal (18.5 to 24.9 kg/m2; 33.5%), overweight (25 to 29.9 kg/m2; 35.4%), obese I (30 to 34.9 kg/m2; 18.1%), obese II (35 to 39.9 kg/m2; 6.4%), and obese III (≥40 kg/m2; 3.6%). Pulmonary complication rates were higher in underweight and obese III patients compared to normal BMI patients (p < 0.001). On multivariable analysis, compared to patients with normal BMI, being underweight was associated with an increased risk of pulmonary complications (adjusted odds ratio [OR]: 1.41, 95% confidence interval [CI]: 1.16 to 1.70) and any postoperative event (adjusted OR: 1.44, 95% CI: 1.26 to 1.64). Obese III patients had an increased risk of any major postoperative complication (adjusted OR: 1.18, 95% CI: 1.02 to 1.36). Overweight and obese class I to II patients had a lower risk of pulmonary complications and any postoperative event. Conclusions BMI is associated with postoperative complications after lung resection for cancer. Being underweight or severely overweight is associated with an increased risk of complications, whereas being overweight or moderately obese appears to have a protective effect. PMID:27476820

  5. Body mass index and the risk of dementia among Louisiana low income diabetic patients.

    Directory of Open Access Journals (Sweden)

    Gang Hu

    Full Text Available BACKGROUND: The association between obesity and dementia risk remains debatable and no studies have assessed this association among diabetic patients. The aim of our study was to investigate the association between body mass index (BMI and dementia risk among middle and low income diabetic patients. METHODOLOGY/PRINCIPAL FINDINGS: The sample included 44,660 diabetic patients (19,618 white and 25,042 African American 30 to 96 years of age without a history of dementia in the Louisiana State University Hospital-Based Longitudinal Study. During a mean follow-up period of 3.9 years, 388 subjects developed incident dementia. The age- and sex-adjusted hazards ratios (HRs for incident dementia at different levels of BMI (≤ 25, 25-26.9, 27-29.9, 30-34.9, and ≥ 35 kg/m(2 were 1.00, 0.53 (95% CI 0.34-0.83, 0.29 (0.18-0.45, 0.37 (0.25-0.56, and 0.31 (0.21-0.48 (P(trend<0.001 in white diabetic patients, and 1.00, 1.00 (95% CI 0.62-1.63, 0.62 (0.39-0.98, 0.56 (0.36-0.86, and 0.65 (0.43-1.01 (P(trend = 0.029 in African American diabetic patients. Further adjustment for other confounding factors affected the results only slightly. There was a significant interaction between race and BMI on dementia risk (χ(2 = 5.52, 1df, p<0.025, such that the association was stronger in white patients. In stratified analyses, the multivariate-adjusted inverse association between BMI and risk of dementia was present in subjects aged 55-64 years, 65-74 years, and ≥ 75 years, in men and women, in non-smokers and smokers, and in subjects with different types of health insurance. CONCLUSIONS/SIGNIFICANCE: Higher baseline BMI was associated with a lower risk of dementia among diabetic patients, and this association was stronger among white than among African American diabetic patients.

  6. El Niño-Southern Oscillation-based index insurance for floods: Statistical risk analyses and application to Peru

    Science.gov (United States)

    Khalil, Abedalrazq F.; Kwon, Hyun-Han; Lall, Upmanu; Miranda, Mario J.; Skees, Jerry

    2007-10-01

    Index insurance has recently been advocated as a useful risk transfer tool for disaster management situations where rapid fiscal relief is desirable and where estimating insured losses may be difficult, time consuming, or subject to manipulation and falsification. For climate-related hazards, a rainfall or temperature index may be proposed. However, rainfall may be highly spatially variable relative to the gauge network, and in many locations, data are inadequate to develop an index because of short time series and the spatial dispersion of stations. In such cases, it may be helpful to consider a climate proxy index as a regional rainfall index. This is particularly useful if a long record is available for the climate index through an independent source and it is well correlated with the regional rainfall hazard. Here El Niño-Southern Oscillation (ENSO) related climate indices are explored for use as a proxy to extreme rainfall in one of the districts of Peru, Piura. The ENSO index insurance product may be purchased by banks or microfinance institutions to aid agricultural damage relief in Peru. Crop losses in the region are highly correlated with floods but are difficult to assess directly. Beyond agriculture, many other sectors suffer as well. Basic infrastructure is destroyed during the most severe events. This disrupts trade for many microenterprises. The reliability and quality of the local rainfall data are variable. Averaging the financial risk across the region is desirable. Some issues with the implementation of the proxy ENSO index are identified and discussed. Specifically, we explore (1) the reliability of the index at different levels of probability of exceedance of maximum seasonal rainfall, (2) the effect of sampling uncertainties and the strength of the proxy's association to local outcome, (3) the potential for clustering of payoffs, (4) the potential that the index could be predicted with some lead time prior to the flood season, and (5) evidence

  7. Middle ear risk index as a prognostic factor in pediatric ossicular reconstruction

    Directory of Open Access Journals (Sweden)

    Khalid Almazrou

    2013-01-01

    Full Text Available Objectives: To study the hearing results in children following ossicular reconstruction and to determine if the middle ear risk index (MERI is a useful tool for predicting the outcome of surgery. Design: A retrospective case series. Setting: A tertiary academic center. Patients: Forty-four children underwent ossicular reconstruction using autologous or alloplastic prostheses from January 1995 to January 2005. Materials and Methods: Patients′ audiograms were evaluated preoperatively and postoperatively for pure-tone average (PTA and air-bone gap (ABG. Each ear was scored using the MERI and a total index was calculated. Results: 23 boys and 21 girls were included in the study. The mean preoperative ABG was 38 dB, and the mean postoperative ABG was 25.3 dB. The mean MERI was 3.40 for excellent results (0-10 dB postoperative ABG, 4.42 for good results (11-20 dB postoperative ABG, 4.45 for fair results (21-30 dB postoperative ABG, and 4.06 for poor results (ABG > 30 dB. The complications included perforation of tympanic membrane (13.6%, worsening of the conductive hearing loss (6.8%, retraction pockets (9.1%, recurrent or residual cholesteatoma (6.8%, high-frequency sensorineural hearing loss (4.45%, and prosthesis extrusion (2.3%. The mean follow-up period was 14 months. Conclusion: Children have poorer hearing outcome following ossicular reconstruction in comparison to the published adults′ results. The MERI was not a reliable tool for predicting the hearing results of ossicular reconstruction in children.

  8. Vulnerability Index to Climate Change and its Application for Community-level Risk Assessment in Thailand

    Directory of Open Access Journals (Sweden)

    Atsamon Limsakul

    2014-06-01

    Full Text Available On the basis of the vulnerability-led approach, the Prevalent Community-level Vulnerability Index (PCVI was developed as a simple composite index used to represent community-level vulnerability to climate change in the socioeconomic and hazard contexts. The PCVI consists of three major components which are Exposure & hazard, Socioeconomic-ecological fragility and Coping capacity. All of these components are further comprised of different indicators, representing different aspects of biophysical and social vulnerability of grass-root communities. Based on the results analyzed in the provincial pilot sites, the PCVI could represent both spatial patterns and magnitudes of vulnerability of each community in consistence with the local economic-social-environmental contexts. It generally reflects the differences in the local contexts and factors that determine overall vulnerability of each community. For the ease in calculating the PCVI especially for the provincial operating staffs and general public, the PREvalent Community Climate Change Vulnerability Tool (RECCC was further developed as a user-friendly, Excel-based program. In conclusions, the outputs of this study that include the PCVI and its database as well as the RECCC program are useful not only for analyzing vulnerability and assessing risks of community to climate change, but also for supporting decision-making process in developing and implementing adaptation activities at provincial level. These outputs were also designed for further integrating as a supplementary part of Provincial�s Decision Supporting System (DSS, with the purpose of promoting the participation of local organizations and stakeholders in coping with the adverse impacts of climate change. However, additional development of ERCCC program, together with dissemination of the vulnerability framework as well as the use of ERCCC program to local organizations needs to be continued.

  9. [Nutritional risk in surgery evaluated by body mass index adjusted or not to elderly patients].

    Science.gov (United States)

    Bicudo-Salomão, Alberto; Aguilar-Nascimento, José Eduardo de; Caporossi, Cervantes

    2006-01-01

    Standard body mass index cut-off points for malnutrition are routinely used for adults independently of their age. The hypothesis of this study was that a cut-off point higher than the usual for the diagnosis of malnutrition might be more precise to access the nutritional risk of aged surgical patients. To evaluate the morbimortality in aged surgical patients and its association with nutritional status assessed by body mass index using either the standard and a higher cut-off point for malnutrition. All patients admitted for operative procedures (n = 1,912) were allocated to either two groups: 65 years old (n = 285). The body mass index was used to access the nutritional status. Two different cut-off points for malnutrition (18.5 or 24 kg/m(2)) were used in the group of older patients. Endpoints of the study were length of stay, morbidity and mortality. Length of stay was higher in patients over 65 years (6 [1-75] days vs. 4 [1-137] days). Both postoperative complications (37/285; 13.0% vs. 109/1627; 6.7%; OR 2.1; IC95% 1.40-3.09) and deaths (15/285; 5.3% vs. 34/1627; 2.1%; OR 2.6; IC95% 1.40-4.84) were most common in the older group. Using a higher cut-off (24 kg/m(2)), the length of stay (8 [1-75] days vs. 4 [1-43] days), postoperative complications (28/152; 18.4% versus 9/133; 6.8%; OR 3,1; IC95% 1.41-6.86) and re-operations (16/152; 10.5% versus 3/133; 2.2%; OR 5.1; IC95% 1.45-17.91) were greater in malnourished patients. However these correlations were not statistically significant with the cut-off point for malnutrition in 18.5 kg/m(2). Morbimortality is higher in surgical patients over 65 years old. In these, the cut-off point set in 24 kg/m(2) was most associated with the occurrence of postoperative complications, re-operations and length of stay.

  10. Development and validation of a prognostic index for fracture risk in older men undergoing prostate cancer treatment

    Science.gov (United States)

    Graham-Steed, Tisheeka R.; Soulos, Pamela R.; Dearing, Natalie; Concato, John; Tinetti, Mary E.; Gross, Cary P.

    2014-01-01

    Objectives Men treated with androgen deprivation therapy (ADT) or radiation therapy (RT) for prostate cancer have an increased risk for fractures. Given uncertainty as to whether specific clinical factors can identify men at increased risk, we sought to develop a prognostic index for risk of fracture in this population. Materials and methods We used the Surveillance, Epidemiology, and End Results-Medicare database to identify men who received ADT or RT after being diagnosed with localized prostate cancer in 2007-2009. Cox proportional hazards models tested the association of potential risk factors with fracture. In a derivation group, hazard ratios were used to assign points for factors independently related to fracture. The prognostic index was then applied to a validation group. Results The sample of 5,824 men had a median age of 73.0 years; 82.9% were white and 8.6% had a fracture within 2 years of treatment for prostate cancer. The Cox model identified 8 variables (age, race, hormone treatment, Elixhauser score, anxiety, Parkinson's, fall-inducing medications and disability status) independently associated with fracture. In the derivation cohort, 4.3% of the sample experienced a fracture in the low-risk group, 8.9% in the intermediate group, and 19.2% in the high-risk group (C statistic, 0.749). The index was applied to the validation cohort (C statistic, 0.782). Conclusion The prognostic index can help to identify patients at increased risk for fracture. This underscores the importance of identifying risk factors for fracture, given the substantial variation in fracture risk in men treated with ADT or RT. PMID:25240918

  11. Development and validation of a prognostic index for fracture risk in older men undergoing prostate cancer treatment.

    Science.gov (United States)

    Graham-Steed, Tisheeka R; Soulos, Pamela R; Dearing, Natalie; Concato, John; Tinetti, Mary E; Gross, Cary P

    2014-10-01

    Men treated with androgen deprivation therapy (ADT) or radiation therapy (RT) for prostate cancer have an increased risk for fractures. Given uncertainty as to whether specific clinical factors can identify men at increased risk, we sought to develop a prognostic index for risk of fracture in this population. We used the Surveillance, Epidemiology, and End Results-Medicare database to identify men who received ADT or RT after being diagnosed with localized prostate cancer in 2007-2009. Cox proportional hazards models tested the association of potential risk factors with fracture. In a derivation group, hazard ratios were used to assign points for factors independently related to fracture. The prognostic index was then applied to a validation group. The sample of 5824 men had a median age of 73.0 years; 82.9% were white and 8.6% had a fracture within 2 years of treatment for prostate cancer. The Cox model identified 8 variables (age, race, hormone treatment, Elixhauser score, anxiety, Parkinson's, fall-inducing medications and disability status) independently associated with fracture. In the derivation cohort, 4.3% of the sample experienced a fracture in the low-risk group, 8.9% in the intermediate group, and 19.2% in the high-risk group (C statistic, 0.749). The index was applied to the validation cohort (C statistic, 0.782). The prognostic index can help to identify patients at increased risk for fracture. This underscores the importance of identifying risk factors for fracture, given the substantial variation in fracture risk in men treated with ADT or RT. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Definition and GIS-based characterization of an integral risk index applied to a chemical/petrochemical area.

    Science.gov (United States)

    Nadal, Martí; Kumar, Vikas; Schuhmacher, Marta; Domingo, José L

    2006-08-01

    A risk map of the chemical/petrochemical industrial area of Tarragona (Catalonia, Spain) was designed following a two-stage procedure. The first step was the creation of a ranking system (Hazard Index) for a number of different inorganic and organic pollutants: heavy metals, polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs) and polychlorinated aromatic hydrocarbons (PAHs) by applying self-organizing maps (SOM) to persistence, bioaccumulation and toxicity properties of the chemicals. PCBs seemed to be the most hazardous compounds, while the light PAHs showed the minimum values. Subsequently, an Integral Risk Index was developed taking into account the Hazard Index and the concentrations of all pollutants in soil samples collected in the assessed area of Tarragona. Finally, a risk map was elaborated by representing the spatial distribution of the Integral Risk Index with a geographic information system (GIS). The results of the present study seem to indicate that the development of an integral risk map might be useful to help in making-decision processes concerning environmental pollutants.

  13. Differentiating the associations of waist circumference and body mass index with cardiovascular disease risk in a Chinese population.

    Science.gov (United States)

    Li, Rui; Shi, Liang; Jia, Jian; Li, Yanyun; Yang, Qundi; Ruan, Ye; Chen, Renjie; Kan, Haidong

    2015-03-01

    It is not known which obesity index best explains variations in cardiovascular disease risk across populations. The objective of this study was to differentiate the associations of waist circumference (WC) and body mass index (BMI) with cardiovascular disease risk in a Chinese population. Cardiovascular risk factors, WC, and BMI were measured in 13 817 adults aged more than 18 years in Shanghai. Higher WC tertiles were associated with higher blood pressure and higher cholesterol, triacylglycerol, and glucose concentrations within each tertile of BMI and vice versa. The odds ratios (ORs) of hypertension, dyslipidemia, and metabolic syndrome increased with successive WC (or BMI) tertiles after adjustment for BMI (or WC) and several covariates. However, BMI tertiles were not associated with the ORs of diabetes after adjustment for WC. WC may be better than BMI as an alternative measure of body fatness or fat distribution for predicting diabetic risks in Chinese adults.

  14. Quantitative autistic trait measurements index background genetic risk for ASD in Hispanic families.

    Science.gov (United States)

    Page, Joshua; Constantino, John Nicholas; Zambrana, Katherine; Martin, Eden; Tunc, Ilker; Zhang, Yi; Abbacchi, Anna; Messinger, Daniel

    2016-01-01

    Recent studies have indicated that quantitative autistic traits (QATs) of parents reflect inherited liabilities that may index background genetic risk for clinical autism spectrum disorder (ASD) in their offspring. Moreover, preferential mating for QATs has been observed as a potential factor in concentrating autistic liabilities in some families across generations. Heretofore, intergenerational studies of QATs have focused almost exclusively on Caucasian populations-the present study explored these phenomena in a well-characterized Hispanic population. The present study examined QAT scores in siblings and parents of 83 Hispanic probands meeting research diagnostic criteria for ASD, and 64 non-ASD controls, using the Social Responsiveness Scale-2 (SRS-2). Ancestry of the probands was characterized by genotype, using information from 541,929 single nucleotide polymorphic markers. In families of Hispanic children with an ASD diagnosis, the pattern of quantitative trait correlations observed between ASD-affected children and their first-degree relatives (ICCs on the order of 0.20), between unaffected first-degree relatives in ASD-affected families (sibling/mother ICC = 0.36; sibling/father ICC = 0.53), and between spouses (mother/father ICC = 0.48) were in keeping with the influence of transmitted background genetic risk and strong preferential mating for variation in quantitative autistic trait burden. Results from analysis of ancestry-informative genetic markers among probands in this sample were consistent with that from other Hispanic populations. Quantitative autistic traits represent measurable indices of inherited liability to ASD in Hispanic families. The accumulation of autistic traits occurs within generations, between spouses, and across generations, among Hispanic families affected by ASD. The occurrence of preferential mating for QATs-the magnitude of which may vary across cultures-constitutes a mechanism by which background genetic liability

  15. High glycemic index diet as a risk factor for depression: analyses from the Women's Health Initiative.

    Science.gov (United States)

    Gangwisch, James E; Hale, Lauren; Garcia, Lorena; Malaspina, Dolores; Opler, Mark G; Payne, Martha E; Rossom, Rebecca C; Lane, Dorothy

    2015-08-01

    The consumption of sweetened beverages, refined foods, and pastries has been shown to be associated with an increased risk of depression in longitudinal studies. However, any influence that refined carbohydrates has on mood could be commensurate with their proportion in the overall diet; studies are therefore needed that measure overall intakes of carbohydrate and sugar, glycemic index (GI), and glycemic load. We hypothesized that higher dietary GI and glycemic load would be associated with greater odds of the prevalence and incidence of depression. This was a prospective cohort study to investigate the relations between dietary GI, glycemic load, and other carbohydrate measures (added sugars, total sugars, glucose, sucrose, lactose, fructose, starch, carbohydrate) and depression in postmenopausal women who participated in the Women's Health Initiative Observational Study at baseline between 1994 and 1998 (n = 87,618) and at the 3-y follow-up (n = 69,954). We found a progressively higher dietary GI to be associated with increasing odds of incident depression in fully adjusted models (OR for the fifth compared with first quintile: 1.22; 95% CI: 1.09, 1.37), with the trend being statistically significant (P = 0.0032). Progressively higher consumption of dietary added sugars was also associated with increasing odds of incident depression (OR for the fifth compared with first quintile: 1.23; 95% CI: 1.07, 1.41; P-trend = 0.0029). Higher consumption of lactose, fiber, nonjuice fruit, and vegetables was significantly associated with lower odds of incident depression, and nonwhole/refined grain consumption was associated with increased odds of depression. The results from this study suggest that high-GI diets could be a risk factor for depression in postmenopausal women. Randomized trials should be undertaken to examine the question of whether diets rich in low-GI foods could serve as treatments and primary preventive measures for depression in postmenopausal women.

  16. Saturated Fat Intake Modulates the Association between an Obesity Genetic Risk Score and Body Mass Index in Two US Populations

    OpenAIRE

    P. Casas-Agustench; Arnett, DK; Smith, CE; Lai, CQ; Parnell, LD; Borecki, IB; Frazier-Wood, AC; Allison, M.; Chen, YDI; Taylor, KD; Rich, SS; Rotter, JI; Lee, Yc; Ordovás, JM

    2014-01-01

    © 2014 Academy of Nutrition and Dietetics. Combining multiple genetic variants related to obesity into a genetic risk score (GRS) might improve identification of individuals at risk of developing obesity. Moreover, characterizing gene-diet interactions is a research challenge to establish dietary recommendations to individuals with higher predisposition to obesity. Our objective was to analyze the association between an obesity GRS and body mass index (BMI) in the Genetics of Lipid Lowering D...

  17. N100 Repetition Suppression Indexes Neuroplastic Defects in Clinical High Risk and Psychotic Youth

    Directory of Open Access Journals (Sweden)

    Joseph Gonzalez-Heydrich

    2016-01-01

    Full Text Available Highly penetrant mutations leading to schizophrenia are enriched for genes coding for N-methyl-D-aspartate receptor signaling complex (NMDAR-SC, implicating plasticity defects in the disease’s pathogenesis. The importance of plasticity in neurodevelopment implies a role for therapies that target these mechanisms in early life to prevent schizophrenia. Testing such therapies requires noninvasive methods that can assess engagement of target mechanisms. The auditory N100 is an obligatory cortical response whose amplitude decreases with tone repetition. This adaptation may index the health of plasticity mechanisms required for normal development. We exposed participants aged 5 to 17 years with psychosis n=22, at clinical high risk (CHR for psychosis n=29, and healthy controls n=17 to an auditory tone repeated 450 times and measured N100 adaptation (mean amplitude during first 150 tones − mean amplitude during last 150 tones. N100 adaptation was reduced in CHR and psychosis, particularly among participants <13 years old. Initial N100 blunting partially accounted for differences. Decreased change in the N100 amplitude with tone repetition may be a useful marker of defects in neuroplastic mechanisms measurable early in life.

  18. A risk of malignancy index in preoperative diagnosis of ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    马水清; 沈铿; 郎景和

    2003-01-01

    Objective To evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass. Methods One hundred and forty women with pelvic masses, at age 30 of years or more were admitted to the Peking Union Medical College Hospital between January 1998 and June 1999. The sensitivity, specificity and positive predictive value of serum CA125 level, ultrasound findings and the menopausal status in diagnosis of ovarian cancer were evaluated separately or combined into the RMI. Results RMI was more accurate than any individual criterion in diagnosing cancer. Using an RMI cutoff level of 200 to indicate malignancy, the RMI derived from this data set gave a sensitivity of 87.3%, a specificity of 84.4%, and a positive predictive value of 82.1%. Conclusions RMI is able to correctly discriminate malignant from benign pelvic mass. It can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery.

  19. Body Mass Index: A Risk Factor for Retinopathy in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Snježana Kaštelan

    2013-01-01

    Full Text Available The aim of the study was to investigate whether body mass index (BMI independently or in correlation with other risk factors is associated with diabetic retinopathy (DR progression. The study included 545 patients with type 2 diabetes. According to DR status, they were divided into three groups: group 1 (no retinopathy; n=296, group 2 (mild/moderate nonproliferative DR; n=118, and group 3 (severe/very severe NPDR or proliferative DR; n=131. Patients without DR were younger than those with signs of retinopathy at time of diabetes onset whilst diabetes duration was longer in groups with severe NPDR and PDR. DR progression was correlated with diabetes duration, BMI, HbA1c, hypertension, and cholesterol. Statistical analyses showed that the progression of retinopathy increased significantly with higher BMI (gr. 1: 26.50 ± 2.70, gr. 2: 28.11 ± 3.00, gr. 3: 28.69 ± 2.50; P<0.01. We observed a significant deterioration of HbA1c and a significant increase in cholesterol and hypertension with an increase in BMI. Correlation between BMI and triglycerides was not significant. Thus, BMI in correlation with HbA1c cholesterol and hypertension appears to be associated with the progression of DR in type 2 diabetes and may serve as a predictive factor for the development of this important cause of visual loss in developed countries.

  20. Effects of 2 Months Aerobic Exercis on Glucose Homeostasis Index and Cardiovascular Risk Factors

    Directory of Open Access Journals (Sweden)

    A Rashidlamir

    2011-06-01

    Full Text Available Introduction: The cause of many metabolic diseases is a progressive increase in fasting insulin levels that is generally associated with inflammatory status. In such conditions, circulating resistin hormonal levels and CRP levels also increase. The aim of the present study was to determine the effect of 2 months aerobic training on insulin resistance and inflammatory markers. Methods: In the study, 30 middle aged healthy men volunteered (Age=38.56±4.77, BMI=25.14±2.16 to participate and based on their body fat percentage were assigned in two equal groups. Experimental group was asked to perform 2 months of aerobic exercise, 4 sessions a week with 60-80% maximum heart rate, while the control group was sedentary during the same period. Blood samples were collected 48 hours before the first session and 48 hours after the last session under similar conditions. Results: Plasma insulin (p≤0.001 and glucose (p≤0.001 levels decreased and consequently insulin resistance index also decreased (p≤0.001 in the experimental group as compared to controls. Also, resistin concentrations increased (p≤0.001, while CRP concentrations decreased (p≤0.001, respectively in the experimental group. Conclusion: In general, it can be concluded that regular aerobic exercise due to improved insulin resistance and plasma levels of two inflammatory markers (CRP and the resistin reduces risk factors of metabolic disease and atherosclerosis and can be used as an effective strategy to prevent such diseases.

  1. Body Mass Index: A Risk Factor for Retinopathy in Type 2 Diabetic Patients

    Science.gov (United States)

    Kaštelan, Snježana; Tomić, Martina; Gverović Antunica, Antonela; Ljubić, Spomenka; Salopek Rabatić, Jasminka; Karabatić, Mirela

    2013-01-01

    The aim of the study was to investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. The study included 545 patients with type 2 diabetes. According to DR status, they were divided into three groups: group 1 (no retinopathy; n = 296), group 2 (mild/moderate nonproliferative DR; n = 118), and group 3 (severe/very severe NPDR or proliferative DR; n = 131). Patients without DR were younger than those with signs of retinopathy at time of diabetes onset whilst diabetes duration was longer in groups with severe NPDR and PDR. DR progression was correlated with diabetes duration, BMI, HbA1c, hypertension, and cholesterol. Statistical analyses showed that the progression of retinopathy increased significantly with higher BMI (gr. 1: 26.50 ± 2.70, gr. 2: 28.11 ± 3.00, gr. 3: 28.69 ± 2.50; P < 0.01). We observed a significant deterioration of HbA1c and a significant increase in cholesterol and hypertension with an increase in BMI. Correlation between BMI and triglycerides was not significant. Thus, BMI in correlation with HbA1c cholesterol and hypertension appears to be associated with the progression of DR in type 2 diabetes and may serve as a predictive factor for the development of this important cause of visual loss in developed countries. PMID:24347825

  2. High atherogenic index of plasma in subclinical hypothyroidism: Implications in assessment of cardiovascular disease risk

    Directory of Open Access Journals (Sweden)

    Stephen R James

    2016-01-01

    Full Text Available Background: A controversy exists regarding the association between subclinical hypothyroidism (SH and dyslipidemia. Moreover, studies on lipid ratios and atherogenic index of plasma (AIP in SH are rare, particularly in the Indian scenario. Aim: This study aimed to investigate abnormalities in conventional lipid profile, lipid ratios, and AIP in SH and attempted to correlate thyroid stimulating hormone (TSH and AIP in SH. Materials and Methods: In this retrospective analysis of patient records of SH subjects and euthyroid subjects, age, free triiodothyronine, free thyroxine, TSH, total cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-C, low-density lipoprotein-cholesterol, lipid ratios, and AIP were compared between the two groups. The correlation of TSH and AIP in SH was studied. Spearman′s correlation, Mann-Whitney U-test and logistic regression analysis were performed. Results: Triglyceride, triglyceride/HDL-C, and AIP were significantly higher in SH as compared to euthyroid group, but there was no correlation between TSH and AIP in SH. AIP emerged as the significant single factor associated with SH in multiple logistic regressions. Conclusion: The positive association of dyslipidemia and SH indicates a need for regular screening of these patients to enable early diagnosis and treatment of dyslipidemia. Even in patients who have a normal conventional lipid profile, lipid ratios, and AIP have to be calculated for better assessment of atherogenic risk.

  3. Environmental risk assessment of registered insecticides in Iran using Environmental Impact Quotient (EIQ index

    Directory of Open Access Journals (Sweden)

    S. Moinoddini

    2016-05-01

    Full Text Available In the last decades, pesticides have been used extensively, in order to control pests and plant diseases, but negative impacts of pesticides caused several environmental problems and put human health in danger. In order to decrease environmental hazards of pesticide, risk of pesticide application should be measured briefly and precisely. In this study environmental impacts of registered insecticides in Iran which applied in 2001-2002, 2003-2004, 2004-2005, are considered using environmental impact quotient (EIQ index. Results showed that among considered insecticides, Imidacloprid, Fipronil and Tiodicarb, potentially (EIQ were the most hazardous insecticides, respectively. Taking rate of application and active ingredient of insecticide in to account, environmental impact (practical toxicity per cultivated hectare (EIQ Field of each provinces were investigated. In this regard, among different province of Iran, Kerman, Mazandaran and Golestan were in danger more than the others, respectively. Besides, considering the amount of agricultural production in provinces, environmental impact per ton of production were calculated for each provinces which three northern provinces of Mazandaran, Golestan and Guilan, respectively endure the most environmental impact per ton of production. Eventually based on environmental impact quotient, results demonstrated that majority of environmental impacts of insecticide in Iran were due to inadequate knowledge and also overuse of a few number of insecticides. Therefore, by improving knowledge about environmental impact of pesticides and also developing environmental friendly and ecological based methods, negative environmental impacts of insecticides will be reduced significantly.

  4. N100 Repetition Suppression Indexes Neuroplastic Defects in Clinical High Risk and Psychotic Youth.

    Science.gov (United States)

    Gonzalez-Heydrich, Joseph; Enlow, Michelle Bosquet; D'Angelo, Eugene; Seidman, Larry J; Gumlak, Sarah; Kim, April; Woodberry, Kristen A; Rober, Ashley; Tembulkar, Sahil; O'Donnell, Kyle; Hamoda, Hesham M; Kimball, Kara; Rotenberg, Alexander; Oberman, Lindsay M; Pascual-Leone, Alvaro; Keshavan, Matcheri S; Duffy, Frank H

    2016-01-01

    Highly penetrant mutations leading to schizophrenia are enriched for genes coding for N-methyl-D-aspartate receptor signaling complex (NMDAR-SC), implicating plasticity defects in the disease's pathogenesis. The importance of plasticity in neurodevelopment implies a role for therapies that target these mechanisms in early life to prevent schizophrenia. Testing such therapies requires noninvasive methods that can assess engagement of target mechanisms. The auditory N100 is an obligatory cortical response whose amplitude decreases with tone repetition. This adaptation may index the health of plasticity mechanisms required for normal development. We exposed participants aged 5 to 17 years with psychosis (n = 22), at clinical high risk (CHR) for psychosis (n = 29), and healthy controls (n = 17) to an auditory tone repeated 450 times and measured N100 adaptation (mean amplitude during first 150 tones - mean amplitude during last 150 tones). N100 adaptation was reduced in CHR and psychosis, particularly among participants <13 years old. Initial N100 blunting partially accounted for differences. Decreased change in the N100 amplitude with tone repetition may be a useful marker of defects in neuroplastic mechanisms measurable early in life.

  5. Dietary glycemic index and glycemic load and risk of pancreatic cancer: a case-control study.

    Science.gov (United States)

    Rossi, Marta; Lipworth, Loren; Polesel, Jerry; Negri, Eva; Bosetti, Cristina; Talamini, Renato; McLaughlin, Joseph K; La Vecchia, Carlo

    2010-06-01

    Carbohydrates and dietary glycemic index (GI) influence the secretion of insulin and insulin-related growth factors and may play a role in the development of diabetes and obesity, both of which have been related to pancreatic cancer risk. We examined the association between dietary GI and glycemic load (GL) and pancreatic cancer by conducting a hospital-based case-control study in Italy in 1991-2008 of 326 cases of pancreatic cancer and 652 control patients. Dietary data were obtained with the use of a validated food-frequency questionnaire. Odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were computed with the use of multiple logistic regression. GI was positively associated with pancreatic cancer, with ORs of 1.56 (95% CI, 1.06-2.30) and 1.78 (95% CI, 1.20-2.62) for the second and third tertiles, respectively, compared with the lowest. No significant association was observed between GL and pancreatic cancer. Consumption of sugar, candy, honey, and jam was positively associated with pancreatic cancer, whereas consumption of fruit was inversely associated. In conclusion, the positive association with high GI, in the absence of an association with dietary GL, fruit, or total carbohydrates, likely reflects the positive association between sweets or refined carbohydrates and pancreatic cancer in this study population. Copyright 2010 Elsevier Inc. All rights reserved.

  6. High atherogenic index of plasma in subclinical hypothyroidism: Implications in assessment of cardiovascular disease risk

    Science.gov (United States)

    James, Stephen R.; Ray, Lopamudra; Ravichandran, Kandasamy; Nanda, Sunil Kumar

    2016-01-01

    Background: A controversy exists regarding the association between subclinical hypothyroidism (SH) and dyslipidemia. Moreover, studies on lipid ratios and atherogenic index of plasma (AIP) in SH are rare, particularly in the Indian scenario. Aim: This study aimed to investigate abnormalities in conventional lipid profile, lipid ratios, and AIP in SH and attempted to correlate thyroid stimulating hormone (TSH) and AIP in SH. Materials and Methods: In this retrospective analysis of patient records of SH subjects and euthyroid subjects, age, free triiodothyronine, free thyroxine, TSH, total cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol, lipid ratios, and AIP were compared between the two groups. The correlation of TSH and AIP in SH was studied. Spearman's correlation, Mann–Whitney U-test and logistic regression analysis were performed. Results: Triglyceride, triglyceride/HDL-C, and AIP were significantly higher in SH as compared to euthyroid group, but there was no correlation between TSH and AIP in SH. AIP emerged as the significant single factor associated with SH in multiple logistic regressions. Conclusion: The positive association of dyslipidemia and SH indicates a need for regular screening of these patients to enable early diagnosis and treatment of dyslipidemia. Even in patients who have a normal conventional lipid profile, lipid ratios, and AIP have to be calculated for better assessment of atherogenic risk. PMID:27730076

  7. N100 Repetition Suppression Indexes Neuroplastic Defects in Clinical High Risk and Psychotic Youth

    Science.gov (United States)

    Gonzalez-Heydrich, Joseph; Bosquet Enlow, Michelle; D'Angelo, Eugene; Seidman, Larry J.; Gumlak, Sarah; Kim, April; Woodberry, Kristen A.; Rober, Ashley; Tembulkar, Sahil; O'Donnell, Kyle; Hamoda, Hesham M.; Kimball, Kara; Rotenberg, Alexander; Oberman, Lindsay M.; Pascual-Leone, Alvaro; Keshavan, Matcheri S.; Duffy, Frank H.

    2016-01-01

    Highly penetrant mutations leading to schizophrenia are enriched for genes coding for N-methyl-D-aspartate receptor signaling complex (NMDAR-SC), implicating plasticity defects in the disease's pathogenesis. The importance of plasticity in neurodevelopment implies a role for therapies that target these mechanisms in early life to prevent schizophrenia. Testing such therapies requires noninvasive methods that can assess engagement of target mechanisms. The auditory N100 is an obligatory cortical response whose amplitude decreases with tone repetition. This adaptation may index the health of plasticity mechanisms required for normal development. We exposed participants aged 5 to 17 years with psychosis (n = 22), at clinical high risk (CHR) for psychosis (n = 29), and healthy controls (n = 17) to an auditory tone repeated 450 times and measured N100 adaptation (mean amplitude during first 150 tones − mean amplitude during last 150 tones). N100 adaptation was reduced in CHR and psychosis, particularly among participants <13 years old. Initial N100 blunting partially accounted for differences. Decreased change in the N100 amplitude with tone repetition may be a useful marker of defects in neuroplastic mechanisms measurable early in life. PMID:26881109

  8. Can the Air Pollution Index be used to communicate the health risks of air pollution?

    Science.gov (United States)

    Li, Li; Lin, Guo-Zhen; Liu, Hua-Zhang; Guo, Yuming; Ou, Chun-Quan; Chen, Ping-Yan

    2015-10-01

    The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM10, SO2, NO2 and the weighted combined API (APIw) with mortality during 2003-2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0-2 days. Harvesting effects appeared after 2 days' exposure. The effect estimate of API over lag 0-15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution.

  9. Dietary carbohydrate, glycemic index, and glycemic load in relation to colorectal cancer risk in the Women's Health Initiative.

    Science.gov (United States)

    Kabat, Geoffrey C; Shikany, James M; Beresford, Shirley A A; Caan, Bette; Neuhouser, Marian L; Tinker, Lesley F; Rohan, Thomas E

    2008-12-01

    Evidence implicating hyperinsulinemia and insulin resistance in the etiology of colorectal cancer suggests that a diet characterized by a high glycemic index and load may increase the risk of this disease, but previous studies have yielded inconsistent results. We assessed the association between intake of total carbohydrates, sugars, fiber, and the glycemic index (GI) and glycemic load (GL) of individual diets, and risk of developing colorectal cancer among 158,800 participants in the Women's Health Initiative (WHI). We used a GI/GL database developed specifically for the WHI food-frequency questionnaire. Over an average of 7.8 years of follow-up, 1,476 incident cases of colorectal cancer were identified. Cox proportional hazards models were used to estimate the association between dietary factors classified by quintiles and risk of colorectal cancer, with adjustment for covariates. Total carbohydrate intake, glycemic index, glycemic load, and intake of sugars and fiber showed no association with colorectal cancer. Analyses by cancer subsite also yielded null results, with the exception of a borderline positive association between glycemic load and rectal cancer (HR for the highest versus lowest quintile 1.84, 95% confidence interval 0.95-3.56, p for trend 0.05). Analyses stratified by tertiles of body mass index and physical activity showed no evidence of effect modification by these factors. Results of this large study do not support of a role of a diet characterized by high glycemic index or load in colorectal carcinogenesis in postmenopausal women.

  10. Copula-based drought risk assessment combined with an integrated index in the Wei River Basin, China

    Science.gov (United States)

    Chang, Jianxia; Li, Yunyun; Wang, Yimin; Yuan, Meng

    2016-09-01

    It is critical to assess drought risk based on a reliably integrated drought index incorporating comprehensive information of meteorology, hydrology and agriculture drought indices, which is of great value for further understanding the future drought tendency, prevention and mitigation. Thus, the primary objective of this study was to focus on constructing a multivariate integrated drought index (MIDI) by coupling four drought indices (i.e., Precipitation Anomaly Percentage (PAP), Runoff Anomaly Percentage (RAP), Standardized Precipitation Index with 6-month aggregation time step (SPI6) and Modified Palmer Drought Severity Index (MPDSI)) to objectively and comprehensively investigate drought risk. The variable fuzzy set theory and entropy weight method are used during the MIDI construction process. Based on the MIDI, a drought event including drought duration and severity is redefined using run theory. Then copula-based drought risk is fully assessed through the joint probability distribution of drought duration and severity. Results indicate the following: (1) the constructed MIDI is consistent with the Standardized Precipitation Index (SPI) and Runoff Anomaly Percentage (RAP) series, and it is more sensitive and effective to capture historical drought events; (2) the drought characteristics present noticeable spatial variability among five subzones, and the entire basin has 49 droughts with the longest drought duration spanning 8.55 months; and (3) the mainstream, especially the middle and lower reaches, has higher occurrences of severe droughts for approximately every 10 years.

  11. Risk of malignancy index used as a diagnostic tool in a tertiary centre for patients with a pelvic mass

    DEFF Research Database (Denmark)

    Håkansson, Fanny; Høgdall, Estrid V S; Nedergaard, Lotte

    2012-01-01

    Abstract Objective. Risk of malignancy index (RMI), based on a serum cancer antigen 125 level, ultrasound findings and menopausal status, is used to discriminate ovarian cancer from benign pelvic mass. In Denmark, patients with pelvic mass and RMI =200 are referred to tertiary gynecologic oncolog...

  12. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: A prospective cohort study

    NARCIS (Netherlands)

    Merry, A.H.H.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2007-01-01

    Background: In the last decades, the incidence of oesophageal and gastric cardia adenocarcinoma has increased rapidly in the Western world. We investigated the association between body mass index (BMI), height and risk of oesophageal and gastric cardia adenocarcinoma. Methods: The Netherlands Cohort

  13. Body Mass Index Increases Risk of Colorectal Adenomas in Men With Lynch Syndrome : The GEOLynch Cohort Study

    NARCIS (Netherlands)

    Botma, Akke; Nagengast, Fokko M.; Braem, Marieke G. M.; Hendriks, Jan C. M.; Kleibeuker, Jan H.; Vasen, Hans F. A.; Kampman, Ellen

    2010-01-01

    Purpose High body mass index (BMI) is an established risk factor for sporadic colorectal cancer. Still, the influence of BMI on hereditary colorectal cancer (eg, Lynch syndrome [LS]), is unknown. The objective of this study was to assess whether BMI is associated with colorectal adenoma occurrence

  14. Body mass index increases risk of colorectal adenomas in men with lunch syndrome: the GEOLynch cohort study

    NARCIS (Netherlands)

    Botma, A.; Nagengast, F.M.; Braem, M.G.M.; Hendriks, J.C.M.; Kleibeuker, J.H.; Vasen, H.F.A.; Kampman, E.

    2010-01-01

    Purpose: High body mass index (BMI) is an established risk factor for sporadic colorectal cancer. Still, the influence of BMI on hereditary colorectal cancer (eg, Lynch syndrome [LS]), is unknown. The objective of this study was to assess whether BMI is associated with colorectal adenoma occurrence

  15. A new clinically applicable age-specific comorbidity index for preoperative risk assessment of ovarian cancer patients

    DEFF Research Database (Denmark)

    Noer, Mette Calundann; Sperling, Cecilie Dyg; Antonsen, Sofie Leisby

    2016-01-01

    OBJECTIVE: To develop and validate a new feasible comorbidity index based on self-reported information suited for preoperative risk assessment of ovarian cancer patients. METHODS: The study was based on patient self-reported data from ovarian cancer patients registered in the Danish Gynecological...

  16. Carbohydrates, glycemic index, glycemic load, and colorectal cancer risk: a systematic review and meta-analysis of cohort studies.

    NARCIS (Netherlands)

    Aune, D.; Chan, D.S.; Lau, R.; Vieira, R.; Greenwood, D.C.; Kampman, E.; Norat, T.

    2012-01-01

    BACKGROUND: Dietary carbohydrate, glycemic index, and glycemic load are thought to influence colorectal cancer risk through hyperinsulinemia. We review and quantitatively summarize in a meta-analysis the evidence from prospective cohort studies. METHODS: We searched the PubMed database for

  17. Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European prospective investigation into cancer and nutrition cohort

    NARCIS (Netherlands)

    Cust, Anne E.; Slimani, Nadia; Kaaks, Rudolf; van Bakel, Marit; Biessy, Carine; Ferrari, Pietro; Laville, Martine; Tjonneland, Anne; Olsen, Anja; Overvad, Kim; Lajous, Martin; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Linseisen, Jakob; Rohrmann, Sabine; Noethlings, Ute; Boeing, Heiner; Palli, Domenico; Sieri, Sabina; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Skeie, Guri; Engeset, Dagrun; Gram, Inger Torhild; Quiros, J. Ramon; Jakszyn, Paula; Sanchez, Maria Jose; Larranaga, Nerea; Navarro, Carmen; Ardanaz, Eva; Wirfalt, Elisabet; Berglund, Goran; Lundin, Eva; Hallmans, Goeran; Bueno-de-Mesquita, H. Bas; Du, Huaidong; Peeters, Petra H. M.; Bingham, Shelia; Khaw, Kay-Tee; Allen, Naomi E.; Key, Timothy J.; Jenab, Mazda; Riboli, Elio

    2007-01-01

    The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), inc

  18. Carbohydrates, glycemic index, glycemic load, and colorectal cancer risk: a systematic review and meta-analysis of cohort studies.

    NARCIS (Netherlands)

    Aune, D.; Chan, D.S.; Lau, R.; Vieira, R.; Greenwood, D.C.; Kampman, E.; Norat, T.

    2012-01-01

    BACKGROUND: Dietary carbohydrate, glycemic index, and glycemic load are thought to influence colorectal cancer risk through hyperinsulinemia. We review and quantitatively summarize in a meta-analysis the evidence from prospective cohort studies. METHODS: We searched the PubMed database for prospecti

  19. Carbohydrates, glycemic index, glycemic load, and colorectal cancer risk : a systematic review and meta-analysis of cohort studies

    NARCIS (Netherlands)

    Aune, D.; Chan, D.S.M.; Lau, R.; Vieira, R.; Greenwood, D.C.; Kampman, E.; Norat, T.

    2012-01-01

    Background Dietary carbohydrate, glycemic index, and glycemic load are thought to influence colorectal cancer risk through hyperinsulinemia. We review and quantitatively summarize in a meta-analysis the evidence from prospective cohort studies. Methods We searched the PubMed database for prospective

  20. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: A prospective cohort study

    NARCIS (Netherlands)

    Merry, A.H.H.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2007-01-01

    Background: In the last decades, the incidence of oesophageal and gastric cardia adenocarcinoma has increased rapidly in the Western world. We investigated the association between body mass index (BMI), height and risk of oesophageal and gastric cardia adenocarcinoma. Methods: The Netherlands Cohort

  1. Unreliability of aortic size index to predict risk of aortic dissection in a patient with Turner syndrome

    Science.gov (United States)

    Nijs, Jan; Gelsomino, Sandro; Lucà, Fabiana; Parise, Orlando; Maessen, Jos G; Meir, Mark La

    2014-01-01

    Aortic size index (ASI) has been proposed as a reliable criterion to predict risk for aortic dissection in Turner syndrome with significant thresholds of 20-25 mm/m2. We report a case of aortic arch dissection in a patient with Turner syndrome who, from the ASI thresholds proposed, was deemed to be at low risk of aortic dissection or rupture and was not eligible for prophylactic surgery. This case report strongly supports careful monitoring and surgical evaluation even when the ASI is < 20 mm/m2 if other significant risk factors are present. PMID:24944765

  2. Decreased body mass index as an independent risk factor for developing chronic kidney disease.

    Science.gov (United States)

    Tokashiki, Kaori; Tozawa, Masahiko; Iseki, Chiho; Kohagura, Kentaro; Kinjo, Kozen; Takishita, Shuichi; Iseki, Kunitoshi

    2009-02-01

    Obesity and metabolic syndrome are risk factors for the development of chronic kidney disease (CKD). Few studies have examined the effect of change in body mass index (DeltaBMI) on CKD incidence in a general screening setting. Subjects of this study were screenees that participated in the screening program of the Okinawa General Health Maintenance Association in 1993 and 2003 in Okinawa, Japan. Using identification number, birth date, sex, and other recorded identifiers, we identified 33,389 subjects among the 1993 screening participants (N = 143,948) who also participated in the 2003 screening. CKD was defined as estimated glomerular filtration rate diet in renal disease study equation. Obesity was defined as BMI > or = 25 kg/m(2). CKD prevalence was 13.8% in 1993 and 22.4% in 2003. The incidence of developing CKD in 10 years was 15.5%. The effect of DeltaBMI on CKD incidence was evaluated after considering other confounding factors such as age, sex, blood pressure, BMI, fasting plasma glucose, and proteinuria. Median DeltaBMI was 1.0%. The adjusted odds ratio (95% CI) for the effect of DeltaBMI on CKD incidence was 1.111 (1.026-1.204, P or = 1% was taken as a reference. DeltaBMI was an independent predictor of CKD incidence. The present results suggest that there was an inverse relationship between DeltaBMI and CKD incidence among screened subjects. The reasons for this observation are not clear, but careful follow-up for DeltaBMI is necessary, particularly in obese men with proteinuria.

  3. 地方政府过度举债、风险累积和治理对策%Excessive Issuance, Cumulative Risks and Governance Strategies of Local Government Debt

    Institute of Scientific and Technical Information of China (English)

    方先明; 张谊浩; 蒋或

    2012-01-01

    Recently, China' s local government has been emerging the phenomenon of excessive issuance of local bonds, showing the characteristics of increasingly complicated forms, largescale expansion, significant growth of balance and relatively unbal anced structure. Factors leading to excessive issuance of local bonds include non supporting after tax system reform, appointment and examination system of local officials, inadequate decision making mechanism, not enough law constraints, and so on. Excessive issuance of local bonds, especially the rapid expansion of financing platform of local government, will lead to a variety of risks, and then slow down the development of local economy. This paper discusses about the scientific and operational governance strategies against the excessive issuance of local bonds and its corresponding cumulative risks.%当前我国地方政府出现了过度举债现象,表现出债务形式日趋复杂,规模大幅扩张,余额增速明显,结构相对失衡的特征。地方政府过度举债的原因在于分税制改革后的不配套、地方干部任命与考核制度、决策机制不完善、法制约束力不够等。地方政府过度举债特别是各级地方政府融资平台的迅速扩张势必诱发各种风险,进而阻碍地方经济发展。为此,文章针对地方政府过度举债及其风险累积,提出兼具科学性及可操作性的治理对策。

  4. Surgical Site Infection (SSI) Rates in the United States, 1992-1998: The National Nosocomial Infections Surveillance System Basic SSI Risk Index

    National Research Council Canada - National Science Library

    Robert P. Gaynes; David H. Culver; Teresa C. Horan; Jonathan R. Edwards; Chesley Richards; James S. Tolson; The National Nosocomial Infections Surveillance System

    2001-01-01

    By use of the National Nosocomial Infections Surveillance (NNIS) System's surgical patient surveillance component protocol, the NNIS basic risk index was examined to predict the risk of a surgical site infection (SSI...

  5. Application of Fuzzy Cluster Analysis Method in Evaluating Relevant Index and Recognizing Risks of Coronary Heart Disease in the Aged

    Institute of Scientific and Technical Information of China (English)

    耿辉; 杨玉坤

    2003-01-01

    The risk recognition model for preventing and monitoring the Coronary Heart Diseases (CHD) in the aged is proposed, which is based on the testing results of four indexes and includes Low Density Lipoprotein (LDL), Total Cholesterol (TC), Triglyceridemia (TG)and age. Some people who took the health checkup in Shanghai Xinhua Hospital are classified into 3 groups,and each group is associated with prevalence risk of contracting CHD. Then the fuzzy recognition method is applied to evaluate the risk of CHD. The accuracy rate is up to 85%. The model is applicable to not only analysis of risk in medical but also analysis of risk in finance, insurance and some other fields.

  6. Mapping cumulative environmental effects, social vulnerability, and health in the San Joaquin Valley, California.

    Science.gov (United States)

    Huang, Ganlin; London, Jonathan

    2012-05-01

    To understand the social distribution of environmental hazards, methods to assess cumulative effects and their health implications are needed. We developed a cumulative environmental hazard index integrating environmental data on pollution sites, air quality, and pesticide use; a social vulnerability index to measure residents' resources to prevent or mitigate health effects; and a health index. We found that communities in California's San Joaquin Valley with high social vulnerability face more environmental burdens and have worse health conditions.

  7. Evaluating perspectives for PRRS virus elimination from pig dense areas with a risk factor based herd index.

    Science.gov (United States)

    Fahrion, A S; Beilage, E grosse; Nathues, H; Dürr, S; Doherr, M G

    2014-06-01

    Porcine reproductive and respiratory syndrome virus (PRRSV) is wide-spread in pig populations globally. In many regions of Europe with intensive pig production and high herd densities, the virus is endemic and can cause disease and production losses. This fuels discussion about the feasibility and sustainability of virus elimination from larger geographic regions. The implementation of a program aiming at virus elimination for areas with high pig density is unprecedented and its potential success is unknown. The objective of this work was to approach pig population data with a simple method that could support assessing the feasibility of a sustainable regional PRRSV elimination. Based on known risk factors such as pig herd structure and neighborhood conditions, an index characterizing individual herds' potential for endemic virus circulation and reinfection was designed. This index was subsequently used to compare data of all pig herds in two regions with different pig- and herd-densities in Lower Saxony (North-West Germany) where PRRSV is endemic. Distribution of the indexed herds was displayed using GIS. Clusters of high herd index densities forming potential risk hot spots were identified which could represent key target areas for surveillance and biosecurity measures under a control program aimed at virus elimination. In an additional step, for the study region with the higher pig density (2463 pigs/km(2) farmland), the potential distribution of PRRSV-free and non-free herds during the implementation of a national control program aiming at national virus elimination was modeled. Complex herd and trade network structures suggest that PRRSV elimination in regions with intensive pig farming like that of middle Europe would have to involve legal regulation and be accompanied by important trade and animal movement restrictions. The proposed methodology of risk index mapping could be adapted to areas varying in size, herd structure and density. Interpreted in the

  8. Hedging Weather Risk for Corn Production in Northeastern China: The Efficiency of Weather-indexed Insurance

    NARCIS (Netherlands)

    Sun, Baojing; Guo, Changhao; Kooten, van G.C.

    2014-01-01

    Purpose – The paper analyzes the hedging efficiency of weather-indexed insurance for corn production in Northeast of China. The purpose of this paper is to identify the potential weather variables that impact corn yields and to analyze the efficiency of weather-indexed insurance under varying

  9. Development of a Convection Risk Index to forecast severe weather, and application to predict maximum wind speeds

    Science.gov (United States)

    Bhuiyan, M. A. E.; Wanik, D. W.; Scerbo, D.; Anagnostou, E. N.

    2015-12-01

    We have developed a tool, the Convection Risk Index (CRI), to represent the severity, timing and location of convection for select geographic areas. The CRI is calculated from the Convection Risk Matrix (CRM), a tabulation of numerous meteorological parameters which are categorized into four broad factors that contribute to convection (surface and lower level moisture, atmospheric instability, vertical wind shear, and lift); each of these factors have historically been utilized by meteorologists to predict the likelihood for development of thunderstorms. The CRM ascribes a specific threshold value to each parameter in such a way that it creates a unique tool used to calculate the risk for seeing the development of thunderstorms. The parameters were combined using a weighted formula and which when calculated, yields the Convection Risk Index 1 to 4 scale, with 4 being the highest risk for seeing strong convection. In addition, we also evaluated the performance of the parameters in the CRM and CRI for predicting the maximum wind speed in areas where we calculated the CRI using nonparametric tree-based model, Bayesian additive trees (BART). The use of the CRI and the predicted wind speeds from BART can be used to better inform emergency preparedness efforts in government and industry.We have developed a tool, the Convection Risk Index (CRI), to represent the severity, timing and location of convection for select geographic areas. The CRI is calculated from the Convection Risk Matrix (CRM), a tabulation of numerous meteorological parameters which are categorized into four broad factors that contribute to convection (surface and lower level moisture, atmospheric instability, vertical wind shear, and lift); each of these factors have historically been utilized by meteorologists to predict the likelihood for development of thunderstorms. The CRM ascribes a specific threshold value to each parameter in such a way that it creates a unique tool used to calculate the risk for

  10. Remote Sensing and GIS Based Risk Index Map For Predicting Forest Fire Danger - Evaluation From Forestry Datasets, India

    Science.gov (United States)

    Prasad, V. K.; Badarinath, K. V. S.

    Forest fires constitute one of the most serious ecological as well as environmental problems affecting most vegetation zones across the world, including India. In this study, we evaluated forest fire risk for sixteen different forest and vegetation types of India. Data from Normalized Difference Vegetation Index (NDVI) from NOAA AVHRR data has been integrated with bioclimatic data and fuel value index to quantify the forest fire risk. Biomass data for different forest types in different pools has been used as ancillary data. In using the fuel value index, calorific value of wood content for 60 species has been collected and aggregated, for specific species. Results from NDVI and precipitation correlations were found to be highly significant for tropical dry deciduous and moist deciduous forests. Spatial patterns in NDVI closely followed seasonal trends in precipitation for most of the forests. An integrated GIS framework with biophysical, biomass, thermo chemical and bioclimatic parameters allowed the calculation of risk indices for the different forest types. The methodology followed in the study and the maps produced are found to be useful for evaluating forest fire risk and for predicting forest fire danger in different vegetation zones in India.

  11. Risk factors and ankle brachial indexes in cerebral infarction combined with peripheral arterial disease

    Institute of Scientific and Technical Information of China (English)

    Huihua Liu; Jun Wang

    2006-01-01

    BACKGROUND: Ankle brachial index(ABI)is widely involved in researches and clinical application of peripheral vascular injury of patients with diabetes (DM);however ,the application in cerebral infarction(CI)is rare.OBJECTIVE: To investigate the possible risk factor of cerebral infarction plus peripheral arterial disease(PAD),compare metabolic characteristics of patients who having CI plus PAD or only having CI,and understand the significance of ABI on screening and diagnosing CI plus PAD of lower limb.DESIGN: Contrast observation based on CI patients.SETTING: Deparment of Neurology,Nanxishan Hospital of Guangxi Zhang Autonomous Region.PARTICIPANTS:A total of 124 CI patients were selected from Department of Neurology.Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2005 to April 2006,including 72 males and 52 females aged from 45 to 88 years.All patients met the diagnostic criteria of cerebrovascular disease established by National Academic Conference of Cerebrovascular Diseases in 1995 and determined as cerebral infarction with MRI or CT examination.All patients provided informed consent.There were 46 cases(37.2%)with CI plus PAD and 78 cases(62.8%)only with CI.METHODS: Blood pressure of bilateral ankles and upper extremities was measured at plain clinostatism with DINAMAP blood pressure monitor(GE Company).The ratio between average systolic pressure of lateral ankle and average systolic pressure of both upper extremities was regarded as ABI.The normal ABI was equal to or more than 0.9.If ABI<0.9 occurred at one side,patients were diagnosed as PAD.On the second morning after hospitalization,blood was collected to measure fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG2h),glycosylated hemoglobin(HbAlc),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).Among them,blood glucose.lipid and other biochemical markers were measured with enzyme chemistry assay

  12. Design and methods of the GLYNDIET study: assessing the role of glycemic index on weight loss and metabolic risk markers

    Directory of Open Access Journals (Sweden)

    Martí Juanola-Falgarona

    2013-04-01

    Full Text Available Background: Glycemic index and/or glycemic load have been explored as an alternative for the prevention and/or management of obesity, cardiovascular disease, type 2 diabetes mellitus, and cancer. Objective: The purpose of the manuscript is to describe the design and methods used in the GLYNDIET Project, a study designed to simultaneously address the questions related to the exactly role of low glycaemic index carbohydrates has on weight loss. Methods: This study was designed as a 6-months randomized, parallel, controlled clinical trial aiming to evaluate the effect of the dietary glycemic index on weight-loss, satiety, glucose and insulin metabolism, lipid profile, inflammation and other emergent metabolic risk markers. Eligible subjects were community-dwelling men and women aged between 30 and 60 years, with a body mass index between 27 and 35 kg/m². Subjects were randomly assigned to three different dietary intervention groups (low glycemic index diet, high glycemic index diet or low-fat diet, that were isocaloric, and did not differ in the amount of dietary fibre. Monthly, study subjects were scheduled for control visits where anthropometry, blood pressure, dietary habits, satiety and physical activity were assessed. Blood, urine and subcutaneous adipose tissue samples were collected at baseline and at the end of the study to further molecular and biochemical measurements. Discussion: The GLYNDIET study was designed to determine if there is a greater effectiveness of a carbohydrate restricted diet with low glycemic index compared to an isocaloric diet with carbohydrates of high glycemic index or low-fat diet on weight loss in middle long-term.

  13. Cyclooxygenase 2 polymorphism and colorectal cancer: -765G>C variant modifies risk associated with smoking and body mass index

    Institute of Scientific and Technical Information of China (English)

    Li-Li Xing; Zhen-Ning Wang; Li Jiang; Yong Zhang; Ying-Ying Xu; Juan Li; Yang Luo; Xue Zhang

    2008-01-01

    AIM: To explore whether cyclooxygenase 2 (COX-2) -765G>C polymorphism is associated with susceptibility of colorectal cancer (CRC) and to evaluate the risk of colorectal cancer in relation to environmental exposures and polymorphism.METHODS: We conducted a case-control study of 137 patients with colorectal cancer and 199 cancer-free controls in northeast China. Multivariate logistic regression analysis was performed to calculate the adjusted odds ratio (OR) and 95% confidence interval (95% CI).RESULTS: The -765G>C polymorphism was not independently associated with CRC risk. However, risk associated with the polymorphism differed by smoking and body mass index (BMI). Smoking and BMI associated risks were stronger among those with -765GG genotype, showing that smokers had a 2.682-fold greater risk of CRC than nonsmokers (51/43 vs 68/126, P = 0.006). Compared to those with a normal body mass index (BMI 18.5-22.9), those with overweight (BMI 23-24.9) had a 3.909-fold higher risk of CRC (OR = 3.909, 95% CI = 2.081-7.344; P < 0.001), while those with obesity (BMI > 25) had a 2.031- fold higher risk of CRC (OR = 1.107, 95% CI = 1.107-3.726; P = 0.022).CONCLUSION: Although COX-2 -765G>C polymorphism is not associated with an increased risk of CRC, -765GG genotype appears to be related to an increased risk in the presence of smoking and higher BMI.

  14. Metabolic risk factors are associated with stiffness index, reflection index and finger skin temperature in children--Physical Activity and Nutrition in Children (PANIC) study.

    Science.gov (United States)

    Veijalainen, Aapo; Tompuri, Tuomo; Laitinen, Tomi; Lintu, Niina; Viitasalo, Anna; Laaksonen, David E; Jääskeläinen, Jarmo; Lakka, Timo A

    2013-01-01

    Childhood metabolic syndrome (MetS) has been found to predict adulthood MetS, type 2 diabetes and cardiovascular disease, emphasizing the early identification of children at increased risk of these diseases. Children with clustering of metabolic risk factors have been reported to have a mild arterial stiffness and endothelial dysfunction, but limited evidence is available from population-based samples of children. The associations of metabolic risk factors with arterial stiffness, tone and endothelial function were studied in 173 prepubertal children (90 girls) 6-8 years of age. MetS was assessed both by continuous MetScore and dichotomously. Stiffness index (SI), reflection index (RI) and finger skin temperature (FST) were measured before and after maximum exercise test, and percent change was calculated for RI (RI%Δ) and FST (FST%Δ). MetScore (r=0.26, P=0.001), fasting insulin (r=0.24, P=0.002), fasting triglycerides (r=0.20, P=0.009), systolic (SBP; r=0.24, P=0.002) and diastolic blood pressure (DBP; r=0.19, P=0.013) correlated with SI. MetScore (r=-0.17, P=0.024, r=0.21, P=0.006), waist circumference (r=-0.19, P=0.012, r=0.23, P=0.003) and SBP (r=-0.16, P=0.035, r=0.21, P=0.005) correlated with RI and FST. High-density lipoprotein cholesterol correlated with FST (r=-0.22, P=0.004) and FST%Δ (r=-0.24, P=0.002). RI decreased and FST increased with exercise (P<0.001). Waist circumference correlated inversely with RI%Δ in boys (r=-0.22, P=0.046) and directly with RI%Δ in girls (r=0.27, P=0.011). Metabolic risk factors are associated with arterial stiffness, tone and endothelial function in prepubertal children. 

  15. High dietary glycemic load and glycemic index increase risk of cardiovascular disease among middle-aged women : a population-based follow-up study

    NARCIS (Netherlands)

    Beulens, Joline W. J.; de Bruijne, Leonie M.; Stolk, Ronald P.; Peeters, Petra H. M.; Bots, Michiel L.; Grobbee, Diederick E.; van der Schouw, Yvonne T.

    2007-01-01

    Objectives The goal of this work was to assess whether high dietary glycemic load and glycemic index are associated with an increased risk of cardiovascular disease (CVD). Background The associations of dietary glycemic index and glycemic load with risk of CVD are not well established, particularly

  16. High dietary glycemic load and glycemic index increase risk of cardiovascular disease among middle-aged women - A population-based follow-up study

    NARCIS (Netherlands)

    Beulens, Joline W. J.; de Bruijne, Leonie M.; Stolk, Ronald P.; Peeters, Petra H. M.; Bots, Michiel L.; Grobbee, Diederick E.; van der Schouw, Yvonne T.

    2007-01-01

    Objectives The goal of this work was to assess whether high dietary glycemic load and glycemic index are associated with an increased risk of cardiovascular disease (CVD). Background The associations of dietary glycemic index and glycemic load with risk of CVD are not well established, particularly

  17. The relative teratogenic index and teratogenic potency: proposed components of developmental toxicity risk assessment.

    Science.gov (United States)

    Fabro, S; Shull, G; Brown, N A

    1982-01-01

    Teratogenicity tests should provide answers to three questions: (1) Can the agent induce developmental defects? ("teratogenic potential"); (2) What are the effective doses? ("teratogenic potency"); and (3) Are effective doses below adult toxic doses? ("teratogenic hazard"). The answers to (2) and (3) should be quantitative in nature, but there are no accepted parameters to express these properties. In this paper we propose parameters for the description of teratogenic potency and hazard in quantitative terms. Derivation and calculation of the parameters are illustrated by the analysis of adult lethality and teratogenicity data of eight structurally related anhydrides and imides, following testing in the CD-1 mouse. Teratogenicity was evaluated following treatment on Days 8-10 of gestation, using an average of four dose groups per compound and at least 10 dams per group. Adult lethality was estimated following a similar 3-day dosage schedule with an average of 6 dose groups per compound and at least 8 animals per group. Dose-response relationships of teratogenicity were fitted to a probit model from which tD50 (median effective dose), and other effective doses were computed. It is proposed that tD05, as a minimum teratogenic dose, best represents teratogenic potency. In this study, potency ranged from 0.17 mmol/kg/day for phenytoin to 5.2 mmol/kg/day for ethosuximide. In order to measure teratogenic hazard a ratio between adult toxic (lethality was chosen as the most appropriate measure) and teratogenic responses was made. Since the dose-response slopes of lethality and teratogenicity were different, a simple ratio between median effective doses could not be used. It is shown that a ratio of LD01 to tD05 provides a "Relative Teratogenic Index" (RTI) which reflects the teratogenic hazard of a test agent. The following RTI values (LD01/tD05) were computed in this study: phthalic anhydride, 0.9; phensuximide, 1.0; succinic anhydride, 1.0; ethosuximide, 1.2; phenytoin

  18. A water risk index for portfolio exposure to climatic extremes: conceptualization and an application to the mining industry

    Science.gov (United States)

    Bonnafous, Luc; Lall, Upmanu; Siegel, Jason

    2017-04-01

    Corporations, industries and non-governmental organizations have become increasingly concerned with growing water risks in many parts of the world. Most of the focus has been on water scarcity and competition for the resource between agriculture, urban users, ecology and industry. However, water risks are multi-dimensional. Water-related hazards include flooding due to extreme rainfall, persistent drought and pollution, either due to industrial operations themselves, or to the failure of infrastructure. Most companies have risk management plans at each operational location to address these risks to a certain design level. The residual risk may or may not be managed, and is typically not quantified at a portfolio scale, i.e. across many sites. Given that climate is the driver of many of these extreme events, and there is evidence of quasi-periodic climate regimes at inter-annual and decadal timescales, it is possible that a portfolio is subject to persistent, multi-year exceedances of the design level. In other words, for a multi-national corporation, it is possible that there is correlation in the climate-induced portfolio water risk across its operational sites as multiple sites may experience a hazard beyond the design level in a given year. Therefore, from an investor's perspective, a need exists for a water risk index that allows for an exploration of the possible space and/or time clustering in exposure across many sites contained in a portfolio. This paper represents a first attempt to develop an index for financial exposure of a geographically diversified, global portfolio to the time-varying risk of climatic extremes using long daily global rainfall datasets derived from climate re-analysis models. Focusing on extreme daily rainfall amounts and using examples from major mining companies, we illustrate how the index can be developed. We discuss how companies can use it to explore their corporate exposure, and what they may need to disclose to investors and

  19. Cumulative radiation exposure in children with cystic fibrosis.

    LENUS (Irish Health Repository)

    O'Reilly, R

    2010-02-01

    This retrospective study calculated the cumulative radiation dose for children with cystic fibrosis (CF) attending a tertiary CF centre. Information on 77 children with a mean age of 9.5 years, a follow up time of 658 person years and 1757 studies including 1485 chest radiographs, 215 abdominal radiographs and 57 computed tomography (CT) scans, of which 51 were thoracic CT scans, were analysed. The average cumulative radiation dose was 6.2 (0.04-25) mSv per CF patient. Cumulative radiation dose increased with increasing age and number of CT scans and was greater in children who presented with meconium ileus. No correlation was identified between cumulative radiation dose and either lung function or patient microbiology cultures. Radiation carries a risk of malignancy and children are particularly susceptible. Every effort must be made to avoid unnecessary radiation exposure in these patients whose life expectancy is increasing.

  20. A new index of abdominal obesity which effectively predicts risk of colon tumor development in female Japanese.

    Science.gov (United States)

    Kaneko, Rena; Nakazaki, Natsuko; Tagawa, Teppei; Ohishi, Chitose; Kusayanagi, Satoshi; Kim, Miniru; Baba, Toshiyuki; Ogawa, Masazumi; Sato, Yuzuru

    2014-01-01

    A relation between abdominal obesity and colorectal tumor development has been reported repeatedly, and is believed to be more remarkable in man than in women. However, the details vary depending on scientific reports. This may be due at least partly to the selected surface anthropometric index in addition to the influence of gender and ethnic groups. To cope with this, we considered a new index of abdominal obesity and evaluated its risk prediction potential. Six hundred ninety five Japanese (262 women and 433 men) who had a colonoscopy were studied. The new index was named as waist circumference to height index (WHI) and was calculated by the formula of waist circumference (cm)/height (m)/height (m). Biochemical and lifestyle factors were investigated preceding the colonoscopy. Statistical analysis was performed using SPSS for Windows. Increase of WHI was associated with altered metabolism of carbohydrate and lipid in both women and men. WHI was positively related with the development of colon tumor of women, while not with that of men. Logistic regression analysis performed for stratified age groups (45-54, 55-64 and 65-74 years) showed that WHI significantly increased odds ratio to 1.31 (CI 1.05-1.64 p=0.01) in women of 55-65 years. In contrast, in men this index WHI reduced the odds ratio insignificantly, while low density lipoprotein and triglyceride significantly increased the odds ratio to 1.01 (CI 1.00-1.03 p=0.02) in the 55-65 year group and to 1.02 (CI 1.00-1.03 p=0.02) in the 45-55 year group. In Japanese the risk factors for colon tumor development are different between women and men. WHI is a simple and efficient predictor of colon tumor risk in Japanese women and may be used to select those who should have colonoscopy.

  1. Cumulative Trauma Among Mayas Living in Southeast Florida.

    Science.gov (United States)

    Millender, Eugenia I; Lowe, John

    2016-01-04

    Mayas, having experienced genocide, exile, and severe poverty, are at high risk for the consequences of cumulative trauma that continually resurfaces through current fear of an uncertain future. Little is known about the mental health and alcohol use status of this population. This correlational study explored t/he relationship of cumulative trauma as it relates to social determinants of health (years in the United States, education, health insurance status, marital status, and employment), psychological health (depression symptoms), and health behaviors (alcohol use) of 102 Guatemalan Mayas living in Southeast Florida. The results of this study indicated that, as specific social determinants of health and cumulative trauma increased, depression symptoms (particularly among women) and the risk for harmful alcohol use (particularly among men) increased. Identifying risk factors at an early stage before serious disease or problems are manifest provides room for early screening leading to early identification, early treatment, and better outcomes.

  2. Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients

    DEFF Research Database (Denmark)

    Podlekareva, D N; Grint, D; Post, F A;

    2013-01-01

    To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome.......To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome....

  3. Valor preditivo do "Clinical Risk Index for Babies" para o risco de mortalidade neonatal Predictive value of the "Clinical Risk Index for Babies" for the risk of neonatal death

    Directory of Open Access Journals (Sweden)

    Oscar T. Matsuoka

    1998-12-01

    Full Text Available OBJETIVO: Comparar o valor preditivo do CRIB (Clinical Risk Index for Babies para o risco de mortalidade neonatal ao peso de nascimento (PN e idade gestacional (IG. MÉTODO: Numa coorte prospectiva foram estudados, durante o ano de 1996, 71 recém-nascidos admitidos na unidade de terapia intensiva, com PN 10 foi de 100%. CONCLUSÕES: O escore de CRIB > 10 correspondeu a maiores especificidade e valor preditivo positivo em relação aos demais parâmetros. A área determinada pela "receiver operating characteristic" relativa ao CRIB também foi superior. O CRIB mostrou-se um marcador mais acurado na previsão de risco de mortalidade quando comparado ao PN ou IG isoladamente.OBJECTIVE: Several indicators, mainly birthweight and gestational age, have been used to predict the mortality risk in neonatal intensive care units. In order to assess the potential value of CRIB in predicting neonatal mortality, the score was used over the first 12 hours of life of the newborns admitted to this unit, during the year of 1996. METHOD: The inclusion criteria consisted of all infants without inevitably lethal congenital malformations, birthweight below 1,500g and/or gestational age less than 31 weeks. Newborn children who died within 12 hours after delivery were excluded. The CRIB score covers birth weight, gestational age, the presence of congenital malformations (not inevitably lethal and three indexes of physiological status during first 12 hours after birth - maximum and minimum appropriate fraction of inspired oxygen and maximum (most acidotic base excess. RESULTS: In a prospective cohort, seventy one newborn children were studied. The birthweight (average was 1,119 ± 275.6 g, gestational age 30 weeks 4/7 ±2 weeks 3/7; male (57%; Apgar 1° min. score <=3 ( 36.2% and Apgar 5° min. score < 5 (5.8%. The mortality rate was 29.6% (gold standard. But mortality rate by birthweight less than 1,000 gr. or gestational age lower than 29 weeks was 60.0% and for the

  4. Fire and explosion risk assessment in a process unit using Dow’s Fire and Explosion Index

    Directory of Open Access Journals (Sweden)

    Z. S. Nezamodini

    2015-01-01

    Full Text Available Introduction: In the process industries, especially industries with hydrocarbons uses, due to flammability and reactivity of materials, high temperature, operation pressure, volatility and evaporability of liquid, fire and explosion hazard always has a great significances.The purpose of this study was to assess the quantitative fire safety using DOW’s fire and explosion index, in an oil extraction industry. .Material and Method: The required information for conducting this research was obtained from process documents, DOW’s fire and explosion guideline,the measured operational parameters and also interviews and consultation with the supervisors and experts. Following, the study was conducted in three phases: 1 determination of DOW index, the radius and area of contact, 2 determination of loss control credit factor and finally 3 loss estimation. .Result: Fire and explosion index in the understudy process unit was calculated 243.68 and thus severity of risk was extremely high and unacceptable. Radius of exposure and loss control credit factor wasobtained62.38 meters and 0.69, respectively. Finally,the most probable loss was estimated about 2863500 dollars. .Conclusion: DOW’s fire and explosion index is a suitable technique to measure the fire risk of whole plant or a part of it. Thus, this criterion can be used to propose the changes or amount of protective equipment according to their effect in reducing the losses.

  5. Relation of body mass index and skinfold thicknesses to cardiovascular disease risk factors in children: the Bogalusa Heart Study1234

    Science.gov (United States)

    Katzmarzyk, Peter T; Dietz, William H; Srinivasan, Sathanur R; Berenson, Gerald S

    2009-01-01

    Background: Adverse levels of cardiovascular disease (CVD) risk factors are related to skinfold thicknesses and body mass index (BMI) among children, but the relative strengths of these associations are unknown. Objective: The objective was to determine whether the sum of the triceps and subscapular skinfold thicknesses (SF sum) is more strongly related to levels of 6 risk factors (triglycerides, LDL and HDL cholesterol, insulin, and systolic and diastolic blood pressure) than is BMI. Design: Cross-sectional analyses of schoolchildren examined in the Bogalusa Heart Study from 1981 to 1994 (n = 6866) were conducted. A risk factor summary index was derived by using principal components analysis. Results: After race, sex, study period, and age were controlled for, almost all comparisons indicated that BMI was more strongly related to risk factor levels than was the SF sum. Although the differences were generally small, many were statistically significant. Associations with the risk factor summary, for example, were r = 0.50 for BMI and r = 0.47 for SF sum (P skinfold-thickness measurements, the advantages of BMI should be considered in the design and interpretation of clinical and epidemiologic studies. PMID:19420092

  6. Sex hormone-binding globulin levels predict insulin sensitivity, disposition index, and cardiovascular risk during puberty

    DEFF Research Database (Denmark)

    Sørensen, Kaspar; Aksglaede, Lise; Munch-Andersen, Thor

    2009-01-01

    Early puberty is associated with increased risk of subsequent cardiovascular disease. Low sex hormone-binding globulin (SHBG) levels are a feature of early puberty and of conditions associated with increased cardiovascular risk. The aim of the present study was to evaluate SHBG as a predictor...... of glucose metabolism and metabolic risk during puberty....

  7. Dietary Glycemic Load, Glycemic Index, and Carbohydrate and Risk of Breast Cancer in the Women’s Health Initiative

    OpenAIRE

    2011-01-01

    Dietary glycemic load (GL), glycemic index (GI), and carbohydrate could be associated with breast cancer risk by influencing long-term blood glucose and insulin concentrations. We examined associations between GL, GI, and carbohydrate and incident breast cancer in 148,767 Women’s Heath Initiative (WHI) participants. Dietary variables were estimated from food frequency questionnaires administered at baseline. Self-reported breast cancers during follow-up were confirmed by medical records revie...

  8. Cumulant expansions for atmospheric flows

    CERN Document Server

    Ait-Chaalal, Farid; Meyer, Bettina; Marston, J B

    2015-01-01

    The equations governing atmospheric flows are nonlinear, and consequently the hierarchy of cumulant equations is not closed. But because atmospheric flows are inhomogeneous and anisotropic, the nonlinearity may manifests itself only weakly through interactions of mean fields with disturbances such as thermals or eddies. In such situations, truncations of the hierarchy of cumulant equations hold promise as a closure strategy. We review how truncations at second order can be used to model and elucidate the dynamics of turbulent atmospheric flows. Two examples are considered. First, we study the growth of a dry convective boundary layer, which is heated from below, leading to turbulent upward energy transport and growth of the boundary layer. We demonstrate that a quasilinear truncation of the equations of motion, in which interactions of disturbances among each other are neglected but interactions with mean fields are taken into account, can successfully capture the growth of the convective boundary layer. Seco...

  9. Electro-cumulation CNF project

    CERN Document Server

    Grishin, V G

    2000-01-01

    bound or free ion current within solid substances; non-plain symmetry; cumulation of the ion interaction. Experimental result: an Ice SuperPolarization. Cold nuclear fusion ? At http://www.shortway.to/to2084 . Keywords: ion, current, solid, symmetry, cumulation, cold nuclear fusion, polarization, depolarization, ionic conductor, superionic conductor, ice, crystal, strain, V-center, V-centre, doped crystal, interstitial impurity, intrinsic color center, high pressure technology, Bridgman, experiment, crowdion, dielectric, proton, layer, defect, lattice, dynamics, electromigration, mobility, muon catalysis, concentration, doping, dopant, conductivity, pycnonuclear reaction, permittivity, dielectric constant, point defects, interstitials, polarizability, imperfection, defect centers, glass, epitaxy, sodium hydroxide, metallic substrate, crystallization, point, tip, susceptibility, ferroelectric, ordering, force, correlation, collective, shift, distortion, coalescence, crowdions, electrolysis.

  10. Changes in ponderal index and body mass index across childhood and their associations with fat mass and cardiovascular risk factors at age 15.

    Directory of Open Access Journals (Sweden)

    Laura D Howe

    Full Text Available BACKGROUND: Little is known about whether associations between childhood adiposity and later adverse cardiovascular health outcomes are driven by tracking of overweight from childhood to adulthood and/or by vascular and metabolic changes from childhood overweight that persist into adulthood. Our objective is to characterise associations between trajectories of adiposity across childhood and a wide range of cardiovascular risk factors measured in adolescence, and explore the extent to which these are mediated by fat mass at age 15. METHODS AND FINDINGS: Using data from the Avon Longitudinal Study of Parents and Children, we estimated individual trajectories of ponderal index (PI from 0-2 years and BMI from 2-10 years using random-effects linear spline models (N = 4601. We explored associations between PI/BMI trajectories and DXA-determined total-body fat-mass and cardiovascular risk factors at 15 years (systolic and diastolic blood pressure, fasting LDL- and HDL-cholesterol, triglycerides, C-reactive protein, glucose, insulin with and without adjustment for confounders. Changes in PI/BMI during all periods of infancy and childhood were associated with greater DXA-determined fat-mass at age 15. BMI changes in childhood, but not PI changes from 0-2 years, were associated with most cardiovascular risk factors in adolescence; associations tended to be strongest for BMI changes in later childhood (ages 8.5-10, and were largely mediated by fat mass at age 15. CONCLUSION: Changes in PI/BMI from 0-10 years were associated with greater fat-mass at age 15. Greater increases in BMI from age 8.5-10 years are most strongly associated with cardiovascular risk factors at age 15, with much of these associations mediated by fat-mass at this age. We found little evidence supporting previous reports that rapid PI changes in infancy are associated with future cardiovascular risk. This study suggests that associations between early overweight and subsequent

  11. Changes in ponderal index and body mass index across childhood and their associations with fat mass and cardiovascular risk factors at age 15.

    Science.gov (United States)

    Howe, Laura D; Tilling, Kate; Benfield, Li; Logue, Jennifer; Sattar, Naveed; Ness, Andy R; Smith, George Davey; Lawlor, Debbie A

    2010-12-08

    Little is known about whether associations between childhood adiposity and later adverse cardiovascular health outcomes are driven by tracking of overweight from childhood to adulthood and/or by vascular and metabolic changes from childhood overweight that persist into adulthood. Our objective is to characterise associations between trajectories of adiposity across childhood and a wide range of cardiovascular risk factors measured in adolescence, and explore the extent to which these are mediated by fat mass at age 15. Using data from the Avon Longitudinal Study of Parents and Children, we estimated individual trajectories of ponderal index (PI) from 0-2 years and BMI from 2-10 years using random-effects linear spline models (N = 4601). We explored associations between PI/BMI trajectories and DXA-determined total-body fat-mass and cardiovascular risk factors at 15 years (systolic and diastolic blood pressure, fasting LDL- and HDL-cholesterol, triglycerides, C-reactive protein, glucose, insulin) with and without adjustment for confounders. Changes in PI/BMI during all periods of infancy and childhood were associated with greater DXA-determined fat-mass at age 15. BMI changes in childhood, but not PI changes from 0-2 years, were associated with most cardiovascular risk factors in adolescence; associations tended to be strongest for BMI changes in later childhood (ages 8.5-10), and were largely mediated by fat mass at age 15. Changes in PI/BMI from 0-10 years were associated with greater fat-mass at age 15. Greater increases in BMI from age 8.5-10 years are most strongly associated with cardiovascular risk factors at age 15, with much of these associations mediated by fat-mass at this age. We found little evidence supporting previous reports that rapid PI changes in infancy are associated with future cardiovascular risk. This study suggests that associations between early overweight and subsequent adverse cardiovascular health are largely due to overweight

  12. C-reactive protein and the MASCC risk index identify high-risk patients with febrile neutropenia and hematologic neoplasms.

    Science.gov (United States)

    Combariza, Juan F; Lombana, Milton; Pino, Luis E; Arango, Marcos

    2015-04-01

    The objective of this study is to assess the prognostic usefulness of the Multinational Association of Supportive Care in Cancer (MASCC) risk score in association with the value of C-reactive protein (CRP) to identify high-risk patients with febrile neutropenia and hematologic neoplasms. A retrospective cohort study in which the MASCC score and the CRP values were used to assess the mortality risk at 30 days among patients with febrile neutropenia and hematologic malignancies was performed. Two hundred thiry-seven patients with febrile neutropenia were analyzed; the mortality rate within 30 days was 9 %. High-risk patients according to the MASCC score were significantly more likely to experience adverse outcomes, such as being transferred to the intensive care unit (RR 3.55; CI 95 % 2.73-6.62, p risk group identified by the MASCC score (HR 3.0; CI 95 % 1.12-13.54, p = 0.032) and the mean levels of CRP (HR 17; CI 95 % 2.21-136.48, p = 0.007) and survival. The survival rate within 30 days was 100 % for the patients with a low-risk MASCC score and a mean CRP less than 15 mg/dL. This rate was only 64 % for high-risk patients with a mean CRP greater than 15 mg/dL. The MASCC risk score combined with the mean CRP value successfully identifies patients with febrile neutropenia and hematological malignancies and a high risk of death.

  13. Body mass index and risk of renal cell cancer: a dose-response meta-analysis of published cohort studies.

    Science.gov (United States)

    Wang, Furan; Xu, Yinghua

    2014-10-01

    Obesity is accepted as one of the major risk factors for renal cell cancer (RCC). However, conflicting results persist for the pooled risks based on the results from case-control and cohort studies combined, and the exact shape of the dose-response relationship has not been clearly defined yet. To help elucidate the role of obesity, PubMed and Embase databases were searched for published cohort studies on associations between body mass index (BMI) and risk of RCC. Random-effects models and dose-response meta-analyses were used to pool study results. Subgroup analyses were conducted by the available characteristics of studies and participants. Cohort studies (21) with 15,144 cases and 9,080,052 participants were identified. Compared to normal weight, the pooled relative risks and the corresponding 95% confidence intervals of RCC were 1.28(1.24-1.33) for preobesity and 1.77(1.68-1.87) for obesity, respectively. A nonlinear dose-response relationship was also found for RCC risk with BMI (p = 0.000), and the risk increased by 4% for each 1 kg/m(2) increment in BMI. There was no significant between-study heterogeneity among studies (I(2) = 35.6% for preobesity and I(2) = 44.2% for obesity, respectively). Subgroup analysis showed a basically consistent result with the overall analysis. These results suggest that increased BMI are associated with increased risk of RCC both for men and women. © 2014 UICC.

  14. Surveillance for surgical site infection (SSI) after neurosurgery: influence of the US or Brest (France) National Nosocomial Infection Surveillance risk index on SSI rates.

    Science.gov (United States)

    Lietard, Claire; Thébaud, Véronique; Besson, Gérard; Lejeune, Benoist

    2008-11-01

    A total of 5,628 neurosurgical patients were observed in France to assess the occurrence of surgical site infection (SSI). Their risk of SSI was defined by calculating both the US National Nosocomial Infection Surveillance and the Brest National Nosocomial Infection Surveillance risk indexes. This study compares SSI rates stratified according to either the US or Brest (France) National Nosocomial Infection Surveillance risk index. The SSI rates were correlated with National Nosocomial Infection Surveillance data involving only local operation durations.

  15. Obesity, ultrasound indexes of fat depots and lipid goal attainment in patients with high and very high cardiovascular risk: A novel approach towards better risk reduction.

    Science.gov (United States)

    Haberka, M; Okopień, B; Gąsior, Z

    2016-02-01

    Our aim was to assess the attainment of primary (low density lipoprotein cholesterol; LDL-C) and secondary (non-high density lipoprotein cholesterol; non-HDL-C) lipid therapeutic goals in relation to obesity, clinical measures of adiposity and ultrasound indexes of fat depots, including the novel index of periarterial adipose tissue (PAT): carotid artery extra media thickness (EMT). High and very high cardiovascular (CV) risk patients (n = 420; F/M: 34/66%; age: 61.2 ± 7 years) with prior statin treatment (≥ 18 months) were enrolled into this cross-sectional study. All patients had a detailed assessment with several anthropometric measures and ultrasound indexes of fat depots indexed to BMI: abdominal (Intra-abdominal Fat Thickness; IAT and Pre-peritoneal Fat Thickness; PreFT), paracardial (Epicardial Fat Thickness; EFT and Pericardial Fat Thickness; PFT) and the new index corresponding to PAT (carotid EMT). Lipid goals attainment in the study group was as follows: 34% (LDL-C goal), 39% (non-HDL-C goal) and 35% (both LDL and non-HDL-C goals). Among ultrasound indexes, patients with both lipid goals attainment revealed significantly lower carotid EMT/BMI (LDL-C goal: 25.2 ± 4.2 vs 27.5 ± 4.1, p obesity and most clinical measures of adiposity, carotid EMT and abdominal IAT, but not other ultrasound indexes of fat depots revealed associations independent from BMI with lipid goal attainment and may help identify patients requiring more aggressive lipid management. Copyright © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  16. Social deprivation index and lymphatic filariasis: a tool for mapping urban areas at risk in northeastern Brazil.

    Science.gov (United States)

    Bonfim, Cristine; Aguiar-Santos, Ana Maria; Pedroza, Dinilson; Costa, Tadeu Rodrigues; Portugal, José Luiz; Oliveira, Conceição; Medeiros, Zulma

    2009-09-01

    This paper describes the construction and application of a social deprivation index that was created to explore the relationship between lymphatic filariasis and socioenvironmental variables in the municipality of Jaboatão dos Guararapes, Pernambuco, Brazil, thereby contributing towards identifying priority areas for interventions. This indicator was obtained from principal-component factor analysis. Variables available from the national census representing socioenvironmental conditions, household characteristics and urban services were used. Epidemiological data came from a parasitological survey on lymphatic filariasis. 23 673 individuals were examined and 323 were positive (1.4%). Two factors that together explained 80.61% of the total variance were selected. The social deprivation strata were capable of indicating a risk gradient, with 74.9% of the microfilaremia cases situated in the high-risk stratum. Principal-component factor analysis was shown to be sensitive for selecting indicators associated with the risk of lymphatic filariasis transmission and for detecting areas potentially at risk. The capacity of the social deprivation index for picking up social inequalities qualifies it as a new tool for use in planning interventions aimed at controlling lymphatic filariasis in urban spaces.

  17. Impact of consumption of vegetable, fruit, grain, and high glycemic index foods on aggressive prostate cancer risk.

    Science.gov (United States)

    Hardin, Jill; Cheng, Iona; Witte, John S

    2011-01-01

    Prostate cancer is a common but complex disease, and distinguishing modifiable risk factors such as diet for more aggressive disease is extremely important. Previous work has detected intriguing associations between vegetable, fruit, and grains and more aggressive prostate cancer, although these remain somewhat unclear. Here we further investigate such potential relationships with a case-control study of 982 men (470 more aggressive prostate cancer cases and 512 control subjects). Comparing the highest to lowest quartiles of intake, we found that increasing intakes of leafy vegetables were inversely associated with risk of aggressive prostate cancer [adjusted odds ratio (OR) = 0.66, 95% CI: 0.46, 0.96; P trend = 0.02], as was higher consumption of high carotenoid vegetables (OR = 0.71, 95% CI: 0.48, 1.04; P trend = 0.04). Conversely, increased consumption of high glycemic index foods were positively associated with risk of aggressive disease (OR = 1.64, 95% CI: 1.05, 2.57; P trend = 0.02). These results were driven by a number of specific foods within the food groups. Our findings support the hypothesis that diets high in vegetables and low in high glycemic index foods decrease risk of aggressive prostate cancer.

  18. Workplace stressors and lifestyle-related cancer risk factors among female physicians: assessment using the Occupational Stress Index.

    Science.gov (United States)

    Belkić, Karen; Nedic, Olesja

    2007-01-01

    This study examined the relationship between work stressors and lifestyle-related cancer risk factors (LRCRF): smoking, obesity, sedentariness and alcohol consumption, among 112 female physicians in Novi Sad, a region of high LRCRF prevalence. The participation rate was 92.6%. Participants completed the physician-specific version of the Occupational Stress Index (OSI). Self-reported data concerning LRCRF and working conditions were cross-validated with medical records, as well as with worksite measurements and expert observations. A total of 35 (31.3%) of the physicians were current smokers and 10 (8.9%) were heavy smokers (>20 cigarettes/day); 23 (20.5%) had a body mass index (BMI) of 28 or more, and 11 (9.8%) were obese (BMI> or =30). Only 27 (24.1%) regularly engaged in recreational physical activity (PA). Slightly over 5% consumed alcohol daily. Altogether 15 (13.4%) had a low lifestyle-related cancer risk profile (not a current smoker, BMIobesity and/or sedentariness) and problems hampering patient care (smoking). There is an urgent need to lower the LRCRF among female physicians in this high risk region. Our findings suggest that diminishing the work stressor burden should be considered when developing intervention strategies aimed at these risk factors.

  19. 经纬网格与流域计算的地形指数累积分布函数及其均值差异分析%Analyses on Differences Between Cumulative Distribution Functions and Means of Topographic Indexes for Grid Cell and Individual Basin

    Institute of Scientific and Technical Information of China (English)

    肖燕; 邓慧平; 孙菽芬

    2012-01-01

    To improve simulations of hydrological processes,the topographic-index hydrological model(TOPMODEL)has been applied to land surface models.The simplified scheme which applies TOPMODEL to grid cells of Global Climate Model(GCM)can simplify application of TOPMODEL in land surface models.The 2°×2°grid cell located in mountainous region of Changjiang basin and the other located in relatively flat region of Amazon basin are selected.The topographic indexes are calculated and statistical properties of topographic indexes for two grid cells are extracted using the data from digital elevation model of the Shuttle Radar Topography Mission.River basins and drainage network are extracted using the same dataset and statistics are extracted for each basin.The difference between the cumulative distribution functions and means of topographic index for whole grid cell and for individual basin are analyzed.the cumulative distribution functions for whole grid cell and individual basin are fitted by exponential function.The main conclusions are summarized as follows:(1)Although there are differences between the cumulative distribution functions and means for whole grid cell and individual basin but the differences are not significant.It may be a reasonable simplification to apply TOPMODEL directly to grid cell of GCM;(2)The exponential function can fit the cumulative distribution functions well.These results provide helpful information for designing a TOPMODEL based and simplified hydrological model for use in land surface model.%为了改进陆面模式对水文过程的模拟,地形指数水文模型(Topographic-index hydrologicalmodel,TOPMODEL)已被应用于陆面模式(Land Surface Models,LSMs)。当前直接将TOPMODEL应用于全球气候模式(Global Climate Model,GCM)的网格单元的方案,简化了TOPMODEL在陆面模式中的应用。按GCM网格单元统计与按流域单元统计的地形指数分布函数之间的差异大小进行分析,可为研

  20. Cumulative Paired φ-Entropy

    Directory of Open Access Journals (Sweden)

    Ingo Klein

    2016-07-01

    Full Text Available A new kind of entropy will be introduced which generalizes both the differential entropy and the cumulative (residual entropy. The generalization is twofold. First, we simultaneously define the entropy for cumulative distribution functions (cdfs and survivor functions (sfs, instead of defining it separately for densities, cdfs, or sfs. Secondly, we consider a general “entropy generating function” φ, the same way Burbea et al. (IEEE Trans. Inf. Theory 1982, 28, 489–495 and Liese et al. (Convex Statistical Distances; Teubner-Verlag, 1987 did in the context of φ-divergences. Combining the ideas of φ-entropy and cumulative entropy leads to the new “cumulative paired φ-entropy” ( C P E φ . This new entropy has already been discussed in at least four scientific disciplines, be it with certain modifications or simplifications. In the fuzzy set theory, for example, cumulative paired φ-entropies were defined for membership functions, whereas in uncertainty and reliability theories some variations of C P E φ were recently considered as measures of information. With a single exception, the discussions in the scientific disciplines appear to be held independently of each other. We consider C P E φ for continuous cdfs and show that C P E φ is rather a measure of dispersion than a measure of information. In the first place, this will be demonstrated by deriving an upper bound which is determined by the standard deviation and by solving the maximum entropy problem under the restriction of a fixed variance. Next, this paper specifically shows that C P E φ satisfies the axioms of a dispersion measure. The corresponding dispersion functional can easily be estimated by an L-estimator, containing all its known asymptotic properties. C P E φ is the basis for several related concepts like mutual φ-information, φ-correlation, and φ-regression, which generalize Gini correlation and Gini regression. In addition, linear rank tests for scale that

  1. Edge-of-field evaluation of the Ohio phosphorus risk index

    Science.gov (United States)

    The Phosphorus Index (PI) has been the cornerstone for phosphorus (P)-based management and planning over the past twenty years; yet, field-scale evaluation of many state PIs has been limited. In this study, measured P loads in surface runoff and tile discharge from 40 agricultural fields in Ohio wit...

  2. Applying the Flood Vulnerability Index as a Knowledge base for flood risk assessment

    NARCIS (Netherlands)

    Balica, S-F.

    2012-01-01

    Floods are one of the most common and widely distributed natural risks to life and property worldwide. An important part of modern flood risk management is to evaluate vulnerability to floods. This evaluation can be done only by using a parametric approach. Worldwide there is a need to enhance our

  3. Handgrip strength cutoff for cardiometabolic risk index among Colombian children and adolescents: The FUPRECOL Study

    Science.gov (United States)

    Ramírez-Vélez, Robinson; Peña-Ibagon, Jhonatan Camilo; Martínez-Torres, Javier; Tordecilla-Sanders, Alejandra; Correa-Bautista, Jorge Enrique; Lobelo, Felipe; García-Hermoso, Antonio

    2017-01-01

    Evidence shows an association between muscular strength (MS) and health among young people, however low muscular strength cut points for the detection of high metabolic risk in Latin-American populations are scarce. The aim of this study was twofold: to explore potential age- and sex-specific thresholds of MS, for optimal cardiometabolic risk categorization among Colombian children and adolescents; and to investigate whether cardiometabolic risk differed by MS group by applying the receiver operating characteristic curve (ROC) cut point. MS was estimated by using a handle dynamometer on 1,950 children and adolescents from Colombia, using MS relative to weight (handgrip strength/body mass). A metabolic risk score was computed from the following components: waist circumference, triglycerides, HDL-c, glucose, and systolic and diastolic blood pressure. ROC analysis showed a significant discriminatory accuracy of MS in identifying the low/high metabolic risk in children and adolescents and in both genders. In children, the handgrip strength/body mass levels for a low metabolic risk were 0.359 and 0.376 in girls and boys, respectively. In adolescents, these points were 0.440 and 0.447 in girls and boys, respectively. In conclusion, the results suggest an MS level relative to weight for having a low metabolic risk, which could be used to identify youths at risk. PMID:28195167

  4. Dietary carbohydrate, fibre, glycaemic index, glycaemic load and the risk of postmenopausal breast cancer

    National Research Council Canada - National Science Library

    Giles, Graham G; Simpson, Julie A; English, Dallas R; Hodge, Allison M; Gertig, Dorota M; MacInnis, Robert J; Hopper, John L

    2006-01-01

    ...) in a prospective study of 324 breast cancers diagnosed in 12,273 post‐menopausal women. Although an increase of 1 standard deviation in carbohydrate was marginally associated with risk of breast cancer, relative risk (RR) 1.31 (95% CI, 0.98, 1.75...

  5. Applying the Flood Vulnerability Index as a Knowledge base for flood risk assessment

    NARCIS (Netherlands)

    Balica, S-F.

    2012-01-01

    Floods are one of the most common and widely distributed natural risks to life and property worldwide. An important part of modern flood risk management is to evaluate vulnerability to floods. This evaluation can be done only by using a parametric approach. Worldwide there is a need to enhance our

  6. High body mass index and cancer risk-a Mendelian randomisation study

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjærg-Hansen, Anne; Smith, George Davey;

    2016-01-01

    108,812 individuals from the general population, we found that observationally high BMI was associated with lower risk of lung and skin cancer overall and with higher risk of breast cancer in postmenopausal women, but not with other types of cancer. BMI increasing alleles were not associated with risk...... of follow-up (range 0-37), 8002 developed non-skin cancer, 3347 non-melanoma skin cancer, 1396 lung cancer, 637 other smoking related cancers, 1203 colon cancer, 159 kidney cancer, 1402 breast cancer, 1062 prostate cancer, and 2804 other cancers. Participants were genotyped for five genetic variants...... associated with BMI. Two Danish general population studies, the Copenhagen General Population and the Copenhagen City Heart Study. In observational analyses, overall risk of non-melanoma skin cancer was 35 % (95 % confidence interval 28-42 %) lower and risk of lung cancer 32 % (19-43 %) lower in individuals...

  7. Weight, height, body mass index and risk of breast cancer in postmenopausal women: a case-control study

    Directory of Open Access Journals (Sweden)

    Vahdaninia Mariam

    2008-09-01

    Full Text Available Abstract Background Many women in Iran have a relatively high body mass index. To investigate whether the condition contributes to excess breast cancer cases, a case-control study was conducted to assess the relationships between anthropometric variables and breast cancer risk in Tehran, Iran. Methods All incident cases of breast cancer in the Iranian Centre for Breast Cancer (ICBC were identified through the case records. Eligible cases were all postmenopausal women with histological confirmed diagnosis of breast cancer during 1996 to year 2000. Controls were randomly selected postmenopausal women attending the ICBC for clinical breast examination during the same period. The body mass index (BMI was calculated based on weights and heights as measured by the ICBC nursing staff. Both tests for trend and logistic regression analysis were performed to calculate odds ratios and 95% confidence intervals as measures of relative risk. Results In all, 116 breast cancer cases and 116 controls were studied. T