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Sample records for greatly elevated risk

  1. Dreissenid mussels from the Great Lakes contain elevated thiaminase activity

    Science.gov (United States)

    Tillitt, D.E.; Riley, S.C.; Evans, A.N.; Nichols, S.J.; Zajicek, J.L.; Rinchard, J.; Richter, C.A.; Krueger, C.C.

    2009-01-01

    We examined thiaminase activity in dreissenid mussels collected at different depths and seasons, and from various locations in Lakes Michigan, Ontario, and Huron. Here we present evidence that two dreissenid mussel species (Dreissena bugensis and D. polymorpha) contain thiaminase activity that is 5-100 fold greater than observed in Great Lakes fishes. Thiaminase activity in zebra mussels ranged from 10,600 to 47,900??pmol g- 1??min- 1 and activities in quagga mussels ranged from 19,500 to 223,800??pmol g- 1??min- 1. Activity in the mussels was greatest in spring, less in summer, and least in fall. Additionally, we observed greater thiaminase activity in dreissenid mussels collected at shallow depths compared to mussels collected at deeper depths. Dreissenids constitute a significant and previously unknown pool of thiaminase in the Great Lakes food web compared to other known sources of this thiamine (vitamin B1)-degrading enzyme. Thiaminase in forage fish of the Great Lakes has been causally linked to thiamine deficiency in salmonines. We currently do not know whether linkages exist between thiaminase activities observed in dreissenids and the thiaminase activities in higher trophic levels of the Great Lakes food web. However, the extreme thiaminase activities observed in dreissenids from the Great Lakes may represent a serious unanticipated negative effect of these exotic species on Great Lakes ecosystems.

  2. Regional elevator survey : grain transportation & industry trends for Great Plains elevators

    Science.gov (United States)

    2001-08-01

    One potential means for gaining insight into the current state of the elevator industry, : and into expectations for future trends, is through a survey. The objective of this study is to profile the transportation and industry characteristics of the ...

  3. Elevational distribution and extinction risk in birds.

    Directory of Open Access Journals (Sweden)

    Rachel L White

    Full Text Available Mountainous regions are hotspots of terrestrial biodiversity. Unlike islands, which have been the focus of extensive research on extinction dynamics, fewer studies have examined mountain ranges even though they face increasing threats from human pressures - notably habitat conversion and climate change. Limits to the taxonomic and geographical extent and resolution of previously available information have precluded an explicit assessment of the relative role of elevational distribution in determining extinction risk. We use a new global species-level avian database to quantify the influence of elevational distribution (range, maximum and midpoint on extinction risk in birds at the global scale. We also tested this relationship within biogeographic realms, higher taxonomic levels, and across phylogenetic contrasts. Potential confounding variables (i.e. phylogenetic, distributional, morphological, life history and niche breadth were also tested and controlled for. We show that the three measures of elevational distribution are strong negative predictors of avian extinction risk, with elevational range comparable and complementary to that of geographical range size. Extinction risk was also found to be positively associated with body weight, development and adult survival, but negatively associated with reproduction and niche breadth. The robust and consistent findings from this study demonstrate the importance of elevational distribution as a key driver of variation in extinction dynamics in birds. Our results also highlight elevational distribution as a missing criterion in current schemes for quantifying extinction risk and setting species conservation priorities in birds. Further research is recommended to test for generality across non-avian taxa, which will require an advance in our knowledge of species' current elevational ranges and increased efforts to digitise and centralise such data.

  4. Elevated Bladder Cancer Risk in New England

    Science.gov (United States)

    A new study has found that drinking water from private wells, particularly dug wells established during the first half of the 20th century, may have contributed to the elevated risk of bladder cancer that has been observed in Maine, New Hampshire, and Vermont for over 50 years.

  5. Elevated transferrin saturation and risk of diabetes

    DEFF Research Database (Denmark)

    Ellervik, Christina; Mandrup-Poulsen, Thomas; Andersen, Henrik Ullits

    2011-01-01

    OBJECTIVE We tested the hypothesis that elevated transferrin saturation is associated with an increased risk of any form of diabetes, as well as type 1 or type 2 diabetes separately. RESEARCH DESIGN AND METHODS We used two general population studies, The Copenhagen City Heart Study (CCHS, N = 9......,121) and The Copenhagen General Population Study (CGPS, N = 24,195), as well as a 1:1 age- and sex-matched population-based case-control study with 6,129 patients with diabetes from the Steno Diabetes Centre and 6,129 control subjects, totaling 8,535 patients with diabetes and 37,039 control subjects. RESULTS...

  6. Quantifying cambial activity of high-elevation conifers in the Great Basin, Nevada, USA

    Science.gov (United States)

    Ziaco, E.; Biondi, F.; Rossi, S.; Deslauriers, A.

    2013-12-01

    Understanding the physiological mechanisms that control the formation of tree rings provides the necessary biological basis for developing dendroclimatic reconstructions and dendroecological histories. Studies of wood formation in the Great Basin are now being conducted in connection with the Nevada Climate-ecohydrological Assessment Network (NevCAN), a recently established transect of valley-to-mountaintop instrumented stations in the Snake and Sheep Ranges of the Great Basin. Automated sensors record meteorological, soil, and vegetational variables at these sites, providing unique opportunities for ecosystem science, and are being used to investigate the ecological implications of xylogenesis. We present here an initial study based on microcores collected during summer 2013 from mountain and subalpine conifers (including Great Basin bristlecone pine, Pinus longaeva) growing on the west slope of Mt. Washington. Samples were taken from the mountain west (SM; 2810 m elevation) and the subalpine west (SS, 3355 m elevation) NevCAN sites on June 16th and 27th, 2013. The SS site was further subdivided in a high (SSH) and a low (SSL) group of trees, separated by about 10 m in elevation. Microscopic analyses showed the effect of elevation on cambial activity, as annual ring formation was more advanced at the lower (mountain) site compared to the higher (subalpine) one. At all sites cambium size showed little variations between the two sampling dates. The number of xylem cells in the radial enlargement phase decreased between the two sampling dates at the mountain site but increased at the subalpine site, confirming a delayed formation of wood at the higher elevations. Despite relatively high within-site variability, a general trend of increasing number of cells in the lignification phase was found at all sites. Mature cells were present only at the mountain site on June 27th. Spatial differences in the xylem formation process emerged at the species level and, within

  7. Genetically elevated bilirubin and risk of ischaemic heart disease

    DEFF Research Database (Denmark)

    Stender, Stefan; Frikke-Schmidt, R; Nordestgaard, B G

    2013-01-01

    Elevated plasma levels of bilirubin, an endogenous antioxidant, have been associated with reduced risk of ischaemic heart disease (IHD) and myocardial infarction (MI). Whether this is a causal relationship remains unclear.......Elevated plasma levels of bilirubin, an endogenous antioxidant, have been associated with reduced risk of ischaemic heart disease (IHD) and myocardial infarction (MI). Whether this is a causal relationship remains unclear....

  8. The Great Recession and risk for child abuse and neglect.

    Science.gov (United States)

    Schneider, William; Waldfogel, Jane; Brooks-Gunn, Jeanne

    2017-01-01

    This paper examines the association between the Great Recession and four measures of the risk for maternal child abuse and neglect: (1) maternal physical aggression; (2) maternal psychological aggression; (3) physical neglect by mothers; and (4) supervisory/exposure neglect by mothers. It draws on rich longitudinal data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of families in 20 U.S. cities (N = 3,177; 50% African American, 25% Hispanic; 22% non-Hispanic white; 3% other). The study collected information for the 9-year follow-up survey before, during, and after the Great Recession (2007-2010). Interview dates were linked to two macroeconomic measures of the Great Recession: the national Consumer Sentiment Index and the local unemployment rate. Also included are a wide range of socio-demographic controls, as well as city fixed effects and controls for prior parenting. Results indicate that the Great Recession was associated with increased risk of child abuse but decreased risk of child neglect. Households with social fathers present may have been particularly adversely affected. Results also indicate that economic uncertainty during the Great Recession, as measured by the Consumer Sentiment Index and the unemployment rate, had direct effects on the risk of abuse or neglect, which were not mediated by individual-level measures of economic hardship or poor mental health.

  9. Geographic variability in elevation and topographic constraints on the distribution of native and nonnative trout in the Great Basin

    Science.gov (United States)

    Warren, Dana R.; Dunham, Jason B.; Hockman-Wert, David

    2014-01-01

    Understanding local and geographic factors influencing species distributions is a prerequisite for conservation planning. Our objective in this study was to model local and geographic variability in elevations occupied by native and nonnative trout in the northwestern Great Basin, USA. To this end, we analyzed a large existing data set of trout presence (5,156 observations) to evaluate two fundamental factors influencing occupied elevations: climate-related gradients in geography and local constraints imposed by topography. We applied quantile regression to model upstream and downstream distribution elevation limits for each trout species commonly found in the region (two native and two nonnative species). With these models in hand, we simulated an upstream shift in elevation limits of trout distributions to evaluate potential consequences of habitat loss. Downstream elevation limits were inversely associated with latitude, reflecting regional gradients in temperature. Upstream limits were positively related to maximum stream elevation as expected. Downstream elevation limits were constrained topographically by valley bottom elevations in northern streams but not in southern streams, where limits began well above valley bottoms. Elevation limits were similar among species. Upstream shifts in elevation limits for trout would lead to more habitat loss in the north than in the south, a result attributable to differences in topography. Because downstream distributions of trout in the north extend into valley bottoms with reduced topographic relief, trout in more northerly latitudes are more likely to experience habitat loss associated with an upstream shift in lower elevation limits. By applying quantile regression to relatively simple information (species presence, elevation, geography, topography), we were able to identify elevation limits for trout in the Great Basin and explore the effects of potential shifts in these limits that could occur in response to changing

  10. Elevation of Derivatives of Reactive Oxygen Metabolites Elevated in Young "Disaster Responders" in Hypertension due to Great East Japan Earthquake.

    Science.gov (United States)

    Shiraishi, Yasunaga; Kujiraoka, Takehiko; Hakuno, Daihiko; Masaki, Nobuyuki; Tokuno, Shinichi; Adachi, Takeshi

    2016-01-01

    There have been very few studies on serum biomarkers associated with hypertension in disaster situations. We assessed biomarkers associated with disaster-related hypertension (DRH) due to the Great East Japan Earthquake of March 2011.We collected blood samples from members of the Japan Self Defense Forces (JSDF) (n = 77) after completing disaster relief operations. We divided them into two groups based on systolic blood pressure. We defined DRH as either systolic blood pressure greater than 140 mmHg or diastolic blood pressure greater than 90 mmHg at the time of completing missions.In subjects with DRH, the mean blood pressure was 143.5 ± 5.0/99.5 ± 2.4 mmHg. Height and body weight measurements were slightly greater in the DRH group but the differences were not significant, and age was significantly higher in the DRH group. There were no differences in serum biochemical tests including metabolic markers, sulfur-containing amino acids, and cytokines. Among nitric oxide-related amino acids, asymmetric dimethylarginine (ADMA) was lower in the DRH group than in the normotension group (0.40 ± 0.02 versus 0.31 ± 0.02 μmol/L P = 0.04). The serum oxidative stress metabolite levels (d-ROMs; indicators of active oxygen metabolite products) were significantly higher in the DRH group (273.6 ± 6.08 versus 313.5 ± 13.7 U.CARR P = 0.016). Using multivariable regression analysis, d-ROMs levels were particularly predictive for DRH.Oxidative stress is associated with DRH in responders to the disaster of the Great East Japan Earthquake.

  11. Ergogenic risks elevate health risks in young athletes.

    Science.gov (United States)

    Giesemer, Bernard A

    2003-11-01

    Young athletes may use many products and techniques in an attempt to increase competitive edge in sports. The doping techniques that were previously seen in elite adult athletes are now being noted in increasingly competitive elementary, middle, and high school male and female athletes. The risk of significant morbidity and mortality associated with the use of these products is substantially increased when other risk factors are present. The risk for heat-related illness and possible heat-related mortality is higher in physiologically immature, overweight, and poorly conditioned young athletes. These are the same athletes who may be more likely to use stimulant or anabolic steroid products in attempts to catch up on training and conditioning regimens, improve their competitive advantage, or improve their physiques. The risk for heat-related incidents is higher in young athletes who are predisposed to these events because of a family trait or a previous heat-related adverse event in their own medical histories. Combinations of these factors (eg, high osmotic dietary supplements, stimulants, pre-existing medical factors, adverse ambient conditions) may significantly increase a young athlete's chances of a serious, potentially fatal event. Similarly, the risk of cardiac-related sudden death in a young athlete is significantly increased by the use of stimulants such as methamphetamine. As is the case with heat-related adverse events, the risk of cardiac-related morbidity and mortality may be significantly increased when other variables are present, such as the presence of other medications and pre-existing medical factors. As athletic competition becomes increasingly intense for younger athletes, pediatricians need to be aware of the possibility that their young patients are using ergogenic aids that may increase the risk for sudden death significantly. Pediatricians should be aware of the products available to these young competitors, and of the co-factors that

  12. Caesarean section greatly increases risk of scar endometriosis.

    Science.gov (United States)

    Nominato, Nilo Sérgio; Prates, Luis Felipe Victor Spyer; Lauar, Isabela; Morais, Jaqueline; Maia, Laura; Geber, Selmo

    2010-09-01

    To estimate the incidence of scar endometriosis after different surgical procedures. A retrospective study of 72 patients diagnosed with scar endometriosis between 1978 and 2003 was performed. Patient age, site of endometriosis, previous operations, time-gap between last surgery and onset of symptoms, nodule characteristics, and recurrence were evaluated. Age ranged from 16 to 48 years. Location varied according to the previous surgery: 46 caesarean section, one hysterectomy, one in abdominal surgery, 19 episiotomy, one was a relapse and two pelvic floor procedures, two women with no previous surgery. The incidence of scar endometriosis after caesarean section was significantly higher than after episiotomy (0.2 and 0.06%, respectively: p<0.00001) with a relative risk of 3.3. Pain was the most frequent symptom. The mean time between surgery and onset of symptoms was 3.7 years. Our findings confirm that scar endometriosis is a rare condition and indicate, probably for the first time, that caesarean section greatly increases the risk of developing scar endometriosis. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Environmental Conditions Associated with Elevated Vibrio parahaemolyticus Concentrations in Great Bay Estuary, New Hampshire.

    Directory of Open Access Journals (Sweden)

    Erin A Urquhart

    Full Text Available Reports from state health departments and the Centers for Disease Control and Prevention indicate that the annual number of reported human vibriosis cases in New England has increased in the past decade. Concurrently, there has been a shift in both the spatial distribution and seasonal detection of Vibrio spp. throughout the region based on limited monitoring data. To determine environmental factors that may underlie these emerging conditions, this study focuses on a long-term database of Vibrio parahaemolyticus concentrations in oyster samples generated from data collected from the Great Bay Estuary, New Hampshire over a period of seven consecutive years. Oyster samples from two distinct sites were analyzed for V. parahaemolyticus abundance, noting significant relationships with various biotic and abiotic factors measured during the same period of study. We developed a predictive modeling tool capable of estimating the likelihood of V. parahaemolyticus presence in coastal New Hampshire oysters. Results show that the inclusion of chlorophyll a concentration to an empirical model otherwise employing only temperature and salinity variables, offers improved predictive capability for modeling the likelihood of V. parahaemolyticus in the Great Bay Estuary.

  14. Quantifying risk of penile prosthesis infection with elevated glycosylated hemoglobin.

    Science.gov (United States)

    Wilson, S K; Carson, C C; Cleves, M A; Delk, J R

    1998-05-01

    Elevation of glycosylated hemoglobin above levels of 11.5 mg.% has been considered a contraindication to penile prosthesis implantation in diabetic patients. We determine the predictive value of glycosylated hemoglobin A1C in penile prosthesis infections in diabetic and nondiabetic patients to confirm or deny this prevalent opinion. We conducted a 2-year prospective study of 389 patients, including 114 diabetics, who underwent 3-piece penile prosthesis implantation. All patients had similar preoperative preparation without regard to diabetic status, control or glycosylated hemoglobin A1C level. Risk of infection was statistically analyzed for diabetics versus nondiabetics, glycosylated hemoglobin A1C values above and below 11.5 mg.%, insulin dependent versus oral medication diabetics, and fasting blood sugars above and below 180 mg.%. Prosthesis infections developed in 10 diabetics (8.7%) and 11 nondiabetics (4.0%). No increased infection rate was observed in diabetics with high fasting sugars or diabetics on insulin. There was no statistically significant increased infection risk with increased levels of glycosylated hemoglobin A1C among all patients or among only the diabetics. In fact, there was no meaningful difference in the median or mean level of glycosylated hemoglobin A1C in the infected and noninfected patients regardless of diabetes. Use of glycosylated hemoglobin A1C values to identify and exclude surgical candidates with increased risk of infections is not proved by this study. Elevation of fasting sugar or insulin dependence also does not increase risk of infection in diabetics undergoing prosthesis implantation.

  15. Elevated land runoff after European settlement perturbs persistent foraminiferal assemblages on the Great Barrier Reef.

    Science.gov (United States)

    Uthicke, S; Patel, F; Ditchburn, R

    2012-01-01

    Coral reefs are under pressure from a variety of human-induced disturbances, but demonstration of ecosystem changes and identification of stressors are often difficult. We tested whether global change or increased agricultural runoff after European settlement of Northeast Australia (ca. 1860) has affected inshore reefs of the Great Barrier Reef. Eleven sediment cores were retrieved from inner reefs, intermediate reefs, and outer-island reefs, and benthic foraminiferal assemblages were analyzed in dated (14C, 210Pb, 137Cs) core sections (N = 82 samples). Data were grouped into six age bands ( 1500 yr). Principal component analysis and two-factor (Zone and Age) permutational analysis of variance (PERMANOVA) suggested that assemblages from the three zones were significantly different from each other over several millennia, with symbiont-bearing (mixotrophic) species dominating the outer reefs. A significant interaction term indicated that within-zone patterns varied. Assemblages in outer reefs unaffected from increased land runoff were persistent until present times. In both other zones, assemblages were also persistent until 150 yr ago, suggesting that benthic foraminiferal assemblages are naturally highly persistent over long (> 2000 yr) timescales. Assemblages in core sections PERMANOVA. With some exceptions, changes on the inner and intermediate reefs were consistent with a model predicting that increased nutrients and higher turbidity enhance relative abundance of heterotrophic species. Given that assemblages did not change in outer-island reefs (not impacted by runoff) we argue that changes in assemblages due to global change can be rejected as an explanation. Thus, the findings are more consistent with the hypothesis that agricultural runoff since European settlement altered foraminiferal assemblages than with the hypothesis that global forcing caused changes.

  16. The 3D Elevation Program—Flood risk management

    Science.gov (United States)

    Carswell, William J.; Lukas, Vicki

    2018-01-25

    Flood-damage reduction in the United States has been a longstanding but elusive societal goal. The national strategy for reducing flood damage has shifted over recent decades from a focus on construction of flood-control dams and levee systems to a three-pronged strategy to (1) improve the design and operation of such structures, (2) provide more accurate and accessible flood forecasting, and (3) shift the Federal Emergency Management Agency (FEMA) National Flood Insurance Program to a more balanced, less costly flood-insurance paradigm. Expanding the availability and use of high-quality, three-dimensional (3D) elevation information derived from modern light detection and ranging (lidar) technologies to provide essential terrain data poses a singular opportunity to dramatically enhance the effectiveness of all three components of this strategy. Additionally, FEMA, the National Weather Service, and the U.S. Geological Survey (USGS) have developed tools and joint program activities to support the national strategy.The USGS 3D Elevation Program (3DEP) has the programmatic infrastructure to produce and provide essential terrain data. This infrastructure includes (1) data acquisition partnerships that leverage funding and reduce duplicative efforts, (2) contracts with experienced private mapping firms that ensure acquisition of consistent, low-cost 3D elevation data, and (3) the technical expertise, standards, and specifications required for consistent, edge-to-edge utility across multiple collection platforms and public access unfettered by individual database designs and limitations.High-quality elevation data, like that collected through 3DEP, are invaluable for assessing and documenting flood risk and communicating detailed information to both responders and planners alike. Multiple flood-mapping programs make use of USGS streamflow and 3DEP data. Flood insurance rate maps, flood documentation studies, and flood-inundation map libraries are products of these

  17. Enterprise Risk Management in the Great City Schools, Spring 2016

    Science.gov (United States)

    Clark, Scott B.; DeCato, Kristen Devan; George, Dave; Henderson, Dana; Henry, Aston A., Jr.; Hoch, Christopher

    2016-01-01

    Public schools have a mandate to educate children in a way that is safe, effective, and cost efficient. The risks involved in achieving that mandate have become increasingly complex, and the need to manage those risks has never been greater. The emergence of widespread, interconnected risks, such as cyber risks and data management, infrastructure…

  18. The Great Recession and the risk for child maltreatment.

    Science.gov (United States)

    Brooks-Gunn, Jeanne; Schneider, William; Waldfogel, Jane

    2013-10-01

    This study draws on the Fragile Families and Child Wellbeing Study (N=2,032), a birth cohort study of families with children from 20 U.S. cities. Interviews occurred between August 2007, and February 2010, when the children were approximately 9 years old. Macro-economic indicators of the Great Recession such as the Consumer Sentiment Index and unemployment and home foreclosure rates were matched to the data to estimate the links between different measures of the Great Recession and high frequency maternal spanking. We find that the large decline in consumer confidence during the Great Recession, as measured by the Consumer Sentiment Index, was associated with worse parenting behavior. In particular, lower levels of consumer confidence were associated with increased levels of high frequency spanking, a parenting behavior that is associated with greater likelihood of being contacted by child protective services. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Sandwich-structured polymer nanocomposites with high energy density and great charge–discharge efficiency at elevated temperatures

    Science.gov (United States)

    Li, Qi; Liu, Feihua; Yang, Tiannan; Gadinski, Matthew R.; Zhang, Guangzu; Chen, Long-Qing; Wang, Qing

    2016-01-01

    The demand for a new generation of high-temperature dielectric materials toward capacitive energy storage has been driven by the rise of high-power applications such as electric vehicles, aircraft, and pulsed power systems where the power electronics are exposed to elevated temperatures. Polymer dielectrics are characterized by being lightweight, and their scalability, mechanical flexibility, high dielectric strength, and great reliability, but they are limited to relatively low operating temperatures. The existing polymer nanocomposite-based dielectrics with a limited energy density at high temperatures also present a major barrier to achieving significant reductions in size and weight of energy devices. Here we report the sandwich structures as an efficient route to high-temperature dielectric polymer nanocomposites that simultaneously possess high dielectric constant and low dielectric loss. In contrast to the conventional single-layer configuration, the rationally designed sandwich-structured polymer nanocomposites are capable of integrating the complementary properties of spatially organized multicomponents in a synergistic fashion to raise dielectric constant, and subsequently greatly improve discharged energy densities while retaining low loss and high charge–discharge efficiency at elevated temperatures. At 150 °C and 200 MV m−1, an operating condition toward electric vehicle applications, the sandwich-structured polymer nanocomposites outperform the state-of-the-art polymer-based dielectrics in terms of energy density, power density, charge–discharge efficiency, and cyclability. The excellent dielectric and capacitive properties of the polymer nanocomposites may pave a way for widespread applications in modern electronics and power modules where harsh operating conditions are present. PMID:27551101

  20. Elevated serum pesticide levels and risk for Alzheimer disease.

    Science.gov (United States)

    Richardson, Jason R; Roy, Ananya; Shalat, Stuart L; von Stein, Richard T; Hossain, Muhammad M; Buckley, Brian; Gearing, Marla; Levey, Allan I; German, Dwight C

    2014-03-01

    The causes of late-onset Alzheimer disease (AD) are not yet understood but likely include a combination of genetic, environmental, and lifestyle factors. Limited epidemiological studies suggest that occupational pesticide exposures are associated with AD. Previously, we reported that serum levels of dichlorodiphenyldichloroethylene (DDE), the metabolite of the pesticide dichlorodiphenyltrichloroethane (DDT), were elevated in a small number of patients with AD (n=20). To evaluate the association between serum levels of DDE and AD and whether the apolipoprotein E (APOE) genotype modifies the association. A case-control study consisting of existing samples from patients with AD and control participants from the Emory University Alzheimer's Disease Research Center and the University of Texas Southwestern Medical School's Alzheimer's Disease Center. Serum levels of DDE were measured in 79 control and 86 AD cases. Serum DDE levels, AD diagnosis, severity of AD measured by the Mini-Mental State Examination score, and interaction with APOE4 status. Levels of DDE were 3.8-fold higher in the serum of those with AD (mean [SEM], 2.64 [0.35] ng/mg cholesterol) when compared with control participants (mean [SEM], 0.69 [0.1] ng/mg cholesterol; P risk for AD (95% CI, 2.54-5.82; P risk for AD and carriers of an APOE4 ε4 allele may be more susceptible to the effects of DDE. Both DDT and DDE increase amyloid precursor protein levels, providing mechanistic plausibility for the association of DDE exposure with AD. Identifying people who have elevated levels of DDE and carry an APOE ε4 allele may lead to early identification of some cases of AD.

  1. Elevated Serum Pesticide Levels and Risk for Alzheimer Disease

    Science.gov (United States)

    Richardson, Jason R.; Roy, Ananya; Shalat, Stuart L.; von Stein, Richard T.; Hossain, Muhammad M.; Buckley, Brian; Gearing, Marla; Levey, Allan I.; German, Dwight C.

    2014-01-01

    IMPORTANCE The causes of late-onset Alzheimer disease (AD) are not yet understood but likely include a combination of genetic, environmental, and lifestyle factors. Limited epidemiological studies suggest that occupational pesticide exposures are associated with AD. Previously, we reported that serum levels of dichlorodiphenyldichloroethylene (DDE), the metabolite of the pesticide dichlorodiphenyltrichloroethane (DDT), were elevated in a small number of patients with AD (n=20). OBJECTIVE To evaluate the association between serum levels of DDE and AD and whether the apolipoprotein E (APOE) genotype modifies the association. DESIGN, SETTING, AND PARTICIPANTS A case-control study consisting of existing samples from patients with AD and control participants from the Emory University Alzheimer’s Disease Research Center and the University of Texas Southwestern Medical School’s Alzheimer’s Disease Center. Serum levels of DDE were measured in 79 control and 86 AD cases. MAIN OUTCOMES AND MEASURES Serum DDE levels, AD diagnosis, severity of AD measured by the Mini-Mental State Examination score, and interaction with APOE4 status. RESULTS Levels of DDE were 3.8-fold higher in the serum of those with AD (mean [SEM], 2.64 [0.35] ng/mg cholesterol) when compared with control participants (mean [SEM], 0.69 [0.1] ng/mg cholesterol; P risk for AD (95% CI, 2.54–5.82; P risk for AD and carriers of an APOE4 ε4 allele may be more susceptible to the effects of DDE. Both DDT and DDE increase amyloid precursor protein levels, providing mechanistic plausibility for the association of DDE exposure with AD. Identifying people who have elevated levels of DDE and carry an APOE ε4 allele may lead to early identification of some cases of AD. PMID:24473795

  2. Recruitment patterns and growth of high-elevation pines in response to climatic variability (1883–2013), in the western Great Basin, USA

    Science.gov (United States)

    Constance I. Millar; Robert D. Westfall; Diane L. Delany; Alan L. Flint; Lorraine E. Flint

    2015-01-01

    Over the period 1883–2013, recruitment of subalpine limber pine (Pinus flexilis E. James) and Great Basin bristlecone pine (Pinus longaeva D.K. Bailey) above the upper tree line, below the lower tree line, and across middle-elevation forest borders occurred at localized sites across four mountain ranges in the western Great...

  3. Elevated rheumatoid factor and long term risk of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Schnohr, Peter

    2012-01-01

    To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis.......To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis....

  4. Elevated Serum Pesticide Levels and Risk of Parkinson Disease

    Science.gov (United States)

    Richardson, Jason R.; Shalat, Stuart L.; Buckley, Brian; Winnik, Bozena; O’Suilleabhain, Padraig; Diaz-Arrastia, Ramon; Reisch, Joan; German, Dwight C.

    2012-01-01

    Background Exposure to pesticides has been reported to increase the risk of Parkinson disease (PD), but identification of the specific pesticides is lacking. Three studies have found elevated levels of organochlorine pesticides in postmortem PD brains. Objective To determine whether elevated levels of organochlorine pesticides are present in the serum of patients with PD. Design Case-control study. Setting An academic medical center. Participants Fifty patients with PD, 43 controls, and 20 patients with Alzheimer disease. Main Outcome Measures Levels of 16 organochlorine pesticides in serum samples. Results β-Hexachlorocyclohexane (β-HCH) was more often detectable in patients with PD (76%) compared with controls (40%) and patients with Alzheimer disease (30%). The median level of β-HCH was higher in patients with PD compared with controls and patients with Alzheimer disease. There were no marked differences in detection between controls and patients with PD concerning any of the other 15 organochlorine pesticides. Finally, we observed a significant odds ratio for the presence of β-HCH in serum to predict a diagnosis of PD vs control (odds ratio, 4.39; 95% confidence interval, 1.67–11.6) and PD vs Alzheimer disease (odds ratio, 5.20), which provides further evidence for the apparent association between serum β-HCH and PD. Conclusions These data suggest that β-HCH is associated with a diagnosis of PD. Further research is warranted regarding the potential role of β-HCH as a etiologic agent for some cases of PD. PMID:19597089

  5. AIDS: Is Any Risk Too Great? The 1987 Perspective.

    Science.gov (United States)

    Hartog-Rapp, Fay

    This report discusses public school legal liability in the Acquired Immune Deficiency Syndrome (AIDS) controversy with regard to the right of privacy of AIDS victims who are students and employees and the concern of risk of contagion to other students and employees and the public's right to know what is going on in their schools. Several steps…

  6. The Great Recession and health risks in African American youth.

    Science.gov (United States)

    Chen, Edith; Miller, Gregory E; Yu, Tianyi; Brody, Gene H

    2016-03-01

    In the present study, we investigated associations of macro-economic conditions - the Great Recession - with cellular epigenetic aging, allostatic load, and self-reported health, in a group that experiences significant health disparities, African Americans. A sample of 330 African American adolescents in Georgia was followed from pre-recession (2007, M age=16.6) to post-recession (2010, M age=19.3). Economic data were collected in both 2007 and 2010. Three groups were formed to represent economic trajectories across the period of the Great Recession (stable low economic hardship, downward mobility, and stable high economic hardship). At age 19, measures of cellular epigenetic aging (derived from leukocyte DNA methylation profiles, reflecting the disparity between a person's biological and chronological age), allostatic load (composite of blood pressure, C reactive protein, cortisol, epinephrine, norepinephrine, and body mass index), and adolescent self-report of health were obtained. Linear trend analyses documented significant differences across all outcomes. The more time adolescents spent under economic hardship, the higher their epigenetic aging [estimate=1.421, SE=0.466, p=.002] and allostatic load [estimate=1.151, SE=0.375, p=.002] scores, and the worse their self-report of health [estimate=4.957, SE=1.800, p=.006]. Specific group comparisons revealed that adolescents in the downward mobility group had higher levels of allostatic load than adolescents in the stable low hardship group [p<.05]. Overall, these findings suggest that the health profiles of African American youth may in part be shaped by environmental macro-economic societal conditions, and that effects on biological markers can be detected relatively early in life. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. National report of Great Britain. Risks and risk assessment according to British legislation

    International Nuclear Information System (INIS)

    Vieweg, K.

    1980-01-01

    Who has got the competence in Great Britain to decide about criteria to be applied and methods to be taken in the prevention of damage thus ensuring the required safety standards and definine the maximum acceptable risk to be taken due to the operation of industrial and other facilities. The answer is laid down in the legal regulations covering virtually all industrial and technical installations. The author discusses the skeleton regulations of the 'Health and Safety at Work Act 1974', which is to be considered as the basis of British industrial law. Giving numerous examples, the author explains the legal status and administrative practice concerning the wide range of conventional technical facilities. Furthermore, he describes legal status and administrative practice concerning nuclear facilities and aircraft. After discussing methods of environmental pollution control, especially air pollution, the author enters into the regulations governing planning procedures of great relevance in Britain's legal practice, and the administrative procedures, shown by the example of the Windscale Inquiry. Finally, the author describes methods of risk assessment in other fields of law and some possible approaches to use risk analyses in the framework of the legal system. (orig./HSCH) [de

  8. The risk communication using the special website of the society of risk analysis for the Great East Japan Earthquake

    International Nuclear Information System (INIS)

    Tsubokawa, Hiroaki; Nagasaka, Toshinari; Sunaga, Yohei; Lee, Taiyoung; Taguchi, Hitoshi; Usuda, Yuichiro

    2011-01-01

    The Society for Risk Analysis Japan built the special website that reply to the people who are concerning the risk related to the Great East Japan Earthquake occurred on March 11, 2011. Although, there were many risk communication activities between the specialists of the risk research and citizens on the website, there are some significant problems for the risk communication using the website. This report summarizes the result of our activity. (author)

  9. NOAA predicts moderate flood potential in Midwest, elevated risk of ice

    Science.gov (United States)

    March 20, 2014 U.S. Spring Flood Risk Map for 2014. U.S. Spring Flood Risk Map for 2014. (Credit: NOAA moderate flood potential in Midwest, elevated risk of ice jams; California and Southwest stuck with drought minor or moderate risk of exceeding flood levels this spring with the highest threat in the southern

  10. Elevated level of serum triglyceride among high risk stress bank ...

    African Journals Online (AJOL)

    The objective of this study was to estimate lipid profile among high risk stress bank employees' correlated with heart disorders in Riyadh, Saudi Arabia. A total of 129 patients with high risk stress employees were involved in this study, which were divided into 69 males and 60 females between the age of 25 to 55 years.

  11. Ecological risk of methylmercury to piscivorous fish of the Great Lakes region.

    Science.gov (United States)

    Sandheinrich, Mark B; Bhavsar, Satyendra P; Bodaly, R A; Drevnick, Paul E; Paul, Eric A

    2011-10-01

    Contamination of fish populations with methylmercury is common in the region of the Laurentian Great Lakes as a result of atmospheric deposition and methylation of inorganic mercury. Using fish mercury monitoring data from natural resource agencies and information on tissue concentrations injurious to fish, we conducted a screening-level risk assessment of mercury to sexually mature female walleye (Sander vitreus), northern pike (Esox lucius), smallmouth bass (Micropterus dolomieu), and largemouth bass (Micropterus salmoides) in the Great Lakes and in interior lakes, impoundments, and rivers of the Great Lakes region. The assessment included more than 43,000 measurements of mercury in fish from more than 2000 locations. Sexually mature female fish that exceeded threshold-effect tissue concentrations of 0.20 μg g(-1) wet weight in the whole body occurred at 8% (largemouth bass) to 43% (walleye) of sites. Fish at 3% to 18% of sites were at risk of injury and exceeded 0.30 μg g(-1) where an alteration in reproduction or survival is predicted to occur. Most fish at increased risk were from interior lakes and impoundments. In the Great Lakes, no sites had sexually mature fish that exceeded threshold-effect concentrations. Results of this screening-level assessment indicate that fish at a substantive number of locations within the Great Lakes region are potentially at risk from methylmercury contamination and would benefit from reduction in mercury concentrations.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  13. Risk factors associated with elevated blood glucose among adults in ...

    African Journals Online (AJOL)

    This cross-sectional study was conducted to assess the risk factors and lifestyles characteristics associated with type 2 diabetes mellitus among adults in Mwanza city, Tanzania. A multistage random sampling technique was used to obtain 640 male and females respondents aged 30 and above years. Data were collected ...

  14. [Risk factors for elevated serum total bile acid in preterm infants].

    Science.gov (United States)

    Song, Yan-Ting; Wang, Yong-Qin; Zhao, Yue-Hua; Zhu, Hai-Ling; Liu, Qian; Zhang, Xiao; Gao, Yi-Wen; Zhang, Wei-Ye; Sang, Yu-Tong

    2018-03-01

    To study the risk factors for elevated serum total bile acid (TBA) in preterm infants. A retrospective analysis was performed for the clinical data of 216 preterm infants who were admitted to the neonatal intensive care unit. According to the presence or absence of elevated TBA (TBA >24.8 μmol/L), the preterm infants were divided into elevated TBA group with 53 infants and non-elevated TBA group with 163 infants. A univariate analysis and an unconditional multivariate logistic regression analysis were used to investigate the risk factors for elevated TBA. The univariate analysis showed that there were significant differences between the elevated TBA group and the non-elevated TBA group in gestational age at birth, birth weight, proportion of small-for-gestational-age infants, proportion of infants undergoing ventilator-assisted ventilation, fasting time, parenteral nutrition time, and incidence of neonatal respiratory failure and sepsis (PTBA in preterm infants. Low birth weight and neonatal sepsis may lead to elevated TBA in preterm infants.

  15. [Serious infection due to biologicals: risk only mildly elevated in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Broeder, A.A. den; Schers, H.J.

    2015-01-01

    Biologicals are often thought to increase the risk of infection. A recent review shows that the risk of serious infection in patients with rheumatoid arthritis being treated with biologicals (standard dose) is only mildly elevated compared with those who are treated with conventional DMARDs only

  16. Elevated Striatal Dopamine Function in Immigrants and Their Children: A Risk Mechanism for Psychosis

    OpenAIRE

    Egerton, A.; Howes, O. D.; Houle, S.; McKenzie, K.; Valmaggia, L. R.; Bagby, M. R.; Tseng, H-H; Bloomfield, M. A. P.; Kenk, M.; Bhattacharyya, S.; Suridjan, I.; Chaddock, C. A.; Winton-Brown, T. T.; Allen, P.; Rusjan, P.

    2017-01-01

    Migration is a major risk factor for schizophrenia but the neurochemical processes involved are unknown. One candidate mechanism is through elevations in striatal dopamine synthesis and release. The objective of this research was to determine whether striatal dopamine function is elevated in immigrants compared to nonimmigrants and the relationship with psychosis. Two complementary case–control studies of in vivo dopamine function (stress-induced dopamine release and dopamine synthesis capaci...

  17. Risk Factors for Elevated Preoperative Alkaline Phosphatase in Patients with Refractory Secondary Hyperparathyroidism.

    Science.gov (United States)

    Yang, Meng; Zhang, Ling; Huang, Linping; Sun, Xiaoliang; Ji, Haoyang; Lu, Yao

    2017-12-01

    Elevated preoperative levels of alkaline phosphatase (ALP) in patients with refractory secondary hyperparathyroidism are correlated with postoperative hypocalcemia and mortality. The aim of this study was to identify the predictors of preoperative ALP in patients with secondary hyperparathyroidism. From April 2012 to December 2015, 220 patients with refractory secondary hyperparathyroidism undergoing total parathyroidectomy without autotransplantation were reviewed. A total of 164 patients presented with elevated preoperative ALP. Univariate analysis showed that patients with elevated ALP were significantly younger. The elevated ALP group had significantly higher levels of preoperative parathyroid hormone (PTH), lower preoperative serum calcium, higher preoperative phosphorus, lower postoperative hypocalcemia, and a longer hospital stay. Logistic regression analysis showed that elevated preoperative PTH was a significant independent risk factor for elevated preoperative ALP (P = 0.000), and its value of 1624 pg/mL was the optimal cutoff point. Factors predictive of elevated preoperative ALP in patients with secondary hyperparathyroidism include preoperative PTH. Earlier surgery, aggressive calcium supplementation, and more careful or aggressive postoperative care for high-risk patients are needed.

  18. Public perception of risks from nuclear power plants in Japan, before the Great East Japan Earthquake

    International Nuclear Information System (INIS)

    Murayama, Rumiko; Nakaune, Naoko; Kishikawa, Hiroki; Uchiyama, Iwao

    2011-01-01

    On this research we aim to clarify public perception of risks from nuclear power plants before the Great East Japan Earthquake. The findings of the questionnaire survey conducted in 2010 showed that 1) about 70% of the people felt that they gained benefit from nuclear power plants and these were needed for their daily life. 2) Fifty percent respondents recognized there was danger to themselves and their family members with regards to nuclear power plants. The risks of nuclear power plants to Japanese society ware estimated higher than that risk to individuals of Japanese public. 3) Perception of risks from nuclear power plants to individual Japanese tended to be slightly lower between 1999 and 2010. (author)

  19. Evaulation of Incidence and Risk Factors for Intraocular Pressure Elevation After Intravitreal Triamcinolone Acetonide Injection

    Directory of Open Access Journals (Sweden)

    Didar Uçar

    2015-05-01

    Full Text Available Objectives: To investigate the effect of intravitreal triamcinolone acetonide (IVTA used for the macular edema on intraocular pressure (IOP and to determine the risk factors for IOP elevation. Materials and Methods: This retrospective study included 93 eyes of 85 patients who had 4 mg intravitreal triamcinolone injection. Of the 85 patients, 56 (65.8% had diabetic macular edema, 22 (25.8% had branch retinal, and 7 (8.2% had central retinal vein occlusion. IOP changes after injection as well as the relation between IOP elevation and age, sex, lens status, etiology of macular edema, baseline IOP were evaluated. Results: Fourty-six male and 39 female patients with mean age 61.58±9.5 years were evaluated. IOP was recorded to be >24 mmHg in 30 eyes (32.2% at follow-up visit after an average of 7.5 weeks. Normalization of IOP with medication was achieved in all IOP elevated eyes. Fifteen of 29 eyes (51.7% with vein occlusion and 15 of 64 eyes (23.3% with diabetic macula edema had IOP elevation (p=0.01. Twenty-six of 73 phakic (35.6% and 4 of 20 pseudophakic eyes (20% had IOP >24 mmHg (p=0.16. There was no association between IOP elevation and sex (p=0.33. Baseline IOP was 16.47±2.8 mmHg in eyes which had elevated IOP and 14.78±2.4 mmHg in the remaining. There was significant relation between IOP elevation and baseline IOP level (p=0.01. Conclusion: Elevated IOP is common side effect after IVTA, but normalization is usually achieved by topical medication. Patients with baseline IOP ≥15 mmHg and vein occlusion have higher risk for IOP elevation. (Turk J Ophthalmol 2015; 45: 86-91

  20. Elevated triglycerides and risk of myocardial infarction in HIV-positive persons

    DEFF Research Database (Denmark)

    Worm, Signe W; Kamara, David Alim; Reiss, Peter

    2011-01-01

    Objectives: To explore the relationship between elevated triglyceride levels and the risk of myocardial infarction (MI) in HIV-positive persons after adjustment for total cholesterol (TC), high-density lipoprotein–cholesterol (HDL-C) and nonlipid risk factors. Background: Although elevated...... triglyceride levels are commonly noted in HIV-positive individuals, it is unclear whether they represent an independent risk factor for MI. Methods: The incidence of MI during follow-up was stratified according to the latest triglyceride level. Multivariable Poisson regression models were used to describe...... the independent association between the latest triglyceride level and MI risk after adjusting for TC and HDL-C, nonlipids cardiovascular disease (CVD) risk factors, HIV and treatment-related factors. Results: The 33 308 persons included in the study from 1999 to 2008 experienced 580 MIs over 178 835 person...

  1. Risk of Dementia Associated with Elevated Plasma Homocysteine in a Latin American Population

    Directory of Open Access Journals (Sweden)

    Inara J. Chacón

    2009-01-01

    Full Text Available The relationship between total homocysteine (tHcy and dementia risk remains controversial, as the association varies among populations and dementia subtypes. We studied a Venezuelan population that has high prevalence of both elevated tHcy and dementia. We tested the hypotheses that (1 elevated tHcy is associated with increased dementia risk, (2 the risk is greater for vascular dementia (VaD than for Alzheimer's disease (AD, and (3 a history of stroke may partly explain this association. 2100 participants (≥55 years old of the Maracaibo Aging Study underwent standardized neurological, neuropsychiatric, and cardiovascular assessments. Elevated tHcy was significantly associated with dementia, primarily VaD. When history of stroke and other confounding factors were taken into account, elevated tHcy remained a significant risk factor in older (>66 years, but not in younger (55–66 years subjects. Ongoing studies of this population may provide insight into the mechanism by which tHcy increases risk for dementia.

  2. Elevated blood pressure among primary school children in Dar es salaam, Tanzania: prevalence and risk factors.

    Science.gov (United States)

    Muhihi, Alfa J; Njelekela, Marina A; Mpembeni, Rose N M; Muhihi, Bikolimana G; Anaeli, Amani; Chillo, Omary; Kubhoja, Sulende; Lujani, Benjamin; Maghembe, Mwanamkuu; Ngarashi, Davis

    2018-02-13

    Whilst the burden of non-communicable diseases is increasing in developing countries, little data is available on blood pressure among Tanzanian children. This study aimed at determining the blood pressure profiles and risk factors associated with elevated blood pressure among primary school children in Dar es Salaam, Tanzania. We conducted a cross sectional survey among 446 children aged 6-17 years from 9 randomly selected primary schools in Dar es Salaam. We measured blood pressure using a standardized digital blood pressure measuring machine (Omron Digital HEM-907, Tokyo, Japan). We used an average of the three blood pressure readings for analysis. Elevated blood pressure was defined as average systolic or diastolic blood pressure ≥ 90th percentile for age, gender and height. The proportion of children with elevated blood pressure was 15.2% (pre-hypertension 4.4% and hypertension 10.8%). No significant gender differences were observed in the prevalence of elevated BP. Increasing age and overweight/obese children were significantly associated with elevated BP (p = 0.0029 and p < 0.0001) respectively. Similar associations were observed for age and overweight/obesity with hypertension. (p = 0.0506 and p < 0.0001) respectively. In multivariate analysis, age above 10 years (adjusted RR = 3.63, 95% CI = 1.03-7.82) was significantly and independently associated with elevated BP in this population of school age children. We observed a higher proportion of elevated BP in this population of school age children. Older age and overweight/obesity were associated with elevated BP. Assessment of BP and BMI should be incorporated in school health program in Tanzania to identify those at risk so that appropriate interventions can be instituted before development of associated complications.

  3. Risk of Myocardial Infarction Attributable to Elevated Levels of Total Cholesterol Among Hypertensives

    NARCIS (Netherlands)

    Glazer, Nicole L.; Smith, Nicholas L.; Heckbert, Susan R.; Doggen, Catharina Jacoba Maria; Lemaitre, Rozenn N.; Psaty, Bruce M.

    2005-01-01

    Background Although cholesterol is an important risk factor for coronary heart disease (CHD) among hypertensives, the burden of CHD among hypertensives that may be due to elevated cholesterol has not been well documented. This study aimed to estimate the proportion of incident myocardial infarction

  4. Assessing drought risk under climate change in the US Great Plains via evaporative demand from downscaled GCM projections

    Science.gov (United States)

    Dewes, C.; Rangwala, I.; Hobbins, M.; Barsugli, J. J.

    2016-12-01

    Drought conditions in the US Great Plains occur primarily in response to periods of low precipitation, but they can be exacerbated by enhanced evaporative demand (E0) during periods of elevated temperatures, radiation, advection, and/or decreased humidity. A number of studies project severe to unprecedented drought conditions for this region later in the 21st century. Yet, we have found that methodological choices in the estimation of E0 and the selection of global climate model (GCM) output account for large uncertainties in projections of drought risk. Furthermore, the coarse resolution of GCMs offers little usability for drought risk assessments applied to socio-ecological systems, and users of climate data for that purpose tend to prefer existing downscaled products. Here we derive a physically based estimation of E0 - the FAO56 Penman-Monteith reference evapotranspiration - using driving variables from the Multivariate Adaptive Constructed Analogs (MACA) dataset, which have a spatial resolution of approximately 4 km. We select downscaled outputs from five CMIP5 GCMs, whereby we aim to represent different scenarios for the future of the Great Plains region (e.g. warm/wet, hot/dry, etc.). While this downscaling methodology removes GCM bias relative to a gridded product for historical data (METDATA), we first examine the remaining bias relative to ground (point) estimates of E0. Next we assess whether the downscaled products preserve the variability of their parent GCMs, in both historical and future (RCP8.5) projections. We then use the E0 estimates to compute multi-scale time series of drought indices such as the Evaporative Demand Drought Index (EDDI) and the Standardized Precipitation-Evaporation Index (SPEI) over the Great Plains region. We also attribute variability and drought anomalies to each of the driving parameters, to tease out the influence of specific model biases and evaluate geographical nuances of E0 drivers. Aside from improved understanding of

  5. The Risk of Intraocular Pressure Elevation in Pediatric Non-infectious Uveitis

    Science.gov (United States)

    Kothari, Srishti; Foster, C. Stephen; Pistilli, Maxwell; Liesegang, Teresa L.; Daniel, Ebenezer; Sen, H. Nida; Suhler, Eric B.; Thorne, Jennifer E.; Jabs, Douglas A.; Levy-Clarke, Grace A.; Nussenblatt, Robert B.; Rosenbaum, James T.; Lawrence, Scott D.; Kempen, John H.

    2015-01-01

    Purpose To characterize the risk and risk factors for intraocular pressure (IOP) elevation in pediatric non-infectious uveitis. Design Multi-center retrospective cohort study. Participants Nine hundred sixteen children (1593 eyes) uveitis followed between January 1978 through December 2007 at five academic uveitis centers in United States. Methods Medical records review by trained, certified experts. Main outcome measures Prevalence and incidence of IOP≥21 and ≥30mmHg and incidence of a rise in IOP by ≥10mmHg. To avoid under ascertainment, outcomes were counted as present when IOP-lowering therapies were in use. Results Initially 251 (15.8%) and 46 eyes (2.9%) had IOP≥21 and ≥30mmHg, respectively. Factors associated with presenting IOP elevation included age 6–12 years (versus other pediatric ages), prior cataract surgery (adjusted odds ratio≥21mmHg [aOR21]=2.42, P=0.01), pars plana vitrectomy (adjusted odds ratio≥30mmHg[aOR30]=11.1, P=0.03), duration of uveitis ≥6 months (aORs30 up to 11.8, Puveitis. Statistically significant risk factors include IOP elevation or use of IOP-lowering treatment in the contralateral eye and local corticosteroid use – that demonstrated a dose-and route of administration-dependent relationship. In contrast, use of immunosuppressive drug therapy did not increase such risk. Pediatric eyes with non-infectious uveitis should be followed closely for IOP elevation when strong risk factors such as the use of local corticosteroids and contralateral IOP elevation are present. PMID:26233626

  6. Risk factors for epistaxis in jump racing in Great Britain (2001-2009).

    Science.gov (United States)

    Reardon, Richard J M; Boden, Lisa A; Mellor, Dominic J; Love, Sandy; Newton, Richard J; Stirk, Anthony J; Parkin, Timothy D

    2015-07-01

    The aim of this study was to evaluate risk factors associated with developing epistaxis in jump racing in Great Britain (GB). A retrospective analysis of records from horses running in all hurdle and steeplechase races in GB between 2001 and 2009 identified diagnoses of epistaxis whilst still at the racecourse. Data were used from 603 starts resulting in epistaxis (event) and 169,065 starts resulting in no epistaxis (non-event) in hurdle racing, and from 550 event starts and 102,344 non-event starts in steeplechase racing. Two multivariable logistic regression models to evaluate risk factors associated with epistaxis were produced. The potential effect of clustering of data (within horse, horse dam, horse sire, trainer, jockey, course, race and race meet) on the associations between risk factors and epistaxis was examined using mixed-effects models. Multiple factors associated with increased risk of epistaxis were identified. Those identified in both types of jump racing included running on firmer ground; horses with >75% of career starts in flat racing and a previous episode of epistaxis recorded during racing. Risk factors identified only in hurdle racing included racing in the spring and increased age at first race; and those identified only in steeplechase racing included running in a claiming race and more starts in the previous 3-6 months. The risk factors identified provide important information about the risk of developing epistaxis. Multiple avenues for further investigation are highlighted, including unmeasured variables at the level of the racecourse. The results of this study can be used to guide the development of interventions to minimise the risk of epistaxis in jump racing. Copyright © 2015. Published by Elsevier Ltd.

  7. Elevated Striatal Dopamine Function in Immigrants and Their Children: A Risk Mechanism for Psychosis.

    Science.gov (United States)

    Egerton, Alice; Howes, Oliver D; Houle, Sylvain; McKenzie, Kwame; Valmaggia, Lucia R; Bagby, Michael R; Tseng, Huai-Hsuan; Bloomfield, Michael A P; Kenk, Miran; Bhattacharyya, Sagnik; Suridjan, Ivonne; Chaddock, Chistopher A; Winton-Brown, Toby T; Allen, Paul; Rusjan, Pablo; Remington, Gary; Meyer-Lindenberg, Andreas; McGuire, Philip K; Mizrahi, Romina

    2017-03-01

    Migration is a major risk factor for schizophrenia but the neurochemical processes involved are unknown. One candidate mechanism is through elevations in striatal dopamine synthesis and release. The objective of this research was to determine whether striatal dopamine function is elevated in immigrants compared to nonimmigrants and the relationship with psychosis. Two complementary case-control studies of in vivo dopamine function (stress-induced dopamine release and dopamine synthesis capacity) in immigrants compared to nonimmigrants were performed in Canada and the United Kingdom. The Canadian dopamine release study included 25 immigrant and 31 nonmigrant Canadians. These groups included 23 clinical high risk (CHR) subjects, 9 antipsychotic naïve patients with schizophrenia, and 24 healthy volunteers. The UK dopamine synthesis study included 32 immigrants and 44 nonimmigrant British. These groups included 50 CHR subjects and 26 healthy volunteers. Both striatal stress-induced dopamine release and dopamine synthesis capacity were significantly elevated in immigrants compared to nonimmigrants, independent of clinical status. These data provide the first evidence that the effect of migration on the risk of developing psychosis may be mediated by an elevation in brain dopamine function. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

  8. [Trust in organizations concerned with risks of the Great East Japan Earthquake].

    Science.gov (United States)

    Nakayachi, Kazuya; Kudo, Daisuke; Ozaki, Taku

    2014-06-01

    This study investigated the levels of public trust in organizations associated with the Great East Japan Earthquake. In Study 1 (N = 639), the levels of trust in eight organizations as well as the determinants of trust--perceived salient value similarity (SVS), ability, and motivation--were measured twice, first immediately after the earthquake and then a year later. The results indicated that the trust levels for six of the eight organizations had been preserved, supporting the double asymmetric effect of trust. The results of structural equation modeling (SEM) revealed that SVS explained trust more when the organization had been less trusted. Trust in the organization explains well the perceived reduction of the target risk. The results of SEM in Study 2 (N = 1,030) replicated those of Study 1, suggesting the stability of the explanatory power of the determinants of trust. Implications of the study for risk management practices are discussed.

  9. Adverse lipid profile elevates risk for subarachnoid hemorrhage: A prospective population-based cohort study.

    Science.gov (United States)

    Lindbohm, Joni; Korja, Miikka; Jousilahti, Pekka; Salomaa, Veikko; Kaprio, Jaakko

    2018-05-05

    Studies report that both high and low total cholesterol (TC) elevates SAH risk. There are few prospective studies on high-density lipoproteins (HDL-C) and low-density lipoproteins (LDL-C), and apparently none concerns apolipoproteins A and B. We aimed to clarify the association between lipid profile and SAH risk. The National FINRISK study provided risk-factor data recorded at enrolment between 1972 and 2007. During 1.52 million person-years of follow-up until 2014, 543 individuals suffered from incident hospitalized SAH or outside-hospital-fatal SAH. Cox proportional hazards model was used to calculate the hazard ratios and multiple imputation predicted ApoA1, ApoB, and LDL-C values for cohorts from a time before apolipoprotein-measurement methods were available. One SD elevation (1.28 mmol/l) in TC elevated SAH risk in men (hazard ratio (HR) 1.15 (95% CIs 1.00-1.32)). Low HDL-C levels increased SAH risk, as each SD decrease (0.37 mmol/l) in HDL-C raised the risk in women (HR 1.29 (95% CIs 1.07-1.55)) and men (HR 1.20 (95% CIs 1.14-1.27)). Each SD increase (0.29 g/l) in ApoA1 decreased SAH risk in women (HR 0.85 (95% CIs 0.74-0.97)) and men (HR 0.88 (95% CIs 0.76-1.02)). LDL-C (SD 1.07 mmol/l) and ApoB (SD 0.28 g/l) elevated SAH risk in men with HR 1.15 (95% CIs 1.01-1.31) and HR 1.26 (95% CIs 1.10-1.44) per one SD increase. Age did not change these findings. An adverse lipid profile seems to elevate SAH risk similar to its effect in other cardiovascular diseases, especially in men. Whether SAH incidence diminishes with increasing statin use remains to be studied. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. The stability of myocardial area at risk estimated electrocardiographically in patients with ST elevation myocardial infarction

    DEFF Research Database (Denmark)

    Carlsen, Esben A; Hassell, Mariëlla E C J; van Hellemond, Irene E G

    2014-01-01

    In patients with ST-elevation myocardial infarction (STEMI) the amount of myocardial area at risk (MaR) indicates the maximal potential loss of myocardium if the coronary artery remains occluded. During the time course of infarct evolution ischemic MaR is replaced by necrosis, which results...... in a decrease in ST segment elevation and QRS complex distortion. Recently it has been shown that combining the electrocardiographic (ECG) Aldrich ST and Selvester QRS scores result in a more accurate estimate of MaR than using either method alone. Therefore, we hypothesized that the combined Aldrich...... reperfusion (ECG2). The combined Aldrich and Selvester score was considered stable if the difference between ECG1 and ECG2 was ST elevation in 4...

  11. Elevated second-trimester serum homocyst(e)ine levels and subsequent risk of preeclampsia.

    Science.gov (United States)

    Sorensen, T K; Malinow, M R; Williams, M A; King, I B; Luthy, D A

    1999-01-01

    Elevated plasma homocyst(e)ine is a risk factor for endothelial dysfunction and vascular disease. In late gestation, levels of homocyst(e)ine are higher in preeclamptics, as compared with normotensive pregnant women. Our objective was to determine whether homocyst(e)ine elevations precede the development of preeclampsia. We used a prospective nested case-control study design to compare second trimester maternal serum homocyst(e)ine concentrations in 52 patients who developed preeclampsia (pregnancy-induced hypertension with proteinuria) compared with 56 women who remained normotensive throughout pregnancy. Study subjects were selected from a base population of 3, 042 women who provided blood samples at an average gestational age of 16 weeks and later delivered at our center. Serum homocyst(e)ine was measured by high-performance liquid chromatography and electrochemical detection. Approximately 29% of preeclamptics, as compared to 13% of controls had homocyst(e)ine levels >/=5.5 micromol/l (upper decile of distribution of control values). Adjusted for maternal age, parity, and body mass-index, a second trimester elevation of homocyst(e)ine was associated with a 3. 2-fold increased risk of preeclampsia (adjusted OR = 3.2; 95% CI 1. 1-9.2; p = 0.030). There was evidence of a interaction between maternal adiposity (as indicated by her prepregnancy body mass index) and parity with second trimester elevations in serum homocyst(e)ine. Nulliparous women with elevated homocyst(e)ine levels experienced a 9.7-fold increased risk of preeclampsia as compared with multiparous women without homocyst(e)ine elevations (95% CI 2.1-14.1; p = 0.003). Women with a higher prepregnancy body mass index (>/=21.4 kg/m(2), or upper 50th percentile) and who also had elevated homocyst(e)ine levels, as compared with leaner women without homocyst(e)ine elevations were 6.9 times more likely to later develop preeclampsia (95% CI 1.4-32.1; p = 0.016). Our findings are consistent with other

  12. Antimalarials as a risk factor for elevated muscle enzymes in systemic lupus erythematosus.

    Science.gov (United States)

    Tselios, K; Gladman, D D; Su, Jiandong; Urowitz, M B

    2016-04-01

    To investigate the relationship between antimalarials (AM) and elevated muscle enzymes in systemic lupus erythematosus (SLE). 325 lupus patients with abnormal creatine phosphokinase (CPK) for at least two consecutive clinic visits were enrolled; 54 patients on statins/fibrates (n = 43) and/or active myositis (n = 14) were excluded. The control group consisted of 1453 lupus patients with no CPK elevation during follow-up. Descriptive statistics and Cox regression analyses were performed, p < 0.05 was considered significant. Cases and controls did not differ regarding age at SLE diagnosis, gender ratio, or disease duration. AM use was more frequent in cases, which had more prolonged AM use. Total frequency of elevated CPK in AM users was 216/1322 (16.3%). Chloroquine was associated with a 3.3-fold, and hydroxychloroquine with a 3.1-fold, increased risk for CPK elevation. Black race was associated with higher CPK (HR = 2.941), whereas female gender was protective (HR = 0.697). 203 patients were followed for 7.3 ± 5.6 years; 49.8% had persistent and 14.8% intermittent CPK elevation, while in 35.4% CPK was normalized. Clinical proximal muscle weakness developed in 5/203 patients. Chronic AM use is a potential risk factor for muscle enzyme elevation in SLE patients. CPK abnormalities persist in almost two thirds of the patients, but this remains mainly a biochemical finding, evolving to clinical myopathy in about 2.5%. © The Author(s) 2015.

  13. A method for risk analysis across governance systems: a Great Barrier Reef case study

    International Nuclear Information System (INIS)

    Dale, Allan; Vella, Karen; Potts, Ruth; Pressey, Robert L; Brodie, Jon; Yorkston, Hugh

    2013-01-01

    Healthy governance systems are key to delivering sound environmental management outcomes from global to local scales. There are, however, surprisingly few risk assessment methods that can pinpoint those domains and sub-domains within governance systems that are most likely to influence good environmental outcomes at any particular scale, or those if absent or dysfunctional, most likely to prevent effective environmental management. This paper proposes a new risk assessment method for analysing governance systems. This method is then tested through its preliminary application to a significant real-world context: governance as it relates to the health of Australia’s Great Barrier Reef (GBR). The GBR exists at a supra-regional scale along most of the north eastern coast of Australia. Brodie et al (2012 Mar. Pollut. Bull. 65 81–100) have recently reviewed the state and trend of the health of the GBR, finding that overall trends remain of significant concern. At the same time, official international concern over the governance of the reef has recently been signalled globally by the International Union for the Conservation of Nature (IUCN). These environmental and political contexts make the GBR an ideal candidate for use in testing and reviewing the application of improved tools for governance risk assessment. (letter)

  14. Low serum zinc is associated with elevated risk of cadmium nephrotoxicity

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yu-Sheng, E-mail: Lin.Yu-Sheng@epa.gov [National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC (United States); Ho, Wen-Chao [Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan (China); Caffrey, James L. [Integrative Physiology and Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX (United States); Sonawane, Babasaheb [National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC (United States)

    2014-10-15

    Background: Despite animal evidence suggests that zinc modulates cadmium nephrotoxicity, limited human data are available. Objective: To test the hypothesis that low serum zinc concentrations may increase the risk of cadmium-mediated renal dysfunction in humans. Methods: Data from 1545 subjects aged 20 or older in the National Health and Nutrition Examination Survey (NHANES), 2011–2012 were analyzed. Renal function was defined as impaired when estimated glomerular filtration rate (eGFR) fell below 60 ml/min/1.73 m{sup 2} and/or the urinary albumin-to-creatinine ratio surpassed 2.5 in men and 3.5 mg/mmol in women. Results: Within the study cohort, 117 subjects had reduced eGFR and 214 had elevated urinary albumin. After adjusting for potential confounders, subjects with elevated blood cadmium (>0.53 μg/L) were more likely to have a reduced eGFR (odds ratio [OR]=2.21, 95% confidence interval [CI]: 1.09–4.50) and a higher urinary albumin (OR=2.04, 95% CI: 1.13–3.69) than their low cadmium (<0.18 μg/L) peers. In addition, for any given cadmium exposure, low serum zinc is associated with elevated risk of reduced eGFR (OR=3.38, 95% CI: 1.39–8.28). A similar increase in the odds ratio was observed between declining serum zinc and albuminuria but failed to reach statistical significance. Those with lower serum zinc/blood cadmium ratios were likewise at a greater risk of renal dysfunction (p<0.01). Conclusions: This study results suggest that low serum zinc concentrations are associated with an increased risk of cadmium nephrotoxicity. Elevated cadmium exposure is global public health issue and the assessment of zinc nutritional status may be an important covariate in determining its effective renal toxicity. - Highlights: • Blood cadmium was associated with increased risk of nephrotoxicity. • Low serum zinc may exacerbate risk of cadmium-mediated renal dysfunction. • Both zinc deficiency and elevated cadmium exposure are global public health issues.

  15. Metabolic Syndrome Risks Following the Great Recession in Rural Black Young Adults.

    Science.gov (United States)

    Miller, Gregory E; Chen, Edith; Yu, Tianyi; Brody, Gene H

    2017-09-06

    Some of the country's highest rates of morbidity and mortality from cardiovascular disease are found in lower-income black communities in the rural Southeast. Research suggests these disparities originate in the early decades of life, and partly reflect the influence of broader socioeconomic forces acting on behavioral and biological processes that accelerate cardiovascular disease progression. However, this hypothesis has not been tested explicitly. Here, we examine metabolic syndrome (MetS) in rural black young adults as a function of their family's economic conditions before and after the Great Recession. In an ongoing prospective study, we followed 328 black youth from rural Georgia, who were 16 to 17 years old when the Great Recession began. When youth were 25, we assessed MetS prevalence using the International Diabetes Federation's guidelines. The sample's overall MetS prevalence was 18.6%, but rates varied depending on family economic trajectory from before to after the Great Recession. MetS prevalence was lowest (10.4%) among youth whose families maintained stable low-income conditions across the Recession. It was intermediate (21.8%) among downwardly mobile youth (ie, those whose families were lower income before the Recession, but slipped into poverty). The highest MetS rates (27.5%) were among youth whose families began the Recession in poverty, and sank into more meager conditions afterwards. The same patterns were observed with 3 alternative MetS definitions. These patterns suggest that broader economic forces shape cardiometabolic risk in young blacks, and may exacerbate disparities already present in this community. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  16. Elevated lipoprotein(a) and risk of aortic valve stenosis in the general population

    DEFF Research Database (Denmark)

    Kamstrup, Pia R; Tybjærg-Hansen, Anne; Nordestgaard, Børge G

    2014-01-01

    OBJECTIVES: The purpose of this study was to determine whether elevated lipoprotein(a) levels and corresponding LPA risk genotypes (rs10455872, rs3798220, kringle IV type 2 repeat polymorphism) prospectively associate with increased risk of aortic valve stenosis (AVS). BACKGROUND: The etiologic...... to 90 mg/dl), and 2.9 (95% CI: 1.8 to 4.9) for levels greater than 95th percentile (>90 mg/dl), versus levels less than the 22nd percentile (rs3798220 minor alleles, and of low number of KIV-2 repeats (trend, all p...

  17. Suicide risk among young children after the Great East Japan Earthquake: A follow-up study.

    Science.gov (United States)

    Fujiwara, Takeo; Yagi, Junko; Homma, Hiroaki; Mashiko, Hirobumi; Nagao, Keizo; Okuyama, Makiko

    2017-07-01

    On 11 March 2011, the Great East Japan Earthquake and subsequent tsunami hit East Japan. We aim to investigate the impact of trauma experiences related to the earthquake on suicide risk among young children, stratified by child sex. Participants at baseline were children who were exposed to the 2011 disaster at preschool age (affected area, n=198; unaffected area, n=82, total n=280). From July 2013 to May 2014, suicide risk was assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a follow-up interview conducted by a child psychiatrist or psychologist (N=210, follow-up rate: 75%). Among young girls in the affected area, 12 out of 65 (18.5%) showed suicidal ideation, which is significantly higher than girls in the unaffected area (4.7%, p for chi-square=0.036). In the multivariate model adjusted for potential confounders and mediators, the odds ratio for 4 or more trauma experiences related to the earthquake was 5.74 (95% confidence interval: 0.83-39.6, p=0.076) compared to no trauma experience related to the earthquake. Among young boys, trauma exposure was not associated with suicidal ideation. Our findings showed that young girls who experienced earthquake-related trauma at preschool age had a higher suicidal ideation 3 years after the earthquake. Copyright © 2017. Published by Elsevier B.V.

  18. Elevated Lipoprotein(a) Levels, LPA Risk Genotypes, and Increased Risk of Heart Failure in the General Population

    DEFF Research Database (Denmark)

    Kamstrup, Pia R; Nordestgaard, Børge G

    2016-01-01

    OBJECTIVES: This study sough to test whether elevated lipoprotein(a) levels and corresponding LPA risk genotypes (low number of kringle IV type 2 repeats, rs3798220 and rs10455872, minor allele carriers) are associated with an increased risk of heart failure (HF). BACKGROUND: Elevated lipoprotein...

  19. Elevated uric acid and obesity-related cardiovascular disease risk factors among hypertensive youth.

    Science.gov (United States)

    Reschke, Lauren D; Miller, Edgar R; Fadrowski, Jeffrey J; Loeffler, Lauren F; Holmes, Kathryn W; Appel, Lawrence J; Brady, Tammy M

    2015-12-01

    Uric acid (UA) is associated with high blood pressure in adolescents and with left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) in adults. We sought to determine if UA is independently associated with CVD risk factors and left ventricular mass (LVM) over time in hypertensive youth. This was a 1-year prospective observational study of hypertensive children aged 3-19 years. Cross-sectional and longitudinal associations of serum UA with CVD risk factors and LVM were explored. Of the 49 children who completed both the baseline and 12-month assessments, at baseline the mean age was 13.8 years and mean UA was 5.5 mg/dL; 24% had elevated UA, 51% were overweight/obese and 39% had LVH. Measures of adiposity, low high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, LVM and LVH were all significantly associated with elevated UA at baseline, but not with change over time. Each 1 mg/dL increase in baseline UA was associated with a 2.5 g/m(2.7) increase in the LVM index at follow-up (95% confidence interval 0.64, 4.39; p = 0.01); after adjustment for age, sex, race, body mass index z-score, change in UA, time, blood pressure and medication use, this association was no longer significant. Hypertensive children with elevated UA have a higher prevalence of obesity-related CVD risk factors. Among hypertensive children, UA may be a marker of adiposity and not an independent CVD risk factor.

  20. Risk stratification in non-ST elevation acute coronary syndromes: Risk scores, biomarkers and clinical judgment

    Directory of Open Access Journals (Sweden)

    David Corcoran

    2015-09-01

    Clinical guidelines recommend an early invasive strategy in higher risk NSTE-ACS. The Global Registry of Acute Coronary Events (GRACE risk score is a validated risk stratification tool which has incremental prognostic value for risk stratification compared with clinical assessment or troponin testing alone. In emergency medicine, there has been a limited adoption of the GRACE score in some countries (e.g. United Kingdom, in part related to a delay in obtaining timely blood biochemistry results. Age makes an exponential contribution to the GRACE score, and on an individual patient basis, the risk of younger patients with a flow-limiting culprit coronary artery lesion may be underestimated. The future incorporation of novel cardiac biomarkers into this diagnostic pathway may allow for earlier treatment stratification. The cost-effectiveness of the new diagnostic pathways based on high-sensitivity troponin and copeptin must also be established. Finally, diagnostic tests and risk scores may optimize patient care but they cannot replace patient-focused good clinical judgment.

  1. Effect of glenohumeral elevation on subacromial supraspinatus compression risk during simulated reaching.

    Science.gov (United States)

    Lawrence, Rebekah L; Schlangen, Dustin M; Schneider, Katelyn A; Schoenecker, Jonathan; Senger, Andrea L; Starr, William C; Staker, Justin L; Ellermann, Jutta M; Braman, Jonathan P; Ludewig, Paula M

    2017-10-01

    Mechanical subacromial rotator cuff compression is one theoretical mechanism in the pathogenesis of rotator cuff disease. However, the relationship between shoulder kinematics and mechanical subacromial rotator cuff compression across the range of humeral elevation motion is not well understood. The purpose of this study was to investigate the effect of humeral elevation on subacromial compression risk of the supraspinatus during a simulated functional reaching task. Three-dimensional anatomical models were reconstructed from shoulder magnetic resonance images acquired from 20 subjects (10 asymptomatic, 10 symptomatic). Standardized glenohumeral kinematics from a simulated reaching task were imposed on the anatomic models and analyzed at 0, 30, 60, and 90° humerothoracic elevation. Five magnitudes of humeral retroversion were also imposed on the models at each angle of humerothoracic elevation to investigate the impact of retroversion on subacromial proximities. The minimum distance between the coracoacromial arch and supraspinatus tendon and footprint were quantified. When contact occurred, the magnitude of the intersecting volume between the supraspinatus tendon and coracoacromial arch was also quantified. The smallest minimum distance from the coracoacromial arch to the supraspinatus footprint occurred between 30 and 90°, while the smallest minimum distance to the supraspinatus tendon occurred between 0 and 60°. The magnitude of humeral retroversion did not significantly affect minimum distance to the supraspinatus tendon except at 60 or 90° humerothoracic elevation. The results of this study provide support for mechanical rotator cuff compression as a potential mechanism for the development of rotator cuff disease. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2329-2337, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  2. Maternal steroids in egg yolk as a pathway to translate predation risk to offspring : Experiments with great tits

    NARCIS (Netherlands)

    Coslovsky, Michael; Groothuis, Ton; de Vries, Bonnie; Richner, Heinz

    2012-01-01

    Exposure of mothers to risk of predation can induce phenotypic changes in offspring as shown in several species. We previously found that cross-fostered great tit (Parus major) chicks of females exposed to increased predation risk were smaller and lighter, but had faster wing growth than control

  3. Risk of death in heart disease is associated with elevated urinary globotriaosylceramide.

    Science.gov (United States)

    Schiffmann, Raphael; Forni, Sabrina; Swift, Caren; Brignol, Nastry; Wu, Xiaoyang; Lockhart, David J; Blankenship, Derek; Wang, Xuan; Grayburn, Paul A; Taylor, Matthew R G; Lowes, Brian D; Fuller, Maria; Benjamin, Elfrida R; Sweetman, Lawrence

    2014-02-04

    Elevated urinary globotriaosylceramide (Gb3) has been considered a hallmark of Fabry disease, an X-linked lysosomal disorder that is a risk factor for most types of heart disease. We screened 1421 consecutive patients with common forms of heart disease for Fabry disease by measuring urinary Gb3 in whole urine using tandem mass spectrometry, α-galactosidase A activity in dried blood spots, and we looked for GLA mutations by parallel sequencing of the whole gene (exons and introns) in pooled genomic DNA samples followed by Sanger sequencing verification. GLA variants were found in 13 patients. In the 1408 patients without GLA mutations, urinary Gb3 levels were significantly higher in heart disease patients compared to 116 apparently healthy controls (median difference=10.0 ng/mL and P<0.001). Urinary lipid profiling showed that levels of 5 other lipids significantly distinguished between urine of patients with Fabry disease (n=7) and heart disease patients with elevated urinary Gb3 (n=6). Sphingomyelin and Gb3 levels were abnormal in the left ventricular wall of patients with ischemic heart failure. Elevated levels of urinary Gb3 were independently associated with increased risk of death in the average follow-up of 17 months (hazard ratio=1.59 for increase in Gb3 of 200, 95% CI=1.36 and 1.87, and P<0.0001). In heart disease patients who do not have Fabry disease or GLA gene mutations, a higher level of urinary Gb3 is positively associated with near-term mortality. The elevation of urinary Gb3 and that of other lipids suggests that heart disease is associated with multiorgan lipid abnormalities. clinicaltrials.gov. Unique Identifier: NCT01019629.

  4. Early Risk stratification for Arrhythmic death in Patients with ST-Elevation Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Sadr-Ameli

    2007-01-01

    Full Text Available Background: Sudden cardiac death is a leading cause of death in patients with ST-elevation myocardial infarction (MI. According to high cost of modern therapeutic modalities it is of paramount importance to define protocols for risk stratification of post-MI patients before considering expensive devices such as implantable cardioverter-defibrillator.Methods: One hundred and thirty seven patients with acute ST-elevation MI were selected and underwent echocardiographic study, holter monitoring and signal-averaged electrocardiography (SAECG. Then, the patients were followed for 12 ±3 months.Results: During follow-up, 13 deaths (9.5% occurred; nine cases happened as sudden cardiac death (6.6%. The effect of ejection fraction (EF less than 40% on occurrence of arrhythmic events was significant (P<0.001. Sensitivity and positive predictive value of EF<40% was 100% and 76.95% respectively. Although with lesser sensitivity and predictive power than EF<40%, abnormal heart rate variability (HRV and SAECG had also significant effects on occurrence of sudden death (P=0.02 and P=0.003 respectively. Nonsustained ventricular tachycardia was not significantly related to risk of sudden death in this study (P=0.20.Conclusions: This study indicated that EF less than 40% is the most powerful predictor of sudden cardiac death in post MI patients. Abnormal HRV and SAECG are also important predictors and can be added to EF for better risk stratification.

  5. Prognostic Usefulness of Low Ischemic Risk SPECT in non-ST Segment Elevation Acute Coronary Syndromes

    International Nuclear Information System (INIS)

    Castillo Costa, Yanina; Mauro, Victor; Perez, Roberto; Charask, Adrian; Fairman, Enrique; Gomez Santamaria, Hector; Goral, Jorge; Barrero, Carlos

    2009-01-01

    Background: Myocardial perfusion imaging tests are used for the clinical assessment of patients hospitalized with non-ST segment elevation acute coronary syndromes (NSTACS) who have favorable in-hospital outcomes with medical therapy. However, the prognostic relevance of a .low ischemic risk. (LR) single photon emission computed tomography (SPECT) in patients with NSTACS managed with a conservative approach is uncertain, as most of the information derives from patients with chronic coronary artery disease. Objectives: 1) To analyze the outcomes of patients with NSTACS and LR SPECT at discharge, 2) to compare the results of a normal SPECT with transient perfusion defects (TPDs), permanent perfusion defects (PPDs) or combined defects (CDs), and 3) to determine the additional value of SPECT to classic risk variables. Material and Methods: Patients admitted to the CCU with a NSTACS were included. Follow-up was continued during 12 months. Definitions: Clinical risk based on TIMI risk score. LR SPECT (under exercise or pharmacological stress): TPDs ≤ 3/17 segments, PPDs ≤ 3/17 segments, CPDs: TPDs + PPDs and normal: absence of defects. Clinical events (CEs): death/infarction or rehospitalization due to angina. Results: A total of 137 patients were included (median age 59 years, 60% were men). A low TIMI risk score was present in 54% of patients and 46% presented a moderate risk. CE: 5.8%. The incidence of clinical events related to perfusion defects was as follows: normal: 2.1%, TPD: 4.5%, PPD: 5.9% and CPD: 25% (p [es

  6. Elevated risk of child maltreatment in families with stepparents but not with adoptive parents.

    Science.gov (United States)

    van Ijzendoorn, Marinus H; Euser, Eveline M; Prinzie, Peter; Juffer, Femmie; Bakermans-Kranenburg, Marian J

    2009-11-01

    Does child maltreatment occur more often in adoptive and stepfamilies than in biological families? Data were collected from all 17 Dutch child protective services (CPS) agencies on 13,538 cases of certified child maltreatment in 2005. Family composition of the maltreated children was compared to a large national representative sample of the Netherlands Kinship Panel Study (NKPS). Larger families, one-parent families, and families with a stepparent showed elevated risks for child maltreatment. Adoptive families, however, showed significantly less child maltreatment than expected. The findings are discussed in the context of parental investment theory that seems to be applicable to stepparents but not to adoptive parents.

  7. Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: cohort study based on longitudinal data from the Framingham Heart Study

    Science.gov (United States)

    Staerk, Laila; Wang, Biqi; Preis, Sarah R; Larson, Martin G; Lubitz, Steven A; Ellinor, Patrick T; McManus, David D; Ko, Darae; Weng, Lu-Chen; Lunetta, Kathryn L; Frost, Lars; Benjamin, Emelia J

    2018-01-01

    Abstract Objective To examine the association between risk factor burdens—categorized as optimal, borderline, or elevated—and the lifetime risk of atrial fibrillation. Design Community based cohort study. Setting Longitudinal data from the Framingham Heart Study. Participants Individuals free of atrial fibrillation at index ages 55, 65, and 75 years were assessed. Smoking, alcohol consumption, body mass index, blood pressure, diabetes, and history of heart failure or myocardial infarction were assessed as being optimal (that is, all risk factors were optimal), borderline (presence of borderline risk factors and absence of any elevated risk factor), or elevated (presence of at least one elevated risk factor) at index age. Main outcome measure Lifetime risk of atrial fibrillation at index age up to 95 years, accounting for the competing risk of death. Results At index age 55 years, the study sample comprised 5338 participants (2531 (47.4%) men). In this group, 247 (4.6%) had an optimal risk profile, 1415 (26.5%) had a borderline risk profile, and 3676 (68.9%) an elevated risk profile. The prevalence of elevated risk factors increased gradually when the index ages rose. For index age of 55 years, the lifetime risk of atrial fibrillation was 37.0% (95% confidence interval 34.3% to 39.6%). The lifetime risk of atrial fibrillation was 23.4% (12.8% to 34.5%) with an optimal risk profile, 33.4% (27.9% to 38.9%) with a borderline risk profile, and 38.4% (35.5% to 41.4%) with an elevated risk profile. Overall, participants with at least one elevated risk factor were associated with at least 37.8% lifetime risk of atrial fibrillation. The gradient in lifetime risk across risk factor burden was similar at index ages 65 and 75 years. Conclusions Regardless of index ages at 55, 65, or 75 years, an optimal risk factor profile was associated with a lifetime risk of atrial fibrillation of about one in five; this risk rose to more than one in three in individuals with at least

  8. Associations of dairy cow behavior, barn hygiene, cow hygiene, and risk of elevated somatic cell count.

    Science.gov (United States)

    Devries, T J; Aarnoudse, M G; Barkema, H W; Leslie, K E; von Keyserlingk, M A G

    2012-10-01

    Poor dairy cow hygiene has been consistently associated with elevated somatic cell count (SCC) and the risk of subclinical mastitis. The objective of this study was to determine the associations between dairy cow standing and lying behavior, barn hygiene, cow hygiene, and the risk of experiencing elevated SCC. Lactating Holstein dairy cows (n=69; 86 ± 51 DIM; parity: 2.0 ± 1.2; means ± SD), kept in 1 of 2 groups, were monitored over a 4-mo period. Each group contained 61 ± 1 (mean ± SD) cows over the study period; complete data were obtained from 37 and 32 animals within each respective group. Cows were housed in a sand-bedded, freestall barn with 2 symmetrical pens, each with a free cow traffic automatic milking system. To vary barn hygiene, in 4 consecutive 28-d periods, alley manure scrapers in each of the 2 pens were randomly assigned to frequencies of operation of 3, 6, 12, and 24 times per day. During the last 7 d of each period, cow hygiene (upper leg/flank, lower legs, and udder; scale of 1 = very clean to 4 = very dirty) and stall hygiene (number of 0.15×0.15-m squares contaminated with manure in a 1.20×1.65-m grid) were recorded. Standing and lying behavior of the cows were collected during those days using data loggers. Individual-cow SCC was recorded at the beginning and end of each 28-d period. Elevated SCC was used as an indicator of subclinical mastitis; incidence of elevated SCC was defined as having a SCC >200,000 cells/mL at the end of each 28-d period, when SCC was <100,000 cells/mL at the beginning of the period. Less frequent scraping of the barn alleys was associated with cows having poorer hygiene. Poor udder hygiene was associated with poor stall hygiene. Longer lying duration was associated with poor hygiene of the upper legs/flank and udder. Greater premilking standing duration was associated with poor udder hygiene and decreased frequency of lying bouts was associated with poor hygiene of the lower legs. Higher milk yield was

  9. Identifying Adolescents at Highly Elevated Risk for Suicidal Behavior in the Emergency Department

    Science.gov (United States)

    Berona, Johnny; Czyz, Ewa; Horwitz, Adam G.; Gipson, Polly Y.

    2015-01-01

    Abstract Objective: The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. Method: Participants were 81 adolescents, ages 14–19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. Results: Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). Conclusions: In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior. PMID:25746114

  10. Elevated Serum Neopterin is Associated with Increased Risk of Cardiovascular Events in Acute Coronary Syndromes

    Directory of Open Access Journals (Sweden)

    Anwar Santoso

    2009-04-01

    Full Text Available BACKGROUND: Neopterin is a soluble biomarker of monocyte activation and its increased concentration might be expressed in atherosclerosis. Until recently, there has been lacking of information on the prognostic role of neopterin in acute coronary syndromes (ACS. The study was aimed at measuring the associations between elevated serum neopterin and increased risk of cardiovascular (CV events in ACS. METHODS: This was a prospective cohort study, recruited 71 ACS patients from January 31 through August 31, 2007 in Sanglah Hospital of Udayana School of Medicine, Denpasar, Bali. Cardiovascular events, such as: CV death, recurrent myocardial infarction, stroke and recurrent myocardial ischemia were previously defined. Relative risk and survival rate were measured successively by Cox proportional model and Kaplan-Meier curve. RESULTS: Of 71 ACS patients aged 56.8±9.5 years, 21 (29.5% subjects underwent CV events. Overall mean followup was 151.6 (95% CI: 129.7-173.5 days. Baseline characteristic were similarly distributed between groups with the highest quartile neopterin level (≥14.7 nmol/L than those with lowest quartile (≤6.2 nmol/L. Patients with the highest quartile had the worst survival curve than those with the lowest quartile (log-rank test; p=0.047. On Cox proportional model, relative risk of highest quartile group was 5.84 (95% CI: 1.19-28.47; p=0.029 compared to lowest quartile, after being adjusted with other predictors. CONCLUSIONS: Elevated serum neopterin is associated with increased risk of CV events in acute coronary syndromes. KEYWORDS: neopterin, cardiovascular events, acute coronary syndromes.

  11. Elevated body mass index and risk of postoperative CSF leak following transsphenoidal surgery

    Science.gov (United States)

    Dlouhy, Brian J.; Madhavan, Karthik; Clinger, John D.; Reddy, Ambur; Dawson, Jeffrey D.; O’Brien, Erin K.; Chang, Eugene; Graham, Scott M.; Greenlee, Jeremy D. W.

    2012-01-01

    Object Postoperative CSF leakage can be a serious complication after a transsphenoidal surgical approach. An elevated body mass index (BMI) is a significant risk factor for spontaneous CSF leaks. However, there is no evidence correlating BMI with postoperative CSF leak after transsphenoidal surgery. The authors hypothesized that patients with elevated BMI would have a higher incidence of CSF leakage complications following transsphenoidal surgery. Methods The authors conducted a retrospective review of 121 patients who, between August 2005 and March 2010, underwent endoscopic endonasal transsphenoidal surgeries for resection of primarily sellar masses. Patients requiring extended transsphenoidal approaches were excluded. A multivariate statistical analysis was performed to investigate the association of BMI and other risk factors with postoperative CSF leakage. Results In 92 patients, 96 endonasal endoscopic transsphenoidal surgeries were performed that met inclusion criteria. Thirteen postoperative leaks occurred and required subsequent treatment, including lumbar drainage and/or reoperation. The average BMI of patients with a postoperative CSF leak was significantly greater than that in patients with no postoperative CSF leak (39.2 vs 32.9 kg/m2, p = 0.006). Multivariate analyses indicate that for every 5-kg/m2 increase in BMI, patients undergoing a transsphenoidal approach for a primarily sellar mass have 1.61 times the odds (95% CI 1.10–2.29, p = 0.016, by multivariate logistic regression) of having a postoperative CSF leak. Conclusions Elevated BMI is an independent predictor of postoperative CSF leak after an endonasal endoscopic transsphenoidal approach. The authors recommend that patients with BMI greater than 30 kg/m2 have meticulous sellar reconstruction at surgery and close monitoring postoperatively. PMID:22443502

  12. The effect of oral contraception on cardiometabolic risk factors in women with elevated androgen levels.

    Science.gov (United States)

    Krysiak, Robert; Gilowska, Małgorzata; Okopień, Bogusław

    2017-02-01

    In unselected reproductive-aged women, use of combined estrogen-progestin oral contraceptive pills has been linked with an increased risk of vascular disease. The aim of this study was to investigate the effect of oral contraception on cardiometabolic risk factors in a population of women with hyperandrogenism. The study included 16 untreated women with elevated testosterone levels and 15 matched healthy women who were then treated with oral contraceptive pills containing ethinyl estradiol (30μg) and drospirenone (3mg). Plasma lipids, glucose homeostasis markers, circulating levels of androgens, uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen and homocysteine, as well as urinary albumin-to-creatinine ratio (UACR) were assessed at baseline and after 12 weeks of treatment. Compared to healthy women, women with elevated androgen levels showed increased plasma levels of hsCRP, fibrinogen and homocysteine, as well as a higher value of UACR. Oral contraception reduced androgen levels only in hyperandrogenic women. In healthy women, ethinyl estradiol plus drospirenone increased plasma levels of insulin, hsCRP, fibrinogen and homocysteine, while in women with elevated androgen levels their effect was limited only to a small increase in hsCRP. Our results suggest that a deteriorating effect of oral contraceptive pills containing ethinyl estradiol and drospirenone in hyperandrogenic women is weaker than in healthy young women and that ethinyl estradiol/drospirenone combination therapy may be safely used in the former group of patients. Copyright © 2016. Published by Elsevier Urban & Partner Sp. z o.o.

  13. Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women.

    Science.gov (United States)

    Janssen, Ian; Baumgartner, Richard N; Ross, Robert; Rosenberg, Irwin H; Roubenoff, Ronenn

    2004-02-15

    The purpose of this study was to determine skeletal muscle cutpoints for identifying elevated physical disability risk in older adults. Subjects included 4,449 older (> or = 60 years) participants from the Third National Health and Nutrition Examination Survey during 1988-1994. Physical disability was assessed by questionnaire, and bioimpedance was used to estimate skeletal muscle, which was normalized for height. Receiver operating characteristics were used to develop the skeletal muscle cutpoints associated with a high likelihood of physical disability. Odds for physical disability were compared in subjects whose measures fell above and below these cutpoints. Skeletal muscle cutpoints of 5.76-6.75 and values in men were 8.51-10.75 and skeletal muscle values, women with moderate- and high-risk skeletal muscle values had odds for physical disability of 1.41 (95% confidence interval (CI): 0.97, 2.04) and 3.31 (95% CI: 1.91, 5.73), respectively. The corresponding odds in men were 3.65 (95% CI: 1.92, 6.94) and 4.71 (95% CI: 2.28, 9.74). This study presents skeletal muscle cutpoints for physical disability risk in older adults. Future applications of these cutpoints include the comparison of morbidity risk in older persons with normal muscle mass and those with sarcopenia, the determination and comparison of sarcopenia prevalences, and the estimation of health-care costs attributable to sarcopenia.

  14. Higher Risk of Abdominal Obesity, Elevated LDL Cholesterol and Hypertriglyceridemia, but not of Hypertension, in People Living with HIV

    DEFF Research Database (Denmark)

    Gelpi, Marco; Afzal, Shoaib; Lundgren, Jens

    2018-01-01

    Background: People living with HIV (PLWH) have lower life expectancy than uninfected individuals, partly explained by excess risk of cardiovascular diseases (CVD) and CVD risk factors. We investigated the association between HIV infection and abdominal obesity, elevated LDL cholesterol (LDL...... and underwent blood pressure, waist-, hip-, weight-, and height-measurements. Non-fasting blood samples were obtained from all participants. We assessed whether HIV was independently associated with abdominal obesity, elevated LDL-C, hypertriglyceridemia and hypertension using logistic regression models...... adjusted for known risk factors. Results: HIV infection was associated with higher risk of abdominal obesity (adjusted odds ratio (aOR): 1.92[1.60-2.30]) for a given BMI, elevated LDL-C (aOR: 1.32[1.09-1.59]), hypertriglyceridemia (aOR 1.76[1.49-2.08]), and lower risk of hypertension (aOR: 0.63[0.54 - 0...

  15. Pituitary gland volume and psychosocial stress among children at elevated risk for schizophrenia.

    Science.gov (United States)

    Cullen, A E; Day, F L; Roberts, R E; Pariante, C M; Laurens, K R

    2015-11-01

    Pituitary volume enlargements have been observed among individuals with first-episode psychosis. These abnormalities are suggestive of hypothalamic-pituitary-adrenal (HPA) axis hyperactivity, which may contribute to the development of psychosis. However, the extent to which these abnormalities characterize individuals at elevated risk for schizophrenia prior to illness onset is currently unclear, as volume increases, decreases and no volume differences have all been reported relative to controls. The current study aimed to determine whether antipsychotic-naive, putatively at-risk children who present multiple antecedents of schizophrenia (ASz) or a family history of illness (FHx) show pituitary volume abnormalities relative to typically developing (TD) children. An additional aim was to explore the association between pituitary volume and experiences of psychosocial stress. ASz (n = 30), FHx (n = 22) and TD (n = 32) children were identified at age 9-12 years using a novel community-screening procedure or as relatives of individuals with schizophrenia. Measures of pituitary volume and psychosocial stress were obtained at age 11-14 years. Neither ASz nor FHx children showed differences in pituitary volume relative to TD children. Among FHx children only, pituitary volume was negatively associated with current distress relating to negative life events and exposure to physical punishment. The lack of pituitary volume abnormalities among ASz and FHx children is consistent with our previous work demonstrating that these children are not characterized by elevated diurnal cortisol levels. The findings imply that these biological markers of HPA axis hyperactivity, observed in some older samples of high-risk individuals, may emerge later, more proximally to disease onset.

  16. Elevated endogenous erythropoietin concentrations are associated with increased risk of brain damage in extremely preterm neonates.

    Directory of Open Access Journals (Sweden)

    Steven J Korzeniewski

    Full Text Available We sought to determine, in very preterm infants, whether elevated perinatal erythropoietin (EPO concentrations are associated with increased risks of indicators of brain damage, and whether this risk differs by the co-occurrence or absence of intermittent or sustained systemic inflammation (ISSI.Protein concentrations were measured in blood collected from 786 infants born before the 28th week of gestation. EPO was measured on postnatal day 14, and 25 inflammation-related proteins were measured weekly during the first 2 postnatal weeks. We defined ISSI as a concentration in the top quartile of each of 25 inflammation-related proteins on two separate days a week apart. Hypererythropoietinemia (hyperEPO was defined as the highest quartile for gestational age on postnatal day 14. Using logistic regression and multinomial logistic regression models, we compared risks of brain damage among neonates with hyperEPO only, ISSI only, and hyperEPO+ISSI, to those who had neither hyperEPO nor ISSI, adjusting for gestational age.Newborns with hyperEPO, regardless of ISSI, were more than twice as likely as those without to have very low (< 55 Mental (OR 2.3; 95% CI 1.5-3.5 and/or Psychomotor (OR 2.4; 95% CI 1.6-3.7 Development Indices (MDI, PDI, and microcephaly at age two years (OR 2.4; 95%CI 1.5-3.8. Newborns with both hyperEPO and ISSI had significantly increased risks of ventriculomegaly, hemiparetic cerebral palsy, microcephaly, and MDI and PDI < 55 (ORs ranged from 2.2-6.3, but not hypoechoic lesions or other forms of cerebral palsy, relative to newborns with neither hyperEPO nor ISSI.hyperEPO, regardless of ISSI, is associated with elevated risks of very low MDI and PDI, and microcephaly, but not with any form of cerebral palsy. Children with both hyperEPO and ISSI are at higher risk than others of very low MDI and PDI, ventriculomegaly, hemiparetic cerebral palsy, and microcephaly.

  17. Elevated venous thromboembolism risk in preeclampsia: molecular mechanisms and clinical impact.

    Science.gov (United States)

    Egan, Karl; Kevane, Barry; Ní Áinle, Fionnuala

    2015-08-01

    Venous thromboembolism (VTE) remains a leading cause of maternal death and morbidity in the developed world. Strategies for prevention of VTE in pregnancy have been the subject of recent guidelines and consensus statements. These guidelines recommend thrombosis prevention in women who have risk factors associated with an elevated VTE risk. Preeclampsia is characterized by maternal hypertension and proteinuria developing after 20 weeks gestation, complicating up to 7% of pregnancies and is associated with a massive annual morbidity and mortality burden. Women with preeclampsia have been shown to be at increased risk of VTE with studies to date suggesting that this risk may be up to 5-fold greater than the risk of pregnancy-associated VTE in the general population. Despite the fact that preeclampsia is so common and potentially devastating, our understanding of its pathogenesis and potential therapeutic strategies remain poor. In addition, the mechanisms underlying the prothrombotic phenotype in preeclampsia are also poorly characterized although a number of potential mechanisms have been postulated. Derangements of platelet and endothelial activation and impairment of endogenous anti-coagulant pathways have been reported and may contribute to the observed VTE risk. Recently, evidence for the role of neutrophil extracellular traps (NETs) and cell-free DNA in the pathogenesis of VTE has emerged and some evidence exists to suggest that this may be of relevance in preeclampsia. Future studies aimed at understanding the diagnostic and potential therapeutic relevance of this procoagulant state are likely to be of enormous clinical benefit for pregnant women affected with this potentially devastating condition. © 2015 Authors; published by Portland Press Limited.

  18. Elevated Risk of Posttraumatic Stress in Sexual Minority Youths: Mediation by Childhood Abuse and Gender Nonconformity

    Science.gov (United States)

    Rosario, Margaret; Corliss, Heather L.; Koenen, Karestan C.; Austin, S. Bryn

    2012-01-01

    Objectives. We examined whether lifetime risk of posttraumatic stress disorder (PTSD) was elevated in sexual minority versus heterosexual youths, whether childhood abuse accounted for disparities in PTSD, and whether childhood gender nonconformity explained sexual-orientation disparities in abuse and subsequent PTSD. Methods. We used data from a population-based study (n = 9369, mean age = 22.7 years) to estimate risk ratios for PTSD. We calculated the percentage of PTSD disparities by sexual orientation accounted for by childhood abuse and gender nonconformity, and the percentage of abuse disparities by sexual orientation accounted for by gender nonconformity. Results. Sexual minorities had between 1.6 and 3.9 times greater risk of probable PTSD than heterosexuals. Child abuse victimization disparities accounted for one third to one half of PTSD disparities by sexual orientation. Higher prevalence of gender nonconformity before age 11 years partly accounted for higher prevalence of abuse exposure before age 11 years and PTSD by early adulthood in sexual minorities (range = 5.2%–33.2%). Conclusions. Clinicians, teachers, and others who work with youths should consider abuse prevention and treatment measures for gender-nonconforming children and sexual minority youths. PMID:22698034

  19. Heavy cannabis users at elevated risk of stroke: evidence from a general population survey.

    Science.gov (United States)

    Hemachandra, Dilini; McKetin, Rebecca; Cherbuin, Nicolas; Anstey, Kaarin J

    2016-06-01

    Case reports and hospital-based case-control studies suggest that cannabis use may increase the risk of stroke. We examined the risk of non-fatal stroke or transient ischemic attack (TIA) among cannabis users in the general community. A general population survey of Australians aged 20-24 years (n=2,383), 40-44 years (n=2,525) and 60-64 years (n=2,547) was used to determine the odds of lifetime stroke or TIA among participants who had smoked cannabis in the past year while adjusting for other stroke risk factors. There were 153 stroke/TIA cases (2.1%). After adjusting for age cohort, past year cannabis users (n=1,043) had 3.3 times the rate of stroke/TIA (95% CI 1.8-6.3, pcannabis weekly or more often (IRR 4.7, 95% CI 2.1-10.7) with no elevation among participants who used cannabis less often. Heavy cannabis users in the general community have a higher rate of non-fatal stroke or transient ischemic attack than non-cannabis users. © 2015 Public Health Association of Australia.

  20. PERSONAL AND ENVIRONMENTAL RISK FACTORS SIGNIFICANTLY ASSOCIATED WITH ELEVATED BLOOD LEAD LEVELS IN RURAL THAI CHILDREN.

    Science.gov (United States)

    Swaddiwudhipong, Witaya; Kavinum, Suporn; Papwijitsil, Ratchadaporn; Tontiwattanasap, Worawit; Khunyotying, Wanlee; Umpan, Jiraporn; BoonthuM, Ratchaneekorn; Kaewnate, Yingyot; Boonmee, Sasis; Thongchub, Winai; Rodsung, Thassanee

    2014-11-01

    A community-based study was conducted to determine personal risk factors and environmental sources of lead exposure for elevated blood lead levels (≥ 10 µg/dl, EBLLs) among rural children living at the Thailand-Myanmar border in Tak Province, northwestern Thailand. Six hundred ninety-five children aged 1-14 years old were screened for BLLs. Environmental specimens for lead measurements included samples of water from the streams, taps, and household containers, house floor dust, and foods. Possible lead release from the cooking ware was determined using the leaching method with acetic acid. The overall prevalence of EBLLs was 47.1% and the geometric mean level of blood lead was 9.16 µg/dl. Personal risk factors significantly associated with EBLLs included being male, younger age, anemia, and low weight-for-age. Significant environmental risk factors were exposure to a lead-acid battery of solar energy system and use of a non-certified metal cooking pot. Some families whose children had high BLLs reported production of lead bullets from the used batteries at home. About one-third of the house dust samples taken near batteries contained lead content above the recommended value, compared with none of those taken from other areas and from the houses with no batteries. The metal pots were safe for cooking rice but might be unsafe for acidic food preparation. Both nutritional intervention and lead exposure prevention programs are essential to reduce EBLLs in this population.

  1. Intervention Research with Youths at Elevated Risk for Suicide: Meeting the Ethical and Regulatory Challenges of Informed Consent and Assent

    Science.gov (United States)

    King, Cheryl A.; Kramer, Anne C.

    2008-01-01

    Intervention research with youths at elevated risk for suicidal behavior and suicide--a vulnerable and high risk population--presents investigators with numerous ethical challenges. This report specifically addresses those challenges involving the informed consent and assent process with parents/guardians and youths. The challenges are delineated…

  2. Mercury and selenium contamination in waterbird eggs and risk to avian reproduction at Great Salt Lake, Utah

    Science.gov (United States)

    Ackerman, Joshua T.; Herzog, Mark P.; Hartman, Christopher A.; Isanhart, John P.; Herring, Garth; Vaughn, Sharon; Cavitt, John F.; Eagles-Smith, Collin A.; Browers, Howard; Cline, Chris; Vest, Josh

    2015-01-01

    The wetlands of the Great Salt Lake ecosystem are recognized regionally, nationally, and hemispherically for their importance as breeding, wintering, and migratory habitat for diverse groups of waterbirds. Bear River Migratory Bird Refuge is the largest freshwater component of the Great Salt Lake ecosystem and provides critical breeding habitat for more than 60 bird species. However, the Great Salt Lake ecosystem also has a history of both mercury and selenium contamination, and this pollution could reduce the health and reproductive success of waterbirds. The overall objective of this study was to evaluate the risk of mercury and selenium contamination to birds breeding within Great Salt Lake, especially at Bear River Migratory Bird Refuge, and to identify the waterbird species and areas at greatest risk to contamination. We sampled eggs from 33 species of birds breeding within wetlands of Great Salt Lake during 2010 ̶ 2012 and focused on American avocets (Recurvirostra americana), black-necked stilts (Himantopus mexicanus), Forster’s terns (Sterna forsteri), white-faced ibis (Plegadis chihi), and marsh wrens (Cistothorus palustris) for additional studies of the effects of contaminants on reproduction.

  3. CAN TIMI RISK SCORE PREDICT ANGIOGRAPHIC INVOLVEMENT IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION?

    Directory of Open Access Journals (Sweden)

    Allahyar Golabchi

    2010-11-01

    Full Text Available BACKGROUND: In most studies, the agreeable risk scores for ST-elevation myocardial infarction (STEMI consist of thrombolytic in myocardial infarction (TIMI risk score and modified Gensini risk score. Researchers showed significant relations between TIMI with angiography scores in patients with UA/NSTEMI. We studied this relation in patients with STEMI.    METHODS: We studied CCU patients with STEMI hospitalized in several hospitals of Isfahan, Iran from September 2007 to June 2008. Sampling method of 240 patients was random and simple. Exclusion criteria were incomplete history, nonspecific electrocardiogram changes, left bundle branch block and not accomplished angiography or accomplished angiography after 2 months of STEMI. Questionnaire indices collected on the basis of TIMI (0-14 points. Echocardiography and angiography were done and then, we used Gensini (0-400 points to review films of angiography. Spearman`s rank test and Pearson correlation coefficient were used to study the relation between these scores.    RESULTS: One hundred and sixty one patients were male and their average age was 60.02 years. Averages of TIMI and Gensini scores were 6.30 ± 2.5 and 120.77 ± 50.4, respectively. Study showed significant relation between TIMI, age and LVEF (P <0.001, r=-0.46. Also, between Gensini and age, gender and LVEF significant relation was found (P <0.001. But, a meaningful correlation didn’t exist between TIMI and the gender (P =0.08. Our study proved direct relation between TIMI risk scores and modified Gensini scores (P <0.001, r=0.55.     CONCLUSION: We may decide quickly and correctly in emergency room to distinguish which patients with STEMI could derive a benefit from invasive strategies using TIMI score. Also, TIMI risk score can be a good predictor to determine the extension of coronary artery disease in patients with STEMI. As a result, we suggest determination of TIMI score for any patient entered emergency room. Also

  4. Strategies for Worksite Health Interventions to Employees with Elevated Risk of Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Lu Meng

    2017-06-01

    Full Text Available Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n = 13, cardiovascular diseases (n = 8, and diabetes (n = 6. Intervention strategies included instructional education/counseling (n = 20, workplace environmental change (n = 6, physical activity (n = 10, use of technology (n = 10, and incentives (n = 13. Self-reported data (n = 21, anthropometric measurements (n = 17, and laboratory tests (n = 14 were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.

  5. Strategies for Worksite Health Interventions to Employees with Elevated Risk of Chronic Diseases.

    Science.gov (United States)

    Meng, Lu; Wolff, Marilyn B; Mattick, Kelly A; DeJoy, David M; Wilson, Mark G; Smith, Matthew Lee

    2017-06-01

    Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity ( n   =  13), cardiovascular diseases ( n   =  8), and diabetes ( n   =  6). Intervention strategies included instructional education/counseling ( n   =  20), workplace environmental change ( n   =  6), physical activity ( n   =  10), use of technology ( n   =  10), and incentives ( n   =  13). Self-reported data ( n   =  21), anthropometric measurements ( n   =  17), and laboratory tests ( n   =  14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.

  6. Influence of Child and Adult Elevated Blood Pressure on Adult Arterial Stiffness: The Cardiovascular Risk in Young Finns Study.

    Science.gov (United States)

    Aatola, Heikki; Koivistoinen, Teemu; Tuominen, Heikki; Juonala, Markus; Lehtimäki, Terho; Viikari, Jorma S A; Raitakari, Olli T; Kähönen, Mika; Hutri-Kähönen, Nina

    2017-09-01

    Elevated blood pressure (BP) in childhood has been associated with increased adult arterial stiffness, the independent predictor of cardiovascular and all-cause mortality. The favorable BP change from childhood to adulthood and the risk of high adult arterial stiffness has not been reported. We examined the effect of child and adult BP on pulse wave velocity (PWV) assessed in adulthood among 1540 white adults followed-up for 27 years since baseline (1980, aged 6-18 years). Childhood elevated BP was defined according to the tables from the National High Blood Pressure Education Program. In adulthood, BP was classified as elevated if systolic BP ≥120 mm Hg, diastolic BP ≥80 mm Hg, or self-reported use of antihypertensive medications. PWV was measured in 2007 by whole-body impedance cardiography, and high PWV was defined as values at or above the age-, sex-, and heart rate-specific 80th percentile. Individuals with persistently elevated BP and individuals with normal child but elevated adult BP had increased risk of high adult PWV (relative risk [95% confidence interval], 3.18 [2.22-4.55] and 2.64 [1.79-3.88], respectively) in comparison with individuals with normal (both child and adult) BP. In contrast, individuals with elevated BP in childhood but not in adulthood did not have significantly increased risk of high PWV (relative risk [95% confidence interval], 1.26[0.80-1.99]). The results were consistent when different definitions for child and adult elevated BP were applied. These findings highlight the importance of BP control in the primary prevention of cardiovascular diseases. © 2017 American Heart Association, Inc.

  7. Decision making for breast cancer prevention among women at elevated risk.

    Science.gov (United States)

    Padamsee, Tasleem J; Wills, Celia E; Yee, Lisa D; Paskett, Electra D

    2017-03-24

    Several medical management approaches have been shown to be effective in preventing breast cancer and detecting it early among women at elevated risk: 1) prophylactic mastectomy; 2) prophylactic oophorectomy; 3) chemoprevention; and 4) enhanced screening routines. To varying extents, however, these approaches are substantially underused relative to clinical practice recommendations. This article reviews the existing research on the uptake of these prevention approaches, the characteristics of women who are likely to use various methods, and the decision-making processes that underlie the differing choices of women. It also highlights important areas for future research, detailing the types of studies that are particularly needed in four key areas: documenting women's perspectives on their own perceptions of risk and prevention decisions; explicit comparisons of available prevention pathways and their likely health effects; the psychological, interpersonal, and social processes of prevention decision making; and the dynamics of subgroup variation. Ultimately, this research could support the development of interventions that more fully empower women to make informed and values-consistent decisions, and to move towards favorable health outcomes.

  8. Elevated C-peptide and insulin predict increased risk of colorectal adenomas in normal mucosa

    International Nuclear Information System (INIS)

    Vidal, Adriana C; Keku, Temitope O; Lund, Pauline Kay; Hoyo, Cathrine; Galanko, Joseph; Burcal, Lauren; Holston, Rachel; Massa, Berri; Omofoye, Oluwaseun; Sandler, Robert S

    2012-01-01

    Lower concentrations of the insulin–like growth factor binding protein-1 (IGFBP-1) and elevated concentrations of insulin or C-peptide have been associated with an increase in colorectal cancer risk (CRC). However few studies have evaluated IGFBP-1 and C-peptide in relation to adenomatous polyps, the only known precursor for CRC. Between November 2001 and December 2002, we examined associations between circulating concentrations of insulin, C-peptide, IGFBP-1 and apoptosis among 190 individuals with one or more adenomatous polyps and 488 with no adenomatous polyps using logistic regression models. Individuals with the highest concentrations of C-peptide were more likely to have adenomas (OR = 2.2, 95% CI 1.4-4.0) than those with the lowest concentrations; associations that appeared to be stronger in men (OR = 4.4, 95% CI 1.7-10.9) than women. Individuals with high insulin concentrations also had a higher risk of adenomas (OR = 3.5, 95% CI 1.7-7.4), whereas higher levels of IGFBP-1 were associated with a reduced risk of adenomas in men only (OR = 0.3, 95% CI 0.1-0.7). Overweight and obese individuals with higher C-peptide levels (>1 st Q) were at increased risk for lower apoptosis index (OR = 2.5, 95% CI 0.9-7.1), an association that remained strong in overweight and obese men (OR = 6.3, 95% CI 1.0-36.7). Higher levels of IGFBP-1 in overweight and obese individuals were associated with a reduced risk of low apoptosis (OR = 0.3, 95% CI 0.1-1.0). Associations between these peptides and the apoptosis index in overweight and obese individuals, suggest that the mechanism by which C-peptide could induce adenomas may include its anti-apoptotic properties. This study suggests that hyperinsulinemia and IGF hormones predict adenoma risk, and that outcomes associated with colorectal carcinogenesis maybe modified by gender

  9. Hemlock resources at risk in the Great Smoky Mountains National Park

    Science.gov (United States)

    Kristine D. Johnson; Fred P. Hain; Katherine S. Johnson; Felton Hastings

    2000-01-01

    Eastern hemlock (Tsuga canadensis (L.) Carr) is the dominant species in a variety of sites in Great Smoky Mountains National Park. Hemlock covers approximately 3820 acres (1528 hectares) or one percent of the Park, which at 524,856 acres is the largest area managed as wilderness in the eastern United States. Since timber was never harvested in about...

  10. [Sinus floor elevation and augmentation. Evidence-based analysis of prognosis and risk factors].

    Science.gov (United States)

    Strietzel, F P

    2004-03-01

    It was the aim of this investigation to analyze evidence of prognosis, predictors, and risk factors concerning sinus floor elevation and augmentation (SFEA). A MEDLINE search was performed to analyze the literature published between 1990 and 2002, limited to keywords ("sinus floor elevation and dental implants", "complications", "success"), study type (randomized as well as clinical prospective studies, retrospective studies, reviews), and language (German or English). Of 229 publications identified, 72 met the inclusion criteria (22 prospective and 47 retrospective studies, 3 reviews). Considering the augmentation material [autogenous bone (AB), bone substitution materials (BSM), and combinations of AB and BSM], the frequency of implant loss was not significantly different (AB 8%, BSM 9%, AB + BSM 5%, p>0.09) after an observation period of 2-4 years. The average duration of the healing period was 6 months (AB) and 8 months (BSM) with simultaneous SFEA and implantation and 6-7 months (AB and BSM) for the staged approach after an average healing period of 6 months for the augmentation materials. Frequency of implant loss was not different between simultaneous and staged approaches (7-8%). Postoperative sinusitis occurred in 3-8% of the cases. Smoking, positive sinusitis history, obstructive pathoses of the nose and ostium, allergic rhino-pathoses, use of short implants (bruxism, and uncontrolled early loading of implants were identified as predictors for complications. Presupposing proper consideration of indications, SFEA should be considered as an evidence-based and clinically established method for implant prosthetic rehabilitation of the atrophic posterior maxilla with an overall cumulative survival rate of 90% within an average observation period of 4 years.

  11. Early elevation of soluble CD14 may help identify trauma patients at high risk for infection.

    Science.gov (United States)

    Carrillo, E H; Gordon, L; Goode, E; Davis, E; Polk, H C

    2001-05-01

    Elevated levels of soluble CD14 (sCD14) have been implicated in both gram-positive and gram-negative sepsis, and it has been associated with high mortality in trauma patients who become infected. Eleven healthy volunteers and 25 adult trauma patients with multiple injuries and a mean Injury Severity Score of 32 participated. Whole blood was obtained at intervals. Immunohistochemistry was used to quantify membrane CD14 (mCD14), by flow cytometry and plasma levels of sCD14 by enzyme-linked immunosorbent assay. Analysis of variance and Student's T test with Mann-Whitney posttest were used to determine significance at p < 0.05. On posttrauma day 1, sCD14 was significantly different in the plasma of infected patients compared with normal controls (7.16 +/- 1.87 microg/mL vs. 4.4 +/- 0.92 microg/mL, p < 0.01), but not significantly different from noninfected patients. The percentage of monocytes expressing mCD14 in trauma patients did not differentiate them from normal controls; however, mCD14 receptor density did demonstrate significance in septic trauma patients (n = 15) versus normal controls on posttrauma day 3 (p = 0.0065). On the basis of our data, mCD14 did not differentiate infected and noninfected trauma patients, although trauma in general reduced mCD14 and elevated sCD14. Interestingly, 100% of patients who exceeded plasma levels of 8 microg/mL of sCD14 on day 1 after injury developed infections. Therefore, early high expressers of sCD14 may be at higher risk for infectious complications after trauma.

  12. Does the increase in ambient CO2 concentration elevate allergy risks posed by oak pollen?

    Science.gov (United States)

    Kim, Kyu Rang; Oh, Jae-Won; Woo, Su-Young; Seo, Yun Am; Choi, Young-Jin; Kim, Hyun Seok; Lee, Wi Young; Kim, Baek-Jo

    2018-05-01

    Oak pollen is a major respiratory allergen in Korea, and the distribution of oak trees is expected to increase by ecological succession and climate change. One of the drivers of climate change is increasing CO2, which is also known to amplify the allergy risk of weed pollen by inducing elevated allergenic protein content. However, the impact of CO2 concentration on tree pollen is not clearly understood due to the experimental difficulties in carrying out extended CO2 treatment. To study the response of pollen production of sawtooth oak trees (Quercus acutissima) to elevated levels of ambient CO2, three open-top chambers at the National Institute of Forest Science in Suwon, Korea were utilized with daytime (8 am-6 pm) CO2 concentrations of ambient (× 1.0, 400 ppm), × 1.4 ( 560 ppm), and × 1.8 ( 720 ppm) treatments. Each chamber had three sawtooth oak trees planted in September 2009. One or two trees per chamber matured to bloom in 2016. Five to six catkins were selected per tree and polyethylene bags were attached to collect pollen grains. The total number of catkins per tree was counted and the number and weight of pollen grains per catkin were measured. Oak allergen—Que a 1 (Allergon Co., Uppsala, Sweden)—was extracted and purified to make an ELISA kit by which the antigen levels in the pollen samples were quantified. Total pollen counts per tree of the × 1.4 and × 1.8 treatments showed significant increase of 353 and 1299%, respectively, from the × 1.0 treatment (p < 0.001). Allergenic protein contents at the × 1.4 and × 1.8 treatments also showed significant increase of 12 and 11%, respectively (p = 0.011). The × 1.8 treatment induced significant difference from the × 1.0 treatment in terms of pollen production and allergenic protein content, whereas the × 1.4 treatment showed mixed significance. In summary, the oak trees under the elevated CO2 levels, which are expected in the changing climate, produced significantly higher amount of pollen and

  13. Inclisiran in Patients at High Cardiovascular Risk with Elevated LDL Cholesterol.

    Science.gov (United States)

    Ray, Kausik K; Landmesser, Ulf; Leiter, Lawrence A; Kallend, David; Dufour, Robert; Karakas, Mahir; Hall, Tim; Troquay, Roland P T; Turner, Traci; Visseren, Frank L J; Wijngaard, Peter; Wright, R Scott; Kastelein, John J P

    2017-04-13

    In a previous study, a single injection of inclisiran, a chemically synthesized small interfering RNA designed to target PCSK9 messenger RNA, was found to produce sustained reductions in low-density lipoprotein (LDL) cholesterol levels over the course of 84 days in healthy volunteers. We conducted a phase 2, multicenter, double-blind, placebo-controlled, multiple-ascending-dose trial of inclisiran administered as a subcutaneous injection in patients at high risk for cardiovascular disease who had elevated LDL cholesterol levels. Patients were randomly assigned to receive a single dose of placebo or 200, 300, or 500 mg of inclisiran or two doses (at days 1 and 90) of placebo or 100, 200, or 300 mg of inclisiran. The primary end point was the change from baseline in LDL cholesterol level at 180 days. Safety data were available through day 210, and data on LDL cholesterol and proprotein convertase subtilisin-kexin type 9 (PCSK9) levels were available through day 240. A total of 501 patients underwent randomization. Patients who received inclisiran had dose-dependent reductions in PCSK9 and LDL cholesterol levels. At day 180, the least-squares mean reductions in LDL cholesterol levels were 27.9 to 41.9% after a single dose of inclisiran and 35.5 to 52.6% after two doses (PLDL cholesterol levels: 48% of the patients who received the regimen had an LDL cholesterol level below 50 mg per deciliter (1.3 mmol per liter) at day 180. At day 240, PCSK9 and LDL cholesterol levels remained significantly lower than at baseline in association with all inclisiran regimens. Serious adverse events occurred in 11% of the patients who received inclisiran and in 8% of the patients who received placebo. Injection-site reactions occurred in 5% of the patients who received injections of inclisiran. In our trial, inclisiran was found to lower PCSK9 and LDL cholesterol levels among patients at high cardiovascular risk who had elevated LDL cholesterol levels. (Funded by the Medicines Company

  14. Uncertainty and risk management after the Great Moderation: the role of risk (mis)management by financial institutions

    NARCIS (Netherlands)

    Blommestein, H.J.; Hoogduin, L.H.; Peeters, J.J.W.

    2009-01-01

    Since the early eighties volatility of GDP and inflation has been declining steadily in many countries. Financial innovation has been identified as one of the key factors driving this „Great Moderation‟. Financial innovation was considered to have improved significantly the allocation and sharing of

  15. Genetically elevated non-fasting triglycerides and calculated remnant cholesterol as causal risk factors for myocardial infarction

    DEFF Research Database (Denmark)

    Jørgensen, Anders Berg; Frikke-Schmidt, Ruth; West, Anders Sode

    2012-01-01

    AimsElevated non-fasting triglycerides mark elevated levels of remnant cholesterol. Using a Mendelian randomization approach, we tested whether genetically increased remnant cholesterol in hypertriglyceridaemia due to genetic variation in the apolipoprotein A5 gene (APOA5) associates with an incr......AimsElevated non-fasting triglycerides mark elevated levels of remnant cholesterol. Using a Mendelian randomization approach, we tested whether genetically increased remnant cholesterol in hypertriglyceridaemia due to genetic variation in the apolipoprotein A5 gene (APOA5) associates...... with an increased risk of myocardial infarction (MI).Methods and resultsWe resequenced the core promoter and coding regions of APOA5 in individuals with the lowest 1% (n = 95) and highest 2% (n = 190) triglyceride levels in the Copenhagen City Heart Study (CCHS, n = 10 391). Genetic variants which differed...... in frequency between the two extreme triglyceride groups (c.-1131T > C, S19W, and c.*31C > T; P-value: 0.06 to...

  16. A GIS-based tool for bioaccumulation risk analysis and its application to study polychlorinated biphenyls in the Great Lakes

    Directory of Open Access Journals (Sweden)

    Fernanda P. Maciel

    2018-01-01

    Full Text Available This paper presents a GIS-based tool named Arc-BEST (Bioaccumulation Evaluation Screening Tool to perform spatially distributed bioaccumulation risk analyses. Estimating bioaccumulation risk is important to help predict potentially adverse effects from contaminants on ecosystems and human health, which are key factors in the development of sound public policy. Arc-BEST is based on the BEST model in the U.S. Army Corps of Engineers BRAMS (Bioaccumulation Risk Assessment Modeling System software, released in 2012. It predicts concentration of concern contaminants in predators’ tissues from concentrations in organisms at the bottom of the food chain, and corresponding bioaccumulation factors. Additionally, it estimates carcinogenic and non-carcinogenic risks for humans that consume those species. The greatest contribution of Arc-BEST is that it enables the automated use of digital spatial data sets, which improves model creation speed, analysis and visualization of results, and comparison and cross-referencing with other geographic datasets. Furthermore, the model was improved to consider up to four trophic levels. The code is written in Python and is open-source. In this work Arc-BEST is used as part of a screening-level risk assessment process in order to identify hot spots where further studies and monitoring should be performed to ensure humans and ecosystems health. The tool is successfully applied to a case study in the Laurentian Great Lakes, where long-term effects of polychlorinated biphenyls (PCBs is performed, based on measured concentrations in zebra mussels (Dreissena polymorpha, and local bioaccumulation factors from previous studies. Zebra mussels have a great filtration capacity and high bioconcentration rates, increasing the bioavailability of contaminants for predator species. PCBs concentrations in different-level predators are predicted. Furthermore, health risks for humans that consume sport fish are estimated for various

  17. Time-varying individual risk attitudes over the Great Recession: A comparison of Germany and Ukraine

    NARCIS (Netherlands)

    Dohmen, T.J.; Lehmann, H.; Pignatti, N.

    We use the panel data of the German Socio-Economic Panel (SOEP) and of the Ukrainian Longitudinal Monitoring Survey (ULMS) to investigate whether risk attitudes have primary (exogenous) determinants that are valid in different stages of economic development and in a different structural context,

  18. Metals Additive Manufacturing. Great Promise in Mitigating Shortages but Some Risks Remain

    Science.gov (United States)

    2016-11-01

    risks for obsolescence man- agement. As we leverage the growth of this new technol- 39 Defense AT&L: November-December 2016 ogy, it will be...such as re- placing a few obsolescent parts or castings and building prototypes. In addition, AM is used to create special tooling in lieu of...improvements in cost and schedule . Similar successes were obtained by the America Makes- funded project led by the Youngstown Business Incubator (YBI) that

  19. Preliminary assessment of the risk of volcanism at a proposed nuclear-waste repository in the southern Great Basin

    International Nuclear Information System (INIS)

    Crowe, B.M.; Carr, W.J.

    1980-01-01

    Volcanic hazard studies of the southern Great Basin are being conducted on behalf of the Nevada Nuclear Waste Storage Investigations program. Current work is chiefly concerned with characterizing the geology, chronology, and tectonic setting of Pliocene and Quaternary volcanism in the Nevada Test Site region, and assessing volcanic risk through consequence and probability studies, particularly with respect to a potential site in the southwestern Nevada Test Site. Young ( - 6 volcanic events per year. Based on this rate, the annual probability of disruption of a 10-km 2 repository located within a 25-km radius circle centered at Yucca Mountain, southwestern Nevada Test Site, is 10 - 8 . A larger area, 50-km radius, yields a disruption probability of 10 - 9 per year. Current tectonic zonation studies of the southern Great Basin will reduce the calculated probabilities of basaltic eruption for certain areas. 21 references, 3 figures

  20. Prevalence of cardiovascular risk factors in youth with type 1 diabetes and elevated body mass index.

    Science.gov (United States)

    Redondo, Maria J; Foster, Nicole C; Libman, Ingrid M; Mehta, Sanjeev N; Hathway, Joanne M; Bethin, Kathleen E; Nathan, Brandon M; Ecker, Michelle A; Shah, Avni C; DuBose, Stephanie N; Tamborlane, William V; Hoffman, Robert P; Wong, Jenise C; Maahs, David M; Beck, Roy W; DiMeglio, Linda A

    2016-04-01

    The prevalence of cardiovascular risk factors in children with type 1 diabetes and elevated BMI in the USA is poorly defined. We aimed to test the hypothesis that children with type 1 diabetes who are overweight or obese have increased frequencies of hypertension, dyslipidemia, and micro-/macroalbuminuria compared to their healthy weight peers. We studied 11,348 children 2 to 18 years of age enrolled in T1D Exchange between September 2010 and August 2012 with type 1 diabetes for ≥1 year and BMI ≥ 5th age-/sex-adjusted percentile (mean age 12 years, 49 % female, 78 % non-Hispanic White). Overweight and obesity were defined based on Centers for Disease Control and Prevention criteria. Diagnoses of hypertension, dyslipidemia, and micro-/macroalbuminuria were obtained from medical records. Logistic and linear regression models were used to assess factors associated with weight status. Of the 11,348 participants, 22 % were overweight and 14 % obese. Hypertension and dyslipidemia were diagnosed in 1.0 % and 3.8 % of participants, respectively; micro-/macroalbuminuria was diagnosed in 3.8 % of participants with available data (n = 7,401). The odds of either hypertension or dyslipidemia were higher in obese than healthy weight participants [OR 3.5, 99 % confidence interval (CI) 2.0-6.1 and 2.2, 99 % CI 1.6-3.1, respectively]. Obese participants tended to be diagnosed with micro-/macroalbuminuria less often than healthy weight participants (OR 0.6, 99 % CI 0.4-1.0). Obese children with type 1 diabetes have a higher prevalence of hypertension and dyslipidemia than healthy weight children with type 1 diabetes. The possible association of obesity with lower micro-/macroalbuminuria rates warrants further investigation.

  1. Usefulness of ST elevation score by using vector-projected virtual 187-channel ECG for risk stratification in patients with Brugada-type ECG pattern

    Directory of Open Access Journals (Sweden)

    Shoko Ishikawa

    2012-08-01

    Conclusion: The ST elevation score in VP-ECG objectively documented the degree of ST elevation in surface ECG in Brugada-type ECG patterns. The ST-elevation score might be useful for risk stratification in patients with asymptomatic Brugada syndrome.

  2. Risk factors and consequences of maternal anaemia and elevated haemoglobin levels during pregnancy: a population-based prospective cohort study.

    Science.gov (United States)

    Gaillard, Romy; Eilers, Paul H C; Yassine, Siham; Hofman, Albert; Steegers, Eric A P; Jaddoe, Vincent W V

    2014-05-01

    To determine sociodemographic and life style-related risk factors and trimester specific maternal, placental, and fetal consequences of maternal anaemia and elevated haemoglobin levels in pregnancy. In a population-based prospective cohort study of 7317 mothers, we measured haemoglobin levels in early pregnancy [gestational age median 14.4 weeks (inter-quartile-range 12.5-17.5)]. Anaemia (haemoglobin ≤11 g/dl) and elevated haemoglobin levels (haemoglobin ≥13.2 g/dl) were defined according to the WHO criteria. Maternal blood pressure, placental function and fetal growth were measured in each trimester. Data on gestational hypertensive disorders and birth outcomes was collected from hospitals. Older maternal age, higher body mass index, primiparity and European descent were associated with higher haemoglobin levels (P pregnancy (mean differences 5.1 mmHg, 95% confidence interval [CI] 3.8, 6.5 and 4.1 mmHg, 95% CI 3.0, 5.2, respectively) and with a higher risk of third trimester uterine artery notching (RR 1.3, 95% CI 1.0, 1.7). As compared with maternal normal haemoglobin levels, not anaemia, but elevated haemoglobin levels were associated with fetal head circumference, length, and weight growth restriction from third trimester onwards (P pregnancy. Elevated haemoglobin levels are associated with increased risks of maternal, placental, and fetal complications. © 2014 John Wiley & Sons Ltd.

  3. Progressive Seismic Failure, Seismic Gap, and Great Seismic Risk across the Densely Populated North China Basin

    Science.gov (United States)

    Yin, A.; Yu, X.; Shen, Z.

    2014-12-01

    Although the seismically active North China basin has the most complete written records of pre-instrumentation earthquakes in the world, this information has not been fully utilized for assessing potential earthquake hazards of this densely populated region that hosts ~200 million people. In this study, we use the historical records to document the earthquake migration pattern and the existence of a 180-km seismic gap along the 600-km long right-slip Tangshan-Hejian-Cixian (THC) fault zone that cuts across the North China basin. The newly recognized seismic gap, which is centered at Tianjin with a population of 11 million people and ~120 km from Beijing (22 million people) and Tangshan (7 million people), has not been ruptured in the past 1000 years by M≥6 earthquakes. The seismic migration pattern in the past millennium suggests that the epicenters of major earthquakes have shifted towards this seismic gap along the THC fault, which implies that the 180- km gap could be the site of the next great earthquake with M≈7.6 if it is ruptured by a single event. Alternatively, the seismic gap may be explained by aseismic creeping or seismic strain transfer between active faults.

  4. Priority setting for invasive species management: risk assessment of Ponto-Caspian invasive species into Great Britain.

    Science.gov (United States)

    Gallardo, Belinda; Aldridge, David C

    2013-03-01

    Invasive species drive important ecological and economic losses across wide geographies, with some regions supporting especially large numbers of nonnative species and consequently suffering relatively high impacts. For this reason, integrated risk assessments able to screen a suite of multiple invaders over large geographic areas are needed for prioritizing the allocation of limited resources. A total of 16 Ponto-Caspian aquatic species (10 gammarids, one isopod, two mysids, and three fishes) have been short-listed as recent or potential future invaders of British waters, whose introduction and spread is of high concern. In this study, we use multiple modeling techniques to assess their risk of establishment and spread into Great Britain. Climate suitability maps for these 16 species differed depending on the eastern and western distribution of species in continental Europe, which was related to their respective migration corridor: southern (Danube-Rhine rivers), and northern (Don and Volga rivers and Baltic lakes). Species whose suitability was high across large parts of Great Britain included four gammarids (Cheliorophium robustum, Dikerogammarus bispinosus, D. villosus, and Echinogammarus trichiatus) and a mysid (Hemimysis anomala). A climatic "heat map" combining the results of all 16 species together pointed to the southeast of England as the area most vulnerable to multiple invasions, particularly the Thames, Anglian, Severn, and Humber river basin districts. Regression models further suggested that alkalinity concentration > 120 mg/L in southeast England may favor the establishment of Ponto-Caspian invaders. The production of integrated risk maps for future invaders provides a means for the scientifically informed prioritization of resources toward particular species and geographic regions. Such tools have great utility in helping environmental managers focus efforts on the most effective prevention, management, and monitoring programs.

  5. Cardiovascular risks and elevation of serum DHT vary by route of testosterone administration: a systematic review and meta-analysis.

    Science.gov (United States)

    Borst, Stephen E; Shuster, Jonathan J; Zou, Baiming; Ye, Fan; Jia, Huanguang; Wokhlu, Anita; Yarrow, Joshua F

    2014-11-27

    Potential cardiovascular (CV) risks of testosterone replacement therapy (TRT) are currently a topic of intense interest. However, no studies have addressed CV risk as a function of the route of administration of TRT. Two meta-analyses were conducted, one of CV adverse events (AEs) in 35 randomized controlled trials (RCTs) of TRT lasting 12 weeks or more, and one of 32 studies reporting the effect of TRT on serum testosterone and dihydrotestosterone (DHT). CV risks of TRT: Of 2,313 studies identified, 35 were eligible and included 3,703 mostly older men who experienced 218 CV-related AEs. No significant risk for CV AEs was present when all TRT administration routes were grouped (relative risk (RR) = 1.28, 95% confidence interval (CI): 0.76 to 2.13, P = 0.34). When analyzed separately, oral TRT produced significant CV risk (RR = 2.20, 95% CI: 1.45 to 3.55, P = 0.015), while neither intramuscular (RR = 0.66, 95% CI: 0.28 to 1.56, P = 0.32) nor transdermal (gel or patch) TRT (RR = 1.27, 95% CI: 0.62 to 2.62, P = 0.48) significantly altered CV risk. Serum testosterone/DHT following TRT: Of 419 studies identified, 32 were eligible which included 1,152 men receiving TRT. No significant difference in the elevation of serum testosterone was present between intramuscular or transdermal TRT. However, transdermal TRT elevated serum DHT (5.46-fold, 95% CI: 4.51 to 6.60) to a greater magnitude than intramuscular TRT (2.20-fold, 95% CI: 1.74 to 2.77). Oral TRT produces significant CV risk. While no significant effects on CV risk were observed with either injected or transdermal TRT, the point estimates suggest that further research is needed to establish whether administration by these routes is protective or detrimental, respectively. Differences in the degree to which serum DHT is elevated may underlie the varying CV risk by TRT administration route, as elevated serum dihydrotestosterone has been shown to be associated with CV risk in observational studies.

  6. Prevalence of Elevated Cardiovascular Risks in Young Adults: A Cross-sectional Analysis of National Health and Nutrition Examination Surveys.

    Science.gov (United States)

    Patel, Krishna K; Taksler, Glen B; Hu, Bo; Rothberg, Michael B

    2017-06-20

    The 2013 cholesterol management guidelines from the American College of Cardiology and American Heart Association (ACC/AHA) recommend lipid screening in all adults older than 20 years to identify those at increased risk for atherosclerotic cardiovascular disease (ASCVD). Statins may be considered for patients with elevated 10-year risk (>5%) or a low-density lipoprotein cholesterol (LDL-C) level of 4.92 mmol/L (190 mg/dL) or greater. To describe the prevalence of elevated ASCVD risk among nondiabetic adults younger than 50 years. Cross-sectional. NHANES (National Health and Nutrition Examination Survey), 1999 to 2000 through 2011 to 2012. Adults aged 30 to 49 years without known ASCVD or diabetes. 10-year ASCVD risk was estimated by using the 2013 ACC/AHA ASCVD risk calculator. Participants were subdivided by age, sex, and history of smoking and hypertension. The percentages of adults in each subgroup with a 10-year ASCVD risk greater than 5% and of those with an LDL-C level of 4.92 mmol/L (190 mg/dL) or greater were estimated. Low-prevalence subgroups were defined as those in which a greater than 1% prevalence of elevated cardiovascular risk could be ruled out (that is, the upper 95% confidence bound for prevalence was ≤1%). Overall, 9608 NHANES participants representing 67.9 million adults were included, with approximately half (47.12%, representing 32 million adults) in low-prevalence subgroups. In the absence of smoking or hypertension, 0.09% (95% CI, 0.02% to 0.35%) of adult men younger than 40 years and 0.04% (CI, 0.0% to 0.26%) of adult women younger than 50 years had an elevated risk. Among other subgroups, 0% to 75.9% of participants had an increased risk. Overall, 2.9% (CI, 2.3% to 3.5%) had an LDL-C level of 4.92 mmol/L (190 mg/dL) or greater. No information was available regarding cardiovascular outcomes. In the absence of risk factors, the prevalence of increased ASCVD risk is low among women younger than 50 and men younger than 40 years. None.

  7. Early identification and preventive care for elevated cardiovascular disease risk within a remote Australian Aboriginal primary health care service

    Directory of Open Access Journals (Sweden)

    O'Dea Kerin

    2011-01-01

    Full Text Available Abstract Background Cardiovascular disease (CVD is the single greatest contributor to the gap in life expectancy between Indigenous and non-Indigenous Australians. Our objective is to determine if holistic CVD risk assessment, introduced as part of the new Aboriginal and Torres Strait Islander Adult Health Check (AHC, results in better identification of elevated CVD risk, improved delivery of preventive care for CVD and improvements in the CVD risk profile for Aboriginal adults in a remote community. Methods Interrupted time series study over six years in a remote primary health care (PHC service involving Aboriginal adults identified with elevated CVD risk (N = 64. Several process and outcome measures were audited at 6 monthly intervals for three years prior to the AHC (the intervention and three years following: (i the proportion of guideline scheduled CVD preventive care services delivered, (ii mean CVD medications prescribed and dispensed, (iii mean PHC consultations, (iv changes in participants' CVD risk factors and estimated absolute CVD risk and (v mean number of CVD events and iatrogenic events. Results Twenty-five percent of AHC participants were identified as having elevated CVD risk. Of these, 84% had not been previously identified during routine care. Following the intervention, there were significant improvements in the recorded delivery of preventive care services for CVD (30% to 53%, and prescription of CVD related medications (28% to 89% (P P = 0.004 following the intervention. However, there were no significant changes in the mean number of PHC consultations or mean number of CVD events or iatrogenic events. Conclusions Holistic CVD risk assessment during an AHC can lead to better and earlier identification of elevated CVD risk, improvement in the recorded delivery of preventive care services for CVD, intensification of treatment for CVD, and improvements in participants' CVD risk profile. Further research is required on

  8. Obese adolescents with polycystic ovarian syndrome have elevated cardiovascular disease risk markers.

    Science.gov (United States)

    Patel, Sonali S; Truong, Uyen; King, Martina; Ferland, Annie; Moreau, Kerrie L; Dorosz, Jennifer; Hokanson, John E; Wang, Hong; Kinney, Gregory L; Maahs, David M; Eckel, Robert H; Nadeau, Kristen J; Cree-Green, Melanie

    2017-04-01

    Women with polycystic ovarian syndrome (PCOS) have evidence of subclinical cardiovascular disease (CVD). However, insulin resistance, an important factor in the development of CVD in adults, is common in adolescents with PCOS, yet data in adolescents are limited. Therefore, we sought to measure insulin resistance and CVD markers in obese youth with and without PCOS. Thirty-six PCOS and 17 non-PCOS adolescent girls who were obese, sedentary, and non-hypertensive were recruited from clinics located within the Children's Hospital Colorado. Following 3 days of controlled diet and restricted exercise, fasting plasma samples were obtained prior to a hyperinsulinemic euglycemic clamp. PCOS girls were more insulin resistant than controls (glucose infusion rate 5.24±1.86 mg/kg/min vs 9.10±2.69; p<0.001). Girls with PCOS had blood pressure in the normal range, but had greater carotid intima-media thickness (cIMT) (0.49±0.07 mm vs 0.44±0.06; p=0.038), beta stiffness index (5.1±1.3 U vs 4.4±0.9; p=0.037), and reduced arterial compliance (1.95±0.47 mm 2 /mmHg × 10 -1 vs 2.13±0.43; p=0.047). PCOS girls had a normal mean lipid profile, yet had a more atherogenic lipoprotein cholesterol distribution and had persistent elevations of free fatty acids despite hyperinsulinemia (68±28 μmol/mL vs 41±10; p=0.001), both potential contributors to CVD. Free fatty acid concentrations correlated best with all CVD markers. In summary, adolescent girls with PCOS have greater cIMT and stiffer arteries than girls without PCOS, perhaps related to altered lipid metabolism, even when clinical measures of blood pressure and cholesterol profiles are 'normal'. Therefore, management of adolescent PCOS should include assessment of CVD risk factor development.

  9. Hydrologic Vulnerability and Risk Assessment Associated With the Increased Role of Fire on Western Landscapes, Great Basin, USA

    Science.gov (United States)

    Williams, C. J.; Pierson, F. B.; Robichaud, P. R.; Spaeth, K. E.; Hardegree, S. P.; Clark, P. E.; Moffet, C. A.; Al-Hamdan, O. Z.; Boll, J.

    2010-12-01

    Landscape-scale plant community transitions and altered fire regimes across Great Basin, USA, rangelands have increased the likelihood of post-fire flooding and erosion events. These hazards are particularly concerning for western urban centers along the rangeland urban-wildland interface where natural resources, property, and human life are at risk. Extensive conversion of 4-7 million hectares of Great Basin shrub-steppe to cheatgrass-dominated (Bromus tectorum) grasslands has increased the frequency and size of wildland fires within these ecosystems. Fire frequencies have increased by more than an order of magnitude and occur on 3-10 year intervals across much of the cheatgrass-dominated landscape. Extensive tree (Pinus spp. and Juniperus spp.) encroachment into wooded shrub-steppe has increased heavy fuel loads. Ladder fuels in these ecosystems promote rapidly spreading, high-intensity and severe ground-surface-crown fires. These altered fuel structures across much of the historical Great Basin shrub-steppe have initiated an upsurge in large rangeland wildfires and have increased the spatial and temporal vulnerability of these landscapes to amplified runoff and erosion. Resource and infrastructure damages, and loss of life have been reported due to flooding following recent large-scale burning of western rangelands and dry forests. We present a decade of post-fire rangeland hydrologic research that provides a foundation for conceptual modeling of the hydrologic impacts associated with an increased role of rangeland wildfires. We highlight advancements in predictive tools to address this large-scale phenomenon and discuss vital research voids requiring attention. Our geographic emphasis is the Great Basin Region, however, these concepts likely extend elsewhere given the increased role of fire in many geographic regions and across rangeland-to-forest ecotones in the western United States.

  10. Environmental impacts of the foot and mouth disease outbreak in Great Britain in 2001: the use of risk analysis to manage the risks in the countryside.

    Science.gov (United States)

    Taylor, K C

    2002-12-01

    Restrictions imposed for more than ten months throughout Great Britain in 2001 to control and eradicate foot and mouth disease (FMD) had a damaging effect on tourism and rural businesses. Risk assessment can play a valuable role in ensuring that the action taken is proportionate to the risk, and that countryside activities are allowed to resume when this can be done without compromising the objective of controlling and eradicating the disease. A risk assessment unit was established at the commencement of the epidemic to consider the risks posed by particular activities, to identify ways of managing those risks, and to make recommendations which could be used by policy makers when deciding what action to take. The assessments produced by the unit were published and the scientific rationale which supported policy and procedural changes was thereby exposed to public scrutiny and criticism. The author lists the activities subjected to veterinary risk assessments and describes how the process was used to consider public access to the countryside, leading to policy changes which within nine months resulted in the reopening of more than 96% of footpaths and bridleways without causing new outbreaks of FMD. A completed risk assessment is also included.

  11. June 9-10, 2015: A case study of the Great Plains Low-Level Jet during PECAN (Plains Elevated Convection at Night)

    Science.gov (United States)

    Sullivan, Sharon M.

    Observations as part of the Plains Elevated Convection at Night (PECAN) campaign have allowed for an examination of the thermodynamic and dynamic structure of the LLJ using ground-based and airborne measurements in central Kansas. A shallow jet with wind speeds near 20 m s-1 formed during the nighttime hours on 10 June 2015. The University of Wyoming King Air research aircraft conducted two research flights beginning at sunset and ending near dawn, capturing the full evolution of the LLJ. Each flight included a series of vertical sawtooth maneuvers and isobaric legs along a fixed track at 38.7°N between 98.89°W and 100.3°W. This case featured classic signatures of the LLJ, including but not limited to the inertial oscillation of the ageostrophic wind. Forcing of the LLJ was analyzed using cross sections of D-values that allowed the vertical structure of the horizontal pressure gradient and hence thermal wind to be examined. A series of numerical simulations of the 10 June 2015 case study were made using the Weather Research and Forecasting (WRF) model to compare with observations. Output grids indicated that a temperature gradient of 6°C over 500 km was present between the surface and 850 hPa. Warmer temperatures were found to the west from the surface up to 600 hPa. The 600 hPa geostrophic winds were from the north. As a result, only weak southerly geostrophic winds were able to develop at the surface. The terrain-induced thermal wind was sufficiently large to overcome the adverse pressure gradient in the free atmosphere, but could only produce weak southerly geostrophic winds at the surface of about 11.4 m s-1.

  12. Effects of prescribed burning on marsh-elevation change and the risk of wetland loss

    Science.gov (United States)

    McKee, Karen L.; Grace, James B.

    2012-01-01

    Marsh-elevation change is the net effect of biophysical processes controlling inputs versus losses of soil volume. In many marshes, accumulation of organic matter is an important contributor to soil volume and vertical land building. In this study, we examined how prescribed burning, a common marsh-management practice, may affect elevation dynamics in the McFaddin National Wildlife Refuge, Texas by altering organic-matter accumulation. Experimental plots were established in a brackish marsh dominated by Spartina patens, a grass found throughout the Gulf of Mexico and Atlantic marshes. Experimental plots were subjected to burning and nutrient-addition treatments and monitored for 3.5 years (April 2005 – November 2008). Half of the plots were burned once in 2006; half of the plots were fertilized seasonally with nitrogen, phosphorus, and potassium. Before and after the burns, seasonal measurements were made of soil physicochemistry, vegetation structure, standing and fallen plant biomass, aboveground and belowground production, decomposition, and accretion and elevation change (measured with Surface Elevation Tables (SET)). Movements in different soil strata (surface, root zone, subroot zone) were evaluated to identify which processes were contributing to elevation change. Because several hurricanes occurred during the study period, we also assessed how these storms affected elevation change rates. The main findings of this study were as follows: 1. The main drivers of elevation change were accretion on the marsh surface and subsurface movement below the root zone, but the relative influence of these processes varied temporally. Prior to Hurricanes Gustav and Ike (September 2008), the main driver was subsurface movement; after the hurricane, both accretion and subsurface movement were important. 2. Prior to Hurricanes Gustav and Ike, rates of elevation gain and accretion above a marker horizon were higher in burned plots compared to nonburned plots, whereas

  13. Cluster analyses of 20th century growth patterns in high elevation Great Basin bristlecone pine in the Snake Mountain Range, Nevada, USA

    Science.gov (United States)

    Tran, T. J.; Bruening, J. M.; Bunn, A. G.; Salzer, M. W.; Weiss, S. B.

    2015-12-01

    Great Basin bristlecone pine (Pinus longaeva) is a useful climate proxy because of the species' long lifespan (up to 5000 years) and the climatic sensitivity of its annually-resolved rings. Past studies have shown that growth of individual trees can be limited by temperature, soil moisture, or a combination of the two depending on biophysical setting at the scale of tens of meters. We extend recent research suggesting that trees vary in their growth response depending on their position on the landscape to analyze how growth patterns vary over time. We used hierarchical cluster analysis to examine the growth of 52 bristlecone pine trees near the treeline of Mount Washington, Nevada, USA. We classified growth of individual trees over the instrumental climate record into one of two possible scenarios: trees belonging to a temperature-sensitive cluster and trees belonging to a precipitation-sensitive cluster. The number of trees in the precipitation-sensitive cluster outnumbered the number of trees in the temperature-sensitive cluster, with trees in colder locations belonging to the temperature-sensitive cluster. When we separated the temporal range into two sections (1895-1949 and 1950-2002) spanning the length of the instrumental climate record, we found that most of the 52 trees remained loyal to their cluster membership (e.g., trees in the temperature-sensitive cluster in 1895-1949 were also in the temperature sensitive cluster in 1950-2002), though not without exception. Of those trees that do not remain consistent in cluster membership, the majority changed from temperature-sensitive to precipitation-sensitive as time progressed. This could signal a switch from temperature limitation to water limitation with warming climate. We speculate that topographic complexity in high mountain environments like Mount Washington might allow for climate refugia where growth response could remain constant over the Holocene.

  14. Risk factors of late cardiogenic shock and mortality in ST-segment elevation myocardial infarction patients

    DEFF Research Database (Denmark)

    Obling, Laust; Frydland, Martin; Hansen, Rikke

    2018-01-01

    BACKGROUND: The incidence of cardiogenic shock (CS) in patients with ST-segment elevation myocardial infarction (STEMI) is as high as 10%. The majority of patients are thought to develop CS after admission (late CS), but the incidence in a contemporary STEMI cohort admitted for primary percutaneo...

  15. Towards quantitave ecological risk assessment of elevated carbon dioxide levels in the marine environment

    NARCIS (Netherlands)

    Vries, de P.; Tamis, J.E.; Foekema, E.M.; Klok, T.C.; Murk, A.J.

    2013-01-01

    The environmental impact of elevated carbon dioxide (CO2) levels has become of more interest in recent years. This, in relation to globally rising CO2 levels and related considerations of geological CO2 storage as a mitigating measure. In the present study effect data from literature were collected

  16. Elevating your elevator talk

    Science.gov (United States)

    An important and often overlooked item that every early career researcher needs to do is compose an elevator talk. The elevator talk, named because the talk should not last longer than an average elevator ride (30 to 60 seconds), is an effective method to present your research and yourself in a clea...

  17. Why Different Drought Indexes Show Distinct Future Drought Risk Outcomes in the U.S. Great Plains?

    Science.gov (United States)

    Feng, S.; Hayes, M. J.; Trnka, M.

    2015-12-01

    Vigorous discussions and disagreements about the future changes in drought intensity in the US Great Plains have been taking place recently within the literature. These discussions have involved widely varying estimates based on drought indices and model-based projections of the future. To investigate and understand the causes for such a disparity between these previous estimates, we analyzed 10 commonly-used drought indexes using the output from 26 state-of-the-art climate models. These drought indices were computed using potential evapotranspiration estimated by the physically-based Penman-Monteith method (PE_pm) and the empirically-based Thornthwaite method (PE_th). The results showed that the short-term drought indicators are similar to modeled surface soil moisture and show a small but consistent drying trend in the future. The long-term drought indicators and the total column soil moisture, however, are consistent in projecting more intense future drought. When normalized, the drought indices with PE_th all show unprecedented and possibly unrealistic future drying, while the drought indices with PE_pm show comparable dryness with the modeled soil moisture. Additionally, the drought indices with PE_pm are closely related to soil moisture during both the 20th and 21st Centuries. Overall, the drought indices with PE_pm, as well as the modeled total column soil moisture, suggest a widespread and very significant drying of the Great Plains region toward the end of the Century. Our results suggested that the sharp contracts about future drought risk in the Great Plains discussed in previous studies are caused by 1) comparing the projected changes in short-term droughts with that of the long-term droughts, and/or 2) computing the atmospheric evaporative demand using the empirically-based method (e.g., PE_th). Our analysis may be applied for drought projections in other regions across the globe.

  18. Sarcopenia is a risk factor for elevated aminotransferase in men independently of body mass index, dietary habits, and physical activity.

    Science.gov (United States)

    Yoo, Ki Deok; Jun, Dae Won; Lee, Kang Nyeong; Lee, Hang Lak; Lee, Oh Young; Yoon, Byung Chul; Choi, Ho Soon

    2015-04-01

    Aminotransferase activity is a surrogate marker of liver injury showing strong correlations with obesity and metabolic syndrome. However, elevated aminotransferase activity is not uncommon in non-obese and non-alcoholic patients in clinical practice. To examine the relationship between sarcopenia and aminotransferase activity in a large population-based cohort. Data from the Korean National Health and Nutrition Examinations were used. A total of 13,431 subjects were included. A whole-body dual X-ray absorptiometry scan was performed on each patient to measure total and regional muscle mass. Appendicular skeletal muscle mass indices were also obtained. The prevalence of sarcopenia was significantly higher in the group with elevated aminotransferase levels than in the normal liver enzyme group (males: 26.5% vs. 16.9%; females: 38.3% vs. 22.1%, plevels. The frequency of elevated aminotransferase increased in male patients with sarcopenia after adjusting for potential confounding factors including age, body mass index, fasting glucose level, dietary, and exercise habits. However, the correlation was no longer observed in women after adjusting for body mass index. Sarcopenia is a risk factor for elevated aminotransferase in men, independently of body mass index, dietary habits, and physical activity. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Science Fiction and the Risks of the Anthropocene: Anticipated Transformations in Dale Pendell’s The Great Bay

    Directory of Open Access Journals (Sweden)

    Weik von Mossner, Alexa

    2014-11-01

    Full Text Available Covering the time span from 2021 to 16000 N.C., Dale Pendell’s speculative novel The Great Bay chronicles the profound climatic, geological and ecological transformations that California undergoes during these fourteen millennia. Human life becomes unimaginably small on such a time scale, and Pendell responds to that representational challenge by compiling a wide variety of texts that zero in on individual humans at different points in the future rather than offering a continuous story or central character. In a way, that place is taken by the geographical region that is the focus of the narrative and gives the book its title. Timothy Morton has argued that because we live in the Anthropocene we can no longer understand history as exclusively human. Pendell’s “Chronicle of the Collapse” suggests that the same is true for storytelling, offering readers the story of a nonhuman protagonist that changes slowly over time. The result is a highly fragmented narrative that is interesting for what it tries to achieve but at the same time remarkably unengaging. In its distant and distanced rendering of future ecological change and human anguish, The Great Bay is a grave reminder not only of the incalculable risks of the Anthropocene, but also of the basic tenets of realist storytelling.

  20. Sector model analysis of risk on cross-jurisdictional treatment of disaster waste related to the Great East Japan Earthquake

    International Nuclear Information System (INIS)

    Nagashima, Miori; Itokawa, Etsuko; Ozuka, Yohei

    2012-01-01

    This study addressed the controversial issue of disaster waste treatment in the reconstruction efforts following the Great East Japan Earthquake. Using the Sector Model (Matsumoto 2009), we categorized a range of actions taken in relation to the cross-jurisdictional treatment into the four sectors, government, industry, academia, and private. The analysis through this Sector Model made it possible to map the entire layout of waste treatment, inclusive of less-visible industry and academia sectors. Accordingly, we have argued that differences of risk awareness are not necessarily due to sector differences but rather depend on two aspects of the disaster waste treatment; the safety levels and the nationwide treatment of waste in Japan. We further suggest that the discrepancy in the arguments on safety levels emerged as a result of scientific under-determination and cross-jurisdictional treatment from social and/or political under-determination. (author)

  1. Great Lakes

    Science.gov (United States)

    Edsall, Thomas A.; Mac, Michael J.; Opler, Paul A.; Puckett Haecker, Catherine E.; Doran, Peter D.

    1998-01-01

    The Great Lakes region, as defined here, includes the Great Lakes and their drainage basins in Minnesota, Wisconsin, Illinois, Indiana, Ohio, Pennsylvania, and New York. The region also includes the portions of Minnesota, Wisconsin, and the 21 northernmost counties of Illinois that lie in the Mississippi River drainage basin, outside the floodplain of the river. The region spans about 9º of latitude and 20º of longitude and lies roughly halfway between the equator and the North Pole in a lowland corridor that extends from the Gulf of Mexico to the Arctic Ocean.The Great Lakes are the most prominent natural feature of the region (Fig. 1). They have a combined surface area of about 245,000 square kilometers and are among the largest, deepest lakes in the world. They are the largest single aggregation of fresh water on the planet (excluding the polar ice caps) and are the only glacial feature on Earth visible from the surface of the moon (The Nature Conservancy 1994a).The Great Lakes moderate the region’s climate, which presently ranges from subarctic in the north to humid continental warm in the south (Fig. 2), reflecting the movement of major weather masses from the north and south (U.S. Department of the Interior 1970; Eichenlaub 1979). The lakes act as heat sinks in summer and heat sources in winter and are major reservoirs that help humidify much of the region. They also create local precipitation belts in areas where air masses are pushed across the lakes by prevailing winds, pick up moisture from the lake surface, and then drop that moisture over land on the other side of the lake. The mean annual frost-free period—a general measure of the growing-season length for plants and some cold-blooded animals—varies from 60 days at higher elevations in the north to 160 days in lakeshore areas in the south. The climate influences the general distribution of wild plants and animals in the region and also influences the activities and distribution of the human

  2. The impact of the Great Recession on health-related risk factors, behaviour and outcomes in England.

    Science.gov (United States)

    Jofre-Bonet, Mireia; Serra-Sastre, Victoria; Vandoros, Sotiris

    2018-01-01

    This paper examines the impact that the Great Recession had on individuals' health behaviours and risk factors such as diet choices, smoking, alcohol consumption, and Body Mass Index, as well as on intermediate health outcomes in England. We exploit data on about 9000 households from the Health Survey for England for the period 2001-2013 and capture the change in macroeconomic conditions using regional unemployment rates and an indicator variable for the onset of the recession. Our findings indicate that the recession is associated with a decrease in the number of cigarettes smoked - which translated into a moderation in smoking intensity - and a reduction in alcohol intake. The recession indicator itself is associated with a decrease in fruit intake, a shift of the BMI distribution towards obesity, an increase in medicines consumption, and the likelihood of suffering from diabetes and mental health problems. These associations are often stronger for the less educated and for women. When they exist, the associations with the unemployment rate (UR) are nevertheless similar before and after 2008. Our results suggest that some of the health risks and intermediate health outcomes changes may be due to mechanisms not captured by worsened URs. We hypothesize that the uncertainty and the negative expectations generated by the recession may have influenced individual health outcomes and behaviours beyond the adjustments induced by the worsened macroeconomic conditions. The net effect translated into the erosion of the propensity to undertake several health risky behaviours but an exacerbation of some morbidity indicators. Overall, we find that the recession led to a moderation in risky behaviours but also to worsening of some risk factors and health outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Elevated hemostasis markers after pneumonia increases one-year risk of all-cause and cardiovascular deaths.

    Science.gov (United States)

    Yende, Sachin; D'Angelo, Gina; Mayr, Florian; Kellum, John A; Weissfeld, Lisa; Kaynar, A Murat; Young, Tammy; Irani, Kaikobad; Angus, Derek C

    2011-01-01

    Acceleration of chronic diseases, particularly cardiovascular disease, may increase long-term mortality after community-acquired pneumonia (CAP), but underlying mechanisms are unknown. Persistence of the prothrombotic state that occurs during an acute infection may increase risk of subsequent atherothrombosis in patients with pre-existing cardiovascular disease and increase subsequent risk of death. We hypothesized that circulating hemostasis markers activated during CAP persist at hospital discharge, when patients appear to have recovered clinically, and are associated with higher mortality, particularly due to cardiovascular causes. In a cohort of survivors of CAP hospitalization from 28 US sites, we measured D-Dimer, thrombin-antithrombin complexes [TAT], Factor IX, antithrombin, and plasminogen activator inhibitor-1 at hospital discharge, and determined 1-year all-cause and cardiovascular mortality. Of 893 subjects, most did not have severe pneumonia (70.6% never developed severe sepsis) and only 13.4% required intensive care unit admission. At discharge, 88.4% of subjects had normal vital signs and appeared to have clinically recovered. D-dimer and TAT levels were elevated at discharge in 78.8% and 30.1% of all subjects, and in 51.3% and 25.3% of those without severe sepsis. Higher D-dimer and TAT levels were associated with higher risk of all-cause mortality (range of hazard ratios were 1.66-1.17, p = 0.0001 and 1.46-1.04, p = 0.001 after adjusting for demographics and comorbid illnesses) and cardiovascular mortality (p = 0.009 and 0.003 in competing risk analyses). Elevations of TAT and D-dimer levels are common at hospital discharge in patients who appeared to have recovered clinically from pneumonia and are associated with higher risk of subsequent deaths, particularly due to cardiovascular disease.

  4. Elevated hemostasis markers after pneumonia increases one-year risk of all-cause and cardiovascular deaths.

    Directory of Open Access Journals (Sweden)

    Sachin Yende

    Full Text Available Acceleration of chronic diseases, particularly cardiovascular disease, may increase long-term mortality after community-acquired pneumonia (CAP, but underlying mechanisms are unknown. Persistence of the prothrombotic state that occurs during an acute infection may increase risk of subsequent atherothrombosis in patients with pre-existing cardiovascular disease and increase subsequent risk of death. We hypothesized that circulating hemostasis markers activated during CAP persist at hospital discharge, when patients appear to have recovered clinically, and are associated with higher mortality, particularly due to cardiovascular causes.In a cohort of survivors of CAP hospitalization from 28 US sites, we measured D-Dimer, thrombin-antithrombin complexes [TAT], Factor IX, antithrombin, and plasminogen activator inhibitor-1 at hospital discharge, and determined 1-year all-cause and cardiovascular mortality.Of 893 subjects, most did not have severe pneumonia (70.6% never developed severe sepsis and only 13.4% required intensive care unit admission. At discharge, 88.4% of subjects had normal vital signs and appeared to have clinically recovered. D-dimer and TAT levels were elevated at discharge in 78.8% and 30.1% of all subjects, and in 51.3% and 25.3% of those without severe sepsis. Higher D-dimer and TAT levels were associated with higher risk of all-cause mortality (range of hazard ratios were 1.66-1.17, p = 0.0001 and 1.46-1.04, p = 0.001 after adjusting for demographics and comorbid illnesses and cardiovascular mortality (p = 0.009 and 0.003 in competing risk analyses.Elevations of TAT and D-dimer levels are common at hospital discharge in patients who appeared to have recovered clinically from pneumonia and are associated with higher risk of subsequent deaths, particularly due to cardiovascular disease.

  5. Asian dust storm elevates children's respiratory health risks: a spatiotemporal analysis of children's clinic visits across Taipei (Taiwan.

    Directory of Open Access Journals (Sweden)

    Hwa-Lung Yu

    Full Text Available Concerns have been raised about the adverse impact of Asian dust storms (ADS on human health; however, few studies have examined the effect of these events on children's health. Using databases from the Taiwan National Health Insurance and Taiwan Environmental Protection Agency, this study investigates the documented daily visits of children to respiratory clinics during and after ADS that occurred from 1997 to 2007 among 12 districts across Taipei City by applying a Bayesian structural additive regressive model controlled for spatial and temporal patterns. This study finds that the significantly impact of elevated children's respiratory clinic visits happened after ADS. Five of the seven lagged days had increasing percentages of relative rate, which was consecutively elevated from a 2-day to a 5-day lag by 0.63%∼2.19% for preschool children (i.e., 0∼6 years of age and 0.72%∼3.17% for school children (i.e., 7∼14 years of age. The spatial pattern of clinic visits indicated that geographical heterogeneity was possibly associated with the clinic's location and accessibility. Moreover, day-of-week effects were elevated on Monday, Friday, and Saturday. We concluded that ADS may significantly increase the risks of respiratory diseases consecutively in the week after exposure, especially in school children.

  6. Geologic and Geophysicsal Studies of Natural Hazards and Risks in the Gulf of Peter the Great, Japan Sea

    Science.gov (United States)

    Anokhin, Vladimir; Shcherbakov, Viktor; Motychko, Viktor; Slinchenkov, Vladimir; Sokolov, Georgy; Kotov, Sergey; Kartashov, Sergey

    2013-04-01

    geological zoning, map of the major hydro- and lithodynamic processes, hydraulic and geochemical maps and sections, seismotectonic map, map of endogenous geodynamics map exogenous geological processes, map assess the overall geo-ecological situations etc. As a result of the first stage of these studies we identified the following significant hazards and risks faced by the region: 1. Seismic hazards - along seismoactivity faults in the region. 2. Tsunami hasards in the coasts of Amursky, Ussuriysky and other gulf of the region. 3. Destruction of shore, including landslides, in many littoral zones of the region. 4. Avalanche sedimentation in Amursky, Ussuriysky gulfs. 5. Gas emissions in bottom of the shelf zone. 6. Industrial pollution in aquatories near industrial centres. Estimation of hazards and risks in the Gulf of Peter the Great will be continued.

  7. Tensor-based morphometry of cannabis use on brain structure in individuals at elevated genetic risk of schizophrenia.

    Science.gov (United States)

    Welch, K A; Moorhead, T W; McIntosh, A M; Owens, D G C; Johnstone, E C; Lawrie, S M

    2013-10-01

    Schizophrenia is associated with various brain structural abnormalities, including reduced volume of the hippocampi, prefrontal lobes and thalami. Cannabis use increases the risk of schizophrenia but reports of brain structural abnormalities in the cannabis-using population have not been consistent. We used automated image analysis to compare brain structural changes over time in people at elevated risk of schizophrenia for familial reasons who did and did not use cannabis. Magnetic resonance imaging (MRI) scans were obtained from subjects at high familial risk of schizophrenia at entry to the Edinburgh High Risk Study (EHRS) and approximately 2 years later. Differential grey matter (GM) loss in those exposed (n=23) and not exposed to cannabis (n=32) in the intervening period was compared using tensor-based morphometry (TBM). Cannabis exposure was associated with significantly greater loss of right anterior hippocampal (pcorrected=0.029, t=3.88) and left superior frontal lobe GM (pcorrected=0.026, t=4.68). The former finding remained significant even after the exclusion of individuals who had used other drugs during the inter-scan interval. Using an automated analysis of longitudinal data, we demonstrate an association between cannabis use and GM loss in currently well people at familial risk of developing schizophrenia. This observation may be important in understanding the link between cannabis exposure and the subsequent development of schizophrenia.

  8. Maternal exposure to childhood abuse is associated with elevated risk of autism

    Science.gov (United States)

    Roberts, Andrea L.; Lyall, Kristen; Rich-Edwards, Janet W.; Ascherio, Alberto; Weisskopf, Marc G.

    2014-01-01

    Context Adverse perinatal circumstances have been associated with increased risk of autism. Women exposed to childhood abuse experience more adverse perinatal circumstances than women unexposed, but whether abuse is associated with autism in offspring is unknown. Objective To determine whether maternal exposure to childhood abuse is associated with risk of autism, and whether possible increased risk is accounted for by higher prevalence of adverse perinatal circumstances among abused women, including gestational diabetes, preeclampsia, selective serotonin reuptake inhibitor use, intimate partner abuse, prior abortion, pregnancy less than 37 weeks, low birth weight, alcohol use, and smoking during pregnancy. Design and Setting Nurses’ Health Study II, a population-based longitudinal cohort of 116,430 women. Patients or Other Participants Participants with data on childhood abuse and child’s autism status (97% White). Controls were randomly selected from among children of women who did not report autism in offspring (N mothers of children with autism = 451; N mothers of children without autism=52,498). Main Outcome Measure Autism spectrum disorder, assessed by maternal report, validated with the Autism Diagnostic Interview-Revised in a subsample. Results Exposure to abuse was associated with increased risk of autism in children in a monotonically increasing fashion. The highest level of abuse was associated with the greatest prevalence of autism (1.8% versus 0.7% in women not abused, P = 0.005) and the greatest risk for autism adjusted for demographic factors (risk ratio=3.7, 95% confidence interval=2.3, 5.8). All adverse perinatal circumstances were more prevalent in women abused except low birth weight. Adjusted for perinatal factors, the association of maternal abuse with autism was slightly attenuated (highest level of abuse, risk ratio = 3.0, 95% confidence interval=1.9, 4.9). Conclusions We identify an intergenerational association between childhood

  9. Elevated blood pressure and its associated risk factors among adolescents of a North Indian City - A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Senthamizh Prasad

    2017-01-01

    Full Text Available Context: Amidst the uncertainty in childhood blood pressure (BP thresholds, besides the ambiguity in levels and duration of BP elevation causing organ damage, hypertension is present in substantial number of asymptomatic children and adolescents with only a few studies disclosing the setup. With projection of deaths due to noncommunicable diseases in 2030 rising to 52 million, it is necessary to know about the knowledge of present adolescents about BP and its modifiable risk factors. Aims: (1 To assess the prevalence of elevated BP among adolescents and to ascertain the associated risk factors. (2 To assess adolescent's knowledge about BP and its modifiable factors. Settings and Design: A community-based cross-sectional study was conducted on school going adolescents of Lucknow, from September 2014 to August 2015. Subjects and Methods: BP, height, and weight were measured following standard protocols, Centers for Disease Control and Prevention charts for finding respective cut-off values and oral questionnaire for assessing lifestyle risk factors were used. Statistical Analysis: Chi-square, unpaired t-test, and logistic regression were used. Results: Of the 1041 participants, elevated BP (BP percentile ≥90 was prevalent in 24.2%. On regression, factors such as obesity (adjusted odds ratio [aOR] = 5.8, 95% confidence interval [CI] = 3.6–9.4, low fruit diet (aOR = 3.3, 95% CI = 2.1–5.4, and frequent junk food consumption (aOR = 1.9, 95% CI = 1.3–2.8 raised the odds of elevated BP while it was lowered by being physically active (aOR = 0.67, 95% CI = 0.46–0.97. Of 86.3% of children (n = 898 who were fathomed of BP, only less than third (33% and 21.9% acquainted of BP raising and lowering practices, respectively. Conclusions: Prevalence of high BP is colossal with only a few children knowing its amendable nature. Strenuous efforts targeting detrimental behaviors and imparting the sense of healthy lifestyle enhancing practices are vital to

  10. Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk.

    Science.gov (United States)

    Tisher, Kristen; Mann, Kimberly; VanDyke, Sarah; Johansson, Charity; Vallabhajosula, Srikant

    2018-03-05

    Supervised balance training shows immediate benefit for older adults at fall risk. The long-term effectiveness of such training can be enhanced by implementing a safe and simple home exercise program (HEP). We investigated the effects of a12-week unsupervised HEP following supervised clinic-based balance training on functional mobility, balance, fall risk, and gait. Six older adults with an elevated fall risk obtained an HEP and comprised the HEP group (HEPG) and five older adults who were not given an HEP comprised the no HEP group (NoHEPG). The HEP consisted of three static balance exercises: feet-together, single-leg stance, and tandem. Each exercise was to be performed twice for 30-60 s, once per day, 3 days per week for 12 weeks. Participants were educated on proper form, safety, and progression of exercises. Pre- and post-HEP testing included Berg Balance Scale (BBS), Timed Up and Go, Short Physical Performance Battery (SPPB) assessments, Activities-Balance Confidence, Late-Life Functional Disability Instrument and instrumented assessments of balance and gait (Limits of Stability, modified Clinical Test of Sensory Interaction on Balance, Gait). A healthy control group (HCG; n = 11) was also tested. For most of the measures, the HEPG improved to the level of HCG. Though task-specific improvements like BBS and SPPB components were seen, the results did not carry over to more dynamic assessments. Results provide proof of concept that a simple HEP can be independently implemented and effective for sustaining and/or improving balance in older adults at elevated fall-risk after they have undergone a clinic-based balance intervention.

  11. High levels of vitamin D in relation to reduced risk of schizophrenia with elevated C-reactive protein.

    Science.gov (United States)

    Zhu, Dao-min; Liu, Yong; Zhang, Ai-guo; Chu, Zhao-xue; Wu, Qing; Li, Hui; Ge, Jin-fang; Dong, Yi; Zhu, Peng

    2015-08-30

    There is growing evidence on the novel role of vitamin D in reducing inflammation. This study aimed to examine the hypothesis that vitamin D is inversely associated with C-reactive protein (CRP) in patients with schizophrenia, and high levels of vitamin D may be linked to reduced risk of schizophrenia with elevated CRP. Ninety-three patients with schizophrenia and 93 family-matched controls were recruited in this cross-sectional study. Plasma concentrations of CRP and 25-hydroxyvitamin D [25(OH)D] were measured using commercial kits. Information about demographic characteristics and clinic data were obtained by interviews or medical records. Mean levels of CRP and 25(OH)D were 43.3% higher and 26.7% lower for patients compared to controls, respectively. 25(OH)D were inversely associated with CRP in the patients, but not in the controls. The proportions of patients significantly increased with increasing quartiles of CRP, while significantly decreased with increasing quartiles of 25(OH)D. Among individuals with high CRP, participants with high 25(OH)D have significantly lower proportion (adjusted OR =0.217, 95% CI 0.063, 0.751) of schizophrenia compared to those with low 25(OH)D. The evidence suggested that high levels of vitamin D may be linked to reduced risk of schizophrenia with elevated CRP. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Hepatic lipase, genetically elevated high-density lipoprotein, and risk of ischemic cardiovascular disease

    DEFF Research Database (Denmark)

    Johannsen, Trine Holm; Kamstrup, Pia R; Andersen, Rolf V

    2008-01-01

    73M, N193S, S267F, L334F, T383M, and -480c>t influence levels of lipids, lipoproteins, and apolipoproteins and risk of ICD. DESIGN: For the cross-sectional study, we genotyped 9003 individuals from the Copenhagen City Heart Study; hereof were 8971 individuals included in the prospective study, 1747...

  13. Dyslipidemias and Elevated Cardiovascular Risk on Lopinavir-Based Antiretroviral Therapy in Cambodia

    Science.gov (United States)

    Ly, Sowath; Ouk, Vara; Chanroeurn, Hak; Thavary, Saem; Boroath, Ban; Canestri, Ana; Viretto, Gérald; Delfraissy, Jean-François; Ségéral, Olivier

    2016-01-01

    Background Lopinavir/ritonavir (LPV/r) is widely used in Cambodia with high efficacy but scarce data exist on long-term metabolic toxicity. Methods We carried out a cross-sectional and retrospective study evaluating metabolic disorders and cardiovascular risk in Cambodian patients on LPV/r-based antiretroviral therapy (ART) for > 1 year followed in Calmette Hospital, Phnom Penh. Data collected included cardiovascular risk factors, fasting blood lipids and glucose, and retrospective collection of bioclinical data. We estimated the 10-year risks of coronary heart disease with the Framingham, Ramathibodi-Electricity Generating Authority of Thailand (Rama-EGAT), and the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) risk equations. We identified patients with LDL above targets defined by the French expert group on HIV and by the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group (IDSA-AACTG). Results Of 115 patients enrolled—mean age 40.9 years, 69.2% male, mean time on LPV/r 3.8 years—40 (34.8%) had hypercholesterolemia (> 2.40 g/L), and 69 (60.0%) had low HDL cholesterol (dyslipidemia was high in this cohort of HIV-infected Cambodian patients on LPV/r. Roughly one third had high LDL levels requiring specific intervention. PMID:27579612

  14. Elevated Bathing-Associated Disease Risks Despite Certified Water Quality: A Cohort Study

    Directory of Open Access Journals (Sweden)

    Christos Hadjichristodoulou

    2012-04-01

    Full Text Available Bacteriological water quality criteria have been recommended to ensure bathers’ health. However, this risk-assessment approach is based mainly on routine measurements of fecal pollution indicator bacteria in seawater, and may not be adequate to protect bathers effectively. The aim of this study was to assess the risks of symptoms related to infectious diseases among bathers after exposure to seawater which was of excellent quality according to EU guidelines. This study is a cohort study recruiting bathers and non-bathers. Water samples were collected for estimating bacterial indicators. Univariable and multivariable analysis was performed to compare the risks of developing symptoms/diseases between bathers and non-bathers. A total of 3805 bathers and 572 non-bathers were included in the study. Water analysis results demonstrated excellent quality of bathing water. Significantly increased risks of symptoms related to gastrointestinal infections (OR = 3.60, 95% CI 1.28–10.13, respiratory infections (OR = 1.92, 95% CI 1.00–3.67, eye infections (OR = 2.43, 95% CI 1.27–4.63 and ear infections (OR = 17.21, 95% CI 2.42–122.34 were observed among bathers compared with non-bathers. Increased rates of medical consultation and medication use were also observed among bathers. There was evidence that bathers experienced increased morbidity compared with non-bathers though the bathing waters met bacteriological water quality criteria. These results suggest that risk assessments of recreational seawaters should not only focus on bacteriological water quality criteria.

  15. Risk of Microgravity-Induced Visual Impairment and Elevated Intracranial Pressure (VIIP)

    Science.gov (United States)

    Otto, Christian

    2011-01-01

    Eight cases identified, represent 23.5% of the 34 crewmembers flown on the ISS, with inflight visual changes and pre-to-postflight refractive changes. In some cases, the changes were transient while in others they are persistent with varying degrees of visual impairment. (1) Decreased intraocular pressure (IOP) postflight was observed in 3 cases. (2) Fundoscopic exams revealed postflight findings of choroidal folds in 4 cases, optic disc edema in 5 cases and presence of cotton wool spots in 3 cases. (3) Optical coherence tomography (OCT) confirmed findings of choroidal folds and disc edema and documented retinal nerve fiber layer thickening (4 cases). (4) Findings from MRI examinations showed posterior globe flattening (5 cases) and optic nerve sheath distension (6 cases). (5) Opening cerebrospinal fluid (CSF) pressure was elevated in 4 cases postflight reflecting raised intracranial pressure. While the etiology remains unknown, hypotheses speculate that venous insufficiency or hypertension in the brain caused by cephalad fluid shifts during spaceflight are possible mechanisms for ocular changes in astronauts.

  16. Elevated fasting insulin levels increase the risk of abdominal obesity in Korean men.

    Science.gov (United States)

    Park, Sung Keun; Oh, Chang-Mo; Jung, Taegi; Choi, Young-Jun; Chung, Ju Youn; Ryoo, Jae-Hong

    2017-04-01

    This study was designed to investigate whether an elevated fasting insulin level predicts abdominal obesity. A cohort study was conducted with 13,707 non-obese Korean men. They were categorized into 4 groups according to the quartile of fasting insulin level, and followed up from 2005 to 2010. Incidence rates of obesity were compared among the 4 groups during follow-up, and a Cox proportional hazards model was used to calculate hazard ratios (HRs) for abdominal obesity according to fasting insulin level. The overall incidence rate of obesity was 16.2%, but the rate increased in proportion to the fasting insulin level (quartiles 1-4: 9.8%, 12.4%, 16.9%, 25.5%, Pobesity increased proportionally to baseline fasting insulin level in an unadjusted model. However, after adjustment for covariates, including baseline waist circumference (WC), only in the quartile 4 group was the statistical significance of the association maintained [quartile 2-4; abdominal obesity: 0.89 (0.76-1.02), 1.00 (0.86-1.14) and 1.24 (1.08-1.43), P for trend obesity was highest in the group with the highest fasting insulin levels, an overall proportional relationship between fasting insulin level and incident abdominal obesity was not found. Additionally, this association was largely accounted for by baseline WC. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Reducing the risk of ventilator-acquired pneumonia through head of bed elevation.

    Science.gov (United States)

    Keeley, Libby

    2007-01-01

    It has been suggested that placing critically ill ventilated patients in a semirecumbent position minimizes the likelihood of nosocomial pneumonia. This pilot study explores whether the incidence of ventilator-acquired pneumonia (VAP) can be reduced by elevating the head of the bed to 45 degrees. The design is quantitative in nature, using a randomized controlled trial. The method involves adult ventilated patients being randomly assigned to one of two positions, i.e. 45 degrees raised head of bed (treatment group) or 25 degrees raised head of bed (control group). Data collection relied upon the diagnosis of clinically suspected and microbiologically confirmed pneumonia defined by the Consensus Conference on VAP. Thirty patients were included in the study--17 in the treatment group and 13 in the control group. Results showed that 29% (five) in the treatment group and 54% (seven) in the control group contracted VAP (P VAP in the patients nursed at 45 degrees. However, because of the sample size this difference did not reach statistical significance.

  18. A partner-related risk behavior index to identify people at elevated risk for sexually transmitted infections.

    Science.gov (United States)

    Crosby, Richard; Shrier, Lydia A

    2013-04-01

    The purpose of this study was to develop and test a sexual-partner-related risk behavior index to identify high-risk individuals most likely to have a sexually transmitted infection (STI). Patients from five STI and adolescent medical clinics in three US cities were recruited (N = 928; M age = 29.2 years). Data were collected using audio-computer-assisted self-interviewing. Of seven sexual-partner-related variables, those that were significantly associated with the outcomes were combined into a partner-related risk behavior index. The dependent variables were laboratory-confirmed infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. Nearly one-fifth of the sample (169/928; 18.4%) tested positive for an STI. Three of the seven items were significantly associated with having one or more STIs: sex with a newly released prisoner, sex with a person known or suspected of having an STI, and sexual concurrency. In combined form, this three-item index was significantly associated with STI prevalence (p one or more of three STIs. This index could be used to prioritize and guide intensified clinic-based counseling for high-risk patients of STI and other clinics.

  19. Neighborhood level health risk assessment of lead paint removal activities from elevated steel bridges

    Energy Technology Data Exchange (ETDEWEB)

    Conway, R.F.; Cohen, J.T.; Bowers, T.

    1999-07-01

    The New York City Department of Transportation (NYCDOT) has adopted strict containment and monitoring procedures during paint removal activities on its bridges because of the increasing awareness about lead poisoning in children in urban environments and the potential risk of lead-based paint releases during those activities. NYCDOT owns nearly 800 bridges scattered throughout New York City. Before undertaking paint removal activities as part of its ongoing preventive maintenance and rehabilitation program, NYCDOT recently conducted an analysis to determine the public health risk posed to children living near them. The analysis the first of its kind to assess the actual public health risk potential during both routine operations and upset conditions, or accidental releases evaluated the total and incremental blood lead levels from paint removal activities on more than 5,000 children from 6 months to 6 years old. Increases in baseline blood lead levels were estimated using several models, including EPA's Integrated Exposure Uptake Biokinetic (IEUBK) Model. This model estimates steady-state blood lead levels in children, reflecting exposure to lead in multiple media over an extended period of time. Increases in lead exposure from paint removal activities in the area surrounding the bridges was estimated using EPA's Industrial Source Complex (ISC3) model to calculate ambient air and deposition levels. Potential releases from the containment and ancillary equipment used in the paint removal process were modeled based on different release scenarios ranging from routine operations to complete failure of containment. To estimate the paint removal activities' contribution to long-term exterior dust lead levels (and its related interior component), a stochastic simulation model was developed for each block in the study area.

  20. Genetic Analysis of Elevated Mastitis Risk Based on Mastitis Indicator Data

    DEFF Research Database (Denmark)

    Sørensen, Lars Peter; Løvendahl, Peter

    Whole-genome sequences and multiple trait phenotypes from large numbers of individuals will soon be available. Well established statistical modeling approaches enable the genetic analyses of complex trait phenotypes while accounting for a variety of additive and non-additive genetic mechanisms....... These modeling approaches have proven to be highly useful to determine population genetic parameters as well as prediction of genetic risk or value. We present statistical modelling approaches that use prior biological information for evaluating the collective action of sets of genetic variants. We have applied...

  1. Salutary effects of high-intensity interval training in persons with elevated cardiovascular risk.

    Science.gov (United States)

    Fleg, Jerome L

    2016-01-01

    Although moderate-intensity continuous training (MICT) has been the traditional model for aerobic exercise training for over four decades, a growing body of literature has demonstrated equal if not greater improvement in aerobic capacity and similar beneficial effects on body composition, glucose metabolism, blood pressure, and quality of life from high-intensity interval training (HIIT). An advantage of HIIT over MICT is the shorter time required to perform the same amount of energy expenditure. The current brief review summarizes the effects of HIIT on peak aerobic capacity and cardiovascular risk factors in healthy adults and those with various cardiovascular diseases, including coronary artery disease, chronic heart failure, and post heart transplantation.

  2. Mutual mortality of great horned owl and southern black racer: a potential risk of raptors preying on snakes

    Science.gov (United States)

    Roger W. Perry; Raymond E. Brown; D. Craig Rudolph

    2001-01-01

    We encountered a dead southern black racer snake (Coluber constrictor priapus) coiled around a dead Great Horned Owl (Bubo virginianus). We suggest the owl was strangled by the snake before the snake did of wounds inflicted by the owl. There are previous reports of intense physical struggle between Great Horned Owls (and...

  3. Elevation of isoprostanes in polycystic ovary syndrome and its relationship with cardiovascular risk factors.

    Science.gov (United States)

    Calzada, M; López, N; Noguera, J A; Mendiola, J; Torres, A M

    2018-04-23

    To evaluate the plasma level of 8-isoprostanes in women with polycystic ovary syndrome. To also investigate whether there is a relationship between 8-isoprostanes and several cardiovascular risk factors. A total of 125 women with polycystic ovary syndrome and 169 healthy women were enrolled in this case-control study. 8-Isoprostanes and different parameters were measured in all subjects. Patients were evaluated for the presence of polycystic ovary syndrome according to the Rotterdam Consensus Conference criteria. 8-Isoprostanes levels were significantly higher in patients with polycystic ovary syndrome (138.4 ± 104.1 pg/mL) compared with control group (68.6 ± 34.3 pg/mL) (p polycystic ovary syndrome patients with high 8-isoprostanes than those with normal 8-isoprostanes (p polycystic ovary syndrome group had a positive correlation with waist circumference, triglycerides, low-density lipoprotein cholesterol, apolipoprotein B, homocysteine, insulin, homeostatic model assessment for insulin resistance. Patients with polycystic ovary syndrome have higher 8-isoprostanes levels and it is associated with several cardiovascular risk factors.

  4. A novel measure of poverty and its association with elevated sexual risk behavior among young Black MSM.

    Science.gov (United States)

    Mena, Leandro; Crosby, Richard A; Geter, Angelica

    2017-05-01

    This study determined whether a novel (single-item) measure of poverty is associated with elevated sexual risk among young Black men who have sex with men who reside in a US city with high HIV seroprevalence. A convenience sample of 600 Black men who have sex with men (ages 16-29) completed a computer-assisted self-interview. The questionnaire included an item asking men, 'In the past 12 months have you missed meals because you did not have enough money to eat?' Selected measures of sexual risk and prevalence of chlamydia, gonorrhea, and HIV were assessed as outcomes of this novel measure of poverty. About 22% had missed meals due to lack of money. In age-adjusted analyses, these men were more likely to report: (1) having concurrent sex partners ( P = .03), (2) having sex with partners who were generally five or more years older ( P = .02), (3) not using condoms the first time they had sex with their most recent new partner ( P = .015), (4) having sex with persons not known by name ( P = .02), (5) depending on sex partners for food, money, and shelter ( P poverty may be predictive of many sexual risk behaviors. Clinicians may benefit this population by including this question as part of their patient interview and prioritizing services when indicated.

  5. Elevated serum advanced glycation endproducts in obese indicate risk for the metabolic syndrome: a link between healthy and unhealthy obesity?

    Science.gov (United States)

    Uribarri, Jaime; Cai, Weijing; Woodward, Mark; Tripp, Elizabeth; Goldberg, Laurie; Pyzik, Renata; Yee, Kalle; Tansman, Laurie; Chen, Xue; Mani, Venkatesh; Fayad, Zahi A; Vlassara, Helen

    2015-05-01

    Although obesity can predispose to the metabolic syndrome (MS), diabetes, and cardiovascular disease, not all obese subjects develop MS, hence the need for new indicators of risk for this syndrome. Advanced glycation end products (AGEs) correlate with factors involved in the MS, including inflammation and insulin resistance (IR). Because AGEs can be derived from food and are modifiable, it is important to determine whether they are a risk factor for MS. The objective of this study was to assess the association of endogenous and exogenous AGEs with MS criteria. The following data were collected in a cross-sectional study of subjects with and without the MS: serum AGEs (sAGEs) and mononuclear cell AGEs, metabolites, pro- and antiinflammatory markers, body fat mass measures, including abdominal magnetic resonance imaging, and caloric and dietary AGE (dAGE) consumption. The study was conducted in the general community. Participants included 130 MS and 139 non-MS subjects of both sexes, older than 50 years. sAGEs ((ϵ)N-carboxymethyllysine, methylglyoxal) were markedly elevated in obese persons with more than one other MS criteria but not in obese without MS criteria. sAGEs directly correlated with markers of IR (HOMA) and inflammation (leptin, TNFα, RAGE) and inversely with innate defenses (SIRT1, AGE receptor 1 [AGER1], glyoxalase-I, adiponectin). sAGEs correlated with dAGEs but not with calories, nutrient consumption, or fat mass measures. Consumption of dAGE, but not of calories, was markedly higher in MS than in non-MS. High sAGEs, a modifiable risk factor for IR, may indicate risk for the MS, type 2 diabetes, and cardiovascular disease. High dietary AGE consumption and serum AGE levels may link healthy obesity to at-risk obesity.

  6. Elevated corticotropin releasing hormone (CRH) during pregnancy and risk of postpartum depression (PPD).

    Science.gov (United States)

    Meltzer-Brody, Samantha; Stuebe, Alison; Dole, Nancy; Savitz, David; Rubinow, David; Thorp, John

    2011-01-01

    Perinatal depression has a prevalence of 10% with devastating consequences for mother and baby. The prospective identification of those at risk for postpartum (PPD) or prenatal (PND) depression has led to biomarker searches in pregnancy. There are conflicting reports of associations between midpregnancy placental CRH (pCRH) and PPD or PND. The objective of the study was to quantify the association of maternal pCRH with PPD and PND. This was a prospective cohort study (the Pregnancy, Infection, and Nutrition Study). The study was conducted at a prenatal clinics at the University of North Carolina at Chapel Hill. Patients included 1230 pregnant women. The relationship between pCRH at less than 20 wk and 24-29 wk and maternal depression assessed in pregnancy [Center for Epidemiologic Studies Depression Scale (CES-D)] and postpartum (12 wk and 1 yr) with the Edinburgh Postnatal Depression Scale (EPDS). At 24-29 wk, 24.8% of women had CES-D score of 17 or greater, and 9.7% had a CES-D score of 25 or greater. At 12 wk postpartum, 18.2% of women had an EPDS score of 10 or greater and 7.6% had an EPDS score of 13 or greater. CRH measures at less than 20 wk and 24-29 wk were inversely correlated with a CES-D score at 24-29 wk (n = 1080, P PPD (covariate-adjusted odds ratio per sd 0.99, 95% confidence interval 0.69-1.42). Higher midpregnancy pCRH was not associated with an increased risk of PND or PPD.

  7. High early life stress and aberrant amygdala activity: risk factors for elevated neuropsychiatric symptoms in HIV+ adults.

    Science.gov (United States)

    Clark, Uraina S; Sweet, Lawrence H; Morgello, Susan; Philip, Noah S; Cohen, Ronald A

    2017-06-01

    Relative to HIV-negative adults, HIV+ adults report elevated levels of early life stress (ELS). In non-HIV samples, high ELS has been linked to abnormalities in brain structure and function, as well as increased risk of neuropsychiatric symptoms. Yet, little is known about the neural effects of high ELS, and their relation to elevated neuropsychiatric symptoms, in HIV+ adults. Recent studies have revealed combined effects of HIV and high ELS on amygdala morphometry. Aberrant amygdala activity is prominently implicated in studies of neuropsychiatric symptomology in non-HIV samples. Hence, this preliminary study examined: 1) the combined effects of HIV and high ELS on amygdala activity, and 2) the relation between amygdala activity and neuropsychiatric symptoms in HIV+ adults. We included 28 HIV+ adults and 25 demographically-matched HIV-negative control (HC) adults. ELS exposure was quantified using a retrospective ELS questionnaire, which defined four groups: HIV+ Low-ELS (N = 15); HIV+ High-ELS (N = 13); HC Low-ELS (N = 16); and HC High-ELS (N = 9). Participants completed a battery of neuropsychiatric measures. BOLD fMRI assessed amygdala reactivity during explicit observation of fearful/angry faces. High-ELS participants demonstrated reduced levels of amygdala reactivity relative to Low-ELS participants. HIV+ High-ELS participants reported higher levels of neuropsychiatric symptoms than all other groups. In the HIV+ group, lower amygdala responses were associated with higher neuropsychiatric symptoms, particularly depression, anxiety, and alexithymia. Collectively, these results suggest that high ELS exposure is a significant risk factor for neuropsychiatric symptoms in HIV+ adults. Furthermore, our results implicate ELS-related abnormalities in amygdala activity in the etiology of neuropsychiatric symptoms in HIV+ adults.

  8. Elevated blood eosinophils in early infancy are predictive of atopic dermatitis in children with risk for atopy.

    Science.gov (United States)

    Rossberg, Siri; Gerhold, Kerstin; Geske, Thomas; Zimmermann, Kurt; Menke, Georg; Zaino, Mohammad; Wahn, Ulrich; Hamelmann, Eckard; Lau, Susanne

    2016-11-01

    Accessible markers to predict the development of atopic diseases are highly desirable but yet matter of debate. We investigated the role of blood eosinophils at 4 weeks and 7 months of life and their association with developing atopic dermatitis (AD) in a birth cohort of children with atopic heredity. Infant blood samples for eosinophil counts were taken from 559 infants at 4 weeks and from 467 infants at 7 month of life with at least one atopic parent. Elevation of blood eosinophils was defined as ≥ 5% of total leukocytes and the asscociation for the occurrence of AD was assessed by entering 2 × 2 tables and the odds ratios were estimated followed by hypothesis testing against the alternate working hypothesis: odds ratio 1. Survival analysis was carried out estimating the Kaplan-Meier product limit estimator from the life-time table of AD score and time to AD manifestation stratified by the eosinophil binary score. Elevated blood eosinophils observed at 4 weeks were significantly associated with the occurrence of AD in the whole cohort at the age of 7 months (p = 0.007), 1 year (p = 0.004), 2 years (p = 0.007) and 3 years (p = 0.006) of life. AD occurred app. 12 weeks earlier in infants with elevated blood eosinophils at 4 weeks of life. Blood eosinophil counts ≥5% at 7 months of life failed to show significance for AD; for eosinophils at 4.5% a significant association at 7 months (p = 0.005), and 1 year of life (p = 0.039), 2 years (p = 0.033) and 3 years (p = 0.034) was observed. Elevated blood eosinophils at age 4 weeks have a predictive value for the onset of atopic dermatitis in infancy and early childhood in children with high risk for atopy. Early eosinophil counts may therefore be helpful for counseling parents to provide infant skincare but furthermore identify individuals for interventional trials aiming at allergy prevention. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Elevated risk of incarceration among street-involved youth who initiate drug dealing

    Directory of Open Access Journals (Sweden)

    Carly Hoy

    2016-11-01

    Full Text Available Abstract Background Street-involved youth are known to be an economically vulnerable population that commonly resorts to risky activities such as drug dealing to generate income. While incarceration is common among people who use illicit drugs and associated with increased economic vulnerability, interventions among this population remain inadequate. Although previous research has documented the role of incarceration in further entrenching youth in both the criminal justice system and street life, less is known whether recent incarceration predicts initiating drug dealing among vulnerable youth. This study examines the relationship between incarceration and drug dealing initiation among street-involved youth. Methods Between September 2005 and November 2014, data were collected through the At-Risk Youth Study, a cohort of street-involved youth who use illicit drugs, in Vancouver, Canada. An extended Cox model with time-dependent variables was used to examine the relationship between recent incarceration and initiation into drug dealing, controlling for relevant confounders. Results Among 1172 youth enrolled, only 194 (16.6% were drug dealing naïve at baseline and completed at least one additional study visit to facilitate the assessment of drug dealing initiation. Among this sample, 56 (29% subsequently initiated drug dealing. In final multivariable Cox regression analysis, recent incarceration was significantly associated with initiating drug dealing (adjusted hazard ratio = 2.31; 95% confidence interval (CI 1.21–4.42, after adjusting for potential confounders. Measures of recent incarceration lagged to the prior study follow-up were not found to predict initiation of drug dealing (hazard ratio = 1.50; 95% CI 0.66–3.42. Conclusions These findings suggest that among this study sample, incarceration does not appear to significantly propel youth to initiate drug dealing. However, the initiation of drug dealing among youth coincides

  10. Elevated risk of venous thromboembolic events in patients with inflammatory myopathies

    Directory of Open Access Journals (Sweden)

    Nowak M

    2016-06-01

    Full Text Available Michał Nowak, Katarzyna Królak-Nowak, Aleksandra Sobolewska-Włodarczyk, Jakub Fichna, Marcin Włodarczyk Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland Abstract: Venous thromboembolism (VTE is a multifactorial disease manifesting as either deep vein thrombosis or pulmonary embolism. Its prevalence makes VTE a significant issue for both the individual – as a negative factor influencing the quality of life and prognosis – and the society due to economic burden. VTE is the third most common vascular disorder in Western countries, after myocardial infarction and stroke, making it a major cause of in-hospital mortality, responsible for 5%–10% of hospital deaths. Despite many studies conducted, only 50%–60% provoking factors have been identified, while the remaining 40%–50% have been classified as idiopathic or unprovoked. Chronic inflammatory disorders, with their underlying prothrombotic state, reveal an increased risk of VTE (six to eight times compared with the general population. Among the inflammatory disorders, we can identify inflammatory myopathies – a group of rare, chronic diseases featuring weakness and inflammation of muscles with periods of exacerbation and remission; their main classes are polymyositis and dermatomyositis. The objective of this review is to emphasize the need of VTE prophylaxis in individuals with inflammatory myopathies in order to reduce morbidity and mortality rates among those patients and improve their quality of life and prognosis. Keywords: deep vein thrombosis, pulmonary embolism, inflammation, polymyositis, dermatomyositis, prothrombotic state

  11. Climate change effects on wildland fire risk in the Northeastern and Great Lakes states predicted by a downscaled multi-model ensemble

    NARCIS (Netherlands)

    Kerr, Gaige Hunter; DeGaetano, Arthur T.; Stoof, Cathelijne R.; Ward, Daniel

    2018-01-01

    This study is among the first to investigate wildland fire risk in the Northeastern and the Great Lakes states under a changing climate. We use a multi-model ensemble (MME) of regional climate models from the Coordinated Regional Downscaling Experiment (CORDEX) together with the Canadian Forest

  12. Elevated post-void residual volume in a geriatric post-hip fracture assessment in women-associated factors and risk of mortality.

    Science.gov (United States)

    Nuotio, Maria S; Luukkaala, Tiina; Tammela, Teuvo

    2018-04-09

    Multiple factors contribute to elevated post-void residual urine volumes (PVR), but they may indicate detrusor underactivity (DU), especially in older women. The aim here was to examine factors associated with and prognostic significance of elevated PVR in a geriatric post-hip fracture assessment in a female population. Consecutive female hip fracture patients (n = 409) aged 65 years and older were included. PVR was measured by bladder scanner. PVR of 160 ml or more was deemed elevated. Age-adjusted univariate logistic regression analyses were conducted to examine the association of the domains of the comprehensive geriatric assessment (CGA) with elevated PVR. Cox proportional hazards model was used to determine the age-adjusted association of an elevated PVR with 1-year mortality. Of the patients, 64 (15.6%) had elevated PVR. Having urinary or fecal incontinence, difficulties in physical activities of daily living, malnutrition, poor performance on Timed Up and Go and Elderly Mobility Scale were significantly associated with elevated PVR. Difficulties in instrumental activities of daily living, renal dysfunction, constipation, polypharmacy, nocturia, cognitive impairment and depressive mood were not associated with elevated PVR. Elevated PVR significantly increased the risk of mortality 1 year post hip fracture. Elevated PVR is relatively common in older female hip fracture patients and associated with physical functioning, malnutrition and risk of mortality. Even though a causal relationship cannot be confirmed, the findings may suggest a relationship between DU and physical frailty. PVR deserves to be included in the CGA of frail older patients including women.

  13. Deaths from cerebrovascular diseases correlated to month of birth: elevated risk of death from subarachnoid hemorrhage among summer-born

    Science.gov (United States)

    Nonaka, K.; Imaizumi, Y.

    It has been suggested that maternal nutrition, and fetal and infant growth have an important effect on the risk of cardiovascular disease in adult life. We investigated the population-based distribution of deaths from cerebrovascular diseases (ICD9 codes 430, 431, or 434) in Japan in 1986-1994 as a function of birth month, by examining death-certificate records. For a total of 853 981 people born in the years 1900-1959, the distribution of the number of deaths according to the month of birth was compared with the distribution expected from the monthly numbers of all births for each sex and for the corresponding birth decade. For those born between 1920 and 1949, there were significant discrepancies between the actual numbers of deaths from subarachnoid hemorrhage (ICD9 430) and the numbers expected, and these differences were related to the month of birth. Those born in summer, June-September, consistently had an elevated risk of death, particularly men, where the excess risk was 8%-23%. This tendency was also observed, less distinctly but significantly, for deaths from intracerebral hemorrhage (ICD9 431), but was not observed for those dying from occlusion of the cerebral arteries (ICD9 434). The observation that the risk of dying from subarachnoid hemorrhage was more than 10% higher among those born in the summer implies that at least one in ten deaths from subarachnoid hemorrhage has its origin at a perinatal stage. Although variations in hypertension in later life, which could possibly be ''programmed'' during the intra-uterine stages, could be an explanation for this observation, the disease-specific nature of the observation suggests the involvement of aneurysm formation, which is a predominant cause of subarachnoid hemorrhage.

  14. Influence of an elevated nutrition risk score (NRS) on survival in patients following gastrectomy for gastric cancer.

    Science.gov (United States)

    Bachmann, J; Müller, T; Schröder, A; Riediger, C; Feith, M; Reim, D; Friess, H; Martignoni, M E

    2015-07-01

    In the last years, the impact of weight loss in patients with malignant tumors has come more and more into the focus of clinical research, as the occurrence of weight loss is often associated with a reduced survival. Weight loss can be a hint for metastases in patients suffering from malignant tumors; furthermore, these patients are usually not able to be treated with chemotherapy. The aim of the study was to show the influence of weight loss and an elevated nutrition risk score on survival following tumor resection in patients suffering from gastric cancer. In 99 patients in whom a gastrectomy due to gastric cancer was performed, the nutrition risk score was calculated and its influence on mortality, morbidity and survival was analyzed. Of the included patients, 45 % of the patients gave a history of weight loss; they had significantly more often a NRS ≥ 3. In UICC stage 1a/b, a NRS ≥ 3 was associated with a significantly reduced survival compared to patients with a NRS gastric cancer, the influence of a reduced NRS is negligible.

  15. An alarming trend: Change in the risk profile of patients with ST elevation myocardial infarction over the last two decades.

    Science.gov (United States)

    Mentias, Amgad; Hill, Elizabeth; Barakat, Amr F; Raza, Mohammad Q; Youssef, Dalia; Banerjee, Kinjal; Sawant, Abhishek C; Ellis, Stephen; Murat Tuzcu, E; Kapadia, Samir R

    2017-12-01

    Coronary artery disease (CAD) is the leading cause of mortality around the world. We sought to study changes in the risk profile of patients presenting with ST elevation myocardial infarction (STEMI). We retrospectively studied all patients presenting with STEMI to our center between 1995 and 2014. Patients were divided into four quartiles, 5years each. Baseline risk factors and comorbidities were recorded. Sub-analysis was done for patients with established CAD and their household incomes. A total of 3913 patients (67.9% males) were included; 42.5% presented with anterior STEMI and 57.5% inferior STEMI. Ages were 64±12, 62±13, 61±13 and 60±13 in the four quartiles respectively. Obesity prevalence was 31, 37, 38 and 40% and diabetes mellitus prevalence was 24, 25, 24 and 31%, while hypertension was 55, 67, 70 and 77%, respectively, prisk factors and more focus on preventive cardiology, patients presenting with STEMI over the past 20years are getting younger and more obese, with more prevalence of smoking, hypertension, and diabetes mellitus. This trend is greater in the lower income population. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. A new risk scoring model for prediction of poor coronary collateral circulation in acute non-ST-elevation myocardial infarction.

    Science.gov (United States)

    İleri, Mehmet; Güray, Ümit; Yetkin, Ertan; Gürsoy, Havva Tuğba; Bayır, Pınar Türker; Şahin, Deniz; Elalmış, Özgül Uçar; Büyükaşık, Yahya

    2016-01-01

    We aimed to investigate the clinical features associated with development of coronary collateral circulation (CCC) in patients with acute non-ST-elevation myocardial infarction (NSTEMI) and to develop a scoring model for predicting poor collateralization at hospital admission. The study enrolled 224 consecutive patients with NSTEMI admitted to our coronary care unit. Patients were divided into poor (grade 0 and 1) and good (grade 2 and 3) CCC groups. In logistic regression analysis, presence of diabetes mellitus, total white blood cell (WBC) and neutrophil counts and neutrophil to lymphocyte ratio (NLR) were found as independent positive predictors of poor CCC, whereas older age (≥ 70 years) emerged as a negative indicator. The final scoring model was based on 5 variables which were significant at p risk score ≤ 1, 29 had good CCC (with a 97% negative predictive value). On the other hand, 139 patients had risk score ≥ 4; out of whom, 130 (with a 93.5% positive predictive value) had poor collateralization. Sensitivity and specificity of the model in predicting poor collateralization in patients with scores ≤ 1 and ≥ 4 were 99.2% (130/131) and +76.3 (29/38), respectively. This study represents the first prediction model for degree of coronary collateralization in patients with acute NSTEMI.

  17. Developing a Game Interface to Assess Risk Perception with Respect to Two Key Dimensions of Risk (Frequency and Severity) in Contexts Where Risks Are Elevated from Their Accepted, "Typical" Values.

    Science.gov (United States)

    Goodman, William M; Ma, Zhenfeng; Andrade, Angie

    2015-06-01

    This four-stage study culminated in a game interface designed to calibrate people's perceptions of net risk (combining frequency and severity), in contexts where risks are elevated from their accepted, "typical" values, as when avalanche threats elevate the risks of "skiing" above levels skiers normally accept. Risk prompts are displayed dynamically, in naturalistic language, and not, for example, as static displays of dollar amounts or probabilities. Individual differences are measured. In Stage 1 (pilot), focus groups (n=9) piloted procedures, visual prompts, and examples of contexts where risks elevated from the "usual," for use in upcoming stages. In Stage 2 (exploratory), participants (primarily students; n=119; mean age, 20.1 years; 64 percent male) were assigned to risk contexts, answered demographic and risk-history questions, and then matched risk-description prompts to perceived "appropriate" levels along an ordinal risk scale. Descriptive measures and graphs showed response distributions; chi-squared analyses compared responses for different demographics. In Stage 3 (manipulating "cards"), participants (n=80; mean age, 37 years; 60 percent male) matched naturalistic risk prompts with ordinal risk positions. Regressions compared cards' placements with their "expected" (per exploratory Stage 2) placements. In Stage 4, the interface was coded in the Unity(®) (implemented at Business and IT Capstone, University of Ontario Institute of Technology, Oshawa, ON, Canada) development environment. In Stage 1, ambiguities in draft wordings/displays for Stage 2 were identified and corrected. Three risk contexts emerged: traffic/hidden intersection; skiing/avalanche; and swimming/drowning. In Stage 2, for traffic and skiing contexts, responses relating ordinal risk categories to realistic examples were observed to cluster around values potentially usable as markers. No associations appeared with demographic variables. In Stage 3, actual and "expected" ordinal-risk

  18. Living at a Geographically Higher Elevation Is Associated with Lower Risk of Metabolic Syndrome: Prospective Analysis of the SUN Cohort

    Directory of Open Access Journals (Sweden)

    Amaya Lopez-Pascual

    2017-01-01

    Full Text Available Living in a geographically higher altitude affects oxygen availability. The possible connection between environmental factors and the development of metabolic syndrome (MetS feature is not fully understood, being the available epidemiological evidence still very limited. The aim of the present study was to evaluate the longitudinal association between altitude and incidence of MetS and each of its components in a prospective Spanish cohort, The Seguimiento Universidad de Navarra (SUN project. Our study included 6860 highly educated subjects (university graduates free from any MetS criteria at baseline. The altitude of residence was imputed with the postal code of each individual subject residence according to the data of the Spanish National Cartographic Institute and participants were categorized into tertiles. MetS was defined according to the harmonized definition. Cox proportional hazards models were used to assess the association between the altitude of residence and the risk of MetS during follow-up. After a median follow-up period of 10 years, 462 incident cases of MetS were identified. When adjusting for potential confounders, subjects in the highest category of altitude (>456 m exhibited a significantly lower risk of developing MetS compared to those in the lowest tertile (<122 m of altitude of residence [Model 2: Hazard ratio = 0.75 (95% Confidence interval: 0.58–0.97; p for trend = 0.029]. Living at geographically higher altitude was associated with a lower risk of developing MetS in the SUN project. Our findings suggest that geographical elevation may be an important factor linked to metabolic diseases.

  19. Low physical activity is a determinant for elevated blood pressure in high cardiovascular risk obstructive sleep apnea.

    Science.gov (United States)

    Mendelson, Monique; Tamisier, Renaud; Laplaud, David; Dias-Domingos, Sonia; Baguet, Jean-Philippe; Moreau, Laurent; Koltes, Christian; Chavez, Léonidas; de Lamberterie, Gilles; Herengt, Frédéric; Levy, Patrick; Flore, Patrice; Pépin, Jean-Louis

    2014-08-01

    Obstructive sleep apnea (OSA) is associated with cardiovascular morbidity, including hypertension. Beyond the severity of nocturnal hypoxia, other factors such as metabolic abnormalities but also sedentary behaviors and insufficient physical activity may contribute to elevated blood pressure (BP). To clarify the respective role of these factors as determinants of BP in OSA patients, we examined the relationship between BP and anthropometrics, severity of sleep apnea, and objectively measured physical activity and sedentary behaviors. Ninety-five adults presenting with OSA (apnea-hypopnea index > 10 events/h) and high cardiovascular risk (63.3 ± 8.8 y; body mass index: 29.9 ± 4.9 kg/m(2); apnea-hypopnea index: 41.3 ± 17.5/h; cardiovascular risk score: 13.5 ± 3.7%) were included. Physical activity and sedentary behaviors were objectively assessed by actigraphy, and self-measured home BP monitoring was measured. Logistic regression models adjusted for sex, age, and body mass index were built to identify the predictors of self-measured morning and evening BP. Physical activity was significantly related to obesity but not to the severity of sleep apnea or sleepiness. Sedentary behaviors were associated with self-measured morning and evening systolic BP (r = 0.32, P = .002; r = 0.29, P = .004). Steps per day were inversely associated with evening BP (r = -0.27, P = .01). Univariate analysis identified steps/d and time spent in vigorous physical activity as determinants for evening self-measured BP. In multivariate analysis, only steps/d were identified as a significant determinant of evening BP. Physical activity is the major determinant for evening BP in adults with OSA presenting high cardiovascular risk. Our results emphasize the need for lifestyle counseling programs in combination with CPAP to encourage regular physical activity in OSA subjects to obtain better BP control. (ClinicalTrials.gov registration NCT01226641.)

  20. Bayesian Averaging over Many Dynamic Model Structures with Evidence on the Great Ratios and Liquidity Trap Risk

    NARCIS (Netherlands)

    R.W. Strachan (Rodney); H.K. van Dijk (Herman)

    2008-01-01

    textabstractA Bayesian model averaging procedure is presented that makes use of a finite mixture of many model structures within the class of vector autoregressive (VAR) processes. It is applied to two empirical issues. First, stability of the Great Ratios in U.S. macro-economic time series is

  1. Great Apes

    Science.gov (United States)

    Sleeman, Jonathan M.; Cerveny, Shannon

    2014-01-01

    Anesthesia of great apes is often necessary to conduct diagnostic analysis, provide therapeutics, facilitate surgical procedures, and enable transport and translocation for conservation purposes. Due to the stress of remote delivery injection of anesthetic agents, recent studies have focused on oral delivery and/or transmucosal absorption of preanesthetic and anesthetic agents. Maintenance of the airway and provision of oxygen is an important aspect of anesthesia in great ape species. The provision of analgesia is an important aspect of the anesthesia protocol for any procedure involving painful stimuli. Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are often administered alone, or in combination to provide multi-modal analgesia. There is increasing conservation management of in situ great ape populations, which has resulted in the development of field anesthesia techniques for free-living great apes for the purposes of translocation, reintroduction into the wild, and clinical interventions.

  2. Longitudinal association of obesity, metabolic syndrome and diabetes with risk of elevated aminotransferase levels in a cohort of Mexican health workers.

    Science.gov (United States)

    Flores, Yvonne N; Auslander, Allyn; Crespi, Catherine M; Rodriguez, Michael; Zhang, Zuo-Feng; Durazo, Francisco; Salmerón, Jorge

    2016-05-01

    In Mexico, chronic liver disease have been increasingly found along with the rapidly growing prevalence of obesity, diabetes and metabolic syndrome (MS). We aimed to investigate the longitudinal association between these three factors and risk of elevated alanine aminotransferase (ALT) levels (>40 U/L), a marker for liver damage, in a cohort of Mexican adults. Data were obtained from two separate waves of the Mexican Health Worker Cohort Study: Wave 1 (2004-2006) and Wave 2 (2011-2013). Unconditional logistic regression models were employed to determine the cross-sectional and longitudinal association between these risk factors and elevated ALT levels. The prevalence of elevated ALT was significantly higher among men, individuals aged under 60 years, those who were overweight or obese, diabetic, with MS or heavy/binge drinkers. The longitudinal results indicated that weight gain between waves that resulted in a change in body mass index, along with remaining overweight or obese, were significantly associated with an increased risk of elevated ALT levels. A significantly increased risk of developing elevated ALT was also observed among those who acquired diabetes or MS from Wave 1 to Wave 2. Weight gain and acquiring diabetes or MS are associated with a significant risk of having elevated ALT. These results, within the context of the rapid increase in global obesity rates, call urgently for programs to help to prevent chronic liver disease. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  3. Socially disadvantaged city districts show a higher incidence of acute ST-elevation myocardial infarctions with elevated cardiovascular risk factors and worse prognosis.

    Science.gov (United States)

    Schmucker, J; Seide, S; Wienbergen, H; Fiehn, E; Stehmeier, J; Günther, K; Ahrens, W; Hambrecht, R; Pohlabeln, H; Fach, A

    2017-09-22

    The importance of socioeconomic status (SES) for coronary heart disease (CHD)-morbidity is subject of ongoing scientific investigations. This study was to explore the association between SES in different city-districts of Bremen/Germany and incidence, severity, treatment modalities and prognosis for patients with ST-elevation myocardial infarctions (STEMI). Since 2006 all STEMI-patients from the metropolitan area of Bremen are documented in the Bremen STEMI-registry. Utilizing postal codes of their home address they were assigned to four groups in accordance to the Bremen social deprivation-index (G1: high, G2: intermediate high, G3: intermediate low, G4: low socioeconomic status). Three thousand four hundred sixty-two consecutive patients with STEMI admitted between 2006 and 2015 entered analysis. City areas with low SES showed higher adjusted STEMI-incidence-rates (IR-ratio 1.56, G4 vs. G1). This elevation could be observed in both sexes (women IRR 1.63, men IRR 1.54) and was most prominent in inhabitants  3000 U/l, OR 1.95, 95% CI 1.4-2.8) and severe impairment of LV-function post-STEMI (OR 2.0, 95% CI 1.2-3.4). Long term follow-up revealed that lower SES was associated with higher major adverse cardiac or cerebrovascular event (MACCE)-rates after 5 years: G1 30.8%, G2 35.7%, G3 36.0%, G4 41.1%, p (for trend) = 0.02. This worse prognosis could especially be shown for young STEMI-patients (<50 yrs. of age) 5-yr. mortality-rates(G4 vs. G1) 18.4 vs. 3.1%, p = 0.03 and 5-year-MACCE-rates (G4 vs. G1) 32 vs. 6.3%, p = 0.02. This registry-data confirms the negative association of low socioeconomic status and STEMI-incidence, with higher rates of smoking and obesity, more extensive infarctions and worse prognosis for the socio-economically deprived.

  4. Intrinsic clotting factors in dependency of age, sex, body mass index, and oral contraceptives: definition and risk of elevated clotting factor levels.

    Science.gov (United States)

    Luxembourg, Beate; Schmitt, Joern; Humpich, Marek; Glowatzki, Matthias; Seifried, Erhard; Lindhoff-Last, Edelgard

    2009-10-01

    Elevated clotting factors have been demonstrated to be a risk factor for venous thromboembolism (VTE). The aim of our study was to investigate the impact of age, sex, body mass index, and oral contraceptives on the clotting factor activities of factors VIII, IX, XI, and XII and their impact on the cutoff definition and risk of VTE associated with elevated clotting factors. Factor VIII, IX, XI, and XII activities were measured in 499 blood donors and 286 patients with VTE. Age and body mass index predicted significantly and independently the clotting factor activities of factors VIII, IX, and XI, whereas use of oral contraceptives predicted factor IX, XI, and XII levels. Percentiles of clotting factor activities, which are often used for the cutoff definition of elevated clotting factors, varied due to the effect of age, body mass index, and oral contraceptives. The adjusted odds ratios for VTE were 10.3 [95% confidence interval (CI) 5.1-20.7], 6.1 (95% CI 3.1-12.0), and 3.3 (95% CI 1.9-5.8) for elevated factors VIII, IX, and XI, respectively. Furthermore, our study demonstrates for the first time that elevated factor XII is associated with an increased risk of VTE (adjusted odds ratio 2.9, 95% CI 1.6-5.3).

  5. Elevated Venous Thromboembolism Risk Following Colectomy for IBD Is Equal to Those for Colorectal Cancer for Ninety Days After Surgery.

    Science.gov (United States)

    Ali, Fadwa; Al-Kindi, Sadeer G; Blank, Jacqueline J; Peterson, Carrie Y; Ludwig, Kirk A; Ridolfi, Timothy J

    2018-03-01

    The risk of postoperative venous thromboembolism is high in patients with colon cancer and IBD. Although The American Society of Colon and Rectal Surgeons suggests posthospital prophylaxis after surgery in patients with colon cancer, there are no such recommendations for patients with IBD. This study aims to analyze the incidence and risk factors for postoperative venous thromboembolism. This was a retrospective review using the Explorys platform. Aggregated electronic medical records from 26 major health care systems across the United States from 1999 to 2017 were used for this study. Patients who underwent colon surgery were included. Patients were followed up to 90 days postoperatively for deep vein thrombosis and pulmonary embolism. A total of 75,620 patients underwent colon resections, including 32,020 patients with colon cancer, 9850 patients with IBD, and 33,750 patients with diverticulitis. The 30-day incidence of venous thromboembolism was higher in patients with cancer and IBD than in patients with diverticulitis (2.9%, 3.1%, and 2.4%, p < 0.001 for both comparisons). The 30-day incidence of venous thromboembolism in patients with ulcerative colitis is greater than in patients with Crohn's disease (4.1% vs 2.1%, p < 0.001). The cumulative incidence of venous thromboembolism increased from 1.2% at 7 days after surgery to 4.3% at 90 days after surgery in patients with cancer, and from 1.3% to 4.3% in patients with IBD. In multivariable analysis, increase in the risk of venous thromboembolism was associated with cancer diagnosis, IBD diagnosis, age ≥60, smoking, and obesity. This study was limited by its retrospective nature and by the use of the aggregated electronic database, which is based on charted codes and contains only limited collateral clinical data. Because of the elevated and sustained risk of postoperative thromboembolism, patients with IBD, especially ulcerative colitis, might benefit from extended thromboembolism prophylaxis similar to that

  6. Elevated resting heart rate is associated with greater risk of cardiovascular and all-cause mortality in current and former smokers

    DEFF Research Database (Denmark)

    Jensen, Magnus T; Marott, Jacob L; Jensen, Gorm B

    2010-01-01

    . Current and former smokers had, irrespective of tobacco consumption, greater relative risk of elevated RHR compared to never smokers. The relative risk of all-cause mortality per 10bpm increase in RHR was (95% CI): 1.06 (1.01-1.10) in never smokers, 1.11 (1.07-1.15) in former smokers, 1.13 (1......BACKGROUND: Elevated resting heart rate is associated with mortality in general populations. Smokers may be at particular risk. The association between resting heart rate (RHR), smoking status and cardiovascular and total mortality was investigated in a general population. METHODS: Prospective.......09-1.16) in moderate smokers, and 1.13 (1.10-1.16) in heavy smokers. There was no gender difference. The risk estimates for cardiovascular and all-cause mortality were essentially similar. In univariate analyses, the difference in survival between a RHR in the highest (>80bpm) vs lowest quartile (...

  7. Elevated resting heart rate is associated with greater risk of cardiovascular and all-cause mortality in current and former smokers

    DEFF Research Database (Denmark)

    Jensen, Magnus T; Marott, Jacob L; Jensen, Gorm B

    2010-01-01

    BACKGROUND: Elevated resting heart rate is associated with mortality in general populations. Smokers may be at particular risk. The association between resting heart rate (RHR), smoking status and cardiovascular and total mortality was investigated in a general population. METHODS: Prospective....... Current and former smokers had, irrespective of tobacco consumption, greater relative risk of elevated RHR compared to never smokers. The relative risk of all-cause mortality per 10bpm increase in RHR was (95% CI): 1.06 (1.01-1.10) in never smokers, 1.11 (1.07-1.15) in former smokers, 1.13 (1.......09-1.16) in moderate smokers, and 1.13 (1.10-1.16) in heavy smokers. There was no gender difference. The risk estimates for cardiovascular and all-cause mortality were essentially similar. In univariate analyses, the difference in survival between a RHR in the highest (>80bpm) vs lowest quartile (...

  8. Environmental fate and ecotoxicological risk of the antibiotic sulfamethoxazole across the Katari catchment (Bolivian Altiplano) : application of the GREAT-ER model

    OpenAIRE

    Archundia, D.; Boithias, Laurie; Duwig, Céline; Morel, M. C.; Aviles, G. F.; Martins, J. M. F.

    2018-01-01

    Antibiotics are emergent contaminants that can induce adverse effects in terrestrial and aquatic organisms. The surface water compartment is of particular concern as it receives direct waste water discharge. Modeling is highlighted as an essential tool to understand the fate and behavior of these compounds and to assess their eco-toxicological risk. This study aims at testing the ability of the GREAT-ER model in simulating sulfamethoxazole (SMX) concentrations in the surface waters of the ari...

  9. 164Ile allele in the beta2-Adrenergic receptor gene is associated with risk of elevated blood pressure in women. The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Sethi, AA; Tybjærg-Hansen, A; Jensen, Gorm Boje

    2005-01-01

    Since beta2-adrenergic receptors are important regulators of blood pressure, genetic variation in this receptor could explain risk of elevated blood pressure in selected individuals. We tested the hypothesis that Gly16Arg, Gln27Glu, and Thr164Ile in the beta2-adrenergic receptor gene associated w...

  10. Great Expectations

    NARCIS (Netherlands)

    Dickens, Charles

    2005-01-01

    One of Dickens's most renowned and enjoyable novels, Great Expectations tells the story of Pip, an orphan boy who wishes to transcend his humble origins and finds himself unexpectedly given the opportunity to live a life of wealth and respectability. Over the course of the tale, in which Pip

  11. Relation of the aortic stiffness with the GRACE risk score in patients with the non ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Omer, Gedikli; Gokhan, Aksan; Adem, Uzun; Sabri, Demircan; Korhan, Soylu

    2014-01-01

    Current guidelines recommend clinical risk scoring systems for the patients diagnosed and determinated treatment strategy with in Non-ST-elevation elevation myocardial infarction (NSTEMI). Previous studies demonstrated association between aortic elasticity properties, stiffness and severity CAD. However, the associations between Aortic stiffness, elasticity properties and clinical risk scores have not been investigated. In the present study we have evaluated the relation between the Global Registry of Acute Coronary Events (GRACE) risk score and aortic stiffness in patients with NSTEMI. We prospectively analyzed 87 consecutive patients with NSTEMI. Aortic elastic parameter and stiffness parameter were calculated from the echocardiographically derived thoracic aortic diameters (mm/m(2)), and the measurement of pulse pressure obtained by cuff sphygmomanometry. We have categorized the patients in to two groups as low ((n = 45) (GRACE risk score ≤ 140)) and high ((n = 42) (GRACE risk score > 140)) risk group according to GRACE risk score and compare the both groups. Table 1 shows baseline characteristics of patients. Our study showed that Aortic strain was significantly low (3.5 ± 1.4, 7.9 ± 2.3 respectively, p < 0.001) and aortic stiffness index was significantly high (3.9 ± 0.38; 3 ± 0.35, respectively, p < 0.001) in the high risk group values compared to those with low risk group. The aortic stiffness index was the only independent predictor of GRACE risk score (OR: 119.390; 95% CI: 2.925-4872.8; p = 0.011) in multivariate analysis. We found a significant correlation between aortic stiffness, impaired elasticity and GRACE risk score. Aortic stiffness index was the only independent variable of the high GRACE risk score. The inclusion of aortic stiffness into the GRACE risk score could allow improved risk classification of patients with ACS at admission and this may be important in the diagnosis, follow up and treatment of the patients.

  12. Relationships Between Simple Toe Elevation Angle in the Standing Position and Dynamic Balance and Fall Risk Among Community-Dwelling Older Adults.

    Science.gov (United States)

    Takatori, Katsuhiko; Matsumoto, Daisuke

    2015-10-01

    To investigate the relationships between toe elevation ability in the standing position and dynamic balance and fall risk among community-dwelling older adults. Cross-sectional survey. General community. Community-dwelling older adults (N = 287). Toe elevation angles in the standing position. Intra-rater and inter-rater reliability of measurements of the toe elevation angle was high (internal coefficient of correlation [ICC] (1,2) = 0.94 for the former and ICC (2,1) = 0.90 for the latter). Significant correlations were found between the toe elevation angle and age (r = -0.20, P fall in the previous 6 months had a significantly lower toe elevation angle compared with subjects who did not experience a fall (t = 2.19, P balance ability and appears to be a simple screening test for fall risk in community-dwelling older adults. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  13. Human and bovine viruses and bacteria at three Great Lakes beaches: Environmental variable associations and health risk

    Science.gov (United States)

    Corsi, Steven R.; Borchardt, Mark A.; Carvin, Rebecca B.; Burch, Tucker R; Spencer, Susan K.; Lutz, Michelle A.; McDermott, Colleen M.; Busse, Kimberly M.; Kleinheinz, Gregory; Feng, Xiaoping; Zhu, Jun

    2016-01-01

    Waterborne pathogens were measured at three beaches in Lake Michigan, environmental factors for predicting pathogen concentrations were identified, and the risk of swimmer infection and illness was estimated. Waterborne pathogens were detected in 96% of samples collected at three Lake Michigan beaches in summer, 2010. Samples were quantified for 22 pathogens in four microbial categories (human viruses, bovine viruses, protozoa, and pathogenic bacteria). All beaches had detections of human and bovine viruses and pathogenic bacteria indicating influence of multiple contamination sources at these beaches. Occurrence ranged from 40 to 87% for human viruses, 65–87% for pathogenic bacteria, and 13–35% for bovine viruses. Enterovirus, adenovirus A, Salmonella spp., Campylobacter jejuni, bovine polyomavirus, and bovine rotavirus A were present most frequently. Variables selected in multiple regression models used to explore environmental factors that influence pathogens included wave direction, cloud cover, currents, and water temperature. Quantitative Microbial Risk Assessment was done for C. jejuni, Salmonella spp., and enteroviruses to estimate risk of infection and illness. Median infection risks for one-time swimming events were approximately 3 × 10–5, 7 × 10–9, and 3 × 10–7 for C. jejuni, Salmonella spp., and enteroviruses, respectively. Results highlight the importance of investigating multiple pathogens within multiple categories to avoid underestimating the prevalence and risk of waterborne pathogens.

  14. Excessive blood pressure elevation upon awakening involves an exaggerated cardiac response to slight physical activity: a possible mechanism underlying the risk of 'morning surge'.

    Science.gov (United States)

    Wakamatsu, Yoshimasa; Takeda, Yutaka; Tanaka, Satoru; Yamamoto, Koji; Yamashita, Sumiyo; Sugiura, Tomonori; Dohi, Yasuaki; Kimura, Genjiro

    2012-10-01

    An exaggerated elevation in blood pressure around waking potentially increases the risk of cardiovascular events, even in individuals with normal blood pressure at other-fold of day. The impact of such a transient blood pressure elevation is disproportionate to its short duration, and the reason has not been elucidated. We hypothesize that individuals with such a blood pressure abnormality receive a cardiovascular overload, even from slight physical activities that are frequently undertaken in daily life. A total of 16 patients with essential hypertension (52 ± 15 years) staying at hospital for lifestyle education participated in this study. Morning blood pressure elevation was assessed with 24 h ambulatory blood pressure monitoring. Cardiovascular responses to unloaded pedaling, including blood pressure changes, were assessed in a limited maximum exercise test using an electronically braked bicycle ergometer. Changes in the systolic blood pressure caused by unloaded pedaling correlated positively with the elevation in systolic blood pressure around waking (r = 0.52, P = 0.05). Moreover, waking elevation of the systolic blood pressure correlated with changes in all of the following cardiovascular variables during unloaded pedaling: heart rate (r = 0.69, P = 0.003), oxygen consumption (r = 0.73, P = 0.001), oxygen pulse (r = 0.62, P = 0.001), and rate pressure product (r = 0.64, P = 0.008), respectively. These observations indicate that individuals with prominent blood pressure elevation upon awakening also experience cardiovascular overload from slight physical activities.

  15. Randomized trial of a phone- and web-based weight loss program for women at elevated breast cancer risk: the HELP study.

    Science.gov (United States)

    Cadmus-Bertram, Lisa; Nelson, Sandahl H; Hartman, Sheri; Patterson, Ruth E; Parker, Barbara A; Pierce, John P

    2016-08-01

    Excess weight and physical inactivity are modifiable risk factors for breast cancer. Behavioral intervention is particularly important among women with an elevated risk profile. This trial tested an intervention that trained women to use a self-monitoring website to increase activity and lose weight. Women with BMI ≥27.5 kg/m(2) at elevated breast cancer risk were randomized to the intervention (N = 71) or usual care (N = 34). The intervention group received telephone-based coaching and used web-based self-monitoring tools. At 6 months, significant weight loss was observed in the intervention group (4.7 % loss from starting weight; SD = 4.7 %) relative to usual care (0.4 % gain; SD = 3.0 %) (p web- and phone-based approach produced modest but significant improvements in weight and physical activity for women at elevated breast cancer risk.

  16. Effects of elevated CO[sub 2], nutrition and climate warming on bud phenology in Sitka spruce (Pecea sitchensis) and the impact on the risk of frost damage

    Energy Technology Data Exchange (ETDEWEB)

    Murray, M.B.; Smith, R.I.; Leith, I.D.; Fowler, D.; Friend, A.D. (Inst. of Terrestrial Ecology, Penicuik, Midlothian (United Kingdom)); Lee, H.S.J.; Jarvis, P.G. (Edinburgh Univ., Edinburgh, Midlothian (United Kingdom))

    Effects of elevated CO[sub 2], clone, and plant nutrition on bud dormancy of Sitka spruce were examined. Sitka spruce seedlings were fumigated with ambient or elevated concentrations of CO[sub 2] in open-top chambers for three growing seasons. In 1991 and 1992, elevated CO[sub 2] delayed bud burst in the spring and advanced bud set in the autumn. In a second study, four clones of Sitka spruce taken from two provenances, at 43 and 54[degree] N, were fumigated with ambient or elevated CO[sub 2]. Elevated CO[sub 2] had no effect on bud dormancy of the Skidegate a clone, but it reduced the growing season of the North Bend b clone by 20 d. In a third study, Sitka spruce seedlings growing in ambient or elevated CO[sub 2] were supplied with one of three nutrient regimes, low (0.1), medium (0.5) and high (2.0 times potential) using a method and solution based on the Ingestad technique. Elevated CO[sub 2] did not affect bud dormancy using the high nutrient treatment, but it reduced the growing season of plants in low nutrient treatment by 22 d. The effect of elevated CO[sub 2] plus a 0, 2 or 4[degree]C climatic warming on the timing of bud burst was assessed using a simulation model and meteorological data from three sites. The model predicted that: doubling the CO[sub 2] concentration in the absence of climatic warming will delay the onset of bud burst at all three sites; climatic warming in ambient CO[sub 2] will hasten bud burst; and climatic warming in elevated CO[sub 2] will hasten bud burst but to a lesser extent than warming alone. At all sites, elevated CO[sub 2] and climatic warming increased the mean daily temperature on the date of bud burst, reducing the risk of frost damage. 42 refs., 6 figs., 2 tabs.

  17. An assessment of driving fitness in patients with visual impairment to understand the elevated risk of motor vehicle accidents.

    Science.gov (United States)

    Kunimatsu-Sanuki, Shiho; Iwase, Aiko; Araie, Makoto; Aoki, Yuki; Hara, Takeshi; Nakazawa, Toru; Yamaguchi, Takuhiro; Ono, Hiroshi; Sanuki, Tomoyuki; Itoh, Makoto

    2015-02-27

    To assess the driving fitness of patients with glaucoma by identifying specific areas and degrees of visual field impairment that threaten safe driving. Case-control study. This prospective study included 36 patients with advanced glaucoma, defined as Humphrey field analyzer (HFA; 24-2 SITA standard program) measurements of mean deviation in both eyes of worse than -12 dB, and 36 age-matched and driving exposure time-matched normal subjects. All participants underwent testing in a novel driving simulator (DS) system. Participants were recruited between September 2010 and January 2012. The number of collisions with simulated hazards and braking response time in 14 DS scenarios was recorded. Monocular HFA 24-2 test results from both eyes were merged to calculate the binocular integrated visual field (IVF). The position of the IVF subfields in which the collision-involved patients had lower sensitivity than the collision-uninvolved patients was compared with the track of the hazard. The cut-off value to predict an elevated risk of collisions was determined, as were its sensitivity and specificity, with the area under the receiver operating characteristic (AUROC) curve. Patients with advanced glaucoma were involved in a significantly higher number of collisions in the DS than the age-matched and driving exposure time-matched normal subjects (119 vs 40, respectively, p<0.0001), especially in four specific DS scenarios. In these four scenarios, IVF sensitivity was significantly lower in the collision-involved patients than in the collision-uninvolved patients in subfields on or near the track of the simulated hazard (p<0.05). The subfields with the largest AUROC curve had values ranging from 0.72 to 0.91 and were located in the paracentral visual field just below the horizontal. Our novel DS system effectively assessed visual impairment, showing that simulators may have future potential in educating patients. Published by the BMJ Publishing Group Limited. For

  18. Positive autoantibodies to ZnT8 indicate elevated risk for additional autoimmune conditions in patients with Addison's disease.

    Science.gov (United States)

    Fichna, Marta; Rogowicz-Frontczak, Anita; Żurawek, Magdalena; Fichna, Piotr; Gryczyńska, Maria; Zozulińska-Ziółkiewicz, Dorota; Ruchała, Marek

    2016-07-01

    Autoimmune Addison's disease (AAD) associates with exceptional susceptibility to develop other autoimmune conditions, including type 1 diabetes (T1D), marked by positive serum autoantibodies to insulin (IAA), glutamic acid decarboxylase (GADA) and insulinoma-associated protein 2 (IA-2A). Zinc transporter 8 (ZnT8) is a new T1D autoantigen, encoded by the SLC30A8 gene. Its polymorphic variant rs13266634C/T seems associated with the occurrence of serum ZnT8 antibodies (ZnT8A). This study was designed to determine the prevalence of serum ZnT8A and their clinical implication in 140 AAD patients. Other beta cell and thyroid-specific autoantibodies were also investigated, and ZnT8A results were confronted with the rs13266634 genotype. ZnT8A were detectable in 8.5 %, GADA in 20.7 %, IA-2A in 5.7 %, IAA in 1.6 % and various anti-thyroid antibodies in 7.1-67.8 % individuals. Type 1 diabetes was found in 10 % AAD patients. ZnT8A were positive in 57.1 % of T1D patients and 3.4 % non-diabetic AAD. Analysis of ZnT8A enabled to identify autoimmunity in two (14.3 %) T1D individuals previously classified as autoantibody-negative. ZnT8A-positive patients revealed significantly higher number of autoimmune conditions (p < 0.001), increased prevalence of T1D (p < 0.001) and other beta cell-specific autoantibodies. Carriers of the rs13266634 T-allele displayed increased frequency (p = 0.006) and higher titres of ZnT8A (p = 0.002). Our study demonstrates high incidence of ZnT8A in AAD patients. ZnT8A are associated with coexisting T1D and predictive of T1D in non-diabetic subjects. Moreover, positive ZnT8A in AAD indicate elevated risk for additional autoimmune conditions. Autoantibodies to beta cell antigens, comprising ZnT8, could be included in routine screening panels in AAD.

  19. Homocysteine enhances the predictive value of the GRACE risk score in patients with ST-elevation myocardial infarction.

    Science.gov (United States)

    Fan, Yan; Wang, Jianjun; Zhang, Sumei; Wan, Zhaofei; Zhou, Dong; Ding, Yanhong; He, Qinli; Xie, Ping

    2017-09-01

    The present study aims to investigate whether the addition of homocysteine level to the Global Registry of Acute Coronary Events (GRACE) risk score enhances its predictive value for clinical outcomes in ST-elevation myocardial infarction (STEMI). A total of 1143 consecutive patients with STEMI were included in this prospective cohort study. Homocysteine was detected, and the GRACE score was calculated. The predictive power of the GRACE score alone or combined with homocysteine was assessed by the receiver operating characteristic (ROC) analysis, methods of net reclassification improvement (NRI) and integrated discrimination improvement (IDI). During a median follow-up period of 36.7 months, 271 (23.7%) patients reached the clinical endpoints. It showed that the GRACE score and homocysteine could independently predict all-cause death [GRACE: HR=1.031 (1.024-1.039), p<0.001; homocysteine: HR=1.023 (1.018-1.028), p<0.001] and MACE [GRACE: HR=1.008 (1.005-1.011), p<0.001; homocysteine: HR=1.022 (1.018-1.025), p<0.001]. When they were used in combination to assess the clinical outcomes, the area under the ROC curve significantly increased from 0.786 to 0.884 (95% CI=0.067-0.128, Z=6.307, p<0.001) for all-cause death and from 0.678 to 0.759 (95% CI=0.055-0.108, Z=5.943, p<0.001) for MACE. The addition of homocysteine to the GRACE model improved NRI (all-cause death: 0.575, p<0.001; MACE: 0.621, p=0.008) and IDI (all-cause death: 0.083, p<0.001; MACE: 0.130, p=0.016), indicating effective discrimination and reclassification. Both the GRACE score and homocysteine are significant and independent predictors for clinical outcomes in patients with STEMI. A combination of them can develop a more predominant prediction for clinical outcomes in these patients.

  20. N-terminal pro brain natriuretic peptide on admission for early risk stratification of patients with chest pain and no ST-segment elevation.

    Science.gov (United States)

    Jernberg, Tomas; Stridsberg, Mats; Venge, Per; Lindahl, Bertil

    2002-08-07

    The study evaluated the prognostic value of single measurement of N-terminal pro brain natriuretic peptide (NT-proBNP) obtained on admission in patients with symptoms suggestive of an acute coronary syndrome and no ST-segment elevation. Patients with symptoms suggestive of an acute coronary syndrome and no ST-segment elevation constitute a large and heterogeneous population. Early risk stratification has been based on clinical background factors, electrocardiography (ECG) and biochemical markers of myocardial damage. The neurohormonal activation has, so far, received less attention. The NT-proBNP was analyzed on admission in 755 patients admitted because of chest pain and no ST-segment elevation. Patients were followed concerning death for 40 months (median). The median NT-proBNP level was 400 (111 to 1646) ng/l. Compared to the lowest quartile, patients in the second, third and fourth quartiles had a relative risk of subsequent death of 4.2 (1.6 to 11.1), 10.7 (4.2 to 26.8) and 26.6 (10.8 to 65.5), respectively. When NT-proBNP was added to a Cox regression model including clinical background factors, ECG and troponin T, the NT-proBNP levels were independently associated with prognosis. A single measurement of NT-proBNP on admission will substantially improve the early risk stratification of patients with symptoms suggestive of an acute coronary syndrome and no ST-segment elevation. A combination of clinical background factors, ECG, troponin T and NT-proBNP obtained on admission will provide a highly discerning tool for risk stratification and further clinical decisions.

  1. Is {sup 131}I ablation necessary for patients with low-risk papillary thyroid carcinoma and slightly elevated stimulated thyroglobulin after thyroidectomy?

    Energy Technology Data Exchange (ETDEWEB)

    Rosario, Pedro Weslley; Mourao, Gabriela Franco, E-mail: pedrowsrosario@gmail.com [Santa Casa de Belo Horizonte, MG (Brazil). Instituto de Ensino e Pesquisa

    2016-02-15

    Objective: This prospective study evaluated the recurrence rate in low-risk patients with papillary thyroid cancer (PTC) who presented slightly elevated thyroglobulin (Tg) after thyroidectomy and who did not undergo ablation with {sup 131}I. Subjects and methods: The study included 53 low-risk patients (non aggressive histology; pT1b-3, cN0pNx, M0) with slightly elevated Tg after thyroidectomy (> 1 ng/mL, but ≤ 5 ng/mL after levothyroxine withdrawal or ≤ 2 ng/mL after recombinant human TSH). Results: The time of follow-up ranged from 36 to 96 months. Lymph node metastases were detected in only one patient (1.9%). Fifty-two patients continued to present negative neck ultrasound. None of these patients without apparent disease presented an increase in Tg. Conclusions: Low-risk patients with PTC who present slightly elevated Tg after thyroidectomy do not require ablation with {sup 131}I. (author)

  2. Climate change effects on wildland fire risk in the Northeastern and Great Lakes states predicted by a downscaled multi-model ensemble

    Science.gov (United States)

    Kerr, Gaige Hunter; DeGaetano, Arthur T.; Stoof, Cathelijne R.; Ward, Daniel

    2018-01-01

    This study is among the first to investigate wildland fire risk in the Northeastern and the Great Lakes states under a changing climate. We use a multi-model ensemble (MME) of regional climate models from the Coordinated Regional Downscaling Experiment (CORDEX) together with the Canadian Forest Fire Weather Index System (CFFWIS) to understand changes in wildland fire risk through differences between historical simulations and future projections. Our results are relatively homogeneous across the focus region and indicate modest increases in the magnitude of fire weather indices (FWIs) during northern hemisphere summer. The most pronounced changes occur in the date of the initialization of CFFWIS and peak of the wildland fire season, which in the future are trending earlier in the year, and in the significant increases in the length of high-risk episodes, defined by the number of consecutive days with FWIs above the current 95th percentile. Further analyses show that these changes are most closely linked to expected changes in the focus region's temperature and precipitation. These findings relate to the current understanding of particulate matter vis-à-vis wildfires and have implications for human health and local and regional changes in radiative forcings. When considering current fire management strategies which could be challenged by increasing wildland fire risk, fire management agencies could adapt new strategies to improve awareness, prevention, and resilience to mitigate potential impacts to critical infrastructure and population.

  3. Antiretroviral Drugs and Risk of Chronic Alanine Aminotransferase Elevation in Human Immunodeficiency Virus (HIV)-Monoinfected Persons

    DEFF Research Database (Denmark)

    Kovari, Helen; Sabin, Caroline A; Ledergerber, Bruno

    2016-01-01

    Background.  Although human immunodeficiency virus (HIV)-positive persons on antiretroviral therapy (ART) frequently have chronic liver enzyme elevation (cLEE), the underlying cause is often unclear. Methods.  Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study participants without ...

  4. Elevated resting heart rate is an independent risk factor for cardiovascular disease in healthy men and women.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2010-04-01

    Elevated resting heart rate (RHR) is known to be associated with reduced survival but inconsistencies remain, including lack of significance in most studies of healthy women, lack of independence from systolic blood pressure (SBP) in some, and the suggestion that RHR is merely functioning as a marker of physical inactivity or other comorbidities. We aimed to clarify these inconsistencies.

  5. Relationships of elevated systemic pentraxin-3 levels with high-risk coronary plaque components and impaired myocardial perfusion after percutaneous coronary intervention in patients with ST-elevation acute myocardial infarction.

    Science.gov (United States)

    Kimura, Shigeki; Inagaki, Hiroshi; Haraguchi, Go; Sugiyama, Tomoyo; Miyazaki, Toru; Hatano, Yu; Yoshikawa, Shunji; Ashikaga, Takashi; Isobe, Mitsuaki

    2014-01-01

    We aimed to assess the relationships of pentraxin-3 (PTX3) with coronary plaque components and myocardial perfusion after percutaneous coronary intervention (PCI) in order to clarify the mechanisms underlying the prognostic function of PTX3 in ST-elevation acute myocardial infarction (STEMI) patients. We enrolled 75 STEMI patients who underwent pre-PCI virtual histology (VH)-intravascular ultrasound. Relationships of the systemic pre-PCI PTX3 level with coronary plaque components and post-PCI myocardial blush grade (MBG) were evaluated. Lesions with elevated pre-PCI PTX3 (median ≥3.79ng/ml) had higher frequencies of VH-derived thin-cap fibroatheroma (65.8% vs. 24.3%, P2 on admission (hazard ratio, 5.356; 95% CI, 1.409-20.359; P=0.014) as independent predictors of adverse cardiac events during follow-up. Systemic pre-PCI PTX3 was associated with high-risk plaque components and impaired post-PCI myocardial perfusion. Thus, PTX3 may be a reliable predictor of outcome in STEMI patients.

  6. Effect of elevated levels of coagulation factors on the risk of venous thrombosis in long-distance travelers

    NARCIS (Netherlands)

    Kuipers, Saskia; Cannegieter, Suzanne C.; Doggen, Catharina Jacoba Maria; Rosendaal, Frits R.

    2009-01-01

    Risk of venous thrombosis is increased after long-distance travel. Identifying high-risk groups may provide a basis for targeted prevention. We assessed the effect of increased levels of coagulation factors and combinations of risk factors in travelers in a large case-control study. We calculated

  7. Does present use of cardiovascular medication reflect elevated cardiovascular risk scores estimated ten years ago? A population based longitudinal observational study

    Directory of Open Access Journals (Sweden)

    Straand Jørund

    2011-03-01

    Full Text Available Abstract Background It is desirable that those at highest risk of cardiovascular disease should have priority for preventive measures, eg. treatment with prescription drugs to modify their risk. We wanted to investigate to what extent present use of cardiovascular medication (CVM correlates with cardiovascular risk estimated by three different risk scores (Framingham, SCORE and NORRISK ten years ago. Methods Prospective logitudinal observational study of 20 252 participants in The Hordaland Health Study born 1950-57, not using CVM in 1997-99. Prescription data obtained from The Norwegian Prescription Database in 2008. Results 26% of men and 22% of women aged 51-58 years had started to use some CVM during the previous decade. As a group, persons using CVM scored significantly higher on the risk algorithms Framingham, SCORE and NORRISK compared to those not treated. 16-20% of men and 20-22% of women with risk scores below the high-risk thresholds for the three risk scores were treated with CVM, while 60-65% of men and 25-45% of women with scores above the high-risk thresholds received no treatment. Among women using CVM, only 2.2% (NORRISK, 4.4% (SCORE and 14.5% (Framingham had risk scores above the high-risk values. Low education, poor self-reported general health, muscular pains, mental distress (in females only and a family history of premature cardiovascular disease correlated with use of CVM. Elevated blood pressure was the single factor most strongly predictive of CVM treatment. Conclusion Prescription of CVM to middle-aged individuals by large seems to occur independently of estimated total cardiovascular risk, and this applies especially to females.

  8. Estimating risk factors for farm-level transmission of disease: Foot and mouth disease during the 2001 epidemic in Great Britain

    Directory of Open Access Journals (Sweden)

    Paul R. Bessell

    2010-09-01

    Full Text Available Controlling an epidemic would be aided by establishing whether particular individuals in infected populations are more likely to transmit infection. However, few analyses have characterised such individuals. Such analyses require both data on who infected whom and on the likely determinants of transmission; data that are available at the farm level for the 2001 Foot and Mouth Disease epidemic in Great Britain. Using these data a putative number of daughter infected premises (IPs resulting from each IP was calculated where these daughters were within 3 km of the IP. A set of possible epidemiological, demographic, spatial and temporal risk factors were analysed, with the final multivariate generalised linear model (Poisson error term having 6 statistically significant (p<0.05 main effects including geographic area, local cattle and sheep densities, and the number of non-IP culls. This model demonstrates that farms are heterogeneous in their propensity to transmit infection to other farms and, importantly, that it may be possible to identify holdings that are at high risk of spreading disease a priori. Such information could be used to help prioritise the response to an epidemic. Keywords: Foot and mouth disease, Epidemiology, Risk modelling, Livestock, Disease control

  9. High serum carotenoids are associated with lower risk for developing elevated serum alanine aminotransferase among Japanese subjects: the Mikkabi cohort study.

    Science.gov (United States)

    Sugiura, Minoru; Nakamura, Mieko; Ogawa, Kazunori; Ikoma, Yoshinori; Yano, Masamichi

    2016-04-01

    Many recent studies have shown that antioxidant vitamins and/or carotenoids may reduce liver disease, but this association has not been well established with thorough longitudinal cohort studies. The objective of this study was to longitudinally investigate whether serum carotenoids at baseline are associated with the risk of developing elevated serum alanine aminotransferase (ALT) among Japanese subjects. We conducted a follow-up study of 1073 males and females aged between 30 and 79 years at baseline from the Mikkabi prospective cohort study. Those who participated in the baseline study and completed follow-up surveys were examined longitudinally. Exclusions included excessive alcohol consumption (≥60 g alcohol/d), hepatitis B and C and having a history of medication use for liver disease. A cohort of 213 males and 574 females free of elevated serum ALT (>30 IU/ml) at baseline was studied. Over a mean follow-up period of 7·4 (sd 3·1) years, thirty-one males and forty-nine females developed new elevated serum ALT. After adjustments for confounders, the hazard ratios for elevated serum ALT in the highest tertiles of basal serum β-carotene, β-cryptoxanthin and total provitamin A carotenoids against the lowest tertiles were 0·43 (95 % CI 0·22, 0·81), 0·51 (CI 0·27, 0·94) and 0·52 (CI 0·28, 0·97), respectively. For α-carotene and lycopene, borderline reduced risks were also observed; however, these were not significant. Our results further support the hypothesis that antioxidant carotenoids, especially provitamin A carotenoids, might help prevent earlier pathogenesis of non-alcoholic liver disease in Japanese subjects.

  10. Description of veterinary events and risk factors for fatality in National Hunt flat racing Thoroughbreds in Great Britain (2000-2013).

    Science.gov (United States)

    Allen, S E; Rosanowski, S M; Stirk, A J; Verheyen, K L P

    2017-11-01

    No large-scale studies have described veterinary events occurring in National Hunt (NH) flat racing or investigated risk factors for fatality in this race type. To describe injuries and conditions requiring veterinary attendance on race day and to determine risk factors for racehorse fatality in NH flat racing in Great Britain. Retrospective cohort study (2000-2013). Information from all NH flat races held over the study period, including horse, race and veterinary event report details, was combined. Veterinary events were described by type and anatomical structure(s) affected. Incidence per 1000 starts were calculated for all veterinary events and by event group, and stratified by certain horse- and race-level variables. Risk factors for fatality were determined using multivariable logistic regression modelling. Over the 14-year study period, 544 veterinary events were recorded, providing an overall incidence of 13.0 events per 1000 starts. The most common events were bone injuries (23.5%) and tendon or ligament injuries (16.4%). A fatal outcome was recorded for 117 horses (21.5% of all events), resulting in an incidence of 2.9 deaths per 1000 starts. Odds of fatality were 4.33 (95% confidence interval [CI] 1.59-11.82; P = 0.02) times higher in races restricted to conditional jockeys compared to those that were not. Horses starting in their first race experienced 1.44 (95% CI 1.00-2.08; P = 0.05) times the odds of death compared to those that had raced before. Classification of veterinary events frequently relied upon presumptive diagnosis. This study provides a benchmark for the ongoing surveillance of veterinary events in NH flat racing. These results support the phasing out of NH flat races restricted to conditional jockeys and highlight the need for further work to establish why NH flat racing Thoroughbreds competing in their first race are at increased risk for death. © 2017 EVJ Ltd.

  11. Data Elevator

    Energy Technology Data Exchange (ETDEWEB)

    2017-04-29

    Data Elevator: Efficient Asynchronous Data Movement in Hierarchical Storage Systems Multi-layer storage subsystems, including SSD-based burst buffers and disk-based parallel file systems (PFS), are becoming part of HPC systems. However, software for this storage hierarchy is still in its infancy. Applications may have to explicitly move data among the storage layers. We propose Data Elevator for transparently and efficiently moving data between a burst buffer and a PFS. Users specify the final destination for their data, typically on PFS, Data Elevator intercepts the I/O calls, stages data on burst buffer, and then asynchronously transfers the data to their final destination in the background. This system allows extensive optimizations, such as overlapping read and write operations, choosing I/O modes, and aligning buffer boundaries. In tests with large-scale scientific applications, Data Elevator is as much as 4.2X faster than Cray DataWarp, the start-of-art software for burst buffer, and 4X faster than directly writing to PFS. The Data Elevator library uses HDF5's Virtual Object Layer (VOL) for intercepting parallel I/O calls that write data to PFS. The intercepted calls are redirected to the Data Elevator, which provides a handle to write the file in a faster and intermediate burst buffer system. Once the application finishes writing the data to the burst buffer, the Data Elevator job uses HDF5 to move the data to final destination in an asynchronous manner. Hence, using the Data Elevator library is currently useful for applications that call HDF5 for writing data files. Also, the Data Elevator depends on the HDF5 VOL functionality.

  12. Magnitude and consequences of undertreatment of high-risk patients with non-ST segment elevation acute coronary syndromes: insights from the DESCARTES Registry.

    Science.gov (United States)

    Heras, M; Bueno, H; Bardají, A; Fernández-Ortiz, A; Martí, H; Marrugat, J

    2006-11-01

    To analyse intensity of treatment of high-risk patients with non-ST elevation acute coronary syndromes (NSTEACS) included in the DESCARTES (Descripción del Estado de los Sindromes Coronarios Agudos en un Registro Temporal Español) registry. Patients with NSTEACS (n = 1877) admitted to 45 randomly selected Spanish hospitals in April and May 2002 were studied. Patients with ST segment depression and troponin rise were considered high risk (n = 478) and were compared with non-high risk patients (n = 1399). 46.9% of high-risk patients versus 39.5% of non-high-risk patients underwent angiography (p = 0.005), 23.2% versus 18.8% (p = 0.038) underwent percutaneous revascularisation, and 24.9% versus 7.4% (p or = 4, 2-3 and or = 4 (OR 2.87, 95% CI 1.27 to 6.52, p = 0.012). Class I recommended treatments were underused in high-risk patients in the DESCARTES registry. This undertreatment was an independent predictor of death of patients with an acute coronary syndrome.

  13. Myocardial area at risk after ST-elevation myocardial infarction measured with the late gadolinium enhancement after scar remodeling and T2-weighted cardiac magnetic resonance imaging

    DEFF Research Database (Denmark)

    Lønborg, Jacob; Engstrøm, Thomas; Mathiasen, Anders B

    2011-01-01

    To evaluate the myocardial area at risk (AAR) measured by the endocardial surface area (ESA) method on late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) when applied after scar remodeling (3 months after index infarction) compared to T2-weighted CMR imaging. One hundred...... and sixty nine patients with ST-elevation myocardial infarction, treated with primary percutaneous coronary intervention, underwent one CMR within 1 week after index treatment to determine the AAR with T2-weighted imaging and a second scan 3 months after to measure AAR with the ESA method...

  14. Myocardial area at risk after ST-elevation myocardial infarction measured with the late gadolinium enhancement after scar remodeling and T2-weighted cardiac magnetic resonance imaging

    DEFF Research Database (Denmark)

    Lønborg, Jacob; Engstrøm, Thomas; Mathiasen, Anders B

    2012-01-01

    To evaluate the myocardial area at risk (AAR) measured by the endocardial surface area (ESA) method on late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) when applied after scar remodeling (3 months after index infarction) compared to T2-weighted CMR imaging. One hundred...... and sixty nine patients with ST-elevation myocardial infarction, treated with primary percutaneous coronary intervention, underwent one CMR within 1 week after index treatment to determine the AAR with T2-weighted imaging and a second scan 3 months after to measure AAR with the ESA method...

  15. Accumulation, sources and health risks of trace metals in elevated geochemical background soils used for greenhouse vegetable production in southwestern China.

    Science.gov (United States)

    Zhang, Haidong; Huang, Biao; Dong, Linlin; Hu, Wenyou; Akhtar, Mohammad Saleem; Qu, Mingkai

    2017-03-01

    Greenhouse vegetable cultivation with substantive manure and fertilizer input on soils with an elevated geochemical background can accumulate trace metals in soils and plants leading to human health risks. Studies on trace metal accumulation over a land use shift duration in an elevated geochemical background scenario are lacking. Accumulation characteristics of seven trace metals in greenhouse soil and edible plants were evaluated along with an assessment of the health risk to the consumers. A total of 118 greenhouse surface soils (0-20cm) and 30 vegetables were collected from Kunming City, Yunnan Province, southwestern China, and analyzed for total Cd, Pb, Cu, Zn, As, Hg, and Cr content by ICP-MS and AFS. The trace metals were ordered Cu>Cd>Hg>Zn>Pb>As>Cr in greenhouse soils accumulation level, and the geo-accumulation index suggested the soil more severely polluted with Cd, Cu, Hg and Zn. The greenhouse and open-field soils had significant difference in Cd, Cr and Zn. The duration of shift from paddy to greenhouse land-use significantly influenced trace metal accumulation with a dramatic change during five to ten year greenhouse land-use, and continuous increase of Cd and Hg. A spatial pattern from north to south for Cd and Hg and a zonal pattern for Cu and Zn were found. An anthropogenic source primarily caused trace metal accumulation, where the principal component analysis/multiple linear regression indicated a contribution 61.2%. While the assessment showed no potential risk for children and adults, the hazard health risks index was greater than one for adolescents. The extended duration of land use as greenhouses caused the trace metal accumulation, rotation in land use should be promoted to reduce the health risks. Copyright © 2016. Published by Elsevier Inc.

  16. Metal levels in flathead sole (Hippoglossoides elassodon) and great sculpin (Myoxocephalus polyacanthocephalus) from Adak Island, Alaska: Potential risk to predators and fishermen

    International Nuclear Information System (INIS)

    Burger, Joanna; Gochfeld, Michael; Jeitner, Christian; Burke, Sean; Stamm, Timothy

    2007-01-01

    Increasingly there is a need to assess the contaminant levels in fish as indicators of the health and well-being of both the fish and their consumers, including humans. This paper examines the levels of arsenic, cadmium, chromium, lead, manganese, mercury, and selenium in the kidney, liver, and muscle of great sculpin and flathead sole from Adak Island in the Aleutian Islands, Alaska. Both species are consumed by the local Aleuts and others. There were significant differences in the levels of heavy metals as a function of tissue for both fish species; the liver of sculpin and sole generally had the highest levels of most metals, except for arsenic, lead, and selenium. Sole had significantly higher mean levels of arsenic in kidney (32,384 vs. 531 ppb, wet weight), liver (18,954 vs. 2532 ppb), and muscle (19,452 vs. 1343 ppb) than did sculpin. Sole also had higher mean levels of cadmium (230 vs. 63 ppb), lead (1236 vs. 48 ppb), mercury (150 vs. 107 ppb), and selenium (5215 vs. 1861 ppb) in kidney than did sculpin. There were significant correlations among weight and length measurements for both species. However, except for mercury, there were few significant correlations among tissue types for most metals. Only mercury and manganese levels were significantly correlated with size for sculpin (but not for sole). Levels of arsenic, lead, and mercury may pose a risk to predators that consume them, and arsenic and mercury may pose a risk to human consumers

  17. An elevator

    Energy Technology Data Exchange (ETDEWEB)

    Loginovskiy, V.I.; Medinger, N.V.; Rasskazov, V.A.; Solonitsyn, V.A.

    1983-01-01

    An elevator is proposed which includes a body, spring loaded cams and a shut-off ring. To increase the reliability of the elevator by eliminating the possibility of spontaneous shifting of the shut-off ring, the latter is equipped with handles hinged to it and is made with evolvent grooves. The cams are equipped with rollers installed in the evolvent grooves of the shut off ring, where the body is made with grooves for the handles.

  18. Genetically elevated apolipoprotein A-I, high-density lipoprotein cholesterol levels, and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Lundegaard, Christiane; Tybjærg-Hansen, Anne; Grande, Peer

    2010-01-01

    Epidemiologically, levels of high-density lipoprotein (HDL) cholesterol and its major protein constituent, apolipoprotein A-I (apoA-I), are inversely related to risk of ischemic heart disease (IHD).......Epidemiologically, levels of high-density lipoprotein (HDL) cholesterol and its major protein constituent, apolipoprotein A-I (apoA-I), are inversely related to risk of ischemic heart disease (IHD)....

  19. Is elevated risk of child maltreatment in immigrant families associated with socioeconomic status? Evidence from three sources.

    Science.gov (United States)

    Alink, Lenneke R A; Euser, Saskia; van Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J

    2013-01-01

    In this study we tested whether children from Dutch-immigrant families are at increased risk for maltreatment, and if so, what factors could explain this risk. Three data sources from the second Netherlands Prevalence Study of Maltreatment of Youth (NPM-2010) were used to answer these questions. First, 1127 professionals from various occupational branches (sentinels) were asked to report each child (including some background information on the child and family) for whom they suspected child maltreatment during a period of three months. Second, we included the 2010 data from the Dutch Child Protective Services and third, 1759 high school students aged 11-17 years filled out a questionnaire on their experiences of maltreatment in the past year. We found that children from traditional immigrant families with a relatively long migration history in the Netherlands (Turkish, Moroccan, Surinamese, and Antillean) and from nontraditional immigrant families (African [except Morocco], Eastern European, Central Asian, and South and Central American; often refugees) were at increased risk for child maltreatment compared to native Dutch families. However, in the professionals' and CPS data this risk disappeared for the traditional immigrant families after correction for educational level of the parents and for step-parenthood. Within the group of families with low education or step-parents, the risk for child maltreatment was similar for traditional immigrant families as for native Dutch families. Nontraditional families remained at increased risk after correction for sociodemographic and family factors. In conclusion, we found that children from both traditional and nontraditional immigrant families are at increased risk for maltreatment as compared to children from native Dutch families. For the traditional immigrants this risk could partially be explained by socioeconomic status. This implies that socioeconomic factors should be taken into account when outlining policies to

  20. "Soldier's Heart": A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder.

    Science.gov (United States)

    Pollard, Harvey B; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M; Dalgard, Clifton L; Srivastava, Meera; Wilkerson, Matthew D; Stein, Murray B; Ursano, Robert J

    2016-01-01

    "Soldier's Heart," is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test ( P = 3 × 10 -54 ). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test ( P = 1.8 × 10 -16 ). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation.

  1. “Soldier’s Heart”: A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Harvey B. Pollard

    2016-09-01

    Full Text Available Soldier’s Heart, is an American Civil War term linking post-traumatic stress disorder (PTSD with increased propensity for cardiovascular disease (CVD. We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks.We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1 and Tumor Necrosis Factor alpha (TNFA. We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher’s Exact Test (P= 3*10-54. We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher’s Exact Test (P= 1.8*10-16. Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation.

  2. “Soldier's Heart”: A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder

    Science.gov (United States)

    Pollard, Harvey B.; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M.; Dalgard, Clifton L.; Srivastava, Meera; Wilkerson, Matthew D.; Stein, Murray B.; Ursano, Robert J.

    2016-01-01

    “Soldier's Heart,” is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test (P = 3 × 10−54). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test (P = 1.8 × 10−16). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation. PMID:27721742

  3. Monocular Elevation Deficiency - Double Elevator Palsy

    Science.gov (United States)

    ... Español Condiciones Chinese Conditions Monocular Elevation Deficiency/ Double Elevator Palsy En Español Read in Chinese What is monocular elevation deficiency (Double Elevator Palsy)? Monocular Elevation Deficiency, also known by the ...

  4. The GREAT-ER model in China: Evaluating the risk of both treated and untreated wastewater discharges and a consideration to the future.

    Science.gov (United States)

    Jackson, Benjamin; Jones, Kevin; Sweetman, Andrew

    2016-04-01

    As a result of rapid economic development, the production and usage of chemicals in China has risen significantly. This has resulted in China's environment becoming degraded. The Chinese government has attempted to ease these problems with significant investment towards upgrading the wastewater network. These efforts have initially focused upon large cities; progressing towards smaller populations within the most recent 5 year plan. However rural populations were largely overlooked, ~90% of rural settlements do not have treatment facilities for their wastewater. The next (13th) five year plan is a great opportunity to improve upon wastewater infrastructure. This transition is particularly important and it is essential for the government to prioritise settlements to provide treatment facilities and to improve water quality in receiving waters. This study focuses upon the use of a catchment model in order make progress towards this goal. A reliable model which can capture the complexity of the catchment is needed, but one without complexity in itself, in order for it to be developed and validated without an excessive requirement for data. The Geo-referenced Regional Exposure Assessment Tool for European Rivers (GREAT-ER) model is a catchment-scale stochastic-deterministic GIS model. It is primarily used for higher-tier chemical risk assessment. Emissions are from point source only and are calculated based upon population and calculated emission rates per capita. Dilution and transportation are determined using low-flow statistics within each stretch; calculated based upon catchment soil and topographic properties. Removal of the contaminant can occur prior to emission and in-stream. The lowest tier methodology applies a simple 1st-order removal rate and a flat percentage removal for in-stream and sewage treatment work removal respectively. The data requirements are relatively low, although still challenging for many situations. Many authors have reported reasonable

  5. Increased fall risk is associated with elevated co-contraction about the ankle during static balance challenges in older adults.

    Science.gov (United States)

    Nelson-Wong, Erika; Appell, Ryan; McKay, Mike; Nawaz, Hannah; Roth, Joanna; Sigler, Robert; Third, Jacqueline; Walker, Mark

    2012-04-01

    Falls are a leading contributor to disability in older adults. Increased muscle co-contraction in the lower extremities during static and dynamic balance challenges has been associated with aging, and also with a history of falling. Co-contraction during static balance challenges has not been previously linked with performance on clinical tests designed to ascertain fall risk. The purpose of this study was to investigate the relationship between co-contraction about the ankle during static balance challenges with fall risk on a commonly used dynamic balance assessment, the Four Square Step Test (FSST). Twenty-three volunteers (mean age 73 years) performed a series of five static balance challenges (Romberg eyes open/closed, Sharpened Romberg eyes open/closed, and Single Leg Standing) with continuous electromyography (EMG) of bilateral tibialis anterior and gastrocnemius muscles. Participants then completed the FSST and were categorized as 'at-risk' or 'not-at-risk' to fall based on a cutoff time of 12 s. Co-contraction was quantified with co-contraction index (CCI). CCI during narrow base conditions was positively correlated with time to complete FSST. High CCIs during all static balance challenges with the exception of Romberg stance with eyes closed were predictive of being at-risk to fall based on FSST time, odds ratio 19.3. The authors conclude that co-contraction about the ankle during static balance challenges can be predictive of performance on a dynamic balance test.

  6. Placental invasion, preeclampsia risk and adaptive molecular evolution at the origin of the great apes: evidence from genome-wide analyses.

    Science.gov (United States)

    Crosley, E J; Elliot, M G; Christians, J K; Crespi, B J

    2013-02-01

    Recent evidence from chimpanzees and gorillas has raised doubts that preeclampsia is a uniquely human disease. The deep extravillous trophoblast (EVT) invasion and spiral artery remodeling that characterizes our placenta (and is abnormal in preeclampsia) is shared within great apes, setting Homininae apart from Hylobatidae and Old World Monkeys, which show much shallower trophoblast invasion and limited spiral artery remodeling. We hypothesize that the evolution of a more invasive placenta in the lineage ancestral to the great apes involved positive selection on genes crucial to EVT invasion and spiral artery remodeling. Furthermore, identification of placentally-expressed genes under selection in this lineage may identify novel genes involved in placental development. We tested for positive selection in approximately 18,000 genes using the ratio of non-synonymous to synonymous amino acid substitution for protein-coding DNA. DAVID Bioinformatics Resources identified biological processes enriched in positively selected genes, including processes related to EVT invasion and spiral artery remodeling. Analyses revealed 295 and 264 genes under significant positive selection on the branches ancestral to Hominidae (Human, Chimp, Gorilla, Orangutan) and Homininae (Human, Chimp, Gorilla), respectively. Gene ontology analysis of these gene sets demonstrated significant enrichments for several functional gene clusters relevant to preeclampsia risk, and sets of placentally-expressed genes that have been linked with preeclampsia and/or trophoblast invasion in other studies. Our study represents a novel approach to the identification of candidate genes and amino acid residues involved in placental pathologies by implicating them in the evolution of highly-invasive placenta. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Assessment of risk to aquatic biota from elevated salinity -- a case study from the Hunter River, Australia.

    Science.gov (United States)

    Muschal, Monika

    2006-05-01

    An ecological risk assessment was performed on salinity levels of the Hunter River and its tributaries to respond to concerns that high salinity may be damaging aquatic ecosystems. Probabilistic techniques were used to assess likelihood and consequence, and hence the risk to aquatic biota from salinity. Continuous electrical conductivity distributions were used to describe the likelihood that high salinity would occur (exposure dataset) and toxicity values were compiled from the limited literature sources available to describe the consequence of high salinity (effects dataset). The assessment was preliminary in the sense that it modelled risk on the basis of existing data and did not undertake site-specific toxicity testing. Some sections of the Hunter River catchment have geologies that are saline because of their marine origins. Catchment development has increased the liberation rates of salts into surface-waters. Such modifying activities include coal-mining, power generation and land clearing. The aquatic biota of tributaries had a greater risk of impairment from high salinity than that of the Hunter River. High salinities in the tributaries were attributed to the combined factors of naturally saline geologies, increased liberation of salts due to modification of the landscape, and reduced dilution by flushing flows. A salinity guideline trigger value of 1100 mg L(-1) was recommended.

  8. Strong reactive movement response of the medium-sized European hare to elevated predation risk in short vegetation

    NARCIS (Netherlands)

    Weterings, Martijn J.A.; Zaccaroni, Marco; Koore, van der Nikki; Zijlstra, Linda M.; Kuipers, Henry J.; Langevelde, van Frank; Wieren, van Sipke E.

    2016-01-01

    Reactive movement responses of prey are affected by habitat characteristics, such as cover, which determine predation risk. Open habitats with low cover facilitate predator detection, movement and escape, while closed habitats reduce the ability to detect predators and hinder movement. We

  9. The risk of cancer as a result of elevated levels of nitrate in drinking water and vegetables in Central India.

    Science.gov (United States)

    Taneja, Pinky; Labhasetwar, Pawan; Nagarnaik, Pranav; Ensink, Jeroen H J

    2017-08-01

    The objective of the present study was to determine the effect of nitrates on the incidence of gastrointestinal (GI) cancer development. Nitrate converted to nitrite under reducing conditions of gut results in the formation of N-nitrosamines which are linked to an increased gastric cancer risk. A population of 234 individuals with 78 cases of GI cancer and 156 controls residing at urban and rural settings in Nagpur and Bhandara districts of India were studied for 2 years using a case-control study. A detailed survey of 16 predictor variables using Formhub software was carried out. Nitrate concentrations in vegetables and primary drinking water supplies were measured. The logistic regression model showed that nitrate was statistically significant in predicting increasing risk of cancer when potential confounders were kept at base level (P value of 0.001 nitrate in drinking water; 0.003 for nitrate in vegetable) at P nitrate in drinking water at >45 mg/L level of nitrate was associated with a higher risk of GI cancers. Analysis suggests that nitrate concentration in drinking water was found statistically significant in predicting cancer risk with an odds ratio of 1.20.

  10. SECTOR-SPECIFIC STRUCTURE OF THE REGIONAL ECONOMY AS A FACTOR OF ELEVATION OF RISKS TO ITS ECONOMIC SECURITY

    Directory of Open Access Journals (Sweden)

    Rostislav BILYK

    2016-07-01

    Full Text Available The article analyzes a sector-specific specialization of the regional economy in Ukraine. It also reveals possibility and conditions of transformation of a sector-specific specialization of the region and risks to its economic security. The article suggests an assessment of influence of a sector-specific specialization on occurrence of threats to the economic security of the region.

  11. Elevated plasma vitamin B12 levels and risk of venous thromboembolism among cancer patients: A population-based cohort study

    DEFF Research Database (Denmark)

    Arendt, Johan Frederik Håkonsen; Farkas, Dora Kormendine; Pedersen, Lars

    2017-01-01

    INTRODUCTION: Both venous thromboembolism (VTE) and high plasma vitamin B12 levels (cobalamin, Cbl) are markers of occult cancer and aggressive cancer with a poor prognosis. In this population-based cohort study, we assessed VTE risk among cancer patients with high plasma Cbl levels. MATERIALS...

  12. Steroid but not Biological Therapy Elevates the risk of Venous Thromboembolic Events in Inflammatory Bowel Disease: A Meta-Analysis.

    Science.gov (United States)

    Sarlos, Patricia; Szemes, Kata; Hegyi, Peter; Garami, Andras; Szabo, Imre; Illes, Anita; Solymar, Margit; Petervari, Erika; Vincze, Aron; Par, Gabriella; Bajor, Judit; Czimmer, Jozsef; Huszar, Orsolya; Varju, Peter; Farkas, Nelli

    2018-03-28

    Inflammatory bowel disease [IBD] is associated with a 1.5- to 3-fold increased risk of venous thromboembolism [VTE] events. The aim of this study was to determine the risk of VTE in IBD as a complication of systemic corticosteroids and anti-tumour necrosis factor alpha [TNFα] therapies. A systematic review and meta-analysis was conducted, which conforms to the Preferred Reporting Items for Systematic Reviews and Meta-analyses [PRISMA] statement. PubMed, EMBASE, Cochrane Library and Web of Science were searched for English-language studies published from inception inclusive of 15 April 2017. The population-intervention-comparison-outcome [PICO] format and statistically the random-effects and fixed-effect models were used to compare VTE risk during steroid and anti-TNFα treatment. Quality of the included studies was assessed using the Newcastle-Ottawa scale. The PROSPERO registration number is 42017070084. We identified 817 records, of which eight observational studies, involving 58518 IBD patients, were eligible for quantitative synthesis. In total, 3260 thromboembolic events occurred. Systemic corticosteroids were associated with a significantly higher rate of VTE complication in IBD patients as compared to IBD patients without steroid medication (odds ratio [OR]: 2.202; 95% confidence interval [CI]: 1.698-2.856, p < 0.001). In contrast, treatment with anti-TNFα agents resulted in a 5-fold decreased risk of VTE compared to steroid medication [OR: 0.267; 95% CI: 0.106-0.674, p = 0.005]. VTE risk should be carefully assessed and considered when deciding between anti-TNFα and steroids in the management of severe flare-ups. Thromboprophylaxis guidelines should be followed, no matter the therapy choice.

  13. The Identification of a Threshold of Long Work Hours for Predicting Elevated Risks of Adverse Health Outcomes.

    Science.gov (United States)

    Conway, Sadie H; Pompeii, Lisa A; Gimeno Ruiz de Porras, David; Follis, Jack L; Roberts, Robert E

    2017-07-15

    Working long hours has been associated with adverse health outcomes. However, a definition of long work hours relative to adverse health risk has not been established. Repeated measures of work hours among approximately 2,000 participants from the Panel Study of Income Dynamics (1986-2011), conducted in the United States, were retrospectively analyzed to derive statistically optimized cutpoints of long work hours that best predicted three health outcomes. Work-hours cutpoints were assessed for model fit, calibration, and discrimination separately for the outcomes of poor self-reported general health, incident cardiovascular disease, and incident cancer. For each outcome, the work-hours threshold that best predicted increased risk was 52 hours per week or more for a minimum of 10 years. Workers exposed at this level had a higher risk of poor self-reported general health (relative risk (RR) = 1.28; 95% confidence interval (CI): 1.06, 1.53), cardiovascular disease (RR = 1.42; 95% CI: 1.24, 1.63), and cancer (RR = 1.62; 95% CI: 1.22, 2.17) compared with those working 35-51 hours per week for the same duration. This study provides the first health risk-based definition of long work hours. Further examination of the predictive power of this cutpoint on other health outcomes and in other study populations is needed. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Posttraumatic stress disorder symptom severity is associated with reduced default mode network connectivity in individuals with elevated genetic risk for psychopathology.

    Science.gov (United States)

    Miller, Danielle R; Logue, Mark W; Wolf, Erika J; Maniates, Hannah; Robinson, Meghan E; Hayes, Jasmeet P; Stone, Annjanette; Schichman, Steven; McGlinchey, Regina E; Milberg, William P; Miller, Mark W

    2017-07-01

    Accumulating evidence suggests that posttraumatic stress disorder (PTSD) is associated with disrupted default mode network (DMN) connectivity, but findings across studies have not been uniform. Individual differences in relevant genes may account for some of the reported variability in the relationship between DMN connectivity and PTSD. In this study, we investigated this possibility using genome-wide association study (GWAS) derived polygenic risk scores (PRSs) for relevant psychiatric traits. We hypothesized that the association between PTSD and DMN connectivity would be moderated by genetic risk for one or more psychiatric traits such that individuals with elevated polygenic risk for psychopathology and severe PTSD would exhibit disrupted DMN connectivity. Participants were 156 white, non-Hispanic veterans of the wars in Iraq and Afghanistan who were genotyped and underwent resting state functional magnetic resonance imaging and clinical assessment. PRSs for neuroticism, anxiety, major depressive disorder, and cross-disorder risk (based on five psychiatric disorders) were calculated using summary statistics from published large-scale consortia-based GWASs. Cross-disorder polygenic risk influenced the relationship between DMN connectivity and PTSD symptom severity such that individuals at greater genetic risk showed a significant negative association between PTSD symptom severity and connectivity between the posterior cingulate cortex and right middle temporal gyrus. Polygenic risk for neuroticism, anxiety, and major depressive disorder did not influence DMN connectivity directly or through an interaction with PTSD. Findings illustrate the potential power of genome-wide PRSs to advance understanding of the relationship between PTSD and DMN connectivity, a putative neural endophenotype of the disorder. © 2017 Wiley Periodicals, Inc.

  15. Association of Thalamic Dysconnectivity and Conversion to Psychosis in Youth and Young Adults at Elevated Clinical Risk

    Science.gov (United States)

    Anticevic, Alan; Haut, Kristen; Murray, John D.; Repovs, Grega; Yang, Genevieve J.; Diehl, Caroline; McEwen, Sarah C.; Bearden, Carrie E.; Addington, Jean; Goodyear, Bradley; Cadenhead, Kristin S.; Mirzakhanian, Heline; Cornblatt, Barbara A.; Olvet, Doreen; Mathalon, Daniel H.; McGlashan, Thomas H.; Perkins, Diana O.; Belger, Aysenil; Seidman, Larry J.; Tsuang, Ming T.; van Erp, Theo G. M.; Walker, Elaine F; Hamann, Stephan; Woods, Scott W; Qiu, Maolin; Cannon, Tyrone D.

    2016-01-01

    IMPORTANCE Severe neuropsychiatric conditions, such as schizophrenia, affect distributed neural computations. One candidate system profoundly altered in chronic schizophrenia involves the thalamocortical networks. It is widely acknowledged that schizophrenia is a neurodevelopmental disorder that likely affects the brain before onset of clinical symptoms. However, no investigation has tested whether thalamocortical connectivity is altered in individuals at risk for psychosis or whether this pattern is more severe in individuals who later develop full-blown illness. OBJECTIVES To determine whether baseline thalamocortical connectivity differs between individuals at clinical high risk for psychosis and healthy controls, whether this pattern is more severe in those who later convert to full-blown illness, and whether magnitude of thalamocortical dysconnectivity is associated with baseline prodromal symptom severity. DESIGN, SETTING, AND PARTICIPANTS In this multicenter, 2-year follow-up, case-control study, we examined 397 participants aged 12–35 years of age (243 individuals at clinical high risk of psychosis, of whom 21 converted to full-blown illness, and 154 healthy controls). The baseline scan dates were January 15, 2010, to April 30, 2012. MAIN OUTCOMES AND MEASURES Whole-brain thalamic functional connectivity maps were generated using individuals’ anatomically defined thalamic seeds, measured using resting-state functional connectivity magnetic resonance imaging. RESULTS Using baseline magnetic resonance images, we identified thalamocortical dysconnectivity in the 243 individuals at clinical high risk for psychosis, which was particularly pronounced in the 21 participants who converted to full-blown illness. The pattern involved widespread hypoconnectivity between the thalamus and prefrontal and cerebellar areas, which was more prominent in those who converted to full-blown illness (t173 = 3.77, P < .001, Hedge g = 0.88). Conversely, there was marked

  16. Enoxaparin injection for the treatment of high-risk patients with non-ST elevation acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Caroline Schmidt-Lucke

    2007-05-01

    Full Text Available Caroline Schmidt-Lucke, Heinz-Peter SchultheissCharité Medical University Berlin, Campus Benjamin Franklin, Dept. of Cardiology and Pulmology, GermanyAbstract: Non-ST elevation acute coronary syndrome (NSTE-ACS refers to a cardiovascular disorder characterized by intracoronary thrombus formation on a disrupted atherosclerotic plaque with partial or transient occlusion. Generation of thrombin resulting from exposure of collagen leads to activation of platelets and conversion of fibrinogen to fibrin, thus forming a platelet-rich thrombus. The main therapeutic objective is to protect the patient from thrombotic complications, independent of the choice of antithrombotic agents. The management of NSTE myocardial infarction (MI is constantly evolving. For primarily conservative strategy, enoxaparin has been proven superior to unfractioned heparin (UFH. With early invasive strategy providing better clinical outcome compared with conservative strategy, the effectiveness of enoxaparin in reducing death and MI rates is now being reconsidered in the era of poly-pharmacotherapy, early percutaneous coronary interventions and drug eluting stents. Bleeding complications can be minimized by avoiding cross-over from UFH to enoxaparin or vice versa, or by reducing the dosage of enoxaparin. We review the studies of enoxaparin and discuss its current role in the contemporary treatment of NSTE-ACS.Keywords: low-molecular weight heparin, NSTEMI, treatment

  17. Excessive early-life dietary exposure: a potential source of elevated brain iron and a risk factor for Parkinson's disease.

    Science.gov (United States)

    Hare, Dominic J; Cardoso, Bárbara Rita; Raven, Erika P; Double, Kay L; Finkelstein, David I; Szymlek-Gay, Ewa A; Biggs, Beverley-Ann

    2017-01-01

    Iron accumulates gradually in the ageing brain. In Parkinson's disease, iron deposition within the substantia nigra is further increased, contributing to a heightened pro-oxidant environment in dopaminergic neurons. We hypothesise that individuals in high-income countries, where cereals and infant formulae have historically been fortified with iron, experience increased early-life iron exposure that predisposes them to age-related iron accumulation in the brain. Combined with genetic factors that limit iron regulatory capacity and/or dopamine metabolism, this may increase the risk of Parkinson's diseases. We propose to (a) validate a retrospective biomarker of iron exposure in children; (b) translate this biomarker to adults; (c) integrate it with in vivo brain iron in Parkinson's disease; and (d) longitudinally examine the relationships between early-life iron exposure and metabolism, brain iron deposition and Parkinson's disease risk. This approach will provide empirical evidence to support therapeutically addressing brain iron deposition in Parkinson's diseases and produce a potential biomarker of Parkinson's disease risk in preclinical individuals.

  18. Genetically elevated fetuin-A levels, fasting glucose levels, and risk of type 2 diabetes: the cardiovascular health study.

    Science.gov (United States)

    Jensen, Majken K; Bartz, Traci M; Djoussé, Luc; Kizer, Jorge R; Zieman, Susan J; Rimm, Eric B; Siscovick, David S; Psaty, Bruce M; Ix, Joachim H; Mukamal, Kenneth J

    2013-10-01

    Fetuin-A levels are associated with higher risk of type 2 diabetes, but it is unknown if the association is causal. We investigated common (>5%) genetic variants in the fetuin-A gene (AHSG) fetuin-A levels, fasting glucose, and risk of type 2 diabetes. Genetic variation, fetuin-A levels, and fasting glucose were assessed in 2,893 Caucasian and 542 African American community-living individuals 65 years of age or older in 1992-1993. Common AHSG variants (rs4917 and rs2248690) were strongly associated with fetuin-A concentrations (Pfasting glucose concentrations (1.9 mg/dL [95% CI, 1.2-2.7] higher per SD in Caucasians), but Mendelian randomization analyses using both SNPs as unbiased proxies for measured fetuin-A did not support an association between genetically predicted fetuin-A levels and fasting glucose (-0.3 mg/dL [95% CI, -1.9 to 1.3] lower per SD in Caucasians). The difference between the associations of fasting glucose with actual and genetically predicted fetuin-A level was statistically significant (P=0.001). Results among the smaller sample of African Americans trended in similar directions but were statistically insignificant. Common variants in the AHSG gene are strongly associated with plasma fetuin-A concentrations, but not with risk of type 2 diabetes or glucose concentrations, raising the possibility that the association between fetuin-A and type 2 diabetes may not be causal.

  19. Associations of herd- and cow-level factors, cow lying behavior, and risk of elevated somatic cell count in free-stall housed lactating dairy cows.

    Science.gov (United States)

    Watters, M E Alexandrea; Meijer, Karin M A; Barkema, Herman W; Leslie, Kenneth E; von Keyserlingk, Marina A G; Devries, Trevor J

    2013-09-01

    Recent evidence suggests that the risk of intramammary infection in dairy cows is related to lying patterns. The objectives of this study were to quantify the standing and lying behavior of dairy cows milked 3×/d, determine the cow- and herd-level factors associated with these behaviors, and relate these findings to the risk of an elevated somatic cell count (SCC). Five commercial free-stall dairy herds in Eastern Ontario, milking 3×/d, were enrolled in a longitudinal study. Forty Holstein-Friesian cows/herd were randomly selected as focal animals based on days in milk (cow SCC was recorded at the beginning of each period and end of the final period. Elevated SCC (eSCC) was used as an indicator of subclinical mastitis. A new incident eSCC was defined as an individual cow that started the period with a SCC cows for hygiene and lameness. Throughout the course of the study, cows averaged 11.2h/d of lying time, split into 8.6 lying bouts/d that were on average 84.6 min in length. Later lactation cows had longer daily lying times that were split into fewer lying bouts of longer duration than cows earlier in lactation. Lame cows had longer daily lying times and lying bout durations than non-lame cows. Cows with greater milk yield had lower lying times than lower producing cows. Average post-milking standing time across the study herds was 103 min. Manipulation of feed (feed delivery or push-up) by the stockperson, in the hour before milking or shortly thereafter, resulted in the longest post-milking standing times. Over the study period, 48 new eSCC were detected, resulting in a mean herd incidence rate of 0.91 eSCC/cow-year at risk for all study herds. A non-linear relationship between post-milking standing time and eSCC incidence was found; compared to those cows that lie down cows that lie down for the first time >90 min after milking had a lower risk of acquiring a new eSCC. The risk of experiencing an eSCC was also increased in multiparous cows, and in those cows

  20. An exploratory GIS-based method to identify and characterise landscapes with an elevated epidemiological risk of Rhodesian human African trypanosomiasis

    Directory of Open Access Journals (Sweden)

    Wardrop Nicola A

    2012-11-01

    Full Text Available Abstract Background Specific land cover types and activities have been correlated with Trypanosoma brucei rhodesiense distributions, indicating the importance of landscape for epidemiological risk. However, methods proposed to identify specific areas with elevated epidemiological risk (i.e. where transmission is more likely to occur tend to be costly and time consuming. This paper proposes an exploratory spatial analysis using geo-referenced human African trypanosomiasis (HAT cases and matched controls from Serere hospital, Uganda (December 1998 to November 2002 to identify areas with an elevated epidemiological risk of HAT. Methods Buffers 3 km from each case and control were used to represent areas in which village inhabitants would carry out their daily activities. It was hypothesised that the selection of areas where several case village buffers overlapped would enable the identification of locations with increased risk of HAT transmission, as these areas were more likely to be frequented by HAT cases in several surrounding villages. The landscape within these overlap areas should more closely relate to the environment in which transmission occurs as opposed to using the full buffer areas. The analysis was carried out for each of four annual periods, for both cases and controls, using a series of threshold values (number of overlapping buffers, including a threshold of one, which represented the benchmark (e.g. use of the full buffer area as opposed to the overlap areas. Results A greater proportion of the overlap areas for cases consisted of seasonally flooding grassland and lake fringe swamp, than the control overlap areas, correlating well with the preferred habitat of the predominant tsetse species within the study area (Glossina fuscipes fuscipes. The use of overlap areas also resulted in a greater difference between case and control landscapes, when compared with the benchmark (using the full buffer area. Conclusions These results

  1. Prognostic Value of the Thrombolysis in Myocardial Infarction Risk Score in ST-Elevation Myocardial Infarction Patients With Left Ventricular Dysfunction (from the EPHESUS Trial).

    Science.gov (United States)

    Popovic, Batric; Girerd, Nicolas; Rossignol, Patrick; Agrinier, Nelly; Camenzind, Edoardo; Fay, Renaud; Pitt, Bertram; Zannad, Faiez

    2016-11-15

    The Thrombolysis in Myocardial Infarction (TIMI) risk score remains a robust prediction tool for short-term and midterm outcome in the patients with ST-elevation myocardial infarction (STEMI). However, the validity of this risk score in patients with STEMI with reduced left ventricular ejection fraction (LVEF) remains unclear. A total of 2,854 patients with STEMI with early coronary revascularization participating in the randomized EPHESUS (Epleronone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) trial were analyzed. TIMI risk score was calculated at baseline, and its predictive value was evaluated using C-indexes from Cox models. The increase in reclassification of other variables in addition to TIMI score was assessed using the net reclassification index. TIMI risk score had a poor predictive accuracy for all-cause mortality (C-index values at 30 days and 1 year ≤0.67) and recurrent myocardial infarction (MI; C-index values ≤0.60). Among TIMI score items, diabetes/hypertension/angina, heart rate >100 beats/min, and systolic blood pressure model, lower LVEF, lower estimated glomerular filtration rate (eGFR), and previous MI were significantly associated with all-cause mortality. The predictive accuracy of this model, which included LVEF and eGFR, was fair for both 30-day and 1-year all-cause mortality (C-index values ranging from 0.71 to 0.75). In conclusion, TIMI risk score demonstrates poor discrimination in predicting mortality or recurrent MI in patients with STEMI with reduced LVEF. LVEF and eGFR are major factors that should not be ignored by predictive risk scores in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Elevated plasma macrophage migration inhibitor factor as a risk factor for the development of post-stroke depression in ischemic stroke.

    Science.gov (United States)

    Xu, Tingting; Pu, Shuang; Ni, Ying; Gao, Mingqing; Li, Xuemei; Zeng, Xianwei

    2018-07-15

    Macrophage migration inhibitory factor (MIF), a central cytokine of the innate immunity and inflammatory responses, has been reported to link to the pathophysiology of cardiovascular disease and depression. The aim of this study was to test the possible association between plasma MIF and the development of post-stroke depression (PSD) in Chinese patients with acute ischemic stroke (AIS). The first-ever AIS patients who were hospitalized at Affiliated Hospital of Weifang Medical College during the period from November 2015 to September 2017 were included. Neurological and neuropsychological evaluations were conducted at the 3-month follow-up. Plasma concentrations of MIF were tested by Quantikine Human MIF Immunoassay. Plasma levels of homocysteine (HCY), C-reactive protein (CRP) and Interleukin 6 (IL-6) were also tested. Results were expressed as percentages for categorical variables and as medians (Interquartile range-IQR) for the continuous variables. Finally, 333 stroke patients were included, and 95 out of those patients (28.5%) were classified as major depression. In the patients with major depression, plasma levels of MIF were higher compared with those in patients free-depression [27.3(IQR, 23.5-34.9) ng/ml vs. 20.9(IQR, 17.0-24.8) ng/ml; Z = 8.369, P < 0.001]. For each 1unit increase of MIF, the unadjusted and adjusted risk of PSD increased by 18% (odds ratios [OR]: 1.18; 95% confidence interval [CI], 1.13-1.23, P < 0.001) and 11% (1.11; 1.02-1.16, P = 0.001), respectively. In a multivariate model using the elevated levels of MIF (≥median) vs. normal (risk factors, Area Under the Receiver Operating Characteristic curve (AUROC; standard error) was increased from 0.81(0.025) to 0.86(0.019). A

  3. Salutary effects of high-intensity interval training in persons with elevated cardiovascular risk [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Jerome L. Fleg

    2016-09-01

    Full Text Available Although moderate-intensity continuous training (MICT has been the traditional model for aerobic exercise training for over four decades, a growing body of literature has demonstrated equal if not greater improvement in aerobic capacity and similar beneficial effects on body composition, glucose metabolism, blood pressure, and quality of life from high-intensity interval training (HIIT. An advantage of HIIT over MICT is the shorter time required to perform the same amount of energy expenditure. The current brief review summarizes the effects of HIIT on peak aerobic capacity and cardiovascular risk factors in healthy adults and those with various cardiovascular diseases, including coronary artery disease, chronic heart failure, and post heart transplantation.

  4. Elevated fasting plasma cortisol is associated with ischemic heart disease and its risk factors in people with type 2 diabetes: the Edinburgh type 2 diabetes study.

    Science.gov (United States)

    Reynolds, Rebecca M; Labad, Javier; Strachan, Mark W J; Braun, Anke; Fowkes, F Gerry R; Lee, Amanda J; Frier, Brian M; Seckl, Jonathan R; Walker, Brian R; Price, Jackie F

    2010-04-01

    Increased activity of the hypothalamic-pituitary-adrenal (HPA) axis may underlie the metabolic syndrome, but whether circulating cortisol levels predict cardiovascular end points is less clear. People with type 2 diabetes are at increased cardiovascular disease risk and thus are suitable to study associations of plasma cortisol with cardiovascular risk. We aimed to assess whether altered HPA axis activity was associated with features of the metabolic syndrome and ischemic heart disease in people with type 2 diabetes. We conducted a cross-sectional cohort study in the general community, including 919 men and women aged 67.9 (4.2) yr with type 2 diabetes (the Edinburgh Type 2 Diabetes Study). We measured fasting morning plasma cortisol. Associations between cortisol levels, features of the metabolic syndrome, obesity, and ischemic heart disease were determined. Elevated plasma cortisol levels were associated with raised fasting glucose and total cholesterol levels (P cortisol levels were associated with prevalent ischemic heart disease (>800 vs. cortisol is also associated with a greater prevalence of ischemic heart disease, independent of conventional risk factors. Understanding the role of cortisol in the pathogenesis of ischemic heart disease merits further exploration.

  5. Factors associated with non-participation and drop-out in a lifestyle intervention for workers with an elevated risk of cardiovascular disease

    Directory of Open Access Journals (Sweden)

    van der Beek Allard J

    2009-12-01

    Full Text Available Abstract Background Non-response and drop-out are problems that are commonly encountered in health promotion trials. Understanding the health-related characteristics of non-participants and drop-outs and the reasons for non-participation and drop-out may be beneficial for future intervention trials. Methods Male construction workers with an elevated risk of cardiovascular disease (CVD were invited to participate in a lifestyle intervention study. In order to investigate the associations between participation and CVD risk factors, and drop-out and CVD risk factors, crude and multiple logistic regression analyses were performed. The reasons for non-participation and drop-out were assessed qualitatively. Results 20% of the workers who were invited decided to participate; 8.6% of the participants dropped out before the first follow-up measurement. The main reasons for non-participation were 'no interest', 'current (para-medical treatment', and 'feeling healthy', and for drop-out they were 'lack of motivation', 'current (para-medical treatment', and 'disappointment'. Participants were 4.2 years older, had a higher blood pressure, higher total cholesterol, and lower HDL cholesterol than non-participants, and were more likely to report 'tiredness and/or stress' and 'chest pain and/or shortness of breath'. After adjusting for age, most risk factors were not significantly associated with participation. Drop-outs were 4.6 years younger than those who completed the study. The prevalence of smoking was higher among non-participants and drop-outs. Conclusion Participants had a worse CVD risk profile than non-participants, mainly because of the difference in age. Non-participants and drop-outs were younger and more likely to be smokers. The main reasons for non-participation and drop-out were health-related. Investigators in the field of health promotion should be encouraged to share comparable information. Trial registration Current Controlled Trials ISRCTN

  6. Early versus late percutaneous revascularization in patients hospitalized with non ST-segment elevation myocardial infarction: The atherosclerosis risk in communities surveillance study.

    Science.gov (United States)

    Arora, Sameer; Matsushita, Kunihiro; Qamar, Arman; Stacey, R Brandon; Caughey, Melissa C

    2018-02-01

    Current guidelines recommend early invasive intervention (<24 hr) for high risk patients with non-ST-segment elevation myocardial infarction (NSTEMI). A delayed invasive strategy (24-72 hr) is considered reasonable for low risk patients. The real-world effectiveness of this strategy is unknown. The ARIC Study has conducted hospital surveillance of acute myocardial infarction (MI) since 1987. NSTEMI was classified using a validated algorithm. We limited our study to patients undergoing early (<24 hr of the event onset), or late (≥24 hr) percutaneous coronary intervention (PCI). Patients were stratified into low (TIMI score 2-4), and high risk (TIMI score 5-7, or presence of cardiogenic shock, ventricular fibrillation, or cardiac arrest). Associations between early versus late PCI and mortality were analyzed using multivariable logistic regression adjusted for demographics, hospitalization year, TIMI score, and comorbidities. From 1987 to 2012, 6,746 patients were hospitalized with NSTEMI and underwent PCI. Most were white (79%), male (68%), with mean age 61 years. The 28-day and 1-year mortality were 2% and 5%, respectively. Most revascularizations (65%) were late. After accounting for potential confounders, early PCI was associated with a 58% reduced 28-day mortality (OR = 0.42; 95% CI: 0.21-0.84) for the entire population, and 57% reduced mortality (OR = 0.43; 95% CI: 0.21-0.88) for high risk patients. By 1-year of follow up, there was no significant difference in mortality with respect to early vs. late PCI. In hospitalized NSTEMI patients with high risk of clinical events, early PCI is associated with improved 28-day survival. © 2017 Wiley Periodicals, Inc.

  7. A cultural practice of drinking realgar wine leading to elevated urinary arsenic and its potential health risk.

    Science.gov (United States)

    Zhang, Ying-Nan; Sun, Guo-Xin; Huang, Qing; Williams, Paul N; Zhu, Yong-Guan

    2011-07-01

    Toasting friends and family with realgar wines and painting children's foreheads and limbs with the leftover realgar/alcohol slurries is an important customary ritual during the Dragon Boat Festival (DBF); a Chinese national holiday and ancient feast day celebrated throughout Asia. Realgar is an arsenic sulfide mineral, and source of highly toxic inorganic arsenic. Despite the long history of realgar use during the DBF, associated risk to human health by arsenic ingestion or percutaneous adsorption is unknown. To address this urine samples were collected from a cohort of volunteers who were partaking in the DBF festivities. The total concentration of arsenic in the wine consumed was 70 mg L⁻¹ with all the arsenic found to be inorganic. Total arsenic concentrations in adult urine reached a maximum of ca. 550 μg L⁻¹ (mean 220.2 μg L⁻¹) after 16 h post-ingestion of realgar wine, while face painting caused arsenic levels in children's urine to soar to 100 μg L⁻¹ (mean 85.3 μg L⁻¹) 40 h after the initial paint application. The average concentration of inorganic arsenic in the urine of realgar wine drinkers on average doubled 16 h after drinking, although this was not permanent and levels subsided after 28 h. As would be expected in young children, the proportions of organic arsenic in the urine remained high throughout the 88-h monitoring period. However, even when arsenic concentrations in the urine peaked at 40 h after paint application, concentrations in the urine only declined slightly thereafter, suggesting pronounced longer term dermal accumulation and penetration of arsenic. Drinking wines blended with realgar or using realgar based paints on children does result in the significant absorption of arsenic and therefore presents a potentially serious and currently unquantified health risk. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Elevated SLC26A4 gene promoter methylation is associated with the risk of presbycusis in men.

    Science.gov (United States)

    Xu, Jin; Zheng, Jiachen; Shen, Wanjing; Ma, Lili; Zhao, Ming; Wang, Xubo; Tang, Jiyuan; Yan, Jihong; Wu, Zhenhua; Zou, Zuquan; Bu, Shizhong; Xi, Yang

    2017-07-01

    Presbycusis affects approximately one-third of people over the age of 65 and is a worldwide health problem. In the current study, whether the methylation level of solute carrier family 26 member 4 (SLC26A4) predicted an increased risk of presbycusis was investigated. Peripheral blood samples from 102 patients with presbycusis and 104 controls were collected, and the methylation of the CpG sites of SLC26A4 was measured by applying pyrosequencing technology combined with sodium bisulfate DNA conversion chemistry. Within the SLC26A4 promoter region, one CpG site (CpG3) exhibited a significantly (Ppresbycusis (26.5±5.56%) compared with the controls (23.8±3.85%). Significantly different CpG3 methylation levels were observed between the patients with presbycusis and the controls among the male participants (P=0.0004). In addition, a significant decrease in the transcriptional level of SLC26A4 in peripheral blood was observed in the patients with presbycusis compared with the controls. Furthermore, analyses of the receiver operating characteristic (ROC) curves indicated that CpG3 methylation at the SLC26A4 promoter predicted the risk of presbycusis in the male participants (AUC=0.684, 95% CI=0.584‑0.784, P=0.001). The results demonstrated the significance of the CpG site methylation level of SLC26A4, and thus provides a potential marker for the diagnosis of presbycusis.

  9. Understanding factors that influence the use of risk scoring instruments in the management of patients with unstable angina or non-ST-elevation myocardial infarction in the Netherlands: a qualitative study of health care practitioners’ perceptions.

    NARCIS (Netherlands)

    Engel, J.; Heeren, M.J.; Wulp, I. van der; Bruijne, M.C. de; Wagner, C.

    2014-01-01

    Background Cardiac risk scores estimate a patient’s risk of future cardiac events or death. They are developed to inform treatment decisions of patients diagnosed with unstable angina or non-ST-elevation myocardial infarction. Despite recommending their use in guidelines and

  10. Transulnar sheathless percutaneous coronary intervention during bivalirudin infusion in high-risk elderly female with non-ST segment elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Marina Mustilli

    2012-06-01

    Full Text Available Due to the ageing population and raised life expectancy, elderly patients are increasingly referred for percutaneous coronary intervention (PCI during acute coronary syndromes (ACS. Bleeding complications are not infrequent during ACS, occurring in 2-5% of patients with prognostic and economic consequences. In particular, periprocedural bleeding and vascular complications are associated with worse clinical outcome, prolonged hospital stay and increased short- and long-term mortality, especially in elderly patients with acute coronary syndromes. We report the case of an 83-year old female referred to our hospital because of non-ST segment elevation myocardial infarction with high bleeding risk and unsuitable radial artery undergoing transulnar sheathless PCI during bivalirudin infusion. The clinical, technical, pharmacological and prognostic implications are discussed.

  11. Elevator wheel

    Energy Technology Data Exchange (ETDEWEB)

    Zhornik, V.I.; Cherkov, Ye.M.; Simonov, A.A.

    1982-01-01

    An elevator wheel is suggested for unloading a sunken product from a bath of a heavy-average separator including discs of a bucket with inner walls, and covering sheets hinged to the buckets. In order to improve the degree of dehydration of the removed product, the inner wall of each bucket is made of sheets installed in steps with gaps of one in relation to the other.

  12. [Perspective on the nuclear power plant accident caused by the great east Japan earthquake and tsunami: health impairment risks due to pollution by radioactive materials from the damaged plant as recognized by experts and by the general population and role of the experts].

    Science.gov (United States)

    Sugita, Minoru; Miyakawa, Michiko

    2012-01-01

    Large amounts of radioactive materials were leaked into the environment from the Fukushima Daiichi Nuclear Power Plant (FDNPP) of the Tokyo Electric Power Company damaged by the 2011 Great East Japan Earthquake and accompanying tsunami. Increased health impairment risks due to the leaked radioactive materials are of concern over a long period of time and over a wide geographical area. From the results of epidemiologic studies conducted after the Chernobyl accident, the health risks are not anticipated to be very marked. The purpose of the present study is to examine (i) the elevated health risks as viewed by the general population, (ii) tolerance to the risks that the general population suffer from their viewpoint, and (iii) the overall picture as seen by researchers and experts in specialized areas of study after the accident. Information was obtained from articles in print and on the Internet and by interviewing a psychologist and tens of employees of several corporations. Epidemiologic studies conducted after the severe accident of the nuclear power plant in Chernobyl revealed an elevated risk of thyroid cancer in children due to (131)I while elevated risks due to radioactive materials other than (131)I were not detected. The amount of radioactive materials leaked into the environment from the FDNPP was less than that in Chernobyl. Therefore, it is possible to estimate that health impairment risks due to the leaked radioactive materials from the FDNPP are low. However, it is impossible to conclude a zero risk. It is likely that the general population does not fully understand the health impairment risks due to the leaked radioactive materials from the FDNPP. Although no increased incidences of diseases other than thyroid cancer of children were scientifically shown en masse from studies in Chernobyl, individual risks and results in the future caused by the severe accident of FDNPP cannot be denied. Much of the general population is apt to demand the security of

  13. Perspective on the nuclear power plant accident caused by the great east Japan earthquake and tsunami. Health impairment risks due to pollution by radioactive materials from the damaged plant as recognized by experts and by the general population and role of the experts

    International Nuclear Information System (INIS)

    Sugita, Minoru; Miyakawa, Michiko

    2012-01-01

    Large amounts of radioactive materials were leaked into the environment from the Fukushima Daiichi Nuclear Power Plant (FDNPP) of the Tokyo Electric Power Company damaged by the 2011 Great East Japan Earthquake and accompanying tsunami. Increased health impairment risks due to the leaked radioactive materials are of concern over a long period of time and over a wide geographical area. From the results of epidemiologic studies conducted after the Chernobyl accident, the health risks are not anticipated to be very marked. The purpose of the present study is to examine the elevated health risks as viewed by the general population, tolerance to the risks that the general population suffer from their viewpoint, and the overall picture as seen by researchers and experts in specialized areas of study after the accident. Information was obtained from articles in print and on the Internet and by interviewing a psychologist and tens of employees of several corporations. Epidemiologic studies conducted after the severe accident of the nuclear power plant in Chernobyl revealed an elevated risk of thyroid cancer in children due to 131 I while elevated risks due to radioactive materials other than 131 I were not detected. The amount of radioactive materials leaked into the environment from the FDNPP was less than that in Chernobyl. Therefore, it is possible to estimate that health impairment risks due to the leaked radioactive materials from the FDNPP are low. However, it is impossible to conclude a zero risk. It is likely that the general population does not fully understand the health impairment risks due to the leaked radioactive materials from the FDNPP. Although no increased incidences of diseases other than thyroid cancer of children were scientifically shown en masse from studies in Chernobyl, individual risks and results in the future caused by the severe accident of FDNPP cannot be denied. Much of the general population is apt to demand the security of a zero risk from

  14. Prevalence and risk factors for depressive reaction among resident survivors after the tsunami following the Great East Japan Earthquake, March 11, 2011.

    Directory of Open Access Journals (Sweden)

    Chieko Matsubara

    Full Text Available The Great East Japan Earthquake caused a gigantic tsunami which devastated coastal areas of northern Japan on 11 March 2011. Despite the large number of 'resident survivors' who continued to reside in their damaged houses on the second or upper floors, research on the mental health of these individuals has been limited. This study explored the prevalence of depressive reaction and risk factors for depressive reaction among these resident survivors.A cross-sectional household health support needs screening was conducted for resident survivors in Higashi-Matsushima city, Miyagi prefecture, two to four months after the tsunami. The health interview that was conducted including mental status, assessed by the Patient Health Questionnaire-2 (PHQ-2.Of 5,454 respondents, 8.1% had depressive reaction. After adjustment by the number of weeks from the tsunami and the mortality rate at each respondent's place of residence, depressive reaction was significantly associated with house flooding below or above the ground floor (odds ratios of 1.92, 2.36, respectively, the unavailability of gas supply (odds ratio, 1.67, being female (odds ratio, 1.47, middle aged or elderly (odds ratios of 2.41, 2.42, respectively, regular intake of psychotropic medicine(s since before the tsunami (odds ratio, 2.53 and the presence of one to five or more than six cohabiters (odds ratios of 0.61, 0.52, respectively.The results suggest a considerable psychological burden (depressive reaction following the tsunami among resident survivors. Special supports for families with psychiatric problems need to be considered among resident survivors. Restoration of lifeline utilities and the strengthening of social ties of persons living alone may help prevent depressive reaction among resident survivors after a tsunami.

  15. Prevalence and risk factors for depressive reaction among resident survivors after the tsunami following the Great East Japan Earthquake, March 11, 2011.

    Science.gov (United States)

    Matsubara, Chieko; Murakami, Hitoshi; Imai, Koubun; Mizoue, Tetsuya; Akashi, Hidechika; Miyoshi, Chiaki; Nakasa, Tamotsu

    2014-01-01

    The Great East Japan Earthquake caused a gigantic tsunami which devastated coastal areas of northern Japan on 11 March 2011. Despite the large number of 'resident survivors' who continued to reside in their damaged houses on the second or upper floors, research on the mental health of these individuals has been limited. This study explored the prevalence of depressive reaction and risk factors for depressive reaction among these resident survivors. A cross-sectional household health support needs screening was conducted for resident survivors in Higashi-Matsushima city, Miyagi prefecture, two to four months after the tsunami. The health interview that was conducted including mental status, assessed by the Patient Health Questionnaire-2 (PHQ-2). Of 5,454 respondents, 8.1% had depressive reaction. After adjustment by the number of weeks from the tsunami and the mortality rate at each respondent's place of residence, depressive reaction was significantly associated with house flooding below or above the ground floor (odds ratios of 1.92, 2.36, respectively), the unavailability of gas supply (odds ratio, 1.67), being female (odds ratio, 1.47), middle aged or elderly (odds ratios of 2.41, 2.42, respectively), regular intake of psychotropic medicine(s) since before the tsunami (odds ratio, 2.53) and the presence of one to five or more than six cohabiters (odds ratios of 0.61, 0.52, respectively). The results suggest a considerable psychological burden (depressive reaction) following the tsunami among resident survivors. Special supports for families with psychiatric problems need to be considered among resident survivors. Restoration of lifeline utilities and the strengthening of social ties of persons living alone may help prevent depressive reaction among resident survivors after a tsunami.

  16. Elevated risk of type 2 diabetes for development of Alzheimer disease: a key role for oxidative stress in brain.

    Science.gov (United States)

    Butterfield, D Allan; Di Domenico, Fabio; Barone, Eugenio

    2014-09-01

    Alzheimer disease (AD) is the most common form of dementia among the elderly and is characterized by progressive loss of memory and cognition. Epidemiological data show that the incidence of AD increases with age and doubles every 5 years after 65 years of age. From a neuropathological point of view, amyloid-β-peptide (Aβ) leads to senile plaques, which, together with hyperphosphorylated tau-based neurofibrillary tangles and synapse loss, are the principal pathological hallmarks of AD. Aβ is associated with the formation of reactive oxygen (ROS) and nitrogen (RNS) species, and induces calcium-dependent excitotoxicity, impairment of cellular respiration, and alteration of synaptic functions associated with learning and memory. Oxidative stress was found to be associated with type 2 diabetes mellitus (T2DM), which (i) represents another prevalent disease associated with obesity and often aging, and (ii) is considered to be a risk factor for AD development. T2DM is characterized by high blood glucose levels resulting from increased hepatic glucose production, impaired insulin production and peripheral insulin resistance, which close resemble to the brain insulin resistance observed in AD patients. Furthermore, growing evidence suggests that oxidative stress plays a pivotal role in the development of insulin resistance and vice versa. This review article provides molecular aspects and the pharmacological approaches from both preclinical and clinical data interpreted from the point of view of oxidative stress with the aim of highlighting progresses in this field. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Shifts in functional traits elevate risk of fire-driven tree dieback in tropical savanna and forest biomes.

    Science.gov (United States)

    Pellegrini, Adam F A; Franco, Augusto C; Hoffmann, William A

    2016-03-01

    Numerous predictions indicate rising CO2 will accelerate the expansion of forests into savannas. Although encroaching forests can sequester carbon over the short term, increased fires and drought-fire interactions could offset carbon gains, which may be amplified by the shift toward forest plant communities more susceptible to fire-driven dieback. We quantify how bark thickness determines the ability of individual tree species to tolerate fire and subsequently determine the fire sensitivity of ecosystem carbon across 180 plots in savannas and forests throughout the 2.2-million km(2) Cerrado region in Brazil. We find that not accounting for variation in bark thickness across tree species underestimated carbon losses in forests by ~50%, totaling 0.22 PgC across the Cerrado region. The lower bark thicknesses of plant species in forests decreased fire tolerance to such an extent that a third of carbon gains during forest encroachment may be at risk of dieback if burned. These results illustrate that consideration of trait-based differences in fire tolerance is critical for determining the climate-carbon-fire feedback in tropical savanna and forest biomes. © 2015 John Wiley & Sons Ltd.

  18. The Great Recession was not so Great

    NARCIS (Netherlands)

    van Ours, J.C.

    2015-01-01

    The Great Recession is characterized by a GDP-decline that was unprecedented in the past decades. This paper discusses the implications of the Great Recession analyzing labor market data from 20 OECD countries. Comparing the Great Recession with the 1980s recession it is concluded that there is a

  19. Elevated risks for amyotrophic lateral sclerosis and blood disorders in Ashkenazi schizophrenic pedigrees suggest new candidate genes in schizophrenia

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, A.B. [Columbia Univ. School of Public Health, New York, NY (United States)

    1994-09-15

    Among relatives of Ashkenazi schizophrenic probands the rate of amyotrophic lateral sclerosis was 3/1,000, compared to expected population rates of approximately 2/100,000. Relative risk of bleeding disorders, including hematologic cancers, was increased more than three-fold compared to controls. Co-occurrence of motor neuron disease and blood dyscrasias, accompanied by psychosis, has long been recognized. A virally-mediated autoimmune pathogenesis has been proposed. However, the familial co-occurrence of these three disease entities raises the possibility that the disease constellation be considered as a manifestation of a common underlying genetic defect. Such expansion of the spectrum of affectation might enhance the power of both candidate gene and linkage studies. Based on these findings, the loci suggested as candidate regions in schizophrenia include a potential hot spot on chromosome 21q21-q22, involving the superoxide dismutase and amyloid precursor protein genes. Alternatively, genes on other chromosomes involved in the expression, transcription, or regulation of these genes, or associated with the illnesses of high frequency in these pedigrees are suggested. Candidates include the choroid plexus transport protein, transthyretin at 18q11.2-q12.1; the t(14;18)(q22;21) characterizing B-cell lymphoma-2, the most common form of hematologic cancer; and the 14q24 locus of early onset Alzheimer`s disease, c-Fos, transforming growth factor beta 3, and heat shock protein A2. Expression of hematologic cancers and the suggested candidate genes are known to involve retinoid pathways, and retinoid disregulation has been proposed as a cause of schizophrenia. 67 refs., 2 figs., 1 tab.

  20. National Elevation Dataset

    Science.gov (United States)

    ,

    2002-01-01

    The National Elevation Dataset (NED) is a new raster product assembled by the U.S. Geological Survey. NED is designed to provide National elevation data in a seamless form with a consistent datum, elevation unit, and projection. Data corrections were made in the NED assembly process to minimize artifacts, perform edge matching, and fill sliver areas of missing data. NED has a resolution of one arc-second (approximately 30 meters) for the conterminous United States, Hawaii, Puerto Rico and the island territories and a resolution of two arc-seconds for Alaska. NED data sources have a variety of elevation units, horizontal datums, and map projections. In the NED assembly process the elevation values are converted to decimal meters as a consistent unit of measure, NAD83 is consistently used as horizontal datum, and all the data are recast in a geographic projection. Older DEM's produced by methods that are now obsolete have been filtered during the NED assembly process to minimize artifacts that are commonly found in data produced by these methods. Artifact removal greatly improves the quality of the slope, shaded-relief, and synthetic drainage information that can be derived from the elevation data. Figure 2 illustrates the results of this artifact removal filtering. NED processing also includes steps to adjust values where adjacent DEM's do not match well, and to fill sliver areas of missing data between DEM's. These processing steps ensure that NED has no void areas and artificial discontinuities have been minimized. The artifact removal filtering process does not eliminate all of the artifacts. In areas where the only available DEM is produced by older methods, then "striping" may still occur.

  1. An elevator

    Energy Technology Data Exchange (ETDEWEB)

    Gusev, A.S.; Peshkov, L.P.; Rozin, M.M.; Shestov, A.G.

    1983-01-01

    An elevator is proposed which includes a body, a flap, a lock with a catch and a spring-loaded shut-off clamp in the form of upper and lower horizontal levers which are connected by a handle and an axle and one end of which is made in the form of an eccentric cam. The size of the eccentricity of the cam of the levers is increased toward the handle of the clamp in order to increase the operational reliability and to extend the service life.

  2. An elevator

    Energy Technology Data Exchange (ETDEWEB)

    Rastorguyev, M.A.; Maloyarovslavtesv, D.A.; Prokopov, O.I.; Tukayev, Sh.V.; Zanilov, I.F.

    1983-01-01

    An elevator is proposed which includes a body with a turning collar locking device and a rod with longitudinal grooves, which are flexibly linked with jaws positioned in grooves in the body. To increase safety through ensuring automatic locking of the jaws in the closed position, the locking device is made in the form of head on wedges, spring loaded relative to the collar and made with cams and positioned with the capability of interacting with the grooves of the rod and through the cams with the collar.

  3. Bucket elevator

    OpenAIRE

    Chromek, Jiří

    2013-01-01

    Cílem této bakalářské práce je návrh svislého korečkového elevátoru, který má sloužit k dopravě obilovin s dopravní výškou 19 m a dopravovaným množstvím 100 t/hod. Práce se skládá z popisu korečkového elevátoru a jeho hlavních částí, zmiňující se v úvodní rešerši. Tato práce je zaměřena na funkční a kapacitní výpočet, určení pohonu a napínacího zařízení. Další výpočet je kontrolní, skládající se z pevnostní kontroly hnacího hřídele, výpočtu pera, životnosti ložisek a výpočtu napínacího zaříze...

  4. The accuracy of the National Equine Database in relation to vector-borne disease risk modelling of horses in Great Britain.

    Science.gov (United States)

    Robin, C A; Lo Iacono, G; Gubbins, S; Wood, J L N; Newton, J R

    2013-05-01

    The National Equine Database (NED) contains information on the size and distribution of the horse population, but the data quality remains unknown. These data could assist with surveillance, research and contingency planning for equine infectious disease outbreaks. 1) To assess the extent of obsolete and missing data from NED, 2) evaluate the extent of spatial separation between horse and owner location and 3) identify relationships between spatial separation and land use. Two questionnaires were used to assess data accuracy in NED utilising local authority passport inspections and distribution of questionnaires to 11,000 horse owners. A subset of 1010 questionnaires was used to assess horse-owner geographic separation. During 2005-2010, 17,048 passports were checked through local authority inspections. Of these, 1558 passports (9.1%; 95% confidence interval [CI] 8.7-9.5%) were noncompliant, with 963 (5.6%; 95% CI 5.3-6.0%) containing inaccurate information and 595 (3.5%; 95% CI 3.2-3.8%) classified as missing. Of 1382 questionnaires completed by horse owners, 380 passports were obsolete (27.5%; 95% CI 25.2-29.9%), with 162 (11.7%; 95% CI 10.0-13.4%) being retained for deceased horses and 218 (15.8%; 95% CI 13.9-17.7%) having incorrect ownership details. Fifty-three per cent (95% CI 49.9-56.1%) of owners kept their horse(s) at home and 92% (95% CI 90.3-93.7%) of horses resided within 10 km of their owners. Data from a small sample survey suggest the majority of data on NED are accurate but a proportion of inaccuracies exist that may cause delay in locating horses and contacting owners during a disease outbreak. The probability that horses are located in the same postcode sector as the owner's home address is larger in rural areas. Appropriate adjustment for population size, horse-owner spatial separation and land usage would facilitate meaningful use of the national horse population derived from NED for risk modelling of incursions of equine diseases into Great

  5. Comparison of the TIMI and the GRACE risk scores with the extent of coronary artery disease in patients with non-ST-elevation acute coronary syndrome

    International Nuclear Information System (INIS)

    Mahmood, M.; Achakzai, A.S.; Akhtar, P.; Zaman, K.S.

    2013-01-01

    Objective: To compare the accuracy of the Global Registry of Acute Coronary Events risk score and the Thrombolysis In Myocardial Infarction risk score in predicting the extent of coronary artery disease in patients with non-ST segment elevation acute coronary syndrome. Methods: The cross-sectional study comprising 406 consecutive patients was conducted at the National Institute of Cardiovascular Diseases, Karachi, from August 2010 to March 2011. For all patients, the GRACE and TIMI RS's relevant scores on the two indices were calculated on admission using specified variables. The patients underwent coronary angiography to determine the extent of the disease. A significant level was defined as >70% stenosis in any major epicardial artery or >50% stenosis in the left main coronary artery. SPSS 19 was used for statistical analysis. Results: Both the indices showed good predictive value in identifying the extent of the disease. A Thrombolysis In Myocardial Infarction score >4 and Global Registry of Acute Coronary Events score >133 was significantly associated with 3vessel disease and left main disease, while for the former score <4 and latter score <133 was associated with normal or non-obstructive coronary disease (p<0.01). On comparison of the two risk scores, the discriminatory accuracy of the latter was significantly superior to the former in predicting 2vessel, 3vessel and left main diseases (p<0.05). Conclusion: Although both the indices were helpful in predicting the extent of the disease, the Global Registry showed better performance and was more strongly associated with multi-vessel and left main coronary artery disease. (author)

  6. Elevated dry-season malaria prevalence associated with fine-scale spatial patterns of environmental risk: a case-control study of children in rural Malawi.

    Science.gov (United States)

    Townes, Lindsay R; Mwandama, Dyson; Mathanga, Don P; Wilson, Mark L

    2013-11-11

    Understanding the role of local environmental risk factors for malaria in holo-endemic, poverty-stricken settings will be critical to more effectively implement- interventions aimed at eventual elimination. Household-level environmental drivers of malaria risk during the dry season were investigated in rural southern Malawi among children Authority (TA) regions dominated by small-scale agriculture. Ten villages were randomly selected from TA Sitola (n = 6) and Nsamala (n = 4). Within each village, during June to August 2011, a census was conducted of all households with children under-five and recorded their locations with a geographic position system (GPS) device. At each participating house, a nurse administered a malaria rapid diagnostic test (RDT) to children under five years of age, and a questionnaire to parents. Environmental data were collected for each house, including land cover within 50-m radius. Variables found to be significantly associated with P. falciparum infection status in bivariate analysis were included in generalized linear models, including multivariate logistic regression (MLR) and multi-level multivariate logistic regression (MLLR). Spatial clustering of RDT status, environmental factors, and Pearson residuals from MLR and MLLR were analysed using the Getis-Ord Gi* statistic. Of 390 children enrolled from six villages in Sitola (n = 162) and four villages in Nsamala (n = 228), 45.6% tested positive (n = 178) for Plasmodium infection by RDT. The MLLR modelled the statistical relationship of Plasmodium positives and household proximity to agriculture ( 2.58, p < 0.01) predominantly within TA Sitola, while residuals from MLLR showed no such clustering. This study provides evidence for significant, dry-season heterogeneity of malaria prevalence strongly linked to peridomestic land use, and particularly of elevated risk associated with nearby crop production.

  7. At-admission risk stratification for in-hospital life-threatening ventricular arrhythmias and death in non-ST elevation myocardial infarction patients.

    Science.gov (United States)

    Zorzi, Alessandro; Turri, Riccardo; Zilio, Filippo; Spadotto, Veronica; Baritussio, Anna; Peruzza, Francesco; Gasparetto, Nicola; Marra, Martina Perazzolo; Cacciavillani, Luisa; Marzari, Armando; Tarantini, Giuseppe; Iliceto, Sabino; Corrado, Domenico

    2014-12-01

    Identification of patients with non-ST elevation acute myocardial infarction (NSTEMI) at higher risk of in-hospital life-threatening ventricular arrhythmias (LT-VA) and death is crucial for determining appropriate levels of care/monitoring during hospitalisation. We assessed predictors of in-hospital LT-VA and all-cause mortality in a consecutive series of NSTEMI patients. We prospectively studied 1325 consecutive patients (69.7% males, median age 70 (61-79) years) presenting with NSTEMI and undergoing continuous electrocardiographic monitoring. The primary study end-point was the occurrence of spontaneous (unrelated to coronary interventions) in-hospital LT-VA, including sustained ventricular tachycardia and ventricular fibrillation; the secondary end-point was in-hospital mortality from all causes. Of 1325 patients, 21 (1.5%) experienced LT-VA and 62 (4.7%) died from either arrhythmias (n=1) or other causes (n=61). Seven of the 20 patients who survived LT-VA subsequently died of heart failure. Independent predictors of in-hospital LT-VA were the Global Registry of Acute Coronary Events (GRACE) score >140 (odds ratio (OR)=7.5; 95% confidence interval (CI) 1.7-33.3; p=0.008) and left ventricular ejection fraction (LV-EF)140 (OR=14.6; 95% CI 3.4-62) and LV-EF 140 and LV-EF<35%, while it was respectively 0.2% and 0% among the 627 (47.3%) with GRACE score ≤140 and LV-EF ≥35%. Simple risk stratification at admission based on GRACE score and echocardiographic LV-EF allows early identification of NSTEMI patients at higher risk of both in-hospital LT-VA and all-cause mortality. © The European Society of Cardiology 2014.

  8. D-Dimer Levels before HIV Seroconversion Remain Elevated Even after Viral Suppression and Are Associated with an Increased Risk of Non-AIDS Events.

    Directory of Open Access Journals (Sweden)

    Matthew S Freiberg

    Full Text Available The mechanism underlying the excess risk of non-AIDS diseases among HIV infected people is unclear. HIV associated inflammation/hypercoagulability likely plays a role. While antiretroviral therapy (ART may return this process to pre-HIV levels, this has not been directly demonstrated. We analyzed data/specimens on 249 HIV+ participants from the US Military HIV Natural History Study, a prospective, multicenter observational cohort of >5600 active duty military personnel and beneficiaries living with HIV. We used stored blood specimens to measure D-dimer and Interleukin-6 (IL-6 at three time points: pre-HIV seroconversion, ≥6 months post-HIV seroconversion but prior to ART initiation, and ≥6 months post-ART with documented HIV viral suppression on two successive evaluations. We evaluated the changes in biomarker levels between time points, and the association between these biomarker changes and future non-AIDS events. During a median follow-up of 3.7 years, there were 28 incident non-AIDS diseases. At ART initiation, the median CD4 count was 361cells/mm3; median duration of documented HIV infection 392 days; median time on ART was 354 days. Adjusted mean percent increase in D-dimer levels from pre-seroconversion to post-ART was 75.1% (95% confidence interval 24.6-148.0, p = 0.002. This increase in D-dimer was associated with a significant 22% increase risk of future non-AIDS events (p = 0.03. Changes in IL-6 levels across time points were small and not associated with future non-AIDS events. In conclusion, ART initiation and HIV viral suppression does not eliminate HIV associated elevation in D-dimer levels. This residual pathology is associated with an increased risk of future non-AIDS diseases.

  9. Prevalencia de dislipemia y riesgo cardiovascular elevado en pacientes con artritis reumatoide Prevalence of dyslipidemia and elevated cardiovascular risk in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    María Jezabel Haye Salinas

    2013-02-01

    Full Text Available Los objetivos del estudio fueron comparar la frecuencia de riesgo cardiovascular (CV elevado y dislipemia (DLP en pacientes con artritis reumatoide (AR y en controles, identificar variables de la enfermedad asociadas a DLP y estimar el porcentaje de pacientes con AR medicados para DLP. Estudio de corte transversal que incluyó 409 pacientes con AR y 624 controles. El riesgo CV se determinó con las clasificaciones NCEP y SCORE modificados por European League Against Rheumatism (EULAR. Para DLP se utilizó la definición de Adult Treatment Panel III (ATP III. La frecuencia de riesgo CV elevado fue similar en pacientes con AR y controles excepto cuando fue definida por NCEP-EULAR (7% vs. 2%; p = 0.00002. La DLP fue encontrada en el 43% de los pacientes con AR y en el 47% de los controles (p = 0.15. Los pacientes con AR y DLP tuvieron más manifestaciones extra-articulares (36% vs. 24%; p = 0.01 y mayor velocidad de sedimentación globular (VSG (21 (13-35 vs. 18 (10-30 mm; p = 0.003. El tratamiento recibido para DLP varió según la definición utilizada (11% a 32%. Se encontró mayor riesgo CV en los pacientes con AR solo cuando se definió por NCEP- EULAR. Los pacientes con AR y DLP tuvieron mayor VSG y manifestaciones extra-articulares. La mayoría de los pacientes con AR y DLP no estaban recibiendo tratamiento hipolipemiante.The objectives of this study were to compare the frequency of dyslipidemia (DLP and the elevated cardiovascular risk between rheumatoid arthritis (RA patients and a control group, to identify disease-related factors associated with the presence of DLP and to estimate the frequency of RA patients receiving treatment for DLP. This is a cross sectional study that included 409 RA patients and 624 controls. Cardiovascular (CV risk was determined using the Framingham score, National Cholesterol Education Program (NCEP and the Systematic Coronary Risk Evaluation (SCORE adapted versions according to the European League Against

  10. Great Lakes Science Center

    Data.gov (United States)

    Federal Laboratory Consortium — Since 1927, Great Lakes Science Center (GLSC) research has provided critical information for the sound management of Great Lakes fish populations and other important...

  11. N-terminal pro-brain natriuretic peptide for additional risk stratification in patients with non-ST-elevation acute coronary syndrome and an elevated troponin T: an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy

    NARCIS (Netherlands)

    Windhausen, Fons; Hirsch, Alexander; Sanders, Gerard T.; Cornel, Jan Hein; Fischer, Johan; van Straalen, Jan P.; Tijssen, Jan G. P.; Verheugt, Freek W. A.; de Winter, Robbert J.

    2007-01-01

    BACKGROUND: New evidence has emerged that the assessment of multiple biomarkers such as cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with non-ST-elevation acute coronary syndrome (nSTE-ACS) provides unique prognostic information. The purpose of this

  12. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes.

    Science.gov (United States)

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E; Bourne, Jessica E; Voth, Elizabeth; Little, Jonathan P

    2015-09-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P fasting plasma glucose (P fasting glucose. Copyright © 2015 the American Physiological Society.

  13. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes

    Science.gov (United States)

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E.; Bourne, Jessica E.; Voth, Elizabeth

    2015-01-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P HIIT and MICT (P HIIT and MICT (P HIIT or MICT can improve cardiorespiratory fitness and glucose control and lead to reductions in TLR2 and TLR4 expression. MICT, which involved a longer duration of exercise, may be superior for reducing fasting glucose. PMID:26139217

  14. Rosuvastatin for primary prevention among individuals with elevated high-sensitivity c-reactive protein and 5% to 10% and 10% to 20% 10-year risk. Implications of the Justification for Use of Statins in Prevention

    DEFF Research Database (Denmark)

    Ridker, Paul M; Macfadyen, Jean G; Nordestgaard, Børge G

    2010-01-01

    Recent primary prevention guidelines issued in Canada endorse the use of statin therapy among individuals at "intermediate risk" who have elevated levels of high-sensitivity C-reactive protein (hsCRP). However, trial data directly addressing whether this recommendation defines a patient populatio...

  15. Prognosis and high-risk complication identification in unselected patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Andersson, Hedvig; Ripa, Maria Sejersten; Clemmensen, Peter

    2010-01-01

    The aim of this study was to evaluate treatment with primary percutaneous coronary intervention (PCI) in unselected patients with ST-segment elevation myocardial infarction (STEMI).......The aim of this study was to evaluate treatment with primary percutaneous coronary intervention (PCI) in unselected patients with ST-segment elevation myocardial infarction (STEMI)....

  16. Congruency within rural social networks as an indicator of interpersonal influence on risk judgments: the great stir caused by BSE in a village in northern Germany.

    Science.gov (United States)

    Lehmkuhl, Markus J

    2008-10-01

    In the following survey, congruency within a sample of 150 rural social networks ascertained by comparing independently gathered data is used as an indicator of interpersonal influence concerning BSE-related current knowledge and consumption habits. Our findings suggest that friends, relatives and acquaintances mutually orientated each other about what was worth knowing about BSE. Concerning the behavioral dimension of risk judgments, our findings indicate that social networks obtained within the village explored have activated collective resistance against fear. This is explained by the character of the risk source. Positive attitudes towards conventional farming obviously contributed to the social identity of villagers. The devaluation of conventional farming as a source of societal threat by the mass media touched on an integral part of the self-definitions of villagers and activated resistance within their social networks. It is argued that a central point in explaining the role of interpersonal influence in risk judgments is not only the dimension of risk judgments but the character of the risk source. If attitudes concerning a risk source contribute positively to one's identity, the devaluation of the risk source by mass media coverage may enhance the probability of collective resistance against fear.

  17. Elevated Thyroid Peroxidase Antibody Increases Risk of Post-partum Depression by Decreasing Prefrontal Cortex BDNF and 5-HT Levels in Mice.

    Science.gov (United States)

    Zhou, Yingying; Wang, Xinyi; Zhao, Yuhang; Liu, Aihua; Zhao, Tong; Zhang, Yuanyuan; Shan, Zhongyan; Teng, Weiping

    2016-01-01

    Post-partum depression (PPD) is a common mental disease in the perinatal period that profoundly affects mothers and their offspring. Some clinical studies have found that PPD is related to thyroid peroxidase antibodies (TPOAbs); however, the mechanism underlying this relationship is unclear. Female C57BL/6 mice immunized with adenovirus encoding the cDNA of the full-length mTPO (mTPO-Ad) were used to establish the isolated TPOAb-positive mouse model in the present study. Maternal depressive-like behaviors were assessed using the forced swimming test (FST), sucrose preference test (SPT), and tail suspension test (TST) post-partum. The serum TPOAb titer was measured by enzyme-linked immunosorbent assay (ELISA) before pregnancy and post-partum. Furthermore, in the prefrontal cortex, the mRNA and protein expression levels of brain-derived neurotrophic factor (BDNF) were measured, serotonin (5-HT) levels were measured by ultra-high-performance liquid chromatography-tandem mass-spectrometry (UHPLC-MS/MS), and total thyroxine (TT4) levels were determined by ELISA. Compared with the controls, the mice immunized with mTPO-Ad displayed depressive behaviors, with a significantly lower sucrose preference (SP) at the 12-h time point and a longer immobility time in the FST and TST, which were accompanied by a lower expression of BDNF and 5-HT but no change in the TT4 concentration in the prefrontal cortex. Together, these findings suggest that elevated TPOAb may increase the risk of subsequent PPD and decrease the concentration of BDNF and 5-HT in the prefrontal cortex.

  18. Social support buffering of the relation between low income and elevated blood pressure in at-risk African-American adults.

    Science.gov (United States)

    Coulon, S M; Wilson, D K

    2015-10-01

    Socioeconomic disadvantage has been linked to elevated blood pressure (BP), and the purpose of this study was to assess whether interpersonal social supports buffer these adverse relations in African-American adults. In three communities matched demographically, a subsample of participants (N = 204) of the Positive Action for Today's Health trial provided measures of perceived social support, annual household income, and BP. Multiple regression analyses with cross-product interactions were conducted using follow-up data. The sample had a mean age of 52.8 years (SD = 15.1), and was predominantly female (66 %) with a high body mass index (M = 33.5, SD = 14.7). Results indicated an inverse relation between social support and diastolic BP (B = -.178, p = .005), and also an interaction with income (p = .046), such that higher social support related to lower diastolic BP in the lowest-income individuals (B = -1.05). The same direct (B = -.141, p = .025) and interacting (B = -1.42, p = .040) social support effects were present for systolic BP, however the omnibus model for systolic BP was not significant, F(6, 196) = 1.80, p = .09. The hypothesized buffering effect of social support on the adverse relation of income to BP was partially supported in at-risk African-American adults. Future prevention efforts for reducing the impact of socioeconomic stress on BP may aim to increase perceptions of social support.

  19. Incidence and risk factors of ventricular fibrillation before primary angioplasty in patients with first ST-elevation myocardial infarction: a nationwide study in Denmark.

    Science.gov (United States)

    Jabbari, Reza; Engstrøm, Thomas; Glinge, Charlotte; Risgaard, Bjarke; Jabbari, Javad; Winkel, Bo Gregers; Terkelsen, Christian Juhl; Tilsted, Hans-Henrik; Jensen, Lisette Okkels; Hougaard, Mikkel; Chiuve, Stephanie E; Pedersen, Frants; Svendsen, Jesper Hastrup; Haunsø, Stig; Albert, Christine M; Tfelt-Hansen, Jacob

    2015-01-05

    We aimed to investigate the incidence and risk factors for ventricular fibrillation (VF) before primary percutaneous coronary intervention (PPCI) among patients with ST-segment elevation myocardial infarction (STEMI) in a prospective nationwide setting. In this case-control study, patients presenting within the first 12 hours of first STEMI who survived to undergo angiography and subsequent PPCI were enrolled. Over 2 years, 219 cases presenting with VF before PPCI and 441 controls without preceding VF were enrolled. Of the 219 case patients, 182 (83%) had STEMI with out-of-hospital cardiac arrest due to VF, and 37 (17%) had cardiac arrest upon arrival to the emergency room. Medical history was collected by standardized interviews and by linkage to national electronic health records. The incidence of VF before PPCI among STEMI patients was 11.6%. Multivariable logistic regression analysis identified novel associations between atrial fibrillation and alcohol consumption with VF. Patients with a history of atrial fibrillation had a 2.80-fold odds of experiencing VF before PPCI (95% CI 1.10 to 7.30). Compared with nondrinkers, patients who consumed 1 to 7 units, 8 to 14 units, or >15 units of alcohol per week had an odds ratio (OR) of 1.30 (95% CI, 0.80 to 2.20), 2.30 (95% CI, 1.20 to 4.20), or 3.30 (95% CI, 1.80 to 5.90), respectively, for VF. Previously reported associations for preinfarction angina (OR 0.46; 95% CI 0.32 to 0.67), age of history of sudden death (OR 1.60; 95% CI 1.10 to 2.40) were all associated with VF. Several easily assessed risk factors were associated with VF occurring out-of-hospital or on arrival at the emergency room before PPCI in STEMI patients, thus providing potential avenues for investigation regarding improved identification and prevention of life-threatening ventricular arrhythmias. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  20. Effects of Daily Almond Consumption on Cardiometabolic Risk and Abdominal Adiposity in Healthy Adults With Elevated LDL‐Cholesterol: A Randomized Controlled Trial

    Science.gov (United States)

    Berryman, Claire E.; West, Sheila G.; Fleming, Jennifer A.; Bordi, Peter L.; Kris‐Etherton, Penny M.

    2015-01-01

    Background Evidence consistently shows that almond consumption beneficially affects lipids and lipoproteins. Almonds, however, have not been evaluated in a controlled‐feeding setting using a diet design with only a single, calorie‐matched food substitution to assess their specific effects on cardiometabolic risk factors. Methods and Results In a randomized, 2‐period (6 week/period), crossover, controlled‐feeding study of 48 individuals with elevated LDL‐C (149±3 mg/dL), a cholesterol‐lowering diet with almonds (1.5 oz. of almonds/day) was compared to an identical diet with an isocaloric muffin substitution (no almonds/day). Differences in the nutrient profiles of the control (58% CHO, 15% PRO, 26% total fat) and almond (51% CHO, 16% PRO, 32% total fat) diets were due to nutrients inherent to each snack; diets did not differ in saturated fat or cholesterol. The almond diet, compared with the control diet, decreased non‐HDL‐C (−6.9±2.4 mg/dL; P=0.01) and LDL‐C (−5.3±1.9 mg/dL; P=0.01); furthermore, the control diet decreased HDL‐C (−1.7±0.6 mg/dL; P<0.01). Almond consumption also reduced abdominal fat (−0.07±0.03 kg; P=0.02) and leg fat (−0.12±0.05 kg; P=0.02), despite no differences in total body weight. Conclusions Almonds reduced non‐HDL‐C, LDL‐C, and central adiposity, important risk factors for cardiometabolic dysfunction, while maintaining HDL‐C concentrations. Therefore, daily consumption of almonds (1.5 oz.), substituted for a high‐carbohydrate snack, may be a simple dietary strategy to prevent the onset of cardiometabolic diseases in healthy individuals. Clinical Trial Registration URL: www.clinicaltrials.gov; Unique Identifier: NCT01101230. PMID:25559009

  1. Effects of daily almond consumption on cardiometabolic risk and abdominal adiposity in healthy adults with elevated LDL-cholesterol: a randomized controlled trial.

    Science.gov (United States)

    Berryman, Claire E; West, Sheila G; Fleming, Jennifer A; Bordi, Peter L; Kris-Etherton, Penny M

    2015-01-05

    Evidence consistently shows that almond consumption beneficially affects lipids and lipoproteins. Almonds, however, have not been evaluated in a controlled-feeding setting using a diet design with only a single, calorie-matched food substitution to assess their specific effects on cardiometabolic risk factors. In a randomized, 2-period (6 week/period), crossover, controlled-feeding study of 48 individuals with elevated LDL-C (149±3 mg/dL), a cholesterol-lowering diet with almonds (1.5 oz. of almonds/day) was compared to an identical diet with an isocaloric muffin substitution (no almonds/day). Differences in the nutrient profiles of the control (58% CHO, 15% PRO, 26% total fat) and almond (51% CHO, 16% PRO, 32% total fat) diets were due to nutrients inherent to each snack; diets did not differ in saturated fat or cholesterol. The almond diet, compared with the control diet, decreased non-HDL-C (-6.9±2.4 mg/dL; P=0.01) and LDL-C (-5.3±1.9 mg/dL; P=0.01); furthermore, the control diet decreased HDL-C (-1.7±0.6 mg/dL; P<0.01). Almond consumption also reduced abdominal fat (-0.07±0.03 kg; P=0.02) and leg fat (-0.12±0.05 kg; P=0.02), despite no differences in total body weight. Almonds reduced non-HDL-C, LDL-C, and central adiposity, important risk factors for cardiometabolic dysfunction, while maintaining HDL-C concentrations. Therefore, daily consumption of almonds (1.5 oz.), substituted for a high-carbohydrate snack, may be a simple dietary strategy to prevent the onset of cardiometabolic diseases in healthy individuals. www.clinicaltrials.gov; Unique Identifier: NCT01101230. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  2. Inter-arm blood pressure difference and mortality: a cohort study in an asymptomatic primary care population at elevated cardiovascular risk.

    Science.gov (United States)

    Clark, Christopher E; Taylor, Rod S; Butcher, Isabella; Stewart, Marlene Cw; Price, Jackie; Fowkes, F Gerald R; Shore, Angela C; Campbell, John L

    2016-05-01

    Differences in blood pressure between arms are associated with increased cardiovascular mortality in cohorts with established vascular disease or substantially elevated cardiovascular risk. To explore the association of inter-arm difference (IAD) with mortality in a community-dwelling cohort that is free of cardiovascular disease. Cohort analysis of a randomised controlled trial in central Scotland, from April 1998 to October 2008. Volunteers from Lanarkshire, Glasgow, and Edinburgh, free of pre-existing vascular disease and with an ankle-brachial index ≤0.95, had systolic blood pressure measured in both arms at recruitment. Inter-arm blood pressure differences were calculated and examined for cross-sectional associations and differences in prospective survival. Outcome measures were cardiovascular events and all-cause mortality during mean follow-up of 8.2 years. Based on a single pair of measurements, 60% of 3350 participants had a systolic IAD ≥5 mmHg and 38% ≥10 mmHg. An IAD ≥5 mmHg was associated with increased cardiovascular mortality (adjusted hazard ratio [HR] 1.91, 95% confidence interval [CI] = 1.19 to 3.07) and all-cause mortality (adjusted HR 1.44, 95% CI = 1.15 to 1.79). Within the subgroup of 764 participants who had hypertension, IADs of ≥5 mmHg or ≥10 mmHg were associated with both cardiovascular mortality (adjusted HR 2.63, 95% CI = 0.97 to 7.02, and adjusted HR 2.96, 95% CI = 1.27 to 6.88, respectively) and all-cause mortality (adjusted HR 1.67, 95% CI = 1.05 to 2.66, and adjusted HR 1.63, 95% CI = 1.06 to 2.50, respectively). IADs ≥15 mmHg were not associated with survival differences in this population. Systolic IADs in blood pressure are associated with increased risk of cardiovascular events, including mortality, in a large cohort of people free of pre-existing vascular disease. © British Journal of General Practice 2016.

  3. Clinical presentation, Quality of care, Risk factors and Outcomes in Women with Acute ST-Elevation Myocardial Infarction (STEMI): An Observational Report from Six Middle Eastern Countries.

    Science.gov (United States)

    Shehab, Abdulla; AlHabib, Khalid F; Bhagavathula, Akshaya Srikanth; Hersi, Ahmad; Alfaleh, Hussam; Alshamiri, Mostafa Q; Ullah, Anhar; Sulaiman, Khadim; Almahmeed, Wael; Al Suwaidi, Jassim; Alsheikh-Ali, Alwai A; Amin, Haitham; Al Jarallah, Mohammed; Salam, Amar M

    2018-03-14

    Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. To examine the clinical presentation, patient management, quality of care, risk factors and in-hospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries. The study included 2928 patients; 296 women (10.1%) and 2632 men (89.9%). Clinical presentations, management and in-hospital outcomes were compared between the 2 groups. Women were 10 years older and more likely to have diabetes mellitus, hypertension, and hyperlipidemia compared with men who were more likely to be smokers (all p<0.001). Women had longer median symptom-onset to emergency department (ED) arrival times (230 vs. 170 min, p<0.001) and ED to diagnostic ECG (8 vs. 6 min., p<0.001). When primary percutaneous coronary intervention (PPCI) was performed, women had longer door-to-balloon time (DBT) (86 vs. 73 min., p=0.009). When thrombolytic therapy was not administered, women were less likely to receive PPCI (69.7 vs. 76.7%, p=0.036). The mean duration of hospital stay was longer in women (6.03 ± 22.51 vs. 3.41 ± 19.45 days, p=0.032) and the crude in-hospital mortality rate was higher in women (10.4 vs. 5.2%, p<0.001). However, after adjustments, multivariate analysis revealed a statistically non-significant trend of higher in-hospital mortality among women than men (6.4 vs. 4.6%), (p=0.145). Our study demonstrates that women in our region have almost double the mortality from STEMI compared with men. Although this can partially be explained by older age and higher risk profiles in women, however, correction of identified gaps in quality of care should be attempted to reduce

  4. Screening for elevated risk of liver disease in preschool children (aged 2-5 years) being seen for obesity management.

    Science.gov (United States)

    Beacher, Daniel R; Ariza, Adolfo J; Fishbein, Mark H; Binns, Helen J

    2014-01-01

    Elevated alanine aminotransferase can heighten concern for the presence of nonalcoholic fatty liver disease in obese children. Guidelines recommend alanine aminotransferase screening of obese children start at the age of 10 years. We examined alanine aminotransferase values routinely obtained for tertiary obesity care among preschool (2-5 years) and school-age children. Medical records of children attending a tertiary obesity clinic and with alanine aminotransferase measured within 6 months of the initial visit were reviewed. Children with known genetic abnormalities were excluded. Children were grouped by age to focus attention on groups not covered by screening guidelines. Associations with elevated alanine aminotransferase (>30 IU/L) were examined. A total of 284 records were analyzed (73 preschool, 143 young school-age (6-9 years), 68 older school-age (10-11 years)). Children were primarily Hispanic and had body mass index ≥ 99th percentile (preschool children 92%, young school-age 73%, older school-age 59%). In all, 26% of preschool children had elevated alanine aminotransferase (young school-age 30%, older school-age 44%). Preschool children with elevated alanine aminotransferase had higher body mass index compared to preschool children with alanine aminotransferase ≤ 30 IU/L (median body mass index 27.8 kg/m(2) vs 24.0 kg/m(2); Mann-Whitney U test, p = 0.003), but there was no disparity for elevated alanine aminotransferase related to Hispanic ethnicity. For older children, Hispanic ethnicity, not body mass index, predicted elevated alanine aminotransferase. Alanine aminotransferase elevation was common in these preschool children. Screening severely obese children for elevated alanine aminotransferase should begin at the age of 2 years.

  5. Screening for elevated risk of liver disease in preschool children (aged 2–5 years being seen for obesity management

    Directory of Open Access Journals (Sweden)

    Daniel R Beacher

    2014-10-01

    Full Text Available Objectives: Elevated alanine aminotransferase can heighten concern for the presence of nonalcoholic fatty liver disease in obese children. Guidelines recommend alanine aminotransferase screening of obese children start at the age of 10 years. We examined alanine aminotransferase values routinely obtained for tertiary obesity care among preschool (2–5 years and school-age children. Methods: Medical records of children attending a tertiary obesity clinic and with alanine aminotransferase measured within 6 months of the initial visit were reviewed. Children with known genetic abnormalities were excluded. Children were grouped by age to focus attention on groups not covered by screening guidelines. Associations with elevated alanine aminotransferase (>30 IU/L were examined. Results: A total of 284 records were analyzed (73 preschool, 143 young school-age (6–9 years, 68 older school-age (10–11 years. Children were primarily Hispanic and had body mass index ≥ 99th percentile (preschool children 92%, young school-age 73%, older school-age 59%. In all, 26% of preschool children had elevated alanine aminotransferase (young school-age 30%, older school-age 44%. Preschool children with elevated alanine aminotransferase had higher body mass index compared to preschool children with alanine aminotransferase ≤ 30 IU/L (median body mass index 27.8 kg/m2 vs 24.0 kg/m2; Mann–Whitney U test, p = 0.003, but there was no disparity for elevated alanine aminotransferase related to Hispanic ethnicity. For older children, Hispanic ethnicity, not body mass index, predicted elevated alanine aminotransferase. Conclusion: Alanine aminotransferase elevation was common in these preschool children. Screening severely obese children for elevated alanine aminotransferase should begin at the age of 2 years.

  6. Genotype-specific risk factors for Staphylococcus aureus in Swiss dairy herds with an elevated yield-corrected herd somatic cell count.

    Science.gov (United States)

    Berchtold, B; Bodmer, M; van den Borne, B H P; Reist, M; Graber, H U; Steiner, A; Boss, R; Wohlfender, F

    2014-01-01

    Bovine mastitis is a frequent problem in Swiss dairy herds. One of the main pathogens causing significant economic loss is Staphylococcus aureus. Various Staph. aureus genotypes with different biological properties have been described. Genotype B (GTB) of Staph. aureus was identified as the most contagious and one of the most prevalent strains in Switzerland. The aim of this study was to identify risk factors associated with the herd-level presence of Staph. aureus GTB and Staph. aureus non-GTB in Swiss dairy herds with an elevated yield-corrected herd somatic cell count (YCHSCC). One hundred dairy herds with a mean YCHSCC between 200,000 and 300,000cells/mL in 2010 were recruited and each farm was visited once during milking. A standardized protocol investigating demography, mastitis management, cow husbandry, milking system, and milking routine was completed during the visit. A bulk tank milk (BTM) sample was analyzed by real-time PCR for the presence of Staph. aureus GTB to classify the herds into 2 groups: Staph. aureus GTB-positive and Staph. aureus GTB-negative. Moreover, quarter milk samples were aseptically collected for bacteriological culture from cows with a somatic cell count ≥150,000cells/mL on the last test-day before the visit. The culture results allowed us to allocate the Staph. aureus GTB-negative farms to Staph. aureus non-GTB and Staph. aureus-free groups. Multivariable multinomial logistic regression models were built to identify risk factors associated with the herd-level presence of Staph. aureus GTB and Staph. aureus non-GTB. The prevalence of Staph. aureus GTB herds was 16% (n=16), whereas that of Staph. aureus non-GTB herds was 38% (n=38). Herds that sent lactating cows to seasonal communal pastures had significantly higher odds of being infected with Staph. aureus GTB (odds ratio: 10.2, 95% CI: 1.9-56.6), compared with herds without communal pasturing. Herds that purchased heifers had significantly higher odds of being infected with

  7. Mercury in terrestrial forested systems with highly elevated mercury deposition in southwestern China: The risk to insects and potential release from wildfires

    International Nuclear Information System (INIS)

    Zhou, Jun; Wang, Zhangwei; Sun, Ting; Zhang, Huan; Zhang, Xiaoshan

    2016-01-01

    Forests are considered a pool of mercury in the global mercury cycle. However, few studies have investigated the distribution of mercury in the forested systems in China. Tieshanping forest catchment in southwest China was impacted by mercury emissions from industrial activities and coal combustions. Our work studied mercury content in atmosphere, soil, vegetation and insect with a view to estimating the potential for mercury release during forest fires. Results of the present study showed that total gaseous mercury (TGM) was highly elevated and the annual mean concentration was 3.51 ± 1.39 ng m"−"2. Of the vegetation tissues, the mercury concentration follows the order of leaf/needle > root > bark > branch > bole wood for each species. Total ecosystem mercury pool was 103.5 mg m"−"2 and about 99.4% of the mercury resides in soil layers (0–40 cm). The remaining 0.6% (0.50 mg m"−"2) of mercury was stored in biomass. The large mercury stocks in the forest ecosystem pose a serious threat for large pluses to the atmospheric mercury during potential wildfires and additional ecological stress to forest insect: dung beetles, cicada and longicorn, with mercury concentration of 1983 ± 446, 49 ± 38 and 7 ± 5 ng g"−"1, respectively. Hence, the results obtained in the present study has implications for global estimates of mercury storage in forests, risks to forest insect and potential release to the atmosphere during wildfires. - Highlights: • Mercury in air, soil, biomass and insect were studied at a subtropical forest. • 99.4% of the total ecosystem mercury pools was resided in soil layers. • High mercury pools were large pulses to the atmosphere during potential wildfires. • High mercury deposition in forest pose an ecological stress to insect. - Large mercury pools in forest pose a serious threat for large pluses to the atmospheric mercury during potential wildfires and ecological stress to insect.

  8. Multi-vendor, multicentre comparison of contrast-enhanced SSFP and T2-STIR CMR for determining myocardium at risk in ST-elevation myocardial infarction

    Science.gov (United States)

    Nordlund, David; Klug, Gert; Heiberg, Einar; Koul, Sasha; Larsen, Terje H.; Hoffmann, Pavel; Metzler, Bernhard; Erlinge, David; Atar, Dan; Aletras, Anthony H.; Carlsson, Marcus; Engblom, Henrik; Arheden, Håkan

    2016-01-01

    Aims Myocardial salvage, determined by cardiac magnetic resonance imaging (CMR), is used as end point in cardioprotection trials. To calculate myocardial salvage, infarct size is related to myocardium at risk (MaR), which can be assessed by T2-short tau inversion recovery (T2-STIR) and contrast-enhanced steady-state free precession magnetic resonance imaging (CE-SSFP). We aimed to determine how T2-STIR and CE-SSFP perform in determining MaR when applied in multicentre, multi-vendor settings. Methods and results A total of 215 patients from 17 centres were included after percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction. CMR was performed within 1–8 days. These patients participated in the MITOCARE or CHILL-MI cardioprotection trials. Additionally, 8 patients from a previous study, imaged 1 day post-CMR, were included. Late gadolinium enhancement, T2-STIR, and CE-SSFP images were acquired on 1.5T MR scanners (Philips, Siemens, or GE). In 65% of the patients, T2-STIR was of diagnostic quality compared with 97% for CE-SSFP. In diagnostic quality images, there was no difference in MaR by T2-STIR and CE-SSFP (bias: 0.02 ± 6%, P = 0.96, r2 = 0.71, P < 0.001), or between treatment and control arms. No change in size or quality of MaR nor ability to identify culprit artery was seen over the first week after the acute event (P = 0.44). Conclusion In diagnostic quality images, T2-STIR and CE-SSFP provide similar estimates of MaR, were constant over the first week, and were not affected by treatment. CE-SSFP had a higher degree of diagnostic quality images compared with T2 imaging for sequences from two out of three vendors. Therefore, CE-SSFP is currently more suitable for implementation in multicentre, multi-vendor clinical trials. PMID:27002140

  9. Herbicides: A new threat to the Great Barrier Reef

    International Nuclear Information System (INIS)

    Lewis, Stephen E.; Brodie, Jon E.; Bainbridge, Zoe T.; Rohde, Ken W.; Davis, Aaron M.; Masters, Bronwyn L.; Maughan, Mirjam; Devlin, Michelle J.; Mueller, Jochen F.; Schaffelke, Britta

    2009-01-01

    The runoff of pesticides (insecticides, herbicides and fungicides) from agricultural lands is a key concern for the health of the iconic Great Barrier Reef, Australia. Relatively low levels of herbicide residues can reduce the productivity of marine plants and corals. However, the risk of these residues to Great Barrier Reef ecosystems has been poorly quantified due to a lack of large-scale datasets. Here we present results of a study tracing pesticide residues from rivers and creeks in three catchment regions to the adjacent marine environment. Several pesticides (mainly herbicides) were detected in both freshwater and coastal marine waters and were attributed to specific land uses in the catchment. Elevated herbicide concentrations were particularly associated with sugar cane cultivation in the adjacent catchment. We demonstrate that herbicides reach the Great Barrier Reef lagoon and may disturb sensitive marine ecosystems already affected by other pressures such as climate change. - Herbicide residues have been detected in Great Barrier Reef catchment waterways and river water plumes which may affect marine ecosystems.

  10. Impact of acute hyperglycemia on myocardial infarct size, area at risk and salvage in patients with ST elevation myocardial infarction and the association with exenatide treatment - results from a randomized study

    DEFF Research Database (Denmark)

    Lønborg, Jacob Thomsen; Vejlstrup, Niels Grove; Kelbæk, Henning Skov

    2014-01-01

    Hyperglycemia upon hospital admission in patients with ST-segment elevation myocardial infarction (STEMI) occurs frequently and is associated with adverse outcomes. It is, however, unsettled as to whether an elevated blood glucose level is the cause or consequence of increased myocardial damage....... In addition, whether the cardioprotective effect of exenatide, a glucose-lowering drug, is dependent on hyperglycemia remains unknown. The objectives of this substudy were to evaluate the association between hyperglycemia and infarct size, myocardial salvage, and area at risk, and to assess the interaction...... between exenatide and hyperglycemia. A total of 210 STEMI patients were randomized to receive intravenous exenatide or placebo before percutaneous coronary intervention. Hyperglycemia was associated with larger area at risk and infarct size compared with patients with normoglycemia, but the salvage index...

  11. Hyalomma ticks on northward migrating birds in southern Spain: Implications for the risk of entry of Crimean-Congo haemorrhagic fever virus to Great Britain.

    Science.gov (United States)

    England, Marion E; Phipps, Paul; Medlock, Jolyon M; Atkinson, Peter M; Atkinson, Barry; Hewson, Roger; Gale, Paul

    2016-06-01

    Crimean-Congo haemorrhagic fever virus (CCHFV) is a zoonotic virus transmitted by Hyalomma ticks, the immature stages of which may be carried by migratory birds. In this study, a total of 12 Hyalomma ticks were recovered from five of 228 migratory birds trapped in Spring, 2012 in southern Spain along the East Atlantic flyway. All collected ticks tested negative for CCHFV. While most birds had zero Hyalomma ticks, two individuals had four and five ticks each and the statistical distribution of Hyalomma tick counts per bird is over-dispersed compared to the Poisson distribution, demonstrating the need for intensive sampling studies to avoid underestimating the total number of ticks. Rates of tick exchange on migratory birds during their northwards migration will affect the probability that a Hyalomma tick entering Great Britain is positive for CCHFV. Drawing on published data, evidence is presented that the latitude of a European country affects the probability of entry of Hyalomma ticks on wild birds. Further data on Hyalomma infestation rates and tick exchange rates are required along the East Atlantic flyway to further our understanding of the origin of Hyalomma ticks (i.e., Africa or southern Europe) and hence the probability of entry of CCHFV into GB. © 2016 The Society for Vector Ecology.

  12. THE PREVALENCE OF ELEVATED LEVELS OF C-REACTIVE PROTEIN AND ITS ASSOCIATION WITH TRADITIONAL RISK FACTORS AND MORBIDITY AMONG RESIDENTS OF THE RUSSIAN FEDERATION (ACCORDING TO THE ESSE-RF STUDY

    Directory of Open Access Journals (Sweden)

    S. E. Evstifeeva

    2015-09-01

    Full Text Available Aim. To study the association of high-sensitivity C-reactive protein (hsCRP level with socio-demographic, behavioral and traditional risk factors in different regions of the Russian Federation (RF.Material and methods. Data of the multicenter epidemiological study of cardiovascular disease in different regions of the Russian Federation (ESSE-RF were used. Representative sample of the unorganized male and female population aged 25-64 from 6 regions of the Russian Federation was drown. 3407 men and 6354 women (n=9761 were included into the study. Standard questionnaire was applied in all subjects. Gender, age, level of education, place of residence and region of residence, traditional risk factors and diseases were analyzed. HsCRP level (level ≥3.0 mg/l was defined as elevated one was evaluated to detect of indolent inflammation.Results. HsCRP levels in women was significantly higher compared to males (p<0.005. The average prevalence of elevated hsCRP in the regions was 24.2%, for men - 21.4%, and for women - 25.7% (p<0.005. Significant age-related dynamics of hsCRP (p<0.0001 was found. The average level of hsCRP was significantly lower (p<0.0001 in a cohort of persons with higher education against these with lower level of education. Level of hsCRP as well as prevalence of elevated hsCRP level were higher in villagers than this in the urban population (p<0.05. Prevalence of elevated hsCRP in patients with traditional risk factors after adjustment for sex, age, and region of residence showed that the elevated hsCRP was mostly associated with metabolic factors and diseases that were characterized by systemic inflammation.Conclusion. Elevated level of hsCRP (≥3.0 mg/l was significantly associated with female gender, with an older, less educated, and smoking population of Russians. After the multivariate adjustment there remained significant associations (p<0.0001 of elevated hsCRP level with obesity, including abdominal obesity, hyperglycemia

  13. THE PREVALENCE OF ELEVATED LEVELS OF C-REACTIVE PROTEIN AND ITS ASSOCIATION WITH TRADITIONAL RISK FACTORS AND MORBIDITY AMONG RESIDENTS OF THE RUSSIAN FEDERATION (ACCORDING TO THE ESSE-RF STUDY

    Directory of Open Access Journals (Sweden)

    S. E. Evstifeeva

    2014-01-01

    Full Text Available Aim. To study the association of high-sensitivity C-reactive protein (hsCRP level with socio-demographic, behavioral and traditional risk factors in different regions of the Russian Federation (RF.Material and methods. Data of the multicenter epidemiological study of cardiovascular disease in different regions of the Russian Federation (ESSE-RF were used. Representative sample of the unorganized male and female population aged 25-64 from 6 regions of the Russian Federation was drown. 3407 men and 6354 women (n=9761 were included into the study. Standard questionnaire was applied in all subjects. Gender, age, level of education, place of residence and region of residence, traditional risk factors and diseases were analyzed. HsCRP level (level ≥3.0 mg/l was defined as elevated one was evaluated to detect of indolent inflammation.Results. HsCRP levels in women was significantly higher compared to males (p<0.005. The average prevalence of elevated hsCRP in the regions was 24.2%, for men - 21.4%, and for women - 25.7% (p<0.005. Significant age-related dynamics of hsCRP (p<0.0001 was found. The average level of hsCRP was significantly lower (p<0.0001 in a cohort of persons with higher education against these with lower level of education. Level of hsCRP as well as prevalence of elevated hsCRP level were higher in villagers than this in the urban population (p<0.05. Prevalence of elevated hsCRP in patients with traditional risk factors after adjustment for sex, age, and region of residence showed that the elevated hsCRP was mostly associated with metabolic factors and diseases that were characterized by systemic inflammation.Conclusion. Elevated level of hsCRP (≥3.0 mg/l was significantly associated with female gender, with an older, less educated, and smoking population of Russians. After the multivariate adjustment there remained significant associations (p<0.0001 of elevated hsCRP level with obesity, including abdominal obesity, hyperglycemia

  14. National Elevation Dataset (NED)

    Data.gov (United States)

    Kansas Data Access and Support Center — The U.S. Geological Survey has developed a National Elevation Database (NED). The NED is a seamless mosaic of best-available elevation data. The 7.5-minute elevation...

  15. Elevated Liver Enzymes

    Science.gov (United States)

    Symptoms Elevated liver enzymes By Mayo Clinic Staff Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Inflamed or ... than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated ...

  16. Great Lakes Literacy Principles

    Science.gov (United States)

    Fortner, Rosanne W.; Manzo, Lyndsey

    2011-03-01

    Lakes Superior, Huron, Michigan, Ontario, and Erie together form North America's Great Lakes, a region that contains 20% of the world's fresh surface water and is home to roughly one quarter of the U.S. population (Figure 1). Supporting a $4 billion sport fishing industry, plus $16 billion annually in boating, 1.5 million U.S. jobs, and $62 billion in annual wages directly, the Great Lakes form the backbone of a regional economy that is vital to the United States as a whole (see http://www.miseagrant.umich.edu/downloads/economy/11-708-Great-Lakes-Jobs.pdf). Yet the grandeur and importance of this freshwater resource are little understood, not only by people in the rest of the country but also by many in the region itself. To help address this lack of knowledge, the Centers for Ocean Sciences Education Excellence (COSEE) Great Lakes, supported by the U.S. National Science Foundation and the National Oceanic and Atmospheric Administration, developed literacy principles for the Great Lakes to serve as a guide for education of students and the public. These “Great Lakes Literacy Principles” represent an understanding of the Great Lakes' influences on society and society's influences on the Great Lakes.

  17. The Next Great Generation?

    Science.gov (United States)

    Brownstein, Andrew

    2000-01-01

    Discusses ideas from a new book, "Millennials Rising: The Next Great Generation," (by Neil Howe and William Strauss) suggesting that youth culture is on the cusp of a radical shift with the generation beginning with this year's college freshmen who are typically team oriented, optimistic, and poised for greatness on a global scale. Includes a…

  18. Estimating the Exposure of Coral Reefs and Seagrass Meadows to Land-Sourced Contaminants in River Flood Plumes of the Great Barrier Reef: Validating a Simple Satellite Risk Framework with Environmental Data

    Directory of Open Access Journals (Sweden)

    Caroline Petus

    2016-03-01

    Full Text Available River runoff and associated flood plumes (hereafter river plumes are a major source of land-sourced contaminants to the marine environment, and are a significant threat to coastal and marine ecosystems worldwide. Remote sensing monitoring products have been developed to map the spatial extent, composition and frequency of occurrence of river plumes in the Great Barrier Reef (GBR, Australia. There is, however, a need to incorporate these monitoring products into Risk Assessment Frameworks as management decision tools. A simple Satellite Risk Framework has been recently proposed to generate maps of potential risk to seagrass and coral reef ecosystems in the GBR focusing on the Austral tropical wet season. This framework was based on a “magnitude × likelihood” risk management approach and GBR plume water types mapped from satellite imagery. The GBR plume water types (so called “Primary” for the inshore plume waters, “Secondary” for the midshelf-plume waters and “Tertiary” for the offshore plume waters represent distinct concentrations and combinations of land-sourced and marine contaminants. The current study aimed to test and refine the methods of the Satellite Risk Framework. It compared predicted pollutant concentrations in plume water types (multi-annual average from 2005–2014 to published ecological thresholds, and combined this information with similarly long-term measures of seagrass and coral ecosystem health. The Satellite Risk Framework and newly-introduced multi-annual risk scores were successful in demonstrating where water conditions were, on average, correlated to adverse biological responses. Seagrass meadow abundance (multi-annual change in % cover was negatively correlated to the multi-annual risk score at the site level (R2 = 0.47, p < 0.05. Relationships between multi-annual risk scores and multi-annual changes in proportional macroalgae cover (as an index for coral reef health were more complex (R2 = 0.04, p

  19. A Common Variant in SCN5A and the Risk of Ventricular Fibrillation Caused by First ST-Segment Elevation Myocardial Infarction

    DEFF Research Database (Denmark)

    Jabbari, Reza; Glinge, Charlotte; Jabbari, Javad

    2017-01-01

    Background Several common genetic variants have been associated with either ventricular fibrillation (VF) or sudden cardiac death (SCD). However, replication efforts have been limited. Therefore, we aimed to analyze whether such variants may contribute to VF caused by first ST-elevation myocardia...

  20. The risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio

    NARCIS (Netherlands)

    Brisco, Meredith A.; Zile, Michael R.; ter Maaten, Jozine M.; Hanberg, Jennifer S.; Wilson, F. Perry; Parikh, Chirag; Testani, Jeffrey M.

    2016-01-01

    Background: Renal dysfunction (RD) is associated with reduced survival in HF; however, not all RD is mechanistically or prognostically equivalent. Notably, RD associated with "pre-renal" physiology, as identified by an elevated blood urea nitrogen to creatinine ratio (BUN/Cr), identifies a

  1. Criticism by community people and poor workplace communication as risk factors for the mental health of local welfare workers after the Great East Japan Earthquake: A cross-sectional study.

    Science.gov (United States)

    Ueda, Ikki; Sakuma, Atsushi; Takahashi, Yoko; Shoji, Wataru; Nagao, Ayami; Abe, Mikika; Suzuki, Yuriko; Matsuoka, Hiroo; Matsumoto, Kazunori

    2017-01-01

    After a large-scale natural disaster, demand for social welfare services increases, and the mental health of local social welfare workers becomes a matter of great concern because of their dual role as support providers and disaster survivors. We examined whether work-related social stressors, including criticism by community people and poor workplace communication, were associated with increased risk of post-traumatic stress disorder (PTSD), depression, or psychological distress 20-22 months after the Great East Japan Earthquake (GEJE; March 11, 2011) in local social welfare workers. Demographic characteristics, disaster-related risk factors (near-death experience, dead/missing family members, loss of housing), and work-related social risk factors (criticism, lack of communication) were obtained 20-22 months after the GEJE from 822 local workers. Questionnaires measured PTSD, depression, and psychological stress. Bivariate and multivariate regression analyses were applied. More local social welfare workers suffered from mental health problems than would be expected. Criticism by community people was significantly associated with probable PTSD and high psychological distress (adjusted odds ratio = 2.31 and 2.55, respectively). Furthermore, lack of workplace communication was associated with probable PTSD, depression, and high psychological distress (adjusted odds ratio = 3.97, 4.27, and 4.65, respectively). Almost 2 years after the disaster, local relief workers still suffered from mental health problems. Because post-disaster work-related social stressors constitute risk factors for these mental health problems, measures to improve working conditions and prevent and treat mental disorders should be a priority.

  2. Criticism by community people and poor workplace communication as risk factors for the mental health of local welfare workers after the Great East Japan Earthquake: A cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Ikki Ueda

    Full Text Available After a large-scale natural disaster, demand for social welfare services increases, and the mental health of local social welfare workers becomes a matter of great concern because of their dual role as support providers and disaster survivors. We examined whether work-related social stressors, including criticism by community people and poor workplace communication, were associated with increased risk of post-traumatic stress disorder (PTSD, depression, or psychological distress 20-22 months after the Great East Japan Earthquake (GEJE; March 11, 2011 in local social welfare workers. Demographic characteristics, disaster-related risk factors (near-death experience, dead/missing family members, loss of housing, and work-related social risk factors (criticism, lack of communication were obtained 20-22 months after the GEJE from 822 local workers. Questionnaires measured PTSD, depression, and psychological stress. Bivariate and multivariate regression analyses were applied. More local social welfare workers suffered from mental health problems than would be expected. Criticism by community people was significantly associated with probable PTSD and high psychological distress (adjusted odds ratio = 2.31 and 2.55, respectively. Furthermore, lack of workplace communication was associated with probable PTSD, depression, and high psychological distress (adjusted odds ratio = 3.97, 4.27, and 4.65, respectively. Almost 2 years after the disaster, local relief workers still suffered from mental health problems. Because post-disaster work-related social stressors constitute risk factors for these mental health problems, measures to improve working conditions and prevent and treat mental disorders should be a priority.

  3. ST Elevations and Elevated Cardiac Enzymes Not Always a STEMI: Two Case Reports.

    Science.gov (United States)

    Fernández Fernández, Juan; Deliz-Guzmán, Claudia; Andino-Colón, César; Claudio-Hernández, Héctor; Lugo-Amador, Nannette

    2016-01-01

    Chest pain is a common complaint in the emergency department (ED). Besides a careful history and physical exam; electrocardiogram, laboratory tests and imaging studies are widely available diagnostic tests that are used for patient assessment. When ST elevation and elevated cardiac enzymes are present the most likely diagnosis are ST elevation myocardial infarction (STEMI) or myocarditis. In this case report we present two low risk patients for major adverse cardiac event with ST elevation and elevated cardiac enzymes and how a careful risk assessment and detailed electrocardiogram evaluation could help differentiating between these two diagnoses.

  4. Predictive value of NT-proBNP for 30-day mortality in patients with non-ST-elevation acute coronary syndromes: a comparison with the GRACE and TIMI risk scores.

    Science.gov (United States)

    Schellings, Dirk Aam; Adiyaman, Ahmet; Dambrink, Jan-Henk E; Gosselink, At Marcel; Kedhi, Elvin; Roolvink, Vincent; Ottervanger, Jan Paul; Van't Hof, Arnoud Wj

    2016-01-01

    The biomarker N-terminal pro-brain natriuretic peptide (NT-proBNP) predicts outcome in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). Whether NT-proBNP has incremental prognostic value beyond established risk strategies is still questionable. To evaluate the predictive value of NT-proBNP for 30-day mortality over and beyond the Global Registry of Acute Coronary Events (GRACE) and Thrombolysis In Myocardial Infarction (TIMI) risk scores in patients with NSTE-ACS. Patients included in our ACS registry were candidates. NT-proBNP levels on admission were measured and the GRACE and TIMI risk scores were assessed. We compared the predictive value of NT-proBNP to both risk scores and evaluated whether NT-proBNP improves prognostication by using receiver operator curves and measures of discrimination improvement. A total of 1324 patients were included and 50 patients died during follow-up. On logistic regression analysis NT-proBNP and the GRACE risk score (but not the TIMI risk score) both independently predicted mortality at 30 days. The predictive value of NT-proBNP did not differ significantly compared to the GRACE risk score (area under the curve [AUC]) 0.85 vs 0.87 p =0.67) but was considerably higher in comparison to the TIMI risk score (AUC 0.60 p risk score by adding NT-proBNP did not improve prognostication: AUC 0.86 ( p =0.57), integrated discrimination improvement 0.04 ( p =0.003), net reclassification improvement 0.12 ( p =0.21). In patients with NSTE-ACS, NT-proBNP and the GRACE risk score (but not the TIMI risk score) both have good and comparable predictive value for 30-day mortality. However, incremental prognostic value of NT-proBNP beyond the GRACE risk score could not be demonstrated.

  5. Additive prognostic value of left ventricular ejection fraction to the TIMI risk score for in-hospital and long-term mortality in patients with ST segment elevation myocardial infarction.

    Science.gov (United States)

    Wei, Xue-Biao; Liu, Yuan-Hui; He, Peng-Cheng; Jiang, Lei; Zhou, Ying-Ling; Chen, Ji-Yan; Tan, Ning; Yu, Dan-Qing

    2017-01-01

    To investigate whether the addition of left ventricular ejection fraction (LVEF) to the TIMI risk score enhances the prediction of in-hospital and long-term death in ST segment elevation myocardial infarction (STEMI) patients. 673 patients with STEMI were divided into three groups based on TIMI risk score for STEMI: low-risk group (TIMI ≤3, n = 213), moderate-risk group (TIMI 4-6, n = 285), and high-risk group (TIMI ≥7, n = 175). The predictive value was evaluated using the receiver operating characteristic. Multivariate logistic regression was used to determine risk predictors. The rates of in-hospital death (0.5 vs 3.2 vs 10.3 %, p risk group. Multivariate analysis showed that TIMI risk score (OR 1.24, 95 % CI 1.04-1.48, P = 0.015) and LVEF (OR 3.85, 95 % CI 1.58-10.43, P = 0.004) were independent predictors of in-hospital death. LVEF had good predictive value for in-hospital death (AUC: 0.838 vs 0.803, p = 0.571) or 1-year death (AUC: 0.743 vs 0.728, p = 0.775), which was similar to TIMI risk score. When compared with the TIMI risk score alone, the addition of LVEF was associated with significant improvements in predicting in-hospital (AUC: 0.854 vs 0.803, p = 0.033) or 1-year death (AUC: 0.763 vs 0.728, p = 0.016). The addition of LVEF to TIMI risk score enhanced net reclassification improvement (0.864 for in-hospital death, p value to TIMI risk score.

  6. Future water availability in the largest freshwater Mediterranean lake is at great risk as evidenced from simulations with the SWAT model.

    Science.gov (United States)

    Bucak, Tuba; Trolle, Dennis; Andersen, Hans Estrup; Thodsen, Hans; Erdoğan, Şeyda; Levi, Eti E; Filiz, Nur; Jeppesen, Erik; Beklioğlu, Meryem

    2017-03-01

    Inter- and intra-annual water level fluctuations and changes in water flow regime are intrinsic characteristics of Mediterranean lakes. Additionally, considering climate change projections for the water-limited Mediterranean region, increased air temperatures and decreased precipitation are anticipated, leading to dramatic declines in lake water levels as well as severe water scarcity problems. The study site, Lake Beyşehir, the largest freshwater lake in the Mediterranean basin, is - like other Mediterranean lakes - threatened by climatic changes and over-abstraction of water for irrigated crop farming. Therefore, implementation of strict water level management policies is required. In this study, an integrated modeling approach was used to predict the future water levels of Lake Beyşehir in response to potential future changes in climate and land use. Water level estimation was performed by linking the catchment model Soil and Water Assessment Tool (SWAT) with a Support Vector Regression model (ε-SVR). The projected increase in temperature and decrease in precipitation based on the climate change models led to an enhanced potential evapotranspiration and reduced total runoff. On the other hand, the effects of various land use scenarios within the catchment appeared to be comparatively insignificant. According to the ε-SVR model results, changes in hydrological processes caused a water level reduction for all scenarios. Moreover, the MPI-ESM-MR General Circulation Model outputs produced the most dramatic results by predicting that Lake Beyşehir may dry out by the 2040s with the current outflow regime. The results indicate that shallow Mediterranean lakes may face a severe risk of drying out and losing their ecosystem values in the near future if the current intensity of water abstraction is not reduced. In addition, the results also demonstrate that outflow management and sustainable use of water sources are vital to sustain lake ecosystems in water

  7. Interaction between dietary marine-derived n-3 fatty acids intake and J-point elevation on the risk of cardiac death: a 24-year follow-up of Japanese men.

    Science.gov (United States)

    Hisamatsu, Takashi; Miura, Katsuyuki; Ohkubo, Takayoshi; Yamamoto, Takashi; Fujiyoshi, Akira; Miyagawa, Naoko; Kadota, Aya; Takashima, Naoyuki; Okuda, Nagako; Matsumura, Yasuhiro; Yoshita, Katsushi; Kita, Yoshikuni; Murakami, Yoshitaka; Nakamura, Yasuyuki; Okamura, Tomonori; Horie, Minoru; Okayama, Akira; Ueshima, Hirotsugu

    2013-07-01

    Higher marine-derived n-3 fatty acids (MDn3FAs) intake reduces the risk of sudden cardiac death via antiarrhythmic effects. The article evaluates whether MDn3FAs intake attenuates the increased risk of cardiac death associated with J-point elevation (JPE), characterised by an elevation of QRS-ST junction (J-point) ≥0.1 mV on electrocardiography. A prospective population-based cohort study. The National Survey on Circulatory Disorders and the National Nutrition Survey of Japan. A total of 4348 community-dwelling men (mean age 49.3 years), without cardiovascular diseases at baseline, from randomly selected areas across Japan. Cardiac death (200 men) during the 24-year follow-up. Dietary MDn3FAs intake was assessed using a dietary method to estimate individual intake of household-based weighed food records for 3 days. Cox models were used to calculate HRs and 95% CIs adjusted for possible confounding factors. JPE was present in 340 participants (7.8%). The median daily intake of MDn3FAs was 0.35%kcal (0.92 g/day). The risk of cardiac death was significantly higher in participants with JPE than in those without JPE in the low intake group (death was statistically significant (p=0.006). The increased risk of cardiac death associated with JPE may be attenuated by higher dietary MDn3FAs intake.

  8. HIV and Elevated Mental Health Problems: Diagnostic, Treatment, and Risk Patterns for Symptoms of Depression, Anxiety, and Stress in a National Community-Based Cohort of Gay Men Living with HIV.

    Science.gov (United States)

    Heywood, Wendy; Lyons, Anthony

    2016-08-01

    People living with HIV (PLHIV) have almost double the risk of depression than the rest of the population, and depression and anxiety among PLHIV have been linked with greater disease progression and other physical health problems. Studies to date, however, have focused almost exclusively on depression or general mental health. Much less research has investigated predictors of anxiety and generalized stress among HIV-positive gay men. This paper reports findings from a national community-based sample of 357 HIV-positive Australians gay men aged 18 years and older. Participants reported elevated rates of depression, anxiety, and generalized stress symptoms. A significant proportion of men with elevated depression and anxiety symptoms were not receiving treatment or had not been diagnosed. Risk factors for elevated mental health concerns included experiences of internalized stigma and discrimination. Anxiety was also associated with lower T-cell CD4 counts. A key protective factor was access to social support. The type of support, in particular emotional support, was found to be more important than the source of support. Our findings suggest that greater emphasis is needed on mental health screening and the provision of emotional support for PLHIV.

  9. Great Indoors Awards 2007

    Index Scriptorium Estoniae

    2007-01-01

    Hollandis Maastrichtis jagati 17. XI esimest korda rahvusvahelist auhinda The Great Indoors Award. Aasta sisekujundusfirmaks valiti Masamichi Katayama asutatud Wonderwall. Auhinna said veel Zaha Hadid, Heatherwick Studio, Ryui Nakamura Architects ja Item Idem

  10. Great Lakes Bathymetry

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lakes Michigan, Erie, Saint Clair, Ontario and Huron has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and...

  11. Children with Elevated Psychosocial Risk Load Benefit Most from a Family-Based Preventive Intervention: Exploratory Differential Analyses from the German "Strengthening Families Program 10-14" Adaptation Trial.

    Science.gov (United States)

    Bröning, Sonja; Baldus, Christiane; Thomsen, Monika; Sack, Peter-Michael; Arnaud, Nicolas; Thomasius, Rainer

    2017-11-01

    While the effectiveness of substance use prevention programs such as the Strengthening Families Program 10-14 (SFP) has been demonstrated in the USA, European SFP adaptations have not replicated these sizable effects. Following the rationale of the risk moderation hypothesis positing that elevated risk groups may benefit more from a preventive intervention than lower-risk groups, we reanalyzed evaluation data from a randomized controlled trial testing the adapted German version of SFP (SFP-D). We hypothesized a differential impact of risk status on intervention results. The study employed a minimal control condition. Of the N = 292 participating children, 73.5% qualified as at-risk because they lived in a deprived urban district, and 26.5% qualified as high risk because they additionally scored as "difficult" in the German Strengths and Difficulty Questionnaire (parents' reports using gender- and age-specific German norms). Outcomes were children's self-reports on substance use, mental health, family functioning, and quality of life. Data were analyzed with repeated measures linear mixed models and relative risk analyses. The high-risk group in the SFP-D condition achieved the best results compared with all other groups, especially in mental health and quality of life. Relative risk analyses on tobacco [alcohol] abstinence showed that an additional percentage of 29.8% [16.0%] of high-risk children in nonabstinent controls would have remained abstinent if they had participated in SFP-D. We conclude that risk load influences the impact of substance use prevention programs and discuss to what extent differential analyses can add value to prevention research.

  12. Understanding factors that influence the use of risk scoring instruments in the management of patients with unstable angina or non-ST-elevation myocardial infarction in the Netherlands: a qualitative study of health care practitioners' perceptions.

    Science.gov (United States)

    Engel, Josien; Heeren, Marie-Julie; van der Wulp, Ineke; de Bruijne, Martine C; Wagner, Cordula

    2014-09-22

    Cardiac risk scores estimate a patient's risk of future cardiac events or death. They are developed to inform treatment decisions of patients diagnosed with unstable angina or non-ST-elevation myocardial infarction. Despite recommending their use in guidelines and evidence of their prognostic value, they seem underused in practice. The purpose of the study was to gain insight in the motivation for implementing cardiac risk scores, and perceptions of health care practitioners towards the use of these instruments in clinical practice. This qualitative study involved semi-structured interviews with 31 health care practitioners at 11 hospitals throughout the Netherlands. Participants were approached through purposive sampling to represent a broad range of participant- and hospital characteristics, and included cardiologists, medical residents, medical interns, nurse practitioners and an emergency physician. The Pettigrew and Whipp Framework for strategic change was used as a theoretical basis. Data were initially analysed through open coding to avoid forcing data into categories predetermined by the framework. Cardiac risk score use was dependent on several factors, including IT support, clinical relevance for daily practice, rotation of staff and workload. Both intrinsic and extrinsic drivers for implementation were identified. Reminders, feedback and IT solutions were strategies used to improve and sustain the use of these instruments. The scores were seen as valuable support systems in improving uniformity in treatment practices, educating interns, conducting research and quantifying a practitioner's own risk assessment. However, health care practitioners varied in their perceptions regarding the influence of cardiac risk scores on treatment decisions. Health care practitioners disagree on the value of cardiac risk scores for clinical practice. Practitioners driven by intrinsic motivations predominantly experienced benefits in policy-making, education and research

  13. Does elevated C-reactive protein increase atrial fibrillation risk? A Mendelian randomization of 47,000 individuals from the general population

    DEFF Research Database (Denmark)

    Marott, Sarah C W; Nordestgaard, Børge G; Zacho, Jeppe

    2010-01-01

    The purpose of this study was to test whether the association of C-reactive protein (CRP) with increased risk of atrial fibrillation is a robust and perhaps even causal association.......The purpose of this study was to test whether the association of C-reactive protein (CRP) with increased risk of atrial fibrillation is a robust and perhaps even causal association....

  14. Lycopene supplementation elevates circulating insulin-like growth factor binding protein-1 and -2 concentrations in persons at greater risk of colorectal cancer.

    NARCIS (Netherlands)

    Vrieling, A.; Voskuil, D.W.; Bonfrer, J.M.; Korse, C.M.; Doorn, J. van; Cats, A.; Depla, A.C.; Timmer, R.; Witteman, B.J.M.; Leeuwen, F.E. van; Veer, L.J. van 't; Rookus, M.A.; Kampman, E.

    2007-01-01

    BACKGROUND: Higher circulating insulin-like growth factor I (IGF-I) concentrations have been related to a greater risk of cancer. Lycopene intake is inversely associated with cancer risk, and experimental studies have shown that it may affect the IGF system, possibly through an effect on IGF-binding

  15. Lycopene supplementation elevates circulating insulin-like growth factor-binding protein-1 and-2 concentrations in persons at greater risk of colorectal cancer

    NARCIS (Netherlands)

    Vrieling, A.; Voskuil, D.W.; Bonfrer, J.M.; Korse, C.M.; Doorn, J.; Cats, A.; Depla, A.C.; Timmer, R.; Witteman, B.J.M.; Leeuwen, van F.E.; van't Veer, L.J.; Rookus, M.A.; Kampman, E.

    2007-01-01

    Background: Higher circulating insulin-like growth factor I (IGF-I) concentrations have been related to a greater risk of cancer. Lycopene intake is inversely associated with cancer risk, and experimental studies have shown that it may affect the IGF system, possibly through an effect on IGF-binding

  16. The GREAT3 challenge

    International Nuclear Information System (INIS)

    Miyatake, H; Mandelbaum, R; Rowe, B

    2014-01-01

    The GRavitational lEnsing Accuracy Testing 3 (GREAT3) challenge is an image analysis competition that aims to test algorithms to measure weak gravitational lensing from astronomical images. The challenge started in October 2013 and ends 30 April 2014. The challenge focuses on testing the impact on weak lensing measurements of realistically complex galaxy morphologies, realistic point spread function, and combination of multiple different exposures. It includes simulated ground- and space-based data. The details of the challenge are described in [1], and the challenge website and its leader board can be found at http://great3challenge.info and http://great3.projects.phys.ucl.ac.uk/leaderboard/, respectively

  17. Nothing Great Is Easy

    OpenAIRE

    Stansbie, Lisa

    2014-01-01

    A solo exhibition of 13 pieces of art work.\\ud \\ud Nothing Great is Easy is an exhibition of sculpture, film, drawing and photography that proposes reconstructed narratives using the sport of swimming and in particular the collective interaction and identity of the channel swimmer. The work utilises the processes, rituals/rules, language and the apparatus of sport.\\ud \\ud “Nothing great is easy” are the words on the memorial to Captain Matthew Webb who was the first man to swim the English ch...

  18. Iowa Bedrock Surface Elevation

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — This Digital Elevation Model (DEM) of the bedrock surface elevation in Iowa was compiled using all available data, principally information from GEOSAM, supplemented...

  19. Effects on elevating cancer risk in population exposed to natural radionuclide 226Ra if parent radionuclide 238U is entered the body by inhalation or ingestion

    International Nuclear Information System (INIS)

    Zupunski, Lj.; Trobok, M.; Gordanic, V.; Spasic-Jokic, V.; Sovilj, P.

    2009-01-01

    People have always been exposed to ionizing radiation originating from natural radionuclides including 238 U, 40 K, 232 Th that exist in earths crust. Although received doses are small, due to the fact that threshold does not exist, there is a certain risk of developing cancer. Purpose of this study was to measure 238 U concentrations in soil of Bela Crkva territory. Based on these measurements, risks of developing cancers are calculated using Monte Carlo method.(author) [sr

  20. The Great Mathematician Project

    Science.gov (United States)

    Goldberg, Sabrina R.

    2013-01-01

    The Great Mathematician Project (GMP) introduces both mathematically sophisticated and struggling students to the history of mathematics. The rationale for the GMP is twofold: first, mathematics is a uniquely people-centered discipline that is used to make sense of the world; and second, students often express curiosity about the history of…

  1. What great managers do.

    Science.gov (United States)

    Buckingham, Marcus

    2005-03-01

    Much has been written about the qualities that make a great manager, but most of the literature overlooks a fundamental question: What does a great manager actually do? While there are countless management styles, one thing underpins the behavior of all great managers. Above all, an exceptional manager comes to know and value the particular quirks and abilities of her employees. She figures out how to capitalize on her staffers' strengths and tweaks her environment to meet her larger goals. Such a specialized approach may seem like a lot of work. But in fact, capitalizing on each person's uniqueness can save time. Rather than encourage employees to conform to strict job descriptions that may include tasks they don't enjoy and aren't good at, a manager who develops positions for his staff members based on their unique abilities will be rewarded with behaviors that are far more efficient and effective than they would be otherwise. This focus on individuals also makes employees more accountable. Because staffers are evaluated on their particular strengths and weaknesses, they are challenged to take responsibility for their abilities and to hone them. Capitalizing on a person's uniqueness also builds a stronger sense of team. By taking the time to understand what makes each employee tick, a great manager shows that he sees his people for who they are. This personal investment not only motivates individuals but also galvanizes the entire team. Finally, this approach shakes up existing hierarchies, which leads to more creative thinking. To take great managing from theory to practice, the author says, you must know three things about a person: her strengths, the triggers that activate those strengths, and how she learns. By asking the right questions, squeezing the right triggers, and becoming aware of your employees' learning styles, you will discover what motivates each person to excel.

  2. Scenario-based tsunami risk assessment using a static flooding approach and high-resolution digital elevation data: An example from Muscat in Oman

    Science.gov (United States)

    Schneider, Bastian; Hoffmann, Gösta; Reicherter, Klaus

    2016-04-01

    Knowledge of tsunami risk and vulnerability is essential to establish a well-adapted Multi Hazard Early Warning System, land-use planning and emergency management. As the tsunami risk for the coastline of Oman is still under discussion and remains enigmatic, various scenarios based on historical tsunamis were created. The suggested inundation and run-up heights were projected onto the modern infrastructural setting of the Muscat Capital Area. Furthermore, possible impacts of the worst-case tsunami event for Muscat are discussed. The approved Papathoma Tsunami Vulnerability Assessment Model was used to model the structural vulnerability of the infrastructure for a 2 m tsunami scenario, depicting the 1945 tsunami and a 5 m tsunami in Muscat. Considering structural vulnerability, the results suggest a minor tsunami risk for the 2 m tsunami scenario as the flooding is mainly confined to beaches and wadis. Especially traditional brick buildings, still predominant in numerous rural suburbs, and a prevalently coast-parallel road network lead to an increased tsunami risk. In contrast, the 5 m tsunami scenario reveals extensively inundated areas and with up to 48% of the buildings flooded, and therefore consequently a significantly higher tsunami risk. We expect up to 60000 damaged buildings and up to 380000 residents directly affected in the Muscat Capital Area, accompanied with a significant loss of life and damage to vital infrastructure. The rapid urbanization processes in the Muscat Capital Area, predominantly in areas along the coast, in combination with infrastructural, demographic and economic growth will additionally increase the tsunami risk and therefore emphasizes the importance of tsunami risk assessment in Oman.

  3. IGF-1 levels across the spectrum of normal to elevated in acromegaly: relationship to insulin sensitivity, markers of cardiovascular risk and body composition.

    Science.gov (United States)

    Reid, Tirissa J; Jin, Zhezhen; Shen, Wei; Reyes-Vidal, Carlos M; Fernandez, Jean Carlos; Bruce, Jeffrey N; Kostadinov, Jane; Post, Kalmon D; Freda, Pamela U

    2015-12-01

    Activity of acromegaly is gauged by levels of GH and IGF-1 and epidemiological studies demonstrate that their normalization reduces acromegaly's excess mortality rate. However, few data are available linking IGF-1 levels to features of the disease that may relate to cardiovascular (CV) risk. Therefore, we tested the hypothesis that serum IGF-1 levels relative to the upper normal limit relate to insulin sensitivity, serum CV risk markers and body composition in acromegaly. In this prospective, cross-sectional study conducted at a pituitary tumor referral center we studied 138 adult acromegaly patients, newly diagnosed and previously treated surgically, with fasting and post-oral glucose levels of endocrine and CV risk markers and body composition assessed by DXA. Active acromegaly is associated with lower insulin sensitivity, body fat and CRP levels than acromegaly in remission. %ULN IGF-1 strongly predicts insulin sensitivity, better than GH and this persists after adjustment for body fat and lean tissue mass. %ULN IGF-1 also relates inversely to CRP levels and fat mass, positively to lean tissue and skeletal muscle estimated (SM(E)) by DXA, but not to blood pressure, lipids, BMI or waist circumference. Gender interacts with the IGF-1-lean tissue mass relationship. Active acromegaly presents a unique combination of features associated with CV risk, reduced insulin sensitivity yet lower body fat and lower levels of some serum CV risk markers, a pattern that is reversed in remission. %ULN IGF-1 levels strongly predict these features. Given the known increased CV risk of active acromegaly, these findings suggest that of these factors insulin resistance is most strongly related to disease activity and potentially to the increased CV risk of active acromegaly.

  4. Great magnetic storms

    International Nuclear Information System (INIS)

    Tsurutani, B.T.; Yen Te Lee; Tang, F.; Gonzalez, W.D.

    1992-01-01

    The five largest magnetic storms that occurred between 1971 and 1986 are studied to determine their solar and interplanetary causes. All of the events are found to be associated with high speed solar wind streams led by collisionless shocks. The high speed streams are clearly related to identifiable solar flares. It is found that (1) it is the extreme values of the southward interplanetary magnetic fields rather than solar wind speeds that are the primary causes of great magnetic storms, (2) shocked and draped sheath fields preceding the driver gas (magnetic cloud) are at least as effective in causing the onset of great magnetic storms (3 of 5 events ) as the strong fields within the driver gas itself, and (3) precursor southward fields ahead of the high speed streams allow the shock compression mechanism (item 2) to be particularly geoeffective

  5. The great intimidators.

    Science.gov (United States)

    Kramer, Roderick M

    2006-02-01

    After Disney's Michael Eisner, Miramax's Harvey Weinstein, and Hewlett-Packard's Carly Fiorina fell from their heights of power, the business media quickly proclaimed thatthe reign of abrasive, intimidating leaders was over. However, it's premature to proclaim their extinction. Many great intimidators have done fine for a long time and continue to thrive. Their modus operandi runs counter to a lot of preconceptions about what it takes to be a good leader. They're rough, loud, and in your face. Their tactics include invading others' personal space, staging tantrums, keeping people guessing, and possessing an indisputable command of facts. But make no mistake--great intimidators are not your typical bullies. They're driven by vision, not by sheer ego or malice. Beneath their tough exteriors and sharp edges are some genuine, deep insights into human motivation and organizational behavior. Indeed, these leaders possess political intelligence, which can make the difference between paralysis and successful--if sometimes wrenching--organizational change. Like socially intelligent leaders, politically intelligent leaders are adept at sizing up others, but they notice different things. Those with social intelligence assess people's strengths and figure out how to leverage them; those with political intelligence exploit people's weaknesses and insecurities. Despite all the obvious drawbacks of working under them, great intimidators often attract the best and brightest. And their appeal goes beyond their ability to inspire high performance. Many accomplished professionals who gravitate toward these leaders want to cultivate a little "inner intimidator" of their own. In the author's research, quite a few individuals reported having positive relationships with intimidating leaders. In fact, some described these relationships as profoundly educational and even transformational. So before we throw out all the great intimidators, the author argues, we should stop to consider what

  6. Great Lakes Energy Institute

    Energy Technology Data Exchange (ETDEWEB)

    Alexander, J. Iwan [Case Western Reserve Univ., Cleveland, OH (United States)

    2012-11-18

    The vision of the Great Lakes Energy Institute is to enable the transition to advanced, sustainable energy generation, storage, distribution and utilization through coordinated research, development, and education. The Institute will place emphasis on translating leading edge research into next generation energy technology. The Institute’s research thrusts focus on coordinated research in decentralized power generation devices (e.g. fuel cells, wind turbines, solar photovoltaic devices), management of electrical power transmission and distribution, energy storage, and energy efficiency.

  7. Elevated soluble urokinase receptor values in CSF, age and bacterial meningitis infection are independent and additive risk factors of fatal outcome

    DEFF Research Database (Denmark)

    Tzanakaki, G; Paparoupa, M; Kyprianou, M

    2012-01-01

    The aim of the present study was to evaluate the potential role of cerebrospinal fluid soluble urokinase receptor (suPAR) level, infection and age as risk factors for fatal outcome in patients suspected of having meningitis and/or bacteraemia on admission to hospital. A total of 545 cerebrospinal...

  8. Understanding the elevated risk of substance use by adolescents in special education and residential youth care : The role of individual, family and peer factors

    NARCIS (Netherlands)

    Kepper, Annelies|info:eu-repo/dai/nl/313935157; Van Den Eijnden, Regina|info:eu-repo/dai/nl/17399394X; Monshouwer, Karin|info:eu-repo/dai/nl/202651967; Vollebergh, Wilma|info:eu-repo/dai/nl/090632893

    2014-01-01

    Adolescents who attend special education for behavioural problems (SEB) and adolescents who live in a residential youth care institution (RYC) are characterised by behavioural disorders and problematic family backgrounds and have an increased risk for substance use. Though it is likely that the high

  9. Developing biosafety risk hypotheses for invertebrates exposed to GM plants using conceptual food webs: a case study with elevated triacylglyceride levels in ryegrass.

    Science.gov (United States)

    Barratt, Barbara I P; Todd, Jacqui H; Burgess, Elisabeth P J; Malone, Louise A

    2010-01-01

    Regulators are acutely aware of the need for meaningful risk assessments to support decisions on the safety of GM crops to non-target invertebrates in determining their suitability for field release. We describe a process for developing appropriate, testable risk hypotheses for invertebrates in agroecosystems that might be exposed to plants developed by GM and future novel technologies. An existing model (PRONTI) generates a ranked list of invertebrate species for biosafety testing by accessing a database of biological, ecological and food web information about species which occur in cropping environments and their potential interactions with a particular stressor (Eco Invertebase). Our objective in this contribution is to explore and further utilise these resources to assist in the process of problem formulation by identifying potentially significant effects of the stressor on the invertebrate community and the ecosystem services they provide. We propose that for high ranking species, a conceptual food web using information in Eco Invertebase is constructed, and using an accepted regulatory risk analysis framework, the likelihood of risk, and magnitude of impact for each link in the food web is evaluated. Using as filters only those risks evaluated as likely to extremely likely, and the magnitude of an effect being considered as moderate to massive, the most significant potential effects can be identified. A stepwise approach is suggested to develop a sequence of appropriate tests. The GM ryegrass plant used as the "stressor" in this study has been modified to increase triacylglyceride levels in foliage by 100% to increase the metabolisable energy content of forage for grazing animals. The high-ranking "test" species chosen to illustrate the concept are New Zealand native species Wiseana cervinata (Walker) (Lepidoptera: Hepialidae), Persectania aversa (Walker) (Lepidoptera: Noctuidae), and the self-introduced grey field slug, Deroceras reticulatum (Müller).

  10. The long- and short-term impact of elevated body mass index on the risk of new atrial fibrillation the WHS (women's health study).

    Science.gov (United States)

    Tedrow, Usha B; Conen, David; Ridker, Paul M; Cook, Nancy R; Koplan, Bruce A; Manson, Joann E; Buring, Julie E; Albert, Christine M

    2010-05-25

    The purpose of this study was to characterize the relationship between changes in body mass index (BMI) and incident atrial fibrillation (AF) in a large cohort of women. Obesity and AF are increasing public health problems. The importance of dynamic obesity-associated AF risk is uncertain, and mediators are not well characterized. Cases of AF were confirmed by medical record review in 34,309 participants in the Women's Health Study. Baseline and updated measures of BMI were obtained from periodic questionnaires. During 12.9 +/- 1.9 years of follow-up, 834 AF events were confirmed. BMI was linearly associated with AF risk, with a 4.7% (95% confidence interval [CI]: 3.4 to 6.1, p WHS]: A Randomized Trial of Low-Dose Aspirin and Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer; NCT00000479). Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  11. Does a single session of high-intensity interval training provoke a transient elevated risk of falling in seniors and adults?

    OpenAIRE

    Donath, Lars; Kurz, Eduard; Roth, Ralf; Hanssen, Henner; Schmidt-Trucksäss, Arno; Zahner, Lukas; Faude, Oliver

    2015-01-01

    Balance and strength training can reduce seniors' fall risk up to 50%. Available evidence suggests that acute bouts of neuromuscular and endurance exercise deteriorate postural control. High-intensity endurance training has been successfully applied in different populations. Thus, it seemed valuable to examine the acute effects of high-intensity interval training (HIIT) on neuromuscular performance in seniors and young adults.; The acute impact of a HIIT session on balance performance and mus...

  12. Escape by the Balearic Lizard (Podarcis lilfordi is affected by elevation of an approaching predator, but not by some other potential predation risk factors

    Directory of Open Access Journals (Sweden)

    William E. Cooper

    2011-12-01

    Full Text Available Many predation risk factors to affect escape behavior by lizards, but effects of some potential risk factors are unknown or are variable among species. We studied effects of several risk factors on escape responses by the Balearic lizard (Podarcis lilfordi, Lacertidae on escape responses. Escape was elicited by an approaching experimenter who recorded flight initiation distance (predator-prey distance when escape begins and distance fled. When an experimenter approached from above (upslope, flight initiation distance and distance fled were longer than when the experimenter approached from below. This novel effect suggests that lizards exposed to aerial predation might have been naturally selected to respond rapidly to predators approaching from above or that effects of path inclination of escape ability may differ between predators and prey in a manner requiring a larger margin of safety during approaches from above than below. Although sex differences in aspects of escape occur in some lizards, including lacertids, no sex difference was observed in P. lilfordi. Because vigilance and some other aspects of antipredatory behavior exhibit cortical lateralization, we tested effects of approach from the left and right sides of lizards. As predicted by optimal escape theory, side of approach did not affect flight initiation distance. Because many lizards have color vision and respond to pigmentation of conspecifics in social settings, researchers have often worn only drably colored clothing when simulating predators. This precaution may be unnecessary because flight initiation distance did not differ among investigator shirt colors (red, orange, olive.

  13. Elevated Potassium Levels in Patients With Congestive Heart Failure: Occurrence, Risk Factors, and Clinical Outcomes: A Danish Population-Based Cohort Study.

    Science.gov (United States)

    Thomsen, Reimar Wernich; Nicolaisen, Sia Kromann; Hasvold, Pål; Garcia-Sanchez, Ricardo; Pedersen, Lars; Adelborg, Kasper; Egfjord, Martin; Egstrup, Kenneth; Sørensen, Henrik Toft

    2018-05-22

    Data on the true burden of hyperkalemia in patients with heart failure (HF) in a real-world setting are limited. Incidence rates of hyperkalemia (first blood test with a potassium level >5.0 mmol/L) in primary or hospital care were assessed in a population-based cohort of patients with incident HF diagnoses in northern Denmark from 2000 to 2012. Risk factors and clinical outcomes were compared in patients with HF with versus without hyperkalemia. Of 31 649 patients with HF, 39% experienced hyperkalemia (mean follow-up, 2.2 years). Risks of experiencing a second, third, or fourth event were 43%, 54%, and 60%, respectively. Among patients with HF with stage 3A, 3B, 4, or 5 kidney dysfunction, 26%, 35%, 44%, and 48% experienced hyperkalemia within the first year. Important hyperkalemia risk factors included chronic kidney disease (prevalence ratio, 1.46; 95% confidence interval [CI], 1.43-1.49), diabetes mellitus (prevalence ratio, 1.38; 95% CI, 1.32-1.45), and spironolactone use (prevalence ratio, 1.48; 95% CI, 1.42-1.54). In patients with HF who developed hyperkalemia, 53% had any acute-care hospitalization 6 months before the hyperkalemia event, increasing to 74% 6 months after hyperkalemia (before-after risk ratio, 1.41; 95% CI, 1.38-1.44). Compared with matched patients with HF without hyperkalemia, adjusted 6-month hazard ratios in patients with hyperkalemia were 2.75-fold (95% CI, 2.65-2.85) higher for acute-care hospitalization and 3.39-fold (95% CI, 3.19-3.61) higher for death. Almost 4 in 10 patients with HF develop hyperkalemia, and many patients have recurrent hyperkalemia episodes. Hyperkalemia risk is strongly associated with degree of reduced kidney function and use of spironolactone. Hyperkalemia is associated with severe clinical outcomes and death in HF. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  14. Idiopathic great saphenous phlebosclerosis.

    Directory of Open Access Journals (Sweden)

    Ahmadreza Jodati

    2013-06-01

    Full Text Available Arterial sclerosis has been extensively described but reports on venous sclerosis are very sparse. Phlebosclerosis refers to the thickening and hardening of the venous wall. Despite its morphological similarities with arteriosclerosis and potential morbid consequences, phlebosclerosis has gained only little attention. We report a 72 year old male with paralysis and atrophy of the right leg due to childhood poliomyelitis who was referred for coronary artery bypass surgery. The great saphenous vein, harvested from the left leg, showed a hardened cord-like obliterated vein. Surprisingly, harvested veins from the atrophic limb were normal and successfully used for grafting.

  15. Great software debates

    CERN Document Server

    Davis, A

    2004-01-01

    The industry’s most outspoken and insightful critic explains how the software industry REALLY works. In Great Software Debates, Al Davis, shares what he has learned about the difference between the theory and the realities of business and encourages you to question and think about software engineering in ways that will help you succeed where others fail. In short, provocative essays, Davis fearlessly reveals the truth about process improvement, productivity, software quality, metrics, agile development, requirements documentation, modeling, software marketing and sales, empiricism, start-up financing, software research, requirements triage, software estimation, and entrepreneurship.

  16. Making Psychotherapy Great Again?

    Science.gov (United States)

    Plakun, Eric M

    2017-05-01

    Psychotherapy never stopped being as "great" as other treatments. This column explores the evidence base for both psychotherapy and medications, using depression as a specific example. The limitations are comparable for psychotherapy and medication, with much of the evidence based on small degrees of "statistically significant" rather than "clinically meaningful" change. Our field's biomedical emphasis leads to a false assumption that most patients present with single disorders, when comorbidity is the rule rather than the exception. This false assumption contributes to limitations in the evidence base and in our ability to treat patients optimally.

  17. Effects of isoflavone-containing soya protein on ex vivo cholesterol efflux, vascular function and blood markers of CVD risk in adults with moderately elevated blood pressure: a dose-response randomised controlled trial.

    Science.gov (United States)

    Richter, Chesney K; Skulas-Ray, Ann C; Fleming, Jennifer A; Link, Christina J; Mukherjea, Ratna; Krul, Elaine S; Kris-Etherton, Penny M

    2017-05-01

    Emerging CVD risk factors (e.g. HDL function and central haemodynamics) may account for residual CVD risk experienced by individuals who meet LDL-cholesterol and blood pressure (BP) targets. Recent evidence suggests that these emerging risk factors can be modified by polyphenol-rich interventions such as soya, but additional research is needed. This study was designed to investigate the effects of an isoflavone-containing soya protein isolate (delivering 25 and 50 g/d soya protein) on HDL function (i.e. ex vivo cholesterol efflux), macrovascular function and blood markers of CVD risk. Middle-aged adults (n 20; mean age=51·6 (sem 6·6) years) with moderately elevated brachial BP (mean systolic BP=129 (sem 9) mmHg; mean diastolic BP=82·5 (sem 8·4) mmHg) consumed 0 (control), 25 and 50 g/d soya protein in a randomised cross-over design. Soya and control powders were consumed for 6 weeks each with a 2-week compliance break between treatment periods. Blood samples and vascular function measures were obtained at baseline and following each supplementation period. Supplementation with 50 g/d soya protein significantly reduced brachial diastolic BP (-2·3 mmHg) compared with 25 g/d soya protein (Tukey-adjusted P=0·03) but not the control. Soya supplementation did not improve ex vivo cholesterol efflux, macrovascular function or other blood markers of CVD risk compared with the carbohydrate-matched control. Additional research is needed to clarify whether effects on these CVD risk factors depend on the relative health of participants and/or equol producing capacity.

  18. De stille elever

    DEFF Research Database (Denmark)

    Winther-Lindqvist, Ditte Alexandra

    2012-01-01

    Det er blevet en afgørende samværskompetence i uddannelsessystemet at stå aktivt frem og deltage verbalt i skoleklassens liv både fagligt og socialt. Men ikke alle elever deltager lige villigt verbalt i plenum. Artiklen handler om de stille elever og konsekvenserne af stillehed i skolen. Det...... foreslås at skolesystemet sanktionerer ældre elever hårdere for stillehed end yngre elever og det forklares med at skolelivet også er en kultivering henimod elevhed som social identitet og denne er der forventning om at eleverne mestrer i udskolingen....

  19. Impact of newly diagnosed abnormal glucose regulation on long-term prognosis in low risk patients with ST-elevation myocardial infarction: A follow-up study

    Directory of Open Access Journals (Sweden)

    Abdelnoor Michael

    2011-07-01

    Full Text Available Abstract Background Patients with acute myocardial infarction and newly detected abnormal glucose regulation have been shown to have a less favourable prognosis compared to patients with normal glucose regulation. The importance and timing of oral glucose tolerance testing (OGTT in patients with acute myocardial infarction without known diabetes is uncertain. The aim of the present study was to evaluate the impact of abnormal glucose regulation classified by an OGTT in-hospital and at three-month follow-up on clinical outcome in patients with acute ST elevation myocardial infarction (STEMI without known diabetes. Methods Patients (n = 224, age 58 years with a primary percutanous coronary intervention (PCI treated STEMI were followed for clinical events (all-cause mortality, non-fatal myocardial re-infarction, recurrent ischemia causing hospital admission, and stroke. The patients were classified by a standardised 75 g OGTT at two time points, first, at a median time of 16.5 hours after hospital admission, then at three-month follow-up. Based on the OGTT results, the patients were categorised according to the WHO criteria and the term abnormal glucose regulation was defined as the sum of impaired fasting glucose, impaired glucose tolerance and type 2-diabetes. Results The number of patients diagnosed with abnormal glucose regulation in-hospital and at three-month was 105 (47% and 50 (25%, respectively. During the follow up time of (median 33 (27, 39 months, 58 (25.9% patients experienced a new clinical event. There were six deaths, 15 non-fatal re-infarction, 33 recurrent ischemia, and four strokes. Kaplan-Meier analysis of survival free of composite end-points showed similar results in patients with abnormal and normal glucose regulation, both when classified in-hospital (p = 0.4 and re-classified three months later (p = 0.3. Conclusions Patients with a primary PCI treated STEMI, without previously known diabetes, appear to have an excellent

  20. Annual North Dakota Elevator Marketing Report, 2008-09

    Science.gov (United States)

    2009-12-01

    The Annual North Dakota Elevator Marketing Report for 2008-09 was prepared by Kimberly Vachal and Laurel Benson, : Upper Great Plains Transportation Institute. The authors gratefully acknowledge the assistance of the North Dakota : Grain Dealers Asso...

  1. Annual North Dakota Elevator Marketing Report, 2009-10

    Science.gov (United States)

    2010-11-01

    The Annual North Dakota Elevator Marketing Report for 2009-10 was prepared by Kimberly Vachal and Laurel Benson, : Upper Great Plains Transportation Institute. The authors gratefully acknowledge the assistance of the North Dakota : Wheat Commission a...

  2. Annual North Dakota Elevator Marketing Report, 2007-08

    Science.gov (United States)

    2008-12-01

    The Annual North Dakota Elevator Marketing Report for 2007-08 was prepared by Kimberly Vachal and Laurel Benson, : Upper Great Plains Transportation Institute. The authors gratefully acknowledge the assistance of the North Dakota : Grain Dealers Asso...

  3. Annual North Dakota Elevator Marketing Report, 2010-11

    Science.gov (United States)

    2011-12-01

    The Annual North Dakota Elevator Marketing Report for 2010-11 was prepared by Kimberly Vachal and Laurel Benson, Upper Great Plains Transportation Institute. The authors gratefully acknowledge the assistance of the North Dakota Wheat Commission and t...

  4. Great Britain at CERN

    CERN Multimedia

    2006-01-01

    From 14 to 16 November 2006 Administration Building, Bldg. 60/61 - ground and 1st floor 09.30 - 17.30 Fifteen companies will present their latest technologies at the 'Great Britain at CERN' exhibition. British industry will exhibit products and technologies related to the field of particle physics. The main fields represented will be computing technologies, electrical engineering, electronics, mechanical engineering, vacuum & low temperature technologies and particle detectors. The exhibition is organised by BEAMA Exhibitions (the British Electrotechnical and Allied Manufacturers Association). Below you will find: a list of the exhibitors. A detailed programme will be available in due course: from your Departmental secretariat, from the Reception information desk, Building 33, at the exhibition itself. A detailed list of the companies is available at the following FI link: http://fi-dep.web.cern.ch/fi-dep/structure/memberstates/exhibitions_visits.htm LIST OF EXHIBITORS 3D Metrics Almat...

  5. Great Britain at CERN

    CERN Multimedia

    2006-01-01

    From 14 to 16 November 2006 Administration Building, Bldg. 60/61 - ground and 1st floor 09.30 - 17.30 Fifteen companies will present their latest technologies at the 'Great Britain at CERN' exhibition. British industry will exhibit products and technologies related to the field of particle physics. The main fields represented will be computing technologies, electrical engineering, electronics, mechanical engineering, vacuum & low temperature technologies and particle detectors. The exhibition is organised by BEAMA Exhibitions (the British Electrotechnical and Allied Manufacturers Association). Below you will find: a list of the exhibitors. A detailed programme will be available in due course: from your Departmental secretariat, from the Reception information desk, Building 33, at the exhibition itself. A detailed list of the companies is available at the following FI link: http://fi-dep.web.cern.ch/fi-dep/structure/memberstates/exhibitions_visits.htm LIST OF EXHIBITORS 3D Metrics Alma...

  6. Soluble CD36 and risk markers of insulin resistance and atherosclerosis are elevated in polycystic ovary syndrome and significantly reduced during pioglitazone treatment

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Højlund, Kurt; Andersen, Marianne

    2007-01-01

    Objective: We investigated the relation between soluble CD36 (sCD36), risk markers of atherosclerosis and body composition, and glucose and lipid metabolism in polycystic ovary syndrome (PCOS) Research Design and Methods: Thirty PCOS patients were randomized to pioglitazone, 30 mg/day or placebo...... units), oxLDL (44.9 (26.9 - 75.1) vs. 36.1 (23.4 - 55.5) U/l), and hsCRP (0.26 (0.03 - 2.41) vs. 0.12 (0.02 - 0.81) mg/dl) were significantly increased in PCOS patients vs. controls (geometric mean (+/- 2SD)). In PCOS, positive correlations were found between central fat mass and sCD36 (r=0.43), hs......CRP (r=0.43), and IL-6 (r=0.42), all pPCOS patients and controls (n=44). sCD36 and oxLDL were significant...

  7. The GCKR rs780094 polymorphism is associated with elevated fasting serum triacylglycerol, reduced fasting and OGTT-related insulinaemia, and reduced risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Sparsø, T; Andersen, G; Nielsen, T

    2007-01-01

    to metabolic traits (mainly fasting hypertriacylglycerolaemia) and traits related to pancreatic beta cell function. METHODS: The polymorphism was genotyped in 16,853 Danes using Taqman allelic discrimination. Association was analysed in case-control studies and quantitative trait analyses. We also analysed...... the possible interactive effect between the GCK -30G>A polymorphism and the GCKR rs780094 variant on metabolic traits. RESULTS: The minor GCKR A-allele of rs780094 is associated with an increased level of fasting serum triacylglycerol (p = 6 x 10(-14)), impaired fasting (p = 0.001) and OGTT-related insulin...... release (p = 3 x 10(-6)), reduced homeostasis model assessment of insulin resistance (p = 0.0004), WHO-defined dyslipidaemia (p = 6 x 10(-9)) and a modestly decreased risk of type 2 diabetes (p = 0.01). Significantly increased fasting serum insulin concentrations were demonstrated when analysing the GCK...

  8. A user-friendly risk-score for predicting in-hospital cardiac arrest among patients admitted with suspected non ST-elevation acute coronary syndrome - The SAFER-score.

    Science.gov (United States)

    Faxén, Jonas; Hall, Marlous; Gale, Chris P; Sundström, Johan; Lindahl, Bertil; Jernberg, Tomas; Szummer, Karolina

    2017-12-01

    To develop a simple risk-score model for predicting in-hospital cardiac arrest (CA) among patients hospitalized with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). Using the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART), we identified patients (n=242 303) admitted with suspected NSTE-ACS between 2008 and 2014. Logistic regression was used to assess the association between 26 candidate variables and in-hospital CA. A risk-score model was developed and validated using a temporal cohort (n=126 073) comprising patients from SWEDEHEART between 2005 and 2007 and an external cohort (n=276 109) comprising patients from the Myocardial Ischaemia National Audit Project (MINAP) between 2008 and 2013. The incidence of in-hospital CA for NSTE-ACS and non-ACS was lower in the SWEDEHEART-derivation cohort than in MINAP (1.3% and 0.5% vs. 2.3% and 2.3%). A seven point, five variable risk score (age ≥60 years (1 point), ST-T abnormalities (2 points), Killip Class >1 (1 point), heart rate Model discrimination was good in the derivation cohort (c-statistic 0.72) and temporal validation cohort (c-statistic 0.74), and calibration was reasonable with a tendency towards overestimation of risk with a higher sum of score points. External validation showed moderate discrimination (c-statistic 0.65) and calibration showed a general underestimation of predicted risk. A simple points score containing five variables readily available on admission predicts in-hospital CA for patients with suspected NSTE-ACS. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Factors that elevate the internal radionuclide and chemical retention, dose and health risks to infants and children in a radiological-nuclear emergency

    International Nuclear Information System (INIS)

    Richardson, R. B.

    2009-01-01

    The factors that influence the dose and risk to vulnerable population groups from exposure and internal uptake of chemicals are examined and, in particular, the radionuclides released in chemical, biological, radiological, nuclear and explosive events. The paper seeks to identify the areas that would benefit from further research. The intake and body burdens of carbon and calcium were assessed as surrogates for contaminants that either act like or bind to hydrocarbons (e.g. tritium and 14 C) or bone-seeking radionuclides (e.g. 90 Sr and 239 Pu). The shortest turnover times for such materials in the whole body were evaluated for the newborn: 11 d and 0.5 y for carbon and calcium, respectively. However, their biokinetic behaviour is complicated by a particularly high percentage of the gut-absorbed dietary intake of carbon (∼16%) and calcium (∼100%) that is incorporated into the soft tissue and skeleton of the growing neonate. The International Commission on Radiological Protection dose coefficients (Sv Bq -1 ) were examined for 14 radionuclides, including 9 of concern because of their potential use in radiological dispersal devices. The dose coefficients for a 3-month-old are greater than those for adults (2-56 times more for ingestion and 2-12 times for inhalation). The age-dependent dose and exposure assessment of contaminant intakes would improve by accounting for gender and growth where it is currently neglected. Health risk is evaluated as the product of the exposure and hazard factors, the latter being about 10-fold greater in infants than in adults. The exposure factor is also approximately 10-fold higher for ingestion by infants than by adults, and unity for inhalation varying with the contaminant. Qualitative and quantitative physiological and epidemiological evidence supports infants being more vulnerable to cancer and neurological deficit than older children). (authors)

  10. Quantifying the adverse effect of excessive heat on children: An elevated risk of hand, foot and mouth disease in hot days.

    Science.gov (United States)

    Zhang, Wangjian; Du, Zhicheng; Zhang, Dingmei; Yu, Shicheng; Hao, Yuantao

    2016-01-15

    Hand, foot and mouth disease (HFMD) is a common childhood infection and has become a major public health issue in China. Considerable research has focused on the role of meteorological factors such as temperature and relative humidity in HFMD development. However, no studies have specifically quantified the impact of another major environmental agent, excessive heat, on HFMD. The current study was designed to help address this research gap. Case-based HFMD surveillance data and daily meteorological data collected between 2010 and 2012 was obtained from China CDC and the National Meteorological Information Center, respectively. Distributed lag nonlinear models were applied to assess the impact of excessive heat on HFMD and its variability across social-economic status and age groups. After controlling the effects of several potential confounders, the commonly hot days were found to positively affect the HFMD burdens with the relative risk (RR) peaking at around 6 days of lag. The RR of HFMD in the Pearl-River Delta Region was generally higher and persisted longer than that in the remaining developing areas. Regarding the inter-age group discrepancy, children aged 3-6 years old had the highest risk of HFMD under conditions of excessive heat whereas those greater than 6 years old had the lowest. The lag structure of the impact of the extremely hot days was quite similar to that of the commonly hot days, although the relative effect of these two kinds of conditions of excessive heat might vary across regions. This study indicated significantly facilitating effects of excessive heat on HFMD especially among those aged 3-6 and from developed areas. Results from the current study were particularly practical and important for developing area-and-age-targeted control programs in the context of climate change and urbanization. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Undervisning af tosprogede elever

    DEFF Research Database (Denmark)

    Horst, Christian

    2003-01-01

    Artiklen fremdrager hovedresultaterne fra Virginia P. Collier's og Wayne P. Thomas's længdeundersøgelser af tosprogede elever i USA, som formentlig er de mest omfattende undersøgelser af undervisningen af tosprogede elever overhovedet. Resultaterne diskuteres i relation til udviklingen af en...

  12. Effects of elevated CO

    NARCIS (Netherlands)

    Xue, Sha; Yang, Xiaomei; Liu, Guobin; Gai, Lingtong; Zhang, Changsheng; Ritsema, Coen J.; Geissen, Violette

    2017-01-01

    Elevated CO2 and drought are key consequences of climate change and affect soil processes and plant growth. This study investigated the effects of elevated CO2 and drought on the microbial biomass and enzymatic activities in the rhizospheres of Bothriochloa ischaemum and

  13. Elevator and hydraulics; Elevator to yuatsu

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, I. [Hitachi, Ltd., Tokyo (Japan)

    1994-07-15

    A hydraulic type elevator is installed in relatively lower buildings as compared with a rope type elevator, but the ratio in the number of installation of the former elevator is increasing. This paper explains from its construction and features to especially various control systems for the riding comfort and safety. A direct push-up system with hydraulic jacks arranged beneath a car, and an indirect push-up system that has hydraulic jacks arranged on flank of a car and transmits the movement of a plunger via a rope are available. The latter system eliminates the need of large holes to embed hydraulic jacks. While the speed is controlled by controlling flow rates of high-pressure oil, the speed, position, acceleration and even time differential calculus of the acceleration must be controlled severely. The system uses two-step control for the through-speed and the landing speed. Different systems that have been realized may include compensation for temperatures in flow rate control valves, load pressures, and oil viscosity, from learning control to fuzzy control for psychological effects, or control of inverters in motors. 13 refs., 12 figs., 1 tab.

  14. Does a single session of high-intensity interval training provoke a transient elevated risk of falling in seniors and adults?

    Science.gov (United States)

    Donath, Lars; Kurz, Eduard; Roth, Ralf; Hanssen, Henner; Schmidt-Trucksäss, Arno; Zahner, Lukas; Faude, Oliver

    2015-01-01

    Balance and strength training can reduce seniors' fall risk up to 50%. Available evidence suggests that acute bouts of neuromuscular and endurance exercise deteriorate postural control. High-intensity endurance training has been successfully applied in different populations. Thus, it seemed valuable to examine the acute effects of high-intensity interval training (HIIT) on neuromuscular performance in seniors and young adults. The acute impact of a HIIT session on balance performance and muscle activity after exercise cessation and during post-exercise recovery was examined in young and old adults. We intended to investigate whether a transient exercise-induced fall-risk may occur in both groups. 20 healthy seniors (age 70 (SD 4) years) and young adults (age 27 (SD 3) years) were examined on 3 days. After exhaustive ramp-like treadmill testing in order to determine maximal heart rate (HRmax) on the first day, either a 4 × 4 min HIIT at 90% of HRmax or a control condition (CON) was randomly performed on the second and third day, respectively. Balance performance (postural sway) was assessed during single limb stance with open eyes (SLEO) and double limb stance with closed eyes (DLEC). EMG was recorded for the soleus (SOL), anterior tibialis (TIB), gastrocnemius (GM) and peroneus longus (PL) muscles at the dominant leg. All measures were collected before, immediately as well as 10, 30 and 45 min after HIIT and CON, respectively. Compared to CON, HIIT induced significant increases of postural sway immediately after exercise cessation during SLEO in both groups (adults: p seniors: p = 0.007, Δ = +15% sway). Increased sway during DLEC was only found for seniors immediately and 10 min after HIIT (post: p = 0.003, Δ = +14% sway, 10 min post: p = 0.004, Δ = +18% sway). Muscle activity was increased during SLEO for TIB until 10 min post in seniors (0.008 seniors seems to prolong this period up to 30 min. Thus, the advantage of HIIT with regard to time efficiency seems

  15. Blood Pressure Is the Determinant for the Increased Risk for Intracranial Arterial Stenosis in Subjects with Elevated Glycated Hemoglobin Levels: The Kangbuk Samsung Health Study.

    Science.gov (United States)

    Oh, Hyung-Geun; Rhee, Eun-Jung

    2016-11-01

    Ischemic stroke is known to be an important vascular complication of diabetes. Intracranial arterial stenosis (ICAS) is considered as an important cause of stroke in Asians. We aimed to analyze the risk for ICAS assessed by transcranial Doppler (TCD) ultrasonography in different groups of young Korean subjects divided by glycated hemoglobin (HbA1c) levels. This study included 10,437 participants without history of cardiovascular diseases (81.3% men, mean age 43 years) from a health screening program, in whom TCD ultrasonography was used to detect greater than 50% ICAS based on criteria modified from the SONIA (Stroke Outcomes and Neuroimaging of Intracranial Atherosclerosis) trial. The subjects were divided into 3 groups according to HbA1c levels: HbA1c < 5.7%, 5.7 ≤ HbA1c < 6.5%, and HbA1c ≥ 6.5% or under medication for diabetes. Among the participants, 3.0% of the subjects had ICAS. The subjects with ICAS tended to have higher mean HbA1c level compared with those without ICAS (5.8 ± .8 versus 5.7 ± .6, P = .063). The proportion of subjects with ICAS significantly increased as the HbA1c increased from the first to the third group (2.8%, 3.0%, 4.6%, P for linear trend = .022). In logistic regression analysis with ICAS as the dependent variable, the group with HbA1c ≥ 6.5% showed significantly increased odds ratio for ICAS with subjects with HbA1c < 5.7% as the reference after adjustment for confounding variables (1.575, 95% confidence interval 1.056-2.347). However, this significance disappeared with inclusion of presence of hypertension in the model. The risk for ICAS assessed by TCD was increased in young Korean subjects with HbA1c ≥ 6.5%. However, this significance was attenuated after adjustment for presence of hypertension, suggesting the importance of hypertension in ICAS. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  16. Quantification of both the area-at-risk and acute myocardial infarct size in ST-segment elevation myocardial infarction using T1-mapping.

    Science.gov (United States)

    Bulluck, Heerajnarain; Hammond-Haley, Matthew; Fontana, Marianna; Knight, Daniel S; Sirker, Alex; Herrey, Anna S; Manisty, Charlotte; Kellman, Peter; Moon, James C; Hausenloy, Derek J

    2017-08-01

    A comprehensive cardiovascular magnetic resonance (CMR) in reperfused ST-segment myocardial infarction (STEMI) patients can be challenging to perform and can be time-consuming. We aimed to investigate whether native T1-mapping can accurately delineate the edema-based area-at-risk (AAR) and post-contrast T1-mapping and synthetic late gadolinium (LGE) images can quantify MI size at 1.5 T. Conventional LGE imaging and T2-mapping could then be omitted, thereby shortening the scan duration. Twenty-eight STEMI patients underwent a CMR scan at 1.5 T, 3 ± 1 days following primary percutaneous coronary intervention. The AAR was quantified using both native T1 and T2-mapping. MI size was quantified using conventional LGE, post-contrast T1-mapping and synthetic magnitude-reconstructed inversion recovery (MagIR) LGE and synthetic phase-sensitive inversion recovery (PSIR) LGE, derived from the post-contrast T1 maps. Native T1-mapping performed as well as T2-mapping in delineating the AAR (41.6 ± 11.9% of the left ventricle [% LV] versus 41.7 ± 12.2% LV, P = 0.72; R 2 0.97; ICC 0.986 (0.969-0.993); bias -0.1 ± 4.2% LV). There were excellent correlation and inter-method agreement with no bias, between MI size by conventional LGE, synthetic MagIR LGE (bias 0.2 ± 2.2%LV, P = 0.35), synthetic PSIR LGE (bias 0.4 ± 2.2% LV, P = 0.060) and post-contrast T1-mapping (bias 0.3 ± 1.8% LV, P = 0.10). The mean scan duration was 58 ± 4 min. Not performing T2 mapping (6 ± 1 min) and conventional LGE (10 ± 1 min) would shorten the CMR study by 15-20 min. T1-mapping can accurately quantify both the edema-based AAR (using native T1 maps) and acute MI size (using post-contrast T1 maps) in STEMI patients without major cardiovascular risk factors. This approach would shorten the duration of a comprehensive CMR study without significantly compromising on data acquisition and would obviate the need to perform T2 maps and LGE imaging.

  17. Great plains regional climate assessment technical report

    Science.gov (United States)

    The Great Plains region (GP) plays important role in providing food and energy to the economy of the United States. Multiple climatic and non-climatic stressors put multiple sectors, livelihoods and communities at risk, including agriculture, water, ecosystems and rural and tribal communities. The G...

  18. BDNF VAL66MET Polymorphism Elevates the Risk of Bladder Cancer via MiRNA-146b in Micro-Vehicles

    Directory of Open Access Journals (Sweden)

    Cong Li

    2018-01-01

    Full Text Available Background/Aims: Emerging studies on brain-derived neurotrophic factor (BDNF have shown that might be novel biomarkers and therapeutic targets for cancer. We explore the role of BDNF in the tumorigenesis of bladder cancer and the underlying molecular mechanism. Methods: 368 patients with diagnosed bladder cancer and 352 healthy controls were enrolled to evaluate the association of BDNF and the miR-146b. Bioinformatics algorithm analysis and luciferase assay were performed to identify the target genes of miR-146b. Real-time PCR and western-blot were carried out to validate the relationship between miR-146b and CRK. MTT assay and FACS were used to evaluated the proliferation and apoptosis of cancer cells. MVs were isolated and transfect into the culture cells to confirm the above observation. Results: The clinical study shows that BDNF Met/Met was significantly associated with the risk of bladder cancer. In addition, comparing with Val/Val and Val/Met, Met/Met has lower miR-146b level. Luciferase assay shows that BDNF Val/Val is apparently enhanced miR-146b promoter-luciferase, but not BDNF Met/Met. Based on luciferase assay, CRK is a direct target gene of miR-146b. MiR-146b mimics significantly inhibited the expression of CRK and activation of AKT level. The expression of CRK and the activation of AKT (p-AKT were significantly inhibited by MV-BDNF Val/Val-miR-146b or MV-BDNF Val/Met-miR-146b, but not MV-BDNF Met/Met-miR-146b. MV-BDNF Val/Val-miR-146b or Val/Met-miR-146b obviously inhibited cell proliferation, which eliminated by CRK. Meanwhile, with MV-BDNF Met/Met-miR-146b or Met/Met-miR-146b+CRK did not affect the proliferation. MV-BDNF Val/Val-miR-146b or Val/Met-miR-146b enhanced cell apoptosis, which could be eliminated by CRK. Meanwhile, MV-BDNF Met/Met-miR-146b or Met/Met-miR-146b+CRK did not promote apoptosis. Conclusion: BDNF VAL66MET polymorphism is associated with miR-146b and its target gene CRK. MiR-146b and CRK mediated BDNF VAL66

  19. Elevators or stairs?

    Science.gov (United States)

    Shah, Sachin; O’Byrne, Michael; Wilson, Merne; Wilson, Thomas

    2011-01-01

    Background: Staff in hospitals frequently travel between floors and choose between taking the stairs or elevator. We compared the time savings with these two options. Methods: Four people aged 26–67 years completed 14 trips ranging from one to six floors, both ascending and descending. We compared the amount of time per floor travelled by stairs and by two banks of elevators. Participants reported their fatigue levels using a modified Borg scale. We performed two-way analysis of variance to compare the log-transformed data, with participant and time of day as independent variables. Results: The mean time taken to travel between each floor was 13.1 (standard deviation [SD] 1.7) seconds by stairs and 37.5 (SD 19.0) and 35.6 (SD 23.1) seconds by the two elevators (F = 8.61, p elevator equaled about 15 minutes a day. Self-reported fatigue was less than 13 (out of 20) on the Borg scale for all participants, and they all stated that they were able to continue their duties without resting. The extra time associated with elevator use was because of waiting for its arrival. There was a difference in the amount of time taken to travel by elevator depending on the time of day and day of the week. Interpretation: Taking the stairs rather than the elevator saved about 15 minutes each workday. This 3% savings per workday could translate into improved productivity as well as increased fitness. PMID:22159365

  20. Effect of high-dose pitavastatin on glucose homeostasis in patients at elevated risk of new-onset diabetes: insights from the CAPITAIN and PREVAIL-US studies.

    Science.gov (United States)

    Chapman, M J; Orsoni, A; Robillard, P; Hounslow, N; Sponseller, C A; Giral, P

    2014-05-01

    Statin treatment may impair glucose homeostasis and increase the risk of new-onset diabetes mellitus, although this may depend on the statin, dose and patient population. We evaluated the effects of pitavastatin 4 mg/day on glucose homeostasis in patients with metabolic syndrome in the CAPITAIN trial. Findings were validated in a subset of patients enrolled in PREVAIL-US. Participants with a well defined metabolic syndrome phenotype were recruited to CAPITAIN to reduce the influence of confounding factors. Validation and comparison datasets were selected comprising phenotypically similar subsets of individuals enrolled in PREVAIL-US and treated with pitavastatin or pravastatin, respectively. Mean change from baseline in parameters of glucose homeostasis (fasting plasma glucose [FPG], glycated hemoglobin [HbA1c], insulin, quantitative insulin-sensitivity check index [QUICKI] and homeostasis model of assessment-insulin resistance [HOMA-IR]) and plasma lipid profile were assessed at 6 months (CAPITAIN) and 3 months (PREVAIL-US) after initiating treatment. In CAPITAIN (n = 12), no significant differences from baseline in HbA1c, insulin, HOMA-IR and QUICKI were observed at day 180 in patients treated with pitavastatin. A small (4%) increase in FPG from baseline to day 180 (P  0.05). Similar results were observed for pravastatin in the comparison dataset (n = 14). Other than a small change in FPG in the CAPITAIN study, neutral effects of pitavastatin on glucose homeostasis were observed in two cohorts of patients with metabolic syndrome, independent of its efficacy in reducing levels of atherogenic lipoproteins. The small number of patients and relatively short follow-up period represent limitations of the study. Nevertheless, these data suggest that statin-induced diabetogenesis may not represent a class effect.

  1. Trial occlusion to assess the risk of persistent pulmonary arterial hypertension after closure of a large patent ductus arteriosus in adolescents and adults with elevated pulmonary artery pressure.

    Science.gov (United States)

    Zhang, Duan-Zhen; Zhu, Xian-Yang; Lv, Bei; Cui, Chun-Sheng; Han, Xiu-Min; Sheng, Xiao-Tang; Wang, Qi-Guang; Zhang, Po

    2014-08-01

    No method is available to predict whether patients with patent ductus arteriosus (PDA) and severe pulmonary arterial hypertension (PAH) will show persistent postprocedural PAH (PP-PAH) after PDA closure. This study evaluated the usefulness of trial occlusion for predicting PP-PAH after transcatheter PDA closure in patients with severe PAH. Trial occlusion was performed in 137 patients (age ≥12 years) with PDA and severe PAH. All patients undergoing trial occlusion had a mean pulmonary artery pressure ≥45 mm Hg, pulmonary:systemic flow (Qp/Qs) ratio >1.5, and pulmonary:systemic resistance (Rp/Rs) ratio closure. Linear correlation analysis revealed weak or moderate relationships between the baseline and post-trial pulmonary artery pressures and pulmonary:systemic pressure (Pp/Ps) ratios. Patients were followed up for 1 to 10 years (median: 5 years). PP-PAH (systolic pulmonary artery pressure >50 mm Hg by Doppler echocardiography) was detected in 17 patients (13%), who displayed no significant differences in sex and age compared with patients without PP-PAH. According to discriminant analysis, the strongest discriminators between patients with and without PP-PAH were the baseline left ventricular end-diastolic volume and the baseline and post-trial systolic Pp/Ps ratios. In particular, a post-trial systolic Pp/Ps ratio >0.5 correctly classified 100% of the PP-PAH and non-PAH patients. Trial occlusion is a feasible method to predict PP-PAH in patients with PDA and severe PAH. A post-trial systolic Pp/Ps ratio >0.5 indicates a high risk of PP-PAH occurrence after device closure. © 2014 American Heart Association, Inc.

  2. Stroke-attributable death among older persons during the great recession.

    Science.gov (United States)

    Falconi, April; Gemmill, Alison; Karasek, Deborah; Goodman, Julia; Anderson, Beth; Lee, Murray; Bellows, Benjamin; Catalano, Ralph

    2016-05-01

    Epidemiological evidence indicates an elevated risk for stroke among stressed persons, in general, and among individuals who have lost their job, in particular. We, therefore, tested the hypothesis that stroke accounted for a larger fraction of deaths during the Great Recession than expected from other deaths and from trends, cycles, and other forms of autocorrelation. Based on vital statistics death data from California spanning 132 months from January 2000 through December 2010, we found support for the hypothesis. These findings appear attributable to non-Hispanic white men, who experienced a 5% increase in their monthly odds of stroke-attributable death. Total mortality in this group, however, did not increase. Findings suggest that 879 deaths among older white men shifted from other causes to stroke during the 36 months following the start of the Great Recession. We infer the Great Recession may have affected social, biologic, and behavioral risk factors that altered the life histories of older white men in ways that shifted mortality risk toward stroke. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Review: The Great Gatsby

    Directory of Open Access Journals (Sweden)

    Antonia de Jesus Sales

    2016-08-01

    Full Text Available A presente resenha busca discutir a tradução de The Great Gatsby para o contexto brasileiro. Diversas traduções foram feitas, em diversas épocas e com repercussão positiva no contexto brasileiro. Para o presente estudo, foi observada a tradução de Vanessa Bárbara, de 2011. Nesse sentido, o aspecto biográficos do autor e a forma como se apresentam os personagens na obra são fatores de cotejamento na obra original e na tradução brasileira. Francis Scott Key Fitzgerald (1896 – 1940 é famoso por ter em suas obras traços biográficos, algo que certamente influencia o leitor que adentra a sua obra. Quanto à recepção de O Grande Gatsby no contexto brasileiro, há que se considerar que O Grande Gatsby teve diversas traduções no Brasil. Depois dessa tradução de Vanessa Bárbara, em 2011, outras três vieram em 2013, juntamente com o filme. Há que considerar os aspectos comerciais embutidos nessas traduções e que muito corroboram para o resultado final. Prova disso são as capas, que são sempre diferenciadas em cada edição lançada. O tradutor nem sempre pode opinar sobre questões como estas. A tradução, a meu ver, é uma obra de qualidade, visto que a tradutora buscou ser fiel, sem dificultar a interpretação da obra para o leitor.

  4. Review: The Great Gatsby

    Directory of Open Access Journals (Sweden)

    Antonia de Jesus Sales

    2016-05-01

    Full Text Available A presente resenha busca discutir a tradução de The Great Gatsby para o contexto brasileiro. Diversas traduções foram feitas, em diversas épocas e com repercussão positiva no contexto brasileiro. Para o presente estudo, foi observada a tradução de Vanessa Bárbara, de 2011. Nesse sentido, o aspecto biográficos do autor e a forma como se apresentam os personagens na obra são fatores de cotejamento na obra original e na tradução brasileira. Francis Scott Key Fitzgerald (1896 – 1940 é famoso por ter em suas obras traços biográficos, algo que certamente influencia o leitor que adentra a sua obra. Quanto à recepção de O Grande Gatsby no contexto brasileiro, há que se considerar que O Grande Gatsby teve diversas traduções no Brasil. Depois dessa tradução de Vanessa Bárbara, em 2011, outras três vieram em 2013, juntamente com o filme. Há que considerar os aspectos comerciais embutidos nessas traduções e que muito corroboram para o resultado final. Prova disso são as capas, que são sempre diferenciadas em cada edição lançada. O tradutor nem sempre pode opinar sobre questões como estas. A tradução, a meu ver, é uma obra de qualidade, visto que a tradutora buscou ser fiel, sem dificultar a interpretação da obra para o leitor.

  5. Timing of intervention in high-risk non-ST-elevation acute coronary syndromes in PCI versus non-PCI centres : Sub-group analysis of the ELISA-3 trial.

    Science.gov (United States)

    Badings, E A; Remkes, W S; Dambrink, J-H E; The, S H K; Van Wijngaarden, J; Tjeerdsma, G; Rasoul, S; Timmer, J R; van der Wielen, M L J; Lok, D J A; van 't Hof, A W J

    2016-03-01

    To compare the effect of timing of intervention in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) in percutaneous coronary intervention (PCI) versus non-PCI centres. A post-hoc sub-analysis was performed of the ELISA III trial, a randomised multicentre trial investigating outcome of early ( 48 h) angiography and revascularisation in 542 patients with high-risk NSTE-ACS. 90 patients were randomised in non-PCI centres and tended to benefit more from an early invasive strategy than patients included in the PCI centre (relative risk 0.23 vs. 0.85 [p for interaction = 0.089] for incidence of the combined primary endpoint of death, reinfarction and recurrent ischaemia after 30 days of follow-up). This was largely driven by reduction in recurrent ischaemia. In non-PCI centres, patients randomised to the late group had a 4 and 7 day longer period until PCI or coronary artery bypass grafting, respectively. This difference was less pronounced in the PCI centre. This post-hoc analysis from the ELISA-3 trial suggests that NSTE-ACS patients initially hospitalised in non-PCI centres show the largest benefit from early angiography and revascularisation, associated with a shorter waiting time to revascularisation. Improved patient logistics and transfer between non-PCI and PCI centres might therefore result in better clinical outcome.

  6. Elevated temperature fracture mechanics

    International Nuclear Information System (INIS)

    Tomkins, B.

    1979-01-01

    The application of fracture mechanics concepts to cracks at elevated temperatures is examined. Particular consideration is given to the characterisation of crack tip stress-strain fields and parameters controlling crack extension under static and cyclic loads. (author)

  7. The great transition.

    Science.gov (United States)

    Lieberthal, Kenneth; Lieberthal, Geoffrey

    2003-10-01

    As China's economy grows and opens further, the opportunity it presents to multinationals is changing. Foreign companies are moving to country development and new strategic choices. Now, foreign firms can actually go after the Chinese domestic market, and it's worth going after. Improvements in China's infrastructure, workforce, and regulatory environment are making it possible for companies to lower their costs to reap new competitive advantages. Multifaceted and often-shifting risks accompany this shifting opportunity. The reforms required for admission into the WTO will be politically difficult for China to implement, and its progress will be slowed by the scarcity of resources for the country's shaky banking system, the inadequacy of the social safety net, environmental problems, and local governments' cash shortage. China's breathtaking 9% average annual GDP growth rests on an unsteady foundation of overcapitalized state-owned enterprises, which have oversupplied many markets, and fiercely protectionist regional government officials pursuing growth-at-almost-all-costs policies. Frequent changes in regulations, bureaucracies, and reporting relationships will continue to make planning difficult, and, as the SARS epidemic demonstrated, there is always the potential for serious disruptions. But for at least the next ten years, multinationals should be the biggest winners in China. To reap the benefits, a multinational must properly nest its effort into its overall organization, show "one face to China" at the national level but also tailor local strategies, be wary of joint ventures, and mitigate risk, in particular the theft of intellectual property. China is a major opportunity for companies that forthrightly face its complexities. It will remain largely inscrutable--and unprofitable--for the rest.

  8. Great Lakes Environmental Database (GLENDA)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Great Lakes Environmental Database (GLENDA) houses environmental data on a wide variety of constituents in water, biota, sediment, and air in the Great Lakes area.

  9. Indsatser for tosprogede elever

    DEFF Research Database (Denmark)

    Andersen, Dines; Jakobsen, Vibeke; Jensen, Vibeke Myrup

    Fagligt set klarer tosprogede elever sig dårligere i skolen og det videre uddannelsessystem end ’danske’ elever. Kommuner og folkeskoler har derfor sat en række tiltag i værk, som sigter mod at forbedre de tosprogede elevers skole- og uddannelsessituation. Rapporten kortlægger og analyserer...... af klasseundervisningen. Analysen viser, at de elever, der bliver taget ud af klassen for at få ekstra undervisning i dansk som andetsprog, klarer sig dårligere end elever, der modtager ekstraundervisningen i klassen eller uden for skoletid. Undersøgelsen er baseret på spørgeskemaundersøgelser blandt...... kommunale forvaltningschefer, skoleledere, lærere og forældre til børn i 2. klasse samt lærere til og elever i 9. klasse, SFI’s forløbsundersøgelse af årgang 1995 og registerdata. Undersøgelsen er via Ministeriet for Børn og Undervisning betalt med midler fra satspuljeaftalen 2009 om integration....

  10. Soil Erosion Research Based on USLE in Great Khinggan

    OpenAIRE

    Wei Li; Wenyi Fan; Xuegang Mao

    2014-01-01

    Based on the amended model of USLE universal soil loss equation and GIS technology, combined with the natural geographical features of Great Khinggan area, it has conducted quantitative analysis of the factor in Soil loss equation. Uses 2011 years TM/ETM images classification are land uses/cover type figure, combination Great Khinggan area Digital Elevation Model (DEM) and soil type distribution figure and research regional rainfall information, we gets all factors values of space distributio...

  11. The heart and great vessels

    International Nuclear Information System (INIS)

    Condon, V.

    1985-01-01

    Heart disease is the fifth most common cause of death in infants and children (preceded by anoxic and hypoxic conditions, gross congenital malformations, accidental death, and immaturity). Of all the cardiac lesions, congenital heart disease (CHD) makes up the gross majority, accounting for approximately 90% of all cardiac deaths. Approximately two-thirds of all infants who die from CHD do so within the first year of life; of these, approximately one-third die within the first month. The most common cause of death in the first month is hypoplastic left heart syndrome and lesions associated with it, i.e., aortic atresia/critical aortic stenosis and mitral atresia/critical mitral stenosis. Severe coarctation of the aorta (coarctation syndrome) and transposition of the great arteries are the other most important causes of death in this age group. CHD occurs as a familial condition in approximately 1-4% of cases; ventricular septal defects, patent ductus arteriosus, and atrial septal defect are particularly common forms. Parental age plays an important role, with a significantly increased risk of CHD in infants of mothers over 39 years of age. Patent ductus arteriosus is more prevalent in firstborn children, particularly those born prematurely to young mothers. Environmental factors, such as exposure to teratogenic agents, have also been shown to increase the incidence of CHD. Children with various syndromes also have increased incidence of CHD. Down syndrome is a classic example, as are other trisomies

  12. Myocarditis with ST elevation and elevated cardiac enzymes misdiagnosed as an ST-elevation myocardial infarction.

    Science.gov (United States)

    Sheldon, Seth H; Crandall, Mark A; Jaffe, Allan S

    2012-12-01

    Acute myocarditis can mimic ST-elevation myocardial infarction (STEMI). Quickly determining the correct diagnosis is critical given the "time is muscle" implication with a STEMI and the potential adverse effects associated with use of fibrinolytic therapy. A 46-year-old man presented to a rural emergency department with chest pain, and an electrocardiogram (ECG) read as showing 0.1 mV of ST-segment elevation in leads III and aVF. His initial cardiac troponin T was 0.44 ng/mL. He received fibrinolytic therapy for presumed STEMI. Cardiac magnetic resonance imaging was later performed and showed epicardial delayed enhancement consistent with myocarditis. Upon further questioning, he acknowledged 3 days of stuttering chest discomfort and a recent upper respiratory infection, as well as similar chest pain in his wife. A systematic evaluation is essential for acute chest pain, including a focused history, identification of cardiac risk factors, and ECG interpretation. A history of recent viral illness, absence of cardiac risk factors, or ECG findings inconsistent with a single anatomic lesion would suggest a potential alternate diagnosis to STEMI. This case emphasizes the importance of a focused history in the initial evaluation of chest pain. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Interaktive tavler - interaktive elever

    DEFF Research Database (Denmark)

    Reusch, Charlotte F.; Otzen, Elsebeth

    Abstract, Poster-præsentation 13.-14. juni 2012, Pilotprojekt: Interaktive tavler – interaktive elever Lektor, cand. pæd., Elsebeth Otzen og Lektor, cand. mag., Charlotte Reusch, Institut for Skole og Læring, Læreruddannelsen, Professionshøjskolen Metropol, København Hvordan motiverer en interaktiv...... tavle lærere og elever? Hvad sker der mellem elev, stof og lærer, når læreren bliver i stand til at billedliggøre og dynamisere sine oplæg på tavlen? Bliver læreroplæg prioriteret? Bliver eleverne aktive, eller ender den interaktive tavle med blot at understøtte lærerens envejskommunikation til klassen......? Og hvad sker der mellem eleverne? Disse spørgsmål var igangsættende for arbejdet med pilotprojektet Interaktive tavler – interaktive elever, som blev afviklet i skoleåret 2010-2011. Projektet blev udført af en tværfaglig gruppe, bestående af lektorer i matematik, biologi og dansk i læreruddannelsen...

  14. Udeskole og elevers handlekompetence

    DEFF Research Database (Denmark)

    Breiting, Søren

    2011-01-01

    Elever elsker at komme væk fra undervisningen i skolen. Er det positivt eller negativt? Og hvad har betydning for, at eleverne får mest muligt ud af oplevelserne uden for skolen? Forskellige former for udeskole giver nogle oplagte muligheder, så eleverne udvikler sig som engagerede borgere i et...

  15. Interaktive tavler - interaktive elever

    DEFF Research Database (Denmark)

    Reusch, Charlotte; Otzen, Elsebeth

    Abstract, Poster-præsentation 13.-14. juni 2012, Pilotprojekt: Interaktive tavler ? interaktive elever Lektor, cand. pæd., Elsebeth Otzen og Lektor, cand. mag., Charlotte Reusch, Institut for Skole og Læring, Læreruddannelsen, Professionshøjskolen Metropol, København Hvordan motiverer en interaktiv...... tavle lærere og elever? Hvad sker der mellem elev, stof og lærer, når læreren bliver i stand til at billedliggøre og dynamisere sine oplæg på tavlen? Bliver læreroplæg prioriteret? Bliver eleverne aktive, eller ender den interaktive tavle med blot at understøtte lærerens envejskommunikation til klassen......? Og hvad sker der mellem eleverne? Disse spørgsmål var igangsættende for arbejdet med pilotprojektet Interaktive tavler ? interaktive elever, som blev afviklet i skoleåret 2010-2011. Projektet blev udført af en tværfaglig gruppe, bestående af lektorer i matematik, biologi og dansk i læreruddannelsen...

  16. Lunar transportation scenarios utilising the Space Elevator.

    Science.gov (United States)

    Engel, Kilian A

    2005-01-01

    The Space Elevator (SE) concept has begun to receive an increasing amount of attention within the space community over the past couple of years and is no longer widely dismissed as pure science fiction. In light of the renewed interest in a, possibly sustained, human presence on the Moon and the fact that transportation and logistics form the bottleneck of many conceivable lunar missions, it is interesting to investigate what role the SE could eventually play in implementing an efficient Earth to Moon transportation system. The elevator allows vehicles to ascend from Earth and be injected into a trans-lunar trajectory without the use of chemical thrusters, thus eliminating gravity loss, aerodynamic loss and the need of high thrust multistage launch systems. Such a system therefore promises substantial savings of propellant and structural mass and could greatly increase the efficiency of Earth to Moon transportation. This paper analyzes different elevator-based trans-lunar transportation scenarios and characterizes them in terms of a number of benchmark figures. The transportation scenarios include direct elevator-launched trans-lunar trajectories, elevator launched trajectories via L1 and L2, as well as launch from an Earth-based elevator and subsequent rendezvous with lunar elevators placed either on the near or on the far side of the Moon. The benchmark figures by which the different transfer options are characterized and evaluated include release radius (RR), required delta v, transfer times as well as other factors such as accessibility of different lunar latitudes, frequency of launch opportunities and mission complexity. The performances of the different lunar transfer options are compared with each other as well as with the performance of conventional mission concepts, represented by Apollo. c2005 Elsevier Ltd. All rights reserved.

  17. Lunar transportation scenarios utilising the Space Elevator

    Science.gov (United States)

    Engel, Kilian A.

    2005-07-01

    The Space Elevator (SE) concept has begun to receive an increasing amount of attention within the space community over the past couple of years and is no longer widely dismissed as pure science fiction. In light of the renewed interest in a, possibly sustained, human presence on the Moon and the fact that transportation and logistics form the bottleneck of many conceivable lunar missions, it is interesting to investigate what role the SE could eventually play in implementing an efficient Earth to Moon transportation system. The elevator allows vehicles to ascend from Earth and be injected into a trans-lunar trajectory without the use of chemical thrusters, thus eliminating gravity loss, aerodynamic loss and the need of high thrust multistage launch systems. Such a system therefore promises substantial savings of propellant and structural mass and could greatly increase the efficiency of Earth to Moon transportation. This paper analyzes different elevator-based trans-lunar transportation scenarios and characterizes them in terms of a number of benchmark figures. The transportation scenarios include direct elevator-launched trans-lunar trajectories, elevator-launched trajectories via L1 and L2, as well as launch from an Earth-based elevator and subsequent rendezvous with lunar elevators placed either on the near or on the far side of the Moon. The benchmark figures by which the different transfer options are characterized and evaluated include release radius (RR), required Δv, transfer times as well as other factors such as accessibility of different lunar latitudes, frequency of launch opportunities and mission complexity. The performances of the different lunar transfer options are compared with each other as well as with the performance of conventional mission concepts, represented by Apollo.

  18. What Caused the Great Depression?

    Science.gov (United States)

    Caldwell, Jean; O'Driscoll, Timothy G.

    2007-01-01

    Economists and historians have struggled for almost 80 years to account for the American Great Depression, which began in 1929 and lasted until the early years of World War II. In this article, the authors discuss three major schools of thought on the causes of the Great Depression and the long failure of the American economy to return to full…

  19. Bayesian model averaging in vector autoregressive processes with an investigation of stability of the US great ratios and risk of a liquidity trap in the USA, UK and Japan

    NARCIS (Netherlands)

    R.W. Strachan (Rodney); H.K. van Dijk (Herman)

    2007-01-01

    textabstractA Bayesian model averaging procedure is presented within the class of vector autoregressive (VAR) processes and applied to two empirical issues. First, stability of the "Great Ratios" in U.S. macro-economic time series is investigated, together with the presence and e¤ects of permanent

  20. Space elevator systems level analysis

    Energy Technology Data Exchange (ETDEWEB)

    Laubscher, B. E. (Bryan E.)

    2004-01-01

    The Space Elevator (SE) represents a major paradigm shift in space access. It involves new, untried technologies in most of its subsystems. Thus the successful construction of the SE requires a significant amount of development, This in turn implies a high level of risk for the SE. This paper will present a systems level analysis of the SE by subdividing its components into their subsystems to determine their level of technological maturity. such a high-risk endeavor is to follow a disciplined approach to the challenges. A systems level analysis informs this process and is the guide to where resources should be applied in the development processes. It is an efficient path that, if followed, minimizes the overall risk of the system's development. systems level analysis is that the overall system is divided naturally into its subsystems, and those subsystems are further subdivided as appropriate for the analysis. By dealing with the complex system in layers, the parameter space of decisions is kept manageable. Moreover, A rational way to manage One key aspect of a resources are not expended capriciously; rather, resources are put toward the biggest challenges and most promising solutions. This overall graded approach is a proven road to success. The analysis includes topics such as nanotube technology, deployment scenario, power beaming technology, ground-based hardware and operations, ribbon maintenance and repair and climber technology.

  1. Skuldertesten "Kombineret Elevation"

    DEFF Research Database (Denmark)

    Clausen, Mikkel Bek; Overkær, Brian

    2010-01-01

    Formål: At udarbejde en testprotokol for testen Kombineret Elevation (KE) og undersøge test-retest variationen ved test af elite svømmere, samt diskutere testens relevans og validitet. Materiale og Metode: 9 elite og 10 sub-elite svømmere, heraf var 11 mænd og 8 kvinder, gennemførte testen KE 2...

  2. Risk

    Science.gov (United States)

    Cole, Stephen R.; Hudgens, Michael G.; Brookhart, M. Alan; Westreich, Daniel

    2015-01-01

    The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

  3. Reduced high-molecular-weight adiponectin and elevated high-sensitivity C-reactive protein are synergistic risk factors for metabolic syndrome in a large-scale middle-aged to elderly population: the Shimanami Health Promoting Program Study.

    Science.gov (United States)

    Tabara, Yasuharu; Osawa, Haruhiko; Kawamoto, Ryuichi; Tachibana-Iimori, Rieko; Yamamoto, Miyuki; Nakura, Jun; Miki, Tetsuro; Makino, Hideich; Kohara, Katsuhiko

    2008-03-01

    In Western countries, one of the most important modifiable targets for the prevention of cardiovascular diseases is metabolic syndrome. Adiponectin is an adipose tissue-specific plasma protein that inversely associates with metabolic syndrome. Among several molecular isoforms, high-molecular-weight (HMW) complex is considered the active form. Increased serum high-sensitivity C-reactive protein (hsCRP) concentration also associates with metabolic syndrome, and adiponectin could modulate plasma C-reactive protein levels. Here, through cross-sectional investigation, we investigated whether reduced HMW adiponectin and increased hsCRP levels in plasma are synergistically associated with metabolic syndrome. Measurement of HMW complex of adiponectin is one of the novelties of this study. We analyzed 1845 community-dwelling middle-aged to elderly subjects (62+/-13 yr). Plasma HMW adiponectin levels were measured by ELISA. Clinical parameters were obtained from the subjects' personal health records, evaluated at their annual medical check-up. Each component of metabolic syndrome, except for raised blood pressure, showed significantly lower plasma HMW adiponectin concentrations for both men and women (P<0.001). In contrast, plasma hsCRP levels were significantly higher in subjects with metabolic disorders (P<0.001). After adjusting for other confounding factors, HMW adiponectin [log normalized, odds ratio 0.084 (95% confidence interval 0.050-0.142), P<0.001] and hsCRP [3.009 (2.175-4.163), P<0.001] were identified as independent determinants of metabolic syndrome. In addition to the direct associations, we also observed a synergistic effect between these two molecules (F=11.8, P<0.001). Reduced HMW adiponectin and elevated hsCRP are synergistically associated with the accumulation of metabolic disorders. The combination of these markers would be useful for identifying at-risk populations.

  4. Neural Correlates of Sensory Hyporesponsiveness in Toddlers at High Risk for Autism Spectrum Disorder

    Science.gov (United States)

    Simon, David M.; Damiano, Cara R.; Woynaroski, Tiffany G.; Ibañez, Lisa V.; Murias, Michael; Stone, Wendy L.; Wallace, Mark T.; Cascio, Carissa J.

    2017-01-01

    Altered patterns of sensory responsiveness are a frequently reported feature of Autism Spectrum Disorder (ASD). Younger siblings of individuals with ASD are at a greatly elevated risk of a future diagnosis of ASD, but little is known about the neural basis of sensory responsiveness patterns in this population. Younger siblings (n = 20) of children…

  5. Investigation on cause of the elevator turbine wear

    Science.gov (United States)

    Zhang, J.; Ouyang, W. P.; Xue, J. A.

    2018-03-01

    Elevator traction turbine is often worn for various reasons, causing serious safety hazard. It is explained the main causes of traction wheel wear in detail in combination with a large number of engineering experience. The effect of turbine wear on the actual operation of the elevator is verified by contrast experiment, which is helpful to identify risks early. It is put forward on some reasonable suggestions for elevator inspection, maintenance and management.

  6. Great Lakes Environmental Research Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — NOAA-GLERL and its partners conduct innovative research on the dynamic environments and ecosystems of the Great Lakes and coastal regions to provide information for...

  7. What Caused the Great Recession?

    OpenAIRE

    Homburg, Stefan

    2014-01-01

    This paper examines five possible explanations for the Great Recession of 2008 and 2009, using data for the United States and the eurozone. Of these five hypotheses, four are not supported by the data, while the fifth appears reasonable.

  8. Arthroscopy of the great toe

    NARCIS (Netherlands)

    Frey, C.; van Dijk, C. N.

    1999-01-01

    The few available reports of arthroscopic treatment of the first MTP joint in the literature indicate favorable outcome. However, arthroscopy of the great toe is an advanced technique and should only be undertaken by experienced surgeons

  9. Preeclampsia as the great impostor.

    Science.gov (United States)

    Goodlin, R C

    1991-06-01

    In contrast with a generation ago when preeclampsia was misdiagnosed as medical or surgical disease unrelated to pregnancy, today's diagnostic errors are those that consider surgical and medical problems as either pregnancy-induced hypertension or as the hemolysis, elevated liver enzymes, and low platelet count syndrome. Eleven case histories are presented of significant medical or surgical problems that were initially diagnosed as hemolysis, elevated liver enzymes, and low platelet count syndrome or pregnancy-induced hypertension. The incorrect diagnosis of medical-surgical cases during pregnancy often meant that appropriate therapy was delayed and that the rate of iatrogenic prematurity was increased.

  10. The Sixth Great Mass Extinction

    Science.gov (United States)

    Wagler, Ron

    2012-01-01

    Five past great mass extinctions have occurred during Earth's history. Humanity is currently in the midst of a sixth, human-induced great mass extinction of plant and animal life (e.g., Alroy 2008; Jackson 2008; Lewis 2006; McDaniel and Borton 2002; Rockstrom et al. 2009; Rohr et al. 2008; Steffen, Crutzen, and McNeill 2007; Thomas et al. 2004;…

  11. Transposition of the great arteries

    Directory of Open Access Journals (Sweden)

    Castela Eduardo

    2008-10-01

    Full Text Available Abstract Transposition of the great arteries (TGA, also referred to as complete transposition, is a congenital cardiac malformation characterised by atrioventricular concordance and ventriculoarterial (VA discordance. The incidence is estimated at 1 in 3,500–5,000 live births, with a male-to-female ratio 1.5 to 3.2:1. In 50% of cases, the VA discordance is an isolated finding. In 10% of cases, TGA is associated with noncardiac malformations. The association with other cardiac malformations such as ventricular septal defect (VSD and left ventricular outflow tract obstruction is frequent and dictates timing and clinical presentation, which consists of cyanosis with or without congestive heart failure. The onset and severity depend on anatomical and functional variants that influence the degree of mixing between the two circulations. If no obstructive lesions are present and there is a large VSD, cyanosis may go undetected and only be perceived during episodes of crying or agitation. In these cases, signs of congestive heart failure prevail. The exact aetiology remains unknown. Some associated risk factors (gestational diabetes mellitus, maternal exposure to rodenticides and herbicides, maternal use of antiepileptic drugs have been postulated. Mutations in growth differentiation factor-1 gene, the thyroid hormone receptor-associated protein-2 gene and the gene encoding the cryptic protein have been shown implicated in discordant VA connections, but they explain only a small minority of TGA cases. The diagnosis is confirmed by echocardiography, which also provides the morphological details required for future surgical management. Prenatal diagnosis by foetal echocardiography is possible and desirable, as it may improve the early neonatal management and reduce morbidity and mortality. Differential diagnosis includes other causes of central neonatal cyanosis. Palliative treatment with prostaglandin E1 and balloon atrial septostomy are usually

  12. Risk

    Science.gov (United States)

    Barshi, Immanuel

    2016-01-01

    Speaking up, i.e. expressing ones concerns, is a critical piece of effective communication. Yet, we see many situations in which crew members have concerns and still remain silent. Why would that be the case? And how can we assess the risks of speaking up vs. the risks of keeping silent? And once we do make up our minds to speak up, how should we go about it? Our workshop aims to answer these questions, and to provide us all with practical tools for effective risk assessment and effective speaking-up strategies..

  13. A spider elevator

    Energy Technology Data Exchange (ETDEWEB)

    Butylkin, A.V.; Butylkin, V.A.; Izosimov, A.M.

    1983-01-01

    A spider elevator is proposed which contains a body, a wedge clamp with wedges hinged to each other, a subassembly for holding the wedge clamp in the open and closed positions and a mechanism for changing the wedge clamp, which is made in the form of levers with ears for cleats and installed in the body with the capability of turning. To increase reliability in the operational mode through using the external force for clamping the pipe, the free ends of the levers are hinged with the body by a power cylinder.

  14. Elevator Control Strategies

    OpenAIRE

    Ceder, Frederick; Nordin, Alexandra

    2013-01-01

    The purpose of this essay is to investigate if it is eective to switch strategies for elevators during one day in an oce building. This essay describes some of the strategies in use today, followed by a comparison and analysis of two of the strategies described. We have also implemented optimizations to one of these strategies. From our test results we can conclude that our optimized strategy worked and produced better results on average waiting time and total traveling time than the two stra...

  15. 3D Elevation Program: summary for Vermont

    Science.gov (United States)

    Carswell, William J.

    2015-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Vermont, elevation data are critical for hazard mitigation, geologic resource assessment, natural resources conservation, agriculture and precision farming, flood risk management, infrastructure and construction management, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  16. 3D Elevation Program: summary for Nebraska

    Science.gov (United States)

    Carswell, William J.

    2015-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Nebraska, elevation data are critical for agriculture and precision farming, natural resources conservation, flood risk management, infrastructure and construction management, geologic resource assessment and hazard mitigation, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  17. Automatic pipe elevator

    Energy Technology Data Exchange (ETDEWEB)

    Haney, K.M.; Willis, C.A.

    1987-03-17

    This patent describes an elevator adapted for use with a power swivel for supporting a drilling or production tubular, the elevator comprising: at least two jaws, each jaw having a clamping surface; a connector member for supporting the jaws, the connector member comprising an upper end, a lower end, means for coupling the upper end to the power swivel, means for coupling the lower end to a tubular. The member also comprises means for defining a passageway extending from the upper end to the lower end through the connector member to allow drilling mud to be passed from the power swivel through the bore, into the tubular; and linkage means mounted between the connector member and the jaws for coupling the jaws to the connector member and for maintaining the clamping surfaces of the jaws in clamping engagement with the tubular when the connector member and the tubular are urged apart relative to one another. The linkage means is configured such that the force by which the clamping surfaces clamp the tubular increases as the force urging the connector member and the tubular apart increases.

  18. Elevation data for floodplain mapping

    National Research Council Canada - National Science Library

    Committee on Floodplain Mapping Technologies; National Research Council; Division on Earth and Life Studies; National Research Council

    2007-01-01

    .... Elevation Data for Floodplain Mapping shows that there is sufficient two-dimensional base map imagery to meet FEMA's flood map modernization goals, but that the three-dimensional base elevation data...

  19. Comparison of recreational health risks associated with surfing and swimming in dry weather and post-storm conditions at Southern California beaches using quantitative microbial risk assessment (QMRA).

    Science.gov (United States)

    Tseng, Linda Y; Jiang, Sunny C

    2012-05-01

    Southern California is an increasingly urbanized hotspot for surfing, thus it is of great interest to assess the human illness risks associated with this popular ocean recreational water sport from exposure to fecal bacteria contaminated coastal waters. Quantitative microbial risk assessments were applied to eight popular Southern California beaches using readily available enterococcus and fecal coliform data and dose-response models to compare health risks associated with surfing during dry weather and storm conditions. The results showed that the level of gastrointestinal illness risks from surfing post-storm events was elevated, with the probability of exceeding the US EPA health risk guideline up to 28% of the time. The surfing risk was also elevated in comparison with swimming at the same beach due to ingestion of greater volume of water. The study suggests that refinement of dose-response model, improving monitoring practice and better surfer behavior surveillance will improve the risk estimation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Problems of the measures against 'the reputational risk' of Fukushima farm products involved in the emergency recommendation regarding the response to the great east Japan earthquake by science council of Japan

    International Nuclear Information System (INIS)

    Karaki, Hideaki

    2014-01-01

    The recommendation in the title is pointed out for its verification to be unsatisfactory and problematic. The reputational risk comes from the harmful rumors or misinformation, having caused the damage of lowered prices of Fukushima farm products. Various investigations by market researchers and analyzers have revealed that, in a total, consumers hardly keep from buying the products and that mediators' demand for discount is the major cause of their lowered prices. In September, 2013 that the actual situation of the rumor harm gradually became clear as above, the Council recommended that the measures against the harm is to establish the test system for elucidating the distribution of radioactivity and soil elements in every farm field for consumers' safety and ease. This recommendation defined that the incompleteness of decontamination of the production site was the cause of the harm, and described details of the possible test system, whereas there was scarce mentioning about its purpose, expected results and cost-benefit effect. Investigations by the author and by questionnaires by his foundation and Consumer Affairs Agency revealed that many consumers scarcely had the interest in such test results, and thus, of which outcomes are not always evident. Under the situation, the efficacy of the test system seems obscure. Rather, risk communication is conceivably more important as the measures against the reputational risk than such a test system, which leads to the true risk management based on common recognition and exchange of opinions about the risk. (T.T.)

  1. Quantification of myocardium at risk in ST- elevation myocardial infarction: a comparison of contrast-enhanced steady-state free precession cine cardiovascular magnetic resonance with coronary angiographic jeopardy scores.

    Science.gov (United States)

    De Palma, Rodney; Sörensson, Peder; Verouhis, Dinos; Pernow, John; Saleh, Nawzad

    2017-07-27

    Clinical outcome following acute myocardial infarction is predicted by final infarct size evaluated in relation to left ventricular myocardium at risk (MaR). Contrast-enhanced steady-state free precession (CE-SSFP) cardiovascular magnetic resonance imaging (CMR) is not widely used for assessing MaR. Evidence of its utility compared to traditional assessment methods and as a surrogate for clinical outcome is needed. Retrospective analysis within a study evaluating post-conditioning during ST elevation myocardial infarction (STEMI) treated with coronary intervention (n = 78). CE-SSFP post-infarction was compared with angiographic jeopardy methods. Differences and variability between CMR and angiographic methods using Bland-Altman analyses were evaluated. Clinical outcomes were compared to MaR and extent of infarction. MaR showed correlation between CE-SSFP, and both BARI and APPROACH scores of 0.83 (p < 0.0001) and 0.84 (p < 0.0001) respectively. Bias between CE-SSFP and BARI was 1.1% (agreement limits -11.4 to +9.1). Bias between CE-SSFP and APPROACH was 1.2% (agreement limits -13 to +10.5). Inter-observer variability for the BARI score was 0.56 ± 2.9; 0.42 ± 2.1 for the APPROACH score; -1.4 ± 3.1% for CE-SSFP. Intra-observer variability was 0.15 ± 1.85 for the BARI score; for the APPROACH score 0.19 ± 1.6; and for CE-SSFP -0.58 ± 2.9%. Quantification of MaR with CE-SSFP imaging following STEMI shows high correlation and low bias compared with angiographic scoring and supports its use as a reliable and practical method to determine myocardial salvage in this patient population. Clinical trial registration information for the parent clinical trial: Karolinska Clinical Trial Registration (2008) Unique identifier: CT20080014. Registered 04 th January 2008.

  2. Fucosyltransferase 2 (FUT2) non-secretor status and blood group B are associated with elevated serum lipase activity in asymptomatic subjects, and an increased risk for chronic pancreatitis: a genetic association study.

    Science.gov (United States)

    Weiss, Frank Ulrich; Schurmann, Claudia; Guenther, Annett; Ernst, Florian; Teumer, Alexander; Mayerle, Julia; Simon, Peter; Völzke, Henry; Radke, Dörte; Greinacher, Andreas; Kuehn, Jens-Peter; Zenker, Martin; Völker, Uwe; Homuth, Georg; Lerch, Markus M

    2015-04-01

    Serum lipase activities above the threefold upper reference limit indicate acute pancreatitis. We investigated whether high lipase activity-within the reference range and in the absence of pancreatitis-are associated with genetic single nucleotide polymorphisms (SNP), and whether these identified SNPs are also associated with clinical pancreatitis. Genome-wide association studies (GWAS) on phenotypes 'serum lipase activity' and 'high serum lipase activity' were conducted including 3966 German volunteers from the population-based Study-of-Health-in-Pomerania (SHIP). Lead SNPs associated on a genome-wide significance level were replicated in two cohorts, 1444 blood donors and 1042 pancreatitis patients. Initial discovery GWAS detected SNPs within or near genes encoding the ABO blood group specifying transferases A/B (ABO), Fucosyltransferase-2 (FUT2), and Chymotrypsinogen-B2 (CTRB2), to be significantly associated with lipase activity levels in asymptomatic subjects. Replication analyses in blood donors confirmed the association of FUT-2 non-secretor status (OR=1.49; p=0.012) and ABO blood-type-B (OR=2.48; p=7.29×10(-8)) with high lipase activity levels. In pancreatitis patients, significant associations were found for FUT-2 non-secretor status (OR=1.53; p=8.56×10(-4)) and ABO-B (OR=1.69, p=1.0×10(-4)) with chronic pancreatitis, but not with acute pancreatitis. Conversely, carriers of blood group O were less frequently affected by chronic pancreatitis (OR=0.62; p=1.22×10(-05)) and less likely to have high lipase activity levels (OR=0.59; p=8.14×10(-05)). These are the first results indicating that ABO blood type-B as well as FUT2 non-secretor status are common population-wide risk factors for developing chronic pancreatitis. They also imply that, even within the reference range, elevated lipase activities may indicate subclinical pancreatic injury in asymptomatic subjects. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  3. An elevator wheel

    Energy Technology Data Exchange (ETDEWEB)

    Zhornik, V.I.; Cherkov, Ye.M.; Simonov, A.A.

    1982-01-01

    This invention deals with mineral enrichment and is primarily for unloading submerged products of enrichment during separation in heavy mediums. An elevator wheel is proposed for unloading the submerged product from the bath of a heavy to medium separator which includes ladle disks with internal walls and overlapping sheets hinged to the ends. In order to increase the degree of dehydration of the unloaded product, the internal wall of each ladle is made of sheets installed in stages with clearances relative to each other. The advantages of the proposed device include an improvement in the degree of dehydration of the submerged product in the ladles and a reduction in the carry away of the heavy medium with the enrichment products.

  4. Famous puzzles of great mathematicians

    CERN Document Server

    Petković, Miodrag S

    2009-01-01

    This entertaining book presents a collection of 180 famous mathematical puzzles and intriguing elementary problems that great mathematicians have posed, discussed, and/or solved. The selected problems do not require advanced mathematics, making this book accessible to a variety of readers. Mathematical recreations offer a rich playground for both amateur and professional mathematicians. Believing that creative stimuli and aesthetic considerations are closely related, great mathematicians from ancient times to the present have always taken an interest in puzzles and diversions. The goal of this

  5. Patterns of care and persistence after incident elevated blood pressure.

    Science.gov (United States)

    Daley, Matthew F; Sinaiko, Alan R; Reifler, Liza M; Tavel, Heather M; Glanz, Jason M; Margolis, Karen L; Parker, Emily; Trower, Nicole K; Chandra, Malini; Sherwood, Nancy E; Adams, Kenneth; Kharbanda, Elyse O; Greenspan, Louise C; Lo, Joan C; O'Connor, Patrick J; Magid, David J

    2013-08-01

    Screening for hypertension in children occurs during routine care. When blood pressure (BP) is elevated in the hypertensive range, a repeat measurement within 1 to 2 weeks is recommended. The objective was to assess patterns of care after an incident elevated BP, including timing of repeat BP measurement and likelihood of persistently elevated BP. This retrospective study was conducted in 3 health care organizations. All children aged 3 through 17 years with an incident elevated BP at an outpatient visit during 2007 through 2010 were identified. Within this group, we assessed the proportion who had a repeat BP measured within 1 month of their incident elevated BP and the proportion who subsequently met the definition of hypertension. Multivariate analyses were used to identify factors associated with follow-up BP within 1 month of initial elevated BP. Among 72,625 children and adolescents in the population, 6108 (8.4%) had an incident elevated BP during the study period. Among 6108 with an incident elevated BP, 20.9% had a repeat BP measured within 1 month. In multivariate analyses, having a follow-up BP within 1 month was not significantly more likely among individuals with obesity or stage 2 systolic elevation. Among 6108 individuals with an incident elevated BP, 84 (1.4%) had a second and third consecutive elevated BP within 12 months. Whereas >8% of children and adolescents had an incident elevated BP, the great majority of BPs were not repeated within 1 month. However, relatively few individuals subsequently met the definition of hypertension.

  6. Making a Great First Impression

    Science.gov (United States)

    Evenson, Renee

    2007-01-01

    Managers and business owners often base hiring decisions on first impressions. That is why it is so important to teach students to make a great first impression--before they go on that first job interview. Managers do not have unrealistic expectations, they just want to hire people who they believe can develop into valuable employees. A nice…

  7. Great Basin paleoenvironmental studies project

    International Nuclear Information System (INIS)

    1993-01-01

    Project goals, project tasks, progress on tasks, and problems encountered are described and discussed for each of the studies that make up the Great Basin Paleoenvironmental Studies Project for Yucca Mountain. These studies are: Paleobotany, Paleofauna, Geomorphology, and Transportation. Budget summaries are also given for each of the studies and for the overall project

  8. The Great Books and Economics.

    Science.gov (United States)

    Hartley, James E.

    2001-01-01

    Describes an introductory economics course in which all of the reading material is drawn from the Great Books of Western Civilization. Explains the rationale and mechanics of the course. Includes an annotated course syllabus that details how the reading material relates to the lecture material. (RLH)

  9. Great tit hatchling sex ratios

    NARCIS (Netherlands)

    Lessells, C.M.; Mateman, A.C.; Visser, J.

    1996-01-01

    The sex of Great Tit Parus major nestlings was determined using PCR RAPDs. Because this technique requires minute amounts of DNA, chicks could be sampled soon (0-2d) after hatching, before any nestling mortality occurred. The proportion of males among 752 chicks hatching in 102 broods (98.9% of

  10. The Great Gatsby. [Lesson Plan].

    Science.gov (United States)

    Zelasko, Ken

    Based on F. Scott Fitzgerald's novel "The Great Gatsby," this lesson plan presents activities designed to help students understand that adapting part of a novel into a dramatic reading makes students more intimate with the author's intentions and craft; and that a part of a novel may lend itself to various oral interpretations. The main activity…

  11. Great Basin wildlife disease concerns

    Science.gov (United States)

    Russ Mason

    2008-01-01

    In the Great Basin, wildlife diseases have always represented a significant challenge to wildlife managers, agricultural production, and human health and safety. One of the first priorities of the U.S. Department of Agriculture, Division of Fish and Wildlife Services was Congressionally directed action to eradicate vectors for zoonotic disease, particularly rabies, in...

  12. How to write a great business plan.

    Science.gov (United States)

    Sahlman, W A

    1997-01-01

    Every seasoned investor knows that detailed financial projections for a new company are an act of imagination. Nevertheless, most business plans pour far too much ink on the numbers - and far too little on the information that really matters. Why? William Sahlman suggests that a great business plan is one that focuses on a series of questions. These questions relate to the four factors critical to the success of every new venture: the people, the opportunity, the context, and the possibilities for both risk and reward. The questions about people revolve around three issues: What do they know? Whom do they know? and How well are they known? As for opportunity, the plan should focus on two questions: Is the market for the venture's product or service large or rapidly growing (or preferably both)? and Is the industry structurally attractive? Then, in addition to demonstrating an understanding of the context in which their venture will operate, entrepreneurs should make clear how they will respond when that context inevitably changes. Finally, the plan should look unflinchingly at the risks the new venture faces, giving would-be backers a realistic idea of what magnitude of reward they can expect and when they can expect it. A great business plan is not easy to compose, Sahlman acknowledges, largely because most entrepreneurs are wild-eyed optimists. But one that asks the right questions is a powerful tool. A better deal, not to mention a better shot at success, awaits entrepreneurs who use it.

  13. High prevalence of elevated blood lead levels in both rural and urban Iowa newborns: Spatial patterns and area-level covariates.

    Science.gov (United States)

    Carrel, Margaret; Zahrieh, David; Young, Sean G; Oleson, Jacob; Ryckman, Kelli K; Wels, Brian; Simmons, Donald L; Saftlas, Audrey

    2017-01-01

    Lead in maternal blood can cross the placenta and result in elevated blood lead levels in newborns, potentially producing negative effects on neurocognitive function, particularly if combined with childhood lead exposure. Little research exists, however, into the burden of elevated blood lead levels in newborns, or the places and populations in which elevated lead levels are observed in newborns, particularly in rural settings. Using ~2300 dried bloods spots collected within 1-3 days of birth among Iowa newborns, linked with the area of mother's residence at the time of birth, we examine the spatial patterns of elevated (>5 μg/dL) blood lead levels and the ecological-level predictors of elevated blood lead levels. We find that one in five newborns exceed the 5 μg/dL action level set by the US Centers for Disease Control & Prevention (CDC). Bayesian spatial zero inflated regression indicates that elevated blood lead in newborns is associated with areas of increased pre-1940s housing and childbearing-age women with low educational status in both rural and urban settings. No differences in blood lead levels or the proportion of children exceeding 5 μg/dL are observed between urban and rural maternal residence, though a spatial cluster of elevated blood lead is observed in rural counties. These characteristics can guide the recommendation for testing of infants at well-baby appointments in places where risk factors are present, potentially leading to earlier initiation of case management. The findings also suggest that rural populations are at as great of risk of elevated blood lead levels as are urban populations. Analysis of newborn dried blood spots is an important tool for lead poisoning surveillance in newborns and can direct public health efforts towards specific places and populations where lead testing and case management will have the greatest impact.

  14. Group control of elevators

    Energy Technology Data Exchange (ETDEWEB)

    Umeda, Yasukazu; Hikita, Shiro; Tuji, Sintaro (Mitsubishi Electric Corp., Tokyo (Japan))

    1988-09-05

    Items to be evaluated in the group control of elevators, and a typical control system are described. A new system in which the fuzzy rule base is employed is introduced together with the configuration. The items to be evaluated are waiting time, riding time, accuracy of forecasting, energy saving, and ease of usage. The everage waiting time of less than 20 seconds with less than 3% waiting rate of more than 60 seconds is accepted as a satisfactory service condition. There are many conflicting matters in group-controlling, and the study for the controlling must deal with the optimization of multi-purpose problems. The standards for group-control evaluation differ according to building structures and the tastes of users, and an important problem is where to give emphasis of the evaluation. The TRAFFIC PATTERN LEARNING METHOD has been applied in the system for careful control to accommodate the traffic. No specific function is provided for the evaluation, but the call allocation is made by fuzzy rule-base. The configuration of a new group-control system is introduced. 7 references, 7 figures, 1 table.

  15. Southern Great Plains Safety Orientation

    Energy Technology Data Exchange (ETDEWEB)

    Schatz, John

    2014-05-01

    Welcome to the Atmospheric Radiation Measurement (ARM) Climate Research Facility (ARM) Southern Great Plains (SGP) site. This U.S. Department of Energy (DOE) site is managed by Argonne National Laboratory (ANL). It is very important that all visitors comply with all DOE and ANL safety requirements, as well as those of the Occupational Safety and Health Administration (OSHA), the National Fire Protection Association, and the U.S. Environmental Protection Agency, and with other requirements as applicable.

  16. Effects of genotype, elevated CO2 and elevated O3 on aspen phytochemistry and aspen leaf beetle Chrysomela crotchi performance

    Science.gov (United States)

    Leanne M. Vigue; Richard L. Lindroth

    2010-01-01

    Trembling aspen Populus tremuloides Michaux is an important forest species in the Great Lakes region and displays tremendous genetic variation in foliar chemistry. Elevated carbon dioxide (CO2) and ozone (O3) may also influence phytochemistry and thereby alter the performance of insect herbivores such as...

  17. Temperature-induced elevation of basal metabolic rate does not affect testis growth in great tits

    NARCIS (Netherlands)

    Caro, S.P.; Visser, M.E.

    2009-01-01

    The timing of reproduction varies from year to year in many bird species. To adjust their timing to the prevailing conditions of that year, birds use cues from their environment. However, the relative importance of these cues, such as the initial predictive (e. g. photoperiod) and the supplemental

  18. U.S. Coastal Lidar Elevation Data - Including the Great Lakes and Territories, 1996 - present

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Coastal Services Center manages and distributes lidar data for the coastal United States, including territorial possessions via the Digital Coast Data...

  19. Lærer-elev-relationer

    DEFF Research Database (Denmark)

    Laursen, Per Fibæk; Nielsen, Anne Maj

    2015-01-01

    I kapitlet belyser vi relationskompetence i forholdet mellem lærer og elever og hvordan læreren kan arbejde med forhold til elever og med sin opmærksomhed på relationsarbejdet. Afslutningsvis ser vi på hvordan lærere fortsat kan udvikle deres relationskompetence.......I kapitlet belyser vi relationskompetence i forholdet mellem lærer og elever og hvordan læreren kan arbejde med forhold til elever og med sin opmærksomhed på relationsarbejdet. Afslutningsvis ser vi på hvordan lærere fortsat kan udvikle deres relationskompetence....

  20. Tanzania Elevation and Surface Characteristics

    Data.gov (United States)

    US Agency for International Development — The dataset displays Elevation, Slope, Aspect, Topographic Position Index, Terrain Ruggedness, and Roughness based on Shuttle Radar Topography Mission (SRTM) (3...

  1. Learning and the Great Moderation

    OpenAIRE

    Bullard, James B.; Singh, Aarti

    2009-01-01

    We study a stylized theory of the volatility reduction in the U.S. after 1984 - the Great Moderation - which attributes part of the stabilization to less volatile shocks and another part to more difficult inference on the part of Bayesian households attempting to learn the latent state of the economy. We use a standard equilibrium business cycle model with technology following an unobserved regime-switching process. After 1984, according to Kim and Nelson (1999a), the variance of U.S. macroec...

  2. Pricing regulations in Great Britain

    International Nuclear Information System (INIS)

    Cicoletti, G.

    1993-01-01

    This paper briefly describes the structure and functions of Great Britain's essential electric power regulatory authority institutionalized by the 1989 British Electricity Act, i.e., the Office of Electricity Regulation, OFFER, and the responsibilities and tasks of the head of OFFER -the Director General of Electricity Supply (DGES). In particular, with regard to the latter, the paper describes how the DGES works together with regional electricity commissions to ensure the respect, by the various utilities, of consumer price caps and compliance with overall quality of service standards, as well as, to oversee 'pooling' activities by producers and distributors

  3. Pricing regulations in Great Britain

    International Nuclear Information System (INIS)

    Cicoletti, G.

    1993-01-01

    This paper briefly describes the structure and functions of Great Britain's essential electric power regulatory authority institutionalized by the 1989 British Electricity Act, i.e., the Office of Electricity Regulation, OFFER, and the responsibilities and tasks of the head of OFFER - the Director General of Electricity Supply (DGES). In particular, with regard to the latter, the paper describes how the DGES works together with regional electricity commissions to ensure the respect, by the various utilities, of consumer price caps and compliance with overall quality of service standards, as well as, to oversee 'pooling' activities by producers and distributors

  4. What killed Alexander the Great?

    Science.gov (United States)

    Battersby, Cameron

    2007-01-01

    The cause of the death of the Macedonian King, Alexander the Great, at Babylon in 323 BC has excited interest and conjecture throughout the ages. The information available in the surviving ancient sources, none of which is contemporaneous, has been reviewed and compared with modern knowledge as set out in several well-known recent surgical texts. The ancient sources record epic drinking by the Macedonian nobility since at least the time of Phillip II, Alexander's father. Alexander's sudden illness and death is likely to have resulted from a surgical complication of acute alcoholic excess.

  5. Commanders of the Great Victory

    Directory of Open Access Journals (Sweden)

    Anatoly Dmitriyevich Borshchov

    2015-01-01

    Full Text Available The honorary title of «commander» as well as the «admiral» is granted to a military or naval figure on the basis of public recognition of his personal contribution to the success of actions. Generals are usually individuals with creative thinking, the ability to foresee the development of military events. Generals usually have such personality traits as a strong will and determination, rich combat experience, credibility and high organizational skills. In an article dedicated to the 70th anniversary of the Soviet victory in the Great War examines the experience of formation and practice of the most talent-ed Soviet military leaders.

  6. Elevation of the diaphragmatic cupola

    International Nuclear Information System (INIS)

    Semenov, V.M.; Talesnik, M.R.

    1988-01-01

    Altogether 45 patients with elevation of the diaphragmatic cupola were examined. A high frequency of erroneous initial interpretation of examination results was noted in inflammatory and tumorous lesions and congenital conditions. Routine and contrast methods (pneumoperitoneum, bronchography, pleurography and fistulography) were used. Disease-related methods of X-ray investigation were proposed. A variety of causes of diaphragm elevation was indicated

  7. Space Station tethered elevator system

    Science.gov (United States)

    Haddock, Michael H.; Anderson, Loren A.; Hosterman, K.; Decresie, E.; Miranda, P.; Hamilton, R.

    1989-01-01

    The optimized conceptual engineering design of a space station tethered elevator is presented. The tethered elevator is an unmanned, mobile structure which operates on a ten-kilometer tether spanning the distance between Space Station Freedom and a platform. Its capabilities include providing access to residual gravity levels, remote servicing, and transportation to any point along a tether. The report discusses the potential uses, parameters, and evolution of the spacecraft design. Emphasis is placed on the elevator's structural configuration and three major subsystem designs. First, the design of elevator robotics used to aid in elevator operations and tethered experimentation is presented. Second, the design of drive mechanisms used to propel the vehicle is discussed. Third, the design of an onboard self-sufficient power generation and transmission system is addressed.

  8. Great apes prefer cooked food.

    Science.gov (United States)

    Wobber, Victoria; Hare, Brian; Wrangham, Richard

    2008-08-01

    The cooking hypothesis proposes that a diet of cooked food was responsible for diverse morphological and behavioral changes in human evolution. However, it does not predict whether a preference for cooked food evolved before or after the control of fire. This question is important because the greater the preference shown by a raw-food-eating hominid for the properties present in cooked food, the more easily cooking should have been adopted following the control of fire. Here we use great apes to model food preferences by Paleolithic hominids. We conducted preference tests with various plant and animal foods to determine whether great apes prefer food items raw or cooked. We found that several populations of captive apes tended to prefer their food cooked, though with important exceptions. These results suggest that Paleolithic hominids would likewise have spontaneously preferred cooked food to raw, exapting a pre-existing preference for high-quality, easily chewed foods onto these cooked items. The results, therefore, challenge the hypothesis that the control of fire preceded cooking by a significant period.

  9. Studying The Great Russian Revolution

    Directory of Open Access Journals (Sweden)

    A. V. Torkunov

    2017-01-01

    Full Text Available The article revises an established view of Russian Revolution as two separate events - February Revolution and October Revolution. The author supports the concept of the «Great Russian Revolution», which unites these two events in a single process of revolutionary development. The author draws attention to the following advantages of the concept under consideration. First, it conceptualizes the revolution as a process contingent of a local and global historical context. In this sense, the revolution is presented as the transition of society to the modern stage of development, meaning the transition to modernity. Second, revolutionary events in Russia are considered from the point of view of the evolution of the spatial and socioeconomic distribution and rearrangement of key social groups: peasantry, elites, national and ethnic minorities. Third, it takes into account the personal factor in the revolutionary events, the influence of individual personalities on escalation or the reduction of socio-political tensions. Fourth, it draws attention to the fact that revolutions imply the use of various forms of political violence. Each revolution is characterized by a unique correlation of forms and intensity of political violence. Finally, it gives a normative assessment of the Revolution, encouraging a national discussion on the results and consequences of this great event.

  10. Use of and inhospital outcomes after early clopidogrel therapy in patients not undergoing an early invasive strategy for treatment of non-ST-segment elevation myocardial infarction: results from Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the American College of Cardiology/American Heart Association guidelines (CRUSADE).

    Science.gov (United States)

    Alexander, Deepu; Ou, Fang-Shu; Roe, Matthew T; Pollack, Charles V; Ohman, E Magnus; Cannon, Christopher P; Gibler, W Brian; Fintel, Dan J; Peterson, Eric D; Brown, David L

    2008-09-01

    Although current guidelines recommend early initiation of clopidogrel in patients with non-ST-segment elevation myocardial infarction (NSTEMI), the degree to which it has been adopted in clinical practice remains unclear. We sought to determine patterns of early (vs 9.5%, P = .90). Until recently, up to 50% of NSTEMI patients in contemporary practice in the United States not undergoing PCI within 24 hours of arrival in the United States are not treated according to guideline recommendations. Among a high-risk NSTEMI population not undergoing PCI within 24 hours of arrival, the nonrandomized short-term use of clopidogrel is associated with a lower risk of inhospital mortality without an increased risk of major bleeding.

  11. Unpacking the great transmission debate

    Science.gov (United States)

    Denning, Kathryn

    2010-12-01

    The debate about the wisdom of sending interstellar transmissions is well-known to those involved in SETI, and frustrating for many. Its tendency towards intractability is a result of multiple factors, including: different models of the scientist's role as citizen and/or leader; disparate ideas about society's readiness to cope with frontier science; variable political substrates, particularly ideas concerning individual freedom and state control; competing ideologies of globalization; and the perceived relative risks and benefits of contact. (Variations in the latter, i.e. assessments of the risks and benefits of contact, derive partly from different thinking styles, including tolerance for risk, and partly from inferences based upon episodes of biological and cultural contact on Earth.) Unpacking the debate into its components may be of use to those debating policy about SETI transmissions, or at the very least, help keep in focus what, precisely, the perennial arguments are really about.

  12. Analysis of lidar elevation data for improved identification and delineation of lands vulnerable to sea-level rise

    Science.gov (United States)

    Gesch, Dean B.

    2009-01-01

    The importance of sea-level rise in shaping coastal landscapes is well recognized within the earth science community, but as with many natural hazards, communicating the risks associated with sea-level rise remains a challenge. Topography is a key parameter that influences many of the processes involved in coastal change, and thus, up-to-date, high-resolution, high-accuracy elevation data are required to model the coastal environment. Maps of areas subject to potential inundation have great utility to planners and managers concerned with the effects of sea-level rise. However, most of the maps produced to date are simplistic representations derived from older, coarse elevation data. In the last several years, vast amounts of high quality elevation data derived from lidar have become available. Because of their high vertical accuracy and spatial resolution, these lidar data are an excellent source of up-to-date information from which to improve identification and delineation of vulnerable lands. Four elevation datasets of varying resolution and accuracy were processed to demonstrate that the improved quality of lidar data leads to more precise delineation of coastal lands vulnerable to inundation. A key component of the comparison was to calculate and account for the vertical uncertainty of the elevation datasets. This comparison shows that lidar allows for a much more detailed delineation of the potential inundation zone when compared to other types of elevation models. It also shows how the certainty of the delineation of lands vulnerable to a given sea-level rise scenario is much improved when derived from higher resolution lidar data.

  13. The Great Hedge of India

    International Nuclear Information System (INIS)

    Moxham, Roy

    2015-01-01

    The 'Great Hedge of India', a 3 700 kilometre-long hedge installed by the British customs to safeguard the colonial salt tax system and avoid salt smuggling totally faded from both memory and records (e.g. maps) in less than a century. Roy Moxham found traces of the hedge in a book footnote and searched it for several years until he found its meagre remains. The speaker wrote a book about this quest. He said that this story reveals how things disappear when they are no longer useful and, especially, when they are linked to parts of history that are not deemed particularly positive (the hedge was a means of colonial power)

  14. Gypsum karst in Great Britain

    Directory of Open Access Journals (Sweden)

    Cooper A.H.

    1996-01-01

    Full Text Available In Great Britain the most spectacular gypsum karst development is in the Zechstein gypsum (late Permian mainly in north-eastern England. The Midlands of England also has some karst developed in the Triassic gypsum in the vicinity of Nottingham. Along the north-east coast, south of Sunderland, well-developed palaeokarst, with magnificent breccia pipes, was produced by dissolution of Permian gypsum. In north-west England a small gypsum cave system of phreatic origin has been surveyed and recorded. A large actively evolving phreatic gypsum cave system has been postulated beneath the Ripon area on the basis of studies of subsidence and boreholes. The rate of gypsum dissolution here, and the associated collapse lead to difficult civil engineering and construction conditions, which can also be aggravated by water abstraction.

  15. Great-Britain at CERN

    CERN Multimedia

    C. Laignel

    2004-01-01

    From 23 to 25 November 2004 Administration Building Bldg 60/61 - ground and 1st floor 09.30 - 17.30 Twenty five companies will present their latest technology at the "Great-Britain at CERN" exhibition. British industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: electrical engineering, electronics, mechanical engineering, vacuum & low temperatures technologies, particles detectors and telecommunications. The exhibition is organised by BEAMA Exhibitions, The British Electrotechnical and Allied Manufacturer's Association There follows : the list of exhibitors. A detailed programme will be available in due course at : your Departemental secretariat, the reception information desk, Building 33, the exhibition. A detailed list of firms is available under the following FI link: http://fi-dep.web.cern.ch/fi-dep/structure/memberstates/exhibitions_visits.htm 1 Accles & Pollock 2 A S Scientific Products Ltd 3 C...

  16. Great Basin Experimental Range: Annotated bibliography

    Science.gov (United States)

    E. Durant McArthur; Bryce A. Richardson; Stanley G. Kitchen

    2013-01-01

    This annotated bibliography documents the research that has been conducted on the Great Basin Experimental Range (GBER, also known as the Utah Experiment Station, Great Basin Station, the Great Basin Branch Experiment Station, Great Basin Experimental Center, and other similar name variants) over the 102 years of its existence. Entries were drawn from the original...

  17. The origin of 'Great Walls'

    International Nuclear Information System (INIS)

    Shandarin, Sergei F.

    2009-01-01

    A new semi-analytical model that explains the formation and sizes of the 'great walls' - the largest structures observed in the universe is suggested. Although the basis of the model is the Zel'dovich approximation it has been used in a new way very different from the previous studies. Instead of traditional approach that evaluates the nonlinear density field it has been utilized for identification of the regions in Lagrangian space that after the mapping to real or redshift space (depending on the kind of structure is studied) end up in the regions where shell-crossing occurs. The set of these regions in Lagrangian space form the progenitor of the structure and after the mapping it determines the pattern of the structure in real or redshift space. The particle trajectories have crossed in such regions and the mapping is no longer unique there. The progenitor after mapping makes only one stream in the multi-stream flow regions therefore it does not comprise all the mass. Nevertheless, it approximately retains the shape of the structure. The progenitor of the structure in real space is determined by the linear density field along with two non-Gaussian fields derived from the initial potential. Its shape in Eulerian space is also affected by the displacement field. The progenitor of the structure in redshift space also depends on these fields but in addition it is strongly affected by two anisotropic fields that determine the pattern of great walls as well as their huge sizes. All the fields used in the mappings are derived from the linear potential smoothed at the current scale of nonlinearity which is R nl = 2.7 h −1 Mpc for the adopted parameters of the ΛCDM universe normalized to σ 8 = 0.8. The model predicts the existence of walls with sizes significantly greater than 500 h −1 Mpc that may be found in sufficiently large redshift surveys

  18. The Great Warming Brian Fagan

    Science.gov (United States)

    Fagan, B. M.

    2010-12-01

    The Great Warming is a journey back to the world of a thousand years ago, to the Medieval Warm Period. Five centuries of irregular warming from 800 to 1250 had beneficial effects in Europe and the North Atlantic, but brought prolonged droughts to much of the Americas and lands affected by the South Asian monsoon. The book describes these impacts of warming on medieval European societies, as well as the Norse and the Inuit of the far north, then analyzes the impact of harsh, lengthy droughts on hunting societies in western North America and the Ancestral Pueblo farmers of Chaco Canyon, New Mexico. These peoples reacted to drought by relocating entire communities. The Maya civilization was much more vulnerable that small-scale hunter-gatherer societies and subsistence farmers in North America. Maya rulers created huge water storage facilities, but their civilization partially collapsed under the stress of repeated multiyear droughts, while the Chimu lords of coastal Peru adapted with sophisticated irrigation works. The climatic villain was prolonged, cool La Niñalike conditions in the Pacific, which caused droughts from Venezuela to East Asia, and as far west as East Africa. The Great Warming argues that the warm centuries brought savage drought to much of humanity, from China to Peru. It also argues that drought is one of the most dangerous elements in today’s humanly created global warming, often ignored by preoccupied commentators, but with the potential to cause over a billion people to starve. Finally, I use the book to discuss the issues and problems of communicating multidisciplinary science to the general public.

  19. Context-Aware Elevator Scheduling

    OpenAIRE

    Strang, Thomas; Bauer, Christian

    2007-01-01

    Research on context-aware systems is usually user-centric and thus focussed on the context of a specific user to serve his or her needs in an optimized way. In this paper, we want to apply core concepts developed in research on context-awareness in a system-centric way, namely to elevator systems. We show with three different examples that the performance of an elevator system can be significantly improved if the elevator control has access to contextual knowledge. The first example demons...

  20. Use of non-steroidal anti-inflammatory drugs that elevate cardiovascular risk: an examination of sales and essential medicines lists in low-, middle-, and high-income countries.

    Directory of Open Access Journals (Sweden)

    Patricia McGettigan

    Full Text Available BACKGROUND: Certain non-steroidal anti-inflammatory drugs (NSAIDs (e.g., rofecoxib [Vioxx] increase the risk of heart attack and stroke and should be avoided in patients at high risk of cardiovascular events. Rates of cardiovascular disease are high and rising in many low- and middle-income countries. We studied the extent to which evidence on cardiovascular risk with NSAIDs has translated into guidance and sales in 15 countries. METHODS AND FINDINGS: Data on the relative risk (RR of cardiovascular events with individual NSAIDs were derived from meta-analyses of randomised trials and controlled observational studies. Listing of individual NSAIDs on Essential Medicines Lists (EMLs was obtained from the World Health Organization. NSAID sales or prescription data for 15 low-, middle-, and high-income countries were obtained from Intercontinental Medical Statistics Health (IMS Health or national prescription pricing audit (in the case of England and Canada. Three drugs (rofecoxib, diclofenac, etoricoxib ranked consistently highest in terms of cardiovascular risk compared with nonuse. Naproxen was associated with a low risk. Diclofenac was listed on 74 national EMLs, naproxen on just 27. Rofecoxib use was not documented in any country. Diclofenac and etoricoxib accounted for one-third of total NSAID usage across the 15 countries (median 33.2%, range 14.7-58.7%. This proportion did not vary between low- and high-income countries. Diclofenac was by far the most commonly used NSAID, with a market share close to that of the next three most popular drugs combined. Naproxen had an average market share of less than 10%. CONCLUSIONS: Listing of NSAIDs on national EMLs should take account of cardiovascular risk, with preference given to low risk drugs. Diclofenac has a risk very similar to rofecoxib, which was withdrawn from worldwide markets owing to cardiovascular toxicity. Diclofenac should be removed from EMLs.

  1. After the great nuclear debate

    Energy Technology Data Exchange (ETDEWEB)

    Hill, J [UKAEA Headquarters, London

    1981-01-01

    Problems of public perception of nuclear power (environmental damage, risks of large disasters, the effect of low level radiation, nuclear waste management) are considered and their correspondence to the problems as seen from inside the industry examined. The problems of public presentation by the industry of what it is trying to do and of explaining why it believes that what it is doing is responsible and in the long term interests of the society are discussed.

  2. FEMA DFIRM Base Flood Elevations

    Data.gov (United States)

    Minnesota Department of Natural Resources — The Base Flood Elevation (BFE) table is required for any digital data where BFE lines will be shown on the corresponding Flood Insurance Rate Map (FIRM). Normally,...

  3. Advanced energy saving hydraulic elevator

    Energy Technology Data Exchange (ETDEWEB)

    Garrido, A.; Sevilleja, J.; Servia, A.

    1993-08-24

    An hydraulic elevator is described comprising: a counterweighted elevator comprising a car, a counterweight, and a rope connecting the car and the counterweight; a ram having a first reaction surface for driving one of the car or the counterweight upwardly and a second reaction surface for driving one of the car or the counterweight downwardly; multiplier means for moving the car a distance greater than a stroke of the ram, the multiplier means connecting the ram to the counterweighted elevator, the multiplier means comprising: a first pulley; a second pulley; means for rigidly connecting the first and second pulley, the means having a length corresponding to a rise of the hydraulic elevator, the means attaching to the ram; and a pulley rope which: has a first end attaching to a first fixed point, extends about the first pulley, extends about the second pulley, and has a second end attaching to a second fixed point.

  4. Space Elevators Preliminary Architectural View

    Science.gov (United States)

    Pullum, L.; Swan, P. A.

    Space Systems Architecture has been expanded into a process by the US Department of Defense for their large scale systems of systems development programs. This paper uses the steps in the process to establishes a framework for Space Elevator systems to be developed and provides a methodology to manage complexity. This new approach to developing a family of systems is based upon three architectural views: Operational View OV), Systems View (SV), and Technical Standards View (TV). The top level view of the process establishes the stages for the development of the first Space Elevator and is called Architectural View - 1, Overview and Summary. This paper will show the guidelines and steps of the process while focusing upon components of the Space Elevator Preliminary Architecture View. This Preliminary Architecture View is presented as a draft starting point for the Space Elevator Project.

  5. Coastal Digital Elevation Models (DEMs)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digital elevation models (DEMs) of U.S. and other coasts that typically integrate ocean bathymetry and land topography. The DEMs support NOAA's mission to understand...

  6. Base Flood Elevation (BFE) Lines

    Data.gov (United States)

    Department of Homeland Security — The Base Flood Elevation (BFE) table is required for any digital data where BFE lines will be shown on the corresponding Flood Insurance Rate Map (FIRM). Normally if...

  7. Elevated Fixed Platform Test Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Elevated Fixed Platform (EFP) is a helicopter recovery test facility located at Lakehurst, NJ. It consists of a 60 by 85 foot steel and concrete deck built atop...

  8. Elevator buttons as unrecognized sources of bacterial colonization in hospitals.

    Science.gov (United States)

    Kandel, Christopher E; Simor, Andrew E; Redelmeier, Donald A

    2014-01-01

    Elevators are ubiquitous and active inside hospitals, potentially facilitating bacterial transmission. The objective of this study was to estimate the prevalence of bacterial colonization on elevator buttons in large urban teaching hospitals. A total of 120 elevator buttons and 96 toilet surfaces were swabbed over separate intervals at 3 tertiary care hospitals on weekdays and weekends in Toronto, Ontario. For the elevators, swabs were taken from 2 interior buttons (buttons for the ground floor and one randomly selected upper-level floor) and 2 exterior buttons (the "up" button from the ground floor and the "down" button from the upper-level floor). For the toilet surfaces, swabs were taken from the exterior and interior handles of the entry door, the privacy latch, and the toilet flusher. Samples were obtained using standard bacterial collection techniques, followed by plating, culture, and species identification by a technician blind to sample source. The prevalence of colonization of elevator buttons was 61% (95% confidence interval 52%-70%). No significant differences in colonization prevalence were apparent in relation to location of the buttons, day of the week, or panel position within the elevator. Coagulase-negative staphylococci were the most common organisms cultured, whereas Enterococcus and Pseudomonas species were infrequent. Elevator buttons had a higher prevalence of colonization than toilet surfaces (61% v. 43%, p = 0.008). Hospital elevator buttons were commonly colonized by bacteria, although most pathogens were not clinically relevant. The risk of pathogen transmission might be reduced by simple countermeasures.

  9. Energy efficient elevators and escalators

    Energy Technology Data Exchange (ETDEWEB)

    Patrao, Carlos; Fong, Joao; Almeida, Anibal de (Dep. Electrical Engineering, Univ. of Coimbra, Coimbra (Portugal)); Rivet, Luc

    2009-07-01

    Elevators and escalators are the crucial element that makes it practical to live and work several floors above ground - more than 4,3 million units are installed in Europe. Due to ageing of the European population the installation of elevators in single family houses is experiencing a significant growth, as well as equipping existing buildings. Elevators use about 4% of the electricity in tertiary sector buildings. High untapped saving potentials exist with respect to energy-efficient technologies, investment decisions and behavioural approaches, in these sectors. This paper presents preliminary results from the IEE project E4, whose overall objective is the improvement of the energy performance of elevators and escalators, in tertiary sector buildings and in multi family residential buildings. The project is characterizing people conveyors electricity consumption in the tertiary sector and in residential buildings in the EU. The installed park is characterised by a survey among elevators national associations in each country. An assessment of the barriers has been made in the first phase of the project and will be presented. Monitoring campaigns in elevators and escalators are being conducted in each country according to a common developed methodology. More than fifty elevators and escalators will be audited. This will allow the collection of load curves (start up, travel up and down, travel full and empty), including the characterization of standby consumption. Standby consumption of an elevator can represent up to 80% of the total energy consumed per year, and can be drastically reduced. This paper presents the preliminary results of the first ten audits performed in Portugal by Isr-UC.

  10. Digital Soil Mapping Using Landscape Stratification for Arid Rangelands in the Eastern Great Basin, Central Utah

    OpenAIRE

    Fonnesbeck, Brook B.

    2015-01-01

    Digital soil mapping typically involves inputs of digital elevation models, remotely sensed imagery, and other spatially explicit digital data as environmental covariates to predict soil classes and attributes over a landscape using statistical models. Digital imagery from Landsat 5, a digital elevation model, and a digital geology map were used as environmental covariates in a 67,000-ha study area of the Great Basin west of Fillmore, UT. A “pre-map” was created for selecting sampling locatio...

  11. Tipping Points, Great and Small

    Science.gov (United States)

    Morrison, Foster

    2010-12-01

    The Forum by Jordan et al. [2010] addressed environmental problems of various scales in great detail, but getting the critical message through to the formulators of public policies requires going back to basics, namely, that exponential growth (of a population, an economy, or most anything else) is not sustainable. When have you heard any politician or economist from anywhere across the ideological spectrum say anything other than that more growth is essential? There is no need for computer models to demonstrate “limits to growth,” as was done in the 1960s. Of course, as one seeks more details, the complexity of modeling will rapidly outstrip the capabilities of both observation and computing. This is common with nonlinear systems, even simple ones. Thus, identifying all possible “tipping points,” as suggested by Jordan et al. [2010], and then stopping just short of them, is impractical if not impossible. The main thing needed to avoid environmental disasters is a bit of common sense.

  12. OPEN-SOURCE DIGITAL ELEVATION MODEL (DEMs EVALUATION WITH GPS AND LiDAR DATA

    Directory of Open Access Journals (Sweden)

    N. F. Khalid

    2016-09-01

    Full Text Available Advanced Spaceborne Thermal Emission and Reflection Radiometer-Global Digital Elevation Model (ASTER GDEM, Shuttle Radar Topography Mission (SRTM, and Global Multi-resolution Terrain Elevation Data 2010 (GMTED2010 are freely available Digital Elevation Model (DEM datasets for environmental modeling and studies. The quality of spatial resolution and vertical accuracy of the DEM data source has a great influence particularly on the accuracy specifically for inundation mapping. Most of the coastal inundation risk studies used the publicly available DEM to estimated the coastal inundation and associated damaged especially to human population based on the increment of sea level. In this study, the comparison between ground truth data from Global Positioning System (GPS observation and DEM is done to evaluate the accuracy of each DEM. The vertical accuracy of SRTM shows better result against ASTER and GMTED10 with an RMSE of 6.054 m. On top of the accuracy, the correlation of DEM is identified with the high determination of coefficient of 0.912 for SRTM. For coastal zone area, DEMs based on airborne light detection and ranging (LiDAR dataset was used as ground truth data relating to terrain height. In this case, the LiDAR DEM is compared against the new SRTM DEM after applying the scale factor. From the findings, the accuracy of the new DEM model from SRTM can be improved by applying scale factor. The result clearly shows that the value of RMSE exhibit slightly different when it reached 0.503 m. Hence, this new model is the most suitable and meets the accuracy requirement for coastal inundation risk assessment using open source data. The suitability of these datasets for further analysis on coastal management studies is vital to assess the potentially vulnerable areas caused by coastal inundation.

  13. Improved early risk stratification of patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention using a combination of serum soluble ST2 and NT-proBNP.

    Directory of Open Access Journals (Sweden)

    Jongwook Yu

    Full Text Available Although soluble suppression of tumorigenicity 2 (sST2 in serum is known to be associated with ischemic heart disease and heart failure, data regarding its prognostic impact in ST-segment elevation myocardial infarction (STEMI is limited. We evaluated the prognostic impacts of serum sST2 and other serum biomarkers in STEMI patients undergoing primary percutaneous coronary intervention (PCI.Consecutive all 323 patients with STEMI that underwent primary PCI were enrolled. Blood tests and samples were obtained in an emergency room. The primary endpoint was 1-year major adverse cardiovascular and cerebrovascular events (MACCEs, defined as a composite of cardiovascular death, non-fatal MI, non-fatal stroke, and ischemia-driven revascularization.Mean age was 59.1±13.1 years (men 84%. MACCE (20 cardiovascular deaths, 7 non-fatal MI, 4 non-fatal stroke, 7 ischemia-driven revascularizations occurred in 38 patients (12%. After adjusting for confounding factors, Cox regression analysis revealed that high serum sST2 (>75.8 ng/mL mean value, adjusted hazard ratio 2.098, 95% CI 1.008-4.367, p = 0.048 and high serum NT-proBNP level (>400 pg/mL, adjusted hazard ratio 2.606, 95% CI 1.086-6.257, p = 0.032 at the time of presentation independently predicted MACCE within a year of primary PCI. Furthermore, when high serum sST2 level was combined with high serum NT-proBNP level, the hazard ratio of MACCE was highest (adjusted hazard ratio 7.93, 95% CI 2.97-20.38, p<0.001.Elevated serum levels of sST2 or NT-proBNP at the time of presentation were found to predict 1-year MACCE independently and elevated serum levels of sST2 plus NT-proBNP were associated with even poorer prognosis in patients with STEMI undergoing primary PCI.

  14. Great Britain Storm Surge Modeling for a 10,000-Year Stochastic Catalog with the Effect of Sea Level Rise

    Science.gov (United States)

    Keshtpoor, M.; Carnacina, I.; Blair, A.; Yablonsky, R. M.

    2017-12-01

    Storm surge caused by Extratropical Cyclones (ETCs) has significantly impacted not only the life of private citizens but also the insurance and reinsurance industry in Great Britain. The storm surge risk assessment requires a larger dataset of storms than the limited recorded historical ETCs. Thus, historical ETCs were perturbed to generate a 10,000-year stochastic catalog that accounts for surge-generating ETCs in the study area with return periods from one year to 10,000 years. Delft3D-Flexible Mesh hydrodynamic model was used to numerically simulate the storm surge along the Great Britain coastline. A nested grid technique was used to increase the simulation grid resolution up to 200 m near the highly populated coastal areas. Coarse and fine mesh models were calibrated and validated using historical recorded water elevations. Then, numerical simulations were performed on a 10,000-year stochastic catalog. The 50-, 100-, and 500-year return period maps were generated for Great Britain coastal areas. The corresponding events with return periods of 50-, 100-, and 500-years in Humber Bay and Thames River coastal areas were identified, and simulated with the consideration of projected sea level rises to reveal the effect of rising sea levels on the inundation return period maps in two highly-populated coastal areas. Finally, the return period of Storm Xaver (2013) was determined with and without the effect of rising sea levels.

  15. The great US nuclear gamble

    International Nuclear Information System (INIS)

    McCaughey, John.

    1997-01-01

    An unlikely combination of PECO, United States Energy company, and British Energy, with its nuclear plant operation expertise, are combining their interests as the AmerGen Energy Company. AmerGen is seeking to take over ailing US nuclear plants and boost their performance, to the benefit of consumers, and shareholders alike. Considerable financial and public face risks are at stake for the two companies, but despite its public unpopularity, nuclear power generates more than 20% of US electric power, and so the payback is also potentially, correspondingly high. This paper explores this history and likely success of this surprising cooperative venture. (UK)

  16. Topobathymetric elevation model development using a new methodology: Coastal National Elevation Database

    Science.gov (United States)

    Danielson, Jeffrey J.; Poppenga, Sandra K.; Brock, John C.; Evans, Gayla A.; Tyler, Dean; Gesch, Dean B.; Thatcher, Cindy A.; Barras, John

    2016-01-01

    During the coming decades, coastlines will respond to widely predicted sea-level rise, storm surge, and coastalinundation flooding from disastrous events. Because physical processes in coastal environments are controlled by the geomorphology of over-the-land topography and underwater bathymetry, many applications of geospatial data in coastal environments require detailed knowledge of the near-shore topography and bathymetry. In this paper, an updated methodology used by the U.S. Geological Survey Coastal National Elevation Database (CoNED) Applications Project is presented for developing coastal topobathymetric elevation models (TBDEMs) from multiple topographic data sources with adjacent intertidal topobathymetric and offshore bathymetric sources to generate seamlessly integrated TBDEMs. This repeatable, updatable, and logically consistent methodology assimilates topographic data (land elevation) and bathymetry (water depth) into a seamless coastal elevation model. Within the overarching framework, vertical datum transformations are standardized in a workflow that interweaves spatially consistent interpolation (gridding) techniques with a land/water boundary mask delineation approach. Output gridded raster TBDEMs are stacked into a file storage system of mosaic datasets within an Esri ArcGIS geodatabase for efficient updating while maintaining current and updated spatially referenced metadata. Topobathymetric data provide a required seamless elevation product for several science application studies, such as shoreline delineation, coastal inundation mapping, sediment-transport, sea-level rise, storm surge models, and tsunami impact assessment. These detailed coastal elevation data are critical to depict regions prone to climate change impacts and are essential to planners and managers responsible for mitigating the associated risks and costs to both human communities and ecosystems. The CoNED methodology approach has been used to construct integrated TBDEM models

  17. Elevated resting heart rate, physical fitness and all-cause mortality

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Suadicani, Poul; Hein, Hans Ole

    2013-01-01

    To examine whether elevated resting heart rate (RHR) is an independent risk factor for mortality or a mere marker of physical fitness (VO2Max).......To examine whether elevated resting heart rate (RHR) is an independent risk factor for mortality or a mere marker of physical fitness (VO2Max)....

  18. The great East Japan earthquake

    Energy Technology Data Exchange (ETDEWEB)

    Fluke, R.

    2011-06-15

    'Full text:' More formally called the Tohoku-Chihou-Taiheiyo-Oki Earthquake of March 11, 2011, it was the ensuing tsunami that caused the most death and destruction to the north-east coastal region of Japan. It is also what caused the multiple meltdowns at Fukushima Dai-ichi. Reactor Unit 1, ironically, was scheduled to be permanently shut down for decommissioning just two weeks later. The Fukushima Dai-ichi nuclear power plant has a tsunami protection barrier designed for the worst recorded tsunami in that area since 1896 - to a height of 5.7 m. The plant itself is on an elevated grade of about 10 m. The tsunami, reported to be 14-15 m, caused inundation of the entire site with at least four metres of seawater. The seawater flooded the turbine building and damaged electrical equipment including the emergency diesel generators, leaving the entire six-unit nuclear power plan without any source of AC power, known as the 'station blackout scenario'. There are numerous reports available on-line at various sites. The Japanese Government report is frank and forthcoming on the causes and the lessons learned, and the lAEA Mission report is in-depth and well presented, not only as a factual account of the events but as a unified source of the conclusions and lessons learned. Photos of the catastrophe are available at the TEPCO web site: http://www.tepco.co.jp/en/index-e.html. In this edition of the Bulletin there is a 'layman's' description of CANDU and BWR design in terms of the fundamental safety principles - Control, Cool and Contain as well as a description of how these principles were met, or not met at Fukushima Dai-ichi. Also, an excerpt from the IAEA Expert Mission is included. We 'technocrats' sometimes forget about the human aspects of a nuclear disaster. An essay by Dr. Michael Edwards is included entitled 'Psychology, Philosophy and Nuclear Science'. Other references to the events appear throughout this

  19. The great East Japan earthquake

    International Nuclear Information System (INIS)

    Fluke, R.

    2011-01-01

    'Full text:' More formally called the Tohoku-Chihou-Taiheiyo-Oki Earthquake of March 11, 2011, it was the ensuing tsunami that caused the most death and destruction to the north-east coastal region of Japan. It is also what caused the multiple meltdowns at Fukushima Dai-ichi. Reactor Unit 1, ironically, was scheduled to be permanently shut down for decommissioning just two weeks later. The Fukushima Dai-ichi nuclear power plant has a tsunami protection barrier designed for the worst recorded tsunami in that area since 1896 - to a height of 5.7 m. The plant itself is on an elevated grade of about 10 m. The tsunami, reported to be 14-15 m, caused inundation of the entire site with at least four metres of seawater. The seawater flooded the turbine building and damaged electrical equipment including the emergency diesel generators, leaving the entire six-unit nuclear power plan without any source of AC power, known as the 'station blackout scenario'. There are numerous reports available on-line at various sites. The Japanese Government report is frank and forthcoming on the causes and the lessons learned, and the lAEA Mission report is in-depth and well presented, not only as a factual account of the events but as a unified source of the conclusions and lessons learned. Photos of the catastrophe are available at the TEPCO web site: http://www.tepco.co.jp/en/index-e.html. In this edition of the Bulletin there is a 'layman's' description of CANDU and BWR design in terms of the fundamental safety principles - Control, Cool and Contain as well as a description of how these principles were met, or not met at Fukushima Dai-ichi. Also, an excerpt from the IAEA Expert Mission is included. We 'technocrats' sometimes forget about the human aspects of a nuclear disaster. An essay by Dr. Michael Edwards is included entitled 'Psychology, Philosophy and Nuclear Science'. Other references to the events appear throughout this edition.(author)

  20. Perforation of the sinus membrane during sinus floor elevation

    DEFF Research Database (Denmark)

    von Arx, Thomas; Fodich, Ivo; Bornstein, Michael M

    2014-01-01

    PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical and radiogra......PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical...

  1. Soil salinity study in Northern Great Plains sodium affected soil

    Science.gov (United States)

    Kharel, Tulsi P.

    Climate and land-use changes when combined with the marine sediments that underlay portions of the Northern Great Plains have increased the salinization and sodification risks. The objectives of this dissertation were to compare three chemical amendments (calcium chloride, sulfuric acid and gypsum) remediation strategies on water permeability and sodium (Na) transport in undisturbed soil columns and to develop a remote sensing technique to characterize salinization in South Dakota soils. Forty-eight undisturbed soil columns (30 cm x 15 cm) collected from White Lake, Redfield, and Pierpont were used to assess the chemical remediation strategies. In this study the experimental design was a completely randomized design and each treatment was replicated four times. Following the application of chemical remediation strategies, 45.2 cm of water was leached through these columns. The leachate was separated into 120- ml increments and analyzed for Na and electrical conductivity (EC). Sulfuric acid increased Na leaching, whereas gypsum and CaCl2 increased water permeability. Our results further indicate that to maintain effective water permeability, ratio between soil EC and sodium absorption ratio (SAR) should be considered. In the second study, soil samples from 0-15 cm depth in 62 x 62 m grid spacing were taken from the South Dakota Pierpont (65 ha) and Redfield (17 ha) sites. Saturated paste EC was measured on each soil sample. At each sampling points reflectance and derived indices (Landsat 5, 7, 8 images), elevation, slope and aspect (LiDAR) were extracted. Regression models based on multiple linear regression, classification and regression tree, cubist, and random forest techniques were developed and their ability to predict soil EC were compared. Results showed that: 1) Random forest method was found to be the most effective method because of its ability to capture spatially correlated variation, 2) the short wave infrared (1.5 -2.29 mum) and near infrared (0

  2. Development of Simulator for High-Speed Elevator System

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Hyung Min; Kim, Sung Jun; Sul, Seung Ki; Seok, Ki Riong [Seoul National University, Seoul(Korea); Kwon, Tae Seok [Hanyang University, Seoul(Korea); Kim, Ki Su [Konkuk University, Seoul(Korea); Shim, Young Seok [Inha University, incheon(Korea)

    2002-02-01

    This paper describes the dynamic load simulator for high-speed elevator system, which can emulate 3-mass system as well as equivalent 1-mass system 1-mass system. In order to implement the equivalent inertia of entire elevator system, the conventional simulators have generally utilized the mechanical inertia(flywheel) with large radius, which makes the entire system large and heavy. In addition, the mechanical inertia should be replaced each time in order to test another elevator system. In this paper, the dynamic load simulation methods using electrical inertia are presented so that the volume and weight of simulator system are greatly reduced and the adjustment of inertia value can be achieved easily by software. Experimental results show the feasibility of this simulator system. (author). 5 refs., 7 figs., 2 tabs.

  3. Complex behavior of elevators in peak traffic

    Science.gov (United States)

    Nagatani, Takashi

    2003-08-01

    We study the dynamical behavior of elevators in the morning peak traffic. We present a stochastic model of the elevators to take into account the interactions between elevators through passengers. The dynamics of the elevators is expressed in terms of a coupled nonlinear map with noises. The number of passengers carried by an elevator and the time-headway between elevators exhibit the complex behavior with varying elevator trips. It is found that the behavior of elevators exhibits a deterministic chaos even if there are no noises. The chaotic motion depends on the loading parameter, the maximum capacity of an elevator, and the number of elevators. When the loading parameter is superior to the threshold, each elevator carries a full load of passengers throughout its trip. The dependence of the threshold (transition point) on the elevator capacity is clarified.

  4. Cosmic Reason of Great Glaciation

    Science.gov (United States)

    Bagrov, Alexander; Murtazov, Andrey

    The origin of long-time and global glaciations in the past of our planet, which have been named «great», is still not clear. Both the advance of glaciers and their subsequent melting must be connected with some energy consuming processes. There is a powerful energy source permanently functioning throughout the Earth’s history - the solar radiation. The equality of the incoming shortwave solar energy and the transformed long-wave energy emitted by the Earth provides for the whole ecosphere’s sustainable evolution. Great glaciations might be caused by space body falls into the world oceans. If the body is large enough, it can stir waters down to the bottom. The world waters are part of the global heat transfer from the planet’s equator to its poles (nowadays, mostly to the North Pole). The mixing of the bottom and surface waters breaks the circulation of flows and they stop. The termination of heat transfer to the poles will result in an icecap at high latitudes which in its turn will decrease the total solar heat inflow to the planet and shift the pole ice boarder to the equator. This positive feedback may last long and result in long-time glaciations. The oceanic currents will remain only near the equator. The factor obstructing the global cooling is the greenhouse effect. Volcanic eruptions supply a lot of carbon dioxide into the atmosphere. When due to the increased albedo the planet receives less solar heat, plants bind less carbon oxide into biomass and more of it retains in the atmosphere. Therefore, the outflow of heat from the planet decreases and glaciations does not involve the whole planet. The balance established between the heat inflow and heat losses is unstable. Any imbalance acts as a positive feed-back factor. If the volcanic activity grows, the inflow of the carbon dioxide into the atmosphere will cause its heating-up (plants will fail to reproduce themselves quickly enough to utilize the carbonic acid). The temperature growth will lead to

  5. Vessels for elevated temperature service

    International Nuclear Information System (INIS)

    O'Donnell, W.J.; Porowski, J.S.

    1983-01-01

    The subject is covered in chapters, entitled: introduction (background; elevated temperature concerns; design tools); design of pressure vessels for elevated temperature per ASME code; basic elevated temperature failure modes; allowable stresses and strains per ASME code (basic allowable stress limits; ASME code limits for bending; time-fraction summations; strain limits; buckling and instability; negligible creep and stress-rupture effects); combined membrane and bending stresses in creep regime; thermal stress cycles; bounding methods based on elastic core concept (bounds on accumulated strains; more accurate bounds; strain ranges; maximum stresses; strains at discontinuities); elastic follow-up; creep strain concentrations; time-dependent fatigue (combined creep rupture and fatigue damage; limits for inelastic design analyses; limits for elastic design analyses); flaw evaluation techniques; type 316 stainless steel; type 304 stainless steel; steel 2 1/4Cr1Mo; Inconel 718; Incolloy 800; Hastelloy X; detailed inelastic design analyses. (U.K.)

  6. Climate change, elevational range shifts, and bird extinctions.

    Science.gov (United States)

    Sekercioglu, Cagan H; Schneider, Stephen H; Fay, John P; Loarie, Scott R

    2008-02-01

    Limitations imposed on species ranges by the climatic, ecological, and physiological effects of elevation are important determinants of extinction risk. We modeled the effects of elevational limits on the extinction risk of landbirds, 87% of all bird species. Elevational limitation of range size explained 97% of the variation in the probability of being in a World Conservation Union category of extinction risk. Our model that combined elevational ranges, four Millennium Assessment habitat-loss scenarios, and an intermediate estimate of surface warming of 2.8 degrees C, projected a best guess of 400-550 landbird extinctions, and that approximately 2150 additional species would be at risk of extinction by 2100. For Western Hemisphere landbirds, intermediate extinction estimates based on climate-induced changes in actual distributions ranged from 1.3% (1.1 degrees C warming) to 30.0% (6.4 degrees C warming) of these species. Worldwide, every degree of warming projected a nonlinear increase in bird extinctions of about 100-500 species. Only 21% of the species predicted to become extinct in our scenarios are currently considered threatened with extinction. Different habitat-loss and surface-warming scenarios predicted substantially different futures for landbird species. To improve the precision of climate-induced extinction estimates, there is an urgent need for high-resolution measurements of shifts in the elevational ranges of species. Given the accelerating influence of climate change on species distributions and conservation, using elevational limits in a tested, standardized, and robust manner can improve conservation assessments of terrestrial species and will help identify species that are most vulnerable to global climate change. Our climate-induced extinction estimates are broadly similar to those of bird species at risk from other factors, but these estimates largely involve different sets of species.

  7. Troponin elevation in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Ioannis N. Mavridis

    2015-03-01

    Full Text Available Troponin (tr elevation in aneurysmal subarachnoid hemorrhage (SAH patients is often difficult to be appropriately assessed by clinicians, causing even disagreements regarding its management between neurosurgeons and cardiologists. The purpose of this article was to review the literature regarding the clinical interpretation of tr elevation in SAH. We searched for articles in PubMed using the key words: “troponin elevation” and “subarachnoid hemorrhage”. All of them, as well as relative neurosurgical books, were used for this review. Some type of cardiovascular abnormality develops in most SAH patients. Neurogenic stunned myocardium is a frequent SAH complication, due to catecholamine surge which induces cardiac injury, as evidenced by increased serum tr levels, electrocardiographic (ECG changes and cardiac wall motion abnormalities. Tr elevation, usually modest, is an early and specific marker for cardiac involvement after SAH and its levels peak about two days after SAH. Cardiac tr elevation predictors include poor clinical grade, intraventricular hemorrhage, loss of consciousness at ictus, global cerebral edema, female sex, large body surface area, lower systolic blood pressure, higher heart rate and prolonged Q-Tc interval. Elevated tr levels are associated with disability and death (especially tr >1 μg/L, worse neurological grade, systolic and diastolic cardiac dysfunction, pulmonary congestion, longer intensive care unit stay and incidence of vasospasm. Tr elevation is a common finding in SAH patients and constitutes a rightful cause of worry about the patients' cardiac function and prognosis. It should be therefore early detected, carefully monitored and appropriately managed by clinicians.

  8. Historie i spillefilm - for elever

    DEFF Research Database (Denmark)

    Tønnesen, Lone Guldbrandt

    2016-01-01

    MOOC om historiebrug i spillefilm, hvor elever kan lære om, hvordan spillefilm bruger fortiden, og om hvordan vores opfattelse af historien både sætter sig spor i filmene og bliver påvirket af dem.......MOOC om historiebrug i spillefilm, hvor elever kan lære om, hvordan spillefilm bruger fortiden, og om hvordan vores opfattelse af historien både sætter sig spor i filmene og bliver påvirket af dem....

  9. Tether Elevator Crawler Systems (TECS)

    Science.gov (United States)

    Swenson, Frank R.

    1987-01-01

    One of the needs of the experimenters on the space station is access to steady and controlled-variation microgravity environments. A method of providing these environments is to place the experiment on a tether attached to the space station. This provides a high degree of isolation from structural oscillations and vibrations. Crawlers can move these experiments along the tethers to preferred locations, much like an elevator. This report describes the motion control laws developed for these crawlers and the testing of laboratory models of these tether elevator crawlers.

  10. The Arctic : the great breakup

    International Nuclear Information System (INIS)

    Lemieux, R.

    2007-01-01

    The impact that climate change has had on the famous Northwest passage in Canada's Arctic was discussed. The water channel through the Arctic Islands is now navigable during the summer and it has been predicted that in 40 years, it may be navigable throughout the entire year. Although the Arctic is still covered with snow, the icebergs which navigators have feared no longer exist. Environment Canada has cautioned that Canada's extreme north would be most at risk from global warming, with temperatures increasing by 6 degrees, or 3 times higher than in moderate zones. The joint Canadian-United States program Surface Heat Budget of the Arctic has also confirmed that the waters of the Beaufort Sea are less salty and relatively warmer. Climatologists also project that the predicted increase in snowfall will act as an insulation blanket, thereby preventing the ice from thickening. Scientists stated that the gigantic polar cap, which has been frozen for the past 3.2 million years, will have fissures everywhere by 2080. The Northwest passage will become easily accessible in less than 10 years. This article raised questions regarding the role of the Northwest passage as an international maritime route. It presented the case of the first successful passage of a U.S. commercial oil tanker in 1969 which created controversy regarding Canada's territorial waters. Fourty years later, this issue is still not resolved. The article questioned whether there should be more cooperation on both the Canadian and American sides in light of the shared common interests such as commerce, science and security. It was noted that although Canada has sovereignty of the Arctic Islands, there are eight other countries who share the Arctic. 4 figs

  11. Elevated 1-hour postload plasma glucose levels identify subjects with normal glucose tolerance but impaired β-cell function, insulin resistance, and worse cardiovascular risk profile: the GENFIEV study.

    Science.gov (United States)

    Bianchi, Cristina; Miccoli, Roberto; Trombetta, Maddalena; Giorgino, Francesco; Frontoni, Simona; Faloia, Emanuela; Marchesini, Giulio; Dolci, Maria A; Cavalot, Franco; Cavallo, Gisella; Leonetti, Frida; Bonadonna, Riccardo C; Del Prato, Stefano

    2013-05-01

    In subjects with normal glucose tolerance (NGT) 1-hour postload plasma glucose (1-h oral glucose tolerance test [OGTT]) of >155 mg/dL predicts type 2 diabetes (T2DM) and is associated with subclinical atherosclerosis. The purpose of this study was to evaluate β-cell function, insulin resistance, and cardiovascular risk profile in subjects with NGT with a 1-h OGTT glucose of >155 mg/dL. The GENFIEV (Genetics, PHYsiopathology, and Evolution of Type 2 diabetes) study is a multicenter study recruiting individuals at high risk of T2DM. A total of 926 subjects underwent a 75-g OGTT for assessment of plasma glucose and C-peptide for mathematical modeling of β-cell function (derivative and proportional control). Fasting insulin, lipid profile, and clinical parameters were determined as well. A 1-hour OGTT glucose of >155 mg/dL was found in 39% of subjects with NGT, 76% with impaired fasting glucose (IFG), 90% with impaired glucose tolerance (IGT), and 99% and 98% with IFG + IGT or newly diagnosed T2DM, respectively. Among subjects with NGT (n = 474), those with 1-hour OGTT glucose of >155 mg/dL were more insulin-resistant and had worse β-cell function than those with 1-hour OGTT glucose of ≤155 mg/dL. Moreover, glycosylated hemoglobin, blood pressure, low-density lipoprotein cholesterol, and triglycerides were higher in subjects with NGT with 1-hour OGTT glucose of >155 mg/dL, whereas high-density lipoprotein cholesterol was lower compared with that in subjects with NGT with 1-hour OGTT glucose of ≤155 mg/dL. Compared with subjects with IGT, those with NGT with 1-hour OGTT glucose of >155 mg/dL had comparable cardiovascular risk profile and insulin resistance but slightly better β-cell function. Among subjects with NGT, those with 1-hour OGTT glucose of >155 mg/dL showed lower insulin sensitivity, impaired β-cell function, and worse cardiovascular risk profile and therefore are at greater risk of developing T2DM and cardiovascular disease.

  12. Dannelsen af den ansvarlige elev

    DEFF Research Database (Denmark)

    Larsen, Jesper

    2010-01-01

    Denne artikel handler om den del af lærergerningen, der har at gøre med udarbejdelse af elevplaner. Der tages udgangspunkt i en foucaultsk forståelse, hvor beskrivelsen af den enkelte elev udtrykker et særligt normativt ideal om, hvilke former for elevhed der er de ønskværdige i den danske...

  13. Methylphenidatinduceret ST-elevations-myokardieinfarkt

    DEFF Research Database (Denmark)

    Ruwald, Martin Huth; Ruwald, Anne-Christine Huth; Tønder, Niels

    2012-01-01

    Adult attention deficit and hyperkinetic disorder (ADHD) is increasingly diagnosed and treated with methylphenidate. We present the case of an 20 year-old man, who was diagnosed with ADHD and suffered a ST elevation acute myocardial infarction due to coronary vasospasm related to an overdose...

  14. Elevated lactate during psychogenic hyperventilation

    NARCIS (Netherlands)

    ter Avest, E.; Patist, F. M.; ter Maaten, J. C.; Nijsten, M. W. N.

    Study objective Elevated arterial lactate levels are closely related to morbidity and mortality in various patient categories. In the present retrospective study, the relation between arterial lactate, partial pressure of carbon dioxide (Pco(2)) and pH was systematically investigated in patients who

  15. Delphi survey of issues after the Great East Japan Earthquake

    International Nuclear Information System (INIS)

    Maeda, Yasunobu; Seo, Kami; Motoyoshi, Tadahiro; Okada, Shinya

    2011-01-01

    The Great East Japan Earthquake on March 11, 2011 has catastrophic impacts on Japan. Japan is currently on the way to recovery. However, as the damage on the country as well as society is so serious, Japanese society is urged to change some systems including hazard management, energy policy, information systems and city planning. These changes are accompanied with social group realignments, thus necessarily followed by various risks. To cope with these risk issues, SRA-Japan established the special research committee for the Great East Japan Earthquake. The aim of the committee is, from viewpoints of risk analysts, to create and relate messages about risk issues in 2-3 years, in ten years and in thirty years from the earthquake. To do this, the committee garners SRA-Japan member's opinions about possible risks in Japan by using Delphi method. In SRA-Japan, there are over 600 members in interdisciplinary fields from various backgrounds, thus the messages are expected to be helpful for Japanese society to lower its risks and to optimize the resource allocation. The research is now underway. An interim report will be presented. (author)

  16. A Case of Isolated Elevated Copper Levels during Pregnancy

    Directory of Open Access Journals (Sweden)

    LaToya R. Walker

    2011-01-01

    Full Text Available Introduction. Outside of Wilson's Disease, abnormal copper metabolism is a rare condition. In pregnancy, excess copper levels can be associated with intrauterine growth restriction, preeclampsia and neurological disease. Case Report. A 32 year old Gravida 4 para 2012 with an obstetrical history complicated by elevated copper levels presented for routine prenatal care. Her children had elevated copper levels at birth, with her firstborn child being diagnosed with autism and suffering three myocardial infarctions and being treated for elevated copper levels. During her prior pregnancies, she declined treatment for her elevated copper levels. During this pregnancy, she had declined chelation therapy and instead choose zinc therapy. She delivered a healthy infant with normal copper levels. Conclusion. Alterations in copper metabolism are rare, the consequences in pregnancy can be devastating. While isolated elevations of copper in pregnancy is exceedingly rare, it is treated the same as Wilson's disease. The goal is to prevent fetal growth restricting and neurological sequelae in the newborn and preeclampsia in the mother. Counseling, along with treatment options and timely delivery can greatly improve neonatal and maternal outcome.

  17. Modelling of aluminium sheet forming at elevated temperatures

    NARCIS (Netherlands)

    van den Boogaard, Antonius H.; Huetink, Han

    2004-01-01

    The formability of Al–Mg sheet can be improved considerably, by increasing the temperature. By heating the sheet in areas with large shear strains, but cooling it on places where the risk of necking is high, the limiting drawing ratio can be increased to values above 2.5. At elevated temperatures,

  18. Tree-ring reconstruction of the level of Great Salt Lake, USA

    Science.gov (United States)

    R. Justin DeRose; Shih-Yu Wang; Brendan M. Buckley; Matthew F. Bekker

    2014-01-01

    Utah's Great Salt Lake (GSL) is a closed-basin remnant of the larger Pleistocene-age Lake Bonneville. The modern instrumental record of the GSL-level (i.e. elevation) change is strongly modulated by Pacific Ocean coupled ocean/atmospheric oscillations at low frequency, and therefore reflects the decadalscale wet/dry cycles that characterize the region. A within-...

  19. Elevation uncertainty in coastal inundation hazard assessments

    Science.gov (United States)

    Gesch, Dean B.; Cheval, Sorin

    2012-01-01

    Coastal inundation has been identified as an important natural hazard that affects densely populated and built-up areas (Subcommittee on Disaster Reduction, 2008). Inundation, or coastal flooding, can result from various physical processes, including storm surges, tsunamis, intense precipitation events, and extreme high tides. Such events cause quickly rising water levels. When rapidly rising water levels overwhelm flood defenses, especially in heavily populated areas, the potential of the hazard is realized and a natural disaster results. Two noteworthy recent examples of such natural disasters resulting from coastal inundation are the Hurricane Katrina storm surge in 2005 along the Gulf of Mexico coast in the United States, and the tsunami in northern Japan in 2011. Longer term, slowly varying processes such as land subsidence (Committee on Floodplain Mapping Technologies, 2007) and sea-level rise also can result in coastal inundation, although such conditions do not have the rapid water level rise associated with other flooding events. Geospatial data are a critical resource for conducting assessments of the potential impacts of coastal inundation, and geospatial representations of the topography in the form of elevation measurements are a primary source of information for identifying the natural and human components of the landscape that are at risk. Recently, the quantity and quality of elevation data available for the coastal zone have increased markedly, and this availability facilitates more detailed and comprehensive hazard impact assessments.

  20. Elevated carboxyhemoglobin: sources of carbon monoxide exposure.

    Science.gov (United States)

    Buchelli Ramirez, Herminia; Fernández Alvarez, Ramón; Rubinos Cuadrado, Gemma; Martinez Gonzalez, Cristina; Rodriguez Jerez, Francisco; Casan Clara, Pere

    2014-11-01

    Inhalation of carbon monoxide (CO) can result in poisoning, with symptoms ranging from mild and nonspecific to severe, or even death. CO poisoning is often underdiagnosed because exposure to low concentrations goes unnoticed, and threshold values for normal carboxyhemoglobin vary according to different authors. The aim of our study was to analyze carboxyhemoglobin (COHb) levels in an unselected population and detect sources of CO exposure In a cross-sectional descriptive study, we analyzed consecutive arterial blood gas levels processed in our laboratory. We selected those with COHb≥2.5% in nonsmokers and ≥5% in smokers. In these cases a structured telephone interview was conducted. Elevated levels of COHb were found in 64 (20%) of 306 initial determinations. Of these, data from 51 subjects aged 65±12 years, 31 (60%) of which were men, were obtained. Mean COHb was 4.0%. Forty patients (78%) were non-smokers with mean COHb of 3.2%, and 11 were smokers with COHb of 6.7%. In 45 patients (88.2%) we detected exposure to at least one source of ambient CO other than cigarette smoke. A significant proportion of individuals from an unselected sample had elevated levels of COHb. The main sources of CO exposure were probably the home, so this possibility should be explored. The population should be warned about the risks and encouraged to take preventive measures. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  1. Elevator deflections on the icing process

    Science.gov (United States)

    Britton, Randall K.

    1990-01-01

    The effect of elevator deflection of the horizontal stabilizer for certain icing parameters is investigated. Elevator deflection can severely change the lower and upper leading-edge impingement limits, and ice can accrete on the elevator itself. Also, elevator deflection had practically no effect on the maximum local collection efficiency. It is shown that for severe icing conditions (large water droplets), elevator deflections that increase the projected height of the airfoil can significantly increase the total collection efficiency of the airfoil.

  2. 'Great Power Style' in China's Economic Policy

    DEFF Research Database (Denmark)

    Jiang, Yang

    2011-01-01

    China’s ascendance attracts concern, even though Beijing claims to be a responsible great power and tries to demonstrate its ‘great power style’ in economic diplomacy. This article therefore discusses the following questions: to what extent does the current notion and practice of Chinese ‘great...... power style’ in economic diplomacy comply with, or differ from, the criteria of benign hegemony; and what are the major constraining factors? Conceptually, China’s ‘great power style’ is rooted in ancient Chinese political philosophy and institution, but it highly resembles the Western notion of benign...

  3. Elevated Plasma C-Terminal Endothelin-1 Precursor Fragment Concentrations Are Associated with Less Anxiety in Patients with Cardiovascular Risk Factors. Results from the Observational DIAST-CHF Study.

    Science.gov (United States)

    Meyer, Thomas; Chavanon, Mira-Lynn; Herrrmann-Lingen, Christoph; Roggenthien, Maren; Nolte, Kathleen; Pieske, Burkert; Wachter, Rolf; Edelmann, Frank

    2015-01-01

    The role of endothelin-1 (ET-1) in the neurobiology of anxiety is unknown, therefore, we assessed in the observational multicenter DIAST-CHF study whether the C-terminal ET-1 precursor fragment (CT-proET-1) is linked to anxiety. Plasma concentrations of CT-proET-1 were measured in a total of 1,410 patients presenting with cardiovascular risk factors (mean age 66.91±8.2 years, 49.3% males, mean left ventricular ejection fraction 60.0±8.2%) who had completed the Hospital Anxiety and Depression Scale (HADS) questionnaire. Among the total study cohort (n = 1,410), there were 118 subjects (8.4%) with an HADS anxiety score above the cut-off level of 11 suggestive of clinically relevant anxiety. Plasma CT-proET-1 levels were significantly lower in the group of anxious patients as compared to non-anxious patients (p = 0.013). In regression models adjusted for sex, age, systolic blood pressure, and diameters of left atrium and ventricle, plasma CT-proET-1 was again linked to anxiety (Exp(β) = 0.247, 95%-confidence interval [95%-CI] = 0.067-0.914, p = 0.036). Given the high prevalence of depressive disorders in anxious patients, we additionally included the HADS depression score as an independent variable in the models and found that CT-proET-1 remained a significant predictor of anxiety, independent of comorbid depression (Exp(β) = 0.114, 95%-CI = 0.023-0.566, p = 0.008). Our data from a population-based study in outpatients with cardiovascular risk factors revealed that circulating CT-proET-1 levels are negatively associated with anxiety. Further investigations are required to clarify the putative anxiolytic effect of ET-1 or its precursor molecules in humans and to decipher its mechanistic pathways.

  4. Elevated Plasma C-Terminal Endothelin-1 Precursor Fragment Concentrations Are Associated with Less Anxiety in Patients with Cardiovascular Risk Factors. Results from the Observational DIAST-CHF Study.

    Directory of Open Access Journals (Sweden)

    Thomas Meyer

    Full Text Available The role of endothelin-1 (ET-1 in the neurobiology of anxiety is unknown, therefore, we assessed in the observational multicenter DIAST-CHF study whether the C-terminal ET-1 precursor fragment (CT-proET-1 is linked to anxiety.Plasma concentrations of CT-proET-1 were measured in a total of 1,410 patients presenting with cardiovascular risk factors (mean age 66.91±8.2 years, 49.3% males, mean left ventricular ejection fraction 60.0±8.2% who had completed the Hospital Anxiety and Depression Scale (HADS questionnaire.Among the total study cohort (n = 1,410, there were 118 subjects (8.4% with an HADS anxiety score above the cut-off level of 11 suggestive of clinically relevant anxiety. Plasma CT-proET-1 levels were significantly lower in the group of anxious patients as compared to non-anxious patients (p = 0.013. In regression models adjusted for sex, age, systolic blood pressure, and diameters of left atrium and ventricle, plasma CT-proET-1 was again linked to anxiety (Exp(β = 0.247, 95%-confidence interval [95%-CI] = 0.067-0.914, p = 0.036. Given the high prevalence of depressive disorders in anxious patients, we additionally included the HADS depression score as an independent variable in the models and found that CT-proET-1 remained a significant predictor of anxiety, independent of comorbid depression (Exp(β = 0.114, 95%-CI = 0.023-0.566, p = 0.008.Our data from a population-based study in outpatients with cardiovascular risk factors revealed that circulating CT-proET-1 levels are negatively associated with anxiety. Further investigations are required to clarify the putative anxiolytic effect of ET-1 or its precursor molecules in humans and to decipher its mechanistic pathways.

  5. Når elever producerer

    DEFF Research Database (Denmark)

    Bremholm, Jesper; Hansen, Rune; Slot, Marie Falkesgaard

    2017-01-01

    Dette kapitel præsenterer centrale resultater fra studiet Elevopgaver og elevproduktion i det 21. århundrede der blandt andet rummer den første større kvantitative undersøgelse af opgavedidaktik og elevers produktive arbejde i den danske grundskole. Studiet omfatter også en kvalitativ del, og i...... undersøgelsen præsenteres og diskuteres gennem en række konkrete eksempler fra de berørte fag. I forhold til elevers produktive arbejde peger undersøgelsens resultater både på potentialer og særlige barrierer i forbindelse med at udvikle en kompetenceorienteret undervisning. I kapitlet argumenteres desuden...

  6. Læring mellem elever

    DEFF Research Database (Denmark)

    Georgsen, Marianne; Davidsen, Jacob

    2010-01-01

    I denne rapport præsenteres resultater fra følgeforskningen til projektet Læring gennem Bevægelse, som er gennemført på Søndervangskolen i Hammel i perioden august 2009 - maj 2010. Projektet er gennemført i samspil mellem lærere, it-vejleder, elever og skolens ledelse. Projektets overordnede formål...

  7. Science on a space elevator

    Energy Technology Data Exchange (ETDEWEB)

    Laubscher, B. E. (Bryan E.); Jorgensen, A. M. (Anders M.)

    2004-01-01

    The Space Elevator (SE) represents a major paradigm shift in space access. If the SE's promise of low cost access can be realized, everything becomes economically more feasible to accomplish in space. In this paper we describe in-situ science stations mounted on a science-dedicated space elevator tether. The concept presented here involves a carbon nanotube ribbon that is constructed by an existing space elevator and then science sensors are stationed along the ribbon at differing altitudes. The finished ribbon can be moved across the earth to the position at which its scientific measurements are to be taken. The ability to station scientific, in-situ instrumentation at different altitudes for round-the-clock observations is a unique capability of the SE. The environments that the science packages sense range from the troposphere out beyond the magnetopause of the magnetosphere on the solar side of the earth. Therefore, the very end of the SE can sense the solar wind. The measurements at various points along its length include temperature, pressure, density, sampling, chemical analyses, wind speed, turbulence, free oxygen, electromagnetic radiation, cosmic rays, energetic particles and plasmas in the earth's magnetosphere and the solar wind. There exist some altitudes that are difficult to access with aircraft or balloons or rockets and so remain relatively unexplored. The space elevator solves these problems and opens these regions up to in-situ measurements. Without the need for propulsion, the SE provides a more benign and pristine environment for atmospheric measurements than available with powered aircraft. Moreover, replacing and upgrading instrumentation is expected to be very cost effective with the SE. Moving and stationing the science SE affords the opportunity to sense multiple regions of the atmosphere. The SE's geosynchronous, orbital motion through the magnetosphere, albeit nominally with Earth's magnetic field, will trace a plane

  8. The Great Pretender: Rectal Syphilis Mimic a Cancer

    Directory of Open Access Journals (Sweden)

    Andrea Pisani Ceretti

    2015-01-01

    Full Text Available Rectal syphilis is a rare expression of the widely recognised sexual transmitted disease, also known as the great imitator for its peculiarity of being confused with mild anorectal diseases because of its vague symptoms or believed rectal malignancy, with the concrete risk of overtreatment. We present the case of a male patient with primary rectal syphilis, firstly diagnosed as rectal cancer; the medical, radiological, and endoscopic features are discussed below.

  9. Natural and artificial radioactivity in Great Bratislava

    International Nuclear Information System (INIS)

    Lanc, J.

    1997-01-01

    The results of the aviation measurement of the gamma-radiation are presented in the form of the maps of iso-lines of the concentration of the natural radioactive elements (potassium, uranium, thorium) and artificial radionuclides (cesium-137, cesium-134). From the obtained dates the maps of dose rate of the gamma-radiation in the air are calculated, of the dose equivalent rate and the map of the fraction of the dose equivalent rate from the natural elements potassium, uranium, thorium. The natural radioactivity of the minerals in the Great Bratislava region, especially for the extreme low values of the contain of the thorium, does not amount the average values of the radioactivity of the Earth crust. The area activity of cesium-137 are in the range 2 - 10 kBq.m -2 and cesium-134 is 1 - 2.5 kBq.m -2 . From the point of view of the summary level of the external irradiation from the Earth surface the measured zone as relative even is evaluated, in the range 10-100 nSv.h -1 . The total average level of the dose rate of the external irradiation of man (inclusively from the cosmic radiation 40-50 nSv.h -1 ) in the conditions of Bratislava is 100 nSv.h -1 . The contribution of external component of the irradiation is 40-100 nSv.h -1 (0.1-0.3 mSv.y -1 ). The dose equivalent commitment of internal component from the cesium-137 is for the all age category of the population under the level negligible risk 0.01 mSv.y -1 [sk

  10. Altered Expression Levels of MMP1, MMP9, MMP12, TIMP1, and IL-1β as a Risk Factor for the Elevated IOP and Optic Nerve Head Damage in the Primary Open-Angle Glaucoma Patients

    Directory of Open Access Journals (Sweden)

    Lukasz Markiewicz

    2015-01-01

    Full Text Available The aim of presented work was to analyze the impact of particular polymorphic changes in the promoter regions of the -1607 1G/2G MMP1, -1562 C/T MMP9, -82 A/G MMP12, -511 C/T IL-1β, and 372 T/C TIMP1 genes on their expression level in POAG patients. Blood and aqueous humor samples acquired from 50 patients with POAG and 50 control subjects were used for QPCR and protein levels analysis by ELISA. In vivo promoter activity assays were carried on HTM cells using dual luciferase assay. All studied subjects underwent ophthalmic examination, including BCVA, intraocular pressure, slit-lamp examination, gonioscopy, HRT, and OCT scans. Patients with POAG are characterized by an increased mRNA expression of MMP1, MMP9, MMP12, and IL-1β genes as compared to the control group (P<0.001. Aqueous humor acquired from patients with POAG displayed increased protein expression of MMP1, MMP9, MMP12, and IL-1β compared to the control group (P<0.001. Allele -1607 1G of MMP1 gene possesses only 42,91% of the -1607 2G allele transcriptional activity and allele -1562 C of MMP9 gene possesses only 21,86% of the -1562 T allele. Increased expression levels of metalloproteinases can be considered as a risk factor for the development of POAG.

  11. Distinct soil bacterial communities along a small-scale elevational gradient in alpine tundra

    Directory of Open Access Journals (Sweden)

    Congcong eShen

    2015-06-01

    Full Text Available The elevational diversity pattern for microorganisms has received great attention recently but is still understudied, and phylogenetic relatedness is rarely studied for microbial elevational distributions. Using a bar-coded pyrosequencing technique, we examined the biodiversity patterns for soil bacterial communities of tundra ecosystem along 2000–2500 m elevations on Changbai Mountain in China. Bacterial taxonomic richness displayed a linear decreasing trend with increasing elevation. Phylogenetic diversity and mean nearest taxon distance (MNTD exhibited a unimodal pattern with elevation. Bacterial communities were more phylogenetically clustered than expected by chance at all elevations based on the standardized effect size of MNTD metric. The bacterial communities differed dramatically among elevations, and the community composition was significantly correlated with soil total carbon, total nitrogen, C:N ratio, and dissolved organic carbon. Multiple ordinary least squares regression analysis showed that the observed biodiversity patterns strongly correlated with soil total carbon and C:N ratio. Taken together, this is the first time that a significant bacterial diversity pattern has been observed across a small-scale elevational gradient. Our results indicated that soil carbon and nitrogen contents were the critical environmental factors affecting bacterial elevational distribution in Changbai Mountain tundra. This suggested that ecological niche-based environmental filtering processes related to soil carbon and nitrogen contents could play a dominant role in structuring bacterial communities along the elevational gradient.

  12. Great Expectations for Middle School Counselors

    Science.gov (United States)

    Wright, Robert J.

    2012-01-01

    During the Great Recession, 2008 to 2010, school systems scrambled to balance budgets, and the ratio of counselors to students became even larger. To make matters worse, the Great Recession had a major impact on cuts in educational funding. Budget cutbacks tend to occur where the public will be least likely to notice. The loss of teachers and the…

  13. Great Books. What Works Clearinghouse Intervention Report

    Science.gov (United States)

    What Works Clearinghouse, 2011

    2011-01-01

    "Great Books" is a program that aims to improve the reading, writing, and critical thinking skills of students in kindergarten through high school. The program is implemented as a core or complementary curriculum and is based on the Shared Inquiry[TM] method of learning. The purpose of "Great Books" is to engage students in…

  14. Great ape genetic diversity and population history

    DEFF Research Database (Denmark)

    Prado-Martinez, Javier; Sudmant, Peter H; Kidd, Jeffrey M

    2013-01-01

    Most great ape genetic variation remains uncharacterized; however, its study is critical for understanding population history, recombination, selection and susceptibility to disease. Here we sequence to high coverage a total of 79 wild- and captive-born individuals representing all six great ape...

  15. Libraries Achieving Greatness: Technology at the Helm

    Science.gov (United States)

    Muir, Scott P.

    2009-01-01

    Libraries have been around for thousands of years. Many of them are considered great because of their magnificent architecture or because of the size of their collections. This paper offers ten case studies of libraries that have used technology to achieve greatness. Because almost any library can implement technology, a library does not have to…

  16. Recensie "The Great Reset" : Richard Florida

    NARCIS (Netherlands)

    Roy van Dalm

    2010-01-01

    Like the Great Depression and the Long Depression before it, experts have viewed prolonged economic downturns as crises. In The Great Reset , bestselling author Richard Florida argues that we should instead see the recent recession as an opportunity to create entirely new ways of working and living

  17. NASA's Risk Management System

    Science.gov (United States)

    Perera, Jeevan S.

    2011-01-01

    Leadership is key to success. Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks -- risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  18. Mechanism for elevated temperature leaching

    International Nuclear Information System (INIS)

    Kenna, B.T.; Murphy, K.D.

    1979-01-01

    Long-term, elevated temperature leaching and subsequent electron microprobe analysis of simulated waste glass and ceramic materials have been completed. A cyclic leaching pattern was found in all systems over a 20-month period. It appears that the leaching of mobile ions by simple diffusional processes is modified by more complex chemical interactions. The release of immobile ions is primarily a function of their chemical interactions in the matrix which suggests that these ions may be complex species when released into solution. A mechanism is proposed which incorporates these ideas and the cyclic phenomenon observed

  19. PLC VVVF Elevator Control System

    OpenAIRE

    Tang, Yujian; Gui, Tianyu

    2016-01-01

    The aim of the thesis is to introduce the PLC VVVF elevator and its control system. The thesis can be divided into three parts. The first part is about the overview of the lift: the kinds of the lift and the structure of the lift, it shows the knowledge about the components and the operating systems of the lift. The second part is about the PLC control system, it’s about the operations of the lift from the introduction about the hardware and software of the PLC control system. And the thi...

  20. Amorphisation during elevated temperature implantation

    International Nuclear Information System (INIS)

    Carter, G.; Nobes, M.J.; Elliman, R.G.

    1994-01-01

    Transition state theory is employed to predict the rates of amorphous zone recrystallization by direct thermal and radiation mediated thermal annealing processes. These rates are functions of zone radius and are employed to describe the competition between amorphous zone generation and annealing during elevated temperature heavy ion implantation of, particularly, Si and the accumulation of amorphousness with increasing ion fluence. This analysis predicts a change from monotonic to sigmoidal to biexponential accumulation functions with increasing annealing rate or substrate temperature in agreement with experiments. A logarithmic dependence of ion flux density upon substrate temperature for the achievement of defined fractional amorphisation is predicted and is also in agreement with the experiment. (author)

  1. Pacific salmonines in the Great Lakes Basin

    Science.gov (United States)

    Claramunt, Randall M.; Madenjian, Charles P.; Clapp, David; Taylor, William W.; Lynch, Abigail J.; Léonard, Nancy J.

    2012-01-01

    Pacific salmon (genus Oncorhynchus) are a valuable resource, both within their native range in the North Pacific rim and in the Great Lakes basin. Understanding their value from a biological and economic perspective in the Great Lakes, however, requires an understanding of changes in the ecosystem and of management actions that have been taken to promote system stability, integrity, and sustainable fisheries. Pacific salmonine introductions to the Great Lakes are comprised mainly of Chinook salmon, coho salmon, and steelhead and have accounted for 421, 177, and 247 million fish, respectively, stocked during 1966-2007. Stocking of Pacific salmonines has been effective in substantially reducing exotic prey fish abundances in several of the Great Lakes (e.g., lakes Michigan, Huron, and Ontario). The goal of our evaluation was to highlight differences in management strategies and perspectives across the basin, and to evaluate policies for Pacific salmonine management in the Great Lakes. Currently, a potential conflict exists between Pacific salmonine management and native fish rehabilitation goals because of the desire to sustain recreational fisheries and to develop self-sustaining populations of stocked Pacific salmonines in the Great Lakes. We provide evidence that suggests Pacific salmonines have not only become naturalized to the food webs of the Great Lakes, but that their populations (specifically Chinook salmon) may be fluctuating in concert with specific prey (i.e., alewives) whose populations are changing relative to environmental conditions and ecosystem disturbances. Remaining questions, however, are whether or not “natural” fluctuations in predator and prey provide enough “stability” in the Great Lakes food webs, and even more importantly, would a choice by managers to attempt to reduce the severity of predator-prey oscillations be antagonistic to native fish restoration efforts. We argue that, on each of the Great Lakes, managers are pursuing

  2. ESTRATIFICACIÓN DEL RIESGO EN EL SÍNDROME CORONARIO AGUDO CON ELEVACIÓN DEL SEGMENTO ST / Risk stratification in acute coronary syndrome with ST-segment elevation

    Directory of Open Access Journals (Sweden)

    Luis Alberto Rodríguez López

    2010-12-01

    to assess poor prognostic factors prior to hospital discharge by performing submaximal ergometry and echocardiogram. Material and Methods: A descriptive, prospective study was performed on 85 patients with infarction who received or not thrombolytic therapy, in the University Hospital "Dr. Celestino Hernandez Robau" Santa Clara, and who underwent ergometry and echocardiography prior to hospital discharge in order to identify poor prognosis variables. Results: Males were predominant (82.2%, the group aged 55 years and over (47,1 %, hypertension (80% and smoking (75,2 %. The most common location was the posterior-inferior (78.8 % left ventricle ejection fraction was better in patients treated with thrombolysis, and those who had poor ventricular function were identified (10.6%, 74,1 % had functional class I and 21 patients (24,7 % with poor prognosis were identified. There was no significant difference compared to thrombolytic therapy, but the patients who received it had a better clinical behavior. Conclusions: There were 31 patients with positive stress testing and poor prognosis, 5 of them with functional class III, which also showed decreased LVEF. Submaximal exercise testing and two-dimensional echocardiography are first-choice tools in the prognostic assessment of patients with AMI, due to its existence in almost all hospitals, low cost, little or no risk and easy to perform, and reproduce.

  3. The 3D Elevation Program: summary for North Dakota

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of North Dakota, elevation data are critical for agriculture and precision farming, natural resources conservation, water supply and quality, infrastructure and construction management, flood risk management, geologic resource assessment and hazard mitigation, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  4. The 3D Elevation Program: summary for Connecticut

    Science.gov (United States)

    Carswell, William J.

    2015-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Connecticut, elevation data are critical for coastal zone management, flood risk management, natural resources conservation, agriculture and precision farming, sea level rise and subsidence, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  5. The 3D Elevation Program: summary for Wyoming

    Science.gov (United States)

    Carswell, William J.

    2015-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Wyoming, elevation data are critical for geologic resource assessment and hazard mitigation, flood risk management, water supply an quality, natural resources conservation, agriculture and precision farming, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  6. The 3D Elevation Program: summary for Iowa

    Science.gov (United States)

    Carswell, William J.

    2015-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Iowa, elevation data are critical for agriculture and precision farming, infrastructure and construction management, natural resources conservation, flood risk management, water supply and quality, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  7. The 3D Elevation Program: summary for South Carolina

    Science.gov (United States)

    Carswell, William

    2015-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of South Carolina, elevation data are critical for flood risk management, natural resources conservation, agriculture and precision farming, infrastructure and construction management, forest resources management, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  8. The 3D Elevation Program: summary for Arkansas

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Arkansas, elevation data are critical for agriculture and precision farming, natural resources conservation, flood risk management, infrastructure and construction management, forest resources management, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  9. The 3D Elevation Program: summary for New Mexico

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of New Mexico, elevation data are critical for infrastructure and construction management, natural resources conservation, flood risk management, agriculture and precision farming, geologic resource assessment and hazard mitigation, forest resources management, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  10. The 3D Elevation Program: summary for North Carolina

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, and recreation. For the State of North Carolina, elevation data are critical for flood risk management, natural resources conservation, agriculture and precision farming, infrastructure and construction management, forest resources management, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  11. The 3D Elevation Program: summary for Ohio

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Ohio, elevation data are critical for agriculture and precision farming, natural resources conservation, flood risk management, infrastructure and construction management, water supply and quality, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  12. The 3D Elevation Program: summary for Indiana

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Indiana, elevation data are critical for flood risk management, agriculture and precision farming, natural resources conservation, infrastructure and construction management, aviation navigation and safety, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  13. The 3D Elevation Program: summary for Colorado

    Science.gov (United States)

    Carswell, William J.

    2013-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Colorado, elevation data are critical for natural resources conservation, agriculture and precision farming, infrastructure and construction management, flood risk management, geologic resource assessment and hazards mitigation, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  14. The 3D Elevation Program: summary for Mississippi

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Mississippi, elevation data are critical for infrastructure and construction management, flood risk management, agriculture and precision farming, natural resources conservation, forest resources management, water supply and quality, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  15. The 3D Elevation Program: summary for Illinois

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Illinois, elevation data are critical for flood risk management, water supply and quality, infrastructure and construction management, agriculture and precision farming, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  16. The 3D Elevation Program: summary for Nevada

    Science.gov (United States)

    Carswell, William J.

    2015-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Nevada, elevation data are critical for infrastructure and construction management, natural resources conservation, flood risk management, geologic resource assessment and hazard mitigation, agriculture and precision farming, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  17. The 3D Elevation Program: summary for Alabama

    Science.gov (United States)

    Carswell, William J.

    2013-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Alabama, elevation data are critical for flood risk management; infrastructure and construction management; wildfire management, planning, and response; natural resources conservation; geologic resource assessment and hazards mitigation; and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  18. The 3D Elevation Program: summary for Massachusetts

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the Commonwealth of Massachusetts, elevation data are critical for flood risk management, natural resources conservation, agriculture and precision farming, infrastructure and construction management, coastal zone management, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  19. The 3D Elevation Program: summary for Oklahoma

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Oklahoma, elevation data are critical for flood risk management, infrastructure and construction management, agriculture and precision farming, natural resources conservation, wildlife and habitat management, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of local, State, and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.

  20. The 3D Elevation Program: summary for Georgia

    Science.gov (United States)

    Carswell, William J.

    2014-01-01

    Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Georgia, elevation data are critical for infrastructure and construction management, natural resources conservation, flood risk management, agriculture and precision farming, forest resources management, water supply and quality, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.