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Sample records for generalized mantel-haenszel analysis

  1. An Empirical Bayes Approach to Mantel-Haenszel DIF Analysis.

    Science.gov (United States)

    Zwick, Rebecca; Thayer, Dorothy T.; Lewis, Charles

    1999-01-01

    Developed an empirical Bayes enhancement to Mantel-Haenszel (MH) analysis of differential item functioning (DIF) in which it is assumed that the MH statistics are normally distributed and that the prior distribution of underlying DIF parameters is also normal. (Author/SLD)

  2. An adaptive Mantel-Haenszel test for sensitivity analysis in observational studies.

    Science.gov (United States)

    Rosenbaum, Paul R; Small, Dylan S

    2017-06-01

    In a sensitivity analysis in an observational study with a binary outcome, is it better to use all of the data or to focus on subgroups that are expected to experience the largest treatment effects? The answer depends on features of the data that may be difficult to anticipate, a trade-off between unknown effect-sizes and known sample sizes. We propose a sensitivity analysis for an adaptive test similar to the Mantel-Haenszel test. The adaptive test performs two highly correlated analyses, one focused analysis using a subgroup, one combined analysis using all of the data, correcting for multiple testing using the joint distribution of the two test statistics. Because the two component tests are highly correlated, this correction for multiple testing is small compared with, for instance, the Bonferroni inequality. The test has the maximum design sensitivity of two component tests. A simulation evaluates the power of a sensitivity analysis using the adaptive test. Two examples are presented. An R package, sensitivity2x2xk, implements the procedure. © 2016, The International Biometric Society.

  3. Comparison of Three Software Programs for Evaluating DIF by Means of the Mantel-Haenszel Procedure: EASY-DIF, DIFAS and EZDIF

    Science.gov (United States)

    Padilla, Jose Luis; Hidalgo, M. Dolores; Benitez, Isabel; Gomez-Benito, Juana

    2012-01-01

    The analysis of differential item functioning (DIF) examines whether item responses differ according to characteristics such as language and ethnicity, when people with matching ability levels respond differently to the items. This analysis can be performed by calculating various statistics, one of the most important being the Mantel-Haenszel,…

  4. Mantel--Haenszel analysis of Oxford data. II. Independent effects of fetal irradiation subfactors

    International Nuclear Information System (INIS)

    Kneale, G.W.; Stewart, A.M.

    1976-01-01

    A Mantel-Haenszel analysis of fetal irradiation subfactors indicated that most of the extra x-rayed cases in the Oxford Survey of Childhood Cancers were radiation induced. First trimester exposures were rare but probably ten times more dangerous than later exposures. Ratios of observed: expected numbers of cancer deaths were lower for children with abnormal x-rays than for other x-rayed children, and lower for recent than remote exposures. The first of these differences was probably due to several antenatal conditions having positive associations with obstetric radiography and several causes of early (noncancer) deaths; the second one was probably due to a progressive lowering of film doses between 1940 and the present time. A rare cause of fetal irradiation (hydramnios), whose associations with congenital defects are well documented, led to the discovery that two faults in the International Classification of Diseases and Causes of Death have contributed to mistaken ideas about the etiology of childhood cancers: Neoplasms were not listed among the official causes of stillbirths, and cystic tumors of the kidneys and lungs of infants were not listed as neoplasms

  5. Sensitivity of Mantel Haenszel Model and Rasch Model as Viewed From Sample Size

    OpenAIRE

    ALWI, IDRUS

    2011-01-01

    The aims of this research is to study the sensitivity comparison of Mantel Haenszel and Rasch Model for detection differential item functioning, observed from the sample size. These two differential item functioning (DIF) methods were compared using simulate binary item respon data sets of varying sample size,  200 and 400 examinees were used in the analyses, a detection method of differential item functioning (DIF) based on gender difference. These test conditions were replication 4 tim...

  6. Type I Error Inflation in DIF Identification with Mantel-Haenszel: An Explanation and a Solution

    Science.gov (United States)

    Magis, David; De Boeck, Paul

    2014-01-01

    It is known that sum score-based methods for the identification of differential item functioning (DIF), such as the Mantel-Haenszel (MH) approach, can be affected by Type I error inflation in the absence of any DIF effect. This may happen when the items differ in discrimination and when there is item impact. On the other hand, outlier DIF methods…

  7. MANTEL-HAENSZEL TYPE ESTIMATORS FOR THE COUNTER-MATCHED SAMPLING DESIGN IN NESTED CASE-CONTROL STUDY

    OpenAIRE

    Fujii, Yoshinori; Zhang, Zhong-Zhan; 藤井, 良宜

    2001-01-01

    We are concerned with a counter-matched nested case-control study. Assuming the proportional hazards model, the Mantel-Haenszel estimators of hazard rates are presented in two situations. The proposed estimators can be calculated without estimating the nuisance parameter. Consistent estimators of the variance of the proposed hazard rate estimators are also developed. We compare these estimators to the maximum partial likelihood estimators in the asymptotic variance. The methods are illustrate...

  8. Dose-Weighted Adjusted Mantel-Haenszel Tests for Numeric Scaled Strata in a Randomized Trial

    Science.gov (United States)

    Gansky, Stuart A.; Cheng, Nancy F.; Koch, Gary G.

    2011-01-01

    A recent three-arm parallel groups randomized clinical prevention trial had a protocol deviation causing participants to have fewer active doses of an in-office treatment than planned. The original statistical analysis plan stipulated a minimal assumption randomization-based extended Mantel-Haenszel (EMH) trend test of the high frequency, low frequency, and zero frequency treatment groups and a binary outcome. Thus a dose-weighted adjusted EMH (DWAEMH) test was developed with an extra set of weights corresponding to the number of active doses actually available, in the spirit of a pattern mixture model. The method can easily be implemented using standard statistical software. A set of Monte Carlo simulations using a logistic model was undertaken with (and without) actual dose-response effects through 1000 replicates for empirical power estimates (and 2100 for empirical size). Results showed size was maintained and power was improved for DWAEMH versus EMH and logistic regression Wald tests in the presence of a dose effect and treatment by dose interaction. PMID:21709814

  9. Power and sample size evaluation for the Cochran-Mantel-Haenszel mean score (Wilcoxon rank sum) test and the Cochran-Armitage test for trend.

    Science.gov (United States)

    Lachin, John M

    2011-11-10

    The power of a chi-square test, and thus the required sample size, are a function of the noncentrality parameter that can be obtained as the limiting expectation of the test statistic under an alternative hypothesis specification. Herein, we apply this principle to derive simple expressions for two tests that are commonly applied to discrete ordinal data. The Wilcoxon rank sum test for the equality of distributions in two groups is algebraically equivalent to the Mann-Whitney test. The Kruskal-Wallis test applies to multiple groups. These tests are equivalent to a Cochran-Mantel-Haenszel mean score test using rank scores for a set of C-discrete categories. Although various authors have assessed the power function of the Wilcoxon and Mann-Whitney tests, herein it is shown that the power of these tests with discrete observations, that is, with tied ranks, is readily provided by the power function of the corresponding Cochran-Mantel-Haenszel mean scores test for two and R > 2 groups. These expressions yield results virtually identical to those derived previously for rank scores and also apply to other score functions. The Cochran-Armitage test for trend assesses whether there is an monotonically increasing or decreasing trend in the proportions with a positive outcome or response over the C-ordered categories of an ordinal independent variable, for example, dose. Herein, it is shown that the power of the test is a function of the slope of the response probabilities over the ordinal scores assigned to the groups that yields simple expressions for the power of the test. Copyright © 2011 John Wiley & Sons, Ltd.

  10. Nonparametric analysis of blocked ordered categories data: some examples revisited

    Directory of Open Access Journals (Sweden)

    O. Thas

    2006-08-01

    Full Text Available Nonparametric analysis for general block designs can be given by using the Cochran-Mantel-Haenszel (CMH statistics. We demonstrate this with four examples and note that several well-known nonparametric statistics are special cases of CMH statistics.

  11. Dismantling the Mantel tests

    DEFF Research Database (Denmark)

    Guillot, Gilles; Rousset, François

    2012-01-01

    1. The simple and partialMantel tests are routinely used in many areas of evolutionary biology to assess the significance of the association between two ormorematrices of distances relative to the same pairs of individuals or demes. Partial Mantel tests rather than simple Mantel tests are widely...

  12. Dismantling the Mantel tests

    DEFF Research Database (Denmark)

    Guillot, Gilles

    The simple and partial Mantel tests are routinely used in many areas of evolutionary biology to assess the significance of the association between two or more matrices of distances relative to the same pairs of individuals or demes. Partial Mantel tests rather than simple Mantel tests are widely...

  13. Beta-binomial model for meta-analysis of odds ratios.

    Science.gov (United States)

    Bakbergenuly, Ilyas; Kulinskaya, Elena

    2017-05-20

    In meta-analysis of odds ratios (ORs), heterogeneity between the studies is usually modelled via the additive random effects model (REM). An alternative, multiplicative REM for ORs uses overdispersion. The multiplicative factor in this overdispersion model (ODM) can be interpreted as an intra-class correlation (ICC) parameter. This model naturally arises when the probabilities of an event in one or both arms of a comparative study are themselves beta-distributed, resulting in beta-binomial distributions. We propose two new estimators of the ICC for meta-analysis in this setting. One is based on the inverted Breslow-Day test, and the other on the improved gamma approximation by Kulinskaya and Dollinger (2015, p. 26) to the distribution of Cochran's Q. The performance of these and several other estimators of ICC on bias and coverage is studied by simulation. Additionally, the Mantel-Haenszel approach to estimation of ORs is extended to the beta-binomial model, and we study performance of various ICC estimators when used in the Mantel-Haenszel or the inverse-variance method to combine ORs in meta-analysis. The results of the simulations show that the improved gamma-based estimator of ICC is superior for small sample sizes, and the Breslow-Day-based estimator is the best for n⩾100. The Mantel-Haenszel-based estimator of OR is very biased and is not recommended. The inverse-variance approach is also somewhat biased for ORs≠1, but this bias is not very large in practical settings. Developed methods and R programs, provided in the Web Appendix, make the beta-binomial model a feasible alternative to the standard REM for meta-analysis of ORs. © 2017 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd. © 2017 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

  14. Gender and Socioeconomic Status DIF on The WISC-IV Turkish Form Items: A Comparison of DIF Detection Tecniques

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    Elif Bengi ÜNSAL ÖZBERK

    2017-03-01

    Full Text Available The purpose of this study is to investigate potential gender and socio-economic status bias in theWechler Intelligence Scale for Children: Fourth Edition (WISC-4 by using several differential item functioning detection techniques. In this study, WISC-4 Turkish standardization test pilot data including 817 children were used. In accordance with the purpose of the study, 315 items were used both in polytomously scored subtests such as Block Design, Similarities, Digit Span, Vocabulary, Letter-Number Sequencing, Comprehension, and dichotomously scored subtests such as Picture Concepts, Matrix Reasoning, Picture Completion, Information, Arithmetic, and Word Reasoning. While Rasch Model, Mantel-Haenszel, and SIBTEST DIF detection techniques were used for dichotomously scored items, Partila Credit Model, Mantel, and Poly-SIBTEST techniques were used for polytomously scored items. In terms of DIF techniques, Mantel-Haenszel, SIBTEST and Mantel Test, Poly-SIBTEST analyses provided similar results when DIF based on gender was investigated. In addition Mantel-Haenszel, Rasch estimations and Partial Credit Model, Mantel Test results were similar while investigating DIF according to socioeconomic status.

  15. Gideon Mantell and the Discovery of Dinosaurs

    Science.gov (United States)

    Dean, Dennis R.

    1999-01-01

    Gideon Mantell and the Discovery of Dinosaurs is a scholarly yet accessible biography--the first in a generation--of a pioneering dinosaur hunter and scholar. Gideon Mantell discovered the Iguanodon (a famous tale set right in this book) and several other dinosaur species, spent over twenty-five years restoring Iguanodon fossils, and helped establish the idea of an Age of Reptiles that ended with their extinction at the conclusion of the Mesozoic Era. He had significant interaction with such well-known figures as James Parkinson, Georges Cuvier, Charles Lyell, Roderick Murchison, Charles Darwin, and Richard Owen. Dennis Dean, a well-known scholar of geology and the Victorian era, here places Mantell's career in its cultural context, employing original research in archives throughout the world, including the previously unexamined Mantell family papers in New Zealand.

  16. Evaluation of the effectiveness of laser in situ keratomileusis and photorefractive keratectomy for myopia : A meta-analysis

    OpenAIRE

    Yang, Xin-Jun; Yan, Hong-Tao; Nakahori, Yutaka

    2003-01-01

    Objective: To evaluate the effectiveness of laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) for correcting myopia. Methods : Study selection, data extraction, and quality assessment were performed by two of authors independently. Summary odds ratios and 95% confidence intervals were calculated by DerSimonian amp Laird random-effects model and Mantel-Haenszel (fixed-effects) model. All calculations were based on an intention-to-treat and per protocol analysis. Result...

  17. Is desvenlafaxine effective and safe in the treatment of menopausal ...

    African Journals Online (AJOL)

    Meta-analysis was conducted by including double-blind randomized controlled studies on the effectiveness and safety of desvenlafaxine in the treatment of hot flashes. The effectiveness, safety and tolerability of desvenlafaxine were determined by standardized mean differences (SMDs) and Mantel-Haenszel odds ratio.

  18. Clinical Validation of the "Sedentary Lifestyle" Nursing Diagnosis in Secondary School Students

    Science.gov (United States)

    de Oliveira, Marcos Renato; da Silva, Viviane Martins; Guedes, Nirla Gomes; de Oliveira Lopes, Marcos Venícios

    2016-01-01

    This study clinically validated the nursing diagnosis of "sedentary lifestyle" (SL) among 564 Brazilian adolescents. Measures of diagnostic accuracy were calculated for defining characteristics, and Mantel--Haenszel analysis was used to identify related factors. The measures of diagnostic accuracy showed that the following defining…

  19. DIF Trees: Using Classification Trees to Detect Differential Item Functioning

    Science.gov (United States)

    Vaughn, Brandon K.; Wang, Qiu

    2010-01-01

    A nonparametric tree classification procedure is used to detect differential item functioning for items that are dichotomously scored. Classification trees are shown to be an alternative procedure to detect differential item functioning other than the use of traditional Mantel-Haenszel and logistic regression analysis. A nonparametric…

  20. Using Loss Functions for DIF Detection: An Empirical Bayes Approach.

    Science.gov (United States)

    Zwick, Rebecca; Thayer, Dorothy; Lewis, Charles

    2000-01-01

    Studied a method for flagging differential item functioning (DIF) based on loss functions. Builds on earlier research that led to the development of an empirical Bayes enhancement to the Mantel-Haenszel DIF analysis. Tested the method through simulation and found its performance better than some commonly used DIF classification systems. (SLD)

  1. Development of ocular hypertension secondary to tamponade with light versus heavy silicone oil: A systematic review

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    Vito Romano

    2015-01-01

    Full Text Available Aim: The intraocular silicone oil (SO tamponades used in the treatment of retinal detachment (RD have been associated with a difference ocular hypertension (OH rate. To clarify, if this complication was associated to use of standard SO (SSO versus heavy SO (HSO, we performed a systematic review and meta-analysis of comparative study between two kind of SO (standard or light vs. heavy for the treatment of RD and macular hole, without restriction to study design. Materials and Methods: The methodological quality of two randomized clinical trials (RCTs were evaluated using the criteria given in the Cochrane Handbook for Systematic Reviews of Intervention, while three non-RCTs were assessed with the Newcastle-Ottawa Scale and Strengthening the Reporting of Observational Studies in Epidemiology checklists. We calculated Mantel-Haenszel risk ratio (RR with 95% confidence intervals (95% CIs. The primary outcome was the rate of patients with OH treated with SSO compared to HSO. Results: There were a higher number of rates of OH in HSO compared to SSO. This difference was statistically significant with the fixed effect model (Mantel-Haenszel RR; 1.55; 95% CI, 1.06-2.28; P = 0.02 while there was not significative difference with the random effect model (Mantel-Haenszel RR; 1.51; 95% CI, 0.98-2.33; P = 0.06. Conclusion: We noted a trend that points out a higher OH rate in HSO group compared to SSO, but this finding, due to the small size and variable design of studies, needs to be confirmed in well-designed and large size RCTs.

  2. [Contrast-induced nephropathy in patients at risk of renal failure undergoing computed tomography: systematic review and meta-analysis of randomized controlled trials].

    Science.gov (United States)

    Arana, Estanislao; Catalá-López, Ferrán

    2010-09-11

    We evaluated and quantified by meta-analysis techniques the incidence of contrast-induced nephropathy (CIN) in patients at risk undergoing computed tomography (CT). We conducted a systematic review of randomized controlled clinical trials designated to evaluate the nephrotoxicity related to iso-osmolar contrast media (IOCM) compared to low-osmolar contrast media (LOCM). Main electronic databases searched included PubMed/MEDLINE, EMBASE, ISI Web of Knowledge and Virtual Health Library (BVS-BIREME), as well as abstracts presented at related scientific societies meetings. Prior to data extraction, definitions of nephrotoxicity and risk population were established. Besides meta-analysis, the global agreement between CIN definitions was evaluated with Mantel-Haenszel stratified test. Five studies were included with 716 randomized patients. When CIN was defined as increased serum creatinine (SCr)>or=25%, the relative risk (RR) was 0.71 (CI95%: 0.40-1.26)-in favor of IOCM-and when it was defined as SCr>or=0.5mg/dL it showed a RR 1.48 (CI95%: 0.37-5.87)-favoring LOCM-in the four studies used this criterion. Mantel-Haenszel stratified test was chi2=2.51 (p=0.8). In patients with renal failure undergoing CT there is a similar risk of CIN with the administration of any contrast media studied. CIN incidence depends on the chosen criteria and is lower with the definition of SCr>or=0.5mg/dL at 24-72h. No agreement was found between CIN definitions were adopted. Copyright © 2009 Elsevier España, S.L. All rights reserved.

  3. Nonparametric tests for equality of psychometric functions.

    Science.gov (United States)

    García-Pérez, Miguel A; Núñez-Antón, Vicente

    2017-12-07

    Many empirical studies measure psychometric functions (curves describing how observers' performance varies with stimulus magnitude) because these functions capture the effects of experimental conditions. To assess these effects, parametric curves are often fitted to the data and comparisons are carried out by testing for equality of mean parameter estimates across conditions. This approach is parametric and, thus, vulnerable to violations of the implied assumptions. Furthermore, testing for equality of means of parameters may be misleading: Psychometric functions may vary meaningfully across conditions on an observer-by-observer basis with no effect on the mean values of the estimated parameters. Alternative approaches to assess equality of psychometric functions per se are thus needed. This paper compares three nonparametric tests that are applicable in all situations of interest: The existing generalized Mantel-Haenszel test, a generalization of the Berry-Mielke test that was developed here, and a split variant of the generalized Mantel-Haenszel test also developed here. Their statistical properties (accuracy and power) are studied via simulation and the results show that all tests are indistinguishable as to accuracy but they differ non-uniformly as to power. Empirical use of the tests is illustrated via analyses of published data sets and practical recommendations are given. The computer code in MATLAB and R to conduct these tests is available as Electronic Supplemental Material.

  4. Efficacy of etravirine combined with darunavir or other ritonavir-boosted protease inhibitors in HIV-1-infected patients

    DEFF Research Database (Denmark)

    Vingerhoets, J; Calvez, V; Flandre, P

    2015-01-01

    data. METHODS: Two international (EuroSIDA; EUResist Network) and five national (France, Italy, Spain, Switzerland and UK) cohorts provided data (collected in 2007-2012). Stratum-adjusted (for confounding factors) Mantel-Haenszel differences in virological responses (viral load

  5. Aerosol characterization in a gas mantel factory

    International Nuclear Information System (INIS)

    Cunha, K.D. da; Moura, J.J.; Simoes, F.; d'Oliveira, D.; Leite, V.C.B.; Alves, Rex N.; Silva, I.C.M. da.

    1997-01-01

    The workers in a gas mantel manufacturing are exposed to aerosol containing Th and it decay products, which are hazardous to health. For health damage evaluation it is necessary to determine the inhaled particle size, the Th and thoron concentration in the aerosol breathing fraction. A cascade impactor, a stack filter unit and individual air sampler were used to characterize the airborne particles containing Th. The thoron and radon air concentration were determined using Tsivoglu, Kusnetz, Rolle and Two filters methods. (author). 5 refs., 1 fig., 1 tab

  6. A petition to Mr Peel: Gideon Mantell and the trial of Hannah Russell.

    Science.gov (United States)

    Flanagan, R J; Watson, K D

    2009-07-01

    In the summer of 1826, Hannah Russell was tried for petty treason, viz. the murder of her husband, Benjamin Russell, by poisoning. Their lodger, Daniel Leney, was indicted as her accomplice. The exact circumstances surrounding the death were unclear but Hannah was known to have purchased white arsenic (arsenious oxide). A local surgeon, Thomas Evans, supported at the post-mortem examination by two further surgeons, not only reported severe corrosion of the gastrointestinal tract, but also the recovery of nearly an eighth of an ounce of arsenic from the victim's stomach. Both accused were convicted and sentenced to death. Leney was executed, but Hannah Russell was respited because the trial judge, Sir Robert Graham, had doubts as to a direction he had given to the jury. The surgeon and paleontologist Gideon Mantell took up her case, stressing that death from arsenic could not have taken place as quickly as was alleged and maintaining that the chemical evidence of arsenic poisoning was inconclusive. He gained the support of some eminent chemists and physicians. Subsequently, forensic toxicologists [Sir] Robert Christison and Alfred Swaine Taylor pointed out that Mantell's arguments as to the possible time to death in arsenic poisoning were quite wrong. Moreover, Evans gave details of the analyses he and his colleagues had undertaken to Christison, who pronounced the findings sound, as indeed did Mantell after Evans and his colleagues published details of their investigations in the Sussex Advertiser. Papers in The National Archives show that Hannah was pardoned for the offence for which she was indicted, leaving it open to prefer a lesser charge. That this was never done may have been due to Mantell's campaign, at least in part, but the pardon she did receive was due to the concern of the trial judge as to the implications of the evidence presented at trial.

  7. An Effect Size Measure for Raju's Differential Functioning for Items and Tests

    Science.gov (United States)

    Wright, Keith D.; Oshima, T. C.

    2015-01-01

    This study established an effect size measure for differential functioning for items and tests' noncompensatory differential item functioning (NCDIF). The Mantel-Haenszel parameter served as the benchmark for developing NCDIF's effect size measure for reporting moderate and large differential item functioning in test items. The effect size of…

  8. Many multicenter trials had few events per center, requiring analysis via random-effects models or GEEs.

    Science.gov (United States)

    Kahan, Brennan C; Harhay, Michael O

    2015-12-01

    Adjustment for center in multicenter trials is recommended when there are between-center differences or when randomization has been stratified by center. However, common methods of analysis (such as fixed-effects, Mantel-Haenszel, or stratified Cox models) often require a large number of patients or events per center to perform well. We reviewed 206 multicenter randomized trials published in four general medical journals to assess the average number of patients and events per center and determine whether appropriate methods of analysis were used in trials with few patients or events per center. The median number of events per center/treatment arm combination for trials using a binary or survival outcome was 3 (interquartile range, 1-10). Sixteen percent of trials had less than 1 event per center/treatment combination, 50% fewer than 3, and 63% fewer than 5. Of the trials which adjusted for center using a method of analysis which requires a large number of events per center, 6% had less than 1 event per center-treatment combination, 25% fewer than 3, and 50% fewer than 5. Methods of analysis that allow for few events per center, such as random-effects models or generalized estimating equations (GEEs), were rarely used. Many multicenter trials contain few events per center. Adjustment for center using random-effects models or GEE with model-based (non-robust) standard errors may be beneficial in these scenarios. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Atherectomy for peripheral arterial disease.

    Science.gov (United States)

    Ambler, Graeme K; Radwan, Rami; Hayes, Paul D; Twine, Christopher P

    2014-03-17

    Symptomatic peripheral arterial disease may be treated by a number of options including exercise therapy, angioplasty, stenting and bypass surgery. Atherectomy is an alternative technique where atheroma is excised by a rotating cutting blade. The objective of this review was to analyse randomised controlled trials comparing atherectomy against any established treatment for peripheral arterial disease in order to evaluate the effectiveness of atherectomy. The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched November 2013) and CENTRAL (2013, Issue 10). Trials databases were searched for details of ongoing or unpublished studies. Randomised controlled trials (RCTs) comparing atherectomy and other established treatments were selected for inclusion. All participants had symptomatic peripheral arterial disease with either claudication or critical limb ischaemia and evidence of lower limb arterial disease. Two review authors (GA and CT) screened studies for inclusion, extracted data and assessed the quality of the trials. Any disagreements were resolved through discussion. Four trials were included with a total of 220 participants (118 treated with atherectomy, 102 treated with balloon angioplasty) and 259 treated vessels (129 treated with atherectomy, 130 treated with balloon angioplasty). All studies compared atherectomy with angioplasty. No study was properly powered or assessors blinded to the procedures and there was a high risk of selection, attrition, detection and reporting biases.The estimated risk of success was similar between the treatment modalities although the confidence interval (CI) was compatible with small benefits of either treatment for the initial procedural success rate (Mantel-Haenszel risk ratio (RR) 0.92, 95% CI 0.44 to 1.91, P = 0.82), patency at six months (Mantel-Haenszel RR 0.92, 95% CI 0.51 to 1.66, P = 0.79) and patency at 12 months (Mantel-Haenszel RR 1.17, 95% CI 0

  10. Chronic hypertension and the risk for adverse pregnancy outcome after superimposed pre-eclampsia.

    Science.gov (United States)

    Vanek, M; Sheiner, E; Levy, A; Mazor, M

    2004-07-01

    To determine the risk factors and pregnancy outcome of patients with chronic hypertension during pregnancy after controlling for superimposed preeclampsia. A comparison of all singleton term (>36 weeks) deliveries occurring between 1988 and 1999, with and without chronic hypertension, was performed. Stratified analyses, using the Mantel-Haenszel technique, and a multiple logistic regression model were performed to control for confounders. Chronic hypertension complicated 1.6% (n=1807) of all deliveries included in the study (n=113156). Using a multivariable analysis, the following factors were found to be independently associated with chronic hypertension: maternal age >40 years (OR=3.1; 95% CI 2.7-3.6), diabetes mellitus (OR=3.6; 95% CI 3.3-4.1), recurrent abortions (OR=1.5; 95% CI 1.3-1.8), infertility treatment (OR=2.9; 95% CI 2.3-3.7), and previous cesarean delivery (CD; OR=1.8 CI 1.6-2.0). After adjustment for superimposed preeclampsia, using the Mantel-Haenszel technique, pregnancies complicated with chronic hypertension had higher rates of CD (OR=2.7; 95% CI 2.4-3.0), intra uterine growth restriction (OR=1.7; 95% CI 1.3-2.2), perinatal mortality (OR=1.6; 95% CI 1.01-2.6) and post-partum hemorrhage (OR=2.2; 95% CI 1.4-3.7). Chronic hypertension is associated with adverse pregnancy outcome, regardless of superimposed preeclampsia.

  11. Efficacy of aprepitant for prevention of postoperative nausea and vomiting. Systematic review and meta-analysis of randomized clinical trials

    Directory of Open Access Journals (Sweden)

    Berrío Valencia, Marta Inés

    2014-10-01

    Full Text Available Objective: To evaluate the efficacy of aprepitant compared with other antiemetics for the prevention of postoperative nausea and vomiting in adults who underwent general anesthesia. Methods: Systematic review of randomized clinical trials with meta-analysis, that evaluated the efficacy of aprepitant in comparatison with other antiemetics for the prevention of postoperative nausea and vomiting, antiemetic rescue and adverse effects. The search was done in The Cochrane Library, EBSCO, EMBASE, LILACS, OVID, PubMed, SciELO, ScienceDirect, Scopus and Google Scholar. Heterogeneity was defined with the Cochran Q and I2 statistic, the model fixed and random effects were used, the Mantel-Haenszel for relative risk of each outcome and its respective confidence interval 95% were used. Results: There was significant difference in favor of aprepitant for the prevention of vomiting at 24 (RR 0.52; 95% CI: 0.38-0.7 and at 48 hours (RR 0.51; 95% CI: 0.39 to 0.67 but not for nausea at 24 hours (RR 1.16; 95% CI: 0.85-1.6. Conclusions: Aprepitant prevents postoperative vomiting, but not nausea, at 24 and 48 hours.

  12. Sensitivity analysis for missing dichotomous outcome data in multi-visit randomized clinical trial with randomization-based covariance adjustment.

    Science.gov (United States)

    Li, Siying; Koch, Gary G; Preisser, John S; Lam, Diana; Sanchez-Kam, Matilde

    2017-01-01

    Dichotomous endpoints in clinical trials have only two possible outcomes, either directly or via categorization of an ordinal or continuous observation. It is common to have missing data for one or more visits during a multi-visit study. This paper presents a closed form method for sensitivity analysis of a randomized multi-visit clinical trial that possibly has missing not at random (MNAR) dichotomous data. Counts of missing data are redistributed to the favorable and unfavorable outcomes mathematically to address possibly informative missing data. Adjusted proportion estimates and their closed form covariance matrix estimates are provided. Treatment comparisons over time are addressed with Mantel-Haenszel adjustment for a stratification factor and/or randomization-based adjustment for baseline covariables. The application of such sensitivity analyses is illustrated with an example. An appendix outlines an extension of the methodology to ordinal endpoints.

  13. The trace fossil Lepidenteron lewesiensis (Mantell, 1822) from the Upper Cretaceous of southern Poland

    Science.gov (United States)

    Jurkowska, Agata; Uchman, Alfred

    2013-12-01

    Jurkowska, A. and Uchman, A. 2013. The trace fossil Lepidenteron lewesiensis (Mantell, 1822) from the Upper Cretaceous of southern Poland. Acta Geologica Polonica, 63(4), 611-623. Warszawa. Lepidenteron lewesiensis (Mantell, 1822) is an unbranched trace fossil lined with small fish scales and bones, without a constructed wall. It is characteristic of the Upper Cretaceous epicontinental, mostly marly sediments in Europe. In the Miechow Segment of the Szczecin-Miechow Synclinorium in southern Poland, it occurs in the Upper Campanian-Lower Maastrichtian deeper shelf sediments, which were deposited below wave base and are characterized by total bioturbation and a trace fossil assemblage comprising Planolites, Palaeophycus, Thalassinoides , Trichichnus, Phycosiphon, Zoophycos and Helicodromites that is typical of the transition from the distal Cruziana to the Zoophycos ichnofacies. L. lewesiensis was produced by a burrowing predator or scavenger of fishes. The tracemaker candidates could be eunicid polychaetes or anguillid fishes.

  14. Funcionamiento diferencial del item en la evaluación internacional PISA. Detección y comprensión. [Differential Item Functioning in the PISA Project: Detection and Understanding

    Directory of Open Access Journals (Sweden)

    Paula Elosua

    2006-08-01

    Full Text Available This report analyses the differential item functioning (DIF in the Programme for Indicators of Student Achievement PISA2000. The items studied are coming from the Reading Comprehension Test. We analyzed the released items from this year because we wanted to join the detection of DIF and its understanding. The reference group is the sample of United Kingdom and the focal group is the Spanish sample. The procedures of detection are Mantel-Haenszel, Logistic Regression and the standardized mean difference, and their extensions for polytomous items. Two items were flagged and the post-hoc analysis didn’t explain the causes of DIF entirely. Este trabajo analiza el funcionamiento diferencial del ítem (FDI de la prueba de comprensión lectora de la evaluación PISA2000 entre la muestras del Reino Unido y España. Se estudian los ítems liberados con el fin de aunar las fases de detección del FDI con la comprensión de sus causas. En la fase de detección se comparan los resultados de los procedimientos Mantel-Haenszel, Regresión Logística y Medias Estandarizadas en sus versiones para ítems dicotómicos y politómicos. Los resultados muestran que dos ítems presentan funcionamiento diferencial aunque el estudio post-hoc llevado a cabo sobre su contenido no ha podido precisar sus causas.

  15. Effect of gargling with tea and ingredients of tea on the prevention of influenza infection: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Kazuki Ide

    2016-05-01

    Full Text Available Abstract Background Influenza viruses can spread easily from person to person, and annual influenza epidemics are serious public health issues worldwide. Non-pharmaceutical public health interventions could potentially be effective for combatting influenza epidemics, but combined interventions and/or interventions with greater effectiveness are needed. Experimental studies have reported that tea and its ingredients (especially catechins have antiviral activities. Although several clinical studies have investigated the use of tea or its ingredients to prevent influenza infections, the effect of gargling these substances has remained uncertain. Methods We conducted a meta-analysis of randomized controlled studies and prospective cohort studies to assess the effect of gargling with tea and its ingredients on the prevention of influenza infection. The published literature was searched using the Cochrane Library, PubMed/MEDLINE (1966 to September 2015, Web of Science (1981 to September 2015, and Ichu-shi Web (1983 to September 2015. The extracted studies were read by two reviewers independently, and their overall scientific quality was evaluated. Studies meeting our inclusion criteria were pooled using the Mantel-Haenszel method in a fixed effects model and were also analyzed in a random effects model. The qualities of the model fits were assessed using the Akaike information criterion (AIC and Bayesian information criterion (BIC. Results The literature search and review identified 5 studies that met the inclusion criteria for the meta-analysis (total number of participants, 1890; mean age range, 16–83 years. The participants who gargled with tea or its ingredients showed a lower risk of influenza infection than did participants who gargled with placebo/water or who did not gargle (fixed effects model, Mantel-Haenszel method: relative risk [RR] = 0.70, 95 % confidence interval [CI] = 0.54–0.89; random effects model: RR = 0.71, 95

  16. Prognostic value of HER-2/neu expression in epithelial ovarian cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Kai; Guan, Chenan; Yu, Junhui; Jin, Xiaoxiao; Sun, Ling; Zheng, Lingzhi; Xia, Liang; Zhang, Yuquan

    2017-09-26

    This study aimed to conduct a meta-analysis to investigate the association between human epidermal growth factor receptor 2 (HER-2/neu) expression and survival in patients with epithelial ovarian cancer (EOC). HER-2/neu is one of the most frequently studied molecular biological parameters in EOC, but its prognostic impact has not been fully assessed. PubMed and Embase were searched for studies that reported HER-2/neu expression and survival in patients with EOC. The primary outcome was overall survival (OS), and the secondary outcome was progression-free survival (PFS). Hazard ratios (HRs) with 95% confidence interval (CI) were determined using Mantel-Haenszel random-effects model. Publication bias was investigated using funnel plots and Egger's test. A total of 56 studies (N=7212) were included in the analysis. The results showed that patients possessing HER-2/neu expression had significant disadvantages in OS (HR = 1.41; 95%CI, 1.31 to 1.51; P present study findings provided further indication that HER-2/neu expression in patients with EOC has an adverse impact on OS and PFS.

  17. Mortality among workers exposed to external ionizing radiation at a nuclear facility in Ohio

    International Nuclear Information System (INIS)

    Wiggs, L.D.; Cox-DeVore, C.A.; Wilkinson, G.S.; Reyes, M.

    1991-01-01

    In a cohort mortality study of white men employed by the Mound Facility (1947 through 1979), observed deaths did not exceed those expected based on US death rates for the overall cohort or for the subcohort monitored for external ionizing radiation. Among the radiation-monitored subcohort, mortality for workers with cumulative radiation doses of at least 10 mSv was not significantly increased when compared with mortality for coworkers with cumulative doses of less than 10 mSv. A significant dose-response based on a Mantel-Haenszel test of trend was observed for all leukemias. However, when a death from chronic lymphatic leukemia, a type of leukemia generally not regarded as radiogenic, was removed from the analyses, the strength of the dose-response was reduced

  18. Relación entre actividad física, y el riesgo de desarrollar enfermedad coronaria y diabetes mellitus en un grupo de trabajadores de una empresa de transporte de servicio público de la ciudad de Bogotá D.C. en el año 2014.

    OpenAIRE

    Pinilla Quiroga, Victor Cesar; Rico Mayorga, Diana Marcela; Triana Erazo, Andres Felipe

    2015-01-01

    El riesgo cardiovascular, definido como la probabilidad de presentar un evento en un periodo determinado, se puede determinar con base a un estudio muy utilizado, el estudio de Framingham. Se llevó a cabo un estudio corte transversal en 102 conductores para establecer la relación entre actividad física, y el riesgo de desarrollar enfermedad coronaria y diabetes mellitus. Se exploraron posibles asociaciones entre variables, utilizando la prueba de independencia Chi cuadrado de Mantel-Haenszel,...

  19. Is Ki-67 of Diagnostic Value in Distinguishing Between Partial and Complete Hydatidiform Moles? A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Zhao, Yue; Xiong, Guang-Wu; Zhang, Xiao-Wei; Hang, B O

    2018-02-01

    To demonstrate the value of Ki-67 in distinguishing between partial and complete hydatidiform moles. We searched electronic databases included Medline, WOK, Cochrane Library and CNKI, through January 24, 2015. Experts were consulted, and references from related articles were examined. The meta-analysis was conducted with RevMan5.3, according to the PRISMA guidelines. Mantel-Haenszel estimates were calculated and pooled under a random effect model, with data expressed as odds ratio (OR) and 95% confidence interval (CI). We analyzed eight trials with a total of 337 participants who underwent uterine curettage and met the inclusion criteria. A significantly higher expression of Ki-67 was observed in complete than in partial hydatidiform moles (OR=3.28; 95%CI=1.80-5.96; pvalue in distinguishing between partial and complete hydatidiform moles. However, the present study had only a limited number of samples, so investigation of a greater number of cases is needed to confirm this conclusion. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  20. Transversus abdominis plane (TAP) block in laparoscopic colorectal surgery improves postoperative pain management: a meta-analysis.

    Science.gov (United States)

    Hain, E; Maggiori, L; Prost À la Denise, J; Panis, Y

    2018-04-01

    Transversus abdominis plane (TAP) block is a locoregional anaesthesia technique of growing interest in abdominal surgery. However, its efficacy following laparoscopic colorectal surgery is still debated. This meta-analysis aimed to assess the efficacy of TAP block after laparoscopic colorectal surgery. All comparative studies focusing on TAP block after laparoscopic colorectal surgery have been systematically identified through the MEDLINE database, reviewed and included. Meta-analysis was performed according to the Mantel-Haenszel method for random effects. End-points included postoperative opioid consumption, morbidity, time to first bowel movement and length of hospital stay. A total of 13 studies, including 7 randomized controlled trials, were included, comprising a total of 600 patients who underwent laparoscopic colorectal surgery with TAP block, compared with 762 patients without TAP block. Meta-analysis of these studies showed that TAP block was associated with a significantly reduced postoperative opioid consumption on the first day after surgery [weighted mean difference (WMD) -14.54 (-25.14; -3.94); P = 0.007] and a significantly shorter time to first bowel movement [WMD -0.53 (-0.61; -0.44); P plane (TAP) block in laparoscopic colorectal surgery improves postoperative opioid consumption and recovery of postoperative digestive function without any significant drawback. Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland.

  1. Patellar denervation with electrocautery in total knee arthroplasty without patellar resurfacing: a meta-analysis.

    Science.gov (United States)

    Cheng, Tao; Zhu, Chen; Guo, Yongyuan; Shi, Sifeng; Chen, Desheng; Zhang, Xianlong

    2014-11-01

    The impact of patellar denervation with electrocautery in total knee arthroplasty (TKA) on post-operative outcomes has been under debate. This study aims to conduct a meta-analysis and systematic review to compare the benefits and risks of circumpatellar electrocautery with those of non-electrocautery in primary TKAs. Comparative and randomized clinical studies were identified by conducting an electronic search of articles dated up to September 2012 in PubMed, EMBASE, Scopus, and the Cochrane databases. Six studies that focus on a total of 849 knees were analysed. A random-effects model was conducted using the inverse-variance method for continuous variables and the Mantel-Haenszel method for dichotomous variables. There was no significant difference in the incidence of anterior knee pain between the electrocautery and non-electrocautery groups. In term of patellar score and Knee Society Score, circumpatellar electrocautery improved clinical outcomes compared with non-electrocautery in TKAs. The statistical differences were in favour of the electrocautery group but have minimal clinical significance. In addition, the overall complications indicate no statistical significance between the two groups. This study shows no strong evidence either for or against electrocautery compared with non-electrocautery in TKAs. Therapeutic study (systematic review and meta-analysis), Level III.

  2. Evaluation of the effectiveness of laser in situ keratomileusis and photorefractive keratectomy for myopia: a meta-analysis.

    Science.gov (United States)

    Yang, Xin-Jun; Yan, Hong-Tao; Nakahori, Yutaka

    2003-08-01

    To evaluate the effectiveness of laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) for correcting myopia. Study selection, data extraction, and quality assessment were performed by two of authors independently. Summary odds ratios and 95% confidence intervals were calculated by DerSimonian & Laird random-effects model and Mantel-Haenszel (fixed-effects) model. All calculations were based on an intention-to-treat and per protocol analysis. Five hundred and eighty eyes (476 patients) from 5 randomized controlled trials were included in this study. At > or = 6 months follow-up, by random-effects model, the pooled odds ratios (OR, for LASIK vs. PRK) of postoperative uncorrected visual acuity (UCVA) of 20/20 or better for all trials were 1.31 (95% CI=0.77-2.22) by per protocol analysis and 1.18 (95% CI=0.74-1.88) by intention-to-treat analysis. In the refractive outcome, the pooled OR of the postoperative spherical equivalent refraction within +/-0.5 diopter (D) of emmetropia did not show any statistical significance, for which the OR were 0.75 (95% CI=0.48-1.18) by per protocol analysis and 0.70 (95% CI=0.47-1.04) by intention-to-treat analysis. LASIK and PRK were found to be similarly effective for the correction of myopia from -1.5 to -15.0 D in a greater than 6 month follow-up.

  3. Work-related health problems among resident immigrant workers in Italy and Spain

    Directory of Open Access Journals (Sweden)

    Aldo Rosano

    2012-09-01

    Full Text Available

    Background: in both Spain and Italy the number of immigrants has strongly increased in the last 20 years, currently representing more than the 10% of workforce in each country. The segregation of immigrants into unskilled or risky jobs brings negative consequences for their health. The objective of this study is to compare prevalence of work-related health problems between immigrants and native workers in Italy and Spain.

    Methods: data come from the Italian Labour Force Survey (n=65 779 and Spanish Working Conditions Survey (n=11 019, both conducted in 2007. We analyzed merged datasets to evaluate whether interviewees, both natives and migrants, judge their health being affected by their work conditions and, if so, which specific diseases. For migrants, we considered those coming from countries with a value of the Human Development Index lower than 0.85. Logistic regression models were used, including gender, age, and education as adjusting factors.

    Results: migrants reported skin diseases (Mantel-Haenszel pooled OR=1.49; 95%CI: 0.59-3.74 and musculoskeletal problems among those employed in agricultural sector (Mantel-Haenszel pooled OR=1.16; 95%CI: 0.69-1.96 more frequently than natives; country-specific analysis showed higher risks of musculoskeletal problems among migrants compared to the non-migrant population in Italy (OR=1.17; 95% CI: 0.48-1.59 and of respiratory problems in Spain (OR=2.02; 95%CI: 1.02-4.0. In both countries the risk of psychological stress was predominant among national workers.

    Conclusions: this collaborative study allows to strength the evidence concerning the health of migrant workers in Southern European countries.

  4. Validity of measures of pain and symptoms in HIV/AIDS infected households in resources poor settings: results from the Dominican Republic and Cambodia

    Directory of Open Access Journals (Sweden)

    Morineau Guy

    2006-03-01

    Full Text Available Abstract Background HIV/AIDS treatment programs are currently being mounted in many developing nations that include palliative care services. While measures of palliative care have been developed and validated for resource rich settings, very little work exists to support an understanding of measurement for Africa, Latin America or Asia. Methods This study investigates the construct validity of measures of reported pain, pain control, symptoms and symptom control in areas with high HIV-infected prevalence in Dominican Republic and Cambodia Measures were adapted from the POS (Palliative Outcome Scale. Households were selected through purposive sampling from networks of people living with HIV/AIDS. Consistencies in patterns in the data were tested used Chi Square and Mantel Haenszel tests. Results The sample persons who reported chronic illness were much more likely to report pain and symptoms compared to those not chronically ill. When controlling for the degrees of pain, pain control did not differ between the chronically ill and non-chronically ill using a Mantel Haenszel test in both countries. Similar results were found for reported symptoms and symptom control for the Dominican Republic. These findings broadly support the construct validity of an adapted version of the POS in these two less developed countries. Conclusion The results of the study suggest that the selected measures can usefully be incorporated into population-based surveys and evaluation tools needed to monitor palliative care and used in settings with high HIV/AIDS prevalence.

  5. NFKBIZ polymorphisms and susceptibility to pneumococcal disease in European and African populations

    Science.gov (United States)

    Chapman, Stephen J; Khor, Chiea C; Vannberg, Fredrik O; Rautanen, Anna; Segal, Shelley; Moore, Catrin E; Davies, Robert J O; Day, Nicholas P; Peshu, Norbert; Crook, Derrick W; Berkley, James A; Williams, Thomas N; Scott, J Anthony; Hill, Adrian V S

    2011-01-01

    The proinflammatory transcription factor nuclear factor-kappaB (NF-κB) plays a central role in host defence against pneumococcal disease. Both rare mutations and common polymorphisms in the NFKBIA gene encoding the NF-κB inhibitor IκB-α associate with susceptibility to bacterial disease, but the possible role of polymorphisms within the related IκB-ζ gene NFKBIZ in the development of invasive pneumococcal disease has not previously been reported. To investigate this further, we examined the frequencies of 22 single-nucleotide polymorphisms spanning NFKBIZ in two case-control studies, comprising UK Caucasian (n=1008) and Kenyan (n=723) individuals. Nine polymorphisms within a single UK linkage disequilibrium block and all four polymorphisms within the equivalent, shorter Kenyan linkage disequilibrium block displayed either significant association with invasive pneumococcal disease or a trend towards association. For each polymorphism, heterozygosity was associated with protection from invasive pneumococcal disease when compared to the combined homozygous states (e.g. for rs600718, Mantel-Haenszel 2×2 χ2=7.576, P=0.006, OR=0.67, 95% CI for OR: 0.51-0.88; for rs616597, Mantel-Haenszel 2×2 χ2=8.715, P=0.003, OR=0.65, 95% CI: 0.49-0.86). We conclude that multiple NFKBIZ polymorphisms associate with susceptibility to invasive pneumococcal disease in humans. The study of multiple populations may aid fine-mapping of associations within extensive regions of strong linkage disequilibrium (‘transethnic mapping’). PMID:19798075

  6. Development of the first permanent mandibular molar in young children with bilateral complete cleft lip and palate (BCCLP)

    DEFF Research Database (Denmark)

    N.V., Hermann; T.A., Darvann; S., Kreiborg

    2017-01-01

    . The relationship between stage of mineralization in BCCLP and controls was tested using a Mantel-Haenszel test. Pearson's correlation coefficient R was used to describe the relationship between FW and FM. Differences between group means of FW as well as of CW were tested using Student's t-test. Level......Background/Purpose: Previous studies have shown that the develop-ment of the first permanent mandibular molar (M1inf.) is deviant in children with unilateral cleft lip and palate (UCCLP) and in children with isolated cleft palate (CP). Also, a significant correlation between severity of CP...

  7. Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial.

    Science.gov (United States)

    Llewellyn-Jones, R H; Baikie, K A; Smithers, H; Cohen, J; Snowdon, J; Tennant, C C

    1999-09-11

    To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. Population of residential facility in Sydney living in self care units and hostels. 220 depressed residents aged >/=65 without severe cognitive impairment. The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. Geriatric depression scale. Intention to treat analysis was used. There was significantly more movement to "less depressed" levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents.

  8. Sodium-glucose cotransporter 2 (SGLT2) inhibitors and fracture risk in patients with type 2 diabetes mellitus: A meta-analysis.

    Science.gov (United States)

    Ruanpeng, Darin; Ungprasert, Patompong; Sangtian, Jutarat; Harindhanavudhi, Tasma

    2017-09-01

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors could potentially alter calcium and phosphate homeostasis and may increase the risk of bone fracture. The current meta-analysis was conducted to investigate the fracture risk among patients with type 2 diabetes mellitus treated with SGLT2 inhibitors. Randomized controlled trials that compared the efficacy of SGLT2 inhibitors to placebo were identified. The risk ratios of fracture among patients who received SGLT2 inhibitors versus placebo were extracted from each study. Pooled risk ratios and 95% confidence intervals were calculated using a random-effect, Mantel-Haenszel analysis. A total of 20 studies with 8286 patients treated with SGLT2 inhibitors were included. The pooled risk ratio of bone fracture in patients receiving SGLT2 inhibitors versus placebo was 0.67 (95% confidence interval, 0.42-1.07). The pooled risk ratio for canagliflozin, dapagliflozin, and empagliflozin was 0.66 (95% confidence interval, 0.37-1.19), 0.84 (95% confidence interval, 0.22-3.18), and 0.57 (95% confidence interval, 0.20-1.59), respectively. Increased risk of bone fracture among patients with type 2 diabetes mellitus treated with SGLT2 inhibitors compared with placebo was not observed in this meta-analysis. However, the results were limited by short duration of treatment/follow-up and low incidence of the event of interest. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Breast cancer in female radium dial workers first employed before 1930

    International Nuclear Information System (INIS)

    Adams, E.E.; Brues, A.M.

    1980-01-01

    Female radium dial workers first employed before 1930 were analyzed for breast cancer mortality and incidence using method and rate tables described by Monson and the Mantel-Haenszel summary chi-square test for significance. Of 1180 located women, 736 were measured to estimate radium intake. This measured group was analyzed for breast cancer mortality and incidence according to four possible risk factors: radium intake dose, duration of employment, age at first exposure, and parity. The measured women showed a significant excess of breast cancer incidence and mortality only among those women with a radium intake of 50 μCi or greater

  10. A Community-Based Randomized Trial of Hepatitis B Screening Among High-Risk Vietnamese Americans.

    Science.gov (United States)

    Ma, Grace X; Fang, Carolyn Y; Seals, Brenda; Feng, Ziding; Tan, Yin; Siu, Philip; Yeh, Ming Chin; Golub, Sarit A; Nguyen, Minhhuyen T; Tran, Tam; Wang, Minqi

    2017-03-01

    To evaluate the effectiveness of a community-based liver cancer prevention program on hepatitis B virus (HBV) screening among low-income, underserved Vietnamese Americans at high risk. We conducted a cluster randomized trial involving 36 Vietnamese community-based organizations and 2337 participants in Pennsylvania, New Jersey, and New York City between 2009 and 2014. We randomly assigned 18 community-based organizations to a community-based multilevel HBV screening intervention (n = 1131). We randomly assigned the remaining 18 community-based organizations to a general cancer education program (n = 1206), which included information about HBV-related liver cancer prevention. We assessed HBV screening rates at 6-month follow-up. Intervention participants were significantly more likely to have undergone HBV screening (88.1%) than were control group participants (4.6%). In a Cochran-Mantel-Haenszel analysis, the intervention effect on screening outcomes remained statistically significant after adjustment for demographic and health care access variables, including income, having health insurance, having a regular health provider, and English proficiency. A community-based, culturally appropriate, multilevel HBV screening intervention effectively increases screening rates in a high-risk, hard-to-reach Vietnamese American population.

  11. Notes on testing equality and interval estimation in Poisson frequency data under a three-treatment three-period crossover trial.

    Science.gov (United States)

    Lui, Kung-Jong; Chang, Kuang-Chao

    2016-10-01

    When the frequency of event occurrences follows a Poisson distribution, we develop procedures for testing equality of treatments and interval estimators for the ratio of mean frequencies between treatments under a three-treatment three-period crossover design. Using Monte Carlo simulations, we evaluate the performance of these test procedures and interval estimators in various situations. We note that all test procedures developed here can perform well with respect to Type I error even when the number of patients per group is moderate. We further note that the two weighted-least-squares (WLS) test procedures derived here are generally preferable to the other two commonly used test procedures in the contingency table analysis. We also demonstrate that both interval estimators based on the WLS method and interval estimators based on Mantel-Haenszel (MH) approach can perform well, and are essentially of equal precision with respect to the average length. We use a double-blind randomized three-treatment three-period crossover trial comparing salbutamol and salmeterol with a placebo with respect to the number of exacerbations of asthma to illustrate the use of these test procedures and estimators. © The Author(s) 2014.

  12. Adjusting for multiple prognostic factors in the analysis of randomised trials

    Science.gov (United States)

    2013-01-01

    Background When multiple prognostic factors are adjusted for in the analysis of a randomised trial, it is unclear (1) whether it is necessary to account for each of the strata, formed by all combinations of the prognostic factors (stratified analysis), when randomisation has been balanced within each stratum (stratified randomisation), or whether adjusting for the main effects alone will suffice, and (2) the best method of adjustment in terms of type I error rate and power, irrespective of the randomisation method. Methods We used simulation to (1) determine if a stratified analysis is necessary after stratified randomisation, and (2) to compare different methods of adjustment in terms of power and type I error rate. We considered the following methods of analysis: adjusting for covariates in a regression model, adjusting for each stratum using either fixed or random effects, and Mantel-Haenszel or a stratified Cox model depending on outcome. Results Stratified analysis is required after stratified randomisation to maintain correct type I error rates when (a) there are strong interactions between prognostic factors, and (b) there are approximately equal number of patients in each stratum. However, simulations based on real trial data found that type I error rates were unaffected by the method of analysis (stratified vs unstratified), indicating these conditions were not met in real datasets. Comparison of different analysis methods found that with small sample sizes and a binary or time-to-event outcome, most analysis methods lead to either inflated type I error rates or a reduction in power; the lone exception was a stratified analysis using random effects for strata, which gave nominal type I error rates and adequate power. Conclusions It is unlikely that a stratified analysis is necessary after stratified randomisation except in extreme scenarios. Therefore, the method of analysis (accounting for the strata, or adjusting only for the covariates) will not

  13. Outcomes following polyetheretherketone (PEEK) cranioplasty: Systematic review and meta-analysis.

    Science.gov (United States)

    Punchak, Maria; Chung, Lawrance K; Lagman, Carlito; Bui, Timothy T; Lazareff, Jorge; Rezzadeh, Kameron; Jarrahy, Reza; Yang, Isaac

    2017-07-01

    Polyetheretherketone (PEEK) has been used in cranioplasty since the early 2000s. However, there remains limited data that compares its long-term complication rate to autologous grafts and titanium mesh implants. To compare complication and implant failure rates after PEEK, autologous and titanium mesh cranioplasties, the authors of this study conducted a systematic review using the PubMed database. Studies that contained outcome data on complication rates of PEEK cranioplasty patients and studies that compared outcomes of patients who underwent PEEK cranioplasties versus other materials were included in the meta-analysis. Pooled odds ratios using the Mantel-Haenszel method were used for analysis. Fifteen articles, comprised of 183 PEEK cranioplasty patients were included. Of these patients, 15.3% developed post-operative complications and 8.7% experienced implant failure requiring reoperation. Patients who underwent cranioplasties with PEEK implants had 0.130 times the odds of developing post-operative complications (P=0.065) and 0.574 times the odds of implant failure compared to patients with autologous bone graft cranioplasties (P=0.629). Patients who had undergone PEEK cranioplasties had 0.127 times the odds of developing post-op complications (P=0.360) and 0.170 times the odds of implant failure compared to individuals who had undergone titanium mesh cranioplasties (P=0.168). The analysis was severely limited by the paucity in literature. However, there was a trend toward lower post-operative complication rates following PEEK cranioplasty versus autologous grafts, and lower implant failure rates with PEEK versus titanium mesh implants. Copyright © 2017. Published by Elsevier Ltd.

  14. Exact association test for small size sequencing data.

    Science.gov (United States)

    Lee, Joowon; Lee, Seungyeoun; Jang, Jin-Young; Park, Taesung

    2018-04-20

    Recent statistical methods for next generation sequencing (NGS) data have been successfully applied to identifying rare genetic variants associated with certain diseases. However, most commonly used methods (e.g., burden tests and variance-component tests) rely on large sample sizes. Notwithstanding, due to its-still high cost, NGS data is generally restricted to small sample sizes, that cannot be analyzed by most existing methods. In this work, we propose a new exact association test for sequencing data that does not require a large sample approximation, which is applicable to both common and rare variants. Our method, based on the Generalized Cochran-Mantel-Haenszel (GCMH) statistic, was applied to NGS datasets from intraductal papillary mucinous neoplasm (IPMN) patients. IPMN is a unique pancreatic cancer subtype that can turn into an invasive and hard-to-treat metastatic disease. Application of our method to IPMN data successfully identified susceptible genes associated with progression of IPMN to pancreatic cancer. Our method is expected to identify disease-associated genetic variants more successfully, and corresponding signal pathways, improving our understanding of specific disease's etiology and prognosis.

  15. A comparison of three methods of assessing differential item functioning (DIF) in the Hospital Anxiety Depression Scale: ordinal logistic regression, Rasch analysis and the Mantel chi-square procedure.

    Science.gov (United States)

    Cameron, Isobel M; Scott, Neil W; Adler, Mats; Reid, Ian C

    2014-12-01

    It is important for clinical practice and research that measurement scales of well-being and quality of life exhibit only minimal differential item functioning (DIF). DIF occurs where different groups of people endorse items in a scale to different extents after being matched by the intended scale attribute. We investigate the equivalence or otherwise of common methods of assessing DIF. Three methods of measuring age- and sex-related DIF (ordinal logistic regression, Rasch analysis and Mantel χ(2) procedure) were applied to Hospital Anxiety Depression Scale (HADS) data pertaining to a sample of 1,068 patients consulting primary care practitioners. Three items were flagged by all three approaches as having either age- or sex-related DIF with a consistent direction of effect; a further three items identified did not meet stricter criteria for important DIF using at least one method. When applying strict criteria for significant DIF, ordinal logistic regression was slightly less sensitive. Ordinal logistic regression, Rasch analysis and contingency table methods yielded consistent results when identifying DIF in the HADS depression and HADS anxiety scales. Regardless of methods applied, investigators should use a combination of statistical significance, magnitude of the DIF effect and investigator judgement when interpreting the results.

  16. Traditional cardiovascular risk factors and coronary collateral circulation: Protocol for a systematic review and meta-analysis of case-control studies.

    Science.gov (United States)

    Xing, Zhenhua; Pei, Junyu; Tang, Liang; Hu, Xinqun

    2018-04-01

    Well-developed coronary collateral circulation usually results in fewer infarct size, improved cardiac function, and fewer mortality. Traditional coronary risk factors (diabetes, hypertension, and smoking) have some effects on coronary collateral circulation. However, the association between these risk factors and coronary collateral circulation are controversial. Given the confusing evidences regarding traditional cardiovascular risk factors on coronary collateral circulation, we performed this meta-analysis protocol to investigate the relationship between traditional risk factors of coronary artery disease and coronary collateral circulation. MEDINE, EMBASE, and Science Citation Index will be searched to identify relevant studies. The primary outcomes of this meta-analysis are well-developed coronary collateral circulation. Meta-analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) of traditional coronary risk factors (diabetes, smoking, hypertriton). Pooled ORs were computed as the Mantel-Haenszel-weighted average of the ORs for all included studies. Sensitivity analysis, quality assessment, publication bias analysis, and the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE) will be performed to ensure the reliability of our results. This study will provide a high-quality synthesis of current evidence of traditional risk factors on collateral circulation. This conclusion of our systematic review and meta-analysis will provide evidence to judge whether traditional risk factors affects coronary collateral circulation.Ethics and dissemination: Ethical approval is not required because our systematic review and meta-analysis will be based on published data without interventions on patients. The findings of this study will be published in a peer-reviewed journal.

  17. Prophylactic mesh to prevent parastomal hernia after end colostomy: a meta-analysis and trial sequential analysis.

    Science.gov (United States)

    López-Cano, M; Brandsma, H-T; Bury, K; Hansson, B; Kyle-Leinhase, I; Alamino, J G; Muysoms, F

    2017-04-01

    Prevention of parastomal hernia (PSH) formation is crucial, given the high prevalence and difficulties in the surgical repair of PSH. To investigate the effect of a preventive mesh in PSH formation after an end colostomy, we aimed to meta-analyze all relevant randomized controlled trials (RCTs). We searched five databases. For each trial, we extracted risk ratios (RRs) of the effects of mesh or no mesh. The primary outcome was incidence of PSH with a minimum follow-up of 12 months with a clinical and/or computed tomography diagnosis. RRs were combined using the random-effect model (Mantel-Haenszel). To control the risk of type I error, we performed a trial sequential analysis (TSA). Seven RCTs with low risk of bias (451 patients) were included. Meta-analysis for primary outcome showed a significant reduction of the incidence of PSH using a mesh (RR 0.43, 95% CI 0.26-0.71; P = 0.0009). Regarding TSA calculation for the primary outcome, the accrued information size (451) was 187.1% of the estimated required information size (RIS) (241). Wound infection showed no statistical differences between groups (RR 0.77, 95% CI 0.39-1.54; P = 0.46). PSH repair rate showed a significant reduction in the mesh group (RR 0.28 (95% CI 0.10-0.78; P = 0.01). PSH prevention with mesh when creating an end colostomy reduces the incidence of PSH, the risk for subsequent PSH repair and does not increase wound infections. TSA shows that the RIS is reached for the primary outcome. Additional RCTs in the previous context are not needed.

  18. Clustering of Mycobacterium tuberculosis Cases in Acapulco: Spoligotyping and Risk Factors

    Directory of Open Access Journals (Sweden)

    Elizabeth Nava-Aguilera

    2011-01-01

    Full Text Available Recurrence and reinfection of tuberculosis have quite different implications for prevention. We identified 267 spoligotypes of Mycobacterium tuberculosis from consecutive tuberculosis patients in Acapulco, Mexico, to assess the level of clustering and risk factors for clustered strains. Point cluster analysis examined spatial clustering. Risk analysis relied on the Mantel Haenszel procedure to examine bivariate associations, then to develop risk profiles of combinations of risk factors. Supplementary analysis of the spoligotyping data used SpolTools. Spoligotyping identified 85 types, 50 of them previously unreported. The five most common spoligotypes accounted for 55% of tuberculosis cases. One cluster of 70 patients (26% of the series produced a single spoligotype from the Manila Family (Clade EAI2. The high proportion (78% of patients infected with cluster strains is compatible with recent transmission of TB in Acapulco. Geomatic analysis showed no spatial clustering; clustering was associated with a risk profile of uneducated cases who lived in single-room dwellings. The Manila emerging strain accounted for one in every four cases, confirming that one strain can predominate in a hyperendemic area.

  19. Surgical timing of the orbital "blowout" fracture

    DEFF Research Database (Denmark)

    Damgaard, Olaf Ehlers; Larsen, Christian Grønhøj; Felding, Ulrik Ascanius

    2016-01-01

    ). Patients were evaluated for diplopia and enophthalmos.  Review Methods: We followed the statements of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Pooled odds ratios were estimated with the fixed effects method of Mantel-Haenszel.  Results: We identified 5 studies...... with available outcome data (N = 442). Patients in the late group showed an odds ratio of 3.3 (P =.027) for persistent postoperative diplopia as compared with the early group. We found no significant difference between the groups when assessing postoperative enophthalmos as an isolated symptom.  Conclusion: We...... found a significantly increased risk of persistent diplopia in patients who were operated >14 days after the trauma....

  20. Effect of socioeconomic level on knowledge of stroke in the general population: A social inequality gradient.

    Science.gov (United States)

    Ramírez-Moreno, J M; Alonso-González, R; Peral Pacheco, D; Millán-Nuñez, M V; Roa-Montero, A; Constantino-Silva, A B; Aguirre-Sánchez, J J

    2016-01-01

    Socioeconomic status is a factor that influences health-related behaviour in individuals as well as health conditions in entire populations. The objective of the present study was to analyse the sociodemographic factors that may influence knowledge of stroke. Cross-sectional study. A representative sample was selected by double randomisation. Face-to-face interviews were carried out by previously trained medical students using a structured questionnaire with open- and closed-ended questions. Adequate knowledge was previously defined. The Mantel-Haenszel test and adjusted logistic regression analysis were used to assess the association between knowledge of stroke and the study variables. 2411 subjects were interviewed (59.9% women; mean age 49.0 [SD 17.3] years) Seventy-three per cent were residents of urban areas, 24.7% had a university education, and 15.2% had a low level of schooling. Only 2.1% reported earning more than 40 000 euros/year, with 29.9% earning less than 10 000. Nearly 74% reported having an excellent or good state of health. The unemployment rate was 17.0%. Prevalence of "adequate knowledge" was 39.7% (95% CI: 37.7%-41.6%). Trend analysis showed an association between knowledge of stroke and income (z=10.14, P<0.0001); educational level (z=15.95, P<0.0001); state of health (z=7.92, P<0.0001); and employment status (z=8.98, P<0.0001). Educational level, income, employment status, and state of health are independent factors for adequate knowledge of stroke. Public awareness campaigns should present material using simple language and efforts should be directed toward the most disadvantaged social strata in particular. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  1. The English version of the four-dimensional symptom questionnaire (4DSQ) measures the same as the original Dutch questionnaire: a validation study.

    Science.gov (United States)

    Terluin, Berend; Smits, Niels; Miedema, Baukje

    2014-12-01

    Translations of questionnaires need to be carefully validated to assure that the translation measures the same construct(s) as the original questionnaire. The four-dimensional symptom questionnaire (4DSQ) is a Dutch self-report questionnaire measuring distress, depression, anxiety and somatization. To evaluate the equivalence of the English version of the 4DSQ. 4DSQ data of English and Dutch speaking general practice attendees were analysed and compared. The English speaking group consisted of 205 attendees, aged 18-64 years, in general practice, in Canada whereas the Dutch group consisted of 302 general practice attendees in the Netherlands. Differential item functioning (DIF) analysis was conducted using the Mantel-Haenszel method and ordinal logistic regression. Differential test functioning (DTF; i.e., the scale impact of DIF) was evaluated using linear regression analysis. DIF was detected in 2/16 distress items, 2/6 depression items, 2/12 anxiety items, and 1/16 somatization items. With respect to mean scale scores, the impact of DIF on the scale level was negligible for all scales. On the anxiety scale DIF caused the English speaking patients with moderate to severe anxiety to score about one point lower than Dutch patients with the same anxiety level. The English 4DSQ measures the same constructs like the original Dutch 4DSQ. The distress, depression and somatization scales can employ the same cut-off points as the corresponding Dutch scales. However, cut-off points of the English 4DSQ anxiety scale should be lowered by one point to retain the same meaning as the Dutch anxiety cut-off points.

  2. Human papillomavirus infection and the malignant transformation of sinonasal inverted papilloma: A meta-analysis.

    Science.gov (United States)

    Zhao, Ren-Wu; Guo, Zhi-Qiang; Zhang, Ru-Xin

    2016-06-01

    A growing number of molecular epidemiological studies have been conducted to evaluate the association between human papillomavirus (HPV) infection and the malignancy of sinonasal inverted papilloma (SNIP). However, the results remain inconclusive. Here, a meta-analysis was conducted to quantitatively assess this association. Case-control studies investigating SNIP tissues for presence of HPV DNA were identified. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by the Mantel-Haenszel method. An assessment of publication bias and sensitivity analysis were also performed. We calculated a pooled OR of 2.16 (95% CI=1.46-3.21, P<0.001) without statistically significant heterogeneity or publication bias. Stratification by HPV type showed a stronger association for patients with high-risk HPV (hrHPV) types, HPV-16, HPV-18, and HPV-16/18 infection (OR=8.8 [95% CI: 4.73-16.38], 8.04 [95% CI: 3.34-19.39], 18.57 [95% CI: 4.56-75.70], and 26.24 [4.35-158.47], respectively). When only using PCR studies, pooled ORs for patients with hrHPV, HPV-16, and HPV18 infection still reached statistical significance. However, Egger's test reflected significant publication bias in the HPV-16 sub-analysis (P=0.06), and the adjusted OR was no longer statistically significant (OR=1.65, 95%CI: 0.58-4.63). These results suggest that HPV infection, especially hrHPV (HPV-18), is significantly associated with malignant SNIP. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Maternal SSRI exposure increases the risk of autistic offspring: A meta-analysis and systematic review.

    Science.gov (United States)

    Andalib, S; Emamhadi, M R; Yousefzadeh-Chabok, S; Shakouri, S K; Høilund-Carlsen, P F; Vafaee, M S; Michel, T M

    2017-09-01

    Selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressants used to preclude maternal pregnancy depression. There is a growing body of literature assessing the association of prenatal exposure to SSRIs with autism spectrum disorder (ASD). The present systematic review and meta-analysis reviewed the medical literature and pooled the results of the association of prenatal exposure to SSRIs with ASD. Published investigations in English by June 2016 with keywords of selective serotonin reuptake inhibitors, SSRI, autism spectrum disorder, ASD, pregnancy, childhood, children, neurodevelopment were identified using databases PubMed and PMC, MEDLINE, EMBASE, SCOPUS, and Google Scholar. Cochran's Q statistic-value (Q), degree of freedom (df), and I 2 indices (variation in odds ratio [OR] attributable to heterogeneity) were calculated to analyze the risk of heterogeneity of the within- and between-study variability. Pooled odds ratio (OR) and 95% confidence interval (CI) were reported by a Mantel-Haenszel test. There was a non-significant heterogeneity for the included studies ([Q=3.61, df=6, P=0.730], I 2 =0%). The pooled results showed a significant association between prenatal SSRI exposure and ASD (OR=1.82, 95% CI=1.59-2.10, Z=8.49, P=0.00). The evidence from the present study suggests that prenatal exposure to SSRIs is associated with a higher risk of ASD. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Risk factors for developing tooth sensitivity and gingival irritation associated with nightguard vital bleaching.

    Science.gov (United States)

    Leonard, R H; Haywood, V B; Phillips, C

    1997-08-01

    The purpose of this study was to determine risk factors in the development of tooth sensitivity and gingival irritation associated with the nightguard vital bleaching technique. The potential risk factors evaluated (sex, age, reported allergy, whitening solution, number of times the solution was changed daily [its usage pattern], and dental arch) were collected from the daily log form turned in by each of the 64 participants after completion of the 6-week lightening process. Also evaluated for each participant, from color slides, were tooth characteristics such as gingival recession, defective restorations, abfraction lesions, enamel-cementum abrasion, etc, and reported side effects. The generalized Mantel-Haenszel statistic was used to assess the association between the potential risk factors and the development of tooth sensitivity and/or gingival irritation. No statistical relationship existed between age, sex, allergy, tooth characteristics, or the dental arch lightened and the development of side effects. Initially, a statistically significant association existed between side effects and the whitening solution used. However, when the analysis was controlled for usage pattern, this relationship disappeared. Patients who changed the whitening solution more than once a day reported statistically significantly more side effects than did those who did not change the whitening solution during their usage time.

  5. Risk factors for postoperative delirium in patients undergoing major head and neck cancer surgery: a meta-analysis.

    Science.gov (United States)

    Zhu, Yun; Wang, Gangpu; Liu, Shengwen; Zhou, Shanghui; Lian, Ying; Zhang, Chenping; Yang, Wenjun

    2017-06-01

    Postoperative delirium is common after extensive surgery. This study aimed to collate and synthesize published literature on risk factors for delirium in patients with head and neck cancer surgery. Three databases were searched (MEDLINE, Embase, and Cochrane Library) between January 1987 and July 2016. The Newcastle Ottawa Scale (NOS) was adopted to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods. They provided a total of 1940 patients (286 with delirium and 1654 without), and predominantly included patients undergoing head and neck cancer surgery. The incidence of postoperative delirium ranged from 11.50% to 36.11%. Ten statistically significant risk factors were identified in pooled analysis. Old age, age >70 years, male sex, duration of surgery, history of hypertension, blood transfusions, tracheotomy, American Society of Anesthesiologists physical status grade at least III, flap reconstruction and neck dissection were more likely to sustain delirium after head and neck cancer surgery. Delirium is common in patients undergoing major head neck cancer surgery. Several risk factors were consistently associated with postoperative delirium. These factors help to highlight patients at risk of developing delirium and are suitable for preventive action. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  6. Terbinafine in the treatment of dermatophyte toenail onychomycosis: a meta-analysis of efficacy for continuous and intermittent regimens.

    Science.gov (United States)

    Gupta, A K; Paquet, M; Simpson, F; Tavakkol, A

    2013-03-01

    To compare mycological and complete cures of terbinafine continuous and intermittent regimens in the treatment of toenail onychomycosis. The PubMed database was searched using the terms "terbinafine", "onychomycosis", "continuous" and "pulse(d)" or "intermittent". The inclusion criteria were head-to-head comparison of terbinafine pulse and continuous regimens for dermatophyte toenail infections. Risk ratios were calculated for intention-to-treat and evaluable patient analyses, when possible. Pooled estimates for total and subgroup analyses were calculated using a random effect model, Mantel-Haenszel method and their probabilities were calculated with z-statistics. Nine studies from eight publications were included. Two continuous regimens and four intermittent regimens were investigated. A pooled risk ratio of 0.87 was obtained for intention-to-treat (95% CI: 0.79-0.96, P = 0.004, n = 6) and evaluable patient (95% CI: 0.80-0.96, P = 0.003, n = 8) analyses of mycological cure, favouring continuous terbinafine. For complete cure, pooled risk ratios of 0.97 (95% CI: 0.77-1.23, P = 0.82, n = 7) for intention-to-treat and 0.93 (95% CI: 0.76-1.13, P = 0.44, n = 9) for evaluable patient analyses showed equality of the two regimens. The pulse regimen that demonstrated consistently comparable results to the continuous terbinafine regimen was two pulses of terbinafine 250 mg/day for 4 weeks on/4 weeks off. Meta-analysis of published studies of toenail onychomycosis showed that a continuous terbinafine regimen is generally significantly superior to a pulsed terbinafine regimen for mycological cure. In contrast, some pulse terbinafine regimens were as effective as continuous terbinafine regimens for complete cure. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  7. Does prolonged β-lactam infusions improve clinical outcomes compared to intermittent infusions? A meta-analysis and systematic review of randomized, controlled trials

    Directory of Open Access Journals (Sweden)

    Van Arendonk Kyle J

    2011-06-01

    Full Text Available Abstract Background The emergence of multi-drug resistant Gram-negatives (MDRGNs coupled with an alarming scarcity of new antibiotics has forced the optimization of the therapeutic potential of available antibiotics. To exploit the time above the minimum inhibitory concentration mechanism of β-lactams, prolonging their infusion may improve outcomes. The primary objective of this meta-analysis was to determine if prolonged β-lactam infusion resulted in decreased mortality and improved clinical cure compared to intermittent β-lactam infusion. Methods Relevant studies were identified from searches of MEDLINE, EMBASE, and CENTRAL. Heterogeneity was assessed qualitatively, in addition to I2 and Chi-square statistics. Pooled relative risks (RR and 95% confidence intervals (CI were calculated using Mantel-Haenszel random-effects models. Results Fourteen randomized controlled trials (RCTs were included. Prolonged infusion β-lactams were not associated with decreased mortality (n= 982; RR 0.92; 95% CI:0.61-1.37 or clinical cure (n = 1380; RR 1.00 95% CI:0.94-1.06 compared to intermittent infusions. Subgroup analysis for β-lactam subclasses and equivalent total daily β-lactam doses yielded similar results. Most studies had notable methodological flaws. Conclusions No clinical advantage was observed for prolonged infusion β-lactams. The limited number of studies with MDRGNs precluded evaluation of prolonged infusion of β-lactams for this subgroup. A large, multicenter RCT with critically ill patients infected with MDRGNs is needed.

  8. Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials

    Science.gov (United States)

    Varadhan, Krishna K; Neal, Keith R

    2012-01-01

    Objective To compare the safety and efficacy of antibiotic treatment versus appendicectomy for the primary treatment of uncomplicated acute appendicitis. Design Meta-analysis of randomised controlled trials. Population Randomised controlled trials of adult patients presenting with uncomplicated acute appendicitis, diagnosed by haematological and radiological investigations. Interventions Antibiotic treatment versus appendicectomy. Outcome measures The primary outcome measure was complications. The secondary outcome measures were efficacy of treatment, length of stay, and incidence of complicated appendicitis and readmissions. Results Four randomised controlled trials with a total of 900 patients (470 antibiotic treatment, 430 appendicectomy) met the inclusion criteria. Antibiotic treatment was associated with a 63% (277/438) success rate at one year. Meta-analysis of complications showed a relative risk reduction of 31% for antibiotic treatment compared with appendicectomy (risk ratio (Mantel-Haenszel, fixed) 0.69 (95% confidence interval 0.54 to 0.89); I2=0%; P=0.004). A secondary analysis, excluding the study with crossover of patients between the two interventions after randomisation, showed a significant relative risk reduction of 39% for antibiotic therapy (risk ratio 0.61 (0.40 to 0.92); I2=0%; P=0.02). Of the 65 (20%) patients who had appendicectomy after readmission, nine had perforated appendicitis and four had gangrenous appendicitis. No significant differences were seen for treatment efficacy, length of stay, or risk of developing complicated appendicitis. Conclusion Antibiotics are both effective and safe as primary treatment for patients with uncomplicated acute appendicitis. Initial antibiotic treatment merits consideration as a primary treatment option for early uncomplicated appendicitis. PMID:22491789

  9. Idade materna como fator de risco: estudo com primigestas na faixa etária igual ou superior a 28 anos La edad materna como un factor de riesgo: estudio com primigestas en la facha etaria igual o superior a 28 años Maternal age as a risk factor: a study on first time pregnant women with age equal or higher than 28 years old

    Directory of Open Access Journals (Sweden)

    Cristina Maria Garcia de Lima Parada

    1999-10-01

    después de controlado el tipo de parto, para las siguientes complicaciones perinatales: taquipnea transitoria del recien nacido, cianosis generalizada ao nacer e infección neonatal.This is a transverse-type designed study with the aim analise maternal age as a risk factor, and as not a risk factor, through the verification of incidents during pregnancy, birth and puerperium of first time pregnant women with age equal or higher than 28 years old; as well as birth conditions and discharge of their newborns, comparing them with a group of first time pregnant women from 20 to 27 years old. The study was carried out in Botucatu, São Paulo, from January, 1990 to June, 1995. The statistical analysis, discussed at the level of 5% of significance, was developed through Mann-Whitney test, Goodman test and the evaluation of relative risk and corrected relative risk through Mantel-Haenszel technique. We concluded that maternal age equal or higher than 28 years old, is not a pregnancy, puerperal and intrapartum risk factor, although, on the other hand, it was a risk factor even after controlled parturition for the following perinatal incidents: newborn tachypnea, generalized cyanosis at birth and neonatal infection.

  10. Efficacy and safety profile of antibiotic prophylaxis usage in clean and clean-contaminated plastic and reconstructive surgery: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Zhang, Yi; Dong, Jiasheng; Qiao, Yufei; He, Jinguang; Wang, Tao; Ma, Sunxiang

    2014-01-01

    There is no consensus with regard to antibiotic prophylaxis usage in clean and clean-contaminated plastic and reconstructive surgery. This meta-analysis sought to assess the efficacy and safety of antibiotic prophylaxis and to determine appropriate duration of prophylaxis. An English language literature search was conducted using PubMed and the Cochrane Collaboration for randomized controlled trials (RCTs) that evaluate the use of antibiotic prophylaxis to prevent postoperative surgical site infection (SSI) in patients undergoing clean and clean-contaminated plastic and reconstructive surgery. Data from intention-to-treat analyses were used where available. For the dichotomous data, results for each study were odds ratio (OR) with 95% confidence interval (CI) and combined for meta-analysis using the Mantel-Haenszel method or the DerSimonian and Laird method. Study quality was critically appraised by 2 reviewers using established criteria. STATA version 12 was used for meta-analyses. Twelve RCTs involving 2395 patients were included, of which 8 trials were considered to be of high methodological quality. Effect of antibiotic prophylaxis in plastic and reconstructive surgery was found favorable over placebo in SSI prevention (13 studies; 2449 participants; OR, 0.53; 95% CI, 0.4-0.7; P plastic surgeries with high-risk factors and clean-contaminated plastic surgeries. Besides, a short-course administration regimen seemed to be of adequate efficacy and safety. High-quality prospective trials on larger scale are needed to further confirm these findings.

  11. The use of office-based sedation and general anesthesia by board certified pediatric dentists practicing in the United States.

    Science.gov (United States)

    Olabi, Nassim F; Jones, James E; Saxen, Mark A; Sanders, Brian J; Walker, Laquia A; Weddell, James A; Schrader, Stuart M; Tomlin, Angela M

    2012-01-01

    The purpose of this study is to explore the use of office-based sedation by board-certified pediatric dentists practicing in the United States. Pediatric dentists have traditionally relied upon self-administered sedation techniques to provide office-based sedation. The use of dentist anesthesiologists to provide office-based sedation is an emerging trend. This study examines and compares these two models of office-based sedations. A survey evaluating office-based sedation of diplomates of the American Board of Pediatric Dentistry (ABPD) based on gender, age, years in practice, practice types, regions, and years as a diplomate of the ABPD was completed by 494 active members. The results were summarized using frequencies and percentages. Relationships of dentist age, gender, and number of years in practice with the use of intravenous (IV) sedation was completed using two-way contingency tables and Mantel-Haenszel tests for ordered categorical data. Relationships of office-based sedation use and the type of one's practice were examined using Pearson chi-square tests. Of the 1917 surveys e-mailed, 494 completed the survey for a response rate of 26%. Over 70% of board-certified US pediatric dentists use some form of sedation in their offices. Less than 20% administer IV sedation, 20 to 40% use a dentist anesthesiologist, and 60 to 70% would use dentist anesthesiologists if one were available.

  12. A systematic review and meta-analysis to compare the efficacy of acyclovir 3% ophthalmic ointment to idoxuridine in curing herpetic keratitis by Day 7 of treatment.

    Science.gov (United States)

    Balderson, Diane E; Cai, Gengqian; Fries, Michael A; Kleinman, David M; McLaughlin, Megan M; Trivedi, Trupti M; Wurzelmann, John I; Young, Sheila B

    2015-04-17

    This objective of the review and analysis is to demonstrate that acyclovir (ACV) 3% ophthalmic ointment is superior to idoxuridine (IDU) in treating herpetic keratitis (HK) presenting as dendritic and geographic ulcer sub-types. Publications in human subjects were identified by searching the Ovid MEDLINE database through April 2011, combining medical subject headings (MESH) "Keratitis, Herpetic/" AND "Acyclovir/" limiting by the key words "topical" OR "ointment" and also restricted to MESH "Administration, Topical/" OR "Ointments/". The results were cross checked with the references used in the Cochrane Database Syst Rev. 1:1-134, 2009 and GlaxoSmithKline clinical documents related to acyclovir. Randomized, double-masked studies in subjects diagnosed with HK with head to head comparator arms of ACV ophthalmic ointment and topical IDU that had actual or calculable healing rates at Day seven. Data independently extracted from identified articles by two authors of this manuscript. Data from seven randomized, controlled trials (RCT) evaluating 432 subjects that met inclusion criteria (214 were treated with ACV and 218 were treated with IDU) and had Day seven healing rates calculable. All sub-classified lesions were identified as either dendritic ulcers (n = 185) or geographic ulcers (n = 35). The Cochran-Mantel-Haenszel (CMH) method in Biometrics 10:417-51, 1954 and JNCI 22:719-48, 1959, controlling for study, was performed as the primary analysis using SAS v9. Homogeneity was assessed using Breslow-Day-Tarone (BDT) test in IARC 1:1-32, 1980 and Biometrika 72:91-5, 1985. The analysis was performed with outliers removed to assess their impact. ACV showed statistically significant greater odds of healing HK at Day seven in all subjects (Odds Ratio 3.95, 95% CI2.60, 6.00, p p p = 0.0244). ACV 3% ophthalmic ointment is a valuable intervention for dendritic and geographic corneal ulcers. ACV and IDU were generally well tolerated in the studies reviewed.

  13. Candidate genes in panic disorder

    DEFF Research Database (Denmark)

    Howe, A. S.; Buttenschön, Henriette N; Bani-Fatemi, A.

    2016-01-01

    The utilization of molecular genetics approaches in examination of panic disorder (PD) has implicated several variants as potential susceptibility factors for panicogenesis. However, the identification of robust PD susceptibility genes has been complicated by phenotypic diversity, underpowered...... association studies and ancestry-specific effects. In the present study, we performed a succinct review of case-control association studies published prior to April 2015. Meta-analyses were performed for candidate gene variants examined in at least three studies using the Cochrane Mantel-Haenszel fixed......-effect model. Secondary analyses were also performed to assess the influences of sex, agoraphobia co-morbidity and ancestry-specific effects on panicogenesis. Meta-analyses were performed on 23 variants in 20 PD candidate genes. Significant associations after correction for multiple testing were observed...

  14. Breast cancer in female radium dial workers first employed before 1930

    International Nuclear Information System (INIS)

    Adams, E.E.; Brues, A.M.

    1982-01-01

    Female radium dial workers first employed before 1930 were analyzed for breast cancer mortality and incidence using method and rate tables described by Manson and the Mantel-Haenszel summary chi-square test for significance. Of 1180 located women, 736 were measured to estimate radium intake. This measured group was analyzed for breast cancer mortality and incidence according to four possible risk factors: radium intake dose, duration of employment, age at first exposure, and parity. The located women had a mortality ratio of 1.51 (p < 0.05). The measured women showed a significant excess of breast cancer incidence and mortality only among those women with a radium intake of 50 μCi or greater. Although not significant, incidence and mortality ratios were slightly higher for nulliparous women

  15. Total abdominal hysterectomy versus minimal-invasive hysterectomy: a systemic review and meta-analysis

    International Nuclear Information System (INIS)

    Aragon Palmero, Felipe Jorge; Exposito Exposito, Moises

    2011-01-01

    INTRODUCTION. At the present time three types of hysterectomies are used: the vaginal hysterectomy and the minimal-invasive hysterectomy (MIH). The objective of present research was to compare the MIH and the total abdominal hysterectomy (TAH) in women presenting with benign uterine diseases. METHODS. A systemic review was made and a meta-analysis from the following databases: MEDLINE, EBSCO HOST AND The Cochrane Central Register of Controlled Trials. Only the controlled and randomized studies were selected. The data of all studies were combined and also the relative risk (RR) with a 95% CI was used with the Mantel-Haenszel method as an effect measure for dichotomy variables. For the analysis of continuing variables the mean difference was used. In all the comparisons performed the results were obtained with the fix effect and randomized forms. RESULTS. A total of 53 transoperative complications were registered in the MIH hysterectomy versus 17 in the TAH group (RR: 1,78; 95% CI: 1,04-3.05). Postoperative complications evolved in a similar way in both groups without significant differences from the statistical point of view. The blood losses, the hospital stay and the patient's reincorporation to usual and work activities were lesser in the laparoscopy group; however, the operative time is higher when it is compared with TAH (mean difference: 37,36; 95% CI: 34,36-39,93). CONCLUSIONS. Both techniques have advantages and disadvantages. The indication of MIH must to be individualized according to the clinical situation of each patient and these not to be performed in those centers without a properly trained surgical staff and with experience in advanced minimal invasive surgery. (author)

  16. Assessment of clinical efficacy and safety in a randomized double-blind study of etanercept and sulfasalazine in patients with ankylosing spondylitis from Eastern/Central Europe, Latin America, and Asia.

    Science.gov (United States)

    Damjanov, Nemanja; Shehhi, Waleed Al; Huang, Feng; Kotak, Sameer; Burgos-Vargas, Ruben; Shirazy, Khalid; Bananis, Eustratios; Szumski, Annette; Llamado, Lyndon J Q; Mahgoub, Ehab

    2016-05-01

    Despite the demonstrated efficacy of etanercept for the treatment of ankylosing spondylitis (AS), sulfasalazine is often prescribed, especially in countries with limited access to biologic agents. The objective of this subset analysis of the ASCEND trial was to compare the efficacy of etanercept and sulfasalazine in treating patients with AS from Asia, Eastern/Central Europe, and Latin America. A total of 287 patients, 190 receiving etanercept 50 mg once weekly and 97 receiving sulfasalazine 3 g daily, from eight countries were included in this subset analysis. Differences in disease activity and patient-reported outcomes assessing health-related quality-of-life (HRQoL) parameters in response to treatment were analyzed using the Cochran-Mantel-Haenszel test for categorical efficacy endpoints and analysis of covariance model for continuous variables. At week 16, a significantly greater proportion of patients receiving etanercept achieved ASAS20 (79.0 %) compared with patients receiving sulfasalazine (61.9 %; p = 0.002). At week 16, treatment with etanercept also resulted in significantly better responses than sulfasalazine for ASAS40 (64.7 vs. 35.1 %; p Disease Activity Index (65.8 vs. 42.3 %; p Asia, Central/Eastern Europe, and Latin America.

  17. Clipping Versus Coiling in the Management of Posterior Communicating Artery Aneurysms with Third Nerve Palsy: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Gaberel, Thomas; Borha, Alin; di Palma, Camille; Emery, Evelyne

    2016-03-01

    To compare surgical clipping with endovascular coiling in terms of recovery from oculomotor nerve palsy (ONP) in the management of posterior communicating artery (PCoA) aneurysms causing third nerve palsy. We conducted a systematic review of the literature and meta-analysis. The meta-analysis included 11 relevant studies involving 384 patients with third nerve palsy caused by PCoA aneurysms at baseline, of whom 257 (67.0%) were treated by clipping and 127 were treated by coiling (33.0%). Pooled odds ratios of the impact of clipping or coiling on complete ONP recovery, lack of ONP recovery, and procedure-related death were calculated. The overall complete ONP recovery rate was 42.5% in the coiling group compared with 83.6% in the clipping group. The increase in complete ONP recovery in the clipping group corresponds to an overall pooled Mantel-Haenszel odds ratio of 4.44 (95% confidence interval = 1.66-11.84). Subgroup analysis revealed a clear benefit of clipping over coiling in patients with ruptured aneurysms, but not in patients with unruptured aneurysms. No procedure-related deaths were reported by any of the 11 studies. Surgical clipping of PCoA aneurysms causing third nerve palsy achieves better ONP recovery than endovascular coiling; this could be particularly true in the case of ruptured aneurysms. In view of the purely observational data, statements about this effect should be made with great caution. A randomized trial would better address the therapeutic dilemma, but pending the results of such a trial, we recommend treating PCoA aneurysms causing ONP with surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Is there an increased risk of post-operative surgical site infection after orthopaedic surgery in HIV patients? A systematic review and meta-analysis.

    Science.gov (United States)

    Kigera, James W M; Straetemans, Masja; Vuhaka, Simplice K; Nagel, Ingeborg M; Naddumba, Edward K; Boer, Kimberly

    2012-01-01

    There is dilemma as to whether patients infected with the Human Immunodeficiency Virus (HIV) requiring implant orthopaedic surgery are at an increased risk for post-operative surgical site infection (SSI). We conducted a systematic review to determine the effect of HIV on the risk of post-operative SSI and sought to determine if this risk is altered by antibiotic use beyond 24 hours. We searched electronic databases, manually searched citations from relevant articles, and reviewed conference proceedings. The risk of postoperative SSI was pooled using Mantel-Haenszel method. We identified 18 cohort studies with 16 mainly small studies, addressing the subject. The pooled risk ratio of infection in the HIV patients when compared to non-HIV patients was 1.8 (95% Confidence Interval [CI] 1.3-2.4), in studies in Africa this was 2.3 (95% CI 1.5-3.5). In a sensitivity analysis the risk ratio was reduced to 1.4 (95% CI 0.5-3.8). The risk ratio of infection in patients receiving prolonged antibiotics compared to patients receiving antibiotics for up to 24 hours was 0.7 (95% CI 0.1-4.2). The results may indicate an increased risk in HIV infected patients but these results are not robust and inconclusive after conducting the sensitivity analysis removing poor quality studies. There is need for larger good quality studies to provide conclusive evidence. To better develop surgical protocols, further studies should determine the effect of reduced CD4 counts, viral load suppression and prolonged antibiotics on the risk for infection.

  19. Métodos para estimar razão de prevalência em estudos de corte transversal Métodos para estimar razón de prevalencia en estudios de cohorte transversal Methods for estimating prevalence ratios in cross-sectional studies

    Directory of Open Access Journals (Sweden)

    Leticia M S Coutinho

    2008-12-01

    Full Text Available OBJETIVO: Comparar empiricamente as regressões de Cox, log-binomial, Poisson e logística para estimar razões de prevalência em estudos de corte transversal. MÉTODOS: Foram utilizados dados de um estudo epidemiológico transversal (n=2.072, de base populacional, realizado com idosos na cidade de São Paulo (SP, entre maio de 2003 e abril de 2005. Diagnósticos de demência, possíveis casos de transtorno mental comum e autopercepção de saúde ruim foram escolhidos como desfechos com prevalência baixa, intermediária e alta, respectivamente. Foram utilizadas variáveis de confusão com duas ou mais categorias ou valores contínuos. Valores de referência para estimativas por ponto e por intervalo para as razões de prevalência (RP foram obtidos pelo método de estratificação de Mantel-Haenszel. Estimativas ajustadas foram calculadas utilizando regressões de Cox e Poisson com variância robusta, e regressão log-binomial. Odds ratios (OR brutos e ajustados foram obtidos pela regressão logística. RESULTADOS: As estimativas por ponto e por intervalo obtidas pelas regressões de Cox e Poisson foram semelhantes à obtida pela estratificação de Mantel-Haenszel, independentemente da prevalência do desfecho e das covariáveis do modelo. O modelo log-binomial apresentou dificuldade de convergência quando o desfecho tinha prevalência alta e havia covariável contínua no modelo. A regressão logística produziu estimativas por ponto e por intervalo maiores do que as obtidas pelos outros métodos, principalmente para os desfechos com maiores prevalências iniciais. Se interpretados como estimativas de RP, os OR superestimariam as associações para os desfechos com prevalência inicial baixa, intermediária e alta em 13%, quase 100% e quatro vezes mais, respectivamente. CONCLUSÕES: Em análise de dados de estudos de corte transversal, os modelos de Cox e Poisson com variância robusta são melhores alternativas que a regressão log

  20. Effects of Misbehaving Common Items on Aggregate Scores and an Application of the Mantel-Haenszel Statistic in Test Equating. CSE Report 688

    Science.gov (United States)

    Michaelides, Michalis P.

    2006-01-01

    Consistent behavior is a desirable characteristic that common items are expected to have when administered to different groups. Findings from the literature have established that items do not always behave in consistent ways; item indices and IRT item parameter estimates of the same items differ when obtained from different administrations.…

  1. Sobrepeso em crianças menores de 6 anos de idade em Florianópolis, SC Overweight in children under 6 years of age in Florianópolis, SC, Brazil

    Directory of Open Access Journals (Sweden)

    Arlete Catarina Tittoni Corso

    2003-01-01

    Full Text Available Verificou-se a prevalência de sobrepeso através do índice de peso para altura, classificação expressa em escore-Z, padrão de referência do National Center for Health Statistics, em 3 806 crianças menores de seis anos de idade, residentes no município de Florianópolis, Estado de Santa Catarina, Brasil. Obteve-se uma prevalência de 1,9% de desnutrição e 6,8% de sobrepeso, sendo este predominante em crianças residentes em áreas não carentes, do sexo feminino e menores de dois anos de idade. A prevalência de sobrepeso deste estudo foi comparada com aquelas encontradas em outras regiões do Brasil e em outros países. Aplicou-se o teste chi2 (Mantel-Haenszel, para verificar a associação de casos com sobrepeso entre áreas carentes e não carentes, sexo e faixa etária. Observou-se associação estatisticamente significante (pThe prevalence of overweight in 3,806 children under six years of age, living in the city of Florianópolis, state of Santa Catarina, Brazil, was determined through weight for height Z-scores (National Center for Health Statistics reference. Results showed an incidence of 1.9% for malnutrition and 6.8% for overweight, and this last one predominated in female children under the age of two, living in not-so-poor areas. The prevalence of overweight in this study was compared to those found in other regions of Brazil and in other countries. The chi2 Mantel-Haenszel test was applied to verify the association of overweight occurrence with poor/not poor areas, sex and age. Statistically significant association (p<0.05 was observed among children under two years of age. This result is similar to the one found by Pesquisa Nacional sobre Saúde e Nutrição for Brazil in 1989.

  2. Secondary Psychometric Examination of the Dimensional Obsessive-Compulsive Scale: Classical Testing, Item Response Theory, and Differential Item Functioning.

    Science.gov (United States)

    Thibodeau, Michel A; Leonard, Rachel C; Abramowitz, Jonathan S; Riemann, Bradley C

    2015-12-01

    The Dimensional Obsessive-Compulsive Scale (DOCS) is a promising measure of obsessive-compulsive disorder (OCD) symptoms but has received minimal psychometric attention. We evaluated the utility and reliability of DOCS scores. The study included 832 students and 300 patients with OCD. Confirmatory factor analysis supported the originally proposed four-factor structure. DOCS total and subscale scores exhibited good to excellent internal consistency in both samples (α = .82 to α = .96). Patient DOCS total scores reduced substantially during treatment (t = 16.01, d = 1.02). DOCS total scores discriminated between students and patients (sensitivity = 0.76, 1 - specificity = 0.23). The measure did not exhibit gender-based differential item functioning as tested by Mantel-Haenszel chi-square tests. Expected response options for each item were plotted as a function of item response theory and demonstrated that DOCS scores incrementally discriminate OCD symptoms ranging from low to extremely high severity. Incremental differences in DOCS scores appear to represent unbiased and reliable differences in true OCD symptom severity. © The Author(s) 2014.

  3. [Smoking among nursing students in Catalonia: knowledge, attitudes and practice].

    Science.gov (United States)

    Heras Tébar, A; García Sanchón, C; Hernández López, M C; Ballestín, N; Nebot, M

    1997-01-01

    Determine the prevalence and characteristics of tobaccoism, as well as some attitudes and their knowledge about tobaccoism in nursing university students in Catalonia. A descriptive study with transversal section has been done. A self-filling anonymous questionnaire was designed following the guidelines of the European Regional Office of the W.H.O. We selected a sample of conglomerates of classrooms at random which was stratified according to levels in all the university schools in Catalonia. The field work was performed during the first term of the academic year 1994-1995 handing the questionnaires individually to the students and collecting them once filled. In the data analysis we used the ji squared test to Pearson with the Yates' correction and the lineal tendency test of Mantel-Haenszel. 904 students answered the questionnaire. The global prevalence of smokers is 38.7% (IC 95%: 35.8-41.6). There were no significant differences when considering levels or sex. The prevalence of tobaccoism in students over 24 years of age is 13% higher (p Catalonia has been observed for the nursing professionals in the year 2000.

  4. Risk factors for the introduction of high pathogenicity Avian Influenza virus into poultry farms during the epidemic in the Netherlands in 2003.

    Science.gov (United States)

    Thomas, M E; Bouma, A; Ekker, H M; Fonken, A J M; Stegeman, J A; Nielen, M

    2005-06-10

    An epidemic of high pathogenicity Avian Influenza (HPAI) occurred in the Netherlands in 2003. A census survey of 173 infected and 401 uninfected commercial poultry farms was carried out to identify factors associated with the introduction of the HPAI virus into poultry farms. Data on farm size, production characteristics, type of housing, presence of cattle and pigs were gathered by the National Inspection Service for Livestock and Meat from all farms included in this study. For each risk factor (RF) available for analysis, the Mantel-Haenszel odds ratio was calculated (stratified on farm size and housing type). We found an increased risk of HPAI virus introduction in layer finisher type poultry: OR = 2.05 (95% confidence interval, CI = 1.29-3.27). An explanation for this increased risk is the high number of contacts between these farms, especially via cardboard egg trays used for removal of eggs during the epidemic. Our analysis did not indicate significant differences between the infected and uninfected farms with regard to housing type, presence of cattle or pigs. Since layer finisher type farms are assumed to be at higher risk for HPAI virus introduction, more specific control measures might be applied in future outbreaks.

  5. Effects of Exercise on Mild-to-Moderate Depressive Symptoms in the Postpartum Period: A Meta-analysis.

    Science.gov (United States)

    McCurdy, Ashley P; Boulé, Normand G; Sivak, Allison; Davenport, Margie H

    2017-06-01

    To examine the influence of exercise on depressive symptoms and the prevalence of depression in the postpartum period. A structured search of MEDLINE, EMBASE, CINAHL, Sport Discus, Ovid's All EBM Reviews, and ClinicalTrials.gov databases was performed with dates from the beginning of the databases until June 16, 2016. The search combined keywords and MeSH-like terms including, but not limited to, "exercise," "postpartum," "depression," and "randomized controlled trial." Randomized controlled trials comparing postpartum exercise (structured, planned, repetitive physical activity) with the standard care for which outcomes assessing depressive symptoms or depressive episodes (as defined by trial authors) were assessed. Trials were identified as prevention trials (women from the general postpartum population) or treatment trials (women were classified as having depression by the trial authors). Effect sizes with 95% confidence intervals (CIs) were calculated using Hedges' g method and standardized mean differences in postintervention depression outcomes were pooled using a random-effects model. Across all 16 trials (1,327 women), the pooled standardized mean difference was -0.34 (95% CI -0.50 to -0.19, I=37%), suggesting a small effect of exercise among all postpartum women on depressive symptoms. Among the 10 treatment trials, a moderate effect size of exercise on depressive symptoms was found (standardized mean difference-0.48, 95% CI -0.73 to -0.22, I=42%). In six prevention trials, a small effect (standardized mean difference-0.22, 95% CI -0.36 to -0.08, I=2%) was found. In women with depression preintervention, exercise increased the odds of resolving depression postintervention by 54% (odds ratio 0.46, Mantel-Haenszel method, 95% CI 0.25-0.84, I=0%). The trials included in this meta-analysis were small and some had methodologic limitations. Light-to-moderate intensity aerobic exercise improves mild-to-moderate depressive symptoms and increases the likelihood that

  6. PedGenie: meta genetic association testing in mixed family and case-control designs

    Directory of Open Access Journals (Sweden)

    Allen-Brady Kristina

    2007-11-01

    Full Text Available Abstract Background- PedGenie software, introduced in 2006, includes genetic association testing of cases and controls that may be independent or related (nuclear families or extended pedigrees or mixtures thereof using Monte Carlo significance testing. Our aim is to demonstrate that PedGenie, a unique and flexible analysis tool freely available in Genie 2.4 software, is significantly enhanced by incorporating meta statistics for detecting genetic association with disease using data across multiple study groups. Methods- Meta statistics (chi-squared tests, odds ratios, and confidence intervals were calculated using formal Cochran-Mantel-Haenszel techniques. Simulated data from unrelated individuals and individuals in families were used to illustrate meta tests and their empirically-derived p-values and confidence intervals are accurate, precise, and for independent designs match those provided by standard statistical software. Results- PedGenie yields accurate Monte Carlo p-values for meta analysis of data across multiple studies, based on validation testing using pedigree, nuclear family, and case-control data simulated under both the null and alternative hypotheses of a genotype-phenotype association. Conclusion- PedGenie allows valid combined analysis of data from mixtures of pedigree-based and case-control resources. Added meta capabilities provide new avenues for association analysis, including pedigree resources from large consortia and multi-center studies.

  7. Meta-analysis reveals association between most common class II haplotype in full-heritage Native Americans and rheumatoid arthritis.

    Science.gov (United States)

    Williams, R C; Jacobsson, L T; Knowler, W C; del Puente, A; Kostyu, D; McAuley, J E; Bennett, P H; Pettitt, D J

    1995-01-01

    The association of RA with the alleles at the HLA system was tested among Pima and Tohono O'odham Indians (Pimans) of the Gila River Indian Community of Arizona. Serologic class I (HLA-A, -B, and -C) alleles were typed in 51 individuals with RA and in 302 without RA. Serologic class II (HLA-DR, DQ; DR52 DR53) alleles were typed in a subset of 47 with RA and 147 without RA. Molecular subtypes of DR3X6, DRB1*1402, and *1406 were determined in 29 individuals, 16 with RA and 13 without RA. Among the cases with RA, 46 of 47 had the serologic antigen HLA-DR3X6, as did 140 of 147 of those without the disease. However, this association was not statistically significant because of the high prevalence of the antigen in the controls. Data from Pimans were analyzed with similar results from the Tlingit and Yakima Indians. A meta-analysis employing the Mantel-Haenszel procedure, stratified by tribe, revealed a statistically significant association between the most common haplotype, DRB1*1402 DQA1*0501 DQB1*0301 DRB3*0101, and RA (summary odds ratio = 2.63, 95% confidence interval = 1.08, 6.46). There was also a statistically significant difference in the genotype distributions of one class I locus, HLA-C, between those with and without RA (chi 2 = 12.4, 5 df; p = 0.03). It is concluded that the association with the most common class II haplotype in full-heritage Native Americans might help explain their high prevalence of RA.

  8. Efficacy and safety of solifenacin plus tamsulosin oral controlled absorption system in men with lower urinary tract symptoms: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Ming-Chao Li

    2015-02-01

    Full Text Available We performed a meta-analysis to compare treatment with a combination of solifenacin plus tamsulosin oral controlled absorption system (TOCAS with placebo or TOCAS monotherapy. The aim of the meta-analysis was to clarify the efficacy and safety of the combination treatments method for lower urinary tract symptoms (LUTS. We searched for trials of men with LUTS that were randomized to combination treatment compared with TOCAS monotherapy or placebo. We pooled data from three placebo-controlled trials meeting inclusion criteria. Primary outcomes of interest included changes in International Prostate Symptom Score (IPSS and urinary frequency. We also assessed postvoid residual, maximum urinary flow rate, incidence of urinary retention (UR, adverse events. Data were pooled using random or fixed effect models for continuous outcomes and the Mantel-Haenszel method to generate risk ratio. Reductions in IPSS storage subscore and total urgency and frequency score (TUFS were observed with solifenacin 6 mg plus TOCAS compared with placebo (P< 0.0001 and P< 0.0001, respectively. Reductions in IPSS storage subscore and TUFS were observed with solifenacin 9 mg plus TOCAS compared with placebo (P = 0.003 and P= 0.0006, respectively. Reductions in TUFS was observed with solifenacin 6 mg plus TOCAS compared with TOCAS (P = 0.01. Both combination treatments were well tolerated, with low incidence of UR. Solifenacin 6 mg plus TOCAS significantly improved total IPSS, storage and voiding symptoms compared with placebo. Solifenacin 6 mg plus TOCAS also improved storage symptoms compared with TOCAS alone. There was no additional benefit of solifenacin 9 mg compared with 6 mg when used in combination with TOCAS.

  9. Accuracy of Lung Ultrasonography versus Chest Radiography for the Diagnosis of Adult Community-Acquired Pneumonia: Review of the Literature and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Xiong Ye

    Full Text Available Lung ultrasonography (LUS is being increasingly utilized in emergency and critical settings. We performed a systematic review of the current literature to compare the accuracy of LUS and chest radiography (CR for the diagnosis of adult community-acquired pneumonia (CAP. We searched in Pub Med, EMBASE dealing with both LUS and CR for diagnosis of adult CAP, and conducted a meta-analysis to evaluate the diagnostic accuracy of LUS in comparison with CR. The diagnostic standard that the index test compared was the hospital discharge diagnosis or the result of chest computed tomography scan as a "gold standard". We calculated pooled sensitivity and specificity using the Mantel-Haenszel method and pooled diagnostic odds ratio using the DerSimonian-Laird method. Five articles met our inclusion criteria and were included in the final analysis. Using hospital discharge diagnosis as reference, LUS had a pooled sensitivity of 0.95 (0.93-0.97 and a specificity of 0.90 (0.86 to 0.94, CR had a pooled sensitivity of 0.77 (0.73 to 0.80 and a specificity of 0.91 (0.87 to 0.94. LUS and CR compared with computed tomography scan in 138 patients in total, the Z statistic of the two summary receiver operating characteristic was 3.093 (P = 0.002, the areas under the curve for LUS and CR were 0.901 and 0.590, respectively. Our study indicates that LUS can help to diagnosis adult CAP by clinicians and the accuracy was better compared with CR using chest computed tomography scan as the gold standard.

  10. Risk of wound infection and safety profile of amoxicillin in healthy patients which required third molar surgery: a systematic review and meta-analysis.

    Science.gov (United States)

    Isiordia-Espinoza, M A; Aragon-Martinez, O H; Martínez-Morales, J F; Zapata-Morales, J R

    2015-11-01

    The aim of this systematic review and meta-analysis was to assess the risk of surgical wound infection and the adverse effects of amoxicillin in healthy patients who required excision of third molars. We identified eligible reports from searches of PubMed, Medline®, the Cochrane Library, Imbiomed, LILACS, and Google Scholar. Studies that met our minimum requirements were evaluated using inclusion and exclusion criteria and the Oxford Quality Scale. Those with a score of 3 or more on this Scale were included and their data were extracted and analysed. For evaluation of the risk of infection the absolute risk reduction, number needed to treat, and 95% CI were calculated. For evaluation of the risk of an adverse effect the absolute risk increase, number needed to harm, and 95% CI were calculated using the Risk Reduction Calculator. Each meta-analysis was made with the help of the Mantel-Haenszel random effects model, and estimates of risk (OR) and 95% CI were calculated using the Review Manager 5.3, from the Cochrane Library. A significant risk was assumed when the lower limit of the 95% CI was greater than 1. Probabilities of less than 0.05 were accepted as significant. The results showed that there was no reduction in the risk of infection when amoxicillin was given before or after operation compared with an untreated group or placebo. In conclusion, this study suggests that amoxicillin given prophylactically or postoperatively does not reduce the risk of infection in healthy patients having their third molars extracted. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. A Meta-Analysis of Socio-Demographic Factors Predicting Birth in ...

    African Journals Online (AJOL)

    METHODS: A meta-analysis of Mantel–Haenszel odds ratios was conducted by including 24 articles which were reported between 2000 and 2013 from developing countries. A computer-based search was done from MEDLINE, African Journals Online, Google Scholar and HINARI databases. Included studies did compare ...

  12. At-Risk Variant in TCF7L2 for Type II Diabetes Increases Risk of Schizophrenia

    DEFF Research Database (Denmark)

    Hansen, Thomas; Ingason, Andrés; Djurovic, Srdjan

    2011-01-01

    BACKGROUND: Schizophrenia is associated with increased risk of type II diabetes and metabolic disorders. However, it is unclear whether this comorbidity reflects shared genetic risk factors, at-risk lifestyle, or side effects of antipsychotic medication. METHODS: Eleven known risk variants of type...... (SGENE+) using Mantel-Haenszel test. RESULTS: One type II diabetes at-risk allele located in TCF7L2, rs7903146 [T], was associated with schizophrenia in the discovery sample (p = .0052) and in the replication with an odds ratio of 1.07 (95% confidence interval 1.01-1.14, p = .033). CONCLUSION...... II diabetes were genotyped in patients with schizophrenia in a sample of 410 Danish patients, each matched with two healthy control subjects on sex, birth year, and month. Replication was carried out in a large multinational European sample of 4089 patients with schizophrenia and 17,597 controls...

  13. Transparent polyurethane film as an intravenous catheter dressing. A meta-analysis of the infection risks.

    Science.gov (United States)

    Hoffmann, K K; Weber, D J; Samsa, G P; Rutala, W A

    1992-04-15

    To obtain a quantitative estimate of the impact on infectious complications of using transparent dressings with intravenous catheters. Meta-analysis of all studies published in the English literature, including abstracts, letters, and reports that examined the primary research question of infection risks associated with transparent compared with gauze dressings for use on central and peripheral venous catheters. Studies were identified by use of the MEDLINE database using the indexing terms occlusive dressings, transparent dressings, and infection and by review of referenced bibliographies. Seven of the 15 studies (47%) of central venous catheters and seven of 12 studies (58%) of peripheral catheters met our inclusion criteria for analysis. All studies used a prospective cohort design, utilized hospitalized patients, and reported at least one of our defined outcomes. Data for each study were abstracted independently by three investigators. At least three studies were used in the analysis of each outcome. Applying a Mantel-Haenszel chi 2 analysis, use of transparent dressings on central venous catheters was significantly associated with an elevated relative risk (RR) of catheter tip infection (RR = 1.78; 95% confidence interval [CI], 1.38 to 2.30). Catheter-related sepsis (RR = 1.69; 95% CI, 0.97 to 2.95) and bacteremia (RR = 1.63; 95% CI, 0.76 to 3.47) were both associated with an elevated RR. Use of transparent dressings on peripheral catheters was associated with an elevated RR of catheter-tip infection (RR = 1.53; 95% CI, 1.18 to 1.99) but not phlebitis (RR = 1.02; 95% CI, 0.86 to 1.20), infiltration (RR = 1.12; 95% CI, 0.92 to 1.37), or skin colonization (RR = 0.99; 95% CI, 0.90 to 1.09). The results demonstrated a significantly increased risk of catheter-tip infection with the use of transparent compared with gauze dressings when used with either central or peripheral catheters. An increased risk of bacteremia and catheter sepsis associated with the use of

  14. Angioplasty Guided by Intravascular Ultrasound: Meta-Analysis of Randomized Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Figueiredo, José Albuquerque Neto de, E-mail: jafneto@cardiol.br; Nogueira, Iara Antonia Lustosa [Universidade Federal do Maranhão, São Luiz, MA (Brazil); Figueiro, Mabel Fernandes; Buehler, Anna Maria; Berwanger, Otavio [Instituto de Ensino e Pesquisa do Hospital do Coração, São Paulo, SP (Brazil)

    2013-08-15

    The impact of intravascular ultrasound (IVUS) use on stenting has shown inconclusive results. Systematic review and meta-analysis of the impact of IVUS on stenting regarding the clinical and angiographic evolution. A search was performed in Medline/Pubmed, CENTRAL, Embase, Lilacs, Scopus and Web of Science databases. It included randomized clinical trials (RCTs) that evaluated the implantation of stents guided by IVUS, compared with those using angiography alone (ANGIO). The minimum follow-up duration was six months and the following outcomes were assessed: thrombosis, mortality, myocardial infarction, percutaneous and surgical revascularization, major adverse cardiovascular events (MACE) and restenosis. The binary outcomes were presented considering the number of events in each group; the estimates were generated by a random effects model, considering Mantel-Haenszel statistics as weighting agent and magnitude of effect for the relative risk (RR) with its respective 95% confidence interval (95%CI). Higgins I{sup 2} test was used to quantify the consistency between the results of each study. A total of 2,689 articles were evaluated, including 8 RCTs. There was a 27% reduction in angiographic restenosis (RR: 0.73, 95% CI: 0.54-0.97, I{sup 2} = 51%) and statistically significant reduction in the rates of percutaneous revascularization and overall (RR: 0.88; 95% CI: 0.51 to 1.53, I{sup 2} = 61%, RR: 0.73, 95% CI: 0.54 to 0.99, I{sup 2} = 55%), with no statistical difference in surgical revascularization (RR: 0.95, 95% CI: 0.52-1.74, I{sup 2} = 0%) in favor of IVUS vs. ANGIO. There were no differences regarding the other outcomes in the comparison between the two strategies. Angioplasty with stenting guided by IVUS decreases the rates of restenosis and revascularization, with no impact on MACE, acute myocardial infarction, mortality or thrombosis outcomes.

  15. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Moran, Lisa J; Misso, Marie L; Wild, Robert A; Norman, Robert J

    2010-01-01

    BACKGROUND Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women associated with impaired glucose tolerance (IGT), type 2 diabetes mellitus (DM2) and the metabolic syndrome. METHODS A literature search was conducted (MEDLINE, CINAHL, EMBASE, clinical trial registries and hand-searching) identifying studies reporting prevalence or incidence of IGT, DM2 or metabolic syndrome in women with and without PCOS. Data were presented as odds ratio (OR) [95% confidence interval (CI)] with fixed- and random-effects meta-analysis by Mantel-Haenszel methods. Quality testing was based on Newcastle-Ottawa Scaling and The Cochrane Collaboration's risk of bias assessment tool. Literature searching, data abstraction and quality appraisal were performed by two investigators. RESULTS A total of 2192 studies were reviewed and 35 were selected for final analysis. Women with PCOS had increased prevalence of IGT (OR 2.48, 95% CI 1.63, 3.77; BMI-matched studies OR 2.54, 95% CI 1.44, 4.47), DM2 (OR 4.43, 95% CI 4.06, 4.82; BMI-matched studies OR 4.00, 95% CI 1.97, 8.10) and metabolic syndrome (OR 2.88, 95% CI 2.40, 3.45; BMI-matched studies OR 2.20, 95% CI 1.36, 3.56). One study assessed IGT/DM2 incidence and reported no significant differences in DM2 incidence (OR 2.07, 95% CI 0.68, 6.30). One study assessed conversion from normal glucose tolerance to IGT/DM2 (OR 2.4, 95% CI 0.7, 8.0). No studies reported metabolic syndrome incidence. CONCLUSIONS Women with PCOS had an elevated prevalence of IGT, DM2 and metabolic syndrome in both BMI and non-BMI-matched studies. Few studies have determined IGT/DM2 or metabolic syndrome incidence in women with and without PCOS and further research is required.

  16. Some confounding factors in the study of mortality and occupational exposures

    International Nuclear Information System (INIS)

    Gilbert, E.S.

    1982-01-01

    With the recent interest in the study of occupational exposures, the impact of certain selective biases in the groups studied is a matter of some concern. In this paper, data from the Hanford nuclear facility population (southeastern Washington State, 1947-1976), which includes many radiation workers, are used to illustrate a method for examining the effect on mortality of such potentially confounding variables as calendar year, length of time since entering the industry, employment status, length of employment, job category, and initial employment year. The analysis, which is based on the Mantel-Haenszel procedure as adapted for a prospective study, differs from most previous studies of occupational variables which have relied primarily on comparing standardized mortality ratios (utilizing an external control) for various subgroups of the population. Results of this analysis confirm other studies in that reduced death rates are observed for early years of follow-up and for those with higher socioeconomic status (as indicated by job category). In addition, workers employed less than two years and especially terminated workers are found to have elevated death rates as compared with the remainder of the study population. It is important that such correlations be taken into account in planning and interpreting analyses of the effects of occupational exposure

  17. Embarazo en la adolescencia y factores sociodemográficos en Guantánamo en 1998 Pregnancy in adolescence and sociodemographic factors in Guantánamo

    Directory of Open Access Journals (Sweden)

    Oscar Soto Martínez

    2004-02-01

    Full Text Available Se realizó un estudio de casos y controles con el objetivo de identificar factores de riesgo del embarazo en la adolescencia. Se estudiaron a todas las pacientes (37 con edades entre 12 y 19 años, pertenecientes al Policlínico "Emilio Daudinot", embarazadas en el año 1998 (casos y 37 adolescentes (controles que nunca han estado embarazadas, de igual área de salud y edades que los casos. Se aplicó un cuestionario a cada una de las adolescentes. Los datos se procesaron en SPSS 9.0. Estos se presentan en tablas y figuras donde se utilizan las medidas de resumen del nivel analítico. Se obtuvo la significación de la asociación mediante la prueba X2 de Mantell- Haenszel, en el que se prefijó el 95 % para el intervalo de confianza. A las variables significativas se les determinó el grado de asociación mediante el odds ratio. Resultaron significativas de forma bivariada el número de casamientos (OR 6,48 [2,39;15,56], la ocupación (OR 6,13 [2,05;14,23], el estado civil (OR 2,13 [1,26;3,86].A case-control study was conducted aimed at identifying the risk factors of pregnancy in adolescence. All the patients aged 12-19 (37 from "Emilio Daudinot" Polyclinic that got pregnant in 1998 and 37 adolescents (controls who have never been pregnant with the same age and from the same area were studied. Every adolescent answered a questionnaire. Ddata were processed in SPSS 9.0 and they were shown in tables and figures where the summary measures of the analytical level were used. The association significance was obtained by Mantell-Haenszel X2 test, in which 95 % was prefixed as the confidence interval. The association degree was determined in the significant variables by the odds ratio. The number of marriages (OR 6,48 [2,39;15,56], the occupation (OR 6,13 [2,05;14,23], and the marital status (OR 2,13 [1,26;3,86] proved to be significant in a bivariated way.

  18. Applied Prevalence Ratio estimation with different Regression models: An example from a cross-national study on substance use research.

    Science.gov (United States)

    Espelt, Albert; Marí-Dell'Olmo, Marc; Penelo, Eva; Bosque-Prous, Marina

    2016-06-14

    To examine the differences between Prevalence Ratio (PR) and Odds Ratio (OR) in a cross-sectional study and to provide tools to calculate PR using two statistical packages widely used in substance use research (STATA and R). We used cross-sectional data from 41,263 participants of 16 European countries participating in the Survey on Health, Ageing and Retirement in Europe (SHARE). The dependent variable, hazardous drinking, was calculated using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C). The main independent variable was gender. Other variables used were: age, educational level and country of residence. PR of hazardous drinking in men with relation to women was estimated using Mantel-Haenszel method, log-binomial regression models and poisson regression models with robust variance. These estimations were compared to the OR calculated using logistic regression models. Prevalence of hazardous drinkers varied among countries. Generally, men have higher prevalence of hazardous drinking than women [PR=1.43 (1.38-1.47)]. Estimated PR was identical independently of the method and the statistical package used. However, OR overestimated PR, depending on the prevalence of hazardous drinking in the country. In cross-sectional studies, where comparisons between countries with differences in the prevalence of the disease or condition are made, it is advisable to use PR instead of OR.

  19. Identifying group-sensitive physical activities: a differential item functioning analysis of NHANES data.

    Science.gov (United States)

    Gao, Yong; Zhu, Weimo

    2011-05-01

    The purpose of this study was to identify subgroup-sensitive physical activities (PA) using differential item functioning (DIF) analysis. A sub-unweighted sample of 1857 (men=923 and women=934) from the 2003-2004 National Health and Nutrition Examination Survey PA questionnaire data was used for the analyses. Using the Mantel-Haenszel, the simultaneous item bias test, and the ANOVA DIF methods, 33 specific leisure-time moderate and/or vigorous PA (MVPA) items were analyzed for DIF across race/ethnicity, gender, education, income, and age groups. Many leisure-time MVPA items were identified as large DIF items. When participating in the same amount of leisure-time MVPA, non-Hispanic blacks were more likely to participate in basketball and dance activities than non-Hispanic whites (NHW); NHW were more likely to participated in golf and hiking than non-Hispanic blacks; Hispanics were more likely to participate in dancing, hiking, and soccer than NHW, whereas NHW were more likely to engage in bicycling, golf, swimming, and walking than Hispanics; women were more likely to participate in aerobics, dancing, stretching, and walking than men, whereas men were more likely to engage in basketball, fishing, golf, running, soccer, weightlifting, and hunting than women; educated persons were more likely to participate in jogging and treadmill exercise than less educated persons; persons with higher incomes were more likely to engage in golf than those with lower incomes; and adults (20-59 yr) were more likely to participate in basketball, dancing, jogging, running, and weightlifting than older adults (60+ yr), whereas older adults were more likely to participate in walking and golf than younger adults. DIF methods are able to identify subgroup-sensitive PA and thus provide useful information to help design group-sensitive, targeted interventions for disadvantaged PA subgroups. © 2011 by the American College of Sports Medicine

  20. Cardiovascular and heart failure safety profile of vildagliptin: a meta-analysis of 17 000 patients.

    Science.gov (United States)

    McInnes, G; Evans, M; Del Prato, S; Stumvoll, M; Schweizer, A; Lukashevich, V; Shao, Q; Kothny, W

    2015-11-01

    To report the cardiovascular (CV) safety profile and heart failure (HF) risk of vildagliptin from a large pool of studies, including trials in high-risk patients with type 2 diabetes mellitus (T2DM), such as those with congestive HF and/or moderate/severe renal impairment. We conducted a retrospective meta-analysis of prospectively adjudicated CV events. Patient-level data were pooled from 40 double-blind, randomized controlled phase III and IV vildagliptin studies. The primary endpoint was occurrence of major adverse CV events (MACEs; myocardial infarction, stroke and CV death). Assessments of the individual MACE components and HF events (requiring hospitalization or new onset) were secondary endpoints. The risk ratio (RR) of vildagliptin (50 mg once- and twice-daily combined) versus comparators (placebo and all non-vildagliptin treatments) was calculated using the Mantel-Haenszel (M-H) method. Of the 17 446 patients, 9599 received vildagliptin (9251.4 subject-years of exposure) and 7847 received comparators (7317.0 subject-years of exposure). The mean age of the patients was 57 years, body mass index 30.5 kg/m(2) (nearly 50% obese), glycated haemoglobin concentration 8.1% and T2DM duration 5.5 years. A MACE occurred in 83 (0.86%) vildagliptin-treated patients and 85 (1.20%) comparator-treated patients, with an M-H RR of 0.82 [95% confidence interval (CI) 0.61-1.11]. Similar RRs were observed for the individual events. Confirmed HF events were reported in 41 (0.43%) vildagliptin-treated patients and 32 (0.45%) comparator-treated patients, with an M-H RR 1.08 (95% CI 0.68-1.70). This large meta-analysis indicates that vildagliptin is not associated with an increased risk of adjudicated MACEs relative to comparators. Moreover, this analysis did not find a significant increased risk of HF in vildagliptin-treated patients. © 2015 John Wiley & Sons Ltd.

  1. Are There Gender Differences in Emotion Comprehension? Analysis of the Test of Emotion Comprehension.

    Science.gov (United States)

    Fidalgo, Angel M; Tenenbaum, Harriet R; Aznar, Ana

    2018-01-01

    This article examines whether there are gender differences in understanding the emotions evaluated by the Test of Emotion Comprehension (TEC). The TEC provides a global index of emotion comprehension in children 3-11 years of age, which is the sum of the nine components that constitute emotion comprehension: (1) recognition of facial expressions, (2) understanding of external causes of emotions, (3) understanding of desire-based emotions, (4) understanding of belief-based emotions, (5) understanding of the influence of a reminder on present emotional states, (6) understanding of the possibility to regulate emotional states, (7) understanding of the possibility of hiding emotional states, (8) understanding of mixed emotions, and (9) understanding of moral emotions. We used the answers to the TEC given by 172 English girls and 181 boys from 3 to 8 years of age. First, the nine components into which the TEC is subdivided were analysed for differential item functioning (DIF), taking gender as the grouping variable. To evaluate DIF, the Mantel-Haenszel method and logistic regression analysis were used applying the Educational Testing Service DIF classification criteria. The results show that the TEC did not display gender DIF. Second, when absence of DIF had been corroborated, it was analysed for differences between boys and girls in the total TEC score and its components controlling for age. Our data are compatible with the hypothesis of independence between gender and level of comprehension in 8 of the 9 components of the TEC. Several hypotheses are discussed that could explain the differences found between boys and girls in the belief component. Given that the Belief component is basically a false belief task, the differences found seem to support findings in the literature indicating that girls perform better on this task.

  2. Systematic review and meta-analysis of the sero-epidemiological association between Epstein Barr virus and multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Yahya H Almohmeed

    Full Text Available BACKGROUND: A role for Epstein Barr virus (EBV in multiple sclerosis (MS has been postulated. Previous systematic reviews found higher prevalences of anti-EBV antibodies in MS patients compared to controls, but many studies have since been published, and there is a need to apply more rigorous systematic review methods. METHODOLOGY/PRINCIPAL FINDINGS: We examined the link between EBV and MS by conducting a systematic review and meta-analysis of case-control and cohort studies that examined the prevalence of anti-EBV antibodies in the serum of cases and controls. We searched Medline and Embase databases from 1960 to 2012, with no language restriction. The Mantel-Haenszel odds ratios (OR for anti-EBV antibodies sero-positivity were calculated, and meta-analysis conducted. Quality assessment was performed using a modified version of the Newcastle Ottawa scale. Thirty-nine studies were included. Quality assessment found most studies reported acceptable selection and comparability of cases and controls. However the majority had poor reporting of ascertainment of exposure. Most studies found a higher sero-prevalence of anti-EBNA IgG and anti-VCA IgG in cases compared to controls. The results for anti-EA IgG were mixed with only half the studies finding a higher sero-prevalence in cases. The meta-analysis showed a significant OR for sero-positivity to anti-EBNA IgG and anti-VCA IgG in MS cases (4.5 [95% confidence interval (CI 3.3 to 6.6, p<0.00001] and 4.5 [95% CI 2.8 to 7.2, p<0.00001] respectively. However, funnel plot examination suggested publication bias for the reporting of the anti-EBNA IgG. No significant difference in the OR for sero-positivity to anti-EA IgG was found (1.4 [95% CI 0.9 to 2.1, p = 0.09]. CONCLUSION/SIGNIFICANCE: These findings support previous systematic reviews, however publication bias cannot be excluded. The methodological conduct of studies could be improved, particularly with regard to reporting and conduct of

  3. Multi-center analysis of glucocerebrosidase mutations in Parkinson disease

    Science.gov (United States)

    Sidransky, Ellen; Nalls, Michael A.; Aasly, Jan O.; Aharon-Peretz, Judith; Annesi, Grazia; Barbosa, Egberto Reis; Bar-Shira, Anat; Berg, Daniela; Bras, Jose; Brice, Alexis; Chen, Chiung-Mei; Clark, Lorraine N.; Condroyer, Christel; De Marco, Elvira Valeria; Dürr, Alexandra; Eblan, Michael J.; Fahn, Stanley; Farrer, Matthew; Fung, Hon-Chung; Gan-Or, Ziv; Gasser, Thomas; Gershoni-Baruch, Ruth; Giladi, Nir; Griffith, Alida; Gurevich, Tanya; Januario, Cristina; Kropp, Peter; Lang, Anthony E.; Lee-Chen, Guey-Jen; Lesage, Suzanne; Marder, Karen; Mata, Ignacio F.; Mirelman, Anat; Mitsui, Jun; Mizuta, Ikuko; Nicoletti, Giuseppe; Oliveira, Catarina; Ottman, Ruth; Orr-Urtreger, Avi; Pereira, Lygia V.; Quattrone, Aldo; Rogaeva, Ekaterina; Rolfs, Arndt; Rosenbaum, Hanna; Rozenberg, Roberto; Samii, Ali; Samaddar, Ted; Schulte, Claudia; Sharma, Manu; Singleton, Andrew; Spitz, Mariana; Tan, Eng-King; Tayebi, Nahid; Toda, Tatsushi; Troiano, André; Tsuji, Shoji; Wittstock, Matthias; Wolfsberg, Tyra G.; Wu, Yih-Ru; Zabetian, Cyrus P.; Zhao, Yi; Ziegler, Shira G.

    2010-01-01

    Background Recent studies indicate an increased frequency of mutations in the gene for Gaucher disease, glucocerebrosidase (GBA), among patients with Parkinson disease. An international collaborative study was conducted to ascertain the frequency of GBA mutations in ethnically diverse patients with Parkinson disease. Methods Sixteen centers participated, including five from the Americas, six from Europe, two from Israel and three from Asia. Each received a standard DNA panel to compare genotyping results. Genotypes and phenotypic data from patients and controls were analyzed using multivariate logistic regression models and the Mantel Haenszel procedure to estimate odds ratios (ORs) across studies. The sample included 5691 patients (780 Ashkenazi Jews) and 4898 controls (387 Ashkenazi Jews). Results All 16 centers could detect GBA mutations, L444P and N370S, and the two were found in 15.3% of Ashkenazi patients with Parkinson disease (ORs = 4.95 for L444P and 5.62 for N370S), and in 3.2% of non-Ashkenazi patients (ORs = 9.68 for L444P and 3.30 for N370S). GBA was sequenced in 1642 non-Ashkenazi subjects, yielding a frequency of 6.9% for all mutations, demonstrate that limited mutation screens miss half the mutant alleles. The presence of any GBA mutation was associated with an OR of 5.43 across studies. Clinically, although phenotypes varied, subjects with a GBA mutation presented earlier, and were more likely to have affected relatives and atypical manifestations. Conclusion Data collected from sixteen centers demonstrate that there is a strong association between GBA mutations and Parkinson disease. PMID:19846850

  4. Epidemiología de la enfermedad de Chagas en el estado de Veracruz Epidemiology of Chagas disease in the state of Veracruz

    Directory of Open Access Journals (Sweden)

    Elsa L Segura

    2005-06-01

    quantify exposure to risk factors and seropositivity. Odds ratios with 95% confidence intervals and Mantel-Haenszel chi-squared tests were obtained. Multivariate analysis was performed with unconditional logistic regression, variables included in the model were those that had a p-value up to 0.20 in the bivariate analysis. The etiologic fraction in the exposed was also obtained. RESULTS: The prevalence of Chagas disease was between 0 and 2.8%. Jurisdictions at a higher risk were Tuxpan, Panuco and Cordoba; Orizaba showed no risk. The main household risk factors were palma/zacate (palmtree, grass leaves roof and walls, dirt floor, the presence of the vector, and ventilation. CONCLUSIONS: Epidemiological surveillance should emphasize health education, housing improvement, and use of insecticides.

  5. Traditional medicine used in childbirth and for childhood diarrhoea in Nigeria's Cross River State: interviews with traditional practitioners and a statewide cross-sectional study

    Science.gov (United States)

    Sarmiento, Iván; Zuluaga, Germán; Andersson, Neil

    2016-01-01

    Objectives Examine factors associated with use of traditional medicine during childbirth and in management of childhood diarrhoea. Design Cross-sectional cluster survey, household interviews in a stratified last stage random sample of 90 census enumeration areas; unstructured interviews with traditional doctors. Setting Oil-rich Cross River State in south-eastern Nigeria has 3.5 million residents, most of whom depend on a subsistence agriculture economy. Participants 8089 women aged 15–49 years in 7685 households reported on the health of 11 305 children aged 0–36 months in July–August 2011. Primary and secondary outcome measures Traditional medicine used at childbirth and for management of childhood diarrhoea; covariates included access to Western medicine and education, economic conditions, engagement with the modern state and family relations. Cluster-adjusted analysis relied on the Mantel-Haenszel procedure and Mantel extension. Results 24.1% (1371/5686) of women reported using traditional medicine at childbirth; these women had less education, accessed antenatal care less, experienced more family violence and were less likely to have birth certificates for their children. 11.3% (615/5425) of young children with diarrhoea were taken to traditional medical practitioners; these children were less likely to receive BCG, to have birth certificates, to live in households with a more educated head, or to use fuel other than charcoal for cooking. Education showed a gradient with decreasing use of traditional medicine for childbirth (χ2 135.2) and for childhood diarrhoea (χ2 77.2). Conclusions Use of traditional medicine is associated with several factors related to cultural transition and to health status, with formal education playing a prominent role. Any assessment of the effectiveness of traditional medicine should anticipate confounding by these factors, which are widely recognised to affect health in their own right. PMID:27094939

  6. Efficacy of ibuprofen on prevention of high altitude headache: A systematic review and meta-analysis.

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    Juan Xiong

    Full Text Available Ibuprofen is used to prevent high altitude headache (HAH but its efficacy remains controversial. We conducted a systematic review and meta-analysis of randomized, placebo-controlled trials (RCTs of ibuprofen for the prevention of HAH.Studies reporting efficacy of ibuprofen for prevention of HAH were identified by searching electronic databases (until December 2016. The primary outcome was the difference in incidence of HAH between ibuprofen and placebo groups. Risk ratios (RR were aggregated using a Mantel-Haenszel random effect model. Heterogeneity of included trials was assessed using the I2 statistics.In three randomized-controlled clinical trials involving 407 subjects, HAH occurred in 101 of 239 subjects (42% who received ibuprofen and 96 of 168 (57% who received placebo (RR = 0.79, 95% CI 0.66 to 0.96, Z = 2.43, P = 0.02, I2 = 0%. The absolute risk reduction (ARR was 15%. Number needed to treat (NNT to prevent HAH was 7. Similarly, The incidence of severe HAH was significant in the two groups (RR = 0.40, 95% CI 0.17 to 0.93, Z = 2.14, P = 0.03, I2 = 0%. Severe HAH occurred in 3% treated with ibuprofen and 10% with placebo. The ARR was 8%. NNT to prevent severe HAH was 13. Headache severity using a visual analogue scale was not different between ibuprofen and placebo. Similarly, the difference between the two groups in the change in SpO2 from baseline to altitude was not different. One included RCT reported one participant with black stools and three participants with stomach pain in the ibuprofen group, while seven participants reported stomach pain in the placebo group.Based on a limited number of studies ibuprofen seems efficacious for the prevention of HAH and may therefore represent an alternative for preventing HAH with acetazolamide or dexamethasone.

  7. Oral versus intravenous methylprednisolone for the treatment of multiple sclerosis relapses: A meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Shuo Liu

    Full Text Available Intravenous glucocorticoids are recommended for multiple sclerosis (MS. However, they can be inconvenient and expensive. Due to their convenience and low cost, oral glucocorticoids may be an alternative treatment. Recently, several studies have shown that there is no difference in efficacy and safety between oral methylprednisolone (oMP and intravenous methylprednisolone (ivMP.We sought to assess the clinical efficacy, safety and tolerability of oral methylprednisolone versus intravenous methylprednisolone for MS relapses in this meta-analysis.Randomized controlled trials (RCTs evaluating the clinical efficacy, safety and tolerability of oral methylprednisolone versus intravenous methylprednisolone for MS relapses were searched in PubMed, Cochrane Library, Medline, EMBASE and China Biology Medicine until October 25, 2016, without language restrictions. The proportion of patients who had improved by day 28 was chosen as the efficacy outcome. We chose the risk ratio (RR to analyze each trial with the 95% confidence interval (95% CI. We also used the fixed-effects model (Mantel-Haenszel approach to calculate the pooled relative effect estimates.A total of 5 trials were identified, which included 369 patients. The results of our meta-analysis revealed that no significant difference existed in relapse improvement at day 28 between oMP and ivMP (RR 0.96, 95% CI 0.84 to 1.10. No evidence of heterogeneity existed among the trials (P = 0.45, I2 = 0%. Both treatments were equally safe and well tolerated except that insomnia was more likely to occur in the oMP group compared to the ivMP group.Our meta-analysis reveals strong evidence that oMP is not inferior to ivMP in increasing the proportion of patients experiencing clinical improvement at day 28. In addition, both routes of administration are equally well tolerated and safe. These findings suggest that we may be able to replace ivMP with oMP to treat MS relapses.

  8. Tidal volume and mortality in mechanically ventilated children: a systematic review and meta-analysis of observational studies*.

    Science.gov (United States)

    de Jager, Pauline; Burgerhof, Johannes G M; van Heerde, Marc; Albers, Marcel J I J; Markhorst, Dick G; Kneyber, Martin C J

    2014-12-01

    To determine whether tidal volume is associated with mortality in critically ill, mechanically ventilated children. MEDLINE, EMBASE, and CINAHL databases from inception until July 2013 and bibliographies of included studies without language restrictions. Randomized clinical trials and observational studies reporting mortality in mechanically ventilated PICU patients. Two authors independently selected studies and extracted data on study methodology, quality, and patient outcomes. Meta-analyses were performed using the Mantel-Haenszel random-effects model. Heterogeneity was quantified using I. Study quality was assessed using the Newcastle-Ottawa Score for cohort studies. Out of 142 citations, seven studies met the inclusion criteria, and additional two articles were identified from references of the found articles. One was excluded. These eight studies included 1,756 patients. Mortality rates ranged from 13% to 42%. There was no association between tidal volume and mortality when tidal volume was dichotomized at 7, 8, 10, or 12 mL/kg. Comparing patients ventilated with tidal volume less than 7 mL/kg and greater than 10 mL/kg or greater than 12 mL/kg and tidal volume less than 8 mL/kg and greater than 10 mL/kg or greater than 12 mL/kg also showed no association between tidal volume and mortality. Limiting the analysis to patients with acute lung injury/acute respiratory distress syndrome did not change these results. Heterogeneity was observed in all pooled analyses. A relationship between tidal volume and mortality in mechanically ventilated children could not be identified, irrespective of the severity of disease. The significant heterogeneity observed in the pooled analyses necessitates future studies in well-defined patient populations to understand the effects of tidal volume on patient outcome.

  9. Current trends in Irish perinatal mortality.

    LENUS (Irish Health Repository)

    Mahony, R

    2010-06-01

    This was a retrospective review of normally formed perinatal deaths among 176,620 births at the National Maternity Hospital (1984-2007). Prelabor stillbirths were categorised by presumed cause of death including unexplained, intrauterine growth retardation (IUGR), placental abruption, red cell alloimmunisation (RCA) and deaths related to prematurity. Peripartum deaths included intrapartum and first week neonatal deaths. The post-mortem rate, initially almost 100%, fell to 60%. Data were analysed using the Mantel-Haenszel chi square test for trends. In the study period there was a significant reduction in the PNM, largely because of a fall in death related to prematurity, term peripartum death, death at 42 weeks or greater, placental abruption, death related to IUGR and RCA (P < 0.01). Overall the unexplained still birth rate was unchanged throughout the study period (p = 0.8) despite a highly significant (p < 0.001) increase in obstetric intervention particularly induction of labor and caesarean section.

  10. The status of rheumatoid factor and anti-cyclic citrullinated peptide antibody are not associated with the effect of anti-TNFα agent treatment in patients with rheumatoid arthritis: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Qianwen Lv

    Full Text Available OBJECTIVES: This meta-analysis was conducted to investigate whether the status of rheumatoid factor (RF and anti-cyclic citrullinated peptide (anti-CCP antibody are associated with the clinical response to anti-tumor necrosis factor (TNF alpha treatment in rheumatoid arthritis (RA. METHODS: A systemic literature review was performed using the MEDLINE, SCOPUS, Cochrane Library, ISI Web of Knowledge, and Clinical Trials Register databases, and Hayden's criteria of quality assessment for prognostic studies were used to evaluate all of the studies. The correlation between the RF and anti-CCP antibody status with the treatment effect of anti-TNFα agents was analyzed separately using the Mantel Haenszel method. A fixed-effects model was used when there was no significant heterogeneity; otherwise, a random-effects model was applied. Publication bias was assessed using Egger's linear regression and a funnel plot. RESULTS: A total of 14 studies involving 5561 RA patients meeting the inclusion criteria were included. The overall analysis showed that the pooled relative risk for the predictive effects of the RF and anti-CCP antibody status on patient response to anti-TNFα agents was 0.98 (95% CI: 0.91-1.05, p=0.54 and 0.88 (95% CI: 0.76-1.03, p=0.11, respectively, with I(2 values of 43% (p=0.05 and 67% (p<0.01, respectively. Subgroup analyses of different anti-TNFα treatments (infliximab vs. etanercept vs. adalimumab vs. golimumab, response criteria (DAS28 vs. ACR20 vs. EULAR response, follow-up period (≥ 6 vs. <6 months, and ethnic group did not reveal a significant association for the status of RF and anti-CCP. CONCLUSIONS: Neither the RF nor anti-CCP antibody status in RA patients is associated with a clinical response to anti-TNFα treatment.

  11. Clinical and Echocardiographic Outcomes Following Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: Meta-Analysis and Meta-Regression.

    Science.gov (United States)

    Mohananey, Divyanshu; Jobanputra, Yash; Kumar, Arnav; Krishnaswamy, Amar; Mick, Stephanie; White, Jonathon M; Kapadia, Samir R

    2017-07-01

    Transcatheter aortic valve replacement has become the procedure of choice for inoperable, high-risk, and many intermediate-risk patients with aortic stenosis. Conduction abnormalities are a common finding after transcatheter aortic valve replacement and often result in permanent pacemaker (PPM) implantation. Data pertaining to the clinical impact of PPM implantation are controversial. We used meta-analysis techniques to summarize the effect of PPM implantation on clinical and echocardiographic outcomes after transcatheter aortic valve replacement. Data were summarized as Mantel-Haenszel relative risk (RR) and 95% confidence intervals (CIs) for dichotomous variables and as standardized mean difference and 95% CI for continuous variables We used the Higgins I 2 statistic to evaluate heterogeneity. We found that patients with and without PPM have similar all-cause mortality (RR, 0.85; 95% CI, 0.70-1.03), cardiovascular mortality (RR, 0.84; 95% CI, 0.59-1.18), myocardial infarction (RR, 0.47; 95% CI, 0.20-1.11), and stroke (RR, 1.26; 95% CI, 0.70-2.26) at 30 days. The groups were also comparable in all-cause mortality (RR, 1.03; 95% CI, 0.92-1.16), cardiovascular mortality (RR, 0.69; 95% CI, 0.39-1.24), myocardial infarction (RR, 0.58; 95% CI, 0.30-1.13), and stroke (RR, 0.70; 95% CI, 0.47-1.04) at 1 year. We observed that the improvement in left ventricular ejection fraction was significantly greater in the patients without PPM (standardized mean difference, 0.22; 95% CI, 0.12-0.32). PPM implantation is not associated with increased risk of all-cause mortality, cardiovascular mortality, stroke, or myocardial infarction both at short- and long-term follow-up. However, PPM is associated with impaired left ventricular ejection fraction recovery post-transcatheter aortic valve replacement. © 2017 American Heart Association, Inc.

  12. Psychiatric diagnoses in 3275 suicides: a meta-analysis

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    Turecki Gustavo

    2004-11-01

    Full Text Available Abstract Background It is well known that most suicide cases meet criteria for a psychiatric disorder. However, rates of specific disorders vary considerably between studies and little information is known about gender and geographic differences. This study provides overall rates of total and specific psychiatric disorders in suicide completers and presents evidence supporting gender and geographic differences in their relative proportion. Methods We carried out a review of studies in which psychological autopsy studies of suicide completers were performed. Studies were identified by means of MEDLINE database searches and by scanning the reference list of relevant publications. Twenty-three variables were defined, 16 of which evaluating psychiatric disorders. Mantel-Haenszel Weighted Odds Ratios were estimated for these 16 outcome variables. Results Twenty-seven studies comprising 3275 suicides were included, of which, 87.3% (SD 10.0% had been diagnosed with a mental disorder prior to their death. There were major gender differences. Diagnoses of substance-related problems (OR = 3.58; 95% CI: 2.78–4.61, personality disorders (OR = 2.01; 95% CI: 1.38–2.95 and childhood disorders (OR = 4.95; 95% CI: 2.69–9.31 were more common among male suicides, whereas affective disorders (OR = 0.66; 95% CI: 0.53–0.83, including depressive disorders (OR = 0.53; 95% CI: 0.42–0.68 were less common among males. Geographical differences are also likely to be present in the relative proportion of psychiatric diagnoses among suicides. Conclusions Although psychopathology clearly mediates suicide risk, gender and geographical differences seem to exist in the relative proportion of the specific psychiatric disorders found among suicide completers.

  13. Prevalence of cancer risk factors among women radiologists and radiology assistants in Lithuania

    International Nuclear Information System (INIS)

    Samerdokiene, V.; Kurtinaitis, J.; Atkocius, V. and others

    2005-01-01

    The aim of the work was to study potential cancer risk factors among radiologists and non-radiologists in Lithuania. Cancer risk factors were investigated among female medical staff at the departments of ionizing (243, 33.33%) and non-ionizing environment (486, 66.67%). The questionnaire covered the diet, lifestyle, reproductive factors as well as the demographic and physical characteristics. Univariate analysis was done separately for physicians and nurses. Each of risk factors was evaluated in stratified analysis for unequal ORs using Mantel-Haenszel estimate control for age and occupation. Evaluation of features of risk factors among radiologists vs. non-radiologists has shown that smoking was most the prevalent risk factor among radiologists and radiology assistants. Despite the relatively low prevalence, the questionnaire data showed the higher frequency of smoking among radiologists (OR = 2.78, 95% CI 1.12-6.87) and radiology assistants (OR = 2.25, 95% 1.38-3.66) compared to non-radiologists. The prevalence of non-users and occasional users was 74% to 66%, respectively. Alcohol use by smoking among radiologists was influenced insignificantly. The cohort of radiologists in Lithuania offer an opportunity for obtaining direct observational evidence on health effects associated with chronic low-dose radiation exposure. The data on possible cancer risk factors can be helpful for validation of the risks in future. (author)

  14. Laparoscopic esophageal myotomy versus pneumatic dilation in the treatment of idiopathic achalasia: a meta-analysis of randomized controlled trials

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    Baniya R

    2017-09-01

    Full Text Available Ramkaji Baniya, Sunil Upadhaya, Jahangir Khan, Suresh Kumar Subedi, Tabrez Shaik Mohammed, Balvant K Ganatra, Ghassan Bachuwa Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint, MI, USA Background: Achalasia is a primary esophageal motility disorder of unknown etiology associated with abnormalities in peristalsis and lower esophageal sphincter relaxation. The disease is incurable; however, definitive treatment procedures like pneumatic dilation (PD/balloon dilation and laparoscopic esophageal myotomy (LEM are performed to relieve dysphagia and related symptoms. Currently, there is paucity of data comparing the outcomes of these procedures. The aim of this meta-analysis is to compare the short- and long-term success rates of PD and LEM. Methods: A thorough systematic search of PubMed, Scopus, clinicaltrials.gov, and Cochrane library was conducted for randomized controlled trials (RCTs comparing the outcomes of PD versus LEM in the treatment of achalasia. The Mantel-Haenszel method and random effect model were used to analyze the data. RCTs with outcome data at 3-month, 1-year, and 5-year intervals were analyzed. Results: A total of 437,378 and 254 patients at 3-month, 1-year, and 5-year intervals were analyzed for outcome data. At 3 months and 1 year, PD was not as effective as LEM (odds ratio [OR]: 0.50; confidence interval [CI] 0.31–0.82; P = 0.009 and OR: 0.47; CI 0.22–0.99; P = 0.21 but at 5 years, one procedure was non-inferior to the other (OR: 0.62; 0.33–1.19; P = 0.34. Conclusion: PD was as effective as LEM in relieving symptoms of achalasia in the long-term. Keywords: achalasia, balloon dilation, pneumatic dilation, laparoscopic myotomy, Heller’s myotomy

  15. Associations between Methylenetetrahydrofolate Reductase (MTHFR Polymorphisms and Non-Alcoholic Fatty Liver Disease (NAFLD Risk: A Meta-Analysis.

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    Man-Yi Sun

    Full Text Available C677T and A1298C are the most common allelic variants of Methylenetetrahydrofolate Reductase (MTHFR gene. The association between MTHFR polymorphisms and the occurrence of non-alcoholic fatty liver disease (NAFLD remains controversial. This study was thus performed to examine whether MTHFR mutations are associated with the susceptibility to NAFLD.A first meta-analysis on the association between the MTHFR polymorphisms and NAFLD risks was carried out via Review Manager 5.0 and Stata/SE 12.0 software. The on-line databases, such as PubMed, EMBASE, CENTRAL, WOS, Scopus and EBSCOhost (updated to April 1st, 2016, were searched for eligible case-control studies. The odd radio (OR, 95% confidence interval (CI and P value were calculated through Mantel-Haenszel statistics under random- or fixed-effect model.Eight articles (785 cases and 1188 controls contributed data to the current meta-analysis. For C677T, increased NAFLD risks were observed in case group under homozygote model (T/T vs C/C, OR = 1.49, 95% CI = 1.03~2.15, P = 0.04 and recessive model (T/T vs C/C+C/T, OR = 1.42, 95% CI = 1.07~1.88, P = 0.02, but not the other genetics models, compared with control group. For A1298C, significantly increased NAFLD risks were detected in allele model (C vs A, OR = 1.53, 95% CI = 1.13~2.07, P = 0.006, homozygote model (C/C vs A/A, OR = 2.81, 95% CI = 1.63~4.85, P = 0.0002, dominant model (A/C+C/C vs A/A, OR = 1.60, 95% CI = 1.06~2.41, P = 0.03 and recessive model (C/C vs A/A+A/C, OR = 2.08, 95% CI = 1.45~3.00, P<0.0001, but not heterozygote model.T/T genotype of MTHFR C677T polymorphism and C/C genotype of MTHFR A1298C are more likely to be associated with the susceptibility to NAFLD.

  16. Associations between Methylenetetrahydrofolate Reductase (MTHFR) Polymorphisms and Non-Alcoholic Fatty Liver Disease (NAFLD) Risk: A Meta-Analysis

    Science.gov (United States)

    Sun, Man-Yi; Zhang, Li; Shi, Song-Li; Lin, Jing-Na

    2016-01-01

    Background C677T and A1298C are the most common allelic variants of Methylenetetrahydrofolate Reductase (MTHFR) gene. The association between MTHFR polymorphisms and the occurrence of non-alcoholic fatty liver disease (NAFLD) remains controversial. This study was thus performed to examine whether MTHFR mutations are associated with the susceptibility to NAFLD. Methods A first meta-analysis on the association between the MTHFR polymorphisms and NAFLD risks was carried out via Review Manager 5.0 and Stata/SE 12.0 software. The on-line databases, such as PubMed, EMBASE, CENTRAL, WOS, Scopus and EBSCOhost (updated to April 1st, 2016), were searched for eligible case-control studies. The odd radio (OR), 95% confidence interval (CI) and P value were calculated through Mantel-Haenszel statistics under random- or fixed-effect model. Results Eight articles (785 cases and 1188 controls) contributed data to the current meta-analysis. For C677T, increased NAFLD risks were observed in case group under homozygote model (T/T vs C/C, OR = 1.49, 95% CI = 1.03~2.15, P = 0.04) and recessive model (T/T vs C/C+C/T, OR = 1.42, 95% CI = 1.07~1.88, P = 0.02), but not the other genetics models, compared with control group. For A1298C, significantly increased NAFLD risks were detected in allele model (C vs A, OR = 1.53, 95% CI = 1.13~2.07, P = 0.006), homozygote model (C/C vs A/A, OR = 2.81, 95% CI = 1.63~4.85, P = 0.0002), dominant model (A/C+C/C vs A/A, OR = 1.60, 95% CI = 1.06~2.41, P = 0.03) and recessive model (C/C vs A/A+A/C, OR = 2.08, 95% CI = 1.45~3.00, P<0.0001), but not heterozygote model. Conclusion T/T genotype of MTHFR C677T polymorphism and C/C genotype of MTHFR A1298C are more likely to be associated with the susceptibility to NAFLD. PMID:27128842

  17. Enamel Hypomineralization in Children With Clefts and the Relationship to Treatment: A Cross-sectional Retrospective Study.

    Science.gov (United States)

    Allam, Eman; Ghoneima, Ahmed; Tholpady, Sunil S; Kula, Katherine

    2018-06-19

    The aim of this study was to determine whether molar incisor hypomineralization (MIH) is greater in patients with cleft lip and palate (CLP) who underwent primary alveolar grafting (PAG) as compared with CLP waiting for secondary alveolar grafting (SAG) and with controls. A retrospective analysis of intraoral photographs of 13 CLP patients who underwent a PAG, 28 CLP prior to SAG, and 60 controls without CLP was performed. Mantel-Haenszel χ tests were used to compare the 3 groups for differences in MIH scores, and Wilcoxon rank sum tests were used to compare the groups for differences in average MIH scores. A 5% significance level was used for all tests. Molar incisor hypomineralization scores were significantly higher for the PAG and SAG groups compared with the control group (P MIH (P = 0.016) compared with the SAG group. Molar incisor hypomineralization average scores were significantly higher for the 2 graft groups compared with the controls (P MIH score and average MIH score for incisors compared with the SAG group (P = 0.03). Cleft lip and palate patients have significantly greater MIH compared with controls, and CLP patients with PAGs have significantly greater MIH in the incisor region compared with CLP patients with SAGs, indicating that subjects with PAGs have more severely affected dentition.

  18. lawstat: An R Package for Law, Public Policy and Biostatistics

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    Wallace Hui

    2008-01-01

    Full Text Available We present a new R software package lawstat that contains statistical tests and procedures that are utilized in various litigations on securities law, antitrust law, equal employment and discrimination as well as in public policy and biostatistics. Along with the well known tests such as the Bartels test, runs test, tests of homogeneity of several sample proportions, the Brunner-Munzel tests, the Lorenz curve, the Cochran-Mantel-Haenszel test and others, the package contains new distribution-free robust tests for symmetry, robust tests for normality that are more sensitive to heavy-tailed departures, measures of relative variability, Levene-type tests against trends in variances etc. All implemented tests and methods are illustrated by simulations and real-life examples from legal cases, economics and biostatistics. Although the package is called lawstat, it presents implementation and discussion of statistical procedures and tests that are also employed in a variety of other applications, e.g., biostatistics, environmental studies, social sciences and others, in other words, all applications utilizing statistical data analysis. Hence, name of the package should not be considered as a restriction to legal statistics. The package will be useful to applied statisticians and "quantitatively alert practitioners" of other subjects as well as an asset in teaching statistical courses.

  19. Understanding the use of NIV in ALS: results of an international ALS specialist survey.

    Science.gov (United States)

    Heiman-Patterson, Terry D; Cudkowicz, Merit E; De Carvalho, Mamede; Genge, Angela; Hardiman, Orla; Jackson, Carlayne E; Lechtzin, Noah; Mitsumoto, Hiroshi; Silani, Vincenzo; Andrews, Jinsy A; Chen, Dafeng; Kulke, Sarah; Rudnicki, Stacy A; van den Berg, Leonard H

    2018-04-16

    To identify common practices of noninvasive ventilation (NIV) use among ALS specialists and how they follow respiratory status in their patients. A 25-item questionnaire on NIV indications/initiation was sent via SurveyMonkey® to ALS specialists identified through membership in NEALS (114 sites in the US) and ENCALS (39 sites in Europe). Descriptive statistics and Cochran-Mantel-Haenszel test for general association were performed. In their initial evaluation, US and European specialists (n = 186) use upright forced vital capacity (FVC) most (92.8% vs 91.1%; p = 0.752). Upright FVC results are most important for US respondents when deciding to prescribe NIV; European respondents consider symptoms of orthopnea and/or dyspnea as most important. European respondents use overnight pulse oximetry (69.8% vs 7.9%; p NIV initiation more in the US than in Europe (70.0% vs 47.5%; p = 0.025). When asked if insurance/other financial constraints affects when they prescribe NIV, more US respondents answered positively (77.2% vs 15.4%; p NIV at VC NIV on respiratory function and the importance of respiratory function to quality of life and survival, understanding differences that influence NIV prescribing is critical. This information may inform future study design and identify areas warranting additional research to develop best practices for NIV implementation.

  20. Fishery biology of the swordfish (Xiphias gladius, Linnaeus 1758 caught by surface longliners based in Itajaí, southern Brazil

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    Ana Lia Campos Quaggio

    2011-06-01

    Full Text Available The Xiphias gladius (Linnaeus, 1758 data used in the present study were obtained from commercial fishing cruises of the pelagic longline fleet based in Itajaí, operating in the Southwest Atlantic. For the Covariance models, fishing effort (number of hooks and catches (kg were pooled and categorized into the following groups: (1 year (1997, 1998, 2001, 2002 and 2007; (2 lunar phase; and (3 seasons, fishing effort being the covariate. The highest mean swordfish catch (kg occurred during the waxing crescent moon and during wintertime. The Mantel-Haenszel procedure was applied to compare the efficiency of the two hooks tested, and showed that the "J" hook type (J 9/0 10º offset, traditionally used by the fleet, catches 1.2-fold more Xiphias gladius than the circle hook (18/0 10º offset, used as an optional device to reduce sea turtle bycatch. The conversion of individual dressed weight (kg into total length (cm from 2000 to 2002, showed that sub-adults represented 66% of the total catch.No presente estudo foram analisados os dados obtidos para Xiphias gladius (Linnaeus, 1758 através de observadores, mapas de bordo e fichas de desembarque de carcaças, coletadas pela frota de espinhel-de-superfície sediada em Itajaí (SC. Modelos de análise de covariância (ANCOVA foram aplicados aos dados de captura (peso em kg do espadarte, tendo como efeitos: (1 anos de 1997, 1998, 2001, 2002 e 2007 (2 fases lunares e (3 épocas do ano. A covariável foi o esforço de pesca (n° de anzóis. As maiores médias de captura ocorreram durante as fases de lua crescente e no inverno. O procedimento estatístico de Mantel-Haenszel foi utilizado para comparar as capturas do espadarte no anzol tipo "Jota" (J 9/0 10º offset, comumente utilizado pela frota, com o anzol tipo "circular" (18/0 10º offset, este último oferecido como alternativa mitigadora à captura de tartarugas marinhas. O teste M-H mostrou que o anzol "Jota" apresentou 1,2 mais chances de capturar

  1. Alojamiento conjunto madre-hijo y lactancia humana exclusiva Joined mother-child hospital lodging and exclusive human lactation

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    SAMUEL FLORES-HUERTA

    1997-03-01

    Full Text Available Objetivo. Conocer la influencia del alojamiento conjunto (AC madre-hijo, en la frecuencia de lactancia humana exclusiva (LHE, desde el nacimiento hasta los cuatro meses de vida. Material y métodos. Estudio de cohortes no aleatorizado realizado en la clínica de lactancia del Hospital "Luis Castelazo Ayala", del Instituto Mexicano del Seguro Social, de enero de 1993 a octubre de 1994, en el que participaron 178 binomios madre-hijo (BMH sanos con gestación de término. El grupo con alojamiento conjunto (AC se integró con 90 BMH, y la madre recibió asesoría para lactar; 88 se atendieron en forma separada, sin asesoría para lactar. Se realizó análisis estadístico de los datos para apreciar frecuencia y asociaciones de las variables. Resultados. La alimentación se registró como LHE, fórmula o ambas. Los grupos con y sin AC se estratificaron por la forma de nacimiento, parto o cesárea. Con X² de Mantel-Haenszel y de rango logarítmico se aceptaron diferencias con pObjective. To determine the influence of joined mother-child hospital lodging (JL on the frequency of exclusive human lactation (EHL from birth to four months of age. Material and methods. Non-randomized cohort study performed at the lactation clinic of the "Luis Castelazo Ayala" Hospital of the Mexican Social Security Institute from January 1993 to October 1994 which included 178 healthy mother-child pairs (MCP with term pregnancy. The jointly lodged group (JL consisted of 90 MCP in which mothers received assessment for lactation; 88 MCP were lodged separately and no assessment was provided. Results were statistically analyzed to determine frequency and variable associations. Results. Feeding was recorded as either EHL, powdered milk or both. Groups with or without JL were stratified by form of birth, either labor or Cesarean section. With the Mantel-Haenszel X² and logarithmic range, differences were significant with p<0.05. During the study, global lactation was similar

  2. Cárie precoce na infância: prevalência e fatores de risco em pré-escolares, aos 48 meses, na cidade de João Pessoa, Paraíba, Brasil Early childhood caries: prevalence and risk factors in 4-year-old preschoolers in João Pessoa, Paraíba, Brasil

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    Andréa Gadelha Ribeiro

    2005-12-01

    Full Text Available O objetivo deste estudo foi verificar a prevalência de cárie precoce na infância em crianças de nível sócio-econômico baixo da grande João Pessoa, Paraíba, Brasil, aos 48 meses de idade, pertencentes a uma coorte. Foram analisados os hábitos alimentares, higiene, exposição ao flúor e presença de defeitos de esmalte. Examinaram-se 224 crianças em domicílio, sob luz natural, utilizando-se a técnica joelho-a-joelho. Cada dente foi limpo com gaze estéril, sendo registrados cárie (OMS e defeitos de esmalte (DDE Index. Durante o exame foi aplicado um questionário para obtenção de dados sobre dieta, higiene, uso de flúor e presença de amamentação natural e/ou artificial. Para análise estatística, utilizou-se o programa SAS com teste não paramétrico Mantel-Haenszel. Observou-se que 10,7% e 33,0% da amostra apresentaram cárie precoce e cárie severa, respectivamente. Dentre as crianças examinadas, 79,9% tinham ao menos um dente com defeito de esmalte, sendo este o único fator estatisticamente significante (p The purpose of the present study was to evaluate the prevalence of early childhood caries (ECC, in a cohort of children of low socioeconomic status at 48 months of age in João Pessoa, Paraíba, Brazil, in relation to feeding practices, oral health behaviors, fluoride exposure, and enamel defects. 224 children were clinically examined in the Knee-Knee position at the children's home under natural light. Teeth were dried and cleaned with gauze, and caries (WHO index and defect (DDE Index were determined. Questionnaires on children's oral hygiene and dietary history were completed by parents or guardians. The SAS statistical program was used with the Mantel-Haenszel tests. The results showed a prevalence of 10.7% and 33.0% for ECC and SECC, respectively. Of all the children examined, 79.9% had at least one tooth with enamel defects, which was the only statistically significant factor (p < 0.001 for ECC. The association

  3. Is higher risk sex common among male or female youths?

    Science.gov (United States)

    Berhan, Yifru; Berhan, Asres

    2015-01-01

    There are several studies that showed the high prevalence of high-risk sexual behaviors among youths, but little is known how significant the proportion of higher risk sex is when the male and female youths are compared. A meta-analysis was done using 26 countries' Demographic and Health Survey data from and outside Africa to make comparisons of higher risk sex among the most vulnerable group of male and female youths. Random effects analytic model was applied and the pooled odds ratios were determined using Mantel-Haenszel statistical method. In this meta-analysis, 19,148 male and 65,094 female youths who reported to have sexual intercourse in a 12-month period were included. The overall OR demonstrated that higher risk sex was ten times more prevalent in male youths than in female youths. The practice of higher risk sex by male youths aged 15-19 years was more than 27-fold higher than that of their female counterparts. Similarly, male youths in urban areas, belonged to a family with middle to highest wealth index, and educated to secondary and above were more than ninefold, eightfold and sixfold at risk of practicing higher risk sex than their female counterparts, respectively. In conclusion, this meta-analysis demonstrated that the practice of risky sexual intercourse by male youths was incomparably higher than female youths. Future risky sex protective interventions should be tailored to secondary and above educated male youths in urban areas.

  4. Patients Receiving Prebiotics and Probiotics Before Liver Transplantation Develop Fewer Infections Than Controls: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Sawas, Tarek; Al Halabi, Shadi; Hernaez, Ruben; Carey, William D; Cho, Won Kyoo

    2015-09-01

    Among patients who have received liver transplants, infections increase morbidity and mortality and prolong hospital stays. Administration of antibiotics and surgical trauma create intestinal barrier dysfunction and microbial imbalances that allow enteric bacteria to translocate to the blood. Probiotics are believed to prevent bacterial translocation by stabilizing the intestinal barrier and stimulating proliferation of the intestinal epithelium, mucus secretion, and motility. We performed a meta-analysis to determine the effects of probiotics on infections in patients receiving liver transplants. We searched PubMed and EMBASE for controlled trials that evaluated the effects of prebiotics and probiotics on infections in patients who underwent liver transplantation. Heterogeneity was analyzed by the Cochran Q statistic. Pooled Mantel-Haenszel relative risks were calculated with a fixed-effects model. We identified 4 controlled studies, comprising 246 participants (123 received probiotics, 123 served as controls), for inclusion in the meta-analysis. In these studies, the intervention groups received enteric nutrition and fiber (prebiotics) with probiotics, and the control groups received only enteric nutrition and fiber without probiotics. The infection rate was 7% in groups that received probiotics vs 35% in control groups (relative risk [RR], 0.21; 95% confidence interval [CI], 0.11-0.41; P = .001). The number needed to treat to prevent 1 infection was 3.6. In subgroup analyses, only 2% of subjects in the probiotic groups developed urinary tract infections, compared with 16% of controls (RR, 0.14; 95% CI, 0.04-0.47; P probiotic groups developed intra-abdominal infections, compared with 11% of controls (RR, 0.27; 95% CI, 0.09-0.78; P = .02). Subjects receiving probiotics also had shorter stays in the hospital than controls (mean difference, 1.41 d; P probiotics and prebiotics before, or on the day of, liver transplantation reduces the rate of infection after

  5. Non-monogamy: risk factor for STI transmission and acquisition and determinant of STI spread in populations.

    Science.gov (United States)

    Aral, Sevgi O; Leichliter, Jami S

    2010-12-01

    The concept of concurrent partnerships, while theoretically appealing, has been challenged at many levels. However, non-monogamy may be an important risk factor for the acquisition and transmission of sexually transmitted infections (STI). One's own non-monogamy is a risk factor for transmitting STI to others, partners' non-monogamy is a risk factor for acquiring STI and, most importantly, mutual non-monogamy is a population level determinant of increased STI spread. This study describes the levels, distribution and correlates of non-monogamy, partners' non-monogamy and mutual non-monogamy among adult men and women in the USA. Data from the National Survey of Family Growth (NSFG) Cycle 6 were used. NSFG is a national household survey of subjects aged 15-44 years in the USA. Cochran-Mantel-Haenszel tests and χ(2) tests were used in the analysis. Among sexually active adults, 17.6% of women and 23.0% of men (an estimated 19 million) reported non-monogamy over the past 12 months in 2002. An estimated 11 million Americans (1 in 10) reported partners' non-monogamy and an estimated 8.4 million (7% of women and 10.5% of men) reported mutual non-monogamy. All three types of non-monogamy were reported more frequently by men than women. Younger age, lower education, formerly or never married status, living below the poverty level and having spent time in jail were associated with all three types of non-monogamy in general. The three types of non-monogamy may be helpful in tailoring prevention messages and targeting prevention efforts to subgroups most likely to spread infection.

  6. Prophylactic therapy with omeprazole for prevention of equine gastric ulcer syndrome (EGUS) in horses in active training: A meta-analysis.

    Science.gov (United States)

    Mason, L V; Moroney, J R; Mason, R J

    2018-04-17

    Guidelines regarding the impact and value of prophylaxis or maintenance therapy in equine gastric ulcer syndrome (EGUS) are not well-established or defined. The merits and the magnitude of effects of prophylaxis for spontaneous or recurrent squamous gastric ulceration in horses in training are uncertain. To pool data from randomised controlled trials (RCTs) to eliminate reporting bias and evaluate the efficacy of prophylactic omeprazole in the prevention of EGUS in training horses, and secondarily to compare prophylactic dosages of omeprazole. Meta-analysis. This meta-analysis was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search identified RCTs comparing omeprazole prophylaxis with sham in prevention of EGUS. Data were analysed using the Mantel-Haenszel test method to calculate risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CIs). Primary outcome was efficacy of prophylaxis. Secondary outcome was endoscopic severity of ulceration. The influence of study characteristics on the outcomes was examined by subgroup analyses. In preventing gastric ulcer occurrence, omeprazole prophylaxis was superior to sham in training horses (7 trials, 566 horses, RR 0.28, 95% CI 0.18-0.43; 23.4% in omeprazole prophylaxis vs. 77.2% in sham; high quality evidence). Prevalence of ulceration was 75.3 and 87.2% in the sham arms of the 1 mg/kg and 2 mg/kg omeprazole groups, respectively. Severity scores were significantly lower for omeprazole vs. sham (mean difference [MD] -1.05; 95% CI -1.35 to -0.69). Subgroup analyses comparing prophylactic omeprazole dosages resulted in a mean difference of -0.94 and -1.60 for the 1 and 2 mg/kg groups, respectively. Studies showed heterogeneity with regard to prophylactic dose. Omeprazole prophylaxis in active training horses significantly reduces gastric ulceration compared with no prophylaxis (sham) with the

  7. Mutation analysis of the ERCC4/FANCQ gene in hereditary breast cancer.

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    Sandra Kohlhase

    Full Text Available The ERCC4 protein forms a structure-specific endonuclease involved in the DNA damage response. Different cancer syndromes such as a subtype of Xeroderma pigmentosum, XPF, and recently a subtype of Fanconi Anemia, FA-Q, have been attributed to biallelic ERCC4 gene mutations. To investigate whether monoallelic ERCC4 gene defects play some role in the inherited component of breast cancer susceptibility, we sequenced the whole ERCC4 coding region and flanking untranslated portions in a series of 101 Byelorussian and German breast cancer patients selected for familial disease (set 1, n = 63 or for the presence of the rs1800067 risk haplotype (set 2, n = 38. This study confirmed six known and one novel exonic variants, including four missense substitutions but no truncating mutation. Missense substitution p.R415Q (rs1800067, a previously postulated breast cancer susceptibility allele, was subsequently screened for in a total of 3,698 breast cancer cases and 2,868 controls from Germany, Belarus or Russia. The Gln415 allele appeared protective against breast cancer in the German series, with the strongest effect for ductal histology (OR 0.67; 95%CI 0.49; 0.92; p = 0.003, but this association was not confirmed in the other two series, with the combined analysis yielding an overall Mantel-Haenszel OR of 0.94 (95% CI 0.81; 1.08. There was no significant effect of p.R415Q on breast cancer survival in the German patient series. The other three detected ERCC4 missense mutations included two known rare variants as well as a novel substitution, p.E17V, that we identified on a p.R415Q haplotype background. The p.E17V mutation is predicted to be probably damaging but was present in just one heterozygous patient. We conclude that the contribution of ERCC4/FANCQ coding mutations to hereditary breast cancer in Central and Eastern Europe is likely to be small.

  8. Generalized canonical correlation analysis with missing values

    NARCIS (Netherlands)

    M. van de Velden (Michel); Y. Takane

    2012-01-01

    textabstractGeneralized canonical correlation analysis is a versatile technique that allows the joint analysis of several sets of data matrices. The generalized canonical correlation analysis solution can be obtained through an eigenequation and distributional assumptions are not required. When

  9. Transform analysis of generalized functions

    CERN Document Server

    Misra, O P

    1986-01-01

    Transform Analysis of Generalized Functions concentrates on finite parts of integrals, generalized functions and distributions. It gives a unified treatment of the distributional setting with transform analysis, i.e. Fourier, Laplace, Stieltjes, Mellin, Hankel and Bessel Series.Included are accounts of applications of the theory of integral transforms in a distributional setting to the solution of problems arising in mathematical physics. Information on distributional solutions of differential, partial differential equations and integral equations is conveniently collected here.The volume will

  10. A meta-analysis of the prevalence of toxoplasma gondii igg antibodies in patients with mental disorders

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    Angela Dragomir1,

    2016-12-01

    Full Text Available OBJECTIVES AND BACKGROUND Toxoplasma gondii infection has been recently associated with schizophrenia and other psychiatric disorders. The aim of the present study was to evaluate the prevalence of T. gondii infection in psychiatric patients by using meta-analytical methods. MATERIALS AND METHODS By systematic research of PUBMED Database, we identified several articles on this issue. We included casecontrol studies focused on the seroprevalence of T. gondii (IgG antibodies in patients with psychiatric disorders and healthy controls, published over the past 10 years R3.2.2. free software for statistical computing and graphics was used to perform the meta-analysis. Data were pooled using a random effects model and Mantel-Haenszel method. RESULTS The PUBMED Database showed references to only seven scientific papers that investigated the prevalence of T. gondii IgG antibodies in psychiatric patients. Six hundred seventy three patients and seven hundred seventy four controls coped with the inclusion criteria and were used in our analysis. We found a significant increase of T. gondii IgG antibodies in patients with schizophrenia and other psychiatric disorders compared with controls (41.6% vs 24.54%, OR = 2.16, 95% CI = [1.45-3.21], P = .001. CONCLUSIONS An increased seroprevalence of T. gondii IgG antibodies has been reported in psychiatric patients. Our study suggests that T. gondii infection may be relevant in order to determine and understand the complex etiology of schizophrenia and other psychiatric disorders. Graphical abstract: Meta-analysis of the prevalence of T. gondii IgG antibodies in patients with mental disorders REFERENCES 1. Hamidinejat H, Ghorbanpoor M, Hosseini H, Alavi SM, Nabavi L, Jalali MH, Borojeni MP, Jafari H, Mohammadaligol S. Toxoplasma gondii infection in first-episode and inpatient individuals with schizophrenia. Int J Infect Dis. 2010;14:e978-81. doi: 10.1016/j.ijid.2010.05.018. 2. Alvarado-Esquivel C, Carrillo-Oropeza D

  11. Substituting missing data in compositional analysis

    Energy Technology Data Exchange (ETDEWEB)

    Real, Carlos, E-mail: carlos.real@usc.es [Area de Ecologia, Departamento de Biologia Celular y Ecologia, Escuela Politecnica Superior, Universidad de Santiago de Compostela, 27002 Lugo (Spain); Angel Fernandez, J.; Aboal, Jesus R.; Carballeira, Alejo [Area de Ecologia, Departamento de Biologia Celular y Ecologia, Facultad de Biologia, Universidad de Santiago de Compostela, 15782 Santiago de Compostela (Spain)

    2011-10-15

    Multivariate analysis of environmental data sets requires the absence of missing values or their substitution by small values. However, if the data is transformed logarithmically prior to the analysis, this solution cannot be applied because the logarithm of a small value might become an outlier. Several methods for substituting the missing values can be found in the literature although none of them guarantees that no distortion of the structure of the data set is produced. We propose a method for the assessment of these distortions which can be used for deciding whether to retain or not the samples or variables containing missing values and for the investigation of the performance of different substitution techniques. The method analyzes the structure of the distances among samples using Mantel tests. We present an application of the method to PCDD/F data measured in samples of terrestrial moss as part of a biomonitoring study. - Highlights: > Missing values in multivariate data sets must be substituted prior to analysis. > The substituted values can modify the structure of the data set. > We developed a method to estimate the magnitude of the alterations. > The method is simple and based on the Mantel test. > The method allowed the identification of problematic variables in a sample data set. - A method is presented for the assessment of the possible distortions in multivariate analysis caused by the substitution of missing values.

  12. E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis

    Science.gov (United States)

    Rahman, Muhammad Aziz; Hann, Nicholas; Wilson, Andrew; Mnatzaganian, George; Worrall-Carter, Linda

    2015-01-01

    Background E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation. Objectives To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation. Data Sources A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases. Methods Published studies, those reported smoking abstinence or reduction in cigarette consumption after the use of e-cigarettes, were included. Studies were systematically reviewed, and meta-analyses were conducted using Mantel-Haenszel fixed-effect and random-effects models. Degree of heterogeneity among studies and quality of the selected studies were evaluated. Results Six studies were included involving 7,551 participants. Meta-analyses included 1,242 participants who had complete data on smoking cessation. Nicotine filled e-cigarettes were more effective for cessation than those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Amongst 1,242 smokers, 224 (18%) reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28). Use of e-cigarettes was also associated with a reduction in the number of cigarettes used. Limitations Included studies were heterogeneous, due to different study designs and gender variation. Whilst we were able to comment on the efficacy of nicotine vs. non-nicotine e-cigarettes for smoking cessation, we were unable to comment on the efficacy of e-cigarettes vs. other interventions for cessation, given the lack of comparator groups in the studies included in this meta-analysis. Conclusions Use of e

  13. E-cigarettes and smoking cessation: evidence from a systematic review and meta-analysis.

    Science.gov (United States)

    Rahman, Muhammad Aziz; Hann, Nicholas; Wilson, Andrew; Mnatzaganian, George; Worrall-Carter, Linda

    2015-01-01

    E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation. To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation. A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases. Published studies, those reported smoking abstinence or reduction in cigarette consumption after the use of e-cigarettes, were included. Studies were systematically reviewed, and meta-analyses were conducted using Mantel-Haenszel fixed-effect and random-effects models. Degree of heterogeneity among studies and quality of the selected studies were evaluated. Six studies were included involving 7,551 participants. Meta-analyses included 1,242 participants who had complete data on smoking cessation. Nicotine filled e-cigarettes were more effective for cessation than those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Amongst 1,242 smokers, 224 (18%) reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28). Use of e-cigarettes was also associated with a reduction in the number of cigarettes used. Included studies were heterogeneous, due to different study designs and gender variation. Whilst we were able to comment on the efficacy of nicotine vs. non-nicotine e-cigarettes for smoking cessation, we were unable to comment on the efficacy of e-cigarettes vs. other interventions for cessation, given the lack of comparator groups in the studies included in this meta-analysis. Use of e-cigarettes is associated with smoking cessation and reduction. More randomised

  14. E-cigarettes and smoking cessation: evidence from a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Muhammad Aziz Rahman

    Full Text Available E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation.To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation.A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases.Published studies, those reported smoking abstinence or reduction in cigarette consumption after the use of e-cigarettes, were included. Studies were systematically reviewed, and meta-analyses were conducted using Mantel-Haenszel fixed-effect and random-effects models. Degree of heterogeneity among studies and quality of the selected studies were evaluated.Six studies were included involving 7,551 participants. Meta-analyses included 1,242 participants who had complete data on smoking cessation. Nicotine filled e-cigarettes were more effective for cessation than those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97. Amongst 1,242 smokers, 224 (18% reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28. Use of e-cigarettes was also associated with a reduction in the number of cigarettes used.Included studies were heterogeneous, due to different study designs and gender variation. Whilst we were able to comment on the efficacy of nicotine vs. non-nicotine e-cigarettes for smoking cessation, we were unable to comment on the efficacy of e-cigarettes vs. other interventions for cessation, given the lack of comparator groups in the studies included in this meta-analysis.Use of e-cigarettes is associated with smoking cessation and reduction. More

  15. Generalized canonical correlation analysis with missing values

    NARCIS (Netherlands)

    M. van de Velden (Michel); Y. Takane

    2009-01-01

    textabstractTwo new methods for dealing with missing values in generalized canonical correlation analysis are introduced. The first approach, which does not require iterations, is a generalization of the Test Equating method available for principal component analysis. In the second approach,

  16. Endothelin 1 gene is not a major modifier of chronic kidney disease advancement among the autosomal dominant polycystic kidney disease patients

    Directory of Open Access Journals (Sweden)

    Annapareddy Shiva Nagendra Reddy

    2016-01-01

    Full Text Available Introduction: Autosomal dominant polycystic kidney disease (ADPKD is characterized by the presence of numerous cysts in the kidney and manifest with various renal and extra-renal complications leading to ESRD. Endothelin may contribute to various renal and extra-renal manifestations pointing to genetic and environmental modifying factors that alter the risk of developing chronic kidney disease (CKD in ADPKD. In the present study we investigated six genes coding for endothelin 1 (EDN1 tagging-single nucleotide polymorphisms (tag-SNPs to unravel the EDN1 gene modifier effect for renal disease progression in ADPKD. Materials and Methods: The tag-SNPs were genotyped using FRET-based KASPar method in 108 ADPKD patients and 119 healthy subjects. Cochran-Armitage trend test was used to determine the association between ADPKD and EDN1 tag-SNPs. Multivariate logistic regression analysis was performed to assess the effect of tag-SNPs on CKD progression. The relationship between different CKD stages and hypertension and their interaction Mantel-Haenszel stratified analysis was performed. Results: All loci are polymorphic and followed Hardy-Weinberg equilibrium. Distribution of EDN1 genotypes and haplotypes in control and ADPKD is not statistically significant. Five SNPs covering 3.4 kb forming single LD block, but the LD was not strong between SNPs. The EDN1 genotypes are not contributing to the CKD advancement among the ADPKD patients. Conclusion: These results suggest that the EDN1 gene is not a major modifier of CKD advancement among ADPKD patients.

  17. Associations of age, aerobic fitness, and body mass index with injury in an operational Army brigade.

    Science.gov (United States)

    Rappole, Catherine; Grier, Tyson; Anderson, Morgan K; Hauschild, Veronique; Jones, Bruce H

    2017-11-01

    To investigate the effects of age, aerobic fitness, and body mass index (BMI) on injury risk in operational Army soldiers. Retrospective cohort study. Male soldiers from an operational Army brigade were administered electronic surveys regarding personal characteristics, physical fitness, and injuries occurring over the last 12 months. Injury risks were stratified by age, 2-mile run time, and BMI. Analyses included descriptive incidence, a Mantel-Haenszel χ 2 test to determine trends, a multivariable logistic regression to determine factors associated with injury, and a one-way analysis of variance (ANOVA). Forty-seventy percent of 1099 respondents reported at least one injury. A linear trend showed that as age, 2-mile run time, and BMI increased, so did injury risk (p<0.01). When controlling for BMI, the most significant independent injury risk factors were older age (odd ratio (OR) 30years-35years/≤24years=1.25, 95%CI: 1.08-2.32), (OR≥36years/≤24years=2.05, 95%CI: 1.36-3.10), and slow run times (OR≥15.9min/≤13.9min=1.91, 95%CI: 1.28-2.85). An ANOVA showed that both run times and BMI increased with age. The stratified analysis and the multivariable logistic regression suggested that older age and poor aerobic fitness are stronger predictors of injury than BMI. Copyright © 2017 Sports Medicine Australia. All rights reserved.

  18. Can macrocirculation changes predict nonhealing diabetic foot ulcers?

    Science.gov (United States)

    Lee, Ye-Na; Kim, Hyon-Surk; Kang, Jeong-A; Han, Seung-Kyu

    2014-01-01

    Transcutaneous partial oxygen tension (TcpO2) is considered the gold standard for assessment of tissue oxygenation, which is an essential factor for wound healing. The purpose of this study was to evaluate the association between macrocirculation and TcpO2 in persons with diabetes mellitus. Ninety-eight patients with diabetic foot ulcers participated in the study (61 men and 37 women). The subjects had a mean age of 66.6 years (range, 30-83 years) and were treated at the Diabetic Wound Center of Korea University Guro Hospital, Seoul, Republic of Korea. Macrocirculation was evaluated using 2 techniques: computed tomographic angiography and Doppler ultrasound. Macrocirculation scores were based on the patency of the two tibial arteries in 98 patients. Computed tomographic angiography and Doppler ultrasound scores (0-4 points) were given according to intraluminal filling defects and arterial pulse waveform of each vessel, respectively. Tissue oxygenation was measured by TcpO2. Macrocirculation scores were statistically analyzed as a function of the TcpO2. Statistical analysis revealed no significant linear trend between the macrocirculation status and TcpO2. Biavariate analysis using the Fisher exact test, Mantel-Haenszel tests, and McNemar-Bowker tests also found no significant relationship between macrocirculation and TcpO2. Computed tomographic angiography and Doppler ultrasound are not sufficiently reliable substitutes for TcpO2 measurements in regard to determining the optimal treatment for diabetic patients.

  19. Occurrence of periodontal pathogens in ethnic groups from a native Brazilian reservation.

    Science.gov (United States)

    Gaetti-Jardim, Elerson; Pereira, Maurício Fabiano; Vieira, Evanice Menezes Marçal; Schweitzer, Christiane Marie; Okamoto, Ana Cláudia; Ávila-Campos, Mario J

    2015-06-01

    The present study was designed to evaluate the occurrence of periodontal pathogens in the subgingival biofilm of 100 native Brazilians living at the Umutina Indian Reservation, Mato Grosso State, Brazil. Periodontal clinical examinations were carried out prior to collection of subgingival biofilm, and the presence of 14 periodontal microorganisms was evaluated by polymerase chain reaction (PCR). The prevalence and risk analysis was performed using Cochran and Mantel-Haenszel statistics for dichotomous variables or Pearson's chi-squared test for analysis of proportions when variables had three or more categories. The interrelations between clinical and microbiological parameters were assessed using Fisher's exact test and the Mann-Whitney U test. Individuals with chronic periodontitis were frequently colonized by the association between Porphyromonas gingivalis and Campylobacter rectus, P. gingivalis and Prevotella intermedia, or P. gingivalis and Tannerella forsythia. Patients with chronic periodontitis were also colonized by Porphyromonas gulae and P. intermedia or by the association between P. gulae and T. forsythia. P. gulae was detected only in the subgingival samples from natives on a traditional diet. Gingival bleeding was associated with Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, T. forsythia, P. gingivalis, P. gulae, Porphyromonas endodontalis, P. intermedia, and Prevotella nigrescens. Treponema denticola was uncommon. Peculiar microbiota was demonstrated to be associated with different periodontal disease statuses in native Brazilians, with modest occurrence of certain pathogens, such as T. denticola, and the presence of P. gulae in natives with gingivitis or chronic periodontitis. Copyright © 2015. Published by Elsevier Ltd.

  20. Risk Factors for Acquired Rifamycin and Isoniazid Resistance: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Neesha Rockwood

    Full Text Available Studies looking at acquired drug resistance (ADR are diverse with respect to geographical distribution, HIV co-infection rates, retreatment status and programmatic factors such as regimens administered and directly observed therapy. Our objective was to examine and consolidate evidence from clinical studies of the multifactorial aetiology of acquired rifamycin and/or isoniazid resistance within the scope of a single systematic review. This is important to inform policy and identify key areas for further studies.Case-control and cohort studies and randomised controlled trials that reported ADR as an outcome during antitubercular treatment regimens including a rifamycin and examined the association of at least 1 risk factor were included. Post hoc, we carried out random effects Mantel-Haenszel weighted meta-analyses of the impact of 2 key risk factors 1 HIV and 2 baseline drug resistance on the binary outcome of ADR. Heterogeneity was assessed used I2 statistic. As a secondary outcome, we calculated median cumulative incidence of ADR, weighted by the sample size of the studies.Meta-analysis of 15 studies showed increased risk of ADR with baseline mono- or polyresistance (RR 4.85 95% CI 3.26 to 7.23, heterogeneity I2 58%, 95% CI 26 to 76%. Meta-analysis of 8 studies showed that HIV co-infection was associated with increased risk of ADR (RR 3.02, 95% CI 1.28 to 7.11; there was considerable heterogeneity amongst these studies (I2 81%, 95% CI 64 to 90%. Non-adherence, extrapulmonary/disseminated disease and advanced immunosuppression in HIV co-infection were other risk factors noted. The weighted median cumulative incidence of acquired multi drug resistance calculated in 24 studies (assuming whole cohort as denominator, regardless of follow up DST was 0.1% (5th to 95th percentile 0.07 to 3.2%.Baseline drug resistance and HIV co-infection were significant risk factors for ADR. There was a trend of positive association with non-adherence which is likely

  1. Hodgkin lymphoma in children, adolescents and young adults - a comparative study of clinical presentation and treatment outcome.

    Science.gov (United States)

    Englund, Annika; Glimelius, Ingrid; Rostgaard, Klaus; Smedby, Karin E; Eloranta, Sandra; Molin, Daniel; Kuusk, Thomas; Brown, Peter de Nully; Kamper, Peter; Hjalgrim, Henrik; Ljungman, Gustaf; Hjalgrim, Lisa Lyngsie

    2018-02-01

    Hodgkin lymphoma (HL) treatment protocols for children, adolescents and young adults traditionally differ, but the biological and clinical justification for this remains uncertain. We compared age-dependent clinical presentation and treatment and outcome for 1072 classical HL patients 0-24 years diagnosed in Denmark (1990-2010) and Sweden (1992-2009) in pediatric (n = 315, Denmark clinical characteristics was assessed with Pearson's chi 2 -test and Mantel-Haenszel trend test. The Kaplan-Meier method was used for survival analyses. Hazard ratios (HR) were used to compare the different treatment groups and calculated using Cox regression. Children (0-9 years) less often presented with advanced disease than adolescents (10-17 years) and young adults (18-24 years) (stage IIB-IV: children 32% vs. adolescents 50%, and adults 55%; p clinical presentation suggesting a rationale of harmonized treatment for these groups. Both adult and pediatric protocols provided high OS with no significant difference between the departments. The less frequent use of radiotherapy in Danish pediatric patients corresponded to a lower EFS, but comparable OS in all groups confirmed effective rescue strategies for the relapsing patients.

  2. Rank-based testing of equal survivorship based on cross-sectional survival data with or without prospective follow-up.

    Science.gov (United States)

    Chan, Kwun Chuen Gary; Qin, Jing

    2015-10-01

    Existing linear rank statistics cannot be applied to cross-sectional survival data without follow-up since all subjects are essentially censored. However, partial survival information are available from backward recurrence times and are frequently collected from health surveys without prospective follow-up. Under length-biased sampling, a class of linear rank statistics is proposed based only on backward recurrence times without any prospective follow-up. When follow-up data are available, the proposed rank statistic and a conventional rank statistic that utilizes follow-up information from the same sample are shown to be asymptotically independent. We discuss four ways to combine these two statistics when follow-up is present. Simulations show that all combined statistics have substantially improved power compared with conventional rank statistics, and a Mantel-Haenszel test performed the best among the proposal statistics. The method is applied to a cross-sectional health survey without follow-up and a study of Alzheimer's disease with prospective follow-up. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Associations between sexual behaviour change in young people and decline in HIV prevalence in Zambia

    Directory of Open Access Journals (Sweden)

    Siziya Seter

    2007-04-01

    Full Text Available Abstract Background Evidence suggests that HIV prevalence amongst young Zambians has declined recently, especially in higher-education groups. We studied trends in key sexual behaviour indicators among 15–24 year-olds from 1995 to 2003, including the associations between sexual behaviour change and education. Methods The data stem from a series of three population-based surveys conducted in 1995 (n = 1720, 1999 (n = 1946 and 2003 (n = 2637. Logistic regression and Extended Mantel Haenszel Chi Square for linear trends were used to compare the three surveys. Results Men and lower-education groups reported more than one sexual partner in the year immediately prior to the survey more frequently than did women and higher-education groups (p Conclusion High risk behaviours clearly decreased, especially in higher-educated and urban groups, and there is a probable association here with the decline in HIV prevalence in the study population. Fewer sexual partners and condom use were among the core factors involved for both sexes; and for women a further factor was delayed child-bearing.

  4. [Clinical research XVII. χ(2) test, from the expected to the observed].

    Science.gov (United States)

    Rivas-Ruiz, Rodolfo; Castelán-Martínez, Osvaldo D; Pérez, Marcela; Talavera, Juan O

    2013-01-01

    When you want to show if there is a statistical association or differences between categorical variables, it is recommended to use the χ(2) test. This nonparametric test is one of the most used in clinical research; it contrasts nominal or ordinal qualitative variables that are observed in clinical practice. This test calculates the p value that determines whether differences between groups are real or due to chance. The χ(2) test is the basis of other tests to analyze qualitative ordinal variables as χ(2) for linear trend, which compares three groups with two outcomes or McNemar test, which contrasts two related samples (a before and afterward comparison) or Mantel-Haenszel χ(2), which controls for potential confounding variables. When using small samples, where the expected results are less than 5, Fisher's exact test should be used. These tests are the most widely used in the medical literature; however, they do not give us the magnitude or the direction of the event and a proper interpretation that requires clinical judgment is needed.

  5. Traditional medicine used in childbirth and for childhood diarrhoea in Nigeria's Cross River State: interviews with traditional practitioners and a statewide cross-sectional study.

    Science.gov (United States)

    Sarmiento, Iván; Zuluaga, Germán; Andersson, Neil

    2016-04-19

    Examine factors associated with use of traditional medicine during childbirth and in management of childhood diarrhoea. Cross-sectional cluster survey, household interviews in a stratified last stage random sample of 90 census enumeration areas; unstructured interviews with traditional doctors. Oil-rich Cross River State in south-eastern Nigeria has 3.5 million residents, most of whom depend on a subsistence agriculture economy. 8089 women aged 15-49 years in 7685 households reported on the health of 11,305 children aged 0-36 months in July-August 2011. Traditional medicine used at childbirth and for management of childhood diarrhoea; covariates included access to Western medicine and education, economic conditions, engagement with the modern state and family relations. Cluster-adjusted analysis relied on the Mantel-Haenszel procedure and Mantel extension. 24.1% (1371/5686) of women reported using traditional medicine at childbirth; these women had less education, accessed antenatal care less, experienced more family violence and were less likely to have birth certificates for their children. 11.3% (615/5425) of young children with diarrhoea were taken to traditional medical practitioners; these children were less likely to receive BCG, to have birth certificates, to live in households with a more educated head, or to use fuel other than charcoal for cooking. Education showed a gradient with decreasing use of traditional medicine for childbirth (χ(2) 135.2) and for childhood diarrhoea (χ(2) 77.2). Use of traditional medicine is associated with several factors related to cultural transition and to health status, with formal education playing a prominent role. Any assessment of the effectiveness of traditional medicine should anticipate confounding by these factors, which are widely recognised to affect health in their own right. 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/

  6. Histerectomía total abdominal frente a histerectomía mínimamente invasiva: revisión sistemática y metaanálisis Total abdominal hysterectomy versus minimal-invasive hysterectomy: a systemic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Felipe Jorge Aragón Palmero

    2011-03-01

    three types of hysterectomies are used: the vaginal hysterectomy and the minimal-invasive hysterectomy (MIH. The objective of present research was to compare the MIH and the total abdominal hysterectomy (TAH in women presenting with benign uterine diseases. METHODS. A systemic review was made and a meta-analysis from the following databases: MEDLINE, EBSCO HOST AND The Cochrane Central Register of Controlled Trials. Only the controlled and randomized studies were selected. The data of all studies were combined and also the relative risk (RR with a 95% CI was used with the Mantel-Haenszel method as an effect measure for dichotomy variables. For the analysis of continuing variables the mean difference was used. In all the comparisons performed the results were obtained with the fix effect and randomized forms. RESULTS. A total of 53 transoperative complications were registered in the MIH hysterectomy versus 17 in the TAH group (RR: 1,78; 95% CI: 1,04-3.05. Postoperative complications evolved in a similar way in both groups without significant differences from the statistical point of view. The blood losses, the hospital stay and the patient's reincorporation to usual and work activities were lesser in the laparoscopy group; however, the operative time is higher when it is compared with TAH (mean difference: 37,36; 95% CI: 34,36-39,93. CONCLUSIONS. Both techniques have advantages and disadvantages. The indication of MIH must to be individualized according to the clinical situation of each patient and these not to be performed in those centers without a properly trained surgical staff and with experience in advanced minimal invasive surgery.

  7. Prevalência e fatores preditivos de retenção urinária diagnosticada por ultrassonografia no período pós-anestésico imediato Prevalencia y factores predictivos de retención urinaria diagnosticada por ultrasonido en el período postanestésico inmediato Prevalence and predictive factors of urinary retention assessed by ultrasound in the immediate post-anesthetic period

    Directory of Open Access Journals (Sweden)

    Adilson José Dal Mago

    2010-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Retenção urinária é uma condição frequente na sala de recuperação pós-anestésica (SRPA. Sobredistensão vesical e consequente lesão do detrusor da bexiga são situações passíveis de prevenção. A ultrassonografia permite medida confiável do volume urinário, determinando a prevalência da distensão vesical pós-operatória. Este estudo teve como objetivo determinar a prevalência de retenção urinária pós-operatória e identificar fatores independentes de previsão de sua ocorrência. MÉTODO: Prospectivamente, foram incluídos no estudo 257 pacientes admitidos na SRPA. As variáveis coletadas incluíram: idade, sexo, estado físico, local da cirurgia, tipo de anestesia, tempos cirúrgico e anestésico, uso ou não de opioides, volume de fluidos administrados, história prévia de sintomas urinários. Medidas do volume vesical foram feitas, por ultrassonografia, na admissão e na alta da SRPA. O critério para caracterizar retenção urinária foi: volume vesical igual ou maior que 600 mL, associado à incapacidade de micção espontânea 30 minutos após o diagnóstico. Análises univariadas e multivariadas foram utilizadas para identificar os fatores preditivos independentes. RESULTADOS: Ocorreu retenção urinária em 19 pacientes (7,39%. Os fatores preditivos independentes identificados foram o volume urinário igual ou maior que 360 mL na admissão à SRPA (Qui-quadrado de Mantel-Haenszel (1 gl = 18,76; p JUSTIFICATIVA Y OBJETIVOS: La retención urinaria es una condición frecuente en la sala de recuperación postanestésica (SRPA. La sobredistensión vesical y la consecuente lesión del detrusor de la vejiga son situaciones que se pueden prevenir. El ultrasonido permite una medida confiable del volumen urinario, determinando la prevalencia de la distensión vesical postoperatoria. Este estudio tuvo el objetivo de determinar la prevalencia de retención urinaria postoperatoria e identificar los

  8. Substituting missing data in compositional analysis

    International Nuclear Information System (INIS)

    Real, Carlos; Angel Fernandez, J.; Aboal, Jesus R.; Carballeira, Alejo

    2011-01-01

    Multivariate analysis of environmental data sets requires the absence of missing values or their substitution by small values. However, if the data is transformed logarithmically prior to the analysis, this solution cannot be applied because the logarithm of a small value might become an outlier. Several methods for substituting the missing values can be found in the literature although none of them guarantees that no distortion of the structure of the data set is produced. We propose a method for the assessment of these distortions which can be used for deciding whether to retain or not the samples or variables containing missing values and for the investigation of the performance of different substitution techniques. The method analyzes the structure of the distances among samples using Mantel tests. We present an application of the method to PCDD/F data measured in samples of terrestrial moss as part of a biomonitoring study. - Highlights: → Missing values in multivariate data sets must be substituted prior to analysis. → The substituted values can modify the structure of the data set. → We developed a method to estimate the magnitude of the alterations. → The method is simple and based on the Mantel test. → The method allowed the identification of problematic variables in a sample data set. - A method is presented for the assessment of the possible distortions in multivariate analysis caused by the substitution of missing values.

  9. Aldosterone synthase gene is not a major susceptibility gene for progression of chronic kidney disease in patients with autosomal dominant polycystic kidney disease

    Directory of Open Access Journals (Sweden)

    Gnanasambandan Ramanathan

    2017-01-01

    Full Text Available Autosomal dominant polycystic kidney disease (ADPKD is the most common heritable kidney disease and is characterized by bilateral renal cysts. Hypertension is a frequent cause of chronic kidney disease (CKD and mortality in patients with ADPKD. The aldosterone synthase gene polymorphisms of the renin-angiotensin-aldosterone system have been extensively studied as hypertension candidate genes. The present study is aimed to investigate the potential modifier effect of CYP11B2 gene on the progression of CKD in ADPKD. One hundred and two ADPKD patients and 106 healthy controls were recruited based on Ravine inclusion and exclusion criteria. The three tag-SNPs within CYP11B2 gene (rs3802230, rs4543, and rs4544 were genotyped using FRET-based KASPar method. Cochran-Armitage trend test was used to assess the potential associations between these polymorphisms and CKD stages. Mantel- Haenszel stratified analysis was used to explore confounding and interaction effects of these polymorphisms. Of the three tag-SNPs genotyped, rs4544 polymorphism was monomorphic and rs3802230 deviated Hardy-Weinberg equilibrium. The CYP11B2 tag-SNPs did not show significant association with ADPKD or CKD. Further, these polymorphisms did not exhibit confounding effect on the relationship between CKD progression and hypertension. Our results suggest that aldosterone synthase gene is not a major susceptibility gene for progression of CKD in South Indian ADPKD patients.

  10. Comparison of the clinical symptoms of myocardial infarction in the middle-aged and elderly

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    Behzad Taghipour

    2014-08-01

    Full Text Available Background: Myocardial infarction is a fatal symbol of cardiovascular diseases, which usually occurs in people over 45 years. However, the incidence of factors such as obesity, high blood pressure, diabetes and metabolic syndrome has increased the risk of developing early cardiovascular diseases in the middle-aged people. This study was conducted to compare the clinical manifestation of myocardial infarction in the middle-aged and elderly people. Methods: In this cross-sectional study, the participants were 366 patients less and more than 55 years old with acute myocardial infarction admitted to the CCU of Imam Reza Hospital in Amol. Data were collected using demographic form and a checklist of clinical symptoms. Statistical analysis was performed by SPSS (version 20 using descriptive statistics, chi-square, odds ratio and the Mantel-Haenszel (α= 0.05 and d=0.3. Results: The results showed that patients over 55 years manifested the symptoms of shortness of breath (1.66, weakness (2.62, vomiting (1.98 and hiccups (2.19 more than the patients under55 years. Also, by controlling the confounding effect of gender, these symptoms had emerged in >55 year-old patients than in <55 year-old ones. Conclusion: According to the results, the elderly patients have more chance of manifesting nonspecific symptoms. Therefore, the healthcare providers, especially nurses should be more careful in this regard during the initial assessment.

  11. Contributions to sensitivity analysis and generalized discriminant analysis

    International Nuclear Information System (INIS)

    Jacques, J.

    2005-12-01

    Two topics are studied in this thesis: sensitivity analysis and generalized discriminant analysis. Global sensitivity analysis of a mathematical model studies how the output variables of this last react to variations of its inputs. The methods based on the study of the variance quantify the part of variance of the response of the model due to each input variable and each subset of input variables. The first subject of this thesis is the impact of a model uncertainty on results of a sensitivity analysis. Two particular forms of uncertainty are studied: that due to a change of the model of reference, and that due to the use of a simplified model with the place of the model of reference. A second problem was studied during this thesis, that of models with correlated inputs. Indeed, classical sensitivity indices not having significance (from an interpretation point of view) in the presence of correlation of the inputs, we propose a multidimensional approach consisting in expressing the sensitivity of the output of the model to groups of correlated variables. Applications in the field of nuclear engineering illustrate this work. Generalized discriminant analysis consists in classifying the individuals of a test sample in groups, by using information contained in a training sample, when these two samples do not come from the same population. This work extends existing methods in a Gaussian context to the case of binary data. An application in public health illustrates the utility of generalized discrimination models thus defined. (author)

  12. Bisphosphonates and risk of cardiovascular events: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Dae Hyun Kim

    Full Text Available Some evidence suggests that bisphosphonates may reduce atherosclerosis, while concerns have been raised about atrial fibrillation. We conducted a meta-analysis to determine the effects of bisphosphonates on total adverse cardiovascular (CV events, atrial fibrillation, myocardial infarction (MI, stroke, and CV death in adults with or at risk for low bone mass.A systematic search of MEDLINE and EMBASE through July 2014 identified 58 randomized controlled trials with longer than 6 months in duration that reported CV events. Absolute risks and the Mantel-Haenszel fixed-effects odds ratios (ORs and 95% confidence intervals (CIs of total CV events, atrial fibrillation, MI, stroke, and CV death were estimated. Subgroup analyses by follow-up duration, population characteristics, bisphosphonate types, and route were performed.Absolute risks over 25-36 months in bisphosphonate-treated versus control patients were 6.5% versus 6.2% for total CV events; 1.4% versus 1.5% for atrial fibrillation; 1.0% versus 1.2% for MI; 1.6% versus 1.9% for stroke; and 1.5% versus 1.4% for CV death. Bisphosphonate treatment up to 36 months did not have any significant effects on total CV events (14 trials; ORs [95% CI]: 0.98 [0.84-1.14]; I2 = 0.0%, atrial fibrillation (41 trials; 1.08 [0.92-1.25]; I2 = 0.0%, MI (10 trials; 0.96 [0.69-1.34]; I2 = 0.0%, stroke (10 trials; 0.99 [0.82-1.19]; I2 = 5.8%, and CV death (14 trials; 0.88 [0.72-1.07]; I2 = 0.0% with little between-study heterogeneity. The risk of atrial fibrillation appears to be modestly elevated for zoledronic acid (6 trials; 1.24 [0.96-1.61]; I2 = 0.0%, not for oral bisphosphonates (26 trials; 1.02 [0.83-1.24]; I2 = 0.0%. The CV effects did not vary by subgroups or study quality.Bisphosphonates do not have beneficial or harmful effects on atherosclerotic CV events, but zoledronic acid may modestly increase the risk of atrial fibrillation. Given the large reduction in fractures with bisphosphonates, changes in

  13. Biostatistics series module 4: Comparing groups - categorical variables

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    Avijit Hazra

    2016-01-01

    Full Text Available Categorical variables are commonly represented as counts or frequencies. For analysis, such data are conveniently arranged in contingency tables. Conventionally, such tables are designated as r × c tables, with r denoting number of rows and c denoting number of columns. The Chi-square (χ2 probability distribution is particularly useful in analyzing categorical variables. A number of tests yield test statistics that fit, at least approximately, a χ2 distribution and hence are referred to as χ2 tests. Examples include Pearson′s χ2 test (or simply the χ2 test, McNemar′s χ2 test, Mantel-Haenszel χ2 test and others. The Pearson′s χ2 test is the most commonly used test for assessing difference in distribution of a categorical variable between two or more independent groups. If the groups are ordered in some manner, the χ2 test for trend should be used. The Fisher′s exact probability test is a test of the independence between two dichotomous categorical variables. It provides a better alternative to the χ2 statistic to assess the difference between two independent proportions when numbers are small, but cannot be applied to a contingency table larger than a two-dimensional one. The McNemar′s χ2 test assesses the difference between paired proportions. It is used when the frequencies in a 2 × 2 table represent paired samples or observations. The Cochran′s Q test is a generalization of the McNemar′s test that compares more than two related proportions. The P value from the χ2 test or its counterparts does not indicate the strength of the difference or association between the categorical variables involved. This information can be obtained from the relative risk or the odds ratio statistic which is measures of dichotomous association obtained from 2 × 2 tables.

  14. How good is endoscopic ultrasound for TNM staging of gastric cancers? A meta-analysis and systematic review

    Institute of Scientific and Technical Information of China (English)

    Srinivas Reddy Puli; Jyotsna Batapati Krishna Reddy; Matthew L Bechtold; Mainor R Antillon; Jamal A Ibdah

    2008-01-01

    AIM: To evaluate the accuracy of endoscopic ultrasound (EUS) for staging of gastric cancers.METHODS: Only EUS studies confirmed by surgery were selected. Only studies from which a 2×2 table could be constructed for true positive, false negative, false positive and true negative values were included. Articles were searched in Medline, Pubmed, Ovid journals, Cumulative index for nursing & allied health literature, International pharmaceutical abstracts, old Medline, Medline nonindexed citations, and Cochrane control trial registry. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement.2×2 tables were constructed with the data extracted from each study. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. Pooling was conducted by both the Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran's Q test based upon inverse variance weights.RESULTS: Initial search identified 1620 reference articles and of these, 376 relevant articles were selected and reviewed. Twenty-two studies (n=1896) which met the inclusion criteria were included in this analysis. Pooled sensitivity of T1 was 88.1% (95% CI:84.5-91.1) and T2 was 82.3% (95% CI: 78.2-86.0). For T3, pooled sensitivity was 89.7% (95% CI:87.1-92.0). T4 had a pooled sensitivity of 99.2% (95% CI: 97.1-99.9). For nodal staging, the pooled sensitivity for N1 was 58.2% (95% CI: 53.5-62.8) and N2 was 64.9% (95% CI: 60.8-68.8). Pooled sensitivity to diagnose distant metastasis was 73.2% (95% CI: 63.2-81.7). The P for chi-squared heterogeneity for all the pooled accuracy estimates was>0.10.CONCLUSION: EUS results are more accurate with advanced disease than early disease. If EUS diagnoses advanced disease, such as T4 disease, the patient is 500 times more likely to have true

  15. Factores de riesgo asociados con el intento suicida y criterios sobre lo ocurrido en adolescentes Risk factors associated with the suicide attempt and the criteria on it happened in the adolescents

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    Alba Cortés Alfaro

    2011-03-01

    Full Text Available Introducción: las tentativas de suicidio se han incrementado considerablemente antes de los 20 años en las últimas décadas. Objetivos: identificar los factores de riesgo asociados con los intentos suicidas en adolescentes de 10 a 19 años. Métodos: se realizó un estudio analítico (casos controles pareados de los adolescentes que tuvieron intento de suicidio en la provincia de Cienfuegos durante el segundo semestre de 2007. Se calcularon porcentajes y medias aritméticas, para identificar asociación se utilizó la prueba chi cuadrado de Mantel y Haenszel y cálculo de odds ratio, sus intervalos de confianza y significación para a= 0,05. Resultados: se identificó asociación con el intento de suicidio de las variables siguientes: deseos de hacerse daño, elaboración de planes anteriores para cometer dicho acto, presencia de desesperanza, maltrato físico, disputa, desconfianza y malas relaciones con los padres, antecedentes familiares de suicidio y enfermedad psiquiátrica, sentirse atormentado, y problemas con la pareja, entre otros. Se encontró que un 9,0 % de los adolescentes estudiados manifestaron no arrepentimiento o sin crítica de lo ocurrido. Conclusiones: existieron factores personales y familiares asociados con los intentos de suicidio, así como un alto porcentaje de adolescentes que intentaron suicidarse con crítica o arrepentimiento de lo ocurrido.Introduction: suicide attempts have increased before the twenties in past decades. Objectives: to identify the risk factors associated with the suicide attempts in adolescents aged 10-19. Methods: an analytical study (matched case-controls was conducted in adolescents with a suicide attempt in the Cienfuegos province during the second semester of 2007. The percentages and arithmetic means were estimated to identify the association we used the Mantel-Haenszel Chi2 test and the odds-ratio calculus, its confidence and signification interval (IC for a= 0,05. Results: the

  16. Generalized Fluid System Simulation Program (GFSSP) Version 6 - General Purpose Thermo-Fluid Network Analysis Software

    Science.gov (United States)

    Majumdar, Alok; Leclair, Andre; Moore, Ric; Schallhorn, Paul

    2011-01-01

    GFSSP stands for Generalized Fluid System Simulation Program. It is a general-purpose computer program to compute pressure, temperature and flow distribution in a flow network. GFSSP calculates pressure, temperature, and concentrations at nodes and calculates flow rates through branches. It was primarily developed to analyze Internal Flow Analysis of a Turbopump Transient Flow Analysis of a Propulsion System. GFSSP development started in 1994 with an objective to provide a generalized and easy to use flow analysis tool for thermo-fluid systems.

  17. Characteristics and heterogeneity of schizoaffective disorder compared with unipolar depression and schizophrenia - a systematic literature review and meta-analysis.

    Science.gov (United States)

    Rink, Lena; Pagel, Tobias; Franklin, Jeremy; Baethge, Christopher

    2016-02-01

    Comparisons of illness characteristics between patients with schizoaffective disorder (SAD) patients and unipolar depression (UD) are rare, even though UD is one of the most important differential diagnoses of SAD. Also, the variability of illness characteristics (heterogeneity) has not been compared. We compared illness characteristics and their heterogeneity among SAD, UD, and - as another important differential diagnosis - schizophrenia (S). In order to reduce sampling bias we systematically searched for studies simultaneously comparing samples of patients with SAD, UD, and S. Using random effects and Mantel-Haenszel models we estimated and compared demographic, illness course and psychopathology parameters, using pooled standard deviations as a measurement of heterogeneity. Out of 155 articles found by an earlier meta-analysis, 765 screened in Medline, 2738 screened in EMBASE, and 855 screened in PsycINFO we selected 24 studies, covering 3714 patients diagnosed according to RDC, DSM-III, DSM-IIIR, DSM-IV, or ICD-10. In almost all key characteristics, samples with schizoaffective disorders fell between unipolar depression and schizophrenia, with a tendency towards schizophrenia. On average, UD patients were significantly older at illness onset (33.0 years, SAD: 25.2, S: 23.4), more often women (59% vs. 57% vs. 39%) and more often married (53% vs. 39% vs. 27%). Their psychopathology was also less severe, as measured by BPRS, GAS, and HAMD. In demographic and clinical variables heterogeneity was roughly 5% larger in UD than in SAD, and samples of patients with schizophrenia had the lowest pooled heterogeneity. A similar picture emerged in a sensitivity analysis with coefficient of variation as the measurement of heterogeneity. Relative to bipolar disorder there are fewer studies including unipolar patients. No studies based on DSM-5 could be included. Regarding unipolar affective disorder this study confirms what we have shown for bipolar disorders in earlier

  18. A meta-analysis of randomized trials assessing the effects of probiotic preparations on oral candidiasis in the elderly.

    Science.gov (United States)

    Ai, Ruixue; Wei, Jiao; Ma, Danhua; Jiang, Lu; Dan, Hongxia; Zhou, Yu; Ji, Ning; Zeng, Xin; Chen, Qianming

    2017-11-01

    Oral candidiasis is the most common fungal infection and can be attributed in part to dysbiosis, an imbalance in the resident oral microflora. Therefore, probiotics, which counter pathogenic microorganisms through competitive, antagonistic, and immunological effects, have been used by some clinicians. To date, the effect of probiotics in preventing oral candidiasis in the elderly is controversial. A systematic review that summarizes and critically appraises the available clinical trials is therefore necessary. Electronic searches were performed using the Pubmed, Embase, and Cochrane databases. Only randomized controlled trials were included. The Mantel-Haenszel test was used to appraise the odds ratio for single studies and an overall combined odds ratio for all studies combined. Three studies matched the inclusion criteria and were homogeneous. The data from one study that estimated candida growth from plaque and saliva were subdivided, thus a total of four studies with 595 people were included. The overall combined odds ratio was 0.54 (95% CI: 0.38-0.77). Three studies provided that active treatment reduced the risk of oral candidiasis more than placebo: Hatakka et al. (OR 0.51, 95% CI 0.26 to 0.97; 192 participants, plaque); Kraft-Bodi et al. (OR 0.46, 95% CI 0.24 to 0.86; 174 participants, palatal); Kraft-Bodi et al. (OR 0.50, 95% CI 0.26 to 0.98; 174 participants, plaque), while one study provided reverse result: Ishikawa et al. (OR 1.24, 95% CI 0.48 to 3.58; 55 participants, saliva). Probiotics have a preventative effect on oral candidiasis in the elderly. Copyright © 2017. Published by Elsevier Ltd.

  19. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review.

    Science.gov (United States)

    Xiong, Shuyu; Sankaridurg, Padmaja; Naduvilath, Thomas; Zang, Jiajie; Zou, Haidong; Zhu, Jianfeng; Lv, Minzhi; He, Xiangui; Xu, Xun

    2017-09-01

    Outdoor time is considered to reduce the risk of developing myopia. The purpose is to evaluate the evidence for association between time outdoors and (1) risk of onset of myopia (incident/prevalent myopia); (2) risk of a myopic shift in refractive error and c) risk of progression in myopes only. A systematic review followed by a meta-analysis and a dose-response analysis of relevant evidence from literature was conducted. PubMed, EMBASE and the Cochrane Library were searched for relevant papers. Of the 51 articles with relevant data, 25 were included in the meta-analysis and dose-response analysis. Twenty-three of the 25 articles involved children. Risk ratio (RR) for binary variables and weighted mean difference (WMD) for continuous variables were conducted. Mantel-Haenszel random-effects model was used to pool the data for meta-analysis. Statistical heterogeneity was assessed using the I 2 test with I 2  ≥ 50% considered to indicate high heterogeneity. Additionally, subgroup analyses (based on participant's age, prevalence of myopia and study type) and sensitivity analyses were conducted. A significant protective effect of outdoor time was found for incident myopia (clinical trials: risk ratio (RR) = 0.536, 95% confidence interval (CI) = 0.338 to 0.850; longitudinal cohort studies: RR = 0.574, 95% CI = 0.395 to 0.834) and prevalent myopia (cross-sectional studies: OR = 0.964, 95% CI = 0.945 to 0.982). With dose-response analysis, an inverse nonlinear relationship was found with increased time outdoors reducing the risk of incident myopia. Also, pooled results from clinical trials indicated that when outdoor time was used as an intervention, there was a reduced myopic shift of -0.30 D (in both myopes and nonmyopes) compared with the control group (WMD = -0.30, 95% CI = -0.18 to -0.41) after 3 years of follow-up. However, when only myopes were considered, dose-response analysis did not find a relationship between time outdoors and myopic

  20. Congenital ventricular septal defects and prenatal exposure to cyclooxygenase inhibitors

    Directory of Open Access Journals (Sweden)

    F. Burdan

    2006-07-01

    Full Text Available Ventricular septal defects (VSDs are common congenital abnormalities which have been reported to be associated with maternal fever and various environmental factors. The aim of the present study was to evaluate the effect of prenatal exposure to cyclooxygenase (COX inhibitors on heart defects. A retrospective statistical analysis was performed using data collected in our laboratory during various teratological studies carried out on albino CRL:(WIWUBR Wistar strain rats from 1997 to 2004. The observations were compared with concurrent and historic control data, as well as findings from other developmental toxicological studies with selective and nonselective COX-2 inhibitors. Despite the lack of significant differences in the frequency of VSDs between drug-exposed and control groups, statistical analysis by the two-sided Mantel-Haenszel test and historical control data showed a higher incidence of heart defects in offspring exposed to nonselective COX inhibitors (30.06/10,000. Unlike other specific inhibitors, aspirin (46.26/10,000 and ibuprofen (106.95/10,000 significantly increased the incidence of the VSD when compared with various control groups (5.38-19.72/10,000. No significant differences in length or weight were detected between fetuses exposed to COX inhibitors and born with VSD and non-malformed offsprings. However, a statistically significant increase of fetal body length and decrease of body mass index were found in fetuses exposed to COX inhibitors when compared with untreated control. We conclude that prenatal exposure to COX inhibitors, especially aspirin and ibuprofen, increased the incidence of VSDs in rat offspring but was not related to fetal growth retardation.

  1. Decreased mortality in patients hospitalized due to respiratory diseases after installation of an intensive care unit in a secondary hospital in the interior of Brazil.

    Science.gov (United States)

    Diogo, Luciano Passamani; Bahlis, Laura Fuchs; Wajner, André; Waldemar, Fernando Starosta

    2015-01-01

    To evaluate the association between the in-hospital mortality of patients hospitalized due to respiratory diseases and the availability of intensive care units. This retrospective cohort study evaluated a database from a hospital medicine service involving patients hospitalized due to respiratory non-terminal diseases. Data on clinical characteristics and risk factors associated with mortality, such as Charlson score and length of hospital stay, were collected. The following analyses were performed: univariate analysis with simple stratification using the Mantel Haenszel test, chi squared test, Student's t test, Mann-Whitney test, and logistic regression. Three hundred thirteen patients were selected, including 98 (31.3%) before installation of the intensive care unit and 215 (68.7%) after installation of the intensive care unit. No significant differences in the clinical and anthropometric characteristics or risk factors were observed between the groups. The mortality rate was 18/95 (18.9%) before the installation of the intensive care unit and 21/206 (10.2%) after the installation of the intensive care unit. Logistic regression analysis indicated that the probability of death after the installation of the intensive care unit decreased by 58% (OR: 0.42; 95%CI 0.205 -0.879; p = 0.021). Considering the limitations of the study, the results suggest a benefit, with a decrease of one death per every 11 patients treated for respiratory diseases after the installation of an intensive care unit in our hospital. The results corroborate the benefits of the implementation of intensive care units in secondary hospitals.

  2. Clinical needs of in-treatment pregnant women with co-occurring disorders: implications for primary care.

    Science.gov (United States)

    Lee King, Patricia A; Duan, Lei; Amaro, Hortensia

    2015-01-01

    We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran-Mantel-Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders.

  3. Knowledge of risk factors, beliefs and practices of female healthcare professionals towards breast cancer, Morocco.

    Science.gov (United States)

    Ghanem, Samia; Glaoui, Meriem; Elkhoyaali, Siham; Mesmoudi, Mohamed; Boutayeb, Saber; Errihani, Hassan

    2011-01-01

    Breast cancer is the most common cancer affecting women in Morocco. Screening for early detection has led to reduction in mortality from the disease. It is known that female healthcare professionals have greater influence on women's positive perception of breast cancer and motivation to practice screening methods for early detection of the disease. This study aims to investigate knowledge of breast cancer risk factors, beliefs about treatment and practice of screening methods among a cohort of female healthcare professionals in Morocco. A cross-sectional study was conducted using a self-administered questionnaire to assess the knowledge of breast cancer risk factors, beliefs about treatment and practice of screening methods among 136 female doctors and nurses working in the university hospital of Rabat, Morocco. Stratified random sampling method was employed. Chi square test, analysis of variance and Mantel-Haenszel test were performed in data analysis using SPSS v19.0. Female doctors were the only professional group that had satisfactory knowledge of risk factors while the nurses had an unsatisfactory knowledge with a mean score of 43%. A half of participants believed that that herbal therapy can cure breast cancer. 75% practice breast self-examination once a month and only 15% have ever had a mammogram. Age, profession and beliefs were not significantly associated with rate of BSE in this study; however this rate is influenced by knowledge of breast cancer risk factors. Results from this study suggest the need for continuing medical education programs aimed at improving knowledge of breast cancer among the nurses.

  4. Analysis of 162 colon injuries in patients with penetrating abdominal trauma: concomitant stomach injury results in a higher rate of infection.

    Science.gov (United States)

    O'Neill, Patricia A; Kirton, Orlando C; Dresner, Lisa S; Tortella, Bartholomew; Kestner, Mark M

    2004-02-01

    Fecal contamination from colon injury has been thought to be the most significant factor for the development of surgical site infection (SSI) after trauma. However, there are increasing data to suggest that other factors may play a role in the development of postinjury infection in patients after colon injury. The purpose of this study was to determine the impact of gastric wounding on the development of SSI and nonsurgical site infection (NSSI) in patients with colon injury. Post hoc analysis was performed on data prospectively collected for 317 patients presenting with penetrating hollow viscus injury. One hundred sixty-two patients with colon injury were subdivided into one of three groups: patients with isolated colon wounds (C), patients with colon and stomach wounds with or without other organ injury (C+S), and patients with colon and other organ injury but no stomach injury (C-S) and assessed for the development of SSI and NSSI. Infection rates were also determined for patients who sustained isolated gastric injury (S) and gastric injury in combination with other injuries other than colon (S-C). Penetrating Abdominal Trauma Index, operative times, and transfusion were assessed. Discrete variables were analyzed by Cochran-Mantel-Haenszel chi2 test and Fisher's exact test. Risk factor analysis was performed by multivariate logistic regression. C+S patients had a higher rate of SSI infection (31%) than C patients (3.6%) (p=0.008) and C-S patients (13%) (p=0.021). Similarly, the incidence of NSSI was also significantly greater in the C+S group (37%) compared with the C patients (7.5%) (p=0.07) and the C-S patients (17%) (p=0.019). There was no difference in the rate of SSI or NSSI between the C and C-S groups (p=0.3 and p=0.24, respectively). The rate of SSI was significantly greater in the C+S patients when compared with the S-C patients (31% vs. 10%, p=0.008), but there was no statistical difference in the rate of NSSI in the C+S group and the S-C group (37

  5. Discourse analysis in general practice: a sociolinguistic approach.

    Science.gov (United States)

    Nessa, J; Malterud, K

    1990-06-01

    It is a simple but important fact that as general practitioners we talk to our patients. The quality of the conversation is of vital importance for the outcome of the consultation. The purpose of this article is to discuss a methodological tool borrowed from sociolinguistics--discourse analysis. To assess the suitability of this method for analysis of general practice consultations, the authors have performed a discourse analysis of one single consultation. Our experiences are presented here.

  6. Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis.

    Science.gov (United States)

    Tesfaye, Gezahegn; Loxton, Deborah; Chojenta, Catherine; Semahegn, Agumasie; Smith, Roger

    2017-11-15

    Antenatal care uptake is among the key indicators for monitoring the progress of maternal outcomes. Early initiation of antenatal care facilitates the timely management and treatment of pregnancy complications to reduce maternal deaths. In Ethiopia, antenatal care utilization is generally low, and delayed initiation of care is very common. We aimed to systematically identify and synthesize available evidence on delayed initiation of antenatal care and the associated factors in Ethiopia. Studies published in English from 1 January 2002 to 30 April 2017 were systematically searched from PubMed, Medline, EMBASE, CINAHL and other relevant sources. Two authors independently reviewed the identified studies against the eligibility criteria. The included studies were critically appraised using the Joanna Briggs-MAStARI instrument for observational studies. Meta-analysis was conducted in RevMan v5.3 for Windows using a Mantel-Haenszel random effects model. The presence of statistical heterogeneity was checked using the Cochran Q test, and its level was quantified using the I 2 statistics. Pooled estimate of the proportion of the outcome variable was calculated. Pooled Odd Ratios with 95% CI were calculated to measure the effect sizes. The pooled magnitude of delayed antenatal care in Ethiopia was 64% (95% CI: 57%, 70%). Maternal age (OR = 0.70; 95% CI: 0.53, 0.93), place of residence (OR = 0.29, 95% CI: 0.16, 0.50), maternal education (OR = 0.49; 95% CI: 0.38, 0.63), husband's education (OR = 0.44; 95% CI: 0.23, 0.85), maternal occupation (OR = 0.75; 95% CI: 0.61, 0.93), monthly income (OR = 2.06; 95% CI: 1.23, 3.45), pregnancy intention (OR = 0.49; 95% CI: 0.40, 0.60), parity (OR = 0.46; 95% CI: 0.36, 0.58), knowledge of antenatal care (OR = 0.40; 95% CI: 0.32, 0.51), women's autonomy (OR = 0.38; 95% CI: 0.15, 0.94), partner involvement (OR = 0.24; 95% CI: 0.07, 0.75), pregnancy complications (OR = 0.23; 95% CI: 0.06, 0

  7. Automatic movie skimming with general tempo analysis

    Science.gov (United States)

    Lee, Shih-Hung; Yeh, Chia-Hung; Kuo, C. C. J.

    2003-11-01

    Story units are extracted by general tempo analysis including tempos analysis including tempos of audio and visual information in this research. Although many schemes have been proposed to successfully segment video data into shots using basic low-level features, how to group shots into meaningful units called story units is still a challenging problem. By focusing on a certain type of video such as sport or news, we can explore models with the specific application domain knowledge. For movie contents, many heuristic rules based on audiovisual clues have been proposed with limited success. We propose a method to extract story units using general tempo analysis. Experimental results are given to demonstrate the feasibility and efficiency of the proposed technique.

  8. EDUCATIONAL INTERVENTION FOR THE CARDIOVASCULAR PREVENTION IN ADOLESCENTS OF SECONDARY BASIC.

    Directory of Open Access Journals (Sweden)

    Yuri Arnold Domínguez

    2011-08-01

    Full Text Available Background: Healthy lifestyles incorporated in early ages could influence the most important behaviours and risk factors for atherosclerotic vascular disease in order to reduce the incidence of this condition during adulthood. Objective: To assess the effectiveness of the educational-participatory intervention on students' knowledge as to cardiovascular risk factors. Material: An educational intervention with a quasi-experimental design was conducted from April 2007 to October 2008 in eighth grade junior high school students from Old Havana (the intervention group and Center Havana (the control group. The nonparametric Chi square tests from McNemar and Mantel-Haenszel were used. Results: There were significant statistical associations with a confidence limit of 95% between initial and final state of knowledge in relation to cardiovascular risk factors in the intervention group (p = 0.0001, in the control group (p = 0.035 and between the study group versus the control group after the intervention (p = 0.0001. Conclusions: An educational-participatory program for health promotion and prevention of major risk factors of cardiovascular disease (inadequate dietary habits, smoking and physical inactivity among adolescents, contributes to increase their knowledge and encourages the adoption of healthy daily habits and lifestyles.

  9. Pregnancy x-rays and childhood cancers: effects of exposure age and radiation dose

    International Nuclear Information System (INIS)

    Gilman, E.A.; Kneale, G.W.; Knox, E.G.; Stewart, A.M.

    1988-01-01

    Using data from the Oxford Survey of Childhood Cancers this paper examines the effect of foetal age and number of films used on the subsequent risk of childhood cancer associated with prenatal x-rays. X-rays early in pregnancy were taken for different reasons and required more films when compared with those taken in late pregnancy. Therefore, Mantel-Haenszel techniques were used to estimate the independent effects of (a) exposure age and (b) number of films. Age at exposure had a clearly significant effect; x-rays taken in the first trimester of pregnancy were 2.69 times as effective as x-rays taken in the third trimester. First trimester exposures were often the result of maternal illnesses, so these maternal illnesses were then included among the controlling factors. When this was done the first trimester x-rays were 2.73 times as effective as later exposures. First trimester x-rays were most strongly associated with the cancers which were diagnosed between 4 and 5 years of age. Although the number of films had no detectable effect upon relative risk calculated over all ages, multiple exposures were demonstrably associated with early age at diagnosis. (author)

  10. Systematic Review of Infrapopliteal Drug-Eluting Stents: A Meta-Analysis of Randomized Controlled Trials

    Energy Technology Data Exchange (ETDEWEB)

    Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr [NHS Foundation Trust, King' s Health Partners, Department of Interventional Radiology, Guy' s and St. Thomas' Hospitals (United Kingdom); Spiliopoulos, Stavros [Patras University Hospital, Department of Interventional Radiology, School of Medicine (Greece); Diamantopoulos, Athanasios [NHS Foundation Trust, King' s Health Partners, Department of Interventional Radiology, Guy' s and St. Thomas' Hospitals (United Kingdom); Karnabatidis, Dimitris [Patras University Hospital, Department of Interventional Radiology, School of Medicine (Greece); Sabharwal, Tarun [NHS Foundation Trust, King' s Health Partners, Department of Interventional Radiology, Guy' s and St. Thomas' Hospitals (United Kingdom); Siablis, Dimitris [Patras University Hospital, Department of Interventional Radiology, School of Medicine (Greece)

    2013-06-15

    IntroductionDrug-eluting stents (DES) have been proposed for the treatment of infrapopliteal arterial disease. We performed a systematic review to provide a qualitative analysis and quantitative data synthesis of randomized controlled trials (RCTs) assessing infrapopliteal DES.Materials and MethodsPubMed (Medline), EMBASE (Excerpta Medical Database), AMED (Allied and Complementary medicine Database), Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), online content, and abstract meetings were searched in September 2012 for eligible RCTs according to the preferred reporting items for systematic reviews and meta-analyses selection process. Risk of bias was assessed using the Cochrane Collaboration's tool. Primary endpoint was primary patency defined as absence of {>=}50 % vessel restenosis at 1 year. Secondary outcome measures included patient survival, limb amputations, change of Rutherford-Becker class, target lesion revascularization (TLR) events, complete wound healing, and event-free survival at 1 year. Risk ratio (RRs) were calculated using the Mantel-Haenszel fixed effects model, and number-needed-to-treat values are reported.ResultsThree RCTs involving 501 patients with focal infrapopliteal lesions were analyzed (YUKON-BTX, DESTINY, and ACHILLES trials). All three RCTs included relatively short and focal infrapopliteal lesions. At 1 year, there was clear superiority of infrapopliteal DES compared with control treatments in terms of significantly higher primary patency (80.0 vs. 58.5 %; pooled RR = 1.37, 95 % confidence interval [CI] = 1.18-1.58, p < 0.0001; number-needed-to-treat (NNT) value = 4.8), improvement of Rutherford-Becker class (79.0 vs. 69.6 %; pooled RR = 1.13, 95 % CI = 1.002-1.275, p = 0.045; NNT = 11.1), decreased TLR events (9.9 vs. 22.0 %; pooled RR = 0.45, 95 % CI = 0.28-0.73, p = 0.001; NNT = 8.3), improved wound healing (76.8 vs. 59.7 %; pooled RR = 1.29, 95 % CI = 1.02-1.62, p = 0.04; NNT = 5.9), and better overall

  11. Harmonic Analysis Associated with the Generalized q-Bessel Operator

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    Ahmed Abouelaz

    2016-01-01

    Full Text Available In this article, we give a new harmonic analysis associated with the generalized q-Bessel operator. We introduce the generalized $q$-Bessel transform, the generalized q-Bessel translation and the generalized $q$-Bessel convolution product.

  12. Case-control study of lung cancer among workers at a uranium processing plant

    International Nuclear Information System (INIS)

    Cookfair, D.L.

    1982-01-01

    The purpose of this case-control study was to investigate the relationship between exposure to radiation resulting from the inhalation of uranium dust and the dust of uranium-bearing compounds and death due to lung cancer. Cases and controls were chosen from a cohort of white male workers employed at one uranium processing plant during World War II. The 330 cases consisted of all lung cancer deaths occurring in the cohort between 1943 and 1973. Level of exposure to radiation and other potential workplace carcinogens was determined for each worker using process manuals, industrial hygiene reports, air monitoring data and individual work histories. Smoking status and information regarding medical variables was determined from employee medical records. Cumulative radiation lung dose among study population members ranged from 0 to 75 rads. Data were analyzed using Mantel-Haenszel stratified analysis and logistic regression. Relative risk was found to increase with increasing level of lung dose exposure even after controlling for age, smoking status and other workplace exposures, but only for those who were over the age of 44 when first exposed. A statistically significant excess in risk was found for men in this hire age group with a cumulative lung dose of 20 rads or more. The risk associated with the overall work environment was also investigated using a summary measure of total workplace exposure called chemical rank. A similar relationship existed between chemical rank and lung cancer to that found for cumulative lung dose and lung cancer

  13. Interobserver agreement in interpretation of radiographic pulmonary changes in dogs in relation to radiology training

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    Tilde Rodrigues Froes

    2014-09-01

    Full Text Available Interpretation of pulmonary radiographs is one of the most difficult aspects of radiology and interobserver variability is high. The aim of this study was to assess variations in interpretation of pulmonary pathology amongst Brazilian veterinarians with different levels of training and experience, using the interpretation by American board-certified radiologists as a reference. We identified areas where interpretation is particularly challenging. Sixty digital canine thoracic radiographic examinations were interpreted by four groups of three Brazilian observers, each group being defined by different levels of training and experience. The radiographic findings of the 4 groups of observers in the study were compared to a reference interpretation established from the findings of three ACVR board-certified radiologists. The degree of discrepancy for each list between each group and the reference interpretation was assessed according to a three-level scoring system: no discrepancy, minor discrepancy, or major discrepancy. Data was analyzed using a Kappa and Cochran-Mantel-Haenszel tests. Brazilian veterinarians with the most training and experience showed the least interobserver variation and best performance when compared to the reference interpretation, followed by those with practical training, but with little work experience in professional practice. The radiographic patterns that were associated with the highest interobserver variability were the vascular, unstructured interstitial and bronchial patterns. Interobserver major discrepancies occurred in all groups, but is more evident in groups with the least training (44.4% and the general practitioners (26.7% group. It can be concluded that training positively influences the accuracy of radiographic interpretation and is recommended to reduce erroneous diagnoses.

  14. Systematic review and meta-analysis of L1-VLP-based human papillomavirus vaccine efficacy against anogenital pre-cancer in women with evidence of prior HPV exposure.

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    Ada Miltz

    Full Text Available BACKGROUND: It is unclear whether L1-VLP-based human papillomavirus (HPV vaccines are efficacious in reducing the likelihood of anogenital pre-cancer in women with evidence of prior vaccine-type HPV exposure. This study aims to determine whether the combined results of the vaccine trials published to date provide evidence of efficacy compared with control (hepatitis A vaccine/placebo. METHODS: A systematic review and meta-analysis was conducted. Randomized-controlled trials (RCTs were identified from MEDLINE, Embase, Web of Science, PubMed, Cochrane Central Register of Controlled Trials and references of identified studies. The bivalent vaccine containing HPV-16 and 18 VLPs from GlaxoSmithKline Biologicals (Rixenstart, Belgium, the quadrivalent vaccine containing HPV-6, 11, 16, and 18 VLPs from Merck & Co., Inc., (Whitehouse Station, NJ USA, and the HPV-16 monovalent vaccine from Merck Research Laboratories (West Point, PA USA were evaluated. FINDINGS: Three RCT reports and two post-trial cohort studies were eligible, comprising data from 13,482 women who were included in the vaccine studies but had evidence of HPV infection at study entry. Data on efficacy was synthesized using the Mantel-Haenszel weighted fixed-effect approach, or where there was heterogeneity between studies, the DerSimonian and Laird weighted random-effect approach. The mean odds ratio (OR and 95% confidence interval (CI for the association between Cervarix, Gardasil and HPV-16 monovalent vaccine and HPV-associated cervical intraepithelial neoplasia grade 3 or worse was 0·90 (95% CI: 0·56, 1·44. For the association between Gardasil and HPV-associated vulval/vaginal intraepithelial neoplasia grades 2-3, the overall OR and 95% CI was 2.25 (95% CI: 0·78, 6.50. Sample size and follow-up were limited. CONCLUSIONS: There was no evidence that HPV vaccines are effective in preventing vaccine-type HPV associated pre-cancer in women with evidence of prior HPV exposure. Small

  15. A new classification of HLA-DRB1 alleles based on acid-base properties of the amino acids located at positions 13, 70 and 71: impact on ACPA status or structural progression, and meta-analysis on 1235 patients with rheumatoid from two cohorts (ESPOIR and EAC cohort).

    Science.gov (United States)

    Ruyssen-Witrand, Adeline; van Steenbergen, Hanna W; van Heemst, Jurgen; Gourraud, Pierre-Antoine; Nigon, Delphine; Lukas, Cédric; Miceli-Richard, Corinne; Jamard, Bénédicte; Cambon-Thomsen, Anne; Cantagrel, Alain; Dieudé, Philippe; van der Helm-van Mil, Annette H M; Constantin, Arnaud

    2015-01-01

    To group HLA-DRB1 alleles based on acid-base properties of amino acids at positions 13, 70 and 71 and analyse their association with the presence of anticitrullinated peptide antibodies (ACPA) and structural progression in 2 cohorts of early rheumatoid arthritis (RA). Patients with RA (N=612) from ESPOIR cohort and from EAC cohort (n=624) were genotyped for HLA-DRB1 alleles. The alleles containing the RAA sequence at positions 72-74 were classified into 3 groups according to the amino acid at positions 13, 70 and 71: BB encoding basic amino acids at positions 13, 70 and 71; A encoding acidic amino acids at positions 70 and 71; and BN encoding either neutral amino acids at position 13 and basic amino acids at positions 70 and 71, or basic amino acid at position 13 and neutral amino acids at positions 70 and 71. The associations between the different alleles and (1) the ACPA presence, and (2) the structural progression were assessed by χ(2) test; a meta-analysis was performed on the 2 cohorts using the Mantel-Haenszel method. After meta-analysis, BB alleles were significantly associated with ACPA presence (OR (95% CI) 4.08 (3.14 to 5.31)) and structural progression (OR (95% CI) 2.33 (1.76 to 3.09)). The alleles protected significantly against ACPA presence (OR (95% CI) 0.37 (0.28 to 0.50)) and structural progression (OR (95% CI) 0.34 (0.23 to 0.50)). This acid-base classification allowed to separate another group BN with an intermediate risk of ACPA production (OR (95% CI) 1.14 (0.91 to 1.44)) and structural progression (OR (95% CI) 1.01 (0.77 to 1.33)). This new classification permitted to make a hierarchy of HLA-DRB1 alleles in terms of association with ACPA presence or structural progression in early RA.

  16. Generalized Path Analysis and Generalized Simultaneous Equations Model for Recursive Systems with Responses of Mixed Types

    Science.gov (United States)

    Tsai, Tien-Lung; Shau, Wen-Yi; Hu, Fu-Chang

    2006-01-01

    This article generalizes linear path analysis (PA) and simultaneous equations models (SiEM) to deal with mixed responses of different types in a recursive or triangular system. An efficient instrumental variable (IV) method for estimating the structural coefficients of a 2-equation partially recursive generalized path analysis (GPA) model and…

  17. Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study

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    Malý Marek

    2002-07-01

    Full Text Available Abstract Background The parasite Toxoplasma gondii infects 30–60% of humans worldwide. Latent toxoplasmosis, i.e., the life-long presence of Toxoplasma cysts in neural and muscular tissues, leads to prolongation of reaction times in infected subjects. It is not known, however, whether the changes observed in the laboratory influence the performance of subjects in real-life situations. Methods The seroprevalence of latent toxoplasmosis in subjects involved in traffic accidents (N = 146 and in the general population living in the same area (N = 446 was compared by a Mantel-Haenszel test for age-stratified data. Correlation between relative risk of traffic accidents and level of anti-Toxoplasma antibody titre was evaluated with the Cochran-Armitage test for trends. Results A higher seroprevalence was found in the traffic accident set than in the general population (Chi2MH = 21.45, p 95= 1.76–4.01 times higher risk of an accident than the toxoplasmosis-negative subjects. The OR significantly increased with level of anti-Toxoplasma antibody titre (p 95 = 1.14–3.03 for the 99 subjects with low antibody titres (8 and 16, higher (OR = 4.78, C.I.95 = 2.39–9.59 for the 37 subjects with moderate titres (32 and 64, and very high (OR = 16.03, C.I.95 = 1.89–135.66 for the 6 subjects with titres higher than 64. Conclusion The subjects with latent toxoplasmosis have significantly increased risk of traffic accidents than the noninfected subjects. Relative risk of traffic accidents decreases with the duration of infection. These results suggest that 'asymptomatic' acquired toxoplasmosis might in fact represent a serious and highly underestimated public health problem, as well as an economic problem.

  18. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Barry, John A; Azizia, Mallika M; Hardiman, Paul J

    2014-01-01

    Polycystic ovary syndrome (PCOS) is a common condition affecting ∼8% of women. The objective of the present study was to quantify separately the risk of endometrial cancer, ovarian cancer and breast cancer in women with PCOS compared with non-PCOS controls, and quantify separately the risk to women of all ages as well as the risk to premenopausal women. We conducted a systematic review and meta-analysis of observational studies. Studies were eligible for inclusion if they compared women with PCOS to non-PCOS groups for fatal or non-fatal gynaecological cancers. Studies listed in MEDLINE and EMBASE published up to 7 October 2013 in any language were identified, and relevant papers were also searched by hand. Relevant data (for example, study design, source of control data, diagnostic criteria) were extracted and tabulated. From 698 references, 11 studies (5 of endometrial cancer and 3 each of ovarian and breast cancer) met the inclusion criteria for the meta-analysis (919 women with PCOS and 72054 non-PCOS controls). Using the Mantel-Haenszel method, with fixed or random effects model as appropriate, women with PCOS were at a significantly increased risk of endometrial cancer (odds ratio (OR), 2.79; 95% confidence interval (CI), 1.31-5.95, P cancers was not significantly increased (OR, 1.41; 95% CI, 0.93-2.15, P cancer (OR, 4.05; 95% CI, 2.42-6.76, P cancer (OR, 2.52; 95% CI, 1.08-5.89, P cancer (OR, 0.78; 95% CI, 0.46-1.32, P cancers in women with PCOS younger than 54 years of age compared with controls of similar age. Current data suggest that women of all ages with PCOS are at an increased risk of endometrial cancer but the risk of ovarian and breast cancer was not significantly increased overall. These results highlight the potential risk of gynaecological cancer morbidities associated with PCOS. However, the available evidence is far from robust and variation in diagnostic criteria for PCOS, associated risk factors (particularly obesity), and selection bias

  19. The Safety of Artemisinin Derivatives for the Treatment of Malaria in the 2nd or 3rd Trimester of Pregnancy: A Systematic Review and Meta-Analysis.

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    Stephanie D Kovacs

    Full Text Available Given the high morbidity for mother and fetus associated with malaria in pregnancy, safe and efficacious drugs are needed for treatment. Artemisinin derivatives are the most effective antimalarials, but are associated with teratogenic and embryotoxic effects in animal models when used in early pregnancy. However, several organ systems are still under development later in pregnancy. We conducted a systematic review and meta-analysis of the occurrence of adverse pregnancy outcomes among women treated with artemisinins monotherapy or as artemisinin-based combination therapy during the 2nd or 3rd trimesters relative to pregnant women who received non-artemisinin antimalarials or none at all. Pooled odds ratio (POR were calculated using Mantel-Haenszel fixed effects model with a 0.5 continuity correction for zero events. Eligible studies were identified through Medline, Embase, and the Malaria in Pregnancy Consortium Library. Twenty studies (11 cohort studies and 9 randomized controlled trials contributed to the analysis, with 3,707 women receiving an artemisinin, 1,951 a non-artemisinin antimalarial, and 13,714 no antimalarial. The PORs (95% confidence interval (CI for stillbirth, fetal loss, and congenital anomalies when comparing artemisinin versus quinine were 0.49 (95% CI 0.24-0.97, I2 = 0%, 3 studies; 0.58 (95% CI 0.31-1.16, I2 = 0%, 6 studies; and 1.00 (95% CI 0.27-3.75, I2 = 0%, 3 studies, respectively. The PORs comparing artemisinin users to pregnant women who received no antimalarial were 1.13 (95% CI 0.77-1.66, I2 = 86.7%, 3 studies; 1.10 (95% CI 0.79-1.54, I2 = 0%, 4 studies; and 0.79 (95% CI 0.37-1.67, I2 = 0%, 3 studies for miscarriage, stillbirth and congenital anomalies respectively. Treatment with artemisinin in 2nd and 3rd trimester was not associated with increased risks of congenital malformations or miscarriage and may be was associated with a reduced risk of stillbirths compared to quinine. This study updates the reviews

  20. Prevalencia de colonización por Moraxella catarrhalis en portadores asintomáticos menores de seis años Prevalence of Moraxella catarrhalis colonization in asymptomatic carriers under six years of age

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    Blanca Leaños-Miranda

    2001-02-01

    Full Text Available OBJETIVO: Determinar la prevalencia de colonización nasofaríngea por Moraxella catarrhalis en niños menores de seis años. MATERIAL Y MÉTODOS: Se realizó una encuesta, de enero a diciembre de 1998, en 604 niños de la ciudad de México, de entre dos meses y cinco años de edad, seleccionados mediante el marco muestral maestro y muestreo por conglomerados. Se tomaron muestras de exudado faríngeo, identificando M. catarrhalis. Se determinó la concentración mínima inhibitoria a diferentes antimicrobianos y detección de beta-lactamasas a través del método iodométrico. Para el análisis se utilizaron frecuencias simples, cálculo de razón de momios, intervalos de confianza al 95% y ji cuadrada de Mantel-Haenzel. Se consideró como estadísticamente significativo un valor de pOBJECTIVE: To determine the prevalence of upper respiratory tract colonization by Moraxella catarrhalis in children under six years of age. MATERIAL AND METHODS: A survey was conducted between January and December 1998 in Mexico City, among children aged 2 months to 5 years, selected through cluster sampling. Pharyngeal samples were taken for M. catarrhalis identification. The minimal inhibitory concentration to different antibiotics was obtained and beta-lactamases were determined by the iodometric test. Statistical analysis consisted of frequency distributions, odds ratios, 95% confidence intervals, and Mantel-Haenszel chi² . Statistical significance was set at p<0.05. RESULTS: After excluding 37 children, the study population was 604 children from Mexico City; M. catarrhalis was present in 130 pharyngeal specimens (22.9%. Most of the strains were positive for beta-lactamase production (75.4%. Eighty percent of the strains was resistant to penicillin and 70% to ampicillin and amoxicillin. None were resistant to cefotaxime, imipenem, meropenem and erythromycin. CONCLUSIONS: Prevalence of M. catarrhalis upper respiratory tract colonization is similar to that of

  1. Non-adiabatic stability analysis of current and magnetic curvature driven modes in cold plasmas penetrated by neutral gas

    International Nuclear Information System (INIS)

    Ohlsson, D.

    1978-08-01

    Previous stability theories concerning electrostatic current and magnetic curvature driven modes in cold plasma mantle boundary layers are generalized. In particular the commonly used adiabatic approximation is relaxed. In the general theory presented important new effects associated with heat conduction, ionization and ohmic heating are found. In combination with viscosity and resistivity these effects introduce additional stabilizing as well as destabilizing effects. Furthermore the present theory typically predicts similar stability properties as the adiabatic theory in the limit |d(1nT)/d(1nn)| >1 the general theory predicts less favourable stability properties. One may speculate that these conclusions also apply to more general types of electrostatic modes associated with density and temperature gradients in cold plasma mantel boundary layers. (author)

  2. Spatial-temporal trend for mother-to-child transmission of HIV up to infancy and during pre-Option B+ in western Kenya, 2007-13.

    Science.gov (United States)

    Waruru, Anthony; Achia, Thomas N O; Muttai, Hellen; Ng'ang'a, Lucy; Zielinski-Gutierrez, Emily; Ochanda, Boniface; Katana, Abraham; Young, Peter W; Tobias, James L; Juma, Peter; De Cock, Kevin M; Tylleskär, Thorkild

    2018-01-01

    Using spatial-temporal analyses to understand coverage and trends in elimination of mother-to-child transmission of HIV (e-MTCT) efforts may be helpful in ensuring timely services are delivered to the right place. We present spatial-temporal analysis of seven years of HIV early infant diagnosis (EID) data collected from 12 districts in western Kenya from January 2007 to November 2013, during pre-Option B+ use. We included in the analysis infants up to one year old. We performed trend analysis using extended Cochran-Mantel-Haenszel stratified test and logistic regression models to examine trends and associations of infant HIV status at first diagnosis with: early diagnosis (ever having breastfed, use of single dose nevirapine, and maternal antiretroviral therapy status. We examined these covariates and fitted spatial and spatial-temporal semiparametric Poisson regression models to explain HIV-infection rates using R-integrated nested Laplace approximation package. We calculated new infections per 100,000 live births and used Quantum GIS to map fitted MTCT estimates for each district in Nyanza region. Median age was two months, interquartile range 1.5-5.8 months. Unadjusted pooled positive rate was 11.8% in the seven-years period and declined from 19.7% in 2007 to 7.0% in 2013, p best in explaining geographical variation in MTCT. Improved EID uptake and reduced MTCT rates are indicators of progress towards e-MTCT. Cojoined analysis of time and covariates in a spatial context provides a robust approach for explaining differences in programmatic impact over time. During this pre-Option B+ period, the prevention of mother to child transmission program in this region has not achieved e-MTCT target of ≤50 infections per 100,000 live births. Geographical disparities in program achievements may signify gaps in spatial distribution of e-MTCT efforts and could indicate areas needing further resources and interventions.

  3. MAGMA: Generalized Gene-Set Analysis of GWAS Data

    NARCIS (Netherlands)

    de Leeuw, C.A.; Mooij, J.M.; Heskes, T.; Posthuma, D.

    2015-01-01

    By aggregating data for complex traits in a biologically meaningful way, gene and gene-set analysis constitute a valuable addition to single-marker analysis. However, although various methods for gene and gene-set analysis currently exist, they generally suffer from a number of issues. Statistical

  4. MAGMA: generalized gene-set analysis of GWAS data.

    NARCIS (Netherlands)

    de Leeuw, C.A.; Mooij, J.M.; Heskes, T.; Posthuma, D.

    2015-01-01

    By aggregating data for complex traits in a biologically meaningful way, gene and gene-set analysis constitute a valuable addition to single-marker analysis. However, although various methods for gene and gene-set analysis currently exist, they generally suffer from a number of issues. Statistical

  5. ASUPAN SENG YANG RENDAH SEBAGAI FAKTOR RISIKO KEPARAHAN PNEUMONIA PADA ANAK USIA 12-59 BULAN

    Directory of Open Access Journals (Sweden)

    Meiry Nasution

    2017-06-01

    Full Text Available Period prevalence of infant pneumonia in Indonesia is 18.5 per mile. The high mortality rate due to pneumonia of 62 percent was found in 10 countries and 5 countries was located in Asia. Zinc is one of micronutrients which is reported to prevent pneumonia as   an acute phase response to infection and help to boost the body immune response. The objective of the study was to determine the impact of zinc intake as risk factor of severe pneumonia in children. A case control study was conducted among children aged 12–59  months in 2 hospitals and 6 health centres, Yogyakarta city. Thirty four children were categorized as having severe pneumonia (cases and 102 children were categorized as having pneumonia (control.  All sample’s mothers completed a semi-quantitative food frequency questionnaire during March-April 2014. Data analysis was performed  using Mantel-Haenszel test and conditional logistic regression, α = 0,05. Results of the study showed that there were 41.2 percent cases and 56.9 percent control were exclusively breast-fed. The  proportion of cases who had inadequate zink intake was higher than control group. There was no difference between inadequate zinc intake and the severe pneumonia (OR 1,08 and  95% CI 0,5-2,3. There was a statistically significant correlation between low-zinc intake and severe pneumonia if second  disease exist (OR 3,8  and 95% CI 1,4 -10,8. As an conclusion, Inadequate zinc intake affected severe pneumonia when the secondary diseases exist in children with pneumonia.   ABSTRAK   Period prevalence pneumonia balita di Indonesia adalah 18,5 per mil. Angka kematian yang tinggi akibat pneumonia sebesar 62 persen terdapat di 10 negara dan 5 negara di antaranya merupakan negara di Asia. Defisiensi seng menyebabkan penurunan kekebalan sel sehingga meningkatkan kerentanan terhadap penyakit pneumonia. Tujuan penelitian ini menganalisis asupan seng yang kurang sebagai faktor risiko keparahan pneumonia pada anak

  6. Texture analysis using Renyi's generalized entropies

    NARCIS (Netherlands)

    Grigorescu, SE; Petkov, N

    2003-01-01

    We propose a texture analysis method based on Renyi's generalized entropies. The method aims at identifying texels in regular textures by searching for the smallest window through which the minimum number of different visual patterns is observed when moving the window over a given texture. The

  7. Generalized Linear Covariance Analysis

    Science.gov (United States)

    Carpenter, James R.; Markley, F. Landis

    2014-01-01

    This talk presents a comprehensive approach to filter modeling for generalized covariance analysis of both batch least-squares and sequential estimators. We review and extend in two directions the results of prior work that allowed for partitioning of the state space into solve-for'' and consider'' parameters, accounted for differences between the formal values and the true values of the measurement noise, process noise, and textita priori solve-for and consider covariances, and explicitly partitioned the errors into subspaces containing only the influence of the measurement noise, process noise, and solve-for and consider covariances. In this work, we explicitly add sensitivity analysis to this prior work, and relax an implicit assumption that the batch estimator's epoch time occurs prior to the definitive span. We also apply the method to an integrated orbit and attitude problem, in which gyro and accelerometer errors, though not estimated, influence the orbit determination performance. We illustrate our results using two graphical presentations, which we call the variance sandpile'' and the sensitivity mosaic,'' and we compare the linear covariance results to confidence intervals associated with ensemble statistics from a Monte Carlo analysis.

  8. Venous thromboembolism prevention in gynecologic cancer surgery: a systematic review.

    Science.gov (United States)

    Einstein, M Heather; Pritts, Elizabeth A; Hartenbach, Ellen M

    2007-06-01

    Advanced age, pelvic surgery, and the presence of malignancy place gynecologic oncology patients at high risk for venous thromboembolism (VTE). This study was designed to systematically analyze the world's literature on VTE in these patients and determine the optimal prophylaxis regimen. Computerized searches of Pubmed, Ovid, DARE, ACP Journal Club, Cochrane Database of Systematic Reviews, and Cochrane Controlled Trials Registry 1966-2005 were performed, as well as EMBASE 1980-2005. Major conferences and target references were hand-searched. Inclusion criteria were randomized controlled trials (RCTs) evaluating VTE prophylaxis with heparin, low-molecular-weight heparin (LMWH), and sequential compression devices (SCD). The search yielded 278 articles; 11 met inclusion criteria. Data were abstracted by one author and analyzed with the Mantel-Haenszel method. The analysis of heparin-versus-control revealed a significant decrease in DVT in patients receiving heparin (RR=0.58, 95% CI 0.35-0.95). There were no significant differences in EBL or transfusions between the two groups. In the 320 patients in the heparin vs. LMWH studies, there was no significant difference in DVT (RR 0.91, 95% CI 0.38-2.17), although power analysis demonstrated insufficient numbers to show a difference. No patient in either group required re-exploration for bleeding. All gynecologic cancer patients should receive VTE prophylaxis. Although heparin, LMWH, and SCD have been shown to be safe and effective, due to the paucity of data in the gynecologic oncology literature, no one prevention modality can be considered superior at this time. Adequately powered RCTs are urgently needed to determine the optimal regimen in these high-risk patients.

  9. Failure of antiarrhythmic drugs to prevent experimental reperfusion ventricular fibrillation.

    Science.gov (United States)

    Naito, M; Michelson, E L; Kmetzo, J J; Kaplinsky, E; Dreifus, L S

    1981-01-01

    Ninety-nine adult mongrel dogs underwent acute ligation of the proximal left anterior descending coronary artery. Thirty minutes later, the occlusion was released to evaluate the effectiveness of five antiarrhythmic protocols in eliminating reperfusion ventricular fibrillation. The five protocols included: protocol 1 --i.v. lidocaine, preligation and prerelease (n = 19); protocol 2 -- i.v. lidocaine, prereperfusion only (n = 22); protocol 3 -- chronic, oral, daily amiodarone for 2 weeks preligation (n = 19); protocol 4 -- i.v. procainamide, preligation and prereperfusion (n = 21); and protocol 5 -- i.v. verapamil, prereperfusion (n = 18). Each regimen was evaluated with respect to the incidence of reperfusion ventricular fibrillation in dogs that survived to reperfusion, and the results were compared to 77 control dogs that underwent identical coronary artery occlusion and release procedures without drug therapy. The incidence of reperfusion ventricular fibrillation was as follows: protocol 1 -- seven of 15 dogs (47%); protocol 2 -- six of 18 (33%); protocol 3 -- 11 of 16 dogs (69%); protocol 4 -- eight of 17 dogs (47%); and protocol 5 -- 10 of 17 dogs (59%), compared with 36 of 60 (60%) in control dogs. Using chi-square analysis, protocol 2 was beneficial (p antecedent coronary artery ligation periods, and predictive risk indexes for the occurrence of reperfusion ventricular fibrillation were developed. the Mantel-Haenszel method of statistical analysis revealed that none of these protocols resulted in a statistically significant reduction in the incidence of reperfusion ventricular fibrillation. Thus, use of these predictive indexes plus appropriate statistical methods has revealed, unexpectedly, limitations in the efficacy of a spectrum of antiarrhythmic agents in preventing reperfusion ventricular fibrillation.

  10. Differences in rates of radiation-induced true and false rib fractures after stereotactic body radiation therapy for Stage I primary lung cancer

    International Nuclear Information System (INIS)

    Miura, Hideharu; Inoue, Toshihiko; Shiomi, Hiroya; Oh, Ryoong-Jin

    2015-01-01

    The purpose of this study was to analyze the dosimetry and investigate the clinical outcomes of radiation-induced rib fractures (RIRFs) after stereotactic body radiotherapy (SBRT). A total of 126 patients with Stage I primary lung cancer treated with SBRT, who had undergone follow-up computed tomography (CT) at least 12 months after SBRT and who had no previous overlapping radiation exposure were included in the study. We used the Mantel-Haenszel method and multiple logistic regression analysis to compare risk factors. We analyzed D(0.5 cm 3 ) (minimum absolute dose received by a 0.5-cm 3 volume) and identified each rib that received a biologically effective dose (BED) (BED3, using the linear-quadratic (LQ) formulation assuming an α/β = 3) of at least 50 Gy. Of the 126 patients, 46 (37%) suffered a total of 77 RIRFs. The median interval from SBRT to RIRF detection was 15 months (range, 3-56 months). The 3-year cumulative probabilities were 45% (95% CI, 34-56%) and 3% (95% CI, 0-6%), for Grades 1 and 2 RIRFs, respectively. Multivariate analysis showed that tumor location was a statistically significant risk factor for the development of Grade 1 RIRFs. Of the 77 RIRFs, 71 (92%) developed in the true ribs (ribs 1-7), and the remaining six developed in the false ribs (ribs 8-12). The BED3 associated with 10% and 50% probabilities of RIRF were 55 and 210 Gy to the true ribs and 240 and 260 Gy to the false ribs. We conclude that RIRFs develop more frequently in true ribs than in false ribs. (author)

  11. Vdrive Evaluation of Remote Steering and Testing in Lasso Electrophysiology Procedures Study: The VERSATILE Study in Atrial Fibrillation Ablation.

    Science.gov (United States)

    Nölker, Georg; Schwagten, Bruno; Deville, J Brian; Burkhardt, J David; Horton, Rodney P; Sha, Qun; Tomassoni, Gery

    2016-03-01

    Circular mapping catheters (CMC) are an essential tool in most atrial fibrillation ablation procedures. The Vdrive™ with V-Loop™ system enables a physician to remotely manipulate a CMC during electrophysiology studies. Our aim was to compare the clinical performance of the system to conventional CMC navigation according to efficiency and safety endpoints. A total of 120 patients scheduled to undergo a CMC study followed by pulmonary vein isolation (PVI) were included. Treatment allocation was randomized 2:1, remote navigation:manual navigation. The primary effectiveness endpoint was assessed based on both successful navigation to the targeted pulmonary vein (PV) and successful recording of PV electrograms. All PVs were treated independently within and between patients. The primary safety endpoint was assessed based on the occurrence of major adverse events (MAEs) through seven days after the study procedure. Primary effectiveness endpoints were achieved in 295/302 PVs in the Vdrive arm (97.7%) and 167/167 PVs in the manual arm (100%). Effectiveness analysis indicates Vdrive non-inferiority (pnon-inferiority = 0.0405; δ = -0.05) per the Cochran-Mantel-Haenszel test adjusted for PV correlation. Five MAEs related to the ablation procedure occurred (three in the Vdrive arm-3.9%; two in the manual arm-2.33%). No device-related MAEs were observed; safety analysis indicates Vdrive non-inferiority (pnon-inferiority = 0.0441; δ = 0.07) per the normal Z test. Remote navigation of a CMC is equivalent to manual in PVI in terms of safety and effectiveness. This allows for single-operator procedures in conjunction with a magnetically guided ablation catheter. © 2016 Wiley Periodicals, Inc.

  12. Entropy-based derivation of generalized distributions for hydrometeorological frequency analysis

    Science.gov (United States)

    Chen, Lu; Singh, Vijay P.

    2018-02-01

    Frequency analysis of hydrometeorological and hydrological extremes is needed for the design of hydraulic and civil infrastructure facilities as well as water resources management. A multitude of distributions have been employed for frequency analysis of these extremes. However, no single distribution has been accepted as a global standard. Employing the entropy theory, this study derived five generalized distributions for frequency analysis that used different kinds of information encoded as constraints. These distributions were the generalized gamma (GG), the generalized beta distribution of the second kind (GB2), and the Halphen type A distribution (Hal-A), Halphen type B distribution (Hal-B) and Halphen type inverse B distribution (Hal-IB), among which the GG and GB2 distribution were previously derived by Papalexiou and Koutsoyiannis (2012) and the Halphen family was first derived using entropy theory in this paper. The entropy theory allowed to estimate parameters of the distributions in terms of the constraints used for their derivation. The distributions were tested using extreme daily and hourly rainfall data. Results show that the root mean square error (RMSE) values were very small, which indicated that the five generalized distributions fitted the extreme rainfall data well. Among them, according to the Akaike information criterion (AIC) values, generally the GB2 and Halphen family gave a better fit. Therefore, those general distributions are one of the best choices for frequency analysis. The entropy-based derivation led to a new way for frequency analysis of hydrometeorological extremes.

  13. Harmonic Analysis Associated with the Generalized Weinstein Operator

    Directory of Open Access Journals (Sweden)

    Ahmed Abouelaz

    2015-11-01

    Full Text Available In this paper we consider a generalized Weinstein operator ∆d,α,n on Rd−1×]0,∞[, which generalizes the Weinstein operator ∆d,α, we define the generalized Weinstein intertwining operator Rα,n which turn out to be transmutation operator between ∆d,α,n and the Laplacian operator ∆d. We build the dual of the generalized Weinstein intertwining operatortRα,n, another hand we prove the formula related Rα,n andtRα,n . We exploit these transmutation operators to develop a new harmonic analysis corresponding to ∆d,α,n.

  14. Functional Generalized Structured Component Analysis.

    Science.gov (United States)

    Suk, Hye Won; Hwang, Heungsun

    2016-12-01

    An extension of Generalized Structured Component Analysis (GSCA), called Functional GSCA, is proposed to analyze functional data that are considered to arise from an underlying smooth curve varying over time or other continua. GSCA has been geared for the analysis of multivariate data. Accordingly, it cannot deal with functional data that often involve different measurement occasions across participants and a large number of measurement occasions that exceed the number of participants. Functional GSCA addresses these issues by integrating GSCA with spline basis function expansions that represent infinite-dimensional curves onto a finite-dimensional space. For parameter estimation, functional GSCA minimizes a penalized least squares criterion by using an alternating penalized least squares estimation algorithm. The usefulness of functional GSCA is illustrated with gait data.

  15. Mediastinitis after coronary artery bypass grafting: the effect of vacuum-assisted closure versus traditional closed drainage on survival and re-infection rate.

    Science.gov (United States)

    Risnes, Ivar; Abdelnoor, Michael; Veel, Terje; Svennevig, Jan Ludvig; Lundblad, Runar; Rynning, Stein Erik

    2014-04-01

    Mediastinitis is treated with either vacuum-assisted closure (VAC) or traditional closed drainage (TCD) with irrigation. The aim of the study was to determine the effect of the two treatments on mortality and re-infection rate in a source population, using 21 314 consecutive patients undergoing isolated coronary artery bypass grafting (CABG) from January 1997 to October 2010. Median observation time was 2·9 years in the VAC group and 8·0 years in the TCD group. The epidemiological design was of an exposed (VAC, n = 64) versus non-exposed (TCD, n = 66) cohort with two endpoints: (1) mortality and (2) failure of sternal wound healing or re-infection. The crude effect of treatment technique versus endpoint was estimated by univariate analysis. Stratification analysis by the Mantel-Haenszel method was performed to quantify confounders and to pinpoint effect modifiers. Adjustment for confounders was performed using Cox regression analysis. Mediastinitis was diagnosed 6-105 (median 14) days after primary operation in the VAC group and 13 (5-29) days in the TCD group. There was no difference between groups in long-term survival. Failure of sternal wound healing or re-infection occurred less frequently in the VAC group (6%) than in the TCD group (21%; relative risk = 0·29, 95% CI = 0·06-0·88, P = 0·01). There are concerns for increase in right ventricle rupture in VAC compared with TCD. There was no difference in survival after VAC therapy and TCD therapy of post-CABG mediastinitis. Failure of sternal wound healing or re-infection was more common after TCD therapy. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  16. General aviation air traffic pattern safety analysis

    Science.gov (United States)

    Parker, L. C.

    1973-01-01

    A concept is described for evaluating the general aviation mid-air collision hazard in uncontrolled terminal airspace. Three-dimensional traffic pattern measurements were conducted at uncontrolled and controlled airports. Computer programs for data reduction, storage retrieval and statistical analysis have been developed. Initial general aviation air traffic pattern characteristics are presented. These preliminary results indicate that patterns are highly divergent from the expected standard pattern, and that pattern procedures observed can affect the ability of pilots to see and avoid each other.

  17. MAGMA: generalized gene-set analysis of GWAS data.

    Science.gov (United States)

    de Leeuw, Christiaan A; Mooij, Joris M; Heskes, Tom; Posthuma, Danielle

    2015-04-01

    By aggregating data for complex traits in a biologically meaningful way, gene and gene-set analysis constitute a valuable addition to single-marker analysis. However, although various methods for gene and gene-set analysis currently exist, they generally suffer from a number of issues. Statistical power for most methods is strongly affected by linkage disequilibrium between markers, multi-marker associations are often hard to detect, and the reliance on permutation to compute p-values tends to make the analysis computationally very expensive. To address these issues we have developed MAGMA, a novel tool for gene and gene-set analysis. The gene analysis is based on a multiple regression model, to provide better statistical performance. The gene-set analysis is built as a separate layer around the gene analysis for additional flexibility. This gene-set analysis also uses a regression structure to allow generalization to analysis of continuous properties of genes and simultaneous analysis of multiple gene sets and other gene properties. Simulations and an analysis of Crohn's Disease data are used to evaluate the performance of MAGMA and to compare it to a number of other gene and gene-set analysis tools. The results show that MAGMA has significantly more power than other tools for both the gene and the gene-set analysis, identifying more genes and gene sets associated with Crohn's Disease while maintaining a correct type 1 error rate. Moreover, the MAGMA analysis of the Crohn's Disease data was found to be considerably faster as well.

  18. Use of probiotics in the treatment of severe acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials

    Science.gov (United States)

    2014-01-01

    Introduction Necrotic tissue infection can worsen the prognosis of severe acute pancreatitis (SAP), and probiotics have been shown to be beneficial in reducing the infection rate in animal experiments and primary clinical trials. However, the results of multicenter randomized clinical trials have been contradictory. Our aim in this study was to systematically review and quantitatively analyze all randomized controlled trials with regard to important outcomes in patients with predicted SAP who received probiotics. Methods A systematic literature search of the PubMed, Embase and Cochrane Library databases was conducted using specific search terms. Eligible studies were randomized controlled trials that compared the effects of probiotic with placebo treatment in patients with predicted SAP. Mean difference (MD), risk ratio (RR) and 95% confidence interval (95% CI) were calculated using the Mantel-Haenszel fixed- and random-effects models. A meta-analysis on the use of probiotics in the treatment of critically ill patients was also performed to serve as a reference. Results In this study, 6 trials comprising an aggregate total of 536 patients were analyzed. Significant heterogeneities were observed in the type, dose, treatment duration and clinical effects of probiotics in these trials. Systematic analysis showed that probiotics did not significantly affect the pancreatic infection rate (RR = 1.19, 95% CI = 0.74 to 1.93; P = 0.47), total infections (RR = 1.09, 95% CI = 0.80 to 1.48; P = 0.57), operation rate (RR = 1.42, 95% CI = 0.43 to 3.47; P = 0.71), length of hospital stay (MD = 2.45, 95% CI = −2.71 to 7.60; P = 0.35) or mortality (RR = 0.72, 95% CI = 0.42 to 1.45; P = 0.25). Conclusions Probiotics showed neither beneficial nor adverse effects on the clinical outcomes of patients with predicted SAP. However, significant heterogeneity was noted between the trials reviewed with regard to the type, dose and

  19. The Study About Physical Activity for Subjects With Prevention of Benign Prostate Hyperplasia

    Directory of Open Access Journals (Sweden)

    Ho Won Lee

    2014-09-01

    Full Text Available PurposeThe number of benign prostatic hyperplasia (BPH subjects has been increasing worldwide, and many studies have been conducted to determine the treatment that can delay drug therapy or surgery. Subsequently, most of these studies involved physical activity (PA and associated factors. Therefore, we aimed to determine factors associated with BPH prevalence based on a review of past and present studies and to investigate the effect of a healthy lifestyle as a protective factor of BPH occurrence.MethodsWe selected 582 subjects aged ≥40 years from an initial 779 subjects recruited from Gyeonggi, Yangpyeong, South Korea, during August 2009 to August 2011. Trained investigators surveyed International Prostate Symptom Score and demographic information, including PA and lifestyle questionnaire during face-to-face interviews; further, they performed digital rectal examination, rectal ultrasonography, and measured prostate-specific antigen levels. The statistical association between PA and BPH was analyzed by logistic regression analysis using multivariable regression models which use categorical variables by the Cochran-Mantel-Haenszel test and continuous variables by the general linear model.ResultsSeven statistically significant variables for PA were selected. Regular exercise, frequency of exercise, sedentary time, nonsedentary time, leisure time PA (metabolic equivalent, hr/wk were not statistically associated with prostate volume but sedentary time (hr/day was the only factor that showed a significant association in the multivariable model, including a linear effect relationship. Subjects with lower levels of sedentary time (4.5-7.0 hr/day had a significantly lower risk of BPH (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.52-1.67 than those with a higher sedentary time (>7 hr/day (OR, 1.72; 95% CI, 0.96-3.09 (P for trend=0.05.ConclusionsOur study showed that reducing sedentary time could have a protective effect and reduce the

  20. Complexity analysis based on generalized deviation for financial markets

    Science.gov (United States)

    Li, Chao; Shang, Pengjian

    2018-03-01

    In this paper, a new modified method is proposed as a measure to investigate the correlation between past price and future volatility for financial time series, known as the complexity analysis based on generalized deviation. In comparison with the former retarded volatility model, the new approach is both simple and computationally efficient. The method based on the generalized deviation function presents us an exhaustive way showing the quantization of the financial market rules. Robustness of this method is verified by numerical experiments with both artificial and financial time series. Results show that the generalized deviation complexity analysis method not only identifies the volatility of financial time series, but provides a comprehensive way distinguishing the different characteristics between stock indices and individual stocks. Exponential functions can be used to successfully fit the volatility curves and quantify the changes of complexity for stock market data. Then we study the influence for negative domain of deviation coefficient and differences during the volatile periods and calm periods. after the data analysis of the experimental model, we found that the generalized deviation model has definite advantages in exploring the relationship between the historical returns and future volatility.

  1. Detecting anxiety in individuals with Parkinson disease: A systematic review.

    Science.gov (United States)

    Mele, Bria; Holroyd-Leduc, Jayna; Smith, Eric E; Pringsheim, Tamara; Ismail, Zahinoor; Goodarzi, Zahra

    2018-01-02

    To examine diagnostic accuracy of anxiety detection tools compared with a gold standard in outpatient settings among adults with Parkinson disease (PD). A systematic review was conducted. MEDLINE, EMABASE, PsycINFO, and Cochrane Database of Systematic Reviews were searched to April 7, 2017. Prevalence of anxiety and diagnostic accuracy measures including sensitivity, specificity, and likelihood ratios were gathered. Pooled prevalence of anxiety was calculated using Mantel-Haenszel-weighted DerSimonian and Laird models. A total of 6,300 citations were reviewed with 6 full-text articles included for synthesis. Tools included within this study were the Beck Anxiety Inventory, Geriatric Anxiety Inventory (GAI), Hamilton Anxiety Rating Scale, Hospital Anxiety and Depression Scale-Anxiety, Parkinson's Anxiety Scale (PAS), and Mini-Social Phobia Inventory. Anxiety diagnoses made included generalized anxiety disorder, social phobia, and any anxiety type. Pooled prevalence of anxiety was 30.1% (95% confidence interval 26.1%-34.0%). The GAI had the best-reported sensitivity of 0.86 and specificity of 0.88. The observer-rated PAS had a sensitivity of 0.71 and the highest specificity of 0.91. While there are 6 tools validated for anxiety screening in PD populations, most tools are only validated in single studies. The GAI is brief and easy to use, with a good balance of sensitivity and specificity. The PAS was specifically developed for PD, is brief, and has self-/observer-rated scales, but with lower sensitivity. Health care practitioners involved in PD care need to be aware of available validated tools and choose one that fits their practice. Copyright © 2017 American Academy of Neurology.

  2. Association of parental stress and early childhood caries

    Directory of Open Access Journals (Sweden)

    Seyed Ebrahim Jabbarifar

    2009-01-01

    Full Text Available Background:Little research has been carried out on whether the parental stress affects children′s oral health in general and dental caries in particular. This study aimed to investigate the association be-tween parental stress and early childhood caries (ECC. Methods: A cross-sectional study was designed that included 250 children of 4-6 year-old; 127 ones attended the pediatric department of Isfahan School of Dentistry who had early childhood caries and a comparison group of 123 caries free children attended five kindergartens and pre-schools in Isfahan city. Clinical examinations were conducted to evaluate the caries status. The parents of the two study groups completed the self-administrated long form of the Parenting Stress Index questionnaire. De-tails of their socio-demographic status were gathered too. The collected data were analyzed by SPSS version 11.5. The nonparametric Mantel-Haenszel test for correlation statistics was used to determine bivariate associations between total parenting stress and their domains scores in the two groups; i.e., those with early childhood caries and the caries free group. Results: Mean score of PSI in the early childhood caries and caries free group were 286.66 ± 66.26 and 273.87 ± 31.03, respectively. There was not any significant relationship between total parental stress and ECC. The scores of the following domains of PSI demonstrated significant differences between ECC and CF groups: child reinforcement, child distractibility, child deficit attention, life stress and relationship with spouse (P = 0.01, 0.01, 0.001, 0.005 respectively. Conclusion: Findings of this study did not show any significant association between total parenting stress score and prevalence of early childhood caries.

  3. Contrast-enhanced 3D MRI of lung perfusion in children with cystic fibrosis - initial results

    International Nuclear Information System (INIS)

    Eichinger, Monika; Puderbach, Michael; Zuna, Ivan; Kauczor, Hans-Ulrich; Fink, Christian; Gahr, Julie; Mueller, Frank-Michael; Ley, Sebastian; Plathow, Christian; Tuengerthal, Siegfried

    2006-01-01

    This paper is a feasibility study of magnetic resonance imaging (MRI) of lung perfusion in children with cystic fibrosis (CF) using contrast-enhanced 3D MRI. Correlation assessment of perfusion changes with structural abnormalities. Eleven CF patients (9 f, 2 m; median age 16 years) were examined at 1.5 T. Morphology: HASTE coronal, transversal (TR/TE/α/ST: 600 ms/28 ms/180 /6 mm), breath-hold 18 s. Perfusion: Time-resolved 3D GRE pulse sequence (FLASH, TE/TR/α: 0.8/1.9 ms/40 ), parallel imaging (GRAPPA, PAT 2). Twenty-five data sets were acquired after intravenous injection of 0.1 mmol/kg body weight of gadodiamide, 3-5 ml/s. A total of 198 lung segments were analyzed by two radiologists in consensus and scored for morphological and perfusion changes. Statistical analysis was performed by Mantel-Haenszel chi-square test. Results showed that perfusion defects were observed in all patients and present in 80% of upper, and 39% of lower lobes. Normal lung parenchyma showed homogeneous perfusion (86%, P<0.0001). Severe morphological changes led to perfusion defects (97%, P<0.0001). Segments with moderate morphological changes showed normal (53%) or impaired perfusion (47%). In conclusion, pulmonary perfusion is easy to judge in segments with normal parenchyma or severe changes. In moderately damaged segments, MRI of lung perfusion may help to better assess actual functional impairment. Contrast-enhanced 3D MRI of lung perfusion has the potential for early vascular functional assessment and therapy control in CF patients. (orig.)

  4. A method to associate all possible combinations of genetic and environmental factors using GxE landscape plot.

    Science.gov (United States)

    Nagaie, Satoshi; Ogishima, Soichi; Nakaya, Jun; Tanaka, Hiroshi

    2015-01-01

    Genome-wide association studies (GWAS) and linkage analysis has identified many single nucleotide polymorphisms (SNPs) related to disease. There are many unknown SNPs whose minor allele frequencies (MAFs) as low as 0.005 having intermediate effects with odds ratio between 1.5~3.0. Low frequency variants having intermediate effects on disease pathogenesis are believed to have complex interactions with environmental factors called gene-environment interactions (GxE). Hence, we describe a model using 3D Manhattan plot called GxE landscape plot to visualize the association of p-values for gene-environment interactions (GxE). We used the Gene-Environment iNteraction Simulator 2 (GENS2) program to simulate interactions between two genetic loci and one environmental factor in this exercise. The dataset used for training contains disease status, gender, 20 environmental exposures and 100 genotypes for 170 subjects, and p-values were calculated by Cochran-Mantel-Haenszel chi-squared test on known data. Subsequently, we created a 3D GxE landscape plot of negative logarithm of the association of p-values for all the possible combinations of genetic and environmental factors with their hierarchical clustering. Thus, the GxE landscape plot is a valuable model to predict association of p-values for GxE and similarity among genotypes and environments in the context of disease pathogenesis. GxE - Gene-environment interactions, GWAS - Genome-wide association study, MAFs - Minor allele frequencies, SNPs - Single nucleotide polymorphisms, EWAS - Environment-wide association study, FDR - False discovery rate, JPT+CHB - HapMap population of Japanese in Tokyo, Japan - Han Chinese in Beijing.

  5. YAP expression in normal and neoplastic breast tissue: an immunohistochemical study.

    Science.gov (United States)

    Jaramillo-Rodríguez, Yolanda; Cerda-Flores, Ricardo M; Ruiz-Ramos, Ruben; López-Márquez, Francisco C; Calderón-Garcidueñas, Ana Laura

    2014-04-01

    Yes-associated protein (YAP) is a transcriptional factor involved in normal cell proliferation, apoptosis and carcinogenesis; however, its contribution to breast cancer (BC) is still controversial. We undertook this study to compare the expression of YAP by immunohistochemistry (IHC) in normal breast tissue of women without breast cancer (BC) (controls), non-neoplastic breast tissue in women with cancer (internal controls) and in four different subtypes of invasive ductal carcinoma. There were 17 controls and 105 tumor cases (53 luminal A, 15 luminal B, 20 overexpression of HER2 and 17 triple negative cases) studied by IHC. Statistical analysis included χ(2) for linear trend (Extended Mantel-Haenszel). There were 40% of internal controls that showed expression of YAP in myoepithelial cells, whereas in controls expression was 100%. In controls, 3/17 (17.6%) showed cytoplasmic staining in luminal cells. There was a significant difference in nuclear expression between the ductal BC subtypes. Luminal A had 4% of positive cases with <10% of cells affected in each case; in contrast, there were 17-20% of positive cases in the other groups with 50% or more of stained cells. YAP expression in stromal cells was not observed in controls or in triple-negative cases, and luminal B pattern had the highest YAP nuclear expression (20%). YAP showed decreased expression in tumor cells compared with normal breast tissue. These findings are consistent with a role of YAP as a suppressor gene in BC and show differences in YAP expression in different patterns of ductal BC. Copyright © 2014 IMSS. Published by Elsevier Inc. All rights reserved.

  6. OPIUM USE IN TRANSITIONAL CELL CARCINOMA OF THE URINARY BLADDER

    Directory of Open Access Journals (Sweden)

    A. Nourbakhsh

    2006-08-01

    Full Text Available Opium use is one of the most common forms of substance abuse in Iran and there are some evidence indicating it is a risk factor of transitional cell carcinoma (TCC of the urinary bladder. The majority of opium users are also cigarette smokers, so consideration of the high prevalence of smoking which is the most important risk factor of TCC of the urinary bladder among opium users is essential to assess the role of opium use as a possible risk factor of TCC. This study was done to evaluate the role of opium as a risk factor of TCC. A case-control study was performed on 255 individuals diagnosed with TCC of the urinary bladder by pathologic light microscopic examination of the tumor biopsies. Control population was chosen from individuals who had no history or presenting signs or symptoms of urinary problems. Case and control groups were matched by sex and age and also by cigarette smoking habits. Forty-one (18.1% of the cases and 12 (5% of controls were recognized to be opium users. Mantel-Haenszel analysis showed an odds ratio of 3.88, with 95% confidence interval of 1.99-7.57 and P value of < 0.001. Results indicate that opium use is a risk factor for TCC. The majority of opium users are also cigarette smokers, which is another important risk factor for TCC. Routine urine cytology and early evaluation in the patients presenting with any of the symptoms of urinary bladder malignancy by means of cystoscopy and urine cytology are highly recommended.

  7. Beneficial effect of statins on total mortality in abdominal aortic aneurysm (AAA) repair.

    Science.gov (United States)

    Mathisen, Sven Ross; Abdelnoor, Michael

    2017-10-01

    In this single center, retrospective cohort study we wished to compare early and total mortality for all patients treated for abdominal aortic aneurysms (AAA) with open surgery who were taking statins compared to those who were not. A cohort of 640 patients with AAA was treated with open surgery between 1999 and 2012. Patients were consecutively recruited from a source population of 390,000; 21.3% were female, and the median age was 73 years. The median follow-up was 3.93 years, with an interquartile range of 1.79-6.58 years. The total follow-up was 2855 patient-years. An explanatory strategy was used. The propensity score (PS) was implemented to control for selection bias and confounders. The crude effect of statin use showed a 78% reduction of the 30-day mortality. A stratified analysis using the Mantel-Haenszel method on quintiles of the PS gave an adjusted effect of the odds ratio equal to 0.43 (95% CI: 0.18-0.96), indicating a 57% reduction of the 30-day mortality for statin users. The adjusted rate ratio was 0.62 (95% CI: 0.45-0.83), indicating a reduction of long-term mortality of 38% for statin users compared to non-users for a median follow-up of 3.93 years. This retrospective cohort study showed a significant beneficial effect of statin use on early and long-term survival for patients treated with open surgery. To be conclusive, our results need to be replicated by a randomized clinical trial.

  8. Functional data analysis of generalized regression quantiles

    KAUST Repository

    Guo, Mengmeng; Zhou, Lan; Huang, Jianhua Z.; Hä rdle, Wolfgang Karl

    2013-01-01

    Generalized regression quantiles, including the conditional quantiles and expectiles as special cases, are useful alternatives to the conditional means for characterizing a conditional distribution, especially when the interest lies in the tails. We develop a functional data analysis approach to jointly estimate a family of generalized regression quantiles. Our approach assumes that the generalized regression quantiles share some common features that can be summarized by a small number of principal component functions. The principal component functions are modeled as splines and are estimated by minimizing a penalized asymmetric loss measure. An iterative least asymmetrically weighted squares algorithm is developed for computation. While separate estimation of individual generalized regression quantiles usually suffers from large variability due to lack of sufficient data, by borrowing strength across data sets, our joint estimation approach significantly improves the estimation efficiency, which is demonstrated in a simulation study. The proposed method is applied to data from 159 weather stations in China to obtain the generalized quantile curves of the volatility of the temperature at these stations. © 2013 Springer Science+Business Media New York.

  9. Functional data analysis of generalized regression quantiles

    KAUST Repository

    Guo, Mengmeng

    2013-11-05

    Generalized regression quantiles, including the conditional quantiles and expectiles as special cases, are useful alternatives to the conditional means for characterizing a conditional distribution, especially when the interest lies in the tails. We develop a functional data analysis approach to jointly estimate a family of generalized regression quantiles. Our approach assumes that the generalized regression quantiles share some common features that can be summarized by a small number of principal component functions. The principal component functions are modeled as splines and are estimated by minimizing a penalized asymmetric loss measure. An iterative least asymmetrically weighted squares algorithm is developed for computation. While separate estimation of individual generalized regression quantiles usually suffers from large variability due to lack of sufficient data, by borrowing strength across data sets, our joint estimation approach significantly improves the estimation efficiency, which is demonstrated in a simulation study. The proposed method is applied to data from 159 weather stations in China to obtain the generalized quantile curves of the volatility of the temperature at these stations. © 2013 Springer Science+Business Media New York.

  10. Attention-Deficit/Hyperactivity Disorder and Lifestyle-Related Behaviors in Children.

    Directory of Open Access Journals (Sweden)

    Lian Tong

    Full Text Available Attention-deficit/hyperactivity disorder (ADHD has been associated with obesity in children. Lifestyle-related behaviors (external eating, screen time and physical inactivity are well known to be associated with increased risk of obesity, but their associations with ADHD are unclear. The objectives of this study were to clarify the associations between ADHD symptoms in children and their associated lifestyle. A cross sectional study was carried out with a total of 785 primary students aged 9 to 13 years old and their parents were recruited by stratified random sampling from primary schools of China. The Cochran-Mantel-Haenszel (CMH test was used to examine the relationships between ADHD symptoms and health related behaviors. We found that children with ADHD symptoms were likely to spend more time using a computer during school days; they were also more likely to eat while using a computer. These children were also more likely to eat while seated in a car, using a smart phone, using a computer at bedtime, and snacking before going to sleep than children without ADHD symptoms. An increased risk of obesity in children with ADHD symptoms was associated with the overuse of electronic devices, eating while using electronic devices, and delaying bedtimes to snack and use electronic devices.

  11. Recent trends in 30-day mortality in patients with blunt splenic injury: A nationwide trauma database study in Japan.

    Science.gov (United States)

    Tanaka, Chie; Tagami, Takashi; Matsumoto, Hisashi; Matsuda, Kiyoshi; Kim, Shiei; Moroe, Yuta; Fukuda, Reo; Unemoto, Kyoko; Yokota, Hiroyuki

    2017-01-01

    Splenic injury frequently occurs after blunt abdominal trauma; however, limited epidemiological data regarding mortality are available. We aimed to investigate mortality rate trends after blunt splenic injury in Japan. We retrospectively identified 1,721 adults with blunt splenic injury (American Association for the Surgery of Trauma splenic injury scale grades III-V) from the 2004-2014 Japan Trauma Data Bank. We grouped the records of these patients into 3 time phases: phase I (2004-2008), phase II (2009-2012), and phase III (2013-2014). Over the 3 phases, we analysed 30-day mortality rates and investigated their association with the prevalence of certain initial interventions (Mantel-Haenszel trend test). We further performed multiple imputation and multivariable analyses for comparing the characteristics and outcomes of patients who underwent TAE or splenectomy/splenorrhaphy, adjusting for known potential confounders and for within-hospital clustering using generalised estimating equation. Over time, there was a significant decrease in 30-day mortality after splenic injury (p splenic injury between 2004 and 2014, even after adjustment for within-hospital clustering and other factors independently associated with mortality. Over time, mortality rates decreased significantly after splenectomy/splenorrhaphy, but not after non-operative management. This information is useful for clinicians when making decisions about treatments for patients with blunt splenic injury.

  12. Learning and Study Strategies Inventory subtests and factors as predictors of National Board of Chiropractic Examiners Part 1 examination performance.

    Science.gov (United States)

    Schutz, Christine M; Dalton, Leanne; Tepe, Rodger E

    2013-01-01

    This study was designed to extend research on the relationship between chiropractic students' learning and study strategies and national board examination performance. Sixty-nine first trimester chiropractic students self-administered the Learning and Study Strategies Inventory (LASSI). Linear trends tests (for continuous variables) and Mantel-Haenszel trend tests (for categorical variables) were utilized to determine if the 10 LASSI subtests and 3 factors predicted low, medium and high levels of National Board of Chiropractic Examiners (NBCE) Part 1 scores. Multiple regression was performed to predict overall mean NBCE examination scores using the 3 LASSI factors as predictor variables. Four LASSI subtests (Anxiety, Concentration, Selecting Main Ideas, Test Strategies) and one factor (Goal Orientation) were significantly associated with NBCE examination levels. One factor (Goal Orientation) was a significant predictor of overall mean NBCE examination performance. Learning and study strategies are predictive of NBCE Part 1 examination performance in chiropractic students. The current study found LASSI subtests Anxiety, Concentration, Selecting Main Ideas, and Test Strategies, and the Goal-Orientation factor to be significant predictors of NBCE scores. The LASSI may be useful to educators in preparing students for academic success. Further research is warranted to explore the effects of learning and study strategies training on GPA and NBCE performance.

  13. Smaller scars--what is the big deal: a survey of the perceived value of laparoscopic pyloromyotomy.

    Science.gov (United States)

    Haricharan, Ramanath N; Aprahamian, Charles J; Morgan, Traci L; Harmon, Carroll M; Georgeson, Keith E; Barnhart, Douglas C

    2008-01-01

    Laparoscopic and open pyloromyotomies are equally safe and effective, with the principal benefit of laparoscopy being better cosmesis. The goal of this study was to measure the perceived value of laparoscopic pyloromyotomy. Four hundred sixteen subjects (177 college freshmen, 126 first-year medical students, and 101 parents) were asked to complete a questionnaire after photographs of mature pyloromyotomy (open and laparoscopic) scars were shown to them. To measure the perceived value, subjects' willingness to pay hypothetical additional out-of-pocket expenses for their preferred operation was assessed. Data were analyzed using Cochran-Mantel-Haenszel test, t test and multivariable regression. Four hundred four surveys were complete. Overall, 74% preferred the appearance after laparoscopy. Eighty-eight percent would pay an additional out-of-pocket amount for their daughter and 85% for their son to have the cosmetic outcome after laparoscopy. Respondents were willing to pay more for their daughters (P < .0001) and sons (P < .0001) than themselves. As expected, income level (P < .0001) influenced the willingness to pay, whereas ethnicity, education, number of children, and sex did not. The cosmetic benefit of laparoscopic pyloromyotomy was valued by a wide demographic with 85% being willing to pay additional expenses for their children to have smaller scars.

  14. Pulmonary Metastasis from Rectal Cancer on Chest CT Is Correlated with 3T MRI Primary Tumor Location

    International Nuclear Information System (INIS)

    Han, Na Yeon; Kim, Min Ju; Park, Beon Jin; Sung, Deuk Jae; Chung, Kyoo Byung; Oh, Yu Whan

    2011-01-01

    To evaluate the association between the incidence of pulmonary metastasis on chest CT and the location of the primary tumor on rectal MRI. One hundred and nine consecutive patients with rectal adenocarcinoma underwent chest CT and 3T rectal MRI. Two radiologists classified the tumor on MRI as an upper (> 10 cm from the anal verge), mid (5-10 cm), or lower rectal tumor (< 5 cm) by consensus. All chest CT scans were retrospectively reviewed for the presence of metastasis. We used Fisher's exact test to evaluate the correlation between the incidence of pulmonary metastasis with the location of the rectal cancer and the Mantel-Haenszel test to control for local tumor stage. We only included the 60 patients with upper (n = 26) or lower (n = 34) rectal cancer, because of the complicated venous drainage system of the mid rectum. Among these, 9 (15%) showed evidence of pulmonary metastasis on chest CT and almost all (89%, 8/9) patients had lower rectal cancer. The incidence of pulmonary metastasis between the two groups was statistically different (p < 0.05) when local tumor stage was controlled. The incidence of pulmonary metastasis was significantly higher for lower than upper rectal cancers when the T-stage of the tumor was accounted for.

  15. Generalized structured component analysis a component-based approach to structural equation modeling

    CERN Document Server

    Hwang, Heungsun

    2014-01-01

    Winner of the 2015 Sugiyama Meiko Award (Publication Award) of the Behaviormetric Society of Japan Developed by the authors, generalized structured component analysis is an alternative to two longstanding approaches to structural equation modeling: covariance structure analysis and partial least squares path modeling. Generalized structured component analysis allows researchers to evaluate the adequacy of a model as a whole, compare a model to alternative specifications, and conduct complex analyses in a straightforward manner. Generalized Structured Component Analysis: A Component-Based Approach to Structural Equation Modeling provides a detailed account of this novel statistical methodology and its various extensions. The authors present the theoretical underpinnings of generalized structured component analysis and demonstrate how it can be applied to various empirical examples. The book enables quantitative methodologists, applied researchers, and practitioners to grasp the basic concepts behind this new a...

  16. A sensory analysis of butter cookies: An application of generalized procrustes analysis

    DEFF Research Database (Denmark)

    Juhl, Hans Jørn

    1994-01-01

    Executive Summary: 1. A sensory analysis is one of the first steps in product development in the food industry. A thorough analysis of the results from such an analysis may give important input to the development process. 2. A sensory analysis on butter cookies is conducted in order to evaluate...... if some butter may be replaced by vegetable fat without a significant change in the sensory profile. The conclusion is that the replacement is possible without a considerable change in the sensory profile. 3. Generalized Procrustes Analysis is used to analyze the results. It is a relatively new technique...

  17. Efficacy and Safety of Metronidazole Monotherapy versus Vancomycin Monotherapy or Combination Therapy in Patients with Clostridium difficile Infection: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Rui Li

    Full Text Available Clostridium difficile infection (CDI has become a global epidemiological problem for both hospitalized patients and outpatients. The most commonly used drugs to treat CDI are metronidazole and vancomycin. The aim of this study was to compare the efficacy and safety of metronidazole monotherapy with vancomycin monotherapy and combination therapy in CDI patients.A comprehensive search without publication status or other restrictions was conducted. Studies comparing metronidazole monotherapy with vancomycin monotherapy or combination therapy in patients with CDI were considered eligible. Meta-analysis was performed using the Mantel-Haenszel fixed-effects model, and odds ratios (ORs with 95% confidence intervals (95% CIs were calculated and reported.Of the 1910 records identified, seventeen studies from thirteen articles (n = 2501 patients were included. No statistically significant difference in the rate of clinical cure was found between metronidazole and vancomycin for mild CDI (OR = 0.67, 95% CI (0.45, 1.00, p = 0.05 or between either monotherapy and combination therapy for CDI (OR = 1.07, 95% CI (0.58, 1.96, p = 0.83; however, the rate of clinical cure was lower for metronidazole than for vancomycin for severe CDI (OR = 0.46, 95% CI (0.26, 0.80, p = 0.006. No statistically significant difference in the rate of CDI recurrence was found between metronidazole and vancomycin for mild CDI (OR = 0.99, 95% CI (0.40, 2.45, p = 0.98 or severe CDI (OR = 0.98, 95% CI (0.63, 1.53, p = 0.94 or between either monotherapy and combination therapy for CDI (OR = 0.91, 95% CI (0.66, 1.26, p = 0.56. In addition, there was no significant difference in the rate of adverse events (AEs between metronidazole and vancomycin (OR = 1.18, 95% CI (0.80, 1.74, p = 0.41. In contrast, the rate of AEs was significantly lower for either monotherapy than for combination therapy (OR = 0.30, 95% CI (0.17, 0.51, p < 0.0001.Metronidazole and vancomycin are equally effective for the

  18. A General Approach to Causal Mediation Analysis

    Science.gov (United States)

    Imai, Kosuke; Keele, Luke; Tingley, Dustin

    2010-01-01

    Traditionally in the social sciences, causal mediation analysis has been formulated, understood, and implemented within the framework of linear structural equation models. We argue and demonstrate that this is problematic for 3 reasons: the lack of a general definition of causal mediation effects independent of a particular statistical model, the…

  19. Colombeau's generalized functions and non-standard analysis

    International Nuclear Information System (INIS)

    Todorov, T.D.

    1987-10-01

    Using some methods of the Non-Standard Analysis we modify one of Colombeau's classes of generalized functions. As a result we define a class ε-circumflex of the so-called meta-functions which possesses all good properties of Colombeau's generalized functions, i.e. (i) ε-circumflex is an associative and commutative algebra over the system of the so-called complex meta-numbers C-circumflex; (ii) Every meta-function has partial derivatives of any order (which are meta-functions again); (iii) Every meta-function is integrable on any compact set of R n and the integral is a number from C-circumflex; (iv) ε-circumflex contains all tempered distributions S', i.e. S' is contained in ε' isomorphically with respect to all linear operations (including the differentiation). Thus, within the class ε-circumflex the problem of multiplication of the tempered distributions is satisfactorily solved (every two distributions in S' have a well-defined product in ε-circumflex). The crucial point is that C-circumflex is a field in contrast to the system of Colombeau's generalized numbers C-bar which is a ring only (C-bar is the counterpart of C-circumflex in Colombeau's theory). In this way we simplify and improve slightly the properties of the integral and notion of ''values of the meta-functions'' as well as the properties of the whole class ε-circumflex itself if compared with the original Colombeau theory. And, what is maybe more important, we clarify the connection between the Non-Standard Analysis and Colombeau's theory of new generalized functions in the framework of which the problem of multiplication of distributions was recently solved. (author). 14 refs

  20. Zinc supplementation for treating diarrhea in children: a systematic review and meta-analysis Administración de suplementos de zinc para tratar la diarrea infantil: revisión sistemática y metanálisis

    Directory of Open Access Journals (Sweden)

    Tais Freire Galvao

    2013-05-01

    Full Text Available OBJECTIVE: To update the available evidence about zinc use for treating diarrhea in children and to assess its effect on the malnourished population, a subgroup that has not been fully explored in previous analyses. METHODS: A systematic review was performed of randomized clinical trials that assessed children up to 5 years old with acute diarrhea who received zinc supplementation. Controls received a placebo or oral rehydration therapy. After searching the main databases, without language restrictions, two independent reviewers selected eligible studies, extracted the data, and assessed the risk of bias of included studies. Meta-analyses were calculated using Mantel-Haenszel or inverse variance random effects. RESULTS: Eighteen of 1 041 studies retrieved were included in the review (n = 7 314 children. Zinc was beneficial for reducing the duration of diarrhea in hours (mean difference [MD] = -20.12, 95% confidence interval [CI] = -29.15 to -11.09, I² = 91%. The effect was greater in malnourished children (MD = -33.17, 95% CI = -33.55 to -27.79, I² = 0%. Diarrhea prevalence on days 3, 5, and 7 was lower in the zinc group. The incidence of vomiting was significantly greater in the group that received zinc than in the control group. Included randomized controlled trials were of low risk of bias in most domains assessed. CONCLUSIONS: Oral zinc supplementation significantly decreases diarrhea duration and has a greater effect on malnourished children. Zinc supplementation seems to be an appropriate public health strategy, mainly in areas of endemic deficiencies.OBJETIVO: Actualizar los datos probatorios disponibles acerca del uso del zinc en el tratamiento de la diarrea infantil y evaluar su efecto en la población malnutrida, un subgrupo no plenamente estudiado en análisis anteriores. MÉTODOS: Se llevó a cabo una revisión sistemática de ensayos clínicos aleatorizados que evaluaban a niños de hasta 5 años de edad con diarrea aguda y a los

  1. Embarazo en la adolescencia y conocimientos sobre sexualidad Pregnancy in adolescence and knowledge about sexuality

    Directory of Open Access Journals (Sweden)

    Oscar Soto Martínez

    2003-12-01

    Full Text Available Se realizó un estudio de casos y controles con el propósito de identificar los factores de riesgo sobre los conocimientos sexuales y el embarazo en la adolescencia. Se estudiaron a todas las pacientes (37 con edades entre 12 y 19 años, pertenecientes al Policlínico "Emilio Daudinot", embarazadas en el año 1998 (casos y, 37 adolescentes (controles que nunca han estado embarazadas, de igual área de salud y edades que los casos. Las variables estudiadas son: edad óptima para el embarazo, los días fértiles para el embarazo, la responsabilidad exclusiva de la mujer en el embarazo, el aborto como método anticonceptivo, y las complicaciones del embarazo en la adolescencia. Se aplicó un cuestionario a cada una de las adolescentes. Los datos fueron procesados en SPSS 9,0. Se obtuvo la significación de la asociación mediante la prueba X2 de Mantell-Haenszel, prefijándose un 95 % para el intervalo de confianza. A las variables significativas se les determinó el grado de asociación mediante el odds ratio. Resultaron significativas de forma bivariada el desconocimiento de edad óptima para el embarazo (OR 7,04 [2,51-19,76], el desconocimiento de los días fértiles (OR 0,25 [0,08-0,832], considerar el embarazo como responsabilidad exclusiva de la mujer (OR 3,12 [1,54-4,33], considerar el aborto como método anticonceptivo (OR 5,74 [2,14-15,42], así como el desconocimiento de las complicaciones del embarazo (OR 2,74 [1,08-6,96].A case-control study was conducted aimed at identifying the risk factors about sexual knowledge and pregnancy in adolescence. All the patients (37 aged 12-19 from "Emilio Daudinot" Polyclinic that got pregnant in 1998 (cases and 37 adolescents (controls that never were pregnant with the same age and from the same area than the cases were studied. The following variables were analyzed: optimum age for pregnancy, abortion as a contraceptive method and pregnancy complications in adolescence. Each adolescent answered a

  2. Algebraic structures in generalized Clifford analysis and applications to boundary value problems

    Directory of Open Access Journals (Sweden)

    José Játem

    2015-12-01

    Full Text Available The present article has a threefold purpose: First it is a survey of the algebraic structures of generalized Clifford-type algebras and shows the main results of the corresponding Clifford-type analysis and its application to boundary value problems known so far. Second it is aimed to implement algorithms to provide the fast and accurate computation of boundary value problems for inhomogeneous equations in the framework of the generalized Clifford analysis. Finally it is also aimed to encourage the development of a generalized discrete Clifford analysis.

  3. Lactancia materna: impacto de la consulta de apoyo a la madre que trabaja Breast feeding: impact of the support consultation to the working mother

    Directory of Open Access Journals (Sweden)

    Soledad Elgueta Noy

    1998-07-01

    studied is formed by 82 mothers attended in the Support Consultation during March '95/ September '95 period and from which a number of 30 people were taken as a sample. The impact of this consultation was evaluated with an instrument employed during an interview to each mother. Data were statistically analyzed with EPIINFO, the Kaplan-Meier survival method and the Mantel-Haenszel test to compare curves of survival. During data analysis authors found that mothers are mainly young adults, stable couples, first-time mothers, with technical and/or professional educational level, chiefly working as office clerks with full-time jobs and having a significant difference between existing minimum salary and the maximum one they earn. The results of this investigation lead us to the conclusion that mothers obtained an exclusive breast-feeding and ideal weaning age.The power of resolution of the Consultation -according to mothers- was satisfactory.The support given to the mother after her reincorporation to work is the most significant intensifier factor in relation with the increase in the probability of keeping on breast-feeding. In conclusion, the Consultation has good impact.

  4. Influence of angiotensin converting enzyme (ACE) gene rs4362 polymorphism on the progression of kidney failure in patients with autosomal dominant polycystic kidney disease (ADPKD).

    Science.gov (United States)

    Ramanathan, Gnanasambandan; Ghosh, Santu; Elumalai, Ramprasad; Periyasamy, Soundararajan; Lakkakula, Bhaskar V K S

    2016-06-01

    Autosomal dominant polycystic kidney disease (ADPKD) is an inherited systemic disorder, characterized by the fluid filled cysts in the kidneys leading to end stage renal failure in later years of life. Hypertension is one of the major factors independently contributing to the chronic kidney disease (CKD) progression. The renin-angiotensin aldosterone system (RAAS) genes have been extensively studied as hypertension candidate genes. The aim of the present study was to investigate the role of angiotensin converting enzyme tagging - single nucleotide polymorphisms (ACE tag-SNPs) in progression of CKD in patients with ADPKD. m0 ethods: In the present study six ACE tagSNPs (angiotensin converting enzyme tag single nucleotide polymorphisms) and insertion/deletion (I/D) in 102 ADPKD patients and 106 control subjects were investigated. The tagSNPs were genotyped using FRET-based KASPar method and ACE ID by polymerase chain reaction (PCR) and electrophoresis. Genotypes and haplotypes were compared between ADPKD patients and controls. Univariate and multivariate logistic regression analyses were performed to assess the effect of genotypes and hypertension on CKD advancement. Mantel-Haenszel (M-H) stratified analysis was performed to study the relationship between different CKD stages and hypertension and their interaction. All loci were polymorphic and except rs4293 SNP the remaining loci followed Hardy-Weinberg equilibrium. Distribution of ACE genotypes and haplotypes in controls and ADPKD patients was not significant. A significant linkage disequilibrium (LD) was observed between SNPs forming two LD blocks. The univariate analysis revealed that the age, hypertension, family history of diabetes and ACE rs4362 contributed to the advancement of CKD. The results suggest that the ACE genotypes are effect modifiers of the relationship between hypertension and CKD advancement among the ADPKD patients.

  5. A general first-order global sensitivity analysis method

    International Nuclear Information System (INIS)

    Xu Chonggang; Gertner, George Zdzislaw

    2008-01-01

    Fourier amplitude sensitivity test (FAST) is one of the most popular global sensitivity analysis techniques. The main mechanism of FAST is to assign each parameter with a characteristic frequency through a search function. Then, for a specific parameter, the variance contribution can be singled out of the model output by the characteristic frequency. Although FAST has been widely applied, there are two limitations: (1) the aliasing effect among parameters by using integer characteristic frequencies and (2) the suitability for only models with independent parameters. In this paper, we synthesize the improvement to overcome the aliasing effect limitation [Tarantola S, Gatelli D, Mara TA. Random balance designs for the estimation of first order global sensitivity indices. Reliab Eng Syst Safety 2006; 91(6):717-27] and the improvement to overcome the independence limitation [Xu C, Gertner G. Extending a global sensitivity analysis technique to models with correlated parameters. Comput Stat Data Anal 2007, accepted for publication]. In this way, FAST can be a general first-order global sensitivity analysis method for linear/nonlinear models with as many correlated/uncorrelated parameters as the user specifies. We apply the general FAST to four test cases with correlated parameters. The results show that the sensitivity indices derived by the general FAST are in good agreement with the sensitivity indices derived by the correlation ratio method, which is a non-parametric method for models with correlated parameters

  6. Generalized linear models with random effects unified analysis via H-likelihood

    CERN Document Server

    Lee, Youngjo; Pawitan, Yudi

    2006-01-01

    Since their introduction in 1972, generalized linear models (GLMs) have proven useful in the generalization of classical normal models. Presenting methods for fitting GLMs with random effects to data, Generalized Linear Models with Random Effects: Unified Analysis via H-likelihood explores a wide range of applications, including combining information over trials (meta-analysis), analysis of frailty models for survival data, genetic epidemiology, and analysis of spatial and temporal models with correlated errors.Written by pioneering authorities in the field, this reference provides an introduction to various theories and examines likelihood inference and GLMs. The authors show how to extend the class of GLMs while retaining as much simplicity as possible. By maximizing and deriving other quantities from h-likelihood, they also demonstrate how to use a single algorithm for all members of the class, resulting in a faster algorithm as compared to existing alternatives. Complementing theory with examples, many of...

  7. Variational analysis and generalized differentiation I basic theory

    CERN Document Server

    Mordukhovich, Boris S

    2006-01-01

    Contains a study of the basic concepts and principles of variational analysis and generalized differentiation in both finite-dimensional and infinite-dimensional spaces. This title presents many applications to problems in optimization, equilibria, stability and sensitivity, control theory, economics, mechanics, and more.

  8. Nonlinear analysis of generalized cross-field current instability

    International Nuclear Information System (INIS)

    Yoon, P.H.; Lui, A.T.Y.

    1993-01-01

    Analysis of the generalized cross-field current instability is carried out in which cross-field drift of both the ions and electrons and their temperatures are permitted to vary in time. The unstable mode under consideration is the electromagnetic generalization of the classical modified-two-stream instability. The generalized instability is made of the modified-two-stream and ion-Weibel modes. The relative importance of the features associated with the ion-Weibel mode and those of the modified-two-stream mode is assessed. Specific applications are made to the Earth's neutral sheet prior to substorm onset and to the Earth's bow shock. The numerical solution indicates that the ion-Weibel mode dominates in the Earth's neutral sheet environment. In contrast, the situation for the bow shock is dominated by the modified-two-stream mode. Notable differences are found between the present calculation and previous results on ion-Weibel mode which restrict the analysis to only parallel propagating waves. However, in the case of Earth's bow shock for which the ion-Weibel mode plays no important role, the inclusion of the electromagnetic ion response is found to differ little from the previous results which treats ions responding only to the electrostatic component of the excited waves

  9. Postpartum education for contraception: a systematic review.

    Science.gov (United States)

    Lopez, Laureen M; Hiller, Janet E; Grimes, David A

    2010-05-01

    Contraceptive education is generally considered a standard component of postpartum care, but the effectiveness is seldom examined. Two-thirds of postpartum women may have unmet needs for contraception, and many adolescents become pregnant again within a year of giving birth. Women may prefer to discuss contraception prenatally or after hospital discharge. The objective of this systematic review was to assess the effects of educational interventions for postpartum mothers about contraceptive use. We searched computerized databases for randomized controlled trials that evaluated the effectiveness of postpartum contraceptive education. The intervention must have started within 1 month after delivery. The Mantel-Haenszel odds ratio was calculated with 95% confidence interval for the dichotomous outcomes. Eight trials met the inclusion criteria. Of 4 short-term interventions, 1 did not have sufficient data and 1 was statistically underpowered. The remaining 2 showed a positive effect on contraceptive use. Of 4 multifaceted programs, 2 showed fewer pregnancies or births among adolescents in the experimental group that had enhanced services, and 1 structured home-visiting program showed more contraceptive use. The effective interventions were conducted in Australia, Nepal, Pakistan, and the United States. Postpartum education about contraception led to more contraception use and fewer unplanned pregnancies. Short-term interventions were limited by self-reported outcomes or showing no effect for many comparisons. The longer-term programs were promising and not necessarily more costly than usual care. Health care providers can determine if 1 of these interventions suits their setting and level of resources. Obstetricians & Gynecologist, Family Physicians. After completing this educational activity, the participant should be better able to assess the importance of assessing delivery methods when examining intervention quality, evaluate the evidence from randomized trials on

  10. Codon 972 polymorphism in the insulin receptor substrate-1 gene, obesity, and risk of noninsulin-dependent diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Sigal, R.J.; Doria, A.; Warram, J.H.; Krolewski, A.S. [Joslin Diabetes Center, Boston, MA (United States)

    1996-04-01

    Because of the role of insulin receptor substrate-1 in insulin action, the insulin receptor substrate-1 gene is a candidate gene for noninsulin-dependent diabetes mellitus (NIDDM). Modest associations between NIDDM and a GGG-AGG single base substitution (corresponding to a glycine-arginine amino acid substitution) in codon 972 of the gene have been found, but none reached statistical significance. To examine further how large a proportion of NIDDM cases could be caused by the mutation, we performed a stratified analysis combining the results from the 6 earlier studies and those from our panel of 192 unrelated NIDDM subjects and 104 healthy controls. In addition, we looked for a possibility that the codon 972 mutation plays a role only in the presence of certain conditions. Genomic DNA samples obtained from NIDDM cases and healthy controls were genotyped using a PCR-restriction fragment length polymorphism protocol modified for genomic DNA. The GGG{r_arrow}AGG substitution was found in 5.7% of the diabetic subjects (11 of 192) and 6.9% of the controls (7 of 104). The difference between groups was not statistically significant, and it was not different from the results of other studies. The Mantel-Haenszel summary odds ratio across all studies was 1.49 (P < 0.05; 95% confidence intervals, 1.01-2.2). This summary odds ratio is consistent with a small proportion of NIDDM cases ({approximately}3%) being caused by the mutation. Exploratory subgroup analyses on our panel suggested a clustering of NIDDM, the codon 972 mutation, and overweight, raising the hypothesis that the mutation may predispose to NIDDM only in the presence of excess body weight. 9 refs., 2 tabs.

  11. Emergency department treatment of viral gastritis using intravenous ondansetron or dexamethasone in children.

    Science.gov (United States)

    Stork, Christine M; Brown, Kathleen M; Reilly, Tracey H; Secreti, LaLaina; Brown, Lawrence H

    2006-10-01

    To compare the efficacy of intravenous ondansetron or dexamethasone compared with intravenous fluid therapy alone in children presenting to the emergency department with refractory vomiting from viral gastritis who had failed attempts at oral hydration. This double-blind, randomized, controlled trial was performed in a tertiary care pediatric emergency department. Children aged 6 months to 12 years presenting with more than three episodes of vomiting in the past 24 hours, mild/moderate dehydration, and failed oral hydration were included. Patients with other medical causes were excluded. Subjects were randomized to dexamethasone 1 mg/kg (15 mg maximum), ondansetron 0.15 mg/kg, or placebo (normal saline [NS], 10 mL). All subjects also received intravenous NS at 10-20 mL/kg/hr. Oral fluid tolerance was evaluated at two and four hours. Those not tolerating oral fluids at four hours were admitted. Discharged patients were evaluated at 24 and 72 hours for vomiting and repeat health care visits. The primary study outcome was hospitalization rates between the groups. Data were analyzed using chi-square test, Kruskal-Wallis test, Mantel-Haenszel test, and analysis of variance, with p hydration than NS-treated patients (29 [67.4%]; relative risk, 1.28; 95% confidence interval = 1.02 to 1.68). There were no differences in number of mean episodes of vomiting or repeat visits to health care at 24 and 72 hours in the ondansetron, dexamethasone, or NS groups. In children with dehydration secondary to vomiting from acute viral gastritis, ondansetron with intravenous rehydration improves tolerance of oral fluids after two hours and reduces the hospital admission rate when compared with intravenous rehydration with or without dexamethasone.

  12. Relationships between Brachial-Ankle Pulse Wave Velocity and Peripheral Neuropathy in Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Byung Kil Ha

    2012-12-01

    Full Text Available BackgroundBrachial-ankle pulse wave velocity (baPWV is known to be a good surrogate marker of clinical atherosclerosis. Atherosclerosis is a major predictor for developing neuropathy. The goal of this study was to determine the relationship between baPWV and diabetic peripheral neuropathy (DPN in patients with type 2 diabetes.MethodsA retrospective cross-sectional study was conducted involving 692 patients with type 2 diabetes. The correlation between increased baPWV and DPN, neurological symptoms, and neurological assessment was analyzed. DPN was examined using the total symptom score (TSS, ankle reflexes, the vibration test, and the 10-g monofilament test. DPN was defined as TSS ≥2 and an abnormal neurological assessment. Data were expressed as means±standard deviation for normally distributed data and as median (interquartile range for non-normally distributed data. Independent t-tests or chi-square tests were used to make comparisons between groups, and a multiple logistic regression test was used to evaluate independent predictors of DPN. The Mantel-Haenszel chi-square test was used to adjust for age.ResultsPatients with DPN had higher baPWV and systolic blood pressure, and were more likely to be older and female, when compared to the control group. According to univariate analysis of risk factors for DPN, the odds ratio of the baPWV ≥1,600 cm/sec was 1.611 (95% confidence interval [CI], 1.072 to 2.422; P=0.021 and the odds ratio in female was 1.816 (95% CI, 1.195 to 2.760; P=0.005.ConclusionIncreased baPWV was significantly correlated with peripheral neuropathy in patients with type 2 diabetes.

  13. The Frequency of Academic Burnout and Related Factors among Medical Students at Shahid Beheshti University of Medical Sciences, Tehran, in 2016

    Directory of Open Access Journals (Sweden)

    Hadi Azimi

    2016-03-01

    Full Text Available Abstract  Background: Academic burnout is the state of negative emotions and low motivation in one’s education. Understanding the status of academic burnout is the primary step to make proper decisions. The present study, therefore, was conducted to investigate comparative degrees of academic burnout among medical students in their first five semesters of medical education at Shahid Beheshti University of Medical Sciences, Tehran, Iran.  Methods: In the present cross-sectional study, a total of 525 medical students at the School of Medicine filled out the Persian version of Maslach Burnout Inventory – Student Survey from January 15 to February 5, 2016. Chi-square, Mantel-Haenszel, and Kruskal–Wallis tests were run in SPSS for data analysis. P-value<0.05 was considered significant.  Results: Based on the collected data, it was shown that 49.2% of the participants were male and 50.8% were female. Only 8 (1.5% participants were married. No statistically significant difference was observed between the variables investigated and academic burnout (P>0.05. It was also observed that only four (0.8% medical students (all new-comers were in low academic burnout group and 521 (99.2% were categorized in medium academic burnout group. Finally, it was found that academic burnout of the students increase as their educational level advance, making the first-semester students having the lowest and fifth-semester students the highest academic burnout indices (P<0.001.  Conclusion: It is concluded that, from among the variables studied, only students’ educational level made a difference in medical students’ academic burnout.Keywords: Academic efficacy; Burnout; Cynicism; Exhaustion; Medical Students 

  14. Extension problem for generalized multi-monogenic functions in Clifford analysis

    International Nuclear Information System (INIS)

    Tran Quyet Thang.

    1992-10-01

    The main purpose of this paper is to extend some properties of multi-monogenic functions, which is a generalization of monogenic functions in higher dimensions, for a class of functions satisfying Vekua-type generalized Cauchy-Riemann equations in Clifford Analysis. It is proved that the Hartogs theorem is valid for these functions. (author). 7 refs

  15. Texture Analysis Using Rényi’s Generalized Entropies

    NARCIS (Netherlands)

    Grigorescu, S.E.; Petkov, N.

    2003-01-01

    We propose a texture analysis method based on Rényi’s generalized entropies. The method aims at identifying texels in regular textures by searching for the smallest window through which the minimum number of different visual patterns is observed when moving the window over a given texture. The

  16. Analysis of Lamellar Structures with Application of Generalized Functions

    Directory of Open Access Journals (Sweden)

    Kipiani Gela

    2016-12-01

    Full Text Available Theory of differential equations in respect of the functional area is based on the basic concepts on generalized functions and splines. There are some basic concepts related to the theory of generalized functions and their properties are considered in relation to the rod systems and lamellar structures. The application of generalized functions gives the possibility to effectively calculate step-variable stiffness lamellar structures. There are also widely applied structures, in that several in which a number of parallel load bearing layers are interconnected by discrete-elastic links. For analysis of system under study, such as design diagrams, there are applied discrete and discrete-continual models.

  17. Download this PDF file

    African Journals Online (AJOL)

    GB

    However, there are no efforts to synthesis the findings of these studies. The objective of this meta-analysis was to determine the strength of the association of birth in the health facility with selected sociodemographic factors. METHODS: A meta-analysis of Mantel–Haenszel odds ratios was conducted by including 24 articles.

  18. Uncertainty Analysis of Few Group Cross Sections Based on Generalized Perturbation Theory

    International Nuclear Information System (INIS)

    Han, Tae Young; Lee, Hyun Chul; Noh, Jae Man

    2014-01-01

    In this paper, the methodology of the sensitivity and uncertainty analysis code based on GPT was described and the preliminary verification calculations on the PMR200 pin cell problem were carried out. As a result, they are in a good agreement when compared with the results by TSUNAMI. From this study, it is expected that MUSAD code based on GPT can produce the uncertainty of the homogenized few group microscopic cross sections for a core simulator. For sensitivity and uncertainty analyses for general core responses, a two-step method is available and it utilizes the generalized perturbation theory (GPT) for homogenized few group cross sections in the first step and stochastic sampling method for general core responses in the second step. The uncertainty analysis procedure based on GPT in the first step needs the generalized adjoint solution from a cell or lattice code. For this, the generalized adjoint solver has been integrated into DeCART in our previous work. In this paper, MUSAD (Modues of Uncertainty and Sensitivity Analysis for DeCART) code based on the classical perturbation theory was expanded to the function of the sensitivity and uncertainty analysis for few group cross sections based on GPT. First, the uncertainty analysis method based on GPT was described and, in the next section, the preliminary results of the verification calculation on a VHTR pin cell problem were compared with the results by TSUNAMI of SCALE 6.1

  19. General classification and analysis of neutron β-decay experiments

    International Nuclear Information System (INIS)

    Gudkov, V.; Greene, G.L.; Calarco, J.R.

    2006-01-01

    A general analysis of the sensitivities of neutron β-decay experiments to manifestations of possible interaction beyond the standard model is carried out. In a consistent fashion, we take into account all known radiative and recoil corrections arising in the standard model. This provides a description of angular correlations in neutron decay in terms of one parameter, which is accurate to the level of ∼10 -5 . Based on this general expression, we present an analysis of the sensitivities to new physics for selected neutron decay experiments. We emphasize that the usual parametrization of experiments in terms of the tree-level coefficients a,A, and B is inadequate when the experimental sensitivities are at the same or higher level relative to the size of the corrections to the tree-level description

  20. A general numerical analysis program for the superconducting quasiparticle mixer

    Science.gov (United States)

    Hicks, R. G.; Feldman, M. J.; Kerr, A. R.

    1986-01-01

    A user-oriented computer program SISCAP (SIS Computer Analysis Program) for analyzing SIS mixers is described. The program allows arbitrary impedance terminations to be specified at all LO harmonics and sideband frequencies. It is therefore able to treat a much more general class of SIS mixers than the widely used three-frequency analysis, for which the harmonics are assumed to be short-circuited. An additional program, GETCHI, provides the necessary input data to program SISCAP. The SISCAP program performs a nonlinear analysis to determine the SIS junction voltage waveform produced by the local oscillator. The quantum theory of mixing is used in its most general form, treating the large signal properties of the mixer in the time domain. A small signal linear analysis is then used to find the conversion loss and port impedances. The noise analysis includes thermal noise from the termination resistances and shot noise from the periodic LO current. Quantum noise is not considered. Many aspects of the program have been adequately verified and found accurate.

  1. Trends in Ambulatory Prescribing of Antiplatelet Therapy among US Ischemic Stroke Patients: 2000–2007

    Directory of Open Access Journals (Sweden)

    Sudeep Karve

    2012-01-01

    Full Text Available Objective. Study objectives were to assess temporal trends and identify patient- and practice-level predictors of the prescription of antiplatelet medications in a national sample of ischemic stroke (IS patients seeking ambulatory care. Methods. IS-related outpatient visits by adults were identified using the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey for the years 2000–2007. We assessed prescribing of antiplatelet medications using the generic drug code and drug entry codes in these data. Temporal trends in antiplatelet prescribing were assessed using the Cochran-Mantel-Haenszel test for trend. Results. We identified 9.5 million IS-related ambulatory visits. Antiplatelet medications were prescribed at 35.5% of visits. Physician office prescribing of the clopidogrel-aspirin combination increased significantly from 0.5% in 2000 to 22.0% in 2007 (P=0.05, whereas prescribing of aspirin decreased from 17.9% to 7.0% (P=0.50 during the same period. Conclusion. We observed a continued increase in prescription of the aspirin-clopidogrel combination from 2000 to 2007. Clinical trial evidence suggests that the aspirin-clopidogrel combination does not provide any additional benefit compared with clopidogrel alone; however, our study findings indicate that even with lack of adequate clinical evidence physician prescribing of this combination has increased in real-world community settings.

  2. An Efficient Stepwise Statistical Test to Identify Multiple Linked Human Genetic Variants Associated with Specific Phenotypic Traits.

    Directory of Open Access Journals (Sweden)

    Iksoo Huh

    Full Text Available Recent advances in genotyping methodologies have allowed genome-wide association studies (GWAS to accurately identify genetic variants that associate with common or pathological complex traits. Although most GWAS have focused on associations with single genetic variants, joint identification of multiple genetic variants, and how they interact, is essential for understanding the genetic architecture of complex phenotypic traits. Here, we propose an efficient stepwise method based on the Cochran-Mantel-Haenszel test (for stratified categorical data to identify causal joint multiple genetic variants in GWAS. This method combines the CMH statistic with a stepwise procedure to detect multiple genetic variants associated with specific categorical traits, using a series of associated I × J contingency tables and a null hypothesis of no phenotype association. Through a new stratification scheme based on the sum of minor allele count criteria, we make the method more feasible for GWAS data having sample sizes of several thousands. We also examine the properties of the proposed stepwise method via simulation studies, and show that the stepwise CMH test performs better than other existing methods (e.g., logistic regression and detection of associations by Markov blanket for identifying multiple genetic variants. Finally, we apply the proposed approach to two genomic sequencing datasets to detect linked genetic variants associated with bipolar disorder and obesity, respectively.

  3. Case-control study of leukemia at a naval nuclear shipyard

    International Nuclear Information System (INIS)

    Stern, F.B.; Waxweiler, R.A.; Beaumont, J.J.

    1986-01-01

    A matched case-control study was conducted of 53 leukemia deaths and of 212 controls within a previously studied cohort of 24,545 on-shore workers employed between January 1, 1952 and August 15, 1977 at the Portsmouth (New Hampshire) Naval Shipyard. The study sought to ascertain a priori whether there was an association between leukemia deaths and occupational exposure to either ionizing radiation or organic solvents. To obtain information on individual exposures, radiation dose histories and detailed work histories by job and shop were evaluated for each subject. No statistically significant associations were found either between ionizing radiation or presumed solvent exposure and myelogenous or lymphatic leukemia. However, when specific job categories and shops were examined without benefit of a priori hypotheses, two occupations, electrician and welder, were found to be associated with leukemia. For electricians, the Mantel-Haenszel odds ratio (ORMH) was significantly elevated for all leukemias (ORMH = 3.00, 95% confidence interval (CI) = 1.29-6.98), particularly for lymphatic leukemia (ORMH = 6.00, 95% CI = 1.47-24.45). For welders, the odds ratio was not significantly elevated for all leukemias (ORMH = 2.25, 95% CI = 0.92-5.53), but was significantly elevated for myeloid leukemia (ORMH = 3.83, 95% CI = 1.28-11.46). These findings persisted when potential confounders were adjusted by means of a conditional logistic regression model

  4. Sterilization Effect of Wet Oxygen Plasma in the Bubbling Method.

    Science.gov (United States)

    Tamazawa, Kaoru; Shintani, Hideharu; Tamazawa, Yoshinori; Shimauchi, Hidetoshi

    2015-01-01

    A new low-temperature sterilization method to replace the ethylene oxide gas sterilization is needed. Strong bactericidal effects of OH and O2H radicals are well known. The purpose of this study was to evaluate the sterilization effect of wet oxygen ("O2+H2O") plasma in the bubbling method, confirming the effect of humidity. Sterility assurance was confirmed by using a biological indicator (Geobacillus stearothermophilus ATCC7953, Namsa, USA). One hundred and eight samples (10(5) spores/carrier) were divided into three groups of 36 in each for treatment with a different type of gas (O2, O2+H2O, Air+H2O). Plasma processing was conducted using a plasma ashing apparatus (13.56 MHz, PACK-3(®), Y. A. C., Japan) under various gas pressures (13, 25, 50 Pa) and gas flows (50, 100, 200 sccm). Fixed plasma treatment parameters were power at 150 W, temperature of 60 ℃, treatment time of 10 min. The samples after treatment were incubated in trypticase soy broth at 58 ℃ for 72 h. The negative culture rate in the "O2+H2O" group was significantly (Mantel-Haenszel procedure, pbubbling method which is the method of introducing vapor into the chamber. The bubbling method seems able to generate OH and O2H radicals in a stable way.

  5. Residential rurality and oral health disparities: influences of contextual and individual factors.

    Science.gov (United States)

    Ahn, SangNam; Burdine, James N; Smith, Matthew Lee; Ory, Marcia G; Phillips, Charles D

    2011-02-01

    The purposes of the study were (a) to identify disparities between urban and rural adults in oral health and (b) to examine contextual (i.e., external environment and access to dental care) and individual (i.e., predisposing, enabling, and lifestyle behavioral) factors associated with oral health problems in a community population. Study data were derived from a two-stage, telephone-mailed survey conducted in 2006. The subjects were 2,591 adults aged 18 years and older. Cochran-Mantel-Haenszel statistics for categorical variables were applied to explore conditional independence between both health access and individual factors and oral health problems after controlling for the urban or rural residence. Logistic regression was used to investigate the simultaneous associations of contextual and individual factors in both rural and urban areas. Approximately one quarter (24.1%) of the study population reported oral health problems. Participants residing in rural areas reported more oral health disparities. Oral health problems were significantly associated with delaying dental care. These problems also were more common among those who were less educated, were African American, skipped breakfast every day, and currently smoked. The study findings suggest that oral health disparities persist for people in rural areas, and improving oral health status is strongly related to better access to oral health care and improved lifestyles in both rural and urban areas.

  6. Prayer for Health and Primary Care: Results From the 2002 National Health Interview Survey

    Science.gov (United States)

    Wilkinson, Joanne E.; Saper, Robert B.; Rosen, Amy K.; Welles, Seth L.; Culpepper, Larry

    2009-01-01

    Background and Objectives Prayer for health (PFH) is common; in 2002, 35% of US adults prayed for their health. We examined the relationship of PFH and primary care visits, with a special focus on African American women, using data from the 2002 National Health Interview Survey (NHIS). Methods We used chi-square analyses to compare the demographic (age group, gender, race, region, marital status, educational level, ethnicity) and health-related covariates (alcohol use, smoking status, and selected medical conditions) between individuals who did and did not pray for their health in the past year. Univariate associations between PFH and visit to primary care provider (PCP), with Mantel-Haenszel adjustment for confounding, were determined. Multivariate regression was used to determine independent factors associated with PFH and PCP visit, with SUDAAN to adjust for the clustered survey design. Results Subjects who prayed were more likely to be female, older than 58, Black, Southern, separated, divorced or widowed, and nondrinkers. Subjects who prayed were also more likely to have seen a PCP within the past year. Black women who prayed were also more likely to see a PCP. Conclusions These findings suggest that people who pray for their health do so in addition to, not instead of, seeking primary care. This finding is maintained but with a smaller effect size, in Black women. PMID:18830839

  7. Dezocine for Preventing Postoperative Pain: A Meta-Analysis of Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Xuelong Zhou

    Full Text Available Dezocine is considered to be an alternative medication for managing postoperative pain. The aim of this study was to assess the efficacy and safety of this drug in this regard.Medline, EMBASE and the Cochrane Central Register of Control Trials (CENTRAL were searched to identify all randomized controlled trials (RCTs that compare dezocine with placebo or dezocine with morphine on postoperative pain. The data were extracted and pooled using Mantel-Haenszel random effects model. Heterogeneity was tested using the I2 statistic with values >50% and Chi2 test with P ≤ 0.05 indicating obvious heterogeneity between the studies.Seven trials evaluating 665 patients were included. The number of patients with at least 50% pain relief was increased (N = 234; RR 3.04, 95% CI 2.27 to 4.08 and physician (N = 465; RR 2.84, 95% CI 1.66 to 4.84 and patient satisfaction (N = 390; RR 2.81, 95% CI 1.85 to 4.26 were improved following the administration of dezocine compared with the placebo. The effects of dezocine were similar to those of morphine in terms of the number of patients reporting at least 50% pain relief within 2-6 h after surgery (N = 235; RR 1.29, 95% CI 1.15 to 1.46 and physician (N = 234; RR 1.18, 95% CI 0.93 to 1.49 and patient (N = 158; RR 1.33, 95% CI 0.93 to 1.92 satisfaction. While, the number of patients with at least 50% pain relief within 0-1 h after surgery increased following dezocine compared with morphine treatment (N = 79; RR 1.45, 95% CI 1.18 to 1.77. There was no difference in the incidence of postoperative nausea and vomiting (PONV following dezocine treatment compared with the placebo (N = 391; RR 1.06, 95% CI 0.42 to 2.68 or morphine treatment (N = 235; RR 0.65, 95% CI 0.14 to 2.93.Dezocine is a promising analgesic for preventing postoperative pain, but further studies are required to evaluate its safety.

  8. Minimising post-operative risk using a Post-Anaesthetic Care Tool (PACT): protocol for a prospective observational study and cost-effectiveness analysis.

    Science.gov (United States)

    Street, Maryann; Phillips, Nicole M; Kent, Bridie; Colgan, Stephen; Mohebbi, Mohammadreza

    2015-06-01

    While the risk of adverse events following surgery has been identified, the impact of nursing care on early detection of these events is not well established. A systematic review of the evidence and an expert consensus study in post-anaesthetic care identified essential criteria for nursing assessment of patient readiness for discharge from the post-anaesthetic care unit (PACU). These criteria were included in a new nursing assessment tool, the Post-Anaesthetic Care Tool (PACT), and incorporated into the post-anaesthetic documentation at a large health service. The aim of this study is to test the clinical reliability of the PACT and evaluate whether the use of PACT will (1) enhance the recognition and response to patients at risk of deterioration in PACU; (2) improve documentation for handover from PACU nurse to ward nurse; (3) result in improved patient outcomes and (4) reduce healthcare costs. A prospective, non-randomised, pre-implementation and post-implementation design comparing: (1) patients (n=750) who have surgery prior to the implementation of the PACT and (2) patients (n=750) who have surgery after PACT. The study will examine the use of the tool through the observation of patient care and nursing handover. Patient outcomes and cost-effectiveness will be determined from health service data and medical record audit. Descriptive statistics will be used to describe the sample and compare the two patient groups (pre-intervention and post-intervention). Differences in patient outcomes between the two groups will be compared using the Cochran-Mantel-Haenszel test and regression analyses and reported as ORs with the corresponding 95% CIs. This study will test the clinical reliability and cost-effectiveness of the PACT. It is hypothesised that the PACT will enable nurses to recognise and respond to patients at risk of deterioration, improve handover to ward nurses, improve patient outcomes, and reduce healthcare costs. Published by the BMJ Publishing Group

  9. Generalized modeling of the fractional-order memcapacitor and its character analysis

    Science.gov (United States)

    Guo, Zhang; Si, Gangquan; Diao, Lijie; Jia, Lixin; Zhang, Yanbin

    2018-06-01

    Memcapacitor is a new type of memory device generalized from the memristor. This paper proposes a generalized fractional-order memcapacitor model by introducing the fractional calculus into the model. The generalized formulas are studied and the two fractional-order parameter α, β are introduced where α mostly affects the fractional calculus value of charge q within the generalized Ohm's law and β generalizes the state equation which simulates the physical mechanism of a memcapacitor into the fractional sense. This model will be reduced to the conventional memcapacitor as α = 1 , β = 0 and to the conventional memristor as α = 0 , β = 1 . Then the numerical analysis of the fractional-order memcapacitor is studied. And the characteristics and output behaviors of the fractional-order memcapacitor applied with sinusoidal charge are derived. The analysis results have shown that there are four basic v - q and v - i curve patterns when the fractional order α, β respectively equal to 0 or 1, moreover all v - q and v - i curves of the other fractional-order models are transition curves between the four basic patterns.

  10. Multigroup Moderation Test in Generalized Structured Component Analysis

    Directory of Open Access Journals (Sweden)

    Angga Dwi Mulyanto

    2016-05-01

    Full Text Available Generalized Structured Component Analysis (GSCA is an alternative method in structural modeling using alternating least squares. GSCA can be used for the complex analysis including multigroup. GSCA can be run with a free software called GeSCA, but in GeSCA there is no multigroup moderation test to compare the effect between groups. In this research we propose to use the T test in PLS for testing moderation Multigroup on GSCA. T test only requires sample size, estimate path coefficient, and standard error of each group that are already available on the output of GeSCA and the formula is simple so the user does not need a long time for analysis.

  11. Coronary Computed Tomography Angiography vs Functional Stress Testing for Patients With Suspected Coronary Artery Disease: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Foy, Andrew J; Dhruva, Sanket S; Peterson, Brandon; Mandrola, John M; Morgan, Daniel J; Redberg, Rita F

    2017-11-01

    Coronary computed tomography angiography (CCTA) is a new approach for the diagnosis of anatomical coronary artery disease (CAD), but it is unclear how CCTA performs compared with the standard approach of functional stress testing. To compare the clinical effectiveness of CCTA with that of functional stress testing for patients with suspected CAD. A systematic literature search was conducted in PubMed and MEDLINE for English-language randomized clinical trials of CCTA published from January 1, 2000, to July 10, 2016. Researchers selected randomized clinical trials that compared a primary strategy of CCTA with that of functional stress testing for patients with suspected CAD and reported data on patient clinical events and changes in therapy. Two reviewers independently extracted data from and assessed the quality of the trials. This analysis followed the PRISMA statement for reporting systematic reviews and meta-analyses and used the Cochrane Collaboration's tool for assessing risk of bias in randomized trials. The Mantel-Haenszel method was used to conduct the primary analysis. Summary relative risks were calculated with a random-effects model. The outcomes of interest were all-cause mortality, cardiac hospitalization, myocardial infarction, invasive coronary angiography, coronary revascularization, new CAD diagnoses, and change in prescription for aspirin and statins. Thirteen trials were included, with 10 315 patients in the CCTA arm and 9777 patients in the functional stress testing arm who were followed up for a mean duration of 18 months. There were no statistically significant differences between CCTA and functional stress testing in death (1.0% vs 1.1%; risk ratio [RR], 0.93; 95% CI, 0.71-1.21) or cardiac hospitalization (2.7% vs 2.7%; RR, 0.98; 95% CI, 0.79-1.21), but CCTA was associated with a reduction in the incidence of myocardial infarction (0.7% vs 1.1%; RR, 0.71; 95% CI, 0.53-0.96). Patients undergoing CCTA were significantly more likely to undergo

  12. The effect of participation in a pro-poor dairy development project on ...

    African Journals Online (AJOL)

    Chi-square and Cochran–Mantel–Haenszel analyses identified factors associated with whether milk was consumed in the previous 24-hour period. Analysis of variance (ANOVA) identified factors associated with frequency of milk consumption. Multivariable logistic regression was applied to estimate associations between ...

  13. Generalized concavity in fuzzy optimization and decision analysis

    CERN Document Server

    Ramík, Jaroslav

    2002-01-01

    Convexity of sets in linear spaces, and concavity and convexity of functions, lie at the root of beautiful theoretical results that are at the same time extremely useful in the analysis and solution of optimization problems, including problems of either single objective or multiple objectives. Not all of these results rely necessarily on convexity and concavity; some of the results can guarantee that each local optimum is also a global optimum, giving these methods broader application to a wider class of problems. Hence, the focus of the first part of the book is concerned with several types of generalized convex sets and generalized concave functions. In addition to their applicability to nonconvex optimization, these convex sets and generalized concave functions are used in the book's second part, where decision-making and optimization problems under uncertainty are investigated. Uncertainty in the problem data often cannot be avoided when dealing with practical problems. Errors occur in real-world data for...

  14. Analysis of Financial Ratio to Distinguish Indonesia Joint Venture General Insurance Company Performance using Discriminant Analysis

    Directory of Open Access Journals (Sweden)

    Subiakto Soekarno

    2012-01-01

    Full Text Available Insurance industry stands as a service business that plays a significant role in Indonesiaeconomical condition. The development of insurance industry in Indonesia, both of generalinsurance and life insurance, has increased very fast. The general insurance industry itselfdivided into two major players which are local private company and Joint Venture Company.Lately, the use of statistical techniques and financial ratios models to asses financial institutionsuch as insurance company have been used as one of the appropriate combination inpredicting the performance of an industry. This research aims to distinguish between JointVenture General Insurance Companies that have a good performance and those who are lessperforming well using Discriminant Analysis. Further, the findings led that DiscriminantAnalysis is able to distinguish Joint Venture General Insurance Companies that have a goodperformance and those who are not performing well. There are also six ratios which are RBC,Technical Reserve to Investment Ratio, Debt Ratio, Return on Equity, Loss Ratio, and ExpenseRatio that stand as the most influential ratios to distinguish the performance of joint venturegeneral insurance companies. In addition, the result suggest business people to be concernedtoward those six ratios, to increase their companies’ performance.Key words: general insurance, financial ratio, discriminant analysis

  15. Extreme learning machine for ranking: generalization analysis and applications.

    Science.gov (United States)

    Chen, Hong; Peng, Jiangtao; Zhou, Yicong; Li, Luoqing; Pan, Zhibin

    2014-05-01

    The extreme learning machine (ELM) has attracted increasing attention recently with its successful applications in classification and regression. In this paper, we investigate the generalization performance of ELM-based ranking. A new regularized ranking algorithm is proposed based on the combinations of activation functions in ELM. The generalization analysis is established for the ELM-based ranking (ELMRank) in terms of the covering numbers of hypothesis space. Empirical results on the benchmark datasets show the competitive performance of the ELMRank over the state-of-the-art ranking methods. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Systematic review and meta-analysis of serious infections with tofacitinib and biologic disease-modifying antirheumatic drug treatment in rheumatoid arthritis clinical trials.

    Science.gov (United States)

    Strand, Vibeke; Ahadieh, Sima; French, Jonathan; Geier, Jamie; Krishnaswami, Sriram; Menon, Sujatha; Checchio, Tina; Tensfeldt, Thomas G; Hoffman, Elaine; Riese, Richard; Boy, Mary; Gómez-Reino, Juan J

    2015-12-15

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Tofacitinib modulates the signaling of cytokines that are integral to lymphocyte activation, proliferation, and function. Thus, tofacitinib therapy may result in suppression of multiple elements of the immune response. Serious infections have been reported in tofacitinib RA trials. However, limited head-to-head comparator data were available within the tofacitinib RA development program to directly compare rates of serious infections with tofacitinib relative to biologic agents, and specifically adalimumab (employed as an active control agent in two randomized controlled trials of tofacitinib). A systematic literature search of data from interventional randomized controlled trials and long-term extension studies with biologics in RA was carried out. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) consensus was followed for reporting results of the review and meta-analysis. Incidence rates (unique patients with events/100 patient-years) for each therapy were estimated based on data from randomized controlled trials and long-term extension studies using a random-effects model. Relative and absolute risk comparisons versus placebo used Mantel-Haenszel methods. The search produced 657 hits. In total, 66 randomized controlled trials and 22 long-term extension studies met the selection criteria. Estimated incidence rates (95% confidence intervals [CIs]) for abatacept, rituximab, tocilizumab, and tumor necrosis factor inhibitors were 3.04 (2.49, 3.72), 3.72 (2.99, 4.62), 5.45 (4.26, 6.96), and 4.90 (4.41, 5.44), respectively. Incidence rates (95% CIs) for tofacitinib 5 and 10 mg twice daily (BID) in phase 3 trials were 3.02 (2.25, 4.05) and 3.00 (2.24, 4.02), respectively. Corresponding incidence rates in long-term extension studies were 2.50 (2.05, 3.04) and 3.19 (2.74, 3.72). The risk ratios (95% CIs) versus placebo for tofacitinib 5 and 10 mg BID

  17. Tritium analysis of urine samples from the general Korean public.

    Science.gov (United States)

    Yoon, Seokwon; Ha, Wi-Ho; Lee, Seung-Sook

    2013-11-01

    The tritium concentrations of urine samples and the effective dose of the general Korean public were evaluated. To achieve accurate HTO analysis of urine samples, we established the optimal conditions for measuring the HTO content of urine samples. Urine samples from 50 Koreans who do not work at a nuclear facility were analyzed on the basis of the results. The average urine analysis result was 2.8 ±1 .4 Bq/L, and the range was 1.8-5.6 Bq/L. The measured values were lower than those reported for other countries. These results show that environmental factors and lifestyle differences are the main factors affecting the tritium level of the general public. © 2013 Elsevier Ltd. All rights reserved.

  18. Is MTHFR polymorphism a risk factor for Alzheimer's disease like APOE? Polimorfismo da MTHFR é um fator de risco para demência de Alzheimer como APOE?

    Directory of Open Access Journals (Sweden)

    Liana Lisboa Fernandez

    2005-03-01

    Full Text Available BACKGROUND: The role of methylenetetrahydrofolate reductase (MTHFR gene polymorphisms as risk factors for the occurence of Alzheimer's disease (AD is still controversial: OBJECTIVE: To verify the association between MTHFR and apolipoprotein E (APOE polymorphisms and Alzheimer's disease. METHOD: This work was conducted as a case-control study. Cases included thirty patients with probable AD. Controls were constituted by 29 individuals without dementia according to neuropsychological tests paired to age, sex, race and educational level. DNA was isolated from peripheral leukocytes of anticoagulated venous blood. Genotyping of APOE and MTHFR were performed by DNA amplification and digestion. The frequences of APOE and MTHFR genotypes were submitted by chi-square test corrected by Fisher test; the APOE genotypes, to chi-square linear tendency test and the frequences of MTHFR mutant and AD, by stratificated anlysis adjust by Mantel-Haenszel method. RESULTS: There was significant difference about APOE4 and APOE2 in the groups. (p=0.002 The odds ratio increased exponentially with the increased number of E4 allele (chi2 linear tendency test. No significant difference was detected on MTHFR genotypes in both case and control groups. CONCLUSION: The APOE4 is a risk factor and demonstrated a dose-depenent effect while APOE2 allele conferred a protection to AD. The MTHFR mutation had no correlation with AD.INTRODUÇÃO: O papel do polimorfismo do gene da metilenotetrahidrofolato redutase (MTHFR como um fator de risco para demência de Alzheimer (DA é controverso ainda. OBJETIVO: Verificar a associação entre os polimorfismos da MTHFR e apolipoproteína E (APOE e DA. MÉTODO: O trabalho foi conduzido como um estudo caso-controle. Trinta pacientes com DA provável foram incluídos no grupo caso. Vinte e nove indivíduos sem demência comprovadas por testes neuropsicológicos, emparelhados pela idade, sexo, cor e nível educacional constituíram o grupo

  19. Intervención educativa para la prevención cardiovascular en adolescentes de secundaria básica.

    Directory of Open Access Journals (Sweden)

    Yuri Arnold Domínguez

    2011-08-01

    Full Text Available

    Fundamento: Los estilos de vida saludables incorporados de manera temprana, podrían actuar sobre las más importantes conductas y factores de riesgo para la enfermedad vascular aterosclerótica, con el objeto de disminuir la incidencia de esta en la edad adulta.
    Objetivo
    : Evaluar la efectividad de la intervención educativa-participativa en los conocimientos de los estudiantes en relación a los factores de riesgos cardiovasculares.
    Material
    : Se realizó una intervención educativa, con un diseño cuasiexperimental, en el período comprendido entre Abril de 2007 y Octubre de 2008, en estudiantes de octavo grado de Secundarias Básicas de los municipios Habana Vieja (grupo intervenido y Centro Habana (grupo control. Se utilizaron la Pruebas no paramétricas de Chi cuadrado de Mc Nemar y Mantel- Haenszel.
    Resultados: Se obtuvieron asociaciones estadísticas significativas con un límite de confianza de un 95 %, entre el estado inicial y final de los conocimientos en relación a los factores de riesgos cardiovasculares en el grupo intervenido (p=0,0001, en el grupo de control (p=0,035 y entre el grupo estudio con respecto al grupo control post-intervención (p=0,0001.
    Conclusiones
    : Un programa educativo-participativo de promoción de salud y prevención de los principales factores de riesgos de enfermedad cardiovascular (hábitos alimentarios inadecuados, tabaquismo y sedentarismo en los adolescentes, contribuye a que cambien sus conocimientos, e incentiva la adopción de hábitos cotidianos y estilos de vida saludables.

    EDUCATIONAL INTERVENTION FOR THE CARDIOVASCULAR PREVENTION IN ADOLESCENTS OF SECONDARY BASIC.

    Background: Healthy lifestyles incorporated in early ages could influence the most important behaviours and risk factors for atherosclerotic vascular disease

  20. Psychological treatment of generalized anxiety disorder: A meta-analysis.

    NARCIS (Netherlands)

    Cuijpers, P.; Sijbrandij, M.; Koole, S.L.; Huibers, M.J.H.; Berking, M.; Andersson, G.

    2014-01-01

    Recent years have seen a near-doubling of the number of studies examining the effects of psychotherapies for generalized anxiety disorder (GAD) in adults. The present article integrates this new evidence with the older literature through a quantitative meta-analysis. A total of 41 studies (with 2132

  1. Parallel Enhancements of the General Mission Analysis Tool, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The General Mission Analysis Tool (GMAT) is a state of the art spacecraft mission design tool under active development at NASA's Goddard Space Flight Center (GSFC)....

  2. Accounting for center in the Early External Cephalic Version trials: an empirical comparison of statistical methods to adjust for center in a multicenter trial with binary outcomes.

    Science.gov (United States)

    Reitsma, Angela; Chu, Rong; Thorpe, Julia; McDonald, Sarah; Thabane, Lehana; Hutton, Eileen

    2014-09-26

    Clustering of outcomes at centers involved in multicenter trials is a type of center effect. The Consolidated Standards of Reporting Trials Statement recommends that multicenter randomized controlled trials (RCTs) should account for center effects in their analysis, however most do not. The Early External Cephalic Version (EECV) trials published in 2003 and 2011 stratified by center at randomization, but did not account for center in the analyses, and due to the nature of the intervention and number of centers, may have been prone to center effects. Using data from the EECV trials, we undertook an empirical study to compare various statistical approaches to account for center effect while estimating the impact of external cephalic version timing (early or delayed) on the outcomes of cesarean section, preterm birth, and non-cephalic presentation at the time of birth. The data from the EECV pilot trial and the EECV2 trial were merged into one dataset. Fisher's exact method was used to test the overall effect of external cephalic version timing unadjusted for center effects. Seven statistical models that accounted for center effects were applied to the data. The models included: i) the Mantel-Haenszel test, ii) logistic regression with fixed center effect and fixed treatment effect, iii) center-size weighted and iv) un-weighted logistic regression with fixed center effect and fixed treatment-by-center interaction, iv) logistic regression with random center effect and fixed treatment effect, v) logistic regression with random center effect and random treatment-by-center interaction, and vi) generalized estimating equations. For each of the three outcomes of interest approaches to account for center effect did not alter the overall findings of the trial. The results were similar for the majority of the methods used to adjust for center, illustrating the robustness of the findings. Despite literature that suggests center effect can change the estimate of effect in

  3. Generalized Multi-Edge Analysis for K-Edge Densitometry

    International Nuclear Information System (INIS)

    Collins, M.

    1998-01-01

    In K-edge densitometry (KED), a continuous-energy x-ray beam is transmitted through a liquid sample. The actinide content of the sample can be measured through analysis of the transmitted portion of the x-ray beam. Traditional methods for KED analysis allow the simultaneous calculation of, at most, two actinide concentrations. A generalized multi-edge KED analytical method is presented, allowing up to six actinide concentrations to be calculated simultaneously. Applications of this method for hybrid KED/x-ray fluorescence (HKED) systems are discussed. Current HKED systems require the operator to know the approximate actinide content of each sample, and manually select the proper analysis mode. The new multi-edge KED technique allows rapid identification of the major actinide components in a sample, independent of actinide content. The proper HKED analysis mode can be selected automatically, without requiring sample content information from the user. Automatic HKED analysis would be especially useful in an analytical laboratory setting, where samples with truly unknown characteristics are encountered. Because this technique requires no hardware modifications, several facilities that use HKED may eventually benefit from this approach

  4. Neutron activation analysis with k0-standardisation : general formalism and procedure

    International Nuclear Information System (INIS)

    Pomme, S.; Hardeman, F.; Robouch, P.; Etxebarria, N.; Arana, G.

    1997-09-01

    Instrumental neutron activation analysis (INAA) with k 0 -standardisation is a powerful tool for multi-element analysis at a broad range of trace element concentrations. An overview is given of the basic principles, fundamental equations, and general procedure of this method. Different aspects of the description of the neutron activation reaction rate are discussed, applying the Hogdahl convention. A general activation-decay formula is derived and its application to INAA is demonstrated. Relevant k 0 -definitions for different activation decay schemes are summarised and upgraded to cases of extremely high fluxes. The main standardisation techniques for INAA are discussed, emphasizing the k 0 -standardisation. Some general aspects of the basic equipment and its calibration are discussed, such as the characterisation of the neutron field and the tuning of the spectrometry part. A method for the prediction and optimisation of the analytical performance of INAA is presented

  5. Linking Brief Functional Analysis to Intervention Design in General Education Settings

    Science.gov (United States)

    Ishuin, Tifanie

    2009-01-01

    This study focused on the utility and applicability of brief functional analysis in general education settings. The purpose of the study was to first identify the environmental variables maintaining noncompliance through a brief functional analysis, and then to design and implement a functionally equivalent intervention. The participant exhibited…

  6. Generalization of the Fourier Convergence Analysis in the Neutron Diffusion Eigenvalue Problem

    International Nuclear Information System (INIS)

    Lee, Hyun Chul; Noh, Jae Man; Joo, Hyung Kook

    2005-01-01

    Fourier error analysis has been a standard technique for the stability and convergence analysis of linear and nonlinear iterative methods. Lee et al proposed new 2- D/1-D coupling methods and demonstrated several advantages of the new methods by performing a Fourier convergence analysis of the methods as well as two existing methods for a fixed source problem. We demonstrated the Fourier convergence analysis of one of the 2-D/1-D coupling methods applied to a neutron diffusion eigenvalue problem. However, the technique cannot be used directly to analyze the convergence of the other 2-D/1-D coupling methods since some algorithm-specific features were used in our previous study. In this paper we generalized the Fourier convergence analysis technique proposed and analyzed the convergence of the 2-D/1-D coupling methods applied to a neutron diffusion Eigenvalue problem using the generalized technique

  7. Stability analysis for a general age-dependent vaccination model

    International Nuclear Information System (INIS)

    El Doma, M.

    1995-05-01

    An SIR epidemic model of a general age-dependent vaccination model is investigated when the fertility, mortality and removal rates depends on age. We give threshold criteria of the existence of equilibriums and perform stability analysis. Furthermore a critical vaccination coverage that is sufficient to eradicate the disease is determined. (author). 12 refs

  8. An analysis of referrals received by a psychiatric unit in a general ...

    African Journals Online (AJOL)

    An analysis of referrals received by a psychiatric unit in a general hospital part 1: the need for and research design adopted to study referrals received by a psychiatric unit in a general hospital: research. M. Dor, V.J. Ehlers, M.M. Van der Merwe ...

  9. Genetic variation at the Th2 immune gene IL13 is associated with IgE-mediated paediatric food allergy.

    Science.gov (United States)

    Ashley, S E; Tan, H-T T; Peters, R; Allen, K J; Vuillermin, P; Dharmage, S C; Tang, M L K; Koplin, J; Lowe, A; Ponsonby, A-L; Molloy, J; Matheson, M C; Saffery, R; Ellis, J A; Martino, D

    2017-08-01

    Food allergies pose a considerable world-wide public health burden with incidence as high as one in ten in 12-month-old infants. Few food allergy genetic risk variants have yet been identified. The Th2 immune gene IL13 is a highly plausible genetic candidate as it is central to the initiation of IgE class switching in B cells. Here, we sought to investigate whether genetic polymorphisms at IL13 are associated with the development of challenge-proven IgE-mediated food allergy. We genotyped nine IL13 "tag" single nucleotide polymorphisms (tag SNPs) in 367 challenge-proven food allergic cases, 199 food-sensitized tolerant cases and 156 non-food allergic controls from the HealthNuts study. 12-month-old infants were phenotyped using open oral food challenges. SNPs were tested using Cochran-Mantel-Haenszel test adjusted for ancestry strata. A replication study was conducted in an independent, co-located sample of four paediatric cohorts consisting of 203 food allergic cases and 330 non-food allergic controls. Replication sample phenotypes were defined by clinical history of reactivity, 95% PPV or challenge, and IL13 genotyping was performed. IL13 rs1295686 was associated with challenge-proven food allergy in the discovery sample (P=.003; OR=1.75; CI=1.20-2.53). This association was also detected in the replication sample (P=.03, OR=1.37, CI=1.03-1.82) and further supported by a meta-analysis (P=.0006, OR=1.50). However, we cannot rule out an association with food sensitization. Carriage of the rs1295686 variant A allele was also associated with elevated total plasma IgE. We show for the first time, in two independent cohorts, that IL13 polymorphism rs1295686 (in complete linkage disequilibrium with functional variant rs20541) is associated with challenge-proven food allergy. © 2017 John Wiley & Sons Ltd.

  10. Renal effects of dexmedetomidine during coronary artery bypass surgery: a randomized placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Scheinin Harry

    2011-05-01

    Full Text Available Abstract Background Dexmedetomidine, an alpha2-adrenoceptor agonist, has been evaluated as an adjunct to anesthesia and for the delivery of sedation and perioperative hemodynamic stability. It provokes dose-dependent and centrally-mediated sympatholysis. Coronary artery bypass grafting (CABG with extracorporeal circulation is a stressful procedure increasing sympathetic nervous system activity which could attenuate renal function due the interrelation of sympathetic nervous system, hemodynamics and renal function. We tested the hypothesis that dexmetomidine would improve kidney function in patients undergoing elective CABG during the first two postoperative days. Methods This was a double-blind, randomized, parallel-group study. Patients with normal renal function and scheduled for elective CABG were randomized to placebo or to infusion of dexmedetomidine to achieve a pseudo steady-state plasma concentration of 0.60 ng/ml. The infusion was started after anesthesia induction and continued until 4 h after surgery. The primary endpoint was creatinine clearance. Other variables included urinary creatinine and output, fractional sodium and potassium excretion, urinary potassium, sodium and glucose, serum and urinary osmolality and plasma catecholamine concentrations. The data were analyzed with repeated-measures ANOVA or Cochran-Mantel-Haenszel test. Results Sixty-six of 87 randomized patients were evaluable for analysis. No significant between-group differences were recorded for any indices of renal function except for a mean 74% increase in urinary output with dexmedetomidine in the first 4 h after insertion of a urinary catheter (p Conclusions Use of intravenous dexmedetomidine did not alter renal function in this cohort of relatively low-risk elective CABG patients but was associated with an increase in urinary output. This study was carried out in 1994-1997 and was thus not registered.

  11. Epidemiologic study of breast cancer in a-bomb survivors

    International Nuclear Information System (INIS)

    Nakamura, Kenichi; McGregor, D.H.; Kato, Hiroo; Wakabayashi, Toshiro.

    1978-08-01

    A case-control study was made on female breast cancer cases and their matched controls in the Life Span Study sample. The index cases were detected during 1958-69 among the 251 breast cancer cases ascertained originally by McGregor et al. The purpose of this study was to define the epidemiologic risk factors of breast cancer among Japanese women, to test for radiation effects in the presence of other risk factors, and to search for interactions. The survey was conducted by interview at home visits for those residing in the Hiroshima and Nagasaki areas, and by mail survey for others. The interview was carried out by several trained interviewers. Information concerning suspected risk factors of breast cancer, such as familial history, education, age at menarche and menopause, marital history, reproductive history, history of breast feeding, etc., was collected for both index cases and controls. Out of 183 original pairs, analysis was made on 164 pairs with available information for both the index and control, using the method of matched samples described by Mantel and Haenszel. There was enhancement of risk for those exposed to high radiation dose (100 rad or more). Although most major results were similar to those of previous studies, a significant increase of risk was observed among those under one of the following conditions: actual duration of marriage was less than 10 years; number of pregnancies was two or less; and age at delivery of first live born child was 27 or over. These factors had a mutual interrelationship and cases with two or more of these risk factors showed higher risk than those with one. Additive interrelationship was demonstrated between radiation dose and these marital or reproductive risk factors in elevating the relative risk of breast cancer. (author)

  12. Marijuana use and increased risk of squamous cell carcinoma of the head and neck.

    Science.gov (United States)

    Zhang, Z F; Morgenstern, H; Spitz, M R; Tashkin, D P; Yu, G P; Marshall, J R; Hsu, T C; Schantz, S P

    1999-12-01

    Marijuana is the most commonly used illegal drug in the United States. In some subcultures, it is widely perceived to be harmless. Although the carcinogenic properties of marijuana smoke are similar to those of tobacco, no epidemiological studies of the relationship between marijuana use and head and neck cancer have been published. The relationship between marijuana use and head and neck cancer was investigated by a case-control study of 173 previously untreated cases with pathologically confirmed diagnoses of squamous cell carcinoma of the head and neck and 176 cancer-free controls at Memorial Sloan-Kettering Cancer Center between 1992 and 1994. Epidemiological data were collected by using a structured questionnaire, which included history of tobacco smoking, alcohol use, and marijuana use. The associations between marijuana use and head and neck cancer were analyzed by Mantel-Haenszel methods and logistic regression models. Controlling for age, sex, race, education, alcohol consumption, pack-years of cigarette smoking, and passive smoking, the risk of squamous cell carcinoma of the head and neck was increased with marijuana use [odds ratio (OR) comparing ever with never users, 2.6; 95% confidence interval (CI), 1.1-6.6]. Dose-response relationships were observed for frequency of marijuana use/day (P for trend marijuana use (P for trend marijuana use were observed with cigarette smoking, mutagen sensitivity, and to a lesser extent, alcohol use. Our results suggest that marijuana use may increase the risk of head and neck cancer with a strong dose-response pattern. Our analysis indicated that marijuana use may interact with mutagen sensitivity and other risk factors to increase the risk of head and neck cancer. The results need to be interpreted with some caution in drawing causal inferences because of certain methodological limitations, especially with regard to interactions.

  13. Evaluation of Safety and Efficacy of Qinming8631 DR Implantable Cardiac Pacemaker in Chinese Patients: A Prospective, Multicenter, Randomized Controlled Trial of the First Domestically Developed Pacemaker of China.

    Science.gov (United States)

    Xiang, Mei-Xiang; Wang, Dong-Qi; Xu, Jing; Zhang, Zheng; Hu, Jian-Xin; Wang, Dong-Mei; Gu, Xiang; Liu, He-Ping; Guo, Tao; Yang, Xiang-Jun; Ling, Feng; Lin, Jia-Feng; Cai, Shang-Lang; Zhu, Guo-Bin; Wang, Jian-An

    2016-11-20

    High cost of imported pacemakers is a main obstacle for Chinese patients suffering from bradyarrhythmia, and a domestically developed pacemaker will help lower the burden. This study aimed to evaluate the safety and efficacy of Qinming8631 DR (Qinming Medical, Baoji, China), the first domestically developed dual-chamber pacemaker of China, compared with a commercially available pacemaker Talos DR (Biotronik, Berlin, Germany) in Chinese patients. A prospective randomized trial was conducted at 14 centers in China. Participants were randomized into trial (Qinming8631 DR) and control (Talos DR) groups. Parameters of the pacing systems were collected immediately after device implantation and during follow-ups. The effective pacing rate at 6-month follow-up was recorded as the primary end point. Electrical properties, magnet response, single- and double-pole polarity conversion, rate response function, and adverse events of the pacing system were analyzed. The Cochran-Mantel-Haenszel Chi-square test, paired t-test, and Wilcoxon signed-rank test were used for measuring primary qualitative outcomes and comparing normally and abnormally distributed measurement data. A total of 225 patients with a diagnosis of bradyarrhythmia and eligible for this study were randomly enrolled into the trial (n = 113) and control (n = 112) groups. They underwent successful pacemaker implantation with acceptable postoperative pacing threshold and sensitivity. Effective pacing rates of trial and control groups were comparable both in the full analysis set and the per protocol set (81.4% vs. 79.5%, P = 0.712 and 95.4% vs. 89.5%, P = 0.143, respectively). In both data sets, noninferiority of the trial group was above the predefined noninferiority limit(-9.5%). This study established the noninferiority of Qinming8631 DR to Talos DR. The safety and efficacy of Qinming8631 DR pacemaker were comparable to those of Talos DR in treating patients with cardiac bradyarrhythmia.

  14. Tenofovir alafenamide versus tenofovir disoproxil fumarate: is there a true difference in efficacy and safety?

    Science.gov (United States)

    Hill, Andrew; Hughes, Sophie L; Gotham, Dzintars; Pozniak, Anton L

    2018-04-01

    Higher plasma tenofovir concentrations are associated with higher risks of renal and bone adverse events. The pharmacokinetic boosters ritonavir (RTV) and cobicistat (COBI) significantly increase plasma area under the curve (AUC) concentrations of tenofovir disoproxil fumarate (TDF), by 25-37%. When combined with RTV or COBI, the dose of tenofovir alafenamide (TAF) is lowered from 25 mg to 10 mg daily, but the TDF dose is maintained at 300 mg daily. To assess the differences in safety and efficacy between tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) in regimens with and without the pharmacokinetic boosters RTV and COBI. A PubMed/Embase search inclusive of dates up to 17 July 2017 identified 11 randomised head-to-head trials (8111 patients) of TDF versus TAF. The Mantel-Haenszel method was used to calculate pooled risk differences and 95% confidence intervals using random-effects models. A pre-defined sub-group analysis compared TAF with TDF, either when boosted with RTV or COBI, or when unboosted. Nine clinical trials compared TAF and TDF for treatment of HIV-1 and two were for hepatitis B treatment. The eleven clinical trials documented 4574 patients with boosting RTV or COBI in both arms, covering 7198 patient-years of follow-up. Some 3537 patients received unboosted regimens, totalling 3595 patient-years of follow-up. Boosted TDF-treated patients showed borderline lower HIV RNA suppression TAF and unboosted TDF. TDF boosted with RTV or COBI was associated with higher risks of bone and renal adverse events, and lower HIV RNA suppression rates, compared with TAF. By contrast, when ritonavir and cobicistat were not used, there were no efficacy differences between TAF and TDF, and marginal differences in safety. The health economic value of TAF versus low-cost generic TDF may be limited when these drugs are used without cobicistat or ritonavir.

  15. Effect of patient decision aid was influenced by presurgical evaluation among patients with osteoarthritis of the knee.

    Science.gov (United States)

    Boland, Laura; Taljaard, Monica; Dervin, Geoffrey; Trenaman, Logan; Tugwell, Peter; Pomey, Marie-Pascale; Stacey, Dawn

    2018-02-01

    Decision aids help patients make total joint arthroplasty decisions, but presurgical evaluation might influence the effects of a decision aid. We compared the effects of a decision aid among patients considering total knee arthroplasty at 2 surgical screening clinics with different evaluation processes. We performed a subgroup analysis of a randomized controlled trial. Patients were recruited from 2 surgical screening clinics: an academic clinic providing 20-minute physician consultations and a community clinic providing 45-minute physiotherapist/nurse consultations with education. We compared the effects of decision quality, decisional conflict and surgery rate using Cochran-Mantel-Haenszel χ 2 tests and the Breslow-Day test. We evaluated 242 patients: 123 from the academic clinic (61 who used the decision aid and 62 controls) and 119 from the community clinic (59 who used the decision aid and 60 controls). Results suggested a between-site difference in the effect of the decision aid on the patients' decision quality ( p = 0.09): at the academic site, patients who used the decision aid were more likely to make better-quality decisions than controls (54% v. 35%, p = 0.044), but not at the community site (47% v. 51%, p = 0.71). Fewer patients who used decision aids at the academic site than at the community site experienced decisional conflict ( p = 0.007) (33% v. 52%, p = 0.05 at the academic site and 40% v. 24%, p = 0.08 at the community site). The effect of the decision aid on surgery rates did not differ between sites ( p = 0.65). The decision aid had a greater effect at the academic site than at the community site, which provided longer consultations with more verbal education. Hence, decision aids might be of greater value when more extensive total knee arthroplasty presurgical assessment and counselling are either impractical or unavailable.

  16. New genetic associations in thiopurine-related bone marrow toxicity among inflammatory bowel disease patients.

    Science.gov (United States)

    Zabala, William; Cruz, Raquel; Barreiro-de Acosta, Manuel; Chaparro, María; Panes, Julián; Echarri, Ana; Esteve, Maria; Carpio, Daniel; Andreu, Montserrat; García-Planella, Esther; Domenech, Eugeni; Carracedo, Angel; Gisbert, Javier P; Barros, Francisco

    2013-04-01

    The toxicity related to thiopurine drug therapy for inflammatory bowel disease (IBD) varies widely among patients. Almost 15-30% of patients with IBD develop side effects during treatment, often bone marrow suppression. Several factors have been implicated in determining this toxicity, mainly individual genetic variation related to formation of active thiopurine metabolites. The aim was to identify genes involved in thiopurine-related myelosuppression. A two-stage investigation of 19,217 coding SNPs (cSNPs) was performed in a Spanish (Inflammatory Bowel Disease Group of Galicia [EIGA]) cohort of 173 IBD patients, 15 with bone marrow suppression. The top 20 cSNPs identified in the first stage with p ENEIDA) cohort (87 patients, 29 with bone marrow suppression). Several cSNPs showed a significant p-value in the allelic joint analysis (p-Cochran-Mantel-Haenszel test ≤2.55 × 10(-3)) despite no cSNP passing correction for multiple testing in the first cohort. Of note is rs3729961 in the gene IL6ST, a transducer signal chain shared by many cytokines including IL6 (p-value combined = 2.36 × 10(-4), odds ratio [95% CI]: 3.41 [1.71-6.78]). In addition, we detected association with rs3749598 in the FSTL5 gene that appears to interact with metalloproteases at the extracellular matrix level (p-value combined = 4.89 × 10(-4)), odds ratio (95% CI): 3.67 (1.68-8.01). We have identified IL6ST and FSLT5 as new bone marrow suppression susceptibility candidate genes after thiopurine treatment in IBD patients. This is the first report of variants associated with thiopurine-related myelosuppression that was identified by a genome-wide association study. Its validation awaits functional analyses and replication in additional studies. Original submitted 14 September 2012; Revision submitted 13 February 2013.

  17. Generalized Analysis of a Distribution Separation Method

    Directory of Open Access Journals (Sweden)

    Peng Zhang

    2016-04-01

    Full Text Available Separating two probability distributions from a mixture model that is made up of the combinations of the two is essential to a wide range of applications. For example, in information retrieval (IR, there often exists a mixture distribution consisting of a relevance distribution that we need to estimate and an irrelevance distribution that we hope to get rid of. Recently, a distribution separation method (DSM was proposed to approximate the relevance distribution, by separating a seed irrelevance distribution from the mixture distribution. It was successfully applied to an IR task, namely pseudo-relevance feedback (PRF, where the query expansion model is often a mixture term distribution. Although initially developed in the context of IR, DSM is indeed a general mathematical formulation for probability distribution separation. Thus, it is important to further generalize its basic analysis and to explore its connections to other related methods. In this article, we first extend DSM’s theoretical analysis, which was originally based on the Pearson correlation coefficient, to entropy-related measures, including the KL-divergence (Kullback–Leibler divergence, the symmetrized KL-divergence and the JS-divergence (Jensen–Shannon divergence. Second, we investigate the distribution separation idea in a well-known method, namely the mixture model feedback (MMF approach. We prove that MMF also complies with the linear combination assumption, and then, DSM’s linear separation algorithm can largely simplify the EM algorithm in MMF. These theoretical analyses, as well as further empirical evaluation results demonstrate the advantages of our DSM approach.

  18. A density Corradi-Hajnal theorem

    Czech Academy of Sciences Publication Activity Database

    Allen, P.; Böttcher, J.; Hladký, Jan; Piguet, D.

    2015-01-01

    Roč. 67, č. 4 (2015), s. 721-758 ISSN 0008-414X Institutional support: RVO:67985840 Keywords : extremal graph theory * Mantel's theorem * Corradi-Hajnal theorem Subject RIV: BA - General Mathematics Impact factor: 0.618, year: 2015 http://cms.math.ca/10.4153/CJM-2014-030-6

  19. Association between incision technique for hamstring tendon harvest in anterior cruciate ligament reconstruction and the risk of injury to the infra-patellar branch of the saphenous nerve: a meta-analysis.

    Science.gov (United States)

    Grassi, Alberto; Perdisa, Francesco; Samuelsson, Kristian; Svantesson, Eleonor; Romagnoli, Matteo; Raggi, Federico; Gaziano, Teide; Mosca, Massimiliano; Ayeni, Olufemi; Zaffagnini, Stefano

    2018-02-08

    To determine how the incision technique for hamstring tendon (HT) harvest in anterior cruciate ligament (ACL) reconstruction affects the risk of injury to the IPBSN and clinical outcome. A systematic literature search of the MEDLINE/Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL) and EBSCOhost electronic databases and clinicaltrials.gov for unpublished studies was performed to identify comparative studies investigating injury to the IPBSN after HT ACL reconstruction by comparing at least two different incision techniques. Data were extracted for the number of patients with evidence of any neurologic deficit corresponding to injury to the IPBSN, area of sensory deficit, the Lysholm score and patient satisfaction. The mean difference (MD) in study outcome between incision groups was assessed. The relative risk (RR) and the number needed to treat (NNT) were calculated. The Chi-square and Higgins' I 2 tests were applied to test heterogeneity. Data were pooled using a Mantel-Haenszel random-effects model if the statistical heterogeneity was > 50% and a fixed-effects model if the statistical heterogeneity was < 50%. The risk of bias was evaluated according to the Cochrane Database questionnaire and the quality of evidence was graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. A total of eight studies (three randomized controlled trials (RCTs) and five comparative studies) were included, of which six compared vertical and oblique incisions, one horizontal and vertical incisions, and one compared all three techniques. HT harvest was performed through a vertical incision in 329 patients, through an oblique incision in 195 patients and through a horizontal incision in 151 patients. Considering the meta-analysis of the RCTs, the performance of a vertical incision significantly increased the risk of causing IPBSN deficiency compared with both oblique and horizontal incision [RR 1.65 (CI 1

  20. Generalized Population Analysis of Three-Center Two-Electron Bonding

    Czech Academy of Sciences Publication Activity Database

    Ponec, Robert; Cooper, D. L.

    2004-01-01

    Roč. 97, č. 6 (2004), s. 1002-1011 ISSN 0020-7608 R&D Projects: GA AV ČR IAA4072006; GA MŠk OC D9.20 Institutional research plan: CEZ:AV0Z4072921 Keywords : multicenter bonding * generalized population analysis * post-Hartree Fock wave functions Subject RIV: CF - Physical ; The oretical Chemistry Impact factor: 1.392, year: 2004

  1. Infection prevention workforce: Potential benefits to educational diversity.

    Science.gov (United States)

    Reese, Sara M; Gilmartin, Heather M

    2017-06-01

    Nurses have historically occupied the infection preventionist (IP) role. As the knowledge and skills needed to advance the field expand, professionals from public health and the laboratory sciences have become IPs. Our study describes the characteristics of current IPs and assesses for relationships between background, certification, experience, and type of work performed. The data were drawn from an existing dataset collected in the conduct of the Association for Professionals in Infection Control and Epidemiology (APIC) MegaSurvey. Descriptive statistics were computed. Associations were calculated using χ 2 or Cochran-Mantel-Haenszel tests. Characteristics of IPs were stratified by work-related activities to allow for comparisons between groups. Of the 13,050 active APIC members, 4,079 participated in the survey (31% response rate). The primary job activity for nurses (97.9%; n = 2,434) was preventing and controlling the transmission of infectious agents or health care-associated infections, for laboratory scientists (97.5%; n = 307) it was the interpretation of surveillance data, and for public health professionals (96.1%; n = 136) it was management and communication: feedback. Infection control departments would benefit from hiring IPs with diverse education and training to address the expanding roles and responsibilities of IPs. This may facilitate the implementation of novel and innovative processes that will impact patient care. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  2. Association between ε2/3/4, Promoter Polymorphism (−491A/T, −427T/C, and −219T/G at the Apolipoprotein E Gene, and Mental Retardation in Children from an Iodine Deficiency Area, China

    Directory of Open Access Journals (Sweden)

    Jun Li

    2014-01-01

    Full Text Available Background. Several common single-nucleotide polymorphisms (SNPs at apolipoprotein E (ApoE have been linked with late onset sporadic Alzheimer’s disease and declining normative cognitive ability in elder people, but we are unclear about their relationship with cognition in children. Results. We studied -491A/T, -427T/C, and -219G/T promoter polymorphisms and ε2/ε3/ε4 at ApoE among children with mental retardation (MR, n=130, borderline MR (n=124, and controls (n=334 from an iodine deficiency area in China. The allelic and genotypic distribution of individual locus did not significantly differ among three groups with Mantel-Haenszel χ2 test (P>0.05. However, frequencies of haplotype of -491A/-427T/-219T/ε4 were distributed as MR > borderline MR > controls (P uncorrected = 0.004, indicating that the presence of this haplotype may increase the risk of disease. Conclusions. In this large population-based study in children, we did not find any significant association between single locus of the four common ApoE polymorphisms (-491A/T, -427T/C, -219T/G, and ε2/3/4 and MR or borderline MR. However, we found that the presence of ATTε4 haplotype was associated with an increased risk of MR and borderline MR. Our present work may help enlarge our knowledge of the cognitive role of ApoE across the lifespan and the mechanisms of human cognition.

  3. Comparing recurrent antibiotic prescriptions in children treated with a brand name or a generic formulation.

    Science.gov (United States)

    Piovani, Daniele; Clavenna, Antonio; Cartabia, Massimo; Bortolotti, Angela; Fortino, Ida; Merlino, Luca; Bonati, Maurizio

    2015-02-01

    The aim of this study was to investigate the rate of recurrent prescriptions and hospital admissions in children receiving a brand name or generic antibiotic prescription. The data source was a database of reimbursed prescriptions. Outpatient children/adolescents brand name formulations and for each age strata (0-5, 6-11, and 12-17 years old) for four antibiotics: amoxicillin, amoxicillin clavulanate, clarithromycin, and cefaclor. The percentage of therapy switches was calculated. Cochran-Mantel-Haenszel test was used to compare the age-adjusted outcomes. In all, 17.5% (57 346) of children received at least one recurrent prescription. The rate of recurrent prescriptions was slightly lower in children receiving any generic (OR 0.96; 95%CI 0.93-0.98), compared with any brand name, antibiotic. The percentage of hospital admissions occurring in children initially treated with a brand name (1.01%; 95%CI 0.98-1.08) or generic (1.03%; 0.96-1.06) antibiotic was not different (p = 0.43). For children receiving amoxicillin clavulanate, the hospital admission rate was slightly higher in the brand name group (p = 0.002), while no differences were found for the other active substances. Children treated with generic antibiotics had no worse safety and effectiveness outcomes when compared with those receiving brand name ones. These results provide additional evidence on the safety of generic antibiotics. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Colon distension, perceived burden and side-effects of CT-colonography for screening using hyoscine butylbromide or glucagon hydrochloride as bowel relaxant

    Energy Technology Data Exchange (ETDEWEB)

    Haan, Margriet C. de, E-mail: margrietcdehaan@gmail.com [Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Boellaard, Thierry N., E-mail: t.n.boellaard@amc.uva.nl [Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Bossuyt, Patrick M., E-mail: p.m.bossuyt@amc.uva.nl [Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Stoker, Jaap, E-mail: j.stoker@amc.uva.nl [Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2012-08-15

    Objective: Compare colonic distension and perceived burden of CT-colonography between participants receiving hyoscine butylbromide (buscopan) and glucagon hydrochloride as bowel relaxant. Materials and methods: Data were collected within a screening trial. Participants received 20 mg buscopan intravenously or 1 mg of glucagon intravenously (if buscopan contra-indicated). Colon distension per segment was assessed using a 4-point scale (prone and supine). Data on perceived burden of CT-colonography were collected using a questionnaire two weeks after the examination. Outcome measures between groups were compared using propensity score matching. We used a stratified Wilcoxon-Mann-Whitney test statistic for quantitative and Cochran-Mantel-Haenszel statistics for categorical variables. Results: 541 participants were included: 336 (62%) received buscopan and 205 received glucagon. All buscopan recipients had an adequately distended colon, compared to 96% in the glucagon group (RR 7.31, 95% CI: 1.61-33.28). More glucagon recipients scored the insufflation as rather or extremely burdensome (25% vs. 16%; overall mean score 2.7 vs. 2.4; p < 0.001) and more found the entire CT-colonography rather or extremely burdensome (14% vs. 7%; 2.2 vs. 1.9; p = 0.001). Most frequently reported side effects were a dry mouth in the buscopan group (15%) and nausea in the glucagon group (13%). Conclusion: Compared to glucagon, premedication with buscopan results in significantly more adequately distended colons and a less burdensome procedure. When buscopan can be used, it is the preferred bowel relaxant.

  5. Disparities in Prevalence of Cardiometablic Risk Factors in Rural, Urban-Poor, and Urban-Middle Class Women in India.

    Directory of Open Access Journals (Sweden)

    Indu Mohan

    Full Text Available Urbanization is an important determinant of cardiovascular disease (CVD risk. To determine location-based differences in CVD risk factors in India we performed studies among women in rural, urban-poor and urban middle-class locations.Population-based cross-sectional studies in rural, urban-poor, and urban-middle class women (35-70 y were performed at multiple sites. We evaluated 6853 women (rural 2616, 5 sites; urban-poor 2008, 4 sites; urban middle-class 2229, 11 sites for socioeconomic, lifestyle, anthropometric and biochemical risk factors. Descriptive statistics are reported.Mean levels of body mass index (BMI, waist circumference, waist-hip ratio (WHR, systolic BP, fasting glucose and cholesterol in rural, urban-poor and urban-middle class women showed significantly increasing trends (ANOVAtrend, p 80 cm (28.3, 63.4, 61.9%, waist >90 cm (8.4, 31.4, 38.2%, waist hip ratio (WHR >0.8 (60.4, 90.7, 88.5, WHR>0.9 (13.0, 44.3, 56.1%, hypertension (31.6, 48.2, 59.0% and hypercholesterolemia (13.5, 27.7, 37.4% (Mantel Haenszel X2 ptrend <0.01. Inverse trend was observed for tobacco use (41.6, 19.6, 9.4%. There was significant association of hypertension, hypercholesterolemia and diabetes with overweight and obesity (adjusted R2 0.89-0.99.There are significant location based differences in cardiometabolic risk factors in India. The urban-middle class women have the highest risk compared to urban-poor and rural.

  6. Third molars and periodontal pathology in American adolescents and young adults: a prevalence study.

    Science.gov (United States)

    Blakey, George H; Gelesko, Savannah; Marciani, Robert D; Haug, Richard H; Offenbacher, Steven; Phillips, Ceib; White, Raymond P

    2010-02-01

    To assess the association between visible third molars and the prevalence of periodontal inflammatory disease of non-third molars. Subjects aged 14 to 45 years with 4 asymptomatic third molars were enrolled in an institutional review board-approved study. Subjects were classified based on whether at least 1 third molar was visible or all third molars were not visible. Full-mouth periodontal probing depth (PD) data, with 6 sites per tooth, were obtained as a measure of a subject's periodontal status. At least 1 non-third molar PD of 4 mm or greater was indicative of periodontal inflammatory disease. Outcomes for the respective groups were compared by use of Cochran-Mantel-Haenszel row mean score statistics. The level of significance for differences was set at .05. The 342 subjects in the visible group were significantly older, with a median age of 26 years (interquartile range, 22.4-32.2 years), as compared with the 69 subjects in the not visible group, with a median age of 21 years (interquartile range, 18.8-24.9 years) (P .05). Most subjects were white. Significantly more subjects with at least a college education were in the visible group than in the not visible group (P adolescents and young adults was significantly associated with periodontal inflammatory disease of non-third molars. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Postgraduation retention of medical students from Otago and Auckland medical programmes.

    Science.gov (United States)

    Shelker, William; Poole, Phillippa; Bagg, Warwick; Wood, Ian; Glue, Paul

    2014-01-24

    Auckland and Otago medical programmes have different methods for selecting students. This study compared postgraduate retention in New Zealand (NZ) of medical graduates from the two medical programmes, to assess whether different selection methods influenced retention. Other variables assessed included entrance category and age at graduation. Anonymised databases were created of all graduates from the Otago Faculty of Medicine (1999-2011) and the Auckland medical programme (2000-2012). Demographic and entry category data were recorded. Retention was defined as presence on the NZ Medical Register in December 2012. Risk differences (RD) were calculated to compare retention between the two medical programmes using the Mantel-Haenszel method. The influence of medical programme entrance category on retention was also tested. The influence of covariates on retaining graduates on the register was evaluated using a multiple logistic regression model. The postgraduate retention of graduates of the two medical programmes over 13 years was identical (Auckland 74.9%, Otago 73.6%, P=0.48). Retention of graduate and non-graduate entry students from both medical programmes was similar by 6 years after graduation. Age during medical school did not affect retention. University of attendance had no effect on postgraduation retention of students on the NZ Medical Register, suggesting that retention is not influenced by the different student selection methods at each programme. The data presented shows that New Zealand graduates regardless of programme completed show a similar profile in terms of retention.

  8. Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis.

    Science.gov (United States)

    Battle, Ceri E; Hutchings, Hayley; Evans, Phillip A

    2012-01-01

    The risk factors for mortality following blunt chest wall trauma have neither been well established or summarised. To summarise the risk factors for mortality in blunt chest wall trauma patients based on available evidence in the literature. A systematic review of English and non-English articles using MEDLINE, EMBASE and the Cochrane Library from their introduction until May 2010. Additional studies were identified by hand-searching bibliographies and contacting relevant clinical experts. Grey literature was sought by searching abstracts from all Emergency Medicine conferences. Broad search terms and inclusion criteria were used to reduce the number of missed studies. A two step study selection process was used. All published and unpublished observational studies were included if they investigated estimates of association between a risk factor and mortality for blunt chest wall trauma patients. A two step data extraction process using pre-defined data fields, including study quality indicators. Each study was appraised using a previously designed quality assessment tool and the STROBE checklist. Where sufficient data were available, odds ratios with 95% confidence intervals were calculated using Mantel-Haenszel method for the risk factors investigated. The I(2) statistic was calculated for combined studies in order to assess heterogeneity. Age, number of rib fractures, presence of pre-existing disease and pneumonia were found to be related to mortality in 29 identified studies. Combined odds ratio of 1.98 (1.86-2.11, 95% CI), 2.02 (1.89-2.15, 95% CI), 2.43 (1.03-5.72, 95% CI) and 5.24 (3.51-7.82) for mortality were calculated for blunt chest wall trauma patients aged 65 years or more, with three or more rib fractures, pre-existing conditions and pneumonia respectively. The risk factors for mortality in patients sustaining blunt chest wall trauma were a patient age of 65 years or more, three or more rib fractures and the presence of pre-existing disease especially

  9. RAPD analysis of Nectomys squamipes (Rodentia, Sigmodontinae populations

    Directory of Open Access Journals (Sweden)

    Almeida Francisca C.

    2000-01-01

    Full Text Available Random amplified of polymorphic DNA (RAPD analysis was used to assess genetic distance and the genetic structure of populations of Nectomys squamipes, a semiaquatic rodent species distributed along watercourses. DNA samples of five populations were analyzed using three primers, producing 45 scorable bands, 31 of which were polymorphic. There was a significant differentiation among populations [F ST = 0.17; phiST = 0.14 (P < 0.004] but gene flow (Nm = 1.25 was sufficient to overcome genetic drift effects. No fixed specific markers were found for any population. The Mantel's test and UPGMA cluster analysis showed a lack of relationship between genetic and geographic distances. The apparent homogeneity indicated by RAPD markers coincided with morphometric data, despite the wide geographic range of N. squamipes. Alternative hypotheses for explaining our results include recurrent processes of local extinction and recolonization or a recent and sudden increase in the geographic distribution of this species.

  10. Neutron activation analysis with k{sub 0}-standardisation : general formalism and procedure

    Energy Technology Data Exchange (ETDEWEB)

    Pomme, S.; Hardeman, F. [Centre de l`Etude de l`Energie Nucleaire, Mol (Belgium); Robouch, P.; Etxebarria, N.; Arana, G. [European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel (Belgium)

    1997-09-01

    Instrumental neutron activation analysis (INAA) with k{sub 0}-standardisation is a powerful tool for multi-element analysis at a broad range of trace element concentrations. An overview is given of the basic principles, fundamental equations, and general procedure of this method. Different aspects of the description of the neutron activation reaction rate are discussed, applying the Hogdahl convention. A general activation-decay formula is derived and its application to INAA is demonstrated. Relevant k{sub 0}-definitions for different activation decay schemes are summarised and upgraded to cases of extremely high fluxes. The main standardisation techniques for INAA are discussed, emphasizing the k{sub 0}-standardisation. Some general aspects of the basic equipment and its calibration are discussed, such as the characterisation of the neutron field and the tuning of the spectrometry part. A method for the prediction and optimisation of the analytical performance of INAA is presented.

  11. A general numerical analysis of the superconducting quasiparticle mixer

    Science.gov (United States)

    Hicks, R. G.; Feldman, M. J.; Kerr, A. R.

    1985-01-01

    For very low noise millimeter-wave receivers, the superconductor-insulator-superconductor (SIS) quasiparticle mixer is now competitive with conventional Schottky mixers. Tucker (1979, 1980) has developed a quantum theory of mixing which has provided a basis for the rapid improvement in SIS mixer performance. The present paper is concerned with a general method of numerical analysis for SIS mixers which allows arbitrary terminating impedances for all the harmonic frequencies. This analysis provides an approach for an examination of the range of validity of the three-frequency results of the quantum mixer theory. The new method has been implemented with the aid of a Fortran computer program.

  12. General overview and perspectives of risk analysis in Cuba

    International Nuclear Information System (INIS)

    Torres, A.; Rodriguez, J.M.; Vilaragut, J.J.; Valhuerdi, C.

    1995-01-01

    This papers shows a general overview of the application of risk analysis techniques in some potentially dangerous industries in Cuba. This paper summarizes the experiences of these sectors in the risk analysis with different specification levels and different approaches. Some experiences in the application of these analyses in the nuclear and aeronautical industries are shown. Some analyses of consequences in cases of accidents in the chemical industries in order to work due and improve emergency plans for responding to accident situations are presented in a more succinct manner. Also the perspectives to develop some of these tendencies and cooperation forms between them are summarized

  13. Occurence of internet addiction in a general population sample: A latent class analysis

    NARCIS (Netherlands)

    Rumpf, H.J.; Vermulst, A.A.; Bischof, A.; Kastirke, N.; Gürtler, D.; Bischof, G.; Meerkerk, G.J.; John, U.; Meyer, C.

    2014-01-01

    Background: Prevalence studies of Internet addiction in the general population are rare. In addition, a lack of approved criteria hampers estimation of its occurrence. Aims: This study conducted a latent class analysis (LCA) in a large general population sample to estimate prevalence. Methods: A

  14. Generalized Correlation Coefficient for Non-Parametric Analysis of Microarray Time-Course Data.

    Science.gov (United States)

    Tan, Qihua; Thomassen, Mads; Burton, Mark; Mose, Kristian Fredløv; Andersen, Klaus Ejner; Hjelmborg, Jacob; Kruse, Torben

    2017-06-06

    Modeling complex time-course patterns is a challenging issue in microarray study due to complex gene expression patterns in response to the time-course experiment. We introduce the generalized correlation coefficient and propose a combinatory approach for detecting, testing and clustering the heterogeneous time-course gene expression patterns. Application of the method identified nonlinear time-course patterns in high agreement with parametric analysis. We conclude that the non-parametric nature in the generalized correlation analysis could be an useful and efficient tool for analyzing microarray time-course data and for exploring the complex relationships in the omics data for studying their association with disease and health.

  15. Treatment of Plaque-Type Psoriasis With Oral CF101: Data from a Phase II/III Multicenter, Randomized, Controlled Trial.

    Science.gov (United States)

    David, Michael; Gospodinov, Dimitar Konstantinov; Gheorghe, Nicola; Mateev, Grisha Stefanov; Rusinova, Mariyana Venelinova; Hristakieva, Evgeniya; Solovastru, Laura Gheuca; Patel, Rita V; Giurcaneanu, Calin; Hitova, Mariela Chepileva; Purcaru, Anca Ioana; Horia, Beti; Tsingov, Iliya Iliev; Yankova, Rumyana Kaloferova; Kadurina, Miroslava Ilieva; Ramon, Michal; Rotaru, Maria; Simionescu, Olga; Benea, Vasile; Demerdjieva, Zdravka Velichkova; Cosgarea, Maria Rodica; Morariu, Horia Silviu; Michael, Ziv; Cristodor, Patricia; Nica, Carmen; Silverman, Michael H; Bristol, David R; Harpaz, Zivit; Farbstein, Motti; Cohen, Shira; Fishman, Pnina

    2016-08-01

    CF101, an adenosine A3 receptor agonist, is an orally bioavailable small molecule drug presenting an anti-psoriatic effect demonstrated in a Phase 2 clinical trial in psoriasis patients. To evaluate the safety and efficacy of CF101 treatment in a Phase 2/3 study in patients with moderate to severe plaque-type psoriasis. This multicenter, double-blind, 2-segment, placebo-controlled study randomized subjects with moderate to severe plaque psoriasis to CF101 1 or 2 mg, or placebo twice daily. At either week 12 (Segment 1) or 16 (Segment 2), the placebo group crossed over to CF101 BID through week 32 in an open-label fashion. At week 12, following an interim analysis, the CF101 1mg group was discontinued due to futility. The primary endpoint was proportion of patients achieving ≥75% improvement in Psoriasis Area Severity Index (PASI 75). Efficacy testing was performed using the Cochran-Mantel Haenszel test, the primary analysis of PASI 75 was performed at the 0.035 significance level. CF101 had an excellent safety profile at all tested dosages with a profile similar to the placebo group. The most common adverse events were infections and gastrointestinal events, and there was no cumulative intolerance over the 32-week dosing period. The study did not meet the primary endpoint of PASI 75 at week 12 (2 mg: 8.5% vs. placebo: 6.9%, P=0.621). However, at week 32, PASI mean percent improvement with CF101 2 mg was 57% (P<0.001) compared to baseline, with linear improvement in PASI 50 (63.5%), 75 (35.5%), 90 (24.7%), and 100 (10.6%). Oral CF101 was found to be safe and very well tolerated, demonstrating evidence of efficacy in patients with moderate to severe plaque psoriasis through 32 weeks of treatment. J Drugs Dermatol. 2016;15(8):931-938.

  16. Impact of a Child Life and Music Therapy Procedural Support Intervention on Parental Perception of Their Child's Distress During Intravenous Placement.

    Science.gov (United States)

    Ortiz, Gabriela S; OʼConnor, Todd; Carey, Jessa; Vella, Adam; Paul, Audrey; Rode, Diane; Weinberg, Alan

    2017-02-21

    Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department. The aim of this study was to investigate the efficacy of this collaborative intervention by evaluating parental perception of their child's distress. This study was a prospective analysis investigating the impact of a child life and music therapy intervention on children aged 4 to 11 years old receiving an IV placement in the pediatric emergency department. Efficacy was evaluated by comparing scores between a 4-question pretest and subsequent 4-question posttest that asked the child's parent to evaluate how they anticipated their child would respond to the procedure, and then to evaluate how they perceived their child to have responded after the procedure. Qualitative data were collected in the form of open-ended comments, which were accommodated at the end of the posttest. Data were analyzed by the Cochran-Mantel-Haenszel method for testing repeated ordinal responses and the PROC GENMOD procedure in the SAS system software. A total of 41 participants were enrolled in this study. Results of the statistical analysis revealed significant differences between all pre- and posttest scores (P music therapy intervention. Improvement was demonstrated across all 4 questions, suggesting that the child life and music therapy intervention supported healthy, adaptive coping and helped to minimize distress experienced by patients during IV placement. These results underscore the importance and potential clinical

  17. Are residents of mountain-top mining counties more likely to have infants with birth defects? The West Virginia experience.

    Science.gov (United States)

    Lamm, Steven H; Li, Ji; Robbins, Shayhan A; Dissen, Elisabeth; Chen, Rusan; Feinleib, Manning

    2015-02-01

    Pooled 1996 to 2003 birth certificate data for four central states in Appalachia indicated higher rates of infants with birth defects born to residents of counties with mountain-top mining (MTM) than born to residents of non-mining-counties (Ahern 2011). However, those analyses did not consider sources of uncertainty such as unbalanced distributions or quality of data. Quality issues have been a continuing problem with birth certificate analyses. We used 1990 to 2009 live birth certificate data for West Virginia to reassess this hypothesis. Forty-four hospitals contributed 98% of the MTM-county births and 95% of the non-mining-county births, of which six had more than 1000 births from both MTM and nonmining counties. Adjusted and stratified prevalence rate ratios (PRRs) were computed both by using Poisson regression and Mantel-Haenszel analysis. Unbalanced distribution of hospital births was observed by mining groups. The prevalence rate of infants with reported birth defects, higher in MTM-counties (0.021) than in non-mining-counties (0.015), yielded a significant crude PRR (cPRR = 1.43; 95% confidence interval [CI] = 1.36-1.52) but a nonsignificant hospital-adjusted PRR (adjPRR = 1.08; 95% CI = 0.97-1.20; p = 0.16) for the 44 hospitals. So did the six hospital data analysis ([cPRR = 2.39; 95% CI = 2.15-2.65] and [adjPRR = 1.01; 95% CI, 0.89-1.14; p = 0.87]). No increased risk of birth defects was observed for births from MTM-counties after adjustment for, or stratification by, hospital of birth. These results have consistently demonstrated that the reported association between birth defect rates and MTM coal mining was a consequence of data heterogeneity. The data do not demonstrate evidence of a "Mountain-top Mining" effect on the prevalence of infants with reported birth defects in WV. © 2014 Wiley Periodicals, Inc.

  18. DIALECT CHECKLIST - PACIFIC NORTHWEST. SUPPLEMENTARY MATERIAL FOR ELEVENTH GRADE UNIT ON "LINGUISTIC GEOGRAPHY AND DIALECT."

    Science.gov (United States)

    Portland Public Schools, OR.

    THE CHECKLIST WAS DESIGNED TO STUDY CHARACTERISTIC WORD USAGE IN THE PACIFIC NORTHWEST. THE STUDENT IS ASKED TO CIRCLE THE WORD IN A GROUP OF WORDS WHICH HE ORDINARILY USES TO DESIGNATE A SPECIFIC THING. FOR INSTANCE--SELF OVER FIREPLACE - MANTEL, MANTEL BOARD, MANTEL PIECE, SHELF, CHILDHOOD WORD FOR MOTHER - MA, MAMA, MOM, MOTHER, MOMMY. ONE…

  19. Factores asociados a la aceptación de salpingoclasia posparto entre mujeres infectadas por el VIH Factors associated with acceptance of postpartum tubal ligation among HIV infected women

    Directory of Open Access Journals (Sweden)

    Ricardo Figueroa-Damián

    2001-04-01

    artículo está disponible en: http://www.insp.mx/salud/index.htmlOBJECTIVE: To identify the factors associated with the acceptance of tubal ligation after childbirth among HIV-infected patients. MATERIAL AND METHODS: A case-control study was conducted from March 1988 to February 1999, at Mexico's National Institute of Perinatology (INPer, in 72 HIV-positive pregnant women. Cases were 49 women who accepted postpartum tubal ligation after childbirth, and controls were 23 women who refused this birth control method. Data collected for each patient were demographic characteristics, sexual and reproductive history, and HIV status. Statistical analysis consisted of descriptive measures, Chi² or Fisher's exact test for categorical variables, and Student's t test for continuous variables. Odds ratios (OR with 95% CI were used to compare groups and potential confounders were assessed by stratified analysis with the Mantel-Haenszel method. RESULTS: The patients' mean age was 25.5 ± 5.5 years. The median gestation period was 27 weeks (range 7 to 40 weeks; 16 women (22.2% had no prenatal care visits at INPer. The median time of HIV positivist awareness was 9 months (range 1 to 108. Variables associated with acceptance of tubal ligation were: having a prior childbirth (OR 11.1, 95% CI 3.4 to 36, pregnancy care from 1995 onward (OR 4.7, 95% CI 1.7 to 13.3, and having given birth to an HIV-infected child (OR 4.6, 95% CI 1.05 to 23.1. Stratified analysis showed no modification of the strength of association of these variables with acceptance of tubal ligation. CONCLUSIONS: A prior childbirth was the most important predictor of tubal ligation acceptance. The English version of this paper is available at: http://www.insp.mx/salud/index.html

  20. Comparison of insulin lispro mix 25 with insulin lispro mix 50 as insulin starter in Chinese patients with type 2 diabetes mellitus (CLASSIFY study): Subgroup analysis of a Phase 4 open-label randomized trial.

    Science.gov (United States)

    Su, Qing; Liu, Chao; Zheng, Hongting; Zhu, Jun; Li, Peng Fei; Qian, Lei; Yang, Wen Ying

    2017-06-01

    Premixed insulins are recommended starter insulins in Chinese patients after oral antihyperglycemic medication (OAM) failure. In the present study, we compared the efficacy and safety of insulin lispro mix 25 (LM25) twice daily (b.i.d.) and insulin lispro mix 50 (LM50) b.i.d. as a starter insulin regimen in Chinese patients with type 2 diabetes mellitus (T2DM) who had inadequate glycemic control with OAMs. The primary efficacy outcome in the present open-label parallel randomized clinical trial was change in HbA1c from baseline to 26 weeks. Patients were randomized in a ratio of 1:  1 to LM25 (n = 80) or LM50 (n = 76). A mixed-effects model with repeated measures was used to analyze continuous variables. The Cochran-Mantel-Haenszel test with stratification factor was used to analyze categorical variables. At the end of the study, LM50 was more efficacious than LM25 in reducing mean HbA1c levels (least-squares [LS] mean difference 0.48; 95 % confidence interval [CI] 0.22, 0.74; P 1). More subjects in the LM50 than LM25 group achieved HbA1c targets of 1) or ≤6.5 % (52.6 % vs 20.0 %; P 1). Furthermore, LM50 was more effective than LM25 at reducing HbA1c in patients with baseline HbA1c, blood glucose excursion, and postprandial glucose greater than or equal to median levels (P ≤ 0.001). The rate and incidence of hypoglycemic episodes and increase in weight at the end of the study were similar between treatment groups. In Chinese patients with T2DM, LM50 was more efficacious than LM25 as a starter insulin. © 2016 The Authors. Journal of Diabetes published by John Wiley & Sons Australia, Ltd and Ruijin Hospital, Shanghai Jiaotong University School of Medicine.

  1. A Note on McDonald's Generalization of Principal Components Analysis

    Science.gov (United States)

    Shine, Lester C., II

    1972-01-01

    It is shown that McDonald's generalization of Classical Principal Components Analysis to groups of variables maximally channels the totalvariance of the original variables through the groups of variables acting as groups. An equation is obtained for determining the vectors of correlations of the L2 components with the original variables.…

  2. Regularized generalized eigen-decomposition with applications to sparse supervised feature extraction and sparse discriminant analysis

    DEFF Research Database (Denmark)

    Han, Xixuan; Clemmensen, Line Katrine Harder

    2015-01-01

    We propose a general technique for obtaining sparse solutions to generalized eigenvalue problems, and call it Regularized Generalized Eigen-Decomposition (RGED). For decades, Fisher's discriminant criterion has been applied in supervised feature extraction and discriminant analysis, and it is for...

  3. Application of generalized function to dynamic analysis of thick plates

    International Nuclear Information System (INIS)

    Zheng, D.; Weng, Z.

    1987-01-01

    The structures with thick plates have been used extensively in national defence, mechanical engineering, chemical engineering, nuclear engineering, civil engineering, etc.. Various theories have been established to deal with the problems of elastic plates, which include the classical theory of thin plates, the improved theory of thick plates, three-dimensional elastical theory. In this paper, the derivative of δ-function is handled by using the generalized function. The dynamic analysis of thick plates subjected the concentrated load is presented. The improved Donnell's equation of thick plates is deduced and employed as the basic equation. The generalized coordinates are solved by using the method of MWR. The general expressions for the dynamic response of elastic thick plates subjected the concentrated load are given. The numerical results for rectangular plates are given herein. The results are compared with those obtained from the improved theory and the classical theory of plates. (orig./GL)

  4. Assessment of Random Assignment in Training and Test Sets using Generalized Cluster Analysis Technique

    Directory of Open Access Journals (Sweden)

    Sorana D. BOLBOACĂ

    2011-06-01

    Full Text Available Aim: The properness of random assignment of compounds in training and validation sets was assessed using the generalized cluster technique. Material and Method: A quantitative Structure-Activity Relationship model using Molecular Descriptors Family on Vertices was evaluated in terms of assignment of carboquinone derivatives in training and test sets during the leave-many-out analysis. Assignment of compounds was investigated using five variables: observed anticancer activity and four structure descriptors. Generalized cluster analysis with K-means algorithm was applied in order to investigate if the assignment of compounds was or not proper. The Euclidian distance and maximization of the initial distance using a cross-validation with a v-fold of 10 was applied. Results: All five variables included in analysis proved to have statistically significant contribution in identification of clusters. Three clusters were identified, each of them containing both carboquinone derivatives belonging to training as well as to test sets. The observed activity of carboquinone derivatives proved to be normal distributed on every. The presence of training and test sets in all clusters identified using generalized cluster analysis with K-means algorithm and the distribution of observed activity within clusters sustain a proper assignment of compounds in training and test set. Conclusion: Generalized cluster analysis using the K-means algorithm proved to be a valid method in assessment of random assignment of carboquinone derivatives in training and test sets.

  5. Computer code for general analysis of radon risks (GARR)

    International Nuclear Information System (INIS)

    Ginevan, M.

    1984-09-01

    This document presents a computer model for general analysis of radon risks that allow the user to specify a large number of possible models with a small number of simple commands. The model is written in a version of BASIC which conforms closely to the American National Standards Institute (ANSI) definition for minimal BASIC and thus is readily modified for use on a wide variety of computers and, in particular, microcomputers. Model capabilities include generation of single-year life tables from 5-year abridged data, calculation of multiple-decrement life tables for lung cancer for the general population, smokers, and nonsmokers, and a cohort lung cancer risk calculation that allows specification of level and duration of radon exposure, the form of the risk model, and the specific population assumed at risk. 36 references, 8 figures, 7 tables

  6. What limits the effectiveness of school-based anti-smoking programmes?

    Science.gov (United States)

    Hrubá, Drahoslava; Zaloudíková, Iva

    2012-03-01

    It is generally accepted that living in families where there are smokers, children are stressed not only by the harmful physical exposure to second-hand and third-hand tobacco smoke, but also by the negative models of the adult relatives' behaviour, as relatives who smoke can inspire children to imitate this behaviour, influencing attitudes towards, and early experiments with smoking. In this paper, some of the most important results about influence of family smoking on the effects of the anti-smoking educational programme "Non-smoking Is Normal" are described. The school-based programme was created by medical and educational specialists and targets children at the first level of primary schools (aged from 6 to 11 years). The data about interesting outcomes of the programme (knowledge, attitudes, behaviour) were collected by anonymous questionnaire, administered twice in each school year: one month before the complex of 5 lectures (pre-tests) and 4-5 months after the last lecture (post-tests). The sample of participants (860-910) was divided into four groups, according to the intervention and family backrounds: (1) programme children from smoking families "P-S"; (2) control children from smoking families "C-S"; (3) programme children from non-smoking families "P-NS"; (4) control children from non-smoking families "C-NS". The differences in the frequency of children's answers were analysed using the tests in statistic Epi Info software, version 6.04a (chi-square, Mantel Haenszel, Yates, Fisher). In the programme group, the number of children with smoking relatives was significantly higher than in the control group (80.1% vs. 73.0%, p non-smoking families, the frequency of critics of adults smoking was significantly higher all the time of the study (p non-smoking parents only at the end of the study (p < 0.05). Despite of the effort to initiate parental participation on the primary prevention of smoking, we have confirmed that smoking in families decreased the

  7. Increased risk of acute angle closure in retinitis pigmentosa: a population-based case-control study.

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    Yu-Chieh Ko

    Full Text Available To investigate the association between retinitis pigmentosa (RP and acute angle closure during a 15-year follow-up period.Using the Taiwan Longitudinal Health Insurance Database 2000, we identified 382 RP patients based on the diagnostic code of RP (International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM 362.74 made during 1996-2010, excluding subjects under age of 20 years at diagnosis or subjects undergoing lens extraction before the index date. The control group included 3820 randomly selected non-RP subjects matched with the RP patients in age, gender and the index date of diagnosis. The incidence of acute angle closure during the study period was observed based on an ICD-9-CM code of 365.22. Cochran-Mantel-Haenszel test was used to determine the odds ratio (OR of having acute angle closure in RP patients.The mean age at the diagnosis of RP was 51.1 years (standard deviation [SD] 16.7. Acute angle closure occurred in 5 RP patients (1.3% and in 15 controls (0.4%. The mean age with the acute angle closure was 53.3 years (SD 8.0 in RP patients and 64.6 years (SD 8.4 in controls (P = 0.015. After adjusting for age, gender and comorbid disorders, RP patients had 3.64-fold (95% confidence interval [CI], 1.29-10.25, P<0.001 greater odds of having acute angle closure. After stratification for gender and age, the risk of acute angle closure in RP was higher in patients under age of 60 years (adjusted OR 11.84; 95% CI, 2.84-49.48 and male patients (adjusted OR 19.36; 95% CI, 3.43-109.40 (both P = 0.001.RP patients had increased risk of acute angle closure than controls. Contrary to the fact that angle closure disease is more prevalent in elderly females in general population, acute angle closure attack occurred earlier in life and the risk was higher in males among RP patients.

  8. Generalized Correlation Coefficient for Non-Parametric Analysis of Microarray Time-Course Data

    DEFF Research Database (Denmark)

    Tan, Qihua; Thomassen, Mads; Burton, Mark

    2017-01-01

    the heterogeneous time-course gene expression patterns. Application of the method identified nonlinear time-course patterns in high agreement with parametric analysis. We conclude that the non-parametric nature in the generalized correlation analysis could be an useful and efficient tool for analyzing microarray...... time-course data and for exploring the complex relationships in the omics data for studying their association with disease and health....

  9. Recovering Intrinsic Fragmental Vibrations Using the Generalized Subsystem Vibrational Analysis.

    Science.gov (United States)

    Tao, Yunwen; Tian, Chuan; Verma, Niraj; Zou, Wenli; Wang, Chao; Cremer, Dieter; Kraka, Elfi

    2018-05-08

    Normal vibrational modes are generally delocalized over the molecular system, which makes it difficult to assign certain vibrations to specific fragments or functional groups. We introduce a new approach, the Generalized Subsystem Vibrational Analysis (GSVA), to extract the intrinsic fragmental vibrations of any fragment/subsystem from the whole system via the evaluation of the corresponding effective Hessian matrix. The retention of the curvature information with regard to the potential energy surface for the effective Hessian matrix endows our approach with a concrete physical basis and enables the normal vibrational modes of different molecular systems to be legitimately comparable. Furthermore, the intrinsic fragmental vibrations act as a new link between the Konkoli-Cremer local vibrational modes and the normal vibrational modes.

  10. A κ-generalized statistical mechanics approach to income analysis

    Science.gov (United States)

    Clementi, F.; Gallegati, M.; Kaniadakis, G.

    2009-02-01

    This paper proposes a statistical mechanics approach to the analysis of income distribution and inequality. A new distribution function, having its roots in the framework of κ-generalized statistics, is derived that is particularly suitable for describing the whole spectrum of incomes, from the low-middle income region up to the high income Pareto power-law regime. Analytical expressions for the shape, moments and some other basic statistical properties are given. Furthermore, several well-known econometric tools for measuring inequality, which all exist in a closed form, are considered. A method for parameter estimation is also discussed. The model is shown to fit remarkably well the data on personal income for the United States, and the analysis of inequality performed in terms of its parameters is revealed as very powerful.

  11. A κ-generalized statistical mechanics approach to income analysis

    International Nuclear Information System (INIS)

    Clementi, F; Gallegati, M; Kaniadakis, G

    2009-01-01

    This paper proposes a statistical mechanics approach to the analysis of income distribution and inequality. A new distribution function, having its roots in the framework of κ-generalized statistics, is derived that is particularly suitable for describing the whole spectrum of incomes, from the low–middle income region up to the high income Pareto power-law regime. Analytical expressions for the shape, moments and some other basic statistical properties are given. Furthermore, several well-known econometric tools for measuring inequality, which all exist in a closed form, are considered. A method for parameter estimation is also discussed. The model is shown to fit remarkably well the data on personal income for the United States, and the analysis of inequality performed in terms of its parameters is revealed as very powerful

  12. Cosplicing network analysis of mammalian brain RNA-Seq data utilizing WGCNA and Mantel correlations

    Directory of Open Access Journals (Sweden)

    Ovidiu Dan Iancu

    2015-05-01

    Full Text Available Across species and tissues and especially in the mammalian brain, production of gene isoforms is widespread. While gene expression coordination has been previously described as a scale-free coexpression network, the properties of transcriptome-wide isoform production coordination have been less studied. Here we evaluate the system-level properties of cosplicing in mouse, macaque and human brain gene expression data using a novel network inference procedure. Genes are represented as vectors/lists of exon counts and distance measures sensitive to exon inclusion rates quantifies differences across samples. For all gene pairs, distance matrices are correlated across samples, resulting in cosplicing or co-transcriptional network matrices. We show that networks including cosplicing information are scale-free and distinct from coexpression. In the networks capturing cosplicing we find a set of novel hubs with unique characteristics distinguishing them from coexpression hubs: heavy representation in neurobiological functional pathways, strong overlap with markers of neurons and neuroglia, long coding lengths, and high number of both exons and annotated transcripts. Further, the cosplicing hubs are enriched in genes associated with autism spectrum disorders. Cosplicing hub homologs across eukaryotes show dramatically increasing intronic lengths but stable coding region lengths. Shared transcription factor binding sites increase coexpression but not cosplicing; the reverse is true for splicing-factor binding sites. Genes with protein-protein interactions have strong coexpression and cosplicing. Additional factors affecting the networks include shared microRNA binding sites, spatial colocalization within the striatum, and sharing a chromosomal folding domain. Cosplicing network patterns remain relatively stable across species.

  13. All-sky analysis of the general relativistic galaxy power spectrum

    Science.gov (United States)

    Yoo, Jaiyul; Desjacques, Vincent

    2013-07-01

    We perform an all-sky analysis of the general relativistic galaxy power spectrum using the well-developed spherical Fourier decomposition. Spherical Fourier analysis expresses the observed galaxy fluctuation in terms of the spherical harmonics and spherical Bessel functions that are angular and radial eigenfunctions of the Helmholtz equation, providing a natural orthogonal basis for all-sky analysis of the large-scale mode measurements. Accounting for all the relativistic effects in galaxy clustering, we compute the spherical power spectrum and its covariance matrix and compare it to the standard three-dimensional power spectrum to establish a connection. The spherical power spectrum recovers the three-dimensional power spectrum at each wave number k with its angular dependence μk encoded in angular multipole l, and the contributions of the line-of-sight projection to galaxy clustering such as the gravitational lensing effect can be readily accommodated in the spherical Fourier analysis. A complete list of formulas for computing the relativistic spherical galaxy power spectrum is also presented.

  14. Use of generalized ordered logistic regression for the analysis of multidrug resistance data.

    Science.gov (United States)

    Agga, Getahun E; Scott, H Morgan

    2015-10-01

    Statistical analysis of antimicrobial resistance data largely focuses on individual antimicrobial's binary outcome (susceptible or resistant). However, bacteria are becoming increasingly multidrug resistant (MDR). Statistical analysis of MDR data is mostly descriptive often with tabular or graphical presentations. Here we report the applicability of generalized ordinal logistic regression model for the analysis of MDR data. A total of 1,152 Escherichia coli, isolated from the feces of weaned pigs experimentally supplemented with chlortetracycline (CTC) and copper, were tested for susceptibilities against 15 antimicrobials and were binary classified into resistant or susceptible. The 15 antimicrobial agents tested were grouped into eight different antimicrobial classes. We defined MDR as the number of antimicrobial classes to which E. coli isolates were resistant ranging from 0 to 8. Proportionality of the odds assumption of the ordinal logistic regression model was violated only for the effect of treatment period (pre-treatment, during-treatment and post-treatment); but not for the effect of CTC or copper supplementation. Subsequently, a partially constrained generalized ordinal logistic model was built that allows for the effect of treatment period to vary while constraining the effects of treatment (CTC and copper supplementation) to be constant across the levels of MDR classes. Copper (Proportional Odds Ratio [Prop OR]=1.03; 95% CI=0.73-1.47) and CTC (Prop OR=1.1; 95% CI=0.78-1.56) supplementation were not significantly associated with the level of MDR adjusted for the effect of treatment period. MDR generally declined over the trial period. In conclusion, generalized ordered logistic regression can be used for the analysis of ordinal data such as MDR data when the proportionality assumptions for ordered logistic regression are violated. Published by Elsevier B.V.

  15. Dental treatment under general anesthesia for special-needs patients: analysis of the literature.

    Science.gov (United States)

    Mallineni, Sreekanth K; Yiu, Cynthia K Y

    2016-11-01

    The aim of the present review was to identify the studies published on dental treatment under general anesthesia for special-needs patients. A comprehensive search of the reported literature from January 1966 to May 2012 was conducted using PubMed, Medline, and Embase. Keywords used in the search were "dental treatment under general anesthesia", "special-needs patients", "medically-compromised patients", and "children", in various combinations. Studies published only on dental treatment under general anesthesia and in English were included. Only 10 studies were available for final analysis. Age range from 1 to 50 years, and restorative procedures, were most prevalent. Only two studies discussed repeated general anesthesia, with rates of 7.2% and 10.2%. Over time, the provision of general anesthesia for special-needs patients has changed from dental clinics to general hospitals. The demand for dental treatment for special-needs patients under general anesthesia continues to increase. Currently, there are no certain accepted protocols for the provision of dental treatment under general anesthesia. © 2015 Wiley Publishing Asia Pty Ltd.

  16. Cost analysis of robotic versus laparoscopic general surgery procedures.

    Science.gov (United States)

    Higgins, Rana M; Frelich, Matthew J; Bosler, Matthew E; Gould, Jon C

    2017-01-01

    Robotic surgical systems have been used at a rapidly increasing rate in general surgery. Many of these procedures have been performed laparoscopically for years. In a surgical encounter, a significant portion of the total costs is associated with consumable supplies. Our hospital system has invested in a software program that can track the costs of consumable surgical supplies. We sought to determine the differences in cost of consumables with elective laparoscopic and robotic procedures for our health care organization. De-identified procedural cost and equipment utilization data were collected from the Surgical Profitability Compass Procedure Cost Manager System (The Advisory Board Company, Washington, DC) for our health care system for laparoscopic and robotic cholecystectomy, fundoplication, and inguinal hernia between the years 2013 and 2015. Outcomes were length of stay, case duration, and supply cost. Statistical analysis was performed using a t-test for continuous variables, and statistical significance was defined as p robotic procedures. Length of stay did not differ for fundoplication or cholecystectomy. Length of stay was greater for robotic inguinal hernia repair. Case duration was similar for cholecystectomy (84.3 robotic and 75.5 min laparoscopic, p = 0.08), but significantly longer for robotic fundoplication (197.2 robotic and 162.1 min laparoscopic, p = 0.01) and inguinal hernia repair (124.0 robotic and 84.4 min laparoscopic, p = ≪0.01). We found a significantly increased cost of general surgery procedures for our health care system when cases commonly performed laparoscopically are instead performed robotically. Our analysis is limited by the fact that we only included costs associated with consumable surgical supplies. The initial acquisition cost (over $1 million for robotic surgical system), depreciation, and service contract for the robotic and laparoscopic systems were not included in this analysis.

  17. Association of statin use with a pathologic complete response to neoadjuvant chemoradiation for rectal cancer

    International Nuclear Information System (INIS)

    Katz, Matthew S.; Minsky, Bruce D.; Saltz, Leonard B.; Riedel, Elyn; Chessin, David B.; Guillem, Jose G.

    2005-01-01

    Purpose: To assess whether 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or statins, might enhance the efficacy of neoadjuvant chemoradiation in rectal cancer. Methods and Materials: Between 1996 and 2001, 358 patients with clinically resectable, nonmetastatic rectal cancer underwent surgery at Memorial Sloan-Kettering Cancer Center after neoadjuvant chemoradiation for either locally advanced tumors or low-lying tumors that would require abdominoperineal resection. We excluded 9 patients for radiation therapy dose <45 Gy or if statin use was unknown, leaving 349 evaluable patients. Median radiation therapy dose was 50.4 Gy (range, 45-55.8 Gy), and 308 patients (88%) received 5-flurouracil-based chemotherapy. Medication use, comorbid illnesses, clinical stage as assessed by digital rectal examination and ultrasound, and type of chemotherapy were analyzed for associations with pathologic complete response (pCR), defined as no microscopic evidence of tumor. Fisher's exact test was used for categoric variables, Mantel-Haenszel test for ordered categoric variables, and logistic regression for multivariate analysis. Results: Thirty-three patients (9%) used a statin, with no differences in clinical stage according to digital rectal examination or ultrasound compared with the other 324 patients. At the time of surgery, 23 nonstatin patients (7%) were found to have metastatic disease, compared with 0% for statin patients. The unadjusted pCR rates with and without statin use were 30% and 17%, respectively (p = 0.10). Variables significant univariately at the p = 0.15 level were entered into a multivariate model, as were nonsteroidal anti-inflammatory drugs (NSAIDs), which were strongly associated with statin use. The odds ratio for statin use on pCR was 4.2 (95% confidence interval, 1.7-12.1; p = 0.003) after adjusting for NSAID use, clinical stage, and type of chemotherapy. Conclusion: In multivariate analysis, statin use is associated with an improved p

  18. Surgery for left ventricular aneurysm: early and late survival after simple linear repair and endoventricular patch plasty.

    Science.gov (United States)

    Lundblad, Runar; Abdelnoor, Michel; Svennevig, Jan Ludvig

    2004-09-01

    Simple linear resection and endoventricular patch plasty are alternative techniques to repair postinfarction left ventricular aneurysm. The aim of the study was to compare these 2 methods with regard to early mortality and long-term survival. We retrospectively reviewed 159 patients undergoing operations between 1989 and 2003. The epidemiologic design was of an exposed (simple linear repair, n = 74) versus nonexposed (endoventricular patch plasty, n = 85) cohort with 2 endpoints: early mortality and long-term survival. The crude effect of aneurysm repair technique versus endpoint was estimated by odds ratio, rate ratio, or relative risk and their 95% confidence intervals. Stratification analysis by using the Mantel-Haenszel method was done to quantify confounders and pinpoint effect modifiers. Adjustment for multiconfounders was performed by using logistic regression and Cox regression analysis. Survival curves were analyzed with the Breslow test and the log-rank test. Early mortality was 8.2% for all patients, 13.5% after linear repair and 3.5% after endoventricular patch plasty. When adjusted for multiconfounders, the risk of early mortality was significantly higher after simple linear repair than after endoventricular patch plasty (odds ratio, 4.4; 95% confidence interval, 1.1-17.8). Mean follow-up was 5.8 +/- 3.8 years (range, 0-14.0 years). Overall 5-year cumulative survival was 78%, 70.1% after linear repair and 91.4% after endoventricular patch plasty. The risk of total mortality was significantly higher after linear repair than after endoventricular patch plasty when controlled for multiconfounders (relative risk, 4.5; 95% confidence interval, 2.0-9.7). Linear repair dominated early in the series and patch plasty dominated later, giving a possible learning-curve bias in favor of patch plasty that could not be adjusted for in the regression analysis. Postinfarction left ventricular aneurysm can be repaired with satisfactory early and late results. Surgical

  19. Offering self-administered oral HIV testing to truck drivers in Kenya to increase testing: a randomized controlled trial.

    Science.gov (United States)

    Kelvin, Elizabeth A; George, Gavin; Mwai, Eva; Nyaga, Eston; Mantell, Joanne E; Romo, Matthew L; Odhiambo, Jacob O; Starbuck, Lila; Govender, Kaymarlin

    2018-01-01

    We conducted a randomized controlled trial among 305 truck drivers from two North Star Alliance roadside wellness clinics in Kenya to see if offering HIV testing choices would increase HIV testing uptake. Participants were randomized to be offered (1) a provider-administered rapid blood (finger-prick) HIV test (i.e., standard of care [SOC]) or (2) a Choice between SOC or a self-administered oral rapid HIV test with provider supervision in the clinic. Participants in the Choice arm who refused HIV testing in the clinic were offered a test kit for home use with phone-based posttest counseling. We compared HIV test uptake using the Mantel Haenszel odds ratio (OR) adjusting for clinic. Those in the Choice arm had higher odds of HIV test uptake than those in the SOC arm (OR = 1.5), but the difference was not statistically significant (p = 0.189). When adding the option to take an HIV test kit for home use, the Choice arm had significantly greater odds of testing uptake (OR = 2.8, p = 0.002). Of those in the Choice arm who tested, 26.9% selected the SOC test, 64.6% chose supervised self-testing in the clinic, and 8.5% took a test kit for home use. Participants varied in the HIV test they selected when given choices. Importantly, when participants who refused HIV testing in the clinic were offered a test kit for home use, an additional 8.5% tested. Offering truck drivers a variety of HIV testing choices may increase HIV testing uptake in this key population.

  20. Anterior Cruciate Ligament Tear: Reliability of MR Imaging to Predict Stability after Conservative Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hye Won; Ahn, Jin Hwan; Ahn, Joong Mo; Yoon, Young Cheol; Hong, Hyun Pyo; Yoo, So Young; Kim, Seon Woo [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-06-15

    The aim of this study is to evaluate the reliability of MR imaging to predict the stability of the torn anterior cruciate ligament (ACL) after complete recovery of the ligament's continuity. Twenty patients with 20 knee injuries (13 males and 7 females; age range, 20 54) were enrolled in the study. The inclusion criteria were a positive history of acute trauma, diagnosis of the ACL tear by both the physical examination and the MR imaging at the initial presentation, conservative treatment, complete recovery of the continuity of the ligament on the follow up (FU) MR images and availability of the KT-2000 measurements. Two radiologists, who worked in consensus, graded the MR findings with using a 3-point system for the signal intensity, sharpness, straightness and the thickness of the healed ligament. The insufficiency of ACL was categorized into three groups according to the KT-2000 measurements. The statistic correlations between the grades of the MR findings and the degrees of ACL insufficiency were analyzed using the Cochran-Mantel-Haenszel test (p < 0.05). The p-values for each category of the MR findings according to the different groups of the KT-2000 measurements were 0.9180 for the MR signal intensity, 1.0000 for sharpness, 0.5038 for straightness and 0.2950 for thickness of the ACL. The MR findings were not significantly different between the different KT-2000 groups. MR imaging itself is not a reliable examination to predict stability of the ACL rupture outcome, even when the MR images show an intact appearance of the ACL.

  1. Sex differences in task distribution and task exposures among Danish house painters: an observational study combining questionnaire data with biomechanical measurements.

    Directory of Open Access Journals (Sweden)

    Thomas Heilskov-Hansen

    Full Text Available OBJECTIVES: Sex differences in occupational biomechanical exposures may be part of the explanation why musculoskeletal complaints and disorders tend to be more common among women than among men. We aimed to determine possible sex differences in task distribution and task-specific postures and movements of the upper extremities among Danish house painters, and to establish sex-specific task exposure matrices. METHODS: To obtain task distributions, we sent out a questionnaire to all members of the Painters' Union in Denmark (N = 9364, of whom 53% responded. Respondents reported their task distributions in a typical week. To obtain task exposures, postures and movements were measured in 25 male and 25 female house painters for one whole working day per person. We used goniometers on the wrists, and inclinometers on the forehead and the upper arms. Participants filled in a logbook allowing task-specific exposures to be identified. Percentiles and % time with non-neutral postures were used to characterise postures. Velocity, range of motion, repetitiveness, and variation were used as measures of movement. Cochran-Mantel-Haenszel statistics and unpaired double-sided t-tests with post-hoc Bonferroni correction were used to evaluate sex differences. RESULTS: Statistically significant (p<0.05 sex differences were revealed in task proportions, but the proportions differed by less than 4%. For task exposures, no statistically significant sex differences were found. CONCLUSIONS: Only minor sex differences were found in task distribution and task exposures regarding postures and movements among Danish house painters. Sex-specific task exposure matrices were established.

  2. Evolution of emphysema in relation to smoking

    International Nuclear Information System (INIS)

    Bellomi, Massimo; Rampinelli, Cristiano; Veronesi, Giulia; Harari, Sergio; Lanfranchi, Federica; Raimondi, Sara; Maisonneuve, Patrick

    2010-01-01

    We have little knowledge about the evolution of emphysema, and relatively little is understood about its evolution in relation to smoking habits. This study aims to assess the evolution of emphysema in asymptomatic current and former smokers over 2 years and to investigate the association with subjects' characteristics. The study was approved by our Ethics Committee and all participants provided written informed consent. We measured emphysema by automatic low-dose computed tomography densitometry in 254 current and 282 former smokers enrolled in a lung-cancer screening. The measures were repeated after 2 years. The association between subjects' characteristics, smoking habits and emphysema were assessed by chi-squared and Wilcoxon tests. Univariate and multivariate odds ratios (OR) with 95% confidence intervals (CI) were calculated for the risk of emphysema worsening according to subjects' characteristics. We assessed the trend of increasing risk of emphysema progression by smoking habits using the Mantel-Haenszel chi-squared test. The median percentage increase in emphysema over a 2-year period was significantly higher in current than in former smokers (OR 1.8; 95% CI 1.3-2.6; p < 0.0001). The risk of worsening emphysema (by 30% in 2 years) in current smokers increased with smoking duration (p for trend <0.02). As emphysema is a known risk factor for lung cancer, its evaluation could be used as a potential factor for identification of a high-risk population. The evaluation of emphysema progression can be added to low-dose CT screening programmes to inform and incite participants to stop smoking. (orig.)

  3. Alojamiento conjunto madre-hijo y lactancia humana exclusiva

    Directory of Open Access Journals (Sweden)

    FLORES-HUERTA SAMUEL

    1997-01-01

    Full Text Available Objetivo. Conocer la influencia del alojamiento conjunto (AC madre-hijo, en la frecuencia de lactancia humana exclusiva (LHE, desde el nacimiento hasta los cuatro meses de vida. Material y métodos. Estudio de cohortes no aleatorizado realizado en la clínica de lactancia del Hospital "Luis Castelazo Ayala", del Instituto Mexicano del Seguro Social, de enero de 1993 a octubre de 1994, en el que participaron 178 binomios madre-hijo (BMH sanos con gestación de término. El grupo con alojamiento conjunto (AC se integró con 90 BMH, y la madre recibió asesoría para lactar; 88 se atendieron en forma separada, sin asesoría para lactar. Se realizó análisis estadístico de los datos para apreciar frecuencia y asociaciones de las variables. Resultados. La alimentación se registró como LHE, fórmula o ambas. Los grupos con y sin AC se estratificaron por la forma de nacimiento, parto o cesárea. Con X² de Mantel-Haenszel y de rango logarítmico se aceptaron diferencias con p< 0.05. Durante el estudio la lactancia global fue semejante entre los grupos. En el primer mes la LHE fue mayor en el grupo con AC, 61 vs 42%, independientemente de la forma de nacimiento (p< 0.05. El AC fue la única variable que influyó para que se diera LHE. Conclusiones. El AC madre-hijo favorece la LHE en el primer mes posnacimiento.

  4. Burnout syndrome and abdominal adiposity among Primary Health Care nursing professionals

    Directory of Open Access Journals (Sweden)

    Magno Conceição das Merces

    2016-12-01

    Full Text Available Abstract Background Accumulation of abdominal adiposity (AA constitutes a risk factor for heart and coronary diseases and for metabolic complications. Research suggests that stress is related to adipogenesis. The burnout syndrome (BS is linked to stress due to the chronicity of work stress. The objective of this study is to estimate the association between BS and AA in Primary Health Care (PHC nursing practitioners. Methods This is confirmatory cross-sectional study with 189 workers from nine municipalities in Bahia, Brazil. The dependent variable was AA, measured by waist circumference. The independent variable was the BS, diagnosed by the Maslach Burnout Inventory (MBI. Sociodemographic and job characteristics, lifestyle, and human biology were taken as covariates and were evaluated as modifiers or confounders by the homogeneity tests and by comparison with the adjusted Mantel-Haenszel test, respectively. Logistic regression was employed to evaluate the association between BS and AA, adjusted for covariates. The adequacy of the final regression model was evaluated by the model’s goodness of fit test and the area under the ROC curve. Results BS prevalence was 10.6% and AA 54%. The variables age, education, hypertension, diabetes, working time, and high emotional exhaustion were associated with AA. An association was found between BS and AA (1.63 adjusted prevalence ratios; 95% CI, 1.29 to 2.06 even after age and working time adjustment. Conclusion The results suggest an association between BS and AA in the analyzed professionals. A significant prevalence of burnout and AA is highlighted.

  5. Geographic disparities in pneumonia-specific under-five mortality rates in Mainland China from 1996 to 2015: a population-based study.

    Science.gov (United States)

    Kang, Leni; He, Chunhua; Miao, Lei; Liang, Juan; Zhu, Jun; Li, Xiaohong; Li, Qi; Wang, Yanping

    2017-06-01

    This study aimed to investigate the disparities in pneumonia-specific under-five mortality rates (U5MRs) among and within three geographic regions in Mainland China from 1996 to 2015. Data were obtained from the national Under-Five Child Mortality Surveillance System and grouped into 2-year periods. The Cochran-Armitage trend test and Cochran-Mantel-Haenszel test were used to assess trends and differences in the pneumonia-specific U5MRs among and within geographic regions. Relative risks (RRs) and 95% confidence intervals (95% CIs) were calculated. The pneumonia-specific U5MR decreased by 90.6%, 89.0%, and 83.5% in East, Middle, and West China, respectively, with a larger decrease in rural areas. The pneumonia-specific U5MR was highest in West China, and was 7.2 (95% CI 5.9-8.7) times higher than that in East China in 2014-2015. In 2014-2015, the RRs were 1.7 (95% CI 1.2-2.5), 1.6 (95% CI 1.1-2.1), and 3.4 (95% CI 2.8-4.0) between rural and urban areas in East, Middle, and West China, respectively. Pneumonia-specific U5MRs decreased from 1996 to 2015 across China, particularly in rural areas. However, disparities remained among and within geographic regions. Additional strategies and interventions should be introduced in West China, especially the rural areas, to further reduce the pneumonia-specific U5MR. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  6. Do people with and without medical conditions respond similarly to the short health anxiety inventory? An assessment of differential item functioning using item response theory.

    Science.gov (United States)

    LeBouthillier, Daniel M; Thibodeau, Michel A; Alberts, Nicole M; Hadjistavropoulos, Heather D; Asmundson, Gordon J G

    2015-04-01

    Individuals with medical conditions are likely to have elevated health anxiety; however, research has not demonstrated how medical status impacts response patterns on health anxiety measures. Measurement bias can undermine the validity of a questionnaire by overestimating or underestimating scores in groups of individuals. We investigated whether the Short Health Anxiety Inventory (SHAI), a widely-used measure of health anxiety, exhibits medical condition-based bias on item and subscale levels, and whether the SHAI subscales adequately assess the health anxiety continuum. Data were from 963 individuals with diabetes, breast cancer, or multiple sclerosis, and 372 healthy individuals. Mantel-Haenszel tests and item characteristic curves were used to classify the severity of item-level differential item functioning in all three medical groups compared to the healthy group. Test characteristic curves were used to assess scale-level differential item functioning and whether the SHAI subscales adequately assess the health anxiety continuum. Nine out of 14 items exhibited differential item functioning. Two items exhibited differential item functioning in all medical groups compared to the healthy group. In both Thought Intrusion and Fear of Illness subscales, differential item functioning was associated with mildly deflated scores in medical groups with very high levels of the latent traits. Fear of Illness items poorly discriminated between individuals with low and very low levels of the latent trait. While individuals with medical conditions may respond differentially to some items, clinicians and researchers can confidently use the SHAI with a variety of medical populations without concern of significant bias. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Effect of reversal of neuromuscular blockade with sugammadex versus usual care on bleeding risk in a randomized study of surgical patients.

    Science.gov (United States)

    Rahe-Meyer, Niels; Fennema, Hein; Schulman, Sam; Klimscha, Walter; Przemeck, Michael; Blobner, Manfred; Wulf, Hinnerk; Speek, Marcel; McCrary Sisk, Christine; Williams-Herman, Debora; Woo, Tiffany; Szegedi, Armin

    2014-11-01

    Previous studies show a prolongation of activated partial thromboplastin time and prothrombin time in healthy volunteers after treatment with sugammadex. The authors investigated the effect of sugammadex on postsurgical bleeding and coagulation variables. This randomized, double-blind trial enrolled patients receiving thromboprophylaxis and undergoing hip or knee joint replacement or hip fracture surgery. Patients received sugammadex 4 mg/kg or usual care (neostigmine or spontaneous recovery) for reversal of rocuronium- or vecuronium-induced neuromuscular blockade. The Cochran-Mantel-Haenszel method, stratified by thromboprophylaxis and renal status, was used to estimate relative risk and 95% confidence interval (CI) of bleeding events with sugammadex versus usual care. Safety was further evaluated by prespecified endpoints and adverse event reporting. Of 1,198 patients randomized, 1,184 were treated (sugammadex n = 596, usual care n = 588). Bleeding events within 24 h (classified by an independent, blinded Adjudication Committee) were reported in 17 (2.9%) sugammadex and 24 (4.1%) usual care patients (relative risk [95% CI], 0.70 [0.38 to 1.29]). Compared with usual care, increases of 5.5% in activated partial thromboplastin time (P sugammadex occurred 10 min after administration and resolved within 60 min. There were no significant differences between sugammadex and usual care for other blood loss measures (transfusion, 24-h drain volume, drop in hemoglobin, and anemia), or risk of venous thromboembolism, and no cases of anaphylaxis. Sugammadex produced limited, transient (<1 h) increases in activated partial thromboplastin time and prothrombin time but was not associated with increased risk of bleeding versus usual care.

  8. An Estimate of the Proportion of Symptomatic Gonococcal, Chlamydial and Non-gonococcal Non-chlamydial Urethritis Attributable to Oral Sex among Men who have Sex with Men

    Science.gov (United States)

    Barbee, Lindley A.; Khosropour, Christine M.; Dombrowski, Julia C.; Manhart, Lisa E.; Golden, Matthew R.

    2016-01-01

    Background Sexually transmitted infections of the pharynx are common among men who have sex with men (MSM); the degree to which these infections are transmitted through oral sex is unknown. Methods We conducted a case-control study of MSM attending Public Health – Seattle & King County STD Clinic between 2001 – 2013 to estimate the proportion of symptomatic urethritis cases attributable to oral sex using two methods. First, we categorized men into the following mutually exclusive behavioural categories based on their self-reported sexual history in the previous 60 days: 1) only received oral sex (IOS); 2) 100% condom usage with insertive anal sex plus oral sex (PIAI); 3) inconsistent condom usage with anal sex (UIAI); and 4) no sex. We then determined the proportion of cases in which men reported the oropharynx as their only urethral exposure (IOS and PIAI). Second, we calculated the population attributable risk percent (PAR%) associated with oral sex using Mantel-Haenszel odds ratio estimates. Results Based on our behavioural categorization method, men reported the oropharynx as their only urethral exposure in the past 60 days in 27.5% of gonococcal, 31.4% of chlamydial, and 35.9% non-gonococcal, non-chlamydial (NGNCU) urethritis cases. The PAR%s for symptomatic gonococcal, chlamydial and NGNCU urethritis attributed to oropharyngeal exposure were 33.8%, 2.7% and 27.1% respectively. Conclusions The pharynx is an important source of gonococcal transmission, and may be important in the transmission of chlamydia and other, unidentified pathogens that cause urethritis. Efforts to increase pharyngeal gonorrhoea screening among MSM could diminish STI transmission. PMID:26297719

  9. Evolution of emphysema in relation to smoking

    Energy Technology Data Exchange (ETDEWEB)

    Bellomi, Massimo [European Institute of Oncology, Department of Radiology, Milan (Italy); University of Milan - IT, School of Medicine, Milan (Italy); Rampinelli, Cristiano [European Institute of Oncology, Department of Radiology, Milan (Italy); Veronesi, Giulia [European Institute of Oncology, Department of Thoracic Surgery, Milan (Italy); Harari, Sergio [Fatebenefratelli-Milanocuore, Pneumology Operative Unit, San Giuseppe Hospital, Milan (Italy); Lanfranchi, Federica [University of Milan - IT, School of Medicine, Milan (Italy); Raimondi, Sara; Maisonneuve, Patrick [European Institute of Oncology, Department of Epidemiology and Biostatistics, Milan (Italy)

    2010-02-15

    We have little knowledge about the evolution of emphysema, and relatively little is understood about its evolution in relation to smoking habits. This study aims to assess the evolution of emphysema in asymptomatic current and former smokers over 2 years and to investigate the association with subjects' characteristics. The study was approved by our Ethics Committee and all participants provided written informed consent. We measured emphysema by automatic low-dose computed tomography densitometry in 254 current and 282 former smokers enrolled in a lung-cancer screening. The measures were repeated after 2 years. The association between subjects' characteristics, smoking habits and emphysema were assessed by chi-squared and Wilcoxon tests. Univariate and multivariate odds ratios (OR) with 95% confidence intervals (CI) were calculated for the risk of emphysema worsening according to subjects' characteristics. We assessed the trend of increasing risk of emphysema progression by smoking habits using the Mantel-Haenszel chi-squared test. The median percentage increase in emphysema over a 2-year period was significantly higher in current than in former smokers (OR 1.8; 95% CI 1.3-2.6; p < 0.0001). The risk of worsening emphysema (by 30% in 2 years) in current smokers increased with smoking duration (p for trend <0.02). As emphysema is a known risk factor for lung cancer, its evaluation could be used as a potential factor for identification of a high-risk population. The evaluation of emphysema progression can be added to low-dose CT screening programmes to inform and incite participants to stop smoking. (orig.)

  10. Effects of Interpersonal Skills Training on MRI Operations in a Saturated Market: A Randomized Trial.

    Science.gov (United States)

    Ajam, Amna A; Nguyen, Xuan V; Kelly, Ronda A; Ladapo, Joseph A; Lang, Elvira V

    2017-07-01

    The aim of this study was to assess the effects of team training on operational efficiency during outpatient MRI. In this institutional review board-approved, HIPAA-compliant study, six MRI outpatient sites of a midwestern hospital system were randomized to serve as controls or have their teams trained in advanced communication skills. The fourth quarter of fiscal year 2015 was the trial baseline. The trial ended in the third quarter (Q3) of fiscal year 2016 (FY16). Equipment utilization (completed scans/available slots), hourly scan rates (total orders completed per machine per hour of operation), and no-show rates stratified by time were analyzed using the Cochran-Mantel-Haenszel method, with individual comparisons performed with Bonferroni correction. The study encompassed 27,425 MRI examinations. Overall volume peaked at baseline and then declined over the following quarters. Compared with baseline, untrained sites experienced significant drops in equipment utilization (P trained sites, these metrics showed no significant change, with maintenance of hourly scan rates of 1.23 and 1.27 and equipment utilization rates of 83% and 85% between baseline and Q3 FY16. No-show rates remained stable at trained sites but increased at untrained sites in the last two quarters (P trained sites from 56th at baseline to 70th and successively decreased at untrained sites from 66th to 44th. MRI outpatient facilities trained in advanced communication techniques may have more favorable operational efficiency than untrained sites in a saturated market. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. Adolescents' self-esteem in single and two-parent families.

    Science.gov (United States)

    Alami, Ali; Khosravan, Shahla; Sadegh Moghadam, Leila; Pakravan, Fateme; Hosseni, Fateme

    2014-04-01

    Self-esteem is one of the basic needs for all individuals especially in adolescence. The aim of this study was to determine associations between adolescents' self-esteem and perceived maternal parenting styles as well as its dimensions in terms of family type. In this analytic cross-sectional study, 356 high school students (250 two-parent nuclear family and 106 single-parent family) participated and filled out the Coppersmith self-esteem and the Robinson and colleagues (2001) perceived parenting styles questionnaires. Data were analyzed by SPSS software, version 18. To assess the relationship between participants' self-esteem and parenting styles and dimensions, Mantel-Haenszel Chi-square test was used to adjust the effect of potential confounder variables. P≤0.05 was considered statistically significant. From a total of 370 questionnaires, 356 questionnaires were completed. The mean±SD of the participants' self-esteem score was 38.49±6.55. Mean±SD of self-esteem score among the two-parent and single-parent students was 39.06±6.36 and 37.42±7.28, respectively (P=0.034). Dominant parenting style in both families was authoritative style. There were significant associations between the respondents' self-esteem and their perceived parenting styles, after matching sex, family income, level of education, and parents job (Pparenting styles and improve self-esteem. Therefore, considering the relationship between child-rearing style and adolescent self-esteem, assessing other relating factors with adolescent self-esteem especially in single-parent family, such as father absence stigma, is suggested.

  12. Maternal age at delivery and order of birth are risk factors for type 1 diabetes mellitus in Upper Silesia, Poland.

    Science.gov (United States)

    Polańska, Joanna; Jarosz-Chobot, Przemysława

    2006-04-01

    Parental age and birth order as risk factors for childhood type 1 diabetes mellitus were investigated using data from the Regional Diabetic Center for Upper Silesia, Poland, in a population-based study of 398 children with type 1 DM aged 0-14 years born between 1979-1996. Noting differences in the proportions of children of different birth order between cases and controls, the data were stratified by birth order. For each stratum, odds ratios and their 95% confidence intervals were calculated to assess risks related to the mother's age. The homogeneity of the odds ratios related to the mother's age between strata was evaluated by the Mantel-Haenszel method. Risks related to mother's age and birth order were also estimated jointly by multivariable logistic regression. Decreased risk in later children compared with firstborns was noted. Increased maternal age was found to be a risk factor for type 1 DM. An increase in the mother's age by one year increases the risk of the child being affected by type 1 DM 1.07 times, and children born as the nth in the family are 1.59 times less exposed to the same risk than those born as the (n-1)th. Children of different birth order have different risks of being affected by type 1 DM. Increased maternal age at the time of delivery is a risk factor for type 1 DM in Upper Silesia, Poland. To avoid bias in estimating risks, the mother's age and child's sequence number should be analyzed jointly.

  13. Teen Dating Violence and Substance Use Following a Natural Disaster: Does Evacuation Status Matter?

    Science.gov (United States)

    Temple, Jeff R.; van den Berg, Patricia; Thomas, John F. “Fred”; Northcutt, James; Thomas, Christopher; Freeman, Daniel H.

    2012-01-01

    Objectives In September of 2008 the Texas coast was directly hit by Hurricane Ike. Galveston was flooded by 14 feet of storm surge, affecting most of the Island’s housing and infrastructure. The purpose of the present study is to examine whether youth who did not evacuate (11%), and subsequently were exposed to Hurricane Ike, exhibit higher rates of substance use and physical and sexual teen dating violence (both perpetration and victimization), relative to adolescents who did evacuate. Setting Public high school in southeast Texas that was in the direct path of Hurricane Ike. Participants An anonymous survey was administered in March 2009 to 1,048 high-school students who returned to Galveston post-storm (41% Hispanic, 23% African-American, 27% White). Main Outcome Measures Teen dating violence and substance use. Results Mantel-Haenszel odds ratios, adjusting for age and ethnicity, were computed. Compared to boys who evacuated, non-evacuating boys were more likely to perpetrate physical dating violence and sexual assault, and to be a victim of sexual assault. Non-evacuating boys and girls were more likely than those who did evacuate to report recent use of excessive alcohol, marijuana, and cocaine. Conclusions School personnel, medical personnel, and mental health service providers should consider screening for evacuation status in seeking to identify those adolescents who most need services after a natural disaster. Further, in addition to addressing internalized emotions and psychological symptoms associated with experiencing trauma, intervention programs should focus on reducing externalized behavior such as substance use and teen dating violence. PMID:22010597

  14. Occupational risk factors associated with voice disorders among teachers.

    Science.gov (United States)

    Thibeault, Susan L; Merrill, Ray M; Roy, Nelson; Gray, Steven D; Smith, Elaine M

    2004-11-01

    This study was designed to determine the occupational risk factors associated with voice disorders among schoolteachers, a high-risk population for developing voice problems. Telephone interviews were completed by 1243 teachers from Utah and Iowa. Response rates were 98% and 95%, respectively. Bivariate analyses were computed and assessed using chi-square test and Cochran-Mantel-Haenszel test, and logistic regression analyses were performed and resulting odds ratios assessed using 95% confidence intervals. Teachers of vocal music, drama, other performing arts and chemistry were at significantly greater risk of having a voice disorder (OR=2.2, 95% CI: 1.2-4.0; OR=2.1, 95% CI: 0.9-4.8; OR=1.6, 95% CI: 1.0-2.4; OR=2.0, 95% CI: 1.1-3.4), while teachers of special and vocational education had a significantly lower risk (OR=0.5, 95% CI: 0.3-0.7; OR=0.6, 95% CI: 0.4-0.9). When adjusted for the intensity of vocalization, only teachers of chemistry were significantly at risk (OR=2.0, 95% CI: 1.1-3.5) while teachers of special education continued to have less of a risk (OR=0.5, 95% CI: 0.4-0.8). Chronic voice disorders were more prevalent among teachers of vocal music (OR=4.1, 95% CI: 2.2-7.9) and less prevalent among teachers of vocational education (OR=0.29, 95% CI: 0.09-0.95). These findings suggest that teachers of specific courses are at greater risk of developing a voice disorder.

  15. Bortezomib-based vs non-bortezomib-based post-transplantation treatment in multiple myeloma patients: a systematic review and meta-analysis of Phase III randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Liu XP

    2015-06-01

    Full Text Available Xiaoping Liu,1 Colin K He,2 Xiangyu Meng,1 Li He,1 Kaili Li,1 Qing Liang,1 Liang Shao,1 Shangqin Liu1 1Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Orient Health Care, NYC, USA Objective: To evaluate the efficacy and safety of bortezomib-based vs non-bortezomib-based post-transplantation therapy in patients with multiple myeloma.Methods: Data of relevant randomized controlled trials assessing the effect of bortezomib as post-transplantation consolidation or maintenance therapy was obtained through a comprehensive search. The outcome measures included response rate, progression-free survival, overall survival, and adverse events (AEs. The hazard ratio (HR, Cochran-Mantel-Haenszel odds ratio (OR, and 95% confidence interval (95% CI were applied to evaluate the effect of bortezomib in relation to the end points such as progression-free survival, overall survival, response rate, and AEs.Results: Three randomized controlled trials comprising 1,518 participants were included in this study. Pooled ORs for the rates of overall response, and complete response and near complete response, were 1.85 and 1.75, respectively. Pooled HR for progression-free survival favored bortezomib-based therapy over non-bortezomib-based therapy (0.73, 95% CI: 0.67–0.81, while no statistically significant difference could be found between the two groups regarding the pooled HR for 3-year overall survival. Moreover, incidence rates of overall adverse events and grade 3 and 4 peripheral neuropathy were similar in the bortezomib-based groups and the non-bortezomib-based groups (P=0.12 and P=0.41, respectively. The corresponding cumulative meta-analyses of the rates of overall response rate, complete response and near complete response, and grades 3 and 4 peripheral neuropathy supported the superiority of bortezomib-based maintenance therapy over consolidation therapy.Conclusion: Bortezomib-based therapy after

  16. Habitat fragmentation causes rapid genetic differentiation and ...

    African Journals Online (AJOL)

    ... city buildings. These results were supported by multiple statistical analyses including Mantel's test, PCOORDA and AMOVA. Genetic enrichment and epigenetic variation studies can be included in habitat fragmentation analysis and its implications in inducing homogenization and susceptibility in natural plant populations.

  17. Mechanistic approach to generalized technical analysis of share prices and stock market indices

    Science.gov (United States)

    Ausloos, M.; Ivanova, K.

    2002-05-01

    Classical technical analysis methods of stock evolution are recalled, i.e. the notion of moving averages and momentum indicators. The moving averages lead to define death and gold crosses, resistance and support lines. Momentum indicators lead the price trend, thus give signals before the price trend turns over. The classical technical analysis investment strategy is thereby sketched. Next, we present a generalization of these tricks drawing on physical principles, i.e. taking into account not only the price of a stock but also the volume of transactions. The latter becomes a time dependent generalized mass. The notion of pressure, acceleration and force are deduced. A generalized (kinetic) energy is easily defined. It is understood that the momentum indicators take into account the sign of the fluctuations, while the energy is geared toward the absolute value of the fluctuations. They have different patterns which are checked by searching for the crossing points of their respective moving averages. The case of IBM evolution over 1990-2000 is used for illustrations.

  18. Analysis of General Power Counting Rules in Effective Field Theory

    CERN Document Server

    Gavela, B M; Manohar, A V; Merlo, L

    2016-01-01

    We derive the general counting rules for a quantum effective field theory (EFT) in $\\mathsf{d}$ dimensions. The rules are valid for strongly and weakly coupled theories, and predict that all kinetic energy terms are canonically normalized. They determine the energy dependence of scattering cross sections in the range of validity of the EFT expansion. The size of cross sections is controlled by the $\\Lambda$ power counting of EFT, not by chiral counting, even for chiral perturbation theory ($\\chi$PT). The relation between $\\Lambda$ and $f$ is generalized to $\\mathsf{d}$ dimensions. We show that the naive dimensional analysis $4\\pi$ counting is related to $\\hbar$ counting. The EFT counting rules are applied to $\\chi$PT, to Standard Model EFT and to the non-trivial case of Higgs EFT, which combines the $\\Lambda$ and chiral counting rules within a single theory.

  19. Cost-effectiveness analysis of HPV vaccination: comparing the general population with socially vulnerable individuals.

    Science.gov (United States)

    Han, Kyu-Tae; Kim, Sun Jung; Lee, Seo Yoon; Park, Eun-Cheol

    2014-01-01

    After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

  20. Generalized solution of design optimization and failure analysis of composite drive shaft

    Energy Technology Data Exchange (ETDEWEB)

    Kollipalli, K.; Shivaramakrishna, K.V.S.; Prabhakaran, R.T.D. [Birla Institute of Technology and Science, Goa (India)

    2012-07-01

    Composites have an edge over conventional metals like steel and aluminum due to higher stiffness-to-weight ratio and strength-to-weight ratio. Due to these advantages, composites can bring out a revolutionary change in materials used in automotive engineering, as weight savings has positive impacts on other attributes like fuel economy and possible noise, vibration and harshness (NVH). In this paper, the drive line system of an automotive system is targeted for use of composites by keeping constraints in view such as such as torque transmission, torsional buckling load and fundamental natural frequency. Composite drive shafts made of three different composites ('HM Carbon/HS Carbon/E-glass'-epoxy) was modeled using Catia V5R16 CPD workbench and a finite element analysis with boundary conditions, fiber orientation and stacking sequence was performed using ANSYS Composite module. Results obtained were compared to theoretical results and were found to be accurate and in the limits. This paper also speaks on drive shaft modeling and analysis generalization i.e., changes in stacking sequence in the future can be incorporated directly into ANSYS model without modeling it again in Catia. Hence the base model and analysis method made up in this analysis generalization facilitated by CAD/CAE can be used to carry out any composite shaft design optimization process. (Author)

  1. Multivariate Generalized Multiscale Entropy Analysis

    Directory of Open Access Journals (Sweden)

    Anne Humeau-Heurtier

    2016-11-01

    Full Text Available Multiscale entropy (MSE was introduced in the 2000s to quantify systems’ complexity. MSE relies on (i a coarse-graining procedure to derive a set of time series representing the system dynamics on different time scales; (ii the computation of the sample entropy for each coarse-grained time series. A refined composite MSE (rcMSE—based on the same steps as MSE—also exists. Compared to MSE, rcMSE increases the accuracy of entropy estimation and reduces the probability of inducing undefined entropy for short time series. The multivariate versions of MSE (MMSE and rcMSE (MrcMSE have also been introduced. In the coarse-graining step used in MSE, rcMSE, MMSE, and MrcMSE, the mean value is used to derive representations of the original data at different resolutions. A generalization of MSE was recently published, using the computation of different moments in the coarse-graining procedure. However, so far, this generalization only exists for univariate signals. We therefore herein propose an extension of this generalized MSE to multivariate data. The multivariate generalized algorithms of MMSE and MrcMSE presented herein (MGMSE and MGrcMSE, respectively are first analyzed through the processing of synthetic signals. We reveal that MGrcMSE shows better performance than MGMSE for short multivariate data. We then study the performance of MGrcMSE on two sets of short multivariate electroencephalograms (EEG available in the public domain. We report that MGrcMSE may show better performance than MrcMSE in distinguishing different types of multivariate EEG data. MGrcMSE could therefore supplement MMSE or MrcMSE in the processing of multivariate datasets.

  2. Generalized functions and Fourier analysis dedicated to Stevan Pilipović on the occasion of his 65th birthday

    CERN Document Server

    Toft, Joachim; Vindas, Jasson; Wahlberg, Patrik

    2017-01-01

    This book gives an excellent and up-to-date overview on the convergence and joint progress in the fields of Generalized Functions and Fourier Analysis, notably in the core disciplines of pseudodifferential operators, microlocal analysis and time-frequency analysis. The volume is a collection of chapters addressing these fields, their interaction, their unifying concepts and their applications and is based on scientific activities related to the International Association for Generalized Functions (IAGF) and the ISAAC interest groups on Pseudo-Differential Operators (IGPDO) and on Generalized Functions (IGGF), notably on the longstanding collaboration of these groups within ISAAC.

  3. Application of generalized function to dynamic analysis of elasto-plastic thick plates

    International Nuclear Information System (INIS)

    Zheng, D.; Weng, Z.

    1987-01-01

    The elasto-plastic dynamic analysis of thick plates is of great significance to the research and the design on an anti-seismic structure and an anti-explosive structure. In this paper, the derivative of δ-function is handled by using the generalized function. The dynamic influence coefficient of thick plates in deduced. A dynamic response of elasto-plastic thick plates its material has hardening behaviour considered, is analysed by using known elastic solutions. The general expressions for the dynamic response of elasto-plastic rectangular thick plates subjected arbitrary loads are given. Detailed computations are performed for the square plates of various height-span ratios. The results are compared with those obtained from the improved theory and the classical theory of plates. The modification of the classical deflection theory for plates is employed. The increment analysis is used for calculations. The yield function is considered as a function of inplane and transverse shear stresses. (orig./GL)

  4. General analysis of slab lasers using geometrical optics.

    Science.gov (United States)

    Chung, Te-yuan; Bass, Michael

    2007-02-01

    A thorough and general geometrical optics analysis of a slab-shaped laser gain medium is presented. The length and thickness ratio is critical if one is to achieve the maximum utilization of absorbed pump power by the laser light in such a medium; e.g., the fill factor inside the slab is to be maximized. We point out that the conditions for a fill factor equal to 1, laser light entering and exiting parallel to the length of the slab, and Brewster angle incidence on the entrance and exit faces cannot all be satisfied at the same time. Deformed slabs are also studied. Deformation along the width direction of the largest surfaces is shown to significantly reduce the fill factor that is possible.

  5. A General Model for Thermal, Hydraulic and Electric Analysis of Superconducting Cables

    CERN Document Server

    Bottura, L; Rosso, C

    2000-01-01

    In this paper we describe a generic, multi-component and multi-channel model for the analysis of superconducting cables. The aim of the model is to treat in a general and consistent manner simultaneous thermal, electric and hydraulic transients in cables. The model is devised for most general situations, but reduces in limiting cases to most common approximations without loss of efficiency. We discuss here the governing equations, and we write them in a matrix form that is well adapted to numerical treatment. We finally demonstrate the model capability by comparison with published experimental data on current distribution in a two-strand cable.

  6. Contributions to sensitivity analysis and generalized discriminant analysis; Contributions a l'analyse de sensibilite et a l'analyse discriminante generalisee

    Energy Technology Data Exchange (ETDEWEB)

    Jacques, J

    2005-12-15

    Two topics are studied in this thesis: sensitivity analysis and generalized discriminant analysis. Global sensitivity analysis of a mathematical model studies how the output variables of this last react to variations of its inputs. The methods based on the study of the variance quantify the part of variance of the response of the model due to each input variable and each subset of input variables. The first subject of this thesis is the impact of a model uncertainty on results of a sensitivity analysis. Two particular forms of uncertainty are studied: that due to a change of the model of reference, and that due to the use of a simplified model with the place of the model of reference. A second problem was studied during this thesis, that of models with correlated inputs. Indeed, classical sensitivity indices not having significance (from an interpretation point of view) in the presence of correlation of the inputs, we propose a multidimensional approach consisting in expressing the sensitivity of the output of the model to groups of correlated variables. Applications in the field of nuclear engineering illustrate this work. Generalized discriminant analysis consists in classifying the individuals of a test sample in groups, by using information contained in a training sample, when these two samples do not come from the same population. This work extends existing methods in a Gaussian context to the case of binary data. An application in public health illustrates the utility of generalized discrimination models thus defined. (author)

  7. Generalized canonical correlation analysis of matrices with missing rows : A simulation study

    NARCIS (Netherlands)

    van de Velden, Michel; Bijmolt, Tammo H. A.

    A method is presented for generalized canonical correlation analysis of two or more matrices with missing rows. The method is a combination of Carroll's (1968) method and the missing data approach of the OVERALS technique (Van der Burg, 1988). In a simulation study we assess the performance of the

  8. Feature extraction with deep neural networks by a generalized discriminant analysis.

    Science.gov (United States)

    Stuhlsatz, André; Lippel, Jens; Zielke, Thomas

    2012-04-01

    We present an approach to feature extraction that is a generalization of the classical linear discriminant analysis (LDA) on the basis of deep neural networks (DNNs). As for LDA, discriminative features generated from independent Gaussian class conditionals are assumed. This modeling has the advantages that the intrinsic dimensionality of the feature space is bounded by the number of classes and that the optimal discriminant function is linear. Unfortunately, linear transformations are insufficient to extract optimal discriminative features from arbitrarily distributed raw measurements. The generalized discriminant analysis (GerDA) proposed in this paper uses nonlinear transformations that are learnt by DNNs in a semisupervised fashion. We show that the feature extraction based on our approach displays excellent performance on real-world recognition and detection tasks, such as handwritten digit recognition and face detection. In a series of experiments, we evaluate GerDA features with respect to dimensionality reduction, visualization, classification, and detection. Moreover, we show that GerDA DNNs can preprocess truly high-dimensional input data to low-dimensional representations that facilitate accurate predictions even if simple linear predictors or measures of similarity are used.

  9. The Social Profile of Students in Basic General Education in Ecuador: A Data Analysis

    Science.gov (United States)

    Buri, Olga Elizabeth Minchala; Stefos, Efstathios

    2017-01-01

    The objective of this study is to examine the social profile of students who are enrolled in Basic General Education in Ecuador. Both a descriptive and multidimensional statistical analysis was carried out based on the data provided by the National Survey of Employment, Unemployment and Underemployment in 2015. The descriptive analysis shows the…

  10. Robust periodic steady state analysis of autonomous oscillators based on generalized eigenvalues

    NARCIS (Netherlands)

    Mirzavand, R.; Maten, ter E.J.W.; Beelen, T.G.J.; Schilders, W.H.A.; Abdipour, A.

    2011-01-01

    In this paper, we present a new gauge technique for the Newton Raphson method to solve the periodic steady state (PSS) analysis of free-running oscillators in the time domain. To find the frequency a new equation is added to the system of equations. Our equation combines a generalized eigenvector

  11. Robust periodic steady state analysis of autonomous oscillators based on generalized eigenvalues

    NARCIS (Netherlands)

    Mirzavand, R.; Maten, ter E.J.W.; Beelen, T.G.J.; Schilders, W.H.A.; Abdipour, A.; Michielsen, B.; Poirier, J.R.

    2012-01-01

    In this paper, we present a new gauge technique for the Newton Raphson method to solve the periodic steady state (PSS) analysis of free-running oscillators in the time domain. To find the frequency a new equation is added to the system of equations. Our equation combines a generalized eigenvector

  12. General practice-based clinical trials in Germany - a problem analysis

    Directory of Open Access Journals (Sweden)

    Hummers-Pradier Eva

    2012-11-01

    Full Text Available Abstract Background In Germany, clinical trials and comparative effectiveness studies in primary care are still very rare, while their usefulness has been recognised in many other countries. A network of researchers from German academic general practice has explored the reasons for this discrepancy. Methods Based on a comprehensive literature review and expert group discussions, problem analyses as well as structural and procedural prerequisites for a better implementation of clinical trials in German primary care are presented. Results In Germany, basic biomedical science and technology is more reputed than clinical or health services research. Clinical trials are funded by industry or a single national programme, which is highly competitive, specialist-dominated, exclusive of pilot studies, and usually favours innovation rather than comparative effectiveness studies. Academic general practice is still not fully implemented, and existing departments are small. Most general practitioners (GPs work in a market-based, competitive setting of small private practices, with a high case load. They have no protected time or funding for research, and mostly no research training or experience. Good Clinical Practice (GCP training is compulsory for participation in clinical trials. The group defined three work packages to be addressed regarding clinical trials in German general practice: (1 problem analysis, and definition of (2 structural prerequisites and (3 procedural prerequisites. Structural prerequisites comprise specific support facilities for general practice-based research networks that could provide practices with a point of contact. Procedural prerequisites consist, for example, of a summary of specific relevant key measures, for example on a web platform. The platform should contain standard operating procedures (SOPs, templates, checklists and other supporting materials for researchers. Conclusion All in all, our problem analyses revealed that

  13. Generalization in the XCSF classifier system: analysis, improvement, and extension.

    Science.gov (United States)

    Lanzi, Pier Luca; Loiacono, Daniele; Wilson, Stewart W; Goldberg, David E

    2007-01-01

    We analyze generalization in XCSF and introduce three improvements. We begin by showing that the types of generalizations evolved by XCSF can be influenced by the input range. To explain these results we present a theoretical analysis of the convergence of classifier weights in XCSF which highlights a broader issue. In XCSF, because of the mathematical properties of the Widrow-Hoff update, the convergence of classifier weights in a given subspace can be slow when the spread of the eigenvalues of the autocorrelation matrix associated with each classifier is large. As a major consequence, the system's accuracy pressure may act before classifier weights are adequately updated, so that XCSF may evolve piecewise constant approximations, instead of the intended, and more efficient, piecewise linear ones. We propose three different ways to update classifier weights in XCSF so as to increase the generalization capabilities of XCSF: one based on a condition-based normalization of the inputs, one based on linear least squares, and one based on the recursive version of linear least squares. Through a series of experiments we show that while all three approaches significantly improve XCSF, least squares approaches appear to be best performing and most robust. Finally we show how XCSF can be extended to include polynomial approximations.

  14. Generalized direct Lyapunov method for the analysis of stability and attraction in general time systems

    International Nuclear Information System (INIS)

    Druzhinina, O V; Shestakov, A A

    2002-01-01

    A generalized direct Lyapunov method is put forward for the study of stability and attraction in general time systems of the following types: the classical dynamical system in the sense of Birkhoff, the general system in the sense of Zubov, the general system in the sense of Seibert, the general system with delay, and the general 'input-output' system. For such systems, with the help of generalized Lyapunov functions with respect to two filters, two quasifilters, or two filter bases, necessary and sufficient conditions for stability and attraction are obtained under minimal assumptions about the mathematical structure of the general system

  15. Application of discriminant analysis and generalized distance measures to uranium exploration

    International Nuclear Information System (INIS)

    Beauchamp, J.J.; Begovich, C.L.; Kane, V.E.; Wolf, D.A.

    1979-10-01

    The National Uranium Resource Evaluation (NURE) Project has as its goal estimation of the nation's uranium resources. It is possible to use discriminant analysis methods on hydrogeochemical data collected in the NURE Program to aid in formulating geochemical models which can be used to identify the anomalous regions necessary for resource estimation. Discriminant analysis methods have been applied to data from the Plainview, Texas Quadrangle which has approximately 850 groundwater samples with more than 40 quantitative measurements per sample. Discriminant analysis topics involving estimation of misclassification probabilities, variable selection, and robust discrimination are applied. A method using generalized distance measures is given which enables assigning samples to a background population or a mineralized population whose parameters were estimated from separate studies. Each topic is related to its relevance in identifying areas of possible interest to uranium exploration

  16. GenAlEx 6.5: genetic analysis in Excel. Population genetic software for teaching and research--an update.

    Science.gov (United States)

    Peakall, Rod; Smouse, Peter E

    2012-10-01

    GenAlEx: Genetic Analysis in Excel is a cross-platform package for population genetic analyses that runs within Microsoft Excel. GenAlEx offers analysis of diploid codominant, haploid and binary genetic loci and DNA sequences. Both frequency-based (F-statistics, heterozygosity, HWE, population assignment, relatedness) and distance-based (AMOVA, PCoA, Mantel tests, multivariate spatial autocorrelation) analyses are provided. New features include calculation of new estimators of population structure: G'(ST), G''(ST), Jost's D(est) and F'(ST) through AMOVA, Shannon Information analysis, linkage disequilibrium analysis for biallelic data and novel heterogeneity tests for spatial autocorrelation analysis. Export to more than 30 other data formats is provided. Teaching tutorials and expanded step-by-step output options are included. The comprehensive guide has been fully revised. GenAlEx is written in VBA and provided as a Microsoft Excel Add-in (compatible with Excel 2003, 2007, 2010 on PC; Excel 2004, 2011 on Macintosh). GenAlEx, and supporting documentation and tutorials are freely available at: http://biology.anu.edu.au/GenAlEx. rod.peakall@anu.edu.au.

  17. Equity and vaccine uptake: a cross-sectional study of measles vaccination in Lasbela District, Pakistan

    Directory of Open Access Journals (Sweden)

    Soberanis José

    2009-10-01

    Full Text Available Abstract Background Achieving equity means increased uptake of health services for those who need it most. But the poorest families continue to have the poorest service. In Pakistan, large numbers of children do not access vaccination against measles despite the national government's effort to achieve universal coverage. Methods A cross-sectional study of a random sample of 23 rural and 9 urban communities in the Lasbela district of south Pakistan, explored knowledge, attitudes and discussion around measles vaccination. Several socioeconomic variables allowed examination of the role of inequities in vaccination uptake; 2479 mothers provided information about 4007 children aged 10 to 59 months. A Mantel-Haenszel stratification analysis, with and without adjustment for clustering, clarified determinants of measles vaccination in urban and rural areas. Results A high proportion of mothers had appropriate knowledge of and positive attitudes to vaccination; many discussed vaccination, but only one half of children aged 10-59 months accessed vaccination. In urban areas, having an educated mother, discussing vaccinations, having correct knowledge about vaccinations, living in a community with a government vaccination facility within 5 km, and living in houses with better roofs were associated with vaccination uptake after adjusting for the effect of each of these variables and for clustering; maternal education was an equity factor even among those with good access. In rural areas, the combination of roof quality and access (vaccination post within 5 km along with discussion about vaccines and knowledge about vaccines had an effect on uptake. Conclusion Stagnating rates of vaccination coverage may be related to increasing inequities. A hopeful finding is that discussion about vaccines and knowledge about vaccines had a positive effect that was independent of the negative effect of inequity - in both urban and rural areas. At least as a short term

  18. Subjective difficulties in young people related to extensive loud music listening

    Directory of Open Access Journals (Sweden)

    Budimčić Milenko

    2010-01-01

    Full Text Available Introduction. For human ear, noise represents every undesirable and valueless sound. In disco clubs, as in some other places with loud music mostly attended by young people, the level of noise sometimes attains over 100 dB. As reported by numerous studies, a high noise level could induce subjective difficulties (ear buzzing, audition loss, vertigo and palpitations, anxiety, high blood pressure, decreased concentration, lowered memory storing. Objective. Assessment of subjective difficulties occurring in young people when staying in places with a high noise level (cafes, disco clubs, rock concerts, which can produce health problems, due to loud music, in association with demographic data, addictions and personal life style data. One of the goals is to find factors leading to subjective difficulties, which would be objectively studied in the second stage of the research and marked as early predictors of possible health problems. Methods. The study was conducted among 780 students of the Higher Healthcare School of Professional Studied in Belgrade. We used a questionnaire with 20 questions, divided into four categories: demographic data, case-history data, subjective problems and addictions of the subjects. In the statistical data processing we used the methods of descriptive and exploratory analysis, chi-square tests, correlation tests and Mantel-Haenszel odds ratio. Results. After listening loud music, 54.0% of examined subjects felt ear buzzing, and 4.6% had hearing damage. The habit of visiting places with loud music, mostly once a week in duration of 2-3 hours per visit had 80.4% of subjects. The presence of subjective complaints after listening of loud music was in association with loud music listening and disco clubs visits. The major reasons of the present subjective difficulties could be predicated by listening of loud music and club visits (r=0.918 and r=0.857. A relative risk for subjective difficulties presentation was 1.599. Conclusion

  19. [Subjective difficulties in young people related to extensive loud music listening].

    Science.gov (United States)

    Budimcić, Milenko; Ignatović, Snezana; Zivić, Ljubica

    2010-01-01

    For human ear, noise represents every undesirable and valueless sound. In disco clubs, as in some other places with loud music mostly attended by young people, the level of noise sometimes attains over 100 dB. As reported by numerous studies, a high noise level could induce subjective difficulties (ear buzzing, audition loss, vertigo and palpitations, anxiety, high blood pressure, decreased concentration, lowered memory storing). Assessment of subjective difficulties occurring in young people when staying in places with a high noise level (cafes, disco clubs, rock concerts), which can produce health problems, due to loud music, in association with demographic data, addictions and personal life style data. One of the goals is to find factors leading to subjective difficulties, which would be objectively studied in the second stage of the research and marked as early predictors of possible health problems. The study was conducted among 780 students of the Higher Healthcare School of Professional Studied in Belgrade. We used a questionnaire with 20 questions, divided into four categories: demographic data, case-history data, subjective problems and addictions of the subjects. In the statistical data processing we used the methods of descriptive and exploratory analysis, chi-square tests, correlation tests and Mantel-Haenszel odds ratio. After listening loud music, 54.0% of examined subjects felt ear buzzing, and 4.6% had hearing damage. The habit of visiting places with loud music, mostly once a week in duration of 2-3 hours per visit had 80.4% of subjects. The presence of subjective complaints after listening of loud music was in association with loud music listening and disco clubs visits.The major reasons of the present subjective difficulties could be predicated by listening of loud music and club visits (r = 0.918 and r = 0.857). A relative risk for subjective difficulties presentation was 1.599. According to the results of our study, over half of children

  20. The skin barrier function gene SPINK5 is associated with challenge-proven IgE-mediated food allergy in infants.

    Science.gov (United States)

    Ashley, S E; Tan, H-T T; Vuillermin, P; Dharmage, S C; Tang, M L K; Koplin, J; Gurrin, L C; Lowe, A; Lodge, C; Ponsonby, A-L; Molloy, J; Martin, P; Matheson, M C; Saffery, R; Allen, K J; Ellis, J A; Martino, D

    2017-09-01

    A defective skin barrier is hypothesized to be an important route of sensitization to dietary antigens and may lead to food allergy in some children. Missense mutations in the serine peptidase inhibitor Kazal type 5 (SPINK5) skin barrier gene have previously been associated with allergic conditions. To determine whether genetic variants in and around SPINK5 are associated with IgE-mediated food allergy. We genotyped 71 "tag" single nucleotide polymorphisms (tag-SNPs) within a region spanning ~263 kb including SPINK5 (~61 kb) in n=722 (n=367 food-allergic, n=199 food-sensitized-tolerant and n=156 non-food-allergic controls) 12-month-old infants (discovery sample) phenotyped for food allergy with the gold standard oral food challenge. Transepidermal water loss (TEWL) measures were collected at 12 months from a subset (n=150) of these individuals. SNPs were tested for association with food allergy using the Cochran-Mantel-Haenszel test adjusting for ancestry strata. Association analyses were replicated in an independent sample group derived from four paediatric cohorts, total n=533 (n=203 food-allergic, n=330 non-food-allergic), mean age 2.5 years, with food allergy defined by either clinical history of reactivity, 95% positive predictive value (PPV) or challenge, corrected for ancestry by principal components. SPINK5 variant rs9325071 (A⟶G) was associated with challenge-proven food allergy in the discovery sample (P=.001, OR=2.95, CI=1.49-5.83). This association was further supported by replication (P=.007, OR=1.58, CI=1.13-2.20) and by meta-analysis (P=.0004, OR=1.65). Variant rs9325071 is associated with decreased SPINK5 gene expression in the skin in publicly available genotype-tissue expression data, and we generated preliminary evidence for association of this SNP with elevated TEWL also. We report, for the first time, association between SPINK5 variant rs9325071 and challenge-proven IgE-mediated food allergy. © 2017 EAACI and John Wiley and Sons A

  1. Generalized causal mediation and path analysis: Extensions and practical considerations.

    Science.gov (United States)

    Albert, Jeffrey M; Cho, Jang Ik; Liu, Yiying; Nelson, Suchitra

    2018-01-01

    Causal mediation analysis seeks to decompose the effect of a treatment or exposure among multiple possible paths and provide casually interpretable path-specific effect estimates. Recent advances have extended causal mediation analysis to situations with a sequence of mediators or multiple contemporaneous mediators. However, available methods still have limitations, and computational and other challenges remain. The present paper provides an extended causal mediation and path analysis methodology. The new method, implemented in the new R package, gmediation (described in a companion paper), accommodates both a sequence (two stages) of mediators and multiple mediators at each stage, and allows for multiple types of outcomes following generalized linear models. The methodology can also handle unsaturated models and clustered data. Addressing other practical issues, we provide new guidelines for the choice of a decomposition, and for the choice of a reference group multiplier for the reduction of Monte Carlo error in mediation formula computations. The new method is applied to data from a cohort study to illuminate the contribution of alternative biological and behavioral paths in the effect of socioeconomic status on dental caries in adolescence.

  2. An examination of generalized anxiety disorder and dysthymic disorder by latent class analysis

    NARCIS (Netherlands)

    Rhebergen, D.; van der Steenstraten, I.M.; Sunderland, M.; de Graaf, R.; ten Have, M.; Lamers, F.; Penninx, B.W.J.H.; Andrews, G.

    2014-01-01

    Background The nosological status of generalized anxiety disorder (GAD) versus dysthymic disorder (DD) has been questioned. The aim of this study was to examine qualitative differences within (co-morbid) GAD and DD symptomatology. Method Latent class analysis was applied to anxious and depressive

  3. Refined generalized multiscale entropy analysis for physiological signals

    Science.gov (United States)

    Liu, Yunxiao; Lin, Youfang; Wang, Jing; Shang, Pengjian

    2018-01-01

    Multiscale entropy analysis has become a prevalent complexity measurement and been successfully applied in various fields. However, it only takes into account the information of mean values (first moment) in coarse-graining procedure. Then generalized multiscale entropy (MSEn) considering higher moments to coarse-grain a time series was proposed and MSEσ2 has been implemented. However, the MSEσ2 sometimes may yield an imprecise estimation of entropy or undefined entropy, and reduce statistical reliability of sample entropy estimation as scale factor increases. For this purpose, we developed the refined model, RMSEσ2, to improve MSEσ2. Simulations on both white noise and 1 / f noise show that RMSEσ2 provides higher entropy reliability and reduces the occurrence of undefined entropy, especially suitable for short time series. Besides, we discuss the effect on RMSEσ2 analysis from outliers, data loss and other concepts in signal processing. We apply the proposed model to evaluate the complexity of heartbeat interval time series derived from healthy young and elderly subjects, patients with congestive heart failure and patients with atrial fibrillation respectively, compared to several popular complexity metrics. The results demonstrate that RMSEσ2 measured complexity (a) decreases with aging and diseases, and (b) gives significant discrimination between different physiological/pathological states, which may facilitate clinical application.

  4. IEEE guide for general principles of reliability analysis of nuclear power generating station protection systems

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    Presented is the Institute of Electrical and Electronics Engineers, Inc. (IEEE) guide for general principles of reliability analysis of nuclear power generating station protection systems. The document has been prepared to provide the basic principles needed to conduct a reliability analysis of protection systems. Included is information on qualitative and quantitative analysis, guides for failure data acquisition and use, and guide for establishment of intervals

  5. Analysis of nonlocal neural fields for both general and gamma-distributed connectivities

    Science.gov (United States)

    Hutt, Axel; Atay, Fatihcan M.

    2005-04-01

    This work studies the stability of equilibria in spatially extended neuronal ensembles. We first derive the model equation from statistical properties of the neuron population. The obtained integro-differential equation includes synaptic and space-dependent transmission delay for both general and gamma-distributed synaptic connectivities. The latter connectivity type reveals infinite, finite, and vanishing self-connectivities. The work derives conditions for stationary and nonstationary instabilities for both kernel types. In addition, a nonlinear analysis for general kernels yields the order parameter equation of the Turing instability. To compare the results to findings for partial differential equations (PDEs), two typical PDE-types are derived from the examined model equation, namely the general reaction-diffusion equation and the Swift-Hohenberg equation. Hence, the discussed integro-differential equation generalizes these PDEs. In the case of the gamma-distributed kernels, the stability conditions are formulated in terms of the mean excitatory and inhibitory interaction ranges. As a novel finding, we obtain Turing instabilities in fields with local inhibition-lateral excitation, while wave instabilities occur in fields with local excitation and lateral inhibition. Numerical simulations support the analytical results.

  6. Use of generalized regression models for the analysis of stress-rupture data

    International Nuclear Information System (INIS)

    Booker, M.K.

    1978-01-01

    The design of components for operation in an elevated-temperature environment often requires a detailed consideration of the creep and creep-rupture properties of the construction materials involved. Techniques for the analysis and extrapolation of creep data have been widely discussed. The paper presents a generalized regression approach to the analysis of such data. This approach has been applied to multiple heat data sets for types 304 and 316 austenitic stainless steel, ferritic 2 1 / 4 Cr-1 Mo steel, and the high-nickel austenitic alloy 800H. Analyses of data for single heats of several materials are also presented. All results appear good. The techniques presented represent a simple yet flexible and powerful means for the analysis and extrapolation of creep and creep-rupture data

  7. MGF Approach to the Analysis of Generalized Two-Ray Fading Models

    KAUST Repository

    Rao, Milind; Lopez-Martinez, F. Javier; Alouini, Mohamed-Slim; Goldsmith, Andrea

    2015-01-01

    We analyze a class of Generalized Two-Ray (GTR) fading channels that consist of two line of sight (LOS) components with random phase plus a diffuse component. We derive a closedform expression for the moment generating function (MGF) of the signal-to-noise ratio (SNR) for this model, which greatly simplifies its analysis. This expression arises from the observation that the GTR fading model can be expressed in terms of a conditional underlying Rician distribution. We illustrate the approach to derive simple expressions for statistics and performance metrics of interest such as the amount of fading, the level crossing rate, the symbol error rate, and the ergodic capacity in GTR fading channels. We also show that the effect of considering a more general distribution for the phase difference between the LOS components has an impact on the average SNR.

  8. Generalized canonical analysis based on optimizing matrix correlations and a relation with IDIOSCAL

    NARCIS (Netherlands)

    Kiers, Henk A.L.; Cléroux, R.; Ten Berge, Jos M.F.

    1994-01-01

    Carroll's method for generalized canonical analysis of two or more sets of variables is shown to optimize the sum of squared inner-product matrix correlations between a consensus matrix and matrices with canonical variates for each set of variables. In addition, the method that analogously optimizes

  9. Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective.

    Science.gov (United States)

    Chandran, D; Woods, C M; Schar, M; Ma, N; Ooi, E H; Athanasiadis, T

    2018-02-01

    To conduct a cost analysis of injection laryngoplasty performed in the operating theatre under local anaesthesia and general anaesthesia. The retrospective study included patients who had undergone injection laryngoplasty as day cases between July 2013 and March 2016. Cost data were obtained, along with patient demographics, anaesthetic details, type of injectant, American Society of Anesthesiologists score, length of stay, total operating theatre time and surgeon procedure time. A total of 20 cases (general anaesthesia = 6, local anaesthesia = 14) were included in the cost analysis. The mean total cost under general anaesthesia (AU$2865.96 ± 756.29) was significantly higher than that under local anaesthesia (AU$1731.61 ± 290.29) (p costs. Procedures performed under local anaesthesia in the operating theatre are associated with shorter operating theatre time and length of stay in the hospital, and provide significant cost savings. Further savings could be achieved if local anaesthesia procedures were performed in the office setting.

  10. Aberration analysis for freeform surface terms overlay on general decentered and tilted optical surfaces.

    Science.gov (United States)

    Yang, Tong; Cheng, Dewen; Wang, Yongtian

    2018-03-19

    Aberration theory helps designers to better understand the nature of imaging systems. However, the existing aberration theory of freeform surfaces has many limitations. For example, it only works in the special case when the central area of the freeform surface is used. In addition, the light footprint is limited to a circle, which does not match the case of an elliptical footprint for general systems. In this paper, aberrations generated by freeform surface term overlay on general decentered and tilted optical surfaces are analyzed. For the case when the off-axis section of a freeform surface is used, the aberration equation for using stop and nonstop surfaces is discussed, and the aberrations generated by Zernike terms up to Z 17/18 are analyzed in detail. To solve the problem of the elliptical light footprint for tilted freeform surfaces, the scaled pupil vector is used in the aberration analysis. The mechanism of aberration transformation is discovered, and the aberrations generated by different Zernike terms in this case are calculated. Finally we proposed aberration equations for freeform terms on general decentered and tilted freeform surfaces. The research result given in this paper offers an important reference for optical designers and engineers, and it is of great importance in developing analytical methods for general freeform system design, tolerance analysis, and system assembly.

  11. A unified MGF-based capacity analysis of diversity combiners over generalized fading channels

    KAUST Repository

    Yilmaz, Ferkan

    2012-03-01

    Unified exact ergodic capacity results for L-branch coherent diversity combiners including equal-gain combining (EGC) and maximal-ratio combining (MRC) are not known. This paper develops a novel generic framework for the capacity analysis of L-branch EGC/MRC over generalized fading channels. The framework is used to derive new results for the gamma-shadowed generalized Nakagami-m fading model which can be a suitable model for the fading environments encountered by high frequency (60 GHz and above) communications. The mathematical formalism is illustrated with some selected numerical and simulation results confirming the correctness of our newly proposed framework. © 2012 IEEE.

  12. Ethnicity, obesity and the prevalence of impaired glucose tolerance and type 2 diabetes in PCOS: a systematic review and meta-regression.

    Science.gov (United States)

    Kakoly, N S; Khomami, M B; Joham, A E; Cooray, S D; Misso, M L; Norman, R J; Harrison, C L; Ranasinha, S; Teede, H J; Moran, L J

    2018-03-26

    Our prior meta-analyses demonstrated an increased prevalence of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) with polycystic ovary syndrome (PCOS), but with substantial clinical heterogeneity. We aimed to update our previous review to quantify the prevalence of IGT and T2DM in PCOS with only quality studies (good and fair quality). We also aimed to examine the contribution of parameters including ethnicity, obesity and method of diagnosing T2DM in explaining the observed heterogeneity in IGT and T2DM prevalence in PCOS. We conducted a literature search (MEDLINE, CINAHL, EMBASE, clinical trial registries and hand-searching) up to June 2016 to identify studies reporting the prevalence of dysglycemia (IGT and T2DM) in women with and without PCOS. We included studies where women with PCOS (defined according to original National Institute of Health) were compared to women without PCOS for the end-points of the prevalence of IGT or T2DM. We excluded case reports, case series, editorials, and narrative reviews. Studies where PCOS was diagnosed by self-report, or where IGT or T2DM were measured by fasting glucose, only were excluded. We assessed the methodological quality of the included studies using a priori criteria based on the Newcastle-Ottawa Scaling (NOS) for non-randomized studies. Data are presented as odds ratio (OR) (95% CI) with random-effects meta-analysis by Mantel-Haenszel methods. We assessed the contribution of demographic and clinical factors to heterogeneity using subgroup and meta-regression analysis. We reviewed 4530 studies and included 40 eligible studies in the final analysis. On meta-analysis of quality studies, women with PCOS had an increased prevalence of IGT (OR = 3.26, 95% CI: 2.17-4.90) and T2DM (OR = 2.87, 95% CI: 1.44-5.72), which differed by ethnicity (for IGT, Asia: 5-fold, the Americas: 4-fold and Europe: 3-fold), was higher with obesity, and doubled among studies using self-report or administrative data for

  13. Identifying At-Risk Students in General Chemistry via Cluster Analysis of Affective Characteristics

    Science.gov (United States)

    Chan, Julia Y. K.; Bauer, Christopher F.

    2014-01-01

    The purpose of this study is to identify academically at-risk students in first-semester general chemistry using affective characteristics via cluster analysis. Through the clustering of six preselected affective variables, three distinct affective groups were identified: low (at-risk), medium, and high. Students in the low affective group…

  14. Application of discriminant analysis and generalized distance measures to uranium exploration

    International Nuclear Information System (INIS)

    Beauchamp, J.J.; Begovich, C.L.; Kane, V.E.; Wolf, D.A.

    1980-01-01

    The National Uranium Resource Evaluation (NURE) Program has as its goal the estimation of the nation's uranium resources. It is possile to use discriminant analysis methods on hydrogeochemical data collected in the NURE Program to aid in fomulating geochemical models that can be used to identify the anomalous areas used in resource estimation. Discriminant' analysis methods have been applied to data from the Plainview, Texas Quadrangle which has approximately 850 groundwater samples with more than 40 quantitative measurements per sample. Discriminant analysis topics involving estimation of misclassification probabilities, variable selection, and robust discrimination are applied. A method using generalized distance measures is given which enables the assignment of samples to a background population or a mineralized population whose parameters were estimated from separate studies. Each topic is related to its relevance in identifying areas of possible interest to uranium exploration. However, the methodology presented here is applicable to the identification of regions associated with other types of resources. 8 figures, 3 tables

  15. A Content Analysis of General Chemistry Laboratory Manuals for Evidence of Higher-Order Cognitive Tasks

    Science.gov (United States)

    Domin, Daniel S.

    1999-01-01

    The science laboratory instructional environment is ideal for fostering the development of problem-solving, manipulative, and higher-order thinking skills: the skills needed by today's learner to compete in an ever increasing technology-based society. This paper reports the results of a content analysis of ten general chemistry laboratory manuals. Three experiments from each manual were examined for evidence of higher-order cognitive activities. Analysis was based upon the six major cognitive categories of Bloom's Taxonomy of Educational Objectives: knowledge, comprehension, application, analysis, synthesis, and evaluation. The results of this study show that the overwhelming majority of general chemistry laboratory manuals provide tasks that require the use of only the lower-order cognitive skills: knowledge, comprehension, and application. Two of the laboratory manuals were disparate in having activities that utilized higher-order cognition. I describe the instructional strategies used within these manuals to foster higher-order cognitive development.

  16. The prevalence of insomnia in the general population in China: A meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xiao-Lan Cao

    Full Text Available This is the first meta-analysis of the pooled prevalence of insomnia in the general population of China. A systematic literature search was conducted via the following databases: PubMed, PsycINFO, EMBASE and Chinese databases (China National Knowledge Interne (CNKI, WanFang Data and SinoMed. Statistical analyses were performed using the Comprehensive Meta-Analysis program. A total of 17 studies with 115,988 participants met the inclusion criteria for the analysis. The pooled prevalence of insomnia in China was 15.0% (95% Confidence interval [CI]: 12.1%-18.5%. No significant difference was found in the prevalence between genders or across time period. The pooled prevalence of insomnia in population with a mean age of 43.7 years and older (11.6%; 95% CI: 7.5%-17.6% was significantly lower than in those with a mean age younger than 43.7 years (20.4%; 95% CI: 14.2%-28.2%. The prevalence of insomnia was significantly affected by the type of assessment tools (Q = 14.1, P = 0.001. The general population prevalence of insomnia in China is lower than those reported in Western countries but similar to those in Asian countries. Younger Chinese adults appear to suffer from more insomnia than older adults.CRD 42016043620.

  17. Contributions to sensitivity analysis and generalized discriminant analysis; Contributions a l'analyse de sensibilite et a l'analyse discriminante generalisee

    Energy Technology Data Exchange (ETDEWEB)

    Jacques, J

    2005-12-15

    Two topics are studied in this thesis: sensitivity analysis and generalized discriminant analysis. Global sensitivity analysis of a mathematical model studies how the output variables of this last react to variations of its inputs. The methods based on the study of the variance quantify the part of variance of the response of the model due to each input variable and each subset of input variables. The first subject of this thesis is the impact of a model uncertainty on results of a sensitivity analysis. Two particular forms of uncertainty are studied: that due to a change of the model of reference, and that due to the use of a simplified model with the place of the model of reference. A second problem was studied during this thesis, that of models with correlated inputs. Indeed, classical sensitivity indices not having significance (from an interpretation point of view) in the presence of correlation of the inputs, we propose a multidimensional approach consisting in expressing the sensitivity of the output of the model to groups of correlated variables. Applications in the field of nuclear engineering illustrate this work. Generalized discriminant analysis consists in classifying the individuals of a test sample in groups, by using information contained in a training sample, when these two samples do not come from the same population. This work extends existing methods in a Gaussian context to the case of binary data. An application in public health illustrates the utility of generalized discrimination models thus defined. (author)

  18. Lovastatin protects against experimental plague in mice.

    Directory of Open Access Journals (Sweden)

    Saravanan Ayyadurai

    Full Text Available BACKGROUND: Plague is an ectoparasite-borne deadly infection caused by Yersinia pestis, a bacterium classified among the group A bioterrorism agents. Thousands of deaths are reported every year in some African countries. Tetracyclines and cotrimoxazole are used in the secondary prophylaxis of plague in the case of potential exposure to Y. pestis, but cotrimoxazole-resistant isolates have been reported. There is a need for additional prophylactic measures. We aimed to study the effectiveness of lovastatin, a cholesterol-lowering drug known to alleviate the symptoms of sepsis, for plague prophylaxis in an experimental model. METHODOLOGY: Lovastatin dissolved in Endolipide was intraperitoneally administered to mice (20 mg/kg every day for 6 days prior to a Y. pestis Orientalis biotype challenge. Non-challenged, lovastatin-treated and challenged, untreated mice were also used as control groups in the study. Body weight, physical behavior and death were recorded both prior to infection and for 10 days post-infection. Samples of the blood, lungs and spleen were collected from dead mice for direct microbiological examination, histopathology and culture. The potential antibiotic effect of lovastatin was tested on blood agar plates. CONCLUSIONS/SIGNIFICANCE: Lovastatin had no in-vitro antibiotic effect against Y. pestis. The difference in the mortality between control mice (11/15; 73.5% and lovastatin-treated mice (3/15; 20% was significant (P<0.004; Mantel-Haenszel test. Dead mice exhibited Y. pestis septicemia and inflammatory destruction of lung and spleen tissues not seen in lovastatin-treated surviving mice. These data suggest that lovastatin may help prevent the deadly effects of plague. Field observations are warranted to assess the role of lovastatin in the prophylaxis of human plague.

  19. In Rural Eastern Ethiopia Hearing Loss Is the Most Frequent Disability during Childhood: A Community Based Survey.

    Science.gov (United States)

    Geda, Biftu; Berhane, Yemane; Assefa, Nega; Worku, Alemayehu

    2016-01-01

    The type and extent of childhood disability in Ethiopia is unknown due to lack of accurate and reliable data. This study tried to assess the magnitude and types of disabilities among children 0-14 years of age in eastern Ethiopia. We conducted a cross-sectional community-based study among households that are under demographic and health surveillance in eastern Ethiopia. The study population consisted of all children aged 0-14 year. A structured questionnaire was used to assess the type and severity of the disability. A total of 21,572 children in the age group 0-14 were screened for disability. Of which 586 (2.7%; 95% CI = 2.5%, 2.9%) had at least one kind of disability at the time of the survey. The proportion of disability increased as children were older; measured by the extended Mantel-Haenszel (M-H) chi square for linear trend (M-H = 48.74; Pdisability; 417 (71.2%; 95% CI = 67.5%, 74.9%). Among children with a disability, 179 (31.0%; 95% CI = 27.3%, 34.7%) had a combination of multiple disabilities and about a third, 200 (34.1%; 95% CI = 30.3%, 37.9%) had developed the disability during infancy. Magnitude of disability was higher among boys 335 (2.98%; 95% CIs = 2.66%, 3.30%) compared to girls 251 (2.44%; 95% CIs = 2.14%, 2.74%). Childhood disability is a health challenge in the study area and is already common at an early age. Permanent disability among children may be prevented by an early screening program in the routine child health services and adequate care, especially for hearing impairment.

  20. The prevalence of traumatic dental injuries to permanent anterior teeth and its relation with predisposing risk factors among 8-13 years school children of Vadodara city: An epidemiological study

    Directory of Open Access Journals (Sweden)

    M C Patel

    2012-01-01

    Full Text Available Background and objective: dental trauma is an irreversible pathology that after occurrence is characterized by life-long debilitating effects. The objectives of this study were to measure the prevalence of anterior teeth fracture and their association with predisposing factors such as lip coverage, molar relationship, overjet, and variables such as age, sex, cause, and place of trauma. Materials and Methods: an epidemiological cross-sectional study was carried out among 3708 school children aged 8-13 years in the Vadodara city. All children completed a questionnaire related to history of trauma to their anterior teeth after which they were examined for lip competence, Angle′s molar relationship amount of overjet and nature of trauma sustained. The results were statistically analyzed using the prevalence test, Chi-square test, and Mantel-Haenszel Common Odds Ratio. Results: the prevalence of traumatic injuries was 8.79% and the ratio of boys: girl′s was 1.28:1. Inadequate lip coverage group sustained about five times more injuries than the adequate lip coverage group (P = 0.000, OR= 5.407. The maximum traumatic injuries were seen in children having Angle Class II Div 1 molar relationship and/or overjet greater than 5.5 mm and was statistically significant (P<0.05. Maximum number of injuries occurred at 9 years of age. The most predominant injuries were enamel fractures, the most common place for occurrence was home and fall against object, the most frequent cause. Conclusion: the prevalence of dental injuries in the Vadodara city is high and it has a great potential to be considered as an emerging public health problem.

  1. Prevalence of the metabolic syndrome in a psychiatric hospital in Mexico.

    Science.gov (United States)

    Díaz-Castro, Lina; Cabello-Rangel, Héctor; Cuevas-Pineda, Guillermo J; Reza-Garduño, Horacio; Castañeda-González, Carlos J

    2011-01-01

    The metabolic syndrome (MS) is formed by elevated blood pressure, hypercholesterolemia, hypertriglyceridemía, hyperglycemia and abdominal obesity. Mexico occupies the second place worldwide in prevalence of obesity. It has been reported that the use of psychopharmaceuticals increase the risk of MS. To detect prevalence of MS in patients with a psychiatric diagnosis with or without psychopharmaceutical treatment. An observational, descriptive study was designed. Informed consent was obtained, enrolling a sample of 216 patients in the six-month period, all of them over 18 years of age. The following variables were measured: blood pressure, weight, height, waist circumference, triglyceride, glucose and high-density lipoprotein serum levels, by colorimetric enzyme assay in Roche analyzer. Student's t-test, and Cochran-Mantel- Haenszel and Fisher's exact test. A total of 50% of the sample had a waist circumference >88 cm; 10% glycemia superior to 110 mg/dl, 30% triglycerides >150 mg/dl; 14% met the MS criteria. When patients with and without MS were grouped, and glucose and triglycerides were compared, a p 0.0001 was obtained. With a 93.4% confidence interval, the relationship between sedentary life and MS was accepted. Women, aged 40-59 years tended to have MS, with 98.4% CI. The only family background associated to MS was obesity (97.7% CI). There is a positive relationship between MS and the use of typical or atypical antipsychotics. SSRIs are significantly related with MS: p 0.072 and 91.5% confidence interval, benzodiazepines with p 0.073 and 92.7% confidence interval. Only 14% of the sample had MS. Psychopharmaceuticals were associated to MS, women between 40 to 59 years having a greater risk.

  2. A Case Study on the Implementation of Local Health Insurance Benefit Packages

    Directory of Open Access Journals (Sweden)

    Supriyantoro Supriyantoro

    2015-06-01

    Full Text Available Background: The variation of benefit packages implemented by some local social health insurance schemes (Jamkesda become an important issue in the effort to integrating them into National Health Insurance (JKN. This study aims to describe implementation of Jamkesda’s benefit packages as a basic consideration in integration to JKN. Methods: Design of this study is case study with qualitative and quantitative aproaches, conducted 2013–2014 in all of districts/cities which already have Jamkesda. Primary and secondary data was collected. Primary data has been collected by focus group discussion, interview, observation, and self administered questioner. Secondary data collected from many sources such as articles, journal, official document, statistics data, and others. Results:Of this study show there is no significant relationship between fiscal capacity group and benefit packages (continuity correction, p value = 0.065. But, districts/cities with high fiscal capacity (high and very high seem likely to have probability 1,920 bigger than lower capacity districts/cities in giving equal or more benefit than existing national social health insurance (Jamkesmas (Mantel-Haenszel, Common Odds Ratio Estimates = 1.920; Confidence Interval 95% =1.008–3.658; asymp. Sig 2 sided = 0.047. There is variation of benefit packages between each Jamkesda. Qualitative results show there are many obstacles faced in giving benefit health services, such as limited community accessibility to health facilities, the absence of health workforce, and lack of health infrastructure and equipment. Recomendation: This study recommends to set a national minimum benefit packages and equalizing percetion of local decission maker.

  3. Anti-NMDA receptor encephalitis and nonencephalitic HSV-1 infection.

    Science.gov (United States)

    Salovin, Amy; Glanzman, Jason; Roslin, Kylie; Armangue, Thais; Lynch, David R; Panzer, Jessica A

    2018-07-01

    To determine whether there is an association between nonencephalitic herpes simplex virus 1 (HSV-1) infection and anti-NMDA receptor encephalitis (anti-NMDARE). Antibody testing was performed using samples from 2 cohorts in a case-control observational study. The cohort "Philadelphia" included 16 serum samples of pediatric anti-NMDARE cases and 42 age-matched controls with other neuroinflammatory disorders studied at the Children's Hospital of Philadelphia and University of Pennsylvania. The cohort "Barcelona" contained 23 anti-NMDARE patient samples and 26 age-matched participants with other neuroinflammatory disorders studied at IDIBAPS-Hospital Clinic, University of Barcelona. The presence of HSV-1 IgG antibodies was examined by ELISA. As an additional control, IgG antibodies to cytomegalovirus (CMV) and Epstein-Barr virus viral capsid antigen (EBV-VCA) were determined. In each cohort, more participants with anti-NMDARE than controls had anti-HSV-1 IgG antibodies. In the Philadelphia cohort (58 participants), 44% of anti-NMDARE cases had antibodies to HSV-1 compared with 14% controls (OR 4.67, 95% CI 1.3-17.3, p = 0.031). In the Barcelona cohort (49 participants), 52% of participants with anti-NMDARE had antibodies to HSV-1 compared with 31% of controls (OR 2.45, 95% CI 0.7-7.9, p = 0.155). Overall, 49% of anti-NMDARE cases have antibodies to HSV-1 in these 2 combined cohorts compared with 21% of controls (Mantel-Haenszel OR 3.21, 95% CI 1.3-7.7, p = 0.007). Past HSV-1 infection was found in significantly more anti-NMDARE cases than controls. This suggests a meaningful association between nonencephalitic HSV-1 infection and development of anti-NMDARE.

  4. Perceptions and opinions of Canadian pet owners about anaesthesia, pain and surgery in small animals.

    Science.gov (United States)

    Steagall, P V; Monteiro, B P; Ruel, H L M; Beauchamp, G; Luca, G; Berry, J; Little, S; Stiles, E; Hamilton, S; Pang, D

    2017-07-01

    The aim of this study was to evaluate the perceptions and opinions of Canadian pet owners about anaesthesia, pain and surgery in dogs and cats. Six Canadian veterinary hospitals participated. Each practice received 200 copies of a questionnaire that were distributed to pet owners. Questions regarding the use of analgesics, anaesthesia, surgery and onychectomy (cats) were included. Responses were transformed into ordinal scores and analysed with a Cochran-Mantel-Haenszel test. A total of 849 out of 1200 questionnaires were returned. Owners believed more frequently that analgesics are needed for surgical procedures than for the medical conditions. Owners rated as very important/important: "knowing what to expect during illness/injury/surgery" (99·3%), "being assured that all necessary analgesic drugs/techniques will be used" (98·6%), "being informed about procedures/risk" (98·5%), and having a board-certified anaesthesiologist (90·5%). Most owners agreed/partly agreed that pain impacts quality of life (94·2%), and affects their pet's behaviour (89·5%). Most respondents (69%) were women; they were significantly more concerned than men about anaesthesia, pain, cost and client-communication. Cat owners believed that analgesics were necessary for some procedures/conditions significantly more often than canine-only owners. Pet owners with previous surgery disagreed more frequently that "pain after surgery can be helpful" and that "pain in animals is easy to recognize" than those without previous surgery. Most owners think onychectomy should be banned in cats (56·4%). This study identified important areas of client communication regarding pain and its control in pets. © 2017 British Small Animal Veterinary Association.

  5. Luminosity profiles and the evolution of shock waves in general relativistic radiating spheres

    International Nuclear Information System (INIS)

    Herrera, L.; Nunez, L.A.

    1989-10-01

    A method recently proposed by the authors to study the evolution of discontinuities in radiating spherically symmetric distributions of matter is systematically applied to model the evolution of a composite radiant sphere. The matter configuration, free of singularities, is divided in two regions by a shock wave front, and at each side of this interface a different equation of state is considered. Solutions are matched across the shock via the Rankine-Hugoniot conditions while the outer region metric joins the Vaidya solution at the boundary surface. The influence on the evolution of these composite spheres of different shapes of neutrino outburst profiles, and particular neutrino-transfer processes from the inner core to the outer mantel is explored. Prospective applications to supernova scenarios are discussed. (author). 18 refs, 4 figs, 1 tab

  6. Gerald: a general environment for radiation analysis and design

    International Nuclear Information System (INIS)

    Boyle, Ch.; Oliveira, P.I.E. de; Oliveira, C.R.E. de; Adams, M.L.; Galan, J.M.

    2005-01-01

    Full text of publication follows: This paper describes the status of the GERALD interactive workbench for the analysis of radiation transport problems. GERALD basically guides the user through the various steps that are necessary to solve a radiation transport problem, and is aimed at education, research and industry. The advantages of such workbench are many: quality assurance of problem setup, interaction of the user with problem solution, preservation of theory and legacy research codes, and rapid proto-typing and testing of new methods. The environment is of general applicability catering for analytical, deterministic and stochastic analysis of the radiation problem and is not tied to one specific solution method or code. However, GERALD is being developed as a portable, modular, open source framework which renders itself quite naturally to the coupling of existing computational tools through specifically developed plug-ins. By offering a common route for setting up, solving and analyzing radiation transport problems GERALD offers the possibility of methods intercomparison and validation. Such flexible radiation transport environment will also facilitate the coupling of radiation physics methods to other physical phenomena and their application to other areas of application such as medical physics and the environment. (authors)

  7. Dimensional Analysis and General Relativity

    Science.gov (United States)

    Lovatt, Ian

    2009-01-01

    Newton's law of gravitation is a central topic in the first-year physics curriculum. A lecturer can go beyond the physical details and use the history of gravitation to discuss the development of scientific ideas; unfortunately, the most recent chapter in this history, general relativity, is not covered in first-year courses. This paper discusses…

  8. The General Factor of Personality: A General Critique.

    Science.gov (United States)

    Revelle, William; Wilt, Joshua

    2013-10-01

    Recently, it has been proposed that all non-cognitive measures of personality share a general factor of personality. A problem with many of these studies is a lack of clarity in defining a general factor. In this paper we address the multiple ways in which a general factor has been identified and argue that many of these approaches find factors that are not in fact general. Through the use of artificial examples, we show that a general factor is not: The first factor or component of a correlation or covariance matrix.The first factor resulting from a bifactor rotation or biquartimin transformationNecessarily the result of a confirmatory factor analysis forcing a bifactor solution We consider how the definition of what constitutes a general factor can lead to confusion, and we will demonstrate alternative ways of estimating the general factor saturation that are more appropriate.

  9. Inverse dynamic analysis of general n-link robot manipulators

    International Nuclear Information System (INIS)

    Yih, T.C.; Wang, T.Y.; Burks, B.L.; Babcock, S.M.

    1996-01-01

    In this paper, a generalized matrix approach is derived to analyze the dynamic forces and moments (torques) required by the joint actuators. This method is general enough to solve the problems of any n-link open-chain robot manipulators with joint combinations of R(revolute), P(prismatic), and S(spherical). On the other hand, the proposed matrix solution is applicable to both nonredundant and redundant robotic systems. The matrix notation is formulated based on the Newton-Euler equations under the condition of quasi-static equilibrium. The 4 x 4 homogeneous cylindrical coordinates-Bryant angles (C-B) notation is applied to model the robotic systems. Displacements, velocities, and accelerations of each joint and link center of gravity (CG) are calculated through kinematic analysis. The resultant external forces and moments exerted on the CG of each link are considered as known inputs. Subsequently, a 6n x 6n displacement coefficient matrix and a 6n x 1 external force/moment vector can be established. At last, the joint forces and moments needed for the joint actuators to control the robotic system are determined through matrix inversion. Numerical examples will be illustrated for the nonredundant industrial robots: Bendix AA/CNC (RRP/RRR) and Unimate 2000 spherical (SP/RRR) robots; and the redundant light duty utility arm (LDUA), modified LDUA, and tank waste retrieval manipulator system

  10. A novel ergodic capacity analysis of diversity combining and multihop transmission systems over generalized composite fading channels

    KAUST Repository

    Yilmaz, Ferkan

    2012-06-01

    Ergodic capacity is an important performance measure associated with reliable communication at the highest rate at which information can be sent over the channel with a negligible probability of error. In the shadow of this definition, diversity receivers (such as selection combining, equal-gain combining and maximal-ratio combining) and transmission techniques (such as cascaded fading channels, amplify-and-forward multihop transmission) are deployed in mitigating various performance impairing effects such as fading and shadowing in digital radio communication links. However, the exact analysis of ergodic capacity is in general not always possible for all of these forms of diversity receivers and transmission techniques over generalized composite fading environments due to it\\'s mathematical intractability. In the literature, published papers concerning the exact analysis of ergodic capacity have been therefore scarce (i.e., only [1] and [2]) when compared to those concerning the exact analysis of average symbol error probability. In addition, they are essentially targeting to the ergodic capacity of the maximal ratio combining diversity receivers and are not readily applicable to the capacity analysis of the other diversity combiners / transmission techniques. In this paper, we propose a novel moment generating function-based approach for the exact ergodic capacity analysis of both diversity receivers and transmission techniques over generalized composite fading environments. As such, we demonstrate how to simultaneously treat the ergodic capacity analysis of all forms of both diversity receivers and multihop transmission techniques. © 2012 IEEE.

  11. Analysis of Students’ Missed Organic Chemistry Quiz Questions that Stress the Importance of Prior General Chemistry Knowledge

    OpenAIRE

    Julie Ealy

    2018-01-01

    A concern about students’ conceptual difficulties in organic chemistry prompted this study. It was found that prior knowledge from general chemistry was critical in organic chemistry, but what were some of the concepts that comprised that prior knowledge? Therefore an analysis of four years of organic chemistry quiz data was undertaken. Multiple general chemistry concepts were revealed that are essential prior knowledge in organic chemistry. The general chemistry concepts that were foun...

  12. Cumulative trauma, hyperarousal, and suicidality in the general population: a path analysis.

    Science.gov (United States)

    Briere, John; Godbout, Natacha; Dias, Colin

    2015-01-01

    Although trauma exposure and posttraumatic stress disorder (PTSD) both have been linked to suicidal thoughts and behavior, the underlying basis for this relationship is not clear. In a sample of 357 trauma-exposed individuals from the general population, younger participant age, cumulative trauma exposure, and all three Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTSD clusters (reexperiencing, avoidance, and hyperarousal) were correlated with clinical levels of suicidality. However, logistic regression analysis indicated that when all PTSD clusters were considered simultaneously, only hyperarousal continued to be predictive. A path analysis confirmed that posttraumatic hyperarousal (but not other components of PTSD) fully mediated the relationship between extent of trauma exposure and degree of suicidal thoughts and behaviors.

  13. A General Model for Representing Arbitrary Unsymmetries in Various Types of Network Analysis

    DEFF Research Database (Denmark)

    Rønne-Hansen, Jan

    1997-01-01

    When dealing with unsymmetric faults various proposals have been put forward. In general they have been characterized by specific treatment of the single fault in accordance with the structure and impedances involved. The model presented is based on node equations and was originally developed for...... complicated fault situation which has not been treated before for traditional transient stability analysis...

  14. General purpose dynamic Monte Carlo with continuous energy for transient analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sjenitzer, B. L.; Hoogenboom, J. E. [Delft Univ. of Technology, Dept. of Radiation, Radionuclide and Reactors, Mekelweg 15, 2629JB Delft (Netherlands)

    2012-07-01

    For safety assessments transient analysis is an important tool. It can predict maximum temperatures during regular reactor operation or during an accident scenario. Despite the fact that this kind of analysis is very important, the state of the art still uses rather crude methods, like diffusion theory and point-kinetics. For reference calculations it is preferable to use the Monte Carlo method. In this paper the dynamic Monte Carlo method is implemented in the general purpose Monte Carlo code Tripoli4. Also, the method is extended for use with continuous energy. The first results of Dynamic Tripoli demonstrate that this kind of calculation is indeed accurate and the results are achieved in a reasonable amount of time. With the method implemented in Tripoli it is now possible to do an exact transient calculation in arbitrary geometry. (authors)

  15. The prevalence of angina symptoms and association with cardiovascular risk factors, among rural, urban and rural to urban migrant populations in Peru

    Directory of Open Access Journals (Sweden)

    Gilman Robert H

    2010-10-01

    Full Text Available Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across differing populations. Methods The PERU MIGRANT study was designed to investigate differences between rural-to-urban migrant and non-migrant groups in specific cardiovascular disease risk factors. Mass-migration seen in Peru from 1980s onwards was largely driven by politically motivated violence resulting in less 'healthy migrant' selection bias. The Rose angina questionnaire was used to record chest pain, which was classified definite, possible and non-exertional. Mental health was measured using the General Health Questionnaire (GHQ-12. Mantel-Haenszel odds ratios (adjusted for age, sex, cardiovascular disease risk factors and mental health were used to assess the risk of chest pain in the migrant and urban groups compared to the rural group, and further to assess the relationship (age and sex-adjusted between risk factors, mental health and chest pain. Results Compared to the urban group, rural dwellers had a greatly increased likelihood of possible/definite angina (multi-adjusted OR 2.82 (1.68- 4.73. Urban and migrant groups had higher levels of risk factors (e.g. smoking - 20.1% urban, 5.5% rural. No diabetes was seen in the rural dwellers who complained of possible/definite angina. Rural dwellers had a higher prevalence of mood disorder and the presence of a mood disorder was associated with possible/definite angina in all three groups, but not consistently with non-exertional chest pain. Conclusion Rural groups had a higher prevalence of angina as

  16. Factors contributing to measles transmission during an outbreak in Kamwenge District, Western Uganda, April to August 2015.

    Science.gov (United States)

    Nsubuga, Fred; Bulage, Lilian; Ampeire, Immaculate; Matovu, Joseph K B; Kasasa, Simon; Tanifum, Patricia; Riolexus, Alex Ario; Zhu, Bao-Ping

    2018-01-08

    In April 2015, Kamwenge District, western Uganda reported a measles outbreak. We investigated the outbreak to identify potential exposures that facilitated measles transmission, assess vaccine effectiveness (VE) and vaccination coverage (VC), and recommend prevention and control measures. For this investigation, a probable case was defined as onset of fever and generalized maculopapular rash, plus ≥1 of the following symptoms: Coryza, conjunctivitis, or cough. A confirmed case was defined as a probable case plus identification of measles-specific IgM in serum. For case-finding, we reviewed patients' medical records and conducted in-home patient examination. In a case-control study, we compared exposures of case-patients and controls matched by age and village of residence. For children aged 9 m-5y, we estimated VC using the percent of children among the controls who had been vaccinated against measles, and calculated VE using the formula, VE = 1 - OR M-H , where OR M-H was the Mantel-Haenszel odds ratio associated with having a measles vaccination history. We identified 213 probable cases with onset between April and August, 2015. Of 23 blood specimens collected, 78% were positive for measles-specific IgM. Measles attack rate was highest in the youngest age-group, 0-5y (13/10,000), and decreased as age increased. The epidemic curve indicated sustained propagation in the community. Of the 50 case-patients and 200 controls, 42% of case-patients and 12% of controls visited health centers during their likely exposure period (OR M-H  = 6.1; 95% CI = 2.7-14). Among children aged 9 m-5y, VE was estimated at 70% (95% CI: 24-88%), and VC at 75% (95% CI: 67-83%). Excessive crowding was observed at all health centers; no patient triage-system existed. The spread of measles during this outbreak was facilitated by patient mixing at crowded health centers, suboptimal VE and inadequate VC. We recommended emergency immunization campaign targeting children <5y in

  17. The effect of using the health smart card vs. CPOE reminder system on the prescribing practices of non-obstetric physicians during outpatient visits for pregnant women in Taiwan.

    Science.gov (United States)

    Long, An-Jim; Chang, Polun

    2012-09-01

    There is an evidence that pregnant women have been prescribed a significant number of improper medications that could lead to potential damage for a developing fetus due to discontinuity of care. The safety of pregnant women raises public concern and there is a need to identify ways to prevent potential adverse events to the pregnant woman. This study used a health smart card with a clinical reminder system to keep continuous records of general outpatient visits of pregnant women to protect them from potential adverse events caused by improper prescription. The health smart card, issued to all 23 million citizens in Taiwan, was used to work with a Computerized Physician Order Entry (CPOE) implemented at a 700-bed teaching medical center in Taipei to provide the outpatient information of pregnant women. FDA pregnancy risk classification was used to categorize the risk of pregnant women. The log file, combined with the physicians' and patients' profiles, were statistically examined using the Mantel-Haenszel technique to evaluate the impact of system in changing physician's prescription behavior. A total of 441 patients ranged in age from 15 to 50 years with 1114 prescriptions involved in FDA pregnancy risk classification C, D, and X during the study period. 144 reminders (13.1%) were accepted by physicians for further assessment and 100 (69.4%) of them were modified. Non-obstetric physicians in non-emergency setting were more intended to accept reminders (27.8%, 4.9 folds than obstetricians). Reminders triggered on patients in second trimester (15.5%) were accepted by all physicians more than third trimester (OR 1.52, psmart card armed with CPOE reminder system and well-defined criteria had the potential to decrease harmful medication prescribed to pregnant patients. The results show better conformance for non-obstetric physicians (26%) and when physicians accepted the alerts they are more likely to went back and review their orders (69%). In sum, reminder criteria

  18. CD209 genetic polymorphism and tuberculosis disease.

    Directory of Open Access Journals (Sweden)

    Fredrik O Vannberg

    2008-01-01

    Full Text Available Tuberculosis causes significant morbidity and mortality worldwide, especially in sub-Saharan Africa. DC-SIGN, encoded by CD209, is a receptor capable of binding and internalizing Mycobacterium tuberculosis. Previous studies have reported that the CD209 promoter single nucleotide polymorphism (SNP-336A/G exerts an effect on CD209 expression and is associated with human susceptibility to dengue, HIV-1 and tuberculosis in humans. The present study investigates the role of the CD209 -336A/G variant in susceptibility to tuberculosis in a large sample of individuals from sub-Saharan Africa.A total of 2,176 individuals enrolled in tuberculosis case-control studies from four sub-Saharan Africa countries were genotyped for the CD209 -336A/G SNP (rs4804803. Significant overall protection against pulmonary tuberculosis was observed with the -336G allele when the study groups were combined (n = 914 controls vs. 1262 cases, Mantel-Haenszel 2 x 2 chi(2 = 7.47, P = 0.006, odds ratio = 0.86, 95%CI 0.77-0.96. In addition, the patients with -336GG were associated with a decreased risk of cavitory tuberculosis, a severe form of tuberculosis disease (n = 557, Pearson's 2x2 chi(2 = 17.34, P = 0.00003, odds ratio = 0.42, 95%CI 0.27-0.65. This direction of association is opposite to a previously observed result in a smaller study of susceptibility to tuberculosis in a South African Coloured population, but entirely in keeping with the previously observed protective effect of the -336G allele.This study finds that the CD209 -336G variant allele is associated with significant protection against tuberculosis in individuals from sub-Saharan Africa and, furthermore, cases with -336GG were significantly less likely to develop tuberculosis-induced lung cavitation. Previous in vitro work demonstrated that the promoter variant -336G allele causes down-regulation of CD209 mRNA expression. Our present work suggests that decreased levels of the DC-SIGN receptor may therefore be

  19. GenAlEx 6.5: genetic analysis in Excel. Population genetic software for teaching and research—an update

    Science.gov (United States)

    Peakall, Rod; Smouse, Peter E.

    2012-01-01

    Summary: GenAlEx: Genetic Analysis in Excel is a cross-platform package for population genetic analyses that runs within Microsoft Excel. GenAlEx offers analysis of diploid codominant, haploid and binary genetic loci and DNA sequences. Both frequency-based (F-statistics, heterozygosity, HWE, population assignment, relatedness) and distance-based (AMOVA, PCoA, Mantel tests, multivariate spatial autocorrelation) analyses are provided. New features include calculation of new estimators of population structure: G′ST, G′′ST, Jost’s Dest and F′ST through AMOVA, Shannon Information analysis, linkage disequilibrium analysis for biallelic data and novel heterogeneity tests for spatial autocorrelation analysis. Export to more than 30 other data formats is provided. Teaching tutorials and expanded step-by-step output options are included. The comprehensive guide has been fully revised. Availability and implementation: GenAlEx is written in VBA and provided as a Microsoft Excel Add-in (compatible with Excel 2003, 2007, 2010 on PC; Excel 2004, 2011 on Macintosh). GenAlEx, and supporting documentation and tutorials are freely available at: http://biology.anu.edu.au/GenAlEx. Contact: rod.peakall@anu.edu.au PMID:22820204

  20. Current contraceptive management in Australian general practice: an analysis of BEACH data.

    Science.gov (United States)

    Mazza, Danielle; Harrison, Christopher; Taft, Angela; Brijnath, Bianca; Britt, Helena; Hobbs, Melissa; Stewart, Kay; Hussainy, Safeera

    2012-07-16

    To determine current contraceptive management by general practitioners in Australia. Analysis of data from a random sample of 3910 Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) survey, a continuous cross-sectional survey of GP activity, between April 2007 and March 2011. Consultations with female patients aged 12-54 years that involved all forms of contraception were analysed. GP and patient characteristics associated with the management of contraception; types of contraception used; rates of encounters involving emergency contraception. Increased age, ethnicity, Indigenous status and holding a Commonwealth Health Care Card were significantly associated with low rates of encounters involving management of contraception. The combined oral contraceptive pill was the most frequently prescribed method of contraception, with moderate prescription of long-acting reversible contraception (LARC), especially among women aged 34-54 years. Rates of consultations concerned with emergency contraception were low, but involved high rates of counselling, advice or education (48%) compared with encounters for general contraception (> 20%). A shift towards prescribing LARC, as recommended in clinical guidelines, has yet to occur in Australian general practice. Better understanding of patient and GP perspectives on contraceptive choices could lead to more effective contraceptive use.

  1. Analysis of Loss of Control Parameters for Aircraft Maneuvering in General Aviation

    Directory of Open Access Journals (Sweden)

    Sameer Ud-Din

    2018-01-01

    Full Text Available A rapid increase in the occurrence of loss of control in general aviation has raised concern in recent years. Loss of control (LOC pertains to unique characteristics in which external and internal events act in conjunction. The Federal Aviation Administration (FAA has approved an Integrated Safety Assessment Model (ISAM for evaluating safety in the National Airspace System (NAS. ISAM consists of an event sequence diagram (ESD with fault trees containing numerous parameters, which is recognized as casual risk model. In this paper, we outline an integrated risk assessment framework to model maneuvering through cross-examining external and internal events. The maneuvering is in the critical flight phase with a high number of LOC occurrences in general aviation, where highly trained and qualified pilots failed to maintain aircraft control irrespective of the preventive nature of the events. Various metrics have been presented for evaluating the significance of these parameters to identify the most important ones. The proposed sensitivity analysis considers the accident, fatality, and risk reduction frequencies that assist in the decision-making process and foresees future risks from a general aviation perspective.

  2. Fasting insulin, insulin resistance and risk of hypertension in the general population: A meta-analysis.

    Science.gov (United States)

    Wang, Feng; Han, Lili; Hu, Dayi

    2017-01-01

    Studies on the association of fasting insulin concentrations or insulin resistance with subsequent risk of hypertension have yielded conflicting results. To quantitatively assess the association of fasting insulin concentrations or homeostasis model assessment insulin resistance (HOMA-IR) with incident hypertension in a general population by performing a meta-analysis. We searched the PubMed and Embase databases until August 31, 2016 for prospective observational studies investigating the elevated fasting insulin concentrations or HOMA-IR with subsequent risk of hypertension in the general population. Pooled risk ratio (RR) and 95% confidence interval (CI) of hypertension was calculated for the highest versus the lowest category of fasting insulin or HOMA-IR. Eleven studies involving 10,230 hypertension cases were identified from 55,059 participants. Meta-analysis showed that the pooled adjusted RR of hypertension was 1.54 (95% CI 1.34-1.76) for fasting insulin concentrations and 1.43 (95% CI 1.27-1.62) for HOMA-IR comparing the highest to the lowest category. Subgroup analysis results showed that the association of fasting insulin concentrations with subsequent risk of hypertension seemed more pronounced in women (RR 2.07; 95% CI 1.19-3.60) than in men (RR 1.48; 95% CI 1.17-1.88). This meta-analysis suggests that elevated fasting insulin concentrations or insulin resistance as estimated by homeostasis model assessment is independently associated with an exacerbated risk of hypertension in the general population. Early intervention of hyperinsulinemia or insulin resistance may help clinicians to identify the high risk of hypertensive population. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Estudo populacional de síndrome pré-menstrual Population study of premenstrual syndrome

    Directory of Open Access Journals (Sweden)

    Celene Maria Longo da Silva

    2006-02-01

    Full Text Available OBJETIVO: Estudar a prevalência e fatores associados à síndrome pré-menstrual, comparando a freqüência encontrada com a auto-referida. MÉTODOS: Foi realizado um estudo transversal, de base populacional, com 1.395 mulheres de 15 a 49 anos no município de Pelotas, Rio Grande do Sul, em 2003. Foram aplicados questionários para medir a prevalência da síndrome pré menstrual por meio de um escore, construído a partir de cinco sintomas pré-menstruais que interferiam na vida familiar ou levavam à falta ao trabalho ou à escola. Foram investigadas associações entre alguns fatores socioeconômicos, demográficos e comportamentais. A síndrome auto-referida foi investigada quanto à sua sensibilidade e especificidade, considerando o escore como padrão-ouro. As análises estatísticas utilizadas foram chi2 de Pearson, Mantel Haenszel e regressão de Poisson, além do coeficiente de Kappa para verificar concordância de respostas. RESULTADOS: A prevalência encontrada foi de 25,2% (IC 95%: 22,5-27,9 e auto-referida 60,3% (IC 95%: 57,4-63,3. Os principais sintomas pré-menstruais foram: irritabilidade, desconforto abdominal, nervosismo, cefaléia, cansaço e mastalgia, todos acima de 50% de prevalência. Mulheres de melhor nível econômico, maior escolaridade, menores de 30 anos e com pele branca apresentaram risco mais elevado. As usuárias de psicofármacos e as que não usavam anticoncepção hormonal apresentaram maior prevalência. A sensibilidade do teste foi de 94%, a especificidade 51% e a acurácia 62%. CONCLUSÕES: Foi alta a prevalência da síndrome pré-menstrual encontrada. Embora a percepção das mulheres seja maior do que aquela medida com o escore, ainda assim, um quarto das mulheres apresentou esse problema de saúde.OBJECTIVE: To study the prevalence of premenstrual syndrome and the factors associated with this, by comparing the obtained frequency with the self-reported frequency. METHODS:This was a cross

  4. Perfil clínico da Enterocolite por Citomegalovírus (CMV na síndrome da imunodeficiência adquirida (Aids Clinical profile of Cytomegalovirus Colitis in AIDS

    Directory of Open Access Journals (Sweden)

    D.B. de Lima

    2000-03-01

    Full Text Available Múltiplos agentes estão envolvidos na etiopatogenia da diarréia em Aids. O exame de fezes e a colonoscopia são elementos decisivos para o diagnóstico específico. A enterocolite por CMV pode cursar com febre, emagrecimento, diarréia intermitente e hematoquesia. Outros agentes causadores de diarréia podem ter o mesmo espectro de apresentação. OBJETIVO: Definir o perfil clínico da enterocolite por CMV em pacientes com Aids, comparando os parâmetros clínicos, endoscópicos e de tempo de sobrevida entre dois grupos com diarréia crônica, grupo A com CMV e grupo B sem CMV. MÉTODOS: Foram acompanhados 48 pacientes com Aids e diarréia de duração maior que 30 dias, sendo 27 do grupo A e 21 do grupo B. Os parâmetros analisados foram idade, situação de risco, duração da diarréia, hematoquesia, intervalo de tempo entre diagnóstico da infecção por HIV e início de diarréia, achados endoscópicos e sobrevida. Foram realizados exames parasitológicos, culturas e colonoscopia com biópsias. Foi utilizado o teste "t-student" para amostras não pareadas e o teste Qui-Quadrado com correção de Yates para variáveis não paramétricas. Foram construídas curvas de sobrevida pelo método descrito por Kaplan-Meier e aplicado o teste de Mantel - Haenszel. Foi assumido como nível de significância estatística o valor de P menor que 0.05. RESULTADOS: O padrão endoscópico da infecção por CMV correspondeu a ulcerações associadas a hemorragia de submucosa 14 (51.8% P P > 0.001. Os outros parâmetros estudados não mostraram significância estatística. CONCLUSÕES: A presença de enterocolite por CMV em Aids é marcador de mau prognóstico e menor sobrevida. Existe um padrão endoscópico sugestivo da infecção por CMV.OBJECTIVE: To determine the clinical profile of CMV colitis in AIDS patients, comparing clinical, endoscopic parameters and survival time between 2 groups of AIDS patients having chronic diarrhea. Group A being CMV

  5. On the stability analysis of a general discrete-time population model involving predation and Allee effects

    International Nuclear Information System (INIS)

    Merdan, H.; Duman, O.

    2009-01-01

    This paper presents the stability analysis of equilibrium points of a general discrete-time population dynamics involving predation with and without Allee effects which occur at low population density. The mathematical analysis and numerical simulations show that the Allee effect has a stabilizing role on the local stability of the positive equilibrium points of this model.

  6. The ICVSIE: A General Purpose Integral Equation Method for Bio-Electromagnetic Analysis.

    Science.gov (United States)

    Gomez, Luis J; Yucel, Abdulkadir C; Michielssen, Eric

    2018-03-01

    An internally combined volume surface integral equation (ICVSIE) for analyzing electromagnetic (EM) interactions with biological tissue and wide ranging diagnostic, therapeutic, and research applications, is proposed. The ICVSIE is a system of integral equations in terms of volume and surface equivalent currents in biological tissue subject to fields produced by externally or internally positioned devices. The system is created by using equivalence principles and solved numerically; the resulting current values are used to evaluate scattered and total electric fields, specific absorption rates, and related quantities. The validity, applicability, and efficiency of the ICVSIE are demonstrated by EM analysis of transcranial magnetic stimulation, magnetic resonance imaging, and neuromuscular electrical stimulation. Unlike previous integral equations, the ICVSIE is stable regardless of the electric permittivities of the tissue or frequency of operation, providing an application-agnostic computational framework for EM-biomedical analysis. Use of the general purpose and robust ICVSIE permits streamlining the development, deployment, and safety analysis of EM-biomedical technologies.

  7. A general purpose program system for high energy physics experiment data acquisition and analysis

    International Nuclear Information System (INIS)

    Li Shuren; Xing Yuguo; Jin Bingnian

    1985-01-01

    This paper introduced the functions, structure and system generation of a general purpose program system (Fermilab MULTI) for high energy physics experiment data acquisition and analysis. Works concerning the reconstruction of MULTI system level 0.5 which can be run on the computer PDP-11/23 are also introduced briefly

  8. An analysis of radiological research publications in high impact general medical journals between 1996 and 2010.

    Science.gov (United States)

    Ku, You Jin; Yoon, Dae Young; Yun, Eun Joo; Baek, Sora; Lim, Kyoung Ja; Seo, Young Lan; Choi, Chul Soon; Bae, Sang Hoon

    2013-06-01

    To evaluate scientific papers published by radiologists in high impact general medical journals between 1996 and 2010. A MEDLINE search was performed in five high impact general medical journals (AIM, BMJ, JAMA, Lancet, and NEJM) for all articles of which a radiologist was the first author between 1996 and 2010. The following information was abstracted from the original articles: radiological subspecialty, imaging technique used, type of research, sample size, study design, statistical analysis, study outcome, declared funding, number of authors, collaboration, and country of the first author. Of 216 (0.19%) articles were published by radiologists in five general medical journals between 1996 and 2010, 83 were original articles. Fifteen (18.1%) original articles were concerned with the field of vascular/interventional radiology, 24 (28.9%) used combined imaging techniques, 76 (91.6%) were clinical research, 63 (75.9%) had a sample size of >50, 65 (78.3%) were prospective, 78 (94.0%) performed statistical analysis, 83 (100%) showed positive study outcomes, 57 (68.7%) were funded, 49 (59.0%) had from four to seven authors, and 79 (95.2%) were collaborative studies. A very small number (0.19%) in five high impact general medical journals was published by radiologists between 1996 and 2010. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Termination of a fe/male transsexual patient's analysis: an example of general validity.

    Science.gov (United States)

    Quinodoz, Danielle

    2002-08-01

    The author describes the termination of an analysis, which, while relating to the particular case of a male-to-female transsexual patient, may be relevant to all analysts, particularly those whose patients need to integrate disavowed and split-off parts of themselves. The patient had undergone sex-change surgery at the age of 20. Having lived as a woman thereafter, she had asked for analysis some twenty years later. The author, who discussed the first three years of that analysis in an earlier paper, as well as her hesitation about undertaking it, considers that its termination after seven years illustrates not only the specific problems posed by transsexuals but also the general ones presented by "heterogeneous patients". To the best of her knowledge, this is the first published case history of a transsexual patient who has undergone surgery. In the author's view, the patient has acquired a new sense of internal unity based on a notion of sex differentiation in which mutual respect between the sexes has replaced confusion and mutual hate, and her quality of life has improved. On the general level, this termination shows how the reduction of paranoid-schizoid anxieties and the reintegration of split-off parts of the personality lead, as the depressive position is worked through, to a better toleration of internal contradictions, a new sense of cohesion of the self and a diminution of the fear of madness.

  10. General analysis of corrections to the standard seesaw formula in grand unified models

    International Nuclear Information System (INIS)

    Barr, S.M.; Kyae, Bumseok

    2004-01-01

    In realistic grand unified models there are typically extra vectorlike matter multiplets at the GUT-scale that are needed to explain the family hierarchy. These contain neutrinos that, when integrated out, can modify the usual neutrino seesaw formula. A general analysis is given. It is noted that such modifications can explain why the neutrinos do not exhibit a strong family hierarchy like the other types of fermions

  11. Stability and bifurcation analysis of a generalized scalar delay differential equation.

    Science.gov (United States)

    Bhalekar, Sachin

    2016-08-01

    This paper deals with the stability and bifurcation analysis of a general form of equation D(α)x(t)=g(x(t),x(t-τ)) involving the derivative of order α ∈ (0, 1] and a constant delay τ ≥ 0. The stability of equilibrium points is presented in terms of the stability regions and critical surfaces. We provide a necessary condition to exist chaos in the system also. A wide range of delay differential equations involving a constant delay can be analyzed using the results proposed in this paper. The illustrative examples are provided to explain the theory.

  12. Predictors of Relapse after Discontinuing Systemic Treatment in Childhood Autoimmune Chronic Uveitis.

    Science.gov (United States)

    Simonini, Gabriele; Bracaglia, Claudia; Cattalini, Marco; Taddio, Andrea; Brambilla, Alice; De Libero, Cinzia; Pires Marafon, Denise; Caputo, Roberto; Cimaz, Rolando

    2017-06-01

    To identify clinical predictors of relapse in childhood autoimmune chronic uveitis after stopping systemic treatment. A retrospective, multicenter, cohort study. Ninety-four children in remission, receiving no treatments and with at least a 6-month followup, were enrolled. A higher probability of maintaining remission after discontinuing treatment was shown in idiopathic compared with juvenile idiopathic arthritis uveitis (Mantel-Cox chi-square = 23.21) if inactivity had been obtained within 6 months from starting systemic treatment (Mantel-Cox chi-square = 24.17) and by antitumor necrosis factor-α treatment (Mantel-Cox chi-square = 6.43). Type of disease, time, and type of systemic therapy to achieve inactivity predict different duration of uveitis remission after treatment withdrawal.

  13. A comparison between fault tree analysis and reliability graph with general gates

    International Nuclear Information System (INIS)

    Kim, Man Cheol; Seong, Poong Hyun; Jung, Woo Sik

    2004-01-01

    Currently, level-1 probabilistic safety assessment (PSA) is performed on the basis of event tree analysis and fault tree analysis. Kim and Seong developed a new method for system reliability analysis named reliability graph with general gates (RGGG). The RGGG is an extension of conventional reliability graph, and it utilizes the transformation of system structures to equivalent Bayesian networks for quantitative calculation. The RGGG is considered to be intuitive and easy-to-use while as powerful as fault tree analysis. As an example, Kim and Seong already showed that the Bayesian network model for digital plant protection system (DPPS), which is transformed from the RGGG model for DPPS, can be shown in 1 page, while the fault tree model for DPPS consists of 64 pages of fault trees. Kim and Seong also insisted that Bayesian network model for DPPS is more intuitive because the one-to-one matching between each node in the Bayesian network model and an actual component of DPPS is possible. In this paper, we are going to give a comparison between fault tree analysis and the RGGG method with two example systems. The two example systems are the recirculation of in Korean standard nuclear power plants (KSNP) and the fault tree model developed by Rauzy

  14. Impact of General Chemistry on Student Achievement and Progression to Subsequent Chemistry Courses: A Regression Discontinuity Analysis

    Science.gov (United States)

    Shultz, Ginger V.; Gottfried, Amy C.; Winschel, Grace A.

    2015-01-01

    General chemistry is a gateway course that impacts the STEM trajectory of tens of thousands of students each year, and its role in the introductory curriculum as well as its pedagogical design are the center of an ongoing debate. To investigate the role of general chemistry in the curriculum, we report the results of a posthoc analysis of 10 years…

  15. Generalized sample entropy analysis for traffic signals based on similarity measure

    Science.gov (United States)

    Shang, Du; Xu, Mengjia; Shang, Pengjian

    2017-05-01

    Sample entropy is a prevailing method used to quantify the complexity of a time series. In this paper a modified method of generalized sample entropy and surrogate data analysis is proposed as a new measure to assess the complexity of a complex dynamical system such as traffic signals. The method based on similarity distance presents a different way of signals patterns match showing distinct behaviors of complexity. Simulations are conducted over synthetic data and traffic signals for providing the comparative study, which is provided to show the power of the new method. Compared with previous sample entropy and surrogate data analysis, the new method has two main advantages. The first one is that it overcomes the limitation about the relationship between the dimension parameter and the length of series. The second one is that the modified sample entropy functions can be used to quantitatively distinguish time series from different complex systems by the similar measure.

  16. Pin-wise Reactor Analysis Based on the Generalized Equivalence Theory

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Hwan Yeal; Heo, Woong; Kim, Yong Hee [KAIST, Daejeon (Korea, Republic of)

    2016-05-15

    In this paper, a pin-wise reactor analysis is performed based on the generalized equivalence theory. From the conventional fuel assembly lattice calculations, pin-wise 2-group cross sections and pin DFs are generated. Based on the numerical results on a small PWR benchmark, it is observed that the pin-wise core analysis provide quite accurate prediction on the effective multiplication factor and the peak pin power error is bounded by about 3% in peripheral fuel assemblies facing the baffle-reflector. Also, it was found that relatively large pin power errors occur along the interface between clearly different fuel assemblies. It is expected that the GET-based pin-by-pin core calculation can be further developed as an advanced method for reactor analysis via improving the group constants and discontinuity factors. Recently, high-fidelity multi-dimensional analysis tools are gaining more attention because of their accurate prediction of local parameters for core design and safety assessment. In terms of accuracy, direct whole-core transport is quite promising. However, it is clear that it is still very costly in terms of the computing time and memory requirements. Another possible solution is the pin-by-pin core analysis in which only small fuel pins are homogenized and the 3-D core analysis is still performed using a low-order operator such as the diffusion theory. In this paper, a pin-by-pin core analysis is performed using the hybrid CMFD (HCMFD) method. Hybrid CMFD is a new global-local iteration method that has been developed for efficient parallel calculation of pinby-pin heterogeneous core analysis. For the HCMFD method, the one-node CMFD scheme is combined with a local two-node CMFD method in a non-linear way. Since the SPH method is iterative and SPH factors are not direction dependent, it is clear that SPH method takes more computing cost and cannot take into account the different heterogeneity and transport effects at each pin interface. Unlike the SPH

  17. An analysis of radiological research publications in high impact general medical journals between 1996 and 2010

    International Nuclear Information System (INIS)

    Ku, You Jin; Yoon, Dae Young; Yun, Eun Joo; Baek, Sora; Lim, Kyoung Ja; Seo, Young Lan; Choi, Chul Soon; Bae, Sang Hoon

    2013-01-01

    Highlights: ► Radiologists published only 0.2% of articles in five general medical journals. ► Most original articles from radiologists were funded and were prospective studies. ► Radiology researchers from only 11 countries published at least one original article. -- Abstract: Objective: To evaluate scientific papers published by radiologists in high impact general medical journals between 1996 and 2010. Methods: A MEDLINE search was performed in five high impact general medical journals (AIM, BMJ, JAMA, Lancet, and NEJM) for all articles of which a radiologist was the first author between 1996 and 2010. The following information was abstracted from the original articles: radiological subspecialty, imaging technique used, type of research, sample size, study design, statistical analysis, study outcome, declared funding, number of authors, collaboration, and country of the first author. Results: Of 216 (0.19%) articles were published by radiologists in five general medical journals between 1996 and 2010, 83 were original articles. Fifteen (18.1%) original articles were concerned with the field of vascular/interventional radiology, 24 (28.9%) used combined imaging techniques, 76 (91.6%) were clinical research, 63 (75.9%) had a sample size of >50, 65 (78.3%) were prospective, 78 (94.0%) performed statistical analysis, 83 (100%) showed positive study outcomes, 57 (68.7%) were funded, 49 (59.0%) had from four to seven authors, and 79 (95.2%) were collaborative studies. Conclusions: A very small number (0.19%) in five high impact general medical journals was published by radiologists between 1996 and 2010

  18. A nonlinear generalization of the Savitzky-Golay filter and the quantitative analysis of saccades.

    Science.gov (United States)

    Dai, Weiwei; Selesnick, Ivan; Rizzo, John-Ross; Rucker, Janet; Hudson, Todd

    2017-08-01

    The Savitzky-Golay (SG) filter is widely used to smooth and differentiate time series, especially biomedical data. However, time series that exhibit abrupt departures from their typical trends, such as sharp waves or steps, which are of physiological interest, tend to be oversmoothed by the SG filter. Hence, the SG filter tends to systematically underestimate physiological parameters in certain situations. This article proposes a generalization of the SG filter to more accurately track abrupt deviations in time series, leading to more accurate parameter estimates (e.g., peak velocity of saccadic eye movements). The proposed filtering methodology models a time series as the sum of two component time series: a low-frequency time series for which the conventional SG filter is well suited, and a second time series that exhibits instantaneous deviations (e.g., sharp waves, steps, or more generally, discontinuities in a higher order derivative). The generalized SG filter is then applied to the quantitative analysis of saccadic eye movements. It is demonstrated that (a) the conventional SG filter underestimates the peak velocity of saccades, especially those of small amplitude, and (b) the generalized SG filter estimates peak saccadic velocity more accurately than the conventional filter.

  19. Computer-assisted semen analysis parameters as predictors for fertility of men from the general population

    DEFF Research Database (Denmark)

    Larsen, L; Scheike, Thomas Harder; Jensen, Tina Kold

    2000-01-01

    The predictive value of sperm motility parameters obtained by computer-assisted semen analysis (CASA) was evaluated for the fertility of men from general population. In a prospective study with couples stopping use of contraception in order to try to conceive, CASA was performed on semen samples...

  20. General Dynamics Convair Division approach to structural analysis of large superconducting coils

    International Nuclear Information System (INIS)

    Baldi, R.W.

    1979-01-01

    This paper describes the overall integrated analysis approach and highlights the results obtained. Most of the procedures and techniques described were developed over the past three years. Starting in late 1976, development began on high-accuracy computer codes for electromagnetic field and force analysis. This effort resulted in completion of a family of computer programs called MAGIC (MAGnetic Integration Calculation). Included in this group of programs is a post-processor called POSTMAGIC that links MAGIC to GDSAP (General Dynamics Structural Analysis Program) by automatically transferring force data. Integrating these computer programs afforded us the capability to readily analyze several different conditions that are anticipated to occur during tokamak operation. During 1977 we initiated the development of the CONVERT program that effectively links our THERMAL ANALYZER program to GDSAP by automatically transferring temperature data. The CONVERT program allowed us the capability to readily predict thermal stresses at several different time phases during the computer-simulated cooldown and warmup cycle. This feature aided us in determining the most crucial time phases and to adjust recommended operating procedure to minimize risk. (orig.)

  1. Dynamic analysis of a new chaotic system with fractional order and its generalized projective synchronization

    International Nuclear Information System (INIS)

    Niu Yu-Jun; Wang Xing-Yuan; Nian Fu-Zhong; Wang Ming-Jun

    2010-01-01

    Based on the stability theory of the fractional order system, the dynamic behaviours of a new fractional order system are investigated theoretically. The lowest order we found to have chaos in the new three-dimensional system is 2.46, and the period routes to chaos in the new fractional order system are also found. The effectiveness of our analysis results is further verified by numerical simulations and positive largest Lyapunov exponent. Furthermore, a nonlinear feedback controller is designed to achieve the generalized projective synchronization of the fractional order chaotic system, and its validity is proved by Laplace transformation theory. (general)

  2. Awareness, Analysis, and Action: Curricular Alignment for Student Success in General Chemistry

    Science.gov (United States)

    2018-01-01

    This article examines the ways that a shared faculty experience across five partner institutions led to a deep awareness of the curriculum and pedagogy of general chemistry coursework, and ultimately, to a collaborative action plan for student success. The team identified key differences and similarities in course content and instructional experiences. The comparative analysis yielded many more similarities than differences, and therefore, the team shifted its focus from “gap analysis” to an exploration of common curricular challenges. To address these challenges, the team developed content for targeted instructional resources that promoted the success of all STEM students across institutions. This article contextualizes the interinstitutional collaboration and closely examines the interactive components (awareness, analysis, and action), critical tools, and productive attitudes that undergirded the curricular alignment process of the STEM Transfer Student Success Initiative (t-STEM). PMID:29657334

  3. Creating Lasting Behavioral Change through the Generalization Analysis Worksheet

    Science.gov (United States)

    Brady, John; Kotkin, Ron

    2011-01-01

    The goal of any behavioral program is to facilitate lasting change. A significant criticism of behavioral programs is that they work in the clinical setting but do not generalize once the clinical program is stopped. The authors suggest that behavioral programs often do not generalize because clinicians fail to plan for generalization to occur…

  4. Generalized Tensor Analysis Model for Multi-Subcarrier Analog Optical Systems

    DEFF Research Database (Denmark)

    Zhao, Ying; Yu, Xianbin; Zheng, Xiaoping

    2011-01-01

    We propose and develop a general tensor analysis framework for a subcarrier multiplex analog optical fiber link for applications in microwave photonics. The goal of this work is to construct an uniform method to address nonlinear distortions of a discrete frequency transmission system. We employ....... In addition, it is demonstrated that each corresponding tensor is formally determined by device structures, which allows for a synthesized study of device combinations more systematically. For implementing numerical methods, the practical significance of the tensor model is it simplifies the derivation...... details compared with series-based approaches by hiding the underlying multi-fold summation and index operation. The integrity of the proposed methodology is validated by investigating the classical intensity modulated system. Furthermore, to give an application model of the tensor formalism, we make...

  5. Use of multivariate extensions of generalized linear models in the analysis of data from clinical trials

    OpenAIRE

    ALONSO ABAD, Ariel; Rodriguez, O.; TIBALDI, Fabian; CORTINAS ABRAHANTES, Jose

    2002-01-01

    In medical studies the categorical endpoints are quite often. Even though nowadays some models for handling this multicategorical variables have been developed their use is not common. This work shows an application of the Multivariate Generalized Linear Models to the analysis of Clinical Trials data. After a theoretical introduction models for ordinal and nominal responses are applied and the main results are discussed. multivariate analysis; multivariate logistic regression; multicategor...

  6. General Education Default and Student Benefit in Inclusive Learning Environments: An Analysis for School Leaders

    Science.gov (United States)

    Menard, Lauren A.

    2011-01-01

    A contextual analysis of the general education default and student benefit is presented from the perspective of school-based compliance with federal mandates from IDEIA [Individuals with Disabilities Education Improvement Act] of 2004. A goal was to inform school administrators striving to develop and maintain effective, inclusive learning…

  7. Structural dynamic analysis with generalized damping models analysis

    CERN Document Server

    Adhikari , Sondipon

    2013-01-01

    Since Lord Rayleigh introduced the idea of viscous damping in his classic work ""The Theory of Sound"" in 1877, it has become standard practice to use this approach in dynamics, covering a wide range of applications from aerospace to civil engineering. However, in the majority of practical cases this approach is adopted more for mathematical convenience than for modeling the physics of vibration damping. Over the past decade, extensive research has been undertaken on more general ""non-viscous"" damping models and vibration of non-viscously damped systems. This book, along with a related book

  8. Comparative analysis of general characteristics of ischemic stroke of BAD and non-BAD CISS subtypes.

    Science.gov (United States)

    Mei, Bin; Liu, Guang-zhi; Yang, Yang; Liu, Yu-min; Cao, Jiang-hui; Zhang, Jun-jian

    2015-12-01

    Based on the recently proposed Chinese ischemic stroke subclassification (CISS) system, intracranial branch atheromatous disease (BAD) is divided into large artery atherosclerosis (LAA) and penetrating artery disease (PAD). In the current retrospective analysis, we compared the general characteristics of BAD-LAA with BAD-PAD, BAD-LAA with non-BAD-LAA and BAD-PAD with non-BAD-PAD. The study included a total of 80 cases, including 45 cases of BAD and 35 cases of non-BAD. Subjects were classified using CISS system: BAD-LAA, BAD-PAD, non-BAD-LAA and non-BAD-PAD. In addition to analysis of general characteristics, the correlation between the factors and the two subtypes of BAD was evaluated. The number of cases included in the analysis was: 32 cases of BAD-LAA, 13 cases of BAD-PAD, 21 cases of non-BAD-LAA, and 14 cases of non-BAD-PAD. Diabetes mellitus affected more non-BAD-LAA patients than BAD-LAA patients (P=0.035). In comparison with non-BAD-PAD, patients with BAD-PAD were younger (P=0.040), had higher initial NIHSS score (PBAD, the PAD subtype was associated with smoking (OR=0.043; P=0.011), higher low-density lipoprotein (OR=5.339; P=0.029), ischemic heart disease (OR=9.383; P=0.047) and diabetes mellitus (OR=12.59; P=0.020). It was concluded that large artery atherosclerosis was the primary mechanism of BAD. The general characteristics showed no significant differences between the CISS subtypes of LAA and PAD within BAD, as well as between the BAD and non-BAD within LAA subtype. Several differences between PAD subtypes of BAD and non-BAD were revealed.

  9. Generalized Phase Contrast

    CERN Document Server

    Glückstad, Jesper

    2009-01-01

    Generalized Phase Contrast elevates the phase contrast technique not only to improve phase imaging but also to cross over and interface with diverse and seemingly disparate fields of contemporary optics and photonics. This book presents a comprehensive introduction to the Generalized Phase Contrast (GPC) method including an overview of the range of current and potential applications of GPC in wavefront sensing and phase imaging, structured laser illumination and image projection, optical trapping and manipulation, and optical encryption and decryption. The GPC method goes further than the restrictive assumptions of conventional Zernike phase contrast analysis and achieves an expanded range of validity beyond weak phase perturbations. The generalized analysis yields design criteria for tuning experimental parameters to achieve optimal performance in terms of accuracy, fidelity and light efficiency. Optimization can address practical issues, such as finding an optimal spatial filter for the chosen application, ...

  10. Bias formulas for sensitivity analysis of unmeasured confounding for general outcomes, treatments, and confounders.

    Science.gov (United States)

    Vanderweele, Tyler J; Arah, Onyebuchi A

    2011-01-01

    Uncontrolled confounding in observational studies gives rise to biased effect estimates. Sensitivity analysis techniques can be useful in assessing the magnitude of these biases. In this paper, we use the potential outcomes framework to derive a general class of sensitivity-analysis formulas for outcomes, treatments, and measured and unmeasured confounding variables that may be categorical or continuous. We give results for additive, risk-ratio and odds-ratio scales. We show that these results encompass a number of more specific sensitivity-analysis methods in the statistics and epidemiology literature. The applicability, usefulness, and limits of the bias-adjustment formulas are discussed. We illustrate the sensitivity-analysis techniques that follow from our results by applying them to 3 different studies. The bias formulas are particularly simple and easy to use in settings in which the unmeasured confounding variable is binary with constant effect on the outcome across treatment levels.

  11. A Women in Radiology Group Fosters Career Development for Faculty and Trainees.

    Science.gov (United States)

    Gaetke-Udager, Kara; Knoepp, Ursula S; Maturen, Katherine E; Leschied, Jessica R; Chong, Suzanne; Klein, Katherine A; Kazerooni, Ella

    2018-07-01

    The objective of our study was to evaluate the outcomes of a women in radiology (WIR) group during the first 6 years of its existence, including members' satisfaction, activities, and differences based on seniority. An anonymous questionnaire was distributed to group members. Survey questions were related to the usefulness of sessions, mentoring, professional opportunities, and camaraderie. Comparisons were made on the basis of training status and seniority. Continuous variables were compared using means, t tests, and correlations, and categoric variables were compared using counts, percentages, and chi-square tests or Mantel-Haenszel tests. Surveys were sent to 61 women, including trainees and faculty; the response rate was 49% (38% of trainees and 53% of faculty). Overall satisfaction score for WIR sessions was high (mean summary score, 1.42 ± 0.37 [SD], with 1 meaning very satisfied and 4 meaning very unsatisfied). Trainees and junior faculty were more likely than senior faculty to report expanded internal networking opportunities (94% vs 69%; p = 0.07), to have gained a mentor (67% vs 8%; p = 0.001), and to have increased research involvement (33% vs 0%; p = 0.02). Both groups were equally likely to have become mentors. Almost all respondents (93%) reported increased camaraderie among women in the department. A WIR group can provide career development tools for its members. In this study, trainees and junior faculty reported increased networking and research involvement and gaining a mentor but were equally likely as senior faculty to have become mentors. Most members reported increased camaraderie among women in the department. A WIR group may help to accelerate professional development among trainees and junior faculty, thereby contributing to a more diverse and enabled workforce.

  12. Healthcare-seeking behaviour of primary caregivers for acute otitis media in children aged 6 months to Panama: results of a cross-sectional survey.

    Science.gov (United States)

    Villarreal, Iris; Turner, Rosario; Jo, Hyejin; Park, Julie; Gemmen, Eric; Pirçon, Jean-Yves; Castrejon, Maria M; Hausdorff, William P

    2017-01-05

    Acute otitis media (AOM) is the most common bacterial childhood infection. However, caregivers with children having mild episodes often do not seek healthcare services, which may lead to an under-appreciation of the disease experienced by the community. The objectives of this survey were to estimate the proportion of primary caregivers who went to a healthcare facility when they suspected that their child aged 6 to Panama (March to May 2013). A 28-item paper questionnaire was administered to assess demographic data, AOM symptoms, as well as potential healthcare-seeking behaviour and factors influencing this behaviour. Potential confounding effects were individually assessed using Chi-squared or Cochran-Mantel-Haenszel tests, and all together in logistic regression models. The total number of eligible participants was 1330 (mean age 28.5 ± 8.0 years). Of these, 245 participants had at least one child whom they suspected had an AOM episode during the past 6 months. Of the 245 participants, 213 (86.9%) sought healthcare at a facility. Several factors were associated with healthcare usage: perceived severity of illness (p = 0.001), occupational status of the caregiver (p = 0.002), household income (p = 0.016) and length of time since the last suspected AOM episode (p = 0.032). When confronted with a child with obvious symptoms of AOM, the majority of caregivers reported seeking healthcare. This behaviour appeared to be associated with factors related to the severity of the illness, the length of time since the last episode, as well as with the income and occupational status of the caregivers themselves. As many episodes of AOM present with non-specific respiratory symptoms, our results apply only to caregivers who were confronted with children with an obvious symptom.

  13. Social Media Utilization at an Academic Radiology Practice.

    Science.gov (United States)

    Koontz, Nicholas A; Kamer, Aaron P; Dodson, Sean C; Capps, Alisha E; Tomblinson, Courtney M; Brown, Brandon P; Frank, Mark S; Heitkamp, Darel E

    2018-01-01

    We report social media (SoMe) utilization trends at an academic radiology department, highlighting differences between trainees and faculty and between Baby Boomers versus Generation X and Millennials. An anonymous online survey regarding SoMe utilization and SoMe-based educational curriculum was distributed to all radiologists (trainees and faculty) in our department. Regular chi-square, ordered (Mantel-Haenszel) chi-square, and Fischer exact tests were performed. The survey instrument was sent to 172 radiologists with a 65% completion rate (N = 112). Eighty-three percent (n = 92) of the respondents use SoMe, with Facebook (67%, n = 75), YouTube (57%, n = 64), Instagram (26%, n = 29), and Twitter (21%, n = 23) as the most commonly used platforms. Eighty-one percent (n = 91) use SoMe for 30 minutes or less per day. Thirty-five percent (n = 39) reported previously using SoMe for educational purposes, although 66% (n = 73) would be willing to join SoMe for educational activities. The faculty are more likely than trainees to avoid using SoMe (30% vs 9%, P < 0.03). Trainees are more likely than faculty to find an electronic case-based curriculum valuable (95% vs 83%, P < 0.05) and are willing to spend more time on cases (P < 0.01). Baby Boomers are less interested in joining SoMe for educational activities than Generation X and Millennials (24% vs 73%, P = 0.0001). Generation gaps between trainees and faculty, as well as between Generation X and Millennials versus Baby Boomers, exist with regard to the use of SoMe, which may be underutilized in radiology education. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  14. The potential biomarkers in predicting pathologic response of breast cancer to three different chemotherapy regimens: a case control study

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    Xu Chaoyang

    2009-07-01

    Full Text Available Abstract Background Preoperative chemotherapy (PCT has become the standard of care in locally advanced breast cancer. The identification of patient-specific tumor characteristics that can improve the ability to predict response to therapy would help optimize treatment, improve treatment outcomes, and avoid unnecessary exposure to potential toxicities. This study is to determine whether selected biomarkers could predict pathologic response (PR of breast tumors to three different PCT regimens, and to identify a subset of patients who would benefit from a given type of treatment. Methods 118 patients with primary breast tumor were identified and three PCT regimens including DEC (docetaxel+epirubicin+cyclophosphamide, VFC (vinorelbine/vincristine+5-fluorouracil+cyclophosphamide and EFC (epirubicin+5-fluorouracil+cyclophosphamide were investigated. Expression of steroid receptors, HER2, P-gp, MRP, GST-pi and Topo-II was evaluated by immunohistochemical scoring on tumor tissues obtained before and after PCT. The PR of breast carcinoma was graded according to Sataloff's classification. Chi square test, logistic regression and Cochran-Mantel-Haenszel assay were performed to determine the association between biomarkers and PR, as well as the effectiveness of each regimen on induction of PR. Results There was a clear-cut correlation between the expression of ER and decreased PR to PCT in all three different regimens (p p Conclusion ER is an independent predictive factor for PR to PCT regimens including DEC, VFC and EFC in primary breast tumors, while HER2 is only predictive for DEC regimen. Expression of PgR, Topo-II, P-gp, MRP and GST-pi are not predictive for PR to any PCT regimens investigated. Results obtained in this clinical study may be helpful for the selection of appropriate treatments for breast cancer patients.

  15. Current outcomes for tricuspid valve infective endocarditis surgery in North America.

    Science.gov (United States)

    Gaca, Jeffrey G; Sheng, Shubin; Daneshmand, Mani; Rankin, J Scott; Williams, Matthew L; O'Brien, Sean M; Gammie, James S

    2013-10-01

    Tricuspid valve (TV) infective endocarditis (IE) accounts for 15% of IE cases and usually is treated medically. Surgical intervention is rare, and understanding of treatment options is based on small series of patients. The purpose of this study was to describe the population and outcomes for isolated TV IE using The Society of Thoracic Surgeons Adult Cardiac Database. Between 2002 and 2009, 910 operations for TV IE were performed. Procedures included replacement, repair, and valvectomy. Healed IE was present in 31.4% (n = 286), and active IE, in 68.5% (n = 624). Baseline patient characteristics as well as operative mortality and morbidity were analyzed, and univariate statistical differences were evaluated by Kruskal-Wallis test and stratum-adjusted Mantel-Haenszel χ(2) tests. The median age was 40 years, with 50.6% male. Replacement of the TV was the most common procedure (n = 490; 53.8%), followed by TV repair (n = 354; 38.9%) and valvectomy (n = 66; 7.2%). Overall operative mortality was 7.3%, with no significant difference in mortality among valvectomy 12%, repair 7.6%, and replacement 6.3% (p = 0.34). Compared with the active group, healed patients experienced a trend toward lower operative mortality (4.2% versus 8.6%; p = 0.06), lower complication rates (35.6% versus 51.4%; p = 0.0004), and shorter overall length of stay (12 versus 22 days; p TV operation for IE is a rare clinical entity with a similar operative mortality to left-sided IE operations. Repair and replacement of the TV had similar perioperative mortality. Patients in the healed TV IE group demonstrated lower complication rates, length of stay, and a trend toward decreased mortality. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Relación entre ingesta de caramelos ácidos, ph salival, estrato socioeconómico y erosión dental en niños de tercero a séptimo año de educación básica de la parroquia de Guayllabamba.

    Directory of Open Access Journals (Sweden)

    Jeanne Prycyla Verdezoto Unaucho

    2014-12-01

    Full Text Available El proceso erosivo involucra diferentes factores donde el ácido cítrico presente en la dieta cumple un papel fundamental, así se propuso evaluar la relación entre consumo de caramelos ácidos, pH salival ácido, estrato socioeconómico y erosión dental en niños de 3ro a 7mo año de educación básica de tres escuelas de la parroquia de Guayllabamba. Mediante un estudio de caso y control 62 niños de entre 7 a 12 años (31 con diagnóstico de erosión dental y 31 controles. Previo consentimiento informado fueron sometidos a encuesta sobre hábitos de consumo de golosinas ácidas, examen clínico visual y registro fotográfico de sus dientes anteriores superiores. Las fotografías obtenidas fueron analizadas por evaluadores calibrados y entrenados en criterios del índice de erosión de O`Brien. De forma complementaria y según resultados de encuesta de consumo aplicada fueron seleccionadas ciertas golosinas para ser analizada su capacidad erosiva. Los datos obtenidos fueron examinados mediante paquete estadístico SPP v 22 a través de pruebas estadísticas de ODDS RATIO, Chi cuadrado, Mantel-Haenszel y ANOVA. Los resultados mostraron alta exposición al consumo de golosinas ácidas, guardando relación con el bajo nivel socio-económico en un porcentaje del 41,9%. La prueba de Chi cuadrado permitió determinar ausencia de relación entre edad y agresividad de la erosión (p=0,33. Concluyendo que el consumo frecuente de golosinas ácidas y un bajo estrato socio-económico es un factor importante para desarrollar erosión dental.

  17. An estimate of the proportion of symptomatic gonococcal, chlamydial and non-gonococcal non-chlamydial urethritis attributable to oral sex among men who have sex with men: a case-control study.

    Science.gov (United States)

    Barbee, Lindley A; Khosropour, Christine M; Dombrowski, Julia C; Manhart, Lisa E; Golden, Matthew R

    2016-03-01

    Sexually transmitted infections (STIs) of the pharynx are common among men who have sex with men (MSM); the degree to which these infections are transmitted through oral sex is unknown. We conducted a case-control study of MSM attending Public Health-Seattle & King County STD Clinic between 2001 and 2013 to estimate the proportion of symptomatic urethritis cases attributable to oral sex using two methods. First, we categorised men into the following mutually exclusive behavioural categories based on their self-reported sexual history in the previous 60 days: (1) only received oral sex (IOS); (2) 100% condom usage with insertive anal sex plus oral sex (PIAI); (3) inconsistent condom usage with anal sex (UIAI); and (4) no sex. We then determined the proportion of cases in which men reported the oropharynx as their only urethral exposure (IOS and PIAI). Second, we calculated the population attributable risk per cent (PAR%) associated with oral sex using Mantel-Haenszel OR estimates. Based on our behavioural categorisation method, men reported the oropharynx as their only urethral exposure in the past 60 days in 27.5% of gonococcal urethritis, 31.4% of chlamydial urethritis and 35.9% non-gonococcal, non-chlamydial urethritis (NGNCU) cases. The PAR%s for symptomatic gonococcal urethritis, chlamydial urethritis and NGNCU attributed to oropharyngeal exposure were 33.8%, 2.7% and 27.1%, respectively. The pharynx is an important source of gonococcal transmission, and may be important in the transmission of chlamydia and other, unidentified pathogens that cause urethritis. Efforts to increase pharyngeal gonorrhoea screening among MSM could diminish STI transmission. 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/

  18. Oseltamivir use and severe abnormal behavior in Japanese children and adolescents with influenza: Is a self-controlled case series study applicable?

    Science.gov (United States)

    Fukushima, Wakaba; Ozasa, Kotaro; Okumura, Akihisa; Mori, Masaaki; Hosoya, Mitsuaki; Nakano, Takashi; Tanabe, Takuya; Yamaguchi, Naoto; Suzuki, Hiroshi; Mori, Mitsuru; Hatayama, Hideaki; Ochiai, Hirotaka; Kondo, Kyoko; Ito, Kazuya; Ohfuji, Satoko; Nakamura, Yosikazu; Hirota, Yoshio

    2017-08-24

    Since the 1990s, self-controlled designs including self-controlled case series (SCCS) studies have been occasionally used in post-marketing evaluation of drug or vaccine safety. An SCCS study was tentatively applied to evaluate the relationship between oseltamivir use and abnormal behavior Type A (serious abnormal behavior potentially leading to an accident or harm to another person) in influenza patients. From the original prospective cohort study with approximately 10,000 Japanese children and adolescents with influenza (aged collaborating hospitals/clinics were analyzed. We hypothesized four combination patterns of the effect period (i.e., the period that effect of oseltamivir on occurrence of abnormal behavior Type A is likely) and the control period. Mantel-Haenszel rate ratio (M-H RR) and its 95% confidence interval (CI) were calculated as the relative risk estimate. Among 28 subjects in the SCCS study, 24 subjects (86%) were administered oseltamivir and 4 subjects (14%) were not. Abnormal behavior Type A was more likely to occur in the effect period than the control period in every pattern (M-H RR: 1.90-29.1). We observed the highest estimate when the effect period was set between the initial intake of oseltamivir and T max (M-H RR: 29.1, 95% CI: 4.21-201). Abnormal behavior Type A was more likely to develop up to approximately 30 times during the period between the initial intake of oseltamivir and T max . However, this period overlapped with the early period of influenza where high fever was observed. Since useful approaches to control the influence of the natural disease course of influenza were not available in this study, we could not deny the possibility that abnormal behavior was induced by influenza itself. The SCCS study was not an optimal method to evaluate the relationship between oseltamivir use and abnormal behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Safety of Methylphenidate and Atomoxetine in Children with Attention-Deficit/Hyperactivity Disorder (ADHD): Data from the Italian National ADHD Registry.

    Science.gov (United States)

    Cortese, Samuele; Panei, Pietro; Arcieri, Romano; Germinario, Elena A P; Capuano, Annalisa; Margari, Lucia; Chiarotti, Flavia; Curatolo, Paolo

    2015-01-01

    The aim of this study was to assess the type and frequency of adverse events (AEs) in children with attention-deficit/hyperactivity disorder (ADHD) treated with methylphenidate or atomoxetine over a 5-year period in a large naturalistic study. We draw on data from the Italian ADHD Registry, a national database for postmarketing phase IV pharmacovigilance of ADHD medications across 90 centers. AEs were defined as severe or mild as per the classification of the Italian Medicines Agency. AE frequency in the two treatment groups was compared using incidence rates per 100 person-years (IR100PY) and incidence rate ratios (IRRs). Mantel-Haenszel adjusted IRRs were calculated to control for psychiatric comorbidity. A total of 1350 and 753 participants (aged 6-18 years, mean age 10.7 ± 2.8) were treated with methylphenidate and atomoxetine, respectively, from 2007 to 2012. Ninety participants (7 %) were switched from methylphenidate to atomoxetine, and 138 (18 %) from atomoxetine to methylphenidate. Thirty-seven children treated with atomoxetine and 12 with methylphenidate had their medication withdrawn. Overall, 645 patients (26.8 %) experienced at least one mild AE (including decreased appetite and irritability, for both drugs) and 95 patients (3.9 %) experienced at least one severe AE (including severe gastrointestinal events). IR100PY were significantly higher in the atomoxetine-treated group compared with the methylphenidate-treated group for a number of mild and severe AEs and for any severe or mild AEs. After controlling for comorbidities, IRR was still significantly higher in the atomoxetine group compared with the methylphenidate group for a number of mild (decreased appetite, weight loss, abdominal pain, dyspepsia, stomach ache, irritability, mood disorder and dizziness) and severe (gastrointestinal, neuropsychiatric, and cardiovascular) AEs. In this naturalistic study, methylphenidate had a better safety profile than atomoxetine.

  20. DRAGO (KIAA0247), a new DNA damage-responsive, p53-inducible gene that cooperates with p53 as oncosuppressor. [Corrected].

    Science.gov (United States)

    Polato, Federica; Rusconi, Paolo; Zangrossi, Stefano; Morelli, Federica; Boeri, Mattia; Musi, Alberto; Marchini, Sergio; Castiglioni, Vittoria; Scanziani, Eugenio; Torri, Valter; Broggini, Massimo

    2014-04-01

    p53 influences genomic stability, apoptosis, autophagy, response to stress, and DNA damage. New p53-target genes could elucidate mechanisms through which p53 controls cell integrity and response to damage. DRAGO (drug-activated gene overexpressed, KIAA0247) was characterized by bioinformatics methods as well as by real-time polymerase chain reaction, chromatin immunoprecipitation and luciferase assays, time-lapse microscopy, and cell viability assays. Transgenic mice (94 p53(-/-) and 107 p53(+/-) mice on a C57BL/6J background) were used to assess DRAGO activity in vivo. Survival analyses were performed using Kaplan-Meier curves and the Mantel-Haenszel test. All statistical tests were two-sided. We identified DRAGO as a new p53-responsive gene induced upon treatment with DNA-damaging agents. DRAGO is highly conserved, and its ectopic overexpression resulted in growth suppression and cell death. DRAGO(-/-) mice are viable without macroscopic alterations. However, in p53(-/-) or p53(+/-) mice, the deletion of both DRAGO alleles statistically significantly accelerated tumor development and shortened lifespan compared with p53(-/-) or p53(+/-) mice bearing wild-type DRAGO alleles (p53(-/-), DRAGO(-/-) mice: hazard ratio [HR] = 3.25, 95% confidence interval [CI] = 1.7 to 6.1, P < .001; p53(+/-), DRAGO(-/-) mice: HR = 2.35, 95% CI = 1.3 to 4.0, P < .001; both groups compared with DRAGO(+/+) counterparts). DRAGO mRNA levels were statistically significantly reduced in advanced-stage, compared with early-stage, ovarian tumors, but no mutations were found in several human tumors. We show that DRAGO expression is regulated both at transcriptional-through p53 (and p73) and methylation-dependent control-and post-transcriptional levels by miRNAs. DRAGO represents a new p53-dependent gene highly regulated in human cells and whose expression cooperates with p53 in tumor suppressor functions.

  1. Perioperative clopidogrel is associated with increased bleeding and blood transfusion at the time of lower extremity bypass.

    Science.gov (United States)

    Jones, Douglas W; Schermerhorn, Marc L; Brooke, Benjamin S; Conrad, Mark F; Goodney, Philip P; Wyers, Mark C; Stone, David H

    2017-06-01

    Controversy persists surrounding the perceived bleeding risk associated with perioperative clopidogrel use in patients undergoing lower extremity bypass (LEB). The purpose of this study was to examine the LEB bleeding risk and clinical sequelae associated with clopidogrel. All LEBs in the Vascular Quality Initiative (VQI) from 2008 to 2014 were studied. The exposure was perioperative clopidogrel. Primary outcomes were blood transfusion, estimated blood loss ≥500 mL, and reoperation for bleeding. Secondary outcomes included mean operative time, major cardiac events, respiratory complications, infectious complications, and in-hospital mortality. Univariate and multivariable analyses were used to analyze patients on the basis of clopidogrel use and its association with outcomes. Nonparametric test for trend and Mantel-Haenszel methods were used to analyze association of clopidogrel use with blood transfusion and secondary outcomes. Among the LEB cohort (N = 9179), 28% (n = 2544) were taking clopidogrel and 72% (n = 6635) were not. Patients taking clopidogrel were more likely to have coronary disease, prior coronary intervention, abnormal findings on stress test, and aspirin use (P blood transfusion (38% vs 24%; P blood loss ≥500 mL (21% vs 12%; P blood transfusion (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.5-2.1; P 2-unit blood transfusion (OR, 2.0; 95% CI, 1.7-2.5; P blood transfusion amount revealed no remaining effect of clopidogrel on major cardiac events (OR, 1.1; P = .4) or respiratory complications (OR, 1.0; P = .8). Perioperative clopidogrel use in LEB surgery is associated with increased blood loss and blood transfusion. Associated clinical sequelae include increased cardiac and pulmonary complications. Accordingly, surgeons should consider discontinuation of perioperative clopidogrel when it is clinically appropriate unless it is strongly indicated at the time of LEB. Copyright © 2017 Society for Vascular Surgery. Published by

  2. Risk Factors for Podoconiosis: Kamwenge District, Western Uganda, September 2015.

    Science.gov (United States)

    Kihembo, Christine; Masiira, Ben; Lali, William Z; Matwale, Gabriel K; Matovu, Joseph K B; Kaharuza, Frank; Ario, Alex R; Nabukenya, Immaculate; Makumbi, Issa; Musenero, Monica; Zhu, Bao-Ping; Nanyunja, Miriam

    2017-06-01

    AbstractPodoconiosis, a noninfectious elephantiasis, is a disabling neglected tropical disease. In August 2015, an elephantiasis case-cluster was reported in Kamwenge District, western Uganda. We investigated to identify the disease's nature and risk factors. We defined a suspected podoconiosis case as onset in a Kamwenge resident of bilateral asymmetrical lower limb swelling lasting ≥ 1 month, plus ≥ 1 of the following associated symptoms: skin itching, burning sensation, plantar edema, lymph ooze, prominent skin markings, rigid toes, or mossy papillomata. A probable case was a suspected case with negative microfilaria antigen immunochromatographic card test (ruling out filarial elephantiasis). We conducted active case-finding. In a case-control investigation, we tested the hypothesis that the disease was caused by prolonged foot skin exposure to irritant soils, using 40 probable case-persons and 80 asymptomatic village control-persons, individually matched by age and sex. We collected soil samples to characterize irritants. We identified 52 suspected (including 40 probable) cases with onset from 1980 to 2015. Prevalence rates increased with age; annual incidence (by reported onset of disease) was stable over time at 2.9/100,000. We found that 93% (37/40) of cases and 68% (54/80) of controls never wore shoes at work (Mantel-Haenszel odds ratio [OR MH ] = 7.7; 95% [confidence interval] CI = 2.0-30); 80% (32/40) of cases and 49% (39/80) of controls never wore shoes at home (OR MH = 5.2; 95% CI = 1.8-15); and 70% (27/39) of cases and 44% (35/79) of controls washed feet at day end (versus immediately after work) (OR = 11; 95% CI = 2.1-56). Soil samples were characterized as rich black-red volcanic clays. In conclusion, this reported elephantiasis is podoconiosis associated with prolonged foot exposure to volcanic soil. We recommended foot hygiene and universal use of protective shoes.

  3. Pregnancy complications, mental health-related problems and type 2 diabetes mellitus in Malaysian women.

    Science.gov (United States)

    Hasan, Syed Shahzad; Thiruchelvam, Kaeshaelya; Ahmed, Syed Imran; Clavarino, Alexandra M; Mamun, Abdullah A; Kairuz, Therese

    2013-01-01

    The aim of this study was to investigate the association between pregnancy complications, mental health-related problems, and type 2 diabetes mellitus (T2DM) in Malaysian women. A case-control study of women with T2DM (n=160) matched by age range to controls without T2DM (n=160). Data were collected in the Negeri Sembilan and PutraJaya regions in Malaysia, from two hospital outpatient clinics, PutraJaya Hospital and Tuanku Jaa'far Hospital Seremban, and one health clinic at Seremban. Validated, interviewer-administered questionnaires were used to obtain the data. The unadjusted and adjusted estimates were calculated using the Mantel-Haenszel method. Neither depression (RR 0.74, 95% CI: 0.39-1.41) nor anxiety (RR 1.00, 95% CI: 0.53-1.88) symptoms increased the risk of T2DM significantly. However, gestational diabetes (RR 1.35, 95% CI: 1.02-1.79), and ≥3 pregnancies (RR 1.39, 95% CI: 1.08-1.79) were significant risk factors for the development of T2DM. T2DM was not a significant risk factor for either depression (RR 1.26, 95% CI: 0.91-1.74) or anxiety symptoms (RR 1.13, 95% CI: 0.59-2.19). In this study, T2DM is not a significant risk factor for depression and anxiety; similarly, neither are depression and anxiety significant risk factors for T2DM. Although prevalence of depression and anxiety is not alarming, the findings reported here should alert clinicians to screen and treat anxiety and depression in people with diabetes and also note the importance of monitoring women with complications in pregnancy for risk of later T2DM. Copyright © 2013 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  4. Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review.

    Science.gov (United States)

    Kazemier, B M; Buijs, P E; Mignini, L; Limpens, J; de Groot, C J M; Mol, B W J

    2014-09-01

    Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered. To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies. An electronic literature search in OVID MEDLINE and EMBASE, complemented by PubMed, to find recent studies. Studies comparing the risk of spontaneous preterm birth after a previous preterm and previous term pregnancy. The absolute risk of recurrence with a 95% confidence interval and the absolute risk of preterm birth after a term delivery were calculated. Data from studies were pooled using the Mantel-Haenszel method. We detected 13 relevant studies. The risk of recurrence of preterm birth was significantly increased in all preterm pregnancy subtypes, compared with their term counterparts. Women pregnant with twins after a previous preterm singleton had the highest absolute risk of recurrence (57.0%, 95% CI 51.9-61.9%), and after a previous term singleton their absolute risk was 25% (95% CI 24.3-26.5%). Women pregnant with a singleton after a previous preterm twin pregnancy have an absolute recurrence risk of 10% (95% CI 8.2-12.3%), whereas a singleton pregnancy after delivering a previous twin up to term yields a low absolute risk of only 1.3% (95% CI 0.8-2.2). Women pregnant with a singleton after a previous preterm singleton have an absolute recurrence risk of 20% (95% CI 19.9-20.6). The risk of recurrence of preterm birth is influenced by the singleton/twin order in both pregnancies, and varies between 10% for a singleton after previous preterm twins to 57% for twins after a previous preterm singleton. © 2014 Royal College of Obstetricians and Gynaecologists.

  5. Migraine, fibromyalgia, and depression among people with IBS: a prevalence study

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    Cabral Howard J

    2006-09-01

    Full Text Available Abstract Background Case descriptions suggest IBS patients are more likely to have other disorders, including migraine, fibromyalgia, and depression. We sought to examine the prevalence of these conditions in cohorts of people with and without IBS. Methods The source of data was a large U.S. health plan from January 1, 1996 though June 30, 2002. We identified all people with a medical claim associated with an ICD-9 code for IBS. A non-IBS cohort was a random sample of people with an ICD-9 code for routine medical care. In the cohorts, we identified all claims for migraine, depression, and fibromyalgia. We estimated the prevalence odds ratios (PORs of each of the three conditions using the Mantel-Haenszel method. We conducted quantitative sensitivity analyses to quantify the impact of residual confounding and in differential outcome identification. Results We identified 97,593 people in the IBS cohort, and a random sample of 27,402 people to compose the non-IBS comparison cohort. With adjustment, there was a 60% higher odds in the IBS cohort of having any one of the three disorders relative to the comparison cohort (POR 1.6, 95% CI 1.5 – 1.7. There was a 40% higher odds of depression in the IBS cohort (POR 1.4, 95% CI 1.3 – 1.4. The PORs for fibromyalgia and migraine were similar (POR for fibromyalgia 1.8, 95% CI 1.7 – 1.9; POR for migraine 1.6, 95% CI 1.4 – 1.7. Differential prevalence of an unmeasured confounder, or imperfect sensitivity or specificity of outcome detection would have impacted the observed results. Conclusion People in the IBS cohort had a 40% to 80% higher prevalence odds of migraine, fibromyalgia, and depression.

  6. Long-term results of radiotherapy for subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (ARMD)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Kyong; Kim, Il Han [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2007-06-15

    We performed this prospective randomized study to evaluate the efficacy and the complications of radiotherapy for Subfoveal CNV in ARMD and to compare the treatment results at two dosages (14.4 Gy and 19.8 Gy). 60 eyes of 55 patients were enrolled, and randomized into 14.4 Gy (31 eyes) or 19.8 Gy (29 eyes) groups. CT was used to plan the radiotherapy. All patients received radiotherapy with a 1.8 Gy daily dose using 4 MV photon. We categorized treatment results as improved, stable, or deteriorated based on visual acuity changes of more than 2 lines on the ETDRS chart. Median follow-up period was 33.5 months. At 12 months, visual acuity improved in 9 (16.7%), stable in 41 (75.9%), and aggravated in 4 (7.4%) of 54 evaluated eyes. At 24 months, 49 eyes (81.7%) were evaluated. Visual acuity improved in 6 (12.2%), was stable in 33 (67.4%), and deteriorated in 10 (20.4%). At 36 months, 37 eyes were evaluated. Six (16.2%) eyes were improved, 21 (56.8%) stable, and 10 (27.0%) deteriorated. No significant difference in response was observed between the 14.4 Gy and 19.8 Gy groups (Mantel-Haenszel {chi} {sup 2} = 0.4756). The proportion of eyes with a vision of 20/100 {<=} increased from 28.3% initially to 32.7% after 24 months of radiotherapy. There were no severe acute or chronic complications. External beam radiotherapy with doses of 14.4 or 19.8 Gy may be an effective treatment for subfoveal CNV in ARMD. No dose-response relationships with respect to treatment response or toxicity were observed between the 14.4 Gy and 19.8 Gy groups.

  7. Circulating tumor cells and their relationship with clinical and morphological characteristics of colorectal cancer

    Directory of Open Access Journals (Sweden)

    O I Kit

    2018-02-01

    Full Text Available Aim. To investigate the dependence of the number of circulating tumor cells in peripheral blood of colorectal cancer patients on the clinical and morphological characteristics of underlying disease. Methods. 91 patients with verified metastatic colorectal cancer Т3-4N1-2М1 were included in the study. The average age of the patients was 61.5±1.7 years. The patients were divided into the study group (laparoscopic surgical treatment, n=44 and control group (open surgical intervention, n=47. The number of circulating tumor cells was determined in CellSearch™ system in the peripheral blood drawn before the intervention. The study of the association of attributes by constructing contingency tables consisted in calculating Pearson’s contingency coefficient c2 with Mantel-Haenszel correction for likelihood (nonparametric correction, estimating statistical significance of contingency and analyzing the tightness of the association by A. Chuprov’s mutual contingency coefficient. Results. We found contingency of the number of circulating tumor cells with clinical and morphological parameters of patients with colorectal cancer. The relationship between potential risk factors and increase of the number of circulating tumor cells in the peripheral blood was observed in all colorectal cancer patients, regardless of the surgical intervention method. The most pronounced association of the number of circulating tumor cells in the peripheral blood of metastatic colorectal cancer patients before surgery according to the mutual contingency coefficient (K was shown to be with present distant metastases (status M1b; K=0.63, p=0.0001 and stage T4 (K=0.56, p=0.0009. Conclusion. The obtained results emphasize the important predictive significance of the circulating tumor cells level in peripheral blood for assessment of the potential for colorectal cancer progression.

  8. Revisited: A Systematic Review of Therapeutic Hypothermia for Adult Patients Following Traumatic Brain Injury.

    Science.gov (United States)

    Watson, Hannah I; Shepherd, Andrew A; Rhodes, Jonathan K J; Andrews, Peter J D

    2018-06-01

    Therapeutic hypothermia has been of topical interest for many years and with the publication of two international, multicenter randomized controlled trials, the evidence base now needs updating. The aim of this systematic review of randomized controlled trials is to assess the efficacy of therapeutic hypothermia in adult traumatic brain injury focusing on mortality, poor outcomes, and new pneumonia. The following databases were searched from January 1, 2011, to January 26, 2018: Cochrane Central Register of Controlled Trial, MEDLINE, PubMed, and EMBASE. Only foreign articles published in the English language were included. Only articles that were randomized controlled trials investigating adult traumatic brain injury sustained following an acute, closed head injury were included. Two authors independently assessed at each stage. Quality was assessed using the Cochrane Collaboration's tool for assessing the risk of bias. All extracted data were combined using the Mantel-Haenszel estimator for pooled risk ratio with 95% CIs. p value of less than 0.05 was considered statistically significant. All statistical analyses were conducted using RevMan 5 (Cochrane Collaboration, Version 5.3, Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). Twenty-two studies with 2,346 patients are included. Randomized controlled trials with a low risk of bias show significantly more mortality in the therapeutic hypothermia group (risk ratio, 1.37; 95% CI, 1.04-1.79; p = 0.02), whereas randomized controlled trials with a high risk of bias show the opposite with a higher mortality in the control group (risk ratio, 0.70; 95% CI, 0.60-0.82; p < 0.00001). Overall, this review is in-keeping with the conclusions published by the most recent randomized controlled trials. High-quality studies show no significant difference in mortality, poor outcomes, or new pneumonia. In addition, this review shows a place for fever control in the management of traumatic brain injury.

  9. Generalization error analysis: deep convolutional neural network in mammography

    Science.gov (United States)

    Richter, Caleb D.; Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir; Cha, Kenny

    2018-02-01

    We conducted a study to gain understanding of the generalizability of deep convolutional neural networks (DCNNs) given their inherent capability to memorize data. We examined empirically a specific DCNN trained for classification of masses on mammograms. Using a data set of 2,454 lesions from 2,242 mammographic views, a DCNN was trained to classify masses into malignant and benign classes using transfer learning from ImageNet LSVRC-2010. We performed experiments with varying amounts of label corruption and types of pixel randomization to analyze the generalization error for the DCNN. Performance was evaluated using the area under the receiver operating characteristic curve (AUC) with an N-fold cross validation. Comparisons were made between the convergence times, the inference AUCs for both the training set and the test set of the original image patches without corruption, and the root-mean-squared difference (RMSD) in the layer weights of the DCNN trained with different amounts and methods of corruption. Our experiments observed trends which revealed that the DCNN overfitted by memorizing corrupted data. More importantly, this study improved our understanding of DCNN weight updates when learning new patterns or new labels. Although we used a specific classification task with the ImageNet as example, similar methods may be useful for analysis of the DCNN learning processes, especially those that employ transfer learning for medical image analysis where sample size is limited and overfitting risk is high.

  10. A clinimetric analysis of the Hopkins Symptom Checklist (SCL-90-R) in general population studies (Denmark, Norway, and Italy)

    DEFF Research Database (Denmark)

    Carrozzino, Danilo; Vassend, Olav; Bjørndal, Flemming

    2016-01-01

    the factor structure. The scalability of the traditional SCL-90-R subscales (somatization, hostility, and interpersonal sensitivity) as well as the affective subscales (depression and anxiety and ADHD) were tested by Mokken’s item response theory model. Results: Across the three general population studies...... the traditional scaled SCL-90-R factor including 83 items was identified by PCA. The Mokken analysis accepted the scalability of both the general factor and the clinical SCL-90-R subscales under examination. Conclusion: The traditional, scaled, general 83 item SCL-90-R scale is a valid measure of general...

  11. Analysis of general and specific combining abilities of popcorn populations, including selfed parents

    Directory of Open Access Journals (Sweden)

    José Marcelo Soriano Viana

    2003-12-01

    Full Text Available Estimation of general and specific combining ability effects in a diallel analysis of cross-pollinating populations, including the selfed parents, is presented in this work. The restrictions considered satisfy the parametric values of the GCA and SCA effects. The method is extended to self-pollinating populations (suitable for other species, without the selfed parents. The analysis of changes in population means due to inbreeding (sensitivity to inbreeding also permits to assess the predominant direction of dominance deviations and the relative genetic variability in each parent population. The methodology was used to select popcorn populations for intra- and inter-population breeding programs and for hybrid production, developed at the Federal University of Viçosa, MG, Brazil. Two yellow pearl grain popcorn populations were selected.

  12. Bonding analysis of planar hypercoordinate atoms via the generalized BLW-LOL.

    Science.gov (United States)

    Bomble, Laetitia; Steinmann, Stephan N; Perez-Peralta, Nancy; Merino, Gabriel; Corminboeuf, Clemence

    2013-10-05

    The multicenter bonding pattern of the intriguing hexa-, hepta-, and octacoordinate boron wheel series (e.g., CB62-, CB7-, B82-, and SiB8 as well as the experimentally detected CB7- isomer) is revised using the block-localized wave function analyzed by the localized orbital locator (BLW-LOL). The more general implementation of BLW combined with the LOL scalar field is not restricted to the analysis of the out-of-plane π-system but can also provide an intuitive picture of the σ-radial delocalization and of the role of the central atom. The results confirm the presence of a π-ring current pattern similar to that of benzene. In addition, the LOLπ isosurfaces along with the maximum intensity in the ΔLOL profiles located above and below the ring suggest that the central atom plays a minor role in the π-delocalized bonding pattern. Finally, the analysis of the σ-framework in these boron wheels is in line with a moderated inner cyclic rather than disk-type delocalization. Copyright © 2013 Wiley Periodicals, Inc.

  13. Ultimate load analysis of prestressed concrete reactor pressure vessels considering a general material law

    International Nuclear Information System (INIS)

    Schimmelpfennig, K.

    1975-01-01

    A method of analysis is presented, by which progressive fracture processes in axisymmetric prestressed concrete pressure vessels during increasing internal pressure can be evaulated by means of a continuum calculation considering a general material law. Formulations used in the analysis concerning material behaviour are derived on one hand from appropriate results of testing small concrete specimens, and are on the other hand gained by parametric studies in order to solve questions still existing by recalulating fracture tests on concrete bodies with more complex states of stress. Due attention is focussed on investigating the behaviour of construction members subjected to high shear forces (end slabs.). (Auth.)

  14. The semi-Markov process. Generalizations and calculation rules for application in the analysis of systems

    International Nuclear Information System (INIS)

    Hirschmann, H.

    1983-06-01

    The consequences of the basic assumptions of the semi-Markov process as defined from a homogeneous renewal process with a stationary Markov condition are reviewed. The notion of the semi-Markov process is generalized by its redefinition from a nonstationary Markov renewal process. For both the nongeneralized and the generalized case a representation of the first order conditional state probabilities is derived in terms of the transition probabilities of the Markov renewal process. Some useful calculation rules (regeneration rules) are derived for the conditional state probabilities of the semi-Markov process. Compared to the semi-Markov process in its usual definition the generalized process allows the analysis of a larger class of systems. For instance systems with arbitrarily distributed lifetimes of their components can be described. There is also a chance to describe systems which are modified during time by forces or manipulations from outside. (Auth.)

  15. Development of a large-scale general purpose two-phase flow analysis code

    International Nuclear Information System (INIS)

    Terasaka, Haruo; Shimizu, Sensuke

    2001-01-01

    A general purpose three-dimensional two-phase flow analysis code has been developed for solving large-scale problems in industrial fields. The code uses a two-fluid model to describe the conservation equations for two-phase flow in order to be applicable to various phenomena. Complicated geometrical conditions are modeled by FAVOR method in structured grid systems, and the discretization equations are solved by a modified SIMPLEST scheme. To reduce computing time a matrix solver for the pressure correction equation is parallelized with OpenMP. Results of numerical examples show that the accurate solutions can be obtained efficiently and stably. (author)

  16. Unsupervised Learning and Generalization

    DEFF Research Database (Denmark)

    Hansen, Lars Kai; Larsen, Jan

    1996-01-01

    The concept of generalization is defined for a general class of unsupervised learning machines. The generalization error is a straightforward extension of the corresponding concept for supervised learning, and may be estimated empirically using a test set or by statistical means-in close analogy ...... with supervised learning. The empirical and analytical estimates are compared for principal component analysis and for K-means clustering based density estimation......The concept of generalization is defined for a general class of unsupervised learning machines. The generalization error is a straightforward extension of the corresponding concept for supervised learning, and may be estimated empirically using a test set or by statistical means-in close analogy...

  17. Cuestionario general de salud-12: análisis de factores en población general de Bucaramanga, Colombia General health questionnaire-12: factor analysis in the general population of Bucaramanga, Colombia

    Directory of Open Access Journals (Sweden)

    Adalberto Campo Arias

    2007-03-01

    Full Text Available ANTECEDENTES: el cuestionario general de salud de doce puntos (GHQ-12 es un instrumento diseñado para cuantificar síntomas emocionales (trastornos mentales comunes en diferentes contextos. Sin embargo, no se conoce la estructura factorial de esta versión en población colombiana. OBJETIVO: conocer la estructura de factores y la mejor forma de puntuación para el GHQ-12 en población general de Bucaramanga, Colombia. MÉTODO: una muestra probabilística de la población general, representada por 2.496 adultos entre 18 y 65 años, diligenció el GHQ-12. Se determinó la consistencia interna y los factores para las formas de puntuación ordinal (0-1-2-3 y binarias (0-0-0-1, 0-0-1-1 y 0-1-1-1. RESULTADOS: la forma ordinal mostró una consistencia interna de 0,779 y dos factores que explicaban 42,5% de la varianza. Por otro lado, la forma binaria 0-1-1-1 presentó una consistencia interna de 0,774; la forma 0-0-1-1, de 0,708; y la forma 0-0-0-1, de 0,360. Las formas binarias 0-1-1-1 y 0-0-1-1 mostraron tres factores responsables de 50,6% y 46,3%, respectivamente. La forma 0-0-0-1 no presentó una aceptable solución factorial. CONCLUSIONES: en Bucaramanga, la forma de puntuación ordinal presenta un mejor comportamiento psicométrico que las binarias. Todas las formas de puntuación muestran alta consistencia interna y aceptable solución factorial, excepto la forma 0-0-0-1 BACKGROUND: The General Health Questionnaire (GHQ-12 was designed to quantify emotional symptoms (common mental disorders in different settings. However, its factor structure is not known in Colombian population. OBJECTIVE: To establish the factor structure and the best form of punctuation for the GHQ-12 in the general population of Bucaramanga, Colombia. METHOD: A probabilistic sample of 2,496 adults from the general population in Bucaramanga, Colombia, completed the GHQ-12. The internal consistency and analysis factor were computed for the ordinal scoring (0-1-2-3 and for

  18. Generalized indices for radiation risk analysis

    International Nuclear Information System (INIS)

    Bykov, A.A.; Demin, V.F.

    1989-01-01

    A new approach to ensuring nuclear safety has begun forming since the early eighties. The approach based on the probabilistic safety analysis, the principles of acceptable risk, the optimization of safety measures, etc. has forced a complex of adequate quantitative methods of assessment, safety analysis and risk management to be developed. The method of radiation risk assessment and analysis hold a prominent place in the complex. National and international research and regulatory organizations ICRP, IAEA, WHO, UNSCEAR, OECD/NEA have given much attention to the development of the conceptual and methodological basis of those methods. Some resolutions of the National Commission of Radiological Protection (NCRP) and the Problem Commission on Radiation Hygiene of the USSR Ministry of Health should be also noted. Both CBA (cost benefit analysis) and other methods of radiation risk analysis and safety management use a system of natural and socio-economic indices characterizing the radiation risk or damage. There exist a number of problems associated with the introduction, justification and use of these indices. For example, the price, a, of radiation damage, or collective dose unit, is a noteworthy index. The difficulties in its qualitative and quantitative determination are still an obstacle for a wide application of CBA to the radiation risk analysis and management. During recent 10-15 years these problems have been a subject of consideration for many authors. The present paper also considers the issues of the qualitative and quantitative justification of the indices of radiation risk analysis

  19. More powerful haplotype sharing by accounting for the mode of inheritance.

    Science.gov (United States)

    Ziegler, Andreas; Ewhida, Adel; Brendel, Michael; Kleensang, André

    2009-04-01

    The concept of haplotype sharing (HS) has received considerable attention recently, and several haplotype association methods have been proposed. Here, we extend the work of Beckmann and colleagues [2005 Hum. Hered. 59:67-78] who derived an HS statistic (BHS) as special case of Mantel's space-time clustering approach. The Mantel-type HS statistic correlates genetic similarity with phenotypic similarity across pairs of individuals. While phenotypic similarity is measured as the mean-corrected cross product of phenotypes, we propose to incorporate information of the underlying genetic model in the measurement of the genetic similarity. Specifically, for the recessive and dominant modes of inheritance we suggest the use of the minimum and maximum of shared length of haplotypes around a marker locus for pairs of individuals. If the underlying genetic model is unknown, we propose a model-free HS Mantel statistic using the max-test approach. We compare our novel HS statistics to BHS using simulated case-control data and illustrate its use by re-analyzing data from a candidate region of chromosome 18q from the Rheumatoid Arthritis (RA) Consortium. We demonstrate that our approach is point-wise valid and superior to BHS. In the re-analysis of the RA data, we identified three regions with point-wise P-values<0.005 containing six known genes (PMIP1, MC4R, PIGN, KIAA1468, TNFRSF11A and ZCCHC2) which might be worth follow-up.

  20. GENOVA: a generalized perturbation theory program for various applications to CANDU core physics analysis (II) - a user's manual

    International Nuclear Information System (INIS)

    Kim, Do Heon; Choi, Hang Bok

    2001-03-01

    A user's guide for GENOVA, a GENeralized perturbation theory (GPT)-based Optimization and uncertainty analysis program for Canada deuterium uranium (CANDU) physics VAriables, was prepared. The program was developed under the framework of CANDU physics design and analysis code RFSP. The generalized perturbation method was implemented in GENOVA to estimate the zone controller unit (ZCU) level upon refueling operation and calculate various sensitivity coefficients for fuel management study and uncertainty analyses, respectively. This documentation contains descriptions and directions of four major modules of GENOVA such as ADJOINT, GADJINT, PERTURB, and PERTXS so that it can be used as a practical guide for GENOVA users. This documentation includes sample inputs for the ZCU level estimation and sensitivity coefficient calculation, which are the main application of GENOVA. The GENOVA can be used as a supplementary tool of the current CANDU physics design code for advanced CANDU core analysis and fuel development

  1. Size and shape in Melipona quadrifasciata anthidioides Lepeletier, 1836 (Hymenoptera; Meliponini

    Directory of Open Access Journals (Sweden)

    LA Nunes

    Full Text Available This study aimed to identify differences in wing shape among populations of Melipona quadrifasciata anthidioides obtained in 23 locations in the semi-arid region of Bahia state (Brazil. Analysis of the Procrustes distances among mean wing shapes indicated that population structure did not determine shape variation. Instead, populations were structured geographically according to wing size. The Partial Mantel Test between morphometric (shape and size distance matrices and altitude, taking geographic distances into account, was used for a more detailed understanding of size and shape determinants. A partial Mantel test between morphometris (shape and size variation and altitude, taking geographic distances into account, revealed that size (but not shape is largely influenced by altitude (r = 0.54 p < 0.01. These results indicate greater evolutionary constraints for the shape variation, which must be directly associated with aerodynamic issues in this structure. The size, however, indicates that the bees tend to have larger wings in populations located at higher altitudes.

  2. Size and shape in Melipona quadrifasciata anthidioides Lepeletier, 1836 (Hymenoptera; Meliponini).

    Science.gov (United States)

    Nunes, L A; Passos, G B; Carvalho, C A L; Araújo, E D

    2013-11-01

    This study aimed to identify differences in wing shape among populations of Melipona quadrifasciata anthidioides obtained in 23 locations in the semi-arid region of Bahia state (Brazil). Analysis of the Procrustes distances among mean wing shapes indicated that population structure did not determine shape variation. Instead, populations were structured geographically according to wing size. The Partial Mantel Test between morphometric (shape and size) distance matrices and altitude, taking geographic distances into account, was used for a more detailed understanding of size and shape determinants. A partial Mantel test between morphometris (shape and size) variation and altitude, taking geographic distances into account, revealed that size (but not shape) is largely influenced by altitude (r = 0.54 p < 0.01). These results indicate greater evolutionary constraints for the shape variation, which must be directly associated with aerodynamic issues in this structure. The size, however, indicates that the bees tend to have larger wings in populations located at higher altitudes.

  3. Generally covariant gauge theories

    International Nuclear Information System (INIS)

    Capovilla, R.

    1992-01-01

    A new class of generally covariant gauge theories in four space-time dimensions is investigated. The field variables are taken to be a Lie algebra valued connection 1-form and a scalar density. Modulo an important degeneracy, complex [euclidean] vacuum general relativity corresponds to a special case in this class. A canonical analysis of the generally covariant gauge theories with the same gauge group as general relativity shows that they describe two degrees of freedom per space point, qualifying therefore as a new set of neighbors of general relativity. The modification of the algebra of the constraints with respect to the general relativity case is computed; this is used in addressing the question of how general relativity stands out from its neighbors. (orig.)

  4. Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case-control study.

    Science.gov (United States)

    Heaman, Maureen I; Moffatt, Michael; Elliott, Lawrence; Sword, Wendy; Helewa, Michael E; Morris, Heather; Gregory, Patricia; Tjaden, Lynda; Cook, Catherine

    2014-07-15

    The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada's universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neighborhoods. We conducted a case-control study with 202 cases (inadequate prenatal care) and 406 controls (adequate prenatal care), frequency matched 1:2 by neighborhood. Women were recruited during their postpartum hospital stay, and were interviewed using a structured questionnaire. Stratified analyses of barriers and motivators associated with inadequate prenatal care were conducted, and the Mantel-Haenszel common odds ratio (OR) was reported when the results were homogeneous across neighborhoods. Chi square analysis was used to test for differences in proportions of cases and controls reporting facilitators that would have helped them get more prenatal care. Of the 39 barriers assessed, 35 significantly increased the odds of inadequate prenatal care for inner-city women. Psychosocial issues that increased the likelihood of inadequate prenatal care included being under stress, having family problems, feeling depressed, "not thinking straight", and being worried that the baby would be apprehended by the child welfare agency. Structural barriers included not knowing where to get prenatal care, having a long wait to get an appointment, and having problems with child care or transportation. Attitudinal barriers included not planning or knowing about the pregnancy, thinking of having an abortion, and believing they did not need prenatal care. Of the 10 motivators assessed, four had a protective effect, such as the desire to learn how to protect one's health. Receiving incentives and getting

  5. Samsung Salmonella Detection Kit. AOAC Performance Tested Method(SM) 021203.

    Science.gov (United States)

    Li, Jun; Cheung, Win Den; Opdyke, Jason; Harvey, John; Chong, Songchun; Moon, Cheol Gon

    2012-01-01

    broths (a total of 441 isolates detected), and correctly excluded all 31 nontarget strains analyzed. For the method comparison, statistical analysis was conducted according to the Mantel-Haenszel Chi-square formula for unpaired test portions, and there was no significant difference in the number of positive samples detected between the Samsung Salmonella Detection Kit and the USDA/FSIS-MLG and FDA/BAM reference methods for all 10 food matrixes.

  6. Court orders on procreation.

    Science.gov (United States)

    Matevosyan, Naira R

    2016-01-01

    The aim of this study is to empirically evaluate judgments entered from 1913 to 2013 in the matters of compulsory sterilization. Holdings and dispositions at the U.S. Appellate and Supreme courts are randomly located in LexisNexis using Shepard's symbols. Continuous variables are processed with the Mantel-Haenszel method. Court orders are used as units of analysis. The majority of cases (56.4 %) concern minors at a mean age of 11.7 years. Forty-four (80 %) petitions are filed by the parents or guardians; 11 (20 %) are parens patriae. Petitions for female sterilization are denied in 56.4 % cases under the Federal Laws (2 U.S.C. 431; 28 U.S.C; 29 U.S.C; 42 U.S.C; 424 U.S.), Procedural due process clause of the 14th Amendment, statutes, and common law precedents. Petitions for female sterilization are granted in 36.4 % cases under the statutory penal codes, the Law of the land, precedents, and the dicta. No significant associations are found between the parity and degree of mental impairment (r = 0.342). Substantial correlations are met between the gender, degree of impairment (r (2) = 0.724), and dispositions (r (2) = 802). The mean age of women is 20.78 years; the mean age of men is 30.25 years. Correlations fail to establish reasoning between the age of the subjects and the entered judgments (r (2) = 0. 356). (1) The female/male ratio (8:1) and age gap of the respondents indicate on a disproportionate impact of the statutes. (2) The procedure of sterilization in itself is incommensurate with equality, as the volume of surgery is uneven in males and females. (3) The case law is instructive with respect to which arguments have not been advanced. (4) Lastly, due to the etiological intricacy of mental impairment, with genetic transmission strikingly different in men and women, expert-witnesses ought to act in a medical vacuum because there is no mathematical certainty as to the transmission mode of the traits in question (exon and intron mutations, triplet repeat

  7. The safety, tolerability, and efficacy of once-daily memantine (28 mg): a multinational, randomized, double-blind, placebo-controlled trial in patients with moderate-to-severe Alzheimer's disease taking cholinesterase inhibitors.

    Science.gov (United States)

    Grossberg, George T; Manes, Facundo; Allegri, Ricardo F; Gutiérrez-Robledo, Luis Miguel; Gloger, Sergio; Xie, Lei; Jia, X Daniel; Pejović, Vojislav; Miller, Michael L; Perhach, James L; Graham, Stephen M

    2013-06-01

    Immediate-release memantine (10 mg, twice daily) is approved in the USA for moderate-to-severe Alzheimer's disease (AD). This study evaluated the efficacy, safety, and tolerability of a higher-dose, once-daily, extended-release formulation in patients with moderate-to-severe AD concurrently taking cholinesterase inhibitors. In this 24-week, double-blind, multinational study (NCT00322153), outpatients with AD (Mini-Mental State Examination scores of 3-14) were randomized to receive once-daily, 28-mg, extended-release memantine or placebo. Co-primary efficacy parameters were the baseline-to-endpoint score change on the Severe Impairment Battery (SIB) and the endpoint score on the Clinician's Interview-Based Impression of Change Plus Caregiver Input (CIBIC-Plus). The secondary efficacy parameter was the baseline-to-endpoint score change on the 19-item Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL19); additional parameters included the baseline-to-endpoint score changes on the Neuropsychiatric Inventory (NPI) and verbal fluency test. Data were analyzed using a two-way analysis of covariance model, except for CIBIC-Plus (Cochran-Mantel-Haenszel test). Safety and tolerability were assessed through adverse events and physical and laboratory examinations. A total of 677 patients were randomized to receive extended-release memantine (n = 342) or placebo (n = 335); completion rates were 79.8 and 81.2 %, respectively. At endpoint (week 24, last observation carried forward), memantine-treated patients significantly outperformed placebo-treated patients on the SIB (least squares mean difference [95 % CI] 2.6 [1.0, 4.2]; p = 0.001), CIBIC-Plus (p = 0.008), NPI (p = 0.005), and verbal fluency test (p = 0.004); the effect did not achieve significance on ADCS-ADL19 (p = 0.177). Adverse events with a frequency of ≥5.0 % that were more prevalent in the memantine group were headache (5.6 vs. 5.1 %) and diarrhea (5.0 vs. 3.9

  8. Changing physician knowledge, attitudes, and beliefs about migraine: evaluation of a new educational intervention.

    Science.gov (United States)

    Patwardhan, Meenal B; Samsa, Gregory P; Lipton, Richard B; Matchar, David B

    2006-05-01

    Use a presurvey of primary care providers (PCPs) enrolled in a continuing medical education (CME) program on headache management to ascertain their existing knowledge, attitudes, and beliefs regarding migraine and use a postsurvey to determine the extent to which the CME program has brought participant knowledge, attitudes, and skills closer to conformance with best evidence. Migraine is a common and debilitating condition, which PCPs may not always manage satisfactorily. In an effort to improve management, the American Headache Society has developed a CME program called BRAINSTORM that encourages PCPs to adopt the US Headache Consortium Guidelines for headache care. A 20-item questionnaire was developed that covered the essential elements of migraine care. The questionnaire was administered before and after a BRAINSTORM presentation to 254 consenting primary care clinicians attending a medical meeting at 1 of 6 sites. A control group of 112 comparable physicians who did not attend the presentation completed the same questionnaire. Prepresentation scores of attendees were compared to scores of nonattendees to assess the generalizability of results. Prepresentation scores on selected questions were used to assess participant baseline knowledge, attitudes, and beliefs. Pre- and postpresentation scores for attendees at all sites were compared using the Mantel-Haenszel statistic to assess the effectiveness of the BRAINSTORM CME. Pre- and postpresentation scores were compared by site using the Breslow-Day test to evaluate any differential impact based on CME location. Prepresentation scores of attendees and nonattendees were found to be similar. No significant difference in performance was noted across sites. A chi-square analysis revealed a statistically significant difference between pre- and postpresentation scores for 16 of the test's 20 questions. In the pretest, all participants scored 66% posttest on all except 2 questions related to prevalence, impact, and

  9. SNAP: A General Purpose Network Analysis and Graph Mining Library.

    Science.gov (United States)

    Leskovec, Jure; Sosič, Rok

    2016-10-01

    Large networks are becoming a widely used abstraction for studying complex systems in a broad set of disciplines, ranging from social network analysis to molecular biology and neuroscience. Despite an increasing need to analyze and manipulate large networks, only a limited number of tools are available for this task. Here, we describe Stanford Network Analysis Platform (SNAP), a general-purpose, high-performance system that provides easy to use, high-level operations for analysis and manipulation of large networks. We present SNAP functionality, describe its implementational details, and give performance benchmarks. SNAP has been developed for single big-memory machines and it balances the trade-off between maximum performance, compact in-memory graph representation, and the ability to handle dynamic graphs where nodes and edges are being added or removed over time. SNAP can process massive networks with hundreds of millions of nodes and billions of edges. SNAP offers over 140 different graph algorithms that can efficiently manipulate large graphs, calculate structural properties, generate regular and random graphs, and handle attributes and meta-data on nodes and edges. Besides being able to handle large graphs, an additional strength of SNAP is that networks and their attributes are fully dynamic, they can be modified during the computation at low cost. SNAP is provided as an open source library in C++ as well as a module in Python. We also describe the Stanford Large Network Dataset, a set of social and information real-world networks and datasets, which we make publicly available. The collection is a complementary resource to our SNAP software and is widely used for development and benchmarking of graph analytics algorithms.

  10. Stability analysis of black holes via a catastrophe theory and black hole thermodynamics in generalized theories of gravity

    International Nuclear Information System (INIS)

    Tamaki, Takashi; Torii, Takashi; Maeda, Kei-ichi

    2003-01-01

    We perform a linear perturbation analysis for black hole solutions with a 'massive' Yang-Mills field (the Proca field) in Brans-Dicke theory and find that the results are quite consistent with those via catastrophe theory where thermodynamic variables play an intrinsic role. Based on this observation, we show the general relation between these two methods in generalized theories of gravity which are conformally related to the Einstein-Hilbert action

  11. Stability analysis of embedded nonlinear predictor neural generalized predictive controller

    Directory of Open Access Journals (Sweden)

    Hesham F. Abdel Ghaffar

    2014-03-01

    Full Text Available Nonlinear Predictor-Neural Generalized Predictive Controller (NGPC is one of the most advanced control techniques that are used with severe nonlinear processes. In this paper, a hybrid solution from NGPC and Internal Model Principle (IMP is implemented to stabilize nonlinear, non-minimum phase, variable dead time processes under high disturbance values over wide range of operation. Also, the superiority of NGPC over linear predictive controllers, like GPC, is proved for severe nonlinear processes over wide range of operation. The necessary conditions required to stabilize NGPC is derived using Lyapunov stability analysis for nonlinear processes. The NGPC stability conditions and improvement in disturbance suppression are verified by both simulation using Duffing’s nonlinear equation and real-time using continuous stirred tank reactor. Up to our knowledge, the paper offers the first hardware embedded Neural GPC which has been utilized to verify NGPC–IMP improvement in realtime.

  12. Vehicle technology under CO2 constraint: a general equilibrium analysis

    International Nuclear Information System (INIS)

    Schaefer, Andreas; Jacoby, Henry D.

    2006-01-01

    A study is presented of the rates of penetration of different transport technologies under policy constraints on CO 2 emissions. The response of this sector is analyzed within an overall national level of restriction, with a focus on automobiles, light trucks, and heavy freight trucks. Using the US as an example, a linked set of three models is used to carry out the analysis: a multi-sector computable general equilibrium model of the economy, a MARKAL-type model of vehicle and fuel supply technology, and a model simulating the split of personal and freight transport among modes. Results highlight the importance of incremental improvements in conventional internal combustion engine technology, and, in the absence of policies to overcome observed consumer discount rates, the very long time horizons before radical alternatives like the internal combustion engine hybrid drive train vehicle are likely to take substantial market share

  13. On Generalization in Qualitatively Oriented Research

    Directory of Open Access Journals (Sweden)

    Philipp Mayring

    2007-09-01

    Full Text Available In this article, I open a debate about the importance and possibilities of generalization in qualitative oriented research. Generalization traditionally is seen as a central aim of science, as a process of theory