WorldWideScience

Sample records for exposure outcomes applications

  1. Assessment of critical exposure and outcome windows in time-to-event analysis with application to air pollution and preterm birth study.

    Science.gov (United States)

    Chang, Howard H; Warren, Joshua L; Darrow, Lnydsey A; Reich, Brian J; Waller, Lance A

    2015-07-01

    In reproductive epidemiology, there is a growing interest to examine associations between air pollution exposure during pregnancy and the risk of preterm birth (PTB). One important research objective is to identify critical periods of exposure and estimate the associated effects at different stages of pregnancy. However, population studies have reported inconsistent findings. This may be due to limitations from the standard analytic approach of treating PTB as a binary outcome without considering time-varying exposures together over the course of pregnancy. To address this research gap, we present a Bayesian hierarchical model for conducting a comprehensive examination of gestational air pollution exposure by estimating the joint effects of weekly exposures during different vulnerable periods. Our model also treats PTB as a time-to-event outcome to address the challenge of different exposure lengths among ongoing pregnancies. The proposed model is applied to a dataset of geocoded birth records in the Atlanta metropolitan area between 1999-2005 to examine the risk of PTB associated with gestational exposure to ambient fine particulate matter [Formula: see text]m in aerodynamic diameter (PM[Formula: see text]). We find positive associations between PM[Formula: see text] exposure during early and mid-pregnancy, and evidence that associations are stronger for PTBs occurring around week 30. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Risks for the development of outcomes related to occupational allergies: an application of the asthma-specific job exposure matrix compared with self-reports and investigator scores on job-training-related exposure.

    Science.gov (United States)

    Suarthana, E; Heederik, D; Ghezzo, H; Malo, J-L; Kennedy, S M; Gautrin, D

    2009-04-01

    Risks for development of occupational sensitisation, bronchial hyper-responsiveness, rhinoconjunctival and chest symptoms at work associated with continued exposure to high molecular weight (HMW) allergens were estimated with three exposure assessment methods. A Cox regression analysis with adjustment for atopy and smoking habit was carried out in 408 apprentices in animal health technology, pastry making, and dental hygiene technology with an 8-year follow-up after training. The risk of continued exposure after training, estimated by the asthma-specific job exposure matrix (JEM), was compared with self-reports and investigator scores on job-training-related exposure. Associations between outcomes and work duration in job(s) related to training were also evaluated. Exposure to animal-derived HMW allergens, subsequent to the apprenticeship period, as estimated by the JEM, was associated with a significantly increased risk for occupational sensitisation (hazard ratio (HR) 6.4; 95% CI 2.3 to 18.2) and rhinoconjunctival symptoms at work (HR 2.6; 95% CI 1.1 to 6.2). Exposure to low molecular weight (LMW) agents significantly increased the risk of developing bronchial hyper-responsiveness (HR 2.3; 95% CI 1.1 to 5.4). Exposure verification appeared to be important to optimise the sensitivity and the specificity, as well as HRs produced by the JEM. Self-reports and investigator scores also indicated that further exposure to HMW allergens increased the risk of developing occupational allergies. The agreement between self-reports, investigator scores, and the JEM were moderate to good. There was no significant association between respiratory outcomes and work duration in jobs related to training. The asthma-specific JEM could estimate the risk of various outcomes of occupational allergies associated with exposure to HMW and LMW allergens, but it is relatively labour intensive. Exposure verification is an important integrated step in the JEM that optimised the performance of

  3. Pregnancy outcome following gestational exposure to azithromycin

    Directory of Open Access Journals (Sweden)

    Woodland C Cindy

    2006-05-01

    Full Text Available Abstract Background Azithromycin is an azalide antibiotic with an extensive range of indications and has become a common treatment option due to its convenient dosing regimen and therapeutic advantages. Human studies addressing gestational use of azithromycin have primarily focused on antibiotic efficacy rather than fetal safety. Our primary objective was to evaluate the possibility of teratogenic risk following gestational exposure to azithromycin. Methods There were 3 groups of pregnant women enrolled in our study: 1 women who took azithromycin. 2 women exposed to non-teratogenic antibiotics for similar indications, and 3 women exposed to non-teratogenic agents. They were matched for gestational age at time of call, maternal age, cigarette and alcohol consumption. Rates of major malformations and other endpoints of interest were compared among the three groups. Results Pregnancy outcome of 123 women in each group was ascertained. There were no statistically significant differences among the three groups in the rates of major malformations; 3.4% (exposed versus 2.3% (disease matched and 3.4% (non teratogen or any other endpoints that were examined. In the azithromycin group, 88 (71.6% women took the drug during the first trimester Conclusion Results suggest that gestational exposure to azithromycin is not associated with an increase in the rate of major malformations above the baseline of 1–3%. Our data adds to previous research showing that macrolide antibiotics, as a group, are generally safe in pregnancy and provides an evidence-based option for health professionals caring for populations with chlamydia.

  4. Prenatal drug exposure: infant and toddler outcomes.

    Science.gov (United States)

    Bandstra, Emmalee S; Morrow, Connie E; Mansoor, Elana; Accornero, Veronica H

    2010-04-01

    This manuscript provides an overview of the current scientific literature on the impact of maternal drug use, specifically opioids and cocaine, during pregnancy on the acute and long-term outcomes of infants and toddlers from birth through age 3 years. Emphasis with regard to opioids is placed on heroin and opioid substitutes used to treat opioid addiction, including methadone, which has long been regarded as the standard of care in pregnancy, and buprenorphine, which is increasingly being investigated and prescribed as an alternative to methadone. Controlled studies comparing methadone at high and low doses, as well as those comparing methadone with buprenorphine, are highlighted and the diagnosis and management of neonatal abstinence syndrome is discussed. Over the past two decades, attention of the scientific and lay communities has also been focused on the potential adverse effects of cocaine and crack cocaine, especially during the height of the cocaine epidemic in the United States. Herein, the findings are summarized from prospective studies comparing cocaine-exposed with non-cocaine-exposed infants and toddlers with respect to anthropometric growth, infant neurobehavior, visual and auditory function, and cognitive, motor, and language development. The potentially stigmatizing label of the so-called "crack baby" preceded the evidence now accumulating from well-designed prospective investigations that have revealed less severe sequelae in the majority of prenatally exposed infants than originally anticipated. In contrast to opioids, which may produce neonatal abstinence syndrome and infant neurobehavioral deficits, prenatal cocaine exposure appears to be associated with what has been described as statistically significant but subtle decrements in neurobehavioral, cognitive, and language function, especially when viewed in the context of other exposures and the caregiving environment which may mediate or moderate the effects. Whether these early findings may

  5. Prenatal lignan exposures, pregnancy urine estrogen profiles and birth outcomes

    International Nuclear Information System (INIS)

    Tang, Rong; Chen, Minjian; Zhou, Kun; Chen, Daozhen; Yu, Jing; Hu, Weiyue; Song, Ling; Hang, Bo; Wang, Xinru; Xia, Yankai

    2015-01-01

    During pregnancy, human exposure to endogenous estrogens and xenoestrogens (such as lignans) may comprehensively impact the gestational maintenance and fetal growth. We measured the concentrations of 5 lignans and the profile of 13 estrogen metabolites (EMs) in the urine samples of 328 pregnant women and examined their associations with birth outcomes. We found significantly positive associations between gestational age and urinary matairesinol (MAT), enterodiol (END) and enterolactone (ENL), as well as 16-hydroxylation pathway EMs. There were consistently positive relationships between END and the 16-hydroxylation pathway EMs. The positive relationships of MAT, END and ENL exposures with the length of gestation were mainly in the low exposure strata of the levels of these EMs. This study reveals that MAT, END and ENL as well as 16-hydroxylation pathway EMs are associated with birth outcomes, and that there are interactive relationships between lignans and 16-hydroxylation pathway EMs with birth outcomes. - Highlights: • We examined relations between prenatal lignan exposures and birth outcomes. • We examined relations between pregnancy urine estrogen profiles and birth outcomes. • MAT, END and ENL are associated with birth outcomes. • 16-hydroxylation pathway EMs are associated with birth outcomes. • There are interactive relationships between ligans and EMs with birth outcomes. - Prenatal lignan exposures and EM levels were interactively related to birth outcomes

  6. Associations of prenatal exposure to phenols with birth outcomes

    International Nuclear Information System (INIS)

    Tang, Rong; Chen, Min-jian; Ding, Guo-dong; Chen, Xiao-jiao; Han, Xiu-mei; Zhou, Kun; Chen, Li-mei; Xia, Yan-kai; Tian, Ying; Wang, Xin-ru

    2013-01-01

    Many phenols are known to mimic or antagonize hormonal activities and may adversely affect fetal growth. A study of 567 pregnant women was conducted to investigate the relationship between prenatal phenol exposure and birth outcomes, including birth weight, length, and gestational age. We measured the concentrations of bisphenol A, benzophenone-3, 4-n-octylphenol and 4-n-nonylphenol in maternal urine and examine their association with birth outcomes. Categories of urinary benzophenone-3 concentration were associated with decreased gestational age in all infants (p for trend = 0.03). Between middle and low exposure groups, we also found bisphenol A was negatively associated with gestational duration (β adjusted = −0.48 week; 95% confidence interval: −0.91, −0.05). After stratification by gender, we found the consistent results in infant boys with those in all infants, but we did not observe significant association for girls. In conclusion, we found prenatal phenol exposure was sex-specifically related to birth outcomes. -- Highlights: •We examined relationship of prenatal exposure to phenols with birth outcomes. •We determined urinary concentrations of various phenols. •BP-3 and BPA were negatively associated with gestational age. •There was sex-specific association between phenol exposure and birth outcomes. -- Prenatal phenol exposure was sex-specifically related to birth outcomes

  7. Risks for the development of outcomes related to occupational allergies: an application of the asthma-specific job exposure matrix compared with self-reports and investigator scores on job-training-related exposure.

    NARCIS (Netherlands)

    Suarthana, E.; Heederik, D.J.J.; Ghezzo, H.; Malo, J.L.; Kennedy, S.M.; Gautrin, D.

    2009-01-01

    BACKGROUND AND AIM: Risks for development of occupational sensitisation, bronchial hyper-responsiveness, rhinoconjunctival and chest symptoms at work associated with continued exposure to high molecular weight (HMW) allergens were estimated with three exposure assessment methods. METHODS: A Cox

  8. Sublethal microcystin exposure and biochemical outcomes among hemodialysis patients.

    Directory of Open Access Journals (Sweden)

    Elizabeth D Hilborn

    Full Text Available Cyanobacteria are commonly-occurring contaminants of surface waters worldwide. Microcystins, potent hepatotoxins, are among the best characterized cyanotoxins. During November, 2001, a group of 44 hemodialysis patients were exposed to microcystins via contaminated dialysate. Serum microcystin concentrations were quantified with enzyme-linked immunosorbent assay which measures free serum microcystin LR equivalents (ME. We describe serum ME concentrations and biochemical outcomes among a subset of patients during 8 weeks following exposure. Thirteen patients were included; 6 were males, patients' median age was 45 years (range 16-80, one was seropositive for hepatitis B surface antigen. The median serum ME concentration was 0.33 ng/mL (range: <0.16-0.96. One hundred thirty nine blood samples were collected following exposure. Patients' biochemical outcomes varied, but overall indicated a mixed liver injury. Linear regression evaluated each patient's weekly mean biochemical outcome with their maximum serum ME concentration; a measure of the extrinsic pathway of clotting function, prothrombin time, was negatively and significantly associated with serum ME concentrations. This group of exposed patients' biochemical outcomes display evidence of a mixed liver injury temporally associated with microcystin exposure. Interpretation of biochemical outcomes are complicated by the study population's underlying chronic disease status. It is clear that dialysis patients are a distinct 'at risk' group for cyanotoxin exposures due to direct intravenous exposure to dialysate prepared from surface drinking water supplies. Careful monitoring and treatment of water supplies used to prepare dialysate is required to prevent future cyanotoxin exposure events.

  9. Neonatal outcome following exposure to organophosphorous pesticides

    Directory of Open Access Journals (Sweden)

    Đorđević M.

    2010-01-01

    Full Text Available The aim of our study was to determine the neonatal outcome in mothers and children exposed to organophosphorous pesticides (OP. We found that 22.4% pregnant women were exposed to organophosphorous pesticides. OP pesticide concentration was higher in breast milk, newborn sera than maternal sera. Newborn parameters such as birth weight, birth length, head circumference, Apgar score and presence of meconium, as well as gestational age of delivery, showed no significant difference between the two groups. However, postpartum weight loss, hospitalization duration, levels of newborn bilirubin and glycaemia differed significantly between the two groups. Morbidity and presence of CNS disorders were six times and more than twelve times higher, respectively, in the OP-exposed than in the OP pesticide non-exposed group.

  10. Risks for the development of outcomes related to occupational allergies: an application of the asthma-specific job exposure matrix compared with self-reports and investigator scores on job-training-related exposure.

    OpenAIRE

    Suarthana, E.; Heederik, D.J.J.; Ghezzo, H.; Malo, J.L.; Kennedy, S.M.; Gautrin, D.

    2009-01-01

    BACKGROUND AND AIM: Risks for development of occupational sensitisation, bronchial hyper-responsiveness, rhinoconjunctival and chest symptoms at work associated with continued exposure to high molecular weight (HMW) allergens were estimated with three exposure assessment methods. METHODS: A Cox regression analysis with adjustment for atopy and smoking habit was carried out in 408 apprentices in animal health technology, pastry making, and dental hygiene technology with an 8-year follow-up aft...

  11. Adverse effects of perinatal nicotine exposure on reproductive outcomes.

    Science.gov (United States)

    Wong, Michael K; Barra, Nicole G; Alfaidy, Nadia; Hardy, Daniel B; Holloway, Alison C

    2015-12-01

    Nicotine exposure during pregnancy through cigarette smoking, nicotine replacement therapies or e-cigarette use continues to be a widespread public health problem, impacting both fetal and postnatal health. Yet, at this time, there remains limited data regarding the safety and efficacy in using these nicotine products during pregnancy. Notably, reports assessing the effect of nicotine exposure on postnatal health outcomes in humans, including reproductive health, are severely lacking. Our current understanding regarding the consequences of nicotine exposure during pregnancy is limited to a few animal studies, which do not comprehensively address the underlying cellular mechanisms involved. This paper aims to critically review the current knowledge from human and animal studies regarding the direct and indirect effects (e.g. obesity) of maternal nicotine exposure, regardless of its source, on reproductive outcomes in pregnancy and postnatal life. Furthermore, this review highlights several key cellular mechanisms involved in these adverse reproductive deficits including oxidative stress, inflammation, and endoplasmic reticulum (ER) stress. By understanding the interplay of the cellular mechanisms involved, further strategies could be developed to prevent the reproductive abnormalities resulting from exposure to nicotine in utero and influence informed clinical guidelines for pregnant women. © 2015 Society for Reproduction and Fertility.

  12. Directly measured secondhand smoke exposure and COPD health outcomes

    Directory of Open Access Journals (Sweden)

    Balmes John

    2006-06-01

    Full Text Available Abstract Background Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD, secondhand smoke (SHS exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL, and dyspnea measured at one year follow-up. Results The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9 and dyspnea (1.0 pts; 95% CI 0.4 to 1.7 after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054, disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063, and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p Conclusion Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking.

  13. Association between exposure to suicide and suicidality outcomes in youth.

    Science.gov (United States)

    Swanson, Sonja A; Colman, Ian

    2013-07-09

    Ecological studies support the hypothesis that suicide may be "contagious" (i.e., exposure to suicide may increase the risk of suicide and related outcomes). However, this association has not been adequately assessed in prospective studies. We sought to determine the association between exposure to suicide and suicidality outcomes in Canadian youth. We used baseline information from the Canadian National Longitudinal Survey of Children and Youth between 1998/99 and 2006/07 with follow-up assessments 2 years later. We included all respondents aged 12-17 years in cycles 3-7 with reported measures of exposure to suicide. We included 8766 youth aged 12-13 years, 7802 aged 14-15 years and 5496 aged 16-17 years. Exposure to a schoolmate's suicide was associated with ideation at baseline among respondents aged 12-13 years (odds ratio [OR] 5.06, 95% confidence interval [CI] 3.04-8.40), 14-15 years (OR 2.93, 95% CI 2.02-4.24) and 16-17 years (OR 2.23, 95% CI 1.43-3.48). Such exposure was associated with attempts among respondents aged 12-13 years (OR 4.57, 95% CI 2.39-8.71), 14-15 years (OR 3.99, 95% CI 2.46-6.45) and 16-17 years (OR 3.22, 95% CI 1.62-6.41). Personally knowing someone who died by suicide was associated with suicidality outcomes for all age groups. We also assessed 2-year outcomes among respondents aged 12-15 years: a schoolmate's suicide predicted suicide attempts among participants aged 12-13 years (OR 3.07, 95% CI 1.05-8.96) and 14-15 years (OR 2.72, 95% CI 1.47-5.04). Among those who reported a schoolmate's suicide, personally knowing the decedent did not alter the risk of suicidality. We found that exposure to suicide predicts suicide ideation and attempts. Our results support school-wide interventions over current targeted interventions, particularly over strategies that target interventions toward children closest to the decedent.

  14. Aerosol exposure: Concepts, criteria, standards and applications

    International Nuclear Information System (INIS)

    Vincent, James H

    2009-01-01

    This paper places Inhaled Particles X in the context of the whole sequence of such symposia, going back to the first one in 1961. It draws together some of the essential principles that have been learned since that earlier meeting about the nature of exposure and exposure assessment and thus provides a framework by which to integrate the new knowledge presented at this latest one. In the process, the importance of understanding the formal definition of aerosol exposure is stressed, including the distinction between exposure intensity and exposure history, and how that relates to some measure of cumulative dose which, in turn, may be linked with knowledge about intrinsic toxicity, etc. This then leads to a definition of exposure standards, and the important ingredients of criteria, sampling and limit values. A summary is provided of the current set of particle size-selective criteria that have been widely agreed in the international occupational and environmental health community. Some ideas are presented about how this set might be expanded for certain applications, the important case of ultrafine aerosols being one of them.

  15. Prenatal exposure to polybrominated diphenyl ethers and birth outcomes

    International Nuclear Information System (INIS)

    Chen, Limei; Wang, Caifeng; Cui, Chang; Ding, Guodong; Zhou, Yijun; Jin, Jun; Gao, Yu; Tian, Ying

    2015-01-01

    This study aimed to examine the potential association between maternal PBDEs and birth outcomes, including birth weight (g), length (cm), head circumference (cm) and gestational age (week). 215 mothers were recruited from a prospective birth cohort in rural northern China between September 2010 and February 2012. Serum PBDE congeners were detected and their association with birth outcomes were examined. The median maternal serum concentrations of BDE-28, -47, -99, -100, -153 were 2.27, 2.26, 3.58, 2.13, 4.87 ng/g lipid, respectively. Maternal LgBDE-28 and LgBDE-100 were negatively associated with birth length (β = −0.92, 95% confidence interval (CI): −1.82, −0.02; β = −0.97, 95% CI: −1.83, −0.08). A negative association was found between LgBDE-28 and birth weight among male infants (β = −253.76, 95% CI: −438.16, −69.36). PBDE congeners were not associated with head circumference, or gestational age. Our results contribute to growing evidence suggesting that PBDEs have adverse effects on birth outcomes. - Highlights: • We examined the relations between maternal exposure to PBDEs and birth outcomes. • BDE-28, -47, -99, -100, and -153 were detected in serum from 215 pregnant women. • There was a negative association between BDE-28, -100 and birth length. • BDE-28 showed a negative association with birth weight among male infants. - Negative associations were found between BDE-28, -100 exposure and birth length as well as between BDE-28 exposure and birth weight in male infants.

  16. Gender differences in cue exposure reactivity and 9-month outcome.

    Science.gov (United States)

    Sterling, Robert C; Dean, Jessica; Weinstein, Stephen P; Murphy, Jennifer; Gottheil, Edward

    2004-07-01

    Gender differences have been shown to be related to the course of cocaine dependence and treatment. While previous research has shown cue exposure procedures to be somewhat effective at reducing reactivity of substance dependent individuals to drug related stimuli, the few studies that have examined gender differences in craving and cue-reactivity have yielded equivocal results. We have recently demonstrated that an active cue-exposure procedure that featured cocaine-dependent individuals receiving immediate feedback about their level of physiological arousal following videotaped exposure to cocaine-related stimuli was capable of positively influencing in-treatment (helplessness, abstinence efficacy) as well as 9-month followup outcome (i.e., urinalysis) indices (Sterling, R., Gottheil, E., Murphy, J., & Weinstein, S. (2001). Cue exposure and abstinence efficacy. College on Problems of Drug Dependence, Phoenix, AZ, June 17, 2001). The purpose of the present study was to determine whether differential in-treatment or 9-month followup outcomes were obtained for male and female study participants. Subjects in this study were 81 individuals (47 male/34 female) who met DSM-IV criteria for cocaine dependence and who had consented to be randomly assigned to either the active cue-exposure or control conditions. Participants were compared along a myriad of pre-treatment, in-treatment, and 9-month followup measures. Other than males reporting more recent employment, there was no obvious systematic pattern of differences on pre-treatment indices. No gender differences in treatment retention were observed. With respect to 9-month followup, no gender differences on measures of addiction severity, psychological functioning, or urinalyses were noted. However males were more "cue-reactive" and more successful at establishing control over their reactivity to the cocaine stimuli. Additional research is needed to determine whether these differences in reactivity can be more clearly

  17. Sensitivity analysis for direct and indirect effects in the presence of exposure-induced mediator-outcome confounders

    Science.gov (United States)

    Chiba, Yasutaka

    2014-01-01

    Questions of mediation are often of interest in reasoning about mechanisms, and methods have been developed to address these questions. However, these methods make strong assumptions about the absence of confounding. Even if exposure is randomized, there may be mediator-outcome confounding variables. Inference about direct and indirect effects is particularly challenging if these mediator-outcome confounders are affected by the exposure because in this case these effects are not identified irrespective of whether data is available on these exposure-induced mediator-outcome confounders. In this paper, we provide a sensitivity analysis technique for natural direct and indirect effects that is applicable even if there are mediator-outcome confounders affected by the exposure. We give techniques for both the difference and risk ratio scales and compare the technique to other possible approaches. PMID:25580387

  18. Children, computer exposure and musculoskeletal outcomes: the development of pathway models for school and home computer-related musculoskeletal outcomes.

    Science.gov (United States)

    Harris, Courtenay; Straker, Leon; Pollock, Clare; Smith, Anne

    2015-01-01

    Children's computer use is rapidly growing, together with reports of related musculoskeletal outcomes. Models and theories of adult-related risk factors demonstrate multivariate risk factors associated with computer use. Children's use of computers is different from adult's computer use at work. This study developed and tested a child-specific model demonstrating multivariate relationships between musculoskeletal outcomes, computer exposure and child factors. Using pathway modelling, factors such as gender, age, television exposure, computer anxiety, sustained attention (flow), socio-economic status and somatic complaints (headache and stomach pain) were found to have effects on children's reports of musculoskeletal symptoms. The potential for children's computer exposure to follow a dose-response relationship was also evident. Developing a child-related model can assist in understanding risk factors for children's computer use and support the development of recommendations to encourage children to use this valuable resource in educational, recreational and communication environments in a safe and productive manner. Computer use is an important part of children's school and home life. Application of this developed model, that encapsulates related risk factors, enables practitioners, researchers, teachers and parents to develop strategies that assist young people to use information technology for school, home and leisure in a safe and productive manner.

  19. Survival and Injury Outcome After TBI: Influence of Pre- and Post-Exposure to Caffeine

    Science.gov (United States)

    2012-10-01

    10-1-0757 TITLE: Survival and Injury Outcome After TBI: Influence of Pre- and Post- Exposure to Caffeine PRINCIPAL INVESTIGATOR...Lusardi, Ph.D. Survival and Injury Outcome After TBI: Influence of Pre- and Post- Exposure to Caffeine 33 Legacy Emanual Hospital & Health Center...Phase 1: Study the prophylactic effects of caffeine exposure prior to FPI

  20. Neonatal outcomes following exposure in utero to fallout from Chernobyl.

    Science.gov (United States)

    Hatch, Maureen; Little, Mark P; Brenner, Alina V; Cahoon, Elizabeth K; Tereshchenko, Valery; Chaikovska, Ludmyla; Pasteur, Igor; Likhtarov, Ilya; Bouville, Andre; Shpak, Victor; Bolshova, Olena; Zamotayeva, Galyna; Grantz, Katherine; Sun, Liping; Mabuchi, Kiyohiko; Albert, Paul; Tronko, Mykola

    2017-12-01

    Iodine 131 (I-131), the principal component of nuclear fallout from the Chernobyl accident, concentrates in the thyroid gland and may pose risks to fetal development. To evaluate this, neonatal outcomes following the accident in April of 1986 were investigated in a cohort of 2582 in utero-exposed individuals from northern Ukraine for whom estimates of fetal thyroid I-131 dose were available. We carried out a retrospective review of cohort members' prenatal, delivery and newborn records. The relationships of dose with neonatal anthropometrics and gestational length were modeled via linear regression with adjustment for potentially confounding variables. We found similar, statistically significant dose-dependent reductions in both head circumference (-1.0 cm/Gy, P = 0.005) and chest circumference (-0.9 cm/Gy, P = 0.023), as well as a similar but non-significant reduction in neonatal length (-0.6 cm/Gy, P = 0.169). Gestational length was significantly increased with increasing fetal dose (0.5 wks/Gy, P = 0.007). There was no significant (P > 0.1) effect of fetal dose on birth weight. The observed associations of radioiodine exposure with decreased head and chest circumference are consistent with those observed in the Japanese in utero-exposed atomic bomb survivors.

  1. Virtual reality exposure therapy: Process and outcome in anxiety disorders

    NARCIS (Netherlands)

    Meyerbröker, K.

    2012-01-01

    Angststoornissen kunnen behandeld worden met exposure-therapie, een van de hoofdcomponenten van cognitieve gedragstherapie. Bij exposure-therapie wordt de patiënt blootgesteld aan datgene waar hij bang voor is zonder dat de gevreesde consequentie optreedt. Dit gebeurt meestal in het echt (exposure

  2. Application of maximum radiation exposure values and monitoring of radiation exposure

    International Nuclear Information System (INIS)

    1996-01-01

    The guide presents the principles to be applied in calculating the equivalent dose and the effective dose, instructions on application of the maximum values for radiation exposure, and instruction on monitoring of radiation exposure. In addition, the measurable quantities to be used in monitoring the radiation exposure are presented. (2 refs.)

  3. The effect of the presence and characteristics of an outlying group on exposure-outcome associations

    NARCIS (Netherlands)

    Coenen, P.; Mathiassen, S.E.; Kingma, I.; Boot, C.R.L.; Bongers, P.M.; van Dieen, J.H.

    2015-01-01

    OBJECTIVES: Physical exposures (eg, lifting or bending) are believed to be risk factors for low-back pain (LBP), but the literature is inconsistent. Exposure and LBP prevalence differ considerably between occupations, and exposure-outcome associations could be severely modified by the presence of

  4. Application of maximum radiation exposure values and monitoring of radiation exposure

    International Nuclear Information System (INIS)

    1993-01-01

    According to the Section 32 of the Radiation Act (592/91) the Finnish Centre for Radiation and Nuclear Safety gives instructions concerning the monitoring of the radiation exposure and the application of the dose limits in Finland. The principles to be applied to calculating the equivalent and the effective doses are presented in the guide. Also the detailed instructions on the application of the maximum exposure values for the radiation work and for the natural radiation as well as the instructions on the monitoring of the exposures are given. Quantities and units for assessing radiation exposure are presented in the appendix of the guide

  5. Pregnancy outcomes after fetal exposure to antithyroid medications or levothyroxine

    DEFF Research Database (Denmark)

    Schurmann, Lene; Hansen, Anne Vinkel; Garne, Ester

    2016-01-01

    AIM: To investigate whether fetal exposure to antithyroid drugs (ATD) and levothyroxine affects gestational age (GA), birth weight, birth length, head circumference and prevalence of congenital anomalies. METHODS: Cohort of all pregnancies from GA 12 weeks recorded in Danish registries from 1995......-2010. Exposure was having a prescription for ATD or levothyroxine from 91 days before to 91 days after pregnancy start (n=8318). The reference group was pregnant women without exposure of ATD or levothyroxine (n=969303). A subpopulation was linked to the Danish EUROCAT congenital anomaly register. RESULTS......: Overall 0.66% of the pregnant women had a prescription for levothyroxine and 0.19% had a prescription for ATD during the exposure period. There was no difference in proportion of live births compared to non-exposed pregnancies, but infants exposed to ATD were more often born very preterm (1.99% versus 0...

  6. A workflow to investigate exposure and pharmacokinetic influences on high-throughput in vitro chemical screening based on adverse outcome pathways, OpenTox USA 2015 Poster

    Science.gov (United States)

    Adverse outcome pathways (AOP) link known population outcomes to a molecular initiating event (MIE) that can be quantified using high-throughput in vitro methods. Practical application of AOPs in chemical-specific risk assessment requires consideration of exposure and absorption,...

  7. Occupational exposures and health outcomes among Latina hotel cleaners.

    Science.gov (United States)

    Hsieh, Yu-Chin Jerrie; Apostolopoulos, Yorghos; Hatzudis, Kiki; Sönmez, Sevil

    2014-01-01

    The poor working conditions of Latina hotel cleaners render them particularly vulnerable to elevated occupational hazards that lead to adverse health outcomes. This article presents a comprehensive review of occupational risks (including physical, chemical, biological, and psychosocial risk factors) and health outcomes (including musculoskeletal disorders, respiratory diseases, dermatological diseases and allergies, and psychological disorders) for Latina hotel cleaners, within their unique sociocultural contexts. Preventive interventions for improving Latina hotel cleaners' work and health conditions are recommended.

  8. Internal exposure dynamics drive the Adverse Outcome Pathways of synthetic glucocorticoids in fish

    Science.gov (United States)

    Margiotta-Casaluci, Luigi; Owen, Stewart F.; Huerta, Belinda; Rodríguez-Mozaz, Sara; Kugathas, Subramanian; Barceló, Damià; Rand-Weaver, Mariann; Sumpter, John P.

    2016-02-01

    The Adverse Outcome Pathway (AOP) framework represents a valuable conceptual tool to systematically integrate existing toxicological knowledge from a mechanistic perspective to facilitate predictions of chemical-induced effects across species. However, its application for decision-making requires the transition from qualitative to quantitative AOP (qAOP). Here we used a fish model and the synthetic glucocorticoid beclomethasone dipropionate (BDP) to investigate the role of chemical-specific properties, pharmacokinetics, and internal exposure dynamics in the development of qAOPs. We generated a qAOP network based on drug plasma concentrations and focused on immunodepression, skin androgenisation, disruption of gluconeogenesis and reproductive performance. We showed that internal exposure dynamics and chemical-specific properties influence the development of qAOPs and their predictive power. Comparing the effects of two different glucocorticoids, we highlight how relatively similar in vitro hazard-based indicators can lead to different in vivo risk. This discrepancy can be predicted by their different uptake potential, pharmacokinetic (PK) and pharmacodynamic (PD) profiles. We recommend that the development phase of qAOPs should include the application of species-species uptake and physiologically-based PK/PD models. This integration will significantly enhance the predictive power, enabling a more accurate assessment of the risk and the reliable transferability of qAOPs across chemicals.

  9. Characterization of population exposure to organochlorines: A cluster analysis application

    NARCIS (Netherlands)

    R.M. Guimarães (Raphael Mendonça); S. Asmus (Sven); A. Burdorf (Alex)

    2013-01-01

    textabstractThis study aimed to show the results from a cluster analysis application in the characterization of population exposure to organochlorines through variables related to time and exposure dose. Characteristics of 354 subjects in a population exposed to organochlorine pesticides residues

  10. Infertility, Pregnancy Loss and Adverse Birth Outcomes in Relation to Maternal Secondhand Tobacco Smoke Exposure

    Science.gov (United States)

    Meeker, John D.; Benedict, Merle D.

    2013-01-01

    A substantial proportion of the etiology involved in female infertility and adverse pregnancy outcomes remains idiopathic. Recent scientific research has suggested a role for environmental factors in these conditions. Secondhand tobacco smoke (STS) contains a number of known or suspected reproductive toxins, and human exposure to STS is prevalent worldwide. Robust evidence exists for the toxic effects of active smoking on fertility and pregnancy, but studies of passive exposure are much more limited in number. While the association between maternal STS exposure and declined birth weight has been fairly well-documented, only recently have epidemiologic studies begun to provide suggestive evidence for delayed conception, altered menstrual cycling, early pregnancy loss (e.g. spontaneous abortion), preterm delivery, and congenital malformations in relation to STS exposure. There is also new evidence that developmental exposures to tobacco smoke may be associated with reproductive effects in adulthood. To date, most studies have estimated maternal STS exposure through self-report even though exposure biomarkers are less prone to error and recall bias. In addition to utilizing biomarkers of STS exposure, future studies should aim to identify vital windows of STS exposure, important environmental co-exposures, individual susceptibility factors, and specific STS constituents associated with female infertility and adverse pregnancy outcomes. The role of paternal exposures/factors should also be investigated. PMID:23888128

  11. A Case Study Application of the Aggregate Exposure Pathway (AEP) and Adverse Outcome Pathway (AOP) Frameworks to Facilitate the Integration of Human Health and Ecological End Points for Cumulative Risk Assessment (CRA)

    Science.gov (United States)

    Cumulative risk assessment (CRA) methods promote the use of a conceptual site model (CSM) to apportion exposures and integrate risk from multiple stressors. While CSMs may encompass multiple species, evaluating end points across taxa can be challenging due to data availability an...

  12. Exposure to antidepressants during pregnancy--prevalences and outcomes

    DEFF Research Database (Denmark)

    Jimenez-Solem, Espen

    2014-01-01

    conflicting. The main challenge is how to discern between the effects of the drug and the effect of the depression itself. We approached this dire problem conducting a nation-wide register based study analyzing the relation between use of antidepressants during pregnancy and the risk of congenital...... that the apparent risk associated with use of SSRIs during pregnancy is not related to the drug exposure, but to unknown characteristics associated with mothers redeeming a prescription for an antidepressant. We found no increased risk of stillbirths or neonatal mortality among off-spring exposed in utero...

  13. Unjustified prenatal radiation exposure in medical applications

    International Nuclear Information System (INIS)

    Cardenas Herrera, J.; Lamadrid, A.I.; Garcia Lima, O.; Diaz Bernal, E.; Freixas, V.; Lopez Bejerano, G.; Sanchez, R.

    2001-01-01

    The exposure to the radiation ionising of pregnant women, frequently constitutes motive of preoccupation for the expectant mother and the medical professionals taken the responsibility with its attention. The protection of the embryo-fetus against the ionising radiation is of singular importance due to its special vulnerability to this agent. On the other hand the diagnosis or treatment with radiations ionising beneficial for the expectant mother, are only indirectly for the embryo-fetus that is exposed to a hazard without perceiving anything. The present paper presents the experience obtained in the clinical and dosimetric evaluation from twenty-one pregnant patients subjected to diverse radiodiagnostic procedures or nuclear medicine during the years 1999-2000. The obtained results evidence that 24% of the patients was subjected to procedures of nuclear medicine with diagnostic purposes. While the period of pregnancy of the patients ranged between 4 and 12 weeks, it could be concluded that in all the cases the doses received by the patients in the whole body did not exceed 2 mSv. When conjugating the period of pregnancy of the patients with the doses received, there is no evidence of significant risk for the embryo-fetus. Paradoxically the physicians of assistance suggested to their patients in all the cases to carry out the interruption of the pregnancy, demonstrating with this decision ignorance on the biological effects of the ionizing radiations during the prenatal exposures. (author)

  14. The effect of the presence and characteristics of an outlying group on exposure-outcome associations.

    Science.gov (United States)

    Coenen, Pieter; Mathiassen, Svend Erik; Kingma, Idsart; Boot, Cécile R L; Bongers, Paulien M; van Dieën, Jaap H

    2015-01-01

    Physical exposures (eg, lifting or bending) are believed to be risk factors for low-back pain (LBP), but the literature is inconsistent. Exposure and LBP prevalence differ considerably between occupations, and exposure-outcome associations could be severely modified by the presence of particular occupational groups. We aimed to investigate the influence of such outlying groups on the properties of associations between exposure and LBP. Lifting and trunk flexion were observed for 371 of 1131 workers within 19 groups. LBP was obtained from all workers during three follow-up years. Both exposure variables were associated with LBP (Pexposures and LBP prevalence substantially affected the exposure-outcome association in the total population. In order to further examine this phenomenon, we assessed, by simulation, the influence of realistic sizes (n=4, 8, 16, 32, 64, 128), mean exposures (e=2000, 3000, 4000 lifts and e=30, 40, 50% trunk flexion time) and LBP prevalences (p=70, 80, 90, 100%) of the outlying group on the strength and certainty of the eventual relationship between exposure and LBP. For each combination of n, e and p, 3000 virtual studies were constructed, including the simulated group together with the other 18 original groups from the parent data-set. Average odds ratios (OR), 95% confidence limits, and power (Pexposure. The size and characteristics of a single group with high exposure and outcome prevalence can strongly influence both the OR point estimate and the likelihood of obtaining significant exposure-outcome associations in studies of large populations. These findings can guide interpretations of prior epidemiological studies and support informed design of future studies.

  15. Use of the Finnish Information System on Occupational Exposure (FINJEM) in epidemiologic, surveillance, and other applications.

    Science.gov (United States)

    Kauppinen, Timo; Uuksulainen, Sanni; Saalo, Anja; Mäkinen, Ilpo; Pukkala, Eero

    2014-04-01

    This paper reviews the use of the Finnish Information System on Occupational Exposure (Finnish job-exposure matrix, FINJEM) in different applications in Finland and other countries. We describe and discuss studies on FINJEM and studies utilizing FINJEM in regard to the validity of exposure estimates, occupational epidemiology, hazard surveillance and prevention, the assessment of health risks and the burden of disease, the assessment of exposure trends and future hazards, and the construction of job-exposure matrices (JEMs) in countries other than Finland. FINJEM can be used as an exposure assessment tool in occupational epidemiology, particularly in large register-based studies. It also provides information for hazard surveillance at the national level. It is able to identify occupations with high average exposures to chemical agents and can therefore serve the priority setting of prevention. However, it has only limited use at the workplace level due to the variability of exposure between workplaces. The national estimates of exposure and their temporal trends may contribute to the assessment of both the recent and future burden of work-related health outcomes. FINJEM has also proved to be useful in the construction of other national JEMs, for example in the Nordic Occupational Cancer study in the Nordic countries. FINJEM is a quantitative JEM, which can serve many purposes and its comprehensive documentation also makes it potentially useful in countries other than Finland.

  16. Pregnancy Outcome after Varenicline Exposure in the First Trimester

    Directory of Open Access Journals (Sweden)

    Yusuf Cem Kaplan

    2014-01-01

    Full Text Available To the best of our knowledge this is the first case report describing exposure to varenicline, an α4β2 nicotinic acetylcholine partial receptor agonist used for smoking cessation therapy in pregnancy. A 29-year-old multiparous woman with an unplanned pregnancy has used varenicline 2 mg/day unintentionally yet regularly 4 weeks from her last menstrual period. Fetal ultrasound performed at each trimester, detailed anomaly scan, and fetal echocardiography which were performed at the 22nd gestational week showed normal fetal growth with no malformations. The patient delivered a healthy baby at the 38th week of gestation with normal Apgar score and physical examination findings. Age-appropriate physical and neurological development of the child has been observed for 6 months. Although it is not possible to draw definitive conclusions, this case report may contribute to the current available limited data regarding the safety of varenicline use in pregnancy.

  17. Prenatal cocaine exposure and neonatal/infant outcomes.

    Science.gov (United States)

    Cambell, Shelly

    2003-01-01

    Illegal drug use throughout the nation is a problem of epidemic proportion. Of particular concern is drug use among pregnant women. In most cases, these women have little hope of achieving a better life for themselves or their children. Illegal drugs, cocaine in particular, can have devastating effects on the neonate. These effects can last well into childhood and can exhibit themselves in academic, social, and family situations. Challenges for the neonatal nurse include early identification of these infants and use of available resources. This article addresses prenatal cocaine use and support services for drug-dependent women, effects of cocaine during the neonatal period, possible neonatal and infant outcomes, and implications for nursing practice.

  18. Protection from potential exposures: application to selected radiation sources

    International Nuclear Information System (INIS)

    1997-09-01

    This ICRP Report begins with the general principles of radiation protection in the case of potential exposures, followed by special issues in application and compliance with regulatory aims. The rest of the report uses event trees or fault trees to derive the logical structure of six scenarios of potential exposure, i.e. two irradiators, a large research accelerator, an accelerator for industrial isotope production, an industrial radiography device using a mobile source of radiation, and finally a medical gamma radiotherapy device. (UK)

  19. CONTROLLED EXPOSURES OF HUMAN VOLUNTEERS TO DIESEL ENGINE EXHAUST: BIOMARKERS OF EXPOSURE AND HEALTH OUTCOMES

    Science.gov (United States)

    Combustion of diesel fuel contributes to ambient air pollutant fine particulate matter (PM) and gases. Fine PM exposure has been associated with increased mortality due to adverse cardiac events, and morbidity, such as increased hospitalization for asthma symptoms and lung infect...

  20. Periodontal disease and pregnancy outcomes: exposure, risk and intervention.

    Science.gov (United States)

    Clothier, B; Stringer, M; Jeffcoat, Marjorie K

    2007-06-01

    Despite the many advances in medicine, the rate of preterm birth has not significantly decreased in the United States over the past several decades. In fact, the rate rose in 2003 to more than 12% of all births in the United States. This equates to over half a million premature births in the United States alone. Consequently, the identification of risk factors for preterm birth which are amenable to intervention would have far-reaching and long-lasting effects. There is emerging evidence of a relationship between periodontal health and adverse pregnancy outcomes, particularly preterm birth/preterm low-birth-weight infants. Therefore this chapter explores the putative association between periodontal disease and infant prematurity, as well as the results of intervention studies which treated periodontal disease in order to reduce the incidence of prematurity. Of 31 published studies, 22 show a positive association between premature birth and periodontal disease. Ongoing studies are addressing the efficacy of periodontal treatment for decreasing the incidence of infant prematurity.

  1. Assessing Health Outcomes After Environmental Exposures Associated With Open Pit Burning in Deployed US Service Members.

    Science.gov (United States)

    Rohrbeck, Patricia; Hu, Zheng; Mallon, Col Timothy M

    2016-08-01

    This study assessed the long-term health impact of environmental exposures associated with open pit burning in deployed US service members. Two hundred individuals deployed to Balad, Iraq, and Bagram, Afghanistan, with known exposure to open pits, were matched to 200 non-deployed service members. Both cohorts were observed for adverse health outcomes after returning from deployment. Slight increased risks were observed for respiratory diseases in the Bagram cohort (adj RR: 1.259), and for cardiovascular disease in the Balad cohort (adj RR: 1.072), but the findings were not significant. The combined deployed cohort showed lower risks for adverse health outcomes, suggesting a healthy deployer effect. In conclusion, this study did not find significantly increased risks for selected health outcomes after burn pit exposure during deployment among two deployed cohorts compared with a non-deployed cohort.

  2. Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study.

    Science.gov (United States)

    Forcadell, Eduard; Torrents-Rodas, David; Vervliet, Bram; Leiva, David; Tortella-Feliu, Miquel; Fullana, Miquel A

    2017-11-01

    Fear extinction models have a key role in our understanding of anxiety disorders and their treatment with exposure therapy. Here, we tested whether individual differences in fear extinction learning and fear extinction recall in the laboratory were associated with the outcomes of an exposure therapy analog (ETA). Fifty adults with fear of spiders participated in a two-day fear-learning paradigm assessing fear extinction learning and fear extinction recall, and then underwent a brief ETA. Correlational analyses indicated that enhanced extinction learning was associated with better ETA outcome. Our results partially support the idea that individual differences in fear extinction learning may be associated with exposure therapy outcome, but suggest that further research in this area is needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Pregnancy outcomes after paternal radiofrequency field exposure aboard fast patrol boats.

    Science.gov (United States)

    Baste, Valborg; Moen, Bente E; Oftedal, Gunnhild; Strand, Leif Age; Bjørge, Line; Mild, Kjell Hansson

    2012-04-01

    To investigate adverse reproductive outcomes among male employees in the Royal Norwegian Navy exposed to radiofrequency electromagnetic fields aboard fast patrol boats. Cohort study of Royal Norwegian Navy servicemen linked to the Medical Birth Registry of Norway, including singleton offspring born between 1967 and 2008 (n = 37,920). Exposure during the last 3 months before conception (acute) and exposure more than 3 months before conception (nonacute) were analyzed. Perinatal mortality and preeclampsia increased after service aboard fast patrol boats during an acute period and also after increased estimated radiofrequency exposure during an acute period, compared with service aboard other vessels. No associations were found between nonacute exposure and any of the reproductive outcomes. Paternal work aboard fast patrol boats during an acute period was associated with perinatal mortality and preeclampsia, but the cause is not clear.

  4. Inhalational and dermal exposures during spray application of biocides.

    Science.gov (United States)

    Berger-Preiss, Edith; Boehncke, Andrea; Könnecker, Gustav; Mangelsdorf, Inge; Holthenrich, Dagmar; Koch, Wolfgang

    2005-01-01

    Data on inhalational and potential dermal exposures during spray application of liquid biocidal products were generated. On the one hand, model experiments with different spraying devices using fluorescent tracers were carried out to investigate the influence of parameters relevant to the exposure (e.g. spraying equipment, nozzle size, direction of application). On the other hand, measurements were performed at selected workplaces (during disinfection operations in food and feed areas; pest control operations for private, public and veterinary hygiene; wood protection and antifouling applications) after application of biocidal products such as Empire 20, Responsar SC, Omexan-forte, Actellic, Perma-forte; Fendona SC, Pyrethrum mist; CBM 8, Aldekol Des 03, TAD CID, Basileum, Basilit. The measurements taken in the model rooms demonstrated dependence of the inhalation exposure on the type of spraying device used, in the following order: "spraying with low pressure" < "airless spraying" < "fogging" indicating that the particle diameter of the released spray droplets is the most important parameter. In addition inhalation exposure was lowest when the spraying direction was downward. Also for the potential dermal exposure, the spraying direction was of particular importance: overhead spraying caused the highest contamination of body surfaces. The data of inhalational and potential dermal exposures gained through workplace measurements showed considerable variation. During spraying procedures with low-pressure equipments, dose rates of active substances inhaled by the operators ranged from 7 to 230 microg active substance (a.s.)/h. An increase in inhaled dose rates (6-33 mg a.s./h) was observed after use of high application volumes/time unit during wood protection applications indoors. Spraying in the veterinary sector using medium-pressure sprayers led to inhaled dose rates between 2 and 24mga.s./h. The highest inhaled dose rates were measured during fogging (114 mg a

  5. Evaluation of radiological exposure from Plowshare applications, 1967--1975

    International Nuclear Information System (INIS)

    Barton, C.J.; Kaye, S.V.

    1975-08-01

    A review of the highlights and accomplishments of the nine-year program, FY 1967-75, at ORNL on the evaluation of the radiological exposure from Plowshare applications is presented. Conclusions based on the studies summarized are given. Chronological lists of presentations, reports and open literature publications on the various investigations of the program are appended to the report. (auth)

  6. What Doesn't Kill You Makes You Weaker: Prenatal Pollution Exposure and Educational Outcomes

    Science.gov (United States)

    Sanders, Nicholas J.

    2012-01-01

    I examine the impact of prenatal total suspended particulate (TSP) exposure on educational outcomes using county-level variation in the timing and severity of the industrial recession of the early 1980s as a shock to ambient TSPs (similar to Chay and Greenstone 2003b). I then instrument for pollution levels using county-level changes in relative…

  7. Exposure to Childhood Sexual and Physical Abuse and Subsequent Educational Achievement Outcomes

    Science.gov (United States)

    Boden, Joseph M.; Horwood, L. John; Fergusson, David M.

    2007-01-01

    Objective: This paper examined the relationship between exposure to sexual and physical abuse (CSA and CPA) in childhood and later educational achievement outcomes in late adolescence and early adulthood in a birth cohort of over 1,000 children studied to age 25. Method: Retrospective data on CSA and CPA were gathered at ages 18 and 21 and used to…

  8. Neurological outcome in school-age children after in utero exposure to coumarins

    NARCIS (Netherlands)

    Wesseling, J; Van Driel, D; Smrkovsky, M; Van der Veer, E; Geven-Boere, LM; Sauer, PJJ; Touwen, BCL

    The effect of prenatal exposure to coumarins (acenocoumarol, phenprocoumon) on neurological outcome was assessed in a cohort of 306 children aged 7-15 years. Findings were compared with those in a non-exposed cohort of 267 children, matched for sex, age, and demographic region. We used a

  9. Seeing Green: Mere Exposure to Money Triggers a Business Decision Frame and Unethical Outcomes

    Science.gov (United States)

    Kouchaki, Maryam; Smith-Crowe, Kristin; Brief, Arthur P.; Sousa, Carlos

    2013-01-01

    Can mere exposure to money corrupt? In four studies, we examined the likelihood of unethical outcomes when the construct of money was activated through the use of priming techniques. The results of Study 1 demonstrated that individuals primed with money were more likely to demonstrate unethical intentions than those in the control group. In Study…

  10. Exposure to organophosphate flame retardants in spray polyurethane foam applicators: Role of dermal exposure.

    Science.gov (United States)

    Bello, Anila; Carignan, Courtney C; Xue, Yalong; Stapleton, Heather M; Bello, Dhimiter

    2018-04-01

    Spray polyurethane foam (SPF) is a highly effective thermal insulation material that has seen considerable market growth in the past decade. Organophosphate flame retardants (PFRs) are added to SPF formulations to meet fire code requirements. A common flame retardant used in SPF formulations is tris 1-chloro 2-propyl phosphate (TCIPP), a suspected endocrine disruptor. Exposure monitoring efforts during SPF applications have focused primarily on the isocyanate component, a potent respiratory and dermal sensitizer. However, to our knowledge, there is no monitoring data for TCIPP. To characterize occupational exposures to TCIPP and other flame retardants during SPF insulation. Workers at four SPF insulation sites and one foam removal site (total n = 14) were recruited as part of this pilot study. Personal inhalation exposure to TCIPP was monitored with a CIP-10MI inhalable sampler and potential dermal exposure was assessed through the use of a glove dosimeter. Biomarkers of TCIPP and three other PFRs were measured in urine collected from workers pre-and post-shift. Linear mixed effect models were used to analyze associations of urinary biomarkers with inhalation and dermal exposures and paired t-tests were used to examine the difference on the means of urinary biomarkers pre-and post-shift. Chemical analysis of all species was performed with liquid chromatography-electrospray ionization tandem mass spectrometry. Geometric mean (GM) concentrations of TCIPP in personal air monitors and glove dosimeters collected from SPF applicators, 294.7 μg/m 3 and 18.8 mg/pair respectively. Overall, GM concentrations of the two TCIPP urinary biomarkers BCIPP and BCIPHIPP and (6.2 and 88.8 μg/mL) were 26-35 times higher than reported in the general population. Post-shift levels of TCIPP biomarkers were higher than pre-shift even though workers at insulation sites wore supplied air respirators, gloves and coveralls. The urinary biomarkers for the other PFRs were not

  11. A Review of Nitrates in Drinking Water: Maternal Exposure and Adverse Reproductive and Developmental Outcomes

    Science.gov (United States)

    Manassaram, Deana M.; Backer, Lorraine C.; Moll, Deborah M.

    2006-01-01

    In this review we present an update on maternal exposure to nitrates in drinking water in relation to possible adverse reproductive and developmental effects, and also discuss nitrates in drinking water in the United States. The current standard for nitrates in drinking water is based on retrospective studies and approximates a level that protects infants from methemoglobinemia, but no safety factor is built into the standard. The current standard applies only to public water systems. Drinking water source was related to nitrate exposure (i.e., private systems water was more likely than community system water to have nitrate levels above the maximum contaminant limit). Animal studies have found adverse reproductive effects resulting from higher doses of nitrate or nitrite. The epidemiologic evidence of a direct exposure–response relationship between drinking water nitrate level and adverse reproductive effect is still not clear. However, some reports have suggested an association between exposure to nitrates in drinking water and spontaneous abortions, intrauterine growth restriction, and various birth defects. Uncertainties in epidemiologic studies include the lack of individual exposure assessment that would rule out confounding of the exposure with some other cause. Nitrates may be just one of the contaminants in drinking water contributing to adverse outcomes. We conclude that the current literature does not provide sufficient evidence of a causal relationship between exposure to nitrates in drinking water and adverse reproductive effects. Future studies incorporating individual exposure assessment about users of private wells—the population most at risk—should be considered. PMID:16507452

  12. Outcome of Accidental Exposure Prone to Blood Borne Viral Infections in an Educational Hospital

    Directory of Open Access Journals (Sweden)

    Shahnaz Sali

    2016-04-01

    Full Text Available Background: The risk for transmission of blood-borne viruses (BBVs such as Human immunodeficiency virus (HIV, hepatitis B virus (HBV and hepatitis C virus (HCV due to occupational exposure is a major concern in the health care setting.Materials and Methods: This study among 337 health care workers (HCWs accidentally exposed to BBVs was carried out from January 2009 to March 2015. The data were reviewed in labbafinejhad hospital, Tehran, Iran.Results: 4 HCWs had exposure to HBS Ag positive, which HBS antibody titer of them was higher than 10 mlu/ml, 6 HCWs were exposed to HCV seropositive patients underwent laboratory investigations for  HCV-antibody on 4,12, 24 weeks that results were negative. 3 cases had exposure to HIV seropositive patients which received standard antiretroviral post exposure prophylaxis.Conclusion: Timely performance for PEP (Post Exposure Prophylaxis reducing BBVs transmission among HCWs.prophylaxis. Conclusions: Timely performance for  PEP(Post Exposure Prophylaxis reducing BBVs transmission among HCWs.Key words: Outcome; Accidental Exposure; Blood Borne Viral Infections

  13. The effects of prenatal cannabis exposure on fetal development and pregnancy outcomes: a protocol.

    Science.gov (United States)

    Gunn, Jayleen K L; Rosales, Cecilia B; Center, Katherine E; Nuñez, Annabelle V; Gibson, Steven J; Ehiri, John E

    2015-03-13

    The effects of exposure to marijuana in utero on fetal development are not clear. Given that the recent legislation on cannabis in the US is likely to result in increased use, there is a need to assess the effects of prenatal cannabis exposure on fetal development and pregnancy outcomes. The objective of this review is to assess the effects of prenatal exposure to cannabis on pregnancy outcomes (including maternal and child outcomes). Major databases will be searched from inception to the latest issue, with the aim of identifying studies that reported the effects of prenatal exposure to cannabis on fetal development and pregnancy outcomes. Two investigators will independently review all titles and abstracts to identify potential articles. Discrepancies will be resolved by repeated review, discussion and consensus. Study quality assessment will be undertaken, using standard protocols. To qualify for inclusion, studies must report at least one maternal or neonatal outcome post partum. Cross-sectional, case-control, cohort and randomised controlled trials published in English will be included. In order to rule out the effects of other drugs that may affect fetal development and pregnancy outcomes, studies will only be included if they report outcomes of prenatal exposure to cannabis while excluding other illicit substances. Data from eligible studies will be extracted, and data analysis will include a systematic review and critical appraisal of evidence, and meta-analysis if data permit. Meta-analysis will be conducted if three or more studies report comparable statistics on the same outcome. The review which will result from this protocol has not already been conducted. Preparation of the review will follow the procedures stated in this protocol, and will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ethical approval of data will not be required since the review will use data that are already available in the

  14. [Relationship between pesticide exposure and adverse pregnancy outcomes among reproductive couples in rural areas of China].

    Science.gov (United States)

    Qu, Y M; Chen, S; Li, J J; Jin, R R; Pan, H; Jiang, Y

    2017-06-10

    Objective: To analyze the association between pesticide exposure and adverse pregnancy outcomes in women from the rural areas of China. Methods: Data of "National Free Preconception Health Examination Project (NFPHEP)" from January 2010 to December 2012 was used for analysis. A total of 248 501 families that were planning to deliver a baby in the next 6 months were enrolled. Data on paternal exposure to pesticides before or during pregnancy was collected through questionnaires, with related outcomes on pregnancy recorded by doctors. Results: Among all the 248 501 participants, 1 806 (0.74 % ) women and 2 653 (1.09 % ) men reported to have been exposed to pesticide before pregnancy, with 505 (0.21 % ) reported of having been exposed to pesticide during the period of pregnancy. Maternal exposure to pesticide was found a risk factor related to stillbirth ( OR =3.37, 95 %CI : 2.05-5.55), peculiar smell pregnancy ( OR =3.17, 95 %CI :1.18-8.55) and low birth weight ( OR =7.56, 95 % CI : 5.36-10.66). Paternal exposure to pesticide was also found related to miscarriage ( OR =1.37, 95 % CI : 1.03-1.80), low birth weight ( OR =3.65, 95 % CI :1.51-8.84), or giant infant ( OR =0.64, 95 %CI : 0.44-0.93). Maternal exposure to pesticide during pregnancy appeared a risk factor on miscarriage ( OR =4.65, 95 % CI : 3.47-6.24). Other adverse outcomes on pregnancy would include premature birth and high birth weight. Conclusion: Parental pesticide exposure appeared a risk factor on stillbirth, peculiar smell pregnancy, low birth weight and miscarriage.

  15. Pesticide Exposure and Neurodevelopmental Outcomes: Review of the Epidemiologic and Animal Studies

    Science.gov (United States)

    Burns, Carol J.; McIntosh, Laura J.; Mink, Pamela J.; Jurek, Anne M.; Li, Abby A.

    2013-01-01

    Assessment of whether pesticide exposure is associated with neurodevelopmental outcomes in children can best be addressed with a systematic review of both the human and animal peer-reviewed literature. This review analyzed epidemiologic studies testing the hypothesis that exposure to pesticides during pregnancy and/or early childhood is associated with neurodevelopmental outcomes in children. Studies that directly queried pesticide exposure (e.g., via questionnaire or interview) or measured pesticide or metabolite levels in biological specimens from study participants (e.g., blood, urine, etc.) or their immediate environment (e.g., personal air monitoring, home dust samples, etc.) were eligible for inclusion. Consistency, strength of association, and dose response were key elements of the framework utilized for evaluating epidemiologic studies. As a whole, the epidemiologic studies did not strongly implicate any particular pesticide as being causally related to adverse neurodevelopmental outcomes in infants and children. A few associations were unique for a health outcome and specific pesticide, and alternative hypotheses could not be ruled out. Our survey of the in vivo peer-reviewed published mammalian literature focused on effects of the specific active ingredient of pesticides on functional neurodevelopmental endpoints (i.e., behavior, neuropharmacology and neuropathology). In most cases, effects were noted at dose levels within the same order of magnitude or higher compared to the point of departure used for chronic risk assessments in the United States. Thus, although the published animal studies may have characterized potential neurodevelopmental outcomes using endpoints not required by guideline studies, the effects were generally observed at or above effect levels measured in repeated-dose toxicology studies submitted to the U.S. Environmental Protection Agency (EPA). Suggestions for improved exposure assessment in epidemiology studies and more effective

  16. Campylobacter, Salmonella, and Yersinia antibodies and pregnancy outcome in Danish women with occupational exposure to animals

    DEFF Research Database (Denmark)

    Kantsø, Bjørn; Andersen, Anne-Marie Nybo; Mølbak, Kåre

    2014-01-01

    to occupational exposure to animals in women exposed to food producing animals. METHODS: We used data and blood samples from the Danish National Birth Cohort. Serum samples collected during the first trimester from 192 pregnant women who were occupationally exposed to domestic animals and 188 randomly selected...... unexposed pregnant women were analysed for IgG, IgM, and IgA antibodies against Campylobacter, Salmonella, and Yersinia. Pregnancy outcomes of interest were identified through the Danish National Patient Register. RESULTS: Women with occupational exposure to animals had significantly higher IgG antibody...

  17. Food and beverage television advertising exposure and youth consumption, body mass index and adiposity outcomes.

    Science.gov (United States)

    Powell, Lisa M; Wada, Roy; Khan, Tamkeen; Emery, Sherry L

    2017-05-01

    This study examined the relationships between exposure to food and beverage product television advertisements and consumption and obesity outcomes among youth. Individual-level data on fast-food and soft drink consumption and body mass index (BMI) for young adolescents from the Early Childhood Longitudinal Study - Kindergarten Cohort (1998-1999) and adiposity measures for children from the U.S. National Health and Nutrition Examination Survey (2003-2004) were combined with designated market area (DMA) Nielsen media advertising ratings data. To account for unobserved individual-level and DMA-level heterogeneity, various fixed- and random-effects models were estimated. The results showed that exposure to soft drink and sugar-sweetened beverage advertisements are economically and statistically significantly associated with higher frequency of soft drink consumption among youth even after controlling for unobserved heterogeneity, with elasticity estimates ranging from 0.4 to 0.5. The association between fast-food advertising exposure and fast-food consumption disappeared once we controlled for unobservables. Exposure to cereal advertising was significantly associated with young adolescents' BMI percentile ranking but exposures to fast-food and soft drink advertisements were not. The results on adiposity outcomes revealed that children's exposure to cereal advertising was associated with both percent body and trunk fatness; fast-food advertising was significantly associated with percent trunk fatness and marginally significantly associated with percent body fatness; and, exposure to SSB advertising was marginally significantly associated with percent body and trunk fatness. The study results suggest that continued monitoring of advertising is important and policy debates regarding the regulation of youth-directed marketing are warranted.

  18. Antibiotic exposure in neonates and early adverse outcomes: a systematic review and meta-analysis.

    Science.gov (United States)

    Esaiassen, Eirin; Fjalstad, Jon Widding; Juvet, Lene Kristine; van den Anker, John N; Klingenberg, Claus

    2017-07-01

    To systematically review and meta-analyse the relationship between antibiotic exposure in neonates and the following early adverse outcomes: necrotizing enterocolitis (NEC), invasive fungal infections (IFIs) and/or death. Data sources were PubMed, Embase, Medline and the Cochrane Database (to December 2016), supplemented by manual searches of reference lists. Randomized controlled trials (RCTs) and observational studies were included if they provided data on different categories of antibiotic exposures (yes versus no, long versus short duration, and/or broad- versus narrow-spectrum regimens) and the risk of developing NEC, IFI and/or death in the neonatal period. Two reviewers extracted data and evaluated the risk of bias using the Cochrane Handbook, adapted to include observational studies. When appropriate, meta-analyses were conducted using the random-effect model. We identified 9 RCTs and 38 observational studies. The quality of the majority of studies was poor to moderate. There was a significant association between prolonged antibiotic exposure and an increased risk of NEC in five observational studies (5003 participants) and/or risk of death in five observational studies (13 534 participants). Eleven of 15 studies with data on broad- versus narrow-spectrum regimens reported an increased risk of IFI after broad-spectrum antibiotic exposure, in particular with third-generation cephalosporins and carbapenems. Meta-analysis was limited by few and old RCTs, insufficient sample sizes and diversity of antibiotic exposure and outcomes reported. Prolonged antibiotic exposure in uninfected preterm infants is associated with an increased risk of NEC and/or death, and broad-spectrum antibiotic exposure is associated with an increased risk of IFI. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Neonatal exposure to phenobarbital potentiates schizophrenia-like behavioral outcomes in the rat.

    Science.gov (United States)

    Bhardwaj, S K; Forcelli, P A; Palchik, G; Gale, K; Srivastava, L K; Kondratyev, A

    2012-06-01

    Previous work has indicated an association between seizures early in life and increased risk of psychiatric disorders, including schizophrenia. However, because early-life seizures are commonly treated with antiepileptic drugs (AEDs) such as phenobarbital, the possibility that drug treatment may affect later-life psychiatric outcomes needs to be evaluated. We therefore tested the hypothesis that phenobarbital exposure in the neonatal rat increases the risk of schizophrenia-like behavioral abnormalities in adulthood. Thus, in this study, we examined the effects of a single acute neonatal exposure to phenobarbital on adult behavioral outcomes in the rat neonatal ventral hippocampal (nVH) lesion model of schizophrenia. We compared these outcomes to those in rats a) without nVH lesions and b) with nVH lesions, without phenobarbital. The tasks used for behavioral evaluation were: amphetamine-induced locomotion, prepulse inhibition, elevated plus-maze, and novel object recognition task. We found that neonatal phenobarbital treatment (in the absence of nVH lesions) was sufficient to disrupt sensorimotor gating (as tested by prepulse inhibition) in adulthood to an extent equivalent to nVH lesions. Additionally, neonatal phenobarbital exposure enhanced the locomotor response to amphetamine in adult animals with and without nVH lesions. Our findings suggest that neonatal exposure to phenobarbital can predispose to schizophrenia-like behavioral abnormalities. Our findings underscore the importance of examining AED exposure early in life as a potential risk factor for later-life neuropsychiatric abnormalities in clinical populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Socio-environmental exposures and health outcomes among persons with sickle cell disease

    OpenAIRE

    Asnani, Monika R.; Knight Madden, Jennifer; Reid, Marvin; Greene, Lisa-Gaye; Lyew-Ayee, Parris

    2017-01-01

    There is much variability in the expression of sickle cell disease (SCD) and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to c...

  1. Prenatal nonylphenol exposure, oxidative and nitrative stress, and birth outcomes: A cohort study in Taiwan

    International Nuclear Information System (INIS)

    Wang, Pei-Wei; Chen, Mei-Lien; Huang, Li-Wei; Yang, Winnie; Wu, Kuen-Yuh; Huang, Yu-Fang

    2015-01-01

    Data concerning the effects of prenatal exposures to nonylphenol (NP) and oxidative stress on neonatal birth outcomes from human studies are limited. A total of 146 pregnant women were studied (1) to investigate the association between prenatal NP exposure and maternal oxidative/nitrative stress biomarkers of DNA damage (8-hydroxy-2’-deoxyguanosine (8-OHdG), 8-nitroguanine (8-NO 2 Gua)) and lipid peroxidation (8-iso-prostaglandin F 2α (8-isoPF 2α ), 4-hydroxy-2-nonenal-mercapturic acid (HNE-MA)) and (2) to explore the associations among oxidative stress biomarkers, NP exposure, and neonatal birth outcomes, including gestational age, birth weight, length, Ponderal index, and head and chest circumferences. NP significantly increased the 8-OHdG and 8-NO 2 Gua levels. All infants born to mothers with urinary 8-OHdG levels above the median exhibited a significantly shorter gestational duration (B adjusted  = −4.72 days; 95% CI: −8.08 to −1.36 days). No clear association was found between NP levels and birth outcomes. Prenatal 8-OHdG levels might be a novel biomarker for monitoring fetal health related to NP exposure. - Highlights: • A cohort of pregnant women was established and followed until delivery. • NP significantly increased 8-OHdG and 8-NO 2 Gua levels. • Maternal 8-OHdG levels were associated with significantly decreased gestational duration. • No clear association was observed between NP and birth outcomes. - NP increased 8-OHdG and 8-NO 2 Gua levels; high 8-OHdG levels significantly decreased gestation length.

  2. Role of oxidative stress in cardiovascular disease outcomes following exposure to ambient air pollution.

    Science.gov (United States)

    Kelly, Frank J; Fussell, Julia C

    2017-09-01

    Exposure to ambient air pollution is associated with adverse cardiovascular outcomes. These are manifested through several, likely overlapping, pathways including at the functional level, endothelial dysfunction, atherosclerosis, pro-coagulation and alterations in autonomic nervous system balance and blood pressure. At numerous points within each of these pathways, there is potential for cellular oxidative imbalances to occur. The current review examines epidemiological, occupational and controlled exposure studies and research employing healthy and diseased animal models, isolated organs and cell cultures in assessing the importance of the pro-oxidant potential of air pollution in the development of cardiovascular disease outcomes. The collective body of data provides evidence that oxidative stress (OS) is not only central to eliciting specific cardiac endpoints, but is also implicated in modulating the risk of succumbing to cardiovascular disease, sensitivity to ischemia/reperfusion injury and the onset and progression of metabolic disease following ambient pollution exposure. To add to this large research effort conducted to date, further work is required to provide greater insight into areas such as (a) whether an oxidative imbalance triggers and/or worsens the effect and/or is representative of the consequence of disease progression, (b) OS pathways and cardiac outcomes caused by individual pollutants within air pollution mixtures, or as a consequence of inter-pollutant interactions and (c) potential protection provided by nutritional supplements and/or pharmacological agents with antioxidant properties, in susceptible populations residing in polluted urban cities. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Fetal sex modifies effects of prenatal stress exposure and adverse birth outcomes.

    Science.gov (United States)

    Wainstock, Tamar; Shoham-Vardi, Ilana; Glasser, Saralee; Anteby, Eyal; Lerner-Geva, Liat

    2015-01-01

    Prenatal maternal stress is associated with pregnancy complications, poor fetal development and poor birth outcomes. Fetal sex has also been shown to affect the course of pregnancy and its outcomes. The aim of this study was to evaluate whether fetal sex modifies the association between continuous exposure to life-threatening rocket attack alarms and adverse pregnancy outcomes. A retrospective cohort study was conducted in which the exposed group was comprised of 1846 women exposed to rocket-attack alarms before and during pregnancy. The unexposed group, with similar sociodemographic characteristics, delivered during the same period of time at the same medical center, but resided out of rocket-attack range. Multivariable models for each gender separately, controlling for possible confounders, evaluated the risk associated with exposure for preterm births (PTB), low birthweight (LBW), small for gestational age and small head circumference (HC). In both univariable and multivariable analyses exposure status was a significant risk factor in female fetuses only: PTB (adj. OR = 1.43; 1.04-1.96), LBW (adj. OR = 1.41; 1.02-1.95) and HC stress.

  4. Effect decomposition in the presence of an exposure-induced mediator-outcome confounder

    Science.gov (United States)

    VanderWeele, Tyler J.; Vansteelandt, Stijn; Robins, James M.

    2014-01-01

    Methods from causal mediation analysis have generalized the traditional approach to direct and indirect effects in the epidemiologic and social science literature by allowing for interaction and non-linearities. However, the methods from the causal inference literature have themselves been subject to a major limitation in that the so-called natural direct and indirect effects that are employed are not identified from data whenever there is a variable that is affected by the exposure, which also confounds the relationship between the mediator and the outcome. In this paper we describe three alternative approaches to effect decomposition that give quantities that can be interpreted as direct and indirect effects, and that can be identified from data even in the presence of an exposure-induced mediator-outcome confounder. We describe a simple weighting-based estimation method for each of these three approaches, illustrated with data from perinatal epidemiology. The methods described here can shed insight into pathways and questions of mediation even when an exposure-induced mediator-outcome confounder is present. PMID:24487213

  5. Bias and power in group-based epidemiologic studies of low-back pain exposure and outcome - Effects of study size and exposure measurement efforts

    NARCIS (Netherlands)

    Coenen, P.; Mathiassen, S.E.; Kingma, I.; Boot, C.R.L.; Bongers, P.M.; Dieën, J.H. van

    2015-01-01

    Objectives: Exposure-outcome studies, for instance on work-related low-back pain (LBP), often classify workers into groups for which exposures are estimated from measurements on a sample of workers within or outside the specific study. The present study investigated the influence on bias and power

  6. Estimating overall exposure effects for the clustered and censored outcome using random effect Tobit regression models.

    Science.gov (United States)

    Wang, Wei; Griswold, Michael E

    2016-11-30

    The random effect Tobit model is a regression model that accommodates both left- and/or right-censoring and within-cluster dependence of the outcome variable. Regression coefficients of random effect Tobit models have conditional interpretations on a constructed latent dependent variable and do not provide inference of overall exposure effects on the original outcome scale. Marginalized random effects model (MREM) permits likelihood-based estimation of marginal mean parameters for the clustered data. For random effect Tobit models, we extend the MREM to marginalize over both the random effects and the normal space and boundary components of the censored response to estimate overall exposure effects at population level. We also extend the 'Average Predicted Value' method to estimate the model-predicted marginal means for each person under different exposure status in a designated reference group by integrating over the random effects and then use the calculated difference to assess the overall exposure effect. The maximum likelihood estimation is proposed utilizing a quasi-Newton optimization algorithm with Gauss-Hermite quadrature to approximate the integration of the random effects. We use these methods to carefully analyze two real datasets. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Effects of Elevated Ambient Temperature on Reproductive Outcomes and Offspring Growth Depend on Exposure Time

    Directory of Open Access Journals (Sweden)

    Huda Yahia Hamid

    2012-01-01

    Full Text Available Reproductive performance has been shown to be greatly affected by changes in environmental factors, such as temperature. However, it is also crucial to identify the particular stage of pregnancy that is most adversely affected by elevated ambient temperature. The aims of this study were to determine the effect on reproductive outcomes of exposure to elevated ambient temperature during different stages of pregnancy and to determine the effect of prenatal heat stress on offspring growth. Sixty pregnant rats were used in this study. The rats were divided equally into four groups as group 1 (control, group 2 (exposed to elevated temperature following implantation, group 3 (exposed to elevated temperature during pre- and periimplantation, and group 4 (exposed to elevated temperature during pre- and periimplantation and following implantation. Groups 3 and 4 had prolonged gestation periods, reduced litter sizes, and male-biased sex ratios. Moreover, the growth patterns of group 3 and 4 pups were adversely affected by prenatal exposure to elevated temperature. The differences between group 1 and group 3 and between group 1 and group 4 were highly significant. However, no significant differences were observed between groups 1 and 2 in the gestation length, sex ratios, and growth patterns. Thus, it can be concluded that exposure to elevated ambient temperature during pre- and periimplantation has stronger adverse effects on reproductive outcomes and offspring growth than postimplantation exposure.

  8. Chronic Exposure to Subtherapeutic Antibiotics Aggravates Ischemic Stroke Outcome in Mice

    Directory of Open Access Journals (Sweden)

    Xiao-Hui Dong

    2017-10-01

    Full Text Available Subtherapeutic antibiotics have been widely used in agriculture since the 1950s, which can be accumulated in human body through various approaches and may have long-term consequences. However, there is limited information about the link between chronic subtherapeutic antibiotic exposure and the outcome of ischemic brain injury. Here we showed that long-term treatment with subtherapeutic chlortetracycline, penicillin or vancomycin, which were widely used in agriculture approved by US Food and Drug Administration (FDA, could impair EPC functions, reduce ischemic brain angiogenesis and aggravate cerebral ischemic injury and long-term stroke outcomes in mice. In addition, transplantated EPCs from chronic antibiotic-treated mice showed a lower therapeutic effect on cerebral ischemic injury reduction and local angiogenesis promotion compared to those from control mice, and EPCs from the donor animals could integrate into the recipient ischemic brain in mice. Furthermore, transplanted EPCs might exert paracrine effects on cerebral ischemic injury reduction in mice, which could be impaired by chronic antibiotic exposure. In conclusion, chronic subtherapeutic antibiotic exposure aggravated cerebral ischemic injury in mice, which might be partly attributed to the impairment of both EPC-mediated angiogenesis and EPCs' paracrine effects. These findings reveal a previously unrecognized impact of chronic subtherapeutic antibiotic exposure on ischemic injury.

  9. Effects of in utero tributyltin chloride exposure in the rat on pregnancy outcome.

    Science.gov (United States)

    Adeeko, Adedayo; Li, Daming; Forsyth, Don S; Casey, Valerie; Cooke, Gerard M; Barthelemy, Johanna; Cyr, Daniel G; Trasler, Jacquetta M; Robaire, Bernard; Hales, Barbara F

    2003-08-01

    Tributyltin, an organotin, is ubiquitous in the environment. The consumption of contaminated marine species leads to human dietary exposure to this compound. Tributyltin is an endocrine disruptor in many wildlife species and inhibits aromatase in mammalian placental and granulosa-like tumor cell lines. We investigated the effects of tributyltin chloride exposure on pregnancy outcome in the Sprague-Dawley rat. Timed pregnant rats were gavaged either with vehicle (olive oil) or tributyltin chloride (0.25, 2.5, 10, or 20 mg/kg) from days 0-19 or 8-19 of gestation. On gestational day 20, dams were sacrificed, and pregnancy outcome was determined. Tributyltin and its metabolites (dibutyltin, monobutyltin) were measured in maternal blood by gas chromatography. Both tributyltin and dibutyltin were present in maternal blood at approximately equal concentrations, whereas monobutyltin contributed minimally to total organotins. Organotin concentrations increased in a dose-dependent pattern in dams, independent of the window of exposure. Tributyltin chloride administration significantly reduced maternal weight gain only at the highest dose (20 mg/kg); a significant increase in post-implantation loss and decreased litter sizes, in addition to decreased fetal weights, was observed in this group. Tributyltin chloride exposure did not result in external malformations, nor was there a change in sex ratios. However, exposure to 0.25, 2.5, or 10 mg/kg tributyltin chloride from gestation days (GD) 0-19 resulted in a significant increase in normalized anogenital distances in male fetuses; exposure from days 8-19 had no effect. There was a dramatic increase in the incidence of low weight (exposure to 20 mg/kg tributyltin chloride. Delayed ossification of the fetal skeleton was observed after in utero exposure to either 10 mg/kg or 20 mg/kg tributyltin chloride. Serum thyroxine and triiodothyronine levels were reduced significantly in dams exposed to 10 and 20 mg/kg tributyltin chloride

  10. The application of volume-outcome contouring in data warehousing.

    Science.gov (United States)

    Studnicki, James; Berndt, Donald J; Luther, Stephen L; Fisher, John W

    2004-01-01

    Despite a compelling body of published research on the nature of provider volume and clinical outcomes, healthcare executives and policymakers have not managed to develop and implement systems that are useful in directing patients to higher volume providers via selective referral or avoidance. A specialized data warehouse application, utilizing hospital discharge data linked to physician biographical information, allows detailed analysis of physician and hospital volume and the resulting pattern (contour) of related outcomes such as mortality, complications, and medical errors. The approach utilizes a historical repository of hospital discharge data in which the outcomes of interest, important patient characteristics and risk factors used in severity-adjusting of the outcomes are derived from the coding structure of the data.

  11. Paternal occupational exposure to radiofrequency electromagnetic fields and risk of adverse pregnancy outcome

    International Nuclear Information System (INIS)

    Mjoen, Geir; Saetre, Dag Ottar; Lie, Rolv T.; Tynes, Tore; Blaasaas, Karl Gerhard; Hannevik, Merete; Irgens, Lorentz M.

    2006-01-01

    Background:During the last decades, public concern that radiofrequency radiation (RFR) may be related to adverse reproductive outcomes has been emerging. Our objective was to assess associations between paternal occupational exposure to RFR and adverse pregnancy outcomes including birth defects using population-based data from Norway.Methods:Data on reproductive outcomes derived from the Medical Birth Registry of Norway were linked with data on paternal occupation derived from the general population censuses. An expert panel categorized occupations according to exposure. Using logistic regression, we analyzed 24 categories of birth defects as well as other adverse outcomes.Results:In the offspring of fathers most likely to have been exposed, increased risk was observed for preterm birth (odds ratio (OR): 1.08, 95% confidence interval (CI): 1.03, 1.15). In this group we also observed a decreased risk of cleft lip (OR: 0.63, 95% CI: 0.41, 0.97). In the medium exposed group, we observed increased risk for a category of ,other defects' (OR: 2.40, 95% CI: 1.22, 4.70), and a decreased risk for a category of ,other syndromes' (OR: 0.75, 95% CI: 0.56, 0.99) and upper gastrointestinal defects (OR: 0.61, 95% CI: 0.40, 0.93).Conclusion:The study is partly reassuring for occupationally exposed fathers

  12. 40 CFR 158.1060 - Post-application exposure-criteria for testing

    Science.gov (United States)

    2010-07-01

    ...) Occupational human post-application exposure to pesticide residues on plants or in soil could occur as the...) Residential human post-application exposure to pesticide residues on plants or in soil could occur. Such uses... and industrial or manufacturing facilities. (ii) Residential human post-application exposure to...

  13. Self-Reported and FEMA Flood Exposure Assessment after Hurricane Sandy: Association with Mental Health Outcomes.

    Directory of Open Access Journals (Sweden)

    Wil Lieberman-Cribbin

    Full Text Available Hurricane Sandy caused extensive physical and economic damage; the long-term mental health consequences are unknown. Flooding is a central component of hurricane exposure, influencing mental health through multiple pathways that unfold over months after flooding recedes. Here we assess the concordance in self-reported and Federal Emergency Management (FEMA flood exposure after Hurricane Sandy and determine the associations between flooding and anxiety, depression, and post-traumatic stress disorder (PTSD. Self-reported flood data and mental health symptoms were obtained through validated questionnaires from New York City and Long Island residents (N = 1231 following Sandy. Self-reported flood data was compared to FEMA data obtained from the FEMA Modeling Task Force Hurricane Sandy Impact Analysis. Multivariable logistic regressions were performed to determine the relationship between flooding exposure and mental health outcomes. There were significant discrepancies between self-reported and FEMA flood exposure data. Self-reported dichotomous flooding was positively associated with anxiety (ORadj: 1.5 [95% CI: 1.1-1.9], depression (ORadj: 1.7 [1.3-2.2], and PTSD (ORadj: 2.5 [1.8-3.4], while self-reported continuous flooding was associated with depression (ORadj: 1.1 [1.01-1.12] and PTSD (ORadj: 1.2 [1.1-1.2]. Models with FEMA dichotomous flooding (ORadj: 2.1 [1.5-2.8] or FEMA continuous flooding (ORadj: 1.1 [1.1-1.2] were only significantly associated with PTSD. Associations between mental health and flooding vary according to type of flood exposure measure utilized. Future hurricane preparedness and recovery efforts must integrate micro and macro-level flood exposures in order to accurately determine flood exposure risk during storms and realize the long-term importance of flooding on these three mental health symptoms.

  14. Exposure to phthalates: reproductive outcome and children health. A review of epidemiological studies.

    Science.gov (United States)

    Jurewicz, Joanna; Hanke, Wojciech

    2011-06-01

    Phthalates are a family of industrial chemicals that have been used for a variety of purposes. As the potential consequences of human exposure to phthalates have raised concerns in the general population, they have been studied in susceptible subjects such as pregnant women, infants and children. This article aims at evaluating the impact of exposure to phthalates on reproductive outcomes and children health by reviewing most recent published literature. Epidemiological studies focusing on exposure to phthalates and pregnancy outcome, genital development, semen quality, precocious puberty, thyroid function, respiratory symptoms and neurodevelopment in children for the last ten years were identified by a search of the PubMed, Medline, Ebsco, Agricola and Toxnet literature bases. The results from the presented studies suggest that there are strong and rather consistent indications that phthalates increase the risk of allergy and asthma and have an adverse impact on children's neurodevelopment reflected by quality of alertness among girls, decreased (less masculine) composite score in boys and attention deficit hyperactivity disorder. Results of few studies demonstrate negative associations between phthalate levels commonly experienced by the public and impaired sperm quality (concentration, morphology, motility). Phthalates negatively impact also on gestational age and head circumference; however, the results of the studies were not consistent. In all the reviewed studies, exposure to phthalates adversely affected the level of reproductive hormones (luteinizing hormone, free testosterone, sex hormone-binding globulin), anogenital distance and thyroid function. The urinary levels of phthalates were significantly higher in the pubertal gynecomastia group, in serum in girls with premature thelarche and in girls with precocious puberty. Epidemiological studies, in spite of their limitations, suggest that phthalates may affect reproductive outcome and children health

  15. The Role of Stress Exposure and Family Functioning in Internalizing Outcomes of Urban Families.

    Science.gov (United States)

    Sheidow, Ashli J; Henry, David B; Tolan, Patrick H; Strachan, Martha K

    2014-11-01

    Although research suggests that stress exposure and family functioning are associated with internalizing problems in adolescents and caregivers, surprisingly few studies have investigated the mechanisms that underlie this association. To determine whether family functioning buffers the development of internalizing problems in stress-exposed families, we assessed the relation between stress exposure, family functioning, and internalizing symptoms among a large sample of inner-city male youth and their caregivers living in poverty across five waves of data collection. We hypothesized that stress exposure and family functioning would predict development of subsequent youth and caregiver internalizing problems and that family functioning would moderate this relation, with higher functioning families demonstrating greater resiliency to stress exposure. We used a longitudinal, prospective design to evaluate whether family functioning (assessed at waves one through four) activated or buffered the effects of stress exposure (assessed at wave one) on subsequent internalizing symptoms (assessed at waves four and five). Stress from Developmental Transitions and family functioning were significant predictors of depressive symptoms and anxiety in youth; however, family functioning did not moderate the relation. Family functioning mediated the relation between stress from Daily Hassles and internalizing outcomes suggesting that poor parenting practices, low structure, and low emotional cohesion activate depression and anxiety in youth exposed to chronic and frequent everyday stressors. Surprisingly, only family functioning predicted depressive symptoms in caregivers. Results validate the use of a comprehensive, multi-informant assessment of stress when investigating internalizing outcomes in youth and support using family-based interventions in the treatment and prevention of internalizing.

  16. Prenatal Heavy Metal Exposure and Adverse Birth Outcomes in Myanmar: A Birth-Cohort Study

    Directory of Open Access Journals (Sweden)

    Kyi Mar Wai

    2017-11-01

    Full Text Available Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. This study is part of a birth-cohort study conducted with 419 pregnant women in the Ayeyarwady Division, Myanmar. Face-to-face interviews were performed using a questionnaire, and maternal spot urine samples were collected at the third trimester. Birth outcomes were evaluated at delivery during the follow up. The median values of adjusted urinary arsenic, cadmium, selenium and lead concentration were 74.2, 0.9, 22.6 and 1.8 μg/g creatinine, respectively. Multivariable logistic regression revealed that prenatal cadmium exposure (adjusted odds ratio (OR = 1.10; 95% confidence interval (CI: 1.01–1.21; p = 0.043, gestational age (adjusted OR = 0.83; 95% CI: 0.72–0.95; p = 0.009 and primigravida mothers (adjusted OR = 4.23; 95% CI: 1.31–13.65; p = 0.016 were the predictors of low birth weight. The present study identified that Myanmar mothers were highly exposed to cadmium. Prenatal maternal cadmium exposure was associated with an occurrence of low birth weight.

  17. Prenatal Heavy Metal Exposure and Adverse Birth Outcomes in Myanmar: A Birth-Cohort Study.

    Science.gov (United States)

    Wai, Kyi Mar; Mar, Ohn; Kosaka, Satoko; Umemura, Mitsutoshi; Watanabe, Chiho

    2017-11-03

    Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. This study is part of a birth-cohort study conducted with 419 pregnant women in the Ayeyarwady Division, Myanmar. Face-to-face interviews were performed using a questionnaire, and maternal spot urine samples were collected at the third trimester. Birth outcomes were evaluated at delivery during the follow up. The median values of adjusted urinary arsenic, cadmium, selenium and lead concentration were 74.2, 0.9, 22.6 and 1.8 μg/g creatinine, respectively. Multivariable logistic regression revealed that prenatal cadmium exposure (adjusted odds ratio (OR) = 1.10; 95% confidence interval (CI): 1.01-1.21; p = 0.043), gestational age (adjusted OR = 0.83; 95% CI: 0.72-0.95; p = 0.009) and primigravida mothers (adjusted OR = 4.23; 95% CI: 1.31-13.65; p = 0.016) were the predictors of low birth weight. The present study identified that Myanmar mothers were highly exposed to cadmium. Prenatal maternal cadmium exposure was associated with an occurrence of low birth weight.

  18. Biomarkers, lactate, and clinical scores as outcome predictors in systemic poisons exposures.

    Science.gov (United States)

    Lionte, C; Sorodoc, V; Tuchilus, C; Cimpoiesu, D; Jaba, E

    2017-07-01

    Acute exposure to systemic poisons represents an important challenge in clinical toxicology. We aimed to analyze the potential role of cardiac biomarkers, routine laboratory tests, and clinical scores as morbidity and in-hospital mortality predictors in patients intoxicated with various systemic poisons. We conducted a prospective study on adults acutely exposed to systemic poisons. We determined the PSS, Glasgow Coma Scale (GCS), and we performed electrocardiogram, laboratory tests, lactate and cardiac biomarkers (which were reassessed 4 h, respectively 6 h later). Of 120 patients included, 45% developed complications, 19.2% had a poor outcome, and 5% died. Multivariate logistic regression sustained lactate (odds ratio (OR) 1.58; confidence interval (CI) 95%: 0.97-2.59; p 0.066), MB isoenzyme of creatine kinase (6h-CKMB; OR 1.08; CI 95%: 1.02-1.16; p 0.018) as predictors for a poor outcome. A GCS poisons exposure. Receiver operating characteristic analysis showed that brain natriuretic peptide (area under the curve (AUC), 0.96; CI 95%: 0.92-0.99; p poisons exposure.

  19. Birth outcome measures and prenatal exposure to 4-tert-octylphenol

    International Nuclear Information System (INIS)

    Lv, Shenliang; Wu, Chunhua; Lu, Dasheng; Qi, Xiaojuan; Xu, Hao; Guo, Jianqiu; Liang, Weijiu; Chang, XiuLi

    2016-01-01

    Exposure to 4-tert-octylphenol (tOP) has been linked with adverse health outcomes in animals and humans, while epidemiological studies about associations between prenatal exposure to tOP and fetal growth are extremely limited. We measured urinary tOP concentrations in 1100 pregnant women before their delivery, and examined whether tOP levels were associated with birth outcomes, including weight, length, head circumference and ponderal index at birth. tOP could be detected in all samples, and the median uncorrected and creatinine-corrected tOP concentrations were 0.90 μg/L (range from 0.25 to 20.05 μg/L) and 1.33 μg/g creatinine (range from 0.15 to 42.49 μg/g creatinine), respectively. Maternal urinary log-transformed tOP concentrations were significantly negatively associated with adjusted birth weight [β (g) = −126; 95% confidence interval (CI): −197, −55], birth length [β (cm) = −0.53; 95% CI:−0.93, −0.14], and head circumference [β (cm) = −0.30; 95% CI: −0.54, −0.07], respectively. Additionally, considering sex difference, these significant negative associations were also found among male neonates, while only higher maternal tOP concentrations were associated with a significant decrease in birth weight among female neonates. This study suggested significant negative associations between maternal urinary tOP concentrations and neonatal sizes at birth, and they differed by neonatal sex. Further epidemiological studies are required to more fully elaborate the associations between prenatal tOP exposure and birth outcomes. - Highlights: • We measured 4-tert-octylphenol (tOP) in urine from 1100 Chinese pregnant women. • The associations between maternal tOP levels and birth outcomes were investigated. • Prenatal exposure to tOP in the selected area was widespread at higher levels. • Maternal tOP levels were significantly negatively associated with birth sizes. • The associations between tOP and birth outcomes might

  20. Prospective study of pregnancy outcomes after parental cell phone exposure: the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Baste, Valborg; Oftedal, Gunnhild; Møllerløkken, Ole Jacob; Mild, Kjell Hansson; Moen, Bente E

    2015-07-01

    Research about prenatal exposure to electromagnetic fields from cell phones among expectant parents and reproductive outcome is limited. The aim of this article is to investigate the association between pregnancy outcome and parental cell phone exposure in a large prospective study. The study was based on the Norwegian Mother and Child Cohort Study conducted during the decade 1999-2009. In that study, pregnant women were recruited before a routine ultrasound examination during gestational week 15; they answered a questionnaire at that time and again around gestational week 30. The expectant father was invited to answer a questionnaire during gestational week 15 (2001-2009). The forms contained questions regarding cell phone use. The response rate was 38.7% and the cohort comprised 100,730 singleton births. Pregnancy outcomes were obtained by linkage to the Medical Birth Registry of Norway. The risk of preeclampsia was slightly lower among women with medium and high cell phone exposure compared with low exposure after adjusting for potential confounders. Fathers with testis exposure when using cell phones had a borderline increased risk of perinatal mortality among offspring and a slightly decreased risk of partner developing preeclampsia during pregnancy compared with no cell phone exposure of head or testis. None of the other pregnancy outcomes was associated with cell phone exposure. We found no association between maternal prenatal or paternal preconceptional cell phone exposure and any of the studied pregnancy outcomes. The only risk estimate suggesting a potential increased risk was not consistent with other findings.

  1. Pregnancy outcome after risk assessment of occupational exposure to organic solvents: a prospective cohort study.

    Science.gov (United States)

    Testud, François; D'Amico, Andrea; Lambert-Chhum, Rachel; Garayt, Christelle; Descotes, Jacques

    2010-11-01

    A rational medical, occupational and toxicological approach is instrumental to select objectively among pregnant women exposed to chemicals at the workplace those who should be withdrawn or benefit from improvements of working conditions. Risk assessment is based on a comprehensive review of compounds' hazards and a thorough evaluation of the actual exposure including biomonitoring whenever as possible. Since 1996, the Lyon Poison Center has been conducting a prospective follow-up of pregnant women exposed to chemicals at the workplace. Of these, 206 exposed to organic solvents since conception were selected and matched with 206 exposed to a non-embryotoxic agent. Total withdrawal from the workplace was recommended in 22% of cases, but exposure was not considered to be hazardous to pregnancy in 51%. Overall, no increase in adverse outcomes was found. Maintaining pregnant women at their workplace, particularly most of the laboratory technicians, is reasonably possible after careful toxicological risk assessment. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. In Utero Exposure to Compounds with Dioxin-like Activity and Birth Outcomes

    DEFF Research Database (Denmark)

    Vafeiadi, Marina; Agramunt, Silvia; Pedersen, Marie

    2014-01-01

    BACKGROUND: Maternal exposure to dioxins and dioxin-like compounds may affect fetal growth and development. We evaluated the association between in utero dioxin-like activity and birth outcomes in a prospective European mother-child study. METHODS: We measured dioxin-like activity in maternal...... and cord blood plasma samples collected at delivery using the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR CALUX) bioassay in 967 mother-child pairs, in Denmark, Greece, Norway, Spain, and England. Multiple linear regression models were used to investigate the associations with birth...... weight, gestational age, and head circumference. RESULTS: Plasma dioxin-like activity was higher in maternal sample than in cord samples. Birth weight was lower with medium (-58 g [95% confidence interval (CI) = -176 to 62]) and high (-82 g [-216 to 53]) tertiles of exposure (cord blood) compared...

  3. Bias and power in group-based epidemiologic studies of low-back pain exposure and outcome--effects of study size and exposure measurement efforts.

    Science.gov (United States)

    Coenen, Pieter; Mathiassen, Svend Erik; Kingma, Idsart; Boot, Cécile R L; Bongers, Paulien M; van Dieën, Jaap H

    2015-05-01

    Exposure-outcome studies, for instance on work-related low-back pain (LBP), often classify workers into groups for which exposures are estimated from measurements on a sample of workers within or outside the specific study. The present study investigated the influence on bias and power in exposure-outcome associations of the sizes of the total study population and the sample used to estimate exposures. At baseline, lifting, trunk flexion, and trunk rotation were observed for 371 of 1131 workers allocated to 19 a-priori defined occupational groups. LBP (dichotomous) was reported by all workers during 3 years of follow-up. All three exposures were associated with LBP in this parent study (P power (P power >0.80 (P level = 0.05). A similar performance required n ≥ 30 workers for rotated trunk. Small numbers of observed workers (k) resulted in biased OR, while power was, in general, more sensitive to the total number of workers (n). In epidemiologic studies using a group-based exposure assessment strategy, statistical performance may be sufficient if outcome is obtained from a reasonably large number of workers, even if exposure is estimated from only few workers per group. © The Author 2014. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

  4. Exposure to power-frequency magnetic fields and the risk of infertility and adverse pregnancy outcomes: update on the human evidence and recommendations for future study designs

    Science.gov (United States)

    Lewis, Ryan C.; Hauser, Russ; Maynard, Andrew D.; Neitzel, Richard L.; Wang, Lu; Kavet, Robert; Meeker, John D.

    2016-01-01

    Infertility and adverse pregnancy outcomes are significant public health concerns with global prevalence. Over the past 35 years, research has addressed whether exposure to power-frequency magnetic fields is one of the etiologic factors attributed to these conditions. However, no apparent authoritative reviews on this topic have been published in the peer-reviewed literature for nearly 15 years. This review provides an overview and critical analysis of human studies that were published in the peer-reviewed literature between 2002 and July 2015. Using PubMed, 13 epidemiology studies published during this timeframe that concern exposure to magnetic fields and adverse prenatal (e.g., miscarriage), neonatal (e.g., preterm birth or birth defects), and male fertility (e.g., poor semen quality) outcomes were identified. Some of these studies reported associations whereas others did not, and study design limitations may explain these inconsistencies. Future investigations need to be designed with these limitations in mind to address existing research gaps. In particular, the following issues are discussed: 1) importance of selecting the appropriate study population, 2) need for addressing confounding due to unmeasured physical activity, 3) importance of minimizing information bias from exposure measurement error, 4) consideration of alternative magnetic field exposure metrics, and 5) implications and applications of personal exposure data that is correlated within female-male couples. Further epidemiologic research is needed given the near ubiquitous exposures to power-frequency magnetic fields in the general population. PMID:27030583

  5. Violent crime exposure classification and adverse birth outcomes: a geographically-defined cohort study

    Directory of Open Access Journals (Sweden)

    Herring Amy

    2006-05-01

    Full Text Available Abstract Background Area-level socioeconomic disparities have long been associated with adverse pregnancy outcomes. Crime is an important element of the neighborhood environment inadequately investigated in the reproductive and public health literature. When crime has been used in research, it has been variably defined, resulting in non-comparable associations across studies. Methods Using geocoded linked birth record, crime and census data in multilevel models, this paper explored the relevance of four spatial violent crime exposures: two proximal violent crime categorizations (count of violent crime within a one-half mile radius of maternal residence and distance from maternal residence to nearest violent crime and two area-level crime categorizations (count of violent crimes within a block group and block group rate of violent crimes for adverse birth events among women in living in the city of Raleigh NC crime report area in 1999–2001. Models were adjusted for maternal age and education and area-level deprivation. Results In black and white non-Hispanic race-stratified models, crime characterized as a proximal exposure was not able to distinguish between women experiencing adverse and women experiencing normal birth outcomes. Violent crime characterized as a neighborhood attribute was positively associated with preterm birth and low birth weight among non-Hispanic white and black women. No statistically significant interaction between area-deprivation and violent crime category was observed. Conclusion Crime is variably categorized in the literature, with little rationale provided for crime type or categorization employed. This research represents the first time multiple crime categorizations have been directly compared in association with health outcomes. Finding an effect of area-level violent crime suggests crime may best be characterized as a neighborhood attribute with important implication for adverse birth outcomes.

  6. The Influence of Methotrexate Treatment on Male Fertility and Pregnancy Outcome After Paternal Exposure.

    Science.gov (United States)

    Grosen, Anne; Kelsen, Jens; Hvas, Christian Lodberg; Bellaguarda, Emanuelle; Hanauer, Stephen B

    2017-04-01

    Inflammatory bowel disease incidence peaks during the reproductive years. Methotrexate (MTX) is frequently used for inflammatory bowel disease, but its use during pregnancy is contraindicated in women because of teratogenic effects. The aim of this review is to investigate the influence of MTX on male fertility and pregnancy outcomes after paternal MTX exposure. A systematic literature search was performed by applying 2 focus areas, "methotrexate" and "male fertility or pregnancy outcome." Terms and keywords were used both as MeSH terms and free-text searches. Pertinent articles were searched for additional relevant references. In animal studies, MTX induces aberrations in sperm DNA that have not been identified in humans. The effects of MTX on human sperm quality have only been described in case reports. A transient adverse effect on sperm quality with low-dose MTX has been reported, but several other cases have not found harmful effects of MTX. MTX has not been measured in human sperm ejaculates; yet, the risk of a direct toxic effect on the fetus through MTX-contaminated seminal plasma seems negligible. Until now, 284 pregnancies with paternal MTX exposure have been reported. The outcomes were 248 live births and a total of 13 malformations, with no overt indication of MTX embryopathy. This review reveals the lack of studies on the safety of MTX with regard to male reproduction. It is not clear whether MTX transiently influences male fertility and sperm DNA integrity, and more studies are needed. Comparative cohort studies found no increased risk of adverse pregnancy outcomes.

  7. Fetal magnetic resonance imaging: exposure times and functional outcomes at preschool age

    Energy Technology Data Exchange (ETDEWEB)

    Bouyssi-Kobar, Marine [George Washington University, Institute for Biomedical Sciences, Washington, DC (United States); Children' s National Health System, Advanced Pediatric Brain Imaging Research Laboratory, Departments of Diagnostic Imaging and Radiology, Washington, DC (United States); Du Plessis, Adre J. [Children' s National Health System, Fetal and Transitional Medicine, Washington, DC (United States); Robertson, Richard L. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States); Limperopoulos, Catherine [Children' s National Health System, Advanced Pediatric Brain Imaging Research Laboratory, Departments of Diagnostic Imaging and Radiology, Washington, DC (United States); Children' s National Health System, Fetal and Transitional Medicine, Washington, DC (United States)

    2015-11-15

    Fetal magnetic resonance imaging (MRI) has been routinely used as a noninvasive diagnostic tool for more than a decade; however, there is a paucity of follow-up studies examining the effects of prenatal exposure to 1.5-T MRI on developmental outcome. The objective of this study was to assess the safety of 1.5-T fetal MRI by evaluating functional outcomes of preschool children who were exposed in utero. In the context of a prospective observational study, healthy pregnant women underwent a 1.5-T MRI study using single-shot fast spin echo (SSFSE) sequences during the second or third trimester of pregnancy. The study was approved by the institutional review board at our institution, and written informed consent was obtained from all study participants. MRI scanning times were recorded, and prenatal/postnatal clinical data were collected prospectively. Functional outcomes were assessed using the Vineland Adaptive Behavior Scale (VABS), a widely used, norm-referenced and psychometrically sound functional assessment. We studied 72 healthy pregnant women, who underwent fetal MRI at a mean gestational age of 30.5 ± 3.1 weeks. The cohort of fetuses was composed of 43% females, and 18 fetuses were scanned during the second trimester. All fetuses were born at term with appropriate birth weights (3.54 ± 0.5 kg) for gestational age. Mean age at follow-up testing was 24.5 ± 6.7 months. All children had age-appropriate scores in the communication, daily living, socialization and motor skills subdomains of the VABS (z-scores, P > 0.05). Furthermore, all children passed their newborn otoacoustic emission test and had normal hearing at preschool age. MRI study duration and exposure time to radio frequency waves and SSFSE sequences were not associated with adverse functional outcomes or hearing impairment. Prenatal exposure to 1.5-T MRI during the second or third trimester of pregnancy in a cohort of healthy fetuses is not associated with disturbances in functional outcomes or

  8. Fetal magnetic resonance imaging: exposure times and functional outcomes at preschool age

    International Nuclear Information System (INIS)

    Bouyssi-Kobar, Marine; Du Plessis, Adre J.; Robertson, Richard L.; Limperopoulos, Catherine

    2015-01-01

    Fetal magnetic resonance imaging (MRI) has been routinely used as a noninvasive diagnostic tool for more than a decade; however, there is a paucity of follow-up studies examining the effects of prenatal exposure to 1.5-T MRI on developmental outcome. The objective of this study was to assess the safety of 1.5-T fetal MRI by evaluating functional outcomes of preschool children who were exposed in utero. In the context of a prospective observational study, healthy pregnant women underwent a 1.5-T MRI study using single-shot fast spin echo (SSFSE) sequences during the second or third trimester of pregnancy. The study was approved by the institutional review board at our institution, and written informed consent was obtained from all study participants. MRI scanning times were recorded, and prenatal/postnatal clinical data were collected prospectively. Functional outcomes were assessed using the Vineland Adaptive Behavior Scale (VABS), a widely used, norm-referenced and psychometrically sound functional assessment. We studied 72 healthy pregnant women, who underwent fetal MRI at a mean gestational age of 30.5 ± 3.1 weeks. The cohort of fetuses was composed of 43% females, and 18 fetuses were scanned during the second trimester. All fetuses were born at term with appropriate birth weights (3.54 ± 0.5 kg) for gestational age. Mean age at follow-up testing was 24.5 ± 6.7 months. All children had age-appropriate scores in the communication, daily living, socialization and motor skills subdomains of the VABS (z-scores, P > 0.05). Furthermore, all children passed their newborn otoacoustic emission test and had normal hearing at preschool age. MRI study duration and exposure time to radio frequency waves and SSFSE sequences were not associated with adverse functional outcomes or hearing impairment. Prenatal exposure to 1.5-T MRI during the second or third trimester of pregnancy in a cohort of healthy fetuses is not associated with disturbances in functional outcomes or

  9. Neonatal Morphine Exposure in Very Preterm Infants – Cerebral Development and Outcomes

    Science.gov (United States)

    Steinhorn, Rachel; McPherson, Chris; Anderson, Peter J; Neil, Jeffrey; Doyle, Lex W; Inder, Terrie

    2015-01-01

    Objective To investigate the association of morphine exposure in very preterm infants with cerebral volumes and neurodevelopmental outcome from birth through middle childhood. Study design Observational study of very preterm infants in the Victorian Infant Brain Study cohort. 230 infants born neonatal intensive care unit (NICU) of the Royal Women’s Hospital. 57 (25%) infants received morphine analgesia during their NICU stay at the attending physician’s discretion. Primary outcomes were regional brain volumes at term and 7 years; neurobehavioral performance at term; and cognitive, motor, emotional, behavioral, communication, and executive function scores at age 2 and 7 years. Linear regressions were used to compare outcomes between participants who did and did not receive morphine. Results At term, preterm infants who received morphine had similar rates of grey matter injury to no-morphine infants, but a trend towards smaller cortical volumes in the orbitofrontal (pleft=0.002, pright=0.01) and subgenual (pleft=0.01) regions. At seven years, cortical volumes did not differ between groups. At 2 years, morphine-exposed children were more likely to show behavioral dysregulation (p=0.007) than no-morphine children, but at seven years no detrimental impacts of morphine on neurobehavioral outcome were observed. Conclusions Low-dose morphine analgesia received during neonatal intensive care was associated with early alterations in cerebral structure and short-term neurobehavioral problems that did not persist into childhood. PMID:25919729

  10. Timing and Duration of Drug Exposure Affects Outcomes of a Drug-Nutrient Interaction During Ontogeny

    Directory of Open Access Journals (Sweden)

    Jane Alcorn

    2010-10-01

    Full Text Available Significant drug-nutrient interactions are possible when drugs and nutrients share the same absorption and disposition mechanisms. During postnatal development, the outcomes of drug-nutrient interactions may change with postnatal age since these processes undergo ontogenesis through the postnatal period. Our study investigated the dependence of a significant drug-nutrient interaction (cefepime-carnitine on the timing and duration of drug exposure relative to postnatal age. Rat pups were administered cefepime (5 mg/kg twice daily subcutaneously according to different dosing schedules (postnatal day 1-4, 1-8, 8-11, 8-20, or 1-20. Cefepime significantly reduced serum and heart L-carnitine levels in postnatal day 1-4, 1-8 and 8-11 groups and caused severe degenerative changes in ventricular myocardium in these groups. Cefepime also altered the ontogeny of several key L-carnitine homeostasis pathways. The qualitative and quantitative changes in levels of hepatic γ-butyrobetaine hydroxylase mRNA and activity, hepatic trimethyllysine hydroxlase mRNA, intestinal organic cation/carnitine transporter (Octn mRNA, and renal Octn2 mRNA depended on when during postnatal development the cefepime exposure occurred and duration of exposure. Despite lower levels of heart L-carnitine in earlier postnatal groups, levels of carnitine palmitoyltransferase mRNA and activity, heart Octn2 mRNA and ATP levels in all treatment groups remained unchanged with cefepime exposure. However, changes in other high energy phosphate substrates were noted and reductions in the phosphocreatine/ATP ratio were found in rat pups with normal serum L-carnitine levels. In summary, our data suggest a significant drug-nutrient transport interaction in developing neonates, the nature of which depends on the timing and duration of exposure relative to postnatal age.

  11. The associations between birth outcomes and satellite-estimated maternal PM2.5 exposure in Shanghai, China

    Science.gov (United States)

    Xiao, Q.; Liu, Y.; Strickland, M. J.; Chang, H. H.; Kan, H.

    2017-12-01

    Background: Satellite remote sensing data have been employed for air pollution exposure assessment, with the intent of better characterizing exposure spatio-temproal variations. However, non-random missingness in satellite data may lead to exposure error. Objectives: We explored the differences in health effect estimates due to different exposure metrics, with and without satellite data, when analyzing the associations between maternal PM2.5 exposure and birth outcomes. Methods: We obtained birth registration records of 132,783 singleton live births during 2011-2014 in Shanghai. Trimester-specific and total pregnancy exposures were estimated from satellite PM2.5 predictions with missingness, gap-filled satellite PM2.5 predictions with complete coverage and regional average PM2.5 measurements from monitoring stations. Linear regressions estimated associations between birth weight and maternal PM2.5 exposure. Logistic regressions estimated associations between preterm birth and the first and second trimester exposure. Discrete-time models estimated third trimester and total pregnancy associations with preterm birth. Effect modifications by maternal age and parental education levels were investigated. Results: we observed statistically significant associations between maternal PM2.5 exposure during all exposure windows and adverse birth outcomes. A 10 µg/m3 increase in pregnancy PM2.5 exposure was associated with a 12.85 g (95% CI: 18.44, 7.27) decrease in birth weight for term births, and a 27% (95% CI: 20%, 36%) increase in the risk of preterm birth. Greater effects were observed between first and third trimester exposure and birth weight, as well as between first trimester exposure and preterm birth. Mothers older than 35 years and without college education tended to have higher associations with preterm birth. Conclusions: Gap-filled satellite data derived PM2.5 exposure estimates resulted in reduced exposure error and more precise health effect estimates.

  12. Phthalate Exposure and Health-Related Outcomes in Specific Types of Work Environment

    Directory of Open Access Journals (Sweden)

    Branislav Kolena

    2014-05-01

    Full Text Available Many toxic substances in the workplace can modify human health and quality of life and there is still insufficient data on respiratory outcomes in adults exposed to phthalates. The aim of this work was to assess in waste management workers from the Nitra region of Slovakia (n = 30 the extent of exposure to phthalates and health-related outcomes. Four urinary phthalate metabolites mono(2-ethylhexyl phthalate (MEHP, monobutyl phthalate (MnBP, monoethyl phthalate (MEP and monoisononyl phthalate (MiNP were determined by high-performance liquid chromatography with mass spectrometry (HPLC-MS/MS. Urinary concentration of MEHP was positively associated with ratio of forced expiratory volume in 1 s to forced vital capacity % (FEV1/FVC (r = 0.431; p = 0.018 and MiNP with fat free mass index (FFMI (r = 0.439; p = 0.015. The strongest predictor of pulmonary function was the pack/year index as smoking history that predicted a decrease of pulmonary parameters, the FEV1/FVC, % of predicted values of peak expiratory flow (PEF % of PV and FEV1 % of PV. Unexpectedly, urinary MEHP and MINP were positively associated with pulmonary function expressed as PEF % of PV and FEV1/FVC. We hypothesize that occupational exposure to phthalates estimated from urinary metabolites (MEHP, MiNP can modify pulmonary function on top of lifestyle factors.

  13. Health Outcomes of Exposure to Biological and Chemical Components of Inhalable and Respirable Particulate Matter.

    Science.gov (United States)

    Morakinyo, Oyewale Mayowa; Mokgobu, Matlou Ingrid; Mukhola, Murembiwa Stanley; Hunter, Raymond Paul

    2016-06-14

    Particulate matter (PM) is a key indicator of air pollution and a significant risk factor for adverse health outcomes in humans. PM is not a self-contained pollutant but a mixture of different compounds including chemical and biological fractions. While several reviews have focused on the chemical components of PM and associated health effects, there is a dearth of review studies that holistically examine the role of biological and chemical components of inhalable and respirable PM in disease causation. A literature search using various search engines and (or) keywords was done. Articles selected for review were chosen following predefined criteria, to extract and analyze data. The results show that the biological and chemical components of inhalable and respirable PM play a significant role in the burden of health effects attributed to PM. These health outcomes include low birth weight, emergency room visit, hospital admission, respiratory and pulmonary diseases, cardiovascular disease, cancer, non-communicable diseases, and premature death, among others. This review justifies the importance of each or synergistic effects of the biological and chemical constituents of PM on health. It also provides information that informs policy on the establishment of exposure limits for PM composition metrics rather than the existing exposure limits of the total mass of PM. This will allow for more effective management strategies for improving outdoor air quality.

  14. Health Outcomes of Exposure to Biological and Chemical Components of Inhalable and Respirable Particulate Matter

    Directory of Open Access Journals (Sweden)

    Oyewale Mayowa Morakinyo

    2016-06-01

    Full Text Available Particulate matter (PM is a key indicator of air pollution and a significant risk factor for adverse health outcomes in humans. PM is not a self-contained pollutant but a mixture of different compounds including chemical and biological fractions. While several reviews have focused on the chemical components of PM and associated health effects, there is a dearth of review studies that holistically examine the role of biological and chemical components of inhalable and respirable PM in disease causation. A literature search using various search engines and (or keywords was done. Articles selected for review were chosen following predefined criteria, to extract and analyze data. The results show that the biological and chemical components of inhalable and respirable PM play a significant role in the burden of health effects attributed to PM. These health outcomes include low birth weight, emergency room visit, hospital admission, respiratory and pulmonary diseases, cardiovascular disease, cancer, non-communicable diseases, and premature death, among others. This review justifies the importance of each or synergistic effects of the biological and chemical constituents of PM on health. It also provides information that informs policy on the establishment of exposure limits for PM composition metrics rather than the existing exposure limits of the total mass of PM. This will allow for more effective management strategies for improving outdoor air quality.

  15. Socio-environmental exposures and health outcomes among persons with sickle cell disease.

    Directory of Open Access Journals (Sweden)

    Monika R Asnani

    Full Text Available There is much variability in the expression of sickle cell disease (SCD and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to clinic. Persons travelled relatively long distances to seek SCD care and those travelling longer had less health maintenance visits. Urban patients had a higher prevalence of significant pain crises (69.4% vs. 55.8%, p value<0.001 and respiratory events (21.2% vs. 14%, p value<0.001. Prevalence of leg ulcers did not vary between rural and urban patients but was higher in males than in females. Females also had lower odds of having respiratory events but there was no sex difference in history of painful crises. Persons with more severe genotypes lived in higher poverty and travelled longer for healthcare services. Persons in areas with higher annual rainfall, higher mean temperatures and living farther from factories had less painful crises and respiratory events. The paper highlights a need for better access to healthcare services for Jamaicans with SCD especially in rural areas of the island. It also reports interesting associations between environmental climatic exposures and health outcomes.

  16. Systematic Review of Chromium and Nickel Exposure During Pregnancy and Impact on Child Outcomes.

    Science.gov (United States)

    McDermott, Suzanne; Salzberg, Deborah C; Anderson, Anna Paige; Shaw, Timothy; Lead, Jamie

    2015-01-01

    Some forms of chromium (Cr) and nickel (Ni) are toxic, especially with chronic elevated exposure, and certain forms such as hexavalent chromium or nickel carbonyl were labeled as carcinogens. Since both metals are naturally occurring, and used in industrial processes, individuals may be exposed through ingestion of contaminated food or water, inhalation, or dermal contact. This study focused on the impact of toxic forms of Cr and Ni during pregnancy and outcomes in newborn and young children. A systematic literature review following "The Navigation Guide" was applied, and 16 reports that satisfied the inclusion criteria were scored. Six papers studied birth weight, prematurity, or gestational age: one found an association between Ni and small for gestational age, while another linked Ni with low birth weight; however, four reported no marked associations. Of six studies that examined birth defects, three found no significant associations; one noted an association between Ni and neural tube defects; one showed an association between Ni and structural birth defects; and one reported a weak effect for Cr exposure and musculoskeletal defects. In the remaining four studies, weak associations were found for hexavalent Cr and neuroblastoma, Ni and autism spectrum disorder, Cr and Ni and DNA damage, and Cr and lymphocyte damage. Among the studies that were rated as good for execution and reliability, there was weak evidence of an association between Ni and autism spectrum disorder and small for gestational age, but no significant association between Cr and a child outcome.

  17. A meta-analysis of exposure to particulate matter and adverse birth outcomes

    Directory of Open Access Journals (Sweden)

    Dirga Kumar Lamichhane

    2015-11-01

    Full Text Available Objectives The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW and preterm birth (PTB after taking into consideration the potential confounding effect of maternal smoking. Methods We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to 2.5μm and 10.0 μm in diameter, PM2.5 and PM10, respectively from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. Results In random effects meta-analyses, BW as a continuous outcome was negativelyassociated with 10 μg/m3 increase in PM10 (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p=0.947 and PM2.5 (-22.17 g; 95% CI, -37.93 to -6.41 g; I-squared=92.3%, p <0.001 exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per 10 μg/m3 increase in PM10 (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p =0.977 and PM2.5 (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p <0.001 exposure during entire pregnancy was observed. Effect size of change in BW per 10 μg/m3 increase in PM tended to report stronger associations after adjustment for maternal smoking. Conclusions While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.

  18. The effect of shorter exposure versus prolonged exposure on treatment outcome in Tourette syndrome and chronic tic disorders - an open trial.

    Science.gov (United States)

    van de Griendt, Jolande M T M; van Dijk, Maarten K; Verdellen, Cara W J; Verbraak, Marc J P M

    2018-01-11

    Exposure and response prevention has shown to be an effective strategy and is considered a first-line intervention in the behavioural treatment of tic disorders. Prior research demonstrated significant tic reduction after 12 two hour sessions. In this open trial, the question is addressed whether, relative to these prolonged sessions, exposure sessions of shorter duration yield differential outcome for patients with tic disorders. A total of 29 patients diagnosed with Tourette syndrome (TS) or chronic tic disorder were treated with shorter exposure sessions (1 h), and these data were compared to the data from a study about prolonged exposure (2 h, n = 21). Outcome was measured by the Yale Global Tic Severity Scale (YGTSS). Results suggest that after taking the difference in illness duration between the two groups into account, the effectiveness of shorter exposure sessions is not inferior to that of prolonged exposure. Results suggest that treatment with shorter exposure might be more efficient and more patients can be reached. Future research is needed to gain more insight into the mechanisms underlying the efficacy of behavioural treatments for tics.

  19. Mediating role of stress reactivity in the effects of prenatal tobacco exposure on childhood mental health outcomes.

    Science.gov (United States)

    Park, Aesoon; O'Malley, Stephanie S; King, Sarah L; Picciotto, Marina R

    2014-02-01

    Prenatal tobacco exposure, through maternal smoking during pregnancy, has been associated with adverse mental health outcomes in childhood. However, the mechanisms by which prenatal tobacco exposure compromises mental health later in life are unclear. We hypothesized that sensitized reactivity to stressful life events in early childhood mediates the effect of prenatal tobacco exposure on mental health outcomes in middle childhood, after accounting for earlier mental health outcomes. Data were from 12,308 mothers and their children drawn from the Avon Longitudinal Study of Parents and Children, a large prospective population-based study. Mothers' self-reports of smoking during pregnancy, mothers' ratings of their child's reactivity to stressful life events, and teachers' and mothers' ratings of the Strengths and Difficulties Questionnaire assessing 5 domains of mental health outcomes were measured. A positive association was found between prenatal tobacco exposure and stress reactivity between the ages of 2 and 6. In turn, stress reactivity was positively associated with peer (isolation), hyperactivity, conduct, and emotional problems (but not prosocial behaviors) between the ages of 7 and 11, after accounting for the mental health outcome at age 4 and other confounders. Heightened stress reactivity in preschool ages mediated the effect of prenatal tobacco exposure on adverse mental health outcomes between the ages of 7 and 11. Interventions to assist children exposed to tobacco smoke during gestation in coping with stressful life events may help mitigate psychiatric symptoms in this population.

  20. Adverse pregnancy outcomes after exposure to methylphenidate or atomoxetine during pregnancy

    Directory of Open Access Journals (Sweden)

    Bro SP

    2015-01-01

    Full Text Available Søren Pauli Bro,1 Maiken Ina Siegismund Kjaersgaard,2 Erik Thorlund Parner,2 Merete Juul Sørensen,3 Jørn Olsen,4 Bodil Hammer Bech,4 Lars Henning Pedersen,4,5 Jakob Christensen,6,7 Mogens Vestergaard11Research Unit and Section for General Practice, Department of Public Health, 2Section for Biostatistics, Department of Public Health, Aarhus University, 3Regional Center for Child and Adolescent Psychiatry, Aarhus University Hospital, 4Section for Epidemiology, Department of Public Health, 5Department of Clinical Medicine – Obstetrics and Gynecology, Aarhus University, 6Department of Clinical Pharmacology, 7Department of Neurology, Aarhus University Hospital, Aarhus, DenmarkObjective: To determine if prenatal exposure to methylphenidate (MPH or atomoxetine (ATX increases the risk of adverse pregnancy outcomes in women with attention deficit/hyperactivity disorder (ADHD.Materials and methods: This was a population-based cohort study of all pregnancies in Denmark from 1997 to 2008. Information on use of ADHD medication, ADHD diagnosis, and pregnancy outcomes was obtained from nationwide registers.Results: We identified 989,932 pregnancies, in which 186 (0.02% women used MPH/ATX and 275 (0.03% women had been diagnosed with ADHD but who did not take MPH/ATX. Our reference pregnancies had no exposure to MPH/ATX and no ADHD diagnosis. Exposure to MPH/ATX was associated with an increased risk of spontaneous abortion (SA; ie, death of an embryo or fetus in the first 22 weeks of gestation (adjusted relative risk [aRR] 1.55, 95% confidence interval [CI] 1.03–2.36. The risk of SA was also increased in pregnancies where the mother had ADHD but did not use MPH/ATX (aRR 1.56, 95% CI 1.11–2.20. The aRR of Apgar scores <10 was increased among exposed women (aRR 2.06, 95% CI 1.11–3.82 but not among unexposed women with ADHD (aRR 0.99, 95% CI 0.48–2.05.Conclusion: MPH/ATX was associated with a higher risk of SA, but our study indicated that it may at

  1. Measuring lifetime stress exposure and protective factors in life course research on racial inequality and birth outcomes.

    Science.gov (United States)

    Malat, Jennifer; Jacquez, Farrah; Slavich, George M

    2017-07-01

    There has been a long-standing interest in better understanding how social factors contribute to racial disparities in health, including birth outcomes. A recent emphasis in this context has been on identifying the effects of stress exposure and protective factors experienced over the entire lifetime. Yet despite repeated calls for a life course approach to research on this topic, very few studies have actually assessed how stressors and protective factors occurring over women's lives relate to birth outcomes. We discuss this issue here by describing how challenges in the measurement of lifetime stress exposure and protective factors have prevented researchers from developing an empirically-based life course perspective on health. First, we summarize prevailing views on racial inequality and birth outcomes; second, we discuss measurement challenges that exist in this context; and finally, we describe both new tools and needed tools for assessing lifetime stress exposure and suggest opportunities for integrating information on stress exposure and psychosocial protective factors. We conclude that more studies are needed that integrate information about lifetime stress exposures and the protective factors that promote resilience against such exposures to inform policy and practice recommendations to reduce racial disparities in birth outcomes.

  2. Impact of Fluoroquinolone Exposure Prior to Tuberculosis Diagnosis on Clinical Outcomes in Immunocompromised Patients.

    Science.gov (United States)

    Lee, Ju Young; Lee, Hyun Jung; Kim, Yong Kyun; Yu, Shinae; Jung, Jiwon; Chong, Yong Pil; Lee, Sang-Oh; Choi, Sang-Ho; Shim, Tae Sun; Kim, Yang Soo; Woo, Jun Hee; Kim, Sung-Han

    2016-07-01

    There have been concerns about an association of fluoroquinolone (FQ) use prior to tuberculosis (TB) diagnosis with adverse outcomes. However, FQ use might prevent clinical deterioration in missed TB patients, especially in those who are immunocompromised, until they receive definitive anti-TB treatment. All adult immunocompromised patients with smear-negative and culture-positive TB at a tertiary care hospital in Korea over a 2-year period were included in this study. Long-term FQ (≥7 days) use was defined as exposure to FQ for at least 7 days prior to TB diagnosis. A total of 194 patients were identified: 33 (17%) in the long-term FQ group and 161 (83%) in the comparator, including a short-term FQ group (n = 23), non-FQ group (n = 78), and a group receiving no antibiotics (n = 60). Patients in the long-term FQ group presented with atypical chest radiologic pattern more frequently than those in the comparator (77% [24/31] versus 46% [63/138]; P = 0.001). The median time from mycobacterial test to positive mycobacterial culture appeared to be longer in the long-term FQ group (8.1 weeks versus 7.7 weeks; P = 0.09), although the difference was not statistically significant. Patients in the long-term FQ group were less likely to receive empirical anti-TB treatment (55% versus 74%; P = 0.03). The median time from mycobacterial test to anti-TB therapy was longer in the long-term FQ group (4.6 weeks versus 2.2 weeks; P 0.99) or in the 30-day (6% versus 6%; P > 0.99) or 90-day (12% versus 12%; P > 0.99) mortality rate between the two groups. FQ exposure (≥7 days) prior to TB diagnosis in immunocompromised patients appears not to be associated with adverse outcomes. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  3. Application of Six Sigma towards improving surgical outcomes.

    Science.gov (United States)

    Shukla, P J; Barreto, S G; Nadkarni, M S

    2008-01-01

    Six Sigma is a 'process excellence' tool targeting continuous improvement achieved by providing a methodology for improving key steps of a process. It is ripe for application into health care since almost all health care processes require a near-zero tolerance for mistakes. The aim of this study is to apply the Six Sigma methodology into a clinical surgical process and to assess the improvement (if any) in the outcomes and patient care. The guiding principles of Six Sigma, namely DMAIC (Define, Measure, Analyze, Improve, Control), were used to analyze the impact of double stapling technique (DST) towards improving sphincter preservation rates for rectal cancer. The analysis using the Six Sigma methodology revealed a Sigma score of 2.10 in relation to successful sphincter preservation. This score demonstrates an improvement over the previous technique (73% over previous 54%). This study represents one of the first clinical applications of Six Sigma in the surgical field. By understanding, accepting, and applying the principles of Six Sigma, we have an opportunity to transfer a very successful management philosophy to facilitate the identification of key steps that can improve outcomes and ultimately patient safety and the quality of surgical care provided.

  4. Applicability of an exposure model for the determination of emissions from mobile phone base stations

    DEFF Research Database (Denmark)

    Breckenkamp, J; Neitzke, H P; Bornkessel, C

    2008-01-01

    Applicability of a model to estimate radiofrequency electromagnetic field (RF-EMF) strength in households from mobile phone base stations was evaluated with technical data of mobile phone base stations available from the German Net Agency, and dosimetric measurements, performed in an epidemiologi......Applicability of a model to estimate radiofrequency electromagnetic field (RF-EMF) strength in households from mobile phone base stations was evaluated with technical data of mobile phone base stations available from the German Net Agency, and dosimetric measurements, performed...... in an epidemiological study. Estimated exposure and exposure measured with dosemeters in 1322 participating households were compared. For that purpose, the upper 10th percentiles of both outcomes were defined as the 'higher exposed' groups. To assess the agreement of the defined 'higher' exposed groups, kappa...... coefficient, sensitivity and specificity were calculated. The present results show only a weak agreement of calculations and measurements (kappa values between -0.03 and 0.28, sensitivity between 7.1 and 34.6). Only in some of the sub-analyses, a higher agreement was found, e.g. when measured instead...

  5. Therapist-Aided Exposure for Women with Lifelong Vaginismus: Mediators of Treatment Outcome: A Randomized Waiting List Control Trial.

    Science.gov (United States)

    Ter Kuile, Moniek M; Melles, Reinhilde J; Tuijnman-Raasveld, Charlotte C; de Groot, Helen E; van Lankveld, Jacques J D M

    2015-08-01

    Therapist-aided exposure seems an effective treatment for lifelong vaginismus, but mechanisms of action have not yet been established. The purpose of the present study was to investigate whether treatment outcome of a therapist-aided exposure treatment was mediated by changes in positive and negative penetration beliefs or feelings of sexual disgust. Participants with lifelong vaginismus were allocated at random to a 3-month exposure (n = 35) or a waiting list control condition (n = 35). Full intercourse was assessed daily during 12 weeks. Secondary outcome measures (complaints about vaginismus and coital pain) were assessed at baseline and after 12 weeks. Possible mediators: penetration beliefs (catastrophic pain beliefs, genital incompatibility beliefs, perceived control beliefs) and feelings of sexual disgust were assessed at baseline and 6 weeks. Treatment outcome (coital frequency, symptoms of vaginismus, and coital pain) at 12 weeks was mediated by changes in negative and positive penetration beliefs at 6 weeks, in particular by more pronounced reduction of catastrophic pain penetration beliefs. No evidence was found that changes in feelings of sexual disgust mediated treatment outcome. The results strongly suggest that therapist-aided exposure affects negative penetration beliefs and that these changes in negative penetration beliefs mediate treatment outcome in women with lifelong vaginismus. Implications for treatment are discussed. © 2015 International Society for Sexual Medicine.

  6. Indoor Exposure and Adverse Birth Outcomes Related to Fetal Growth, Miscarriage and Prematurity—A Systematic Review

    Directory of Open Access Journals (Sweden)

    Evridiki Patelarou

    2014-06-01

    Full Text Available The purpose of this review was to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution and all-day personal exposure with adverse birth outcomes including fetal growth, prematurity and miscarriage. We carried out a systematic literature search of MEDLINE and EMBASE databases with the aim of summarizing and evaluating the results of peer-reviewed epidemiological studies undertaken in “westernized” countries that have assessed indoor air pollution and all-day personal exposure with specific quantitative methods. This comprehensive literature search identified 16 independent studies which were deemed relevant for further review and two additional studies were added through searching the reference lists of all included studies. Two reviewers independently and critically appraised all eligible articles using the Critical Appraisal Skills Programme (CASP tool. Of the 18 selected studies, 14 adopted a prospective cohort design, three were case-controls and one was a retrospective cohort study. In terms of pollutants of interest, seven studies assessed exposure to electro-magnetic fields, four studies assessed exposure to polycyclic aromatic hydrocarbons, four studies assessed PM2.5 exposure and three studies assessed benzene, phthalates and noise exposure respectively. Furthermore, 12 studies examined infant growth as the main birth outcome of interest, six examined spontaneous abortion and three studies assessed gestational age at birth and preterm delivery. This survey demonstrates that there is insufficient research on the possible association of indoor exposure and early life effects and that further research is needed.

  7. Development of mild steel exposure chart for neutron radiography application

    International Nuclear Information System (INIS)

    Hafizal Yazid; Rafhayudi Jamro; Hishamuddin Husain; Muhammad Rawi Mohd Zin; Razali Kassim; Abd Aziz Mohamed; Azali Muhammad

    2004-01-01

    A neutron radiography exposure chart for mild steel was developed to facilitate the determination of exposure time when producing neutron radiographs for any given mild steel thickness. A mild steel sample in the form of step wedge (1-10 mm thick) was exposed to thermal neutron using Direct technique. This technique involves exposing x-ray film-Gadolinium converter housed in one film cassette simultaneously to thermal neutron beam. Gadolinium converters with thickness of 0.025 mm and 0.5 mm were used to observe the effect of converter thickness on radiographic density and exposure time. Collected radiographic density data is then calculated based on manufacturer's film characteristic chart and finally exposure chart for mild steel was plotted. This chart could later be used as a guide for estimating exposure time for any given sample thickness providing other conditions are similar (material, film processing, neutron flux, film density and converter thickness). (Author)

  8. A Workflow to Investigate Exposure and Pharmacokinetic Influences on High-Throughput in Vitro Chemical Screening Based on Adverse Outcome Pathways

    Science.gov (United States)

    Phillips, Martin B.; Leonard, Jeremy A.; Grulke, Christopher M.; Chang, Daniel T.; Edwards, Stephen W.; Brooks, Raina; Goldsmith, Michael-Rock; El-Masri, Hisham; Tan, Yu-Mei

    2015-01-01

    Background Adverse outcome pathways (AOPs) link adverse effects in individuals or populations to a molecular initiating event (MIE) that can be quantified using in vitro methods. Practical application of AOPs in chemical-specific risk assessment requires incorporation of knowledge on exposure, along with absorption, distribution, metabolism, and excretion (ADME) properties of chemicals. Objectives We developed a conceptual workflow to examine exposure and ADME properties in relation to an MIE. The utility of this workflow was evaluated using a previously established AOP, acetylcholinesterase (AChE) inhibition. Methods Thirty chemicals found to inhibit human AChE in the ToxCast™ assay were examined with respect to their exposure, absorption potential, and ability to cross the blood–brain barrier (BBB). Structures of active chemicals were compared against structures of 1,029 inactive chemicals to detect possible parent compounds that might have active metabolites. Results Application of the workflow screened 10 “low-priority” chemicals of 30 active chemicals. Fifty-two of the 1,029 inactive chemicals exhibited a similarity threshold of ≥ 75% with their nearest active neighbors. Of these 52 compounds, 30 were excluded due to poor absorption or distribution. The remaining 22 compounds may inhibit AChE in vivo either directly or as a result of metabolic activation. Conclusions The incorporation of exposure and ADME properties into the conceptual workflow eliminated 10 “low-priority” chemicals that may otherwise have undergone additional, resource-consuming analyses. Our workflow also increased confidence in interpretation of in vitro results by identifying possible “false negatives.” Citation Phillips MB, Leonard JA, Grulke CM, Chang DT, Edwards SW, Brooks R, Goldsmith MR, El-Masri H, Tan YM. 2016. A workflow to investigate exposure and pharmacokinetic influences on high-throughput in vitro chemical screening based on adverse outcome pathways. Environ

  9. Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi.

    Science.gov (United States)

    Sherr, L; Hensels, I S; Skeen, S; Tomlinson, M; Roberts, K J; Macedo, A

    2016-01-01

    Violence during childhood may affect short and long-term educational factors. There is scant literature on younger children from resource poor settings. This study assessed child violence experiences (harsh punishment and exposure to domestic or community violence) and school enrolment, progress and attendance in children attending community-based organisations in South Africa and Malawi (n=989) at baseline and at 15 months' follow-up, examining differential experience of HIV positive, HIV affected and HIV unaffected children. Violence exposure was high: 45.4% experienced some form of psychological violence, 47.8% physical violence, 46.7% domestic violence and 41.8% community violence. Primary school enrolment was 96%. Violence was not associated with school enrolment at baseline but, controlling for baseline, children exposed to psychological violence for discipline were more than ten times less likely to be enrolled at follow-up (OR 0.09; 95% CI 0.01 to 0.57). Harsh discipline was associated with poor school progress. For children HIV positive a detrimental effect of harsh physical discipline was found on school performance (OR 0.10; 95% CI 0.02 to 0.61). Violence experiences were associated with a number of educational outcomes, which may have long-term consequences. Community-based organisations may be well placed to address such violence, with a particular emphasis on the challenges faced by children who are HIV positive. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  10. Hydroquinone PBPK model refinement and application to dermal exposure.

    Science.gov (United States)

    Poet, Torka S; Carlton, Betsy D; Deyo, James A; Hinderliter, Paul M

    2010-11-01

    A physiologically based pharmacokinetic (PBPK) model for hydroquinone (HQ) was refined to include an expanded description of HQ-glucuronide metabolites and a description of dermal exposures to support route-to-route and cross-species extrapolation. Total urinary excretion of metabolites from in vivo rat dermal exposures was used to estimate a percutaneous permeability coefficient (K(p); 3.6×10(-5) cm/h). The human in vivo K(p) was estimated to be 1.62×10(-4) cm/h, based on in vitro skin permeability data in rats and humans and rat in vivo values. The projected total multi-substituted glutathione (which was used as an internal dose surrogate for the toxic glutathione metabolites) was modeled following an exposure scenario based on submersion of both hands in a 5% aqueous solution of HQ (similar to black and white photographic developing solution) for 2 h, a worst-case exposure scenario. Total multi-substituted glutathione following this human dermal exposure scenario was several orders of magnitude lower than the internal total glutathione conjugates in rats following an oral exposure to the rat NOEL of 20 mg/kg. Thus, under more realistic human dermal exposure conditions, it is unlikely that toxic glutathione conjugates (primarily the di- and, to a lesser degree, the tri-glutathione conjugate) will reach significant levels in target tissues. Copyright © 2010. Published by Elsevier Ltd.

  11. The Aggregate Exposure Pathway (AEP): A conceptual framework for advancing exposure science research and applications

    Science.gov (United States)

    Historically, risk assessment has relied upon toxicological data to obtain hazard-based reference levels, which are subsequently compared to exposure estimates to determine whether an unacceptable risk to public health may exist. Recent advances in analytical methods, biomarker ...

  12. Influence of Disease and Patient Characteristics on Daratumumab Exposure and Clinical Outcomes in Relapsed or Refractory Multiple Myeloma

    DEFF Research Database (Denmark)

    Yan, Xiaoyu; Clemens, Pamela L; Puchalski, Thomas

    2018-01-01

    OBJECTIVE: The aim of this study was to understand the influence of disease and patient characteristics on exposure to daratumumab, an immunoglobulin Gκ (IgGκ) monoclonal antibody, and clinical outcomes in relapsed or refractory multiple myeloma (MM). PATIENTS AND METHODS: Baseline myeloma type, ...

  13. Assessing exposure to violence using multiple informants: application of hierarchical linear model.

    Science.gov (United States)

    Kuo, M; Mohler, B; Raudenbush, S L; Earls, F J

    2000-11-01

    The present study assesses the effects of demographic risk factors on children's exposure to violence (ETV) and how these effects vary by informants. Data on exposure to violence of 9-, 12-, and 15-year-olds were collected from both child participants (N = 1880) and parents (N = 1776), as part of the assessment of the Project on Human Development in Chicago Neighborhoods (PHDCN). A two-level hierarchical linear model (HLM) with multivariate outcomes was employed to analyze information obtained from these two different groups of informants. The findings indicate that parents generally report less ETV than do their children and that associations of age, gender, and parent education with ETV are stronger in the self-reports than in the parent reports. The findings support a multivariate approach when information obtained from different sources is being integrated. The application of HLM allows an assessment of interactions between risk factors and informants and uses all available data, including data from one informant when data from the other informant is missing.

  14. Birth outcomes among military personnel after exposure to documented open-air burn pits before and during pregnancy.

    Science.gov (United States)

    Conlin, Ava Marie S; DeScisciolo, Connie; Sevick, Carter J; Bukowinski, Anna T; Phillips, Christopher J; Smith, Tyler C

    2012-06-01

    To examine birth outcomes in military women and men with potential exposure to documented open-air burn pits before and during pregnancy. Electronic data from the Department of Defense Birth and Infant Health Registry and the Defense Manpower Data Center were used to examine the prevalence of birth defects and preterm birth among infants of active-duty women and men who were deployed within a 3-mile radius of a documented open-air burn pit before or during pregnancy. In general, burn pit exposure at various times in relation to pregnancy and for differing durations was not consistently associated with an increase in birth defects or preterm birth in infants of active-duty military personnel. These analyses offer reassurance to service members that burn pit exposure is not consistently associated with these select adverse infant health outcomes.

  15. Increased traffic exposure and negative birth outcomes: a prospective cohort in Australia

    Directory of Open Access Journals (Sweden)

    Wilson Lee-Ann

    2011-04-01

    Full Text Available Abstract Background Pregnant women exposed to traffic pollution have an increased risk of negative birth outcomes. We aimed to investigate the size of this risk using a prospective cohort of 970 mothers and newborns in Logan, Queensland. Methods We examined two measures of traffic: distance to nearest road and number of roads around the home. To examine the effect of distance we used the number of roads around the home in radii from 50 to 500 metres. We examined three road types: freeways, highways and main roads. Results There were no associations with distance to road. A greater number of freeways and main roads around the home were associated with a shorter gestation time. There were no negative impacts on birth weight, birth length or head circumference after adjusting for gestation. The negative effects on gestation were largely due to main roads within 400 metres of the home. For every 10 extra main roads within 400 metres of the home, gestation time was reduced by 1.1% (95% CI: -1.7, -0.5; p-value = 0.001. Conclusions Our results add weight to the association between exposure to traffic and reduced gestation time. This effect may be due to the chemical toxins in traffic pollutants, or because of disturbed sleep due to traffic noise.

  16. The perception of pre- and post-natal marijuana exposure on health outcomes: A content analysis of twitter messages.

    Science.gov (United States)

    Dakkak, H; Brown, R; Twynstra, J; Charbonneau, K; Seabrook, J A

    2018-05-23

    The prevalence of marijuana use during pregnancy ranges from 3- 30% , and most of this is for recreational purposes. Marijuana exposure during pregnancy has been linked with low birth weight babies and other adverse child health outcomes. Twitter is a popular news and social networking outlet, and is frequently used to access information about population health and behavior. The primary objective of this study was to investigate the types of messages disseminated on Twitter about marijuana use and infant and maternal health. The secondary objective was to describe the reported health outcomes associated with prenatal and postnatal marijuana use. Tweets were collected from the inception of Twitter (2006) until April 2017. If tweets included links, these links were examined to investigate the source of the message and to clarify the user's intent. In total, 550 tweets were captured, with most tweets (77.6%) having a neutral tweet tone, suggesting uncertainty about the health effects associated with pre- and post-natal marijuana exposure. The sources attached to the original tweets, however, were more likely to report on negative health outcomes. The most common health outcomes associated with prenatal marijuana exposure were: poor brain development (27.3%), inadequate development of the nervous system (23.6%), low birth weight (23.3%), poor behavioral outcomes (21.0%), and infant memory issues (19.3%). The inverse association between marijuana use and the quality and quantity of milk produced by the mother was the most commonly reported tweet for the lactation period.

  17. Occupational exposure to pesticides and pregnancy outcomes in gardeners and farmers: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Hjøllund, Niels Henrik Ingvar; Andersen, AM

    2006-01-01

    OBJECTIVE: We conducted a follow-up study to examine whether exposure to pesticides during pregnancy had an adverse effect on pregnancy outcomes among Danish gardeners and farmers. METHODS: Using data from the National Birth Cohort in Denmark, we identified 226 pregnancies of gardeners and 214...... regression was applied to analyze late fetal loss and congenital malformations, and logistic regression was used to analyze preterm birth and small for gestational age. RESULTS: There were no significant differences in the studied pregnancy outcomes between gardeners or farmers and all other workers, except...... for an increased risk of very preterm birth for gardeners and a favorable birth weight for farmers. With the exception of biologic approach used in gardening, neither work activities nor exposure to pesticides showed a significant increased risk of adverse birth outcomes among gardeners or farmers. CONCLUSIONS...

  18. Maternal Arsenic Exposure, Arsenic Methylation Efficiency, and Birth Outcomes in the Biomarkers of Exposure to ARsenic (BEAR) Pregnancy Cohort in Mexico

    Science.gov (United States)

    Laine, Jessica E.; Bailey, Kathryn A.; Rubio-Andrade, Marisela; Olshan, Andrew F.; Smeester, Lisa; Drobná, Zuzana; Herring, Amy H.; Stýblo, Miroslav; García-Vargas, Gonzalo G.

    2014-01-01

    Background: Exposure to inorganic arsenic (iAs) from drinking water is a global public health problem, yet much remains unknown about the extent of exposure in susceptible populations. Objectives: We aimed to establish the Biomarkers of Exposure to ARsenic (BEAR) prospective pregnancy cohort in Gómez Palacio, Mexico, to better understand the effects of iAs exposure on pregnant women and their children. Methods: Two hundred pregnant women were recruited for this study. Concentrations of iAs in drinking water (DW-iAs) and maternal urinary concentrations of iAs and its monomethylated and dimethylated metabolites (MMAs and DMAs, respectively) were determined. Birth outcomes were analyzed for their relationship to DW-iAs and to the concentrations and proportions of maternal urinary arsenicals. Results: DW-iAs for the study subjects ranged from iAs that exceeded the World Health Organization’s recommended guideline of 10 μg As/L. DW-iAs was significantly associated with the sum of the urinary arsenicals (U-tAs). Maternal urinary concentrations of MMAs were negatively associated with newborn birth weight and gestational age. Maternal urinary concentrations of iAs were associated with lower mean gestational age and newborn length. Conclusions: Biomonitoring results demonstrate that pregnant women in Gómez Palacio are exposed to potentially harmful levels of DW-iAs. The data support a relationship between iAs metabolism in pregnant women and adverse birth outcomes. The results underscore the risks associated with iAs exposure in vulnerable populations. Citation: Laine JE, Bailey KA, Rubio-Andrade M, Olshan AF, Smeester L, Drobná Z, Herring AH, Stýblo M, García-Vargas GG, Fry RC. 2015. Maternal arsenic exposure, arsenic methylation efficiency, and birth outcomes in the Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort in Mexico. Environ Health Perspect 123:186–192; http://dx.doi.org/10.1289/ehp.1307476 PMID:25325819

  19. Behavioural outcome of school-age children after prenatal exposure to coumarins

    NARCIS (Netherlands)

    Wesseling, J; Van Driel, D; Heymans, HSA; Van der Veer, E; Sauer, PJJ; Touwen, BCL; Smrkovsky, M

    In utero exposure to coumarin derivatives may affect the development of the central nervous system of the child, irrespective of the period of exposure in pregnancy. Little is known about effects on development in the long term. The aim of the present study was to determine whether prenatal exposure

  20. Behavioural outcome of school-age children after prenatal exposure to coumarins

    NARCIS (Netherlands)

    Wesseling, J.; van Driel, D.; Heymans, H. S.; Van der Veer, E.; Sauer, P. J.; Touwen, B. C.; Smrkovsky, M.

    2000-01-01

    In utero exposure to coumarin derivatives may affect the development of the central nervous system of the child, irrespective of the period of exposure in pregnancy. Little is known about effects on development in the long term. The aim of the present study was to determine whether prenatal exposure

  1. Infant and mother related outcomes from exposure to metals with endocrine disrupting properties during pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, A. [Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa (Canada); Kumarathasan, P. [Environmental Health Science and Research Bureau, Health Canada, Ottawa (Canada); Gomes, J., E-mail: jgomes@uottawa.ca [Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa (Canada); McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa (Canada)

    2016-11-01

    Background: Endocrine-related adverse health effects from exposure to heavy metals such as lead, arsenic, cadmium, and mercury are yet to be adequately described. The purpose of this review was to gain insight into maternal exposure to heavy metals, and to identify potential endocrine-related adverse health effects in the mother and the infant. Methods: Relevant databases were searched for original research reports and a total of 46 articles were retained for scrutiny. Required data was extracted from these studies and their methodology was assessed. Results: Impaired fetal growth was observed from exposure to all endocrine disrupting metals, while exposure to lead and arsenic were associated with spontaneous abortion, stillbirth and neonatal deaths. Maternal exposure to arsenic was associated with impaired glucose tolerance in these mothers. Conclusion: Impaired fetal growth, fetal loss, and neonatal deaths were significantly associated with heavy metals exposure during pregnancy; however, hypertension and gestational diabetes require further investigation. - Highlights: • Low and high dose exposure to lead was associated with low birth weight, preterm birth, stillbirths, spontaneous abortions and hypertension. • Exposure to arsenic was associated with fetal loss, stillbirths and spontaneous abortions. • Exposure to cadmium was associated with low birth weight. • Exposure to mercury was associated with spontaneous abortions and neurotoxic effects. • Exposure to copper was associated with low birth weight and spontaneous abortions and exposure to zinc was associated with low birth weight.

  2. Infant and mother related outcomes from exposure to metals with endocrine disrupting properties during pregnancy

    International Nuclear Information System (INIS)

    Rahman, A.; Kumarathasan, P.; Gomes, J.

    2016-01-01

    Background: Endocrine-related adverse health effects from exposure to heavy metals such as lead, arsenic, cadmium, and mercury are yet to be adequately described. The purpose of this review was to gain insight into maternal exposure to heavy metals, and to identify potential endocrine-related adverse health effects in the mother and the infant. Methods: Relevant databases were searched for original research reports and a total of 46 articles were retained for scrutiny. Required data was extracted from these studies and their methodology was assessed. Results: Impaired fetal growth was observed from exposure to all endocrine disrupting metals, while exposure to lead and arsenic were associated with spontaneous abortion, stillbirth and neonatal deaths. Maternal exposure to arsenic was associated with impaired glucose tolerance in these mothers. Conclusion: Impaired fetal growth, fetal loss, and neonatal deaths were significantly associated with heavy metals exposure during pregnancy; however, hypertension and gestational diabetes require further investigation. - Highlights: • Low and high dose exposure to lead was associated with low birth weight, preterm birth, stillbirths, spontaneous abortions and hypertension. • Exposure to arsenic was associated with fetal loss, stillbirths and spontaneous abortions. • Exposure to cadmium was associated with low birth weight. • Exposure to mercury was associated with spontaneous abortions and neurotoxic effects. • Exposure to copper was associated with low birth weight and spontaneous abortions and exposure to zinc was associated with low birth weight.

  3. Chronic particulate exposure, mortality and cardiovascular outcomes in the nurses health study

    Science.gov (United States)

    Adverse health effects of exposures to acute air pollution have been well studied. Fewer studies have examined effects of chronic exposure. Previous studies used exposure estimates for narrow time periods and were limited by the geographic distribution of pollution monitors. This...

  4. Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood.

    Science.gov (United States)

    Sun, Lena S; Li, Guohua; Miller, Tonya L K; Salorio, Cynthia; Byrne, Mary W; Bellinger, David C; Ing, Caleb; Park, Raymond; Radcliffe, Jerilynn; Hays, Stephen R; DiMaggio, Charles J; Cooper, Timothy J; Rauh, Virginia; Maxwell, Lynne G; Youn, Ahrim; McGowan, Francis X

    2016-06-07

    Exposure of young animals to commonly used anesthetics causes neurotoxicity including impaired neurocognitive function and abnormal behavior. The potential neurocognitive and behavioral effects of anesthesia exposure in young children are thus important to understand. To examine if a single anesthesia exposure in otherwise healthy young children was associated with impaired neurocognitive development and abnormal behavior in later childhood. Sibling-matched cohort study conducted between May 2009 and April 2015 at 4 university-based US pediatric tertiary care hospitals. The study cohort included sibling pairs within 36 months in age and currently 8 to 15 years old. The exposed siblings were healthy at surgery/anesthesia. Neurocognitive and behavior outcomes were prospectively assessed with retrospectively documented anesthesia exposure data. A single exposure to general anesthesia during inguinal hernia surgery in the exposed sibling and no anesthesia exposure in the unexposed sibling, before age 36 months. The primary outcome was global cognitive function (IQ). Secondary outcomes included domain-specific neurocognitive functions and behavior. A detailed neuropsychological battery assessed IQ and domain-specific neurocognitive functions. Parents completed validated, standardized reports of behavior. Among the 105 sibling pairs, the exposed siblings (mean age, 17.3 months at surgery/anesthesia; 9.5% female) and the unexposed siblings (44% female) had IQ testing at mean ages of 10.6 and 10.9 years, respectively. All exposed children received inhaled anesthetic agents, and anesthesia duration ranged from 20 to 240 minutes, with a median duration of 80 minutes. Mean IQ scores between exposed siblings (scores: full scale = 111; performance = 108; verbal = 111) and unexposed siblings (scores: full scale = 111; performance = 107; verbal = 111) were not statistically significantly different. Differences in mean IQ scores between sibling pairs were

  5. Impact of environmental tobacco smoke exposure in women on oxidative stress in the antral follicle and assisted reproduction outcomes.

    Science.gov (United States)

    Kazemi, Ashraf; Ramezanzadeh, Fatemeh; Esfahani, Mohammad Hosein Nasr; Saboor-Yaraghi, Ali Akbar; Nejat, Saharnaz; Rahimi-Foroshani, Abbas

    2013-08-01

    Cigarette smoke contains many oxidants and may alter the human reproduction by inducing oxidative stress (OS) in both active and passive smokers. This study was designed to evaluate the effect of environmental tobacco smoke (ETS) exposure on oxidative stress in the follicular fluid and the assisted reproduction outcomes. An observational prospective study was carried out on 236 infertile women, who underwent assisted reproduction cycles. The ETS exposure was assessed using self-reported ETS exposure and the cotinine level in follicular fluid. To evaluate the OS in follicular fluid (FF) malon-di-aldehyde (MDA) and total antioxidant capacity (TAC) were measured. The number of retrieved oocytes, rate of metaphase II stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were considered as the assisted reproduction outcomes. The results were adjusted for age, body mass index, duration, and etiology of infertility; P-values less than 0.05 were considered significant. The MDA and TAC levels in FF were not related to the self-report number of the weekly ETS exposure and cotinine levels in FF. Also, the number of retrieved oocytes, MII stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were not related to the cotinine level and weekly ETS exposure. However, in women whose cotinine levels in FF were lower and equal/above 3.5 ng/ml, the number of retrieved oocytes was higher (12.63 ± .71 vs. 9.28 ± 1.11, P = 0.01). The relationship between the MDA level and cleavage rate (Beta = -18.5, confidence interval-34.9 and-2.1, P assisted reproduction success by influencing the number of available oocytes. Although, the OS in a follicular environment affect the ability of oocytes to reach the specific cleavage stages at appropriate time intervals, it does not mediate poor-assisted reproduction outcomes due to ETS exposure.

  6. Preschool outcomes following prenatal serotonin reuptake inhibitor exposure: differences in language and behavior, but not cognitive function.

    Science.gov (United States)

    Johnson, Katrina C; Smith, Alicia K; Stowe, Zachary N; Newport, D Jeffrey; Brennan, Patricia A

    2016-02-01

    To test the hypothesis that prenatal exposure to serotonin reuptake inhibitors (SRIs) is associated with language and behavioral outcomes in preschool-aged children, while accounting for confounds such as concomitant exposures and maternal mental illness. An observational, prospective, longitudinal study of mental illness in pregnancy was conducted at a university-based women's mental health clinic (April 2010-November 2012). A sample of 178 mother-child dyads participated in a laboratory visit at preschool age (2.5-5.5 years). The majority of women (87%) received psychotropic medication during pregnancy. Psychiatric status (based on DSM-IV), other medication use, and substance use were serially assessed and tested as confounds. Primary outcome measures included standardized measures of expressive language and cognitive function and mother and alternate caregiver ratings of child behavior problems, including the Pervasive Developmental Disorders (PDD) subscale of the Child Behavior Checklist. Linear regression analyses revealed that, after controlling for relevant covariates, expressive language scores from the Test of Early Language Development, 3rd edition, were negatively associated with prenatal SRI exposure (β = -0.15, t = -2.41), while the PDD behavioral problems subscales completed by alternate caregivers and mothers were positively associated with prenatal SRI exposure (β = 0.17, t = 2.01; β = 0.16, t = 2.00, respectively). Cognitive function, measured using the Differential Ability Scales, 2nd edition, was not associated with any medication exposures. The current data suggest a small but significant association between prenatal SRI exposure and preschool outcomes, including expressive language and behavior problems. These data corroborate data from recent, population-based studies, although overall, published findings are mixed. Replication and identification of moderating risk factors are needed to understand potential clinical implications.

  7. Impact of environmental tobacco smoke exposure in women on oxidative stress in the antral follicle and assisted reproduction outcomes

    Science.gov (United States)

    Kazemi, Ashraf; Ramezanzadeh, Fatemeh; Esfahani, Mohammad Hosein Nasr; Saboor-Yaraghi, Ali Akbar; Nejat, Saharnaz; Rahimi-Foroshani, Abbas

    2013-01-01

    Background: Cigarette smoke contains many oxidants and may alter the human reproduction by inducing oxidative stress (OS) in both active and passive smokers. This study was designed to evaluate the effect of environmental tobacco smoke (ETS) exposure on oxidative stress in the follicular fluid and the assisted reproduction outcomes. Materials and Methods: An observational prospective study was carried out on 236 infertile women, who underwent assisted reproduction cycles. The ETS exposure was assessed using self-reported ETS exposure and the cotinine level in follicular fluid. To evaluate the OS in follicular fluid (FF) malon-di-aldehyde (MDA) and total antioxidant capacity (TAC) were measured. The number of retrieved oocytes, rate of metaphase II stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were considered as the assisted reproduction outcomes. The results were adjusted for age, body mass index, duration, and etiology of infertility; P-values less than 0.05 were considered significant. Results: The MDA and TAC levels in FF were not related to the self-report number of the weekly ETS exposure and cotinine levels in FF. Also, the number of retrieved oocytes, MII stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were not related to the cotinine level and weekly ETS exposure. However, in women whose cotinine levels in FF were lower and equal/above 3.5 ng/ml, the number of retrieved oocytes was higher (12.63 ± .71 vs. 9.28 ± 1.11, P = 0.01). The relationship between the MDA level and cleavage rate (Beta = −18.5, confidence interval-34.9 and-2.1, P reproduction success by influencing the number of available oocytes. Although, the OS in a follicular environment affect the ability of oocytes to reach the specific cleavage stages at appropriate time intervals, it does not mediate poor-assisted reproduction outcomes due to ETS exposure. PMID:24379845

  8. Age of first exposure to American football and long-term neuropsychiatric and cognitive outcomes

    Science.gov (United States)

    Alosco, M L; Kasimis, A B; Stamm, J M; Chua, A S; Baugh, C M; Daneshvar, D H; Robbins, C A; Mariani, M; Hayden, J; Conneely, S; Au, R; Torres, A; McClean, M D; McKee, A C; Cantu, R C; Mez, J; Nowinski, C J; Martin, B M; Chaisson, C E; Tripodis, Y; Stern, R A

    2017-01-01

    Previous research suggests that age of first exposure (AFE) to football before age 12 may have long-term clinical implications; however, this relationship has only been examined in small samples of former professional football players. We examined the association between AFE to football and behavior, mood and cognition in a large cohort of former amateur and professional football players. The sample included 214 former football players without other contact sport history. Participants completed the Brief Test of Adult Cognition by Telephone (BTACT), and self-reported measures of executive function and behavioral regulation (Behavior Rating Inventory of Executive Function-Adult Version Metacognition Index (MI), Behavioral Regulation Index (BRI)), depression (Center for Epidemiologic Studies Depression Scale (CES-D)) and apathy (Apathy Evaluation Scale (AES)). Outcomes were continuous and dichotomized as clinically impaired. AFE was dichotomized into football before age 12 corresponded with >2 × increased odds for clinically impaired scores on all measures but BTACT: (odds ratio (OR), 95% confidence interval (CI): BRI, 2.16,1.19–3.91; MI, 2.10,1.17–3.76; CES-D, 3.08,1.65–5.76; AES, 2.39,1.32–4.32). Younger AFE predicted increased odds for clinical impairment on the AES (OR, 95% CI: 0.86, 0.76–0.97) and CES-D (OR, 95% CI: 0.85, 0.74–0.97). There was no interaction between AFE and highest level of play. Younger AFE to football, before age 12 in particular, was associated with increased odds for impairment in self-reported neuropsychiatric and executive function in 214 former American football players. Longitudinal studies will inform youth football policy and safety decisions. PMID:28926003

  9. Age of first exposure to American football and long-term neuropsychiatric and cognitive outcomes.

    Science.gov (United States)

    Alosco, M L; Kasimis, A B; Stamm, J M; Chua, A S; Baugh, C M; Daneshvar, D H; Robbins, C A; Mariani, M; Hayden, J; Conneely, S; Au, R; Torres, A; McClean, M D; McKee, A C; Cantu, R C; Mez, J; Nowinski, C J; Martin, B M; Chaisson, C E; Tripodis, Y; Stern, R A

    2017-09-19

    Previous research suggests that age of first exposure (AFE) to football before age 12 may have long-term clinical implications; however, this relationship has only been examined in small samples of former professional football players. We examined the association between AFE to football and behavior, mood and cognition in a large cohort of former amateur and professional football players. The sample included 214 former football players without other contact sport history. Participants completed the Brief Test of Adult Cognition by Telephone (BTACT), and self-reported measures of executive function and behavioral regulation (Behavior Rating Inventory of Executive Function-Adult Version Metacognition Index (MI), Behavioral Regulation Index (BRI)), depression (Center for Epidemiologic Studies Depression Scale (CES-D)) and apathy (Apathy Evaluation Scale (AES)). Outcomes were continuous and dichotomized as clinically impaired. AFE was dichotomized into football before age 12 corresponded with >2 × increased odds for clinically impaired scores on all measures but BTACT: (odds ratio (OR), 95% confidence interval (CI): BRI, 2.16,1.19-3.91; MI, 2.10,1.17-3.76; CES-D, 3.08,1.65-5.76; AES, 2.39,1.32-4.32). Younger AFE predicted increased odds for clinical impairment on the AES (OR, 95% CI: 0.86, 0.76-0.97) and CES-D (OR, 95% CI: 0.85, 0.74-0.97). There was no interaction between AFE and highest level of play. Younger AFE to football, before age 12 in particular, was associated with increased odds for impairment in self-reported neuropsychiatric and executive function in 214 former American football players. Longitudinal studies will inform youth football policy and safety decisions.

  10. Long-term health outcomes after exposure to repeated concussion in elite level: rugby union players.

    Science.gov (United States)

    McMillan, T M; McSkimming, P; Wainman-Lefley, J; Maclean, L M; Hay, J; McConnachie, A; Stewart, W

    2017-06-01

    There is continuing concern about effects of concussion in athletes, including risk of the neurodegenerative disease chronic traumatic encephalopathy. However, information on long-term health and wellbeing in former athletes is limited. Outcome after exposure to repeated brain injury was investigated in 52 retired male Scottish international rugby players (RIRP) and 29 male controls who were similar in age and social deprivation. Assessment included history of playing rugby and traumatic brain injury, general and mental health, life stress, concussion symptoms, cognitive function, disability and markers of chronic stress (allostatic load). The estimated number of concussions in RIRP averaged 14 (median=7; IQR 5-40). Performance was poorer in RIRP than controls on a test of verbal learning (p=0.022) and of fine co-ordination of the dominant hand (p=0.038) and not significantly different on other cognitive tests (p>0.05). There were no significant associations between number of concussions and performance on cognitive tests. Other than a higher incidence of cardiovascular disease in controls, no group differences were detected in general or mental health or estimates of allostatic load. In RIRP, persisting symptoms attributed to concussion were more common if reporting more than nine concussions (p=0.028), although these symptoms were not perceived to affect social or work functioning. Despite a high number of concussions in RIRP, differences in mental health, social or work functioning were not found late after injury. Subtle group differences were detected on two cognitive tests, the cause of which is uncertain. Prospective group comparison studies on representative cohorts are required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Applicability of western chemical dietary exposure models to the Chinese population.

    Science.gov (United States)

    Zhao, Shizhen; Price, Oliver; Liu, Zhengtao; Jones, Kevin C; Sweetman, Andrew J

    2015-07-01

    A range of exposure models, which have been developed in Europe and North America, are playing an increasingly important role in priority setting and the risk assessment of chemicals. However, the applicability of these tools, which are based on Western dietary exposure pathways, to estimate chemical exposure to the Chinese population to support the development of a risk-based environment and exposure assessment, is unclear. Three frequently used modelling tools, EUSES, RAIDAR and ACC-HUMANsteady, have been evaluated in terms of human dietary exposure estimation by application to a range of chemicals with different physicochemical properties under both model default and Chinese dietary scenarios. Hence, the modelling approaches were assessed by considering dietary pattern differences only. The predicted dietary exposure pathways were compared under both scenarios using a range of hypothetical and current emerging contaminants. Although the differences across models are greater than those between dietary scenarios, model predictions indicated that dietary preference can have a significant impact on human exposure, with the relatively high consumption of vegetables and cereals resulting in higher exposure via plants-based foodstuffs under Chinese consumption patterns compared to Western diets. The selected models demonstrated a good ability to identify key dietary exposure pathways which can be used for screening purposes and an evaluative risk assessment. However, some model adaptations will be required to cover a number of important Chinese exposure pathways, such as freshwater farmed-fish, grains and pork. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Mendelian randomization analysis of a time-varying exposure for binary disease outcomes using functional data analysis methods.

    Science.gov (United States)

    Cao, Ying; Rajan, Suja S; Wei, Peng

    2016-12-01

    A Mendelian randomization (MR) analysis is performed to analyze the causal effect of an exposure variable on a disease outcome in observational studies, by using genetic variants that affect the disease outcome only through the exposure variable. This method has recently gained popularity among epidemiologists given the success of genetic association studies. Many exposure variables of interest in epidemiological studies are time varying, for example, body mass index (BMI). Although longitudinal data have been collected in many cohort studies, current MR studies only use one measurement of a time-varying exposure variable, which cannot adequately capture the long-term time-varying information. We propose using the functional principal component analysis method to recover the underlying individual trajectory of the time-varying exposure from the sparsely and irregularly observed longitudinal data, and then conduct MR analysis using the recovered curves. We further propose two MR analysis methods. The first assumes a cumulative effect of the time-varying exposure variable on the disease risk, while the second assumes a time-varying genetic effect and employs functional regression models. We focus on statistical testing for a causal effect. Our simulation studies mimicking the real data show that the proposed functional data analysis based methods incorporating longitudinal data have substantial power gains compared to standard MR analysis using only one measurement. We used the Framingham Heart Study data to demonstrate the promising performance of the new methods as well as inconsistent results produced by the standard MR analysis that relies on a single measurement of the exposure at some arbitrary time point. © 2016 WILEY PERIODICALS, INC.

  13. Prenatal exposure to Chernobyl fallout in Norway: neurological and developmental outcomes in a 25-year follow-up.

    Science.gov (United States)

    Lie, Rolv Terje; Moster, Dag; Strand, Per; Wilcox, Allen James

    2017-12-01

    Ionizing radiation at high doses early in life may cause neurodevelopmental problems. Possible effects of lower doses are, however, controversial. We use carefully collected exposure data for Norway following the Chernobyl accident in April 1986 combined with population-based registries to assess long-term effects of fetal exposure on neurodevelopmental outcomes. Radiation doses were estimated for each Norwegian municipality for each calendar month from May 1986 to April 1989. We established a cohort of all Norwegian pregnancies during the three-year period of radiation measurement and compared them with appropriate unexposed groups. All cohorts were followed into adulthood. Risks of cerebral palsy, mental retardation, schizophrenia, epilepsy, vision or hearing problems, school dropout, and low income were estimated. We also conducted an analysis of mathematics and language grades using siblings born after the exposure period as comparison. There was little evidence of associations between radiation exposure and cerebral palsy, mental retardation, schizophrenia, epilepsy, or hearing or vision problems associated with radiation exposure. (p-values for trend with exposure dose were 0.27, 0.14, 0.83, 0.35 and 0.42.) Slightly more of the exposed failed to complete high school (p = 0.05), but there was no increase in the proportion with low income (p = 0.38). The natural advantage of older siblings over younger siblings in mathematics grades was diminished with exposure of older siblings (p = 0.003), but there was no association of exposure with Norwegian language grades (p = 0.37). There is scant evidence that the low-dose fallout from Chernobyl in Norway increased the risk for serious neurodevelopmental problems. We cannot exclude the possibility of lower mathematics grades with exposure, similar to a report from Sweden.

  14. The effect of maternal exposure to psychosocial job strain on pregnancy outcomes and child development.

    Science.gov (United States)

    Larsen, Ann Dyreborg

    2015-02-01

    and data from the Danish National Birth Cohort (DNBC). The cohort was established in 1994 and baseline information from the enrolled 100,418 pregnancies was gathered from 1996 to 2002. At their first antenatal visit pregnant women were invited to participate in the cohort by their general practitioner. To contribute the women had to be pregnant, have intentions of carrying the pregnancy to term, reside in Denmark and speak Danish sufficiently well to participate in telephone interviews. When enrolled the women were asked to participate in two telephone interviews during pregnancy at approximately 12-14 and 30-32 weeks of gestation and two after birth when the child was six and 18 months old and a follow-up questionnaire at age seven years.  Exposure to work-related stress was assessed based on information from the first interview on two questions regarding job control and job demands. These questions were interpreted as dimensions of demands and control, and hereafter used as a proxy for the dimensions of the job strain model by Karasek.  Based on their answers, the women were divided into the four job strain categories: high strain, active, passive and low strain. Gestational age at birth, birthweight and congenital malformations were extracted from the Danish Medical Birth Register. The outcome variable on asthma and atopic dermatitis were based on maternal self-reports from the fourth (child 18 months) and fifth (child seven years old) interviews/questionnaires. All studies in the thesis were based on protocols describing methods, analyses etc. prior to handling. No associations were found between exposure to high strain (high demands, low control) during pregnancy and preterm birth, small for gestational age, congenital malformations and asthma in the children when compared to women exposed to low strain (low demands, high control). A protective effect on large for gestational age was observed when exposed to high strain, suggesting an impact on the birthweight

  15. Carcinogen biomonitoring in human exposures and laboratory research: validation and application to human occupational exposures.

    Science.gov (United States)

    Talaska, Glenn; Maier, Andrew; Henn, Scott; Booth-Jones, Angela; Tsuneoka, Yutaka; Vermeulen, Roel; Schumann, Brenda L

    2002-08-05

    A multiple biomarker approach is required to integrate for metabolism, temporal response and exposure-response kinetics, biological relevance, and positive predictive value. Carcinogen DNA adduct analysis can be used in animal and in vitro studies to detect absorption permutations caused by mixture interactions, and to control metabolic variation when specific CYP450 genes (1A1 or 1A2) are knocked out. These enzymes are not critical to the metabolic activation of model Polycyclic Aromatic Compounds (PAC) and aromatic amines, respectively, as suggested by in vitro analysis. Several human studies have been carried out where multiple biomarkers have been measured. In a study of benzidine workers, the similarities in elimination kinetics between urinary metabolites and mutagenicity is likely responsible for a better correlation between these markers than to BZ-DNA adducts in exfoliated cells. In a study of rubber workers, the relationship between specific departments, urinary 1 HP and DNA adducts in exfoliated cells coincided with the historical urinary bladder cancer risk in these departments; the same relationship did not hold for urinary mutagenicity. In a study of automotive mechanics, biomarkers were used to monitor the effectiveness of exposure interventions. These data reinforce the notion that carcinogen biomarkers are useful to monitor exposure, but that a complementary approaches involving effect and perhaps susceptibility biomarkers is necessary to obtain the necessary information.

  16. Complexities of sibling analysis when exposures and outcomes change with time and birth order

    OpenAIRE

    Sudan, M; Kheifets, LI; Arah, OA; Divan, HA; Olsen, J

    2014-01-01

    In this study, we demonstrate the complexities of performing a sibling analysis with a re-examination of associations between cell phone exposures and behavioral problems observed previously in the Danish National Birth Cohort. Children (52,680; including 5441 siblings) followed up to age 7 were included. We examined differences in exposures and behavioral problems between siblings and non-siblings and by birth order and birth year. We estimated associations between cell phone exposures and b...

  17. Orthodontic treatment outcomes obtained by application of a finishing protocol

    Directory of Open Access Journals (Sweden)

    Alvaro Carvajal-Flórez

    2016-04-01

    Full Text Available ABSTRACT Objective: To evaluate the results of a finishing protocol implemented in patients treated in the Orthodontics graduate program at Universidad de Antioquia. Evaluation was carried out by means of the criteria set by the Objective Grading System (OGS of the American Board of Orthodontics (ABO. Methods: Cast models and panoramic radiographs of 34 patients were evaluated. The intervention group (IG consisted of 17 patients (19.88 ± 4.4 years old treated under a finishing protocol. This protocol included training in finishing, application of a finishing guide, brackets repositioning and patient's follow-up. Results of the IG were compared to a control group of 17 patients (21.88 ± 7.0 years old selected by stratified randomization without finishing intervention (CG. Results: The scores for both CG and IG were 38.00 ± 9.0 and 31.41 ± 9.6 (p = 0.048, respectively. The score improved significantly in the IG group, mainly regarding marginal ridges (CG: 5.59 ± 2.2; IG: 3.65 ± 1.8 (p = 0.009 and root angulation (CG: 7.59 ± 2.8; IG: 4.88 ± 2.6 (p = 0.007. Criteria that did not improve, but had the highest scores were: alignment (CG: 6.35 ± 2.7; IG: 6.82 ± 2.8 (p = 0.62 and buccolingual inclination (CG: 3.6 ± 5.88; IG: 5.29 ± 3.9 (p = 0.65. Conclusions: Standardization and implementation of a finishing protocol contributed to improve clinical performance in the Orthodontics graduate program, as expressed by occlusal outcomes. Greater emphasis should be given on the finishing phase to achieve lower scores in the ABO grading system.

  18. Assessment of relevant factors and relationships concerning human dermal exposure to pesticides in greenhouse applications.

    Science.gov (United States)

    Martínez Vidal, Jose L; Egea González, Francisco J; Garrido Frenich, Antonia; Martínez Galera, María; Aguilera, Pedro A; López Carrique, Enrique

    2002-08-01

    Principal component analysis (PCA) was applied to the gas chromatographic data obtained from 23 different greenhouse trials. This was used to establish which factors, including application technique (very small, small, medium and large drop-size), crop characteristics (short/tall, thin/dense) and pattern application of the operator (walking towards or away from the treated area) are relevant to the dermal exposure levels of greenhouse applicators. The results showed that the highest exposure by pesticides during field applications in greenhouses, in the climatic conditions and in the crop conditions typical of a southern European country, occurs on the lower legs and front thighs of the applicators. Similar results were obtained by hierarchical cluster analysis (HCA). Drop-size seems to be very important in determining total exposure, while height and density of crops have little influence on total exposure under the conditions of the present study. No pesticide type is a major factor in total exposure. The application of multiple regression analysis (MRA) allowed assessment of the relationships between the pesticide exposure of the less affected parts of the body with the most affected parts.

  19. Novel Human Radiation Exposure Biomarker Panel Applicable for Population Triage

    Energy Technology Data Exchange (ETDEWEB)

    Bazan, Jose G. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Chang, Polly; Balog, Robert; D' Andrea, Annalisa; Shaler, Thomas; Lin, Hua; Lee, Shirley; Harrison, Travis [SRI International, Menlo Park, California (United States); Shura, Lei; Schoen, Lucy; Knox, Susan J. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Cooper, David E., E-mail: david.cooper@sri.com [SRI International, Menlo Park, California (United States)

    2014-11-01

    Purpose: To identify a panel of radiation-responsive plasma proteins that could be used in a point-of-care biologic dosimeter to detect clinically significant levels of ionizing radiation exposure. Methods and Materials: Patients undergoing preparation for hematopoietic cell transplantation using radiation therapy (RT) with either total lymphoid irradiation or fractionated total body irradiation were eligible. Plasma was examined from patients with potentially confounding conditions and from normal individuals. Each plasma sample was analyzed for a panel of 17 proteins before RT was begun and at several time points after RT exposure. Paired and unpaired t tests between the dose and control groups were performed. Conditional inference trees were constructed based on panels of proteins to compare the non-RT group with the RT group. Results: A total of 151 patients (62 RT, 41 infection, 48 trauma) were enrolled on the study, and the plasma from an additional 24 healthy control individuals was analyzed. In comparison with to control individuals, tenascin-C was upregulated and clusterin was downregulated in patients receiving RT. Salivary amylase was strongly radiation responsive, with upregulation in total body irradiation patients and slight downregulation in total lymphoid irradiation patients compared with control individuals. A panel consisting of these 3 proteins accurately distinguished between irradiated patients and healthy control individuals within 3 days after exposure: 97% accuracy, 0.5% false negative rate, 2% false positive rate. The accuracy was diminished when patients with trauma, infection, or both were included (accuracy, 74%-84%; false positive rate, 14%-33%, false negative rate: 8%-40%). Conclusions: A panel of 3 proteins accurately distinguishes unirradiated healthy donors from those exposed to RT (0.8-9.6 Gy) within 3 days of exposure. These findings have significant implications in terms of triaging individuals in the case of nuclear or other

  20. 40 CFR 158.1000 - Applicator exposure-general requirements.

    Science.gov (United States)

    2010-07-01

    ... requirements. 158.1000 Section 158.1000 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Occupational Safety and Health Administration (OSHA), provide adequate protection from risk under FIFRA for a... and the applicator activity of concern, including formulation type, application methods and rates...

  1. Enhancing Learning Outcomes through Application Driven Activities in Marketing

    Science.gov (United States)

    Stegemann, Nicole; Sutton-Brady, Catherine

    2013-01-01

    This paper introduces an activity used in class to allow students to apply previously acquired information to a hands-on task. As the authors have previously shown active learning is a way to effectively facilitate and improve students' learning outcomes. As a result to improve learning outcomes we have overtime developed a series of learning…

  2. Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses.

    Science.gov (United States)

    Keogh, Ruth H; Mangtani, Punam; Rodrigues, Laura; Nguipdop Djomo, Patrick

    2016-01-05

    Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

  3. Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses

    Directory of Open Access Journals (Sweden)

    Ruth H. Keogh

    2016-01-01

    Full Text Available Abstract Background Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Methods Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. Results The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Conclusions Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

  4. Geospatial exposure to point-of-sale tobacco: real-time craving and smoking-cessation outcomes.

    Science.gov (United States)

    Kirchner, Thomas R; Cantrell, Jennifer; Anesetti-Rothermel, Andrew; Ganz, Ollie; Vallone, Donna M; Abrams, David B

    2013-10-01

    Little is known about the factors that drive the association between point-of-sale marketing and behavior, because methods that directly link individual-level use outcomes to real-world point-of-sale exposure are only now beginning to be developed. Daily outcomes during smoking cessation were examined as a function of both real-time geospatial exposure to point-of-sale tobacco (POST) and subjective craving to smoke. Continuous individual geospatial location data collected over the first month of a smoking-cessation attempt in 2010-2012 (N=475) were overlaid on a POST outlet geodatabase (N=1060). Participants' mobility data were used to quantify the number of times they came into contact with a POST outlet. Participants recorded real-time craving levels and smoking status via ecological momentary assessment (EMA) on cellular telephones. The final data set spanned a total of 12,871 days of EMA and geospatial tracking. Lapsing was significantly more likely on days with any POST contact (OR=1.19, 95% CI=1.18, 1.20), and increasingly likely as the number of daily POST contacts increased (OR=1.07, 95% CI=1.06, 1.08). Overall, daily POST exposure was significantly associated with lapsing when craving was low (OR=1.22, 95% CI=1.20, 1.23); high levels of craving were more directly associated with lapse outcomes. These data shed light on the way mobility patterns drive a dynamic interaction between individuals and the POST environment, demonstrating that quantification of individuals' exposure to POST marketing can be used to identify previously unrecognized patterns of association among individual mobility, the built environment, and behavioral outcomes. © 2013 American Journal of Preventive Medicine.

  5. Obsessive Compulsive Personality Disorder as a Predictor of Exposure and Ritual Prevention Outcome for Obsessive Compulsive Disorder

    OpenAIRE

    Pinto, Anthony; Liebowitz, Michael R.; Foa, Edna B.; Simpson, H. Blair

    2011-01-01

    Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 ses...

  6. Passive Smoke Exposure and Its Effects on Cognition, Sleep, and Health Outcomes in Overweight and Obese Children.

    Science.gov (United States)

    Davis, Catherine L; Tingen, Martha S; Jia, Jenny; Sherman, Forrest; Williams, Celestine F; Bhavsar, Kruti; Wood, Nancy; Kobleur, Jessica; Waller, Jennifer L

    2016-04-01

    Passive smoke exposure (PSE) may be a risk factor for childhood overweight and obesity and is associated with worse neurocognitive development, cognition, and sleep in children. The purpose of the study is to examine the effects of PSE on adiposity, cognition, and sleep in overweight and obese children using an objective measure of PSE. Overweight or obese children (n = 222) aged 7-11 (9.4 ± 1.1 years; 58% black; 58% female; 85% obese) were recruited from schools near Augusta, Georgia, over the course of the school year from 2003-2006 for a clinical trial, with data analyzed in 2009-2010. Passive smoke exposure was measured with plasma cotinine. Health, cognitive, and sleep measures and parent report of smoke exposure were obtained. Overweight and obese children with PSE had greater overall and central adiposity than nonexposed overweight and obese children (p prevent adverse health outcomes related to tobacco use and obesity.

  7. Self-reported parental exposure to pesticide during pregnancy and birth outcomes: the MecoExpo cohort study.

    Directory of Open Access Journals (Sweden)

    Flora Mayhoub

    Full Text Available The MecoExpo study was performed in the Picardy region of northern France, in order to investigate the putative relationship between parental exposures to pesticides (as reported by the mother on one hand and neonatal parameters on the other. The cohort comprised 993 mother-newborn pairs. Each mother completed a questionnaire that probed occupational, domestic, environmental and dietary sources of parental exposure to pesticides during her pregnancy. Multivariate regression analyses were then used to test for associations between the characteristics of parental pesticide exposure during pregnancy and the corresponding birth outcomes. Maternal occupational exposure was associated with an elevated risk of low birth weight (odds ratio (OR [95% confidence interval]: 4.2 [1.2, 15.4]. Paternal occupational exposure to pesticides was associated with a lower than average gestational age at birth (-0.7 weeks; p = 0.0002 and an elevated risk of prematurity (OR: 3.7 [1.4, 9.7]. Levels of domestic exposure to veterinary antiparasitics and to pesticides for indoor plants were both associated with a low birth weight (-70 g; p = 0.02 and -160 g; p = 0.005, respectively. Babies born to women living in urban areas had a lower birth length and a higher risk of low birth length (-0.4 cm, p = 0.006 and OR: 2.9 [1.5, 5.5], respectively. The present study results mainly demonstrate a negative correlation between fetal development on one hand and parental occupational and domestic exposure to pesticides on the other. Our study highlights the need to perform a global and detailed screening of all potential physiological effects when assessing in utero exposure to pesticides.

  8. Self-reported parental exposure to pesticide during pregnancy and birth outcomes: the MecoExpo cohort study.

    Science.gov (United States)

    Mayhoub, Flora; Berton, Thierry; Bach, Véronique; Tack, Karine; Deguines, Caroline; Floch-Barneaud, Adeline; Desmots, Sophie; Stéphan-Blanchard, Erwan; Chardon, Karen

    2014-01-01

    The MecoExpo study was performed in the Picardy region of northern France, in order to investigate the putative relationship between parental exposures to pesticides (as reported by the mother) on one hand and neonatal parameters on the other. The cohort comprised 993 mother-newborn pairs. Each mother completed a questionnaire that probed occupational, domestic, environmental and dietary sources of parental exposure to pesticides during her pregnancy. Multivariate regression analyses were then used to test for associations between the characteristics of parental pesticide exposure during pregnancy and the corresponding birth outcomes. Maternal occupational exposure was associated with an elevated risk of low birth weight (odds ratio (OR) [95% confidence interval]: 4.2 [1.2, 15.4]). Paternal occupational exposure to pesticides was associated with a lower than average gestational age at birth (-0.7 weeks; p = 0.0002) and an elevated risk of prematurity (OR: 3.7 [1.4, 9.7]). Levels of domestic exposure to veterinary antiparasitics and to pesticides for indoor plants were both associated with a low birth weight (-70 g; p = 0.02 and -160 g; p = 0.005, respectively). Babies born to women living in urban areas had a lower birth length and a higher risk of low birth length (-0.4 cm, p = 0.006 and OR: 2.9 [1.5, 5.5], respectively). The present study results mainly demonstrate a negative correlation between fetal development on one hand and parental occupational and domestic exposure to pesticides on the other. Our study highlights the need to perform a global and detailed screening of all potential physiological effects when assessing in utero exposure to pesticides.

  9. Potential Dermal Exposure to Flonicamid and Risk Assessment of Applicators During Treatment in Apple Orchards.

    Science.gov (United States)

    Zhao, Mei-Ai; Yu, Aili; Zhu, Yong-Zhe; Kim, Jeong-Han

    2015-01-01

    Exposure and risk assessments of flonicamid for applicators were performed in apple orchards in Korea. Fifteen experiments were done with two experienced applicators under typical field conditions using a speed sprayer. In this study, cotton gloves, socks, masks, and dermal patches were used to monitor potential dermal exposure to flonicamid, and personal air samplers with XAD-2 resin and glass fiber filter were used to monitor potential inhalation exposure. The analytical methods were validated for the limit of detection, limit of quantitation, reproducibility, linearity of the calibration curve, and recovery of flonicamid from various exposure matrices. The results were encouraging and acceptable for an exposure study. The applicability of XAD-2 resin was evaluated via a trapping efficiency and breakthrough test. During the mixing/loading, the average total dermal exposure was 22.6 μg of flonicamid, corresponding to 4.5×10(-5)% of the prepared amount. For the spraying, the potential dermal exposure was 9.32 mg, and the ratio to applied amount was 1.9 × 10(-2%). The primary exposed body parts were the thigh (2.90 mg), upper arm (1.75 mg), and lower leg (1.66 mg). By comparison, absorbable quantity of exposure was small, only 1.62 μg (3.2×10(-6)%). The margin of safety (MOS) were calculated for risk assessment, in all sets of trials, MOS > 1, indicating the exposure level of flonicamid was considered to be safe in apple orchards. Although this was a limited study, it provided a good estimate of flonicamid exposure for orchard applicators.

  10. Maternal exposure to UV filters: associations with maternal thyroid hormones, IGF-I/IGFBP3 and birth outcomes.

    Science.gov (United States)

    Krause, M; Frederiksen, H; Sundberg, K; Jørgensen, F S; Jensen, L N; Nørgaard, P; Jørgensen, C; Ertberg, P; Petersen, J H; Feldt-Rasmussen, U; Juul, A; Drzewiecki, K T; Skakkebaek, N E; Andersson, A M

    2018-02-01

    Several chemical UV filters/absorbers ('UV filters' hereafter) have endocrine-disrupting properties in vitro and in vivo . Exposure to these chemicals, especially during prenatal development, is of concern. To examine maternal exposure to UV filters, associations with maternal thyroid hormone, with growth factor concentrations as well as to birth outcomes. Prospective study of 183 pregnant women with 2nd trimester serum and urine samples available. Maternal concentrations of the chemical UV filters benzophenone-1 (BP-1) and benzophenone-3 (BP-3) in urine and 4-hydroxy-benzophenone (4-HBP) in serum were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The relationships between 2nd trimester maternal concentrations of the three chemical UV filters and maternal serum concentrations of thyroid hormones and growth factors, as well as birth outcomes (weight, height, and head and abdominal circumferences) were examined. Positive associations between maternal serum concentrations of 4-HBP and triiodothyronine (T 3 ), thyroxine (T 4 ), insulin-like growth factor I (IGF-I) and its binding protein IGFBP3 were observed in mothers carrying male fetuses. Male infants of mothers in the middle 4-HBP exposure group had statistically significantly lower weight and shorter head and abdominal circumferences at birth compared to the low exposure group. Widespread exposure of pregnant women to chemical UV filters and the possible impact on maternal thyroid hormones and growth factors, and on fetal growth, calls for further studies on possible long-term consequences of the exposure to UV filters on fetal development and children's health. © 2018 The authors.

  11. Nickel ferrule applicators: a source of nickel exposure in children.

    Science.gov (United States)

    Jacob, Sharon E; Silverberg, Jonathan I; Rizk, Christopher; Silverberg, Nanette

    2015-01-01

    Eye makeup has been investigated for nickel content and found to have no direct association with nickel allergy and cosmetic dermatitis. However, the tools used (e.g., eyelash curlers, hairdressing scissors, hair curlers, and eye shadow and makeup applicators) may be sources. Nickel is ubiquitous and a wide range of sources have been reported, and makeup applicators (ferrules) now join the list. © 2015 Wiley Periodicals, Inc.

  12. Documentation of quality improvement exposure by internal medicine residency applicants.

    Science.gov (United States)

    Kolade, Victor O; Sethi, Anuradha

    2016-01-01

    Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

  13. Virtual reality application for simulating and minimizing worker radiation exposure

    International Nuclear Information System (INIS)

    Kang, Ki Doo; Hajek, Brian K.; Lee, Yon Sik; Shin, Yoo Jin

    2004-01-01

    To plan work and preclude unexpected radiation exposures in a nuclear power plant, a virtual nuclear plant is a good solution. For this, there are prerequisites such as displaying real time radiation exposure data onto an avatar and preventing speed reduction caused by multiple users on the net-based system. The work space is divided into several sections and radiation information is extracted section by section. Based on the simulation algorithm, real time processing is applied to the events and movements of the avatar. Because there are millions of parts in a nuclear power plant, it is almost impossible to model all of them. Several parts of virtual plant have been modeled using 3D internet virtual reality for the model development. Optimum one-click Active-X is applied for the system, which provides easy access to the virtual plant. Connection time on the net is 20-30 sec for initial loading and 3-4 sec for the 2nd and subsequent times

  14. Root causes, clinical effects, and outcomes of unintentional exposures to buprenorphine by young children.

    Science.gov (United States)

    Lavonas, Eric J; Banner, William; Bradt, Pamela; Bucher-Bartelson, Becki; Brown, Kimberly R; Rajan, Pradeep; Murrelle, Lenn; Dart, Richard C; Green, Jody L

    2013-11-01

    To characterize the rates, root causes, and clinical effects of unintentional exposures to buprenorphine sublingual formulations among young children and to determine whether exposure characteristics differ between formulations. Unintentional exposures to buprenorphine-containing products among children 28 days to less than 6 years old were collected from the Researched Abuse, Diversion, and Addiction-Related Surveillance System Poison Center Program and Reckitt Benckiser Pharmaceuticals' pharmacovigilance system from October 2009-March 2012. After adjustment for drug availability, negative binomial regression was used to estimate average exposure rates. Root cause assessment was conducted, and an expert clinician panel adjudicated causality and severity of moderate to severe adverse events (AEs). A total of 2380 cases were reviewed, including 4 deaths. Exposures to buprenorphine-naloxone combination film were significantly less frequent than exposures to buprenorphine tablets (rate ratio 3.5 [95% CI, 2.7-4.5]) and buprenorphine-naloxone combination tablets (rate ratio 8.8 [7.2-10.6]). The most commonly identified root causes were medication stored in sight, accessed from a bag or purse, and not stored in the original packaging. Among 536 panel review cases, the most common AEs reported for all formulations were lethargy, respiratory depression, miosis, and vomiting. The highest level AE severity did not differ significantly by formulation. Unintentional exposure to buprenorphine can cause central nervous system depression, respiratory depression, and death in young children. Exposure rates to film formulations are significantly less than to tablet formulations. Package and storage deficiencies contribute to unintentional exposures in young children. Copyright © 2013 Mosby, Inc. All rights reserved.

  15. Impact of subspecialty elective exposures on outcomes on the American board of internal medicine certification examination

    Directory of Open Access Journals (Sweden)

    Shanmugam Victoria K

    2012-10-01

    Full Text Available Abstract Background The American Board of Internal Medicine Certification Examination (ABIM-CE is one of several methods used to assess medical knowledge, an Accreditation Council for Graduate Medical Education (ACGME core competency for graduating internal medicine residents. With recent changes in graduate medical education program directors and internal medicine residents are seeking evidence to guide decisions regarding residency elective choices. Prior studies have shown that formalized elective curricula improve subspecialty ABIM-CE scores. The primary aim of this study was to evaluate whether the number of subspecialty elective exposures or the specific subspecialties which residents complete electives in impact ABIM-CE scores. Methods ABIM-CE scores, elective exposures and demographic characteristics were collected for MedStar Georgetown University Hospital internal medicine residents who were first-time takers of the ABIM-CE in 2006–2010 (n=152. Elective exposures were defined as a two-week period assigned to the respective subspecialty. ABIM-CE score was analyzed using the difference between the ABIM-CE score and the standardized passing score (delta-SPS. Subspecialty scores were analyzed using percentage of correct responses. Data was analyzed using GraphPad Prism version 5.00 for Windows. Results Paired elective exposure and ABIM-CE scores were available in 131 residents. There was no linear correlation between ABIM-CE mean delta-SPS and the total number of electives or the number of unique elective exposures. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures (143.4 compared to 129.7, p=0.051. Repeated electives in individual subspecialties were not associated with significant difference in mean ABIM-CE delta-SPS. Conclusions This study did not demonstrate significant positive associations between individual subspecialty elective exposures and ABIM-CE mean delta

  16. Patient Characteristics and Patient Behavior as Predictors of Outcome in Cognitive Therapy and Exposure Therapy for Hypochondriasis.

    Science.gov (United States)

    Richtberg, Samantha; Jakob, Marion; Höfling, Volkmar; Weck, Florian

    2017-06-01

    Psychotherapy for hypochondriasis has greatly improved over the last decades and cognitive-behavioral treatments are most promising. However, research on predictors of treatment outcome for hypochondriasis is rare. Possible predictors of treatment outcome in cognitive therapy (CT) and exposure therapy (ET) for hypochondriasis were investigated. Characteristics and behaviors of 75 patients were considered as possible predictors: sociodemographic variables (sex, age, and cohabitation); psychopathology (pretreatment hypochondriacal symptoms, comorbid mental disorders, and levels of depression, anxiety, and somatic symptoms); and patient in-session interpersonal behavior. Severity of pretreatment hypochondriacal symptoms, comorbid mental disorders, and patient in-session interpersonal behavior were significant predictors in multiple hierarchical regression analyses. Interactions between the predictors and the treatment (CT or ET) were not found. In-session interpersonal behavior is an important predictor of outcome. Furthermore, there are no specific contraindications to treating hypochondriasis with CT or ET. © 2016 Wiley Periodicals, Inc.

  17. CHILDREN'S RESIDENTIAL EXPOSURE TO CHLORPYRIFOS: APPLICATION OF CPPAES FIELD MEASUREMENTS OF CHLORPYRIFOS AND TCPY WITHIN MENTOR/SHEDS PESTICIDES MODEL

    Science.gov (United States)

    The comprehensive individual field-measurements on non-dietary exposure collected in the Children's-Post-Pesticide-Application-Exposure-Study (CPPAES) were used within MENTOR/SHEDS-Pesticides, a physically based stochastic human exposure and dose model. In this application, howev...

  18. The 2008-2009 recession and alcohol outcomes: differential exposure and vulnerability for Black and Latino populations.

    Science.gov (United States)

    Zemore, Sarah E; Mulia, Nina; Jones-Webb, Rhonda J; Liu, Huiguo; Schmidt, Laura

    2013-01-01

    We examined whether race/ethnicity was related to exposure to acute economic losses in the 2008-2009 recession, even accounting for individual-level and geographic variables, and whether it influenced associations between economic losses and drinking patterns and problems. Data were from the 2010 National Alcohol Survey (N = 5,382). Surveys assessed both severe losses (i.e., job and housing loss) and moderate losses (i.e., reduced hours/pay and trouble paying the rent/mortgage) attributed to the 2008-2009 recession. Alcohol outcomes included total annual volume, monthly drunkenness, drinking consequences, and alcohol dependence (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Compared with Whites, Blacks reported significantly greater exposure to job loss and trouble paying the rent/mortgage, and Latinos reported greater exposure to all economic losses. However, only Black-White differences were robust in multivariate analyses. Interaction tests suggested that associations between exposure to economic loss and alcohol problems were stronger among Blacks than Whites. Given severe (vs. no) loss, Blacks had about 13 times the odds of both two or more drinking consequences and alcohol dependence, whereas the corresponding odds ratios for Whites were less than 3. Conversely, associations between economic loss and alcohol outcomes were weak and ambiguous among Latinos. Results suggest greater exposure to economic loss for both Blacks and Latinos (vs. Whites) and that the Black population may be particularly vulnerable to the negative effects of economic hardship on the development and/or maintenance of alcohol problems. Findings extend the economic literature and signal policy makers and service providers that Blacks and Latinos may be at special risk during economic downturns.

  19. Effect of Prenatal Polycyclic Aromatic Hydrocarbons Exposure on Birth Outcomes: The Polish Mother and Child Cohort Study

    Directory of Open Access Journals (Sweden)

    Kinga Polanska

    2014-01-01

    Full Text Available The aim of this study was to assess the impact of PAH exposure on various anthropometric measures of birth outcomes. The study population consisted of 210 nonsmoking pregnant women. Urine samples collected between 20th and 24th week of pregnancy were used for analysis of the following PAH metabolites: 1-, 2-, 3-, 4-, and 9-hydroxyphenanthrene (1-, 2-, 3-, 4-, and 9-OH-PHE, 1-hydroxypyrene (1-OH-PYR, 1,6 + 1,8-dihydroxypyrene (DI-OH-PYR, phenanthrene trans-1,2-dihydrodiol (PHE-1,2-diol, and phenanthrene trans-9,10-dihydrodiol (PHE-9,10-diol by gas chromatography-mass spectrometry. Environmental tobacco smoke exposure (ETS was assessed by cotinine level in saliva using a stable isotope dilution LC-ESI-MS/MS method. The mean PAH metabolite concentrations were in the range of 0.15 µg/g creatinine for 9-OH-PHE to 5.9 µg/g creatinine for PHE-9,10-diol. It was shown that none of the individual PAH exposure markers demonstrate a statistically significant influence on birth outcomes. Interestingly a statistically significant association was found between the sum of OH-PHE along with cotinine level and the cephalization index after adjusting for potential confounders (P=0.04. This study provides evidence that combined exposure of pregnant women to common environmental pollutants such as PAH and ETS might adversely affect fetal development. Thus, reduction of human exposure to these mixtures of hazardous compounds would in particular result in substantial health benefits for newborns.

  20. Effect of prenatal polycyclic aromatic hydrocarbons exposure on birth outcomes: the Polish mother and child cohort study.

    Science.gov (United States)

    Polanska, Kinga; Dettbarn, Gerhard; Jurewicz, Joanna; Sobala, Wojciech; Magnus, Per; Seidel, Albrecht; Hanke, Wojciech

    2014-01-01

    The aim of this study was to assess the impact of PAH exposure on various anthropometric measures of birth outcomes. The study population consisted of 210 nonsmoking pregnant women. Urine samples collected between 20th and 24th week of pregnancy were used for analysis of the following PAH metabolites: 1-, 2-, 3-, 4-, and 9-hydroxyphenanthrene (1-, 2-, 3-, 4-, and 9-OH-PHE), 1-hydroxypyrene (1-OH-PYR), 1,6 + 1,8-dihydroxypyrene (DI-OH-PYR), phenanthrene trans-1,2-dihydrodiol (PHE-1,2-diol), and phenanthrene trans-9,10-dihydrodiol (PHE-9,10-diol) by gas chromatography-mass spectrometry. Environmental tobacco smoke exposure (ETS) was assessed by cotinine level in saliva using a stable isotope dilution LC-ESI-MS/MS method. The mean PAH metabolite concentrations were in the range of 0.15 µg/g creatinine for 9-OH-PHE to 5.9 µg/g creatinine for PHE-9,10-diol. It was shown that none of the individual PAH exposure markers demonstrate a statistically significant influence on birth outcomes. Interestingly a statistically significant association was found between the sum of OH-PHE along with cotinine level and the cephalization index after adjusting for potential confounders (P = 0.04). This study provides evidence that combined exposure of pregnant women to common environmental pollutants such as PAH and ETS might adversely affect fetal development. Thus, reduction of human exposure to these mixtures of hazardous compounds would in particular result in substantial health benefits for newborns.

  1. Exposures and Health Outcomes in Relation to Bioaerosol Emissions From Composting Facilities: A Systematic Review of Occupational and Community Studies

    Science.gov (United States)

    Pearson, Clare; Littlewood, Emma; Douglas, Philippa; Robertson, Sarah; Gant, Timothy W.; Hansell, Anna L.

    2015-01-01

    The number of composting sites in Europe is rapidly increasing, due to efforts to reduce the fraction of waste destined for landfill, but evidence on possible health impacts is limited. This article systematically reviews studies related to bioaerosol exposures within and near composting facilities and associated health effects in both community and occupational health settings. Six electronic databases and bibliographies from January 1960 to July 2014 were searched for studies reporting on health outcomes and/or bioaerosol emissions related to composting sites. Risk of bias was assessed using a customized score. Five hundred and thirty-six papers were identified and reviewed, and 66 articles met the inclusion criteria (48 exposure studies, 9 health studies, 9 health and exposure studies). Exposure information was limited, with most measurements taken in occupational settings and for limited time periods. Bioaerosol concentrations were highest on-site during agitation activities (turning, shredding, and screening). Six studies detected concentrations of either Aspergillus fumigatus or total bacteria above the English Environment Agency’s recommended threshold levels beyond 250 m from the site. Occupational studies of compost workers suggested elevated risks of respiratory illnesses with higher bioaerosol exposures. Elevated airway irritation was reported in residents near composting sites, but this may have been affected by reporting bias. The evidence base on health effects of bioaerosol emissions from composting facilities is still limited, although there is sufficient evidence to support a precautionary approach for regulatory purposes. While data to date are suggestive of possible respiratory effects, further study is needed to confirm this and to explore other health outcomes. PMID:25825807

  2. Transformational leadership: application of magnet's new empiric outcomes.

    Science.gov (United States)

    Meredith, Erin K; Cohen, Elaine; Raia, Lucille V

    2010-03-01

    The many benefits to hospitals throughout the world that achieved Magnet designation is well documented. This status of recognition demands the support of leadership during the Magnet journey. In 2008, the American Nurses Credentialing Center (ANCC) announced a new model for the Magnet Recognition Program that translates the original 14 Forces of Magnetism into Five Model Components. Specifically, this new model includes sources of evidence and empiric outcomes that by definition accentuates transformational nursing leadership. The day-to-day impact of this change places an even greater emphasis on demonstrated outcomes and innovation that may potentially transform nursing practice, quality and safety of care, and the population served. This article provides tangible examples and outcomes for reaching nursing excellence through leadership support and engagement. Published by Elsevier Inc.

  3. Associations of maternal organophosphate pesticide exposure and PON1 activity with birth outcomes in SAWASDEE birth cohort, Thailand

    Science.gov (United States)

    Naksen, Warangkana; Prapamontol, Tippawan; Mangklabruks, Ampica; Chantara, Somporn; Thavornyutikarn, Prasak; Srinual, Niphan; Panuwet, Parinya; Ryan, P. Barry; Riederer, Anne M.; Barr, Dana Boyd

    2015-01-01

    Prenatal organophosphate (OP) pesticide exposure has been reported to be associated with adverse birth outcomes and neurodevelopment. However, the mechanisms of toxicity of OP pesticides on human fetal development have not yet been elucidated. Our pilot study birth cohort, the Study of Asian Women and Offspring’s Development and Environmental Exposures (SAWASDEE cohort) aimed to evaluate environmental chemical exposures and their relation to birth outcomes and infant neurodevelopment in 52 pregnant farmworkers in Fang district, Chiang Mai province, Thailand. A large array of data was collected multiple times during pregnancy including approximately monthly urine samples for evaluation of pesticide exposure, three blood samples for pesticide-related enzyme measurements and questionnaire data. This study investigated the changes in maternal acetylcholinesterase (AChE) and paraoxonase 1 (PON1) activities and their relation to urinary diakylphosphates (DAPs), class-related metabolites of OP pesticides, during pregnancy. Maternal AChE, butyrylcholinesterase (BChE) and PON1 activities were measured three times during pregnancy and urinary DAP concentrations were measured, on average, 8 times from enrollment during pregnancy until delivery. Among the individuals in the group with low maternal PON1 activity (n = 23), newborn head circumference was negatively correlated with log10 maternal ΣDEAP and ΣDAP at enrollment (gestational age=12±3 weeks; β = −1.0 cm, p = 0.03 and β = −1.8 cm, p <0.01, respectively) and at 32 weeks pregnancy (β = −1.1 cm, p = 0.04 and β = −2.6 cm, p = 0.01, respectively). Furthermore, among these mothers, newborn birthweight was also negatively associated with log10 maternal ΣDEAP and ΣDAP at enrollment (β = −219.7 g, p = 0.05 and β = −371.3 g, p = 0.02, respectively). Associations between maternal DAP levels and newborn outcomes were not observed in the group of participants with high maternal PON1 activity. Our results

  4. Effects of in utero and lactational exposure to triphenyltin chloride on pregnancy outcome and postnatal development in rat offspring.

    Science.gov (United States)

    Grote, Konstanze; Hobler, Carolin; Andrade, Anderson J M; Grande, Simone Wichert; Gericke, Christine; Talsness, Chris E; Appel, Klaus E; Chahoud, Ibrahim

    2007-09-05

    The organotin compound (OTC) triphenyltin (TPT) is used extensively as a herbicide, pesticide and fungicide in agriculture as well as, together with tributyltin (TBT), in marine antifouling paints. We studied the effects of in utero exposure to 2 or 6 mg triphenyltinchloride (TPTCl)/kgb.w. on pregnancy outcome and postnatal development in rat offspring. Gravid Wistar rats were treated per gavage from gestational day 6 until the end of lactation. In the 6 mg TPTCl dose group gestational mortality in dams as well as an increased incidence of anticipated and delayed parturition was observed. Furthermore, treatment resulted in a significant increase in perinatal mortality, a decrease in lactational body weight gain as well as in delayed physical maturation of offspring. Similarily, exposure to 2mg TPTCl/kgb.w. resulted in a significant increase in perinatal mortality and in delayed eye opening. Lactational body weight gain and other landmarks of physical maturation were unaffected in the low dose group. We conclude, that in utero exposure to TPTCl at the described dose levels severely affected pregnancy outcome and perinatal survival of offspring. These results were unexpected, as in two earlier studies with pubertal rats TPTCl at the same dose levels no signs of general toxicity were observed.

  5. Methods of estimating population exposures from Plowshare applications

    Energy Technology Data Exchange (ETDEWEB)

    Kaye, S V; Rohwer, P S [Health Physics Division, Oak Ridge National Laboratory, Oak Ridge, TN (United States)

    1969-07-01

    When estimating doses to populations it is necessary to divide the total population into groups that have parameters of similar type and magnitude in order to identify critical population groups. Age groups constitute the most basic and generally useful way of dividing the total population for estimating dose. Models for estimating dose, particularly the internal dose from inhalation and ingestion of radioactivity, should be written as a function of age. The importance of considering age-dependency is emphasized by the fact that some of the internal dose parameters change by much as a factor of ten for some radionuclides when comparing a one year old with an adult. A computer code called INREM has been written which can consider all internal dose parameters as a function of age. The major imitation in using this computer code for all radionuclides is the paucity of age-dependent input data for many radionuclides. Tritium, iodine, cesium, and strontium have been studied in detail with INREM and the results and interpretations are discussed. Another code, EXREM, computes the external dose rates and cumulative doses from both beta particles and gamma photons from submersion in a radioactive cloud, submersion in contaminated water and exposure above a contaminated land surface. This code can consider up to 25 Plowshare detonations and a variety of combinations for calculating doses and dose rates in relation to a detonation schedule. The importance of using both INREM and EXREM to estimate the total dose to a population group is stressed. (author)

  6. Methods of estimating population exposures from Plowshare applications

    International Nuclear Information System (INIS)

    Kaye, S.V.; Rohwer, P.S.

    1969-01-01

    When estimating doses to populations it is necessary to divide the total population into groups that have parameters of similar type and magnitude in order to identify critical population groups. Age groups constitute the most basic and generally useful way of dividing the total population for estimating dose. Models for estimating dose, particularly the internal dose from inhalation and ingestion of radioactivity, should be written as a function of age. The importance of considering age-dependency is emphasized by the fact that some of the internal dose parameters change by much as a factor of ten for some radionuclides when comparing a one year old with an adult. A computer code called INREM has been written which can consider all internal dose parameters as a function of age. The major imitation in using this computer code for all radionuclides is the paucity of age-dependent input data for many radionuclides. Tritium, iodine, cesium, and strontium have been studied in detail with INREM and the results and interpretations are discussed. Another code, EXREM, computes the external dose rates and cumulative doses from both beta particles and gamma photons from submersion in a radioactive cloud, submersion in contaminated water and exposure above a contaminated land surface. This code can consider up to 25 Plowshare detonations and a variety of combinations for calculating doses and dose rates in relation to a detonation schedule. The importance of using both INREM and EXREM to estimate the total dose to a population group is stressed. (author)

  7. Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder.

    Science.gov (United States)

    Pinto, Anthony; Liebowitz, Michael R; Foa, Edna B; Simpson, H Blair

    2011-08-01

    Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Exposure to Perfluorinated Alkyl Substances and Health Outcomes in Children: A Systematic Review of the Epidemiologic Literature

    Science.gov (United States)

    Rappazzo, Kristen M.; Coffman, Evan; Hines, Erin P.

    2017-01-01

    Perfluoroalkyl substances (PFAS), chemicals used to make products stain and stick resistant, have been linked to health effects in adults and adverse birth outcomes. A growing body of literature also addresses health effects in children exposed to PFAS. This review summarizes the epidemiologic evidence for relationships between prenatal and/or childhood exposure to PFAS and health outcomes in children as well as to provide a risk of bias analysis of the literature. A systematic review was performed by searching PubMed for studies on PFAS and child health outcomes. We identified 64 studies for inclusion and performed risk of bias analysis on those studies. We determined that risk of bias across studies was low to moderate. Six categories of health outcomes emerged. These were: immunity/infection/asthma, cardio-metabolic, neurodevelopmental/attention, thyroid, renal, and puberty onset. While there are a limited number of studies for any one particular health outcome, there is evidence for positive associations between PFAS and dyslipidemia, immunity (including vaccine response and asthma), renal function, and age at menarche. One finding of note is that while PFASs are mixtures of multiple compounds few studies examine them as such, therefore the role of these compounds as complex mixtures remains largely unknown. PMID:28654008

  9. Outcomes assessment in cancer: measures, methods, and applications

    National Research Council Canada - National Science Library

    Lipscomb, Joseph; Snyder, Claire; Gotay, Carolyn C

    2005-01-01

    ... on individuals and populations. The findings and recommendations of the working group's 35 internationally recognized members are reported in Outcomes Assessment in Cancer, lucidly written and accessible to both researchers and policy makers in academia, government, and industry. This volume provides the most penetrating yet practical discussion to date of alte...

  10. Potential exposure to endocrine disrupting chemicals and selected adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Bengtsson, Jessica; Thygesen, Pernille Søgaard; Kaerlev, Linda

    2017-01-01

    potential occupational exposure to endocrine disrupting chemicals (EDC) of the mother during pregnancy is associated with preterm birth and low birth weight. Methods: Pregnant women referred to an Occupational Health Clinic (OHC) in two Danish regions (Copenhagen or Aarhus) between 1984 and 2010, suspected...... on the suspicion of other exposures than EDC (n = 620), and to a sample of births by all occupationally active women in the same geographical regions (n = 346,544), including 1,077 births of the referred women’s non-referred pregnancies. Results: No indications of reduced birth weight or increased risk of preterm...... birth were found among women potentially exposed to EDC. Women potentially exposed to EDC had children with a higher birth weight compared to the sample of occupationally active women but not compared to other women referred to an OHC. Conclusions: Potential maternal exposure to EDC at Danish workplaces...

  11. Outcome-Driven Cluster Analysis with Application to Microarray Data.

    Directory of Open Access Journals (Sweden)

    Jessie J Hsu

    Full Text Available One goal of cluster analysis is to sort characteristics into groups (clusters so that those in the same group are more highly correlated to each other than they are to those in other groups. An example is the search for groups of genes whose expression of RNA is correlated in a population of patients. These genes would be of greater interest if their common level of RNA expression were additionally predictive of the clinical outcome. This issue arose in the context of a study of trauma patients on whom RNA samples were available. The question of interest was whether there were groups of genes that were behaving similarly, and whether each gene in the cluster would have a similar effect on who would recover. For this, we develop an algorithm to simultaneously assign characteristics (genes into groups of highly correlated genes that have the same effect on the outcome (recovery. We propose a random effects model where the genes within each group (cluster equal the sum of a random effect, specific to the observation and cluster, and an independent error term. The outcome variable is a linear combination of the random effects of each cluster. To fit the model, we implement a Markov chain Monte Carlo algorithm based on the likelihood of the observed data. We evaluate the effect of including outcome in the model through simulation studies and describe a strategy for prediction. These methods are applied to trauma data from the Inflammation and Host Response to Injury research program, revealing a clustering of the genes that are informed by the recovery outcome.

  12. Application of the ALAP concept to occupational exposure at operating light water reactors

    International Nuclear Information System (INIS)

    Dickson, H.W.; Cottrell, W.D.; Jacobs, D.G.

    1975-01-01

    The application of the as-low-as-practicable (ALAP) concept to radiation exposure of workers at light-water reactors (LWR's) has recently received increased attention. The purpose of the project described is to investigate the means by which occupational exposure at operating LWR's can be reduced to the lowest practicable levels. Nine LWR stations, including 16 operating reactors, were studied in Phase I of the project to identify significant sources of exposure and to determine the magnitude of the exposures. A complete site review consists of compiling information from safety analysis reports, plant technical specifications, and radiation exposure records coupled with an on-site visit for discussions with plant personnel, observation of procedures, and measurement of radiation levels. In Phase II, specific problem areas are being studied in-depth with regard to corrective measures to reduce exposure. Information has been collected on exposure from valve maintenance and repair. Corrective measures will be evaluated with respect to ease of application and cost effectiveness. The results presented will serve as technical backup for the preparation of regulatory guides

  13. Application of ALAP concept to exposure of workers at light-water reactors

    International Nuclear Information System (INIS)

    Dickson, H.W.; Cottrell, W.D.; Jacobs, D.G.

    1975-11-01

    The application of the as-low-as-practicable (ALAP) philosophy to radiation exposure of workers at light-water reactors (LWR's) has recently received increased attention. The purpose of this project is to investigate the means by which occupational exposure at operating LWR's can be reduced to the lowest practicable levels. Nine such LWR stations, including 16 operating reactors, have been studied in phase I of the project to identify significant sources of exposure and to determine the magnitude of the exposures. A complete site review consists of compiling information from safety analysis reports (SAR's), plant technical specifications, and radiation exposure records and then making an on-site visit for discussions with plant personnel, observation of procedures, and measurement of radiation levels. In phase II, specific problem areas are being studied in-depth with regard to corrective measures to reduce exposure. Information has been collected on solving the problem of exposure from valve maintenance and repair. These corrective measures will be evaluated with respect to ease of application and cost effectiveness. The results of this study will serve as technical backup for the preparation of regulatory guides

  14. Risk of Adverse Pregnancy Outcome After Paternal Exposure to Methotrexate Within 90 Days Before Pregnancy

    DEFF Research Database (Denmark)

    Eck, Lasse Karlsen; Jensen, Thomas Bo; Mastrogiannis, Dimitrios

    2017-01-01

    OBJECTIVE: To study the association between paternal exposure to methotrexate within the 90-day period before pregnancy and congenital malformations and stillbirth in the offspring. METHODS: We conducted a nationwide register study. Our cohort consisted of all live births in Denmark between 1997...... group and no increased risk of preterm birth (adjusted OR 1.31, 95% CI 0.66-2.59) among the children from exposed fathers. CONCLUSION: We found no association between paternal exposure to methotrexate within 90 days before pregnancy and congenital malformations, stillbirths, or preterm birth. Available...

  15. Effects of early exposure to phthalates and bisphenols on cardiometabolic outcomes in pregnancy and childhood

    NARCIS (Netherlands)

    Philips, E.M. (Elise M.); V.W.V. Jaddoe (Vincent); Trasande, L. (Leonardo)

    2017-01-01

    textabstractPregnant women are exposed to various chemicals, including endocrine-disrupting chemicals (EDCs) such as phthalates and bisphenols. Increasing evidence suggests that early life exposures to phthalates and bisphenols may contribute to cardiometabolic risks. The aim of this narrative

  16. Complexities of sibling analysis when exposures and outcomes change with time and birth order.

    Science.gov (United States)

    Sudan, Madhuri; Kheifets, Leeka I; Arah, Onyebuchi A; Divan, Hozefa A; Olsen, Jørn

    2014-01-01

    In this study, we demonstrate the complexities of performing a sibling analysis with a re-examination of associations between cell phone exposures and behavioral problems observed previously in the Danish National Birth Cohort. Children (52,680; including 5441 siblings) followed up to age 7 were included. We examined differences in exposures and behavioral problems between siblings and non-siblings and by birth order and birth year. We estimated associations between cell phone exposures and behavioral problems while accounting for the random family effect among siblings. The association of behavioral problems with both prenatal and postnatal exposure differed between siblings (odds ratio (OR): 1.07; 95% confidence interval (CI): 0.69-1.66) and non-siblings (OR: 1.54; 95% CI: 1.36-1.74) and within siblings by birth order; the association was strongest for first-born siblings (OR: 1.72; 95% CI: 0.86-3.42) and negative for later-born siblings (OR: 0.63; 95% CI: 0.31-1.25), which may be because of increases in cell phone use with later birth year. Sibling analysis can be a powerful tool for (partially) accounting for confounding by invariant unmeasured within-family factors, but it cannot account for uncontrolled confounding by varying family-level factors, such as those that vary with time and birth order.

  17. Relationship of Prior Antidepressant Exposure to Long-Term Prospective Outcome in Bipolar I Disorder Outpatients

    NARCIS (Netherlands)

    Post, Robert M.; Leverich, Gabriele S.; Altshuler, Lori L.; Frye, Mark A.; Suppes, Trisha; McElroy, Susan L.; Keck, Paul E.; Nolen, Willem A.; Rowe, Mike; Kupka, Ralph W.; Grunze, Heinz; Goodwin, Frederick K.

    Objective:The long-term impact of prior antidepressant exposure on the subsequent course of bipolar illness remains controversial. Method: 139 outpatients (mean age, 42 years) with bipolar I disorder diagnosed by DSM-IV criteria had a detailed retrospective examination of their prior course of

  18. Virtual reality exposure therapy in anxiety disorders: a systematic review of process-and-outcome studies

    NARCIS (Netherlands)

    Meyerbröker, K.; Emmelkamp, P.M.G.

    2010-01-01

    In recent years, virtual reality exposure therapy (VRET) has become an interesting alternative for the treatment of anxiety disorders. Research has focused on the efficacy of VRET in treating anxiety disorders: phobias, panic disorder, and posttraumatic stress disorder. In this systematic review,

  19. The effects of maternal smoking exposure during pregnancy on postnatal outcomes: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Shih-Hui Huang

    2017-12-01

    Conclusion: Our results demonstrated that maternal smoking exposure during pregnancy is associated with low birth weight and small chest circumference. Although the incidence of active smoking in Taiwanese pregnant women is low, most of them are exposed to passive smoking environment. Further studies are required to evaluate useful interventions to enhance a smoking-free environment during pregnancy.

  20. Potential exposure to endocrine disrupting chemicals and selected adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Bengtsson, Jessica; Thygesen, Pernille Søgaard; Kaerlev, Linda

    2017-01-01

    potential occupational exposure to endocrine disrupting chemicals (EDC) of the mother during pregnancy is associated with preterm birth and low birth weight. Methods: Pregnant women referred to an Occupational Health Clinic (OHC) in two Danish regions (Copenhagen or Aarhus) between 1984 and 2010, suspected...

  1. Complexities of sibling analysis when exposures and outcomes change with time and birth order

    NARCIS (Netherlands)

    Sudan, Madhuri; Kheifets, Leeka I.; Arah, Onyebuchi A.; Divan, Hozefa A.; Olsen, Jørn

    2014-01-01

    In this study, we demonstrate the complexities of performing a sibling analysis with a re-examination of associations between cell phone exposures and behavioral problems observed previously in the Danish National Birth Cohort. Children (52,680; including 5441 siblings) followed up to age 7 were

  2. 75 FR 81332 - Health Outcomes Not Associated With Exposure to Certain Herbicide Agents; Veterans and Agent...

    Science.gov (United States)

    2010-12-27

    ... regarding cancers of the brain and nervous system (including the eye). It found that the new studies were... considered to be associated with herbicide exposure (i.e., b-cell leukemias). Viewing the new evidence in... leukemia (i.e., CLL and other chronic b-cell leukemias). [[Page 81335

  3. Birth outcomes and background exposures to select elements, the Longitudinal Investigation of Fertility and the Environment (LIFE).

    Science.gov (United States)

    Bloom, Michael S; Buck Louis, Germaine M; Sundaram, Rajeshwari; Maisog, Jose M; Steuerwald, Amy J; Parsons, Patrick J

    2015-04-01

    Evidence suggests that trace exposures to select elements may increase the risk for adverse birth outcomes. To investigate further, we used multiple regression to assess associations between preconception parental exposures to Pb, Cd, and total Hg in blood, and 21 elements in urine, with n=235 singleton birth outcomes, adjusted for confounders and partner's exposure. Earlier gestational age at delivery (GA) was associated with higher tertiles of urine maternal W (-1.22 days) and paternal U (-1.07 days), but GA was later for higher tertiles of maternal (+1.11 days) and paternal (+1.30 days) blood Hg. Additional analysis indicated shorter GA associated with higher paternal urine Ba, W, and U, and with higher maternal blood Pb for boys, but GA was longer in association with higher maternal urine Cr. Birth weight (BW) was lower for higher tertiles of paternal urine Cs (-237.85g), U (-187.34g), and Zn (-209.08g), and for higher continuous Cr (P=0.021). In contrast, BW was higher for higher tertiles of paternal urine As (+194.71g) and counterintuitively for maternal blood Cd (+178.52g). Birth length (BL) was shorter for higher tertiles of urine maternal W (-1.22cm) and paternal U (-1.10cm). Yet, higher tertiles of maternal (+1.11cm) and paternal (+1.30) blood Hg were associated with longer BL. Head circumference at delivery was lower for higher tertiles of paternal urine U (-0.83cm), and for higher continuous Mo in boys (-0.57cm). Overall, associations were most consistently indicated for GA and measures of birth size with urine W and U, and paternal exposures were more frequently associated than maternal. Though limited by several factors, ours is the largest multi-element investigation of prospective couple-level trace exposures and birth outcomes to date; the novel observations for W and U merit further investigation. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Modeling lifetime costs and health outcomes attributable to secondhand smoke exposure at home among Korean adult women.

    Science.gov (United States)

    Lee, Jiyae; Han, Ah Ram; Choi, Dalwoong; Lim, Kyung-Min; Bae, SeungJin

    2017-05-17

    The aim of this research is to estimate lifetime costs and health consequences for Korean adult women who were exposed to secondhand smoke (SHS) at home. A Markov model was developed to project the lifetime healthcare costs and health outcomes of a hypothetical cohort of Korean women who are 40 years old and were married to current smokers. The Korean epidemiological data were used to reflect the natural history of SHS-exposed and non-exposed women. The direct healthcare costs (in 2014 US dollars) and quality-adjusted life years (QALYs) were annually discounted at 5% to reflect time preference. The time horizon of the analysis was lifetime and the cycle length was 1 year. Deterministic and probabilistic sensitivity analyses were conducted. In the absence of SHS exposure, Korean women will live 41.32 years or 34.56 QALYs before discount, which corresponded to 17.29 years or 15.35 QALYs after discount. The SHS-exposed women were predicted to live 37.91 years and 31.08 QALYs before discount and 16.76 years and 14.62 QALYs after discount. The estimated lifetime healthcare cost per woman in the SHS non-exposed group was US$11 214 before the discount and US$2465 after discount. The negative impact of SHS exposure on health outcomes and healthcare costs escalated as the time horizon increased, suggesting that the adverse impact of SHS exposure may have higher impact on the later part of the lifetime. The result was consistent across a wide range of assumptions. Life expectancy might underestimate the impact of SHS exposure on health outcomes, especially if the time horizon of the analysis is not long enough. Early intervention on smoking behaviour could substantially reduce direct healthcare costs and improve quality of life attributable to SHS exposure. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Glyphosate in the general population and in applicators: a critical review of studies on exposures.

    Science.gov (United States)

    Solomon, Keith R

    2016-09-01

    The recent classification of glyphosate as a probable human carcinogen by the International Agency for Research on Cancer (IARC) was arrived at without a detailed assessment of exposure. Glyphosate is widely used as an herbicide, which might result in exposures of the general public and applicators. Exposures were estimated from information in the open literature and unpublished reports provided by Monsanto Company. Based on the maximum measured concentration in air, an exposure dose of 1.04 × 10  -   6  mg/kg body mass (b.m.)/d was estimated. Assuming consumption of surface water without treatment, the 90th centile measured concentration would result in a consumed dose of 2.25 × 10  -   5  mg/kg b.m./d. Estimates by the Food and Agriculture Organization of the United Nations (FAO) of consumed doses in food provided a median exposure of 0.005 mg/kg b.m./d (range 0.002-0.013). Based on tolerance levels, the conservative estimate by the US Environmental Protection Agency (US EPA) for exposure of the general population via food and water was 0.088 mg/kg b.m./d (range 0.058-0.23). For applicators, 90th centiles for systemic exposures based on biomonitoring and dosimetry (normalized for penetration through the skin) were 0.0014 and 0.021 mg/kg b.m./d, respectively. All of these exposures are less than the reference dose and the acceptable daily intakes proposed by several regulatory agencies, thus supporting a conclusion that even for these highly exposed populations the exposures were within regulatory limits.

  6. Effects of maternal stress and perinatal fluoxetine exposure on behavioral outcomes of adult male offspring.

    Science.gov (United States)

    Kiryanova, V; Meunier, S J; Vecchiarelli, H A; Hill, M N; Dyck, R H

    2016-04-21

    Women of child-bearing age are the population group at highest risk for depression. In pregnant women, fluoxetine (Flx) is the most widely prescribed selective serotonin reuptake inhibitor (SSRI) used for the treatment of depression. While maternal stress, depression, and Flx exposure have been shown to effect neurodevelopment of the offspring, separately, combined effects of maternal stress and Flx exposure have not been extensively examined. The present study investigated the effects of prenatal maternal stress and perinatal exposure to the SSRI Flx on the behavior of male mice as adults. C57BL/6 dams exposed to chronic unpredictable stress from embryonic (E) day 4 to E18 and non-stressed dams were administered Flx (25 mg/kg/d) in the drinking water from E15 to postnatal day 12. A separate control group consisted of animals that were not exposed to stress or Flx. At 12 days of age, brain levels of serotonin were assessed in the male offspring. At two months of age, the male offspring of mothers exposed to prenatal stress (PS), perinatal Flx, PS and Flx, or neither PS or Flx, went through a comprehensive behavioral test battery. At the end of testing brain-derived neurotropic factor (BDNF) levels were assessed in the frontal cortex of the offspring. Maternal behavior was not altered by either stress or Flx treatment. Treatment of the mother with Flx led to detectible Flx and NorFlx levels and lead to a decrease in serotonin levels in pup brains. In the adult male offspring, while perinatal exposure to Flx increased aggressive behavior, prenatal maternal stress decreased aggressive behavior. Interestingly, the combined effects of stress and Flx normalized aggressive behavior. Furthermore, perinatal Flx treatment led to a decrease in anxiety-like behavior in male offspring. PS led to hyperactivity and a decrease in BDNF levels in the frontal cortex regardless of Flx exposure. Neither maternal stress or Flx altered offspring performance in tests of cognitive

  7. The Relationship Between Provider Competence, Content Exposure, and Consumer Outcomes in Illness Management and Recovery Programs.

    Science.gov (United States)

    McGuire, Alan B; White, Dominique A; Bartholomew, Tom; Flanagan, Mindy E; McGrew, John H; Rollins, Angela L; Mueser, Kim T; Salyers, Michelle P

    2017-01-01

    Provider competence may affect the impact of a practice. The current study examined this relationship in sixty-three providers engaging in Illness Management and Recovery with 236 consumers. Improving upon previous research, the present study utilized a psychometrically validated competence measure in the ratings of multiple Illness Management and Recovery sessions from community providers, and mapped outcomes onto the theory underlying the practice. Provider competence was positively associated with illness self-management and adaptive coping. Results also indicated baseline self-management skills and working alliance may affect the relationship between competence and outcomes.

  8. Application of human volunteer studies in setting exposure limits

    International Nuclear Information System (INIS)

    Bailey, M.R.

    1989-01-01

    Human volunteer studies can provide many of the quantitative data on human radionuclide biokinetics needed to relate organ doses to intakes. They are best suited to characterising parameters that apply to a wide range of compounds, e.g. particle deposition in the respiratory tract, and the retention and excretion of elements after injection into the blood. Their application to quantifying particle clearance from the respiratory tract is discussed, with particular reference to recent findings and the NRPB's programme of volunteer investigations. Evidence to support the view that particle clearance rates are similar for different materials is summarised. Rates of particle clearance from the human lung to the GI tract are calculated from the results of two recent studies. The fraction of the remaining lung content cleared per day is estimated to decrease from ∼ 3 x 10 -3 d -1 at 25 days to ∼ 5 x 10 -4 d -1 at 350 days. There is a large degree of inter-subject variation, with most results conforming to a log-normal distribution with σ g of 1.6. There remains considerable uncertainty about subsequent clearance, and about sites of long-term lung retention. (author)

  9. Gulf War illness: an overview of events, most prevalent health outcomes, exposures, and clues as to pathogenesis.

    Science.gov (United States)

    Kerr, Kathleen J

    2015-01-01

    During or very soon after the 1990-1991 Persian Gulf War, veterans of the conflict began to report symptoms of illness. Common complaints included combinations of cognitive difficulties, fatigue, myalgia, rashes, dyspnea, insomnia, gastrointestinal symptoms and sensitivity to odors. Gradually in the USA, and later in the UK, France, Canada, Denmark and Australia, governments implemented medical assessment programs and epidemiologic studies to determine the scope of what was popularly referred to as "the Gulf War syndrome". Attention was drawn to numerous potentially toxic deployment-related exposures that appeared to vary by country of deployment, by location within the theater, by unit, and by personal job types. Identifying a single toxicant cause was considered unlikely and it was recognized that outcomes were influenced by genetic variability in xenobiotic metabolism. Derived from primary papers and key reports by the Research Advisory Committee on Gulf War Veterans' Illnesses and the Institute of Medicine, a brief overview is presented of war related events, symptoms and diagnostic criteria for Gulf War illness (GWV), some international differences, the various war-related exposures and key epidemiologic studies. Possible exposure interactions and pathophysiologic mechanisms are discussed. Exposures to pyridostigmine bromide, pesticides, sarin and mustard gas or combinations thereof were most associated with GWI, especially in some genotype subgroups. The resultant oxidant stress and background exposome must be assumed to have played a role. Gulf War (GW) exposures and their potential toxic effects should be considered in the context of the human genome, the human exposome and resultant oxidant stress to better characterize this unique environmentally-linked illness and, ultimately, provide a rationale for more effective interventions and future prevention efforts.

  10. Prenatal air pollution exposure induces sexually dimorphic fetal programming of metabolic and neuroinflammatory outcomes in adult offspring.

    Science.gov (United States)

    Bolton, Jessica L; Auten, Richard L; Bilbo, Staci D

    2014-03-01

    Environmental chemical exposures during critical windows of development may contribute to the escalating prevalence of obesity. We tested the hypothesis that prenatal exposure to diesel exhaust particles (DEP), a primary component of air pollution, would prime microglia long-term, resulting in exacerbated metabolic and affective outcomes following exposure to a high-fat diet in adulthood. Time-mated mouse dams were intermittently exposed to respiratory instillations of either vehicle (VEH) or DEP throughout gestation. Adult male and female offspring were then fed either a low-fat diet (LFD) or high-fat diet (HFD) for 9 weeks. The male offspring of DEP-exposed dams exhibited exaggerated weight gain, insulin resistance, and anxiety-like behavior on HFD compared to the male offspring of VEH-exposed dams, whereas female offspring did not differ according to prenatal treatment. Furthermore, HFD induced evidence of macrophage infiltration of both adipose tissue and the brain in both sexes, but these cells were more activated specifically in DEP/HFD males. DEP/HFD males also expressed markedly higher levels of microglial/macrophage, but not astrocyte, activation markers in the hippocampus, whereas females exhibited only a suppression of astrocyte activation markers due to HFD. In a second experiment, DEP male offspring mounted an exaggerated peripheral IL-1β response to an LPS challenge at postnatal day (P)30, whereas their central IL-1β response did not differ from VEH male offspring, which is suggestive of macrophage priming due to prenatal DEP exposure. In sum, prenatal air pollution exposure "programs" offspring for increased susceptibility to diet-induced metabolic, behavioral, and neuroinflammatory changes in adulthood in a sexually dimorphic manner. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Symptom Dimensions in Obsessive-Compulsive Disorder: Phenomenology and Treatment Outcomes with Exposure and Ritual Prevention

    OpenAIRE

    Williams, Monnica T.; Mugno, Beth; Franklin, Martin; Faber, Sonya

    2013-01-01

    Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The cognitive-behavioral treatment with the most empirical support is currently exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings...

  12. Effect of medical x-ray exposure on subsequent reproductive outcomes in scoliosis patients

    International Nuclear Information System (INIS)

    Visscher, W.A.

    1987-01-01

    A retrospective cohort study was done which was designed to assess the effects of medical x-ray exposure on cancer incidence among scoliosis patients. Although the primary purpose of the study was to assess cancer incidence, a secondary goal was to investigate whether diagnostic x-ray exposure is related to adverse reproductive events in the female subjects. A series of case-control analyses were done which were designed to assess these effects. Radiation exposure was measured both by total films received and by an estimate of the number of films received and by an estimate of the number of films which involved ovarian irradiation. Radiation appeared to increase a woman's risk of any adverse event in the overall analysis and her risk of a premature or low birth weight infant in the separate analyses. Radiation did not appear to be related to spontaneous abortion, complications of pregnancy or delivery or birth defects, although the results of the pregnancy complications analysis was suggestive

  13. Hadamard Kernel SVM with applications for breast cancer outcome predictions.

    Science.gov (United States)

    Jiang, Hao; Ching, Wai-Ki; Cheung, Wai-Shun; Hou, Wenpin; Yin, Hong

    2017-12-21

    Breast cancer is one of the leading causes of deaths for women. It is of great necessity to develop effective methods for breast cancer detection and diagnosis. Recent studies have focused on gene-based signatures for outcome predictions. Kernel SVM for its discriminative power in dealing with small sample pattern recognition problems has attracted a lot attention. But how to select or construct an appropriate kernel for a specified problem still needs further investigation. Here we propose a novel kernel (Hadamard Kernel) in conjunction with Support Vector Machines (SVMs) to address the problem of breast cancer outcome prediction using gene expression data. Hadamard Kernel outperform the classical kernels and correlation kernel in terms of Area under the ROC Curve (AUC) values where a number of real-world data sets are adopted to test the performance of different methods. Hadamard Kernel SVM is effective for breast cancer predictions, either in terms of prognosis or diagnosis. It may benefit patients by guiding therapeutic options. Apart from that, it would be a valuable addition to the current SVM kernel families. We hope it will contribute to the wider biology and related communities.

  14. Comparative exposure to DEHP from food contact materials: application of the product intake fraction

    DEFF Research Database (Denmark)

    Ernstoff, Alexi; Jolliet, Olivier; Fantke, Peter

    Quantitative Sustainability Assessment Food contact materials (FCM), e.g. bottles and food handling gloves, can contain potentially endocrine disrupting chemicals, such as di-2-ethylhexyl phthalate(DEHP, CAS: 117-81-7). To investigate the contribution of FCM to dietary DEHP exposure we apply...... thresholds. A hypothetical average PiF for the FCM sector was calculated via production volume and oral exposure doses estimated from NHANES data. In both cases the indication was gloves may contribute more to DEHP exposure when used with certain food items than bottled water. DEHP content in gloves greater...... than 5% would cause exceedance of US EPA threshold when used with certain food items,e.g. radishes based on PiF calculated here. The PiF used in thís context has applications for regulations related to FCM and exposure assessments on a per unit kilo basis....

  15. Endocrine-disrupting activity of hydraulic fracturing chemicals and adverse health outcomes after prenatal exposure in male mice

    Science.gov (United States)

    Kassotis, Christopher D.; Klemp, Kara C.; Vu, Danh C.; Lin, Chung-Ho; Meng, Chun-Xia; Besch-Williford, Cynthia L.; Pinatti, Lisa; Zoeller, R. Thomas; Drobnis, Erma Z.; Balise, Victoria D.; Isiguzo, Chiamaka J.; Williams, Michelle A.; Tillitt, Donald E.; Nagel, Susan C.

    2015-01-01

    Oil and natural gas operations have been shown to contaminate surface and ground water with endocrine-disrupting chemicals. In the current study, we fill several gaps in our understanding of the potential environmental impacts related to this process. We measured the endocrine-disrupting activities of 24 chemicals used and/or produced by oil and gas operations for five nuclear receptors using a reporter gene assay in human endometrial cancer cells. We also quantified the concentration of 16 of these chemicals in oil and gas wastewater samples. Finally, we assessed reproductive and developmental outcomes in male C57BL/6J mice after the prenatal exposure to a mixture of these chemicals. We found that 23 commonly used oil and natural gas operation chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors, and mixtures of these chemicals can behave synergistically, additively, or antagonistically in vitro. Prenatal exposure to a mixture of 23 oil and gas operation chemicals at 3, 30, and 300 μg/kg · d caused decreased sperm counts and increased testes, body, heart, and thymus weights and increased serum testosterone in male mice, suggesting multiple organ system impacts. Our results suggest possible adverse developmental and reproductive health outcomes in humans and animals exposed to potential environmentally relevant levels of oil and gas operation chemicals.

  16. Effects of chronic exposure to low doses of ionizing radiation on the reproductive performance and outcome of an exposed population

    International Nuclear Information System (INIS)

    Mannino, J.A.

    1978-01-01

    This study was designed to test the hypothesis that low doses of ionizing radiation (cumulative dose less than 5.0 rads/yr) effects the reproductive history and/or outcome of a human population. Medically-related personnel who were exposed to low doses of radiation in the course of their employment were compared with medically-related personnel who were not routinely exposed to ionizing radiation. Each population consisted of 3000 persons from the states of Michigan and Ohio. Reproductive performance, history, and outcome of each sample population was compared statistically. Nineteen congenital defects and 47 postnatal defects were recorded for conceptions of the non-exposed population and 50 congenital defects and 83 postnatal defects were recorded for the exposed group. These groups were further broken down as to whether conception took place before, during, or after exposure and the results statistically analyzed. It was found that the exposure population had greater than expected numbers of postnatal defects and less than expected numbers of normal conceptions

  17. Physiologically based pharmacokinetic toolkit to evaluate environmental exposures: Applications of the dioxin model to study real life exposures

    Energy Technology Data Exchange (ETDEWEB)

    Emond, Claude, E-mail: claude.emond@biosmc.com [BioSimulation Consulting Inc, Newark, DE (United States); Ruiz, Patricia; Mumtaz, Moiz [Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, GA (United States)

    2017-01-15

    Chlorinated dibenzo-p-dioxins (CDDs) are a series of mono- to octa-chlorinated homologous chemicals commonly referred to as polychlorinated dioxins. One of the most potent, well-known, and persistent member of this family is 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). As part of translational research to make computerized models accessible to health risk assessors, we present a Berkeley Madonna recoded version of the human physiologically based pharmacokinetic (PBPK) model used by the U.S. Environmental Protection Agency (EPA) in the recent dioxin assessment. This model incorporates CYP1A2 induction, which is an important metabolic vector that drives dioxin distribution in the human body, and it uses a variable elimination half-life that is body burden dependent. To evaluate the model accuracy, the recoded model predictions were compared with those of the original published model. The simulations performed with the recoded model matched well with those of the original model. The recoded model was then applied to available data sets of real life exposure studies. The recoded model can describe acute and chronic exposures and can be useful for interpreting human biomonitoring data as part of an overall dioxin and/or dioxin-like compounds risk assessment. - Highlights: • The best available dioxin PBPK model for interpreting human biomonitoring data is presented. • The original PBPK model was recoded from acslX to the Berkeley Madonna (BM) platform. • Comparisons were made of the accuracy of the recoded model with the original model. • The model is a useful addition to the ATSDR's BM based PBPK toolkit that supports risk assessors. • The application of the model to real-life exposure data sets is illustrated.

  18. Exposure assessment of acrylates/methacrylates in radiation-cured applications

    International Nuclear Information System (INIS)

    1987-01-01

    Occupational exposures to radiation-cured acrylates/methacrylates during their processing and use in coatings, inks, and adhesives were evaluated in 12 walk-through surveys at formulator and applicator sites. Inhalation and dermal-exposure routes were studied. According to the authors, the basic process used to formulate coatings, inks, and adhesives consists of blending raw materials in closed mixing vessels using local exhaust ventilation in the form of elephant trunks at vessel charging and packaging locations. Application methods surveyed included reverse-roll coaters, direct roll coaters, curtain/rain coaters, laminators, pneumatic injection, spray guns, and manual application. At the sites surveyed, the number of workers potentially exposed at each site ranged from two to 142. Process operators at applicator sites had the greatest potential for dermal exposure. Generally, the potential for inhalation exposure was low due to low volatility of the multifunctional acrylates/methacrylates used in the formulations. No reliable air-monitoring data were available at any site. Respirator use was limited and sporadic

  19. Maternal arsenic exposure and birth outcomes: a comprehensive review of the epidemiologic literature focused on drinking water.

    Science.gov (United States)

    Bloom, Michael S; Surdu, Simona; Neamtiu, Iulia A; Gurzau, Eugen S

    2014-09-01

    Inorganic arsenic (iAs) is a human toxicant to which populations may be exposed through consumption of geogenically contaminated groundwater. A growing body of experimental literature corroborates the reproductive toxicity of iAs; however, the results of human studies are inconsistent. Therefore, we conducted a comprehensive review of epidemiologic studies focused on drinking water iAs exposure and birth outcomes to assess the evidence for causality and to make recommendations for future study. We reviewed 18 English language papers assessing birth weight, gestational age, and birth size. Thirteen of the studies were conducted among populations with frequent exposure to high-level groundwater iAs contamination (>10 μg/L) and five studies were conducted in areas without recognized contamination. Most studies comprised small samples and used cross-sectional designs, often with ecologic exposure assessment strategies, although several large prospective investigations and studies with individual-level measurements were also reported. We conclude that: (1) the epidemiologic evidence for an increased risk of low birth weight (water iAs contamination quality epidemiologic studies are necessary to more definitively assess the risk. Copyright © 2014 Elsevier GmbH. All rights reserved.

  20. House dust-mite allergen exposure is associated with serum specific IgE but not with respiratory outcomes.

    Science.gov (United States)

    Bakolis, I; Heinrich, J; Zock, J P; Norbäck, D; Svanes, C; Chen, C M; Accordini, S; Verlato, G; Olivieri, M; Jarvis, D

    2015-06-01

    Exposure to house dust has been associated with asthma in adults, and this is commonly interpreted as a direct immunologic response to dust-mite allergens in those who are IgE sensitized to house dust-mite. Mattress house dust-mite concentrations were measured in a population-based sample of 2890 adults aged between 27 and 56 years living in 22 centers in 10 countries. Generalized linear mixed models were employed to explore the association of respiratory symptoms with house dust-mite concentrations, adjusting for individual and household confounders. There was no overall association of respiratory outcomes with measured house dust-mite concentrations, even in those who reported they had symptoms on exposure to dust and those who had physician-diagnosed asthma. However, there was a positive association of high serum specific IgE levels to HDM (>3.5 kUA /l) with mattress house dust-mite concentrations and a negative association of sensitization to cat with increasing house dust-mite concentrations. In conclusion, there was no evidence that respiratory symptoms in adults were associated with exposure to house dust-mite allergen in the mattress, but an association of house mite with strong sensitization was observed. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Association between Vancomycin Day 1 Exposure Profile and Outcomes among Patients with Methicillin-Resistant Staphylococcus aureus Infective Endocarditis

    Science.gov (United States)

    Casapao, Anthony M.; Lodise, Thomas P.; Davis, Susan L.; Claeys, Kimberly C.; Kullar, Ravina; Levine, Donald P.

    2015-01-01

    Given the critical importance of early appropriate therapy, a retrospective cohort (2002 to 2013) was performed at the Detroit Medical Center to evaluate the association between the day 1 vancomycin exposure profile and outcomes among patients with MRSA infective endocarditis (IE). The day 1 vancomycin area under the concentration-time curve (AUC0–24) and the minimum concentration at 24 h (Cmin 24) was estimated for each patient using the Bayesian procedure in ADAPT 5, an approach shown to accurately predict the vancomycin exposure with low bias and high precision with limited pharmacokinetic sampling. Initial MRSA isolates were collected and vancomycin MIC was determined by broth microdilution (BMD) and Etest. The primary outcome was failure, defined as persistent bacteremia (≥7 days) or 30-day attributable mortality. Classification and regression tree analysis (CART) was used to determine the vancomycin exposure variables associated with an increased probability of failure. In total, 139 patients met study criteria; 76.3% had right-sided IE, 16.5% had left-sided IE, and 7.2% had both left and right-sided IE. A total of 89/139 (64%) experienced failure by composite definition. In the CART analysis, failure was more pronounced in patients with an AUC0–24/MIC as determined by BMD of ≤600 relative to those with AUC0–24/MIC as determined by BMD of >600 (69.8% versus 54.7%, respectively, P = 0.073). In the logistic regression analysis, an AUC/MIC as determined by BMD of ≤600 (adjusted odds ratio, 2.3; 95% confidence interval, 1.01 to 5.37; P = 0.047) was independently associated with failure. Given the retrospective nature of the present study, further prospective studies are required but these data suggest that patients with an AUC0–24/MIC as determined by BMD of ≤600 present an increased risk of failure. PMID:25753631

  2. Acute Cyanide Poisoning: Hydroxocobalamin and Sodium Thiosulfate Treatments with Two Outcomes following One Exposure Event.

    Science.gov (United States)

    Meillier, Andrew; Heller, Cara

    2015-01-01

    Cyanide is rapidly reacting and causes arrest of aerobic metabolism. The symptoms are diffuse and lethal and require high clinical suspicion. Remediation of symptoms and mortality is highly dependent on quick treatment with a cyanide antidote. Presently, there are two widely accepted antidotes: sodium thiosulfate and hydroxocobalamin. These treatments act on different components of cyanide's metabolism. Here, we present two cases resulting from the same source of cyanide poisoning and the use of both antidotes separately used with differing outcomes.

  3. Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility.

    Science.gov (United States)

    da Silva, Marcos Barragan; Almeida, Miriam de Abreu; Panato, Bruna Paulsen; Siqueira, Ana Paula de Oliveira; da Silva, Mariana Palma; Reisderfer, Letícia

    2015-01-01

    to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context.

  4. Interest of the trajectory method for the evaluation of outcomes after in utero drug exposure: example of anxiolytics and hypnotics.

    Science.gov (United States)

    Hurault-Delarue, Caroline; Chouquet, Cécile; Savy, Nicolas; Lacroix, Isabelle; Beau, Anna-Belle; Montastruc, Jean-Louis; Damase-Michel, Christine

    2017-05-01

    The aim of this study was to examine the potential benefit to take into account duration and intensity of drug exposure using the recently published method based on individual drug trajectories. This approach was used to define profiles of exposure to anxiolytics/hypnotics during pregnancy and to evaluate the potential effect on newborn health. The study was performed in EFEMERIS database (54 918 mother-children pairs). An estimation of adaptation to extrauterine life was assessed using several criteria especially cardio-respiratory symptoms. A proxy variable called "neonatal pathology" was created. The occurrence of this event was studied using two approaches: The Standard Method comparing exposed and unexposed newborns, The Trajectory Method comparing the different profiles of exposure. Around 5% of newborns (n = 2768) were identified to be exposed to anxiolytics or hypnotics during pregnancy. Using the Standard Method, 6.2% of exposed newborns developed a "neonatal pathology" against 4.8% of unexposed newborns (odds ratios [OR] = 0.9[0.8-1.2], p = 0.7). With the Trajectory Method taking into account evolution of exposure during pregnancy and treatment intensity, four profiles of pregnant women were identified. A significant difference in the rates of "neonatal pathologies" was observed between profiles (p = 0.0002). Newborns of the two profiles exposed in utero to high constant level of anxiolytics or hypnotics were more at risk of developing "neonatal pathology" than unexposed newborns (OR 1  = 2.0 [1.0-3.9] and OR 2  = 7.6 [2.8-20.5]). The present study demonstrates the interest of this method based on individual drug trajectories for the evaluation of outcomes in pharmaco-epidemiological studies and more specifically during pregnancy. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Baseline psychophysiological and cortisol reactivity as a predictor of PTSD treatment outcome in virtual reality exposure therapy.

    Science.gov (United States)

    Norrholm, Seth Davin; Jovanovic, Tanja; Gerardi, Maryrose; Breazeale, Kathryn G; Price, Matthew; Davis, Michael; Duncan, Erica; Ressler, Kerry J; Bradley, Bekh; Rizzo, Albert; Tuerk, Peter W; Rothbaum, Barbara O

    2016-07-01

    Baseline cue-dependent physiological reactivity may serve as an objective measure of posttraumatic stress disorder (PTSD) symptoms. Additionally, prior animal model and psychological studies would suggest that subjects with greatest symptoms at baseline may have the greatest violation of expectancy to danger when undergoing exposure based psychotherapy; thus treatment approaches which enhanced the learning under these conditions would be optimal for those with maximal baseline cue-dependent reactivity. However methods to study this hypothesis objectively are lacking. Virtual reality (VR) methodologies have been successfully employed as an enhanced form of imaginal prolonged exposure therapy for the treatment of PTSD. Our goal was to examine the predictive nature of initial psychophysiological (e.g., startle, skin conductance, heart rate) and stress hormone responses (e.g., cortisol) during presentation of VR-based combat-related stimuli on PTSD treatment outcome. Combat veterans with PTSD underwent 6 weeks of VR exposure therapy combined with either d-cycloserine (DCS), alprazolam (ALP), or placebo (PBO). In the DCS group, startle response to VR scenes prior to initiation of treatment accounted for 76% of the variance in CAPS change scores, p < 0.001, in that higher responses predicted greater changes in symptom severity over time. Additionally, baseline cortisol reactivity was inversely associated with treatment response in the ALP group, p = 0.04. We propose that baseline cue-activated physiological measures will be sensitive to predicting patients' level of response to exposure therapy, in particular in the presence of enhancement (e.g., DCS). Published by Elsevier Ltd.

  6. Micro-oxygenation of red wine: techniques, applications, and outcomes.

    Science.gov (United States)

    Schmidtke, Leigh M; Clark, Andrew C; Scollary, Geoff R

    2011-02-01

    Wine micro-oxygenation (MOX) is the controlled addition of oxygen to wine in a manner designed to ensure that complete mass transfer of molecular oxygen from gaseous to dissolved state occurs. MOX was initially developed to improve the body, structure, and fruitfulness in red wines with high concentrations of tannins and anthocyanins, by replicating the ingress of oxygen thought to arise from barrel maturation, but without the need for putting all wine to barrel. This review describes the operational parameters essential for the effective performance of the micro-oxidation process as well as the chemical and microbiological outcomes. The methodologies for introducing oxygen into the wine, the rates of oxygen addition, and their relationship to oxygen solubility in the wine matrix are examined. The review focuses on the techniques used for monitoring the MOX process, including sensory assessment, physicochemical properties, and the critical balance of the rate of oxygen addition in relation to maintaining the sulfur dioxide concentration. The chemistry of oxygen reactivity with wine components, the changes in wine composition that occur as a consequence of MOX, and the potential for wine spoilage if proper monitoring is not adopted are examined. Gaps in existing knowledge are addressed focusing on the limitations associated with the transfer of concepts from research trials in small volume tanks to commercial practice, and the dearth of kinetic data for the various chemical and physical processes that are claimed to occur during MOX.

  7. Acute Cyanide Poisoning: Hydroxocobalamin and Sodium Thiosulfate Treatments with Two Outcomes following One Exposure Event

    Directory of Open Access Journals (Sweden)

    Andrew Meillier

    2015-01-01

    Full Text Available Cyanide is rapidly reacting and causes arrest of aerobic metabolism. The symptoms are diffuse and lethal and require high clinical suspicion. Remediation of symptoms and mortality is highly dependent on quick treatment with a cyanide antidote. Presently, there are two widely accepted antidotes: sodium thiosulfate and hydroxocobalamin. These treatments act on different components of cyanide’s metabolism. Here, we present two cases resulting from the same source of cyanide poisoning and the use of both antidotes separately used with differing outcomes.

  8. Exposure to ionizing radiation during pregnancy: Perception of teratogenic risk and outcome

    International Nuclear Information System (INIS)

    Bentur, Y.; Horlatsch, N.; Koren, G.

    1991-01-01

    We quantified the perception of teratogenic risk in women attending the Motherisk program for counseling about diagnostic radiation in pregnancy (n = 50) and compared it with a control group of women exposed to nonteratogenic drugs and chemicals (n = 48). Before receiving known information about the specific exposure, women exposed to radiation assigned themselves a significantly higher teratogenic risk compared with the control group (25.5 +/- 4.3% versus 15.7 +/- 3.0% for major malformations, P less than 0.01). The post-consultation perception of teratogenic risk did not differ between the two groups. Special consideration and attention should be given when counseling pregnant women exposed to low-dose ionizing radiation, as their misperception of teratogenic risk may lead them to unnecessary termination of their pregnancy

  9. Maternal Exposure to Second-hand Smoke and Super Ovulation Outcome for Assisted Reproduction

    Directory of Open Access Journals (Sweden)

    Jila Ganji

    2009-01-01

    Full Text Available Background: The effect of smoking cigarettes is followed by diverse effects on ovaries anddeveloping follicles but the effect of passive smoking on ovarian function is unknown. On the otherhand, the ovarian response to induction is a very important step in assisted reproduction. The aimof this study is to compare ovarian response in passive smokers and non-passive smokers in anassisted reproductive program.Materials and Methods: In a cohort study at the Isfahan Fertility and Infertility Center, there were 72women in the passive smoker group and 72 women in the non-passive smoker group who underwentan assisted reproductive technology (ART program. The follicle number at administration of humanchorionic gonadotropin (HCG, number of gonadotropin ampoules and duration of super ovulationinduction were compared.Results: Statistical analyses indicated that the number of mature follicles in the passive smoker groupwas not different from the control group; but the number of unresponsive cycles to super ovulation inthe passive smoker group (33.3% was significantly higher than the control group (12.5%. Durationof induction and number of gonadotropin ampoules were not different between the two groups.Conclusion: The results of this study show that exposure to second-hand smoke increases the chanceof unresponsiveness to ovulation induction. This condition may be due to the result of decline inovarian reserve in second-hand smokers. The duration of induction and number of gonadotropinampules is similar in the two groups. Furthermore, the results show that exposure to cigarette smokedoes not clinically impact women with good ovarian reserve.

  10. A novel method for standardized application of fungal spore coatings for mosquito exposure bioassays.

    Science.gov (United States)

    Farenhorst, Marit; Knols, Bart G J

    2010-01-20

    Interest in the use of fungal entomopathogens against malaria vectors is growing. Fungal spores infect insects via the cuticle and can be applied directly on the insect to evaluate infectivity. For flying insects such as mosquitoes, however, application of fungal suspensions on resting surfaces is more realistic and representative of field settings. For this type of exposure, it is essential to apply specific amounts of fungal spores homogeneously over a surface for testing the effects of fungal dose and exposure time. Contemporary methods such as spraying or brushing spore suspensions onto substrates do not produce the uniformity and consistency that standardized laboratory assays require. Two novel fungus application methods using equipment developed in the paint industry are presented and compared. Wired, stainless steel K-bars were tested and optimized for coating fungal spore suspensions onto paper substrates. Different solvents and substrates were evaluated. Two types of coating techniques were compared, i.e. manual and automated coating. A standardized bioassay set-up was designed for testing coated spores against malaria mosquitoes. K-bar coating provided consistent applications of spore layers onto paper substrates. Viscous Ondina oil formulations were not suitable and significantly reduced spore infectivity. Evaporative Shellsol T solvent dried quickly and resulted in high spore infectivity to mosquitoes. Smooth proofing papers were the most effective substrate and showed higher infectivity than cardboard substrates. Manually and mechanically applied spore coatings showed similar and reproducible effects on mosquito survival. The standardized mosquito exposure bioassay was effective and consistent in measuring effects of fungal dose and exposure time. K-bar coating is a simple and consistent method for applying fungal spore suspensions onto paper substrates and can produce coating layers with accurate effective spore concentrations. The mosquito bioassay

  11. A novel method for standardized application of fungal spore coatings for mosquito exposure bioassays

    Directory of Open Access Journals (Sweden)

    Knols Bart GJ

    2010-01-01

    Full Text Available Abstract Background Interest in the use of fungal entomopathogens against malaria vectors is growing. Fungal spores infect insects via the cuticle and can be applied directly on the insect to evaluate infectivity. For flying insects such as mosquitoes, however, application of fungal suspensions on resting surfaces is more realistic and representative of field settings. For this type of exposure, it is essential to apply specific amounts of fungal spores homogeneously over a surface for testing the effects of fungal dose and exposure time. Contemporary methods such as spraying or brushing spore suspensions onto substrates do not produce the uniformity and consistency that standardized laboratory assays require. Two novel fungus application methods using equipment developed in the paint industry are presented and compared. Methods Wired, stainless steel K-bars were tested and optimized for coating fungal spore suspensions onto paper substrates. Different solvents and substrates were evaluated. Two types of coating techniques were compared, i.e. manual and automated coating. A standardized bioassay set-up was designed for testing coated spores against malaria mosquitoes. Results K-bar coating provided consistent applications of spore layers onto paper substrates. Viscous Ondina oil formulations were not suitable and significantly reduced spore infectivity. Evaporative Shellsol T solvent dried quickly and resulted in high spore infectivity to mosquitoes. Smooth proofing papers were the most effective substrate and showed higher infectivity than cardboard substrates. Manually and mechanically applied spore coatings showed similar and reproducible effects on mosquito survival. The standardized mosquito exposure bioassay was effective and consistent in measuring effects of fungal dose and exposure time. Conclusions K-bar coating is a simple and consistent method for applying fungal spore suspensions onto paper substrates and can produce coating layers

  12. Occupational radiation exposure during the production of eye applicators and in radiosynovectomy

    International Nuclear Information System (INIS)

    Mielcarek, J.; Barth, I.

    2002-01-01

    Beta-emitters have increasingly been used in medical therapy. Measurements, in particular of the personal dose H p (0.07), were carried out at workplaces of the following areas of application to determine radiation exposure during source production and medical therapy: 1. Production of eye applicators (Ru-106/Rh-106) for the therapy of intra-ocular tumours. This involves handling of unsealed and sealed radioactive substances. 2. Radiosynovectomy (Radiosynoviothesis, RSO). A method used for the therapy of inflammatory joint disease. The used radionuclides Er-169, Re-186 and Y-90 are injected as radioactive solutions. Both areas of application are marked by: handling of high activities (MBq- to GBq-range), very small distances between source and skin, high risk of contamination, unsatisfactory area and personal dose measuring technique. Highly sensitive thermoluminescence detectors (LiF:Mg,Cu,P) were used to determine the beta- exposure especially of the the skin of the hands. Supplementing contamination measurements indicated that additional exposure of the skin was to be expected. A skin dose of 1.4 mSv was caused by the production of eye applicators (daily output). In contrast to this, in the RSO in some cases exposures of the hands due to direct radiation of more than 100 mSv per working day were found. Skin doses caused by contamination were in the same order of magnitude. The exposures could, however, be reduced drastically by using manipulators, the consequent wearing of protective gloves, contamination monitoring and fulfilment of specific safety requirements at work. Consequences for the performance of beta personnel dosimetry are discussed. (orig.)

  13. Web-Based Survey Application to Collect Contextually Relevant Geographic Data With Exposure Times: Application Development and Feasibility Testing

    Science.gov (United States)

    Tobin, Karin; Rudolph, Jonathan; Latkin, Carl

    2018-01-01

    Background Although studies that characterize the risk environment by linking contextual factors with individual-level data have advanced infectious disease and substance use research, there are opportunities to refine how we define relevant neighborhood exposures; this can in turn reduce the potential for exposure misclassification. For example, for those who do not inject at home, injection risk behaviors may be more influenced by the environment where they inject than where they live. Similarly, among those who spend more time away from home, a measure that accounts for different neighborhood exposures by weighting each unique location proportional to the percentage of time spent there may be more correlated with health behaviors than one’s residential environment. Objective This study aimed to develop a Web-based application that interacts with Google Maps application program interfaces (APIs) to collect contextually relevant locations and the amount of time spent in each. Our analysis examined the extent of overlap across different location types and compared different approaches for classifying neighborhood exposure. Methods Between May 2014 and March 2017, 547 participants enrolled in a Baltimore HIV care and prevention study completed an interviewer-administered Web-based survey that collected information about where participants were recruited, worked, lived, socialized, injected drugs, and spent most of their time. For each location, participants gave an address or intersection which they confirmed using Google Map and Street views. Geographic coordinates (and hours spent in each location) were joined to neighborhood indicators by Community Statistical Area (CSA). We computed a weighted exposure based on the proportion of time spent in each unique location. We compared neighborhood exposures based on each of the different location types with one another and the weighted exposure using analysis of variance with Bonferroni corrections to account for

  14. Application and comparison of scoring indices to predict outcomes in patients with healthcare-associated pneumonia

    OpenAIRE

    Fang, Wen-Feng; Yang, Kuang-Yao; Wu, Chieh-Liang; Yu, Chong-Jen; Chen, Chang-Wen; Tu, Chih-Yen; Lin, Meng-Chih

    2011-01-01

    Introduction Healthcare-associated pneumonia (HCAP) is a relatively new category of pneumonia. It refers to infections that occur prior to hospital admission in patients with specific risk factors following contact or exposure to a healthcare environment. There is currently no scoring index to predict the outcomes of HCAP patients. We applied and compared different community acquired pneumonia (CAP) scoring indices to predict 30-day mortality and 3-day and 14-day intensive care unit (ICU) adm...

  15. Radiofrequency ablation of liver tumors (II): clinical application and outcomes.

    Science.gov (United States)

    Vanagas, Tomas; Gulbinas, Antanas; Pundzius, Juozas; Barauskas, Giedrius

    2010-01-01

    Radiofrequency ablation is one of the alternatives in the management of liver tumors, especially in patients who are not candidates for surgery. The aim of this article is to review applicability of radiofrequency ablation achieving complete tumor destruction, utility of imaging techniques for patients' follow-up, indications for local ablative procedures, procedure-associated morbidity and mortality, and long-term results in patients with different tumors. The success of local thermal ablation consists in creating adequate volumes of tissue destruction with adequate "clear margin," depending on improved delivery of radiofrequency energy and modulated tissue biophysiology. Different volumes of coagulation necrosis are achieved applying different types of electrodes, pulsing energy sources, utilizing sophisticated ablation schemes. Some additional methods are used to increase the overall deposition of energy through alterations in tissue electrical conductivity, to improve heat retention within the tissue, and to modulate tolerance of tumor tissue to hyperthermia. Contrast-enhanced computed tomography, magnetic resonance imaging, ultrasound or positron emission tomography are applied to control the effectiveness of radiofrequency ablation. The long-term results of radiofrequency ablation are controversial.

  16. Prenatal exposure to very severe maternal obesity is associated with adverse neuropsychiatric outcomes in children.

    Science.gov (United States)

    Mina, T H; Lahti, M; Drake, A J; Räikkönen, K; Minnis, H; Denison, F C; Norman, J E; Reynolds, R M

    2017-01-01

    Prenatal maternal obesity has been linked to adverse childhood neuropsychiatric outcomes, including increased symptoms of attention deficit hyperactivity disorder (ADHD), internalizing and externalizing problems, affective disorders and neurodevelopmental problems but few studies have studied neuropsychiatric outcomes among offspring born to very severely obese women or assessed potential familial confounding by maternal psychological distress. We evaluated neuropsychiatric symptoms in 112 children aged 3-5 years whose mothers had participated in a longitudinal study of obesity in pregnancy (50 very severe obesity, BMI ⩾40 kg/m2, obese class III and 62 lean, BMI 18.5-25 kg/m2). The mothers completed the Conners' Hyperactivity Scale, Early Symptomatic Syndrome Eliciting Neurodevelopmental Clinical Examination Questionnaire (ESSENCE-Q), Child's Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), and Child Behavior Checklist (CBCL) to assess child neuropsychiatric symptoms. Covariates included child's sex, age, birthweight, gestational age, socioeconomic deprivation levels, maternal age, parity, smoking status during pregnancy, gestational diabetes and maternal concurrent symptoms of anxiety and depression assessed using State Anxiety of Spielberger State-Trait Anxiety Index (STAI) and General Health Questionnaire (GHQ), respectively. Children exposed to prenatal maternal very severe obesity had significantly higher scores in the Conners' Hyperactivity Scale; ESSENCE-Q; total sleep problems in CSHQ; hyperactivity, conduct problems and total difficulties scales of the SDQ; higher externalizing and total problems, anxious/depressed, aggressive behaviour and other problem syndrome scores and higher DSM-oriented affective, anxiety and ADHD problems in CBCL. Prenatal maternal very severe obesity remained a significant predictor of child neuropsychiatric problems across multiple scales independent of demographic factors, prenatal factors and

  17. Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis.

    Science.gov (United States)

    Gunn, J K L; Rosales, C B; Center, K E; Nuñez, A; Gibson, S J; Christ, C; Ehiri, J E

    2016-04-05

    To assess the effects of use of cannabis during pregnancy on maternal and fetal outcomes. 7 electronic databases were searched from inception to 1 April 2014. Studies that investigated the effects of use of cannabis during pregnancy on maternal and fetal outcomes were included. Case-control studies, cross-sectional and cohort studies were included. Data synthesis was undertaken via systematic review and meta-analysis of available evidence. All review stages were conducted independently by 2 reviewers. Maternal, fetal and neonatal outcomes up to 6 weeks postpartum after exposure to cannabis. Meta-analyses were conducted on variables that had 3 or more studies that measured an outcome in a consistent manner. Outcomes for which meta-analyses were conducted included: anaemia, birth weight, low birth weight, neonatal length, placement in the neonatal intensive care unit, gestational age, head circumference and preterm birth. 24 studies were included in the review. Results of the meta-analysis demonstrated that women who used cannabis during pregnancy had an increase in the odds of anaemia (pooled OR (pOR)=1.36: 95% CI 1.10 to 1.69) compared with women who did not use cannabis during pregnancy. Infants exposed to cannabis in utero had a decrease in birth weight (low birth weight pOR=1.77: 95% CI 1.04 to 3.01; pooled mean difference (pMD) for birth weight=109.42 g: 38.72 to 180.12) compared with infants whose mothers did not use cannabis during pregnancy. Infants exposed to cannabis in utero were also more likely to need placement in the neonatal intensive care unit compared with infants whose mothers did not use cannabis during pregnancy (pOR=2.02: 1.27 to 3.21). Use of cannabis during pregnancy may increase adverse outcomes for women and their neonates. As use of cannabis gains social acceptance, pregnant women and their medical providers could benefit from health education on potential adverse effects of use of cannabis during pregnancy. Published by the BMJ

  18. Arsenic exposure and outcomes of antimonial treatment in visceral leishmaniasis patients in Bihar, India: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Meghan R Perry

    2015-03-01

    Full Text Available In the late twentieth century, emergence of high rates of treatment failure with antimonial compounds (SSG for visceral leishmaniasis (VL caused a public health crisis in Bihar, India. We hypothesize that exposure to arsenic through drinking contaminated groundwater may be associated with SSG treatment failure due to the development of antimony-resistant parasites.A retrospective cohort design was employed, as antimony treatment is no longer in routine use. The study was performed on patients treated with SSG between 2006 and 2010. Outcomes of treatment were assessed through a field questionnaire and treatment failure used as a proxy for parasite resistance. Arsenic exposure was quantified through analysis of 5 water samples from within and surrounding the patient's home. A logistic regression model was used to evaluate the association between arsenic exposure and treatment failure. In a secondary analysis survival curves and Cox regression models were applied to assess the risk of mortality in VL patients exposed to arsenic.One hundred and ten VL patients treated with SSG were analysed. The failure rate with SSG was 59%. Patients with high mean local arsenic level had a non-statistically significant higher risk of treatment failure (OR = 1.78, 95% CI: 0.7-4.6, p = 0.23 than patients using wells with arsenic concentration <10 μg/L. Twenty one patients died in our cohort, 16 directly as a result of VL. Arsenic levels ≥ 10 μg/L increased the risk of all-cause (HR 3.27; 95% CI: 1.4-8.1 and VL related (HR 2.65; 95% CI: 0.96-7.65 deaths. This was time dependent: 3 months post VL symptom development, elevated risks of all-cause mortality (HR 8.56; 95% CI: 2.5-29.1 and of VL related mortality (HR 9.27; 95% CI: 1.8-49.0 were detected.This study indicates a trend towards increased treatment failure in arsenic exposed patients. The limitations of the retrospective study design may have masked a strong association between arsenic exposure and selection

  19. Symptom dimensions in obsessive-compulsive disorder: phenomenology and treatment outcomes with exposure and ritual prevention.

    Science.gov (United States)

    Williams, Monnica T; Mugno, Beth; Franklin, Martin; Faber, Sonya

    2013-01-01

    Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. Currently, the cognitive-behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings. Symptom dimensions most reliably identified include contamination/cleaning, doubt about harm/checking, symmetry/ordering, and unacceptable thoughts/mental rituals. The phenomenology of each of these subtypes is described and research literature is summarized, emphasizing the differential effects of EX/RP and its variants on each of these primary symptom dimensions. To date it appears that EX/RP is an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied (i.e. symmetry and ordering). Modifications to treatment may be warranted for some types of symptoms. Clinical implications and directions for future research are discussed. Copyright © 2013 S. Karger AG, Basel.

  20. Adverse pregnancy outcome in rats following exposure to a Salacia reticulata (Celastraceae root extract

    Directory of Open Access Journals (Sweden)

    Ratnasooriya W.D.

    2003-01-01

    Full Text Available The root extract of Salacia reticulata Wight (family: Celastraceae is used in Sri Lanka by traditional practitioners as a herbal therapy for glycemic control even during pregnancy. It is recognized that some clinically used antidiabetic drugs have harmful effects on pregnancy but the effects of the S. reticulata root extract on reproductive outcome is unknown and deserves examination. We determined the effects of the S. reticulata root extract on the reproductive outcome of Wistar rats (250-260 g when administered orally (10 g/kg during early (days 1-7 and mid- (days 7-14 pregnancy. The root extract significantly (P<0.05 enhanced post-implantation losses (control vs treatment: early pregnancy, 4.7 ± 2.4 vs 49.3 ± 13%; mid-pregnancy, 4.7 ± 2.4 vs 41.7 ± 16.1%. Gestational length was unaltered but the pups born had a low birth weight (P<0.05 (early pregnancy, 6.8 ± 0.1 vs 5.3 ± 0.1 g; mid-pregnancy, 6.8 ± 0.1 vs 5.0 ± 0.1 g and low birth index (P<0.05 (early pregnancy, 95.2 ± 2.4 vs 50.7 ± 12.9%; mid-pregnancy, 95.2 ± 2.4 vs 58.3 ± 16.1%, fetal survival ratio (P<0.05 (early pregnancy, 95.2 ± 2.4 vs 50.7 ± 12.9; mid-pregnancy, 95.2 ± 2.4 vs 58.3 ± 16.1, and viability index (P<0.05 (early pregnancy, 94.9 ± 2.6 vs 49.5 ± 12.5%; mid-pregnancy, 94.9 ± 2.6 vs 57.1 ± 16.1%. However, the root extract was non-teratogenic. We conclude that the S. reticulata root extract can be hazardous to successful pregnancy in women and should not be used in pregnancy complicated by diabetes.

  1. Adverse pregnancy outcome in rats following exposure to a Salacia reticulata (Celastraceae) root extract.

    Science.gov (United States)

    Ratnasooriya, W D; Jayakody, J R A C; Premakumara, G A S

    2003-07-01

    The root extract of Salacia reticulata Wight (family: Celastraceae) is used in Sri Lanka by traditional practitioners as a herbal therapy for glycemic control even during pregnancy. It is recognized that some clinically used antidiabetic drugs have harmful effects on pregnancy but the effects of the S. reticulata root extract on reproductive outcome is unknown and deserves examination. We determined the effects of the S. reticulata root extract on the reproductive outcome of Wistar rats (250-260 g) when administered orally (10 g/kg) during early (days 1-7) and mid- (days 7-14) pregnancy. The root extract significantly (P<0.05) enhanced post-implantation losses (control vs treatment: early pregnancy, 4.7 2.4 vs 49.3 13%; mid-pregnancy, 4.7 2.4 vs 41.7 16.1%). Gestational length was unaltered but the pups born had a low birth weight (P<0.05) (early pregnancy, 6.8 0.1 vs 5.3 0.1 g; mid-pregnancy, 6.8 0.1 vs 5.0 0.1 g) and low birth index (P<0.05) (early pregnancy, 95.2 2.4 vs 50.7 12.9%; mid-pregnancy, 95.2 2.4 vs 58.3 16.1%), fetal survival ratio (P<0.05) (early pregnancy, 95.2 2.4 vs 50.7 12.9; mid-pregnancy, 95.2 2.4 vs 58.3 16.1), and viability index (P<0.05) (early pregnancy, 94.9 2.6 vs 49.5 12.5%; mid-pregnancy, 94.9 2.6 vs 57.1 16.1%). However, the root extract was non-teratogenic. We conclude that the S. reticulata root extract can be hazardous to successful pregnancy in women and should not be used in pregnancy complicated by diabetes.

  2. In vivo effect of chronic nicotine exposure on outcome of Plasmodium berghei ANKA malaria

    Directory of Open Access Journals (Sweden)

    Tsige Ketema

    2017-04-01

    Full Text Available Objective: To assess effect of nicotine, major addictive component of tobacco smoke, on outcomes of the deadly malaria parasite using mice as animal model. Methods: Male Swiss albino mice were treated with 100 and 200 µg/mL of nicotine in drinking water daily for 6 weeks followed by Plasmodium berghei ANKA (PbA infection. On the seventh day of post infection (p.i., physical, clinical, histopathological, biochemical and hematological parameters were assessed. Data were analyzed using SPSS software. Results: Nicotine was significantly (P < 0.05 positively associated with lower levels of hemoglobin (Hb, hematocrit (HCT, red blood cells (RBCs, C-reactive protein (CRP and uric acid (UA, higher risk to incidence of pulmonary edema, elevated level of liver and kidney biomarkers. Also significant increment (P < 0.01 of monocyte-lymphocyte count ratio (MLCR was observed. Risk to high temperature, lower platelet count, high parastemia and cerebral malaria was lesser in mice treated with nicotine (100 and 200 µg/mL followed by PbA infection than the positive control. Lack of neurological symptoms might be accounted to the anti-inflammatory property of nicotine that could inhibit production of pro-inflammatory mediators responsible for occurrence of cerebral malaria. Conclusions: This study showed that despite down regulation of most cerebral malaria symptoms nicotine was strongly associated with increased risk to most clinical symptoms of malaria. Thus, like in respiratory infections, nicotine use might enhance susceptibility to malaria.

  3. Potential applications of SIMS technique for environmental monitoring based on exposure of aquatic organisms

    International Nuclear Information System (INIS)

    Noller, B.N.

    2000-01-01

    Full text: The kinds of environmental monitoring applications for which SIMS may be applicable, particularly with aquatic organisms, fall into 2 main categories: a) Undertaking controlled dose experiments with aquatic organisms where the nature of exposure is known together with water concentration, soft tissue and shell concentrations; and b) Using aquatic organisms from historically or currently impacted sites where other data or information may or may not be available to give some insight into the exposure pattern, generally from existing water monitoring data, sediment concentrations and other data such as water release or flow data. The advantage of experiments undertaken under controlled conditions is that they enable modelling to be developed and be applied. Usually the controlled studies with aquatic organisms are undertaken following cases of historical exposure. The usefulness of historical studies is therefore questionable unless a clear link with the organism exposure can be established. Some examples will be given to show how historical data could be used to bridge the information gap

  4. Bystander Exposure to Ultra-Low-Volume Insecticide Applications Used for Adult Mosquito Management

    Directory of Open Access Journals (Sweden)

    Robert K.D. Peterson

    2011-06-01

    Full Text Available A popular and effective management option for adult mosquitoes is the use of insecticides applied by ultra-low-volume (ULV equipment. However, there is a paucity of data on human dermal exposure to insecticides applied by this method. The objective of the current study was to estimate dermal exposures to the insecticide active ingredient permethrin using water- (Aqua-Reslin® and oil-based (Permanone® 30-30 formulations with passive dosimetry. No significant differences in deposition of permethrin were observed between years, distance from the spray source, front or back of the body, or the placement of the patches on the body. However, exposure to Aqua-Reslin was significantly greater than Permanone 30-30 and average concentrations deposited on the body were 4.2 and 2.1 ng/cm2, respectively. The greater deposition of Aqua-Reslin is most likely due to the higher density of the water-based formulation which causes it to settle out faster than the lighter oil-based formulation of Permanone 30-30. The estimated average absorbed dermal exposure for permethrin from Aqua-Reslin and Permanone 30-30 was 0.00009 and 0.00005 mg/kg body weight, respectively. We also found that ground deposition of ULV insecticides can be used as a surrogate for estimating dermal exposure. The estimated exposures support the findings of previous risk assessments that exposure to ULV applications used for mosquito management are below regulatory levels of concern.

  5. Inhalation exposure during spray application and subsequent sanding of a wood sealant containing zinc oxide nanoparticles.

    Science.gov (United States)

    Cooper, Michael R; West, Gavin H; Burrelli, Leonard G; Dresser, Daniel; Griffin, Kelsey N; Segrave, Alan M; Perrenoud, Jon; Lippy, Bruce E

    2017-07-01

    Nano-enabled construction products have entered into commerce. There are concerns about the safety of manufactured nanomaterials, and exposure assessments are needed for a more complete understanding of risk. This study assessed potential inhalation exposure to ZnO nanoparticles during spray application and power sanding of a commercially available wood sealant and evaluated the effectiveness of local exhaust ventilation in reducing exposure. A tradesperson performed the spraying and sanding inside an environmentally-controlled chamber. Dust control methods during sanding were compared. Filter-based sampling, electron microscopy, and real-time particle counters provided measures of exposure. Airborne nanoparticles above background levels were detected by particle counters for all exposure scenarios. Nanoparticle number concentrations and particle size distributions were similar for sanding of treated versus untreated wood. Very few unbound nanoparticles were detected in aerosol samples via electron microscopy, rather nano-sized ZnO was contained within, or on the surface of larger airborne particles. Whether the presence of nanoscale ZnO in these aerosols affects toxicity merits further investigation. Mass-based exposure measurements were below the NIOSH Recommended Exposure Limit for Zn, although there are no established exposure limits for nanoscale ZnO. Local exhaust ventilation was effective, reducing airborne nanoparticle number concentrations by up to 92% and reducing personal exposure to total dust by at least 80% in terms of mass. Given the discrepancies between the particle count data and electron microscopy observations, the chemical identity of the airborne nanoparticles detected by the particle counters remains uncertain. Prior studies attributed the main source of nanoparticle emissions during sanding to copper nanoparticles generated from electric sander motors. Potentially contrary results are presented suggesting the sander motor may not have been

  6. Effect of prenatal alcohol exposure on childhood academic outcomes: contrasting maternal and paternal associations in the ALSPAC study.

    Directory of Open Access Journals (Sweden)

    Rosa Alati

    Full Text Available The impact of low-to-moderate levels of alcohol consumption during pregnancy on child cognitive outcomes has been of recent concern. This study has tested the hypothesis that low-to-moderate maternal alcohol use in pregnancy is associated with lower school test scores at age 11 in the offspring via intrauterine mechanisms.We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC, a birth cohort study based in the South West of England. Analyses were conducted on 7062 participants who had complete data on: maternal and paternal patterns of alcohol use in the first trimester and at 18 weeks' gestation, child's academic outcomes measured at age 11, gender, maternal age, parity, marital status, ethnicity, household crowding, home ownership status and parental education. We contrasted the association of mother's alcohol consumption during pregnancy with child's National Curriculum Key Stage 2 (KS2 test scores with the association for father's alcohol consumption (during the time the mother was pregnant with child's National Curriculum Key Stage 2 (KS2 test scores. We used multivariate linear regression to estimate mean differences and 95% confidence intervals [CI] in KS2 scores across the exposure categories and computed f statistics to compare maternal and paternal associations.Drinking up to 1 unit of alcohol a day during pregnancy was not associated with lower test scores. However, frequent prenatal consumption of 4 units (equivalent to 32 grams of alcohol on each single drinking occasion was associated with reduced educational attainment [Mean change in offspring KS2 score was -0.68 (-1.03, -0.33 for maternal alcohol categories compared to 0.27 (0.07, 0.46 for paternal alcohol categories]. Frequent consumption of 4 units of alcohol during pregnancy may adversely affect childhood academic outcomes via intrauterine mechanisms.

  7. Role of caregiver-reported outcomes in identification of children with prenatal alcohol exposure during the first year of life.

    Science.gov (United States)

    Bakhireva, Ludmila N; Lowe, Jean; Garrison, Laura M; Cano, Sandra; Leyva, Yuridia; Qeadan, Fares; Stephen, Julia M

    2018-05-16

    BackgroundEarlier identification of children with prenatal alcohol exposure (PAE) remains a challenge. The objective of this study was to identify neurobehavioral (NB) outcomes associated with PAE in infants.MethodsThis manuscript evaluates NB outcomes at 6.33±1.12 months of age in 93 infants (39 PAE and 54 No-PAE) recruited prospectively into the ENRICH cohort. PAE was assessed by prospective repeated TLFB interviews and a panel of ethanol biomarkers. NB outcomes were evaluated by the Bayley Scales of Infant Development (BSID-III), Parenting Stress Index (PSI), Infant Behavior Questionnaire (IBQ-R), and Infant Sensory Profile (ISP).ResultsMean maternal age at enrollment was 28.18±5.75, and 64.52% were Hispanic/Latina. Across three TLFB calendars, absolute alcohol per day in the PAE group was 0.44±0.72, corresponding to low-moderate alcohol consumption. While no association was observed between PAE and BSID-III (P's>0.05), PAE was associated with higher scores on the PSI difficult child scale (=13.9; P=0.015), total stress (=13.9; P=0.010), and IBQ negative affect (=8.60; P=0.008) measures after adjustment for covariates.ConclusionsCaregiver-reported assessments may provide a currently unrecognized opportunity to identify behavioral deficits, point to early interventions, and should be included in clinical assessments of infants at-risk for fetal alcohol spectrum disorder.Pediatric Research advance online publication, 16 May 2018; doi:10.1038/pr.2018.26.

  8. Occupational exposures in industrial application of radiation during 1999-2008

    International Nuclear Information System (INIS)

    Sanaye, S.S.; Baburajan, Sujatha; Pawar, S.G.; Nalawade, S.K.; Sapra, B.K.

    2012-01-01

    Application of radiation in industry, medicine and research sector has increase significantly over the years. In industry main applications are industrial radiography, industrial fluoroscopy, radiation processing, luminizing, nucleonic gauges. Since the strength of the source used is generally high compared to other applications as well as the operating conditions prevailing during the exposure, radiological protection plays important role in this sector. Analysis of dose data, available with National Occupational Dose Registry of RPAD, Bhabha Atomic Research Centre, provides some insight into trends in occupational exposures received by industrial radiation workers. This helps in providing information on adequateness of radiation protection practices followed in the industry. This paper presents the trends in occupational exposure received by radiation workers in the industry during past 10 years (1999 to 2008). It is observed that there is a gradual increase in the occupational radiation workers during the period. The number of persons monitored as well as exposed is highest in industrial radiography compared to other sub-categories. Major contribution to collective dose is also from industrial radiography. The highest annual average as well as exposed average doses are contributed by industrial radiography. The monitored persons receiving dose d 5 mSv is 96.9% industry

  9. Optimization (Alara) and probabilistic exposures: the application of optimization criteria to the control of risks due to exposures of a probabilistic nature

    International Nuclear Information System (INIS)

    Gonzalez, A.J.

    1989-01-01

    The paper described the application of the principles of optimization recommended by the International Commission on Radiological Protection (ICRP) to the restrain of radiation risks due to exposures that may or may not be incurred and to which a probability of occurrence can be assigned. After describing the concept of probabilistic exposures, it proposes a basis for a converging policy of control for both certain and probabilistic exposures, namely the dose-risk relationship adopted for radiation protection purposes. On that basis some coherent approaches for dealing with probabilistic exposures, such as the limitation of individual risks, are discussed. The optimization of safety for reducing all risks from probabilistic exposures to as-low-as-reasonably-achievable (ALARA) levels is reviewed in full. The principles of optimization of protection are used as a basic framework and the relevant factors to be taken into account when moving to probabilistic exposures are presented. The paper also reviews the decision-aiding techniques suitable for performing optimization with particular emphasis to the multi-attribute utility-analysis technique. Finally, there is a discussion on some practical application of decision-aiding multi-attribute utility analysis to probabilistic exposures including the use of probabilistic utilities. In its final outlook, the paper emphasizes the need for standardization and solutions to generic problems, if optimization of safety is to be successful

  10. Exposure to Perfluoroalkyl Substances and Metabolic Outcomes in Pregnant Women: Evidence from the Spanish INMA Birth Cohorts.

    Science.gov (United States)

    Matilla-Santander, Nuria; Valvi, Damaskini; Lopez-Espinosa, Maria-Jose; Manzano-Salgado, Cyntia B; Ballester, Ferran; Ibarluzea, Jesús; Santa-Marina, Loreto; Schettgen, Thomas; Guxens, Mònica; Sunyer, Jordi; Vrijheid, Martine

    2017-11-13

    Exposure to perfluoroalkyl substances (PFASs) may increase risk for metabolic diseases; however, epidemiologic evidence is lacking at the present time. Pregnancy is a period of enhanced tissue plasticity for the fetus and the mother and may be a critical window of PFAS exposure susceptibility. We evaluated the associations between PFAS exposures and metabolic outcomes in pregnant women. We analyzed 1,240 pregnant women from the Spanish INMA [Environment and Childhood Project (INfancia y Medio Ambiente)] birth cohort study (recruitment period: 2003-2008) with measured first pregnancy trimester plasma concentrations of four PFASs (in nanograms/milliliter). We used logistic regression models to estimate associations of PFASs (log 10 -transformed and categorized into quartiles) with impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM), and we used linear regression models to estimate associations with first-trimester serum levels of triglycerides, total cholesterol, and C-reactive protein (CRP). Perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were positively associated with IGT (137 cases) [OR per log 10 -unit increase=1.99 (95% CI: 1.06, 3.78) and OR=1.65 ( 95% CI: 0.99, 2.76), respectively]. PFOS and PFHxS associations with GDM (53 cases) were in a similar direction, but less precise. PFOS and perfluorononanoate (PFNA) were negatively associated with triglyceride levels [percent median change per log 10 -unit increase=-5.86% (95% CI: -9.91%, -1.63%) and percent median change per log 10 -unit increase=-4.75% (95% CI: -8.16%, -0.61%, respectively], whereas perfluorooctanoate (PFOA) was positively associated with total cholesterol [percent median change per log 10 -unit increase=1.26% (95% CI: 0.01%, 2.54%)]. PFASs were not associated with CRP in the subset of the population with available data ( n =640). Although further confirmation is required, the findings from this study suggest that PFAS exposures during pregnancy may

  11. Exposure to Perfluoroalkyl Substances and Metabolic Outcomes in Pregnant Women: Evidence from the Spanish INMA Birth Cohorts

    Science.gov (United States)

    Matilla-Santander, Nuria; Valvi, Damaskini; Lopez-Espinosa, Maria-Jose; Manzano-Salgado, Cyntia B.; Ballester, Ferran; Ibarluzea, Jesús; Santa-Marina, Loreto; Schettgen, Thomas; Guxens, Mònica; Sunyer, Jordi

    2017-01-01

    Background: Exposure to perfluoroalkyl substances (PFASs) may increase risk for metabolic diseases; however, epidemiologic evidence is lacking at the present time. Pregnancy is a period of enhanced tissue plasticity for the fetus and the mother and may be a critical window of PFAS exposure susceptibility. Objective: We evaluated the associations between PFAS exposures and metabolic outcomes in pregnant women. Methods: We analyzed 1,240 pregnant women from the Spanish INMA [Environment and Childhood Project (INfancia y Medio Ambiente)] birth cohort study (recruitment period: 2003–2008) with measured first pregnancy trimester plasma concentrations of four PFASs (in nanograms/milliliter). We used logistic regression models to estimate associations of PFASs (log10-transformed and categorized into quartiles) with impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM), and we used linear regression models to estimate associations with first-trimester serum levels of triglycerides, total cholesterol, and C-reactive protein (CRP). Results: Perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were positively associated with IGT (137 cases) [OR per log10-unit increase=1.99 (95% CI: 1.06, 3.78) and OR=1.65 ( 95% CI: 0.99, 2.76), respectively]. PFOS and PFHxS associations with GDM (53 cases) were in a similar direction, but less precise. PFOS and perfluorononanoate (PFNA) were negatively associated with triglyceride levels [percent median change per log10-unit increase=−5.86% (95% CI: −9.91%, −1.63%) and percent median change per log10-unit increase=−4.75% (95% CI: −8.16%, −0.61%, respectively], whereas perfluorooctanoate (PFOA) was positively associated with total cholesterol [percent median change per log10-unit increase=1.26% (95% CI: 0.01%, 2.54%)]. PFASs were not associated with CRP in the subset of the population with available data (n=640). Conclusions: Although further confirmation is required, the findings from this

  12. Children and Caregivers' Exposure to Adverse Childhood Experiences (ACES): Association with Children's and Caregivers' Psychological Outcomes in a Therapeutic Preschool Program.

    Science.gov (United States)

    Ziv, Yair; Sofri, Inbar; Capps Umphlet, Kristen L; Olarte, Stephanie; Venza, Jimmy

    2018-03-31

    Exposure to adverse childhood experiences (ACE) has been found to have a profound negative impact on multiple child outcomes, including academic achievement, social cognition patterns, and behavioral adjustment. However, these links have yet to be examined in preschool children that are already experiencing behavior or social-emotional problems. Thus, the present study examined the links between the caregiver's and the child's exposure to ACE and multiple child and caregiver's outcomes in a sample of 30 preschool children enrolled in a Therapeutic Nursery Program (TNP). Children are typically referred to this TNP due to significant delays in their social emotional development that often result in difficulty functioning in typical childcare, home, and community settings. Analyses revealed some contradictory patterns that may be specific to this clinical sample. Children with higher exposure to ACE showed more biased social information processing patterns and their caregivers reported lower child social skills than caregivers of children with less exposure, however their inhibitory control levels were higher (better control) and staff reported that these children exhibited better social skills as well as better approaches to learning than children with less exposure. No such contradictions were found in relation to the caregiver's exposure to ACE, as it was positively associated with a number of negative child and caregiver outcomes.

  13. Children and Caregivers’ Exposure to Adverse Childhood Experiences (ACES: Association with Children’s and Caregivers’ Psychological Outcomes in a Therapeutic Preschool Program

    Directory of Open Access Journals (Sweden)

    Yair Ziv

    2018-03-01

    Full Text Available Exposure to adverse childhood experiences (ACE has been found to have a profound negative impact on multiple child outcomes, including academic achievement, social cognition patterns, and behavioral adjustment. However, these links have yet to be examined in preschool children that are already experiencing behavior or social-emotional problems. Thus, the present study examined the links between the caregiver’s and the child’s exposure to ACE and multiple child and caregiver’s outcomes in a sample of 30 preschool children enrolled in a Therapeutic Nursery Program (TNP. Children are typically referred to this TNP due to significant delays in their social emotional development that often result in difficulty functioning in typical childcare, home, and community settings. Analyses revealed some contradictory patterns that may be specific to this clinical sample. Children with higher exposure to ACE showed more biased social information processing patterns and their caregivers reported lower child social skills than caregivers of children with less exposure, however their inhibitory control levels were higher (better control and staff reported that these children exhibited better social skills as well as better approaches to learning than children with less exposure. No such contradictions were found in relation to the caregiver’s exposure to ACE, as it was positively associated with a number of negative child and caregiver outcomes.

  14. Concept of malignant significant factor and its applicability for and occupational exposures

    International Nuclear Information System (INIS)

    Hashizume, Tadashi; Maruyama, Takashi; Tateno, Yukio

    1980-01-01

    In the medical and occupational exposures, there is a tradition to use the genetically significant dose as an index of harm to the population although it only includes the genetical effects from ionizing radiations. A similar significant dose for somatic effects such as radiation leukemogenesis and carcinogenesis should be added to the genetically significant dose in order to approach an index of total harm to the population from medical and occupational exposures. For this purpose, leukemia and malignant significant factors were determined based on the induction of malignant diseases including leukemia for the atomic bombs in Hiroshima and Nagasaki and the life expectancy of individuals subject to medical examinations or treatments as well as radiation workers, taking account of the possibility of their deaths due to other diseases or accidents during a latent period of malignant diseases. The resultant significant factors were tabulated as a function of life expectancy for their application to medical and occupational exposures. For an example, the malignant significant factor for a person having the life expectancy of 60, 40 and 20 years was about 0.87, 0.45 and 0.10, respectively. This paper will discuss the applicability of the leukemia and malignant significant factors to the risk estimation of medical and occupational exposures; namely (1) the risk estimation for an individual in the population; (2) the risk estimation for individuals in a given age group who were continuously irradiated with natural radiations or received occupational exposures; (3) the risk estimation for the pupulation in a given age distribution and (4) the risk estimation for individuals after retirement of radiation works. (author)

  15. Adverse Reproductive Health Outcomes and Exposure to Gaseous and Particulate-Matter Air Pollution in Pregnant Women.

    Science.gov (United States)

    Wu, Jun; Laurent, Olivier; Li, Lianfa; Hu, Jianlin; Kleeman, Michael

    2016-07-01

    There is growing epidemiologic evidence of associations between maternal exposure to ambient air pollution and adverse birth outcomes, such as preterm birth (PTB). Recently, a few studies have also reported that exposure to ambient air pollution may also increase the risk of some common pregnancy complications, such as preeclampsia and gestational diabetes mellitus (GDM). Research findings, however, have been mixed. These inconsistent results could reflect genuine differences in the study populations, the study locations, the specific pollutants considered, the designs of the study, its methods of analysis, or random variation. Dr. Jun Wu of the University of California– Irvine, a recipient of HEI’s Walter A. Rosenblith New Investigator Award, and colleagues have examined the association between air pollution and adverse birth and pregnancy outcomes in California women. In addition, they examined the effect modification by socioeconomic status (SES) and other factors. A retrospective nested case–control study was conducted using birth certificate data from about 4.4 million birth records in California from 2001 to 2008. Wu and colleagues analyzed data on low birth weight (LBW) at term (infants born between 37 and 43 weeks of gestation and weighing less than 2500 g), PTB (infants born before 37 weeks of gestation), and preeclampsia (including eclampsia) of the mother during the pregnancy. In addition, they obtained data on GDM for the years 2006– 2008. In the analyses, all outcomes were included as binary variables. Maternal residential addresses at the time of delivery were geocoded, and a large suite of air pollution exposure metrics was considered, such as (1) regulatory monitoring data on concentrations of criteria pollutants NO2, PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter), and ozone (O3) estimated by empirical Bayesian kriging; (2) concentrations of primary and secondary PM2.5 and PM0.1 components and sources estimated by the

  16. Using Social Media Applications for Educational Outcomes in College Teaching: A Structural Equation Analysis

    Science.gov (United States)

    Cao, Yingxia; Ajjan, Haya; Hong, Paul

    2013-01-01

    As more and more faculty members jump on the wagon of social media, an increasing number of publications began to investigate the adoption of social media applications and its motivators in and out of the classrooms. However, little research has paid close attention to the educational outcomes of social media utilization in college teaching. Thus,…

  17. ASSESSING CHILDREN'S EXPOSURES TO PESTICIDES: AN IMPORTANT APPLICATION OF THE STOCHASTIC HUMAN EXPOSURE AND DOSE SIMULATION MODEL (SHEDS)

    Science.gov (United States)

    Accurately quantifying human exposures and doses of various populations to environmental pollutants is critical for the Agency to assess and manage human health risks. For example, the Food Quality Protection Act of 1996 (FQPA) requires EPA to consider aggregate human exposure ...

  18. Human Exposure Model (HEM): A modular, web-based application to characterize near-field chemical exposures and releases

    Science.gov (United States)

    The U.S. EPA’s Chemical Safety and Sustainability research program is developing the Human Exposure Model (HEM) to assess near-field exposures to chemicals that occur in various populations over the entire life cycle of a consumer product. The model will be implemented as a...

  19. Exposure-lag-response in Longitudinal Studies: Application of Distributed Lag Non-linear Models in an Occupational Cohort.

    Science.gov (United States)

    Neophytou, Andreas M; Picciotto, Sally; Brown, Daniel M; Gallagher, Lisa E; Checkoway, Harvey; Eisen, Ellen A; Costello, Sadie

    2018-02-13

    Prolonged exposures can have complex relationships with health outcomes, as timing, duration, and intensity of exposure are all potentially relevant. Summary measures such as cumulative exposure or average intensity of exposure may not fully capture these relationships. We applied penalized and unpenalized distributed lag non-linear models (DLNMs) with flexible exposure-response and lag-response functions in order to examine the association between crystalline silica exposure and mortality from lung cancer and non-malignant respiratory disease in a cohort study of 2,342 California diatomaceous earth workers, followed 1942-2011. We also assessed associations using simple measures of cumulative exposure assuming linear exposure-response and constant lag-response. Measures of association from DLNMs were generally higher than from simpler models. Rate ratios from penalized DLNMs corresponding to average daily exposures of 0.4 mg/m3 during lag years 31-50 prior to the age of observed cases were 1.47 (95% confidence interval (CI) 0.92, 2.35) for lung cancer and 1.80 (95% CI: 1.14, 2.85) for non-malignant respiratory disease. Rate ratios from the simpler models for the same exposure scenario were 1.15 (95% CI: 0.89-1.48) and 1.23 (95% CI: 1.03-1.46) respectively. Longitudinal cohort studies of prolonged exposures and chronic health outcomes should explore methods allowing for flexibility and non-linearities in the exposure-lag-response. © The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

  20. Family Violence Exposure and Health Outcomes Among Older African American Women: Do Spirituality and Social Support Play Protective Roles?

    Science.gov (United States)

    Kaslow, Nadine

    2010-01-01

    Abstract Background Family violence (FV), spirituality, and social support are salient psychosocial determinants of health. FV is associated with poor health among older African American women. The effect of spirituality and social support levels on the health of older African American women is unknown. Methods To assess the role of spirituality and social support as culturally relevant determinants of health status for older African American women independent of FV levels, we used a cross-sectional observational study. Two hundred twelve African American women, aged ≥50, were interviewed in two urban primary care practices. The measures used were (1) Family Violence Against Older Women (FVOW) scale, (2) Physical and Mental Composite Scores of the Short-Form 8® scale, (3) Medical Outcomes of Social Support survey (MOSS), and (4) Spiritual Well-Being Scale (SWBS). Spearman correlation coefficients estimated to test associations among lifetime FV exposure, spirituality, social support, and health status outcomes and multivariate regression models were used to examine the independent effect of spirituality and social support on physical and mental health status, controlling for FV and significant demographic variables. Results Mean participant age was 63.9 years. Higher spirituality levels were significantly associated with better physical health status after adjusting for FV levels and demographic factors (F = 6.17, p = 0.0001). Similarly, higher levels of spirituality and social support both significantly correlated with better mental health status in the multivariate model (F = 13.45, p < 0.0001) that controlled for lifetime FV levels and demographic factors. Conclusions Spirituality and social support are two potentially modifiable determinants of health for older African American women. Culturally appropriate mechanisms to enhance social support and spirituality levels need to be explored as potential inteventions to improve the health of those

  1. Reproductive Outcomes Following Maternal Exposure to the Events of September 11, 2001, at the World Trade Center, in New York City.

    Science.gov (United States)

    Maslow, Carey B; Caramanica, Kimberly; Li, Jiehui; Stellman, Steven D; Brackbill, Robert M

    2016-10-01

    To estimate associations between exposure to the events of September 11, 2001, (9/11) and low birth weight (LBW), preterm delivery (PD), and small size for gestational age (SGA). We matched birth certificates filed in New York City for singleton births between 9/11 and the end of 2010 to 9/11-related exposure data provided by mothers who were World Trade Center Health Registry enrollees. Generalized estimating equations estimated associations between exposures and LBW, PD, and SGA. Among 3360 births, 5.8% were LBW, 6.5% were PD, and 9% were SGA. Having incurred at least 2 of 4 exposures, having performed rescue or recovery work, and probable 9/11-related posttraumatic stress disorder 2 to 3 years after 9/11 were associated with PD and LBW during the early study period. Disasters on the magnitude of 9/11 may exert effects on reproductive outcomes for several years. Women who are pregnant during and after a disaster should be closely monitored for physical and psychological sequelae. In utero and maternal disaster exposure may affect birth outcomes. Researchers studying effects of individual disasters should identify commonalities that may inform postdisaster responses to minimize disaster-related adverse birth outcomes.

  2. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study.

    NARCIS (Netherlands)

    Amant, F.; Calsteren, K. van; Halaska, M.J.; Gziri, M.M.; Hui, W.; Lagae, L.; Willemsen, M.A.A.P.; Kapusta, L.; Calster, B. van; Wouters, H; Heyns, L.; Han, S.N.; Tomek, V.; Mertens, L.; Ottevanger, P.B.

    2012-01-01

    BACKGROUND: Chemotherapy for the treatment of maternal cancers during pregnancy has become more acceptable in the past decade; however, the effect of prenatal exposure to chemotherapy on cardiac and neurodevelopmental outcomes of the offspring is still uncertain. We aimed to record the general

  3. Association between Household Air Pollution Exposure and Chronic Obstructive Pulmonary Disease Outcomes in 13 Low- and Middle-Income Country Settings.

    Science.gov (United States)

    Siddharthan, Trishul; Grigsby, Matthew R; Goodman, Dina; Chowdhury, Muhammad; Rubinstein, Adolfo; Irazola, Vilma; Gutierrez, Laura; Miranda, J Jaime; Bernabe-Ortiz, Antonio; Alam, Dewan; Kirenga, Bruce; Jones, Rupert; van Gemert, Frederick; Wise, Robert A; Checkley, William

    2018-03-01

    Forty percent of households worldwide burn biomass fuels for energy, which may be the most important contributor to household air pollution. To examine the association between household air pollution exposure and chronic obstructive pulmonary disease (COPD) outcomes in 13 resource-poor settings. We analyzed data from 12,396 adult participants living in 13 resource-poor, population-based settings. Household air pollution exposure was defined as using biomass materials as the primary fuel source in the home. We used multivariable regressions to assess the relationship between household air pollution exposure and COPD outcomes, evaluated for interactions, and conducted sensitivity analyses to test the robustness of our findings. Average age was 54.9 years (44.2-59.6 yr across settings), 48.5% were women (38.3-54.5%), prevalence of household air pollution exposure was 38% (0.5-99.6%), and 8.8% (1.7-15.5%) had COPD. Participants with household air pollution exposure were 41% more likely to have COPD (adjusted odds ratio, 1.41; 95% confidence interval, 1.18-1.68) than those without the exposure, and 13.5% (6.4-20.6%) of COPD prevalence may be caused by household air pollution exposure, compared with 12.4% caused by cigarette smoking. The association between household air pollution exposure and COPD was stronger in women (1.70; 1.24-2.32) than in men (1.21; 0.92-1.58). Household air pollution exposure was associated with a higher prevalence of COPD, particularly among women, and it is likely a leading population-attributable risk factor for COPD in resource-poor settings.

  4. Emotion dysregulation mediates the relationship between trauma exposure, post-migration living difficulties and psychological outcomes in traumatized refugees.

    Science.gov (United States)

    Nickerson, Angela; Bryant, Richard A; Schnyder, Ulrich; Schick, Matthis; Mueller, Julia; Morina, Naser

    2015-03-01

    While emotion dysregulation represents an important mechanism underpinning psychological responses to trauma, little research has investigated this in refugees. In the current study, we examined the mediating role of emotion dysregulation in the relationship between refugee experiences (trauma and living difficulties) and psychological outcomes. Participants were 134 traumatized treatment-seeking refugees who completed measures indexing trauma exposure, post-migration living difficulties, difficulties in emotion regulation, posttraumatic stress disorder, depression, and explosive anger. Findings revealed distinctive patterns of emotion dysregulation associated with each of these psychological disorders. Results also indicated that emotion regulation difficulties mediated the association between both trauma and psychological symptoms, and living difficulties and psychological symptoms. Limitations include a cross-sectional design and the use of measures that had not been validated across all cultural groups in this study. These findings underscore the key role of emotion dysregulation in psychological responses of refugees, and highlight potential directions for treatment interventions for traumatized refugees. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Application of a pilot control banding tool for risk level assessment and control of nanoparticle exposures.

    Science.gov (United States)

    Paik, Samuel Y; Zalk, David M; Swuste, Paul

    2008-08-01

    Control banding (CB) strategies offer simplified solutions for controlling worker exposures to constituents that are found in the workplace in the absence of firm toxicological and exposure data. These strategies may be particularly useful in nanotechnology applications, considering the overwhelming level of uncertainty over what nanomaterials and nanotechnologies present as potential work-related health risks, what about these materials might lead to adverse toxicological activity, how risk related to these might be assessed and how to manage these issues in the absence of this information. This study introduces a pilot CB tool or 'CB Nanotool' that was developed specifically for characterizing the health aspects of working with engineered nanoparticles and determining the level of risk and associated controls for five ongoing nanotechnology-related operations being conducted at two Department of Energy research laboratories. Based on the application of the CB Nanotool, four of the five operations evaluated in this study were found to have implemented controls consistent with what was recommended by the CB Nanotool, with one operation even exceeding the required controls for that activity. The one remaining operation was determined to require an upgrade in controls. By developing this dynamic CB Nanotool within the realm of the scientific information available, this application of CB appears to be a useful approach for assessing the risk of nanomaterial operations, providing recommendations for appropriate engineering controls and facilitating the allocation of resources to the activities that most need them.

  6. Beta Radiation Exposure of Personnel in Radiosynovectomy and at the Production of Eye Application

    International Nuclear Information System (INIS)

    Mielcarek, J.; Barth, I.

    2001-01-01

    Full text: Beta radionuclides are increasingly used in nuclear medicine therapy. In a study of exposure at working places with supposed enhanced radiation risk the followings are monitored: 1. Production of eye applicators ( 106 Ru/ 106 Rh) for therapy of intraocular tumours. During the processes radionuclides are used in sealed and unsealed form. 2. Radiosynovectomy (RSO). This therapy is often used in treatment of inflammatory joint disease. The radionuclides 169 Er, 186 Re and 90 Y are applied in form of radioactive solutions. A complex of problems has to be solved here: Handling of high activities (several GBq per day), very small distances between source and skin, high risk of skin contamination, unsatisfactory dose measurement techniques. In our investigations high sensitive thin thermoluminescence dosimeters (LiF:Mg,Cu,P) were used to determine the skin dose of the hands especially fingertips during preparation and application of the radioactive substances at several institutions. During production of eye applicators we found hand doses essentially below the annual limit. But direct radiation at RSO caused more than 100 mSv at the fingertips per working day in some cases. Even higher doses (more than 50% of the annual limit for skin during a working day) were caused by contamination of the hands. By use of manipulators, wearing of appropriate protection gloves and by improvement of directions for work, the radiation exposure could be reduced dramatically. Consequences for individual beta dosimetry and with respect to license of use of beta radionuclides are discussed. (author)

  7. Occupational exposures in industrial application of radiation during 1999-2008

    International Nuclear Information System (INIS)

    Sanaye, Suresh Shantaram; Baburajan, Sujatha; Pawar, Suresh Ganpat; Nalawade, Shailesh Krishna; Sapra, Balvinder Kaur

    2012-01-01

    Radiation sources are used in various industrial applications like industrial radiograph, industrial irradiation, industrial fluoroscopy, nucleonic gauges, well logging etc., Gamma, beta X-ray as well as neutron sources are used for various applications. Number of radiation workers in this field has increased over the years. Due to operating conditions prevailing during the exposure as well as the strength of the sources used in some of the applications, radiation protection plays an important role in this field. Analysis of doses received by radiation workers in industry provides information on trends of doses as well as adequateness of radiation protection practices followed in this sector. In India, National Occupational Dose Registry System (NODRS) of Radiological Physics and Advisory Division (RPAD), Bhabha Atomic Research Centre (BARC) maintains personnel dose information of monitored radiation workers in the country. Analysis of occupational dose data of industrial radiation workers for last 10 years, i.e., 1999-2008 has been presented in this paper. It is observed that even though there is an increase in monitored radiation workers, percentage of persons receiving radiation exposure has come down during this period. There is also a decrease in the average annual dose as well as the collective dose. Further analysis of sub-categories shows that industrial radiography operations are the main contributor for collective dose (about 77%) followed by well logging and industrial X-ray operations (about 8% each). Thus, in addition to industrial radiography attention is also to be given to operations in these areas. (author)

  8. Self-reported exposure to pesticides and radiation related to pregnancy outcome--results from National Natality and Fetal Mortality Surveys

    International Nuclear Information System (INIS)

    Savitz, D.A.; Whelan, E.A.; Kleckner, R.C.

    1989-01-01

    Although fetal development is known to be sensitive to environmental agents, relatively little epidemiologic research has addressed this concern. Effects on pregnancy outcome of self-reported parental exposure to pesticides and to radiation were examined using data from the National Natality and Fetal Mortality Surveys, large national probability samples of live births and stillbirths occurring in 1980. In case-control analyses, maternal exposure to pesticides at home or work was associated with increased risk of stillbirth (odds ratios (ORs) = 1.5-1.6). Paternal pesticide exposure was associated with stillbirth (ORs = 1.2-1.4) and delivery of small-for-gestational-age infants (ORs = 1.4-2.0). A small increased risk of stillbirth (OR = 1.3) was found in relation to either parent's reported exposure to radiation. In spite of limitations in the quality of exposure data and the possibility of biased recall related to pregnancy outcome, associations of reported pesticide exposure to either parent with risk of stillbirth and small-for-gestational-age infants warrant further evaluation

  9. Oxygen Exposure Resulting in Arterial Oxygen Tensions Above the Protocol Goal Was Associated With Worse Clinical Outcomes in Acute Respiratory Distress Syndrome.

    Science.gov (United States)

    Aggarwal, Neil R; Brower, Roy G; Hager, David N; Thompson, B Taylor; Netzer, Giora; Shanholtz, Carl; Lagakos, Adrian; Checkley, William

    2018-04-01

    High fractions of inspired oxygen may augment lung damage to exacerbate lung injury in patients with acute respiratory distress syndrome. Participants enrolled in Acute Respiratory Distress Syndrome Network trials had a goal partial pressure of oxygen in arterial blood range of 55-80 mm Hg, yet the effect of oxygen exposure above this arterial oxygen tension range on clinical outcomes is unknown. We sought to determine if oxygen exposure that resulted in a partial pressure of oxygen in arterial blood above goal (> 80 mm Hg) was associated with worse outcomes in patients with acute respiratory distress syndrome. Longitudinal analysis of data collected in these trials. Ten clinical trials conducted at Acute Respiratory Distress Syndrome Network hospitals between 1996 and 2013. Critically ill patients with acute respiratory distress syndrome. None. We defined above goal oxygen exposure as the difference between the fraction of inspired oxygen and 0.5 whenever the fraction of inspired oxygen was above 0.5 and when the partial pressure of oxygen in arterial blood was above 80 mm Hg. We then summed above goal oxygen exposures in the first five days to calculate a cumulative above goal oxygen exposure. We determined the effect of a cumulative 5-day above goal oxygen exposure on mortality prior to discharge home at 90 days. Among 2,994 participants (mean age, 51.3 yr; 54% male) with a study-entry partial pressure of oxygen in arterial blood/fraction of inspired oxygen that met acute respiratory distress syndrome criteria, average cumulative above goal oxygen exposure was 0.24 fraction of inspired oxygen-days (interquartile range, 0-0.38). Participants with above goal oxygen exposure were more likely to die (adjusted interquartile range odds ratio, 1.20; 95% CI, 1.11-1.31) and have lower ventilator-free days (adjusted interquartile range mean difference of -0.83; 95% CI, -1.18 to -0.48) and lower hospital-free days (adjusted interquartile range mean difference of -1.38; 95

  10. Association of Neurodevelopmental Outcomes and Neonatal Morbidities of Extremely Premature Infants With Differential Exposure to Antenatal Steroids.

    Science.gov (United States)

    Chawla, Sanjay; Natarajan, Girija; Shankaran, Seetha; Pappas, Athina; Stoll, Barbara J; Carlo, Waldemar A; Saha, Shampa; Das, Abhik; Laptook, Abbot R; Higgins, Rosemary D

    2016-12-01

    Many premature infants are born without exposure to antenatal steroids (ANS) or with incomplete courses. This study evaluates the dose-dependent effect of ANS on rates of neonatal morbidities and early childhood neurodevelopmental outcomes of extremely premature infants. To compare rates of neonatal morbidities and 18- to 22-month neurodevelopmental outcomes of extremely premature infants exposed to no ANS or partial or complete courses of ANS. In this observational cohort study, participants were extremely premature infants (birth weight range, 401-1000 g; gestational age, 22-27 weeks) who were born at participating centers of the National Institute of Child Health and Human Development Neonatal Research Network between January 2006 and December 2011. Data were analyzed between October 2013 and May 2016. Rates of death or neurodevelopmental impairment at 18 to 22 months' corrected age. Neurodevelopmental impairment was defined as the presence of any of the following: moderate to severe cerebral palsy, a cognitive score less than 85 on the Bayley Scales of Infant and Toddler Development III, blindness, or deafness. There were 848 infants in the no ANS group, 1581 in the partial ANS group, and 3692 in the complete ANS group; the mean (SD) birth weights were 725 (169), 760 (173), and 753 (170) g, respectively, and the mean (SD) gestational ages were 24.5 (1.4), 24.9 (2), and 25.1 (1.1) weeks. Of 6121 eligible infants, 4284 (70.0%) survived to 18- to 22-month follow-up, and data were available for 3892 of 4284 infants (90.8%). Among the no, partial, and complete ANS groups, there were significant differences in the rates of mortality (43.1%, 29.6%, and 25.2%, respectively), severe intracranial hemorrhage among survivors (23.3%, 19.1%, and 11.7%), death or necrotizing enterocolitis (48.1%, 37.1%, and 32.5%), and death or bronchopulmonary dysplasia (74.9%, 68.9%, and 65.5%). Additionally, death or neurodevelopmental impairment occurred in 68.1%, 54.4%, and 48.1% of

  11. A Workflow to Investigate Exposure and Pharmacokinetic Influences on High-Throughput in Vitro Chemical Screening Based on Adverse Outcome Pathways

    Science.gov (United States)

    Background: Adverse outcome pathways (AOPs) link adverse effects in individuals or populations to a molecular initiating event (MIE) that can be quantified using in vitro methods. Practical application of AOPs in chemical-specific risk assessment requires incorporation of knowled...

  12. Assessment of radiation exposure of personnel during clinical application of radioactive iridium

    Energy Technology Data Exchange (ETDEWEB)

    Dworakowski, M; Krystman-Mazgajska, E; Wysopolski, J [Instytut Onkologii, Warsaw (Poland); Centralne Lab. Ochrony Radiologicznej, Warsaw (Poland))

    1975-01-01

    The authors describe the results of measurements of doses and the evaluation of radiation exposure of the personnel of the Department of General Oncology working with application of radioactive iridium for interstitial and superficial treatment of neoplasma. The doses were measured by the photographic method simultaneously at six sites of the body: on the forehead, left side of the chest, 4th fingers of both hands, and on the left and right sides of the trunk at the level of gonads. The authors believe that introduction of iridium in place of radium will improve the conditions of work from the standpoint of protection against radioactivity.

  13. A conceptual framework to support exposure science research and complete the source-to-outcome continuum for risk assessment

    Science.gov (United States)

    While knowledge of exposure is fundamental to assessing and mitigating risks, exposure information has been costly and difficult to generate. Driven by major scientific advances in analytical methods, biomonitoring, computational tools, and a newly articulated vision for a great...

  14. Toxicogenomic outcomes predictive of forestomach carcinogenesis following exposure to benzo(a)pyrene: Relevance to human cancer risk

    Energy Technology Data Exchange (ETDEWEB)

    Labib, Sarah, E-mail: Sarah.Labib@hc-sc.gc.ca; Guo, Charles H., E-mail: Charles.Guo@hc-sc.gc.ca; Williams, Andrew, E-mail: Andrew.Williams@hc-sc.gc.ca; Yauk, Carole L., E-mail: Carole.Yauk@hc-sc.gc.ca; White, Paul A., E-mail: Paul.White@hc-sc.gc.ca; Halappanavar, Sabina, E-mail: Sabina.Halappanavar@hc-sc.gc.ca

    2013-12-01

    Forestomach tumors are observed in mice exposed to environmental carcinogens. However, the relevance of this data to humans is controversial because humans lack a forestomach. We hypothesize that an understanding of early molecular changes after exposure to a carcinogen in the forestomach will provide mode-of-action information to evaluate the applicability of forestomach cancers to human cancer risk assessment. In the present study we exposed mice to benzo(a)pyrene (BaP), an environmental carcinogen commonly associated with tumors of the rodent forestomach. Toxicogenomic tools were used to profile gene expression response in the forestomach. Adult Muta™Mouse males were orally exposed to 25, 50, and 75 mg BaP/kg-body-weight/day for 28 consecutive days. The forestomach was collected three days post-exposure. DNA microarrays, real-time RT-qPCR arrays, and protein analyses were employed to characterize responses in the forestomach. Microarray results showed altered expression of 414 genes across all treatment groups (± 1.5 fold; false discovery rate adjusted P ≤ 0.05). Significant downregulation of genes associated with phase II xenobiotic metabolism and increased expression of genes implicated in antigen processing and presentation, immune response, chemotaxis, and keratinocyte differentiation were observed in treated groups in a dose-dependent manner. A systematic comparison of the differentially expressed genes in the forestomach from the present study to differentially expressed genes identified in human diseases including human gastrointestinal tract cancers using the NextBio Human Disease Atlas showed significant commonalities between the two models. Our results provide molecular evidence supporting the use of the mouse forestomach model to evaluate chemically-induced gastrointestinal carcinogenesis in humans. - Highlights: • Benzo(a)pyrene-mediated transcriptomic response in the forestomach was examined. • The immunoproteosome subunits and MHC class I

  15. Overview of environmental and occupational vanadium exposure and associated health outcomes: an article based on a presentation at the 8th International Symposium on Vanadium Chemistry, Biological Chemistry, and Toxicology, Washington DC, August 15-18, 2012.

    Science.gov (United States)

    Fortoul, T I; Rojas-Lemus, M; Rodriguez-Lara, V; Gonzalez-Villalva, A; Ustarroz-Cano, M; Cano-Gutierrez, G; Gonzalez-Rendon, S E; Montaño, L F; Altamirano-Lozano, M

    2014-01-01

    Vanadium (V) has a variety of applications that make it suitable for use in ceramic production and decoration, production of pigments for a variety of products, an accelerator for drying paint, production of aniline black dye, and as a mordant in coloring textiles. Taking advantage of its hardness, resilience, ability to form alloys, and its resistance to corrosion, V is also used in the production of tools, steel, machinery, and surgical implants. V is employed in producing photographic developers, batteries, and semi-conductors, and in catalyst-based recycling processes. As technologies have evolved, the use of V has increased in jet aircraft and space technology, as well as in manufacture of ultraviolet filter glass to prevent radiation injury. Due to these myriad uses, the potential for occupational exposure to V is ever-evident. Similarly, there is an increased risk for environmental contamination by V agents themselves or as components of by-products released into the environment. For example, the use of V in sulfuric acid production results in the release of soot and/or fly ash rich in vanadium pentoxide. Petroleum refinery, smelting, welding, and cutting of V-rich steel alloy, the cleaning and repair of oil-fired boilers, and catalysis of chemical productions are other sources of increased airborne V-bearing particles in local/distant environments. Exposure of non-workers to V is an increasing health concern. Studies have demonstrated associations between exposure to airborne V-bearing particles (as part of air pollution) and increased risks of a variety of pathologies like hypertension, dysrhythmia, systemic inflammation, hyper-coagulation, cancers, and bronchial hyper-reactivity. This paper will provide a review of the history of V usage in occupational settings, documented exposure levels, environmental levels of V associated with pollution, epidemiologic data relating V exposure(s) to adverse health outcomes, and governmental responses to protect both

  16. Airway exposure to multi-walled carbon nanotubes disrupts the female reproductive cycle without affecting pregnancy outcomes in mice

    DEFF Research Database (Denmark)

    Johansson, Hanna Katarina Lilith; Hansen, J. S.; Elfving, B.

    2017-01-01

    response and inflammation in experimental animals, which may affect female reproduction. This proof-of-principle study therefore aimed to investigate if lung exposure by intratracheal instillation of the MWCNT NM-400 would affect the estrous cycle and reproductive function in female mice.Results: Estrous...... of irregular cycling after exposure. Our data indicates that MWCNT exposure may interfere with events leading to ovulation....

  17. Exposure of the general public due to wireless LAN applications in public places

    International Nuclear Information System (INIS)

    Schmid, G.; Preiner, P.; Lager, D.; Ueberbacher, R.; Georg, R.

    2007-01-01

    The typical exposure caused by wireless LAN applications in public areas has been investigated in a variety of scenarios. Small-sized (internet cafe) and large-scale (airport) indoor scenarios as well as outdoor scenarios in the environment of access points (AP) supplying for residential areas and public places were considered. The exposure assessment was carried out by numerical GTD/UTD computations based on optical wave propagation, as well as by verifying frequency selective measurements in the considered scenarios under real life conditions. In the small-sized indoor scenario the maximum temporal peak values of power density, spatially averaged over body dimensions, were found to be lower than 20 mW/m 2 , corresponding to 0.2% of the reference level according to the European Council Recommendation 1999/519/EC. Local peak values of power density might be 1-2 orders of magnitude higher, spatial and time-averaged values for usual data traffic conditions might be 2-3 orders of magnitude lower, depending on the actual data traffic. In the considered outdoor scenarios, exposure was several orders of magnitude lower than in indoor scenarios due to the usually larger distances to the AP antennas. (authors)

  18. Infant and childhood neurodevelopmental outcomes following prenatal exposure to selective serotonin reuptake inhibitors: overview and design of a Finnish Register-Based Study (FinESSI

    Directory of Open Access Journals (Sweden)

    Malm Heli

    2012-12-01

    Full Text Available Abstract Background Experimental animal studies and one population-based study have suggested an increased risk for adverse neurodevelopmental outcome after prenatal exposure to SSRIs. We describe the methods and design of a population-based study examining the association between prenatal SSRI exposure and neurodevelopment until age 14. Methods and design This is a cohort study of national registers in Finland: the Medical Birth Register, the Register of Congenital Malformations, the Hospital Discharge Register including inpatient and outpatient data, the Drug Reimbursement Register, and the Population Register. The total study population includes 845,345 women and their live-born, singleton offspring aged 14 or younger and born during Jan 1st 1996-Dec 31st 2010. We will compare the prevalence of psychiatric and neurodevelopmental outcomes in offspring exposed prenatally to SSRIs to offspring exposed to prenatal depression and unexposed to SSRIs. Associations between exposure and outcome are assessed by statistical methods including specific modeling to account for correlated outcomes within families and differences in duration of follow-up between the exposure groups. Descriptive results. Of all pregnant women with pregnancy ending in delivery (n = 859,359, 1.9% used SSRIs. The prevalence of diagnosed depression and depression-related psychiatric disorders within one year before or during pregnancy was 1.7%. The cumulative incidence of registered psychiatric or neurodevelopmental disorders was 6.9% in 2010 among all offspring born during the study period (age range 0–14 years. Discussion The study has the potential for significant public health importance in providing information on prenatal exposure to SSRIs and long-term neurodevelopment.

  19. Association between Exposure of Young Children to Procedures Requiring General Anesthesia and Learning and Behavioral Outcomes in a Population-based Birth Cohort.

    Science.gov (United States)

    Hu, Danqing; Flick, Randall P; Zaccariello, Michael J; Colligan, Robert C; Katusic, Slavica K; Schroeder, Darrell R; Hanson, Andrew C; Buenvenida, Shonie L; Gleich, Stephen J; Wilder, Robert T; Sprung, Juraj; Warner, David O

    2017-08-01

    Exposure of young animals to general anesthesia causes neurodegeneration and lasting behavioral abnormalities; whether these findings translate to children remains unclear. This study used a population-based birth cohort to test the hypothesis that multiple, but not single, exposures to procedures requiring general anesthesia before age 3 yr are associated with adverse neurodevelopmental outcomes. A retrospective study cohort was assembled from children born in Olmsted County, Minnesota, from 1996 to 2000 (inclusive). Propensity matching selected children exposed and not exposed to general anesthesia before age 3 yr. Outcomes ascertained via medical and school records included learning disabilities, attention-deficit/hyperactivity disorder, and group-administered ability and achievement tests. Analysis methods included proportional hazard regression models and mixed linear models. For the 116 multiply exposed, 457 singly exposed, and 463 unexposed children analyzed, multiple, but not single, exposures were associated with an increased frequency of both learning disabilities and attention-deficit/hyperactivity disorder (hazard ratio for learning disabilities = 2.17 [95% CI, 1.32 to 3.59], unexposed as reference). Multiple exposures were associated with decreases in both cognitive ability and academic achievement. Single exposures were associated with modest decreases in reading and language achievement but not cognitive ability. These findings in children anesthetized with modern techniques largely confirm those found in an older birth cohort and provide additional evidence that children with multiple exposures are more likely to develop adverse outcomes related to learning and attention. Although a robust association was observed, these data do not determine whether anesthesia per se is causal.

  20. Intergenerational impact of paternal lifetime exposures to both folic acid deficiency and supplementation on reproductive outcomes and imprinted gene methylation.

    Science.gov (United States)

    Ly, Lundi; Chan, Donovan; Aarabi, Mahmoud; Landry, Mylène; Behan, Nathalie A; MacFarlane, Amanda J; Trasler, Jacquetta

    2017-07-01

    Do paternal exposures to folic acid deficient (FD), and/or folic acid supplemented (FS) diets, throughout germ cell development adversely affect male germ cells and consequently offspring health outcomes? Male mice exposed over their lifetimes to both FD and FS diets showed decreased sperm counts and altered imprinted gene methylation with evidence of transmission of adverse effects to the offspring, including increased postnatal-preweaning mortality and variability in imprinted gene methylation. There is increasing evidence that disruptions in male germ cell epigenetic reprogramming are associated with offspring abnormalities and intergenerational disease. The fetal period is the critical time of DNA methylation pattern acquisition for developing male germ cells and an adequate supply of methyl donors is required. In addition, DNA methylation patterns continue to be remodeled during postnatal spermatogenesis. Previous studies have shown that lifetime (prenatal and postnatal) folic acid deficiency can alter the sperm epigenome and increase the incidence of fetal morphological abnormalities. Female BALB/c mice (F0) were placed on one of four amino-acid defined diets for 4 weeks before pregnancy and throughout pregnancy and lactation: folic acid control (Ctrl; 2 mg/kg), 7-fold folic acid deficient (7FD; 0.3 mg/kg), 10-fold high FS (10FS, 20 mg/kg) or 20-fold high FS (20FS, 40 mg/kg) diets. F1 males were weaned to their respective prenatal diets to allow for diet exposure during all windows of germline epigenetic reprogramming: the erasure, re-establishment and maintenance phases. F0 females were mated with chow-fed males to produce F1 litters whose germ cells were exposed to the diets throughout embryonic development. F1 males were subsequently mated with chow-fed female mice. Two F2 litters, unexposed to the experimental diets, were generated from each F1 male; one litter was collected at embryonic day (E)18.5 and one delivered and followed postnatally. DNA

  1. Value of electron beam tomography (EBT). II. non-cardiac applications and radiation exposure

    International Nuclear Information System (INIS)

    Enzweiler, C.N.H.; Lembcke, A.; Rogalla, P.; Taupitz, M.; Wiese, T.H.; Hamm, B.; Becker, C.R.; Bruening, R.; Reiser, M.F.; Schoepf, U.J.; Felix, R.; Knollmann, F.D.; Georgi, M.; Weisser, G.; Lehmann, K.J.

    2004-01-01

    Electron beam tomography (EBT) has been scientifically evaluated to a much lesser degree for non-cardiac indications than for cardiac purposes. Therefore, four groups of investigators in Berlin (2), Mannheim and Muenchen, which were supported by the Deutsche Forschungsgemeinschaft (DFG), included applications outside the heart in their evaluation of EBT technology. EBT has proven useful to look for pulmonary embolism and to assess other vessels (aorta, aortic branches, and intracranial arteries). Imaging of the lung parenchyma benefits from its intrinsic high contrast and from the fast data acquisition of EBT. Limited photon efficiency, higher radiation exposure, increased noise levels and other artifacts, however markedly reduce the value of EBT for imaging of low contrast objects compared to conventional spiral CT and multislice CT (MSCT), compromising, in particular, the morphologic depiction of parenchymal abdominal organs and the brain. Consequently, scientific studies to further evaluate EBT for scanning of the brain and parenchymal abdominal organs were not pursued. Radiation exposure for non-cardiac EBT studies is up to three times higher than that for respective spiral CT studies, and in children EBT can only be advocated in select cases. Radiation exposure for the various prospectively triggered cardiac examination protocols of EBT is lower than that for conventional coronary angiography. Radiation exposure in cardiac multislice CT exceeds severalfold that of EBT, but the dose efficiency of EBT and MSCT are similar due to higher spatial resolution and less image noise of MSCT. In addition, modifications of MSCT (ECG pulsing) can further reduce radiation exposure to the level of EBT. Technical improvements of the EBT successor scanner 'e-Speed' enable faster data acquisiton at higher spatial resolution. Within comparative studies, the 'e-Speed' will have to prove its value and competitiveness, particularly in comparison with multislice CT. After profound

  2. Characteristics and outcomes of e-cigarette exposure incidents reported to 10 European Poison Centers: a retrospective data analysis

    OpenAIRE

    Vardavas, Constantine I.; Girvalaki, Charis; Filippidis, Filippos T; Oder, Mare; Kastanje, Ruth; de Vries, Irma; Scholtens, Lies; Annas, Anita; Plackova, Silvia; Turk, Rajka; Gruzdyte, Laima; Rato, F?tima; Genser, Dieter; Schiel, Helmut; Bal?zs, Andrea

    2017-01-01

    BACKGROUND: The use of e-cigarettes has increased during the past few years. Exposure to e-cigarette liquids, whether intentional or accidental, may lead to adverse events our aim was to assess factors associated with e-cigarette exposures across European Union Member States (EU MS). METHODS: A retrospective analysis of exposures associated with e-cigarettes reported to national poison centers was performed covering incidents from 2012 to March 2015 from 10 EU MS. De-identified and anonymous ...

  3. Pre-Interventional Kynurenine Predicts Medium-Term Outcome after Contrast Media Exposure Due to Coronary Angiography.

    Science.gov (United States)

    Reichetzeder, Christoph; Heunisch, Fabian; Einem, Gina von; Tsuprykov, Oleg; Kellner, Karl-Heinz; Dschietzig, Thomas; Kretschmer, Axel; Hocher, Berthold

    2017-01-01

    Contrast induced acute kidney injury (CI-AKI) remains a serious complication of contrast media enhanced procedures like coronary angiography. There is still a lack of established biomarkers that help to identify patients at high risk for short and long-term complications. The aim of the current study was to evaluate plasma kynurenine as a predictive biomarker for CI-AKI and long-term complications, measured by the combined endpoint "major adverse kidney events" (MAKE) up to 120 days after CM application. In this prospective cohort study 245 patients undergoing coronary angiography were analyzed. Blood samples were obtained at baseline, 24h and 48h after contrast media (CM) application to diagnose CI-AKI. Patients were followed for 120 days for adverse clinical events including death, the need for dialysis, and a doubling of plasma creatinine. Occurrence of any of these events was summarized in the combined endpoint MAKE. Preinterventional plasma kynurenine was not associated with CI-AKI. Patients who later developed MAKE displayed significantly increased preinterventional plasma kynurenine levels (p<0.0001). ROC analysis revealed that preinterventional kynurenine is highly predictive for MAKE (AUC=0.838; p<0.0001). The optimal cutoff was found at ≥3.5 µmol/L Using this cutoff, the Kaplan-Meier estimator demonstrated that concentrations of plasma kynurenine ≥3.5 µmol/L were significantly associated with a higher prevalence of MAKE until follow up (p<0.0001). This association remained significant in multivariate Cox regression models adjusted for relevant factors of long-term renal outcome. Preinterventional plasma kynurenine might serve as a highly predictive biomarker for MAKE up to 120 days after coronary angiography. © 2017 The Author(s). Published by S. Karger AG, Basel.

  4. Pre-Interventional Kynurenine Predicts Medium-Term Outcome after Contrast Media Exposure Due to Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Christoph Reichetzeder

    2017-05-01

    Full Text Available Background/Aims: Contrast induced acute kidney injury (CI-AKI remains a serious complication of contrast media enhanced procedures like coronary angiography. There is still a lack of established biomarkers that help to identify patients at high risk for short and long-term complications. The aim of the current study was to evaluate plasma kynurenine as a predictive biomarker for CI-AKI and long-term complications, measured by the combined endpoint "major adverse kidney events" (MAKE up to 120 days after CM application. Methods: In this prospective cohort study 245 patients undergoing coronary angiography were analyzed. Blood samples were obtained at baseline, 24h and 48h after contrast media (CM application to diagnose CI-AKI. Patients were followed for 120 days for adverse clinical events including death, the need for dialysis, and a doubling of plasma creatinine. Occurrence of any of these events was summarized in the combined endpoint MAKE. Results: Preinterventional plasma kynurenine was not associated with CI-AKI. Patients who later developed MAKE displayed significantly increased preinterventional plasma kynurenine levels (p<0.0001. ROC analysis revealed that preinterventional kynurenine is highly predictive for MAKE (AUC=0.838; p<0.0001. The optimal cutoff was found at ≥3.5 µmol/L Using this cutoff, the Kaplan-Meier estimator demonstrated that concentrations of plasma kynurenine ≥3.5 µmol/L were significantly associated with a higher prevalence of MAKE until follow up (p<0.0001. This association remained significant in multivariate Cox regression models adjusted for relevant factors of long-term renal outcome. Conclusion: Preinterventional plasma kynurenine might serve as a highly predictive biomarker for MAKE up to 120 days after coronary angiography.

  5. Observations on Three Endpoint Properties and Their Relationship to Regulatory Outcomes of European Oncology Marketing Applications.

    Science.gov (United States)

    Liberti, Lawrence; Stolk, Pieter; McAuslane, James Neil; Schellens, Jan; Breckenridge, Alasdair M; Leufkens, Hubert

    2015-06-01

    Guidance and exploratory evidence indicate that the type of endpoints and the magnitude of their outcome can define a therapy's clinical activity; however, little empirical evidence relates specific endpoint properties with regulatory outcomes. We explored the relationship of 3 endpoint properties to regulatory outcomes by assessing 50 oncology marketing authorization applications (MAAs; reviewed from 2009 to 2013). Overall, 16 (32%) had a negative outcome. The most commonly used hard endpoints were overall survival (OS) and the duration of response or stable disease. OS was a component of 91% approved and 63% failed MAAs. The most commonly used surrogate endpoints were progression-free survival (PFS), response rate, and health-related quality of life assessments. There was no difference (p = .3801) between the approved and failed MAA cohorts in the proportion of hard endpoints used. A mean of slightly more than four surrogate endpoints were used per approved MAA compared with slightly more than two for failed MAAs. Longer OS and PFS duration outcomes were generally associated with approvals, often when not statistically significant. The approved cohort was associated with a preponderance of statistically significant (p < .05) improvements in primary endpoints (p < .0001 difference between the approved and failed groups). Three key endpoint properties (type of endpoint [hard/surrogate], magnitude of an endpoint outcome, and its statistical significance) are consistent with the European Medicines Agency guidance and, notwithstanding the contribution of unique disease-specific circumstances, are associated with a predictable positive outcome for oncology MAAs. Regulatory decisions made by the European Medicines Agency determine which new medicines will be available to European prescribers and for which therapeutic indications. Regulatory success or failure can be influenced by many factors. This study assessed three key properties of endpoints used in

  6. [The interactive neuroanatomical simulation and practical application of frontotemporal transsylvian exposure in neurosurgery].

    Science.gov (United States)

    Balogh, Attila; Czigléczki, Gábor; Papal, Zsolt; Preul, Mark C; Banczerowski, Péter

    2014-11-30

    There is an increased need for new digital education tools in neurosurgical training. Illustrated textbooks offer anatomic and technical reference but do not substitute hands-on experience provided by surgery or cadaver dissection. Due to limited availability of cadaver dissections the need for development of simulation tools has been augmented. We explored simulation technology for producing virtual reality-like reconstructions of simulated surgical approaches on cadaver. Practical application of the simulation tool has been presented through frontotemporal transsylvian exposure. The dissections were performed on two cadaveric heads. Arteries and veins were prepared and injected with colorful silicon rubber. The heads were rigidly fixed in Mayfield headholder. A robotic microscope with two digital cameras in inverted cone method of image acquisition was used to capture images around a pivot point in several phases of dissections. Multilayered, high-resolution images have been built into interactive 4D environment by custom developed software. We have developed the simulation module of the frontotemporal transsylvian approach. The virtual specimens can be rotated or tilted to any selected angles and examined from different surgical perspectives at any stage of dissections. Important surgical issues such as appropriate head positioning or surgical maneuvers to expose deep situated neuroanatomic structures can be simulated and studied by using the module. The simulation module of the frontotemporal transsylvian exposure helps to examine effect of head positioning on the visibility of deep situated neuroanatomic structures and study surgical maneuvers required to achieve optimal exposure of deep situated anatomic structures. The simulation program is a powerful tool to study issues of preoperative planning and well suited for neurosurgical training.

  7. A biokinetic model of inhaled Cm compounds in dogs: Application to human exposure data

    International Nuclear Information System (INIS)

    Guilmette, R.A.; Mewhinney, J.A.

    1989-01-01

    Curium isotopes are major by-products in irradiated nuclear reactor fuel and comprise a significant fraction of the alpha-emitting radionuclide inventory. Although little use is currently being made of purified Cm sources, such usage is possible if reprocessing of spent fuel becomes feasible. Because little information is available on the biokinetics and dosimetry of inhaled Cm compounds, a study was conducted in which adult beagle dogs received a single inhalation exposure to either a monodisperse aerosol of 244Cm2O3 (1.4 micron activity median aerodynamic diameter [AMAD]; sigma g = 1.16) or a polydisperse aerosol of 244Cm (NO3)3 (1.1 micron AMAD; sigma g = 1.74). At times ranging from 4 h to 2 y after exposure, animals were sacrificed and their tissues analyzed for Cm content. The data describing the uptake and retention of 244Cm in the different organs and tissues and the measured rates of excretion of these dogs formed the basis on which a biokinetic model of Cm metabolism was constructed. This Cm model was based on a previously published model of the biokinetics of 241Am that was shown to be applicable to data from human cases of inhalation exposure to 241Am aerosols. This Cm model was found to be adequate to describe the biological distribution of Cm in dogs and was also applied to the sparse data from humans. Reasonable agreement was found between the model predictions for lung retention of Cm and for urinary excretion patterns in humans

  8. The mediation proportion: a structural equation approach for estimating the proportion of exposure effect on outcome explained by an intermediate variable

    DEFF Research Database (Denmark)

    Ditlevsen, Susanne; Christensen, Ulla; Lynch, John

    2005-01-01

    It is often of interest to assess how much of the effect of an exposure on a response is mediated through an intermediate variable. However, systematic approaches are lacking, other than assessment of a surrogate marker for the endpoint of a clinical trial. We review a measure of "proportion...... of several intermediate variables. Binary or categorical variables can be included directly through threshold models. We call this measure the mediation proportion, that is, the part of an exposure effect on outcome explained by a third, intermediate variable. Two examples illustrate the approach. The first...... example is a randomized clinical trial of the effects of interferon-alpha on visual acuity in patients with age-related macular degeneration. In this example, the exposure, mediator and response are all binary. The second example is a common problem in social epidemiology-to find the proportion...

  9. Relationship between icotinib hydrochloride exposure and clinical outcome in Chinese patients with advanced non-small cell lung cancer.

    Science.gov (United States)

    Ni, Jun; Liu, Dong-Yang; Hu, Bei; Li, Chen; Jiang, Ji; Wang, Han-Ping; Zhang, Li

    2015-09-01

    significantly correlated with the overall survival (OS) (Spearman correlation coefficient, 0.441; P = .012). The disease control rate was correlated with Tmax after a single dose (Spearman correlation coefficient, 0.518; P = .011). Multivariate analysis demonstrated that the area under the concentration-time curve from 0 to last determination time and the area under the curve from 0 to infinite time after a single dose of icotinib hydrochloride were correlated with OS (P = .037 and .042, respectively). The Clast was found to affect progression-free survival (P = .016). Stratification of these patients according to smoking status indicated significant correlation between OS and the area under the concentration-time curve from 0 to last determination time (Spearman correlation coefficient, -0.709; P = .015). Patients with a longer Tmax and higher exposure might experience longer OS and a higher disease control rate. In addition, the increased Clast might prolong the progressive-free survival of patients. However, the relationships between EGFR mutation, pharmacokinetics, and clinical outcomes require further research. © 2015 American Cancer Society.

  10. Psychometric evaluation of self-report outcome measures for prosthetic applications.

    Science.gov (United States)

    Hafner, Brian J; Morgan, Sara J; Askew, Robert L; Salem, Rana

    2016-01-01

    Documentation of clinical outcomes is increasingly expected in delivery of prosthetic services and devices. However, many outcome measures suitable for use in clinical care and research have not been psychometrically tested with prosthesis users. The aim of this study was to determine test-retest reliability, mode-of-administration (MoA) equivalence, standard error of measurement (SEM), and minimal detectable change (MDC) of standardized, self-report instruments that assess constructs of importance to people with lower limb loss. Prosthesis users (n = 201) were randomly assigned to groups based on MoA (i.e., paper, electronic, or mixed-mode). Participants completed two surveys 2 to 3 d apart. Instruments included the Prosthetic Limb Users Survey of Mobility, Prosthesis Evaluation Questionnaire-Mobility Subscale, Activities-Specific Balance Confidence Scale, Quality of Life in Neurological Conditions-Applied Cognition/General Concerns, Patient-Reported Outcomes Measurement Information System Profile, and Socket Comfort Score. Intraclass correlation coefficients indicated all instruments are appropriate for group-level comparisons and select instruments are suitable for individual-level applications. Several instruments showed evidence of possible floor and ceiling effects. All were equivalent across MoAs. SEM and MDC were quantified to facilitate interpretation of outcomes and change scores. These results can enhance clinicians' and researchers' ability to select, apply, and interpret scores from instruments administered to prosthesis users.

  11. Airway exposure to multi-walled carbon nanotubes disrupts the female reproductive cycle without affecting pregnancy outcomes in mice

    DEFF Research Database (Denmark)

    Johansson, Hanna Katarina Lilith; Hansen, J. S.; Elfving, B.

    2017-01-01

    Background: The use of multiwalled carbon nanotubes (MWCNT) is increasing due to a growing use in a variety of products across several industries. Thus, occupational exposure is also of increasing concern, particularly since airway exposure to MWCNTs can induce sustained pulmonary acute phase res...

  12. Characteristics and outcomes of e-cigarette exposure incidents reported to 10 European Poison Centers : a retrospective data analysis

    NARCIS (Netherlands)

    Vardavas, Constantine I; Girvalaki, Charis; Filippidis, Filippos T.; Oder, Mare; Kastanje, Ruth; de Vries, Irma; Scholtens, Lies; Annas, Anita; Plackova, Silvia; Turk, Rajka; Gruzdyte, Laima; Rato, Fátima; Genser, Dieter; Schiel, Helmut; Balázs, Andrea; Donohoe, Elaine; Vardavas, Alexander I; Tzatzarakis, Manolis N; Tsatsakis, Aristidis M; Behrakis, Panagiotis K

    BACKGROUND: The use of e-cigarettes has increased during the past few years. Exposure to e-cigarette liquids, whether intentional or accidental, may lead to adverse events our aim was to assess factors associated with e-cigarette exposures across European Union Member States (EU MS). METHODS: A

  13. Exposure to Severe Urban Air Pollution Influences Cognitive Outcomes, Brain Volume and Systemic Inflammation in Clinically Healthy Children

    Science.gov (United States)

    Calderon-Garciduenas, Lilian; Engle, Randall; Mora-Tiscareno, Antonieta; Styner, Martin; Gomez-Garza, Gilberto; Zhu, Hongtu; Jewells, Valerie; Torres-Jardon, Ricardo; Romero, Lina; Monroy-Acosta, Maria E.; Bryant, Christopher; Gonzalez-Gonzalez, Luis Oscar; Medina-Cortina, Humberto; D'Angiulli, Amedeo

    2011-01-01

    Exposure to severe air pollution produces neuroinflammation and structural brain alterations in children. We tested whether patterns of brain growth, cognitive deficits and white matter hyperintensities (WMH) are associated with exposures to severe air pollution. Baseline and 1 year follow-up measurements of global and regional brain MRI volumes,…

  14. Prenatal exposure to PCB-153, p,p'-DDE and birth outcomes in 9000 mother-child pairs

    DEFF Research Database (Denmark)

    Casas, Maribel; Nieuwenhuijsen, Mark; Martínez, David

    2014-01-01

    Low-level exposure to polychlorinated biphenyl-153 (PCB-153) and dichlorodiphenyldichloroethylene (p-p'-DDE) can impair fetal growth; however, the exposure-response relationship and effect modifiers of such association are not well established. This study is an extension of an earlier European me...

  15. Impact of short-term preconceptional exposure to particulate air pollution on treatment outcome in couples undergoing in vitro fertilization and embryo transfer (IVF/ET)

    Science.gov (United States)

    Maluf, Mariangela; Czeresnia, Carlos Eduardo; Januário, Daniela Aparecida Nicolosi Foltran; Saldiva, Paulo Hilário Nascimento

    2010-01-01

    Purpose To assess the potential effects of short-term exposure to particulate air pollution during follicular phase on clinical, laboratory, and pregnancy outcomes of women undergoing IVF/ET. Methods Retrospective cohort study of 400 first IVF/ET cycles of women exposed to ambient particulate matter during follicular phase. Particulate matter (PM) was categorized into quartiles (Q1: ≤30.48 µg/m3, Q2: 30.49–42.00 µg/m3, Q3: 42.01–56.72 µg/m3, and Q4: >56.72 µg/m3). Results Clinical, laboratory, or treatment variables were not affected by follicular phase PM exposure periods. Women exposed to Q4 period during the follicular phase of conception cycles had a higher risk of miscarriage (odds ratio, 5.05; 95% confidence interval: 1.04–25.51) when compared to women exposed to Q1–3 periods. Conclusion Our results show an association between brief exposure to high levels of ambient PM during the preconceptional period and early pregnancy loss, although no effect of this exposure on clinical, laboratory, and treatment outcomes was observed. PMID:20405197

  16. Application of maximum values for radiation exposure and principles for the calculation of radiation dose

    International Nuclear Information System (INIS)

    2000-01-01

    The guide sets out the mathematical definitions and principles involved in the calculation of the equivalent dose and the effective dose, and the instructions concerning the application of the maximum values of these quantities. further, for monitoring the dose caused by internal radiation, the guide defines the limits derived from annual dose limits (the Annual Limit on Intake and the Derived Air Concentration). Finally, the guide defines the operational quantities to be used in estimating the equivalent dose and the effective dose, and also sets out the definitions of some other quantities and concepts to be used in monitoring radiation exposure. The guide does not include the calculation of patient doses carried out for the purposes of quality assurance

  17. Application of maximum values for radiation exposure and principles for the calculation of radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The guide sets out the mathematical definitions and principles involved in the calculation of the equivalent dose and the effective dose, and the instructions concerning the application of the maximum values of these quantities. further, for monitoring the dose caused by internal radiation, the guide defines the limits derived from annual dose limits (the Annual Limit on Intake and the Derived Air Concentration). Finally, the guide defines the operational quantities to be used in estimating the equivalent dose and the effective dose, and also sets out the definitions of some other quantities and concepts to be used in monitoring radiation exposure. The guide does not include the calculation of patient doses carried out for the purposes of quality assurance.

  18. Does engagement with exposure yield better outcomes? Components of presence as a predictor of treatment response for virtual reality exposure therapy for social phobia.

    Science.gov (United States)

    Price, Matthew; Mehta, Natasha; Tone, Erin B; Anderson, Page L

    2011-08-01

    Virtual reality exposure (VRE) has been shown to be effective for treating a variety of anxiety disorders, including social phobia. Presence, or the level of connection an individual feels with the virtual environment, is widely discussed as a critical construct both for the experience of anxiety within a virtual environment and for a successful response to VRE. Two published studies show that whereas generalized presence relates to fear ratings during VRE, it does not relate to treatment response. However, presence has been conceptualized as multidimensional, with three primary factors (spatial presence, involvement, and realness). These factors can be linked to other research on the facilitation of fear during exposure, inhibitors of treatment response (e.g., distraction), and more recent theoretical discussions of the mechanisms of exposure therapy, such as Bouton's description of expectancy violation. As such, one or more of these components of presence may be more strongly associated with the experience of fear during VRE and treatment response than the overarching construct. The current study (N=41) evaluated relations between three theorized components of presence, fear ratings during VRE, and treatment response for VRE for social phobia. Results suggest that total presence and realness subscale scores were related to in-session peak fear ratings. However, only scores on the involvement subscale significantly predicted treatment response. Implications of these findings are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review.

    Science.gov (United States)

    Massetti, Thais; Crocetta, Tânia Brusque; Silva, Talita Dias da; Trevizan, Isabela Lopes; Arab, Claudia; Caromano, Fátima Aparecida; Monteiro, Carlos Bandeira de Mello

    2017-08-01

    To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials. A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies. Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions. The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR. Implications for Rehabilitation tDCS with VR intervention can be an alternative to traditional rehabilitation programs. tDCS with VR is a promising type of intervention with a variety of positive effects. Application of tDCS with VR is appropriated to both healthy and impaired patients. There is no consensus of tDCS with VR application.

  20. Causal inference with missing exposure information: Methods and applications to an obstetric study.

    Science.gov (United States)

    Zhang, Zhiwei; Liu, Wei; Zhang, Bo; Tang, Li; Zhang, Jun

    2016-10-01

    Causal inference in observational studies is frequently challenged by the occurrence of missing data, in addition to confounding. Motivated by the Consortium on Safe Labor, a large observational study of obstetric labor practice and birth outcomes, this article focuses on the problem of missing exposure information in a causal analysis of observational data. This problem can be approached from different angles (i.e. missing covariates and causal inference), and useful methods can be obtained by drawing upon the available techniques and insights in both areas. In this article, we describe and compare a collection of methods based on different modeling assumptions, under standard assumptions for missing data (i.e. missing-at-random and positivity) and for causal inference with complete data (i.e. no unmeasured confounding and another positivity assumption). These methods involve three models: one for treatment assignment, one for the dependence of outcome on treatment and covariates, and one for the missing data mechanism. In general, consistent estimation of causal quantities requires correct specification of at least two of the three models, although there may be some flexibility as to which two models need to be correct. Such flexibility is afforded by doubly robust estimators adapted from the missing covariates literature and the literature on causal inference with complete data, and by a newly developed triply robust estimator that is consistent if any two of the three models are correct. The methods are applied to the Consortium on Safe Labor data and compared in a simulation study mimicking the Consortium on Safe Labor. © The Author(s) 2013.

  1. Integrating Quality and Safety Competencies to Improve Outcomes: Application in Infusion Therapy Practice.

    Science.gov (United States)

    Sherwood, Gwen; Nickel, Barbara

    Despite intense scrutiny and process improvement initiatives, patient harm continues to occur in health care with alarming frequency. The Quality and Safety Education for Nursing (QSEN) project provides a roadmap to transform nursing by integrating 6 competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As front-line caregivers, nurses encounter inherent risks in their daily work. Infusion therapy is high risk with multiple potential risks for patient harm. This study examines individual and system application of the QSEN competencies and the Infusion Nurses Society's 2016 Infusion Therapy Standards of Practice in the improvement of patient outcomes.

  2. Prenatal coke: what's behind the smoke? Prenatal cocaine/alcohol exposure and school-age outcomes: the SCHOO-BE experience.

    Science.gov (United States)

    Delaney-Black, V; Covington, C; Templin, T; Ager, J; Martier, S; Compton, S; Sokol, R

    1998-06-21

    Despite media reports and educators' concerns, little substantive data have been published to document or refute the emerging reports that children prenatally exposed to cocaine have serious behavioral problems in school. Recent pilot data from this institution have indeed demonstrated teacher-reported problem behaviors following prenatal cocaine exposure after controlling for the effects of prenatal alcohol use and cigarette exposure. Imperative in the study of prenatal exposure and child outcome is an acknowledgement of the influence of other control factors such as postnatal environment, secondary exposures, and parenting issues. We report preliminary evaluation from a large ongoing historical prospective study of prenatal cocaine exposure on school-age outcomes. The primary aim of this NIDA-funded study is to determine if a relationship exists between prenatal cocaine/alcohol exposures and school behavior and, if so, to determine if the relationship is characterized by a dose-response relationship. A secondary aim evaluates the relationship between prenatal cocaine/alcohol exposures and school achievement. Both relationships will be assessed in a black, urban sample of first grade students using multivariate statistical techniques for confounding as well as mediating and moderating prenatal and postnatal variables. A third aim is to evaluate the relationship between a general standardized classroom behavioral measure and a tool designed to tap the effects thought to be specific to prenatal cocaine exposure. This interdisciplinary research team can address these aims because of the existence of a unique, prospectively collected perinatal Database, funded in part by NIAAA and NICHD. The database includes repeated measures of cocaine, alcohol, and other substances for over 3,500 births since 1986. Information from this database is combined with information from the database of one of the largest public school systems in the nation. The final sample will be

  3. Prenatal Coke: What's Behind the Smoke?: Prenatal Cocaine/Alcohol Exposure and School-Age Outcomes: The SCHOO-BE Experiencea.

    Science.gov (United States)

    Delaney-Black, Virginia; Covington, Chandice; Templin, Tom; Ager, Joel; Martier, Sue; Compton, Scott; Sokol, Robert

    1998-06-01

    Despite media reports and educators' concerns, little substantive data have been published to document or refute the emerging reports that children prenatally exposed to cocaine have serious behavioral problems in school. Recent pilot data from this institution have indeed demonstrated teacher-reported problem behaviors following prenatal cocaine exposure after controlling for the effects of prenatal alcohol use and cigarette exposure. Imperative in the study of prenatal exposure and child outcome is an acknowledgment of the influence of other control factors such as postnatal environment, secondary exposures, and parenting issues. We report preliminary evaluation from a large ongoing historical prospective study of prenatal cocaine exposure on school-age outcomes. The primary aim of this NIDA-funded study is to determine if a relationship exists between prenatal cocaine/alcohol exposures and school behavior and, if so, to determine if the relationship is characterized by a dose-response relationship. A secondary aim evaluates the relationship between prenatal cocaine/alcohol exposures and school achievement. Both relationships will be assessed in a black, urban sample of first grade students using multivariate statistical techniques for confounding as well as mediating and moderating prenatal and postnatal variables. A third aim is to evaluate the relationship between a general standardized classroom behavioral measure and a tool designed to tap the effects thought to be specific to prenatal cocaine exposure. This interdisciplinary research team can address these aims because of the existence of a unique, prospectively collected Perinatal Database, funded in part by NIAAA and NICHD. The database includes repeated measures of cocaine, alcohol, and other substances for over 3,500 births since 1986. Information from this database is combined with information from the database of one of the largest public school systems in the nation. The final sample will be composed

  4. Semiparametric methods for estimation of a nonlinear exposure‐outcome relationship using instrumental variables with application to Mendelian randomization

    Science.gov (United States)

    Staley, James R.

    2017-01-01

    ABSTRACT Mendelian randomization, the use of genetic variants as instrumental variables (IV), can test for and estimate the causal effect of an exposure on an outcome. Most IV methods assume that the function relating the exposure to the expected value of the outcome (the exposure‐outcome relationship) is linear. However, in practice, this assumption may not hold. Indeed, often the primary question of interest is to assess the shape of this relationship. We present two novel IV methods for investigating the shape of the exposure‐outcome relationship: a fractional polynomial method and a piecewise linear method. We divide the population into strata using the exposure distribution, and estimate a causal effect, referred to as a localized average causal effect (LACE), in each stratum of population. The fractional polynomial method performs metaregression on these LACE estimates. The piecewise linear method estimates a continuous piecewise linear function, the gradient of which is the LACE estimate in each stratum. Both methods were demonstrated in a simulation study to estimate the true exposure‐outcome relationship well, particularly when the relationship was a fractional polynomial (for the fractional polynomial method) or was piecewise linear (for the piecewise linear method). The methods were used to investigate the shape of relationship of body mass index with systolic blood pressure and diastolic blood pressure. PMID:28317167

  5. Novel Applications of Modified Ultrafiltration and Autologous Priming Techniques to Reduce Blood Product Exposure on ECMO.

    Science.gov (United States)

    Neal, James R; Blau, Caitlin L; Cornelius, Amanda M; Pike, Roxann B; Dearani, Joseph A; Mora, Bassem N

    2016-03-01

    Patients needing the assistance of extracorporeal membrane oxygenation (ECMO) are at risk of hemodilution and, in some instances, may require exposure to large amounts of allogeneic blood products. Patient outcomes can be improved by taking steps to reduce transfusions and hemodilution. Currently, modified ultrafiltration (MUF) is used across the world to reduce hemodilution after cardiopulmonary bypass (CPB). Another common technique during bypass initiation is autologous priming. By applying modified versions of these techniques, ECMO patients may potentially benefit. Usually, patients requiring immediate transition from CPB to ECMO are not stable enough to tolerate MUF. Through alterations of the CPB and ECMO circuit tubing, MUF can be performed once on ECMO. Another technique to potentially lower the transfusion requirements for ECMO patients is a complete circuit blood transfer during an ECMO circuit exchange. While selective component changes are preferred if possible, occasionally a complete circuit change must be done. To minimize hemodilution or prevent priming with blood products, the original ECMO circuit's blood can be transferred to the new ECMO circuit before connecting to the patient. Both of these techniques, in our opinion, helped to reduce the number of transfusions that our ECMO patients have seen during these critical time periods.

  6. Children's residential exposure to chlorpyrifos: Application of CPPAES field measurements of chlorpyrifos and TCPy within MENTOR/SHEDS-Pesticides model

    International Nuclear Information System (INIS)

    Hore, Paromita; Zartarian, Valerie; Xue Jianping; Ozkaynak, Haluk; Wang, S.-W.; Yang, Y.-C.; Chu, P.-Ling; Sheldon, Linda; Robson, Mark; Needham, Larry; Barr, Dana; Freeman, Natalie; Georgopoulos, Panos; Lioy, Paul J.

    2006-01-01

    The comprehensive individual field-measurements on non-dietary exposure collected in the Children's-Post-Pesticide-Application-Exposure-Study (CPPAES) were used within MENTOR/SHEDS-Pesticides, a physically based stochastic human exposure and dose model. In this application, however, the model was run deterministically. The MENTOR/SHEDS-Pesticides employed the CPPAES as input variables to simulate the exposure and the dose profiles for seven children over a 2-week post-application period following a routine residential and professional indoor crack-and-crevice chlorpyrifos application. The input variables were obtained from a personal activity diary, microenvironmental measurements and personal biomonitoring data obtained from CPPAES samples collected from the individual children and in their homes. Simulation results were compared with CPPAES field measured values obtained from the children's homes to assess the utility of the different microenvironmental data collected in CPPAES, i.e. indicator toys and wipe samplers to estimate aggregate exposures that can be result from one or more exposure pathways and routes. The final analyses of the database involved comparisons of the actual data obtained from the individual biomarker samples of a urinary metabolite of chlorpyrifos (TCPy) and the values predicted by MENTOR/SHEDS-Pesticides using the CPPAES-derived variables. Because duplicate diet samples were not part of the CPPAES study design, SHEDs-Pesticides simulated dose profiles did not account for the dietary route. The research provided more confidence in the types of data that can be used in the inhalation and dermal contact modules of MENTOR/SHEDS-Pesticides to predict the pesticide dose received by a child. It was determined that we still need additional understanding about: (1) the types of activities and durations of activities that result in non-dietary ingestion of pesticides and (2) the influence of dietary exposures on the levels of TCPy found in the

  7. Prenatal exposure to dental amalgam in the Seychelles Child Development Nutrition Study: associations with neurodevelopmental outcomes at 9 and 30 months.

    Science.gov (United States)

    Watson, Gene E; Evans, Katie; Thurston, Sally W; van Wijngaarden, Edwin; Wallace, Julie M W; McSorley, Emeir M; Bonham, Maxine P; Mulhern, Maria S; McAfee, Alison J; Davidson, Philip W; Shamlaye, Conrad F; Strain, J J; Love, Tanzy; Zareba, Grazyna; Myers, Gary J

    2012-12-01

    Dental amalgam is approximately 50% metallic mercury and releases mercury vapor into the oral cavity, where it is inhaled and absorbed. Maternal amalgams expose the developing fetus to mercury vapor. Mercury vapor can be toxic, but uncertainty remains whether prenatal amalgam exposure is associated with neurodevelopmental consequences in offspring. To determine if prenatal mercury vapor exposure from maternal dental amalgam is associated with adverse effects to cognition and development in children. We prospectively determined dental amalgam status in a cohort of 300 pregnant women recruited in 2001 in the Republic of Seychelles to study the risks and benefits of fish consumption. The primary exposure measure was maternal amalgam surfaces present during gestation. Maternal occlusal points were a secondary measure. Outcomes were the child's mental (MDI) and psychomotor (PDI) developmental indices of the Bayley Scales of Infant Development-II (BSID-II) administered at 9 and 30 months. Complete exposure, outcome, and covariate data were available on a subset of 242 mother-child pairs. The number of amalgam surfaces was not significantly (p>0.05) associated with either PDI or MDI scores. Similarly, secondary analysis with occlusal points showed no effect on the PDI or MDI scores for boys and girls combined. However, secondary analysis of the 9-month MDI was suggestive of an adverse association present only in girls. We found no evidence of an association between our primary exposure metric, amalgam surfaces, and neurodevelopmental endpoints. Secondary analyses using occlusal points supported these findings, but suggested the possibility of an adverse association with the MDI for girls at 9 months. Given the continued widespread use of dental amalgam, we believe additional prospective studies to clarify this issue are a priority. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. The development of a clinical outcomes survey research application: Assessment Center.

    Science.gov (United States)

    Gershon, Richard; Rothrock, Nan E; Hanrahan, Rachel T; Jansky, Liz J; Harniss, Mark; Riley, William

    2010-06-01

    The National Institutes of Health sponsored Patient-Reported Outcome Measurement Information System (PROMIS) aimed to create item banks and computerized adaptive tests (CATs) across multiple domains for individuals with a range of chronic diseases. Web-based software was created to enable a researcher to create study-specific Websites that could administer PROMIS CATs and other instruments to research participants or clinical samples. This paper outlines the process used to develop a user-friendly, free, Web-based resource (Assessment Center) for storage, retrieval, organization, sharing, and administration of patient-reported outcomes (PRO) instruments. Joint Application Design (JAD) sessions were conducted with representatives from numerous institutions in order to supply a general wish list of features. Use Cases were then written to ensure that end user expectations matched programmer specifications. Program development included daily programmer "scrum" sessions, weekly Usability Acceptability Testing (UAT) and continuous Quality Assurance (QA) activities pre- and post-release. Assessment Center includes features that promote instrument development including item histories, data management, and storage of statistical analysis results. This case study of software development highlights the collection and incorporation of user input throughout the development process. Potential future applications of Assessment Center in clinical research are discussed.

  9. Demonstration of a software design and statistical analysis methodology with application to patient outcomes data sets.

    Science.gov (United States)

    Mayo, Charles; Conners, Steve; Warren, Christopher; Miller, Robert; Court, Laurence; Popple, Richard

    2013-11-01

    With emergence of clinical outcomes databases as tools utilized routinely within institutions, comes need for software tools to support automated statistical analysis of these large data sets and intrainstitutional exchange from independent federated databases to support data pooling. In this paper, the authors present a design approach and analysis methodology that addresses both issues. A software application was constructed to automate analysis of patient outcomes data using a wide range of statistical metrics, by combining use of C#.Net and R code. The accuracy and speed of the code was evaluated using benchmark data sets. The approach provides data needed to evaluate combinations of statistical measurements for ability to identify patterns of interest in the data. Through application of the tools to a benchmark data set for dose-response threshold and to SBRT lung data sets, an algorithm was developed that uses receiver operator characteristic curves to identify a threshold value and combines use of contingency tables, Fisher exact tests, Welch t-tests, and Kolmogorov-Smirnov tests to filter the large data set to identify values demonstrating dose-response. Kullback-Leibler divergences were used to provide additional confirmation. The work demonstrates the viability of the design approach and the software tool for analysis of large data sets.

  10. Development and Application of a Code for Internal Exposure (CINEX) based on the CINDY code

    International Nuclear Information System (INIS)

    Kravchik, T.; Duchan, N.; Sarah, R.; Gabay, Y.; Kol, R.

    2004-01-01

    Internal exposure to radioactive materials at the NRCN is evaluated using the CINDY (Code for Internal Dosimetry) Package. The code was developed by the Pacific Northwest Laboratory to assist the interpretation of bioassay data, provide bioassay projections and evaluate committed and calendar-year doses from intake or bioassay measurement data. It provides capabilities to calculate organ dose and effective dose equivalents using the International Commission on Radiological Protection (ICRP) 30 approach. The CINDY code operates under DOS operating system and consequently its operation needs a relatively long procedure which also includes a lot of manual typing that can lead to personal human mistakes. A new code has been developed at the NRCN, the CINEX (Code for Internal Exposure), which is an Excel application and leads to a significant reduction in calculation time (in the order of 5-10 times) and in the risk of personal human mistakes. The code uses a database containing tables which were constructed by the CINDY and contain the bioassay values predicted by the ICRP30 model after an intake of an activity unit of each isotope. Using the database, the code than calculates the appropriate intake and consequently the committed effective dose and organ dose. Calculations with the CINEX code were compared to similar calculations with the CINDY code. The discrepancies were less than 5%, which is the rounding error of the CINDY code. Attached is a table which compares parameters calculated with the CINEX and the CINDY codes (for a class Y uranium). The CINEX is now used at the NRCN to calculate occupational intakes and doses to workers with radioactive materials

  11. Application of physiologically based pharmacokinetic modeling in setting acute exposure guideline levels for methylene chloride.

    NARCIS (Netherlands)

    Bos, Peter Martinus Jozef; Zeilmaker, Marco Jacob; Eijkeren, Jan Cornelis Henri van

    2006-01-01

    Acute exposure guideline levels (AEGLs) are derived to protect the human population from adverse health effects in case of single exposure due to an accidental release of chemicals into the atmosphere. AEGLs are set at three different levels of increasing toxicity for exposure durations ranging from

  12. Analytic strategies to evaluate the association of time-varying exposures to HIV-related outcomes: Alcohol consumption as an example.

    Science.gov (United States)

    Cook, Robert L; Kelso, Natalie E; Brumback, Babette A; Chen, Xinguang

    2016-01-01

    As persons with HIV are living longer, there is a growing need to investigate factors associated with chronic disease, rate of disease progression and survivorship. Many risk factors for this high-risk population change over time, such as participation in treatment, alcohol consumption and drug abuse. Longitudinal datasets are increasingly available, particularly clinical data that contain multiple observations of health exposures and outcomes over time. Several analytic options are available for assessment of longitudinal data; however, it can be challenging to choose the appropriate analytic method for specific combinations of research questions and types of data. The purpose of this review is to help researchers choose the appropriate methods to analyze longitudinal data, using alcohol consumption as an example of a time-varying exposure variable. When selecting the optimal analytic method, one must consider aspects of exposure (e.g. timing, pattern, and amount) and outcome (fixed or time-varying), while also addressing minimizing bias. In this article, we will describe several analytic approaches for longitudinal data, including developmental trajectory analysis, generalized estimating equations, and mixed effect models. For each analytic strategy, we describe appropriate situations to use the method and provide an example that demonstrates the use of the method. Clinical data related to alcohol consumption and HIV are used to illustrate these methods.

  13. Pesticide Application and Khat Chewing as Predictors of the Neurological Health Outcomes among Pesticide Applicators in a Vector Control Unit, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Ahmed A Ismail

    2018-01-01

    Full Text Available Background: Pesticide applicators are at risk of developing neurological symptoms and neurobehavioral deficits. This risk may increase if the applicator chews stimulant plants like khat. Objective: To examine the sociodemographic and exposure determinants of neurological symptoms presentation, neurobehavioral performance, and cholinesterase activity among pesticide applicators in a vector control unit, Saudi Arabia. Methods: In a cross-sectional study, 30 pesticide applicators and 32 non-applicators from a vector control unit in Jazan region, Saudi Arabia, were studied. The study participants completed an exposure and medical questionnaire, and a neurobehavioral test battery. Their blood samples were also tested for the measurement of butyryl cholinesterase (BChE. Results: The mean blood BChE level was no significantly different between the applicators and non-applicators. Working in pesticide application and chewing khat were significant predictors of the neurological symptoms presentation and neurobehavioral deficits among the study participants. Each factor was associated with about 40% of the symptoms included in the questionnaire. Exposure to pyrethroids was significantly associated with a decrement in symbol digit test latency, tapping (TAP non-preferred hand, and TAP alternating hands measures, representing the executive and motor speed/coordination functions. Khat chewing was associated with TAP preferred and non-preferred hands and serial digit learning measures, representing the memory and motor speed/coordination functions. Conclusions: It seems that being exposed to pyrethroids and chewing khat are associated with neurological and neurobehavioral drawbacks among pesticide applicators.

  14. Identification of fipronil metabolites in rodents by time-of-flight mass spectrometry for application in a human exposure study

    Science.gov (United States)

    Fipronil is a phenylpyrazole insecticide commonly used in residential and agricultural applications. To understand more about the potential risks associated with fipronil, dosed Long Evans rats were evaluated for metabolites to develop a set of biomarkers for use in human exposur...

  15. Timing of prenatal maternal exposure to severe life events and adverse pregnancy outcomes: A population study of 2.6 million pregnancies

    Science.gov (United States)

    Class, Quetzal A.; Lichtenstein, Paul; Långström, Niklas; D'Onofrio, Brian M.

    2011-01-01

    Objective To identify the impact of timing of prenatal stress exposure on offspring risk for shortened gestational age (GA), preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) using a population-based sample. Methods Swedish longitudinal population registries were linked to study all individuals born in Sweden 1973–2004. Prenatal maternal stress exposure was defined as death of the father of the child or first degree relative of the mother. Using linear and logistic regression, timing of stress exposure was examined across pregnancy, by month, and by novel periods created based on month of stress exposure findings. Results A total of 2,618,777 live-born, singleton infants without congenital anomalies were included; 32,286 exposed to prenatal maternal stress. Examining associations between stress exposure and outcome by the month revealed that risk increases mid-gestation, particularly following months 5 and 6. Combining months 1–4, 5 and 6, and 7–9 as potential periods of differing vulnerability, it was found that stress during period 2 (months 5 and 6) was associated with the greatest risk for shortened GA (−0.52 days, SE=0.15, p=0.0006), PTB (OR=1.24, 99% CI=1.08–1.42), LBW (OR=1.38, 99% CI=1.19–1.61), and SGA (OR=1.25, 99% CI=1.05–1.49). Conclusions Risk for shortened GA, PTB, LBW, and SGA are greater following stress exposure during the 5th and/or 6th month of pregnancy. It may be beneficial to refine future analyses to these months. Possible mechanisms include alterations in the hypothalamic-pituitary-adrenal axis and associated stress-responsive molecular regulators. PMID:21321257

  16. Effect of exposure time reduction towards sensitivity and SNR for computed radiography (CR) application in NDT

    International Nuclear Information System (INIS)

    Sapizah Rahim; Khairul Anuar Mohd Salleh; Noorhazleena Azaman; Shaharudin Sayuti; Siti Madiha Muhammad Amir; Arshad Yassin; Abdul Razak Hamzah

    2010-01-01

    Signal-to-noise ratio (SNR) and sensitivity study of Computed Radiography (CR) system with reduction of exposure time is presented. The purposes of this research are to determine the behavior of SNR toward three different thicknesses (step wedge; 5, 10 and 15 mm) and the ability of CR system to recognize hole type penetrameter when the exposure time decreased up to 80 % according to the exposure chart (D7; ISOVOLT Titan E). It is shown that the SNR is decreased with decreasing of exposure time percentage but the high quality image is achieved until 80 % reduction of exposure time. (author)

  17. Effect of individual parameter changes on the outcome of the estimated short-term dietary exposure to pesticides.

    Science.gov (United States)

    van der Velde-Koerts, Trijntje; Breysse, Nicolas; Pattingre, Lauriane; Hamey, Paul Y; Lutze, Jason; Mahieu, Karin; Margerison, Sam; Ossendorp, Bernadette C; Reich, Hermine; Rietveld, Anton; Sarda, Xavier; Vial, Gaelle; Sieke, Christian

    2018-06-03

    In 2015 a scientific workshop was held in Geneva, where updating the International Estimate of Short-Term Intake (IESTI) equations was suggested. This paper studies the effects of the proposed changes in residue inputs, large portions, variability factors and unit weights on the overall short-term dietary exposure estimate. Depending on the IESTI case equation, a median increase in estimated overall exposure by a factor of 1.0-6.8 was observed when the current IESTI equations are replaced by the proposed IESTI equations. The highest increase in the estimated exposure arises from the replacement of the median residue (STMR) by the maximum residue limit (MRL) for bulked and blended commodities (case 3 equations). The change in large portion parameter does not have a significant impact on the estimated exposure. The use of large portions derived from the general population covering all age groups and bodyweights should be avoided when large portions are not expressed on an individual bodyweight basis. Replacement of the highest residue (HR) by the MRL and removal of the unit weight each increase the estimated exposure for small-, medium- and large-sized commodities (case 1, case 2a or case 2b equations). However, within the EU framework lowering of the variability factor from 7 or 5 to 3 counterbalances the effect of changes in other parameters, resulting in an estimated overall exposure change for the EU situation of a factor of 0.87-1.7 and 0.6-1.4 for IESTI case 2a and case 2b equations, respectively.

  18. Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6-12 Years of Age in Mexico.

    Science.gov (United States)

    Bashash, Morteza; Thomas, Deena; Hu, Howard; Martinez-Mier, E Angeles; Sanchez, Brisa N; Basu, Niladri; Peterson, Karen E; Ettinger, Adrienne S; Wright, Robert; Zhang, Zhenzhen; Liu, Yun; Schnaas, Lourdes; Mercado-García, Adriana; Téllez-Rojo, Martha María; Hernández-Avila, Mauricio

    2017-09-19

    Some evidence suggests that fluoride may be neurotoxic to children. Few of the epidemiologic studies have been longitudinal, had individual measures of fluoride exposure, addressed the impact of prenatal exposures or involved more than 100 participants. Our aim was to estimate the association of prenatal exposure to fluoride with offspring neurocognitive development. We studied participants from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project. An ion-selective electrode technique was used to measure fluoride in archived urine samples taken from mothers during pregnancy and from their children when 6-12 y old, adjusted for urinary creatinine and specific gravity, respectively. Child intelligence was measured by the General Cognitive Index (GCI) of the McCarthy Scales of Children's Abilities at age 4 and full scale intelligence quotient (IQ) from the Wechsler Abbreviated Scale of Intelligence (WASI) at age 6-12. We had complete data on 299 mother-child pairs, of whom 287 and 211 had data for the GCI and IQ analyses, respectively. Mean (SD) values for urinary fluoride in all of the mothers (n=299) and children with available urine samples (n=211) were 0.90 (0.35) mg/L and 0.82 (0.38) mg/L, respectively. In multivariate models we found that an increase in maternal urine fluoride of 0.5mg/L (approximately the IQR) predicted 3.15 (95% CI: -5.42, -0.87) and 2.50 (95% CI -4.12, -0.59) lower offspring GCI and IQ scores, respectively. In this study, higher prenatal fluoride exposure, in the general range of exposures reported for other general population samples of pregnant women and nonpregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 6-12 y. https://doi.org/10.1289/EHP655.

  19. Feasibility of smartphone application and social media intervention on breast cancer survivors' health outcomes.

    Science.gov (United States)

    Pope, Zachary; Lee, Jung Eun; Zeng, Nan; Lee, Hee Yun; Gao, Zan

    2018-02-17

    Breast cancer survivors are at risk for poor health, with physical activity a possible treatment. Little research has examined how technology might promote breast cancer survivor physical activity or health. The aim of this study is to investigate the feasibility of employing a commercially available mobile health application- and social media-based health education intervention to improve breast cancer survivor physical activity or health.Ten breast cancer survivors (X̅ age = 45.80 ± 10.23 years; X̅ weight = 79.51 ± 20.85 kg) participated in this 10-week single-group pilot study from 2015 to 2016. Participants downloaded the MapMyFitness application, documented all physical activity with MapMyFitness, and were enrolled in a Social Cognitive Theory-based, Facebook-delivered health education intervention. Objectively measured physical activity, weight or body composition, cardiovascular fitness, psychosocial constructs, and quality of life indices were measured at baseline and 10 weeks. Intervention use and acceptability was evaluated during and following the intervention. Descriptive statistics were calculated for all study outcomes, with qualitative analyses performed regarding use and acceptability. At postintervention, average daily moderate-to-vigorous physical activity and steps increased by 2.6 min and 1,657, respectively, with notable decreases in weight (2.4 kg) and body fat percentage (2.3%). Physical activity-related social support and ability to engage in social roles or activity demonstrated the greatest improvements among all psychosocial and quality of life indices, respectively. Participants enjoyed the feedback and tracking features of MapMyFitness, with most finding the Facebook component helpful. All participants recommended the intervention for future use.Physical activity interventions combining commercially available mobile health applications and theoretically based social media-delivered health interventions may promote certain

  20. Teleconference versus Face-to-Face Scientific Peer Review of Grant Application: Effects on Review Outcomes

    Science.gov (United States)

    Gallo, Stephen A.; Carpenter, Afton S.; Glisson, Scott R.

    2013-01-01

    Teleconferencing as a setting for scientific peer review is an attractive option for funding agencies, given the substantial environmental and cost savings. Despite this, there is a paucity of published data validating teleconference-based peer review compared to the face-to-face process. Our aim was to conduct a retrospective analysis of scientific peer review data to investigate whether review setting has an effect on review process and outcome measures. We analyzed reviewer scoring data from a research program that had recently modified the review setting from face-to-face to a teleconference format with minimal changes to the overall review procedures. This analysis included approximately 1600 applications over a 4-year period: two years of face-to-face panel meetings compared to two years of teleconference meetings. The average overall scientific merit scores, score distribution, standard deviations and reviewer inter-rater reliability statistics were measured, as well as reviewer demographics and length of time discussing applications. The data indicate that few differences are evident between face-to-face and teleconference settings with regard to average overall scientific merit score, scoring distribution, standard deviation, reviewer demographics or inter-rater reliability. However, some difference was found in the discussion time. These findings suggest that most review outcome measures are unaffected by review setting, which would support the trend of using teleconference reviews rather than face-to-face meetings. However, further studies are needed to assess any correlations among discussion time, application funding and the productivity of funded research projects. PMID:23951223

  1. Teleconference versus face-to-face scientific peer review of grant application: effects on review outcomes.

    Directory of Open Access Journals (Sweden)

    Stephen A Gallo

    Full Text Available Teleconferencing as a setting for scientific peer review is an attractive option for funding agencies, given the substantial environmental and cost savings. Despite this, there is a paucity of published data validating teleconference-based peer review compared to the face-to-face process. Our aim was to conduct a retrospective analysis of scientific peer review data to investigate whether review setting has an effect on review process and outcome measures. We analyzed reviewer scoring data from a research program that had recently modified the review setting from face-to-face to a teleconference format with minimal changes to the overall review procedures. This analysis included approximately 1600 applications over a 4-year period: two years of face-to-face panel meetings compared to two years of teleconference meetings. The average overall scientific merit scores, score distribution, standard deviations and reviewer inter-rater reliability statistics were measured, as well as reviewer demographics and length of time discussing applications. The data indicate that few differences are evident between face-to-face and teleconference settings with regard to average overall scientific merit score, scoring distribution, standard deviation, reviewer demographics or inter-rater reliability. However, some difference was found in the discussion time. These findings suggest that most review outcome measures are unaffected by review setting, which would support the trend of using teleconference reviews rather than face-to-face meetings. However, further studies are needed to assess any correlations among discussion time, application funding and the productivity of funded research projects.

  2. Development of gamma exposure chart (Selenium-75) for Industrial Radiography Application

    International Nuclear Information System (INIS)

    Sapizah Rahim; Shaharudin Sayuti; Noorhazleena Azaman

    2011-01-01

    Radiographic exposure can be determined by either trial exposure, reference to previous data or using exposure chart. Without previous data, exposure chart is the easiest and economic way to achieve correct exposure. It will minimize re-shoot and time. This paper presents the development of gamma exposure chart for Selenium-75 source. Film radiography method has been chosen for this development using steel step wedge blocks. Agfa Structurix D7 films have been used during the exposure and the optical density of the films was measured by using X-Rite densitometer. Method of development of the chart is explained. The chart is tested on pipe and welded plate test sample and the results are discussed. (author)

  3. Disclosure of Temporary Exposures as Permanent Website Applications through the Patrimonial Survey

    Science.gov (United States)

    Corso, Juan; Garcia-Almirall, Pilar; López, Daniel; Casals, Jordi

    2017-10-01

    looms, cloths, dresses, books, among others, accompanied by panels with texts and images that contain the information that each exhibition shows. Virtual applications allow such temporary exposures to become an interactive model, in which information can be permanently consulted. A virtual tour where the user can interact with the information panels and observe in detail the different objects of the exhibition. The results of this work manage to generate a powerful mechanism of diffusion and approximation to the society of the cultural heritage that, otherwise, as a whole as exhibition would disappear.

  4. A Systematic Review of Carcinogenic Outcomes and Potential Mechanisms from Exposure to 2,4-D and MCPA in the Environment

    Directory of Open Access Journals (Sweden)

    Katherine von Stackelberg

    2013-01-01

    Full Text Available Chlorophenoxy compounds, particularly 2,4-dichlorophenoxyacetic acid (2,4-D and 4-chloro-2-methylphenoxyacetic acid (MCPA, are amongst the most widely used herbicides in the United States for both agricultural and residential applications. Epidemiologic studies suggest that exposure to 2,4-D and MCPA may be associated with increased risk non-Hodgkins lymphoma (NHL, Hodgkin’s disease (HD, leukemia, and soft-tissue sarcoma (STS. Toxicological studies in rodents show no evidence of carcinogenicity, and regulatory agencies worldwide consider chlorophenoxies as not likely to be carcinogenic or unclassifiable as to carcinogenicity. This systematic review assembles the available data to evaluate epidemiologic, toxicological, pharmacokinetic, exposure, and biomonitoring studies with respect to key cellular events noted in disease etiology and how those relate to hypothesized modes of action for these constituents to determine the plausibility of an association between exposure to environmentally relevant concentrations of 2,4-D and MCPA and lymphohematopoietic cancers. The combined evidence does not support a genotoxic mode of action. Although plausible hypotheses for other carcinogenic modes of action exist, a comparison of biomonitoring data to oral equivalent doses calculated from bioassay data shows that environmental exposures are not sufficient to support a causal relationship. Genetic polymorphisms exist that are known to increase the risk of developing NHL. The potential interaction between these polymorphisms and exposures to chlorophenoxy compounds, particularly in occupational settings, is largely unknown.

  5. Exposure to Perfluoroalkyl Substances and Metabolic Outcomes in Pregnant Women: Evidence from the Spanish INMA Birth Cohorts

    NARCIS (Netherlands)

    Matilla-Santander, N. (Nuria); D. Valvi (Damaskini); M.-J. Lopez-Espinosa (Maria-Jose); Manzano-Salgado, C.B. (Cyntia B.); F. Ballester (Ferran); J. Ibarluzea (Jesús); L. Santa-Marina (Loreto); T. Schettgen (Thomas); M. Guxens Junyent (Mònica); J. Sunyer (Jordi); M. Vrijheid (Martine)

    2017-01-01

    textabstractBACKGROUND: Exposure to perfluoroalkyl substances (PFASs) may increase risk for metabolic diseases; however, epidemiologic evidence is lacking at the present time. Pregnancy is a period of enhanced tissue plasticity for the fetus and the mother and may be a critical window of PFAS

  6. Characteristics and outcomes of e-cigarette exposure incidents reported to 10 European Poison Centers: a retrospective data analysis

    Directory of Open Access Journals (Sweden)

    Constantine I. Vardavas

    2017-08-01

    Our study highlighted parameters related to e-cigarette exposure incidents in 10 EU MS, the results of which indicate that consideration should be given to the design features which may mitigate risks, thereby protecting users, non-users and especially children.

  7. Anxiety affecting parkinsonian outcome and motor efficiency in adults of an Ohio community with environmental airborne manganese exposure.

    Science.gov (United States)

    Manganese (Mn) is a nutrient and neurotoxicant sometimes associated with mood, motor and neurological effects. Reports of health effects from occupational exposure to Mn are well known, but the reported links to environmental airborne Mn (Mn-Air) are less conclusive. Marietta, OH...

  8. Application of MOSFET detectors for dosimetry in small animal radiography using short exposure times.

    Science.gov (United States)

    De Lin, Ming; Toncheva, Greta; Nguyen, Giao; Kim, Sangroh; Anderson-Evans, Colin; Johnson, G Allan; Yoshizumi, Terry T

    2008-08-01

    Digital subtraction angiography (DSA) X-ray imaging for small animals can be used for functional phenotyping given its ability to capture rapid physiological changes at high spatial and temporal resolution. The higher temporal and spatial requirements for small-animal imaging drive the need for short, high-flux X-ray pulses. However, high doses of ionizing radiation can affect the physiology. The purpose of this study was to verify and apply metal oxide semiconductor field effect transistor (MOSFET) technology to dosimetry for small-animal diagnostic imaging. A tungsten anode X-ray source was used to expose a tissue-equivalent mouse phantom. Dose measurements were made on the phantom surface and interior. The MOSFETs were verified with thermoluminescence dosimeters (TLDs). Bland-Altman analysis showed that the MOSFET results agreed with the TLD results (bias, 0.0625). Using typical small animal DSA scan parameters, the dose ranged from 0.7 to 2.2 cGy. Application of the MOSFETs in the small animal environment provided two main benefits: (1) the availability of results in near real-time instead of the hours needed for TLD processes and (2) the ability to support multiple exposures with different X-ray techniques (various of kVp, mA and ms) using the same MOSFET. This MOSFET technology has proven to be a fast, reliable small animal dosimetry method for DSA imaging and is a good system for dose monitoring for serial and gene expression studies.

  9. Letter to the Editor: Applications Air Q Model on Estimate Health Effects Exposure to Air Pollutants

    Directory of Open Access Journals (Sweden)

    Gholamreza Goudarzi

    2016-02-01

    Full Text Available Epidemiologic studies in worldwide have measured increases in mortality and morbidity associated with air pollution (1-3. Quantifying the effects of air pollution on the human health in urban area causes an increasingly critical component in policy discussion (4-6. Air Q model was proved to be a valid and reliable tool to predicts health effects related to criteria  pollutants (particulate matter (PM, ozone (O3, nitrogen dioxide (NO2, sulfur dioxide (SO2, and carbon monoxide (CO, determinate  the  potential short term effects of air pollution  and allows the examination of various scenarios in which emission rates of pollutants are varied (7,8. Air Q software provided by the WHO European Centre for Environment and Health (ECEH (9. Air Q model is based on cohort studies and used to estimates of both attributable average reductions in life-span and numbers of mortality and morbidity associated with exposure to air pollution (10,11. Applications

  10. Collaborative writing applications in healthcare: effects on professional practice and healthcare outcomes.

    Science.gov (United States)

    Archambault, Patrick M; van de Belt, Tom H; Kuziemsky, Craig; Plaisance, Ariane; Dupuis, Audrey; McGinn, Carrie A; Francois, Rebecca; Gagnon, Marie-Pierre; Turgeon, Alexis F; Horsley, Tanya; Witteman, William; Poitras, Julien; Lapointe, Jean; Brand, Kevin; Lachaine, Jean; Légaré, France

    2017-05-10

    Collaborative writing applications (CWAs), such as wikis and Google Documents, hold the potential to improve the use of evidence in both public health and healthcare. Although a growing body of literature indicates that CWAs could have positive effects on healthcare, such as improved collaboration, behavioural change, learning, knowledge management, and adaptation of knowledge to local context, this has never been assessed systematically. Moreover, several questions regarding safety, reliability, and legal aspects exist. The objectives of this review were to (1) assess the effects of the use of CWAs on process (including the behaviour of healthcare professionals) and patient outcomes, (2) critically appraise and summarise current evidence on the use of resources, costs, and cost-effectiveness associated with CWAs to improve professional practices and patient outcomes, and (3) explore the effects of different CWA features (e.g. open versus closed) and different implementation factors (e.g. the presence of a moderator) on process and patient outcomes. We searched CENTRAL, MEDLINE, Embase, and 11 other electronic databases. We searched the grey literature, two trial registries, CWA websites, individual journals, and conference proceedings. We also contacted authors and experts in the field. We did not apply date or language limits. We searched for published literature to August 2016, and grey literature to September 2015. We included randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-and-after (CBA) studies, interrupted time series (ITS) studies, and repeated measures studies (RMS), in which CWAs were used as an intervention to improve the process of care, patient outcomes, or healthcare costs. Teams of two review authors independently assessed the eligibility of studies. Disagreements were resolved by discussion, and when consensus was not reached, a third review author was consulted. We screened 11,993 studies identified

  11. Impact of barbecued meat consumed in pregnancy on birth outcomes accounting for personal prenatal exposure to airborne polycyclic aromatic hydrocarbons: Birth cohort study in Poland.

    Science.gov (United States)

    Jedrychowski, Wieslaw; Perera, Frederica P; Tang, Deliang; Stigter, Laura; Mroz, Elzbieta; Flak, Elzbieta; Spengler, John; Budzyn-Mrozek, Dorota; Kaim, Irena; Jacek, Ryszard

    2012-04-01

    We previously reported an association between prenatal exposure to airborne polycyclic aromatic hydrocarbons (PAH) and lower birth weight, birth length, and head circumference. The main goal of the present analysis was to assess the possible impact of coexposure to PAH-containing barbecued meat consumed during pregnancy on birth outcomes. The birth cohort consisted of 432 pregnant women who gave birth at term (>36 wk of gestation). Only non-smoking women with singleton pregnancies, 18-35 y of age, and who were free from chronic diseases such as diabetes and hypertension, were included in the study. Detailed information on diet over pregnancy was collected through interviews and the measurement of exposure to airborne PAHs was carried out by personal air monitoring during the second trimester of pregnancy. The effect of barbecued meat consumption on birth outcomes (birth weight, length, and head circumference at birth) was adjusted in multiple linear regression models for potential confounding factors such as prenatal exposure to airborne PAHs, child's sex, gestational age, parity, size of mother (maternal prepregnancy weight, weight gain in pregnancy), and prenatal environmental tobacco smoke. The multivariable regression model showed a significant deficit in birth weight associated with barbecued meat consumption in pregnancy (coeff = -106.0 g; 95%CI: -293.3, -35.8). The effect of exposure to airborne PAHs was about the same magnitude order (coeff. = -164.6 g; 95%CI: -172.3, -34.7). Combined effect of both sources of exposure amounted to birth weight deficit of 214.3 g (95%CI: -419.0, -9.6). Regression models performed for birth length and head circumference showed similar trends but the estimated effects were of borderline significance level. As the intake of barbecued meat did not affect the duration of pregnancy, the reduced birth weight could not have been mediated by a shortened gestation period. In conclusion, the study results provided epidemiologic

  12. Potential Dermal Exposure in greenhouses for manual sprayers: Analysis of the mix/load, application and re-entry stages

    International Nuclear Information System (INIS)

    Ramos, Laura M.; Querejeta, Giselle A.; Flores, Andrea P.; Hughes, Enrique A.; Zalts, Anita; Montserrat, Javier M.

    2010-01-01

    An evaluation of the Potential Dermal Exposure for the mix/load, application and re-entry stages, associated with procymidone and deltamethrin usage, was carried out for tomatoes grown in greenhouses of small production units in Argentina. Eight experiments were done with four different operators, under typical field conditions with a lever operated backpack sprayer. The methodology applied was based on the Whole Body Dosimetry technique, evaluating a set of different data for the mix and load, application and re-entry operations. These results indicated that the Potential Dermal Exposure of the application step was (38 ± 17) mL h -1 with the highest proportion on torso, head and arms. When the three stages were compared, re-entry was found to contribute least towards the total Potential Dermal Exposure; meanwhile in all cases, except one, the mix/load operation was the stage with highest exposure. The Margin of Safety for each different operation was also calculated and the proportion of pesticide drift from the greenhouse to the environment is presented. These results emphasize the importance of improving the personal protection measures in the mix and load stage, an operation that is not usually associated with high-risk in small production units.

  13. Potential Dermal Exposure in greenhouses for manual sprayers: Analysis of the mix/load, application and re-entry stages

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, Laura M.; Querejeta, Giselle A.; Flores, Andrea P.; Hughes, Enrique A.; Zalts, Anita [Instituto de Ciencias, Universidad Nacional de General Sarmiento (UNGS), J. M. Gutierrez 1150, (B1613GSX) Los Polvorines, Prov. de Buenos Aires (Argentina); Montserrat, Javier M., E-mail: jmontser@ungs.edu.ar [Instituto de Ciencias, Universidad Nacional de General Sarmiento (UNGS), J. M. Gutierrez 1150, (B1613GSX) Los Polvorines, Prov. de Buenos Aires (Argentina); Instituto de Investigaciones en Ingenieria Genetica y Biologia Molecular (CONICET), Vuelta de Obligado 2490, 2o piso, Buenos Aires (Argentina)

    2010-09-01

    An evaluation of the Potential Dermal Exposure for the mix/load, application and re-entry stages, associated with procymidone and deltamethrin usage, was carried out for tomatoes grown in greenhouses of small production units in Argentina. Eight experiments were done with four different operators, under typical field conditions with a lever operated backpack sprayer. The methodology applied was based on the Whole Body Dosimetry technique, evaluating a set of different data for the mix and load, application and re-entry operations. These results indicated that the Potential Dermal Exposure of the application step was (38 {+-} 17) mL h{sup -1} with the highest proportion on torso, head and arms. When the three stages were compared, re-entry was found to contribute least towards the total Potential Dermal Exposure; meanwhile in all cases, except one, the mix/load operation was the stage with highest exposure. The Margin of Safety for each different operation was also calculated and the proportion of pesticide drift from the greenhouse to the environment is presented. These results emphasize the importance of improving the personal protection measures in the mix and load stage, an operation that is not usually associated with high-risk in small production units.

  14. Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6–12 Years of Age in Mexico

    Science.gov (United States)

    Thomas, Deena; Hu, Howard; Angeles Martinez-Mier, E.; Sanchez, Brisa N.; Basu, Niladri; Peterson, Karen E.; Ettinger, Adrienne S.; Wright, Robert; Zhang, Zhenzhen; Liu, Yun; Schnaas, Lourdes; Mercado-García, Adriana; María Téllez-Rojo, Martha; Hernández-Avila, Mauricio

    2017-01-01

    Background: Some evidence suggests that fluoride may be neurotoxic to children. Few of the epidemiologic studies have been longitudinal, had individual measures of fluoride exposure, addressed the impact of prenatal exposures or involved more than 100 participants. Objective: Our aim was to estimate the association of prenatal exposure to fluoride with offspring neurocognitive development. Methods: We studied participants from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project. An ion-selective electrode technique was used to measure fluoride in archived urine samples taken from mothers during pregnancy and from their children when 6–12 y old, adjusted for urinary creatinine and specific gravity, respectively. Child intelligence was measured by the General Cognitive Index (GCI) of the McCarthy Scales of Children’s Abilities at age 4 and full scale intelligence quotient (IQ) from the Wechsler Abbreviated Scale of Intelligence (WASI) at age 6–12. Results: We had complete data on 299 mother–child pairs, of whom 287 and 211 had data for the GCI and IQ analyses, respectively. Mean (SD) values for urinary fluoride in all of the mothers (n=299) and children with available urine samples (n=211) were 0.90 (0.35) mg/L and 0.82 (0.38) mg/L, respectively. In multivariate models we found that an increase in maternal urine fluoride of 0.5mg/L (approximately the IQR) predicted 3.15 (95% CI: −5.42, −0.87) and 2.50 (95% CI −4.12, −0.59) lower offspring GCI and IQ scores, respectively. Conclusions: In this study, higher prenatal fluoride exposure, in the general range of exposures reported for other general population samples of pregnant women and nonpregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 6–12 y. https://doi.org/10.1289/EHP655 PMID:28937959

  15. Pesticide exposure and end-stage renal disease risk among wives of pesticide applicators in the Agricultural Health Study.

    Science.gov (United States)

    Lebov, Jill F; Engel, Lawrence S; Richardson, David; Hogan, Susan L; Sandler, Dale P; Hoppin, Jane A

    2015-11-01

    Pesticide exposure has been found to cause renal damage and dysfunction in experimental studies, but epidemiological research on the renal effects of chronic low-level pesticide exposure is limited. We investigated the relationships between end-stage renal disease (ESRD) among wives of licensed pesticide applicators (N=31,142) in the Agricultural Health Study (AHS) and (1) personal pesticide use, (2) exposure to the husband's pesticide use, and (3) other pesticide-associated farming and household activities. AHS participants reported pesticide exposure via self-administered questionnaires at enrollment (1993-1997). ESRD cases were identified via linkage to the United States Renal Data System. Associations between ESRD and pesticide exposures were estimated with Cox proportional hazard regression models controlling for age at enrollment. Models of associations with farming and household factors were additionally adjusted for personal use of pesticides. We identified 98 ESRD cases diagnosed between enrollment and 31 December 2011. Although women who ever applied pesticides (56% of cohort) were less likely than those who did not apply to develop ESRD (Hazard Ratio (HR): 0.42; 95% CI: 0.28, 0.64), among women who did apply pesticides, the rate of ESRD was significantly elevated among those who reported the highest (vs. lowest) cumulative general pesticide use (HR: 4.22; 95% CI: 1.26, 14.20). Among wives who never applied pesticides, ESRD was associated with husbands' ever use of paraquat (HR=1.99; 95% CI: 1.14, 3.47) and butylate (HR=1.71; 95% CI: 1.00, 2.95), with a positive exposure-response pattern for husband's cumulative use of these pesticides. ESRD may be associated with direct and/or indirect exposure to pesticides among farm women. Future studies should evaluate indirect exposure risk among other rural populations. Published by Elsevier Inc.

  16. Exposure to severe urban air pollution influences cognitive outcomes, brain volume and systemic inflammation in clinically healthy children.

    Science.gov (United States)

    Calderón-Garcidueñas, Lilian; Engle, Randall; Mora-Tiscareño, Antonieta; Styner, Martin; Gómez-Garza, Gilberto; Zhu, Hongtu; Jewells, Valerie; Torres-Jardón, Ricardo; Romero, Lina; Monroy-Acosta, Maria E; Bryant, Christopher; González-González, Luis Oscar; Medina-Cortina, Humberto; D'Angiulli, Amedeo

    2011-12-01

    Exposure to severe air pollution produces neuroinflammation and structural brain alterations in children. We tested whether patterns of brain growth, cognitive deficits and white matter hyperintensities (WMH) are associated with exposures to severe air pollution. Baseline and 1 year follow-up measurements of global and regional brain MRI volumes, cognitive abilities (Wechsler Intelligence Scale for Children-Revised, WISC-R), and serum inflammatory mediators were collected in 20 Mexico City (MC) children (10 with white matter hyperintensities, WMH(+), and 10 without, WMH(-)) and 10 matched controls (CTL) from a low polluted city. There were significant differences in white matter volumes between CTL and MC children - both WMH(+) and WMH(-) - in right parietal and bilateral temporal areas. Both WMH(-) and WMH(+) MC children showed progressive deficits, compared to CTL children, on the WISC-R Vocabulary and Digit Span subtests. The cognitive deficits in highly exposed children match the localization of the volumetric differences detected over the 1 year follow-up, since the deficits observed are consistent with impairment of parietal and temporal lobe functions. Regardless of the presence of prefrontal WMH, Mexico City children performed more poorly across a variety of cognitive tests, compared to CTL children, thus WMH(+) is likely only partially identifying underlying white matter pathology. Together these findings reveal that exposure to air pollution may perturb the trajectory of cerebral development and result in cognitive deficits during childhood. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Calreticulin exposure by malignant blasts correlates with robust anticancer immunity and improved clinical outcome in AML patients

    Science.gov (United States)

    Fucikova, Jitka; Truxova, Iva; Hensler, Michal; Becht, Etienne; Kasikova, Lenka; Moserova, Irena; Vosahlikova, Sarka; Klouckova, Jana; Church, Sarah E.; Cremer, Isabelle; Kepp, Oliver; Kroemer, Guido; Galluzzi, Lorenzo; Salek, Cyril

    2016-01-01

    Cancer cell death can be perceived as immunogenic by the host only when malignant cells emit immunostimulatory signals (so-called “damage-associated molecular patterns,” DAMPs), as they die in the context of failing adaptive responses to stress. Accumulating preclinical and clinical evidence indicates that the capacity of immunogenic cell death to (re-)activate an anticancer immune response is key to the success of various chemo- and radiotherapeutic regimens. Malignant blasts from patients with acute myeloid leukemia (AML) exposed multiple DAMPs, including calreticulin (CRT), heat-shock protein 70 (HSP70), and HSP90 on their plasma membrane irrespective of treatment. In these patients, high levels of surface-exposed CRT correlated with an increased proportion of natural killer cells and effector memory CD4+ and CD8+ T cells in the periphery. Moreover, CRT exposure on the plasma membrane of malignant blasts positively correlated with the frequency of circulating T cells specific for leukemia-associated antigens, indicating that ecto-CRT favors the initiation of anticancer immunity in patients with AML. Finally, although the levels of ecto-HSP70, ecto-HSP90, and ecto-CRT were all associated with improved relapse-free survival, only CRT exposure significantly correlated with superior overall survival. Thus, CRT exposure represents a novel powerful prognostic biomarker for patients with AML, reflecting the activation of a clinically relevant AML-specific immune response. PMID:27802968

  18. Maternal exposure to UV filters and associations to maternal thyroid hormones and IGF-I/IGFBP3 and birth outcomes

    DEFF Research Database (Denmark)

    Krause, Marianna; Frederiksen, Hanne; Sundberg, Karin

    2018-01-01

    as birth outcomes (weight, height, and head and abdominal circumferences) were examined. RESULTS: Positive associations between maternal serum concentrations of 4-HBP and triiodothyronine (T3), thyroxine (T4), Insulin-like Growth Factor-I (IGF-I) and its binding protein IGFBP3, were observed in mothers...

  19. Multi-pathway exposure modelling of chemicals in cosmetics with application to shampoo

    DEFF Research Database (Denmark)

    Ernstoff, Alexi S.; Fantke, Peter; Csiszar, Susan A.

    2016-01-01

    We present a novel multi-pathway, mass balance based, fate and exposure model compatible with life cycle and high-throughput screening assessments of chemicals in cosmetic products. The exposures through product use as well as post-use emissions and environmental media were quantified based...

  20. Multi-pathway exposure modelling of chemicals in cosmetics with application to shampoo

    Science.gov (United States)

    We present a novel multi-pathway, mass balance based, fate and exposure model compatible with life cycle and high-throughput screening assessments of chemicals in cosmetic products. The exposures through product use as well as post-use emissions and environmental media were quant...

  1. Organic solvent exposure and depressive symptoms among licensed pesticide applicators in the Agricultural Health Study.

    Science.gov (United States)

    Siegel, Miriam; Starks, Sarah E; Sanderson, Wayne T; Kamel, Freya; Hoppin, Jane A; Gerr, Fred

    2017-11-01

    Although organic solvents are often used in agricultural operations, neurotoxic effects of solvent exposure have not been extensively studied among farmers. The current analysis examined associations between questionnaire-based metrics of organic solvent exposure and depressive symptoms among farmers. Results from 692 male Agricultural Health Study participants were analyzed. Solvent type and exposure duration were assessed by questionnaire. An "ever-use" variable and years of use categories were constructed for exposure to gasoline, paint/lacquer thinner, petroleum distillates, and any solvent. Depressive symptoms were ascertained with the Center for Epidemiologic Studies Depression Scale (CES-D); scores were analyzed separately as continuous (0-60) and dichotomous (distillates, and short duration of petroleum distillate exposure and continuous CES-D score (p < 0.05). Although nearly all associations were positive, fewer statistically significant associations were observed between metrics of solvent exposure and the dichotomized CES-D variable. Solvent exposures were associated with depressive symptoms among farmers. Efforts to limit exposure to organic solvents may reduce the risk of depressive symptoms among farmers.

  2. Effect of Intraoperative mitomycin-c application in outcome of external dacryocystorhinostomy

    International Nuclear Information System (INIS)

    Jawad, M.; Ali, Z.; Aftab, H.

    2015-01-01

    Background: Patients develop postoperative fibrosis at the site of operation after dacryocystorhinostomy (DCR) which results in impairment of the osteum patency. This quasi-experimental study was undertaken to determine the role of intraoperative Mitomycin C (MMC) application in maintaining postoperative patency of the osteum. Methodology: The present study was conducted at the Eye department of Ayub Medical College, Abbottabad on patients in whom routine DCR was indicated. Subjects were divided into mitomycin C (Test) and non mitomycin C (Control) groups. In test group, Mitomycin C was applied to the anastomosed flaps and osteotomy site for 30 minutes. Postoperative patients were followed for up to 6 months and outcome of patency was documented. Results: A.total of 73 patients were included, divided into test (30) and control (43) groups. An overall success rate of 86.3 percentage was obtained for patent ostia; this was based on 96.67 percentage success in test group compared to 79.1 percentage in the control group (p=0.031). Conclusion: Intraoperative application of Mitomycin-C significantly improves the success rate in external dacryocystorhinostomy. (author)

  3. Effects of a liquefied petroleum gas stove intervention on pollutant exposure and adult cardiopulmonary outcomes (CHAP): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Fandiño-Del-Rio, Magdalena; Goodman, Dina; Kephart, Josiah L; Miele, Catherine H; Williams, Kendra N; Moazzami, Mitra; Fung, Elizabeth C; Koehler, Kirsten; Davila-Roman, Victor G; Lee, Kathryn A; Nangia, Saachi; Harvey, Steven A; Steenland, Kyle; Gonzales, Gustavo F; Checkley, William

    2017-11-03

    Biomass fuel smoke is a leading risk factor for the burden of disease worldwide. International campaigns are promoting the widespread adoption of liquefied petroleum gas (LPG) in resource-limited settings. However, it is unclear if the introduction and use of LPG stoves, in settings where biomass fuels are used daily, reduces pollution concentration exposure, improves health outcomes, or how cultural and social barriers influence the exclusive adoption of LPG stoves. We will conduct a randomized controlled, field intervention trial of LPG stoves and fuel distribution in rural Puno, Peru, in which we will enroll 180 female participants aged 25-64 years and follow them for 2 years. After enrollment, we will collect information on sociodemographic characteristics, household characteristics, and cooking practices. During the first year of the study, LPG stoves and fuel tanks will be delivered to the homes of 90 intervention participants. During the second year, participants in the intervention arm will keep their LPG stoves, but the gas supply will stop. Control participants will receive LPG stoves and vouchers to obtain free fuel from distributors at the beginning of the second year, but gas will not be delivered. Starting at baseline, we will collect longitudinal measurements of respiratory symptoms, pulmonary function, blood pressure, endothelial function, carotid artery intima-media thickness, 24-h dietary recalls, exhaled carbon monoxide, quality-of-life indicators, and stove-use behaviors. Environmental exposure assessments will occur six times over the 2-year follow-up period, consisting of 48-h personal exposure and kitchen concentration measurements of fine particulate matter and carbon monoxide, and 48-h kitchen concentrations of nitrogen dioxide for a subset of 100 participants. Findings from this study will allow us to better understand behavioral patterns, environmental exposures, and cardiovascular and pulmonary outcomes resulting from the adoption of

  4. Application of Physiologically-Based Pharmacokinetic Modeling for the Prediction of Tofacitinib Exposure in Japanese.

    Science.gov (United States)

    Suzuki, Misaki; Tse, Susanna; Hirai, Midori; Kurebayashi, Yoichi

    2017-05-09

    Tofacitinib (3-[(3R,4R)-4-methyl-3-[methyl(7H-pyrrolo[2,3-d]pyrimidin-4-yl)amino]piperidin-1-yl]-3 -oxopropanenitrile) is an oral Janus kinase inhibitor that is approved in countries including Japan and the United States for the treatment of rheumatoid arthritis, and is being developed across the globe for the treatment of inflammatory diseases. In the present study, a physiologically-based pharmacokinetic model was applied to compare the pharmacokinetics of tofacitinib in Japanese and Caucasians to assess the potential impact of ethnicity on the dosing regimen in the two populations. Simulated plasma concentration profiles and pharmacokinetic parameters, i.e. maximum concentration and area under plasma concentration-time curve, in Japanese and Caucasian populations after single or multiple doses of 1 to 30 mg tofacitinib were in agreement with clinically observed data. The similarity in simulated exposure between Japanese and Caucasian populations supports the currently approved dosing regimen in Japan and the United States, where there is no recommendation for dose adjustment according to race. Simulated results for single (1 to 100 mg) or multiple doses (5 mg twice daily) of tofacitinib in extensive and poor metabolizers of CYP2C19, an enzyme which has been shown to contribute in part to tofacitinib elimination and is known to exhibit higher frequency in Japanese compared to Caucasians, were also in support of no recommendation for dose adjustment in CYP2C19 poor metabolizers. This study demonstrated a successful application of physiologically-based pharmacokinetic modeling in evaluating ethnic sensitivity in pharmacokinetics at early stages of development, presenting its potential value as an efficient and scientific method for optimal dose setting in the Japanese population.

  5. Fish consumption and prenatal methylmercury exposure: cognitive and behavioral outcomes in the main cohort at 17 years from the Seychelles child development study.

    Science.gov (United States)

    Davidson, Philip W; Cory-Slechta, Deborah A; Thurston, Sally W; Huang, Li-Shan; Shamlaye, Conrad F; Gunzler, Douglas; Watson, Gene; van Wijngaarden, Edwin; Zareba, Grazyna; Klein, Jonathan D; Clarkson, Thomas W; Strain, J J; Myers, Gary J

    2011-12-01

    People worldwide depend upon daily fish consumption as a major source of protein and other nutrients. Fish are high in nutrients essential for normal brain development, but they also contain methylmercury (MeHg), a neurotoxicant. Our studies in a population consuming fish daily have indicated no consistent pattern of adverse associations between prenatal MeHg and children's development. For some endpoints we found performance improved with increasing prenatal exposure to MeHg. Follow up studies indicate this association is related to the beneficial nutrients present in fish. To determine if the absence of adverse outcomes and the presence of beneficial associations between prenatal MeHg and developmental outcomes previously reported persists into adolescence. This study was conducted on the Main Cohort of the Seychelles Child Development Study (SCDS). We examined the association between prenatal MeHg exposure and subjects' performance at 17 years of age on 27 endpoints. The test battery included the Wisconsin Card Sorting Test (WCST), the California Verbal Learning Test (CVLT), the Woodcock-Johnson (W-J-II) Achievement Test, subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB), and measures of problematic behaviors. Analyses for all endpoints were adjusted for postnatal MeHg, sex, socioeconomic status, maternal IQ, and child's age at testing and the child's IQ was added for problematic behavioral endpoints. Mean prenatal MeHg exposure was 6.9 ppm. There was no association between prenatal MeHg and 21 endpoints. Increasing prenatal MeHg was associated with better scores on four endpoints (higher W-J-II math calculation scores, reduced numbers of trials on the Intra-Extradimensional Shift Set of the CANTAB), fewer reports of substance use and incidents of and referrals for problematic behaviors in school. Increasing prenatal MeHg was adversely associated with one level of referrals to a school counselor. At age 17 years there was no consistent

  6. Video-enabled cue-exposure-based intervention improves postdischarge drinking outcomes among alcohol-dependent men: A prospective study at a government addiction treatment setting in India.

    Science.gov (United States)

    Nattala, Prasanthi; Murthy, Pratima; Leung, Kit Sang; Rentala, Sreevani; Ramakrishna, Jayashree

    2017-04-25

    Returning to alcohol use following inpatient treatment occurs due to various real life cues/triggers. It is a challenge to demonstrate to patients how to deal with these triggers during inpatient treatment. Aims of the current study were (a) to evaluate the effectiveness of video-enabled cue-exposure-based intervention (VE-CEI) in influencing treatment outcomes in alcohol dependence, (b) to identify postdischarge predictors of intervention failure (returning to ≥50% of baseline alcohol consumption quantity/day). The VE-CEI comprises live action videos in which human characters model various alcohol use cues and strategies to deal with them effectively. The VE-CEI was administered to an inpatient alcohol-dependent sample (n = 43) and compared with treatment as usual (TAU) (n = 42) at a government addiction treatment setting in India. Patients were followed up over 6 months postdischarge to evaluate effectiveness of the VE-CEI on specific drinking outcomes. Over 6-month follow-up, VE-CEI group (vs. TAU) reported significantly lesser alcohol consumption quantity, fewer drinking days, and lower intervention failure rates. Results of multivariate Cox regression showed that participants who did not receive VE-CEI had an elevated risk of intervention failure (hazards ratio: 11.14; 95% confidence interval [4.93, 25.15]), other intervention failure predictors being early-onset dependence and increased baseline drinking. Findings provide evidence from India for effectiveness of cue-exposure-based intervention delivered using video technology in improving postdischarge treatment outcomes.

  7. Pesticide exposure and end-stage renal disease risk among wives of pesticide applicators in the Agricultural Health Study✩

    Science.gov (United States)

    Lebov, Jill F.; Engel, Lawrence S.; Richardson, David; Hogan, Susan L.; Sandler, Dale P.; Hoppin, Jane A.

    2015-01-01

    Background Pesticide exposure has been found to cause renal damage and dysfunction in experimental studies, but epidemiological research on the renal effects of chronic low-level pesticide exposure is limited. We investigated the relationships between end-stage renal disease (ESRD) among wives of licensed pesticide applicators (N = 31,142) in the Agricultural Health Study (AHS) and (1) personal pesticide use, (2) exposure to the husband's pesticide use, and (3) other pesticide-associated farming and household activities. Methods AHS participants reported pesticide exposure via self-administered questionnaires at enrollment (1993–1997). ESRD cases were identified via linkage to the United States Renal Data System. Associations between ESRD and pesticide exposures were estimated with Cox proportional hazard regression models controlling for age at enrollment. Models of associations with farming and household factors were additionally adjusted for personal use of pesticides. Results We identified 98 ESRD cases diagnosed between enrollment and 31 December 2011. Although women who ever applied pesticides (56% of cohort) were less likely than those who did not apply to develop ESRD (Hazard Ratio (HR): 0.42; 95% CI: 0.28, 0.64), among women who did apply pesticides, the rate of ESRD was significantly elevated among those who reported the highest (vs. lowest) cumulative general pesticide use (HR: 4.22; 95% CI: 1.26, 14.20). Among wives who never applied pesticides, ESRD was associated with husbands' ever use of paraquat (HR = 1.99; 95% CI: 1.14, 3.47) and butylate (HR = 1.71; 95% CI: 1.00, 2.95), with a positive exposure–response pattern for husband’s cumulative use of these pesticides. Conclusions ESRD may be associated with direct and/or indirect exposure to pesticides among farm women. Future studies should evaluate indirect exposure risk among other rural populations. PMID:26505650

  8. Applicability of Long Duration Exposure Facility environmental effects data to the design of Space Station Freedom electrical power system

    Science.gov (United States)

    Christie, Robert J.; Lu, Cheng-Yi; Aronoff, Irene

    1992-01-01

    Data defining space environmental effects on the Long Duration Exposure Facility (LDEF) are examined in terms of the design of the electrical power system (EPS) of the Space Station Freedom (SSF). The significant effects of long-term exposure to space are identified with respect to the performance of the LDEF's materials, components, and systems. A total of 57 experiments were conducted on the LDEF yielding information regarding coatings, thermal systems, electronics, optics, and power systems. The resulting database is analyzed in terms of the specifications of the SSF EPS materials and subsystems and is found to be valuable in the design of control and protection features. Specific applications are listed for findings regarding the thermal environment, atomic oxygen, UV and ionizing radiation, debris, and contamination. The LDEF data are shown to have a considerable number of applications to the design and planning of the SSF and its EPS.

  9. Application of Dempster–Shafer theory in dose response outcome analysis

    International Nuclear Information System (INIS)

    Chen Wenzhou; Cui Yunfeng; Yu Yan; Galvin, James; Xiao Ying; He Yanyan; Hussaini, Yousuff M

    2012-01-01

    The Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) reviews summarize the currently available three-dimensional dose/volume/outcome data from multi-institutions and numerous articles to update and refine the normal tissue dose/volume tolerance guidelines. As pointed out in the review, the data have limitations and even some inconsistency. However, with the help of new physical and statistical techniques, the information in the review could be updated so that patient care can be continually improved. The purpose of this work is to demonstrate the application of a mathematical theory, the Dempster–Shafer theory, in dose/volume/outcome data analysis. We applied this theory to the original data obtained from published clinical studies describing dose response for radiation pneumonitis. Belief and plausibility concepts were introduced for dose response evaluation. We were also able to consider the uncertainty and inconsistency of the data from these studies with Yager's combination rule, a special methodology of Dempster–Shafer theory, to fuse the data at several specific doses. The values of belief and plausibility functions were obtained at the corresponding doses. Then we applied the Lyman–Kutcher–Burman (LKB) model to fit these values and a belief–plausibility range was obtained. This range could be considered as a probability range to assist physicians and treatment planners in determining acceptable dose–volume constraints. Finally, the parameters obtained from the LKB model fitting were compared with those in Emami and Burman's papers and those from other frequentist statistics methods. We found that Emami and Burman's parameters are within the belief–plausibility range we calculated by the Dempster–Shafer theory. (paper)

  10. Application of Dempster-Shafer theory in dose response outcome analysis

    Science.gov (United States)

    Chen, Wenzhou; Cui, Yunfeng; He, Yanyan; Yu, Yan; Galvin, James; Hussaini, Yousuff M.; Xiao, Ying

    2012-09-01

    The Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) reviews summarize the currently available three-dimensional dose/volume/outcome data from multi-institutions and numerous articles to update and refine the normal tissue dose/volume tolerance guidelines. As pointed out in the review, the data have limitations and even some inconsistency. However, with the help of new physical and statistical techniques, the information in the review could be updated so that patient care can be continually improved. The purpose of this work is to demonstrate the application of a mathematical theory, the Dempster-Shafer theory, in dose/volume/outcome data analysis. We applied this theory to the original data obtained from published clinical studies describing dose response for radiation pneumonitis. Belief and plausibility concepts were introduced for dose response evaluation. We were also able to consider the uncertainty and inconsistency of the data from these studies with Yager's combination rule, a special methodology of Dempster-Shafer theory, to fuse the data at several specific doses. The values of belief and plausibility functions were obtained at the corresponding doses. Then we applied the Lyman-Kutcher-Burman (LKB) model to fit these values and a belief-plausibility range was obtained. This range could be considered as a probability range to assist physicians and treatment planners in determining acceptable dose-volume constraints. Finally, the parameters obtained from the LKB model fitting were compared with those in Emami and Burman's papers and those from other frequentist statistics methods. We found that Emami and Burman's parameters are within the belief-plausibility range we calculated by the Dempster-Shafer theory.

  11. Prenatal cigarette smoke exposure: Pregnancy outcome and gestational changes in plasma nicotine concentration, hematocrit, and carboxyhemoglobin in a newly standardized rat model

    International Nuclear Information System (INIS)

    Farkas, Svetlana; Hussein, Jabeen; Ariano, Robert E.; Sitar, Daniel S.; Hasan, Shabih U.

    2006-01-01

    Epidemiological studies support an association between perinatal cigarette smoke (CS) exposure and a number of severe pre- and postnatal complications. However, the mechanisms through which CS enhances such risks largely remain unknown. One of the reasons for our inability to discover such mechanisms has been the unavailability of a clinically relevant and physiologically concordant animal model. A number of studies have previously used nicotine (Nic) as surrogate for CS. We sought to (1) establish the amount of CS exposure to achieve plasma Nic concentrations observed among moderate to heavy smokers (20-60 ng/ml) (2) investigate the temporal changes in plasma Nic concentrations, carboxyhemoglobin, and hematocrit with advancing pregnancy, and (3) elucidate the effects of CS exposure on pregnancy outcome. Pregnant Sprague-Dawley rats were exposed to various doses of CS or room air (Sham) from days 6 to 21 of gestation. Exposure to 6000 ml/day of CS led to very high plasma Nic concentrations and increased maternal and fetal mortality (P < 0.001). The plasma Nic concentrations remained higher than those observed in moderate smokers until the CS dose was reduced to 1000 ml/day and showed dose-dependent temporal changes with advancing gestational age. Significant increases in carboxyhemoglobin and hematocrit were observed in the CS group as compared with the Sham group (P < 0.001). In addition, prenatally CS exposed fetuses had lower birth weight as compared with the Sham group (P = 0.04). Our current study establishes a newly standardized and physiologically relevant model to investigate the mechanisms of CS-mediated adverse effects during the critical period of fetal development

  12. Pregnancy outcome after 1st-trimester inadvertent exposure to barium sulphate as a contrast media for upper gastrointestinal tract radiography.

    Science.gov (United States)

    Han, B H; Lee, K S; Han, J Y; Choi, J S; Ahn, H K; Ryu, H M; Yang, J H; Han, H W; Nava-Ocampo, A A

    2011-10-01

    Despite barium being used as a contrast media for decades, the specific assessment of its safety in pregnant women is scarce. We are reporting the favourable pregnancy outcome in women who were inadvertently exposed to barium swallow and associated ionising radiation, early in pregnancy. A control group of age- and gravidity-matched unexposed pregnant women was also included. There were 32 live-born babies in the exposed group and 94 in the control group. Women had undergone diagnostic upper gastrointestinal tract (UGT) fluoroscopic examination at 3.3 ± 1.5 weeks' gestation. Estimated maternal radiation dose secondary to barium swallow varied widely, the maximum dose was estimated to be 2.45 mSv. Similar pregnancy outcomes were observed between the groups. The number of babies born with major malformations was not significantly different (p = 1.0) between cases and controls: one (3.1%) vs three (3.2%), respectively. In conclusion, our small prospective cohort study of women suggests no association between inadvertent exposure to ionising radiation and barium sulphate during fluoroscopic barium swallow and adverse fetal outcomes.

  13. Carcinogen derived biomarkers: applications in studies of human exposure to secondhand tobacco smoke

    OpenAIRE

    Hecht, S

    2004-01-01

    Objective: To review the literature on carcinogen derived biomarkers of exposure to secondhand tobacco smoke (SHS). These biomarkers are specifically related to known carcinogens in tobacco smoke and include urinary metabolites, DNA adducts, and blood protein adducts.

  14. Surface Exposure Geochronology Using Cosmogenic Nuclides: Applications in Antarctic Glacial Geology

    Science.gov (United States)

    1994-02-01

    in rocks, are particularly promising for directly dating 1 geological surfaces . In 1934, Grosse et al. first suggested that cosmic rays produce rare...and muons produced by cosmic ray irteractions in the atmosphere and in rocks, and spallation by I neutrons produced in muon capture reactions (Kurz...stable isotopes are useful for surface 3 exposure studies because they can act as integrators of cosmic ray exposure on long time scales, potentially up

  15. Application of maximum values for radiation exposure and principles for the calculation of radiation doses

    International Nuclear Information System (INIS)

    2007-08-01

    The guide presents the definitions of equivalent dose and effective dose, the principles for calculating these doses, and instructions for applying their maximum values. The limits (Annual Limit on Intake and Derived Air Concentration) derived from dose limits are also presented for the purpose of monitoring exposure to internal radiation. The calculation of radiation doses caused to a patient from medical research and treatment involving exposure to ionizing radiation is beyond the scope of this ST Guide

  16. Medical application of radionuclides and the resulting radiation exposure of parts of the population

    International Nuclear Information System (INIS)

    Keller, K.D.; Gloebel, B.; Andres, C.

    1985-01-01

    In a big hospital an investigation was made to find out to what extent the radionuclides used there contribute to the radiation exposure of the population living in the vicinity. The hospital used about 100 Ci of short-lived radionuclides a year. By applying the calculation basis stipulated by the Federal Ministry of the Interior, the radiation exposure was calculated for unfavourable cases. As a result, up to 30 mrem/a can theoretically be reached. (orig.) [de

  17. Feasibility and outcome of dialogical exposure therapy for posttraumatic stress disorder: a pilot study with 25 outpatients.

    Science.gov (United States)

    Butollo, Willi; König, Julia; Karl, Regina; Henkel, Christine; Rosner, Rita

    2014-01-01

    The research on psychotherapy for posttraumatic stress disorder (PTSD) stems predominantly from a cognitive-behavioral orientation while other approaches are underrepresented. We evaluated dialogical exposure in trauma therapy (DET), a treatment for PTSD combining cognitive-behavioral elements with an interpersonal, gestalt-based framework. In this uncontrolled pilot trial, 25 PTSD patients were treated with DET in an outpatient setting and 21 completed therapy. There was a significant reduction in self-rated PTSD symptoms from pre- to posttreatment. Effect sizes were large in the completer sample and moderate to large in the intent-to-treat sample. General psychopathology also decreased significantly. The dropout rate was rather low at 16%. These results show that further research on DET as a treatment for PTSD is warranted.

  18. Alberta oil sands community exposure and health effects assessment : analysis of health records as a proxy for health outcomes

    International Nuclear Information System (INIS)

    Wang, F.; Mackenzie, A.; Schopflocher, D.; Shaw, S.; Robb, J.; Gabos, S.

    2002-01-01

    A large scale study was conducted to assess potential links between air quality and human health outcomes. Health records were used as a proxy measure for health outcomes. Residents of Fort McMurray and Lethbridge, Alberta, Canada were used in the comparison of risks of selected morbidity and mortality measures during a 3 year period between 1995 and 1998. Data on the socio-demography, morbidity, and mortality were linked by PI and geographic area from the Health Care Insurance Plan, physical and hospital billing systems, and vital statistics death registration. Age was the most important confounder. Asthma incidence for children 3 years or less was examined along with prevalence and mortality of selected diseases for each sex and age group. Results showed that the incidence of asthma varied by age and sex but not by study area. There was no major difference in death from lung cancer, cardiovascular disease, coronary heart disease, respiratory disorders and COPD between residents of the target and control communities. 6 figs

  19. Application of bacterial lipopolysaccharide to improve survival of the black tiger shrimp after Vibrio harveyi exposure.

    Science.gov (United States)

    Rungrassamee, Wanilada; Maibunkaew, Sawarot; Karoonuthaisiri, Nitsara; Jiravanichpaisal, Pikul

    2013-10-01

    This study investigates an effect of bacterial lipopolysaccharide (LPS) as feed supplement to improve immunity of the black tiger shrimp (Penaeus monodon). LPS was coated to commercial feed pellets and given to the shrimp once or twice a day for 10 days before an exposure with shrimp pathogenic bacterium Vibrio harveyi. The growth rates, percent weight gains, total hemocyte and granulocyte counts and survival rates of shrimp between the LPS-coated pellet fed groups and a control group where shrimp fed with commercial feed pellets were compared. After 10 days of the feeding trials, growth rates were not significantly different in all groups, suggesting no toxicity from LPS supplement. To determine beneficial effect of LPS diets, each group was subsequently exposed to V. harveyi by immersion method and the survival rates were recorded for seven days after the immersion. Regardless of the dosages of LPS, the shrimp groups fed with LPS-coated pellets showed higher survival rates than the control group. There was no significant difference in survival rates between the two LPS dosages groups. In addition to survival under pathogen challenge, we also determine effect of LPS on immune-related genes after 10-day feeding trial. Gene expression analysis in the P. monodon intestines revealed that antilipopolysaccharide factor isoform 3 (ALF3), C-type lectin, and mucine-like peritrophin (mucin-like PM) were expressed significantly higher in a group fed with LPS supplemental diet once or twice a day than in a control group. The transcript levels of C-type lectin and mucin-like PM had increased significantly when LPS was given once a day, while significant induction of ALF3 transcripts was observed when shrimp were fed with LPS twice a day. The up-regulation of the immune gene levels in intestines and higher resistance to V. harveyi of the shrimp fed with LPS provide the evidence for potential application of LPS as an immunostimulant in P. monodon farming. Copyright © 2013

  20. Microarray applications to understand the impact of exposure to environmental contaminants in wild dolphins (Tursiops truncatus).

    Science.gov (United States)

    Mancia, Annalaura; Abelli, Luigi; Kucklick, John R; Rowles, Teresa K; Wells, Randall S; Balmer, Brian C; Hohn, Aleta A; Baatz, John E; Ryan, James C

    2015-02-01

    It is increasingly common to monitor the marine environment and establish geographic trends of environmental contamination by measuring contaminant levels in animals from higher trophic levels. The health of an ecosystem is largely reflected in the health of its inhabitants. As an apex predator, the common bottlenose dolphin (Tursiops truncatus) can reflect the health of near shore marine ecosystems, and reflect coastal threats that pose risk to human health, such as legacy contaminants or marine toxins, e.g. polychlorinated biphenyls (PCBs) and brevetoxins. Major advances in the understanding of dolphin biology and the unique adaptations of these animals in response to the marine environment are being made as a result of the development of cell-lines for use in in vitro experiments, the production of monoclonal antibodies to recognize dolphin proteins, the development of dolphin DNA microarrays to measure global gene expression and the sequencing of the dolphin genome. These advances may play a central role in understanding the complex and specialized biology of the dolphin with regard to how this species responds to an array of environmental insults. This work presents the creation, characterization and application of a new molecular tool to better understand the complex and unique biology of the common bottlenose dolphin and its response to environmental stress and infection. A dolphin oligo microarray representing 24,418 unigene sequences was developed and used to analyze blood samples collected from 69 dolphins during capture-release health assessments at five geographic locations (Beaufort, NC, Sarasota Bay, FL, Saint Joseph Bay, FL, Sapelo Island, GA and Brunswick, GA). The microarray was validated and tested for its ability to: 1) distinguish male from female dolphins; 2) differentiate dolphins inhabiting different geographic locations (Atlantic coasts vs the Gulf of Mexico); and 3) study in detail dolphins resident in one site, the Georgia coast, known to

  1. Application of Matrix Projection Exposure Using a Liquid Crystal Display Panel to Fabricate Thick Resist Molds

    Science.gov (United States)

    Fukasawa, Hirotoshi; Horiuchi, Toshiyuki

    2009-08-01

    The patterning characteristics of matrix projection exposure using an analog liquid crystal display (LCD) panel in place of a reticle were investigated, in particular for oblique patterns. In addition, a new method for fabricating practical thick resist molds was developed. At first, an exposure system fabricated in past research was reconstructed. Changes in the illumination optics and the projection lens were the main improvements. Using fly's eye lenses, the illumination light intensity distribution was homogenized. The projection lens was changed from a common camera lens to a higher-grade telecentric lens. In addition, although the same metal halide lamp was used as an exposure light source, the central exposure wavelength was slightly shortened from 480 to 450 nm to obtain higher resist sensitivity while maintaining almost equivalent contrast between black and white. Circular and radial patterns with linewidths of approximately 6 µm were uniformly printed in all directions throughout the exposure field owing to these improvements. The patterns were smoothly printed without accompanying stepwise roughness caused by the cell matrix array. On the bases of these results, a new method of fabricating thick resist molds for electroplating was investigated. It is known that thick resist molds fabricated using the negative resist SU-8 (Micro Chem) are useful because very high aspect patterns are printable and the side walls are perpendicular to the substrate surfaces. However, the most suitable exposure wavelength of SU-8 is 365 nm, and SU-8 is insensitive to light of 450 nm wavelength, which is most appropriate for LCD matrix exposure. For this reason, a novel multilayer resist process was proposed, and micromolds of SU-8 of 50 µm thickness were successfully obtained. As a result, feasibility for fabricating complex resist molds including oblique patterns was demonstrated.

  2. Development of regulatory criteria applicable to control of radiation exposures to the population from products containing radioactive material

    Energy Technology Data Exchange (ETDEWEB)

    Rogers, L R; Western, F [U.S. Atomic Energy Commission, Germantown, MD (United States)

    1969-07-01

    Under the Atomic Energy Act of 1954 as amended, the Atomic Energy Commission is responsible for regulating the possession, use and transfer of byproduct, source and special nuclear materials in accordance with safety standards established by rule of the Commission to protect health and minimize danger to life and property. This paper describes some of the basic considerations in establishing safety criteria and regulations for authorizing the transfer and use of byproduct material (radioisotopes) in products for distribution to the general public. It discusses problems encountered in extending the broad guidance provided by the Federal Radiation Council (FRC) and by the International Commission of Radiological Protection and the National Council on Radiation Protection and Measurements (ICRP-NCRP), which is limited to total exposures of individuals and population groups to radiation from many sources, to appropriate controls on radioactivity in an individual consumer product which represents only one source of population exposures. The paper also discusses possible approaches to accomplishing the regulatory objectives of providing reasonable assurance that (1) the contribution of an individual product to total exposures that might be permitted under FRC and ICRP-NCRP guidance should not be disproportionate to the benefits to be derived, and (2) appropriate efforts are made to limit exposures to the population from individual classes of sources of exposure as far as practicable. Existing criteria and regulations pertaining to the control of radiation exposure to the population from products into which radioactive material is purposely introduced are described, and additional considerations which must be taken into account for the development of further criteria and regulations which are applicable to the possible wide-scale distribution of products containing radioactive material as a result of the Plowshare Programs are explored. (author)

  3. Development of regulatory criteria applicable to control of radiation exposures to the population from products containing radioactive material

    International Nuclear Information System (INIS)

    Rogers, L.R.; Western, F.

    1969-01-01

    Under the Atomic Energy Act of 1954 as amended, the Atomic Energy Commission is responsible for regulating the possession, use and transfer of byproduct, source and special nuclear materials in accordance with safety standards established by rule of the Commission to protect health and minimize danger to life and property. This paper describes some of the basic considerations in establishing safety criteria and regulations for authorizing the transfer and use of byproduct material (radioisotopes) in products for distribution to the general public. It discusses problems encountered in extending the broad guidance provided by the Federal Radiation Council (FRC) and by the International Commission of Radiological Protection and the National Council on Radiation Protection and Measurements (ICRP-NCRP), which is limited to total exposures of individuals and population groups to radiation from many sources, to appropriate controls on radioactivity in an individual consumer product which represents only one source of population exposures. The paper also discusses possible approaches to accomplishing the regulatory objectives of providing reasonable assurance that (1) the contribution of an individual product to total exposures that might be permitted under FRC and ICRP-NCRP guidance should not be disproportionate to the benefits to be derived, and (2) appropriate efforts are made to limit exposures to the population from individual classes of sources of exposure as far as practicable. Existing criteria and regulations pertaining to the control of radiation exposure to the population from products into which radioactive material is purposely introduced are described, and additional considerations which must be taken into account for the development of further criteria and regulations which are applicable to the possible wide-scale distribution of products containing radioactive material as a result of the Plowshare Programs are explored. (author)

  4. HERCA WG Medical Applications / Sub WG 'Exposure of Asymptomatic Individuals in Health Care' - 'Position Paper on Screening'

    International Nuclear Information System (INIS)

    Griebel, Juergen; Ebdon-Jackson, Steve

    2012-05-01

    Over the course of several meetings the HERCA-Working Group (WG) 'Medical Applications' has discussed the exposure of asymptomatic individuals in health care. In particular, the discussions focused on the issue of the early detection of severe diseases, by use of X-rays, for those who do not present with symptoms. An important and established example is the use of X-ray mammography to detect early breast cancer and this has traditionally been referred to as screening. An emerging application is the use of computed tomography in a range of circumstances, some of which may be better described as a separate category of medical exposure as they are neither diagnostic nor screening in the accepted sense. The discussions have indicated that it is pivotal to clearly define the relevant terms generally applied and to clearly differentiate these terms from diagnostic examinations used in health care. In this context, it is important to note, that the revision of the Euratom Basic Safety Standards (Euratom BSS) Directive is under way and addresses in particular medical radiological procedures on asymptomatic individuals, intended to be performed for early detection of disease (Draft Proposal 29 September 2011 Article 54). Hereby, two types of examinations of asymptomatic individuals, (that in some cases have both been referred to as screening) are addressed: (1) exposures as part of screening programmes and (2) exposures associated with individual health assessment. On adoption, this directive will have significant implications for and a substantial impact on the work of the radiation protection authorities in Europe. In this position paper the WG 'Medical Applications' proposes a clear distinction between screening and radiological procedures as part of an individual health assessment and highlights special requirements for the latter. Finally, the impact on the work of radiation protection authorities in Europe is addressed

  5. Calculating Clinically Significant Change: Applications of the Clinical Global Impressions (CGI) Scale to Evaluate Client Outcomes in Private Practice

    Science.gov (United States)

    Kelly, Peter James

    2010-01-01

    The Clinical Global Impressions (CGI) scale is a therapist-rated measure of client outcome that has been widely used within the research literature. The current study aimed to develop reliable and clinically significant change indices for the CGI, and to demonstrate its application in private psychological practice. Following the guidelines…

  6. Improved cortisol exposure-time profile and outcome in patients with adrenal insufficiency: a prospective randomized trial of a novel hydrocortisone dual-release formulation.

    Science.gov (United States)

    Johannsson, G; Nilsson, A G; Bergthorsdottir, R; Burman, P; Dahlqvist, P; Ekman, B; Engström, B E; Olsson, T; Ragnarsson, O; Ryberg, M; Wahlberg, J; Biller, B M K; Monson, J P; Stewart, P M; Lennernäs, H; Skrtic, S

    2012-02-01

    Patients with treated adrenal insufficiency (AI) have increased morbidity and mortality rate. Our goal was to improve outcome by developing a once-daily (OD) oral hydrocortisone dual-release tablet with a more physiological exposure-time cortisol profile. The aim was to compare pharmacokinetics and metabolic outcome between OD and the same daily dose of thrice-daily (TID) dose of conventional hydrocortisone tablets. We conducted an open, randomized, two-period, 12-wk crossover multicenter trial with a 24-wk extension at five university hospital centers. The trial enrolled 64 adults with primary AI; 11 had concomitant diabetes mellitus (DM). The same daily dose of hydrocortisone was administered as OD dual-release or TID. We evaluated cortisol pharmacokinetics. Compared with conventional TID, OD provided a sustained serum cortisol profile 0-4 h after the morning intake and reduced the late afternoon and the 24-h cortisol exposure. The mean weight (difference = -0.7 kg, P = 0.005), systolic blood pressure (difference = -5.5 mm Hg, P = 0.0001) and diastolic blood pressure (difference: -2.3 mm Hg; P = 0.03), and glycated hemoglobin (absolute difference = -0.1%, P = 0.0006) were all reduced after OD compared with TID at 12 wk. Compared with TID, a reduction in glycated hemoglobin by 0.6% was observed in patients with concomitant DM during OD (P = 0.004). The OD dual-release tablet provided a more circadian-based serum cortisol profile. Reduced body weight, reduced blood pressure, and improved glucose metabolism were observed during OD treatment. In particular, glucose metabolism improved in patients with concomitant DM.

  7. Identification of fipronil metabolites by time-of-flight mass spectrometry for application in a human exposure study.

    Science.gov (United States)

    McMahen, Rebecca L; Strynar, Mark J; Dagnino, Sonia; Herr, David W; Moser, Virginia C; Garantziotis, Stavros; Andersen, Erik M; Freeborn, Danielle L; McMillan, Larry; Lindstrom, Andrew B

    2015-05-01

    Fipronil is a phenylpyrazole insecticide commonly used in residential and agricultural applications. To understand more about the potential risks for human exposure associated with fipronil, urine and serum from dosed Long Evans adult rats (5 and 10mg/kg bw) were analyzed to identify metabolites as potential biomarkers for use in human biomonitoring studies. Urine from treated rats was found to contain seven unique metabolites, two of which had not been previously reported-M4 and M7 which were putatively identified as a nitroso compound and an imine, respectively. Fipronil sulfone was confirmed to be the primary metabolite in rat serum. The fipronil metabolites identified in the respective matrices were then evaluated in matched human urine (n=84) and serum (n=96) samples from volunteers with no known pesticide exposures. Although no fipronil or metabolites were detected in human urine, fipronil sulfone was present in the serum of approximately 25% of the individuals at concentrations ranging from 0.1 to 4ng/mL. These results indicate that many fipronil metabolites are produced following exposures in rats and that fipronil sulfone is a useful biomarker in human serum. Furthermore, human exposure to fipronil may occur regularly and require more extensive characterization. Published by Elsevier Ltd.

  8. Multi-pathway exposure modeling of chemicals in cosmetics with application to shampoo.

    Science.gov (United States)

    Ernstoff, Alexi S; Fantke, Peter; Csiszar, Susan A; Henderson, Andrew D; Chung, Susie; Jolliet, Olivier

    2016-01-01

    We present a novel multi-pathway, mass balance based, fate and exposure model compatible with life cycle and high-throughput screening assessments of chemicals in cosmetic products. The exposures through product use as well as post-use emissions and environmental media were quantified based on the chemical mass originally applied via a product, multiplied by the product intake fractions (PiF, the fraction of a chemical in a product that is taken in by exposed persons) to yield intake rates. The average PiFs for the evaluated chemicals in shampoo ranged from 3×10(-4) up to 0.3 for rapidly absorbed ingredients. Average intake rates ranged between nano- and micrograms per kilogram bodyweight per day; the order of chemical prioritization was strongly affected by the ingredient concentration in shampoo. Dermal intake and inhalation (for 20% of the evaluated chemicals) during use dominated exposure, while the skin permeation coefficient dominated the estimated uncertainties. The fraction of chemical taken in by a shampoo user often exceeded, by orders of magnitude, the aggregated fraction taken in by the population through post-use environmental emissions. Chemicals with relatively high octanol-water partitioning and/or volatility, and low molecular weight tended to have higher use stage exposure. Chemicals with low intakes during use (<1%) and subsequent high post-use emissions, however, may yield comparable intake for a member of the general population. The presented PiF based framework offers a novel and critical advancement for life cycle assessments and high-throughput exposure screening of chemicals in cosmetic products demonstrating the importance of consistent consideration of near- and far-field multi-pathway exposures. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. HERA: A dynamic web application for visualizing community exposure to flood hazards based on storm and sea level rise scenarios

    Science.gov (United States)

    Jones, Jeanne M.; Henry, Kevin; Wood, Nathan; Ng, Peter; Jamieson, Matthew

    2017-12-01

    The Hazard Exposure Reporting and Analytics (HERA) dynamic web application was created to provide a platform that makes research on community exposure to coastal-flooding hazards influenced by sea level rise accessible to planners, decision makers, and the public in a manner that is both easy to use and easily accessible. HERA allows users to (a) choose flood-hazard scenarios based on sea level rise and storm assumptions, (b) appreciate the modeling uncertainty behind a chosen hazard zone, (c) select one or several communities to examine exposure, (d) select the category of population or societal asset, and (e) choose how to look at results. The application is designed to highlight comparisons between (a) varying levels of sea level rise and coastal storms, (b) communities, (c) societal asset categories, and (d) spatial scales. Through a combination of spatial and graphical visualizations, HERA aims to help individuals and organizations to craft more informed mitigation and adaptation strategies for climate-driven coastal hazards. This paper summarizes the technologies used to maximize the user experience, in terms of interface design, visualization approaches, and data processing.

  10. HERA: A dynamic web application for visualizing community exposure to flood hazards based on storm and sea level rise scenarios

    Science.gov (United States)

    Jones, Jeanne M.; Henry, Kevin; Wood, Nathan J.; Ng, Peter; Jamieson, Matthew

    2017-01-01

    The Hazard Exposure Reporting and Analytics (HERA) dynamic web application was created to provide a platform that makes research on community exposure to coastal-flooding hazards influenced by sea level rise accessible to planners, decision makers, and the public in a manner that is both easy to use and easily accessible. HERA allows users to (a) choose flood-hazard scenarios based on sea level rise and storm assumptions, (b) appreciate the modeling uncertainty behind a chosen hazard zone, (c) select one or several communities to examine exposure, (d) select the category of population or societal asset, and (e) choose how to look at results. The application is designed to highlight comparisons between (a) varying levels of sea level rise and coastal storms, (b) communities, (c) societal asset categories, and (d) spatial scales. Through a combination of spatial and graphical visualizations, HERA aims to help individuals and organizations to craft more informed mitigation and adaptation strategies for climate-driven coastal hazards. This paper summarizes the technologies used to maximize the user experience, in terms of interface design, visualization approaches, and data processing.

  11. Chromosomal analysis and application of biological dosimetry in two cases of apparent over exposure

    International Nuclear Information System (INIS)

    Guerrero C, C.; Brena V, M.

    2002-01-01

    The gamma radiation calibration curve of 60 Co is used which was generated in the ININ Laboratory of Biology to calculate the exposure dose of two workers whose dosemeters marked values above of the limit allowed. The analysis indicates that in a first case, the aberrations frequency corresponded to the basal value, therefore there is not over exposure. The aberrations frequency of the second case is lightly above to the basal value and therefore the probability favors to what the physical dosimetry indicates. (Author)

  12. A Virtual Reality Exposure Therapy Application for Iraq War Post Traumatic Stress Disorder

    National Research Council Canada - National Science Library

    Pair, Jarrell; Allen, Brian; Dautricourt, Matthieu; Treskunov, Anton; Liewer, Matt; Graap, Ken; Reger, Greg; Rizzo, Albert

    2006-01-01

    .... The aim of the current paper is to present the rationale, technical specifications, application features, and user-centered design process for the development of a Virtual Iraq PTSD VR therapy application...

  13. Data from three prospective longitudinal human cohorts of prenatal marijuana exposure and offspring outcomes from the fetal period through young adulthood

    Directory of Open Access Journals (Sweden)

    Gabrielle L. McLemore

    2016-12-01

    Full Text Available This article includes data from three prospective longitudinal human cohorts of prenatal marijuana exposure (PME and offspring outcomes from the fetal period through young adulthood. The table herein contains an overview of the major adverse effects associated with PME from the following human cohorts: (1 The Ottawa Prenatal Prospective Study (OPPS; (2 The Maternal Health Practices and Child Development Study (MHPCD; and (3 The Generation R Study (Gen R. In the OPPS, fetal gestational age was measured and age-appropriate standardized neuropsychological instruments were used to assess neonatal responses, and infant–child and adolescent–young adult cognitive and behavioral skills. In the MHPCD, birth length and weight, neonatal body length, and infant–child sleep, cognition, and behavioral parameters were measured. In the Gen R, birth weight and growth were measured, as were infant–child attention and aggression. The data in this article are in support of our report entitled “Prenatal Cannabis Exposure - The "First Hit" to the Endocannabinoid System” (K.A. Richardson, A.K. Hester, G.L. McLemore, 2016 [13].

  14. Maternal diet, prenatal exposure to dioxin-like compounds and birth outcomes in a European prospective mother-child study (NewGeneris).

    Science.gov (United States)

    Papadopoulou, Eleni; Kogevinas, Manolis; Botsivali, Maria; Pedersen, Marie; Besselink, Harrie; Mendez, Michelle A; Fleming, Sarah; Hardie, Laura J; Knudsen, Lisbeth E; Wright, John; Agramunt, Silvia; Sunyer, Jordi; Granum, Berit; Gutzkow, Kristine B; Brunborg, Gunnar; Alexander, Jan; Meltzer, Helle Margrete; Brantsæter, Anne Lise; Sarri, Katerina; Chatzi, Leda; Merlo, Domenico F; Kleinjans, Jos C; Haugen, Margaretha

    2014-06-15

    Maternal diet can result in exposure to environmental contaminants including dioxins which may influence foetal growth. We investigated the association between maternal diet and birth outcomes by defining a dioxin-rich diet. We used validated food frequency questionnaires to assess the diet of pregnant women from Greece, Spain, United Kingdom, Denmark and Norway and estimated plasma dioxin-like activity by the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR-CALUX®) bioassay in 604 maternal blood samples collected at delivery. We applied reduced rank regression to identify a dioxin-rich dietary pattern based on dioxin-like activity (DR-CALUX®) levels in maternal plasma, and calculated a dioxin-diet score as an estimate of adherence to this dietary pattern. In the five country population, dioxin-diet score was characterised by high consumption of red and white meat, lean and fatty fish, low-fat dairy and low consumption of salty snacks and high-fat cheese, during pregnancy. The upper tertile of the dioxin-diet score was associated with a change in birth weight of -121g (95% confidence intervals: -232, -10g) compared to the lower tertile after adjustment for confounders. A small non-significant reduction in gestational age was also observed (-1.4days, 95% CI: -3.8, 1.0days). Our results suggest that maternal diet might contribute to the exposure of the foetus to dioxins and dioxin-like compounds and may be related to reduced birth weight. More studies are needed to develop updated dietary guidelines for women of reproductive age, aiming to the reduction of dietary exposure to persistent organic pollutants as dioxins and dioxin-like compounds. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Gene expression profiling to identify potentially relevant disease outcomes and support human health risk assessment for carbon black nanoparticle exposure.

    Science.gov (United States)

    Bourdon, Julie A; Williams, Andrew; Kuo, Byron; Moffat, Ivy; White, Paul A; Halappanavar, Sabina; Vogel, Ulla; Wallin, Håkan; Yauk, Carole L

    2013-01-07

    New approaches are urgently needed to evaluate potential hazards posed by exposure to nanomaterials. Gene expression profiling provides information on potential modes of action and human relevance, and tools have recently become available for pathway-based quantitative risk assessment. The objective of this study was to use toxicogenomics in the context of human health risk assessment. We explore the utility of toxicogenomics in risk assessment, using published gene expression data from C57BL/6 mice exposed to 18, 54 and 162 μg Printex 90 carbon black nanoparticles (CBNP). Analysis of CBNP-perturbed pathways, networks and transcription factors revealed concomitant changes in predicted phenotypes (e.g., pulmonary inflammation and genotoxicity), that correlated with dose and time. Benchmark doses (BMDs) for apical endpoints were comparable to minimum BMDs for relevant pathway-specific expression changes. Comparison to inflammatory lung disease models (i.e., allergic airway inflammation, bacterial infection and tissue injury and fibrosis) and human disease profiles revealed that induced gene expression changes in Printex 90 exposed mice were similar to those typical for pulmonary injury and fibrosis. Very similar fibrotic pathways were perturbed in CBNP-exposed mice and human fibrosis disease models. Our synthesis demonstrates how toxicogenomic profiles may be used in human health risk assessment of nanoparticles and constitutes an important step forward in the ultimate recognition of toxicogenomic endpoints in human health risk. As our knowledge of molecular pathways, dose-response characteristics and relevance to human disease continues to grow, we anticipate that toxicogenomics will become increasingly useful in assessing chemical toxicities and in human health risk assessment. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Pregnancy outcome after in utero exposure to local anesthetics as part of dental treatment: A prospective comparative cohort study.

    Science.gov (United States)

    Hagai, Aharon; Diav-Citrin, Orna; Shechtman, Svetlana; Ornoy, Asher

    2015-08-01

    Dental treatment and use of local anesthetics during pregnancy generally are considered harmless because of lack of evidence of adverse pregnancy effects. Data on the safety of dental treatment and local anesthetics during pregnancy are scant. Dental care is often a reason for concern both among women and their health care providers. The primary objective of this study was to evaluate the rate of major anomalies after exposure to local anesthetics as part of dental care during pregnancy. The authors performed a prospective, comparative observational study at the Israeli Teratology Information Services between 1999 and 2005. The authors followed 210 pregnancies exposed to dental local anesthetics (112 [53%] in the first trimester) and compared them with 794 pregnancies not exposed to teratogens. The rate of major anomalies was not significantly different between the groups (4.8% versus 3.3%, P = .300). There was no difference in the rate of miscarriages, gestational age at delivery, or birth weight. The most common types of dental treatment were endodontic treatment (43%), tooth extraction (31%), and tooth restoration (21%). Most women (63%) were not exposed to additional medications. Approximately one-half (51%) of the women were not exposed to dental radiography, and 44% were exposed to radiation, mostly bite-wing radiography. This study's results suggest that use of dental local anesthetics, as well as dental treatment during pregnancy, do not represent a major teratogenic risk. There seems to be no reason to prevent pregnant women from receiving dental treatment and local anesthetics during pregnancy. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  17. High Intrapatient Variability of Tacrolimus Exposure in the Early Period After Liver Transplantation Is Associated With Poorer Outcomes.

    Science.gov (United States)

    Rayar, Michel; Tron, Camille; Jézéquel, Caroline; Beaurepaire, Jean Marie; Petitcollin, Antoine; Houssel-Debry, Pauline; Camus, Christophe; Verdier, Marie Clémence; Dehlawi, Ammar; Lakéhal, Mohamed; Desfourneaux, Véronique; Meunier, Bernard; Sulpice, Laurent; Bellissant, Eric; Boudjema, Karim; Lemaitre, Florian

    2018-03-01

    Tacrolimus (TAC) is the cornerstone of immunosuppressive regimen in liver transplantation (LT). Its pharmacokinetics is characterized by a high interpatient and intrapatient variability (IPV) leading to an unpredictable dose-response relationship. The aim of our study was to evaluate the impact of TAC IPV (IPV) on graft and patient outcomes after LT. We retrospectively analyzed 812 LT recipients treated with TAC. The IPV of TAC concentrations was estimated by calculating the coefficient of variation (CV) of whole blood trough concentrations. Patients were categorized in 2 groups: low IPV (CV < 40%) and high IPV (CV ≥ 40%). There were significantly more neurologic complications (31.2% vs 16.6%, P < 0.001), cardiovascular complications (19.7% vs 9.7%, P < 0.001), and acute renal failure requiring dialysis (8.5% vs 2.2%, P < 0.001) in the high CV group than in the low CV group. Moreover, graft survival was significantly poorer in the high CV group (hazard ratio, 1.42; 95% confidence interval, 1.04-1.95; P = 0.03). A pretransplantation elevated Model for End-Stage Liver Disease score (P < 0.001) and Child-Pugh grade (P < 0.001) were identified as risk factors for presenting a high CV. A high CV of TAC concentrations was found to be predictive of TAC-related toxicity and poorer survival.

  18. Barrier function and natural moisturizing factor levels after cumulative exposure to a fruit-derived organic acid and a detergent: different outcomes in atopic and healthy skin and relevance for occupational contact dermatitis in the food industry.

    Science.gov (United States)

    Angelova-Fischer, Irena; Hoek, Anne-Karin; Dapic, Irena; Jakasa, Ivone; Kezic, Sanja; Fischer, Tobias W; Zillikens, Detlef

    2015-12-01

    Fruit-derived organic compounds and detergents are relevant exposure factors for occupational contact dermatitis in the food industry. Although individuals with atopic dermatitis (AD) are at risk for development of occupational contact dermatitis, there have been no controlled studies on the effects of repeated exposure to multiple irritants, relevant for the food industry, in atopic skin. The aim of the study was to investigate the outcomes of repeated exposure to a fruit-derived organic acid and a detergent in AD compared to healthy volunteers. The volunteers were exposed to 2.0% acetic acid (AcA) and/or 0.5% sodium lauryl sulfate (SLS) in controlled tandem repeated irritation test. The outcomes were assessed by measurements of erythema, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) levels. In the AD volunteers, repeated AcA exposure led to barrier disruption and significant TEWL increase; no significant differences after the same exposure in the healthy controls were found. Repeated exposure to SLS and the irritant tandems enhanced the reactions and resulted in a significantly higher increase in TEWL in the AD compared to the control group. Cumulative irritant exposure reduced the NMF levels in both groups. Differences in the severity of irritant-induced barrier impairment in atopic individuals contribute to the risk for occupational contact dermatitis in result of multiple exposures to food-derived irritants and detergents. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Mercapturic acids as biomarkers of exposure to electrophilic chemicals: applications to environmental and industrial chemicals.

    NARCIS (Netherlands)

    de Rooij, B.M.; Commandeur, J.N.M.; Vermeulen, N.P.E.

    1998-01-01

    The use of mercapturic acids (N-acetyl-L-cysteine S-conjugates, MAs) in the biological monitoring of human exposure to environmental and industrial chemicals is receiving more and more attention. Mercapturic acids (MAs) are formed from glutathione (GSH) S-conjugates via the MA-pathway. Although this

  20. Viewer knowledge: application of exposure-based layperson knowledge in genre-specific animation production

    NARCIS (Netherlands)

    Visch, V.; Tan, E.; Saakes, D.

    2015-01-01

    Laypeople are increasingly motivated to participate in design processes, but what knowledge do they actually possess that enables such participation? Some studies show that laypeople have gained detailed product knowledge from exposure. This knowledge can be applied to accurately recognize product

  1. Optimization of exposure procedures for sub-quarter-micron CMOS applications

    Science.gov (United States)

    Hotta, Shoji; Onozuka, Toshihiko; Fukumoto, Keiko; Shirai, Seiichiro; Okazaki, Shinji

    1998-06-01

    We investigated various exposure procedures to minimize the Critical Dimension (CD) variation for the patterning of sub- quarter micron gates. To examine dependence of the CD variation on the pattern pitch and defocus conditions, the light intensity profiles of four different mask structures: (1) a binary mask with clear field, (2) a binary mask with dark field, (3) a phase-edge type phase-shifting mask (a phase-edge PSM) with clear field, and (4) a halftone phase- shifting mask (a halftone PSM) were compared, where exposure wavelength was 248 nm and numerical aperture (NA) of KrF stepper was 0.55. For 200-nm gate patterns, dependence of the CD variation on the pattern pitch and defocus conditions was minimized by a phase-edge PSM with clear field. By optimizing the illumination condition for a phase-edge PSM exposure, we obtained the CD variation of 10 nm at the minimum gate pitch of 0.8 micrometer and the defocus condition of plus or minus 0.4 micrometer. Applying the optimized exposure procedure to the device fabrication process, we obtained the total CD variation of plus or minus 27 nm.

  2. Application of Exposure-based Layperson Knowledge in Genre-specific Animation Production

    NARCIS (Netherlands)

    Visch, V.; Saakes, D.

    2015-01-01

    Laypeople are increasingly motivated to participate in design processes, but what knowledge do they actually possess that enables such participation? Some studies show that laypeople have gained detailed product knowledge from exposure. This knowledge can be applied to accurately recognize product

  3. Viewer knowledge : Application of exposure-based layperson knowledge in genre-specific animation production

    NARCIS (Netherlands)

    Visch, V.T.; Tan, E.; Saakes, D.

    2015-01-01

    Laypeople are increasingly motivated to participate in design processes, but what knowledge do they actually possess that enables such participation? Some studies show that laypeople have gained detailed product knowledge from exposure. This knowledge can be applied to accurately recognize product

  4. The potential application of European market research data in dietary exposure modelling of food additives.

    Science.gov (United States)

    Tennant, David Robin; Bruyninckx, Chris

    2018-03-01

    Consumer exposure assessments for food additives are incomplete without information about the proportions of foods in each authorised category that contain the additive. Such information has been difficult to obtain but the Mintel Global New Products Database (GNPD) provides information about product launches across Europe over the past 20 years. These data can be searched to identify products with specific additives listed on product labels and the numbers compared with total product launches for food and drink categories in the same database to determine the frequency of occurrence. There are uncertainties associated with the data but these can be managed by adopting a cautious and conservative approach. GNPD data can be mapped with authorised food categories and with food descriptions used in the EFSA Comprehensive European Food Consumption Surveys Database for exposure modelling. The data, when presented as percent occurrence, could be incorporated into the EFSA ANS Panel's 'brand-loyal/non-brand loyal exposure model in a quantitative way. Case studies of preservative, antioxidant, colour and sweetener additives showed that the impact of including occurrence data is greatest in the non-brand loyal scenario. Recommendations for future research include identifying occurrence data for alcoholic beverages, linking regulatory food codes, FoodEx and GNPD product descriptions, developing the use of occurrence data for carry-over foods and improving understanding of brand loyalty in consumer exposure models.

  5. Dosimetry of Exposure to Electromagnetic Fields in Daily Life and Medical Applications

    NARCIS (Netherlands)

    J.F. Bakker (Jurriaan)

    2012-01-01

    textabstractElectromagnetic fields (EMF) are present everywhere in our environment but are usually invisible to the human eye. EMF for example generated by mobile phones and 50Hz power lines, can cause electric fields, currents and tissue heating in the human body. In the past, exposure limits were

  6. Comet assay as a human biomonitoring tool: application in occupational exposure to antineoplastic drugs

    Directory of Open Access Journals (Sweden)

    Carina Ladeira

    2015-05-01

    Occupational exposure to antineoplastic drugs is associated with genotoxic effects, although comet assay analyzed parameters were higher in exposed comparing with controls, were not significant. Also the study of the susceptibility biomarkers did not show statistical significant differences, the small size of our sample hampered the finding of a possible association, let alone a causality relationship.

  7. Observations on health outcome studies of exposure of the worker and the general population during the nuclear reactor accident at three mile island

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1988-01-01

    The nuclear reactor accident at Three Mile Island in March 1979 resulted in the release of radioactivity to the environment. Radiation exposure of the workers and the general population living in the vicinity of the damaged nuclear reactor was estimated based on dose measurements, meteorological conditions, demographic characteristics, reconstruction of the source term, and a number of other factors. The projected estimates of potential delayed health effects in the worker and general population, notable cancer, developmental abnormalities of the newborn, and genetic ill-health, were carefully estimated based on then-current knowledge of radiation risks and statistical techniques of analysis. Almost a decade later, we now have epidemiological and statistical data on certain of these health outcomes in the exposed populations at risk. Discussion includes the reliability of the initial radiation risk estimates, the major illnesses of concern, the mental stress and behavioral effects at the time of and following the accident, and the current findings of the ongoing studies of the health outcomes of the vulnerable populations at risk

  8. Drawing Nomograms with R: applications to categorical outcome and survival data.

    Science.gov (United States)

    Zhang, Zhongheng; Kattan, Michael W

    2017-05-01

    Outcome prediction is a major task in clinical medicine. The standard approach to this work is to collect a variety of predictors and build a model of appropriate type. The model is a mathematical equation that connects the outcome of interest with the predictors. A new patient with given clinical characteristics can be predicted for outcome with this model. However, the equation describing the relationship between predictors and outcome is often complex and the computation requires software for practical use. There is another method called nomogram which is a graphical calculating device allowing an approximate graphical computation of a mathematical function. In this article, we describe how to draw nomograms for various outcomes with nomogram() function. Binary outcome is fit by logistic regression model and the outcome of interest is the probability of the event of interest. Ordinal outcome variable is also discussed. Survival analysis can be fit with parametric model to fully describe the distributions of survival time. Statistics such as the median survival time, survival probability up to a specific time point are taken as the outcome of interest.

  9. Application of Adverse Outcome Pathways to U.S. EPA's Endocrine Disruptor Screening Program.

    Science.gov (United States)

    Browne, Patience; Noyes, Pamela D; Casey, Warren M; Dix, David J

    2017-09-01

    The U.S. EPA's Endocrine Disruptor Screening Program (EDSP) screens and tests environmental chemicals for potential effects in estrogen, androgen, and thyroid hormone pathways, and it is one of the only regulatory programs designed around chemical mode of action. This review describes the EDSP's use of adverse outcome pathway (AOP) and toxicity pathway frameworks to organize and integrate diverse biological data for evaluating the endocrine activity of chemicals. Using these frameworks helps to establish biologically plausible links between endocrine mechanisms and apical responses when those end points are not measured in the same assay. Pathway frameworks can facilitate a weight of evidence determination of a chemical's potential endocrine activity, identify data gaps, aid study design, direct assay development, and guide testing strategies. Pathway frameworks also can be used to evaluate the performance of computational approaches as alternatives for low-throughput and animal-based assays and predict downstream key events. In cases where computational methods can be validated based on performance, they may be considered as alternatives to specific assays or end points. A variety of biological systems affect apical end points used in regulatory risk assessments, and without mechanistic data, an endocrine mode of action cannot be determined. Because the EDSP was designed to consider mode of action, toxicity pathway and AOP concepts are a natural fit. Pathway frameworks have diverse applications to endocrine screening and testing. An estrogen pathway example is presented, and similar approaches are being used to evaluate alternative methods and develop predictive models for androgen and thyroid pathways. https://doi.org/10.1289/EHP1304.

  10. Applicant attraction to organizations and job choice: a meta-analytic review of the correlates of recruiting outcomes.

    Science.gov (United States)

    Chapman, Derek S; Uggerslev, Krista L; Carroll, Sarah A; Piasentin, Kelly A; Jones, David A

    2005-09-01

    Attracting high-performing applicants is a critical component of personnel selection and overall organizational success. In this study, the authors meta-analyzed 667 coefficients from 71 studies examining relationships between various predictors with job-organization attraction, job pursuit intentions, acceptance intentions, and job choice. The moderating effects of applicant gender, race, and applicant versus nonapplicant status were also examined. Results showed that applicant attraction outcomes were predicted by job-organization characteristics, recruiter behaviors, perceptions of the recruiting process, perceived fit, and hiring expectancies, but not recruiter demographics or perceived alternatives. Path analyses showed that applicant attitudes and intentions mediated the predictor-job choice relationships. The authors discuss the implications of these findings for recruiting theory, research, and practice. Copyright 2005 APA, all rights reserved.

  11. Industrial production and professional application of manufactured nanomaterials-enabled end products in Dutch industries: potential for exposure.

    Science.gov (United States)

    Bekker, Cindy; Brouwer, Derk H; Tielemans, Erik; Pronk, Anjoeka

    2013-04-01

    In order to make full use of the opportunities while responsibly managing the risks of working with manufactured nanomaterials (MNM), we need to gain insight into the potential level of exposure to MNM in the industry. Therefore, the goal of this study was to obtain an overview of the potential MNM exposure scenarios within relevant industrial sectors, applied exposure controls, and number of workers potentially exposed to MNM in Dutch industrial sectors producing and applying MNM-enabled end products in the Netherlands. A survey was conducted in three phases: (i) identification of MNM-enabled end products; (ii) identification of relevant industrial sectors; and (iii) a tiered telephone survey to estimate actual use of the products among 40 sector organizations/knowledge centres (Tier 1), 350 randomly selected companies (Tier 2), and 110 actively searched companies (Tier 3). The most dominant industrial sectors producing or applying MNM-enabled end products (market penetration >5%) are shoe repair shops, automotive, construction, paint, metal, and textile cleaning industry. In the majority of the companies (76%), potential risks related to working with MNM are not a specific point of interest. The total number of workers potentially exposed to MNM during the production or application of MNM-enabled end products was estimated at approximately 3000 workers in the Netherlands. The results of this study will serve as a basis for in-depth exposure and health surveys that are currently planned in the Netherlands. In addition, the results can be used to identify the most relevant sectors for policy makers and future studies focussing on evaluating the risks of occupational exposure to MNM.

  12. The relationship between study sponsorship, risks of bias, and research outcomes in atrazine exposure studies conducted in non-human animals: Systematic review and meta-analysis.

    Science.gov (United States)

    Bero, L; Anglemyer, A; Vesterinen, H; Krauth, D

    2016-01-01

    A critical component of systematic review methodology is the assessment of the risks of bias of studies that are included in the review. There is controversy about whether funding source should be included in a risk of bias assessment of animal toxicology studies. To determine whether industry research sponsorship is associated with methodological biases, the results, or conclusions of animal studies examining the effect of exposure to atrazine on reproductive or developmental outcomes. We searched multiple electronic databases and the reference lists of relevant articles to identify original research studies examining the effect of any dose of atrazine exposure at any life stage on reproduction or development in non-human animals. We compared methodological risks of bias, the conclusions of the studies, the statistical significance of the findings, and the magnitude of effect estimates between industry sponsored and non-industry sponsored studies. Fifty-one studies met the inclusion criteria. There were no differences in methodological risks of bias in industry versus non-industry sponsored studies. 39 studies tested environmentally relevant concentrations of atrazine (11 industry sponsored, 24 non-industry sponsored, 4 with no funding disclosures). Non-industry sponsored studies (12/24, 50.0%) were more likely to conclude that atrazine was harmful compared to industry sponsored studies (2/11, 18.1%) (p value=0.07). A higher proportion of non-industry sponsored studies reported statistically significant harmful effects (8/24, 33.3%) compared to industry-sponsored studies (1/11; 9.1%) (p value=0.13). The association of industry sponsorship with decreased effect sizes for harm outcomes was inconclusive. Our findings support the inclusion of research sponsorship as a risk of bias criterion in tools used to assess risks of bias in animal studies for systematic reviews. The reporting of other empirically based risk of bias criteria for animal studies, such as blinded

  13. Exposure-response relationships for select cancer and non-cancer health outcomes in a cohort of U.S. firefighters from San Francisco, Chicago and Philadelphia (1950-2009).

    Science.gov (United States)

    Daniels, Robert D; Bertke, Stephen; Dahm, Matthew M; Yiin, James H; Kubale, Travis L; Hales, Thomas R; Baris, Dalsu; Zahm, Shelia H; Beaumont, James J; Waters, Kathleen M; Pinkerton, Lynne E

    2015-10-01

    To examine exposure-response relationships between surrogates of firefighting exposure and select outcomes among previously studied US career firefighters. Eight cancer and four non-cancer outcomes were examined using conditional logistic regression. Incidence density sampling was used to match each case to 200 controls on attained age. Days accrued in firefighting assignments (exposed-days), run totals (fire-runs) and run times (fire-hours) were used as exposure surrogates. HRs comparing 75th and 25th centiles of lagged cumulative exposures were calculated using loglinear, linear, log-quadratic, power and restricted cubic spline general relative risk models. Piecewise constant models were used to examine risk differences by time since exposure, age at exposure and calendar period. Among 19,309 male firefighters eligible for the study, there were 1333 cancer deaths and 2609 cancer incidence cases. Significant positive associations between fire-hours and lung cancer mortality and incidence were evident. A similar relation between leukaemia mortality and fire-runs was also found. The lung cancer associations were nearly linear in cumulative exposure, while the association with leukaemia mortality was attenuated at higher exposure levels and greater for recent exposures. Significant negative associations were evident for the exposure surrogates and colorectal and prostate cancers, suggesting a healthy worker survivor effect possibly enhanced by medical screening. Lung cancer and leukaemia mortality risks were modestly increasing with firefighter exposures. These findings add to evidence of a causal association between firefighting and cancer. Nevertheless, small effects merit cautious interpretation. We plan to continue to follow the occurrence of disease and injury in this cohort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. FERAL : Network-based classifier with application to breast cancer outcome prediction

    NARCIS (Netherlands)

    Allahyar, A.; De Ridder, J.

    2015-01-01

    Motivation: Breast cancer outcome prediction based on gene expression profiles is an important strategy for personalize patient care. To improve performance and consistency of discovered markers of the initial molecular classifiers, network-based outcome prediction methods (NOPs) have been proposed.

  15. OSL surface exposure dating of a lithic quarry in Tibet: Laboratory validation and application

    DEFF Research Database (Denmark)

    Gliganic, L.A.; Meyer, M.C.; Sohbati, R.

    2018-01-01

    developed OSL Surface exposure dating technique (OSL-Surf) to date flake scars at lithic quarry sites. We performed the first quantitative validation of the model describing the OSL-Surf dating technique using a controlled laboratory experiment. Our results show that longer laboratory bleaching durations......-depth profile that could be used to calibrate the model to estimate the exposure duration of a flake scar associated with human exploitation of the area. Finally, we observe that the μ parameter of the OSL-Surf model varies considerably between the laboratory-bleached and two naturally daylight-bleached...... datasets, despite having identical lithologies. We thus infer that, in addition to lithological controls, the μ parameter is primarily sensitive to the daylight irradiation geometry and only weakly dependent on spectrum of the incident light; this interpretation implies a narrow effective bleaching...

  16. Workplace exposure to nanoparticles and the application of provisional nanoreference values in times of uncertain risks

    Science.gov (United States)

    van Broekhuizen, Pieter; van Broekhuizen, Fleur; Cornelissen, Ralf; Reijnders, Lucas

    2012-03-01

    Nano reference values (NRVs) for occupational use of nanomaterials were tested as provisional substitute for Occupational Exposure Limits (OELs). NRVs can be used as provisional limit values until Health-Based OELs or derived no-effect levels (DNEL) become available. NRVs were defined for 8 h periods (time weighted average) and for short-term exposure periods (15 min-time weighted average). To assess the usefulness of these NRVs, airborne number concentrations of nanoparticles (NPs) in the workplace environment were measured during paint manufacturing, electroplating, light equipment manufacturing, non-reflective glass production, production of pigment concentrates and car refinishing. Activities monitored were handling of solid engineered NPs (ENP), abrasion, spraying and heating during occupational use of nanomaterials (containing ENPs) and machining nanosurfaces. The measured concentrations are often presumed to contain ENPs as well as process-generated NPs (PGNP). The PGNP are found to be a significant source for potential exposure and cannot be ignored in risk assessment. Levels of NPs identified in workplace air were up to several millions of nanoparticles/cm3. Conventional components in paint manufacturing like CaCO3 and talc may contain a substantial amount of nanosized particulates giving rise to airborne nanoparticle concentrations. It is argued that risk assessments carried out for e.g. paint manufacturing processes using conventional non-nano components should take into account potential nanoparticle emissions as well. The concentrations measured were compared with particle-based NRVs and with mass-based values that have also been proposed for workers protection. It is concluded that NRVs can be used for risk management for handling or processing of nanomaterials at workplaces provided that the scope of NRVs is not limited to ENPs only, but extended to the exposure to process-generated NPs as well.

  17. Workplace exposure to nanoparticles and the application of provisional nanoreference values in times of uncertain risks

    International Nuclear Information System (INIS)

    Broekhuizen, Pieter van; Broekhuizen, Fleur van; Cornelissen, Ralf; Reijnders, Lucas

    2012-01-01

    Nano reference values (NRVs) for occupational use of nanomaterials were tested as provisional substitute for Occupational Exposure Limits (OELs). NRVs can be used as provisional limit values until Health-Based OELs or derived no-effect levels (DNEL) become available. NRVs were defined for 8 h periods (time weighted average) and for short-term exposure periods (15 min-time weighted average). To assess the usefulness of these NRVs, airborne number concentrations of nanoparticles (NPs) in the workplace environment were measured during paint manufacturing, electroplating, light equipment manufacturing, non-reflective glass production, production of pigment concentrates and car refinishing. Activities monitored were handling of solid engineered NPs (ENP), abrasion, spraying and heating during occupational use of nanomaterials (containing ENPs) and machining nanosurfaces. The measured concentrations are often presumed to contain ENPs as well as process-generated NPs (PGNP). The PGNP are found to be a significant source for potential exposure and cannot be ignored in risk assessment. Levels of NPs identified in workplace air were up to several millions of nanoparticles/cm 3 . Conventional components in paint manufacturing like CaCO 3 and talc may contain a substantial amount of nanosized particulates giving rise to airborne nanoparticle concentrations. It is argued that risk assessments carried out for e.g. paint manufacturing processes using conventional non-nano components should take into account potential nanoparticle emissions as well. The concentrations measured were compared with particle-based NRVs and with mass-based values that have also been proposed for workers protection. It is concluded that NRVs can be used for risk management for handling or processing of nanomaterials at workplaces provided that the scope of NRVs is not limited to ENPs only, but extended to the exposure to process-generated NPs as well.

  18. Effectiveness of the ‘Home-but not Alone’ mobile health application educational programme on parental outcomes

    DEFF Research Database (Denmark)

    Shorey, Shefaly; Peng Mei, Yvonne; Danbjørg, Dorthe Boe

    2017-01-01

    -time parents and parents already with kids on the day of their discharge from a public hospital. Eligible parents will be randomly allocated to either a control group (receiving routine care) or an intervention group (routine care plus access to the 'Home-but not Alone' mobile health application. Outcome...... measures comprise of parenting self-efficacy, social support, parenting satisfaction and postnatal depression. Data will be collected at the baseline (on the day of discharge) and at four weeks postpartum. DISCUSSION: This will be an empirical study that evaluates a theory-based educational programme...... delivered via an innovative mobile health application on parental outcomes. Results from this study will enhance parenting self-efficacy, social support and parenting satisfaction, which may then reduce parental risks of postnatal depression....

  19. Psychometric evaluation of self-report outcome measures for prosthetic applications

    OpenAIRE

    Hafner, Brian J.; Morgan, Sara J.; Askew, Robert L.; Salem, Rana

    2016-01-01

    Documentation of clinical outcomes is increasingly expected in delivery of prosthetic services and devices. However, many outcome measures suitable for use in clinical care and research have not been psychometrically tested with prosthesis users. The aim of this study was to determine test-retest reliability, mode-of-administration (MoA) equivalence, standard error of measurement (SEM), and minimal detectable change (MDC) of standardized, self-report instruments that assess constructs of impo...

  20. Radiation exposure and image quality in x-Ray diagnostic radiology physical principles and clinical applications

    CERN Document Server

    Aichinger, Horst; Joite-Barfuß, Sigrid; Säbel, Manfred

    2012-01-01

    The largest contribution to radiation exposure to the population as a whole arises from diagnostic X-rays. Protecting the patient from radiation is a major aim of modern health policy, and an understanding of the relationship between radiation dose and image quality is of pivotal importance in optimising medical diagnostic radiology. In this volume the data provided for exploring these concerns are partly based on X-ray spectra, measured on diagnostic X-ray tube assemblies, and are supplemented by the results of measurements on phantoms and simulation calculations.

  1. A novel application of capnography during controlled human exposure to air pollution

    Directory of Open Access Journals (Sweden)

    Fila Michael

    2006-10-01

    Full Text Available Abstract Background The objective was to determine the repeatability and stability of capnography interfaced with human exposure facility. Methods Capnographic wave signals were obtained from five healthy volunteers exposed to particle-free, filtered air during two consecutive 5 min intervals, 10 min apart, within the open and then the sealed and operational human exposure facility (HEF. Using a customized setup comprised of the Oridion Microcap® portable capnograph, DA converter and AD card, the signal was acquired and saved as an ASCII file for subsequent processing. The minute ventilation (VE, respiratory rate (RR and expiratory tidal volume (VTE were recorded before and after capnographic recording and then averaged. Each capnographic tracing was analyzed for acceptable waves. From each recorded interval, 8 to 19 acceptable waves were selected and measured. The following wave parameters were obtained: total length and length of phase II and III, slope of phase II and III, area under the curve and area under phase III. In addition, we recorded signal measures including the mean, standard deviation, mode, minimum, maximum – which equals end-tidal CO2 (EtCO2, zero-corrected maximum and true RMS. Results Statistical analysis using a paired t-test for means showed no statistically significant changes of any wave parameters and wave signal measures, corrected for RR and VTE, comparing the measures when the HEF was open vs. sealed and operational. The coefficients of variation of the zero-corrected and uncorrected EtCO2, phase II absolute difference, signal mean, standard deviation and RMS were less than 10% despite a sub-atmospheric barometric pressure, and slightly higher temperature and relative humidity within the HEF when operational. Conclusion We showed that a customized setup for the acquisition and processing of the capnographic wave signal, interfaced with HEF was stable and repeatable. Thus, we expect that analysis of capnographic

  2. Non parametric denoising methods based on wavelets: Application to electron microscopy images in low exposure time

    International Nuclear Information System (INIS)

    Soumia, Sid Ahmed; Messali, Zoubeida; Ouahabi, Abdeldjalil; Trepout, Sylvain; Messaoudi, Cedric; Marco, Sergio

    2015-01-01

    The 3D reconstruction of the Cryo-Transmission Electron Microscopy (Cryo-TEM) and Energy Filtering TEM images (EFTEM) hampered by the noisy nature of these images, so that their alignment becomes so difficult. This noise refers to the collision between the frozen hydrated biological samples and the electrons beam, where the specimen is exposed to the radiation with a high exposure time. This sensitivity to the electrons beam led specialists to obtain the specimen projection images at very low exposure time, which resulting the emergence of a new problem, an extremely low signal-to-noise ratio (SNR). This paper investigates the problem of TEM images denoising when they are acquired at very low exposure time. So, our main objective is to enhance the quality of TEM images to improve the alignment process which will in turn improve the three dimensional tomography reconstructions. We have done multiple tests on special TEM images acquired at different exposure time 0.5s, 0.2s, 0.1s and 1s (i.e. with different values of SNR)) and equipped by Golding beads for helping us in the assessment step. We herein, propose a structure to combine multiple noisy copies of the TEM images. The structure is based on four different denoising methods, to combine the multiple noisy TEM images copies. Namely, the four different methods are Soft, the Hard as Wavelet-Thresholding methods, Bilateral Filter as a non-linear technique able to maintain the edges neatly, and the Bayesian approach in the wavelet domain, in which context modeling is used to estimate the parameter for each coefficient. To ensure getting a high signal-to-noise ratio, we have guaranteed that we are using the appropriate wavelet family at the appropriate level. So we have chosen âĂIJsym8âĂİ wavelet at level 3 as the most appropriate parameter. Whereas, for the bilateral filtering many tests are done in order to determine the proper filter parameters represented by the size of the filter, the range parameter and the

  3. Education Levels and Mortgage Application Outcomes: Evidence of Financial Literacy. Discussion Paper No. 1369-09

    Science.gov (United States)

    Collins, J. Michael

    2009-01-01

    This paper uses 2005 Home Mortgage Disclosure Act data aggregated by census tract to measure the relationship between census tract-level college completion rates and the rates at which first lien refinance mortgage applicants submit incomplete loan applications, withdraw loan applications before they are reviewed, and reject lender approved loan…

  4. Adverse reproductive and developmental health outcomes following prenatal exposure to a 2 hydraulic fracturing chemical mixture in female C57Bl/6 mice

    Science.gov (United States)

    Kassotis, Christopher D.; Bromfield, John J.; Klemp, Kara C.; Meng, Chun-Xia; Wolfe, Andrew R.; Zoeller, Thomas; Balise, Victoria D.; Isiguzo, Chiamaka J.; Tillitt, Donald E.; Nagel, Susan C.

    2016-01-01

    Unconventional oil and gas operations using hydraulic fracturing can contaminate surface and groundwater with endocrine-disrupting chemicals. We have previously shown that 23 of 24 commonly used hydraulic fracturing chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors in a human endometrial cancer cell reporter gene assay and that mixtures can behave synergistically, additively, or antagonistically on these receptors. In the current study, pregnant female C57Bl/6 dams were exposed to a mixture of 23 commonly used unconventional oil and gas chemicals at approximately 3, 30, 300, and 3000 μg/kg·d, flutamide at 50 mg/kg·d, or a 0.2% ethanol control vehicle via their drinking water from gestational day 11 through birth. This prenatal exposure to oil and gas operation chemicals suppressed pituitary hormone concentrations across experimental groups (prolactin, LH, FSH, and others), increased body weights, altered uterine and ovary weights, increased heart weights and collagen deposition, disrupted folliculogenesis, and other adverse health effects. This work suggests potential adverse developmental and reproductive health outcomes in humans and animals exposed to these oil and gas operation chemicals, with adverse outcomes observed even in the lowest dose group tested, equivalent to concentrations reported in drinking water sources. These endpoints suggest potential impacts on fertility, as previously observed in the male siblings, which require careful assessment in future studies. - See more at: http://press.endocrine.org/doi/10.1210/en.2016-1242#sthash.9kqfLvXg.dpuf

  5. Minimum data set to measure rehabilitation needs and health outcome after major trauma: application of an international framework.

    Science.gov (United States)

    Hoffman, Karen P; Playford, Diane E; Grill, Eva; Soberg, Helene L; Brohi, Karim

    2016-06-01

    Measurement of long term health outcome after trauma remains non-standardized and ambiguous which limits national and international comparison of burden of injuries. The World Health Organization (WHO) has recommended the application of the International Classification of Function, Disability and Health (ICF) to measure rehabilitation and health outcome worldwide. No previous poly-trauma studies have applied the ICF comprehensively to evaluate outcome after injury. To apply the ICF categorization in patients with traumatic injuries to identify a minimum data set of important rehabilitation and health outcomes to enable national and international comparison of outcome data. A mixed methods design of patient interviews and an on-line survey. An ethnically diverse urban major trauma center in London. Adult patients with major traumatic injuries (poly-trauma) and international health care professionals (HCPs) working in acute and post-acute major trauma settings. Mixed methods investigated patients and health care professionals (HCPs) perspectives of important rehabilitation and health outcomes. Qualitative patient data and quantitative HCP data were linked to ICF categories. Combined data were refined to identify a minimum data set of important rehabilitation and health outcome categories. Transcribed patient interview data (N.=32) were linked to 234 (64%) second level ICF categories. Two hundred and fourteen HCPs identified 121 from a possible 140 second level ICF categories (86%) as relevant and important. Patients and HCPs strongly agreed on ICF body structures and body functions categories which include temperament, energy and drive, memory, emotions, pain and repair function of the skin. Conversely, patients prioritised domestic tasks, recreation and work compared to HCP priorities of self-care and mobility. Twenty six environmental factors were identified. Patient and HCP data were refined to recommend a 109 possible ICF categories for a minimum data set. The

  6. Infants and young children modeling method for numerical dosimetry studies: application to plane wave exposure

    International Nuclear Information System (INIS)

    Dahdouh, S; Wiart, J; Bloch, I; Varsier, N; Nunez Ochoa, M A; Peyman, A

    2016-01-01

    Numerical dosimetry studies require the development of accurate numerical 3D models of the human body. This paper proposes a novel method for building 3D heterogeneous young children models combining results obtained from a semi-automatic multi-organ segmentation algorithm and an anatomy deformation method. The data consist of 3D magnetic resonance images, which are first segmented to obtain a set of initial tissues. A deformation procedure guided by the segmentation results is then developed in order to obtain five young children models ranging from the age of 5 to 37 months. By constraining the deformation of an older child model toward a younger one using segmentation results, we assure the anatomical realism of the models. Using the proposed framework, five models, containing thirteen tissues, are built. Three of these models are used in a prospective dosimetry study to analyze young child exposure to radiofrequency electromagnetic fields. The results lean to show the existence of a relationship between age and whole body exposure. The results also highlight the necessity to specifically study and develop measurements of child tissues dielectric properties. (paper)

  7. Infants and young children modeling method for numerical dosimetry studies: application to plane wave exposure

    Science.gov (United States)

    Dahdouh, S.; Varsier, N.; Nunez Ochoa, M. A.; Wiart, J.; Peyman, A.; Bloch, I.

    2016-02-01

    Numerical dosimetry studies require the development of accurate numerical 3D models of the human body. This paper proposes a novel method for building 3D heterogeneous young children models combining results obtained from a semi-automatic multi-organ segmentation algorithm and an anatomy deformation method. The data consist of 3D magnetic resonance images, which are first segmented to obtain a set of initial tissues. A deformation procedure guided by the segmentation results is then developed in order to obtain five young children models ranging from the age of 5 to 37 months. By constraining the deformation of an older child model toward a younger one using segmentation results, we assure the anatomical realism of the models. Using the proposed framework, five models, containing thirteen tissues, are built. Three of these models are used in a prospective dosimetry study to analyze young child exposure to radiofrequency electromagnetic fields. The results lean to show the existence of a relationship between age and whole body exposure. The results also highlight the necessity to specifically study and develop measurements of child tissues dielectric properties.

  8. The Validity and Applicability of Using a Generic Exposure Assessment Model for Occupational Exposure to Nano-Objects and Their Aggregates and Agglomerates

    NARCIS (Netherlands)

    Bekker, Cindy; Voogd, Eef; Fransman, Wouter; Vermeulen, Roel

    2016-01-01

    BACKGROUND: Control banding can be used as a first-tier assessment to control worker exposure to nano-objects and their aggregates and agglomerates (NOAA). In a second tier, more advanced modelling approaches are needed to produce quantitative exposure estimates. As currently no general quantitative

  9. The validity and applicability of using a generic exposure assessment model for occupational exposure to nano-objects and their aggregates and agglomerates

    NARCIS (Netherlands)

    Bekker, C.; Voogd, E.; Fransman, W.; Vermeulen, R.

    2016-01-01

    Background: Control banding can be used as a first-tier assessment to control worker exposure to nano-objects and their aggregates and agglomerates (NOAA). In a second tier, more advanced modelling approaches are needed to produce quantitative exposure estimates. As currently no general quantitative

  10. Thinking Through Computational Exposure as an Evolving Paradign Shift for Exposure Science: Development and Application of Predictive Models from Big Data

    Science.gov (United States)

    Symposium Abstract: Exposure science has evolved from a time when the primary focus was on measurements of environmental and biological media and the development of enabling field and laboratory methods. The Total Exposure Assessment Method (TEAM) studies of the 1980s were class...

  11. Contribution of job-exposure matrices for exposure assessment in occupational safety and health monitoring systems: application from the French national occupational disease surveillance and prevention network.

    Science.gov (United States)

    Florentin, Arnaud; Zmirou-Navier, Denis; Paris, Christophe

    2017-08-01

    To detect new hazards ("signals"), occupational health monitoring systems mostly rest on the description of exposures in the jobs held and on reports by medical doctors; these are subject to declarative bias. Our study aims to assess whether job-exposure matrices (JEMs) could be useful tools for signal detection by improving exposure reporting. Using the French national occupational disease surveillance and prevention network (RNV3P) data from 2001 to 2011, we explored the associations between disease and exposure prevalence for 3 well-known pathology/exposure couples and for one debatable couple. We compared the associations measured when using physicians' reports or applying the JEMs, respectively, for these selected diseases and across non-selected RNV3P population or for cases with musculoskeletal disorders, used as two reference groups; the ratio of exposure prevalences according to the two sources of information were computed for each disease category. Our population contained 58,188 subjects referred with pathologies related to work. Mean age at diagnosis was 45.8 years (95% CI 45.7; 45.9), and 57.2% were men. For experts, exposure ratios increase with knowledge on exposure causality. As expected, JEMs retrieved more exposed cases than experts (exposure ratios between 12 and 194), except for the couple silica/silicosis, but not for the MSD control group (ratio between 0.2 and 0.8). JEMs enhanced the number of exposures possibly linked with some conditions, compared to experts' assessment, relative to the whole database or to a reference group; they are less likely to suffer from declarative bias than reports by occupational health professionals.

  12. Functional outcomes of polypropylene midurethral sling resection for treatment of mesh exposure/extrusion: Does it lead to a relapse of incontinence?

    Science.gov (United States)

    Töz, Emrah; Sahin, Cağdaş; Apaydin, Nesin; Ozcan, Aykut; Taner, Cüneyt E

    2015-07-01

    The Burch colposuspension, which was regarded as the gold standard treatment for stress urinary incontinence for several years, has been replaced by minimally invasive sling devices. Although these procedures are simple and minimally invasive, they are associated with complications such as infection, mesh erosion, chronic pain, and de novo detrusor overactivity, which may necessitate surgical resection or tape removal. The aim of the study was to assess urinary function outcomes including continence, after partial resection of suburethral tapes. Patients were admitted for resection of tape due to extrusion/exposure, between 2011 and 2014. Patients were evaluated with physical examination, transvaginal ultrasound, cough stress test, 24-hour bladder diary, Incontinence Impact Questionnairre-7 form and Urogenital Distress Inventory-6 form. Minimum follow-up time was 2 months after treatment of the tape complication (mean 20, range 2 to 38). Recurrence of incontinence after partial tape resection was observed in 9% (3/32) cases. In two patients due to stress urinary incontinence recurrence repeat anti-incontinence surgery was necessary. Although one patient had suffered from incontinence after resection of tape, she did not desire operation. The results of this study indicated that preservation of the anti-incontinence effects of slings might not be dependent on the intactness of the sling. Recurrence of incontinence after partial tape resection is uncommon and in the majority of cases this stress incontinence is minimally and does not require repeat operation.

  13. Applications of the principles of justification and optimisation to products causing public exposure

    International Nuclear Information System (INIS)

    Fleishman, A.B.; Wrixon, A.D.

    1980-01-01

    The application of cost benefit analysis to radiation protection of the public from consumer appliances involving radioactive substances is discussed. The application involves explicitly recognising that benefits involve subjective judgements. An example is given of optimisation for the quality control of gaseous tritium light sources for use in liquid crystal display digital watches. It is concluded that the role of quantitative cost benefit analysis in determining the acceptability of consumer products is likely to be limited; a more pragmatic scheme is likely to be sufficient. (UK)

  14. Nano-risk Science: application of toxicogenomics in an adverse outcome pathway framework for risk assessment of multi-walled carbon nanotubes.

    Science.gov (United States)

    Labib, Sarah; Williams, Andrew; Yauk, Carole L; Nikota, Jake K; Wallin, Håkan; Vogel, Ulla; Halappanavar, Sabina

    2016-03-15

    A diverse class of engineered nanomaterials (ENMs) exhibiting a wide array of physical-chemical properties that are associated with toxicological effects in experimental animals is in commercial use. However, an integrated framework for human health risk assessment (HHRA) of ENMs has yet to be established. Rodent 2-year cancer bioassays, clinical chemistry, and histopathological endpoints are still considered the 'gold standard' for detecting substance-induced toxicity in animal models. However, the use of data derived from alternative toxicological tools, such as genome-wide expression profiling and in vitro high-throughput assays, are gaining acceptance by the regulatory community for hazard identification and for understanding the underlying mode-of-action. Here, we conducted a case study to evaluate the application of global gene expression data in deriving pathway-based points of departure (PODs) for multi-walled carbon nanotube (MWCNT)-induced lung fibrosis, a non-cancer endpoint of regulatory importance. Gene expression profiles from the lungs of mice exposed to three individual MWCNTs with different physical-chemical properties were used within the framework of an adverse outcome pathway (AOP) for lung fibrosis to identify key biological events linking MWCNT exposure to lung fibrosis. Significantly perturbed pathways were categorized along the key events described in the AOP. Benchmark doses (BMDs) were calculated for each perturbed pathway and were used to derive transcriptional BMDs for each MWCNT. Similar biological pathways were perturbed by the different MWCNT types across the doses and post-exposure time points studied. The pathway BMD values showed a time-dependent trend, with lower BMDs for pathways perturbed at the earlier post-exposure time points (24 h, 3d). The transcriptional BMDs were compared to the apical BMDs derived by the National Institute for Occupational Safety and Health (NIOSH) using alveolar septal thickness and fibrotic lesions

  15. Reference values and their application to the monitoring of occupational exposure to natural uranium compounds

    International Nuclear Information System (INIS)

    1986-09-01

    Natural uranium compounds, which enter the oxide fuel cycle offer physico-chemical characteristics dependent on their structure and their production process. These characteristics govern their biological behaviour and the degree of their radioactive and chemical toxicity. The monitoring of workers occupationnally exposed to these compounds is carried out by bioassays; in order to get the best interpretation, the resulting data must be compared to reference values. These values must be closely related to the type of contaminant and the real exposure conditions. In this report, the occupational medicine services working group has examined the possibilities of obtaining such reference values and suggests recommendations and operational values covering most situations found in routine monitoring [fr

  16. Radiologic exposure conditions and resultant skin doses in application of xeroradiography to the orthodontic diagnosis

    International Nuclear Information System (INIS)

    Nakasima, A.; Nakata, S.; Shimizu, K.; Takahama, Y.

    1980-01-01

    Xeroradiography is the recording of radiologic image by a photoelectric process rather than the photochemical one used in conventional radiography. In order to investigate the advantages and disadvantages of xeroradiography in the orthodontic field, minimum xeroradiologic exposure conditions for skull projections, joint projections, and hand projections were established by thirteen examiners and the relationship between the image production and x-ray radiation was compared with conventional film techniques. The advantages of xeroradiograph were finer and clear images caused by the edge effect and wide latitude of xeroradiography; the main hazard was the unavoidable larger skin dose required by the projection procedures. The skin doses with xeroradiography were 2.4 to 16.2 times larger than those with conventional film techniques

  17. Low-loss microelectrodes fabricated using reverse-side exposure for a tunable ferroelectric capacitor application

    Science.gov (United States)

    Yoon, Yong-Kyu; Stevenson Kenney, J.; Hunt, Andrew T.; Allen, Mark G.

    2006-02-01

    Narrowly spaced thick microelectrodes are fabricated using a self-aligned multiple reverse-side exposure scheme for an improved quality-factor tunable ferroelectric capacitor. The microelectrodes are fabricated on a functional substrate—a thin film ferroelectric (barium strontium titanate, BST; BaxSr1-xTiO3) coated sapphire substrate, which has an electric-field-dependent dielectric property providing tuning functionality, as well as UV transparency permitting an additional degree of freedom in photolithography steps. The microelectrode process has been applied to interdigitated capacitor fabrication, where a critical challenge is maintaining narrow gaps between electrodes for high tunability, while simultaneously forming thick electrodes to minimize conductor loss. A single mask, self-aligned reverse-side exposure through the transparent substrate achieves both these goals. A single-finger test capacitor with an electrode gap of 1.2 µm and an electrode thickness of 2.2 µm is fabricated and characterized. Tunability (T = 100 × (C0 - Cbias)/C0) of 33% at 10 V has been achieved at 100 kHz. The 2.2 µm thick structure shows improvement of Q-factor compared to that of a 0.1 µm thick structure. To demonstrate the scalability of this process, a 102-finger interdigitated capacitor is fabricated and characterized at 100 kHz and 1 GHz. The structure is embedded in a 25 µm thick epoxy resin SU-8 for passivation. A quality factor decrease of 15-25%, tunability decrease of 2-3% and capacitance increase of 6% are observed due to the expoxy resin after passivation. High frequency performance of the capacitor has been measured to be 15.9 pF of capacitance, 28.1% tunability at 10 V and a quality factor of 16 (at a 10 V dc bias) at 1 GHz.

  18. Building a Bridge Between Genetics and Outcomes Research: Application in Autism (The AutGO Study).

    Science.gov (United States)

    Talebizadeh, Zohreh; Shah, Ayten

    2018-03-05

    Concerns over the need to improve translational aspects of genetics research studies and engaging community members in the research process have been noted in the literature and raised by patient advocates. In addition to the work done by patient advocacy groups, organizations such as the Patient-Centered Outcomes Research Institute advocate for a change in the culture of research from being researcher-driven to becoming more patient-driven. Our project, Autism Genetics and Outcomes (AutGO), consists of two phases. The goal for phase I was to initiate a general discussion around the main topic (i.e., linking genetics and outcomes research). We used the Patient-Centered Outcomes Research Institute engagement approach to: (aim 1) develop a partnership with a wide range of stakeholders to assess their perspective on developing projects that use both genetics and outcomes research data/principles; (aim 2) identify barriers, facilitators, and needs to promote engagement in patient-centered genetics research; and (aim 3) distill and describe actions that may facilitate utilization of patient/parent perspectives in designing genetics research studies. In phase I, we formed a community advisory board composed of 33 participants, including outcomes and genetics researchers, clinicians, healthcare providers, patients/family members, and community/industry representatives, and convened six sessions over the 12-month period. We structured the sessions as a combination of online PowerPoint presentations, surveys, and in-person group discussions. During the sessions, we discussed topics pertaining to linking genetics and outcomes research and reviewed relevant materials, including patient stories, research projects, and existing resources. Two sets of surveys, project evaluations (k = 2) and session evaluations (k = 6), were distributed among participants. Feedback was analyzed using content analysis strategies to identify the themes and subthemes. Herein, we describe: the

  19. DEVELOPING A SMARTPHONE APPLICATION TO IMPROVE CARE AND OUTCOMES IN ADOLESCENT ARTHRITIS THROUGH PATIENT INPUT

    Directory of Open Access Journals (Sweden)

    Alice Ran Cai

    2015-09-01

    Full Text Available Background: Juvenile idiopathic arthritis (JIA affects around 1 in 1,000 young people (YP in the UK. Flare-ups of JIA cause joint pain and swelling, and are often accompanied with fatigue, stiffness, sleep problems, higher negative emotions, and reduced participation in activities. As a result, JIA can negatively impact educational, psychosocial, and physical development and wellbeing, especially during puberty. In addition, missing medications, poor clinic attendance, as well as low levels of physical activity complicate the management of this disease in adolescence. Using smartphone technologies to engage YP with their care has the potential to improve health outcomes for this age group. No such smartphone app has yet been developed in collaboration with YP with JIA and consultations with Healthcare Professionals (HCPs. Aims: To develop a smartphone app that facilitates collection of information deemed important by YP with JIA and clinicians involved in their care. Methods: Phase 1 carried out five focus groups (FGs: two with YP (one with 10- to 15-year olds and one with 16- to 24-year olds, one with parents, and two with HCPs working in paediatric and adult rheumatology. Participants were guided by semi-structured interview questions focusing on how to develop an interesting and easy-to-use app that can help YP improve self-management and increase understanding and adherence to treatment. Phase 2 developed the app by integrating participants’ ideas and suggestions. The app’s acceptability and usability were then evaluated through four FGs: two with YP (one with 10- to 14-year olds and one with 16- to 23-year olds and two with HCPs. Participants were provided with the app on a smartphone and were asked to navigate through its various features. Participants’ perceptions of the app and suggestions for improvements were sought via qualitative interview responses and user observations. Results: Qualitative content analysis was used to

  20. A novel method for standardized application of fungal spore coatings for mosquito exposure bioassays

    NARCIS (Netherlands)

    Farenhorst, M.; Knols, B.G.J.

    2010-01-01

    Background: Interest in the use of fungal entomopathogens against malaria vectors is growing. Fungal spores infect insects via the cuticle and can be applied directly on the insect to evaluate infectivity. For flying insects such as mosquitoes, however, application of fungal suspensions on resting

  1. A novel method for standardized application of fungal spore coatings for mosquito exposure bioassays

    NARCIS (Netherlands)

    Farenhorst, Marit; Knols, Bart G. J.

    2010-01-01

    Interest in the use of fungal entomopathogens against malaria vectors is growing. Fungal spores infect insects via the cuticle and can be applied directly on the insect to evaluate infectivity. For flying insects such as mosquitoes, however, application of fungal suspensions on resting surfaces is

  2. A Two-Step Approach for Analysis of Nonignorable Missing Outcomes in Longitudinal Regression: an Application to Upstate KIDS Study.

    Science.gov (United States)

    Liu, Danping; Yeung, Edwina H; McLain, Alexander C; Xie, Yunlong; Buck Louis, Germaine M; Sundaram, Rajeshwari

    2017-09-01

    Imperfect follow-up in longitudinal studies commonly leads to missing outcome data that can potentially bias the inference when the missingness is nonignorable; that is, the propensity of missingness depends on missing values in the data. In the Upstate KIDS Study, we seek to determine if the missingness of child development outcomes is nonignorable, and how a simple model assuming ignorable missingness would compare with more complicated models for a nonignorable mechanism. To correct for nonignorable missingness, the shared random effects model (SREM) jointly models the outcome and the missing mechanism. However, the computational complexity and lack of software packages has limited its practical applications. This paper proposes a novel two-step approach to handle nonignorable missing outcomes in generalized linear mixed models. We first analyse the missing mechanism with a generalized linear mixed model and predict values of the random effects; then, the outcome model is fitted adjusting for the predicted random effects to account for heterogeneity in the missingness propensity. Extensive simulation studies suggest that the proposed method is a reliable approximation to SREM, with a much faster computation. The nonignorability of missing data in the Upstate KIDS Study is estimated to be mild to moderate, and the analyses using the two-step approach or SREM are similar to the model assuming ignorable missingness. The two-step approach is a computationally straightforward method that can be conducted as sensitivity analyses in longitudinal studies to examine violations to the ignorable missingness assumption and the implications relative to health outcomes. © 2017 John Wiley & Sons Ltd.

  3. Theoretical determination of spectrum-exposure rate conversion operator of HPGe detector and its application to the measurement of environmental gamma-ray exposure rate

    International Nuclear Information System (INIS)

    Park, Ch.M.; Choi, B.I.; Kwak, S.S.; Ji, P.K.; Kim, T.W.; Park, Y.W.; Yoon, B.K.

    1993-01-01

    A conversion operator between spectrum and exposure rate, using a portable HPGe detector for environmental radiation monitoring, was determined theoretically under the assumption of uniform distribution of radiation source on the ground surface. The measurement results were compared with those of a pressurized ionization chamber. The results obtained with the HPGe detector were slightly lower. The method can be easily applied to any gamma ray detector to obtain a spectrum - exposure-rate conversion factor for computing the exposure rate of environmental gamma radiation. (N.T.) 15 refs.; 6 figs.; 3 tabs

  4. Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity

    Science.gov (United States)

    Awan, Shaheen N.; Roy, Nelson

    2009-01-01

    Purpose: The purpose of this experiment was to assess the ability of an acoustic model composed of both time-based and spectral-based measures to track change following voice disorder treatment and to serve as a possible treatment outcomes measure. Method: A weighted, four-factor acoustic algorithm consisting of shimmer, pitch sigma, the ratio of…

  5. Patient reported outcomes in chronic skin diseases: eHealth applications for clinical practice

    NARCIS (Netherlands)

    van Cranenburgh, O.D.

    2016-01-01

    The overall aim of this thesis was to examine and integrate patient reported outcomes (PROs) in dermatological care. In part I, we specifically examined health-related quality of life (HRQoL), treatment satisfaction, and experiences with care in patients with chronic skin diseases. Our results

  6. Effect of pigtail catheter application on obstetric outcomes in in vitro fertilization/intracytoplasmic sperm injection pregnancies following hyperstimulation syndrome.

    Science.gov (United States)

    Çağlar Aytaç, Pınar; Kalaycı, Hakan; Yetkinel, Selçuk; Alkaş, Didem; Yüksel Şimşek, Seda; Haydardedeoğlu, Bülent; Bulgan Kılıçdağ, Esra

    2017-06-01

    To evaluate the effects of percutaneous pigtail catheter drainage on the outcomes of intracytoplasmic sperm injection (ICSI) pregnancies following moderate or severe ovarian hyperstimulation syndrome (OHSS). This retrospective study included 189 patients hospitalized for OHSS following ICSI treatment in a tertiary in vitro fertilization unit between 2006 and 2014. Pigtail catheters were applied in 63 patients; the other 126 patients did not need that treatment. The obstetric reports of 173 patients could be accessed and were examined to investigate the pregnancy outcomes of those with and without catheters. No complications such as infection or vascular or intra-abdominal organ trauma were observed related to the pigtail application. There were no differences in abortus, preterm labor, gestational diabetes mellitus, and preeclampsia ratio between the pigtail and control groups (p>0.05). The rate of readmission to hospital for OHSS was lower in the pigtail group than in the control group although not statistically significant (p=0.08). Pigtail application is a safe and effective method for draining ascites in patients with OHSS after ICSI treatment. The use of pigtail catheters had no adverse effects on the perinatal outcomes of patients hospitalized with OHSS who became pregnant after ICSI treatment. In addition, the percutaneous drainage of ascites via a pigtail catheter helped prevent the readmission of patients with moderate or severe OHSS.

  7. Application of radioactive substances in research in nuclear medicine: current trends and radiation exposure to the study subjects

    International Nuclear Information System (INIS)

    Minkov, V.; Schwarz, E.R.; Bauer, B.; Nosske, D.; Erzberger, A.; Brix, G.

    2001-01-01

    Aim: Analysis of the application of radioactive substances in research in the field of nuclear medicine in human beings and of the resulting radiation exposure to study subjects. Methods: Assessment of applications for approval submitted in accordance with Paragraph 41 of the Radiation Protection Ordinance, evaluated by the Federal office for Radiation Protection together with the Federal Institute for Pharmaceuticals and Medical Products, within the period from 1997 to 1999. Results: The focus of the studies on the diagnostic application of radioactive substances in medicine evaluated has, since 1998, shifted from oncological to neurological and psychological aspects, while, at the same time, the number of PET studies increased constantly The proportion of healthy study subjects included in the diagnostic studies increased from 7 to 22%. The number of therapeutic applications of radioactive substances has, since 1997, undergone a three-fold increase, and in the process of this, the focus of attention lay within the area of radioimmuno-therapy and endovascular brachytherapy. The effective dose was, among up to 49% of the investigated healthy study subjects higher than 5 mSv, and among up to 6% of these subjects was at levels of over 20 mSv. Up to 22% of the patients received, within the scope of diagnostic studies, an effective dose of between 20 and 50 mSv. An exceeding of the 50 mSv limit occurred among up to 3% of the patients. Conclusions: In spite of the increasing numbers of PET applications, conventional nuclear medicine has maintained its importance in the field of medical research. Further developments in the areas of radiochemistry and molecular biology led to an increase in the importance of radio-immuno therapy. The evaluation of new radiopharmaceuticals and the extension of basic biomedical research, resulted in an increase in the proportion of healthy study subjects included in the studies. The radiation exposure among subjects resulting directly from

  8. The patient-specific functional scale: psychometrics, clinimetrics, and application as a clinical outcome measure.

    Science.gov (United States)

    Horn, Katyana Kowalchuk; Jennings, Sophie; Richardson, Gillian; Vliet, Ditte Van; Hefford, Cheryl; Abbott, J Haxby

    2012-01-01

    Systematic review of the literature. To summarize peer-reviewed literature on the reliability, validity, and responsiveness of the Patient-Specific Functional Scale (PSFS), and to identify its use as an outcome measure. Searches were performed of several electronic databases from 1995 to May 2010. Studies included were published articles containing (1) primary research investigating the psychometric and clinimetrics of the PSFS or (2) the implementation of the PSFS as an outcome measure. We assessed the methodological quality of studies included in the first category. Two hundred forty-two articles published from 1994 to May 2010 were identified. Of these, 66 met the inclusion criteria for this review, with 13 reporting the measurement properties of the PSFS, 55 implementing the PSFS as an outcome measure, and 2 doing both of the above. The PSFS was reported to be valid, reliable, and responsive in populations with knee dysfunction, cervical radiculopathy, acute low back pain, mechanical low back pain, and neck dysfunction. The PSFS was found to be reliable and responsive in populations with chronic low back pain. The PSFS was also reported to be valid, reliable, or responsive in individuals with a limited number of acute, subacute, and chronic conditions. This review found that the PSFS is also being used as an outcome measure in many other conditions, despite a lack of published evidence supporting its validity in these conditions. Although the use of the PSFS as an outcome measure is increasing in physiotherapy practice, there are gaps in the research literature regarding its validity, reliability, and responsiveness in many health conditions.

  9. Mapping clinical outcomes expectations to treatment decisions: an application to vestibular schwannoma management.

    Science.gov (United States)

    Cheung, Steven W; Aranda, Derick; Driscoll, Colin L W; Parsa, Andrew T

    2010-02-01

    Complex medical decision making obligates tradeoff assessments among treatment outcomes expectations, but an accessible tool to perform the necessary analysis is conspicuously absent. We aimed to demonstrate methodology and feasibility of adapting conjoint analysis for mapping clinical outcomes expectations to treatment decisions in vestibular schwannoma (VS) management. Prospective. Tertiary medical center and US-based otologists/neurotologists. Treatment preference profiles among VS stakeholders-61 younger and 74 older prospective patients, 61 observation patients, and 60 surgeons-were assessed for the synthetic VS case scenario of a 10-mm tumor in association with useful hearing and normal facial function. Treatment attribute utility. Conjoint analysis attribute levels were set in accordance to the results of a meta-analysis. Forty-five case series were disaggregated to formulate microsurgery facial nerve and hearing preservation outcomes expectations models. Attribute utilities were computed and mapped to the realistic treatment choices of translabyrinthine craniotomy, middle fossa craniotomy, and gamma knife radiosurgery. Among the treatment attributes of likelihoods of causing deafness, temporary facial weakness for 2 months, and incurable cancer within 20 years, and recovery time, permanent deafness was less important to tumor surgeons, and temporary facial weakness was more important to tumor surgeons and observation patients (Wilcoxon rank-sum, p knife radiosurgery. Mapping clinical outcomes expectations to treatment decisions for a synthetic clinical scenario revealed inhomogeneous drivers of choice selection among study cohorts. Medical decision engines that analyze personal preferences of outcomes expectations for VS and many other diseases may be developed to promote shared decision making among health care stakeholders and transparency in the informed consent process.

  10. Use of standardized outcome measures in physical therapist practice: perceptions and applications.

    Science.gov (United States)

    Jette, Diane U; Halbert, James; Iverson, Courtney; Miceli, Erin; Shah, Palak

    2009-02-01

    Standardized instruments for measuring patients' activity limitations and participation restrictions have been advocated for use by rehabilitation professionals for many years. The available literature provides few recent reports of the use of these measures by physical therapists in the United States. The primary purpose of this study was to determine: (1) the extent of the use of standardized outcome measures and (2) perceptions regarding their benefits and barriers to their use. A secondary purpose was to examine factors associated with their use among physical therapists in clinical practice. The study used an observational design. A survey questionnaire comprising items regarding the use and perceived benefits and barriers of standardized outcome measures was sent to 1,000 randomly selected members of the American Physical Therapy Association (APTA). Forty-eight percent of participants used standardized outcome measures. The majority of participants (>90%) who used such measures believed that they enhanced communication with patients and helped direct the plan of care. The most frequently reported reasons for not using such measures included length of time for patients to complete them, length of time for clinicians to analyze the data, and difficulty for patients in completing them independently. Use of standardized outcome measures was related to specialty certification status, practice setting, and the age of the majority of patients treated. The limitations included an unvalidated survey for data collection and a sample limited to APTA members. Despite more than a decade of development and testing of standardized outcome measures appropriate for various conditions and practice settings, physical therapists have some distance to go in implementing their use routinely in most clinical settings. Based on the perceived barriers, alterations in practice management strategies and the instruments themselves may be necessary to increase their use.

  11. Application of hair as an indicator for trace element exposure in man. A review

    International Nuclear Information System (INIS)

    1994-01-01

    The report presents a comprehensive summary of what is known from the literature on the use of hair as a bioindicator for trace elements. It is split into two parts: The use of hair as a biopsy tissue for trace elements in the human body and the contribution of studies in animals to the application of hair as an indicator for metals and trace elements in man. A separate abstract is prepared for each part. Refs, figs and tabs

  12. Radiation exposure and image quality in X-ray diagnostic radiology. Physical principles and clinical applications. 2. ed.

    International Nuclear Information System (INIS)

    Saebel, Manfred; Aichinger, Horst; Dierker, Joachim; Joite-Barfuss, Sigrid

    2012-01-01

    Diagnostic X-rays are the largest contributor to radiation exposure to the general population, and protecting the patient from radiation damage is a major aim of modern health policy. Once the decision has been taken to use ionising radiation for imaging in a particular patient, it is necessary to optimize the image acquisition process taking into account the diagnostic quality of the images and the radiation dose to the patient. Both image quality and radiation dose are affected by a number of parameters, knowledge of which permits scientifically based decision making. The authors of this second edition of Radiation Exposure and Image Quality in X-ray Diagnostic Radiology have spent many years studying the optimization of radiological imaging. In this book they present in detail the basic physical principles of diagnostic radiology and their application to clinical problems. Particular attention is devoted to evaluation of the dose to the patient, the influence of scattered radiation on image quality, the use of antiscatter grids, and optimization of image quality and dose. The final section is a supplement containing tables of data and graphical depictions of X-ray spectra, interaction coefficients, characteristics of X-ray beams, and other aspects relevant to patient dose calculations. In addition, a complementary CD-ROM contains a user-friendly Excel file database covering these aspects that can be used in the reader's own programs. Since the first edition, the text, figures, tables, and references have all been thoroughly updated, and more detailed attention is now paid to image quality and radiation exposure when using digital imaging and computed tomography. This book will be an invaluable aid to medical physicists when performing calculations relating to patient dose and image quality, and will also prove useful for diagnostic radiologists and engineers. (orig.)

  13. The effect of mobile application interventions on influencing healthy maternal behaviour and improving perinatal health outcomes: a systematic review protocol.

    Science.gov (United States)

    Daly, Lisa M; Horey, Dell; Middleton, Philippa F; Boyle, Frances M; Flenady, Vicki

    2017-02-08

    Perinatal morbidity and mortality remain significant public health issues globally, with enduring impact on the health and well-being of women and their families. Pregnant women who adopt, practice and maintain healthy behaviours can potentially improve the health of themselves and their babies. Mobile applications are an increasingly popular mode of accessing, storing and sharing health information among pregnant women. The main objective of this review is to evaluate the effects of mobile application interventions during pregnancy on maternal behaviour and associated maternal and infant outcomes. This review will include randomised and non-randomised studies which tested use of mobile applications designed to improve either maternal knowledge or behaviours to address known risk factors associated with adverse perinatal health outcomes. This review will include studies which included pregnant women and/or women during birth. The search strategy will utilise a combination of keywords and MeSH terms. Literature databases such as PubMed, Embase, The Cochrane Library, CINAHL and WHO Global Health Library will be searched. Two reviewers will independently screen retrieved citations to determine if they meet inclusion criteria. Studies will be selected that provide information about interventions commenced in early pregnancy, late pregnancy or labour. Comparisons to be made include mobile applications versus interventions relying on paper-based or text-messaging-based communication; interpersonal communication such as face-to-face or telephone conversation; and no intervention or standard care. Quality assessment of included randomised studies will utilise established guidelines provided in the Cochrane Handbook for Systematic Reviews of Interventions. Quality assessment of non-randomised studies will be based on the Risk of Bias in Non-randomised Studies-of Interventions (ROBINS-I) assessment tool. Quality of the evidence will be evaluated using the Grades of

  14. Numerical Exposure Assessment Method for Low Frequency Range and Application to Wireless Power Transfer.

    Directory of Open Access Journals (Sweden)

    SangWook Park

    Full Text Available In this paper, a numerical exposure assessment method is presented for a quasi-static analysis by the use of finite-difference time-domain (FDTD algorithm. The proposed method is composed of scattered field FDTD method and quasi-static approximation for analyzing of the low frequency band electromagnetic problems. The proposed method provides an effective tool to compute induced electric fields in an anatomically realistic human voxel model exposed to an arbitrary non-uniform field source in the low frequency ranges. The method is verified, and excellent agreement with theoretical solutions is found for a dielectric sphere model exposed to a magnetic dipole source. The assessment method serves a practical example of the electric fields, current densities, and specific absorption rates induced in a human head and body in close proximity to a 150-kHz wireless power transfer system for cell phone charging. The results are compared to the limits recommended by the International Commission on Non-Ionizing Radiation Protection (ICNIRP and the IEEE standard guidelines.

  15. Numerical Exposure Assessment Method for Low Frequency Range and Application to Wireless Power Transfer

    Science.gov (United States)

    Kim, Minhyuk

    2016-01-01

    In this paper, a numerical exposure assessment method is presented for a quasi-static analysis by the use of finite-difference time-domain (FDTD) algorithm. The proposed method is composed of scattered field FDTD method and quasi-static approximation for analyzing of the low frequency band electromagnetic problems. The proposed method provides an effective tool to compute induced electric fields in an anatomically realistic human voxel model exposed to an arbitrary non-uniform field source in the low frequency ranges. The method is verified, and excellent agreement with theoretical solutions is found for a dielectric sphere model exposed to a magnetic dipole source. The assessment method serves a practical example of the electric fields, current densities, and specific absorption rates induced in a human head and body in close proximity to a 150-kHz wireless power transfer system for cell phone charging. The results are compared to the limits recommended by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) and the IEEE standard guidelines. PMID:27898688

  16. Numerical Exposure Assessment Method for Low Frequency Range and Application to Wireless Power Transfer.

    Science.gov (United States)

    Park, SangWook; Kim, Minhyuk

    2016-01-01

    In this paper, a numerical exposure assessment method is presented for a quasi-static analysis by the use of finite-difference time-domain (FDTD) algorithm. The proposed method is composed of scattered field FDTD method and quasi-static approximation for analyzing of the low frequency band electromagnetic problems. The proposed method provides an effective tool to compute induced electric fields in an anatomically realistic human voxel model exposed to an arbitrary non-uniform field source in the low frequency ranges. The method is verified, and excellent agreement with theoretical solutions is found for a dielectric sphere model exposed to a magnetic dipole source. The assessment method serves a practical example of the electric fields, current densities, and specific absorption rates induced in a human head and body in close proximity to a 150-kHz wireless power transfer system for cell phone charging. The results are compared to the limits recommended by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) and the IEEE standard guidelines.

  17. The design, construction and application of time varying magnetic exposure system

    International Nuclear Information System (INIS)

    El-Din, S.A.A.; Saad, H.M.; Said, H.H.

    2000-01-01

    An exposure system has been designed and constructed to study the probable biological effects of a-50-Hz alternating field on mice. The system is in the form of a cooled water wooden cage that can accommodate 12 mice at a time. The cage is enclosed into an electromagnet consists of three parallel closely connected rectangular coils able to induce a magnetic field of an intensity up to 200 Gauss. The derivation of the equations to define the spatial distribution of the field due to the currents in the coils is presented. A computer program with basic language is suggested to calculate the field strength into the cage. A comparison is made between these computed values and the corresponding measured ones. A representative experiment was carried out where three mice groups were exposed one for 3 h/day the others were repeated for two days and three days respectively. A change was found in hemoglobin spectrum in comparison with the control group has been noticed. This result can be attributed to the change of the spin states of the heme-iron

  18. Experiences in the evaluation of prenatal unjustified exposure during the medical applications

    International Nuclear Information System (INIS)

    Cardenas Herrera, Juan; Lopez Bejerano, Gladys M.; Gonzalez, Alina Martinez

    2008-01-01

    Full text: The exposure to the radiation ionising of pregnant women frequently constitutes motive of preoccupation for the expectant mother and the medical professionals taken the responsibility with its attention. The protection of the embryo-fetus against the radiations ionising is of singular importance due to its special vulnerability, to this agent. On the other hand the diagnosis or treatment with radiations ionising beneficial for the expectant mother, are only indirectly it for the embryo-fetus that is exposed to a hazard without perceiving anything. The present paper exposes the experience obtained in the clinical and dosimetric evaluation from twenty-one patient subjected 'gestantes' to diverse radiodiagnostic procedures or nuclear medicine, during the years 1999 - 2007. The obtained results evidence that 30% of the patients was subjected to procedures of nuclear medicine with purposes diagnoses or therapeutic. While the period of pregnancy of the patients oscillated between 4 and 13 weeks. It could be concluded that in all the cases the doses received by the patients in the whole body didn't overcome the 2 mSv. When conjugating the period of pregnancy of the patients with the doses received don't have any evidences of significant risks for the embryo-fetus. (author)

  19. Estimation of production rates for in-situ cosmogenic isotopes and application to surface exposure dating: certitudes and uncertainties

    International Nuclear Information System (INIS)

    Graham, I.J.

    1996-01-01

    Cosmogenic nuclides, produced in-situ in rocks by the action of cosmic rays on target nuclei, are increasingly being employed by earth scientists in a wide variety of applications. For example, surface exposure dating is used to determine erosion rates, the age of debris flows, alluvial fans, volcanic eruptions, meteoritic impact craters, and glacial deposits, and the timing of recent movement along faults and tectonic uplift. The technique can thus play a vital role in the study of potential hazards from geological processes, by establishing recurrence intervals between them, and establish chronologies and periodicities for major paleoclimatic events. Before surface exposure dating methods using cosmogenic isotopes can be applied even more widely, production rates of the main nuclides of interest must be better known, and their temporal and spatial variabilities determined. This paper summarises the present state of knowledge on production rates of the currently most useful nuclides ( 10 Be, 26 Al, 36 Cl, 14 C, 3 He and 21 Ne), discusses the main areas of concern, and makes suggestions for future improvement. (author). 83 refs., 7 tabs., 11 figs

  20. The Exposure of Mortgage Borrowers to Interest Rate Risk, Income Risk and House Price Risk – Evidence from Swiss Loan Application Data

    OpenAIRE

    Guin, Benjamin; Brown, Martin

    2015-01-01

    We study the exposure of mortgage borrowers in Switzerland to interest rate, income and house price risks and examine how the households’ choice of risky mortgages is related to individual interest rate expectations and risk-aversion. Our analysis is based on a unique data set of household mortgage applications from September 2012 until January 2014. Our assessment of risk exposure among mortgage borrowers in Switzerland is highly sensitive to the underlying assumptions on mortgage costs, hou...

  1. AMS exposure dating : a case study from Himalaya and Tibet and its application potentials in earth science studies in India

    International Nuclear Information System (INIS)

    Sharma, K.K.

    1999-01-01

    The development of accelerator mass spectrometry (AMS) has made possible low level (10 -6 atoms/gm) measurements of 10 Be, 14 C, 26 Al, 36 Cl, 129 I isotopes in geological materials. Early studies investigated 10 Be atoms of cosmogenic nuclides produced mainly in the atmosphere (called garden variety), which subsequently admixed with the geological material from land surfaces get transported into the ocean waters and fixed in the ocean sediments. Subsequently, focus shifted to in-situ produced long-lived isotopes in quartz and their measurement in the terrestrial samples. This opened a new field of exposure dating and its potential applications in earth sciences and their role to study the time controlled processes resulting in diverse geomorphic landforms

  2. Clinical application of tumor volume in advanced nasopharyngeal carcinoma to predict outcome

    International Nuclear Information System (INIS)

    Lee, Ching-Chih; Huang, Tze-Ta; Lee, Moon-Sing; Hsiao, Shih-Hsuan; Lin, Hon-Yi; Su, Yu-Chieh; Hsu, Feng-Chun; Hung, Shih-Kai

    2010-01-01

    Current staging systems have limited ability to adjust optimal therapy in advanced nasopharyngeal carcinoma (NPC). This study aimed to delineate the correlation between tumor volume, treatment outcome and chemotherapy cycles in advanced NPC. A retrospective review of 110 patients with stage III-IV NPC was performed. All patients were treated first with neoadjuvant chemotherapy, then concurrent chemoradiation, and followed by adjuvant chemotherapy as being the definitive therapy. Gross tumor volume of primary tumor plus retropharyngeal nodes (GTVprn) was calculated to be an index of treatment outcome. GTVprn had a close relationship with survival and recurrence in advanced NPC. Large GTVprn (≧13 ml) was associated with a significantly poorer local control, lower distant metastasis-free rate, and poorer survival. In patients with GTVprn ≧ 13 ml, overall survival was better after ≧4 cycles of chemotherapy than after less than 4 cycles. The incorporation of GTVprn can provide more information to adjust treatment strategy

  3. Modelling variable dropout in randomised controlled trials with longitudinal outcomes: application to the MAGNETIC study.

    Science.gov (United States)

    Kolamunnage-Dona, Ruwanthi; Powell, Colin; Williamson, Paula Ruth

    2016-04-28

    Clinical trials with longitudinally measured outcomes are often plagued by missing data due to patients withdrawing or dropping out from the trial before completing the measurement schedule. The reasons for dropout are sometimes clearly known and recorded during the trial, but in many instances these reasons are unknown or unclear. Often such reasons for dropout are non-ignorable. However, the standard methods for analysing longitudinal outcome data assume that missingness is non-informative and ignore the reasons for dropout, which could result in a biased comparison between the treatment groups. In this article, as a post hoc analysis, we explore the impact of informative dropout due to competing reasons on the evaluation of treatment effect in the MAGNETIC trial, the largest randomised placebo-controlled study to date comparing the addition of nebulised magnesium sulphate to standard treatment in acute severe asthma in children. We jointly model longitudinal outcome and informative dropout process to incorporate the information regarding the reasons for dropout by treatment group. The effect of nebulised magnesium sulphate compared with standard treatment is evaluated more accurately using a joint longitudinal-competing risk model by taking account of such complexities. The corresponding estimates indicate that the rate of dropout due to good prognosis is about twice as high in the magnesium group compared with standard treatment. We emphasise the importance of identifying reasons for dropout and undertaking an appropriate statistical analysis accounting for such dropout. The joint modelling approach accounting for competing reasons for dropout is proposed as a general approach for evaluating the sensitivity of conclusions to assumptions regarding missing data in clinical trials with longitudinal outcomes. EudraCT number 2007-006227-12 . Registration date 18 Mar 2008.

  4. The x-ray source application test cassette for radiation exposures at the OMEGA laser

    Energy Technology Data Exchange (ETDEWEB)

    Fournier, K. B.; Rekow, V.; Emig, J. [Lawrence Livermore National Laboratory, Livermore, California 94551 (United States); Fisher, J. H.; Newlander, C. D. [Fifth Gait Technologies, Inc., Huntsville, Alabama 35803 (United States); Horton, R. [Gray Research, Inc., Huntsville, Alabama 35806 (United States); Davis, J. [Defense Threat Reduction Agency, Fort Belvoir, Virginia 22060 (United States)

    2012-10-15

    We have designed a sample cassette that can be used to position up to six samples in the OMEGA laser chamber. The cassette accommodates round samples up to 38.1 mm (1.5{sup Double-Prime }) in diameter and square samples up to 27 mm on a side, any of which can be up to 12.7 mm thick. Smaller specimens are centered with spacers. The test cassette allows each sample to have a unique filter scheme, with multiple filter regions in front of each sample. This paper will present mechanical design considerations and operational aspects of the x-ray source application cassette.

  5. Personal health and consumer informatics. The impact of health oriented social media applications on health outcomes.

    Science.gov (United States)

    Gibbons, M C

    2013-01-01

    The rapid evolution in the world-wide use of Social Media tools suggests the emergence of a global phenomenon that may have implications in the Personal Health and Consumer Health Informatics domains. However the impact of these tools on health outcomes is not known. The goal of this research was to review the randomized controlled trial (RCT) evidence of the impact of health oriented Social Media informatics tools on health outcomes. Evaluations of Social Media consumer health tools were systematically reviewed. Research was limited to studies published in the English language, published in Medline, published in the calendar year 2012 and limited to studies that utilized a RCT methodological design. Two high quality Randomized Controlled Trials among over 600 articles published in Medline were identified. These studies indicate that Social Media interventions may be able to significantly improve pain control among patients with chronic pain and enhance weight loss maintenance among individuals attempting to lose weight. Significantly more research needs to be done to confirm these early findings, evaluate additional health outcomes and further evaluate emerging health oriented Social Media interventions. Chronic pain and weight control have both socially oriented determinants. These studies suggest that understanding the social component of a disease may ultimately provide novel therapeutic targets and socio-clinical interventional strategies.

  6. Application of benchmark dose modeling to protein expression data in the development and analysis of mode of action/adverse outcome pathways for testicular toxicity.

    Science.gov (United States)

    Chepelev, Nikolai L; Meek, M E Bette; Yauk, Carole Lyn

    2014-11-01

    Reliable quantification of gene and protein expression has potential to contribute significantly to the characterization of hypothesized modes of action (MOA) or adverse outcome pathways for critical effects of toxicants. Quantitative analysis of gene expression by benchmark dose (BMD) modeling has been facilitated by the development of effective software tools. In contrast, protein expression is still generally quantified by a less robust effect level (no or lowest [adverse] effect levels) approach, which minimizes its potential utility in the consideration of dose-response and temporal concordance for key events in hypothesized MOAs. BMD modeling is applied here to toxicological data on testicular toxicity to investigate its potential utility in analyzing protein expression relevant to the proposed MOA to inform human health risk assessment. The results illustrate how the BMD analysis of protein expression in animal tissues in response to toxicant exposure: (1) complements other toxicity data, and (2) contributes to consideration of the empirical concordance of dose-response relationships, as part of the weight of evidence for hypothesized MOAs to facilitate consideration and application in regulatory risk assessment. Lack of BMD analysis in proteomics has likely limited its use for these purposes. This paper illustrates the added value of BMD modeling to support and strengthen hypothetical MOAs as a basis to facilitate the translation and uptake of the results of proteomic research into risk assessment. Copyright © 2014 Her Majesty the Queen in Right of Canada. Journal of Applied Toxicology © 2014 John Wiley & Sons, Ltd.

  7. Application of wildfire simulation methods to assess wildfire exposure in a Mediterranean fire-prone area (Sardinia, Italy)

    Science.gov (United States)

    Salis, M.; Ager, A.; Arca, B.; Finney, M.; Bacciu, V. M.; Spano, D.; Duce, P.

    2012-12-01

    ; Finney et al. 2009; Salis et al. 2012 accepted). In this work, we employed wildfire simulation methods to quantify wildfire exposure to human and ecological values for the island of Sardinia, Italy. The work was focused on the risk and exposure posed by large fires (e.g. 100 - 10,000 ha), and considers historical weather, ignition patterns and fuels. We simulated 100,000 fires using burn periods that replicated the historical size distribution on the Island, and an ignition probability grid derived from historic ignition data. We then examine spatial variation in three exposure components (burn probability, flame length, fire size) among important human and ecological values. The results allowed us to contract exposure among and within the various features examined, and highlighted the importance of human factors in shaping wildfire exposure in Sardinia. The work represents the first application of burn probability modeling in the Mediterranean region, and sets the stage for expanded work in the region to quantify risk from large fires

  8. Improving outcomes following penetrating colon wounds: application of a clinical pathway.

    Science.gov (United States)

    Miller, Preston R; Fabian, Timothy C; Croce, Martin A; Magnotti, Louis J; Elizabeth Pritchard, F; Minard, Gayle; Stewart, Ronald M

    2002-06-01

    During World War II, failure to treat penetrating colon injuries with diversion could result in court martial. Based on this wartime experience, colostomy for civilian colon wounds became the standard of care for the next 4 decades. Previous work from our institution demonstrated that primary repair was the optimal management for nondestructive colon wounds. Optimal management of destructive wounds requiring resection remains controversial. To address this issue, we performed a study that demonstrated risk factors (pre or intraoperative transfusion requirement of more than 6 units of packed red blood cells, significant comorbid diseases) that were associated with a suture line failure rate of 14%, and of whom 33% died. Based on these outcomes, a clinical pathway for management of destructive colon wounds was developed. The results of the implementation of this pathway are the focus of this report. Patients with penetrating colon injury were identified from the registry of a level I trauma center over a 5-year period. Records were reviewed for demographics, injury characteristics, and outcome. Patients with nondestructive injuries underwent primary repair. Patients with destructive wounds but no comorbidities or large transfusion requirement underwent resection and anastomosis, while patients with destructive wounds and significant medical illness or transfusion requirements of more than 6 units/blood received end colostomy. The current patients (CP) were compared to the previous study (PS) to determine the impact of the clinical pathway. Outcomes examined included colon related mortality and morbidity (suture line leak and abscess). Over a 5.5-year period, 231 patients had penetrating colon wounds. 209 survived more 24 hours and comprise the study population. Primary repair was performed on 153 (73%) patients, and 56 patients had destructive injuries (27%). Of these, 40 (71%) had resection and anastomosis and 16 (29%) had diversion. More destructive injuries were

  9. Definition of the applicability domain of the Short Time Exposure (STE) test for predicting the eye irritation of chemicals.

    Science.gov (United States)

    Hayashi, Kazuhiko; Abo, Takayuki; Nukada, Yuko; Sakaguchi, Hitoshi

    2013-05-01

    The Short Time Exposure (STE) test is a simple and easy-to-perform in vitro eye irritation test, that uses the viability of SIRC cells (a rabbit corneal cell line) treated for five minutes as the endpoint. In this study, our goal was to define the applicability domain of the STE test, based on the results obtained with a set of 113 substances. To achieve this goal, chemicals were selected to represent both different chemical classes and different chemical properties, as well as to cover, in a balanced manner, the categories of eye irritation potential according to the Globally Harmonised System (GHS). Accuracy analysis indicated that the rates of false negatives for organic/inorganic salts (75.0%), hydrocarbons (33.3%) and alcohols (23.5%) were high. Many of the false negative results were for solid substances. It is noteworthy that no surfactant resulted in a false negative result in the STE test. Further examination of the physical property data and performance showed a significant improvement in the predictive accuracy, when substances with vapour pressures over 6kPa were excluded from the analyses. Our results indicate that several substances - i.e. certain solids such as salts, alcohols, hydrocarbons, and volatile substances with a vapour pressure over 6kPa - do not fall within the applicability domain of the STE test. Overall, we are encouraged by the performance and improved accuracy of the STE test. 2013 FRAME.

  10. Children's residential exposure to chlorpyrifos: Application of CPPAES field measurements of chlorpyrifos and TCPy within MENTOR/SHEDS-Pesticides model

    Energy Technology Data Exchange (ETDEWEB)

    Hore, Paromita [Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University and the University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School, 170 Frelinghuysen Road, Piscataway, NJ 08855 (United States)]|[New York City Department of Health, 253 Broadway New York, New York 10007 (United States); Zartarian, Valerie; Xue Jianping; Ozkaynak, Haluk [National Exposure Research Laboratory, U.S. EPA, 109 TW Alexander Drive, Research Triangle Park, NC 27709 (United States); Wang, S.-W.; Yang, Y.-C.; Chu, P.-Ling; Robson, Mark; Georgopoulos, Panos [Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University and the University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School, 170 Frelinghuysen Road, Piscataway, NJ 08855 (United States); Sheldon, Linda [National Exposure Research Laboratory, U.S. EPA, 109 TW Alexander Drive, Research Triangle Park, NC 27709 (United States); Needham, Larry Barr, Dana [Contemporary Pesticide Laboratory, Centers for Disease Control, 4770 Buford Highway, Atlanta, GA 30341 (United States); Freeman, Natalie [Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University and the University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School, 170 Frelinghuysen Road, Piscataway, NJ 08855 (United States)]|[University of Florida, Gainesville, FL 32611 (United States); Lioy, Paul J. [Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University and the University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School, 170 Frelinghuysen Road, Piscataway, NJ 08855 (United States)]. E-mail: plioy@eohsi.rutgers.edu

    2006-08-01

    The comprehensive individual field-measurements on non-dietary exposure collected in the Children's-Post-Pesticide-Application-Exposure-Study (CPPAES) were used within MENTOR/SHEDS-Pesticides, a physically based stochastic human exposure and dose model. In this application, however, the model was run deterministically. The MENTOR/SHEDS-Pesticides employed the CPPAES as input variables to simulate the exposure and the dose profiles for seven children over a 2-week post-application period following a routine residential and professional indoor crack-and-crevice chlorpyrifos application. The input variables were obtained from a personal activity diary, microenvironmental measurements and personal biomonitoring data obtained from CPPAES samples collected from the individual children and in their homes. Simulation results were compared with CPPAES field measured values obtained from the children's homes to assess the utility of the different microenvironmental data collected in CPPAES, i.e. indicator toys and wipe samplers to estimate aggregate exposures that can be result from one or more exposure pathways and routes. The final analyses of the database involved comparisons of the actual data obtained from the individual biomarker samples of a urinary metabolite of chlorpyrifos (TCPy) and the values predicted by MENTOR/SHEDS-Pesticides using the CPPAES-derived variables. Because duplicate diet samples were not part of the CPPAES study design, SHEDs-Pesticides simulated dose profiles did not account for the dietary route. The research provided more confidence in the types of data that can be used in the inhalation and dermal contact modules of MENTOR/SHEDS-Pesticides to predict the pesticide dose received by a child. It was determined that we still need additional understanding about: (1) the types of activities and durations of activities that result in non-dietary ingestion of pesticides and (2) the influence of dietary exposures on the levels of TCPy found

  11. Predicting physical activity and outcome expectations in cancer survivors: an application of Self-Determination Theory.

    Science.gov (United States)

    Wilson, Philip M; Blanchard, Chris M; Nehl, Eric; Baker, Frank

    2006-07-01

    The purpose of this study was to examine the contributions of autonomous and controlled motives drawn from Self-Determination Theory (SDT; Intrinsic Motivation and Self-determination in Human Behavior. Plenum Press: New York, 1985; Handbook of Self-determination Research. University of Rochester Press: New York, 2002) towards predicting physical activity behaviours and outcome expectations in adult cancer survivors. Participants were cancer-survivors (N=220) and a non-cancer comparison cohort (N=220) who completed an adapted version of the Treatment Self-Regulation Questionnaire modified for physical activity behaviour (TSRQ-PA), an assessment of the number of minutes engaged in moderate-to-vigorous physical activity (MVPA) weekly, and the anticipated outcomes expected from regular physical activity (OE). Simultaneous multiple regression analyses indicated that autonomous motives was the dominant predictor of OEs across both cancer and non-cancer cohorts (R(2adj)=0.29-0.43), while MVPA was predicted by autonomous (beta's ranged from 0.21 to 0.34) and controlled (beta's ranged from -0.04 to -0.23) motives after controlling for demographic considerations. Cancer status (cancer versus no cancer) did not moderate the motivation-physical activity relationship. Collectively, these findings suggest that the distinction between autonomous and controlled motives is useful and compliments a growing body of evidence supporting SDT as a framework for understanding motivational processes in physical activity contexts with cancer survivors.

  12. Evidence, Goals, and Outcomes in Stuttering Treatment: Applications With an Adolescent Who Stutters.

    Science.gov (United States)

    Marcotte, Anne K

    2018-01-09

    The purpose of this clinical focus article is to summarize 1 possible process that a clinician might follow in designing and conducting a treatment program with John, a 14-year-old male individual who stutters. The available research evidence, practitioner experience, and consideration of individual preferences are combined to address goals, treatment procedures, and outcomes for John. The stuttering treatment research literature includes multiple well-designed reviews and individual studies that have shown the effectiveness of prolonged speech (and smooth speech and related variations) for improving stuttered speech and for improving social, emotional, cognitive, and related variables in adolescents who stutter. Based on that evidence, and incorporating the additional elements of practitioner experience and client preferences, this clinical focus article suggests that John would be likely to benefit from a treatment program based on prolonged speech. The basic structure of 1 possible such program is also described, with an emphasis on the goals and outcomes that John could be expected to achieve.

  13. Application of the principles of justification and optimisation to products causing public exposure

    International Nuclear Information System (INIS)

    Fleishman, A.B.; Wrixon, A.D.

    1980-01-01

    The purpose of this paper is to explore the practical incorporation of the ICRP principles of justification and optimisation into a policy designed to control radioactive consumer products. ICRP recommends the use of cost benefit analysis and differential cost benefit analysis for justification and optimisation respectively, and expresses these procedures in simple mathematical forms. This might suggest that their application should involve quantification and therefore be objective. The problems which arise in such quantification are discussed. These include the derivation of a market demand curve for a given product and its adjustment to remove any distortion of perceived value or risk produced by advertising; the costing of detriment to those who receive no benefit (e.g., as a consequence of uncontrolled disposal); and the costs of the analyses themselves. Furthermore, both cost benefit and differential cost benefit analyses are dependent on availability of market and performance data. This is incompatible with prior approval schemes in which a decision must be made before the product is distributed. Ultimately criteria for product justification must therefore be based on judgements on the acceptability of risk that are political rather than scientific in nature. Optimisation must initially be carried out on an intuitive basis. However as experience is gained with similar products the opportunity for more formal optimisation and the setting of radiological protection standards arise. This requires further value judgements which are illustrated with reference to examples. (author)

  14. Residential Outcomes for Nursing Facility Applicants Who Have Been Diverted: Where Are They 5 Years Later?

    Science.gov (United States)

    Chapin, Rosemary; Baca, Beth; Macmillan, Kelley; Rachlin, Roxanne; Zimmerman, Mary

    2009-01-01

    Purpose: The purpose of this longitudinal study was to determine the length of community tenure for adults aged 60 and older after application for nursing facility (NF) admission and to examine the proportion of older adults who lost community tenure due to either (a) death while a community resident or (b) permanent NF admission. Design and…

  15. Response Scales in Voting Advice Applications : Do Different Designs Produce Different Outcomes?

    NARCIS (Netherlands)

    Rosema, M.; Louwerse, T.

    2016-01-01

    Voting Advice Applications (VAAs) represent popular election campaign tools in many countries, enabling voters to discover which party or candidate provides the best match with their political preferences. This article examines the effects of design choices on these tools by focusing on the response

  16. Response Scales in Voting Advice Applications: Do Different Designs Produce Different Outcomes?

    NARCIS (Netherlands)

    Rosema, Martin; Louwerse, Tom

    2016-01-01

    Voting Advice Applications (VAAs) represent popular election campaign tools in many countries, enabling voters to discover which party or candidate provides the best match with their political preferences. This article examines the effects of design choices on these tools by focusing on the response

  17. Assessing the risk to green sturgeon from application of imidacloprid to control burrowing shrimp in Willapa Bay, Washington--Part II: controlled exposure studies.

    Science.gov (United States)

    Frew, John A; Grue, Christian E

    2015-11-01

    The activities of 2 species of burrowing shrimp have a negative impact on the growth and survival of oysters reared on intertidal mudflats in Willapa Bay and Grays Harbor, Washington (USA). To maintain viable harvests, oyster growers proposed the application of the neonicotinoid insecticide imidacloprid onto harvested beds for the control of burrowing shrimp. In test applications, water column concentrations of imidacloprid were relatively low and dissipated rapidly. The foraging activities of the green sturgeon (listed in the US Endangered Species Act) could result in exposure to higher, more sustained imidacloprid concentrations within sediment porewater and from the consumption of contaminated shrimp. Controlled experiments were conducted using surrogate white sturgeon to determine acute and chronic effect concentrations, to examine overt effects at more environmentally realistic concentrations and durations of exposure, and to assess chemical depuration. The 96-h median lethal concentration was 124 mg L(-1) , and the predicted 35-d no-observed-adverse-effect concentration was 0.7 mg L(-1) . No overt effects were observed following environmentally relevant exposures. Imidacloprid half-life in plasma was greater than 32 h. Measured concentrations of imidacloprid in porewater were significantly lower than the derived acute and chronic effect concentrations for white sturgeon. Exposure risk quotients were calculated using the effect concentrations and estimated environmental exposure. The resulting values were considerably below the level of concern for direct effects from either acute or chronic exposure to an endangered species. © 2015 SETAC.

  18. Regulatory aspects of the medical and occupational exposures in the application of the radiosynoviortesis technique

    International Nuclear Information System (INIS)

    Dumenigo G, C.; Fuente P, A. de la; Quevedo G, J.R.; Lopez F, Y.

    2006-01-01

    The Radiosynoviortesis is a to therapeutic proceed that consists in the injection of a radiopharmaceutical beta transmitter in the synovial cavity of the articulations affected by arthropaties. With it is achieved to cause the fibrosis and remodeling of the synovial membrane obtaining a remarkable improvement in the patients that it includes the disappearance of the pain and the increase of the flexibility of the treated articulation. The technique began to be carried out from 1952 in Europe when it was injected Au 196 in patients affected by rheumatoid arthropaties and starting from then it has gone winning followers in Canada, United States, Australia and some countries of Latin America. Their results are satisfactory and they have been endorsed by the practice. In Cuba it was carried out at November 16, 2002 a clinical essay with the use of this technique, the same one was Graduate by the National Center of Nuclear Safety, in their condition of Regulatory Authority, for it the National Institute of Hematology and Immunology presented the technical documentation that bases its safety. However for the generalization of this technique and their inclusion in the Nuclear Medicine services already existent, the Regulatory Authority has indicated a group of requirements that should be kept in mind in a such way that the application of the Radiosynoviortesis fulfills the Regulation of those 'Basic Norms of Radiological Safety' effective in our country. The present work exposes the particularities and challenges that the Radiosynoviortesis outlines from the point of view of the Radiological Protection, as well as the technical aspects that should be kept in mind for its Licensing, in such way that the is guaranteed safety of the same one in the relative thing to the radiological protection of the patients, those workers and the one publishes. The work reaffirms the feasibility of this to therapeutic proceed from the point of view of the radiological protection, proposing

  19. Application of biotests for the determination of soil ecotoxicity after exposure to biodegradable plastics

    Directory of Open Access Journals (Sweden)

    Susanna Sforzini

    2016-10-01

    Full Text Available Biodegradable plastics are mostly applied in packaging materials (e.g. shopping bags, waste collection bags, catering products, and agricultural applications. In this last case, degradation takes place directly in soil where biodegradable plastic products are intentionally left after use (e.g. mulch films for weeds control. Due to the growing volumes of biodegradable polymers and plastics, interest in their environmental safety is increasing and more research is carried out. Some attempt has been made to apply biotests, used in other sectors of environmental sciences, in the assessment of biodegradable plastics safety. In this work, the quality of soils after biodegradation of the bioplastics Mater-Bi has been assessed with a large array of biotests based on model organisms representative of the different trophic levels in the food chains of the edaphic and aquatic ecosystems. Mater-Bi was degraded under controlled conditions for 6 months at a 1% concentration. The selected organisms included bacteria and protozoa (V. fischeri and D. discoideum, respectively, the green alga P. subcapitata, plants (the monocotyledon S. saccharatum and the dicotyledon L. sativum, and invertebrates animals (D. magna, a freshwater crustacean, and the Oligochaeta earthworm E. andrei, using both acute and chronic endpoints. The results of the applied ecotoxicological tests showed that the Mater-Bi materials tested at very high doses did not affect the soil quality. Soil exposed to Mater-Bi has no noxious effects on edaphic organisms; in particular, mono and dicotyledon plants results, indicate that Mater-Bi plastic products are innocuous for agricultural uses. The use of more sensitive chronic endpoints allows to exclude possible effects at population level. This is the first time that such a comprehensive approach is applied to the assessment of possible ecotoxicity effects induced by biodegradable plastics in soil and represents a possible starting point for

  20. Context-sensitive ecological momentary assessments; integrating real-time exposure measurements, data-analytics and health assessment using a smartphone application.

    Science.gov (United States)

    van Wel, Luuk; Huss, Anke; Bachmann, Philipp; Zahner, Marco; Kromhout, Hans; Fröhlich, Jürg; Vermeulen, Roel

    2017-06-01

    Modern sensor technology makes it possible to collect vast amounts of environmental, behavioural and health data. These data are often linked to contextual information on for example exposure sources which is separately collected with considerable lag time, leading to complications in assessing transient and/or highly spatially variable environmental exposures. Context-Sensitive Ecological Momentary Assessments 1 (CS-EMAs) could be used to address this. We present a case study using radiofrequency-electromagnetic fields (RF-EMF) exposure as an example for implementing CS-EMA in environmental research. Participants were asked to install a custom application on their own smartphone and to wear an RF-EMF exposimeter for 48h. Questionnaires were triggered by the application based on a continuous data stream from the exposimeter. Triggers were divided into four categories: relative and absolute exposure levels, phone calls, and control condition. After the two days of use participants filled in an evaluation questionnaire. 74% of all CS-EMAs were completed, with an average time of 31s to complete a questionnaire once it was opened. Participants reported minimal influence on daily activities. There were no significant differences found between well-being and type of RF-EMF exposure. We show that a CS-EMA based method could be used in environmental research. Using several examples involving environmental stressors, we discuss both current and future applications of this methodology in studying potential health effects of environmental factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Randomness in preference orderings, outcomes and attribute tastes: An application to journey time risk

    DEFF Research Database (Denmark)

    Batley, Richard; Ibáñez Rivas, Juan Nicolás

    2012-01-01

    estimate a mean ‘reliability ratio’ (ratio of the value of standard deviation of journey time to the value of scheduled journey time) of 2.07, against a median of 0.85. The properties of the distribution of the reliability ratio suggest a predominant behaviour of aversion to journey time risk.......Within the broad area of probabilistic modelling of individual discrete choice, we develop three strands of discussion. First, we outline a theoretical framework for the modelling of individual discrete choice under risk, distinguishing between three specific sources of randomness; in preference...... orderings, in outcomes, and in attribute tastes. Second, we apply this theoretical modelling framework to the domain of journey time risk (or ‘reliability’), a subject which has acquired prominence in the transportation policies of many countries. Third, we apply the modelling framework empirically, based...

  2. Application of active learning modalities to achieve medical genetics competencies and their learning outcome assessments

    Directory of Open Access Journals (Sweden)

    Hagiwara N

    2017-12-01

    Full Text Available Nobuko Hagiwara Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, University of California, Davis, CA, USA Abstract: The steadily falling costs of genome sequencing, coupled with the growing number of genetic tests with proven clinical validity, have made the use of genetic testing more common in clinical practice. This development has necessitated nongeneticist physicians, especially primary care physicians, to become more responsible for assessing genetic risks for their patients. Providing undergraduate medical students a solid foundation in genomic medicine, therefore, has become all the more important to ensure the readiness of future physicians in applying genomic medicine to their patient care. In order to further enhance the effectiveness of instructing practical skills in medical genetics, the emphasis of active learning modules in genetics curriculum at medical schools has increased in recent years. This is because of the general acceptance of a better efficacy of active learner-centered pedagogy over passive lecturer-centered pedagogy. However, an objective standard to evaluate students’ skill levels in genomic medicine achieved by active learning is currently missing. Recently, entrustable professional activities (EPAs in genomic medicine have been proposed as a framework for developing physician competencies in genomic medicine. EPAs in genomic medicine provide a convenient guideline for not only developing genomic medicine curriculum but also assessing students’ competency levels in practicing genomic medicine. In this review, the efficacy of different types of active learning modules reported for medical genetics curricula is discussed using EPAs in genomic medicine as a common evaluation standard for modules’ learning outcomes. The utility of the EPAs in genomic medicine for designing active learning modules in undergraduate medical genetics curricula is also discussed. Keywords

  3. Therapeutic outcomes monitoring: application of pharmaceutical care guidelines to community pharmacy.

    Science.gov (United States)

    Grainger-Rousseau, T J; Miralles, M A; Hepler, C D; Segal, R; Doty, R E; Ben-Joseph, R

    1997-01-01

    To design a pharmaceutical care model, and develop and field test a set of community pharmacy guidelines and practice support materials--Therapeutic Outcomes Monitoring (TOM) modules. Concept interviews with pharmacists, physicians, and patients; development and field testing of practice guidelines. Community pharmacies. Five independent, five chain, and two clinic site pharmacies. A prototype TOM module for asthma was developed through a seven-step process. Concept interviews were held with pharmacists, physicians, and patients to determine the desirability and feasibility of the TOM concept, prototype, and materials. Two field tests were completed and modifications made. Results were gathered through further concept interviews at the completion of the second field tests. Participants' opinions and experiences. Pharmacists, physicians, and patients expressed favorable attitudes about community pharmacists' participation in this pharmaceutical care model. Of the 12 participating pharmacists, 7 successfully implemented TOM in their practice sites and participated in the project throughout the testing; 49 patients were recruited into the study; and 22 patients remained in the program at the end of the second field test. In providing TOM services to these patients, the two most problematic areas for the pharmacists were in documenting care and reporting to physicians. A final phase of the TOM project has not been conducted in the United States because of insufficient numbers of patients for evaluating patient outcomes. The TOM project was successful from a technical but not a marketing perspective. Useful practice guidelines can be written and taught to pharmacists. Enrollment of patients was difficult, and the concept is not likely to spread spontaneously within the existing market for pharmaceutical services.

  4. Development of Mobile Educational Services Application to Improve Educational Outcomes using Android Technology

    Directory of Open Access Journals (Sweden)

    Hosam Farouk El-Sofany

    2014-04-01

    Full Text Available Mobile devices have become instruments that allow new ways of interacting with institutional services. This paper describes the development of the Mobile Educational Services Application (MES app for the Android platform. This app allows access to mediated and self-access services, as well as databases, announcements, registration, events, book consultations, schedules, etc. The project provides Mobile and Web-based application tools (apps that allow online access for different users - students, instructors, and administrators. The app provides students with a user friendly, generic, web-based GUI to request educational services, to send text message inquiries, to add, drop, or defer courses, etc.. The app allows instructors to send or receive text messages to and from students using the mobile or web-based interface of the app. In addition to system monitoring, the app provides administrators an online tool to manage, add, update, and delete system information. This tool seeks to be one of the more useful economic apps that use Android technology for applications, using Tablets and mobile devices, for the use of students, instructors and administrators in accessing services in an educational institution.

  5. ACCOUNTING FOR THE ENDOGENEITY OF HEALTH AND ENVIRONMENTAL TOBACCO SMOKE EXPOSURE IN CHILDREN: AN APPLICATION TO CONTINUOUS LUNG FUNCTION

    Science.gov (United States)

    The goal of this study is to estimate an unbiased exposure effect of environmental tobacco smoke (ETS) exposure on children's continuous lung function. A majority of the evidence from health studies suggests that ETS exposure in early life contributes significantly to childhood ...

  6. Berkson error adjustment and other exposure surrogates in occupational case-control studies, with application to the Canadian INTEROCC study.

    Science.gov (United States)

    Oraby, Tamer; Sivaganesan, Siva; Bowman, Joseph D; Kincl, Laurel; Richardson, Lesley; McBride, Mary; Siemiatycki, Jack; Cardis, Elisabeth; Krewski, Daniel

    2018-05-01

    Many epidemiological studies assessing the relationship between exposure and disease are carried out without data on individual exposures. When this barrier is encountered in occupational studies, the subject exposures are often evaluated with a job-exposure matrix (JEM), which consists of mean exposure for occupational categories measured on a comparable group of workers. One of the objectives of the seven-country case-control study of occupational exposure and brain cancer risk, INTEROCC, was to investigate the relationship of occupational exposure to electromagnetic fields (EMF) in different frequency ranges and brain cancer risk. In this paper, we use the Canadian data from INTEROCC to estimate the odds of developing brain tumours due to occupational exposure to EMF. The first step was to find the best EMF exposure surrogate among the arithmetic mean, the geometric mean, and the mean of log-normal exposure distribution for each occupation in the JEM, in comparison to Berkson error adjustments via numerical approximation of the likelihood function. Contrary to previous studies of Berkson errors in JEMs, we found that the geometric mean was the best exposure surrogate. This analysis provided no evidence that cumulative lifetime exposure to extremely low frequency magnetic fields increases brain cancer risk, a finding consistent with other recent epidemiological studies.

  7. Air Pollution Exposure Modeling for Health Studies | Science ...

    Science.gov (United States)

    Dr. Michael Breen is leading the development of air pollution exposure models, integrated with novel personal sensor technologies, to improve exposure and risk assessments for individuals in health studies. He is co-investigator for multiple health studies assessing the exposure and effects of air pollutants. These health studies include participants with asthma, diabetes, and coronary artery disease living in various U.S. cities. He has developed, evaluated, and applied novel exposure modeling and time-activity tools, which includes the Exposure Model for Individuals (EMI), GPS-based Microenvironment Tracker (MicroTrac) and Exposure Tracker models. At this seminar, Dr. Breen will present the development and application of these models to predict individual-level personal exposures to particulate matter (PM) for two health studies in central North Carolina. These health studies examine the association between PM and adverse health outcomes for susceptible individuals. During Dr. Breen’s visit, he will also have the opportunity to establish additional collaborations with researchers at Harvard University that may benefit from the use of exposure models for cohort health studies. These research projects that link air pollution exposure with adverse health outcomes benefit EPA by developing model-predicted exposure-dose metrics for individuals in health studies to improve the understanding of exposure-response behavior of air pollutants, and to reduce participant

  8. Systematic review and meta-analysis of early life exposure to di(2-ethylhexyl) phthalate and obesity related outcomes in rodents

    NARCIS (Netherlands)

    Wassenaar, Pim Nicolaas Hubertus; Legler, Juliette

    Background It has been suggested that the plasticizer di(2-ethylhexyl) phthalate (DEHP) exerts obesogenic effects after pre- or perinatal exposure. Objective A systematic review with meta-analyses was conducted of early life exposure to DEHP, or its biologically active metabolite mono(2-ethylhexyl)

  9. Applicability of the black slug Arion ater for monitoring exposure to polycyclic aromatic hydrocarbons and their subsequent bioactivation into DNA binding metabolites

    NARCIS (Netherlands)

    Hamers, T.; Kalis, E.J.J.; Berg, van den J.H.J.; Maas, L.M.; Schooten, van F.J.; Murk, A.J.

    2004-01-01

    The applicability of terrestrial black slugs Arion ater (Mollusca, Gastropoda) was studied for biomonitoring environmental exposure to polycyclic aromatic hydrocarbons (PAHs). In laboratory experiments, slugs were orally exposed to benzo[a]pyrene (BaP) for a short term (3 days) or a long term (119

  10. Protection of the public in situations of prolonged radiation exposure. The application of the Commission's system of radiological protection to controllable radiation exposure due to natural sources and long-lived radioactive residues.

    Science.gov (United States)

    1999-01-01

    This report provides guidance on the application of the ICRP system of radiological protection to prolonged exposure situations affecting members of the public. It addresses the general application of the Commission's system to the control of prolonged exposures resulting from practices and to the undertaking of interventions in prolonged exposure situations. Additionally, it provides recommendations on generic reference levels for such interventions. The report also considers some specific situations and discusses a number of issues that have been of concern, namely: natural radiation sources that may give rise to high doses; the restoration and rehabilitation of sites where human activities involving radioactive substances have been carried out; the return to 'normality' following an accident that has released radioactive substances to the environment; and the global marketing of commodities for public consumption that contain radioactive substances. Annexes provide some examples of prolonged exposure situations and discuss the radiological protection quantities, radiation-induced health effects and aspects of the Commission's system of radiological protection relevant to prolonged exposure. Quantitative recommendations for prolonged exposures are provided in the report. They must be interpreted with extreme caution; Chapters 4 and 5 stress the upper bound nature of the following values: Generic reference levels for intervention, in terms of existing total annual doses, are given as < approximately 100 mSv, above which intervention is almost always justifiable (situations for which the annual dose threshold for deterministic effects in relevant organs is exceeded will almost always require intervention), and < approximately 10 mSv, below which intervention is not likely to be justifiable (and above which it may be necessary). Intervention exemption levels for commodities, especially building materials, are expressed as an additional annual dose of approximately 1

  11. The impact of arbitrarily applicable relational responding on evaluative learning about hypothetical money and shock outcomes.

    Science.gov (United States)

    Dymond, Simon; Molet, Mikael; Davies, Lynette

    2017-08-01

    Evaluative learning comprises changes in preferences after co-occurrences between conditioned stimuli (CSs) and an unconditioned stimulus (US) of affective value. Co-occurrences may involve relational responding. Two experiments examined the impact of arbitrary relational responding on evaluative preferences for hypothetical money and shock outcomes. In Experiment 1, participants were trained to make arbitrary relational responses by placing CSs of the same size but different colours into boxes and were then instructed that these CSs represented different intensities of hypothetical USs (money or shock). Liking ratings of the CSs were altered in accordance with the underlying bigger/smaller than relations. A reversal of preference was also observed: the CS associated with the smallest hypothetical shock was rated more positively than the CS associated with the smallest amount of hypothetical money. In Experiment 2, procedures from Relational Frame Theory (RFT) established a relational network of more than/less than relations consisting of five CSs (A-B-C-D-E). Overall, evaluative preferences were altered, but not reversed, depending on (a) how stimuli had been related to one another during the learning phase and (b) whether those stimuli referred to money or shocks. The contribution of RFT to evaluative learning research is discussed.

  12. Introduction to methodology of dose-response meta-analysis for binary outcome: With application on software.

    Science.gov (United States)

    Zhang, Chao; Jia, Pengli; Yu, Liu; Xu, Chang

    2018-05-01

    Dose-response meta-analysis (DRMA) is widely applied to investigate the dose-specific relationship between independent and dependent variables. Such methods have been in use for over 30 years and are increasingly employed in healthcare and clinical decision-making. In this article, we give an overview of the methodology used in DRMA. We summarize the commonly used regression model and the pooled method in DRMA. We also use an example to illustrate how to employ a DRMA by these methods. Five regression models, linear regression, piecewise regression, natural polynomial regression, fractional polynomial regression, and restricted cubic spline regression, were illustrated in this article to fit the dose-response relationship. And two types of pooling approaches, that is, one-stage approach and two-stage approach are illustrated to pool the dose-response relationship across studies. The example showed similar results among these models. Several dose-response meta-analysis methods can be used for investigating the relationship between exposure level and the risk of an outcome. However the methodology of DRMA still needs to be improved. © 2018 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  13. Application of active learning modalities to achieve medical genetics competencies and their learning outcome assessments.

    Science.gov (United States)

    Hagiwara, Nobuko

    2017-01-01

    The steadily falling costs of genome sequencing, coupled with the growing number of genetic tests with proven clinical validity, have made the use of genetic testing more common in clinical practice. This development has necessitated nongeneticist physicians, especially primary care physicians, to become more responsible for assessing genetic risks for their patients. Providing undergraduate medical students a solid foundation in genomic medicine, therefore, has become all the more important to ensure the readiness of future physicians in applying genomic medicine to their patient care. In order to further enhance the effectiveness of instructing practical skills in medical genetics, the emphasis of active learning modules in genetics curriculum at medical schools has increased in recent years. This is because of the general acceptance of a better efficacy of active learner-centered pedagogy over passive lecturer-centered pedagogy. However, an objective standard to evaluate students' skill levels in genomic medicine achieved by active learning is currently missing. Recently, entrustable professional activities (EPAs) in genomic medicine have been proposed as a framework for developing physician competencies in genomic medicine. EPAs in genomic medicine provide a convenient guideline for not only developing genomic medicine curriculum but also assessing students' competency levels in practicing genomic medicine. In this review, the efficacy of different types of active learning modules reported for medical genetics curricula is discussed using EPAs in genomic medicine as a common evaluation standard for modules' learning outcomes. The utility of the EPAs in genomic medicine for designing active learning modules in undergraduate medical genetics curricula is also discussed.

  14. Pregnancy outcome after exposure to antidepressants and the role of maternal depression: results from the Norwegian Mother and Child Cohort Study.

    NARCIS (Netherlands)

    Nordeng, H.; Gelder, M.M.H.J. van; Spigset, O.; Koren, G.; Einarson, A.; Eberhard-Gran, M.

    2012-01-01

    Results of previous studies on the safety of antidepressants during pregnancy have been conflicting. The primary objective of this study was to investigate whether first-trimester exposure to antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), was associated with increased

  15. A case study to illustrate the utility of the Aggregate Exposure Pathway and Adverse Outcome Pathway frameworks for integrating human health and ecological data into cumulative risk assessment

    Science.gov (United States)

    Cumulative risk assessment (CRA) methods, which evaluate the risk of multiple adverse outcomes (AOs) from multiple chemicals, promote the use of a conceptual site model (CSM) to integrate risk from relevant stressors. The Adverse Outcome Pathway (AOP) framework can inform these r...

  16. In vitro biological outcome of laser application for modification or processing of titanium dental implants.

    Science.gov (United States)

    Hindy, Ahmed; Farahmand, Farzam; Tabatabaei, Fahimeh Sadat

    2017-07-01

    There are numerous functions for laser in modern implant dentistry including surface treatment, surface coating, and implant manufacturing. As laser application may potentially improve osseointegration of dental implants, we systematically reviewed the literature for in vitro biological responses to laser-modified or processed titanium dental implants. The literature was searched in PubMed, ISI Web, and Scopus, using keywords "titanium dental implants," "laser," "biocompatibility," and their synonyms. After screening the 136 references obtained, 28 articles met the inclusion criteria. We found that Nd:YAG laser was the most commonly used lasers in the treatment or processing of titanium dental implants. Most of the experiments used cell attachment and cell proliferation to investigate bioresponses of the implants. The most commonly used cells in these assays were osteoblast-like cells. Only one study was conducted in stem cells. These in vitro studies reported higher biocompatibility in laser-modified titanium implants. It seems that laser radiation plays a vital role in cell response to dental implants; however, it is necessary to accomplish more studies using different laser types and parameters on various cells to offer a more conclusive result.

  17. Biomonitoring of the mycotoxin Zearalenone: current state-of-the art and application to human exposure assessment.

    Science.gov (United States)

    Mally, Angela; Solfrizzo, Michele; Degen, Gisela H

    2016-06-01

    Zearalenone (ZEN), a mycotoxin with high estrogenic activity in vitro and in vivo, is a widespread food contaminant that is commonly detected in maize, wheat, barley, sorghum, rye and other grains. Human exposure estimates based on analytical data on ZEN occurrence in various food categories and food consumption data suggest that human exposure to ZEN and modified forms of ZEN may be close to or even exceed the tolerable daily intake (TDI) derived by the European Food Safety Authority (EFSA) for some consumer groups. Considering the inherent uncertainties in estimating dietary intake of ZEN that may lead to an under- or overestimation of ZEN exposure and consequently human risk and current lack of data on vulnerable consumer groups, there is a clear need for more comprehensive and reliable exposure data to refine ZEN risk assessment. Human biomonitoring (HBM) is increasingly being recognized as an efficient and cost-effective way of assessing human exposure to food contaminants, including mycotoxins. Based on animal and (limited) human data on the toxicokinetics of ZEN, it appears that excretion of ZEN and its major metabolites may present suitable biomarkers of ZEN exposure. In view of the limitations of available dietary exposure data on ZEN and its modified forms, the purpose of this review is to provide an overview of recent studies utilizing HBM to monitor and assess human exposure to ZEN. Considerations are given to animal and human toxicokinetic data relevant to HBM, analytical methods, and available HBM data on urinary biomarkers of ZEN exposure in different cohorts.

  18. Effects of ROI definition and reconstruction method on quantitative outcome and applicability in a response monitoring trial

    International Nuclear Information System (INIS)

    Krak, Nanda C.; Boellaard, R.; Hoekstra, Otto S.; Hoekstra, Corneline J.; Twisk, Jos W.R.; Lammertsma, Adriaan A.

    2005-01-01

    Quantitative measurement of tracer uptake in a tumour can be influenced by a number of factors, including the method of defining regions of interest (ROIs) and the reconstruction parameters used. The main purpose of this study was to determine the effects of different ROI methods on quantitative outcome, using two reconstruction methods and the standard uptake value (SUV) as a simple quantitative measure of FDG uptake. Four commonly used methods of ROI definition (manual placement, fixed dimensions, threshold based and maximum pixel value) were used to calculate SUV (SUV [MAN] , SUV 15 mm , S