76 FR 52945 - Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Extension of Comment...

Science.gov (United States)

2011-08-24

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPP-2008-0850; FRL-8886-6] Chlorpyrifos Registration... chlorpyrifos registration review; preliminary human health risk assessment. This document extends the comment... . SUPPLEMENTARY INFORMATION: This document extends the public comment period for the chlorpyrifos reregistration...

TCA High Lift Preliminary Assessment

Science.gov (United States)

Wyatt, G. H.; Polito, R. C.; Yeh, D. T.; Elzey, M. E.; Tran, J. T.; Meredith, Paul T.

1999-01-01

This paper presents a TCA (Technology Concept Airplane) High lift Preliminary Assessment. The topics discussed are: 1) Model Description; 2) Data Repeatability; 3) Effect of Inboard L.E. (Leading Edge) Flap Span; 4) Comparison of 14'x22' TCA-1 With NTF (National Transonic Facility) Modified Ref. H; 5) Comparison of 14'x22' and NTF Ref. H Results; 6) Effect of Outboard Sealed Slat on TCA; 7) TCA Full Scale Build-ups; 8) Full Scale L/D Comparisons; 9) TCA Full Scale; and 10) Touchdown Lift Curves. This paper is in viewgraph form.

Preliminary risk assessment for nuclear waste disposal in space. Volume I. Executive summary of technical report

International Nuclear Information System (INIS)

Rice, E.E.; Denning, R.S.; Friedlander, A.L.

1982-01-01

Three major conclusions come from this preliminary risk assessment of nuclear waste disposal in space. Preliminary estimates of space disposal risk are low, even with the estimated uncertainty bounds. If calculated mined geologic repository (MGR) release risks remain low, and the EPA requirements continue to be met, then no additional space disposal study effort is warranted. If risks perceived by the public are significant in the acceptance of mined geologic repositories, then consideration of space disposal as an MGR complement is warranted. As a result of this study, the following recommendations are made to NASA and the US DOE: During the continued evaluation of the mined geologic repository risk over the years ahead by DOE, if any significant increase in the calculated health risk is predicted for the MGR, then space disposal should be reevaluated at that time. The risks perceived by the public for the MGR should be evaluated on a broad basis by an independent organization to evaluate acceptance. If, in the future, MGR risks are found to be significant due to some presently unknown technical or social factor, and space disposal is selected as an alternative that may be useful in mitigating the risks, then the following space disposal study activities are recommended: improvement in chemical processing technology for wastes; payload accident response analysis; risk uncertainty analysis for both MGR and space disposal; health risk modeling that includes pathway and dose estimates; space disposal cost modeling; assessment of space disposal perceived (by public) risk benefit; and space systems analysis supporting risk and cost modeling

Preliminary characterization of risks in the nuclear waste management system based on information in the literature

International Nuclear Information System (INIS)

Daling, P.M.; Rhoads, R.E.; Van Luick, A.E.; Fecht, B.A.; Nilson, S.A.; Sevigny, N.L.; Armstrong, G.R.; Hill, D.H.; Rowe, M.; Stern, E.

1992-01-01

This document presents preliminary information on the radiological and nonradiological risks in the nuclear waste management system. The objective of the study was to (1) review the literature containing information on risks in the nuclear waste management system and (2) use this information to develop preliminary estimates of the potential magnitude of these risks. Information was collected on a broad range of risk categories to assist the US Department of Energy (DOE) in communicating information about the risks in the waste management systems. The study examined all of the portions of the nuclear waste management system currently expected to be developed by the DOE. The scope of this document includes the potential repository, the integral MRS facility, and the transportation system that supports the potential repository and the MRS facility. Relevant literature was reviewed for several potential repository sites and geologic media. A wide range of ''risk categories'' are addressed in this report: (1) public and occupational risks from accidents that could release radiological materials, (2) public and occupational radiation exposure resulting from routine operations, (3) public and occupational risks from accidents involving hazards other than radioactive materials, and (4) public and occupational risks from exposure to nonradioactive hazardous materials during routine operations. The report is intended to provide a broad spectrum of risk-related information about the waste management system. This information is intended to be helpful for planning future studies

Failure mode analysis of preliminary design of ITER divertor impurity monitor

International Nuclear Information System (INIS)

Kitazawa, Sin-iti; Ogawa, Hiroaki

2016-01-01

Highlights: • Divertor impurity influx monitor for ITER (DIM) is procured by JADA. • DIM is designed to observe light from nuclear fusion plasma directly. • DIM is under preliminary design phase. • Failure mode of DIM was prepared for RAMI analysis. • RAMI analysis on DIM was performed to reduce technical risks. - Abstract: The objective of the divertor impurity influx monitor (DIM) for ITER is to measure the parameters of impurities and hydrogen isotopes (tritium, deuterium, and hydrogen) in divertor plasma using visible and UV spectroscopic techniques in the 200–1000 nm wavelength range. In ITER, special provisions are required to ensure accuracy and full functionality of the diagnostic components under harsh conditions (high temperature, high magnetic field, high vacuum condition, and high radiation field). Japan Domestic Agency is preparing the preliminary design of the ITER DIM system, which will be installed in the upper, equatorial and lower ports. The optical and mechanical designs of the DIM are conducted to fit ITER’s requirements. The optical and mechanical designs meet the requirements of spatial resolution. Some auxiliary systems were examined via prototyping. The preliminary design of the ITER DIM system was evaluated by RAMI analysis. The availability of the designed system is adequately high to satisfy the project requirements. However, some equipment does not have certain designs, and this may cause potential technical risks. The preliminary design should be modified to reduce technical risks and to prepare the final design.

Facial emotion perception differs in young persons at genetic and clinical high-risk for psychosis.

Science.gov (United States)

Kohler, Christian G; Richard, Jan A; Brensinger, Colleen M; Borgmann-Winter, Karin E; Conroy, Catherine G; Moberg, Paul J; Gur, Ruben C; Gur, Raquel E; Calkins, Monica E

2014-05-15

A large body of literature has documented facial emotion perception impairments in schizophrenia. More recently, emotion perception has been investigated in persons at genetic and clinical high-risk for psychosis. This study compared emotion perception abilities in groups of young persons with schizophrenia, clinical high-risk, genetic risk and healthy controls. Groups, ages 13-25, included 24 persons at clinical high-risk, 52 first-degree relatives at genetic risk, 91 persons with schizophrenia and 90 low risk persons who completed computerized testing of emotion recognition and differentiation. Groups differed by overall emotion recognition abilities and recognition of happy, sad, anger and fear expressions. Pairwise comparisons revealed comparable impairments in recognition of happy, angry, and fearful expressions for persons at clinical high-risk and schizophrenia, while genetic risk participants were less impaired, showing reduced recognition of fearful expressions. Groups also differed for differentiation of happy and sad expressions, but differences were mainly between schizophrenia and control groups. Emotion perception impairments are observable in young persons at-risk for psychosis. Preliminary results with clinical high-risk participants, when considered along findings in genetic risk relatives, suggest social cognition abilities to reflect pathophysiological processes involved in risk of schizophrenia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Operating performance and environmental and safety risks: A preliminary comparison of majors and independents

International Nuclear Information System (INIS)

Pulsipher, A.G.; Iledare, W.O.; Baumann, R.H.; Mesyanzhinov, D.

1995-01-01

The objective is to compare the safety and environmental records of oil and gas companies operating on the OCS in the Gulf of Mexico over the past decade. The reason for doing so is to help inform public sector policy-makers and private sector decision-makers about the potential safety and environmental risks associated with the expected increased presence of smaller independents in the domestic oil and gas industry in general and on the federal OCS in particular. The preliminary conclusion is that although independents have had a modestly high incidence of fires and explosions than the majors, the difference is not significant statistically and is largely attributable to a few ''bad actors'' rather than demonstrably poorer practice by the group as a whole

A Brief Report: Lessons Learned and Preliminary Findings of Progreso en Salud, an HIV Risk Reduction Intervention for Latina Seasonal Farmworkers.

Science.gov (United States)

Kanamori, Mariano; De La Rosa, Mario; Diez, Stephanie; Weissman, Jessica; Trepka, Mary Jo; Sneij, Alicia; Schmidt, Peter; Rojas, Patria

2016-12-30

Throughout the past decade, HIV rates in Florida-particularly South Florida, where many Latina seasonal farmworkers reside and work-have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV prevention intervention Progreso en Salud (Progress in Health). Among the 114 Latina seasonal farmworker participants, there were significant increases from baseline to 6-month follow-up in the percentages of overall condom use, HIV testing, HIV/AIDS-related communications with friends, HIV knowledge, condom use self-efficacy, and correct use of condoms. Lessons learned from this study can be used to inform future HIV intervention strategies to improve the adoption and maintenance of HIV risk reduction behaviors among high-risk Latina seasonal workers and other high-risk underserved populations. Future research is needed to support our findings.

FN-curves: preliminary estimation of severe accident risks after Fukushima

International Nuclear Information System (INIS)

Vasconcelos, Vanderley de; Soares, Wellington Antonio; Costa, Antonio Carlos Lopes da

2015-01-01

Doubts of whether the risks related to severe accidents in nuclear reactors are indeed very low were raised after the nuclear accident at Fukushima Daiichi in 2011. Risk estimations of severe accidents in nuclear power plants involve both probability and consequence assessment of such events. Among the ways to display risks, risk curves are tools that express the frequency of exceeding a certain magnitude of consequence. Societal risk is often represented graphically in a FN-curve, a type of risk curve, which displays the probability of having N or more fatalities per year, as a function of N, on a double logarithmic scale. The FN-curve, originally introduced for the assessment of the risks in the nuclear industry through the U.S.NRC Reactor Safety Study WASH-1400 (1975), is used in various countries to express and limit risks of hazardous activities. This first study estimated an expected rate of core damage equal to 5x10 -5 by reactor-year and suggested an upper bound of 3x10 -4 by reactor-year. A more recent report issued by Electric Power Research Institute - EPRI (2008) estimates a figure of the order of 2x10 -5 by reactor-year. The Fukushima nuclear accident apparently implies that the observed core damage frequency is higher than that predicted by these probabilistic safety assessments. Therefore, this paper presents a preliminary analyses of the FN-curves related to severe nuclear reactor accidents, taking into account a combination of available data of past accidents, probability modelling to estimate frequencies, and expert judgments. (author)

FN-curves: preliminary estimation of severe accident risks after Fukushima

Energy Technology Data Exchange (ETDEWEB)

Vasconcelos, Vanderley de; Soares, Wellington Antonio; Costa, Antonio Carlos Lopes da, E-mail: vasconv@cdtn.br, E-mail: soaresw@cdtn.br, E-mail: aclc@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

2015-07-01

Doubts of whether the risks related to severe accidents in nuclear reactors are indeed very low were raised after the nuclear accident at Fukushima Daiichi in 2011. Risk estimations of severe accidents in nuclear power plants involve both probability and consequence assessment of such events. Among the ways to display risks, risk curves are tools that express the frequency of exceeding a certain magnitude of consequence. Societal risk is often represented graphically in a FN-curve, a type of risk curve, which displays the probability of having N or more fatalities per year, as a function of N, on a double logarithmic scale. The FN-curve, originally introduced for the assessment of the risks in the nuclear industry through the U.S.NRC Reactor Safety Study WASH-1400 (1975), is used in various countries to express and limit risks of hazardous activities. This first study estimated an expected rate of core damage equal to 5x10{sup -5} by reactor-year and suggested an upper bound of 3x10{sup -4} by reactor-year. A more recent report issued by Electric Power Research Institute - EPRI (2008) estimates a figure of the order of 2x10{sup -5} by reactor-year. The Fukushima nuclear accident apparently implies that the observed core damage frequency is higher than that predicted by these probabilistic safety assessments. Therefore, this paper presents a preliminary analyses of the FN-curves related to severe nuclear reactor accidents, taking into account a combination of available data of past accidents, probability modelling to estimate frequencies, and expert judgments. (author)

Reduced reward anticipation in youth at high-risk for unipolar depression: A preliminary study

Directory of Open Access Journals (Sweden)

Thomas M. Olino

2014-04-01

Full Text Available Offspring of depressed parents are at risk for depression and recent evidence suggests that reduced positive affect (PA may be a marker of risk. We investigated whether self-reports of PA and fMRI-measured striatal response to reward, a neural correlate of PA, are reduced in adolescent youth at high familial risk for depression (HR relative to youth at low familial risk for depression (LR. Functional magnetic resonance imaging assessments were conducted with 14 HR and 12 LR youth. All youth completed an ecological momentary assessment protocol to measure PA in natural settings and a self-report measure of depression symptomatology. Analyses found that HR youth demonstrated lower striatal response than LR youth during both reward anticipation and outcome. However, after controlling for youth self-reports of depression, HR youth demonstrated lower striatal response than LR youth only during reward anticipation. No significant differences were found between HR and LR youth on subjective ratings of PA or depressive symptoms. Results are consistent with previous findings that reduced reward response is a marker of risk for depression, particularly during reward anticipation, even in the absence of (or accounting for disrupted subjective mood. Further examinations of prospective associations between reward response and depression onset are needed.

Risk assessment methodology for Hanford high-level waste tanks

International Nuclear Information System (INIS)

Bott, T.F.; Mac Farlane, D.R.; Stack, D.W.; Kindinger, J.

1992-01-01

A methodology is presented for applying Probabilistic Safety Assessment techniques to quantification of the health risks posed by the high-level waste (HLW) underground tanks at the Department of Energy's Hanford reservation. This methodology includes hazard screening development of a list of potential accident initiators, systems fault trees development and quantification, definition of source terms for various release categories, and estimation of health consequences from the releases. Both airborne and liquid pathway releases to the environment, arising from aerosol and spill/leak releases from the tanks, are included in the release categories. The proposed methodology is intended to be applied to a representative subset of the total of 177 tanks, thereby providing a baseline risk profile for the HLW tank farm that can be used for setting clean-up/remediation priorities. Some preliminary results are presented for Tank 101-SY

A Brief Report: Lessons Learned and Preliminary Findings of Progreso en Salud, an HIV Risk Reduction Intervention for Latina Seasonal Farmworkers

Directory of Open Access Journals (Sweden)

Mariano Kanamori

2016-12-01

Full Text Available Throughout the past decade, HIV rates in Florida—particularly South Florida, where many Latina seasonal farmworkers reside and work—have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV prevention intervention Progreso en Salud (Progress in Health. Among the 114 Latina seasonal farmworker participants, there were significant increases from baseline to 6-month follow-up in the percentages of overall condom use, HIV testing, HIV/AIDS-related communications with friends, HIV knowledge, condom use self-efficacy, and correct use of condoms. Lessons learned from this study can be used to inform future HIV intervention strategies to improve the adoption and maintenance of HIV risk reduction behaviors among high-risk Latina seasonal workers and other high-risk underserved populations. Future research is needed to support our findings.

Reduced reward anticipation in youth at high-risk for unipolar depression: a preliminary study.

Science.gov (United States)

Olino, Thomas M; McMakin, Dana L; Morgan, Judith K; Silk, Jennifer S; Birmaher, Boris; Axelson, David A; Williamson, Douglas E; Dahl, Ronald E; Ryan, Neal D; Forbes, Erika E

2014-04-01

Offspring of depressed parents are at risk for depression and recent evidence suggests that reduced positive affect (PA) may be a marker of risk. We investigated whether self-reports of PA and fMRI-measured striatal response to reward, a neural correlate of PA, are reduced in adolescent youth at high familial risk for depression (HR) relative to youth at low familial risk for depression (LR). Functional magnetic resonance imaging assessments were conducted with 14 HR and 12 LR youth. All youth completed an ecological momentary assessment protocol to measure PA in natural settings and a self-report measure of depression symptomatology. Analyses found that HR youth demonstrated lower striatal response than LR youth during both reward anticipation and outcome. However, after controlling for youth self-reports of depression, HR youth demonstrated lower striatal response than LR youth only during reward anticipation. No significant differences were found between HR and LR youth on subjective ratings of PA or depressive symptoms. Results are consistent with previous findings that reduced reward response is a marker of risk for depression, particularly during reward anticipation, even in the absence of (or accounting for) disrupted subjective mood. Further examinations of prospective associations between reward response and depression onset are needed. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

A literature-based preliminary characterization of risks in the nuclear waste management system

International Nuclear Information System (INIS)

Daling, P.M.; Rhoads, R.E.; Van Luik, A.E.

1990-04-01

The objectives of this study were to (1) review the literature containing information on risks in the nuclear waste management system and (2) use this information to develop preliminary estimates of the potential magnitudes of these risks. Information was collected on a broad range of risk categories to assist the US Department of Energy (DOE) in communicating information about the risks in the waste management system. The study, which was completed prior to passage of the Nuclear Waste Policy Amendments Act of 1987, examined all of the portions of the nuclear waste management system envisioned by the DOE in the 1985 ''Mission Plant for the Civilian Radioactive Waste Management Program.'' As such, there may be statements in this paper that are not consistent with current DOE positions. The scope of this paper includes the repository, the integral Monitored Retrievable Storage (MRS) facility, and the transportation system that supports the repository and the MRS facility. Based on the results of this analysis, it is concluded that the radiological risks in the waste management system are small relative to nonradiological risks and relative to the risks of exposure to natural background radiation. 6 refs., 2 figs., 2 tabs

Preliminary Marine Safety Risk Assessment, Brandon Road Lock and Dam Invasive Species Control Measures

Science.gov (United States)

2016-12-01

Decision makers must include control-measure monitoring and emergency “interventions” to insure safety. The Coast Guard operational commanders...system” incorporates a travelling car on a rail above the barge-loading wharf to prevent loading personnel, cargo surveyors, or others from falling...to the Gulf of Mexico . As “Loopers”, they will have already transited the CSSC electric barriers. Preliminary Marine Safety Risk Assessment, BRLD

Favorable Preliminary Outcomes for Men With Low- and Intermediate-risk Prostate Cancer Treated With 19-Gy Single-fraction High-dose-rate Brachytherapy

Energy Technology Data Exchange (ETDEWEB)

Krauss, Daniel J., E-mail: dkrauss@beaumont.edu [Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Ye, Hong [Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Martinez, Alvaro A. [21st Century Oncology, Farmington Hills, Michigan (United States); Mitchell, Beth; Sebastian, Evelyn; Limbacher, Amy; Gustafson, Gary S. [Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

2017-01-01

Purpose: To report the toxicity and preliminary clinical outcomes of a prospective trial evaluating 19-Gy, single-fraction high-dose-rate (HDR) brachytherapy for men with low- and intermediate-risk prostate cancer. Methods and Materials: A total of 63 patients were treated according to an institutional review board-approved prospective study of single-fraction HDR brachytherapy. Eligible patients had tumor stage ≤T2a, prostate-specific antigen level ≤15 ng/mL, and Gleason score ≤7. Patients with a prostate gland volume >50 cm{sup 3} and baseline American Urologic Association symptom score >12 were ineligible. Patients underwent transrectal ultrasound-guided transperineal implantation of the prostate, followed by single-fraction HDR brachytherapy. Treatment was delivered using {sup 192}Ir to a dose of 19 Gy prescribed to the prostate, with no additional margin applied. Results: Of the 63 patients, 58 had data available for analysis. Five patients had withdrawn consent during the follow-up period. The median follow-up period was 2.9 years (range 0.3-5.2). The median age was 61.4 years. The median gland volume at treatment was 34.8 cm{sup 3}. Of the 58 patients, 91% had T1 disease, 71% had Gleason score ≤6 (29% with Gleason score 7), and the median pretreatment prostate-specific antigen level was 5.1 ng/mL. The acute and chronic grade 2 genitourinary toxicity incidence was 12.1% and 10.3%, respectively. No grade 3 urinary toxicity occurred. No patients experienced acute rectal toxicity grade ≥2, and 2 experienced grade ≥2 chronic gastrointestinal toxicity. Three patients experienced biochemical failure, yielding a 3-year cumulative incidence estimate of 6.8%. Conclusions: Single-fraction HDR brachytherapy is well-tolerated, with favorable preliminary biochemical and clinical disease control rates.

Toward a risk assessment of the spent fuel and high-level nuclear waste disposal system. Risk assessment requirements, literature review, methods evaluation: an interim report

Energy Technology Data Exchange (ETDEWEB)

Hamilton, L.D.; Hill, D.; Rowe, M.D.; Stern, E.

1986-04-01

This report provides background information for a risk assessment of the disposal system for spent nuclear fuel and high-level radioactive waste (HLW). It contains a literature review, a survey of the statutory requirements for risk assessment, and a preliminary evaluation of methods. The literature review outlines the state of knowledge of risk assessment and accident consequence analysis in the nuclear fuel cycle and its applicability to spent fuel and HLW disposal. The survey of statutory requirements determines the extent to which risk assessment may be needed in development of the waste-disposal system. The evaluation of methods reviews and evaluates merits and applicabilities of alternative methods for assessing risks and relates them to the problems of spent fuel and HLW disposal. 99 refs.

Toward a risk assessment of the spent fuel and high-level nuclear waste disposal system. Risk assessment requirements, literature review, methods evaluation: an interim report

International Nuclear Information System (INIS)

Hamilton, L.D.; Hill, D.; Rowe, M.D.; Stern, E.

1986-04-01

This report provides background information for a risk assessment of the disposal system for spent nuclear fuel and high-level radioactive waste (HLW). It contains a literature review, a survey of the statutory requirements for risk assessment, and a preliminary evaluation of methods. The literature review outlines the state of knowledge of risk assessment and accident consequence analysis in the nuclear fuel cycle and its applicability to spent fuel and HLW disposal. The survey of statutory requirements determines the extent to which risk assessment may be needed in development of the waste-disposal system. The evaluation of methods reviews and evaluates merits and applicabilities of alternative methods for assessing risks and relates them to the problems of spent fuel and HLW disposal. 99 refs

Preliminary Safeguards Assessment for the Pebble-Bed Fluoride High-Temperature Reactor (PB-FHR) Concept

Energy Technology Data Exchange (ETDEWEB)

Disser, Jay; Arthur, Edward; Lambert, Janine

2016-09-01

This report examines a preliminary design for a pebble bed fluoride salt-cooled high temperature reactor (PB-FHR) concept, assessing it from an international safeguards perspective. Safeguards features are defined, in a preliminary fashion, and suggestions are made for addressing further nuclear materials accountancy needs.

High-performance instruments in neutron arena of JHP. Preliminary version

International Nuclear Information System (INIS)

Furusaka, M.; Itoh, S.; Otomo, T.; Arai, M.

1996-05-01

This report is a preliminary report of high-performance instruments in neutron arena of JHP (Japan Hadron Project). This report consists of as follows; neutron intensity of neutron arena, development of neutron sources in neutron arena, experimental devices and instrumentation. (J.P.N.)

Development of a Preliminary Model for Evaluating Occupational Health and Safety Risk Management Maturity in Small and Medium-Sized Enterprises

Directory of Open Access Journals (Sweden)

Bilal Kaassis

2018-02-01

Full Text Available Management of occupational health and safety (OHS risks is a crucial component of any business. Numerous investigations have shown that work-related injuries and deaths occur disproportionately in small-to-medium-sized enterprises (SMEs and that this is clearly due to deficient management of OHS risks. The main goal of this work is to develop a base of indicators suitable for evaluating OHS risk management maturity in industrial SMEs. A preliminary model is then proposed for this evaluation, based on a small number of relevant indicators selected from a careful bibliographic review. The work begins with a critical review of the literature and analysis of known concepts, methods, tools and models of measurement of risk analysis maturity in order to extract relevant indicators. The most suitable indicators are then grouped to form the basis of a preliminary model for evaluating OHS risk management maturity in the SME setting. Our findings will help managers of SMEs make sound decisions in their quest to improve the OHS performance of their businesses.

Cost risk analysis of radioactive waste management Preliminary study

International Nuclear Information System (INIS)

Forsstroem, J.

2006-12-01

This work begins with exposition of the basics of risk analysis. These basics are then applied to the Finnish radioactive waste disposal environment in which the nuclear power companies are responsible for all costs of radioactive waste management including longterm disposal of spent fuel. Nuclear power companies prepare cost estimates of the waste disposal on a yearly basis to support the decision making on accumulation of resources to the nuclear waste disposal fund. These cost estimates are based on the cost level of the ongoing year. A Monte Carlo simulation model of the costs of the waste disposal system was defined and it was used to produce preliminary results of its cost risk characteristics. Input data was synthesised by modifying the original coefficients of cost uncertainty to define a cost range for each cost item. This is a suitable method for demonstrating results obtainable by the model but it is not accurate enough for supporting decision making. Two key areas of further development were identified: the input data preparation and identifying and handling of (i.e. eliminating or merging) interacting cost elements in the simulation model. Further development in both of the mentioned areas can be carried out by co-operating with the power companies as they are the sources of the original data. (orig.)

High-Risk List

Science.gov (United States)

2017-01-01

economy. The World Bank has said that “corruption creates an unfavorable business environment by undermining the operation efficiency of firms and... Bank Began as ‘Ponzi Scheme,’” 11/27/2012. 64 Independent Joint Anti-Corruption Monitoring and Evaluation Committee, Unfinished Business : The Follow...HIGH RISK AREA 7: Oversight 51 HIGH-RISK AREA 8: Strategy and Planning 55 CONCLUSION HIGH RISK LIST I JANUARY 11, 2017 2 EXECUTIVE SUMMARY

Preliminary Risk Assessment of the Southwestern Willow Flycatcher (Empidonax traillii extimus) at the Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Gallegos, A.F.; Gonzales, G.J.; Bennett, K.D.; Mullen, M.A.; Foxx, T.S.

1998-10-01

The southwestern willow flycatcher (Empidonax traillii extimus) is the fourth threatened or endangered species to undergo a preliminary assessment for estimating potential risk from environmental contaminants at the Los Alamos National Laboratory. The assessments are being conducted as part of a three-year project to develop a habitat management plan for threatened and endangered species and species of concern at the Laboratory. For the preliminary assessment, estimated doses were compared against toxicity reference values to generate hazard indices (HIs). This assessment included a measure of cumulative effects from multiple contaminants (radionuclides, metals, and organic chemicals) to 100 simulated nest sites located within flycatcher potential habitat. Sources of contaminant values were 10,000-ft{sup 2} grid cells within an Ecological Exposure Unit (EEU). This EEU was estimated around the potential habitat and was based on the maximum home range for the fly catcher identified in the scientific literature. The tools used included a custom FORTRAN program, ECORSK5, and a geographic information system. Food consumption and soil ingestion contaminant pathways were addressed in the assessment. Using a four-category risk evaluation, HI results indicate no appreciable impact is expected to the southwestern willow flycatcher. Information on risk by specific geographical location was generated, which can be used to manage contaminated areas, flycatcher habitat, facility siting, and/or facility operations in order to maintain low levels of risk from contaminants.

Preliminary Risk Assessment of the Southwestern Willow Flycatcher (Empidonax traillii extimus) at the Los Alamos National Laboratory

International Nuclear Information System (INIS)

Gallegos, A.F.; Gonzales, G.J.; Bennett, K.D.; Mullen, M.A.; Foxx, T.S.

1998-01-01

The southwestern willow flycatcher (Empidonax traillii extimus) is the fourth threatened or endangered species to undergo a preliminary assessment for estimating potential risk from environmental contaminants at the Los Alamos National Laboratory. The assessments are being conducted as part of a three-year project to develop a habitat management plan for threatened and endangered species and species of concern at the Laboratory. For the preliminary assessment, estimated doses were compared against toxicity reference values to generate hazard indices (HIs). This assessment included a measure of cumulative effects from multiple contaminants (radionuclides, metals, and organic chemicals) to 100 simulated nest sites located within flycatcher potential habitat. Sources of contaminant values were 10,000-ft 2 grid cells within an Ecological Exposure Unit (EEU). This EEU was estimated around the potential habitat and was based on the maximum home range for the fly catcher identified in the scientific literature. The tools used included a custom FORTRAN program, ECORSK5, and a geographic information system. Food consumption and soil ingestion contaminant pathways were addressed in the assessment. Using a four-category risk evaluation, HI results indicate no appreciable impact is expected to the southwestern willow flycatcher. Information on risk by specific geographical location was generated, which can be used to manage contaminated areas, flycatcher habitat, facility siting, and/or facility operations in order to maintain low levels of risk from contaminants

Sexting behaviors among young Hispanic women: incidence and association with other high-risk sexual behaviors.

Science.gov (United States)

Ferguson, Christopher J

2011-09-01

Several legal cases in the United States in which adolescents were charged with child pornography distribution after sharing nude photographs of themselves with romantic partners or others have highlighted the issue of sexting behaviors among youth. Although policy makers, mental health workers, educators and parents have all expressed concern regarding the potential harm of sexting behaviors, little to no research has examined this phenomenon empirically. The current study presents some preliminary data on the incidence of sexting behavior and associated high risk sexual behaviors in a sample of 207 predominantly Hispanic young women age 16-25. Approximately 20% of young women reported engaging in sexting behavior. Sexting behaviors were not associated with most other high-risk sexual behaviors, but were slightly more common in women who found sex to be highly pleasurable or who displayed histrionic personality traits.

Preliminary risk assessment of the Integral Inherently-Safe Light Water Reactor

International Nuclear Information System (INIS)

McCarroll, Kellen R.; Lee, John C.; Manera, Annalisa; Memmott, Matthew J.; Ferroni, Paolo

2017-01-01

The Integral, Inherently Safe Light Water Reactor (I 2 S-LWR) concept seeks to significantly increase nuclear power plant safety. The project implements a safety-by-design philosophy, eliminating several initiating events and providing novel, passive safety systems at the conceptual phase. Pursuit of unparalleled safety employs an integrated development process linking design with deterministic and probabilistic safety analyses. Unique aspects of the I 2 S-LWR concept and design process present challenges to the probabilistic risk assessment (PRA), particularly regarding overall flexibility, auditability and resolution of results. Useful approaches to initiating events and conditional failures are presented. To exemplify the risk-informed design process using PRA, a trade-off study of two safety system configurations is presented. Although further optimization is required, preliminary results indicate that the I 2 S-LWR can achieve a core damage frequency (CDF) from internal events less than 1.01 × 10 −8 /ry, including reactor vessel ruptures. Containment bypass frequency due to primary heat exchanger rupture is found to be comparable to non-vessel rupture CDF.

Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

International Nuclear Information System (INIS)

Hsieh, Chen-Hsi; Hsieh, Yen-Ping; Lin, Shoei Long; Chen, Chun-Yi; Chen, Chien-An; Shueng, Pei-Wei; Kuo, Ying-Shiung; Liao, Li-Jen; Hu, Kawang-Yu; Lin, Shih-Chiang; Wu, Le-Jung; Lin, Yu-Chin; Chen, Yu-Jen; Wang, Li-Ying

2011-01-01

The aim of this study was to assess the treatment results and toxicity profiles of helical tomotherapy (HT) for postoperative high-risk oral cavity cancer. From December 6, 2006 through October 9, 2009, 19 postoperative high-risk oral cavity cancer patients were enrolled. All of the patients received HT with (84%) or without (16%) chemotherapy. The median follow-up time was 17 months. The 2-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates were 94%, 84%, 92%, and 94%, respectively. The package of overall treatment time > 13 wk, the interval between surgery and radiation ≤ 6 wk, and the overall treatment time of radiation ≤ 7 wk was 21%, 84%, and 79%, respectively. The percentage of grade 3 mucositis, dermatitis, and leucopenia was 42%, 5% and 5%, respectively. HT achieved encouraging clinical outcomes for postoperative high-risk oral cavity cancer patients with high compliance. A long-term follow-up study is needed to confirm these preliminary findings

Preliminary High-Throughput Metagenome Assembly

Energy Technology Data Exchange (ETDEWEB)

Dusheyko, Serge; Furman, Craig; Pangilinan, Jasmyn; Shapiro, Harris; Tu, Hank

2007-03-26

Metagenome data sets present a qualitatively different assembly problem than traditional single-organism whole-genome shotgun (WGS) assembly. The unique aspects of such projects include the presence of a potentially large number of distinct organisms and their representation in the data set at widely different fractions. In addition, multiple closely related strains could be present, which would be difficult to assemble separately. Failure to take these issues into account can result in poor assemblies that either jumble together different strains or which fail to yield useful results. The DOE Joint Genome Institute has sequenced a number of metagenomic projects and plans to considerably increase this number in the coming year. As a result, the JGI has a need for high-throughput tools and techniques for handling metagenome projects. We present the techniques developed to handle metagenome assemblies in a high-throughput environment. This includes a streamlined assembly wrapper, based on the JGI?s in-house WGS assembler, Jazz. It also includes the selection of sensible defaults targeted for metagenome data sets, as well as quality control automation for cleaning up the raw results. While analysis is ongoing, we will discuss preliminary assessments of the quality of the assembly results (http://fames.jgi-psf.org).

Mom Power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers.

Science.gov (United States)

Muzik, Maria; Rosenblum, Katherine L; Alfafara, Emily A; Schuster, Melisa M; Miller, Nicole M; Waddell, Rachel M; Stanton Kohler, Emily

2015-06-01

Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child's early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age parenting competence, and engagement in treatment. Mothers were referred from community health providers for a phase 1 trial to assess feasibility, acceptability, and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty, and single parenthood. Ninety-nine mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post-self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and post-traumatic stress disorder (PTSD)), parenting, and intervention satisfaction. Results indicate that MP participation was associated with reduction in depression, PTSD, and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70 % of the 10 groups (completers; N = 68) improved on parenting and mental health outcomes, in contrast to non-completers (N = 12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Results indicate that MP is feasible, acceptable, and holds promise for improving maternal mental health and parenting competence among high-risk dyads. Further research is warranted to evaluate

Feasibility and early outcome of high-dose-rate Ir-192 brachytherapy as monotherapy in two fractions within 1 day for high-/very high-risk prostate cancer.

Science.gov (United States)

Ashida, Shingo; Yamasaki, Ichiro; Tamura, Kenji; Shimamoto, Tsutomu; Inoue, Keiji; Kariya, Shinji; Kobayashi, Kana; Yamagami, Takuji; Shuin, Taro

2016-05-01

The aim of the present study was to evaluate the feasibility and preliminary outcomes of high-dose-rate (HDR)-brachytherapy as a monotherapy in two fractions within 1 day for localized prostate cancer, including high-/very high-risk cases. Among the 68 patients treated with HDR monotherapy between July 2011 and December 2014, 65 had a minimal follow-up of 12 months without adjuvant androgen deprivation therapy and were enrolled in the present study [42/65 (64.6%) exhibited high-/very high-risk diseases]. HDR monotherapy was performed in two fractions with a minimal interval of 6 h and the prescribed dose was 13.5 Gy (×2). Adverse events (AEs) were assessed using Common Terminology Criteria for Adverse Events (version 4; http://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm#ctc_40), and biochemical failure was assessed by the Phoenix definition. The median follow-up time was 30.1 months. The majority of patients had Grade 0-1 acute AEs. Four patients (6.2%) exhibited urinary retention, requiring a Foley catheter. Grade 3 acute AEs occurred at a frequency of 3.1% and hematuria at 1.5%. The majority of patients also exhibited Grade 0-1 chronic AEs. Grade 3 chronic AEs occurred at a frequency of 1.5% and urethral stricture at 1.5%, for which endoscopic treatment was indicated. Acute and chronic gastrointestinal AEs were uncommon, and no Grade 3 or above AEs developed. Biochemical failure occurred in 4 patients who all exhibited high-/very high-risk diseases. Kaplan-Meier estimated that 3 year biochemical failure-free survival was 91.6% overall and 88.0% in high-/very high-risk cases. The present two-fraction 1 day HDR monotherapy is feasible with minimal AEs and achieved acceptable biochemical control of localized prostate cancer, including high-/very high-risk cases, although long-term follow-up is required.

Shallow-land burial of low-level radioactive wastes: preliminary simulations of long-term health risks

International Nuclear Information System (INIS)

Fields, D.E.; Little, C.A.; Emerson, C.J.; Hiromoto, G.

1982-01-01

PRESTO, a computer code developed for the Environmental Protection Agency for the evaluation of possible health effects associated with shallow-land rad-waste burial areas, has been used to perform simulations for three such sites. Preliminary results for the 1000 y period following site closure suggest that shallow burial, at properly chosen sites, is indeed an appropriate disposal practice for low-level wastes. Periods of maximum risk to subject populations are also inferred

Preliminary risk analysis applied to the handling of health-care waste

Directory of Open Access Journals (Sweden)

Carvalho S.M.L.

2002-01-01

Full Text Available Between 75% and 90% of the waste produced by health-care providers no risk or is "general" health-care waste, comparable to domestic waste. The remaining 10-25% of health-care waste is regarded as hazardous due to one or more of the following characteristics: it may contain infectious agents, sharps, toxic or hazardous chemicals or it may be radioactive. Infectious health-care waste, particularly sharps, has been responsible for most of the accidents reported in the literature. In this work the preliminary risks analysis (PRA technique was used to evaluate practices in the handling of infectious health-care waste. Currently the PRA technique is being used to identify and to evaluate the potential for hazard of the activities, products, and services from facilities and industries. The system studied was a health-care establishment which has handling practices for infectious waste. Thirty-six procedures related to segregation, containment, internal collection, and storage operation were analyzed. The severity of the consequences of the failure (risk that can occur from careless management of infectious health-care waste was classified into four categories: negligible, marginal, critical, and catastrophic. The results obtained in this study showed that events with critics consequences, about 80%, may occur during the implementation of the containment operation, suggesting the need to prioritize this operation. As a result of the methodology applied in this work, a flowchart the risk series was also obtained. In the flowchart the events that can occur as a consequence of a improper handling of infectious health-care waste, which can cause critical risks such as injuries from sharps and contamination (infection from pathogenic microorganisms, are shown.

Methodology and a preliminary data base for examining the health risks of electricity generation from uranium and coal fuels

Energy Technology Data Exchange (ETDEWEB)

El-Bassioni, A.A.

1980-08-01

An analytical model was developed to assess and examine the health effects associated with the production of electricity from uranium and coal fuels. The model is based on a systematic methodology that is both simple and easy to check, and provides details about the various components of health risk. A preliminary set of data that is needed to calculate the health risks was gathered, normalized to the model facilities, and presented in a concise manner. Additional data will become available as a result of other evaluations of both fuel cycles, and they should be included in the data base. An iterative approach involving only a few steps is recommended for validating the model. After each validation step, the model is improved in the areas where new information or increased interest justifies such upgrading. Sensitivity analysis is proposed as the best method of using the model to its full potential. Detailed quantification of the risks associated with the two fuel cycles is not presented in this report. The evaluation of risks from producing electricity by these two methods can be completed only after several steps that address difficult social and technical questions. Preliminary quantitative assessment showed that several factors not considered in detail in previous studies are potentially important. 255 refs., 21 figs., 179 tabs.

Cognitive outcomes in elderly high-risk patients after off-pump versus conventional coronary artery bypass grafting

DEFF Research Database (Denmark)

Jensen, Birte Ostergaard; Hughes, Pia; Rasmussen, Lars S

2006-01-01

It has been suggested that the risk of cerebral dysfunction is less with off-pump coronary artery bypass grafting (OPCAB) than with conventional coronary artery bypass grafting (CCAB). However, evidence for this statement is preliminary, and additional insight is needed.......It has been suggested that the risk of cerebral dysfunction is less with off-pump coronary artery bypass grafting (OPCAB) than with conventional coronary artery bypass grafting (CCAB). However, evidence for this statement is preliminary, and additional insight is needed....

Risk-informed analysis as a support to the preliminary design of the CEA GFR2400

International Nuclear Information System (INIS)

Bertrand, F.; Bassi, C.; Azria, P.; Bentivoglio, F.; Messie, A.; Balmain, M.

2012-01-01

The integration of safety issues in the early phase of the design of a 4. generation reactor of the concepts is expected. For this purpose, probabilistic insights are increasingly employed in the safety demonstration in combination with the deterministic approach in the frame of a so-called risk informed approach. The present paper deals with the safety assessment of the preliminary design of the GFR2400 developed by CEA and how it has been improved in order to fulfil deterministic criteria as well as to reach a risk level comparable to the generation III reactors. GFR2400 is a 2400 MWth, 3-loops, helium-cooled fast reactor developed at a pre-conceptual design stage whose secondary circuit is filled with a mixture of helium and nitrogen, the ternary circuit being filled with water vaporized in 3 steam generators according to a classical Rankine cycle. The resulting cycle efficiency is very close to 45 %. Considering the results obtained with a preliminary level 1 PSA (L1PSA) model, it emerged that an increased reliability of the DHR (Decay Heat Removal) function in high pressure conditions (not corresponding to a LOCA) was suitable to reduce the overall core damage frequency. On the other hand, some small break LOCA situations were not adequately mitigated according to the line of protection deterministic method. Both issues have been solved by design improvements. In addition, this final L1PSA model, characterized by success criteria based on transient calculations performed with the CATHARE2 code and performed in a perimeter extended to all representative internal initiating events at full operating power, permitted to propose design evolutions that did not increase significantly the CDF. In the same time, those evolutions enabled the DHR system to increase its redundancy level as required in the deterministic approach. Finally, a modified design has been reached implying a more extended covering of various accidental situations by means of a progressive DHR

Are MAO-A deficiency states in the general population and in putative high-risk populations highly uncommon?

Science.gov (United States)

Murphy, D L; Sims, K; Eisenhofer, G; Greenberg, B D; George, T; Berlin, F; Zametkin, A; Ernst, M; Breakefield, X O

1998-01-01

Lack of monoamine oxidase A (MAO-A) due to either Xp chromosomal deletions or alterations in the coding sequence of the gene for this enzyme are associated with marked changes in monoamine metabolism and appear to be associated with variable cognitive deficits and behavioral changes in humans and in transgenic mice. In mice, some of the most marked behavioral changes are ameliorated by pharmacologically-induced reductions in serotonin synthesis during early development, raising the question of possible therapeutic interventions in humans with MAO deficiency states. At the present time, only one multi-generational family and a few other individuals with marked MAO-A deficiency states have been identified and studied in detail. Although MAO deficiency states associated with Xp chromosomal deletions were identified by distinct symptoms (including blindness in infancy) produced by the contiguous Norrie disease gene, the primarily behavioral phenotype of individuals with the MAO mutation is less obvious. This paper reports a sequential research design and preliminary results from screening several hundred volunteers in the general population and from putative high-risk groups for possible MAO deficiency states. These preliminary results suggest that marked MAO deficiency states are very rare.

The attitude of risk taking Islamic junior high school (MTs) students in learning mathematics

Science.gov (United States)

Yuni, Y.; Darhim; Turmudi

2018-05-01

This study aims to determine the risk-taking attitude of students at Islamic Junior High School (MTs) in Bekasi towards learning mathematics. This is a preliminary research to get information about risk taking attitude in order to conduct next research. Data are obtained by providing questionnaires of 20 indicators, which includes be careful in act, having peace of mind, resolute in making decisions and confident in the act. Respondents are as many as 97 students of 7th grade students of MTs and taken with random techniques from two MTs in the city of Bekasi. The research instrument was adopted from DOSPERT developed, adapted to the ability of 7th grade students of MTs. The attitude of risk taking is part of the student's responsibility attitude to the learning of mathematics, either during preparation, process or after learning mathematics. The attitude of risk taking is important to know in order to be trained continuously. Because the trained attitude of risk taking will make students succeed in learning and working later.

Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

Directory of Open Access Journals (Sweden)

Chen Yu-Jen

2011-01-01

Full Text Available Abstract Background The aim of this study was to assess the treatment results and toxicity profiles of helical tomotherapy (HT for postoperative high-risk oral cavity cancer. Methods From December 6, 2006 through October 9, 2009, 19 postoperative high-risk oral cavity cancer patients were enrolled. All of the patients received HT with (84% or without (16% chemotherapy. Results The median follow-up time was 17 months. The 2-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates were 94%, 84%, 92%, and 94%, respectively. The package of overall treatment time > 13 wk, the interval between surgery and radiation ≤ 6 wk, and the overall treatment time of radiation ≤ 7 wk was 21%, 84%, and 79%, respectively. The percentage of grade 3 mucositis, dermatitis, and leucopenia was 42%, 5% and 5%, respectively. Conclusions HT achieved encouraging clinical outcomes for postoperative high-risk oral cavity cancer patients with high compliance. A long-term follow-up study is needed to confirm these preliminary findings.

Preliminary Hazard Analysis applied to Uranium Hexafluoride - UF6 production plant

International Nuclear Information System (INIS)

Tomzhinsky, David; Bichmacher, Ricardo; Braganca Junior, Alvaro; Peixoto, Orpet Jose

1996-01-01

The purpose of this paper is to present the results of the Preliminary hazard Analysis applied to the UF 6 Production Process, which is part of the UF 6 Conversion Plant. The Conversion Plant has designed to produce a high purified UF 6 in accordance with the nuclear grade standards. This Preliminary Hazard Analysis is the first step in the Risk Management Studies, which are under current development. The analysis evaluated the impact originated from the production process in the plant operators, members of public, equipment, systems and installations as well as the environment. (author)

Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

Directory of Open Access Journals (Sweden)

Vinayak Muralidhar

2016-02-01

Full Text Available Purpose : Recent retrospective data suggest that brachytherapy (BT boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA 20 ng/ml. Material and methods: We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results : EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258, and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270. Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022. Conclusions : Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease.

Hanford Waste Vitrification Project Building limited scope risk assessment

International Nuclear Information System (INIS)

Braun, D.J.; Lindberg, S.E.; Reardon, M.F.; Wilson, G.P.

1992-10-01

A limited scope risk assessment was performed on the preliminary design of a high-level waste interim storage facility. The Canister Storage Building (CSB) facility will be built to support remediation at the US Department of Energy Hanford Site in Washington State. The CSB will be part of the support facilities for a high level Hanford Waste Vitrification Plant (HWVP). The limited scope risk assessment is based on a preliminary design which uses forced air circulation systems to move air through the building vault. The current building design calls for natural circulation to move air through the building vault

Thrombocytopenia in Moderate- to High-Risk Sutureless Aortic Valve Replacement

Directory of Open Access Journals (Sweden)

Puwadon Thitivaraporn

2018-06-01

Full Text Available Background : This study aimed to compare preliminary data on the outcomes of sutureless aortic valve replacement (SU-AVR with those of aortic valve replacement (AVR. Methods : We conducted a retrospective study of SU-AVR in moderate- to high-risk patients from 2013 to 2016. Matching was performed at a 1:1 ratio using the Society of Thoracic Surgeons predicted risk of mortality score with sex and age. The primary outcome was 30-day mortality. The secondary outcomes were operative outcomes and complications. Results : A total of 277 patients were studied. Ten patients (50% males; median age, 81.5 years underwent SU-AVR. Postoperative echocardiography showed impressive outcomes in the SU-AVR group. The 30-day mortality was 10% in both groups. In our study, the patients in the SU-AVR group developed postoperative thrombocytopenia. Platelet counts decreased from 225X103 /μL preoperatively to 94.5, 54.5, and 50.1X10 3/μL on postoperative days 1, 2, and 3, respectively, showing significant differences compared with the AVR group (p=0.04, p=0.16, and p=0.20, respectively. The median amount of platelet transfusion was higher in the AVR group (12.5 vs. 0 units, p=0.052. Conclusion : There was no difference in the 30-day mortality of moderate- to high-risk patients depending on whether they underwent SU-AVR or AVR. Although SU-AVR is associated with favorable cardiopulmonary bypass and cross-clamp times, it may be associated with postoperative thrombocytopenia.

Not all risks are equal: the risk taking inventory for high-risk sports.

Science.gov (United States)

Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

2013-10-01

Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

Quantitative assessment of the microbial risk of leafy greens from farm to consumption: preliminary framework, data, and risk estimates.

Science.gov (United States)

Danyluk, Michelle D; Schaffner, Donald W

2011-05-01

This project was undertaken to relate what is known about the behavior of Escherichia coli O157:H7 under laboratory conditions and integrate this information to what is known regarding the 2006 E. coli O157:H7 spinach outbreak in the context of a quantitative microbial risk assessment. The risk model explicitly assumes that all contamination arises from exposure in the field. Extracted data, models, and user inputs were entered into an Excel spreadsheet, and the modeling software @RISK was used to perform Monte Carlo simulations. The model predicts that cut leafy greens that are temperature abused will support the growth of E. coli O157:H7, and populations of the organism may increase by as much a 1 log CFU/day under optimal temperature conditions. When the risk model used a starting level of -1 log CFU/g, with 0.1% of incoming servings contaminated, the predicted numbers of cells per serving were within the range of best available estimates of pathogen levels during the outbreak. The model predicts that levels in the field of -1 log CFU/g and 0.1% prevalence could have resulted in an outbreak approximately the size of the 2006 E. coli O157:H7 outbreak. This quantitative microbial risk assessment model represents a preliminary framework that identifies available data and provides initial risk estimates for pathogenic E. coli in leafy greens. Data gaps include retail storage times, correlations between storage time and temperature, determining the importance of E. coli O157:H7 in leafy greens lag time models, and validation of the importance of cross-contamination during the washing process.

Olive oil-diet improves the simvastatin effects with respect to sunflower oil-diet in men with increased cardiovascular risk: a preliminary study.

Science.gov (United States)

Sánchez-Muniz, F J; Bastida, S; Gutiérrez-García, O; Carbajal, A

2009-01-01

Concomitant intake of statins together with certain foods may affect their therapeutic effects. The purpose of this preliminary study was to determine the modulating effect of two culinary oils on the hypolipemic effect of statins. Twenty-five men with severe hypercholesterolemia and high estimate cardiovascular risk (> 20% according to the Adult Treatment Panel III of USA National Institutes of Health, ATP-III) were enrolled in an observational follow-up study to test lipoprotein profile changes after ix month 20-mg/d Simvastatin treatment. Thirteen volunteers using sunflower oil as the habitual culinary fat, and 12 using olive oil, were selected by non-probabilistic incidental sampling. Volunteers consent in follow their habitual diets and to maintain diet characteristics throughout the study. Diet was evaluated through the study by three 24-h recalls and a food frequency questionnaire. The energy contribution of fat (P = 0.019) and MUFA (P alcohol (P = 0.005) was higher in the sunflower oil-group. TC/HDL-cholesterol and the ATP-III 10-year risk percent decreased more (P alcohol intakes were adjusted. Data suggest that although Simvastatin is a very effective hypolipemic drug, olive oil-diets in preference to sunflower oil-diets must be consumed in patients with high cardiovascular risk.

Preliminary microstructural examination of high and low ductility type 316 creep rupture specimens

International Nuclear Information System (INIS)

Bolton, C.J.; Cordwell, J.E.; Hooper, A.J.; Marshall, P.; Steeds, J.; Wickens, A.

1977-09-01

A preliminary report is presented dealing with the examination of creep specimens from five casts of AISI Type 316 stainless steel which ruptured with variable ductility. Specimen microstructures and attempts to identify factors responsible for high or low creep ductility are discussed. (author)

A preliminary spatial assessment of risk: Marine birds and chronic oil pollution on Canada's Pacific coast.

Science.gov (United States)

Fox, C H; O'Hara, P D; Bertazzon, S; Morgan, K; Underwood, F E; Paquet, P C

2016-12-15

Chronic oil pollution poses substantial risks to marine birds and other marine wildlife worldwide. On Canada's Pacific coast, the negative ecological consequences to marine birds and marine ecosystems in general remain poorly understood. Using information relating to oil spill probability of occurrence, areas of overall importance to marine birds, and the at-sea distribution and density of 12 marine bird species and seven bird groups, including multiple Species at Risk, we undertook a spatial assessment of risk. Our results identify two main areas important to marine birds potentially at higher risk of exposure to oil. For individual bird species or species groups, those predicted to have elevated bird densities near the mainland and the northeast coast of Vancouver Island were identified as being at higher potential risk of exposure. Our results, however, should be considered preliminary. As with other anthropogenic stressors, in order to better understand and subsequently mitigate the consequences of chronic oil pollution on marine birds, improved information relating to marine birds and the occurrence of oil spills on Canada's Pacific coast is needed. Copyright © 2016 Elsevier B.V. All rights reserved.

Preliminary stop of the TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia (TOPIC) trial

NARCIS (Netherlands)

Koeneman, M. M.; Kruse, Arnold-Jan; Kooreman, L. F. S.; zur Hausen, Axel; Hopman, Anton H N; Sep, S. J. S.; Van Gorp, T.; Slangen, B. F. M.; van Beekhuizen, H. J.; de Sande, Michiel A. J. van; Gerestein, Cornelis G.; Nijman, H. W.; Kruitwagen, R. F. M. P.

2017-01-01

The "TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia" (TOPIC) trial was stopped preliminary, due to lagging inclusions. This study aimed to evaluate the treatment efficacy and clinical applicability of imiquimod 5% cream in high-grade cervical intraepithelial neoplasia

High Center Volume Does Not Mitigate Risk Associated with Using High Donor Risk Organs in Liver Transplantation.

Science.gov (United States)

Beal, Eliza W; Black, Sylvester M; Mumtaz, Khalid; Hayes, Don; El-Hinnawi, Ashraf; Washburn, Kenneth; Tumin, Dmitry

2017-09-01

High-risk donor allografts increase access to liver transplant, but potentially reduce patient and graft survival. It is unclear whether the risk associated with using marginal donor livers is mitigated by increasing center experience. The United Network for Organ Sharing registry was queried for adult first-time liver transplant recipients between 2/2002 and 12/2015. High donor risk was defined as donor risk index >1.9, and 1-year patient and graft survival were compared according to donor risk index in small and large centers. Multivariable Cox regression estimated the hazard ratio (HR) associated with using high-risk donor organs, according to a continuous measure of annual center volume. The analysis included 51,770 patients. In 67 small and 67 large centers, high donor risk index predicted increased mortality (p = 0.001). In multivariable analysis, high-donor risk index allografts predicted greater mortality hazard at centers performing 20 liver transplants per year (HR 1.35; 95% CI 1.22, 1.49; p donor risk index and center volume was not statistically significant (p = 0.747), confirming that the risk associated with using marginal donor livers was comparable between smaller and larger centers. Results were consistent when examining graft loss. At both small and large centers, high-risk donor allografts were associated with reduced patient and graft survival after liver transplant. Specific strategies to mitigate the risk of liver transplant involving high-risk donors are needed, in addition to accumulation of center expertise.

Evaluation of high pressure Freon decontamination. I. Preliminary tests

International Nuclear Information System (INIS)

Rankin, W.N.

1983-01-01

High-pressure Freon blasting techniques are being evaluated for applications involving the removal of non-adherent radioactive particulate contamination at SRP. Very little waste is generated by this technique because the used Freon can be easily distilled and reused. One of the principle advantages of this technique is that decontaminated electrical equipment can be returned to service immediately without drying, unlike high-pressure water blasting techniques. Preliminary scoutin tests evaluating high-pressure Freon blasting for decontamination at SRP were carried out at Quadrex Co., Oak Ridge, TN, October 12 and 13. DWPF-type contamination (raw sludge plus volatiles) and separations area-type contamination (diluted boiling point (47.6 0 C) allow it to rapidly separate from higher boiling contaminants via distillation with filtration to remove particulate material, and distillation with condensation, the solvent may be recovered for indefinite reuse while reducing the radioactive waste to a minimum. 3 references, 5 figures, 6 tables

A preliminary analysis of the risk of transporting nuclear waste to potential candidate commercial repository sites

International Nuclear Information System (INIS)

Madsen, M.M.

1984-01-01

In accordance with the provisions of the Nuclear Waste Policy Act of 1982, environmental assessments for potential candidate sites are required to provide a basis for selection of the first site for disposal of commercial radioactive waste in deep geologic repositories. A preliminary analysis of the impacts of transportation for each of the five potential sites will be described. Transportation was assumed to be entirely by truck or entirely by rail in order to obtain bounding impacts. This paper presents both radiological and nonradiological risks for the once-through fuel cycle

A metasynthesis of risk perception in women with high risk pregnancies.

Science.gov (United States)

Lee, Suzanne; Ayers, Susan; Holden, Des

2014-04-01

risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies. a systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that reported qualitative research into risk perception in relation to high risk pregnancy. A metasynthesis was developed to describe and interpret the studies. the synthesis resulted in the identification of five themes: determinants of risk perception; not seeing it the way others do; normality versus risk; if the infant is ok, I׳m ok; managing risk. this metasynthesis suggests women at high risk during pregnancy use multiple sources of information to determine their risk status. It shows women are aware of the risks posed by their pregnancies but do not perceive risk in the same way as healthcare professionals. They will take steps to ensure the health of themselves and their infants but these may not include following all medical recommendations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Preliminary analysis of the cost and risk of transporting nuclear waste to potential candidate commercial repository sites

International Nuclear Information System (INIS)

Wilmot, E.L.; Madsen, M.M.; Cashwell, J.W.; Joy, D.S.

1983-06-01

This report documents preliminary cost and risk analyses that were performed in support of the Nuclear Waste Terminal Storage (NWTS) program. The analyses compare the costs and hazards of transporting wastes to each of five regions that contain potential candidate nuclear waste repository sites being considered by the NWTS program. These regions are: the Gulf Interior Region, the Permian Basin, the Paradox Basin, Yucca Mountain, and Hanford. Two fuel-cycle scenarios were analyzed: once-through and reprocessing. Transportation was assumed to be either entirely by truck or entirely by rail for each of the scenarios. The results from the risk analyses include those attributable to nonradiological causes and those attributable to the radioactive character of the wastes being transported. 17 references

[Detecting high risk pregnancy].

Science.gov (United States)

Doret, Muriel; Gaucherand, Pascal

2009-12-20

Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

C-Band Airport Surface Communications System Engineering-Initial High-Level Safety Risk Assessment and Mitigation

Science.gov (United States)

Zelkin, Natalie; Henriksen, Stephen

2011-01-01

This document is being provided as part of ITT's NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract: "New ATM Requirements--Future Communications, C-Band and L-Band Communications Standard Development." ITT has completed a safety hazard analysis providing a preliminary safety assessment for the proposed C-band (5091- to 5150-MHz) airport surface communication system. The assessment was performed following the guidelines outlined in the Federal Aviation Administration Safety Risk Management Guidance for System Acquisitions document. The safety analysis did not identify any hazards with an unacceptable risk, though a number of hazards with a medium risk were documented. This effort represents an initial high-level safety hazard analysis and notes the triggers for risk reassessment. A detailed safety hazards analysis is recommended as a follow-on activity to assess particular components of the C-band communication system after the profile is finalized and system rollout timing is determined. A security risk assessment has been performed by NASA as a parallel activity. While safety analysis is concerned with a prevention of accidental errors and failures, the security threat analysis focuses on deliberate attacks. Both processes identify the events that affect operation of the system; and from a safety perspective the security threats may present safety risks.

Preliminary consideration for research on geological disposal of high-level radioactive waste in China in the period of 2000-2040

International Nuclear Information System (INIS)

Xu Guoqing

2004-01-01

Based on the overseas practical experiences with combination of domestic realistic conditions a preliminary consideration of a long-range plan is proposed for research on geological disposal of high-level radioactive waste in China in the period of 2000-2040. An overview of research on geological disposal of high-level radioactive waste in the overseas and mainland is presented shortly first in this paper. Then the discussion is centered on the preliminary consideration of a long-range plan for research on geological disposal of high-level radioactive waste in China. The partition of stages of research on geological disposal of high-level radioactive waste, the goal, task, research contents and time table for each research stage is stated in this preliminary consideration. The data mentioned above will probably be useful for making plan for geological disposal of high-level radioactive waste in the future in China. (author)

Risk perception in women with high-risk pregnancies

OpenAIRE

Lee, S.

2014-01-01

Risk perception in women with high risk pregnancies affects the decisions they make about antenatal care and so may therefore influence the wellbeing of mother and baby. This article addresses the factors which influence women when making risk assessments and how these assessments may differ from those of healthcare professionals.\\ud \\ud Women use multiple sources of information to determine their risk status including advice from professionals, from other trusted sources, and their own intui...

Prediction on fracture risk of femur with Osteogenesis Imperfecta using finite element models: Preliminary study

Science.gov (United States)

Wanna, S. B. C.; Basaruddin, K. S.; Mat Som, M. H.; Mohamad Hashim, M. S.; Daud, R.; Majid, M. S. Abdul; Sulaiman, A. R.

2017-10-01

Osteogenesis imperfecta (OI) is a genetic disease which affecting the bone geometry. In a severe case, this disease can cause death to patients. The main issue of this disease is the prediction on bone fracture by the orthopaedic surgeons. The resistance of the bone to withstand the force before the bones fracture often become the main concern. Therefore, the objective of the present preliminary study was to investigate the fracture risk associated with OI bone, particularly in femur, when subjected to the self-weight. Finite element (FEA) was employed to reconstruct the OI bone model and analyse the mechanical stress response of femur before it fractures. Ten deformed models with different severity of OI bones were developed and the force that represents patient self-weight was applied to the reconstructed models in static analysis. Stress and fracture risk were observed and analysed throughout the simulation. None of the deformed model were observed experienced fracture. The fracture risk increased with increased severity of the deformed bone. The results showed that all deformed femur models were able to bear the force without experienced fracture when subjected to only the self-weight.

ERCC2 2251A>C genetic polymorphism was highly correlated with early relapse in high-risk stage II and stage III colorectal cancer patients: A preliminary study

Directory of Open Access Journals (Sweden)

Lee Su-Chen

2008-02-01

Full Text Available Abstract Background Early relapse in colorectal cancer (CRC patients is attributed mainly to the higher malignant entity (such as an unfavorable genotype, deeper tumor invasion, lymph node metastasis and advance cancer stage and poor response to chemotherapy. Several investigations have demonstrated that genetic polymorphisms in drug-targeted genes, metabolizing enzymes, and DNA-repairing enzymes are all strongly correlated with inter-individual differences in the efficacy and toxicity of many treatment regimens. This preliminary study attempts to identify the correlation between genetic polymorphisms and clinicopathological features of CRC, and evaluates the relationship between genetic polymorphisms and chemotherapeutic susceptibility of Taiwanese CRC patients. To our knowledge, this study discusses, for the first time, early cancer relapse and its indication by multiple genes. Methods Six gene polymorphisms functional in drug-metabolism – GSTP1 Ile105Val, ABCB1 Ile1145Ile, MTHFR Ala222Val, TYMS double (2R or triple (3R tandem repeat – and DNA-repair genes – ERCC2 Lys751Gln and XRCC1 Arg399Gln – were assessed in 201 CRC patients using a polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP technique and DNA sequencing. Patients were diagnosed as either high-risk stage II (T2 and 3 N0 M0 or III (any T N1 and 2 M0 and were administered adjuvant chemotherapy regimens that included 5-fluorouracil (5FU and leucovorin (LV. The correlations between genetic polymorphisms and patient clinicopathological features and relapses were investigated. Results In this study, the distributions of GSTP1 (P = 0.003, ABCB1 (P = 0.001, TYMS (P ERCC2 (P XRCC1 (P = 0.006 genotypes in the Asian population, with the exception of MTHFR (P = 0.081, differed significantly from their distributions in a Caucasian population. However, the unfavorable genotype ERCC2 2251A>C (P = 0.006, tumor invasion depth (P = 0.025, lymph node metastasis (P = 0

Improving Phonological Awareness in Parents of Children at Risk of Literacy Difficulties: A Preliminary Evaluation of the Boost Program

OpenAIRE

Boyes, Mark E.; Leitão, Suze; Claessen, Mary; Dzidic, Peta; Boyle, Gemma; Perry, Alison; Nayton, Mandy

2017-01-01

Background Phonological awareness is an important skill underpinning the development of early literacy. Given the central role of parents in supporting the development of children’s early literacy skills, and that poor parental phonological awareness is associated with poorer child literacy outcomes, it is possible that improving parent phonological awareness may aid literacy development for at-risk children. This study is a preliminary evaluation of a program aiming to improve phonologica...

Preliminary Guideline for the High Temperature Structure Integrity Assessment Procedure Part II. High Temperature Structural Integrity Assessment

Energy Technology Data Exchange (ETDEWEB)

Lee, Jae Han; Kim, J. B.; Lee, H. Y.; Park, C. G.; Joo, Y. S.; Koo, G. H.; Kim, S. H

2007-02-15

A high temperature structural integrity assessment belongs to the Part II of a whole preliminary guideline for the high temperature structure. The main contents of this guideline are the evaluation procedures of the creep-fatigue crack initiation and growth in high temperature condition, the high temperature LBB evaluation procedure, and the inelastic evaluations of the welded joints in SFR structures. The methodologies for the proper inelastic analysis of an SFR structures in high temperatures are explained and the guidelines of inelastic analysis options using ANSYS and ABAQUS are suggested. In addition, user guidelines for the developed NONSTA code are included. This guidelines need to be continuously revised to improve the applicability to the design and analysis of the SFR structures.

Anticoagulation and high dose liver radiation. A preliminary report

International Nuclear Information System (INIS)

Lightdale, C.J.; Wasser, J.; Coleman, M.; Brower, M.; Tefft, M.; Pasmantier, M.

1979-01-01

Two groups of patients were observed for evidence of acute radiation hepatitis during high dose radiation to the liver. The first group of 18 patients with metastatic liver disease received an average of 4,050 rad to the whole liver. Half received anticoagulation with warfarin. One patient on anticoagulation developed evidence of acute radiation hepatitis while 2 patients did so without anticoagulation. Eleven patients with Hodgkin's disease received 4,000 rad to the left lobe of the liver during extended field radiation. Four of these 11 patients were anticoagulated to therapeutic range. Only one of the fully anticoagulated patients showed changes on liver scan consistent with radiation hepatitis whereas three did so without anticoagulation. No serious sequelae from anticoagulation occurred in either group. These preliminary data suggest that anticoagulation may be safely administered with high dose hepatic radiation and that further trials with anticoagulation are warranted

High-intensity focused ultrasound treatment of placenta accreta after vaginal delivery: a preliminary study.

Science.gov (United States)

Bai, Y; Luo, X; Li, Q; Yin, N; Fu, X; Zhang, H; Qi, H

2016-04-01

To evaluate the safety and efficiency of high-intensity focused ultrasound (HIFU) in the treatment of placenta accreta after vaginal delivery. Enrolled into this study between September 2011 and September 2013 were 12 patients who had been diagnosed with placenta accreta following vaginal delivery and who had stable vital signs. All patients were treated using an ultrasound-guided HIFU treatment system. As indication of the effectiveness of the treatment we considered decreased vascular index on color Doppler imaging, decrease in size of residual placenta compared with pretreatment size on assessment by three-dimensional ultrasound with Virtual Organ Computer-aided Analysis, reduced signal intensity and degree of enhancement on magnetic resonance imaging and avoidance of hysterectomy following treatment. To assess the safety of HIFU treatment, we recorded side effects, hemorrhage, infection, sex steroid levels, return of menses and subsequent pregnancy. Patients were followed up in this preliminary study until December 2013. The 12 patients receiving HIFU treatment had an average postpartum hospital stay of 6.8 days and an average period of residual placental involution of 36.9 days. HIFU treatment did not apparently increase the risk of infection or hemorrhage and no patient required hysterectomy. In all patients menstruation recommenced after an average of 80.2 days, and sex steroid levels during the middle luteal phase of the second menstrual cycle were normal. Two patients became pregnant again during the follow-up period. This preliminary study suggests that ultrasound-guided HIFU is a safe and effective non-invasive method to treat placenta accreta patients after vaginal delivery who have stable vital signs and desire to preserve fertility. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Preliminary estimates of cost savings for defense high level waste vitrification options

International Nuclear Information System (INIS)

Merrill, R.A.; Chapman, C.C.

1993-09-01

The potential for realizing cost savings in the disposal of defense high-level waste through process and design modificatins has been considered. Proposed modifications range from simple changes in the canister design to development of an advanced melter capable of processing glass with a higher waste loading. Preliminary calculations estimate the total disposal cost (not including capital or operating costs) for defense high-level waste to be about $7.9 billion dollars for the reference conditions described in this paper, while projected savings resulting from the proposed process and design changes could reduce the disposal cost of defense high-level waste by up to $5.2 billion

Prescription of the High Risk Narcotics and Trading or Illicit Purchasing of High Risk Narcotics

Directory of Open Access Journals (Sweden)

Nicoleta-Elena Buzatu

2012-05-01

Full Text Available The present essay will analyze the offence of prescribing high risk narcotics and trading or illicit purchasing of high risk narcotics, as it was regulated - together with other offences - by Law no 143 of July 26, 2000 on preventing and fighting against the traffic and illicit consumption of narcotics. The same law defines the meaning of such a phrase “substances which are under national control” by mentioning the fact that they are the narcotics and their precursors listed in Annexes I-IV of the law. The analysis of the offence of prescribing the high risk narcotics and trading or illicit purchasing of high risk narcotics is following the already known structure mentioned in the doctrine and which consists of: object and subjects of the offence, its constituent content: the objective side with its material element, the immediate consequence and causality connections; the subjective side of the offence, as well as forms and modalities of these offences, and the applicable sanctions, of course.

A preliminary assessment of the potential risks from electrical ...

African Journals Online (AJOL)

... Grey-crowned Crane Balearica regulorum, Lesser Flamingo Phoeniconaias minor, White-backed Vulture Gyps africanus, Rüppell's Vulture Gyps rueppellii, Martial Eagle Polemaetus bellicosus, White Stork Ciconia ciconia, Secretarybird Sagittarius serpentarius, and various sit-and-wait raptors. These preliminary findings ...

Preliminary Technology Maturation Plan for Immobilization of High-Level Waste in Glass Ceramics

Energy Technology Data Exchange (ETDEWEB)

Vienna, John D.; Crum, Jarrod V.; Sevigny, Gary J.; Smith, G L.

2012-09-30

A technology maturation plan (TMP) was developed for immobilization of high-level waste (HLW) raffinate in a glass ceramics waste form using a cold-crucible induction melter (CCIM). The TMP was prepared by the following process: 1) define the reference process and boundaries of the technology being matured, 2) evaluate the technology elements and identify the critical technology elements (CTE), 3) identify the technology readiness level (TRL) of each of the CTE’s using the DOE G 413.3-4, 4) describe the development and demonstration activities required to advance the TRLs to 4 and 6 in order, and 5) prepare a preliminary plan to conduct the development and demonstration. Results of the technology readiness assessment identified five CTE’s and found relatively low TRL’s for each of them: • Mixing, sampling, and analysis of waste slurry and melter feed: TRL-1 • Feeding, melting, and pouring: TRL-1 • Glass ceramic formulation: TRL-1 • Canister cooling and crystallization: TRL-1 • Canister decontamination: TRL-4 Although the TRL’s are low for most of these CTE’s (TRL-1), the effort required to advance them to higher values. The activities required to advance the TRL’s are listed below: • Complete this TMP • Perform a preliminary engineering study • Characterize, estimate, and simulate waste to be treated • Laboratory scale glass ceramic testing • Melter and off-gas testing with simulants • Test the mixing, sampling, and analyses • Canister testing • Decontamination system testing • Issue a requirements document • Issue a risk management document • Complete preliminary design • Integrated pilot testing • Issue a waste compliance plan A preliminary schedule and budget were developed to complete these activities as summarized in the following table (assuming 2012 dollars). TRL Budget Year MSA FMP GCF CCC CD Overall $M 2012 1 1 1 1 4 1 0.3 2013 2 2 1 1 4 1 1.3 2014 2 3 1 1 4 1 1.8 2015 2 3 2 2 4 2 2.6 2016 2 3 2 2 4 2 4

Radical prostatectomy for high-risk prostate cancer.

Science.gov (United States)

Yossepowitch, Ofer; Eastham, James A

2008-06-01

Consensus recommendations for the identification and treatment of men whose apparent organ confined prostate cancer has high risk features are lacking. Despite ongoing refinements in surgical technique and improvements in morbidity and functional outcomes, the tradition of steering high-risk patients away from radical prostatectomy (RP) remains steadfast. We performed a medical literature search in English using MEDLINE/PubMed that addressed high risk prostate cancer. We analyzed the literature with respect to the historical evolution of this concept, current risk stratification schemes and treatment guidelines and related short and long term outcomes following RP. Contemporary evidence suggest that patients classified with high-risk prostate cancer by commonly used definitions do not have a uniformly poor prognosis after RP. Many cancers categorized clinically as high risk are actually pathologically confined to the prostate, and most men with such cancers who undergo RP are alive and free of additional therapy long after surgery. RP in the high-risk setting appears to be associated with a similar morbidity as in lower-risk patients. Men with clinically localized high-risk prostate cancer should not be categorically disqualified from local definitive therapy with RP. With careful attention to surgical technique, cancer control rates should improve further, and adverse effects on quality of life after RP should continue to decrease.

Boxing and mixed martial arts: preliminary traumatic neuromechanical injury risk analyses from laboratory impact dosage data.

Science.gov (United States)

Bartsch, Adam J; Benzel, Edward C; Miele, Vincent J; Morr, Douglas R; Prakash, Vikas

2012-05-01

In spite of ample literature pointing to rotational and combined impact dosage being key contributors to head and neck injury, boxing and mixed martial arts (MMA) padding is still designed to primarily reduce cranium linear acceleration. The objects of this study were to quantify preliminary linear and rotational head impact dosage for selected boxing and MMA padding in response to hook punches; compute theoretical skull, brain, and neck injury risk metrics; and statistically compare the protective effect of various glove and head padding conditions. An instrumented Hybrid III 50th percentile anthropomorphic test device (ATD) was struck in 54 pendulum impacts replicating hook punches at low (27-29 J) and high (54-58 J) energy. Five padding combinations were examined: unpadded (control), MMA glove-unpadded head, boxing glove-unpadded head, unpadded pendulum-boxing headgear, and boxing glove-boxing headgear. A total of 17 injury risk parameters were measured or calculated. All padding conditions reduced linear impact dosage. Other parameters significantly decreased, significantly increased, or were unaffected depending on padding condition. Of real-world conditions (MMA glove-bare head, boxing glove-bare head, and boxing glove-headgear), the boxing glove-headgear condition showed the most meaningful reduction in most of the parameters. In equivalent impacts, the MMA glove-bare head condition induced higher rotational dosage than the boxing glove-bare head condition. Finite element analysis indicated a risk of brain strain injury in spite of significant reduction of linear impact dosage. In the replicated hook punch impacts, all padding conditions reduced linear but not rotational impact dosage. Head and neck dosage theoretically accumulates fastest in MMA and boxing bouts without use of protective headgear. The boxing glove-headgear condition provided the best overall reduction in impact dosage. More work is needed to develop improved protective padding to minimize

Client experiences with perinatal healthcare for high-risk and low-risk women

NARCIS (Netherlands)

van Stenus, Cherelle M.V.; Boere-Boonekamp, Magda M.; Kerkhof, Erna F.G.M.; Need, Ariana

2018-01-01

Problem: It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women. Background: In the Netherlands, risk selection divides pregnant women into low- and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of

Preliminary study: Formaldehyde exposure in laboratories of Sharjah university in UAE

OpenAIRE

Ahmed, Hafiz Omer

2011-01-01

Objectives : Laboratory technicians, students, and instructors are at high risk, because they deal with chemicals including formaldehyde. Thus, this preliminary study was conducted to measure the concentration of formaldehyde in the laboratories of the University of Sharjah in UAE. Materials and Methods: Thirty-two air samples were collected and analyzed for formaldehyde using National Institute for Occupational Safety and Health (NIOSH) method 3500. In this method, formaldehyde reacts with c...

Preliminary study on the rate of broncho-pulmonary cancer in a Romanian department (Bihor) for the estimation of radon risk exposure

International Nuclear Information System (INIS)

Vaida, T.; Maghiar, F.; Cosma, C.; Ristoiu, D.; Ramboiu, S.; Pacurar, V.; Poffijn, A.

1996-01-01

The purpose of this paper is a retrospective estimation on the rate of lung cancer at the population in the Bihor district (Romania) in two years (1993 -1994) and the potential bronchopulmonary cancer risk from indoor radon. In this time were found 473 cases with primary bronchopulmonary cancer: 400 men (84.5%) and 73 women (15.4%). Most cases ( 64.4%) were from rural environment while the other 35.5% were from urban environment. Preliminary study on the potential lung cancer risk from indoor radon encompassed 40 cases and 66 non-cancer controls in the period March-July 1995. (author)

Fractionation distribution and preliminary ecological risk assessment of As, Hg and Cd in ornithogenic sediments from the Ross Sea region, East Antarctica

Energy Technology Data Exchange (ETDEWEB)

Lou, Chuangneng [Institute of Polar Environment, School of Earth and Space Sciences, University of Science and Technology of China, Hefei 230026 (China); Liu, Xiaodong, E-mail: ycx@ustc.edu.cn [Institute of Polar Environment, School of Earth and Space Sciences, University of Science and Technology of China, Hefei 230026 (China); Nie, Yaguang [Institute of Polar Environment, School of Earth and Space Sciences, University of Science and Technology of China, Hefei 230026 (China); Emslie, Steven D. [Department of Biology and Marine Biology, University of North Carolina Wilmington, 601S. College Road, Wilmington, NC 28403 (United States)

2015-12-15

To evaluate mobility of toxic elements and their potential ecological risk caused by seabird biovectors, the fractionation distributions of arsenic (As), mercury (Hg) and cadmium (Cd) were investigated in three ornithogenic sediment profiles from the Ross Sea region, East Antarctica. The results show residual As holds a dominant position, and Hg mainly derives from residual, organic matter-bound and humic acid-bound fractions, indicating weak mobility of As and Hg. However, exchangeable Cd occupies a considerable proportion in studied samples, suggesting Cd has strong mobility. The preliminary evaluation of Sediment Quality Guidelines (SGQs) shows adverse biological effects may occur occasionally for As and Cd, and rarely for Hg. Using Risk Assessment Code (RAC), the ecological risk is assessed at moderate, low and very high for As, Hg and Cd pollution, respectively. Organic matter derived from guano is the main factor controlling the mobility of Hg and Cd through adsorption and complexation. - Highlights: • Residual As holds a dominant position in ornithogenic sediments. • Hg mainly derives from residual, organic matter-bound and humic acid-bound fractions. • Exchangeable Cd occupies a considerable proportion in ornithogenic sediments. • TOC is the main factor controlling the mobility of Hg and Cd in studied sediments.

[A model list of high risk drugs].

Science.gov (United States)

Cotrina Luque, J; Guerrero Aznar, M D; Alvarez del Vayo Benito, C; Jimenez Mesa, E; Guzman Laura, K P; Fernández Fernández, L

2013-12-01

«High-risk drugs» are those that have a very high «risk» of causing death or serious injury if an error occurs during its use. The Institute for Safe Medication Practices (ISMP) has prepared a high-risk drugs list applicable to the general population (with no differences between the pediatric and adult population). Thus, there is a lack of information for the pediatric population. The main objective of this work is to develop a high-risk drug list adapted to the neonatal or pediatric population as a reference model for the pediatric hospital health workforce. We made a literature search in May 2012 to identify any published lists or references in relation to pediatric and/or neonatal high-risk drugs. A total of 15 studies were found, from which 9 were selected. A model list was developed mainly based on the ISMP one, adding strongly perceived pediatric risk drugs and removing those where the pediatric use was anecdotal. There is no published list that suits pediatric risk management. The list of pediatric and neonatal high-risk drugs presented here could be a «reference list of high-risk drugs » for pediatric hospitals. Using this list and training will help to prevent medication errors in each drug supply chain (prescribing, transcribing, dispensing and administration). Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

A metasynthesis of risk perception in women with high risk pregnancies

OpenAIRE

Lee, S.; Ayers, S.; Holden, D.

2014-01-01

Introduction: Risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies.\\ud \\ud Methods: A systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that rep...

Resuscitation of newborn in high risk deliveries

International Nuclear Information System (INIS)

Yousaf, U.F.; Hayat, S.

2015-01-01

High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. Methods: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. Results: A total of 90 high risk deliveries were included in the study. Emergency caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. Conclusion: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery. (author)

The nature of the association between childhood ADHD and the development of bipolar disorder: a review of prospective high-risk studies.

Science.gov (United States)

Duffy, Anne

2012-12-01

The author reviewed prospective longitudinal studies of the offspring of parents with bipolar disorder to inform our understanding of the nature of the association between childhood ADHD and the risk of developing bipolar disorder in adolescence and young adulthood. A literature review of published prospective cohort studies of the offspring of bipolar parents since 1985 was undertaken using a comprehensive search strategy in several electronic databases. The author provides a qualitative synthesis of results focusing on ADHD and the association with bipolar disorder in prospectively assessed high-risk offspring. These results are discussed in light of findings from other prospective epidemiological and clinical cohort studies. From the reviewed high-risk studies, evidence suggests that the clinical diagnosis of childhood ADHD is not a reliable predictor of the development of bipolar disorder. However, the author found evidence that symptoms of inattention may be part of a mixed clinical presentation during the early stages of evolving bipolar disorder in high-risk offspring, appearing alongside anxiety and depressive symptoms. The author also found preliminary evidence that childhood ADHD may form part of a neurodevelopmental phenotype in offspring at risk for developing a subtype of bipolar disorder unresponsive to lithium stabilization. While childhood ADHD does not appear to be part of the typical developmental illness trajectory of bipolar disorder, subjective problems with attention can form part of the early course, while neurodevelopmental abnormalities may be antecedents in a subgroup of high-risk children.

Dose-Volume Analysis of Radiation Nephropathy in Children: Preliminary Report of the Risk Consortium

International Nuclear Information System (INIS)

Boelling, Tobias; Ernst, Iris; Pape, Hildegard; Martini, Carmen; Ruebe, Christian; Timmermann, Beate; Fischedick, Karin; Kortmann, Rolf-Dieter; Willich, Normann

2011-01-01

Purpose: To characterize kidney function in children and adolescents who had undergone radiation treatment that included parts of the kidney. Methods and Materials: Patients receiving radiotherapy during childhood or adolescence were prospectively registered in Germany's Registry for the Evaluation of Side Effects after Radiation in Childhood and Adolescence (RiSK). Detailed information was recorded regarding radiation doses at the organs at risk since 2001 all over Germany. Toxicity evaluation was performed according to standardized Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Results: Up to May 2009, 1086 patients from 62 centers were recruited, including 126 patients (median age, 10.2 years) who underwent radiotherapy to parts of the kidneys. Maximal late toxicity (median follow-up 28.5 months in 74 patients) was characterized as Grade 0 (n = 65), 1 (n = 7) or 2 (n = 2). All patients with late effects had received potentially nephrotoxic chemotherapy. A statistically significant difference between patients with and without Grade 1 toxicity, revealing higher exposed kidney volumes in patients with toxicity, was seen for the kidney volume exposed to 20 Gy (V20; p = 0.031) and 30 Gy (V30; p = 0.003). Conclusions: Preliminary data indicate that radiation-induced kidney function impairment is rare in current pediatric multimodal treatment approaches. In the future, RiSK will be able to provide further detailed data regarding dose-volume effect relationships of radiation-associated side effects in pediatric oncology patients.

A preliminary feasibility study of passive in-core thermionic reactors for highly compact space nuclear power systems

International Nuclear Information System (INIS)

Parlos, A.G.; Khan, E.U.; Frymire, R.; Negron, S.; Thomas, J.K.; Peddicord, K.L.

1991-01-01

Results of a preliminary feasibility study on a new concept for a highly compact space reactor power systems are presented. Notwithstanding the preliminary nature of the present study, the results which include a new space reactor configuration and its associated technologies indicate promising avenues for the devleopment of highly compact space reactors. The calculations reported in this study include a neutronic design trade-off study using a two-dimensioinal neutron transport model, as well as a simplified one-dimensional thermal analysis of the reactor core. In arriving at the most desirable configuration, various options have been considered and analyzed, and their advantages/disadvantages have been compared. However, because of space limitation, only the most favorable reactor configuration is presented in this summary

A preliminary typology of caregivers and effects on service utilization of caregiver counseling.

Science.gov (United States)

Pepin, Renee; Williams, Ashley A; Anderson, Lindsay N; Qualls, Sara H

2013-01-01

Caregivers (CGs) of older adults have unique and diverse needs for intervention. The present studies describe the characteristics of CGs and caregiving situations and how these relate to CG therapy utilization patterns in a community mental health setting. Study 1: Through chart review, the researchers explored service utilization patterns and identified preliminary typologies of Caregiver Family Therapy (CFT) clients, N = 23. Study 2: By conducting a second chart review, the researchers sought to determine whether the categories that emerged in Study 1 applied to a second group of CFT clients, N = 36. Study 1: Four distinct categories of CGs emerged: High-Distress (high disorganization, high complexity), Resourceful but At-Risk (low disorganization, high complexity), Non-Committal (high disorganization, low complexity), and Model CGs (low disorganization, low complexity). Study 2: While the ability to classify CGs into category proved to have some inconsistencies, preliminary evidence suggests the ability to predict utilization once CGs were placed into category was good. In Study 2 a fifth category emerged: High Functioning but Static, which suggests CGs were on a continuum ranging from high to low on family organizational style and CG situation complexity. While caregiving situations vary widely among families and across time, this article provides a preliminary typology of CGs that may assist clinicians in tailoring CG interventions to meet the needs of their clients based on information garnered early in therapy, perhaps as early as the intake process.

A Preliminary Review of Fatigue Among Rail Staff

OpenAIRE

Jialin Fan; Andrew P. Smith

2018-01-01

Background: Fatigue is a severe problem in the rail industry, which may jeopardize train crew's health and safety. Nonetheless, a preliminary review of all empirical evidence for train crew fatigue is still lacking. The aim of the present paper is, therefore, to provide a preliminary description of occupational fatigue in the rail industry. This paper reviews the literature with the research question examining the risk factors associated with train crew fatigue, covering both papers published...

Preliminary site characterization at Beishan northwest China-A potential site for China's high-level radioactive waste repository

International Nuclear Information System (INIS)

Wang Ju; Su Rui; Xue Weiming; Zheng Hualing

2004-01-01

Chinese nuclear power plants,radioactive waste and radioactive waste disposal are introduced. Beishan region (Gansu province,Northwest China)for high-level radioactive waste repository and preliminary site characterization are also introduced. (Zhang chao)

Utilization of 3-Month Yoga Program for Adults at High Risk for Type 2 Diabetes: A Pilot Study

Directory of Open Access Journals (Sweden)

Kyeongra Yang

2011-01-01

Full Text Available Various modes of physical activity, combined with dieting, have been widely recommended to prevent or delay type 2 diabetes. Among these, yoga holds promise for reducing risk factors for type 2 diabetes by promoting weight loss, improving glucose levels and reducing blood pressure and lipid levels. This pilot study aimed to assess the feasibility of implementing a 12-week yoga program among adults at high risk for type 2 diabetes. Twenty-three adults (19 Whites and 4 non-Whites were randomly assigned to the yoga intervention group or the educational group. The yoga group participated in a 3-month yoga intervention with sessions twice per week and the educational group received general health educational materials every 2 weeks. All participants completed questionnaires and had blood tests at baseline and at the end of 3 months. Effect sizes were reported to summarize the efficacy of the intervention. All participants assigned to the yoga intervention completed the yoga program without complication and expressed high satisfaction with the program (99.2%. Their yoga session attendance ranged from 58.3 to 100%. Compared with the education group, the yoga group experienced improvements in weight, blood pressure, insulin, triglycerides and exercise self-efficacy indicated by small to large effect sizes. This preliminary study indicates that a yoga program would be a possible risk reduction option for adults at high risk for type 2 diabetes. In addition, yoga holds promise as an approach to reducing cardiometabolic risk factors and increasing exercise self-efficacy for this group.

A spatially-dynamic preliminary risk assessment of the bald eagle at the Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Gonzales, G.J.; Gallegos, A.F.; Foxx, T.S.; Fresquez, P.R.; Mullen, M.A.; Pratt, L.E.; Gomez, P.E.

1998-04-01

The Endangered Species Act of 1973 and the Record of Decision on the Dual Axis Radiographic Hydrodynamic Test Facility at the Los Alamos National Laboratory (LANL) require that the Department of Energy protect the bald eagle (Haliaeetus leucocephalus), a state and federally listed species, from stressors such as contaminants. A preliminary risk assessment of the bald eagle was performed using a custom FORTRAN code, ECORSK5, and the geographical information system. Estimated exposure doses to the eagle for radionuclide, inorganic metal, and organic contaminants were derived for varying ratios of aquatic vs. terrestrial simulated diet and compared against toxicity reference values to generate hazard indices (His). HI results indicate that no appreciable impact to the bald eagle is expected from contaminants at LANL from soil ingestion and food consumption pathways. This includes a measure of cumulative effects from multiple contaminants that assumes linear additive toxicity. Improving model realism by weighting simulated eagle foraging based on distance from potential roost sites increased the HI by 76%, but still to inconsequential levels. Information on risk by specific geographical location was generated, which can be used to manage contaminated areas, eagle habitat, facility siting, and/or facility operations in order to maintain risk from contaminants at low levels.

The high-risk plaque initiative

DEFF Research Database (Denmark)

Falk, Erling; Sillesen, Henrik; Muntendam, Pieter

2011-01-01

The High-Risk Plaque (HRP) Initiative is a research and development effort to advance the understanding, recognition, and management of asymptomatic individuals at risk for a near-term atherothrombotic event such as myocardial infarction or stroke. Clinical studies using the newest technologies...... have been initiated, including the BioImage Study in which novel approaches are tested in a typical health plan population. Asymptomatic at-risk individuals were enrolled, including a survey-only group (n = 865), a group undergoing traditional risk factor scoring (n = 718), and a group in which all...

Preliminary investigation into laser high voltage interaction in the case of streamer-to-leader process using a high power CO2 laser

CSIR Research Space (South Africa)

West, NJ

2006-01-01

Full Text Available This paper describes the preliminary small-scale experiments conducted in order to investigate the influence of intensely focused laser light produced by a CO2 laser on high voltage fields. The laser used operated at a maximum energy of 430 mJ per...

Preliminary remediation goals for ecological endpoints

International Nuclear Information System (INIS)

Efroymson, R.A.; Suter, G.W. II; Sample, B.E.; Jones, D.S.

1996-07-01

Preliminary remediation goals (PRGs) are useful for risk assessment and decision making at Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) sites. PRGs are upper concentration limits for specific chemicals in specific environmental media that are anticipated to protect human health or the environment. They can be used for multiple remedial investigations at multiple facilities. In addition to media and chemicals of potential concern, the development of PRGs generally requires some knowledge or anticipation of future land use. In Preliminary Remediation Goals for Use at the U.S. Department of Energy Oak Ridge Operations Office (Energy Systems 1995), PRGs intended to protect human health were developed with guidance from Risk Assessment Guidance for Superfund: Volume I - Human Health Evaluation Manual, Part B (RAGS) (EPA 1991). However, no guidance was given for PRGs based on ecological risk. The numbers that appear in this volume have, for the most part, been extracted from toxicological benchmarks documents for Oak Ridge National Laboratory (ORNL) and have previously been developed by ORNL. The sources of the quantities, and many of the uncertainties associated with their derivation, are described in this technical memorandum

Preliminary remediation goals for ecological endpoints

International Nuclear Information System (INIS)

Efroymson, R.A.; Suter, G.W. II.

1995-09-01

Preliminary remediation goals (PRGs) are useful for risk assessment and decision making at Comprehensive Environmental Response, compensation, and Liability Act (CERCLA) sites. PRGs are upper concentration limits for specific chemicals in specific environmental media that are anticipated to protect human health or the environment. They can be used for multiple remedial investigations at multiple facilities. In addition to media and chemicals of potential concern, the development of PRGs generally requires some knowledge or anticipation of future land use. In Preliminary Remediation Goals for Use at the US Department of Energy Oak Ridge Operations Office (Energy Systems 1995), PRGs intended to protect human health were developed with guidance from Risk Assessment Guidance for Superfund: Volume I-Human Health Evaluation Manual, Part B (RAGS) (EPA 1991). However, no guidance was given for PRGs based on ecological risk. The numbers that appear in this volume have, for the most part, been extracted from toxicological benchmarks documents for Oak Ridge National Laboratory (ORNL) and have previously been developed by ORNL. The sources of the quantities, and many of the uncertainties associated with their derivation, are described in this technical memorandum

Improving Phonological Awareness in Parents of Children at Risk of Literacy Difficulties: A Preliminary Evaluation of the Boost Program

Directory of Open Access Journals (Sweden)

Mark E. Boyes

2017-09-01

Full Text Available BackgroundPhonological awareness is an important skill underpinning the development of early literacy. Given the central role of parents in supporting the development of children’s early literacy skills, and that poor parental phonological awareness is associated with poorer child literacy outcomes, it is possible that improving parent phonological awareness may aid literacy development for at-risk children. This study is a preliminary evaluation of a program aiming to improve phonological awareness skills of parents in low socioeconomic status communities, and also provide these parents with strategies to support their child’s literacy development.MethodsAfter completing the program, participants were asked if it had helped them learn about how to assist their child’s reading and spelling, whether they planned on using the resources provided, and if they would be likely to attend a future workshop building on the Boost program. Phonological awareness measures (rhyme, syllable, and phoneme level, and measures of overall confidence in performance on the phonological awareness tasks, were administered both before and after attending the program.ResultsAlmost all parents indicated that the program helped with learning how to assist their child’s reading and spelling, that they would use the resources provided, and would likely attend a future workshop. Significant increases in pre- to post-program phonological awareness scores were obtained at the rhyme and phoneme level.ConclusionThe program and associated resources appear acceptable to parents in communities with high rates of literacy problems and improved parents’ phonological awareness skills. However, findings are preliminary and further evaluation using more rigorous methodologies and testing whether improvements in parents’ phonological awareness translate into better literacy outcomes for children is needed.

Patients at High-Risk for Surgical Site Infection.

Science.gov (United States)

Mueck, Krislynn M; Kao, Lillian S

Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-operative management to optimize outcomes. Review of the pertinent English-language literature. High-risk surgical patients may be identified on the basis of individual risk factors or combinations of factors. In particular, statistical models and risk calculators may be useful in predicting infectious risks, both in general and for SSIs. These models differ in the number of variables; inclusion of pre-operative, intra-operative, or post-operative variables; ease of calculation; and specificity for particular procedures. Furthermore, the models differ in their accuracy in stratifying risk. Biomarkers may be a promising way to identify patients at high risk of infectious complications. Although multiple strategies exist for identifying surgical patients at high risk for SSIs, no one strategy is superior for all patients. Further efforts are necessary to determine if risk stratification in combination with risk modification can reduce SSIs in these patient populations.

Installation of carotid stent in a group of patient of high surgical risk for carotid endarterectomy - Preliminary experience

International Nuclear Information System (INIS)

Gomez Hoyos, Juan Fernando; Celis Mejia, Jorge Ignacio; Yepes Sanchez, Carlos Jaime; Duque Botero, Julieta

1998-01-01

Carotid endarterectomy success in symptomatic or asymptomatic patients has been demonstrated in NASCET and ACAS studies. Although, some patients with carotid stenosis have frequently other pathologies which increase risk in endarterectomy or other surgeries like coronary bypass and aortic-iliac reconstruction. Other patients have lesions such as post surgical restenosis, fibromuscular dysplasia, radiation stenosis or tumoral disease, or stenotic lesions above jaw angle. The main objectives of this work are: to demonstrate, upon the results, that multidisciplinary management of 1 patient with symptomatic or not carotid critical stenosis. Let to select, with strict clinical criteria, those doing well with endovascular therapy. To evaluate implantation technique, peryoperatory morbidity and mortality and permeability time with implanted dispositive. In this study, the preliminary experience of the neurovascular group at the Clinica Cardiovascular Santa Maria in Medellin is presented, during an 18 months period of multidisciplinary management in 15 patients, 7 men and 8 women with critical carotid stenosis. 18 procedures were performed and 21 stents were implanted. The mean age was 66 years. All patients had 70% or greater stenotic lesions, and 93.3% were symptomatic. Twelve (80%) had contraindications to perform surgery. one asymptomatic patient (6.6%) was referred with procedure indications and two (13.3%) requested the stent implantation as their own election. the patient with fibromuscular dysplasia was treated with Wallstent (number 4) and the remaining patients were treated with Palmaz stent. technical success was 100%, 3 patients had pacemaker rhythm, one patient (6.6%) presented extra-pyramidal syndrome which responded to medical treatment in 24 hours. one patient developed right side hemiparesis with total recovery in 4 hours. One patient with a critical left carotid artery stenosis presented right side hemiparesis (3/5) and aphasia, nine months later paresis

Approach of fuzzy logic in the preliminary risk analysis of the upstream and downstream lines of an offshore petroleum production unit

Energy Technology Data Exchange (ETDEWEB)

Garcia, Claudio B. [PETROBRAS Transporte S.A. (TRANSPETRO), Rio de Janeiro, RJ (Brazil); Pinho, Edson [Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropedica, RJ (Brazil); Maia Neto, Luiz

2009-07-01

This work consists of the application of a model of qualitative risk assessment based in fuzzy logic for the judgment of criticality of the scenarios of accident identified through the technique of preliminary hazard analysis in the upstream and downstream of an offshore oil production unit already in operation. The model based on fuzzy logic acts as substitute to the traditional Risks Matrix that uses subjective concepts for the categories of expected severity and frequency of the accidents. The structure of the employed model consists of 7 input variables, an internal variable and an output variable, all linked in accordance with the modules of analysis for each type of accident. The developed base of knowledge, that complete the expert system consists of membership functions developed for each one of the variables and a set of 219 distributed inference rules in the 7 different modules. The developed knowledge base, which incorporates the mechanisms of logical reasoning of specialists, assists and guides, with efficiency, the teams that carry through the preliminary hazard analyses with the use of a computer program having previously inserted routines. The employed model incorporates in the knowledge base of the program the existing concepts in the categories of frequency and severity, under the form of membership functions of the linguistic variable and the set of rules. With this, scales subdivided in ranges, defined on the basis of the existing direction present in the risks matrices are used to define the actions to be taken for the analyzed accident scenarios. (author)

Bilateral mammographic density asymmetry and breast cancer risk: A preliminary assessment

Energy Technology Data Exchange (ETDEWEB)

Zheng, Bin, E-mail: zhengb@upmc.edu [Department of Radiology, University of Pittsburgh, 3362 Fifth Ave, Pittsburgh, PA 15213 (United States); Sumkin, Jules H., E-mail: jsumkin@mail.magee.edu [Department of Radiology, Magee Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213 (United States); Zuley, Margarita L., E-mail: zuleyml@upmc.edu [Department of Radiology, Magee Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213 (United States); Wang, Xingwei, E-mail: wangx6@upmc.edu [Department of Radiology, University of Pittsburgh, 3362 Fifth Ave, Pittsburgh, PA 15213 (United States); Klym, Amy H., E-mail: klymah@upmc.edu [Department of Radiology, University of Pittsburgh, 3362 Fifth Ave, Pittsburgh, PA 15213 (United States); Gur, David, E-mail: gurd@upmc.edu [Department of Radiology, University of Pittsburgh, 3362 Fifth Ave, Pittsburgh, PA 15213 (United States)

2012-11-15

To improve efficacy of breast cancer screening and prevention programs, it requires a risk assessment model with high discriminatory power. This study aimed to assess classification performance of using computed bilateral mammographic density asymmetry to predict risk of individual women developing breast cancer in near-term. The database includes 451 cases with multiple screening mammography examinations. The first (baseline) examinations of all case were interpreted negative. In the next sequential examinations, 187 cases developed cancer or surgically excised high-risk lesions, 155 remained negative (not-recalled), and 109 were recalled benign cases. From each of two bilateral cranio-caudal view images acquired from the baseline examination, we computed two features of average pixel value and local pixel value fluctuation. We then computed mean and difference of each feature computed from two images. When applying the computed features and other two risk factors (woman's age and subjectively rated mammographic density) to predict risk of cancer development, areas under receiver operating characteristic curves (AUC) were computed to evaluate the discriminatory/classification performance. The AUCs are 0.633 {+-} 0.030, 0.535 {+-} 0.036, 0.567 {+-} 0.031, and 0.719 {+-} 0.027 when using woman's age, subjectively rated, computed mean and asymmetry of mammographic density, to classify between two groups of cancer-verified and negative cases, respectively. When using an equal-weighted fusion method to combine woman's age and computed density asymmetry, AUC increased to 0.761 {+-} 0.025 (p < 0.05). The study demonstrated that bilateral mammographic density asymmetry could be a significantly stronger risk factor associated to the risk of women developing breast cancer in near-term than woman's age and assessed mean mammographic density.

Bilateral mammographic density asymmetry and breast cancer risk: A preliminary assessment

International Nuclear Information System (INIS)

Zheng, Bin; Sumkin, Jules H.; Zuley, Margarita L.; Wang, Xingwei; Klym, Amy H.; Gur, David

2012-01-01

To improve efficacy of breast cancer screening and prevention programs, it requires a risk assessment model with high discriminatory power. This study aimed to assess classification performance of using computed bilateral mammographic density asymmetry to predict risk of individual women developing breast cancer in near-term. The database includes 451 cases with multiple screening mammography examinations. The first (baseline) examinations of all case were interpreted negative. In the next sequential examinations, 187 cases developed cancer or surgically excised high-risk lesions, 155 remained negative (not-recalled), and 109 were recalled benign cases. From each of two bilateral cranio-caudal view images acquired from the baseline examination, we computed two features of average pixel value and local pixel value fluctuation. We then computed mean and difference of each feature computed from two images. When applying the computed features and other two risk factors (woman's age and subjectively rated mammographic density) to predict risk of cancer development, areas under receiver operating characteristic curves (AUC) were computed to evaluate the discriminatory/classification performance. The AUCs are 0.633 ± 0.030, 0.535 ± 0.036, 0.567 ± 0.031, and 0.719 ± 0.027 when using woman's age, subjectively rated, computed mean and asymmetry of mammographic density, to classify between two groups of cancer-verified and negative cases, respectively. When using an equal-weighted fusion method to combine woman's age and computed density asymmetry, AUC increased to 0.761 ± 0.025 (p < 0.05). The study demonstrated that bilateral mammographic density asymmetry could be a significantly stronger risk factor associated to the risk of women developing breast cancer in near-term than woman's age and assessed mean mammographic density.

Component of the risk analysis

International Nuclear Information System (INIS)

Martinez, I.; Campon, G.

2013-01-01

The power point presentation reviews issues like analysis of risk (Codex), management risk, preliminary activities manager, relationship between government and industries, microbiological danger and communication of risk

Preliminary Screening Analysis for the Environmental Risk Evaluation System: Task 2.1.1: Evaluating Effects of Stressors – Fiscal Year 2010 Progress Report: Environmental Effects of Marine and Hydrokinetic Energy

Energy Technology Data Exchange (ETDEWEB)

Anderson, Richard M.; Copping, Andrea E.; Van Cleve, Frances B.

2010-11-15

Possible environmental effects of marine and hydrokinetic (MHK) energy development are not well understood, and yet regulatory agencies are required to make decisions in spite of substantial uncertainty about environmental impacts and their long-term effects. An understanding of risk associated with likely interactions between MHK installations and aquatic receptors, including animals, habitats, and ecosystems, can help reduce the level of uncertainty and focus regulatory actions and scientific studies on interactions of most concern. As a first step in developing the Pacific Northwest National Laboratory (PNNL) Environmental Risk Evaluation System (ERES), PNNL scientists conducted a preliminary risk screening analysis on three initial MHK cases - a tidal project in Puget Sound using Open Hydro turbines, a wave project off the coast of Oregon using Ocean Power Technologies point attenuator buoys, and a riverine current project in the Mississippi River using Free Flow turbines. Through an iterative process, the screening analysis revealed that top-tier stressors in all three cases were the effects of the dynamic physical presence of the device (e.g., strike), accidents, and effects of the static physical presence of the device (e.g., habitat alteration). Receptor interactions with these stressors at the four highest tiers of risk were dominated by marine mammals (cetaceans and pinnipeds) and birds (diving and non-diving); only the riverine case (Free Flow) included different receptors in the third tier (fish) and the fourth tier (benthic invertebrates). Although this screening analysis provides a preliminary analysis of vulnerability of environmental receptors to stressors associated with MHK installations, probability analysis, especially of risk associated with chemical toxicity and accidents such as oil spills or lost gear, will be necessary to further understand high-priority risks. Subject matter expert review of this process and results is required and is

Preliminary results of steel containment vessel model test

International Nuclear Information System (INIS)

Matsumoto, T.; Komine, K.; Arai, S.

1997-01-01

A high pressure test of a mixed-scaled model (1:10 in geometry and 1:4 in shell thickness) of a steel containment vessel (SCV), representing an improved boiling water reactor (BWR) Mark II containment, was conducted on December 11-12, 1996 at Sandia National Laboratories. This paper describes the preliminary results of the high pressure test. In addition, the preliminary post-test measurement data and the preliminary comparison of test data with pretest analysis predictions are also presented

Jet-Surface Interaction: High Aspect Ratio Nozzle Test, Nozzle Design and Preliminary Data

Science.gov (United States)

Brown, Clifford; Dippold, Vance

2015-01-01

The Jet-Surface Interaction High Aspect Ratio (JSI-HAR) nozzle test is part of an ongoing effort to measure and predict the noise created when an aircraft engine exhausts close to an airframe surface. The JSI-HAR test is focused on parameters derived from the Turbo-electric Distributed Propulsion (TeDP) concept aircraft which include a high-aspect ratio mailslot exhaust nozzle, internal septa, and an aft deck. The size and mass flow rate limits of the test rig also limited the test nozzle to a 16:1 aspect ratio, half the approximately 32:1 on the TeDP concept. Also, unlike the aircraft, the test nozzle must transition from a single round duct on the High Flow Jet Exit Rig, located in the AeroAcoustic Propulsion Laboratory at the NASA Glenn Research Center, to the rectangular shape at the nozzle exit. A parametric nozzle design method was developed to design three low noise round-to-rectangular transitions, with 8:1, 12:1, and 16: aspect ratios, that minimizes flow separations and shocks while providing a flat flow profile at the nozzle exit. These designs validated using the WIND-US CFD code. A preliminary analysis of the test data shows that the actual flow profile is close to that predicted and that the noise results appear consistent with data from previous, smaller scale, tests. The JSI-HAR test is ongoing through October 2015. The results shown in the presentation are intended to provide an overview of the test and a first look at the preliminary results.

Managing and understanding risk perception of surface leaks from CCS sites: risk assessment for emerging technologies and low-probability, high-consequence events

Science.gov (United States)

Augustin, C. M.

2015-12-01

Carbon capture and storage (CCS) has been suggested by the Intergovernmental Panel on Climate Change as a partial solution to the greenhouse gas emissions problem. As CCS has become mainstream, researchers have raised multiple risk assessment issues typical of emerging technologies. In our research, we examine issues occuring when stored carbon dioxide (CO2) migrates to the near-surface or surface. We believe that both the public misperception and the physical reality of potential environmental, health, and commercial impacts of leak events from such subsurface sites have prevented widespread adoption of CCS. This paper is presented in three parts; the first is an evaluation of the systemic risk of a CCS site CO2 leak and models indicating potential likelihood of a leakage event. As the likelihood of a CCS site leak is stochastic and nonlinear, we present several Bayesian simulations for leak events based on research done with other low-probability, high-consequence gaseous pollutant releases. Though we found a large, acute leak to be exceptionally rare, we demonstrate potential for a localized, chronic leak at a CCS site. To that end, we present the second piece of this paper. Using a combination of spatio-temporal models and reaction-path models, we demonstrate the interplay between leak migrations, material interactions, and atmospheric dispersion for leaks of various duration and volume. These leak-event scenarios have implications for human, environmental, and economic health; they also have a significant impact on implementation support. Public acceptance of CCS is essential for a national low-carbon future, and this is what we address in the final part of this paper. We demonstrate that CCS remains unknown to the general public in the United States. Despite its unknown state, we provide survey findings -analyzed in Slovic and Weber's 2002 framework - that show a high unknown, high dread risk perception of leaks from a CCS site. Secondary findings are a

Preliminary screening of bacterial isolates from mining wastes

Directory of Open Access Journals (Sweden)

Rodino S.,

2016-05-01

Full Text Available Developing innovative biotechnology for obtaining new resources of high tech critical metals is strongly influenced by the need to reduce the potential risk of shortages, to support the development of industry at European level. To set up these new technologies is essential to isolate strains with high potential in bioleaching of ore, tailings and mine wastes and bioaccumulation of high tech critical metals. Microorganisms are capable of mediating metal and mineral bioprecipitation. In this paper are presented preliminary studies performed for the isolation of strains existing in mining residues containing high tech critical metals. Were used samples collected from various depths in an area of mining wastes containing high tech critical metals. The samples were fine grounded and the powder was washed with sterile saline water. Exact quantities of samples were dispersed in sterile saline water, shaken for a period of 60 minutes, diluted and plated in triplicate on selective agar. After several steps were isolated 3 strains of gram negative bacteria.

Proton Radiotherapy for High-Risk Pediatric Neuroblastoma: Early Outcomes and Dose Comparison

Energy Technology Data Exchange (ETDEWEB)

Hattangadi, Jona A. [Harvard Radiation Oncology Program, Boston, MA (United States); Rombi, Barbara [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Provincial Agency for Proton Therapy, Trento (Italy); Yock, Torunn I.; Broussard, George [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Friedmann, Alison M.; Huang, Mary [Department of Pediatric Hematology-Oncology, Massachusetts General Hospital, Boston, MA (United States); Chen, Yen-Lin E.; Lu, Hsiao-Ming; Kooy, Hanne [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); MacDonald, Shannon M., E-mail: smacdonald@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)

2012-07-01

Purpose: To report the early outcomes for children with high-risk neuroblastoma treated with proton radiotherapy (RT) and to compare the dose distributions for intensity-modulated photon RT (IMRT), three-dimensional conformal proton RT (3D-CPT), and intensity-modulated proton RT to the postoperative tumor bed. Methods and Materials: All patients with high-risk (International Neuroblastoma Staging System Stage III or IV) neuroblastoma treated between 2005 and 2010 at our institution were included. All patients received induction chemotherapy, surgical resection of residual disease, high-dose chemotherapy with stem cell rescue, and adjuvant 3D-CPT to the primary tumor sites. The patients were followed with clinical examinations, imaging, and laboratory testing every 6 months to monitor disease control and side effects. IMRT, 3D-CPT, and intensity-modulated proton RT plans were generated and compared for a representative case of adjuvant RT to the primary tumor bed followed by a boost. Results: Nine patients were treated with 3D-CPT. The median age at diagnosis was 2 years (range 10 months to 4 years), and all patients had Stage IV disease. All patients had unfavorable histologic characteristics (poorly differentiated histologic features in 8, N-Myc amplification in 6, and 1p/11q chromosomal abnormalities in 4). The median tumor size at diagnosis was 11.4 cm (range 7-16) in maximal dimension. At a median follow-up of 38 months (range 11-70), there were no local failures. Four patients developed distant failure, and, of these, two died of disease. Acute side effects included Grade 1 skin erythema in 5 patients and Grade 2 anorexia in 2 patients. Although comparable target coverage was achieved with all three modalities, proton therapy achieved substantial normal tissue sparing compared with IMRT. Intensity-modulated proton RT allowed additional sparing of the kidneys, lungs, and heart. Conclusions: Preliminary outcomes reveal excellent local control with proton therapy

[Targeting high-risk drugs to optimize clinical pharmacists' intervention].

Science.gov (United States)

Mouterde, Anne-Laure; Bourdelin, Magali; Maison, Ophélie; Coursier, Sandra; Bontemps, Hervé

2016-12-01

By the Order of 6 April 2011, the pharmacist must validate all the prescriptions containing "high-risk drugs" or those of "patients at risk". To optimize this clinical pharmacy activity, we identified high-risk drugs. A list of high-risk drugs has been established using literature, pharmacists' interventions (PI) performed in our hospital and a survey sent to hospital pharmacists. In a prospective study (analysis of 100 prescriptions for each high-risk drug selected), we have identified the most relevant to target. We obtained a statistically significant PI rate (P<0.05) for digoxin, oral anticoagulants direct, oral methotrexate and colchicine. This method of targeted pharmaceutical validation based on high-risk drugs is relevant to detect patients with high risk of medicine-related illness. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

New information on high risk breast screening

International Nuclear Information System (INIS)

Riedl, C.C.; Ponhold, L.; Gruber, R.; Pinker, K.; Helbich, T.H.

2010-01-01

Women with an elevated risk for breast cancer require intensified screening beginning at an early age. Such high risk screening differs considerably from screening in the general population. After an expert has evaluated the exact risk a breast MRI examination should be offered at least once a year and beginning latest at the age of 30 depending on the patients risk category. Complementary mammograms should not be performed before the age of 35. An additional ultrasound examination is no longer recommended. To ensure a high sensitivity and specificity high risk screening should be performed only at a nationally or regionally approved and audited service. Adequate knowledge about the phenotypical characteristics of familial breast cancer is essential. Besides the common malignant phenotypes, benign morphologies (round or oval shape and smooth margins) as well as a low prevalence of calcifications have been described. Using MRI benign contrast media kinetics as well as non-solid lesions with focal, regional and segmental enhancement can often be visualized. (orig.) [de

Preliminary assessment of the risk linked to furan ingestion by babies consuming only ready-to-eat food.

Science.gov (United States)

Scholl, Georges; Humblet, Marie-France; Scippo, Marie-Louise; De Pauw, Edwin; Eppe, Gauthier; Saegerman, Claude

2013-01-01

The risk linked to furan ingestion has been assessed in previous papers for Belgian adults and children. The present paper focuses on infants consuming only ready-to-eat baby food. As there is no Belgian baby dietary database, the furan exposure assessment was carried out by using an Italian infant consumption database and Belgian contamination data. The estimated daily intake (EDI) was calculated according to a deterministic methodology. It involved 42 commercially available ready-to-eat baby food and 36 baby consumption records. The mean EDI was 1460 ng*(kg(bw)*day)⁻¹ which is 3.8 times higher than the 381 ng*(kg(bw)*day)⁻¹ reported for Belgian adults, and 3.5 times higher than the 419 ng*(kg(bw)*day)⁻¹ measured for Belgian children. To assess and characterise the risk for babies' exposure, the margin of exposure (MoE) was calculated. It highlighted that 74% of infants have a MoE < 1000, with a minimum of 140. However, these are only preliminary results as they were calculated from a very small dataset and the infant cytochrome P450 activity is significantly different compared with the adult's. Therefore, the risk linked to furan ingestion by babies should be assessed in a different manner. To this end, additional data regarding a baby diet as well as a better understanding of furan toxicity for babies are needed to characterise more accurately the risk for infants.

High-Risk and Low-Risk Human Papillomavirus and the Absolute Risk of Cervical Intraepithelial Neoplasia or Cancer

DEFF Research Database (Denmark)

Thomsen, Louise T; Frederiksen, Kirsten; Munk, Christian

2014-01-01

OBJECTIVE: To determine the absolute risk of cervical intraepithelial neoplasia (CIN) grade 3 or cervical cancer (CIN 3 or worse) after detection of low-risk human papillomavirus (HPV) and after a negative high-risk HPV test. METHODS: In this prospective cohort study, consecutive liquid......-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark, during 2002-2005. Samples were tested with a clinical test for 13 high-risk and five low-risk HPV types. The cohort (N=35,539; aged 14-90 years) was monitored in a nationwide pathology register for up...... cytology. Detection of low-risk HPV does not predict CIN 3 or worse. Cervical cancer screening should not include testing for low-risk HPV types. LEVEL OF EVIDENCE: II....

High-dose-rate brachytherapy as monotherapy delivered in two fractions within one day for favorable/intermediate-risk prostate cancer: preliminary toxicity data.

Science.gov (United States)

Ghilezan, Michel; Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye, Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy

2012-07-01

To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy × 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy × 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of ≤12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. The median follow-up was 17 months (range, 6-40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Favorable-risk prostate cancer patients treated with a single implant HDR-BT to 24-27 Gy in two fractions

High-Dose-Rate Brachytherapy as Monotherapy Delivered in Two Fractions Within One Day for Favorable/Intermediate-Risk Prostate Cancer: Preliminary Toxicity Data

Energy Technology Data Exchange (ETDEWEB)

Ghilezan, Michel, E-mail: mghilezan@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital and Rose Cancer Institute, Royal Oak, Michigan (United States); Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J. Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy [Department of Radiation Oncology, William Beaumont Hospital and Rose Cancer Institute, Royal Oak, Michigan (United States)

2012-07-01

Purpose: To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy Multiplication-Sign 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy Multiplication-Sign 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. Methods and Materials: A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of {<=}12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. Results: The median follow-up was 17 months (range, 6-40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Conclusions: Favorable-risk

High-Dose-Rate Brachytherapy as Monotherapy Delivered in Two Fractions Within One Day for Favorable/Intermediate-Risk Prostate Cancer: Preliminary Toxicity Data

International Nuclear Information System (INIS)

Ghilezan, Michel; Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J. Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy

2012-01-01

Purpose: To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy × 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy × 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. Methods and Materials: A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of ≤12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. Results: The median follow-up was 17 months (range, 6–40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Conclusions: Favorable-risk prostate cancer patients treated with

High-risk PCI: how to define it today?

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DE Marzo, Vincenzo; D'Amario, Domenico; Galli, Mattia; Vergallo, Rocco; Porto, Italo

2018-04-11

Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we are witnessing an expansion of the high-risk percutaneous coronary interventions (PCI) population. Despite defining what high-risk is remains still unclear, all proposed definitions of high-risk PCI combine features related to three clinical areas: 1) patient risk factors and comorbidities (incorporating those which preclude surgical or percutaneous revascularization such as diabetes, COPD, CKD, lung disease, frailty, advanced age); 2) location of the disease and complexity of coronary anatomy (including multi-vessel disease, left main disease, CTO, bifurcations); 3) hemodynamic clinical status (ventricular dysfunction, concomitant valvular disease or unstable characteristics). Since cardiologists have ascertained the encouraging results in terms of efficacy and rewards compared to the low-risks patients, the important role of treating high-risk patients is becoming more and more relevant to the point that current guidelines have now changed the appropriateness of percutaneous interventions indications. Considering the complexity in managing higher-risk patients with coronary artery disease, the next step to ensure the best care for this type of patients is to create a team-based model of cooperation in order to properly establish the right treatment for the right patient.

[The surveillance of occupational risks. Problems and perspectives of the recent legislative framework after the national preliminary survey].

Science.gov (United States)

Marinaccio, A; Di Marzio, D; Binazzi, Alessandra; Napoli, G; Businelli, A; Crema, M; di Leone, G; Ferrari, D; Ferraris, F; Galli, P; Latini, L; Masucci, A; Quercia, A; Stopponi, Roberta; Vianello, L; Scarselli, A; Massari, Stefania; Iavicoli, S

2010-01-01

Legislation in Italy concerning health, safety and prevention at the workplace recently established a new data communication standard The findings are reported of a specific survey on 18 Local Health Units (ASL) over the entire Italian territory, aimed at identifying the critical points in data management and analyze the available information. The occupational health physician for each company must collect and transmit information on the number of workers submitted to health surveillance protocols to the Local Health Unit. Information must be divided by risk factor and gender Local health Units then transmit the data to the Regions and finally to the Italian National Institute for Occupational Safety and Prevention (ISPESL). A sample of 22.977 companies was studied, providing information on about 410,009 workers undergoing health surveillance protocols. Carrying or moving heavy loads, exposure to noise, VDU and chemical substances were the most frequent risk factors. The difference between genders was significant in risk allocation, with exposures to VDU and biological agents prevalently among females. The information thus collected suffered from a lack of data organization and completeness in the sample under study, but nevertheless provides preliminary evidence of a map of occupational risks on a national basis, confirming the potential for the new law (D.Lgs 81/2008) to investigate health safety and prevention at the workplace.

Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy

Directory of Open Access Journals (Sweden)

Célia Regina Farias de Araújo Lucena

2013-02-01

Full Text Available PURPOSE: To compare pain related to intravitreal injection and panretinal photocoagulation in the management of patients with high-risk proliferative diabetic retinopathy. METHODS: Prospective study including patients with high-risk proliferative diabetic retinopathy and no prior laser treatment randomly assigned to receive panretinal photocoagulation (PRP group or panretinal photocoagulation plus intravitreal ranibizumab (PRPplus group. In all patients, panretinal photocoagulation was administered in two sessions (weeks 0 and 2, and intravitreal ranibizumab was administered at the end of the first laser session in the PRPplus group. Retreatment was performed at weeks 16 and 32 if active new vessels were detected at fluorescein angiography. Patients in the PRPplus group received intravitreal ranibizumab and patients in the PRP group received 500-µm additional spots per quadrant of active new vessels. After the end of retreatment, a 100-degree Visual Analog Scale was used for pain score estimation. The patient was asked about the intensity of pain during the whole procedure (retinal photocoagulation session or intravitreal ranibizumab injection. Statistics for pain score comparison were performed using a non-parametric test (Wilcoxon rank sums. RESULTS: Seventeen patients from PRPplus and 14 from PRP group were evaluated for pain scores. There were no significant differences between both groups regarding gender, glycosylated hemoglobin and disease duration. Mean intravitreal injection pain (±SEM was 4.7 ± 2.1 and was significantly lower (p<0.0001 than mean panretinal photocoagulation pain (60.8 ± 7.8. Twelve out of 17 patients from the PRPplus group referred intensity pain score of zero, while the minimal score found in PRP group was found in one patient with 10.5. CONCLUSION: In patients with high-risk proliferative diabetic retinopathy who needed retreatment for persistent new vessels, there was more comfort for the patient when retreatment

Preliminary Evaluation of MapReduce for High-Performance Climate Data Analysis

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Duffy, Daniel Q.; Schnase, John L.; Thompson, John H.; Freeman, Shawn M.; Clune, Thomas L.

2012-01-01

MapReduce is an approach to high-performance analytics that may be useful to data intensive problems in climate research. It offers an analysis paradigm that uses clusters of computers and combines distributed storage of large data sets with parallel computation. We are particularly interested in the potential of MapReduce to speed up basic operations common to a wide range of analyses. In order to evaluate this potential, we are prototyping a series of canonical MapReduce operations over a test suite of observational and climate simulation datasets. Our initial focus has been on averaging operations over arbitrary spatial and temporal extents within Modern Era Retrospective- Analysis for Research and Applications (MERRA) data. Preliminary results suggest this approach can improve efficiencies within data intensive analytic workflows.

Renal transplantation in high cardiovascular risk patients.

Science.gov (United States)

Bittar, Julio; Arenas, Paula; Chiurchiu, Carlos; de la Fuente, Jorge; de Arteaga, Javier; Douthat, Walter; Massari, Pablo U

2009-10-01

Current transplant success allows recipients with previous contraindications to transplant to have access to this procedure with more frequency and safety. The concept of high-risk patient has changed since the first stages of transplantation. In the first studies, the high-risk concept was based on probability of early graft failure or on a patient's clinical condition to cope with high perioperatory morbimortality. Later on, this concept implied immunological factors that were crucial to ensure transplant success because hypersensitized or polytransfused patients experienced a higher risk of acute rejection and subsequent graft loss. Afterward, the presence of various comorbidities would redefine the high-risk concept for renal transplant mainly considering recipient's clinical aspects. Currently, the change in epidemiological characteristics of patients starting dialysis causes that we now deal with a greater increase of elderly patients, diabetic patients, and patients with history of cardiovascular disease. Today, high-risk patients are those with clinical features that predict an increase in the risk of perioperative morbimortality or death with functioning graft. In this review, we will attempted to analyze currents results of renal transplant outcomes in terms of patients and graft survival in elderly patients, diabetic patients, and patients with previous cardiovascular disease from the most recent experiences in the literature and from experiences in our center. In any of the groups previously analyzed, survival offered by renal transplant is significantly higher compared to dialysis. Besides, these patients are the recipient group that benefit the most with the transplant because their mortality while remaining on dialysis is extremely high. Hence, renal transplantation should be offered more frequently to older patients, diabetic patients, and patients with pretransplant cardiac and peripheral vascular disease. A positive attitude toward renal

Cardiovascular Risk and Serum Hyaluronic Acid: A Preliminary Study in a Healthy Population of Low/Intermediate Risk.

Science.gov (United States)

Papanastasopoulou, Chrysanthi; Papastamataki, Maria; Karampatsis, Petros; Anagnostopoulou, Eleni; Papassotiriou, Ioannis; Sitaras, Nikolaos

2017-01-01

Hyaluronic acid (HA) has been found to be an important trigger of atherosclerosis. In this study, we investigate the possible association of serum HA with cardiovascular disease risk in a population of low/intermediate risk for cardiovascular events. We enrolled 200 subjects with low/intermediate risk for developing cardiovascular disease. High specific C-reactive protein (hsCRP) was used as an indicator of preclinical atherosclerosis. The Framingham score was used to calculate the cardiovascular risk. Participants with dyslipidemia had significantly higher levels of serum HA than those without dyslipidemia (t-test, P = 0.05), higher levels of hsCRP (Kruskal-Wallis test, P = 0.04), and higher cardiovascular risk according to the Framingham score (Kruskal-Wallis test, P = 0.05). Serum HA concentration correlated significantly with the Framingham score for risk for coronary heart disease over the next 10 years (Spearman r = 0.152, P = 0.02). Diabetic volunteers had significantly higher HA than those without diabetes (t-test, P = 0.02). Participants with metabolic syndrome had higher serum HA levels and higher hsCRP (Kruskal-Wallis test, P = 0.01) compared to volunteers without metabolic syndrome (t-test, P = 0.03). Serum HA should be explored as an early marker of atheromatosis and cardiovascular risk. © 2016 Wiley Periodicals, Inc.

Specialized surveillance for individuals at high risk for melanoma: a cost analysis of a high-risk clinic.

Science.gov (United States)

Watts, Caroline G; Cust, Anne E; Menzies, Scott W; Coates, Elliot; Mann, Graham J; Morton, Rachael L

2015-02-01

Regular surveillance of individuals at high risk for cutaneous melanoma improves early detection and reduces unnecessary excisions; however, a cost analysis of this specialized service has not been undertaken. To determine the mean cost per patient of surveillance in a high-risk clinic from the health service and societal perspectives. We used a bottom-up microcosting method to measure resource use in a consecutive sample of 102 patients treated in a high-risk hospital-based clinic in Australia during a 12-month period. Surveillance and treatment of melanoma. All surveillance and treatment procedures were identified through direct observation, review of medical records, and interviews with staff and were valued using scheduled fees from the Australian government. Societal costs included transportation and loss of productivity. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]); the cost discounted across 20 years was A $11,546 (95% CI, A $10,263-$12,829) (US $7839 [95% CI, US $6969-$8710]). The mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710]); the cost discounted across 20 years was A $12,721 (95% CI, A $12,554-$14,463) (US $8637 [95% CI, US $8523-$9820]). Diagnosis of melanoma or nonmelanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for positively skewed health system costs. Microcosting techniques provide an accurate cost estimate for the provision of a specialized service. The high societal cost reflects the time that patients are willing to invest to attend the high-risk clinic. This alternative model of care for a high-risk population has relevance for decision making about health policy.

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.

Physical activity barriers and motivators among high-risk employees.

Science.gov (United States)

Paguntalan, John C; Gregoski, Mathew

2016-11-22

Worksite wellness programs offer an ideal setting to target high-risk sedentary workers to improve health status. Lack of physical activity is associated with increased risk for coronary heart disease and mortality. Despite the risks, the number of sedentary workers is increasing. This study examined the perceived barriers and motivators for physical activity among employees at high-risk for coronary heart disease. A purposive sample of 24 high-risk workers participating in a wellness program in rural South Carolina were enrolled in the study. Qualitative data was obtained through semi-structured face-to-face interviews. Grounded theory was used to analyze qualitative data, and identify overarching themes. Physical limitations due to pain and weakness, lack of motivation, and lack of time emerged as the main barriers to physical activity. Family relationships were reported as the strongest motivator along with social support and potential health benefits. Findings highlight the unique experience of high-risk workers with physical activity. The findingsunderscore the need to design and implement effective interventions specifically designed to meet the needs of high-risk employees.

High-risk regions and outbreak modelling of tularemia in humans.

Science.gov (United States)

Desvars-Larrive, A; Liu, X; Hjertqvist, M; Sjöstedt, A; Johansson, A; Rydén, P

2017-02-01

Sweden reports large and variable numbers of human tularemia cases, but the high-risk regions are anecdotally defined and factors explaining annual variations are poorly understood. Here, high-risk regions were identified by spatial cluster analysis on disease surveillance data for 1984-2012. Negative binomial regression with five previously validated predictors (including predicted mosquito abundance and predictors based on local weather data) was used to model the annual number of tularemia cases within the high-risk regions. Seven high-risk regions were identified with annual incidences of 3·8-44 cases/100 000 inhabitants, accounting for 56·4% of the tularemia cases but only 9·3% of Sweden's population. For all high-risk regions, most cases occurred between July and September. The regression models explained the annual variation of tularemia cases within most high-risk regions and discriminated between years with and without outbreaks. In conclusion, tularemia in Sweden is concentrated in a few high-risk regions and shows high annual and seasonal variations. We present reproducible methods for identifying tularemia high-risk regions and modelling tularemia cases within these regions. The results may help health authorities to target populations at risk and lay the foundation for developing an early warning system for outbreaks.

Laser prostatectomy in high-risk patients

International Nuclear Information System (INIS)

Tayib, Abdulmalik M.

2008-01-01

Objective was to evaluate the short-term tolerability and outcome of high power green light potassium titanyl phosphate laser prostatectomy in high-risk patients with symptomatic benign prostatic hyperplasia. Eleven high risk operative patients were included in this study at the International Medical Center, Jeddah, Kingdom of Saudi Arabia, between January and September 2007. Patients enrolled in this study underwent preoperative and postoperative, cardiac and anesthesia evaluation. Clinical presentations, ultrasound of urinary tract and preoperative laboratory investigation were recorded. All patients underwent high power green light laser prostatectomy using the green light photo vaporization system with setting of 120 watts. The intraoperative and postoperative complications and follow-up were recorded. The patient's age varied between 65-82 years with a mean age of 75.3+-8.6 years old. Seven patients presented with refractory acute urinary retention and 4 patients presented with severe lower urinary tract symptoms. The average prostate volume was 61.22 cc. All patients had uneventful intra- and postoperative course, without the intensive care. The average blood loss was insignificant and only one of the patients required blood transfusion. Foley catheters were removed one day after the procedure. All patients voided satisfactorily after removal of catheter and 8 patients complained of urgency. High power green light laser prostatectomy is a safe and effective method of treating symptomatic benign prostatic hyperplasia in patients with high operative risk. (author)

Risk factors for isolated sleep paralysis in an African American sample: a preliminary study.

Science.gov (United States)

Ramsawh, Holly J; Raffa, Susan D; White, Kamila S; Barlow, David H

2008-12-01

Isolated sleep paralysis (ISP) is a temporary period of involuntary immobility that can occur at sleep onset or offset. It has previously been reported in association with both panic disorder (PD) and posttraumatic stress disorder (PTSD). The current study examined the association between ISP and several possible risk factors--anxiety sensitivity, trauma exposure, life stress, and paranormal beliefs--in a sample of African American participants with and without a history of ISP. Significant between-group differences were found for PD and PTSD diagnoses, anxiety sensitivity, life stress, and certain aspects of paranormal belief, with the ISP group being higher on all of these indices. No differences were found with regard to trauma exposure. Hierarchical regression analyses indicated that PD, anxiety sensitivity, and life stress each contributed unique variance to ISP cognitive symptoms, whereas PTSD and paranormal beliefs did not. These results provide preliminary support for an association between ISP and anxiety sensitivity and corroborate previous reports of ISP's association with PD and life stress. The current trauma/PTSD findings are mixed, however, and warrant future research.

Risk-adaptive optimization: Selective boosting of high-risk tumor subvolumes

International Nuclear Information System (INIS)

Kim, Yusung; Tome, Wolfgang A.

2006-01-01

Background and Purpose: A tumor subvolume-based, risk-adaptive optimization strategy is presented. Methods and Materials: Risk-adaptive optimization employs a biologic objective function instead of an objective function based on physical dose constraints. Using this biologic objective function, tumor control probability (TCP) is maximized for different tumor risk regions while at the same time minimizing normal tissue complication probability (NTCP) for organs at risk. The feasibility of risk-adaptive optimization was investigated for a variety of tumor subvolume geometries, risk-levels, and slopes of the TCP curve. Furthermore, the impact of a correlation parameter, δ, between TCP and NTCP on risk-adaptive optimization was investigated. Results: Employing risk-adaptive optimization, it is possible in a prostate cancer model to increase the equivalent uniform dose (EUD) by up to 35.4 Gy in tumor subvolumes having the highest risk classification without increasing predicted normal tissue complications in organs at risk. For all tumor subvolume geometries investigated, we found that the EUD to high-risk tumor subvolumes could be increased significantly without increasing normal tissue complications above those expected from a treatment plan aiming for uniform dose coverage of the planning target volume. We furthermore found that the tumor subvolume with the highest risk classification had the largest influence on the design of the risk-adaptive dose distribution. The parameter δ had little effect on risk-adaptive optimization. However, the clinical parameters D 5 and γ 5 that represent the risk classification of tumor subvolumes had the largest impact on risk-adaptive optimization. Conclusions: On the whole, risk-adaptive optimization yields heterogeneous dose distributions that match the risk level distribution of different subvolumes within the tumor volume

Risk impact of two accident management strategies

International Nuclear Information System (INIS)

Dingman, S.; Camp, A.

1992-01-01

This report probabilistic Risk Assessment is used to evaluate two accident management strategies: intentionally depressurizing the reactor coolant system of a pressurized water reactor to prevent containment-pressurization during high pressure melt ejection, and flooding the containment of a boiling water reactor to prevent or delay vessel breach. Sensitivity studies indicated that intentional depressurization would not provide a significant risk reduction at Surry. A preliminary evaluation of the containment flooding strategy indicated that it might prove beneficial for some plants, but that further strategy development would be needed to fully evaluate the strategy-

Who Takes Risks in High-Risk Sports? A Typological Personality Approach

Science.gov (United States)

Castanier, Carole; Le Scanff, Christine; Woodman, Tim

2010-01-01

We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing, mountaineering, rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and…

Preliminary study on field buses for the control system of the high voltage of the ATLAS hadronic calorimeter

International Nuclear Information System (INIS)

Drevet, F.; Chadelas, R.; Montarou, G.

1996-01-01

We present here after a preliminary study on field buses for the control system of the high voltage of the photomultipliers of the TILECAL calorimeter. After some generalities, different commercial buses are reviewed (CAN, ARCET, WorldFIP, Profibus and LonWorks). The Profibus and LonWorks solution are more extensively studies as a possible solution for the high voltage system of the TILE hadronic calorimeter. (authors)

A social work study high-risk behavior among teenagers

Directory of Open Access Journals (Sweden)

Mohammad Reza Iravani

2012-01-01

Full Text Available Teenagers are believed the people who are supposed to build the world's future. High-risk behaviors such as addiction to drugs, smoking cigarettes, sex, etc. could significantly hurts teenagers and there must be some supporting programs to reduce these issues as much as possible. This paper performs an empirical investigation to study the different factors influencing high- risk behavior among teenagers who live in a city of Esfahan, Iran. The proposed study designs a questionnaire and distribute between two groups of female and male teenagers. The results indicate that while there is a meaningful relationship between high-risk behaviors and average high school marks among male students there is no meaningful relationship between high-risk behaviors and high school grades among female students. The results also indicate that there is a meaningful difference between gender and high-risk behavior. The season of birth for female and male students is another important factor for having high-risk behaviors. While the order of birth plays an important role among male students, the order of birth is not an important factor among female teenagers. Finally, the results indicate that teenagers' parental financial affordability plays a vital role on both female and male teenagers.

Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

Science.gov (United States)

Shishko, Robert; Jorgensen, Edward J.

1996-01-01

This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

Computer aided approach for qualitative risk assessment of engineered systems

International Nuclear Information System (INIS)

Crowley, W.K.; Arendt, J.S.; Fussell, J.B.; Rooney, J.J.; Wagner, D.P.

1978-01-01

This paper outlines a computer aided methodology for determining the relative contributions of various subsystems and components to the total risk associated with an engineered system. Major contributors to overall task risk are identified through comparison of an expected frequency density function with an established risk criterion. Contributions that are inconsistently high are also identified. The results from this analysis are useful for directing efforts for improving system safety and performance. An analysis of uranium hexafluoride handling risk at a gaseous diffusion uranium enrichment plant using a preliminary version of the computer program EXCON is briefly described and illustrated

Phase 2 Study of Temozolomide-Based Chemoradiation Therapy for High-Risk Low-Grade Gliomas: Preliminary Results of Radiation Therapy Oncology Group 0424

Energy Technology Data Exchange (ETDEWEB)

Fisher, Barbara J., E-mail: barbara.fisher@lhsc.on.ca [London Regional Cancer Program, London, Ontario (Canada); Hu, Chen [Radiation Therapy Oncology Group-Statistical Center, Philadelphia, Pennsylvania (United States); Macdonald, David R. [London Regional Cancer Program, London, Ontario (Canada); Lesser, Glenn J. [Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina (United States); Coons, Stephen W. [Barrow Neurological Institute, Phoenix, Arizona (United States); Brachman, David G. [Arizona Oncology Services Foundation, Phoenix, Arizona (United States); Ryu, Samuel [Henry Ford Hospital, Detroit, Michigan (United States); Werner-Wasik, Maria [Thomas Jefferson University Hospital Center, Philadelphia, Pennsylvania (United States); Bahary, Jean-Paul [Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, Quebec (Canada); Liu, Junfeng [GCE Solutions, Inc., Bloomington, Illinois (United States); Chakravarti, Arnab [The Ohio State University, The James, Columbus, Ohio (United States); Mehta, Minesh [University of Maryland Medical Systems, Baltimore, Maryland (United States)

2015-03-01

Purpose: Radiation Therapy Oncology Group (RTOG) 0424 was a phase 2 study of a high-risk low-grade glioma (LGG) population who were treated with temozolomide (TMZ) and radiation therapy (RT), and outcomes were compared to those of historical controls. This study was designed to detect a 43% increase in median survival time (MST) from 40.5 to 57.9 months and a 20% improvement in 3-year overall survival (OS) rate from 54% to 65% at a 10% significance level (1-sided) and 96% power. Methods and Materials: Patients with LGGs with 3 or more risk factors for recurrence (age ≥40 years, astrocytoma histology, bihemispherical tumor, preoperative tumor diameter of ≥6 cm, or a preoperative neurological function status of >1) were treated with RT (54 Gy in 30 fractions) and concurrent and adjuvant TMZ. Results: From 2005 to 2009, 129 evaluable patients (75 males and 54 females) were accrued. Median age was 49 years; 91% had a Zubrod score of 0 or 1; and 69%, 25%, and 6% of patients had 3, 4, and 5 risk factors, respectively. Patients had median and minimum follow-up examinations of 4.1 years and 3 years, respectively. The 3-year OS rate was 73.1% (95% confidence interval: 65.3%-80.8%), which was significantly improved compared to that of prespecified historical control values (P<.001). Median survival time has not yet been reached. Three-year progression-free survival was 59.2%. Grades 3 and 4 adverse events occurred in 43% and 10% of patients, respectively. One patient died of herpes encephalitis. Conclusions: The 3-year OS rate of 73.1% for RTOG 0424 high-risk LGG patients is higher than that reported for historical controls (P<.001) and the study-hypothesized rate of 65%.

Preliminary evaluation of a predictive blood assay to identify patients at high risk of chemotherapy-induced nausea.

Science.gov (United States)

Kutner, Thomas; Kunkel, Emily; Wang, Yue; George, Kyle; Zeger, Erik L; Ali, Zonera A; Prendergast, George C; Gilman, Paul B; Wallon, U Margaretha

2017-02-01

The aim of this study was to test a new blood-based assay for its ability to predict delayed chemotherapy-induced nausea. Blood drawn from consented patients prior to receiving their first platinum-based therapy was tested for glutathione recycling capacity and normalized to total red cell numbers. This number was used to predict nausea and then compared to patient reported outcomes using the Rotterdam Symptom Check List and medical records. We show that the pathways involved in the glutathione recycling are stable for at least 48 h and that the test was able to correctly classify the risk of nausea for 89.1 % of the patients. The overall incidence of nausea was 21.9 % while women had an incidence of 29.6 %. This might be the first objective test to predict delayed nausea for cancer patients receiving highly emetogenic chemotherapy. We believe that this assay could better guide clinicians in their efforts to provide optimal patient-oriented care.

A spatially-dynamic preliminary risk assessment of the American peregrine falcon at the Los Alamos National Laboratory (version 1)

International Nuclear Information System (INIS)

Gallegos, A.F.; Gonzales, G.J.; Bennett, K.D.

1997-06-01

The Endangered Species Act and the Record of Decision on the Dual Axis Radiographic Hydrodynamic Test Facility at the Los Alamos National Laboratory require protection of the American peregrine falcon. A preliminary risk assessment of the peregrine was performed using a custom FORTRAN model and a geographical information system. Estimated doses to the falcon were compared against toxicity reference values to generate hazard indices. Hazard index results indicated no unacceptable risk to the falcon from the soil ingestion pathway, including a measure of cumulative effects from multiple contaminants that assumes a linear additive toxicity type. Scaling home ranges on the basis of maximizing falcon height for viewing prey decreased estimated risk by 69% in a canyons-based home range and increased estimated risk by 40% in a river-based home range. Improving model realism by weighting simulated falcon foraging based on distance from potential nest sites decreased risk by 93% in one exposure unit and by 82% in a second exposure unit. It was demonstrated that choice of toxicity reference values can have a substantial impact on risk estimates. Adding bioaccumulation factors for several organics increased partial hazard quotients by a factor of 110, but increased the mean hazard index by only 0.02 units. Adding a food consumption exposure pathway in the form of biomagnification factors for 15 contaminants of potential ecological concern increased the mean hazard index to 1.16 (± 1.0), which is above the level of acceptability (1.0). Aroclor-1254, dichlorodiphenyltrichlorethane (DDT) and dichlorodiphenylethelyne (DDE) accounted for 81% of the estimated risk that includes soil ingestion and food consumption Contaminant pathways and a biomagnification component. Information on risk by specific geographical location was generated, which can be used to manage contaminated areas, falcon habitat, facility siting, and/or facility operations. 123 refs., 10 figs., 2 tabs

A spatially-dynamic preliminary risk assessment of the American peregrine falcon at the Los Alamos National Laboratory (version 1)

Energy Technology Data Exchange (ETDEWEB)

Gallegos, A.F.; Gonzales, G.J.; Bennett, K.D. [and others

1997-06-01

The Endangered Species Act and the Record of Decision on the Dual Axis Radiographic Hydrodynamic Test Facility at the Los Alamos National Laboratory require protection of the American peregrine falcon. A preliminary risk assessment of the peregrine was performed using a custom FORTRAN model and a geographical information system. Estimated doses to the falcon were compared against toxicity reference values to generate hazard indices. Hazard index results indicated no unacceptable risk to the falcon from the soil ingestion pathway, including a measure of cumulative effects from multiple contaminants that assumes a linear additive toxicity type. Scaling home ranges on the basis of maximizing falcon height for viewing prey decreased estimated risk by 69% in a canyons-based home range and increased estimated risk by 40% in a river-based home range. Improving model realism by weighting simulated falcon foraging based on distance from potential nest sites decreased risk by 93% in one exposure unit and by 82% in a second exposure unit. It was demonstrated that choice of toxicity reference values can have a substantial impact on risk estimates. Adding bioaccumulation factors for several organics increased partial hazard quotients by a factor of 110, but increased the mean hazard index by only 0.02 units. Adding a food consumption exposure pathway in the form of biomagnification factors for 15 contaminants of potential ecological concern increased the mean hazard index to 1.16 ({+-} 1.0), which is above the level of acceptability (1.0). Aroclor-1254, dichlorodiphenyltrichlorethane (DDT) and dichlorodiphenylethelyne (DDE) accounted for 81% of the estimated risk that includes soil ingestion and food consumption Contaminant pathways and a biomagnification component. Information on risk by specific geographical location was generated, which can be used to manage contaminated areas, falcon habitat, facility siting, and/or facility operations. 123 refs., 10 figs., 2 tabs.

Risk factors and the occurrence of cerebral palsy in high risk infants

Directory of Open Access Journals (Sweden)

Setyo Handryastuti

2018-04-01

Full Text Available Background The incidence of cerebral palsy (CP has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention. Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP. Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age. Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53. Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy. Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.

Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

Science.gov (United States)

2011-01-01

Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92%) used an observational design and focused on women (70%) with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups) and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although evolving, is still

Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

Directory of Open Access Journals (Sweden)

Tilburt Jon C

2011-05-01

Full Text Available Abstract Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92% used an observational design and focused on women (70% with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although

Distribution and preliminary exposure assessment of bisphenol AF (BPAF) in various environmental matrices around a manufacturing plant in China.

Science.gov (United States)

Song, Shanjun; Ruan, Ting; Wang, Thanh; Liu, Runzeng; Jiang, Guibin

2012-12-18

Increasing attention has been paid to bisphenol A and bisphenol (BP) analogues due to high production volumes, wide usage and potential adverse effects. Bisphenol AF (BPAF) is considered a new bisphenol analogue which is used as raw material in plastic industry, but little is known about its occurrence in the environment and the potential associated risk. In this work, BPAF levels and environmental distribution were reported in samples collected around a manufacturing plant and a preliminary exposure risk assessment to local residents was conducted. BPAF was detected in most of the samples, with levels in river ranging between environment and organic carbon was the domain factor during the process. The preliminary BPAF exposure assessment based on the CSOIL model suggested that children could have higher intake of BPAF than adults through inhalation of soils, dermal exposure by soils contact and bathing with well water.

Psychological characteristics in high-risk MSM in China

Directory of Open Access Journals (Sweden)

Chen Guanzhi

2012-01-01

Full Text Available Abstract Background Men who have sex with men (MSM have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26% had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P P > 0.05. A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China.

Predictive risk modelling under different data access scenarios: who is identified as high risk and for how long?

Science.gov (United States)

Johnson, Tracy L; Kaldor, Jill; Sutherland, Kim; Humphries, Jacob; Jorm, Louisa R; Levesque, Jean-Frederic

2018-01-01

Objective This observational study critically explored the performance of different predictive risk models simulating three data access scenarios, comparing: (1) sociodemographic and clinical profiles; (2) consistency in high-risk designation across models; and (3) persistence of high-risk status over time. Methods Cross-sectional health survey data (2006–2009) for more than 260 000 Australian adults 45+ years were linked to longitudinal individual hospital, primary care, pharmacy and mortality data. Three risk models predicting acute emergency hospitalisations were explored, simulating conditions where data are accessed through primary care practice management systems, or through hospital-based electronic records, or through a hypothetical ‘full’ model using a wider array of linked data. High-risk patients were identified using different risk score thresholds. Models were reapplied monthly for 24 months to assess persistence in high-risk categorisation. Results The three models displayed similar statistical performance. Three-quarters of patients in the high-risk quintile from the ‘full’ model were also identified using the primary care or hospital-based models, with the remaining patients differing according to age, frailty, multimorbidity, self-rated health, polypharmacy, prior hospitalisations and imminent mortality. The use of higher risk prediction thresholds resulted in lower levels of agreement in high-risk designation across models and greater morbidity and mortality in identified patient populations. Persistence of high-risk status varied across approaches according to updated information on utilisation history, with up to 25% of patients reassessed as lower risk within 1 year. Conclusion/implications Small differences in risk predictors or risk thresholds resulted in comparatively large differences in who was classified as high risk and for how long. Pragmatic predictive risk modelling design decisions based on data availability or projected

Problem Gambling in Chinese American Adolescents: Characteristics and Risk Factors

Science.gov (United States)

Chiu, Eddie Yu-Wai; Woo, Kent

2012-01-01

This preliminary study examined the characteristics and risk factors of problem gambling among Chinese American adolescents. A total of 192 Chinese American students (aged 13-19) from 9th to 12th grades were recruited from three high schools in San Francisco, California. Students were administered the South Oaks Gambling Screen Revised for…

Preliminary indoor thoron measurements in high radiation background area of southeastern coastal Orissa (India)

International Nuclear Information System (INIS)

Ramola, R. C.; Prasad, G.; Gusain, G. S.; Rautela, B. S.; Choubey, V. M.; Vidya Sagar, D.; Tokonami, S.; Sorimachi, A.; Sahoo, S. K.; Janik, M.; Ishikawa, T.

2010-01-01

This paper presents the preliminary results of radon and thoron measurements in the houses of Chhatrapur area of southeastern coast of Orissa (India). This area is one of the high radiation background radiation areas in India, which consists of monazite sand as the source of thoron. Both active and passive methods were employed for the measurements. Radon and thoron concentrations were measured in the houses of Chhatrapur area using twin cup radon dosemeters, RAD7 and radon-thoron discriminative detector (Raduet). Thoron progeny concentration was also measured in the houses using deposition rate measurements. Radon and thoron concentrations in the houses of study area were found to vary from 8 to 47 Bq m -3 and the below detection level to 77 Bq m -3 , respectively. While thoron progeny concentration in these houses ranges between 0.17 and 4.24 Bq m -3 , preliminary investigation shows that the thoron concentration is higher than radon concentration in the houses of the study area. The thoron progeny concentration was found to be comparatively higher, which forms a base for further study in the area. The comparison between the results of various techniques is presented in this paper. (authors)

Preliminary indoor thoron measurements in high radiation background area of southeastern coastal Orissa (India)

Energy Technology Data Exchange (ETDEWEB)

Ramola, R C; Prasad, G; Gusain, G S; Rautela, B S [Dept. of Physics, H.N.B. Garhwal Univ., Badshahi Thaul, Tehri Garhwal 249 199 (India); Choubey, V M [Wadia Inst. of Himalayan Geology, Dehradun 248 001 (India); Vidya Sagar, D [Health Physics Unit (EAD, BARC), IRE, OSCOM, Matikhalo, Dt. Ganjam, Orissa 761 045 (India); Tokonami, S; Sorimachi, A; Sahoo, S K; Janik, M; Ishikawa, T [National Inst. of Radiological Sciences, Anagawa 4-9-1, Inage-ku, Chiba 263 8555 (Japan)

2010-07-01

This paper presents the preliminary results of radon and thoron measurements in the houses of Chhatrapur area of southeastern coast of Orissa (India). This area is one of the high radiation background radiation areas in India, which consists of monazite sand as the source of thoron. Both active and passive methods were employed for the measurements. Radon and thoron concentrations were measured in the houses of Chhatrapur area using twin cup radon dosemeters, RAD7 and radon-thoron discriminative detector (Raduet). Thoron progeny concentration was also measured in the houses using deposition rate measurements. Radon and thoron concentrations in the houses of study area were found to vary from 8 to 47 Bq m{sup -3} and the below detection level to 77 Bq m{sup -3}, respectively. While thoron progeny concentration in these houses ranges between 0.17 and 4.24 Bq m{sup -3}, preliminary investigation shows that the thoron concentration is higher than radon concentration in the houses of the study area. The thoron progeny concentration was found to be comparatively higher, which forms a base for further study in the area. The comparison between the results of various techniques is presented in this paper. (authors)

Preliminary postclosure risk assessment: Yucca Mountain, Nevada, candidate repository site

International Nuclear Information System (INIS)

Eslinger, P.W.; Elwood, D.M.; Freshley, M.D.; Reimus, P.W.; Tanner, J.E.; Doctor, P.G.; Engel, D.W.; Liebetrau, A.M.; Strenge, D.L.; Van Luik, A.E.

1989-10-01

A study was conducted by the Pacific Northwest Laboratory for the US Department of Energy, Office of Civilian Radioactive Waste Management, to estimate the postclosure risk, in terms of population health effects, of a proposed high-level nuclear waste repository at Yucca Mountain, Nevada. The risk estimates cover a time span of 1 million years following repository closure. Representative disruptive and intrusive events were selected and evaluated in addition to expected conditions. The estimates were generated assuming spent fuel as the waste form and included all important nuclides from inventory, half-life and dose perspectives. The base case results yield an estimate of 36 health effects over the first million years of repository operation. The doses attributed to the repository corresponds to about 0.1 percent of the doses received from natural background radiation. 16 refs., 1 fig

Management of Skin Cancer in the High-Risk Patient.

Science.gov (United States)

Behan, James W; Sutton, Adam; Wysong, Ashley

2016-12-01

Skin cancer is the most common of human cancers and outnumbers all other types of cancer combined in the USA by over threefold. The majority of non-melanoma skin cancers are easily treated with surgery or locally destructive techniques performed under local anesthesia in the cost-effective outpatient setting. However, there is a subset of "high-risk" cases that prove challenging in terms of morbidity, mortality, adjuvant treatment required, as well as overall cost to the health care system. In our opinion, the term "high risk" when applied to skin cancer can mean one of three things: a high-risk tumor with aggressive histologic and/or clinical features with an elevated risk for local recurrence or regional/distant metastasis, a high-risk patient with the ongoing development of multiple skin cancers, and a high-risk patient based on immunosuppression. We have recently proposed classifying NMSC as a chronic disease in a certain subset of patients. Although no consensus definition exists for a chronic disease in medicine, there are three components that are present in most definitions: duration of at least 1 year, need for ongoing medical care, and functional impairment and/or alteration of activities of daily living (ADLs) and quality of life (QOL). Immunosuppression can refer to exogenous (organ or stem cell transplant patients,) or endogenous (HIV, leukemia, lymphoma, genodermatoses with DNA mismatch repair problems or other immunosuppression) causes. These patients are at risk for high-risk tumors and/or the development of multiple tumors.

The "polyenviromic risk score": Aggregating environmental risk factors predicts conversion to psychosis in familial high-risk subjects.

Science.gov (United States)

Padmanabhan, Jaya L; Shah, Jai L; Tandon, Neeraj; Keshavan, Matcheri S

2017-03-01

Young relatives of individuals with schizophrenia (i.e. youth at familial high-risk, FHR) are at increased risk of developing psychotic disorders, and show higher rates of psychiatric symptoms, cognitive and neurobiological abnormalities than non-relatives. It is not known whether overall exposure to environmental risk factors increases risk of conversion to psychosis in FHR subjects. Subjects consisted of a pilot longitudinal sample of 83 young FHR subjects. As a proof of principle, we examined whether an aggregate score of exposure to environmental risk factors, which we term a 'polyenviromic risk score' (PERS), could predict conversion to psychosis. The PERS combines known environmental risk factors including cannabis use, urbanicity, season of birth, paternal age, obstetric and perinatal complications, and various types of childhood adversity, each weighted by its odds ratio for association with psychosis in the literature. A higher PERS was significantly associated with conversion to psychosis in young, familial high-risk subjects (OR=1.97, p=0.009). A model combining the PERS and clinical predictors had a sensitivity of 27% and specificity of 96%. An aggregate index of environmental risk may help predict conversion to psychosis in FHR subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

Preliminary risk assessment of the Mexican Spotted Owl under a spatially-weighted foraging regime at the Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Gallegos, A.F.; Gonzales, G.J.; Bennett, K.D.; Pratt, L.E.

1997-02-01

The Record of Decision on the Dual Axis Radiographic Hydrodynamic Test Facility at the Los Alamos National Laboratory requires that the Department of Energy takes special precautions to protect the Mexican Spotted Owl (Strix occidentalis lucida). In order to do so, risk to the owl presented by radiological and nonradiological contaminants must be estimated. A preliminary risk assessment on the Mexican Spotted Owl in two Ecological Exposure Units (EEUs) was performed using a modified Environmental Protection Agency Quotient method, the FORTRAN model ECORSK4, and a geographic information system. Estimated doses to the owl under a spatially-weighted foraging regime were compared against toxicological reference doses generating hazard indices (HIs) and hazard quotients (HQs) for three risk source types. The average HI was 0.20 for EEU-21 and 0.0015 for EEU-40. Under the risk parameter assumptions made, hazard quotient results indicated no unacceptable risk to the owl, including a measure of cumulative effects from multiple contaminants that assumes a linear additive toxicity type. An HI of 1.0 was used as the evaluative criteria for determining the acceptability of risk. This value was exceeded (1.06) in only one of 200 simulated potential nest sites. Cesium-137, Ni, {sup 239}Pu, Al and {sup 234}U we`re among the constituents with the highest partial HQs. Improving model realism by weighting simulated owl foraging based on distance from potential nest sites decreased the estimated risk by 72% (0.5 HI units) for EEU-21 and by 97.6% (6.3E-02 HI units) for EEU-40. Information on risk by specific geographical location was generated, which can be used to manage contaminated areas, owl habitat, facility siting, and/or facility operations in order to maintain risk from contaminants at acceptably low levels.

Preliminary risk assessment of the Mexican Spotted Owl under a spatially-weighted foraging regime at the Los Alamos National Laboratory

International Nuclear Information System (INIS)

Gallegos, A.F.; Gonzales, G.J.; Bennett, K.D.; Pratt, L.E.

1997-02-01

The Record of Decision on the Dual Axis Radiographic Hydrodynamic Test Facility at the Los Alamos National Laboratory requires that the Department of Energy takes special precautions to protect the Mexican Spotted Owl (Strix occidentalis lucida). In order to do so, risk to the owl presented by radiological and nonradiological contaminants must be estimated. A preliminary risk assessment on the Mexican Spotted Owl in two Ecological Exposure Units (EEUs) was performed using a modified Environmental Protection Agency Quotient method, the FORTRAN model ECORSK4, and a geographic information system. Estimated doses to the owl under a spatially-weighted foraging regime were compared against toxicological reference doses generating hazard indices (HIs) and hazard quotients (HQs) for three risk source types. The average HI was 0.20 for EEU-21 and 0.0015 for EEU-40. Under the risk parameter assumptions made, hazard quotient results indicated no unacceptable risk to the owl, including a measure of cumulative effects from multiple contaminants that assumes a linear additive toxicity type. An HI of 1.0 was used as the evaluative criteria for determining the acceptability of risk. This value was exceeded (1.06) in only one of 200 simulated potential nest sites. Cesium-137, Ni, 239 Pu, Al and 234 U we're among the constituents with the highest partial HQs. Improving model realism by weighting simulated owl foraging based on distance from potential nest sites decreased the estimated risk by 72% (0.5 HI units) for EEU-21 and by 97.6% (6.3E-02 HI units) for EEU-40. Information on risk by specific geographical location was generated, which can be used to manage contaminated areas, owl habitat, facility siting, and/or facility operations in order to maintain risk from contaminants at acceptably low levels

Preliminary application of the draft code case for alloy 617 for a high temperature component

International Nuclear Information System (INIS)

Lee, Hyeong Yeon; Kim, Yong Wan; Song, Kee Nam

2008-01-01

The ASME draft Code Case for Alloy 617 was developed in the late 1980s for the design of very-high-temperature gas cooled reactors. The draft Code Case was patterned after the ASME Code Section III Subsection NH and was intended to cover Ni-Cr-Co-Mo Alloy 617 to 982 .deg. C (1800 .deg. F). But the draft Code Case is still in an incomplete status, lacking necessary material properties and design data. In this study, a preliminary evaluation on the creep-fatigue damage for a high temperature hot duct pipe structure has been carried out according to the draft Code Case. The evaluation procedures and results according to the draft Code Case for Alloy 617 material were compared with those of the ASME Subsection NH and RCC-MR for Alloy 800H material. It was shown that many data including material properties, fatigue and creep data should be supplemented for the draft Code Case. However, when the evaluation results on the creep-fatigue damage according to the draft Code Case, ASME-NH and RCC-MR were compared based on the preliminary evaluation, it was shown that the Alloy 617 results from the draft Code Case tended to be more resistant to the creep damage while less resistant to the fatigue damage than those from the ASME-NH and RCC-MR

Preliminary results from a high-pressure imaging spectroscopic proportional counter

International Nuclear Information System (INIS)

Hall, C.J.; Bazzano, A.; Lewis, R.A.; Parker, B.; Ubertini, P.; Worgan, J.S.

1992-01-01

A new type of high-pressure proportional counter, with both spatial resolution and spectroscopic capabilities is being jointly developed by the Istituto di Astrofisica Spaziale (CNR), Frascati, Italy and the SERC Daresbury Laboratory, Warrington, UK. The characteristics of the detector can be optimized for the particular requirement of the experiment, either for x-ray astronomy observations from space, or for the high count rate applications associated with a synchrotron light source. In its baseline configuration, the detector is filled to 5 bar with a xenon/quench gas mixture and will be sensitive over the energy range 5 keV to 150 keV (2.5 to 0.08 A). The positional resolution will range from 500 μm at the lower energies to around 1 mm at the higher end of the energy range. The current prototype has a sensitive area of 200x200 mm. The final version is hoped to have an area closer to 425x425 mm. The very small photon absorption length in the higher pressure gas allows the parallax effect, a feature of 1 atmosphere detectors, to be greatly reduced. The timing resolution (150 ns) of the detector enables both a high-rate capability and the possibility of the escape gate technique to achieve higher spectral resolution at energies > the Xe K edge. Preliminary results are presented showing the spectral and positional resolution for the prototype detector

Correlation between high-risk pregnancy and developmental delay ...

African Journals Online (AJOL)

Background: The future development of children is considered more than ever now due to the advances in medical knowledge and thus the increase in survival rates of high-risk infants. This study investigated the correlation between high-risk pregnancy and developmental delay in children aged 4- 60 months. Methods: ...

High-Risk Stress Fractures: Diagnosis and Management.

Science.gov (United States)

McInnis, Kelly C; Ramey, Lindsay N

2016-03-01

Stress fractures are common overuse injuries in athletes. They occur during periods of increased training without adequate rest, disrupting normal bone reparative mechanisms. There are a host of intrinsic and extrinsic factors, including biochemical and biomechanical, that put athletes at risk. In most stress fractures, the diagnosis is primarily clinical, with imaging indicated at times, and management focused on symptom-free relative rest with advancement of activity as tolerated. Overall, stress fractures in athletes have an excellent prognosis for return to sport, with little risk of complication. There is a subset of injuries that have a greater risk of fracture progression, delayed healing, and nonunion and are generally more challenging to treat with nonoperative care. Specific locations of high-risk stress fracture include the femoral neck (tension side), patella, anterior tibia, medial malleolus, talus, tarsal navicular, proximal fifth metatarsal, and great toe sesamoids. These sites share a characteristic region of high tensile load and low blood flow. High-risk stress fractures require a more aggressive approach to evaluation, with imaging often necessary, to confirm early and accurate diagnosis and initiate immediate treatment. Treatment consists of nonweight-bearing immobilization, often with a prolonged period away from sport, and a more methodic and careful reintroduction to athletic activity. These stress fractures may require surgical intervention. A high index of suspicion is essential to avoid delayed diagnosis and optimize outcomes in this subset of stress fractures. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Analysis of risk factors for persistent infection of asymptomatic women with high-risk human papilloma virus.

Science.gov (United States)

Shi, Nianmin; Lu, Qiang; Zhang, Jiao; Li, Li; Zhang, Junnan; Zhang, Fanglei; Dong, Yanhong; Zhang, Xinyue; Zhang, Zheng; Gao, Wenhui

2017-06-03

This study aims to prevent persistentinfection, reduce the incidence of cervical cancer, and improve women's health by understanding the theoretical basis of the risk factors for continuous infection of asymptomatic women with high-risk human papilloma virus (HPV) strains via information collected, which includes the persistent infection rate and the most prevalent HPV strain types of high risk to asymptomatic women in the high-risk area of cervical cancer in Linfen, Shanxi Province. Based on the method of cluster sampling, locations were chosen from the industrial county and agricultural county of Linfen, Shanxi Province, namely the Xiangfen and Quwo counties. Use of the convenience sampling (CS) method enables the identification of women who have sex but without symptoms of abnormal cervix for analyzing risk factors of HPV-DNA detection and performing a retrospective questionnaire survey in these 2 counties. Firstly, cervical exfoliated cell samples were collected for thin-layer liquid-based cytology test (TCT), and simultaneously testing high-risk type HPV DNA, then samples with positive testing results were retested to identify the infected HPV types. The 6-month period of testing was done to derive the 6-month persistent infection rate. The retrospective survey included concepts addressed in the questionnaire: basic situation of the research objects, menstrual history, marital status, pregnancy history, sexual habits and other aspects. The questionnaire was divided into a case group and a comparison group, which are based on the high-risk HPV-DNA testing result to ascertain whether or not there is persistent infection. Statistical analysis employed Epidate3.1 software for date entry, SPSS17.0 for date statistical analysis. Select statistic charts, Chi-Square Analysis, single-factor analysis and multivariate Logistic regression analysis to analyze the protective factors and risk factors of high-risk HPV infection. Risk factors are predicted by using the

Partitioning planning studies: Preliminary evaluation of metal and radionuclide partitioning the high-temperature thermal treatment systems

International Nuclear Information System (INIS)

Liekhus, K.; Grandy, J.; Chambers, A.

1997-03-01

A preliminary study of toxic metals and radionuclide partitioning during high-temperature processing of mixed waste has been conducted during Fiscal Year 1996 within the Environmental Management Technology Evaluation Project. The study included: (a) identification of relevant partitioning mechanisms that cause feed material to be distributed between the solid, molten, and gas phases within a thermal treatment system; (b) evaluations of existing test data from applicable demonstration test programs as a means to identify and understand elemental and species partitioning; and, (c) evaluation of theoretical or empirical partitioning models for use in predicting elemental or species partitioning in a thermal treatment system. This preliminary study was conducted to identify the need for and the viability of developing the tools capable of describing and predicting toxic metals and radionuclide partitioning in the most applicable mixed waste thermal treatment processes. This document presents the results and recommendations resulting from this study that may serve as an impetus for developing and implementing these predictive tools

Partitioning planning studies: Preliminary evaluation of metal and radionuclide partitioning the high-temperature thermal treatment systems

Energy Technology Data Exchange (ETDEWEB)

Liekhus, K.; Grandy, J.; Chambers, A. [and others

1997-03-01

A preliminary study of toxic metals and radionuclide partitioning during high-temperature processing of mixed waste has been conducted during Fiscal Year 1996 within the Environmental Management Technology Evaluation Project. The study included: (a) identification of relevant partitioning mechanisms that cause feed material to be distributed between the solid, molten, and gas phases within a thermal treatment system; (b) evaluations of existing test data from applicable demonstration test programs as a means to identify and understand elemental and species partitioning; and, (c) evaluation of theoretical or empirical partitioning models for use in predicting elemental or species partitioning in a thermal treatment system. This preliminary study was conducted to identify the need for and the viability of developing the tools capable of describing and predicting toxic metals and radionuclide partitioning in the most applicable mixed waste thermal treatment processes. This document presents the results and recommendations resulting from this study that may serve as an impetus for developing and implementing these predictive tools.

The Very High Risk Prostate Cancer – a Contemporary Update

Science.gov (United States)

Mano, Roy; Eastham, James; Yossepowitch, Ofer

2017-01-01

Background Treatment of high-risk prostate cancer has evolved considerably over the past two decades, yet patients with very high-risk features may still experience poor outcome despite aggressive therapy. We review the contemporary literature focusing on current definitions, role of modern imaging and treatment alternatives in very high-risk prostate cancer. Methods We searched the MEDLINE database for all clinical trials or practice guidelines published in English between 2000 – 2016 with the following search terms: ‘prostatic neoplasms’ (MeSH Terms) AND (‘high risk’ (keyword) OR ‘locally advanced’ (keyword) OR ‘node positive’ (keyword)). Abstracts pertaining to very high-risk prostate cancer were evaluated and 40 pertinent studies served as the basis for this review. Results The term ‘very’ high-risk prostate cancer remains ill defined. The EAU and NCCN guidelines provide the only available definitions, categorizing those with clinical stage T3-4 or minimal nodal involvement as very-high risk irrespective of PSA level or biopsy Gleason score. Modern imaging with mpMRI and PET-PSMA scans plays a role in pretreatment assessment. Local definitive therapy by external beam radiation combined with androgen deprivation is supported by several randomized clinical trials whereas the role of surgery in the very high-risk setting combined with adjuvant radiation/ androgen deprivation therapy is emerging. Growing evidence suggest neoadjuvant taxane based chemotherapy in the context of a multimodal approach may be beneficial. Conclusions Men with very high-risk tumors may benefit from local definitive treatment in the setting of a multimodal regimen, offering local control and possibly cure in well selected patients. Further studies are necessary to better characterize the ‘very’ high-risk category and determine the optimal therapy for the individual patient. PMID:27618950

The profile of high-risk pregnancy in El-Mansoura city.

Science.gov (United States)

Yassin, Shadia A T; Gamal El-Deen, Amany A; Emam, Mohamed A; Omer, Abeer K F

2005-01-01

Proper screening techniques should be used for all pregnant women attending antenatal clinics to pick up the factors that qualify the pregnant women for a risky pregnancy. High-risk pregnancy identification is a challenging work. This study aimed to describe the profile of high-risk pregnancy in El-Mansoura city. The study was conducted on 750 pregnant women attending antenatal clinics in three hospitals in El-Mansoura city, where 250 women were chosen from each setting. A modified version of Morrison and Olsen (1979) high risk scoring inventory tool was used to collect the socioeconomic, biological, medical, reproductive and current pregnancy risk factors in the study sample. It also assessed the risk level whether low, moderate or high. The results revealed that among all women, 63.8% of the sample were at a high-risk, while 25.0 % of them were at a moderate-risk and only 11.2% were at low-risk. About 70.0% of the high-risk pregnant women were in their third trimester followed by 23.0% in the second trimester and only 7.1% were in the first trimester. About 5.9% of the women were at a high-risk because of polluted housing condition, 1.9% because of heart diseases Class capital I, Ukrainian or II, 5.2% because of diabetes mellitus, 4.2% because of hypertension and 14.9% because of previous cesarean section. On the other hand 14.8% women were at moderate risk because of their illiteracy, 29.2% of them for being short, 14.7%, 10.6% of them because of being teenagers or over 35 years of age, respectively, 12.6% of because they had a history of gestational diabetes and 32.8%of them because of anemia, 23.2% because urinary tract infection, 16.9% because of albuminuria, and 12.0% because of glucoseuria. Finally identifying the profile of high -risk pregnancy women is mandatory.

Establishing a Program for Individuals at High Risk for Breast Cancer

Science.gov (United States)

Cadiz, Fernando; Kuerer, Henry M.; Puga, Julio; Camacho, Jamile; Cunill, Eduardo; Arun, Banu

2013-01-01

Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining “high risk”; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk. PMID:23833688

Preliminaries on pollution risk factors related to mining and ore processing in the Cu-rich pollymetallic belt of Eastern Carpathians, Romania.

Science.gov (United States)

Stumbea, Dan

2013-11-01

The present study focuses on the mineralogical and geochemical patterns of mining and ore-processing wastes from some occurrences in the Eastern Carpathians; its aim is to identify the main factors and processes that could lead to the pollution of the environment. In this respect, the following types of solid waste were investigated: efflorescent salts developed on the surface of rock blocks from a quarry, ore-processing waste from two tailings ponds, and salt crusts developed at the surface of a tailings pond. The potential risks emphasized by these preliminary investigations are the following: (1) the risk of wind-driven removal and transport of the waste from the surface of tailings ponds, given that fine grains prevail (up to 80%); (2) the risk of tailings removal through mechanical transport by water, during heavy rainfall; (3) the appearance of hydrated sulfates on the rock fragments from the mining waste, sulfates which are highly susceptible to the generation of acid mine drainage (pHmine drainage leachates contain; and (5) the development of a salt crust on the flat, horizontal surfaces of the waste deposit, due to this very shape. Statistical data regarding the amount of both major and minor elements in the tailings have revealed two statistical populations for nearly all the toxic metals. This suggests that, beyond the effect that the tailings have upon the environment through their mere presence in a given area, there are alleged additional factors and processes which intensify the pollution: the location of the waste deposit relative to the topography of the area; the shape of the waste deposit; the development of low areas on the surface of the deposit, areas which favor the appearance of salt crusts; and the mineralogy of efflorescent aggregates.

Oil sands tailings preliminary ecological risk assessment

International Nuclear Information System (INIS)

1994-01-01

Chemical data collected from various oil sands soil-tailings mixtures were used to determine the ecological risk that such tailings would pose to terrestrial wildlife at the surface of a reclaimed site. A methodology that could be used to evaluate the risks posed by various reclamation options (for dry land only) was proposed. Risks associated with other reclamation options, such as wet landscapes or deeper in-pit disposal, were not evaluated. Ten constituents (eight organic and two inorganic) were found to pose a threat to terrestrial biota. The relative contribution of different exposure pathways (water and food ingestion, incidental soil ingestion, inhalation) were studied by probabilistic models. Some physical and chemical reclamation alternatives which involve incorporating oil sands tailings in the landscape to produce a surface that could sustain a productive ecosystem, were described. 53 refs., 15 tabs., 3 figs

Drug response prediction in high-risk multiple myeloma

DEFF Research Database (Denmark)

Vangsted, A J; Helm-Petersen, S; Cowland, J B

2018-01-01

from high-risk patients by GEP70 at diagnosis from Total Therapy 2 and 3A to predict the response by the DRP score of drugs used in the treatment of myeloma patients. The DRP score stratified patients further. High-risk myeloma with a predicted sensitivity to melphalan by the DRP score had a prolonged...

Seroepidemiological Study of Brucellosis in High Risk Groups in Boyerahmad 1384

Directory of Open Access Journals (Sweden)

AM Khosravani

2007-01-01

Full Text Available ABSTRACT: Introduction & Objective: Brucellosis is a zoonotic disease that may have a major public health and economic impact in most countries. The disease appears as a Malt fever in humans and abortion in animals. This study was designed to determine the serologic titer of Brucella in high risk and non high risk people in Boyerahmad. Materials & Methods: A retrospective seroepidemiological study was performed on samples collected from 604 high risk and non high risk people using Rose Bengol test, tube standard test as a rapid test and 2 mercaptoethanol (2ME and comb's wright as a confirmatory test. The data collected were analyzed by X2 test via SPSS. Results: Seroprevalence of Brucellosis in high risk people appeared to be high in the Rose Bengal and tube standard test (TST 6.62 at titer ≥1/40 whereas for non high risk it was 0%. Confirmation test in high risk people was shown with 2ME in four people. Conclusion: Brucellosis is a major cause of disease in high risk people which can be due to direct or indirect contact with diary products of the related animals.

Scoring methods and results for qualitative evaluation of public health impacts from the Hanford high-level waste tanks. Integrated Risk Assessment Program

International Nuclear Information System (INIS)

Buck, J.W.; Gelston, G.M.; Farris, W.T.

1995-09-01

The objective of this analysis is to qualitatively rank the Hanford Site high-level waste (HLW) tanks according to their potential public health impacts through various (groundwater, surface water, and atmospheric) exposure pathways. Data from all 149 single-shell tanks (SSTs) and 23 of the 28 double-shell tanks (DSTs) in the Tank Waste Remediation System (TWRS) Program were analyzed for chemical and radiological carcinogenic as well as chemical noncarcinogenic health impacts. The preliminary aggregate score (PAS) ranking system was used to generate information from various release scenarios. Results based on the PAS ranking values should be considered relative health impacts rather than absolute risk values

People at High Risk of Developing Flu-Related Complications

Science.gov (United States)

... Influenza Types Seasonal Avian Swine Variant Pandemic Other People at High Risk of Developing Flu–Related Complications ... related complications if they get sick with influenza. People at High Risk for Developing Flu-Related Complications ...

Diagnostic accuracy of high-definition CT coronary angiography in high-risk patients

International Nuclear Information System (INIS)

Iyengar, S.S.; Morgan-Hughes, G.; Ukoumunne, O.; Clayton, B.; Davies, E.J.; Nikolaou, V.; Hyde, C.J.; Shore, A.C.; Roobottom, C.A.

2016-01-01

Aim: To assess the diagnostic accuracy of computed tomography coronary angiography (CTCA) using a combination of high-definition CT (HD-CTCA) and high level of reader experience, with invasive coronary angiography (ICA) as the reference standard, in high-risk patients for the investigation of coronary artery disease (CAD). Materials and methods: Three hundred high-risk patients underwent HD-CTCA and ICA. Independent experts evaluated the images for the presence of significant CAD, defined primarily as the presence of moderate (≥50%) stenosis and secondarily as the presence of severe (≥70%) stenosis in at least one coronary segment, in a blinded fashion. HD-CTCA was compared to ICA as the reference standard. Results: No patients were excluded. Two hundred and six patients (69%) had moderate and 178 (59%) had severe stenosis in at least one vessel at ICA. The sensitivity, specificity, positive predictive value, and negative predictive value were 97.1%, 97.9%, 99% and 93.9% for moderate stenosis, and 98.9%, 93.4%, 95.7% and 98.3%, for severe stenosis, on a per-patient basis. Conclusion: The combination of HD-CTCA and experienced readers applied to a high-risk population, results in high diagnostic accuracy comparable to ICA. Modern generation CT systems in experienced hands might be considered for an expanded role. - Highlights: • Diagnostic accuracy of High-Definition CT Angiography (HD-CTCA) has been assessed. • Invasive Coronary angiography (ICA) is the reference standard. • Diagnostic accuracy of HD-CTCA is comparable to ICA. • Diagnostic accuracy is not affected by coronary calcium or stents. • HD-CTCA provides a non-invasive alternative in high-risk patients.

The clinical profile of high-risk mentally disordered offenders.

Science.gov (United States)

Yiend, Jenny; Freestone, Mark; Vazquez-Montes, Maria; Holland, Josephine; Burns, Tom

2013-07-01

High-risk mentally disordered offenders present a diverse array of clinical characteristics. To contain and effectively treat this heterogeneous population requires a full understanding of the group's clinical profile. This study aimed to identify and validate clusters of clinically coherent profiles within one high-risk mentally disordered population in the UK. Latent class analysis (a statistical technique to identify clustering of variance from a set of categorical variables) was applied to 174 cases using clinical diagnostic information to identify the most parsimonious model of best fit. Validity analyses were performed. Three identified classes were a 'delinquent' group (n = 119) characterised by poor educational history, strong criminal careers and high recidivism risk; a 'primary psychopathy' group (n = 38) characterised by good educational profiles and homicide offences and an 'expressive psychopathy' group (n = 17) presenting the lowest risk and characterised by more special educational needs and sexual offences. Individuals classed as high-risk mentally disordered offenders can be loosely segregated into three discrete subtypes: 'delinquent', 'psychopathic' or 'expressive psychopathic', respectively. These groups represent different levels of risk to society and reflect differing treatment needs.

Carotid Stenting in Patients With High Risk Versus Standard Risk for Open Carotid Endarterectomy (REAL-1 Trial).

Science.gov (United States)

De Haro, Joaquin; Michel, Ignacio; Bleda, Silvia; Cañibano, Cristina; Acin, Francisco

2017-07-15

Carotid stenting (CAS) has been mainly offered to those patients considered at "high risk" for open carotid endarterectomy based on available data from large randomized clinical trials. However, several recent studies have called medical "high risk" into question for CAS indication. The REAL-1 trial evaluated the safety and perioperative and long-term effectiveness in patients with significant carotid artery stenosis with "high-risk" criteria treated with CAS and proximal protection device (MOMA) compared with those with standard surgical-risk features. This nonrandomized double-arm registry included 125 patients (40% symptomatic), 71 (56%) with "standard-risk" and 54 (44%) with "high-risk" criteria. The primary end point was the cumulative incidence of any major adverse event, a composite of stroke, myocardial infarction, and death within 30 days after the intervention or ipsilateral stroke after 30 days and up to 4 years. There was no significant difference in primary end point rate at 30 days between patients at "standard risk" and those with "high risk" (1.4% vs 1.9% respectively; hazard ratio for "standard risk" 1.1; 95% CI 0.8 to 1.2, p = 0.77) nor estimated 4-year rate of ipsilateral stroke (1.3% vs 1.8%; hazard ratio for "standard risk" 1.05, 95% CI 0.86 to 1.14, p = 0.9). In conclusion, 4-year postprocedure results demonstrated that CAS with proximal device (MOMA) is safe and effective for patients with and without "high-risk" for carotid endarterectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

Debris Flow Risk Management Framework and Risk Analysis in Taiwan, A Preliminary Study

Science.gov (United States)

Tsao, Ting-Chi; Hsu, Wen-Ko; Chiou, Lin-Bin; Cheng, Chin-Tung; Lo, Wen-Chun; Chen, Chen-Yu; Lai, Cheng-Nong; Ju, Jiun-Ping

2010-05-01

Taiwan is located on a seismically active mountain belt between the Philippine Sea plate and Eurasian plate. After 1999's Chi-Chi earthquake (Mw=7.6), landslide and debris flow occurred frequently. In Aug. 2009, Typhoon Morakot struck Taiwan and numerous landslides and debris flow events, some with tremendous fatalities, were observed. With limited resources, authorities should establish a disaster management system to cope with slope disaster risks more effectively. Since 2006, Taiwan's authority in charge of debris flow management, the Soil and Water Conservation Bureau (SWCB), completed the basic investigation and data collection of 1,503 potential debris flow creeks around Taiwan. During 2008 and 2009, a debris flow quantitative risk analysis (QRA) framework, based on landslide risk management framework of Australia, was proposed and conducted on 106 creeks of the 30 villages with debris flow hazard history. Information and value of several types of elements at risk (bridge, road, building and crop) were gathered and integrated into a GIS layer, with the vulnerability model of each elements at risk applied. Through studying the historical hazard events of the 30 villages, numerical simulations of debris flow hazards with different magnitudes (5, 10, 25, 50, 100 and 200 years return period) were conducted, the economic losses and fatalities of each scenario were calculated for each creek. When taking annual exceeding probability into account, the annual total risk of each creek was calculated, and the results displayed on a debris flow risk map. The number of fatalities and frequency were calculated, and the F-N curves of 106 creeks were provided. For F-N curves, the individual risk to life per year of 1.0E-04 and slope of 1, which matched with international standards, were considered to be an acceptable risk. Applying the results of the 106 creeks onto the F-N curve, they were divided into 3 categories: Unacceptable, ALARP (As Low As Reasonable Practicable) and

Predicting reattendance at a high-risk breast cancer clinic.

Science.gov (United States)

Ormseth, Sarah R; Wellisch, David K; Aréchiga, Adam E; Draper, Taylor L

2015-10-01

The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic. Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES-D score ≥ 16), current level of anxiety (State-Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer). A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted "U" relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels. Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.

CARDIOVASCULAR RISK ASSESSMENT IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS WITHIN THE REMARCA STUDY: PRELIMINARY DATA

Directory of Open Access Journals (Sweden)

D. S. Novikova

2015-01-01

Full Text Available Most patients with early rheumatoid arthritis (RA have a high or very high cardiovascular risk (CVR before therapy with disease-modifying antirheumatic drugs (DMARDs. Objective: to evaluate the impact of antirheumatic therapy performed in accordance with the Treat-to-Target strategy on the progression of atherosclerosis and CVR in patients with early RA. Subjects and methods. This investigation enrolled 74 patients (72% women; median age, 56 years with early RA having moderate to high activity (median DAS28, 5.6 who had not previously received DMARDs and glucocorticoids (GCs. All patients were anticyclic citrullinated peptide antibody-positive and 87% of the patients were rheumatoid factor-positive. All patients received methotrexate (MT subcutaneously with dose escalation up to 25–30 mg/week, in case of its inefficiency at 3 months a biological agent (BA was added. After 6 months, 39% of the patients achieved remission; 19% had low; 35 and 7% had moderate and high disease activity, respectively. The majority (n = 20 (69% who achieved remission received MT monotherapy; 9 (31% – MT + BA whereas among the patients who did not achieve remission 15 (33% and 30 (67% respectively. At baseline and after 6 months of treatment, traditional CVR factors were assessed in all patients, by determining the total coronary risk by the SCORE scale, including that modified by EULAR (mSCORE, carotid artery atherosclerosis (CAA by duplex scanning data, coronary calcification (CC by multislice spiral computed tomography and by estimating the degree of CVR.Results and discussion. The rates of hypertension, overweight, abdominal obesity, low activity, smoking, and type 2 diabetes mellitus did not change significantly after 6 months. There were increases in the levels of total cholesterol by 7% (p < 0.05, low-density lipoprotein cholesterol by 9% (p<0.01, high-density lipoprotein cholesterol by 26% (p < 0.005, and body mass index (BMI by 1% (p < 0.01 and a decrease

Relationship between Background Parenchymal Enhancement on High-risk Screening MRI and Future Breast Cancer Risk.

Science.gov (United States)

Grimm, Lars J; Saha, Ashirbani; Ghate, Sujata V; Kim, Connie; Soo, Mary Scott; Yoon, Sora C; Mazurowski, Maciej A

2018-03-27

To determine if background parenchymal enhancement (BPE) on screening breast magnetic resonance imaging (MRI) in high-risk women correlates with future cancer. All screening breast MRIs (n = 1039) in high-risk women at our institution from August 1, 2004, to July 30, 2013, were identified. Sixty-one patients who subsequently developed breast cancer were matched 1:2 by age and high-risk indication with patients who did not develop breast cancer (n = 122). Five fellowship-trained breast radiologists independently recorded the BPE. The median reader BPE for each case was calculated and compared between the cancer and control cohorts. Cancer cohort patients were high-risk because of a history of radiation therapy (10%, 6 of 61), high-risk lesion (18%, 11 of 61), or breast cancer (30%, 18 of 61); BRCA mutation (18%, 11 of 61); or family history (25%, 15 of 61). Subsequent malignancies were invasive ductal carcinoma (64%, 39 of 61), ductal carcinoma in situ (30%, 18 of 61) and invasive lobular carcinoma (7%, 4of 61). BPE was significantly higher in the cancer cohort than in the control cohort (P = 0.01). Women with mild, moderate, or marked BPE were 2.5 times more likely to develop breast cancer than women with minimal BPE (odds ratio = 2.5, 95% confidence interval: 1.3-4.8, P = .005). There was fair interreader agreement (κ = 0.39). High-risk women with greater than minimal BPE at screening MRI have increased risk of future breast cancer. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Preliminary analysis of alternative fuel cycles for proliferation evaluation

Energy Technology Data Exchange (ETDEWEB)

Steindler, M. J.; Ripfel, H. C.F.; Rainey, R. H.

1977-01-01

The ERDA Division of Nuclear Research and Applications proposed 67 nuclear fuel cycles for assessment as to their nonproliferation potential. The object of the assessment was to determine which fuel cycles pose inherently low risk for nuclear weapon proliferation while retaining the major benefits of nuclear energy. This report is a preliminary analysis of these fuel cycles to develop the fuel-recycle data that will complement reactor data, environmental data, and political considerations, which must be included in the overall evaluation. This report presents the preliminary evaluations from ANL, HEDL, ORNL, and SRL and is the basis for a continuing in-depth study. (DLC)

Identification and risk assessment of unknown contaminants migrating from Food Contact Materials

DEFF Research Database (Denmark)

Pieke, Eelco Nicolaas

The exposure of humans to possibly thousands of chemical compounds through food poses a health risk that is questioning our ability to ensure high standards for food safety. Food contact materials (FCM) are a major source of extraneous chemical compounds in food, yet not much knowledge is available...... interpretations. Risk prioritization is successful in classifying estimated risk based on predicted exposure and predicted hazard, and is valuable for to preliminary RA studies. The overarching strategy in this study shows that explorative techniques are valuable tools to help ensure food safety in the future...

[High-grade pressure sores in frail older high-risk persons. A retrospective postmortem case-control-study].

Science.gov (United States)

Von Renteln-Kruse, W; Krause, T; Anders, J; Kühl, M; Heinemann, A; Püschel, K

2004-04-01

Some old persons at risk do develop, but others, at comparable risk, do not develop high-grade pressure sores. To evaluate potentially different risk factors, we performed a post mortem case-control study in old persons who developed high-grade pressure sores within six months until 14 days before death. Consecutive cases with pressure sores grade >/=3 and potential controls at comparably high risk for pressure sores were examined before cremation. After written informed consent had been obtained by the next relatives, all available nursing and medical records of the deceased were thoroughly evaluated. Cases and controls were matched according to age, gender, immobility, and cachexia.A total of 100 cases with 71 pressure sores grade 3 and 29 pressure sores grade 4 were compared to 100 controls with 27 pressure sores grade pressure sores in frail older high-risk persons. Sedative drug effects and impaired patient compliance with preventive and therapeutic measures may also be associated with the development of high-grade pressure sores in old persons at high risk.

Early response to sibutramine in patients not meeting current label criteria: preliminary analysis of SCOUT lead-in period

DEFF Research Database (Denmark)

Caterson, Ian; Coutinho, Walmir; Finer, Nick

2010-01-01

The Sibutramine Cardiovascular Outcomes (SCOUT) trial protocol defines a patient population predominantly outside current European Union label criteria. This article explores responses to sibutramine during the 6-week, single-blind, lead-in period between patients who conformed to the label...... requirements ("conformers") and those who did not ("nonconformers"). SCOUT is an ongoing, randomized, double-blind, placebo-controlled outcome trial in overweight/obese patients at high risk of a cardiovascular event. In total, 10,742 patients received sibutramine and weight management during the lead...... with sibutramine confirms its good tolerability and efficacy in patients who meet current label criteria. Preliminary data from high-risk patients for whom sibutramine is currently contraindicated suggest a low discontinuation rate and few serious adverse events but confirmation from the SCOUT outcome data...

High Framingham risk score decreases quality of life in adults

Directory of Open Access Journals (Sweden)

Christian Yosaputra

2010-04-01

Full Text Available Cardiovascular disease (CVD risk factors, such as diabetes, hypertension, hypercholesterolemia, smoking, and obesity tend to occur together in the general population. Increasing prevalence of multiple CVD risk factors has been related to increased risk of death from coronary heart disease and stroke. Studies have suggested that people with several risk factors of CVD may have impaired health-related quality of life. The objective of this study was to assess the association of CVD risk factors with quality of life (QOL among adults aged 40 to 65 years. A cross-sectional study was conducted involving 220 subjects 40 - 65 years of age at a health center. The CVD risk factors were assessed using the Framingham risk score that is the standard instrument for assessment of the risk of a first cardiac event. The risk factors assessed were age, smoking, blood pressure, total cholesterol and high density lipoprotein cholesterol concentrations. QOL was assessed by means of the WHOQOL-BREF instrument that had been prevalidated. The results of the study showed that 28.2% of subjects were smokers, 56.4% had stage 1 hypertension, 42.8% high total cholesterol and 13.6% low HDL cholesterol. The high risk group amounted to 45.5% and 42.3% constitued an intermediate risk group. High CVD risk scores were significantly associated with a low QOL for all domains (physical, psychological, social and environment (p=0.000. Preventing or reducing the multiple CVD risk factors to improve QOL is necessary among adults.

Development of fault parameters for use in risk assessment modeling in the Pasco Basin, Columbia Plateau, South Central Washington: a preliminary study

International Nuclear Information System (INIS)

Caggiano, J.A.

1982-03-01

Preliminary data on strain rate, seismicity, and estimated earthquake source parameters suggest limitations on the extent of postulated faulting and its impact on a nuclear waste repository in Columbia River basalt. Structural relief of dated basalt flows, attitude of Pliocene sediments, geodetic surveys, size and distribution of earthquakes, and focal mechanism solutions indicate that deformation of basalt under north-south compression was under way in the Miocene and has continued on existing structures at an average rate of much less than 1 mm/yr in the Pasco Basin. Lengths and displacements of mapped faults suggest limits on the postulated fault that could intersect a repository and produce an earthquake of about magnitude 6.5. Using a credible earthquake permits calculation of preliminary source parameters for risk assessment modeling during a single episode of slip on the postulated new fault and indicates displacement of less than or equal to 1, m on a steeply dipping fault of less than or equal to 50 km length could occur. Preliminary source parameter calculations suggest that displacements of less than or equal to 2 cm may occur during microearthquakes in swarms. The area of fault rupture may be tens of square meters up to a few square kilometers, suggesting slip on joints. Seismic moments for postulated earthquakes in the interconnecting fault and microearthquake scenarios compare favorably with reported values for similar-sized earthquakes in different media and suggest that the estimated fault parameters are reasonable until an adequate tectonic model has been developed

Oxaliplatin and capecitabine concomitant with neoadjuvant radiotherapy and extended to the resting period in high risk locally advanced rectal cancer

Energy Technology Data Exchange (ETDEWEB)

Gao, Y.H.; Zeng, Z.F. [State Key Laboratory of Oncology in South China, Guangzhou (China); Sun Yat-sen University Cancer Center, Departments of Radiation Oncology, Guangzhou (China); Zhang, X. [State Key Laboratory of Oncology in South China, Guangzhou (China); Sun Yat-sen University Cancer Center, Departments of Thoracic Surgery, Guangzhou (China); An, X. [State Key Laboratory of Oncology in South China, Guangzhou (China); Sun Yat-sen University Cancer Center, Departments of Medical Oncology, Guangzhou (China); Cai, M.Y. [State Key Laboratory of Oncology in South China, Guangzhou (China); Sun Yat-sen University Cancer Center, Departments of Pathology, Guangzhou (China); Chen, G.; Kong, L.H.; Lin, J.Z.; Wan, D.S.; Pan, Z.Z.; Ding, P.R. [State Key Laboratory of Oncology in South China, Guangzhou (China); Sun Yat-sen University Cancer Center, Departments of Colorectal Surgery, Guangzhou (China)

2014-02-15

Conventional neoadjuvant chemoradiotherapy (CRT) is suboptimal for systemic control in locally advanced rectal cancer (LARC). To improve systemic control, we developed an alternative approach in which an intensified oxaliplatin and capecitabine (XELOX) chemotherapy regimen was administered concomitantly with radiation and extended to the resting period (consolidation chemotherapy) for high-risk LARC. The aim of the current study was to evaluate the short-term efficacy and toxicity of this strategy. Patients with high-risk LARC were treated with CRT. Two cycles of XELOX were administered concomitantly with radiation. Thereafter, an additional cycle of the same regimen was administered during the resting period after completion of CRT. Tumor response, toxicities and surgical complications were recorded. This study includes 36 patients treated with the above strategy. All patients completed the planned concurrent CRT. Because of grade 3 toxicities, 2 patients were unable to complete the additional chemotherapy. Grade 3 toxicities were leucopenia (2.8 %), diarrhea (2.8 %) and radiodermatitis (2.8 %). All patients underwent optimal surgery with total mesorectal excision (TME) and a sphincter-saving procedure was performed in 27 patients (75 %). There was no perioperative mortality. Postoperative complications developed in 7 patients (19.4 %). Pathologic complete regression (pCR),''nearly pCR'' (major regression), and moderate or minimal regression were achieved in 13 (36.1 %), 16 (44.4 %), and 7 patients (19.5 %), respectively. The preliminary results suggest that a XELOX regimen initially administered concomitantly with radiotherapy and then extended to the resting period in high-risk LARC patients is well tolerated. The strategy is highly effective in terms of pCR and nearly pCR rates, and thus warrants further investigation. (orig.)

Preliminary Field Tests and Long-Term Monitoring as a Method of Design Risk Mitigation: A Case Study of Gdańsk Deepwater Container Terminal

Directory of Open Access Journals (Sweden)

Miśkiewicz Mikołaj

2017-09-01

Full Text Available Appropriate risk assessment plays a fundamental role in the design. . The authors propose a possible method of design risk mitigation, which follows recommendations included in Eurocode 7. The so-called “Observational Method” (OM can produce savings in costs and programmes on engineering projects without compromising safety. The case study presented is a complex design solution that deals with the heavy foundations of a gantry crane beam as one of the elements of a Deepwater Container Terminal extension. The paper presents a detailed process of the design of the rear crane beam being a part of the brand new berth, together with its static analysis, as well as the long-term results of observations, which have revealed the real performance of the marine structure. The case presented is based on excessive preliminary field tests and technical monitoring of the structure, and is an example of a successful OM implementation and design risk mitigation.

High Power Laser Laboratory at the Institute of Plasma Physics and Laser Microfusion: equipment and preliminary research

Directory of Open Access Journals (Sweden)

Zaraś-Szydłowska Agnieszka

2015-06-01

Full Text Available The purpose of this paper is to present the newly-opened High Power Laser Laboratory (HPLL at the Institute of Plasma Physics and Laser Microfusion (IPPLM. This article describes the laser, the main laboratory accessories and the diagnostic instruments. We also present preliminary results of the first experiment on ion and X-ray generation from laser-produced plasma that has been already performed at the HPLL.

Telomerase activation by genomic rearrangements in high-risk neuroblastoma

Science.gov (United States)

Peifer, Martin; Hertwig, Falk; Roels, Frederik; Dreidax, Daniel; Gartlgruber, Moritz; Menon, Roopika; Krämer, Andrea; Roncaioli, Justin L.; Sand, Frederik; Heuckmann, Johannes M.; Ikram, Fakhera; Schmidt, Rene; Ackermann, Sandra; Engesser, Anne; Kahlert, Yvonne; Vogel, Wenzel; Altmüller, Janine; Nürnberg, Peter; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Mariappan, Aruljothi; Heynck, Stefanie; Mariotti, Erika; Henrich, Kai-Oliver; Glöckner, Christian; Bosco, Graziella; Leuschner, Ivo; Schweiger, Michal R.; Savelyeva, Larissa; Watkins, Simon C.; Shao, Chunxuan; Bell, Emma; Höfer, Thomas; Achter, Viktor; Lang, Ulrich; Theissen, Jessica; Volland, Ruth; Saadati, Maral; Eggert, Angelika; de Wilde, Bram; Berthold, Frank; Peng, Zhiyu; Zhao, Chen; Shi, Leming; Ortmann, Monika; Büttner, Reinhard; Perner, Sven; Hero, Barbara; Schramm, Alexander; Schulte, Johannes H.; Herrmann, Carl; O’Sullivan, Roderick J.; Westermann, Frank; Thomas, Roman K.; Fischer, Matthias

2016-01-01

Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system1. Roughly half of these tumours regress spontaneously or are cured by limited therapy. By contrast, high-risk neuroblastomas have an unfavourable clinical course despite intensive multimodal treatment, and their molecular basis has remained largely elusive2–4. Here we have performed whole-genome sequencing of 56 neuroblastomas (high-risk, n = 39; low-risk, n = 17) and discovered recurrent genomic rearrangements affecting a chromosomal region at 5p15.33 proximal of the telomerase reverse transcriptase gene (TERT). These rearrangements occurred only in high-risk neuroblastomas (12/39, 31%) in a mutually exclusive fashion with MYCN amplifications and ATRX mutations, which are known genetic events in this tumour type1,2,5. In an extended case series (n = 217), TERT rearrangements defined a subgroup of high-risk tumours with particularly poor outcome. Despite a large structural diversity of these rearrangements, they all induced massive transcriptional upregulation of TERT. In the remaining high-risk tumours, TERT expression was also elevated in MYCN-amplified tumours, whereas alternative lengthening of telomeres was present in neuroblastomas without TERT or MYCN alterations, suggesting that telomere lengthening represents a central mechanism defining this subtype. The 5p15.33 rearrangements juxtapose the TERT coding sequence to strong enhancer elements, resulting in massive chromatin remodelling and DNA methylation of the affected region. Supporting a functional role of TERT, neuroblastoma cell lines bearing rearrangements or amplified MYCN exhibited both upregulated TERT expression and enzymatic telomerase activity. In summary, our findings show that remodelling of the genomic context abrogates transcriptional silencing of TERT in high-risk neuroblastoma and places telomerase activation in the centre of transformation in a large fraction of these tumours. PMID:26466568

Very High-Risk Localized Prostate Cancer: Outcomes Following Definitive Radiation

International Nuclear Information System (INIS)

Narang, Amol K.; Gergis, Carol; Robertson, Scott P.; He, Pei; Ram, Ashwin N.; McNutt, Todd R.; Griffith, Emily; DeWeese, Theodore A.; Honig, Stephanie; Singh, Harleen; Song, Danny Y.; Tran, Phuoc T.; DeWeese, Theodore L.

2016-01-01

Purpose: Existing definitions of high-risk prostate cancer consist of men who experience significant heterogeneity in outcomes. As such, criteria that identify a subpopulation of National Comprehensive Cancer Network (NCCN) high-risk prostate cancer patients who are at very high risk (VHR) for poor survival outcomes following prostatectomy were recently developed at our institution and include the presence of any of the following disease characteristics: multiple NCCN high-risk factors, primary Gleason pattern 5 disease and/or ≥5 biopsy cores with Gleason sums of 8 to 10. Whether these criteria also apply to men undergoing definitive radiation is unclear, as is the optimal treatment regimen in these patients. Methods and Materials: All men consecutively treated with definitive radiation by a single provider from 1993 to 2006 and who fulfilled criteria for NCCN high-risk disease were identified (n=288), including 99 patients (34%) with VHR disease. Multivariate-adjusted competing risk regression models were constructed to assess associations between the VHR definition and biochemical failure (BF), distant metastasis (DM), and prostate cancer–specific mortality (PCSM). Multivariate-adjusted Cox regression analysis assessed the association of the VHR definition with overall mortality (OM). Cumulative incidences of failure endpoints were compared between VHR men and other NCCN high-risk men. Results: Men with VHR disease compared to other NCCN high-risk men experienced a higher 10-year incidence of BF (54.0% vs 35.4%, respectively, P<.001), DM (34.9% vs 13.4%, respectively, P<.001), PCSM (18.5% vs 5.9%, respectively, P<.001), and OM (36.4% vs 27.0%, respectively, P=.04). VHR men with a detectable prostate-specific antigen (PSA) concentration at the end of radiation (EOR) remained at high risk of 10-year PCSM compared to VHR men with an undetectable EOR PSA (31.0% vs 13.7%, respectively, P=.05). Conclusions: NCCN high-risk prostate cancer patients who meet VHR

Child Maltreatment and Clinical Outcome in Individuals at Ultra-High Risk for Psychosis in the EU-GEI High Risk Study

NARCIS (Netherlands)

Kraan, Tamar C.; Velthorst, Eva; Themmen, Manouk; Valmaggia, Lucia; Kempton, Matthew J.; McGuire, Phillip; Van Os, Jim; Rutten, Bart P.F.; Smit, Filip; De Haan, Lieuwe; Van Der Gaag, Mark; McGuire, Philip; Valmaggia, Lucia R.; Calem, Maria; Tognin, Stefania; Modinos, Gemma; Burger, Nadine; Van Dam, Daniella S.; Barrantes-Vidal, Neus; Domínguez-Martínez, Tecelli; Cristóbal-Narváez, Paula; Kwapil, Thomas R.; Monsonet-Bardají, Manel; Hinojosa, Lídia; Riecher-Rössler, Anita; Borgwardt, Stefan; Rapp, Charlotte; Ittig, Sarah; Studerus, Erich; Smieskova, Renata; Bressan, Rodrigo; Gadelha, Ary; Brietzke, Elisa; Asevedo, Graccielle; Asevedo, Elson; Zugman, Andre; Ruhrmann, Stephan; Gebhard, Dominika; Arnhold, Julia; Klosterkötter, Joachim; Nordholm, Dorte; Randers, Lasse; Krakauer, Kristine; Naumann, Tanya Louise; Glenthøj, Louise Birkedal; Nordentoft, Merete; De Hert, Marc; Van Winkel, Ruud; Nelson, Barnaby; McGorry, Patrick

2018-01-01

Background: Child maltreatment has been associated with a wide range of mental disorders in adulthood. Whether child maltreatment is specifically associated with psychosis risk in individuals at ultra-high risk (UHR) for psychosis, or leads to a general vulnerability for overall psychopathology in

InSAR deformation monitoring of high risk landslides

Science.gov (United States)

Singhroy, V.; Li, J.

2013-05-01

During the past year there were at least twenty five media reports of landslides and seismic activities some fatal, occurring in various areas in Canada. These high risk geohazards sites requires high resolution monitoring both spatially and temporally for mitigation purposes, since they are near populated areas and energy, transportation and communication corridors. High resolution air photos, lidar and satellite images are quite common in areas where the landslides can be fatal. Radar interferometry (InSAR) techniques using images from several radar satellites are increasingly being used in slope stability assessment. This presentation provides examples of using high-resolution (1-3m) frequent revisits InSAR techniques from RADARSAT 2 and TerraSAR X to monitor several types of high-risk landslides affecting transportation and energy corridors and populated areas. We have analyses over 200 high resolution InSAR images over a three year period on geologically different landslides. The high-resolution InSAR images are effective in characterizing differential motion within these low velocity landslides. The low velocity landslides become high risk during the active wet spring periods. The wet soils are poor coherent targets and corner reflectors provide an effective means of InSAR monitoring the slope activities.

Screening for Malnutrition in Community Dwelling Older Japanese: Preliminary Development and Evaluation of the Japanese Nutritional Risk Screening Tool (NRST).

Science.gov (United States)

Htun, N C; Ishikawa-Takata, K; Kuroda, A; Tanaka, T; Kikutani, T; Obuchi, S P; Hirano, H; Iijima, K

2016-02-01

Early and effective screening for age-related malnutrition is an essential part of providing optimal nutritional care to older populations. This study was performed to evaluate the adaptation of the original SCREEN II questionnaire (Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II) for use in Japan by examining its measurement properties and ability to predict nutritional risk and sarcopenia in community-dwelling older Japanese people. The ultimate objective of this preliminary validation study is to develop a license granted full Japanese version of the SCREEN II. The measurement properties and predictive validity of the NRST were examined in this cross-sectional study of 1921 community-dwelling older Japanese people. Assessments included medical history, and anthropometric and serum albumin measurements. Questions on dietary habits that corresponded to the original SCREEN II were applied to Nutritional Risk Screening Tool (NRST) scoring system. Nutritional risk was assessed by the Geriatric Nutrition Risk Index (GNRI) and the short form of the Mini-Nutritional Assessment (MNA-SF). Sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People. The nutritional risk prevalences determined by the GNRI and MNA-SF were 5.6% and 34.7%, respectively. The prevalence of sarcopenia was 13.3%. Mean NRST scores were significantly lower in the nutritionally at-risk than in the well-nourished groups. Concurrent validity analysis showed significant correlations between NRST scores and both nutritional risk parameters (GNRI or MNA-SF) and sarcopenia. The areas under the receiver operating characteristic curves (AUC) of NRST for the prediction of nutritional risk were 0.635 and 0.584 as assessed by GNRI and MNA-SF, respectively. AUCs for the prediction of sarcopenia were 0.602 (NRST), 0.655 (age-integrated NRST), and 0.676 (age and BMI-integrated NRST). These results indicate that the NRST is a

The use of comprehensive two-dimensional gas chromatography and structure-activity modeling for screening and preliminary risk assessment of organic contaminants in soil, sediment, and surface water

Energy Technology Data Exchange (ETDEWEB)

Moreira Bastos, Patricia; Haglund, Peter [Umeaa Univ. (Sweden). Dept. of Chemistry

2012-08-15

Purpose: This article aims to investigate the use and benefits of using comprehensive two-dimensional gas chromatography (GC x GC) and structure-activity relationship modeling for screening and prioritization of organic contaminants in complex matrices. The benefit of applying comprehensive screening techniques to samples with high organic contaminant content is primarily that compounds with diverse physicochemical properties can be analyzed simultaneously. Here, a heavily contaminated industrial area was surveyed for organic pollutants by analyzing soil, sediment, and surface water samples. The hazard of the pollutants were ranked using SARs. Material and methods: The water samples were liquid-liquid extracted using dichloromethane and directly analyzed by GC x GC-time-of-flight mass spectrometry (GC x GC-TofMS). Soil and sediment samples were extracted with dichloromethane in an ultrasonic bath and subjected to gel permeation chromatography to eliminate lipids and humic matter. The low molecular weight fraction was then analyzed with GC x GC-TofMS. Results and discussion: More than 10,000 components were found in each sample, of which ca. 300 individual compounds were unambiguously identified using the National Institute of Standards and Technology mass spectra library and authentic reference standards. Alkanes, polycyclic aromatic hydrocarbons, and phthalates were generally the most abundant and were found in all matrices. In contrast, chlorinated compounds such as chlorophenols, biphenyls, and chlorinated pesticides were only detected in samples from a few hotspot regions. The toxicities of the most frequently detected compounds and of the compounds detected at the highest concentrations in samples from hotspot regions were estimated by ecological structure-activity relationships. The ratio of the measured concentration to the predicted toxicity level was then calculated for each compound and used for an initial risk assessment in order to prioritize compounds

Update on the Management of High-Risk Penetrating Keratoplasty.

Science.gov (United States)

Jabbehdari, Sayena; Rafii, Alireza Baradaran; Yazdanpanah, Ghasem; Hamrah, Pedram; Holland, Edward J; Djalilian, Ali R

2017-03-01

In this article, we review the indications and latest management of high-risk penetrating keratoplasty. Despite the immune-privilege status of the cornea, immune-mediated graft rejection still remains the leading cause of corneal graft failure. This is particularly a problem in the high-risk graft recipients, namely patients with previous graft failure due to rejection and those with inflamed and vascularized corneal beds. A number of strategies including both local and systemic immunosuppression are currently used to increase the success rate of high-risk corneal grafts. Moreover, in cases of limbal stem cell deficiency, limbal stem cells transplantation is employed. Corticosteroids are still the top medication for prevention and treatment in cases of corneal graft rejection. Single and combined administration of immunosuppressive agents e.g. tacrolimus, cyclosporine and mycophenolate are promising adjunctive therapies for prolonging graft survival. In the future, cellular and molecular therapies should allow us to achieve immunologic tolerance even in high-risk grafts.

Preliminary Development of Regulatory PSA Models for SFR

International Nuclear Information System (INIS)

Choi, Yong Won; Shin, Andong; Bae, Moohoon; Suh, Namduk; Lee, Yong Suk

2013-01-01

Well developed PRA methodology exists for LWR (Light Water Reactor) and PHWR (Pressurized Heavy Water Reactor). Since KAERI is developing a prototype SFR targeting to apply for a license by 2017, KINS needs to have a PRA models to assess the safety of this prototype reactor. The purpose of this study is to develop the regulatory PSA models for the independent verification of the SFR safety. Since the design of the prototype SFR is not mature yet, we have tried to develop the preliminary models based on the design data of KAERI's previous SFR design. In this study, the preliminary initiating events of level 1 internal event for SFR were selected through reviews of existing PRA (LWR, PRISM, ASTRID and KALIMER-600) models. Then, the event tree for each selected initiating event was developed. The regulatory PRA models of SFR developed are preliminary in a sense, because the prototype SFR design is not mature and provided yet. Still it might be utilized for the forthcoming licensing review in assessing the risk of safety issues and the configuration control of the design

A preliminary model to identify low-risk MBA applicants

Directory of Open Access Journals (Sweden)

CA Bisschoff

2014-08-01

The reliability of the discriminant function rates favourably with 71% (MBA in 3 years, 62% (MBA in 4 years and 83% (dropping out of the programme being categorised correctly by the respective discriminant functions. Being a preliminary model, its predictive capabilities need to be verified in practice before it can  be implemented as tool to render assistance in MBA admissions.  The value of this research lies  in the fact that it constitutes a model that could be employed and improved as a predictive tool in an environment where very limited predictive tools exist.  Therefore, although it is by no means a tried and tested model, it sets the scene by supplying a scientific base from which incremental improvements could result.

High risk process control system assessment methodology

Energy Technology Data Exchange (ETDEWEB)

Santos, Venetia [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio), RJ (Brazil); Zamberlan, Maria Cristina [National Institute of Tehnology (INT), Rio de Janeiro, RJ (Brazil). Human Reliability and Ergonomics Research Group for the Oil, Gas and Energy Sector

2009-07-01

The evolution of ergonomics methodology has become necessary due to the dynamics imposed by the work environment, by the increase of the need of human cooperation and by the high interaction between various sections within a company. In the last 25 years, as of studies made in the high risk process control, we have developed a methodology to evaluate these situations that focus on the assessment of activities and human cooperation, the assessment of context, the assessment of the impact of work of other sectors in the final activity of the operator, as well as the modeling of existing risks. (author)

78 FR 8522 - Chlorpyrifos Registration Review; Preliminary Evaluation of the Potential Risk From...

Science.gov (United States)

2013-02-06

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPP-2008-0850; FRL-9376-5] Chlorpyrifos Registration... preliminary volatilization assessment for the registration review of chlorpyrifos and opens a public comment... assessment for chlorpyrifos uses. After reviewing comments received during the public comment period, EPA...

Mother-Child Interactional Patterns in High- and Low-Risk Mothers.

Science.gov (United States)

Dolz, Laura; Cerezo, M. Angeles; Milner, Joel S.

1997-01-01

A study of 10 high-risk (of child physical abuse) and 10 demographically similar low-risk Spanish mother-child dyads investigated interactional patterns in the home. High-risk mothers made fewer neutral approaches to their children, displayed more negative behaviors toward their children, and made more indiscriminate responses to their children's…

Does mindfulness have potential in eating disorders prevention? A preliminary controlled trial with young adult women.

Science.gov (United States)

Atkinson, Melissa J; Wade, Tracey D

2016-06-01

This preliminary randomized controlled trial assessed the feasibility of a pilot mindfulness-based intervention with respect to reducing the risk of eating disorders in young women. Forty-four young adult women with body image concerns (Mage  = 20.57, SD = 3.22) were randomly allocated to a mindfulness-based or a dissonance-based intervention (3 × 1 h weekly sessions), or to assessment-only control. Self-report measures of eating disorder risk factors, symptoms and related psychosocial impairment were compared at baseline, post-intervention, and at 1- and 6-month follow up. At post-intervention, acceptability ratings for both interventions were high. Mindfulness participants demonstrated statistically significant improvements relative to control at post-intervention for weight and shape concern, dietary restraint, thin ideal internalization, eating disorder symptoms and related psychosocial impairment; however, these gains were largely lost over follow up. Dissonance participants did not show statistically significant improvements relative to control on any outcomes, despite small to moderate effect sizes. These preliminary findings demonstrate the acceptability and short-term efficacy of a mindfulness-based approach to reducing the risk of disordered eating in young women. This provides support for the continued evaluation of mindfulness in the prevention and early intervention of eating disorders, with increased efforts to produce maintenance of intervention gains. © 2014 Wiley Publishing Asia Pty Ltd.

Preliminary risk assessment of common-use pesticides using ...

African Journals Online (AJOL)

of PESTicides) models to predict pesticide exposure and effects on aquatic ecosystems due to spray drift. Vaalharts Irrigation. Scheme is ... to note that PRIMET only accounts for risk due to spray drift and therefore the risk might be ...... Environmental Effects Research Laboratory, Mid-Continent. Ecological Division, Duluth ...

Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study.

Science.gov (United States)

Orozco-Beltran, Domingo; Gil-Guillen, Vicente F; Redon, Josep; Martin-Moreno, Jose M; Pallares-Carratala, Vicente; Navarro-Perez, Jorge; Valls-Roca, Francisco; Sanchis-Domenech, Carlos; Fernandez-Gimenez, Antonio; Perez-Navarro, Ana; Bertomeu-Martinez, Vicente; Bertomeu-Gonzalez, Vicente; Cordero, Alberto; Pascual de la Torre, Manuel; Trillo, Jose L; Carratala-Munuera, Concepcion; Pita-Fernandez, Salvador; Uso, Ruth; Durazo-Arvizu, Ramon; Cooper, Richard; Sanz, Gines; Castellano, Jose M; Ascaso, Juan F; Carmena, Rafael; Tellez-Plaza, Maria

2017-01-01

The potential impact of targeting different components of an adverse lipid profile in populations with multiple cardiovascular risk factors is not completely clear. This study aims to assess the association between different components of the standard lipid profile with all-cause mortality and hospitalization due to cardiovascular events in a high-risk population. This prospective registry included high risk adults over 30 years old free of cardiovascular disease (2008-2012). Diagnosis of hypertension, dyslipidemia or diabetes mellitus was inclusion criterion. Lipid biomarkers were evaluated. Primary endpoints were all-cause mortality and hospital admission due to coronary heart disease or stroke. We estimated adjusted rate ratios (aRR), absolute risk differences and population attributable risk associated with adverse lipid profiles. 51,462 subjects were included with a mean age of 62.6 years (47.6% men). During an average follow-up of 3.2 years, 919 deaths, 1666 hospitalizations for coronary heart disease and 1510 hospitalizations for stroke were recorded. The parameters that showed an increased rate for total mortality, coronary heart disease and stroke hospitalization were, respectively, low HDL-Cholesterol: aRR 1.25, 1.29 and 1.23; high Total/HDL-Cholesterol: aRR 1.22, 1.38 and 1.25; and high Triglycerides/HDL-Cholesterol: aRR 1.21, 1.30, 1.09. The parameters that showed highest population attributable risk (%) were, respectively, low HDL-Cholesterol: 7.70, 11.42, 8.40; high Total/HDL-Cholesterol: 6.55, 12.47, 8.73; and high Triglycerides/HDL-Cholesterol: 8.94, 15.09, 6.92. In a population with cardiovascular risk factors, HDL-cholesterol, Total/HDL-cholesterol and triglycerides/HDL-cholesterol ratios were associated with a higher population attributable risk for cardiovascular disease compared to other common biomarkers.

Reducing sexual risk behavior among high-risk couples in Northern India.

Science.gov (United States)

Jones, Deborah; Bagga, Rashmi; Nehra, Ritu; Deepika; Sethi, Sunil; Walia, Kamini; Kumar, Mahendra; Villar-Loubet, Olga; Lopez, Maria; Weiss, Stephen M

2013-09-01

With a population of 1.1 billion, India is considered to be a country in which effective prevention interventions could contain the development of a human immunodeficiency virus (HIV) epidemic. Heterosexual transmission accounts for 85 % of the extant HIV infections. This study sought to assess the feasibility of conducting a group, culturally tailored behavioral intervention and its impact on sexual barrier use, self-efficacy, knowledge, conflict resolution, and coping among high-risk heterosexual couples in Northern India. This pilot study was conducted at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India from February 2008 to January 2009. Thirty sexually active high-risk couples were drawn from a convenience sample of PGIMER patients attending infectious disease and family planning clinics. Couples participated in 1 month of three weekly gender-concordant behavioral intervention groups and were individually administered assessments preintervention and post-intervention. The intervention was tailored to the Northern Indian context and addressed sexual barrier use, human immunodeficiency virus (HIV)/sexually transmitted infection transmission, and cognitive behavioral skill building focusing on sexual negotiation and communication. The participants had a mean age of 32 years (men) and 29 years (women), and the majority had at least 10 years of education. At baseline, the majority reported inconsistent condom use (knowledge, and women increased their use of positive coping tactics. The results highlight the potential to successfully utilize a group intervention to discuss sensitive issues such as sexual risk behavior among both men and women. Strategies to improve condom use and communication without increasing intimate partner violence in high-risk couples may be an important adjunct to preventing the development of a generalized epidemic in India.

At-risk high school seniors: Science remediation for Georgia's High School Graduation Test

Science.gov (United States)

Carroll, Carolyn M.

State departments of education have created a system of accountability for the academic achievement of students under the mandate of the No Child Left Behind Act of 2001. The Georgia Department of Education established the Georgia High School Graduation Test (GHSGT) as their method of evaluating the academic achievement of high school students. The GHSGT consist of five sections and students must pass all five sections before students they are eligible to receive a diploma. The purpose of the study was to examine the effects of teacher-lead and computer based remediation for a group of high school seniors who have been unsuccessful in passing the science portion of the GHSGT. The objectives of this study include (a) Identify the most effective method of remediation for at-risk students on the science section of the GHSGT, and (b) evaluate the methods of remediation for at-risk students on the science section of GHSGT available to high school students. The participants of this study were at-risk seniors enrolled in one high school during the 2007-2008 school year. The findings of this research study indicated that at-risk students who participated in both types of remediation, teacher-led and computer-based, scored significantly higher than the computer-based remediation group alone. There was no significant relationship between the test scores and the number of times the students were tested.

Screening for Hypoglycemia in Exclusively Breastfed High-risk Neonates.

Science.gov (United States)

Singh, Princy; Upadhyay, Amit; Sreenivas, Vishnubhatla; Jaiswal, Vijay; Saxena, Pranjali

2017-06-15

To determine incidence of hypoglycemia in exclusively breastfed, high-risk but healthy newborns, and risk factors for its development. This observational study enrolled 407 exclusively breastfed high-risk (low birth weight newborns (1800-2499 g), late preterms, small-for-gestation, large-for-gestation and infant of diabetic mother), who did not require admission to neonatal intensive care unit and were kept in postnatal wards with mother. Hypoglycemia was defined as blood glucose £46 mg/dL (2.6 mmol/L). Blood glucose was monitored till 48 hours of life. 27% of the screened newborns developed hypoglycemia in first 48 hours. 31 (7.6%) developed recurrent (>2) episodes, 28 (6.8%) had moderate (<37mg/dL) while 8 (1.9%) developed symptomatic hypoglycemia. With increase in birthweight, risk of hypoglycemia reduced significantly (P=0.003). Hypoglycemia was observed more frequently in first 2 hours as compared to next 48 hours (P=0.0001). Low birth- weight, preterm gestation and male gender was significantly associated with increased risk of hypoglycemia. Healthy, high-risk exclusively breastfed newborns in postnatal wards need close monitoring for hypoglycemia in first 24 hrs of life.

Presence of High-Risk HPV mRNA in Relation to Future High-Grade Lesions among High-Risk HPV DNA Positive Women with Minor Cytological Abnormalities.

Directory of Open Access Journals (Sweden)

Hanna Johansson

Full Text Available Continuous expression of E6- and E7-oncogenes of high-risk human papillomavirus (HPV types is necessary for the development and maintenance of the dysplastic phenotype. The aim of the study was to determine the sensitivity and specificity of the APTIMA HPV mRNA assay (Hologic in predicting future development of high-grade cervical intraepithelial neoplasia (CIN among high-risk HPV-DNA-positive women with atypical squamous cells of undetermined significance (ASCUS or low-grade squamous epithelial lesion (LSIL cytology.Archived SurePath cervical samples of women ≥ 35 years of age with high-risk HPV DNA-positive ASCUS (n = 211 or LSIL, (n = 131 were tested for the presence of high-risk HPV E6/E7 mRNA using the APTIMA HPV assay, and the women were monitored for development of histopathologically verified CIN2+.Twenty-nine percent (61/211 of the women in the ASCUS group, and 34.3% (45/131 in the LSIL group developed CIN2+ within 4.5 years of follow-up. The prevalence of HPV mRNA was 90.0% (95% CI 85.9-94.0 among women with ASCUS and 95.4% (95% CI 91.8-99.0 among women with LSIL. The presence of HPV E6/E7 mRNA was associated with future development of CIN2+ among women with ASCUS and LSIL (p=0.02. The mRNA assay demonstrated high sensitivity in predicting future CIN2+ and CIN3 for index ASCUS (96.7%; 95% CI 87.6-99.4 and 100%; 95% CI 82.2-100, respectively and LSIL (97.8%, 95% CI 86.8-99.9 and 100%, 95% CI 79.9-100, respectively. The corresponding specificity was low, 12.7% (95% CI 7.9-19.3 and 5.8% (95% CI 2.2-13.6, for future CIN2+, respectively. The negative predictive value of the HPV mRNA assay for detecting future CIN3 was 100%, since no mRNA-negative woman developed CIN3 (0/27 as compared to 13.6% (43/315 of the mRNA-positive women (p = 0.03.The APTIMA mRNA assay demonstrated high sensitivity but low specificity in predicting future CIN2+ among women with minor cytological abnormalities. The assay had high negative predictive value for future

Presence of High-Risk HPV mRNA in Relation to Future High-Grade Lesions among High-Risk HPV DNA Positive Women with Minor Cytological Abnormalities

Science.gov (United States)

Johansson, Hanna; Bjelkenkrantz, Kaj; Darlin, Lotten; Dilllner, Joakim; Forslund, Ola

2015-01-01

Objective Continuous expression of E6- and E7-oncogenes of high-risk human papillomavirus (HPV) types is necessary for the development and maintenance of the dysplastic phenotype. The aim of the study was to determine the sensitivity and specificity of the APTIMA HPV mRNA assay (Hologic) in predicting future development of high-grade cervical intraepithelial neoplasia (CIN) among high-risk HPV-DNA-positive women with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous epithelial lesion (LSIL) cytology. Methods Archived SurePath cervical samples of women ≥ 35 years of age with high-risk HPV DNA-positive ASCUS (n = 211) or LSIL, (n = 131) were tested for the presence of high-risk HPV E6/E7 mRNA using the APTIMA HPV assay, and the women were monitored for development of histopathologically verified CIN2+. Results Twenty-nine percent (61/211) of the women in the ASCUS group, and 34.3% (45/131) in the LSIL group developed CIN2+ within 4.5 years of follow-up. The prevalence of HPV mRNA was 90.0% (95% CI 85.9-94.0) among women with ASCUS and 95.4% (95% CI 91.8-99.0) among women with LSIL. The presence of HPV E6/E7 mRNA was associated with future development of CIN2+ among women with ASCUS and LSIL (p=0.02). The mRNA assay demonstrated high sensitivity in predicting future CIN2+ and CIN3 for index ASCUS (96.7%; 95% CI 87.6-99.4 and 100%; 95% CI 82.2-100, respectively) and LSIL (97.8%, 95% CI 86.8-99.9 and 100%, 95% CI 79.9-100, respectively). The corresponding specificity was low, 12.7% (95% CI 7.9-19.3) and 5.8% (95% CI 2.2-13.6), for future CIN2+, respectively. The negative predictive value of the HPV mRNA assay for detecting future CIN3 was 100%, since no mRNA-negative woman developed CIN3 (0/27) as compared to 13.6% (43/315) of the mRNA-positive women (p = 0.03). Conclusion The APTIMA mRNA assay demonstrated high sensitivity but low specificity in predicting future CIN2+ among women with minor cytological abnormalities. The assay had

Fractional laser-mediated photodynamic therapy of high-risk basal cell carcinomas

DEFF Research Database (Denmark)

Haak, C S; Togsverd-Bo, K; Thaysen-Petersen, D

2015-01-01

efficacy and safety of AFXL-mediated PDT (AFXL-PDT) compared with conventional PDT of high-risk nBCC. METHODS: Patients with histologically verified facial nBCC (n = 32) defined as high-risk tumours were included; diameter > 15 mm, tumours located in high-risk zones, or on severely sun-damaged skin...

The high-risk HPV infection and urinary system tumor

Directory of Open Access Journals (Sweden)

Yang Wenyan

2018-04-01

Full Text Available HPV is classified into high-risk and low-risk types depending on its probability of leading to tumorigenesis. Many studies have shown that HPV infection, especially the infection caused by the high-risk type, is always related to prostate cancer, bladder cancer, penile cancer, testicular cancer, and other urinary system tumors. However, previous studies differed in sexual openness and racial genetic susceptibility of the study object, sample size, and experimental methods. Hence, the correlation between high-risk HPV infection and urinary system tumors remains controversial. The early open reading frame of the HPV genome is composed of E1–E7, among which E6 and E7 are the key transfer proteins. The combination of these proteins with oncogene and anti-oncogene may be one of the mechanisms leading to tumorigenesis.

An Overview. High Risk Series.

Science.gov (United States)

General Accounting Office, Washington, DC.

This report provides an overview of efforts undertaken by the U.S. General Accounting Office (GAO) in 1990 to review and report on federal program areas its work identified as high risk because of vulnerabilities to waste, fraud, abuse, and mismanagement. It reviews the current status of efforts to address these concerns. The six categories of…

43 CFR 11.25 - Preassessment screen-preliminary identification of resources potentially at risk.

Science.gov (United States)

2010-10-01

... pathways. (1) The authorized official shall make a preliminary identification of potential exposure... toxicological properties of the oil or hazardous substance. (3) Pathways to be considered shall include, as appropriate, direct contact, surface water, ground water, air, food chains, and particulate movement. (b...

Environmental Survey preliminary report

Energy Technology Data Exchange (ETDEWEB)

1988-04-01

This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Sandia National Laboratories conducted August 17 through September 4, 1987. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with Sandia National Laboratories-Albuquerque (SNLA). The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at SNLA, and interviews with site personnel. 85 refs., 49 figs., 48 tabs.

An assessment of high risk sexual behaviour and HIV transmission ...

African Journals Online (AJOL)

An assessment of high risk sexual behaviour and HIV transmission among migrant oil workers in the Niger Delta area of Nigeria. ... questionnaires to evaluate key high – risk sexual behavioral parameters such as multiplicity of sexual partners, bisexuality (closet homosexuality), high grade sexual behaviour and lesbianism.

Alcohol consumption and high risk sexual behaviour among female ...

African Journals Online (AJOL)

Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1 027 women selected from 'hot spots' in the suburbs of ...

Serving high-risk foods in a high-risk setting: survey of hospital food service practices after an outbreak of listeriosis in a hospital.

Science.gov (United States)

Cokes, Carolyn; France, Anne Marie; Reddy, Vasudha; Hanson, Heather; Lee, Lillian; Kornstein, Laura; Stavinsky, Faina; Balter, Sharon

2011-04-01

Prepared ready-to-eat salads and ready-to-eat delicatessen-style meats present a high risk for Listeria contamination. Because no foodborne illness risk management guidelines exist specifically for US hospitals, a survey of New York City (NYC) hospitals was conducted to characterize policies and practices after a listeriosis outbreak occurred in a NYC hospital. From August through October 2008, a listeriosis outbreak in a NYC hospital was investigated. From February through April 2009, NYC's 61 acute-care hospitals were asked to participate in a telephone survey regarding food safety practices and policies, specifically service of high-risk foods to patients at increased risk for listeriosis. Five patients with medical conditions that put them at high risk for listeriosis had laboratory-confirmed Listeria monocytogenes infection. The Listeria outbreak strain was isolated from tuna salad prepared in the hospital. Fifty-four (89%) of 61 hospitals responded to the survey. Overall, 81% of respondents reported serving ready-to-eat deli meats to patients, and 100% reported serving prepared ready-to-eat salads. Pregnant women, patients receiving immunosuppressive drugs, and patients undergoing chemotherapy were served ready-to-eat deli meats at 77%, 59%, and 49% of hospitals, respectively, and were served prepared ready-to-eat salads at 94%, 89%, and 73% of hospitals, respectively. Only 4 (25%) of 16 respondents reported having a policy that ready-to-eat deli meats must be heated until steaming hot before serving. Despite the potential for severe outcomes of Listeria infection among hospitalized patients, the majority of NYC hospitals had no food preparation policies to minimize risk. Hospitals should implement policies to avoid serving high-risk foods to patients at risk for listeriosis.

Next Generation Nuclear Plant Project Preliminary Project Management Plan

International Nuclear Information System (INIS)

Dennis J. Harrell

2006-01-01

This draft preliminary project management plan presents the conceptual framework for the Next Generation Nuclear Plant (NGNP) Project, consistent with the authorization in the Energy Policy Act of 2005. In developing this plan, the Idaho National Laboratory has considered three fundamental project planning options that are summarized in the following section. Each of these planning options is literally compliant with the Energy Policy Act of 2005, but each emphasizes different approaches to technology development risks, design, licensing and construction risks, and to the extent of commercialization support provided to the industry. The primary focus of this draft preliminary project management plan is to identify those activities important to Critical Decision-1, at which point a decision on proceeding with the NGNP Project can be made. The conceptual project framework described herein is necessary to establish the scope and priorities for the technology development activities. The framework includes: A reference NGNP prototype concept based on what is judged to be the lowest risk technology development that would achieve the needed commercial functional requirements to provide an economically competitive nuclear heat source and hydrogen production capability. A high-level schedule logic for design, construction, licensing, and acceptance testing. This schedule logic also includes an operational shakedown period that provides proof-of-principle to establish the basis for commercialization decisions by end-users. An assessment of current technology development plans to support Critical Decision-1 and overall project progress. The most important technical and programmatic uncertainties (risks) are evaluated, and potential mitigation strategies are identified so that the technology development plans may be modified as required to support ongoing project development. A rough-order-of-magnitude cost evaluation that provides an initial basis for budget planning. This

Screening for breast cancer in a high-risk series

International Nuclear Information System (INIS)

Woodard, E.D.; Hempelmann, L.H.; Janus, J.; Logan, W.; Dean, P.

1982-01-01

A unique cohort of women at increased risk of breast cancer because of prior X-ray treatment of acute mastitis and their selected high-risk siblings were offered periodic breast cancer screening including physical examination of the breasts, mammography, and thermography. Twelve breast cancers were detected when fewer than four would have been expected based on age-specific breast cancer detection rates from the National Cancer institute/American Cancer Society Breast Cancer Demonstration Detection Projects. Mammograpy was positive in all cases but physical examination was positive in only three cases. Thermography was an unreliable indicator of disease. Given the concern over radiation-induced risk, use of low-dose technique and of criteria for participation that select women at high risk of breast cancer will maximize the benefit/risk ratio for mammography screening

Vigilance and iconic memory in children at high risk for alcoholism.

Science.gov (United States)

Steinhauer, S R; Locke, J; Hill, S Y

1997-07-01

Previous studies report reduced visual event-related potential (ERP) amplitudes in young males at high risk for alcoholism. These findings could involve difficulties at several stages of visual processing. This study was aimed at examining vigilance performance and iconic memory functions in children at high risk or low risk for alcoholism. Sustained vigilance and retrieval from iconic memory were evaluated in 54 (29 male) white children at high risk and 47 (25 male) white children at low risk for developing alcoholism. Children were also grouped according to gender and age (younger: 8-12 years; older: 13-18 years). No differences is visual sensitivity, response criterion or reaction time were associated with risk status on the degraded visual stimulus version of the Continuous Performance Test. For the Span of Apprehension, no differences were found due to risk status when only 1 or 5 distractors were presented, although with 9 distractors a significant effect of risk status was found when it was tested as an interaction with gender and age (decreased accuracy for older high-risk boys compared to older low-risk boys). These findings suggest that ERP deviations are not attributable to stages of visual processing deficits, but represent difficulty involving more complex utilization of information. Implications of these results are that the differences between high- and low-risk children that have been reported previously for visual ERP components (e.g., P300) are not attributable to deficits of attentional or iconic memory mechanisms.

On risk, leverage and banks: do highly leveraged banks take on excessive risk?

NARCIS (Netherlands)

Koudstaal, M.; van Wijnbergen, S.

2012-01-01

This paper deals with the relation between excessive risk taking and capital structure in banks. Examining a quarterly dataset of U.S. banks between 1993 and 2010, we find that equity is valued higher when more risky portfolios are chosen when leverage is high, and that more risk taking has a

Risk of caries and oral health: preliminary study

Directory of Open Access Journals (Sweden)

Marcello Gatti

2009-12-01

Full Text Available Introduction. The incidence of injury cariosa remains high, despite the improvements achieved in the last years. Recent national epidemiological surveys, 4 years old children have healthy teeth in 80% of cases at 12 years the percentage is reduced to 50%. In Italy, the almost total absence on the territory of “dental services to the Community”, makes even more difficult to achieve a solution to the problem “caries.” To address this problem, the Ministry of Labor, Health and Social Policy in October 2008 adopted the national guidelines in order to make suggestions to the various professionals (pediatricians, dentists, microbiologists, dental hygienists, etc., making them interact to maintain and restore oral health. It was the first time that the Ministry of Health has addressed the problem by inserting the figure of the microbiologist in dentistry. Aims. The present study aim was to identify subjects at risk of caries by clinical microbiological testing of saliva and the index DMFT/dmft (Decayed, Missing and Filling Permanent Teeth in both adults and particularly children in order to take preventive measures early as reported in “National guidelines for the promotion of oral health and prevention of oral diseases in age of development”. The study began in June 2009 and will last one year with as goal to have, in 2010, 90% of children between 5 and 6 years caries free and 18 years with any lost tooth decay. Materials and methods. Recruited 164 patients were divided into three age groups: 124 adults aged between 20 and 40 years, 40 children which 21 till 5 years old and 19 till 12 years old. Microbiological testing was aimed by finding CFU / ml of saliva of Streptococcus mutans and Lactobacillus spp., Slide CRT bacteria (Ivoclar. Clinically, intraoral examination was performed to evaluate the DMFT (Decayed teeth, Missing or Filling calculated over 28 permanent teeth and the dmft (decayed teeth, missing or filling calculated on 20

MDS. A disease with high radiation-risk

International Nuclear Information System (INIS)

Ban, Sadayuki; Sudo, Hitomi; Saegusa, Kumiko; Sagara, Masashi; Imai, Takashi

2003-01-01

A preliminary epidemiological study demonstrated that myelodysplastic syndrome (MDS) has an excess relative risk per sievert of 13 in atomic bomb survivors. MDS is the only other radiogenic blood disease apart from leukemia. Clinically, MDS involves dysplastic hematopoiesis and an increased risk of leukemic transformation. Because it is uncertain whether MDS pathogenesis affects lymphoid progenitor cells as well as myeloid progenitor cells, we investigated the micronucleus (MN) frequency in peripheral T lymphocytes of twenty-three atomic bomb survivors with MDS and five normal individuals. The spontaneous- and X-ray-induced-MN frequencies were significantly higher in MDS patients than in normal individuals. Interestingly, radiation sensitivity increased along with the severity of MDS clinical subtypes. Because many of the patients in this study had not been exposed to chemo- or radiation-therapy, their unusual radiosensitivities may be related to their chromosomal or genomic instability. To explain the cause of unusual radiosensitivity, we measured the expression levels of four nucleotide excision repair (NER) genes (ERCC1, ERCC3, ERCC5 and XPC) in peripheral blood mononuclear cells using a reverse transcripts-polymerase chain reaction (RT-PCR) method. The ERCC5 gene was expressed at reduced levels in only one of 10 patients with mild symptom. Reduction of NER genes was expressed in four of 11 patients with severe symptom. Immortalized lymphoid cell lines were established from B-lymphocytes infected with Epstein-Barr virus in vitro. The abrogation of radiation-induced-G2/M arrnst was observed in some of MDS-B lymphoid cell lines, but not in the normal B lymphoid cell lines. Our data suggest that the control of chromosomal stability is impaired in pluripotent stem cells of MDS patients, and that DNA repair defects and loss of G2/M arrest may be involved in the pathophysiology of disease progression. (authors)

Diagnosis and Management of High Risk Group for Gastric Cancer

Science.gov (United States)

Yoon, Hyuk; Kim, Nayoung

2015-01-01

Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval. PMID:25547086

Reanalysis of Zion risk

International Nuclear Information System (INIS)

Park, C.K.; Unwin, S.D.; Cazzoli, E.; Tingle, A.; Chun, M.

1988-01-01

As part of the NUREG-1150 effort, Brookhaven National Laboratory (BNL) has undertaken a risk analysis of Zion Unit 1 adopting the methodology developed at Sandia National Laboratories (SNL) under the Severe Accident Risk Rebaselining Program. Resulting of the preliminary version of that analysis are reported here. Completion plans for the Zion study are described also

Highly Enhanced Risk Management Emergency Satellite

DEFF Research Database (Denmark)

Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

HERMES (Highly Enhanced Risk Management Emergency Satellite) is potential European satellite mission for global flood management, being implemented by Technical University Munich and European Space Agency. With its main instrument - a reliable and precise Synthetic Aperture Radar (SAR) antenna...

A support vector machine designed to identify breasts at high risk using multi-probe generated REIS signals: a preliminary assessment

Science.gov (United States)

Gur, David; Zheng, Bin; Lederman, Dror; Dhurjaty, Sreeram; Sumkin, Jules; Zuley, Margarita

2010-02-01

A new resonance-frequency based electronic impedance spectroscopy (REIS) system with multi-probes, including one central probe and six external probes that are designed to contact the breast skin in a circular form with a radius of 60 millimeters to the central ("nipple") probe, has been assembled and installed in our breast imaging facility. We are conducting a prospective clinical study to test the performance of this REIS system in identifying younger women (detection of a highly suspicious breast lesion and 50 were determined negative during mammography screening. REIS output signal sweeps that we used to compute an initial feature included both amplitude and phase information representing differences between corresponding (matched) EIS signal values acquired from the left and right breasts. A genetic algorithm was applied to reduce the feature set and optimize a support vector machine (SVM) to classify the REIS examinations into "biopsy recommended" and "non-biopsy" recommended groups. Using the leave-one-case-out testing method, the classification performance as measured by the area under the receiver operating characteristic (ROC) curve was 0.816 +/- 0.042. This pilot analysis suggests that the new multi-probe-based REIS system could potentially be used as a risk stratification tool to identify pre-screened young women who are at higher risk of having or developing breast cancer.

Postmastectomy irradiation in high-risk breast cancer patients

International Nuclear Information System (INIS)

Overgaard, M.; Juul Christensen, J.; Johansen, H.; Nybo-Rasmussen, A.; Brincker, H.; Kooy, P. van der; Frederiksen, P.L.; Laursen, F.; Panduro, J.; Soerensen, N.E.; Gadeberg, C.C.; Hjelm-Hansen, M.; Overgaard, J.; West Andersen, K.; Zedeler, K.

1988-01-01

All pre- and postmenopausal high-risk breast cancer patients in the protocols DBCG 77 of the Danish Breast Cancer Cooperative Group received postmastectomy irradiation before randomization to either adjuvant systemic therapy or no such treatment. The actuarial loco-regional recurrence rate at 9 years was 6-17%, with the lowest rate in patients who also received additional adjuvant chemotherapy or tamoxifen. In a subsequent study (DBCG 82) the role of postmastectomy irradiation together with systemic treatment was evaluated in high-risk patients. Pre- and menopausal patients were randomized to postmastectomy irradiation+CMF (cyclophosphamide, methotrexate, 5-fluorouracil), CMF alone or CMF+TAM (tamoxifen). Postmenopausal patients were randomized to postmastectomy irradiation+TAM, TAM or CMF+TAM. At 4 years the loco-regional recurrence rate was significantly lower in the irradiated patients (5-7% vs. 23-33%). Further, disease-free survival was significantly improved in both pre- and postmenopausal irradiated patients compared with those who had only systemic treatment. At present, there are no significant differences between survival in the treatment groups. Thus, adjuvant systemic treatment alone (chemotherapy and/or tamoxifen) did not prevent loco-regional recurrences in high-risk patients after mastectomy and axillary lymph node sampling. However, a longer observation time is necessary to evaluate the consequence of primary optimal loco-regional tumour control in high-risk breast cancer patients with respect to survival. (orig.)

Detection of high-risk subtypes of human papillomavirus in cervical swabs: routine use of the Digene Hybrid Capture assay and polymerase chain reaction analysis.

LENUS (Irish Health Repository)

Brennan, M M

2012-02-03

Human papillomaviruses (HPVs) are major causative agents in the pathogenesis of cervical cancer, and more than twenty types are associated with its development. With the introduction of liquid-based preparation systems, it is envisaged that large-scale HPV testing will be established in the near future. Preliminary studies demonstrate the accessibility of these samples for DNA testing using both the Digene Hybrid Capture assay (DHCA) and polymerase chain reaction (PCR) techniques. This study aims to assess the validity and sensitivity of the DHCA system to detect high-risk HPV DNA, using two sets of HPV consensus primers (Gp5+\\/Gp6+ and MY09\\/MY11) in tandem with routine assessment of cervical smear and biopsy samples. Results indicate that the combination of DHCA and PCR detects more high-grade lesions than does the DHCA alone. DHCA-negative cases were categorised by subsequent PCR amplification into low-grade HPV-negative (12\\/16) cervical lesions and high-grade HPV-positive (7\\/9) cervical lesions. Gp5+\\/Gp6+ primers were less sensitive in detecting HPV-positive samples than was the MY09\\/MY11 primer set. These results support the use of high-risk HPV testing by DHCA, with subsequent analysis of DHCA-negative samples by PCR using the MY09\\/MY11 primers.

High-risk facilities. Emergency management in nuclear, chemical and hazardous waste facilities

International Nuclear Information System (INIS)

Kloepfer, Michael

2012-01-01

The book on emergency management in high-risk facilities covers the following topics: Change in the nuclear policy, risk management of high-risk facilities as a constitutional problem - emergency management in nuclear facilities, operational mechanisms of risk control in nuclear facilities, regulatory surveillance responsibilities for nuclear facilities, operational mechanism of the risk control in chemical plants, regulatory surveillance responsibilities for chemical facilities, operational mechanisms of the risk control in hazardous waste facilities, regulatory surveillance responsibilities for hazardous waste facilities, civil law consequences in case of accidents in high-risk facilities, criminal prosecution in case of accidents in high-risk facilities, safety margins as site risk for emission protection facilities, national emergency management - strategic emergency management structures, warning and self-protection of the public in case of CBRN hazards including aspects of the psych-social emergency management.

Breast cancer screening (BCS) chart: a basic and preliminary model for making screening mammography more productive and efficient.

Science.gov (United States)

Poorolajal, Jalal; Akbari, Mohammad Esmaeil; Ziaee, Fatane; Karami, Manoochehr; Ghoncheh, Mahshid

2017-05-15

The breast cancer screening (BCS) chart is suggested as a basic and preliminary tool to improve efficiency of screening mammography. We conducted this case-control study in 2016 and enrolled 1422 women aged 30-75 years, including 506 women with breast cancer (cases) and 916 women without breast cancer (controls). We developed the BCS chart using a multiple logistic regression analysis. We combined the risks of breast cancer to predict the individual risk of breast cancer. Then, we stratified and colored the predicted risk probabilities as follows: green), 05-09% (yellow), 10-14% (orange), 15-19% (red), 20-24% (brown) and ≥25% (black). The BCS chart provides the risk probability of breast cancer, based on age, body mass index, late menopause, having a benign breast disease and a positive family history of breast cancer among the first-degree or the second/third-degree relatives. According to this chart, an individual can be classified in a category of low risk (green), medium risk (yellow and orange), high risk (red and brown) and very high risk (black) for breast cancer. This chart is a flexible and easy to use tool that can detect high-risk subjects and make the screening program more efficient and productive. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Prevalence of xerostomia in an adolescent inpatient psychiatric clinic: a preliminary study.

Science.gov (United States)

Kaur, Manvir; Himadi, Elaine; Chi, Donald L

2016-01-01

Adolescents with psychiatric conditions may be at risk for xerostomia. In this preliminary study, we estimated xerostomia prevalence in adolescents ages 9 to 17 years from an inpatient psychiatric clinic (N = 25) and examined whether: (1) gender and age were associated with xerostomia and (2) xerostomia was associated with self-reported cavities. We used a modified 11-item Xerostomia Index to identify xerostomia (no/yes) and asked if adolescents ever had or currently have cavities (no/yes). The mean age was 14 years (SD = 2.3) and 72% were male. Sixty percent reported xerostomia (SD = 50). There were no significant associations between xerostomia and gender (p = 0.99) or age (p = 0.66), or between xerostomia and past (p = 0.26) or current cavities (p = 0.11). Larger proportions of adolescents with xerostomia reported previous and current cavities. Sixty percent of adolescents from an inpatient psychiatric clinic reported having xerostomia, which may lead to increased caries risk over time. Additional research should examine the prevalence and consequences of xerostomia in high-risk adolescents. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

AIDS Risk Perception and its related factors in Women with High-Risk Behaviors in Iran

Directory of Open Access Journals (Sweden)

Mahin Tafazoli

2016-02-01

Full Text Available Background & aim: AIDS is one of the major public health challenges all over the world. Perceived risk is a significant predictor of high-risk behaviors related to AIDS. Women constitute more than half of the HIV patients, and the rate of female sex workers with AIDS is more than the rest of female population. Therefore, the present study aimed to evaluate AIDS risk perception and its related factors in females with high-risk behaviors in Mashhad, Iran. Methods:This descriptive study was performed on 58 women who were arrested on prostitution charges and imprisoned in Mashhad Vakil Abad Prison in 2013. The data were collected using self-designed questionnaires assessing knowledge regarding AIDS as well as sexual activities and also perceived risk of HIV questionnaire. One-way ANOVA, independent samples t-test, linear regression, and Chi-square tests were run, using SPSS version 16. Results: The mean score of HIV risk perception was 18.43±5.92, which was average. There was a significant relationship between the mean score of perceived risk of HIV and knowledge regarding AIDS (P=0.005, alcohol consumption (P=0.04, history of addiction (P=0.008, using contraceptive methods (P=0.01, condom use during intercourse (P=0.02, voluntary HIV testing (P=0.001, and follow-up of HIV test (P=0.009. Conclusion:The findings of the present study revealed that knowledge, alcohol consumption, history of addiction, contraceptive methods, the rate of condom use during intercourse, as well as voluntary HIV testing and follow-up were associated with perceived risk of HIV infection. Therefore, taking the necessary steps towards health promotion through appropriate training and interventional approaches seems to be mandatory for reducing high-risk behaviors in populations with low risk perception.

The rearing environment and risk for drug abuse: a Swedish national high-risk adopted and not adopted co-sibling control study.

Science.gov (United States)

Kendler, K S; Ohlsson, H; Sundquist, K; Sundquist, J

2016-05-01

Although drug abuse (DA) is strongly familial, with important genetic influences, we need to know more about the role of rearing environment in the risk for DA. To address this question, we utilized a high-risk adopted and non-adopted co-sibling control design. High-risk offspring had one or more biological parents registered for DA, alcohol use disorders or criminal behavior. Using Swedish registries, we identified 1161 high-risk full-sibships and 3085 high-risk half-sibships containing at least one member who was adopted-away and one member who was not. Registration for DA was via national criminal, medical and pharmacy registers. In Sweden, adoptive families are screened to provide high-quality rearing environment for adoptees. Controlling for parental age at birth and gender (and, in half-siblings, high-risk status of the other parent), risk for DA was substantially lower in the full- and half-siblings who were adopted v. not adopted [hazard ratios and 95% confidence intervals: 0.55 (0.45-0·69) and 0.55 (95% CI 0.48-0.63), respectively]. The protective effect of adoption on risk for DA was significantly stronger in the full- and half-sibling pairs with very high familial liability (two high-risk parents) and significantly weaker when the adoptive family was broken by death or divorce, or contained a high-risk parent. In both full- and half-sibling pairs, we found replicated evidence that rearing environment strongly impacts on risk for DA. High-quality rearing environments can substantively reduce risk for DA in those at high genetic risk.

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs.

Science.gov (United States)

Athavale, Priyanka; Thomas, Melanie; Delgadillo-Duenas, Adriana T; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A

2016-01-01

Background . Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods . STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18-39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results . Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion . The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420.

HIV Risk Factors among Pregnant and Non-Pregnant High-Risk Women in New York City.

Science.gov (United States)

Deren, Sherry; And Others

1993-01-01

Compared high-risk pregnant (n=55) and nonpregnant (n=598) women from Harlem on human immunodeficiency virus-related drug and sexual risk behaviors. Found higher percentage of intravenous drug users (IVDUs) among nonpregnant women and no significant differences between pregnant and nonpregnant IVDUs in terms of needle risk behaviors. Pregnant…

Identification of the high risk emergency surgical patient: Which risk prediction model should be used?

Science.gov (United States)

Stonelake, Stephen; Thomson, Peter; Suggett, Nigel

2015-09-01

National guidance states that all patients having emergency surgery should have a mortality risk assessment calculated on admission so that the 'high risk' patient can receive the appropriate seniority and level of care. We aimed to assess if peri-operative risk scoring tools could accurately calculate mortality and morbidity risk. Mortality risk scores for 86 consecutive emergency laparotomies, were calculated using pre-operative (ASA, Lee index) and post-operative (POSSUM, P-POSSUM and CR-POSSUM) risk calculation tools. Morbidity risk scores were calculated using the POSSUM predicted morbidity and compared against actual morbidity according to the Clavien-Dindo classification. The actual mortality was 10.5%. The average predicted risk scores for all laparotomies were: ASA 26.5%, Lee Index 2.5%, POSSUM 29.5%, P-POSSUM 18.5%, CR-POSSUM 10.5%. Complications occurred following 67 laparotomies (78%). The majority (51%) of complications were classified as Clavien-Dindo grade 2-3 (non-life-threatening). Patients having a POSSUM morbidity risk of greater than 50% developed significantly more life-threatening complications (CD 4-5) compared with those who predicted less than or equal to 50% morbidity risk (P = 0.01). Pre-operative risk stratification remains a challenge because the Lee Index under-predicts and ASA over-predicts mortality risk. Post-operative risk scoring using the CR-POSSUM is more accurate and we suggest can be used to identify patients who require intensive care post-operatively. In the absence of accurate risk scoring tools that can be used on admission to hospital it is not possible to reliably audit the achievement of national standards of care for the 'high-risk' patient.

Low- and high-dose radioiodine therapy for low-/intermediate-risk differentiated thyroid cancer. A preliminary clinical trial

International Nuclear Information System (INIS)

Qu Yuan; Huang Rui; Li Lin

2017-01-01

To compare the ablation results, therapeutic responses and adverse reactions between a low dose (1.1 GBq) or high dose (3.7 GBq) of 131 I in low-/intermediate-risk differentiated thyroid cancer (DTC) patients. The factors influencing the ablation result and therapeutic response were also analyzed. The researchers used a random number table to randomly assign the enrolled patients to the low-dose group or high-dose group at a 1:1 ratio, and assessment of ablation result, therapeutic response, and adverse reactions evaluated 6 ± 3 months after therapy. A total of 140 patients were enrolled in the study through October 2014-June 2015. Until February 2016, 132 patients completed the trial. 99 patients were re-examined under thyroid-stimulating hormone (TSH) stimulation 3-9 months after 131 I therapy. For the low-dose and high-dose groups, the success rates of ablation were 52.7% (29/55) and 59.1% (26/44), respectively. The ablation results did not differ significantly between the two groups (P = 0.548). One hundred and thirty two patients were re-examined 2-9 months after 131 I therapy. The low-dose group had an excellent response rate of ∼80% (53/66), an indeterminate response rate of ∼ 20% (13/66), and no cases with a biochemical incomplete response. The high-dose group had an excellent response rate of ∼85% (36/66), an indeterminate response rate of ∼11% (7/66), and a biochemical incomplete response rate of ∼4% (3/66). No significant differences in the therapeutic response were observed between the two groups (P = 0.087). Patients in stage N1b had a significantly lower success rate of ablation than those in stage N0 (P = 0.000). The success rate of ablation increased significantly with lower thyroglobulin (Tg) levels (P = 0.000). A pre-treatment Tg level was significantly associated with a higher excellent response rate (P = 0.002). Pre-treatment-stimulated Tg of 0.47 and 3.09 μg/L were identified as cut-off values for predicting the ablation result and

Analysis and management of risks experienced in tunnel construction

Directory of Open Access Journals (Sweden)

Cagatay Pamukcu

2015-12-01

Full Text Available In this study, first of all, the definitions of "risk", "risk analysis", "risk assessment" and "risk management" were made to avoid any confusions about these terms and significance of risk analysis and management in engineering projects was emphasized. Then, both qualitative and quantitative risk analysis techniques were mentioned and within the scope of the study, Event Tree Analysis method was selected in order to analyze the risks regarding TBM (Tunnel Boring Machine operations in tunnel construction. After all hazards that would be encountered during tunnel construction by TBM method had been investigated, those hazards were undergoing a Preliminary Hazard Analysis to sort out and prioritize the risks with high scores. When the risk scores were taken into consideration, it was seen that the hazards with high risk scores could be classified into 4 groups which are excavation + support induced accidents, accidents stemming from geologic conditions, auxiliary works, and project contract. According to these four classified groups of initiating events, Event Tree Analysis was conducted by taking into care 4 countermeasures apart from each other. Finally, the quantitative and qualitative consequences of Event Tree Analyses, which were undertaken for all initiating events, were investigated and interpreted together by making comparisons and referring to previous studies.

Do cognitive schema mediate the association between childhood trauma and being at ultra-high risk for psychosis?

Science.gov (United States)

Appiah-Kusi, E; Fisher, H L; Petros, N; Wilson, R; Mondelli, V; Garety, P A; Mcguire, P; Bhattacharyya, S

2017-05-01

Exposure to childhood trauma has been associated with psychotic symptoms, being at ultra-high risk for psychosis (UHR), and psychotic disorders such as schizophrenia. Negative self-beliefs have been shown to partially mediate the relationship between childhood trauma and paranoia and have been shown to be characteristic of patients with psychosis. However, whether the association between childhood trauma and being at high risk of developing psychosis (e.g., UHR) and paranoia symptoms is mediated by altered cognitive schema is unknown and warrants investigation to inform preventive interventions. Data was collected on 30 UHR patients from Outreach and Support in South London about exposure to childhood trauma, cognitive schema, paranoia and cannabis use. Relative to healthy controls (n = 38), UHR patients were significantly more likely to report exposure to various types of childhood trauma (emotional and sexual abuse, and emotional and physical neglect), had more negative schema and less positive schema about themselves and others, and were more likely to use cannabis more than once a month. Emotional neglect was found to be significantly associated with UHR status even after controlling for the effects of previous exposure to cannabis use (b = 0.262, 95% CI: 0.115-0.408), and this association was partially mediated by negative self-schema (b = 0.045, 95% CI: 0.004-0.159). Similarly, emotional neglect was significantly associated with paranoia (b = 1.354, 95% CI: 0.246-2.462), and this association was partially mediated by negative self-schema (b = 0.988, 95% CI: 0.323-1.895). These findings provide preliminary evidence about the cognitive mechanisms that may underlie the association between childhood trauma and later risk for psychosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

High-Risk Series: An Update

Science.gov (United States)

2015-02-01

the Medicare Trustees, the Office of the Actuary , and the Congressional Budget Office have raised concerns about whether some of the Medicare... actuarially sound. For more information, see the National Flood Insurance Program section of this High-Risk report. Among other things, the report...and mathematics (STEM) functional community. In addition to the efforts of the Working Group, the President’s Fiscal Year 2013 budget—released in

Implications of Fuzziness for the Practical Management of High-Stakes Risks

Directory of Open Access Journals (Sweden)

Mark Jablonowski

2010-04-01

Full Text Available High-stakes (dangerous, catastrophic risks take on a wider profile as progress unfolds. What are the impacts of technological and social change on the risk landscape? Due to the complexities and dynamics involved, we can only answer these questions approximately. By using the concept of fuzziness, we can formalize our imprecision about high-stakes risk, and therefore place their management on a stronger footing. We review here the impacts of fuzziness, i.e., knowledge imperfection, on high-stakes risk management, including its implementation via computationally intelligent decision aids.

Understanding producers’ motives to adopt sustainable practices: the role of expected rewards, risk perception, and risk tolerance

NARCIS (Netherlands)

Hofenk, D.J.B.; Pennings, J.M.E.; Trujillo Barrera, A.A.

2014-01-01

Abstract The purpose of this study is to examine producers’ motives underlying the adoption of sustainable practices. In particular, we focus on expected economic, social, and personal rewards, and examine the roles of producers’ risk perception and risk tolerance. Preliminary results from a survey

Risk communication: Translating technically complex information to facilitate informed decision-making

International Nuclear Information System (INIS)

Sprecher, W.M.; Turner, E.

1991-01-01

Based on a review of risk communication and related literature, including policy material, this paper describes the newly revamped risk management program of the DOE's Office of Civilian Radioactive Waste Management (OCRWM), and some of the risk-related issues being confronted as the high-level waste management program moves forward. It also describes preliminary activities underway in which the OCRWM is developing strategies for risk communication. The authors offer a definition of risk management as comprised by the components of risk assessment and risk communication. The paper explores the discrepant views that experts and nonexperts have with respect to what constitutes a valid risk assessment model. By illustrating differences in the assessment of risk by experts and lay people, the paper demonstrates how these differences can create challenges in communicating risk and making decisions about risk. Finally, the paper discusses ways in which risk communication could be enhance, and elaborates on the OCRWM's commitment to improve its overall risk management efforts

A Preliminary Review of Fatigue Among Rail Staff

Directory of Open Access Journals (Sweden)

Jialin Fan

2018-05-01

Full Text Available Background: Fatigue is a severe problem in the rail industry, which may jeopardize train crew's health and safety. Nonetheless, a preliminary review of all empirical evidence for train crew fatigue is still lacking. The aim of the present paper is, therefore, to provide a preliminary description of occupational fatigue in the rail industry. This paper reviews the literature with the research question examining the risk factors associated with train crew fatigue, covering both papers published in refereed journals and reports from trade organizations and regulators. It assesses the progress of research on railway fatigue, including research on the main risk factors for railway fatigue, the association between fatigue and railway incidents, and how to better manage fatigue in the railway industry.Methods: Systematic searches were performed in both science and industry databases. The searches considered studies published before August 2017. The main exclusion criterion was fatigue not being directly measured through subjective or objective methods.Results: A total of 31 studies were included in the main review. The causes of fatigue included long working hours, heavy workload, early morning or night shifts, and insufficient sleep. Poor working environment, particular job roles, and individual differences also contributed to fatigue.Conclusion: Fatigue in the rail industry includes most of the features of occupational fatigue, and it is also subject to industry-specific factors. The effect of fatigue on well-being and the fatigued population in the railway industry are still not clear. Future studies can consider associations between occupational risk factors and perceived fatigue by examining the prevalence of fatigue and identifying the potential risk factors in staff within the railway industry.

Dinutuximab in the Treatment of High-Risk Neuroblastoma in Children

Directory of Open Access Journals (Sweden)

Hazal Gur

2017-06-01

Full Text Available Neuroblastoma is the most common extracranial tumor derived from neural crest cells in childhood, and treatment of high-risk neuroblastoma is a difficulty in oncology field. The discovery of new treatment strategies to treat pediatric patients with high-risk neuroblastoma is important. Dinutuximab (ch14.18; Unituxin, a chimeric human-mouse monoclonal antibody, is approved by Food and Drug Administration in 2015 to be used specifically in the treatment of high-risk neuroblastoma. It binds the disialoganglioside (GD2 antigen on the surface of neuroblastoma cells and induces lysis of GD2-expressed neuroblastoma cells via antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity. To enhance its activity, it is used with a combination of granulocyte-macrophage colony-stimulating factor, interleukin 2, and 13- cis -retinoic acid. In this review, we discuss the use of dinutuximab in the treatment of high-risk neuroblastoma.

Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude.

Science.gov (United States)

Miele, Catherine H; Schwartz, Alan R; Gilman, Robert H; Pham, Luu; Wise, Robert A; Davila-Roman, Victor G; Jun, Jonathan C; Polotsky, Vsevolod Y; Miranda, J Jaime; Leon-Velarde, Fabiola; Checkley, William

2016-06-01

Miele, Catherine H., Alan R. Schwartz, Robert H. Gilman, Luu Pham, Robert A. Wise, Victor G. Davila-Roman, Jonathan C. Jun, Vsevolod Y. Polotsky, J. Jaime Miranda, Fabiola Leon-Velarde, and William Checkley. Increased cardiometabolic risk and worsening hypoxemia at high altitude. High Alt Med Biol. 17:93-100, 2016.-Metabolic syndrome, insulin resistance, diabetes, and dyslipidemia are associated with an increased risk of cardiovascular disease. While excessive erythrocytosis is associated with cardiovascular complications, it is unclear how worsening hypoxemia of any degree affects cardiometabolic risk factors in high-altitude populations. We studied the relationship between daytime resting oxyhemoglobin saturation and cardiometabolic risk factors in adult participants living in Puno, Peru (3825 m above sea level). We used multivariable logistic regression models to study the relationship between having a lower oxyhemoglobin saturation and markers of cardiometabolic risk. Nine hundred and fifty-four participants (mean age 55 years, 52% male) had information available on pulse oximetry and markers of cardiometabolic risk. Average oxyhemoglobin saturation was 90% (interquartile range 88%-92%) and 43 (4.5%) had excessive erythrocytosis. Older age, decreased height-adjusted lung function, and higher body mass index (BMI) were associated with having an oxyhemoglobin saturation ≤85%. When adjusting for age, sex, socioeconomic status, having excessive erythrocytosis, and site, we found that each 5% decrease in oxyhemoglobin saturation was associated with a higher adjusted odds of metabolic syndrome (OR = 1.35, 95% CI: 1.07-1.72, p 2 mass units (OR = 1.29, 95% CI: 1.00-1.67, p < 0.05), hemoglobin A1c ≥6.5% (OR = 1.66, 95% CI: 1.09-2.51, p < 0.04), and high sensitivity C-reactive protein (hs-CRP) ≥3 mg/L (OR = 1.46, 95% CI: 1.09-1.96, p < 0.01). In high-altitude populations in Puno, Peru, a higher BMI and lower pulmonary function were

Preliminary Accident Analyses for Conversion of the Massachusetts Institute of Technology Reactor (MITR) from Highly Enriched to Low Enriched Uranium

Energy Technology Data Exchange (ETDEWEB)

Dunn, Floyd E. [Argonne National Lab. (ANL), Argonne, IL (United States); Olson, Arne P. [Argonne National Lab. (ANL), Argonne, IL (United States); Wilson, Erik H. [Argonne National Lab. (ANL), Argonne, IL (United States); Sun, Kaichao S. [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Newton, Jr., Thomas H. [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Hu, Lin-wen [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States)

2013-09-30

The Massachusetts Institute of Technology Reactor (MITR-II) is a research reactor in Cambridge, Massachusetts designed primarily for experiments using neutron beam and in-core irradiation facilities. It delivers a neutron flux comparable to current LWR power reactors in a compact 6 MW core using Highly Enriched Uranium (HEU) fuel. In the framework of its non-proliferation policies, the international community presently aims to minimize the amount of nuclear material available that could be used for nuclear weapons. In this geopolitical context most research and test reactors, both domestic and international, have started a program of conversion to the use of LEU fuel. A new type of LEU fuel based on an alloy of uranium and molybdenum (U-Mo) is expected to allow the conversion of U.S. domestic high performance reactors like MITR. This report presents the preliminary accident analyses for MITR cores fueled with LEU monolithic U-Mo alloy fuel with 10 wt% Mo. Preliminary results demonstrate adequate performance, including thermal margin to expected safety limits, for the LEU accident scenarios analyzed.

Review of SFR Design Safety using Preliminary Regulatory PSA Model

International Nuclear Information System (INIS)

Na, Hyun Ju; Lee, Yong Suk; Shin, Andong; Suh, Nam Duk

2013-01-01

The major objective of this research is to develop a risk model for regulatory verification of the SFR design, and thereby, make sure that the SFR design is adequate from a risk perspective. In this paper, the development result of preliminary regulatory PSA model of SFR is discussed. In this paper, development and quantification result of preliminary regulatory PSA model of SFR is discussed. It was confirmed that the importance PDRC and ADRC dampers is significant as stated in the result of KAERI PSA model. However, the importance can be changed significantly depending on assumption of CCCG and CCF factor of PDRC and ADRC dampers. SFR (sodium-cooled fast reactor) which is Gen-IV nuclear energy system, is designed to accord with the concept of stability, sustainability and proliferation resistance. KALIMER-600, which is under development in Korea, includes passive safety systems (e. g. passive reactor shutdown, passive residual heat removal, and etc.) as well as active safety systems. Risk analysis from a regulatory perspective is needed to support the regulatory body in its safety and licensing review for SFR (KALIMER-600). Safety issues should be identified in the early design phase in order to prevent the unexpected cost increase and delay of the SFR licensing schedule that may be caused otherwise

Evaluation of the Prostate Cancer Prevention Trial Risk Calculator in a High-Risk Screening Population

Science.gov (United States)

Kaplan, David J.; Boorjian, Stephen A.; Ruth, Karen; Egleston, Brian L.; Chen, David Y.T.; Viterbo, Rosalia; Uzzo, Robert G.; Buyyounouski, Mark K.; Raysor, Susan; Giri, Veda N.

2009-01-01

Introduction Clinical factors in addition to PSA have been evaluated to improve risk assessment for prostate cancer. The Prostate Cancer Prevention Trial (PCPT) risk calculator provides an assessment of prostate cancer risk based on age, PSA, race, prior biopsy, and family history. This study evaluated the risk calculator in a screening cohort of young, racially diverse, high-risk men with a low baseline PSA enrolled in the Prostate Cancer Risk Assessment Program. Patients and Methods Eligibility for PRAP include men ages 35-69 who are African-American, have a family history of prostate cancer, or have a known BRCA1/2 mutation. PCPT risk scores were determined for PRAP participants, and were compared to observed prostate cancer rates. Results 624 participants were evaluated, including 382 (61.2%) African-American men and 375 (60%) men with a family history of prostate cancer. Median age was 49.0 years (range 34.0-69.0), and median PSA was 0.9 (range 0.1-27.2). PCPT risk score correlated with prostate cancer diagnosis, as the median baseline risk score in patients diagnosed with prostate cancer was 31.3%, versus 14.2% in patients not diagnosed with prostate cancer (p<0.0001). The PCPT calculator similarly stratified the risk of diagnosis of Gleason score ≥7 disease, as the median risk score was 36.2% in patients diagnosed with Gleason ≥7 prostate cancer versus 15.2% in all other participants (p<0.0001). Conclusion PCPT risk calculator score was found to stratify prostate cancer risk in a cohort of young, primarily African-American men with a low baseline PSA. These results support further evaluation of this predictive tool for prostate cancer risk assessment in high-risk men. PMID:19709072

High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer

Directory of Open Access Journals (Sweden)

Keisei Okamoto

2017-02-01

Full Text Available Purpose : To evaluate the outcomes of high-risk prostate cancer patients treated with biologically effective dose (BED ≥ 220 Gy of high-dose radiotherapy, using low-dose-rate (LDR brachytherapy in combination with external beam radiotherapy (EBRT and short-term androgen deprivation therapy (ADT. Material and methods : From 2005 to 2013, a total of 143 patients with high-risk prostate cancer were treated by radiotherapy of BED ≥ 220 Gy with a combination of LDR brachytherapy, EBRT, and androgen deprivation therapy (ADT. The high-risk patients in the present study included both high-risk and very high-risk prostate cancer. The number of high-risk features were: 60 patients with 1 high-risk factor (42%, 61 patients with 2 high-risk factors (43%, and 22 patients with 3 high-risk factors (15% including five N1 disease. External beam radiotherapy fields included prostate and seminal vesicles only or whole pelvis depending on the extension of the disease. Biochemical failure was defined by the Phoenix definition. Results : Six patients developed biochemical failure, thus providing a 5-year actual biochemical failure-free survival (BFFS rate of 95.2%. Biochemical failure was observed exclusively in cases with distant metastasis in the present study. All six patients with biochemical relapse had clinical failure due to bone metastasis, thus yielding a 5-year freedom from clinical failure (FFCF rate of 93.0%. None of the cases with N1 disease experienced biochemical failure. We observed four deaths, including one death from prostate cancer, therefore yielding a cause-specific survival (CSS rate of 97.2%, and an overall survival (OS rate of 95.5%. Conclusions : High-dose (BED ≥ 220 Gy radiotherapy by LDR in combination with EBRT has shown an excellent outcome on BFFS in high-risk and very high-risk cancer, although causal relationship between BED and BFFS remain to be explained further.

Risk of suicide in high risk pregnancy: an exploratory study.

Science.gov (United States)

Benute, Gláucia Rosana Guerra; Nomura, Roseli Mieko Yamamoto; Jorge, Vanessa Marques Ferreira; Nonnenmacher, Daniele; Fráguas Junior, Renério; Lucia, Mara Cristina Souza de; Zugaib, Marcelo

2011-01-01

To identify the risk of suicidal behavior in high-risk pregnant women at a public hospital in São Paulo. We conducted a semi-structured interview with each of the participants (n = 268) through a previously prepared questionnaire. Risk of suicidal behavior was assessed by the Portuguese version of PRIME-MD. The mean age of patients was 29 years (SD = 0.507) and gestation period was 30 weeks (SD = 0.556). Of the total sample, specific risk of suicide was found in 5% (n = 14). Of these, 85% have a stable relationship (married or cohabitating), the pregnancy was planned in 50% of cases, and 71% have no religion or professional activities. The correlation of risk of suicide with data from marital status, planned birth, age, education, professional practice, risk of prematurity, and religion showed that having a religion is statistically significant (p = 0.012). There were no positive associations for any of the other selected variables when compared with the risk of suicide. By correlating the risk of suicide with other characteristic symptoms of major depression, there was statistical significance in the sample with regard to insomnia or hypersomnia (p = 0.003), fatigue or loss of energy (p = 0.001), decreased or increased appetite (p = 0.005), less interest in daily activities (p = 0.000), depressed mood (p = 0.000), feelings of worthlessness or guilt (p = 0.000), decreased concentration (p = 0.002), and agitation or psychomotor retardation (p = 0.002). We found that religion can be a protective factor against suicidal behavior. Besides providing a social support network needed by women during pregnancy, religion supports belief in life after death and in a loving God, giving purpose to life and self esteem and providing models for coping with crises. The results show the importance of prevention and early diagnosis of suicidal behavior, since suicide is an attempt to move from one sphere to another by force, seeking to solve what seems impossible.

Preliminary assessment of risk of ozone impacts to maize (Zea mays) in Southern Africa

CSIR Research Space (South Africa)

Van Tienhoven, AM

2006-03-01

Full Text Available Surface ozone concentrations in southern Africa exceed air quality guidelines set to protect agricultural crops. This paper addresses a knowledge gap by performing a preliminary assessment of potential ozone impacts on vegetation in southern African...

Radical prostatectomy in clinically localized high-risk prostate cancer

DEFF Research Database (Denmark)

Røder, Martin Andreas; Berg, Kasper Drimer; Christensen, Ib Jarle

2013-01-01

) is regarded as primary therapy by others. This study examined the outcome for high-risk localized PCa patients treated with RP. Material and methods. Of 1300 patients who underwent RP, 231 were identified as high-risk. Patients were followed for biochemical recurrence (BCR) (defined as prostate-specific......Abstract Objective. The optimal therapeutic strategy for high-risk localized prostate cancer (PCa) is controversial. Supported by randomized trials, the combination of external beam radiation therapy (EBRT) and endocrine therapy (ET) is advocated by many, while radical prostatectomy (RP...... antigen ≥ 0.2 ng/ml), metastatic disease and survival. Excluding node-positive patients, none of the patients received adjuvant therapy before BCR was confirmed. Univariate and multivariate analysis was performed with Kaplan-Meier and Cox proportional hazard models. Results. Median follow-up was 4.4 years...

Neoplastic potential of gastric irradiation. IV. Risk estimates

International Nuclear Information System (INIS)

Griem, M.L.; Justman, J.; Weiss, L.

1984-01-01

No significant tumor increase was found in the initial analysis of patients irradiated for peptic ulcer and followed through 1962. A preliminary study was undertaken 22 years later to estimate the risk of cancer due to gastric irradiation for peptic ulcer disease. A population of 2,049 irradiated patients and 763 medically managed patients has been identified. A relative risk of 3.7 was found for stomach cancer and an initial risk estimate of 5.5 x 10(-6) excess stomach cancers per person rad was calculated. A more complete follow-up is in progress to further elucidate this observation and decrease the ascertainment bias; however, preliminary data are in agreement with the Japanese atomic bomb reports

Radiological risk assessment of a radioactively contaminated site

International Nuclear Information System (INIS)

Devgun, J.S.

1990-01-01

A limited-scope preliminary assessment of radiological risk has been conducted at a radioactively contaminated site under current site use conditions and based on the available preliminary radiological characterization data for the site. The assessment provides useful input to the remedial action planning for the site. 8 refs., 1 fig., 2 tabs

Depression, alcohol use, and intimate partner violence among outpatients in rural Uganda: vulnerabilities for HIV, STIs and high risk sexual behavior.

Science.gov (United States)

Kiene, Susan M; Lule, Haruna; Sileo, Katelyn M; Silmi, Kazi Priyanka; Wanyenze, Rhoda K

2017-01-19

Intimate partner violence (IPV), alcohol use, and depression are key vulnerabilities for HIV in Uganda, and taken together may have a synergistic effect on risk. Our objective was to investigate the associations between depression, IPV, and alcohol use and HIV-risk indicators among a sample of outpatients in rural Uganda, and the effect of co-occurrence of these factors on HIV-risk indicators. In a structured interview we collected data on high-risk sexual behavior, depression symptoms, emotional and physical IPV, and alcohol use, as well as a blood sample for HIV and syphilis tests and a urine sample for chlamydia and gonorrhea tests from 325 male and female outpatients receiving provider-initiated HIV testing and counseling (PITC) at a public hospital outpatient clinic in rural Uganda. We used logistic regression and generalized linear modeling to test independent associations between depression, IPV, and alcohol use and HIV-risk indicators, as well as the effect of co-occurrence on HIV-risk indicators. Twelve percent of men and 15% of women had two or more of the following conditions: depression, IPV, and alcohol use; another 29% of men and 33% of women had 1 condition. Each condition was independently associated with HIV risk behavior for men and women, and for women, depression was associated with testing positive for HIV or a sexually transmitted infection (STI). Men with one condition (AOR 2.32, 95% CI 1.95-2.77) and two or more conditions (AOR 12.77, 95% CI 7.97-20.47) reported more high risk sex acts compared to those with no potential co-occurring conditions. For men, experiencing two or more conditions increased risky sex more than one alone (χ 2 24.68, p risk for risky sex (AOR 2.18, 95% CI 1.64-2.91). We also found preliminary evidence suggesting synergistic effects between depression and emotional IPV and between alcohol use and depression. This study demonstrates the co-occurrence of depression, IPV, and alcohol use in men and women in an

A Preliminary Study on the Efficacy of a Community-Based Physical Activity Intervention on Physical Function-Related Risk Factors for Falls Among Breast Cancer Survivors.

Science.gov (United States)

Lee, C Ellen; Warden, Stuart J; Szuck, Beth; Lau, Y K James

2016-08-01

The aim of this study was to examine the effects of a 6-week community-based physical activity (PA) intervention on physical function-related risk factors for falls among 56 breast cancer survivors (BCS) who had completed treatments. This was a single-group longitudinal study. The multimodal PA intervention included aerobic, strengthening, and balance components. Physical function outcomes based on the 4-meter walk, chair stand, one-leg stance, tandem walk, and dynamic muscular endurance tests were assessed at 6-week pre-intervention (T1), baseline (T2), and post-intervention (T3). T1 to T2 and T2 to T3 were the control and intervention periods, respectively. All outcomes, except the tandem walk test, significantly improved after the intervention period (P control period (P > 0.05). Based on the falls risk criterion in the one-leg stance test, the proportion at risk for falls was significantly lower after the intervention period (P = 0.04), but not after the control period. A community-based multimodal PA intervention for BCS may be efficacious in improving physical function-related risk factors for falls, and lowering the proportion of BCS at risk for falls based on specific physical function-related falls criteria. Further larger trials are needed to confirm these preliminary findings.

A Preliminary Study on the Efficacy of a Community-Based Physical Activity Intervention on Physical Function-Related Risk Factors for Falls among Breast Cancer Survivors

Science.gov (United States)

Lee, C. Ellen; Warden, Stuart J.; Szuck, Beth; Lau, Y.K. James

2015-01-01

Objective The aim of this study was to examine the effects of a 6-week community-based physical activity (PA) intervention on physical function-related risk factors for falls among 56 breast cancer survivors (BCS) who had completed treatments. Design This was a single-group longitudinal study. The multimodal PA intervention included aerobic, strengthening and balance components. Physical function outcomes based on the 4-meter walk, chair stand, one-leg stance, tandem walk, and dynamic muscular endurance tests were assessed at 6-week pre-intervention (T1), baseline (T2), and post-intervention (T3). T1-T2 and T2-T3 were the control and intervention periods, respectively. Results All outcomes, except the tandem walk test, significantly improved after the intervention period (p 0.05). Based on the falls risk criterion in the one-leg stance test, the proportion at risk for falls was significantly lower after the intervention period (p = 0.04), but not after the control period. Conclusions A community-based multimodal PA intervention for BCS may be efficacious in improving physical function-related risk factors for falls, and lowering the proportion of BCS at risk for falls based on specific physical function-related falls criteria. Further larger trials are needed to confirm these preliminary findings. PMID:26829081

A preliminary bending fatigue spectrum for steel monostrand cables

DEFF Research Database (Denmark)

Winkler, Jan; Fischer, Gregor; Georgakis, Christos T.

2011-01-01

This paper presents the results of the experimental study on the bending fatigue resistance of high-strength steel monostrand cables. From the conducted fatigue tests in the high-stress, low-cycle region, a preliminary bending fatigue spectrum is derived for the estimation of monostrand cable...... service life expectancy. The presented preliminary bending fatigue spectrum of high-strength monostrands is currently unavailable in the published literature. The presented results provide relevant information on the bending mechanism and fatigue characteristics of monostrand steel cables in tension...... and flexure and show that localized cable bending has a pronounced influence on the fatigue resistance of cables under dynamic excitations....

Cyclin H expression is increased in GIST with very-high risk of malignancy

International Nuclear Information System (INIS)

Dorn, Julian; Spatz, Hanno; Schmieder, Michael; Barth, Thomas FE; Blatz, Annette; Henne-Bruns, Doris; Knippschild, Uwe; Kramer, Klaus

2010-01-01

Risk estimation of gastrointestinal stromal tumours (GIST) is based on tumour size and mitotic rate according to the National Institutes of Health consensus classification. The indication for adjuvant treatment of patients with high risk GIST after R 0 resection with small molecule inhibitors is still a controversial issue, since these patients represent a highly heterogeneous population. Therefore, additional prognostic indicators are needed. Here, we evaluated the prognostic value of cyclin H expression in GIST. In order to identify prognostic factors of GIST we evaluated a single centre cohort of ninety-five GIST patients. First, GISTs were classified with regard to tumour size, mitotic rate and localisation according to the NIH consensus and to three additional suggested risk classifications. Second, Cyclin H expression was analysed. Of ninety-five patients with GIST (53 female/42 male; median age: 66.78a; range 17-94a) risk classification revealed: 42% high risk, 20% intermediate risk, 23% low risk and 15% very low risk GIST. In patients with high risk GIST, the expression of cyclin H was highly predictive for reduced disease-specific survival (p = 0.038). A combination of cyclin H expression level and high risk classification yielded the strongest prognostic indicator for disease-specific and disease-free survival (p ≤ 0.001). Moreover, in patients with tumour recurrence and/or metastases, cyclin H positivity was significantly associated with reduced disease-specific survival (p = 0.016) regardless of risk-classification. Our data suggest that, in addition to high risk classification, cyclin H expression might be an indicator for 'very-high risk' GIST

Risks and injuries in laser and high-frequency applications

Science.gov (United States)

Giering, K.; Philipp, Carsten M.; Berlien, Hans-Peter

1995-01-01

An analysis of injuries and risks using high frequency (HF) and lasers in medicine based on a literature search with MEDLINE was performed. The cases reported in the literature were classified according to the following criteria: (1) Avoidable in an optimal operational procedure. These kind of injuries are caused by a chain of unfortunate incidents. They are in principle avoidable by the 'right action at the right time' which presupposes an appropriate training of the operating team, selection of the optimal parameters for procedure and consideration of all safety instructions. (2) Avoidable, caused by malfunction of the equipment and/or accessories. The injuries classified into this group are avoidable if all safety regulations were fulfilled. This includes a pre-operational check-up and the use of medical lasers and high frequency devices only which meet the international safety standards. (3) Avoidable, caused by misuse/mistake. Injuries of this group were caused by an inappropriate selection of the procedure, wrong medical indication or mistakes during application. (4) Unavoidable, fateful. These injuries can be caused by risks inherent to the type of energy used, malfunction of the equipment and/or accessories though a pre-operational check-up was done. Some risks and complications are common to high frequency and laser application. But whereas these risks can be excluded easily in laser surgery there is often a great expenditure necessary or they are not avoidable if high frequency if used. No unavoidable risks due to laser energy occur.

Observed changes in cardiovascular risk factors among high-risk middle-aged men who received lifestyle counselling: a 5-year follow-up.

Science.gov (United States)

Siren, Reijo; Eriksson, Johan G; Vanhanen, Hannu

2016-12-01

To examine the long-term impact of health counselling among middle-aged men at high risk of CVD. An observational study with a 5-year follow-up. All men aged 40 years in Helsinki have been invited to a visit to evaluate CVD risk from 2006 onwards. A modified version of the North Karelia project risk tool (CVD risk score) served to assess the risk. High-risk men received lifestyle counselling based on their individual risk profile in 2006 and were invited to a follow-up visit in 2011. Of the 389 originally high-risk men, 159 participated in the follow-up visits in 2011. Based on their follow-up in relation the further risk communication, we divided the participants into three groups: primary health care, occupational health care and no control visits. Lifestyle and CVD risk score change. All groups showed improvements in lifestyles. The CVD risk score decreased the most in the group that continued the risk communication visits in their primary health care centre (6.1 to 4.8 [95% CI -1.6 to -0.6]) compared to those who continued risk communication visits in their occupational health care (6.0 to 5.4 [95% CI -1.3 to 0.3]), and to those with no risk communication visits (6.0 to 5.9 [95% CI -0.5 to 0.4]). These findings indicate that individualized lifestyle counselling improves health behaviour and reduces total CVD risk among middle-aged men at high risk of CVD. Sustained improvement in risk factor status requires ongoing risk communication with health care providers. KEY POINTS Studies of short duration have shown that lifestyle changes reduce the risk of cardiovascular disease among high-risk individuals. Sustaining these lifestyle changes and maintaining the lower disease risk attained can prove challenging. Cardiovascular disease (CVD) risk assessment and individualized health counselling for high-risk men, when implemented in primary health care, have the potential to initiate lifestyle changes that support risk reduction. Attaining a sustainable reduction in CVD

Preliminary investigation of changes in x-ray multilayer optics subjected to high radiation flux

International Nuclear Information System (INIS)

Hockaday, M.P.; Blake, R.L.; Grosso, J.S.; Selph, M.M.; Klein, M.M.; Matuska, W. Jr.; Palmer, M.A.; Liefeld, R.J.

1985-01-01

A variety of metal multilayers was exposed to high x-ray flux using Sandia National Laboratories' PROTO II machine in the gas puff mode. Fluxes incident on the multilayers above 700 MW/cm 2 in total radiation, in nominal 20 ns pulses, were realized. The neon hydrogen- and helium-like resonance lines were used to probe the x-ray reflectivity properties of the multilayers as they underwent change of state during the heating pulse. A fluorescer-fiber optic-streak camera system was used to monitor the changes in x-ray reflectivity as a function of time and irradiance. Preliminary results are presented for a W/C multilayer. Work in progress to model the experiment is discussed. 13 refs., 4 figs

High Genomic Instability Predicts Survival in Metastatic High-Risk Neuroblastoma

Directory of Open Access Journals (Sweden)

Sara Stigliani

2012-09-01

Full Text Available We aimed to identify novel molecular prognostic markers to better predict relapse risk estimate for children with high-risk (HR metastatic neuroblastoma (NB. We performed genome- and/or transcriptome-wide analyses of 129 stage 4 HR NBs. Children older than 1 year of age were categorized as “short survivors” (dead of disease within 5 years from diagnosis and “long survivors” (alive with an overall survival time ≥ 5 years. We reported that patients with less than three segmental copy number aberrations in their tumor represent a molecularly defined subgroup with a high survival probability within the current HR group of patients. The complex genomic pattern is a prognostic marker independent of NB-associated chromosomal aberrations, i.e., MYCN amplification, 1p and 11q losses, and 17q gain. Integrative analysis of genomic and expression signatures demonstrated that fatal outcome is mainly associated with loss of cell cycle control and deregulation of Rho guanosine triphosphates (GTPases functioning in neuritogenesis. Tumors with MYCN amplification show a lower chromosome instability compared to MYCN single-copy NBs (P = .0008, dominated by 17q gain and 1p loss. Moreover, our results suggest that the MYCN amplification mainly drives disruption of neuronal differentiation and reduction of cell adhesion process involved in tumor invasion and metastasis. Further validation studies are warranted to establish this as a risk stratification for patients.

High risk bladder cancer: current management and survival

Directory of Open Access Journals (Sweden)

Anna M. Leliveld

2011-04-01

Full Text Available PURPOSE: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC in the Comprehensive Cancer Center North-Netherlands (CCCN and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. MATERIALS AND METHODS: Retrospective analysis of 412 patients with newly diagnosed high risk NMIBC. Clinical, demographic and follow-up data were obtained from the CCCN Cancer Registry and a detailed medical record review. Uni and multivariate analysis was performed to identify factors related to choice of treatment and 5 year recurrence and progression free survival. RESULTS: 74/412 (18% patients with high risk NMIBC underwent a transurethral resection (TUR as single treatment. Adjuvant treatment after TUR was performed in 90.7% of the patients treated in teaching hospitals versus 71.8 % in non-teaching hospitals (p 80 years OR 0.1 p = 0.001 and treatment in non-teaching hospitals (OR 0.25; p < 0.001 were associated with less adjuvant treatment after TUR. Tumor recurrence occurred in 191/392 (49% and progression in 84 /392 (21.4% patients. The mean 5-years progression free survival was 71.6% (95% CI 65.5-76.8. CONCLUSION: In this pattern of care study in high risk NMIBC, 18% of the patients were treated with TUR as single treatment. Age and treatment in non-teaching hospitals were associated with less adjuvant treatment after TUR. None of the variables sex, age, comorbidity, hospital type, stage and year of treatment was associated with 5 year recurrence or progression rates.

High-risk populations identified in Childhood Cancer Survivor Study investigations: implications for risk-based surveillance.

Science.gov (United States)

Hudson, Melissa M; Mulrooney, Daniel A; Bowers, Daniel C; Sklar, Charles A; Green, Daniel M; Donaldson, Sarah S; Oeffinger, Kevin C; Neglia, Joseph P; Meadows, Anna T; Robison, Leslie L

2009-05-10

Childhood cancer survivors often experience complications related to cancer and its treatment that may adversely affect quality of life and increase the risk of premature death. The purpose of this manuscript is to review how data derived from Childhood Cancer Survivor Study (CCSS) investigations have facilitated identification of childhood cancer survivor populations at high risk for specific organ toxicity and secondary carcinogenesis and how this has informed clinical screening practices. Articles previously published that used the resource of the CCSS to identify risk factors for specific organ toxicity and subsequent cancers were reviewed and results summarized. CCSS investigations have characterized specific groups to be at highest risk of morbidity related to endocrine and reproductive dysfunction, pulmonary toxicity, cerebrovascular injury, neurologic and neurosensory sequelae, and subsequent neoplasms. Factors influencing risk for specific outcomes related to the individual survivor (eg, sex, race/ethnicity, age at diagnosis, attained age), sociodemographic status (eg, education, household income, health insurance) and cancer history (eg, diagnosis, treatment, time from diagnosis) have been consistently identified. These CCSS investigations that clarify risk for treatment complications related to specific treatment modalities, cumulative dose exposures, and sociodemographic factors identify profiles of survivors at high risk for cancer-related morbidity who deserve heightened surveillance to optimize outcomes after treatment for childhood cancer.

Development of innovative methods for risk assessment in high-rise construction based on clustering of risk factors

Science.gov (United States)

Okolelova, Ella; Shibaeva, Marina; Shalnev, Oleg

2018-03-01

The article analyses risks in high-rise construction in terms of investment value with account of the maximum probable loss in case of risk event. The authors scrutinized the risks of high-rise construction in regions with various geographic, climatic and socio-economic conditions that may influence the project environment. Risk classification is presented in general terms, that includes aggregated characteristics of risks being common for many regions. Cluster analysis tools, that allow considering generalized groups of risk depending on their qualitative and quantitative features, were used in order to model the influence of the risk factors on the implementation of investment project. For convenience of further calculations, each type of risk is assigned a separate code with the number of the cluster and the subtype of risk. This approach and the coding of risk factors makes it possible to build a risk matrix, which greatly facilitates the task of determining the degree of impact of risks. The authors clarified and expanded the concept of the price risk, which is defined as the expected value of the event, 105 which extends the capabilities of the model, allows estimating an interval of the probability of occurrence and also using other probabilistic methods of calculation.

Dose-stress synergism in cancer risk assessment

International Nuclear Information System (INIS)

Pop-Jordanova, N.; Pop-Jordanov, J.

2001-01-01

Our hypothesis is that the relatively low risk of cancer or leukaemia from depleted uranium, as predicted by the World Health Organization and the International Atomic Energy Agency, is a result of neglecting the synergism between physico-chemical agents and psychological stress agents (here shortly denoted as dose-stress synergism). We use the modified risk assessment model that comprises a psycho-somatic extension, originally developed by us for assessing the risks of energy sources. Our preliminary meta-analysis of animal and human studies on cancers confirmed the existence of stress effects, including the amplifying synergism. Consequently, the psychological stress can increase the probability of even small toxic chemical or ionizing radiation exposure to produce malignancy. Such dose-stress synergism might influence the health risks among military personnel and the residents in the highly stressful environment in the Balkans. Further investigation is needed to estimate the order of magnitude of these combined effects in particular circumstances. (Original)

Is the high-risk strategy to prevent cardiovascular disease equitable?

DEFF Research Database (Denmark)

Wallach Kildemoes, Helle; Diderichsen, Finn; Krasnik, Allan

2012-01-01

ABSTRACT: BACKGROUND: Statins are increasingly prescribed to prevent cardiovascular disease (CVD) in asymptomatic individuals. Yet, it is unknown whether those at higher CVD risk - i.e. individuals in lower socio-economic position (SEP) - are adequately reached by this high-risk strategy. Aim......: To examine whether the Danish implementation of the strategy to prevent cardiovascular disease (CVD) by initiating statin (HMG-CoA reductase inhibitor) therapy in high-risk individuals is equitable across socioeconomic groups. METHODS: Design: Cohort study. Setting and participants: Applying individual...

Radioactive waste shredding: Preliminary evaluation

International Nuclear Information System (INIS)

Soelberg, N.R.; Reimann, G.A.

1994-07-01

The critical constraints for sizing solid radioactive and mixed wastes for subsequent thermal treatment were identified via a literature review and a survey of shredding equipment vendors. The types and amounts of DOE radioactive wastes that will require treatment to reduce the waste volume, destroy hazardous organics, or immobilize radionuclides and/or hazardous metals were considered. The preliminary steps of waste receipt, inspection, and separation were included because many potential waste treatment technologies have limits on feedstream chemical content, physical composition, and particle size. Most treatment processes and shredding operations require at least some degree of feed material characterization. Preliminary cost estimates show that pretreatment costs per unit of waste can be high and can vary significantly, depending on the processing rate and desired output particle size

Awareness and prevalence of metabolic syndrome among high-risk ...

African Journals Online (AJOL)

MetS) in high-risk individuals attending 30 internal medicine clinics in Amman, Jordan, and also to evaluate the various factors associated with increased risk of MetS among them. Methods: This retrospective cross-sectional study was carried out ...

Hanford Waste Vitrification Plant: Preliminary description of waste form and canister

International Nuclear Information System (INIS)

Mitchell, D.E.

1986-01-01

In July 1985, the US Department of Energy's Office of Civilian Radioactive Waste Management established the Waste Acceptance Process as the means by which defense high-level waste producers, such as the Hanford Waste Vitrification Plant, will develop waste acceptance requirements with the candidate geologic repositories. A complete description of the Waste Acceptance Process is contained in the Preliminary Hanford Waste Vitrification Plant Waste Form Qualification Plan. The Waste Acceptance Process defines three documents that high-level waste producers must prepare as a part of the process of assuming that a high-level waste product will be acceptable for disposal in a geologic repository. These documents are the Description of Waste Form and Canister, Waste Compliance Plan, and Waste Qualification Report. This document is the Hanford Waste Vitrification Plant Preliminary Description of Waste Form and Canister for disposal of Neutralized Current Acid Waste. The Waste Acceptance Specifications for the Hanford Waste Vitrification Plant have not yet been developed, therefore, this document has been structured to corresponds to the Waste Acceptance Preliminary Specifications for the Defense Waste Processing Facility High-Level Waste Form. Not all of the information required by these specifications is appropriate for inclusion in this Preliminary Description of Waste Form and Canister. Rather, this description is limited to information that describes the physical and chemical characteristics of the expected high-level waste form. The content of the document covers three major areas: waste form characteristics, canister characteristics, and canistered waste form characteristics. This information will be used by the candidate geologic repository projects as the basis for preliminary repository design activities and waste form testing. Periodic revisions are expected as the Waste Acceptance Process progresses

The risk ogf high-risk jobs : psychological health consequences in forensic physicians and ambulance workers

NARCIS (Netherlands)

Ploeg, E. van der

2003-01-01

The risk of high-risk jobs: Psychological health consequences in forensic doctors and ambulance workers This thesis has shown that forensic physicians and ambulance personnel frequently suffer from psychological complaints as a result of dramatic events and sources of chronic work stress. A

The prevalence of asthma work relatedness: Preliminary data

Directory of Open Access Journals (Sweden)

Wojciech Dudek

2015-12-01

Full Text Available Objectives: About 5–10% of asthmatics do not respond well to standard treatment plan. Occupational exposure may be one of the factors that can be linked with treatment failure. The aim of the study was to assess the prevalence of work-related asthma (WRA among adult asthmatics under follow up in an outpatient allergy clinic and to create a useful tool for detecting individuals with possible WRA. Material and Methods: Preliminary 5-question questionnaire designed to recognize WRA was presented to 300 asthmatics. All patients with positive preliminary verification along with 50 subjects from control group were asked to fill up a detailed questionnaire. The WRA was diagnosed by positive match for asthma symptoms in combination with workplace exposure indicated in the detailed WRA questionnaire followed by confirmation of each WRA case by detailed exposure analysis. Results: Work-related asthma was recognized in 63 subjects (21% of study group. The preliminary questionnaire has 76.9% sensitivity and 94% specificity in recognition of WRA. Occupational exposure to irritants is a risk factor of WRA recognition (relative risk (RR = 2.09 (1.44:3.03. Working in exposure-free environment is a factor against WRA recognition (RR = 0.38 (0.24:0.61. Among subjects with work-related asthma, the uncontrolled course of the disease is significantly more frequent (p = 0.012. Subjects with WRA more often report sickness absenteeism due to asthma than those without WRA (9.6% vs. 3.2%, respectively, but the observed differences did not reach the statistical significance. Conclusions: Short 5-question questionnaire seems to be a promising tool to detect individuals with possible work-related asthma in the outpatient setting for further evaluation and additional attention.

Schizophrenia in High-Risk Children: Sex Differences in Predisposing Factors.

Science.gov (United States)

Mednick, Sarnoff A.; And Others

Reported is a research program to observe children at high risk for schizophrenia and explore possibilities of prevention. Characteristics of the high risk group (n=207) observed during 1962 are discussed, and a theory which suggests that schizophrenia is an evasion of life is explained. Among results of a diagnostic assessment conducted 10 years…

Physical performance following acute high-risk abdominal surgery

DEFF Research Database (Denmark)

Jønsson, Line Rokkedal; Ingelsrud, Lina Holm; Tengberg, Line Toft

2018-01-01

BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical...... are primarily fatigue and abdominal pain. Further studies investigating strategies for early mobilization and barriers to mobilization in the immediate postoperative period after AHA surgery are needed.......BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical...... performance and barriers to independent mobilization among patients who received AHA surgery (postoperative days [POD] 1-7). METHODS: Patients undergoing AHA surgery were consecutively enrolled from a university hospital in Denmark. In the first postoperative week, all patients were evaluated daily...

Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude

OpenAIRE

Miele, Catherine H.; Schwartz, Alan R.; Gilman, Robert H.; Pham, Luu; Wise, Robert A.; Davila-Roman, Victor G.; Jun, Jonathan C.; Polotsky, Vsevolod Y.; Miranda, J. Jaime; Leon-Velarde, Fabiola; Checkley, William

2016-01-01

Miele, Catherine H., Alan R. Schwartz, Robert H. Gilman, Luu Pham, Robert A. Wise, Victor G. Davila-Roman, Jonathan C. Jun, Vsevolod Y. Polotsky, J. Jaime Miranda, Fabiola Leon-Velarde, and William Checkley. Increased cardiometabolic risk and worsening hypoxemia at high altitude. High Alt Med Biol. 17:93���100, 2016.���Metabolic syndrome, insulin resistance, diabetes, and dyslipidemia are associated with an increased risk of cardiovascular disease. While excessive erythrocytosis is associated...

Seroprevalence of Brucellosis and Risk Factors Related to High Risk Occupational Groups in Kazeroon, South of Iran

Directory of Open Access Journals (Sweden)

S Beheshti

2010-03-01

Full Text Available Background: Brucellosis is a major zoonosis worldwide. Many people for their professions are at higher risk of contracting the disease. Objective: To determine the seroprevalence of brucellosis and its risk factors in a group of high risk professions. Methods: In a cross-sectional study, all personnel or students of veterinary schools, slaughters and butchers working in the city were invited to participate (n=141. A comparison group (n=44 randomly selected from patients who were selected at random from people attended our healthcare center for reasons other than the infectious diseases. Results: 4 veterinarians, 15 veterinary assistants, 42 veterinarian students, 52 butchers, 17 slaughters, 8 slaughterhouse workers and 3 chefs made the first group and 14 storekeepers, 5 students of engineering, 11 clerks, 13 freelance workers, and 1 high school student made the comparison group. While the rate of consumption of most of the studied dairy products was almost similar in both groups, comparison group patients consumed more often milk (p<0.001 and cream (p<0.001 than the high risk group. 11 (7.8%; 95% CI: 3.4%–12.2% cases from high risk group and none of the comparison group were found seropositive for Brucella. Conclusion: Profession is the main factor in seropositivity. Consumption of dairy products and raw milk is not associated with a higher risk of seropositivity.

Preliminary assessments for disposal of high-level waste within small islets

International Nuclear Information System (INIS)

Chen, F.L.; Li, S.H.; Yu, G.P.

1991-01-01

This paper analyzes, for the final disposal of high-level waste (HLW), the possibility of a repository sited below the fresh/saline groundwater interface within islet rock formations. Because of their relatively stable tectonics, the offshore islets of some countries (such as those of Taiwan) are worthy of being considered as potential repository sites. Before the emplacement of radwastes in such a repository, however, the mass exchange across the fresh/saline groundwater interface must be limited and the horizontal movement of advective saline ground-water must be extremely low. Theoretical equations for the location and shape of the interface are derived. When radwastes are buried in rock formations, the temperature effect of the decay heat could cause buoyant convection flow of saline groundwater upward across the groundwater interface. This could carry released radionuclides across the groundwater interface to upper formation layers where fresh groundwater flows. The radionuclides could then be carried by the fresh groundwater to the sea. Although basic HLW repository designs should eliminate the significance of this temperature effect, it is incorporated into this preliminary analysis for the purpose of conservative estimations

Conjoint moderate or high-risk alcohol and tobacco use among ...

African Journals Online (AJOL)

2016-03-22

Mar 22, 2016 ... southern Thailand 90.5% were moderate or high-risk tobacco users and 44.6% were moderate or high-risk alcohol users.3 Among general hospital patients in Brazil the rate of comorbidity between alcohol use disorder and nicotine dependence was 3.6%;4 in primary health care TB patients in. South Africa ...

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.

Association of maltreatment with high-risk internet behaviors and offline encounters.

Science.gov (United States)

Noll, Jennie G; Shenk, Chad E; Barnes, Jaclyn E; Haralson, Katherine J

2013-02-01

High-risk Internet behaviors, including viewing sexually explicit content, provocative social networking profiles, and entertaining online sexual solicitations, were examined in a sample of maltreated and nonmaltreated adolescent girls aged 14 to 17 years. The impact of Internet behaviors on subsequent offline meetings was observed over 12 to 16 months. This study tested 2 main hypotheses: (1) maltreatment would be a unique contributor to high-risk Internet behaviors and (2) high-quality parenting would dampen adolescents' propensity to engage in high-risk Internet behaviors and to participate in offline meetings. Online and offline behaviors and parenting quality were gleaned from 251 adolescent girls, 130 of whom experienced substantiated maltreatment and 121 of whom were demographically matched comparison girls. Parents reported on adolescent behaviors and on the level of Internet monitoring in the home. Social networking profiles were objectively coded for provocative self-presentations. Offline meetings with persons first met online were assessed 12 to 16 months later. Thirty percent of adolescents reported having offline meetings. Maltreatment, adolescent behavioral problems, and low cognitive ability were uniquely associated with high-risk Internet behaviors. Exposure to sexual content, creating high-risk social networking profiles, and receiving online sexual solicitations were independent predictors of subsequent offline meetings. High-quality parenting and parental monitoring moderated the associations between adolescent risk factors and Internet behaviors, whereas use of parental control software did not. Treatment modalities for maltreated adolescents should be enhanced to include Internet safety literacy. Adolescents and parents should be aware of how online self-presentations and other Internet behaviors can increase vulnerability for Internet-initiated victimization.

High resolution seismic stratigraphy and Mass Transport Deposits of the proximal continental margin, offshore Quarteira, South Portugal: Preliminary Results.

Science.gov (United States)

Duarte, Débora; Santos, Joana; Terrinha, Pedro; Brito, Pedro; Noiva, João; Ribeiro, Carlos; Roque, Cristina

2017-04-01

More than 300 nautical miles of multichannel seismic reflection data were acquired in the scope of the ASTARTE project (Assessment Strategy and Risk Reduction for Tsunamis in Europe), off Quarteira, Algarve, South Portugal. The main goal of this very high resolution multichannel seismic survey was to obtain high-resolution images of the sedimentary record to try to discern the existence of high energy events, possibly tsunami backwash deposits associated with large magnitude earthquakes generated at the Africa-Eurasia plate boundary This seismic dataset was processed at the Instituto Português do Mar e da Atmosfera (IPMA), with the SeisSpace PROMAX Seismic Processing software. A tailor-made processing flow was applied, focusing in the removal of the seafloor multiple and in the enhancement of the superficial layers. A sparker source, using with 300 J of energy and a fire rate of 0,5 s was used onboard Xunauta, an 18 m long vessel. The preliminary seismostratigraphic interpretation of the Algarve ASTARTE seismic dataset allowed the identification of a complex sequence seismic units of progradational and agradational bodies as well as Mass Transported Deposits (MTD). The MTD package of sediments has a very complex internal structure, 20m of thickness, is apparently spatially controlled by an escarpment probably associated to past sea level low stands. The MTD covers across an area, approximately parallel to an ancient coastline, with >30 km (length) x 5 km (across). Acknowledgements: This work was developed as part of the project ASTARTE (603839 FP7) supported by the grant agreement No 603839 of the European Union's Seventh. The Instituto Portugues do Mar e da Atmosfera acknowledges support by Landmark Graphics (SeisWorks) via the Landmark University Grant Program.

Mapping Risks of Indonesian Tuna Supply Chain

Science.gov (United States)

Karningsih, P. D.; Anggrahini, D.; Kurniati, N.; Suef, M.; Fachrur, A. R.; Syahroni, N.

2018-04-01

Due to its high economic value and is produced by many countries, Tuna is considered as one of the world’s popular fish. Demand for Tuna species are very high and it usually sells in three form: fresh, frozen or canned. Competition in Tuna trading is challengin with the potential risk of price and supply fluctuations. With recent focus of Indonesia government that see the future of Indonesia civilization depend on the oceans and as the three biggest Tuna producing country, Ministry of Marine Affairs and Fisheries should ensure sustainability and competitiveness of Indonesian tuna. Therefore, there is a great need to develop a proper and effective strategy to manage potential risks in Indonesian Tuna supply chain. This paper is aimed at identifying and mapping potential Tuna supply chain risks and its interrelationships that would assist government in determining proper strategies to manage Indonesian Tuna. A framework for identifying Tuna supply chain risks is proposed. Generic risk structure of Supply Chain Risk Identification System is adopted and modified to match with particular object, which is Indonesian Tuna. The proposed model consists of hierarchical and causal structure that encompass potential risks of Tuna supply chain operations from fishing, trading, processing and distribution. The causal structure consist of risk events and its risk agents which is the cause of risk events. To ensure the root cause of risk events are identified properly, five why’s analysis is utilized to obtain risk agents. This proposed model also captures risk interrelationship between internal and external environment of Tuna supply chain. Preliminary result of this study identifies 15 risk events and 13 risk factors on fishing and trading operations and maps their interrelationships.

Conceptual overview and preliminary risk assessment of cryogen use in deep underground mine production

Science.gov (United States)

Sivret, J.; Millar, D. L.; Lyle, G.

2017-12-01

This research conducts a formal risk assessment for cryogenic fueled equipment in underground environments. These include fans, load haul dump units, and trucks. The motivating advantage is zero-emissions production in the subsurface and simultaneous provision of cooling for ultra deep mine workings. The driving force of the engine is the expansion of the reboiled cryogen following flash evaporation using ambient temperature heat. The cold exhaust mixes with warm mine air and cools the latter further. The use of cryogens as ‘fuel’ leads to much increased fuel transport volumes and motivates special considerations for distribution infrastructure and process including: cryogenic storage, distribution, handling, and transfer systems. Detailed specification of parts and equipment, numerical modelling and preparation of design drawings are used to articulate the concept. The conceptual design process reveals new hazards and risks that the mining industry has not yet encountered, which may yet stymie execution. The major unwanted events include the potential for asphyxiation due to oxygen deficient atmospheres, or physical damage to workers due to exposure to sub-cooled liquids and cryogenic gases. The Global Minerals Industry Risk Management (GMIRM) framework incorporates WRAC and Bow-Tie techniques and is used to identify, assess and mitigate risks. These processes operate upon the competing conceptual designs to identify and eliminate high risk options and improve the safety of the lower risk designs.

Ares-I-X Vehicle Preliminary Range Safety Malfunction Turn Analysis

Science.gov (United States)

Beaty, James R.; Starr, Brett R.; Gowan, John W., Jr.

2008-01-01

Ares-I-X is the designation given to the flight test version of the Ares-I rocket (also known as the Crew Launch Vehicle - CLV) being developed by NASA. As part of the preliminary flight plan approval process for the test vehicle, a range safety malfunction turn analysis was performed to support the launch area risk assessment and vehicle destruct criteria development processes. Several vehicle failure scenarios were identified which could cause the vehicle trajectory to deviate from its normal flight path, and the effects of these failures were evaluated with an Ares-I-X 6 degrees-of-freedom (6-DOF) digital simulation, using the Program to Optimize Simulated Trajectories Version 2 (POST2) simulation framework. The Ares-I-X simulation analysis provides output files containing vehicle state information, which are used by other risk assessment and vehicle debris trajectory simulation tools to determine the risk to personnel and facilities in the vicinity of the launch area at Kennedy Space Center (KSC), and to develop the vehicle destruct criteria used by the flight test range safety officer. The simulation analysis approach used for this study is described, including descriptions of the failure modes which were considered and the underlying assumptions and ground rules of the study, and preliminary results are presented, determined by analysis of the trajectory deviation of the failure cases, compared with the expected vehicle trajectory.

Characteristics of High-Risk Pregnancy in Sanglah General Hospital 2011-2014

Directory of Open Access Journals (Sweden)

Ryan Saktika Mulyana

2016-07-01

Full Text Available Background: Pregnant women with a high-risk pregnancy are women with increased risk in pregnancy or childbirth. There is no readily available data available about the characteristics of the high-risk pregnancy in Bali. Objective: Our study aimed to provide a data, to be the base of Sanglah General Hospital resource planning to reduce maternal mortality and morbidity. Method: This was an observational study using medical records of high risk pregnancy patients at Sanglah General Hospital from 2011 to 2014. Inclusion criteria were the patients with complete medical record and exclusion criteria are patient whose medical report incomplete. There was no missing data in this study.Result Over the 4 year study period at Sanglah, there were 1027 high-risk deliveries in 2011, 1590 in 2012, 1590 in 2013, and 948 in 2014. In the 4 years, there were 748 with age ≥ 35 years. The majority were in the age group of 26-30 years. As many as 2932 were multiparous. Overall, 3082 were multigravida and only 197 were grandemultipara. There were 1406 preterm (<37 week. By onset and mode of delivery, 2027 (41.50% had a caesarean section, There were 9 (0.18% Breech deliveries and Neonatal outcomes were recorded, showing that 296 (6.29% had moderate asphyxia and 2189 (4.63% had severe asphyxia. The multiple pregnancy was 197 (3.82% twin pregnancies and 5 (0.1% cases of triplets. The largest group of obstetrics complications in Sanglah hospital was premature rupture of membrane 1652 cases (30.99%. The most common medical disorder of pregnant women at our hospital was anemia, 353 cases (45.43%. The most prevalent congenital anomalies were multiple congenital abnormalities, as many as 18 infants (20.22%.Conclusion: There were a significant number of high-risk pregnancies delivered at Sanglah, with nearly 46.85% being high risk deliveries. Characteristics of these high risk pregnancies can be used to plan appropriate care to reduce the maternal mortality rate.

The Relationship between Parental Control and High-Risk Internet Behaviours in Adolescence

Directory of Open Access Journals (Sweden)

David Álvarez-García

2018-06-01

Full Text Available One of the main predictors of being a victim of cyber-aggression is engaging in high-risk behaviours on the internet. The main objective of this research is to analyse the relationship between two types of parental control (restriction and supervision and engagement in high-risk internet behaviours during adolescence. To that end, and as a secondary objective, we designed and validated the High-risk Internet Behaviours Questionnaire for adolescents, used in this study. We analysed the responses of 946 adolescents aged between 12 and 18 to the High-risk Internet Behaviours Questionnaire and the Questionnaire on Parental Control of Internet Use in Adolescence. The results show that the questionnaire has appropriate metrics of reliability and validity, and show the existence of a statistically significant negative relationship, albeit small, between supervision and engaging in high-risk internet behaviours. We discuss the practical implications of these results.

Yucca Mountain transportation routes: Preliminary characterization and risk analysis

International Nuclear Information System (INIS)

Souleyrette, R.R. II; Sathisan, S.K.; di Bartolo, R.

1991-01-01

In this study, rail and highway routes which may be used for shipments of high-level nuclear waste to a proposed repository at Yucca Mountain, Nevada are characterized. This characterization facilitates three types of impact analysis: comparative study, limited worst-case assessment, and more sophisticated probabilistic risk assessment techniques. Data for relative and absolute impact measures are provided to support comparisons of routes based on selected characteristics. A worst-case scenario assessment is included to determine potentially critical and most likely places for accidents or incidents to occur. The assessment facilitated by the data in this study is limited because impact measures are restricted to the identification of potential areas or persons affected. No attempt is made to quantify the magnitude of these impacts. Most likely locations for accidents to occur are determined relative to other locations within the scope of this study. Independent factors and historical trends used to identify these likely locations are only proxies for accident probability

Preliminary assessment of the ecological risks to wide-ranging wildlife species on the Oak Ridge Reservation. 1996 update

Energy Technology Data Exchange (ETDEWEB)

Sample, B.E.; Hinzman, R.L.; Jackson, B.L.; Baron, L.

1996-09-01

More than approximately 50 years of operations, storage, and disposal of wastes generated by the three facilities on the Oak Ridge Reservation (ORR) (the Oak Ridge K-25 Site, Oak Ridge National Laboratory, and the Oak Ridge Y-12 Plant) has resulted in a mosaic of uncontaminated property and lands that are contaminated to varying degrees. This contaminated property includes source areas and the terrestrial and aquatic habitats down gradient from these source areas. Although the integrator OUs generally contain considerable habitat for biota, the source OUs provide little or no suitable habitat. Historically, ecological risk assessment at Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) sites has focused on species that may be definitively associated with a contaminated area or source OU. Endpoints considered in source OUs include plants, soil/litter invertebrates and processes, aquatic biota found in on-OU sediments and surface waters, and small herbivorous, omnivorous, and vermivorous (i.e., feeding on ground, litter, or soil invertebrates) wildlife. All of these endpoints have limited spatial distributions or home ranges such that numerous individuals or a distinct population can be expected to reside within the boundaries of the source OU. Most analyses are not adequate for large sites with multiple, spatially separated contaminated areas such as the ORR that provide habitat for wide-ranging wildlife species. This report is a preliminary response to a plan for assessing risks to wide-ranging species.

Preliminary assessment of the ecological risks to wide-ranging wildlife species on the Oak Ridge Reservation. 1996 update

International Nuclear Information System (INIS)

Sample, B.E.; Hinzman, R.L.; Jackson, B.L.; Baron, L.

1996-09-01

More than approximately 50 years of operations, storage, and disposal of wastes generated by the three facilities on the Oak Ridge Reservation (ORR) (the Oak Ridge K-25 Site, Oak Ridge National Laboratory, and the Oak Ridge Y-12 Plant) has resulted in a mosaic of uncontaminated property and lands that are contaminated to varying degrees. This contaminated property includes source areas and the terrestrial and aquatic habitats down gradient from these source areas. Although the integrator OUs generally contain considerable habitat for biota, the source OUs provide little or no suitable habitat. Historically, ecological risk assessment at Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) sites has focused on species that may be definitively associated with a contaminated area or source OU. Endpoints considered in source OUs include plants, soil/litter invertebrates and processes, aquatic biota found in on-OU sediments and surface waters, and small herbivorous, omnivorous, and vermivorous (i.e., feeding on ground, litter, or soil invertebrates) wildlife. All of these endpoints have limited spatial distributions or home ranges such that numerous individuals or a distinct population can be expected to reside within the boundaries of the source OU. Most analyses are not adequate for large sites with multiple, spatially separated contaminated areas such as the ORR that provide habitat for wide-ranging wildlife species. This report is a preliminary response to a plan for assessing risks to wide-ranging species

Clinical high risk for psychosis

DEFF Research Database (Denmark)

van der Steen, Y; Gimpel-Drees, J; Lataster, T

2017-01-01

OBJECTIVE: The aim of this study was to assess associations between momentary stress and both affective and psychotic symptoms in everyday life of individuals at clinical high risk (CHR), compared to chronic psychotic patients and healthy controls, in search for evidence of early stress...... and 26 healthy controls. RESULTS: Multilevel models showed significantly larger associations between negative affect (NA) and activity-related stress for CHR patients than for psychotic patients (P = 0.008) and for CHR compared to controls (P

The Mixed Waste Management Facility. Preliminary design review

International Nuclear Information System (INIS)

1995-01-01

This document presents information about the Mixed Waste Management Facility. Topics discussed include: cost and schedule baseline for the completion of the project; evaluation of alternative options; transportation of radioactive wastes to the facility; capital risk associated with incineration; radioactive waste processing; scaling of the pilot-scale system; waste streams to be processed; molten salt oxidation; feed preparation; initial operation to demonstrate selected technologies; floorplans; baseline revisions; preliminary design baseline; cost reduction; and project mission and milestones

[Hemostasiological, lipidemic, and hemodynamic indicators associated with the risk of cardiovascular death in high- and very high-risk patients according to the SCORE scale].

Science.gov (United States)

Kachkovskiĭ, M A; Simerzin, V V; Rybanenko, O A; Kirichenko, N A

2014-01-01

To identify lipidemic, hemostasiological, and hemodynamic indicators associated with the risk of cardiovascular death in high- and very high-risk patients. One hundred and forty-eight patients whose mean age was 50.8 +/- 4.4 years were examined. All the patients were divided into high (1 group) and very high (2 group) cardiovascular death risk groups according to the SCORE scale. Lipid metabolism, hemostatic system parameters (fibrinogen, time of ADP-induced platelet aggregation initiation, D-dimer), endothelial dysfunction markers (von Willebrand factor), and echocardiographic findings were studied. Multivariate regression analysis showed that the odds ratio for a cardiovascular death risk was 1.8 (95% confidence interval (CI), 1.1 to 4.2; p = 0.04) in patients with a D-dimer level of greater than 1 mg/ml, 0.77 (95% CI, 0.6 to 0.97; p = 0.03) in those with an ADP-induced platelet aggregation initiation time of 13.5 sec, 1.04 (95% CI, 1.01 to 1.07; p = 0.02) in those with an end-diastolic volume of more than 123 ml, 1.1 (95% CI, 1.04 to 1.2; p = 0.003) in those with an end-diastolic dimension of more than 51 mm, 1.5 (95% CI, 1.1 to 2.0; p = 0.009) in those with a ventricular septal thickness of more than 11.5 mm, and 2.1 (95% CI, 1.03 to 3.2; p = 0.0032) in those with avon Willebrand factor level of more than 140%. The high levels of von Willebrand factor, D-dimer, ADP-induced platelet aggregation, triglycerides, end-diastolic volume, end-diastolic dimension, and ventricular septal thickness are independent predictors of cardiovascular death in very high-risk patients. These indicators bear out a close relationship between lipid metabolic and hemostatic disturbances and between endothelial dysfunction and intracardiac hemodynamic worsening in these patients.

High prevalence of suicide risk in people living with HIV: who is at higher risk?

Science.gov (United States)

Passos, Susane Müller Klug; Souza, Luciano Dias de Mattos; Spessato, Bárbara Coiro

2014-01-01

A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk.

Forecasting Value-at-Risk Using High-Frequency Information

Directory of Open Access Journals (Sweden)

Huiyu Huang

2013-06-01

Full Text Available in the prediction of quantiles of daily Standard&Poor’s 500 (S&P 500 returns we consider how to use high-frequency 5-minute data. We examine methods that incorporate the high frequency information either indirectly, through combining forecasts (using forecasts generated from returns sampled at different intraday interval, or directly, through combining high frequency information into one model. We consider subsample averaging, bootstrap averaging, forecast averaging methods for the indirect case, and factor models with principal component approach, for both direct and indirect cases. We show that in forecasting the daily S&P 500 index return quantile (Value-at-Risk or VaR is simply the negative of it, using high-frequency information is beneficial, often substantially and particularly so, in forecasting downside risk. Our empirical results show that the averaging methods (subsample averaging, bootstrap averaging, forecast averaging, which serve as different ways of forming the ensemble average from using high-frequency intraday information, provide an excellent forecasting performance compared to using just low-frequency daily information.

Chromosomal imbalance in the progression of high-risk non-muscle invasive bladder cancer

International Nuclear Information System (INIS)

Zieger, Karsten; Wiuf, Carsten; Jensen, Klaus Møller-Ernst; Ørntoft, Torben Falck; Dyrskjøt, Lars

2009-01-01

Non-muscle invasive bladder neoplasms with invasion of the lamina propria (stage T1) or high grade of dysplasia are at 'high risk' of progression to life-threatening cancer. However, the individual course is difficult to predict. Chromosomal instability (CI) is associated with high tumor stage and grade, and possibly with the risk of progression. To investigate the relationship between CI and subsequent disease progression, we performed a case-control-study of 125 patients with 'high-risk' non-muscle invasive bladder neoplasms, 67 with later disease progression, and 58 with no progression. Selection criteria were conservative (non-radical) resections and full prospective clinical follow-up (> 5 years). We investigated primary lesions in 59, and recurrent lesions in 66 cases. We used Affymetrix GeneChip ® Mapping 10 K and 50 K SNP microarrays to evaluate genome wide chromosomal imbalance (loss-of-heterozygosity and DNA copy number changes) in 48 representative tumors. DNA copy number changes of 15 key instability regions were further investigated using QPCR in 101 tumors (including 25 tumors also analysed on 50 K SNP microarrays). Chromosomal instability did not predict any higher risk of subsequent progression. Stage T1 and high-grade tumors had generally more unstable genomes than tumors of lower stage and grade (mostly non-primary tumors following a 'high-risk' tumor). However, about 25% of the 'high-risk' tumors had very few alterations. This was independent of subsequent progression. Recurrent lesions represent underlying field disease. A separate analysis of these lesions did neither reflect any difference in the risk of progression. Of specific chromosomal alterations, a possible association between loss of chromosome 8p11 and the risk of progression was found. However, the predictive value was limited by the heterogeneity of the changes. Chromosomal instability (CI) was associated with 'high risk' tumors

Cortical morphology development in patients with 22q11.2 deletion syndrome at ultra-high risk of psychosis.

Science.gov (United States)

Padula, Maria Carmela; Schaer, Marie; Armando, Marco; Sandini, Corrado; Zöller, Daniela; Scariati, Elisa; Schneider, Maude; Eliez, Stephan

2018-01-17

Patients with 22q11.2 deletion syndrome (22q11DS) present a high risk of developing psychosis. While clinical and cognitive predictors for the conversion towards a full-blown psychotic disorder are well defined and largely used in practice, neural biomarkers do not yet exist. However, a number of investigations indicated an association between abnormalities in cortical morphology and higher symptoms severities in patients with 22q11DS. Nevertheless, few studies included homogeneous groups of patients differing in their psychotic symptoms profile. In this study, we included 22 patients meeting the criteria for an ultra-high-risk (UHR) psychotic state and 22 age-, gender- and IQ-matched non-UHR patients. Measures of cortical morphology, including cortical thickness, volume, surface area and gyrification, were compared between the two groups using mass-univariate and multivariate comparisons. Furthermore, the development of these measures was tested in the two groups using a mixed-model approach. Our results showed differences in cortical volume and surface area in UHR patients compared with non-UHR. In particular, we found a positive association between surface area and the rate of change of global functioning, suggesting that higher surface area is predictive of improved functioning with age. We also observed accelerated cortical thinning during adolescence in UHR patients with 22q11DS. These results, although preliminary, suggest that alterations in cortical volume and surface area as well as altered development of cortical thickness may be associated to a greater probability to develop psychosis in 22q11DS.

Preliminary research results for generation and application of high power ion beams on FLASh II accelerator

International Nuclear Information System (INIS)

Yang Hailiang; Qiu Aici; Zhang Jiasheng; He Xiaoping; Sun Jianfeng; Peng Jianchang; Tang Junping; Ren Shuqing; Ouyang Xiaoping; Zhang Guoguang; Huang Jianjun; Yang Li; Wang Haiyang; Li Jingya; Li Hongyu

2004-01-01

Preliminary results for the generation and application of the high power ion beam (HPIB) on the FLASH II accelerator are reported. The structure and principle of the pinch reflex ion beam diode are introduced. The equation of parapotential flow is corrected for the reduction of diode A-K gap due to the motion of cathode and anode plasma. The HPIB peak current of ∼160 kA is obtained with a peak energy of ∼500 keV. Experimental investigations of generating 6-7 MeV quasi-monoenergetic pulsed γ-rays with high power ion (proton) beams striking 19 F target are presented. In addition, the results of the thermal-mechanical effects on the material irradiated with HPIB, which are applied to the simulation of 1 keV black body radiation x-rays, are also discussed

Assessing the seismic risk potential of South America

Science.gov (United States)

Jaiswal, Kishor; Petersen, Mark D.; Harmsen, Stephen; Smoczyk, Gregory M.

2016-01-01

We present here a simplified approach to quantifying regional seismic risk. The seismic risk for a given region can be inferred in terms of average annual loss (AAL) that represents long-term value of earthquake losses in any one year caused from a long-term seismic hazard. The AAL are commonly measured in the form of earthquake shaking-induced deaths, direct economic impacts or indirect losses caused due to loss of functionality. In the context of South American subcontinent, the analysis makes use of readily available public data on seismicity, population exposure, and the hazard and vulnerability models for the region. The seismic hazard model was derived using available seismic catalogs, fault databases, and the hazard methodologies that are analogous to the U.S. Geological Survey’s national seismic hazard mapping process. The Prompt Assessment of Global Earthquakes for Response (PAGER) system’s direct empirical vulnerability functions in terms of fatality and economic impact were used for performing exposure and risk analyses. The broad findings presented and the risk maps produced herein are preliminary, yet they do offer important insights into the underlying zones of high and low seismic risks in the South American subcontinent. A more detailed analysis of risk may be warranted by engaging local experts, especially in some of the high risk zones identified through the present investigation.

Original Research Identifying patients at high risk for obstructive ...

African Journals Online (AJOL)

determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in ... mainstay of management is CPAP in addition to behavioral ..... the present study has some potential limitations which ... consequences of obstructive sleep apnea and short sleep duration.

Implementation science for ambulatory care safety: a novel method to develop context-sensitive interventions to reduce quality gaps in monitoring high-risk patients.

Science.gov (United States)

McDonald, Kathryn M; Su, George; Lisker, Sarah; Patterson, Emily S; Sarkar, Urmimala

2017-06-24

Missed evidence-based monitoring in high-risk conditions (e.g., cancer) leads to delayed diagnosis. Current technological solutions fail to close this safety gap. In response, we aim to demonstrate a novel method to identify common vulnerabilities across clinics and generate attributes for context-flexible population-level monitoring solutions for widespread implementation to improve quality. Based on interviews with staff in otolaryngology, pulmonary, urology, breast, and gastroenterology clinics at a large urban publicly funded health system, we applied journey mapping to co-develop a visual representation of how patients are monitored for high-risk conditions. Using a National Academies framework and context-sensitivity theory, we identified common systems vulnerabilities and developed preliminary concepts for improving the robustness for monitoring patients with high-risk conditions ("design seeds" for potential solutions). Finally, we conducted a face validity and prioritization assessment of the design seeds with the original interviewees. We identified five high-risk situations for potentially consequential diagnostic delays arising from suboptimal patient monitoring. All situations related to detection of cancer (head and neck, lung, prostate, breast, and colorectal). With clinic participants we created 5 journey maps, each representing specialty clinic workflow directed at evidence-based monitoring. System vulnerabilities common to the different clinics included challenges with: data systems, communications handoffs, population-level tracking, and patient activities. Clinic staff ranked 13 design seeds (e.g., keep patient list up to date, use triggered notifications) addressing these vulnerabilities. Each design seed has unique evaluation criteria for the usefulness of potential solutions developed from the seed. We identified and ranked 13 design seeds that characterize situations that clinicians described 'wake them up at night', and thus could reduce

[German Language Version and Validation of the Risk-Taking Behaviour Scale (RBS-K) for High-Risk Sports].

Science.gov (United States)

Frühauf, Anika; Niedermeier, Martin; Ruedl, Gerhard; Barlow, Matthew; Woodman, Tim; Kopp, Martin

2017-11-23

Background  High-risk sports, particularly climbing, kayaking and extreme skiing, have become increasingly popular. The most widely used psychological survey instrument with regard to risk behaviour in sports is the Sensation Seeking Model, mostly assessed by the Sensation Seeking Scale (SSS-V). Until recently, the literature discussed risk behaviour solely through this model. However, this scale does not measure risk-taking behaviours. In contrast, the Risk-Taking Behaviour Scale (RBS-K) is a three-item scale that measures risk behaviour in high-risk sports. This study aimed to validate a German language version of the RBS-K. Methods  The RBS-K was translated and back-translated between English and German. High-risk sports participants (n = 2399) completed the German version of the RBS-K. Of those participants, 820 completed the RBS-K in person as part of a field survey and 1579 participated in an online survey. To validate the questionnaire, the SSS-V, accident involvement, age and sex were evaluated. The RBS-K divides the sample into deliberate risk takers (mean + standard deviation) and risk-averse persons (mean - standard deviation). We tested for internal consistency and correlations with SSS-V, age, sex and accident involvement. Group differences were calculated between deliberate risk takers and risk-averse persons. Results  For internal consistency, we obtained a Cronbach's alpha of 0.56 and a McDonald's omega of 0.63. Significant correlations were shown between RBS-K and SSS-V as well as age and sex. Compared to risk-averse persons (n = 643, 26.8 %), deliberate risk takers (n = 319, 13.3 %) scored significantly higher in sensation seeking, were significantly younger and primarily male and had a significantly higher accident involvement. Conclusion  The RBS-K discriminates well for age, sex and accident involvement. Also, correlations between the RBS-K and the well-established SSS-V are acceptable. With regard to the results and its

Development and preliminary experimental study on micro-stacked insulator

International Nuclear Information System (INIS)

Ren Chengyan; Yuan Weiqun; Zhang Dongdong; Yan Ping; Wang Jue

2009-01-01

High gradient insulating technology is one of the key technologies in new type dielectric wall accelerator(DWA). High gradient insulator, namely micro-stacked insulator, was developed and preliminary experimental study was done. Based on the finite element and particle simulating method, surface electric field distribution and electron movement track of micro-stacked insulator were numerated, and then the optimized design proposal was put forward. Using high temperature laminated method, we developed micro-stacked insulator samples which uses exhaustive fluorinated ethylene propylene(FEP) as dielectric layer and stainless steel as metal layer. Preliminary experiment of vacuum surface flashover in nanosecond pulse voltage was done and micro-stacked insulator exhibited favorable vacuum surface flashover performance with flashover field strength of near 180 kV/cm. (authors)

Preliminary tests of a high speed vertical axis windmill model

Energy Technology Data Exchange (ETDEWEB)

South, P; Rangi, R S

1971-01-01

This report discusses a fixed-pitch vertical axis windmill that combines the inherent simplicity of this type of machine with a high aerodynamic efficiency and a high relative velocity. A three-bladed rotor was selected as the basic design, having constant chord symmetric airfoil blades configured in a catenary curve such that the rotor diameter is equal to the rotor height. In wind tunnel tests using a 30 inch scale model, it was found that once this rotor was given a very low rotational speed, it picked up speed and ran at a rotor tip velocity/wind speed ratio greater than 1. The number of blades was varied in the testing. A maximum power coefficient of 0.67 was achieved at 17 ft/s wind speed at a tip speed/wind speed ratio of 7.25 for a 2-bladed rotor. Increasing the number of blades above 3 did not result in higher power. The rotor could operate in gusts which double the mean wind velocity. Examination of Reynolds number effects, and taking into account the scale of the model, it was concluded that a full-scale windmill could run at lower velocity ratios than those predicted by the model tests, and that it could self-start under no-load conditions if the cut-in rpm are at least half the rpm for maximum power at the prevailing wind speed. Preliminary estimates show that a 15 ft diameter windmill of this design, designed to operate with a safety factor of 2.5 up to a maximum wind speed of 60 ft/s, would weigh ca 150 lb and could be marketed for ca $60.00, excluding the driven unit, if sufficient quantities were produced to make tooling costs negligible. Similarly, a 30 ft windmill would weigh ca 1000 lb and cost ca $400.00. 2 refs., 6 figs.

[Muscle and bone health as a risk factor of fall among the elderly. An approach to identify high-risk fallers by risk assessment].

Science.gov (United States)

Kikuchi, Reiko; Kozaki, Koichi; Nakamura, Tetsuro; Toba, Kenji

2008-06-01

Fall-induced hip fracture is one of the major causes rendering the elderly to be in a low ADL or bed-ridden status. Fall is not only the cause for fractures, but it lowers elderly peoples'ADL. History of fall, age, decline of motor function, orthostatic hypotension, balance deficit, dementia, drug and environmental factors were raised as possible risk factor for falls. We created a fall predicting score which consist of 21 risk factors and a history of falls. We found that the score is useful to identify high-risk fallers. It would be necessary to identify high-risk fallers early and give an appropriate individual approach.

Characterization of the Human Proteomic Response to Hydrocodone: A Preliminary Study

Science.gov (United States)

2014-05-01

Bjork, S.J. Grant , Does traumatic brain injury increase risk for substance abuse?, J Neurotrauma (2009). [13] D.P. Graham, A.L. Cardon , An update on...Preliminary Study” 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-2-0126 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Lt Col Vikhyat Bebarta, MD 5d. PROJECT

Risk assessments for the disposal of high level radioactive wastes

International Nuclear Information System (INIS)

Smith, C.F.

1975-01-01

The risks associated with the disposal of high level wastes derive from the potential for release of radioactive materials into the environment. The assessment of these risks requires a methodology for risk analysis, an identification of the radioactive sources, and a method by which to express the relative hazard of the various radionuclides that comprise the high level waste. The development of a methodology for risk analysis is carried out after a review of previous work in the area of probabilistic risk assessment. The methodology suggested involves the probabilistic analysis of a general accident consequence distribution. In this analysis, the frequency aspect of the distribution is treated separately from the normalized probability function. At the final stage of the analysis, the frequency and probability characteristics of the distribution are recombined to provide an estimate of the risk. The characterization of the radioactive source term is accomplished using the ORIGEN computer code. Calculations are carried out for various reactor types and fuel cycles, and the overall waste hazard for a projected thirty-five year nuclear power program is determined

DJ-1 is a reliable serum biomarker for discriminating high-risk endometrial cancer.

Science.gov (United States)

Di Cello, Annalisa; Di Sanzo, Maddalena; Perrone, Francesca Marta; Santamaria, Gianluca; Rania, Erika; Angotti, Elvira; Venturella, Roberta; Mancuso, Serafina; Zullo, Fulvio; Cuda, Giovanni; Costanzo, Francesco

2017-06-01

New reliable approaches to stratify patients with endometrial cancer into risk categories are highly needed. We have recently demonstrated that DJ-1 is overexpressed in endometrial cancer, showing significantly higher levels both in serum and tissue of patients with high-risk endometrial cancer compared with low-risk endometrial cancer. In this experimental study, we further extended our observation, evaluating the role of DJ-1 as an accurate serum biomarker for high-risk endometrial cancer. A total of 101 endometrial cancer patients and 44 healthy subjects were prospectively recruited. DJ-1 serum levels were evaluated comparing cases and controls and, among endometrial cancer patients, between high- and low-risk patients. The results demonstrate that DJ-1 levels are significantly higher in cases versus controls and in high- versus low-risk patients. The receiver operating characteristic curve analysis shows that DJ-1 has a very good diagnostic accuracy in discriminating endometrial cancer patients versus controls and an excellent accuracy in distinguishing, among endometrial cancer patients, low- from high-risk cases. DJ-1 sensitivity and specificity are the highest when high- and low-risk patients are compared, reaching the value of 95% and 99%, respectively. Moreover, DJ-1 serum levels seem to be correlated with worsening of the endometrial cancer grade and histotype, making it a reliable tool in the preoperative decision-making process.

High-intensity physical activity, stable relationship, and high education level associate with decreasing risk of erectile dysfunction in 1,000 apparently healthy cardiovascular risk subjects.

Science.gov (United States)

Ettala, Otto O; Syvänen, Kari T; Korhonen, Päivi E; Kaipia, Antti J; Vahlberg, Tero J; Boström, Peter J; Aarnio, Pertti T

2014-09-01

Erectile dysfunction (ED) is especially common in men with cardiovascular diseases (CVDs). However, the data are scarce concerning populations without manifested CVD. The aim of this study was to describe factors associated with ED, especially those associated with decreasing risk of ED, in men with cardiovascular risk factors but without CVD, diabetes, or chronic renal disease. In 2004 to 2007, a cross-sectional population-based sample of men 45 to 70 years old in two rural towns in Finland was collected. Men with previously diagnosed CVD, diabetes, or kidney disease were not invited to the study. In total 1,000 eligible men with cardiovascular risk factors, i.e., central obesity, high scores in the Finnish Diabetes Risk Score, high blood pressure, antihypertensive medication, or family history of coronary heart disease, myocardial infarction, or stroke, were included in the analysis. Questionnaires, clinical measurements, and laboratory tests were obtained. The prevalence of ED was studied comparing the means, and risk factors were studied using multivariate logistic regression analysis. The rate of ED was defined by the International Index of Erectile Function short form (IIEF-5) and by two questions (2Q) about the ability to achieve and to maintain an erection. The prevalence of ED was 57% or 68% using IIEF-5 or 2Q, respectively. Age (odds ratio [OR]: up to 9.16; 95% confidence interval [CI], 5.00-16.79; P physical activity (OR: 0.50; 95% CI, 0.29-0.86; P = 0.045), high education (OR: 0.52; 95% CI, 0.33-0.83; P = 0.013), and stable relationship (OR: 0.43; 95% CI, 0.21-0.88; P = 0.046) were associated with ED. In apparently healthy men with cardiovascular risk factors, decreasing risk of ED is associated with high-intensity physical activity, stable relationship, and high education level. © 2014 International Society for Sexual Medicine.

High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

Directory of Open Access Journals (Sweden)

Andrew T. Taylor

2011-01-01

Full Text Available High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.

Risk factor scenario in an industrial set-up: Need for an effective screening tool to assess the high-risk group

Directory of Open Access Journals (Sweden)

Iyer Uma

2010-01-01

Full Text Available Background: Industrial and technological revolution has resulted in nutrition transition. This calls for analyzing the risk factor scenario in the industrial population. Objective: The objective was to map the prevalence and assess the risk factors of industrial employees. Materials and Methods: The employees of a large petrochemical industry were enrolled (N=269 for the study. Risk factors were elicited through a structured questionnaire. Parameters monitored were fasting blood sugar and lipid profile. Relative risk was calculated to find out significant predictor variables. Results: The employees had high prevalence of overweight (27%, obesity (22%, central obesity (48.7%, prehypertension (43.2%, hypertension (36.6%, and dyslipidemia (41.4%. They had erroneous dietary habits such as low intake of fruits and vegetables and high fat intake. Most of the employees had low physical activity levels. The prevalence of smoking (13.5%, tobacco (28.2%, and alcohol use (22.2% were also high with 15.1% having multiple habits. One-fifth of the employees had metabolic syndrome (MS. Seven predictor variables, namely, family history, BMI, WHR, blood pressure, physical inactivity, TG, and TG/H were identified and used to develop the risk score card to identify people at high risk of CVD and DM. Conclusion: Multiple risk factor scenario among the industrial population studied calls for effective intervention strategies and policy changes to combat the burden of non-communicable diseases. The risk score card can be used to screen the high-risk group in the industrial population.

Are Men at High Risk for Osteoporosis Underscreened? A Quality Improvement Project.

Science.gov (United States)

Jain, Samta; Bilori, Bilori; Gupta, Amit; Spanos, Pete; Singh, Mamta

2016-01-01

Osteoporosis is a major cause of morbidity and mortality in both men and women. The mortality rate in men within 1 year of hip fracture is 37.5%, which is 51% higher than in women. Although clear guidelines exist for osteoporosis screening in women, these are less clear for men. The available guidelines recommend screening high-risk men; however, screening does not appear to be a standard practice. To increase screening rates of osteoporosis in high-risk men in our primary care clinic by 50%. The screening rate of osteoporosis was determined in high-risk male veterans more than 50 years of age enrolled in the resident physician- and nurse practitioner-staffed primary care clinics at a Veterans Affairs Medical Center in Cleveland, OH. High-risk factors included prolonged use of steroids; hypogonadism; and autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and systemic lupus erythematosus, which are known to be associated with osteoporosis. We surveyed health care professional trainees and nurses to explore their barriers to screening for osteoporosis in high-risk men. After creating awareness about the importance of this condition among the health care professionals, we analyzed whether this education had any impact on the screening rate. The baseline screening rate in high-risk men was 11%. After phased surveys and awareness building, the screening rate increased to 20%. Osteoporosis in high-risk men is under-screened. Creating more awareness about the impact of this condition among health professional trainees and nurses can lead to improved screening rates.

Characteristics of high- and low-risk individuals in the PRIORITY study

DEFF Research Database (Denmark)

Tofte, N; Lindhardt, M; Adamova, K

2018-01-01

variable. In a logistic regression model including clinical variables known to be associated with diabetic kidney disease, estimated GFR, gender, log urinary albumin:creatinine ratio and use of renin-angiotensin system-blocking agents remained significant determinants of the CKD273 high-risk group: area......AIM: To compare clinical baseline data in individuals with Type 2 diabetes and normoalbuminuria, who are at high or low risk of diabetic kidney disease based on the urinary proteomics classifier CKD273. METHODS: We conducted a prospective, randomized, double-blind, placebo-controlled international...... multicentre clinical trial and observational study in participants with Type 2 diabetes and normoalbuminuria, stratified into high- or low-risk groups based on CKD273 score. Clinical baseline data for the whole cohort and stratified by risk groups are reported. The associations between CKD273 and traditional...

Zinc and Copper status in children with high family risk of premature cardiovascular disease

International Nuclear Information System (INIS)

Kelishadi, R.; Alikhassy, H.; Amiri, M.

2002-01-01

Zinc and copper are beneficial to health, growth and development and also for the prevention of cardiovascular disease (CVD) with regards to improved dietary habits as a preliminary step in CVD prevention. This study was conducted among 2-18 year old children with high family risk of premature CVD in comparison to controls. One hundred randomly selected children whose parents had premature myocardial infarction were included in this study. The controls were 100 individuals randomly selected from the case group's neighbors and matched for age, sex and socioeconomic status. A four-day food record questionnaire was used to assess zinc and copper intakes and their serum levels were determined using Flame-Atomic Absorption Spectrophotometry. The data were analyzed by SPSS/Windows V6 software, using the student's t and Mantel-Hanzel tests. Significance of differences was considered at P 0.05). Zinc deficiency was more prevalent among the case in boys than their controls (58% vs. 18%, P=0.04). This difference was not significant in girls (44% vs. 40%). The daily intake and serum of level of copper were not significantly different between the case and control groups. No case of copper efficiency was found. The mean systolic blood pressure was not significantly different between the zinc-deficient and zinc-sufficient subjects. Although the mean diastolic blood pressure of the former was higher than the latter, there was no statistically significant difference. About 23.7% of all studied sample had mild-to-moderate degree of failure to thrive, with significantly lower daily intake and serum zinc level than other subjects (5.41+-1.06 mg, 82.09+-12.74 ug/dL vs. 6.89+-2.14 mg, 99.25+-27.15 ug/dL, respectively, P<0.05). It is recommended that emphasis be placed on the consumption of food rich in zinc by children, especially those with high family risk of premature CVD. (author)

Communicating with parents of high-risk infants in neonatal intensive care

OpenAIRE

Yee, Wendy; Ross, Sue

2006-01-01

Good communication between parents and staff about the likely outcome of high-risk infants is essential to ensure parents’ full involvement in decision-making. The present paper discusses the literature on this topic to explore the best practices for professionals communicating with parents of high-risk infants.

Communicating with parents of high-risk infants in neonatal intensive care.

Science.gov (United States)

Yee, Wendy; Ross, Sue

2006-05-01

Good communication between parents and staff about the likely outcome of high-risk infants is essential to ensure parents' full involvement in decision-making. The present paper discusses the literature on this topic to explore the best practices for professionals communicating with parents of high-risk infants.

Preliminary neutronic design of high burnup OTTO cycle pebble bed reactor

International Nuclear Information System (INIS)

Setiadipura, T.; Zuhair; Irwanto, D.

2015-01-01

The pebble bed type High Temperature Gas-cooled Reactor (HTGR) is among the interesting nuclear reactor designs in terms of safety and flexibility for co-generation applications. In addition, the strong inherent safety characteristics of the pebble bed reactor (PBR) which is based on natural mechanisms improve the simplicity of the PBR design, in particular for the Once-Through-Then-Out (OTTO) cycle PBR design. One of the important challenges of the OTTO cycle PBR design, and nuclear reactor design in general, is improving the nuclear fuel utilization which is shown by attaining a higher burnup value. This study performed a preliminary neutronic design study of a 200 MWt OTTO cycle PBR with high burnup while fulfilling the safety criteria of the PBR design.The safety criteria of the design was represented by the per-fuel-pebble maximum power generation of 4.5 kW/pebble. The maximum burnup value was also limited by the tested maximum burnup value which maintained the integrity of the pebble fuel. Parametric surveys were performed to obtain the optimized parameters used in this study, which are the fuel enrichment, per-pebble heavy metal (HM) loading, and the average axial speed of the fuel. An optimum design with burnup value of 131.1 MWd/Kg-HM was achieved in this study which is much higher compare to the burnup of the reference design HTR-MODUL and a previously proposed OTTO-cycle PBR design. This optimum design uses 17% U-235 enrichment with 4 g HM-loading per fuel pebble. (author)

Preliminary Neutronic Design of High Burnup OTTO Cycle Pebble Bed Reactor

Directory of Open Access Journals (Sweden)

T. Setiadipura

2015-04-01

Full Text Available The pebble bed type High Temperature Gas-cooled Reactor (HTGR is among the interesting nuclear reactor designs in terms of safety and flexibility for co-generation applications. In addition, the strong inherent safety characteristics of the pebble bed reactor (PBR which is based on natural mechanisms improve the simplicity of the PBR design, in particular for the Once-Through-Then-Out (OTTO cycle PBR design. One of the important challenges of the OTTO cycle PBR design, and nuclear reactor design in general, is improving the nuclear fuel utilization which is shown by attaining a higher burnup value. This study performed a preliminary neutronic design study of a 200 MWt OTTO cycle PBR with high burnup while fulfilling the safety criteria of the PBR design.The safety criteria of the design was represented by the per-fuel-pebble maximum power generation of 4.5 kW/pebble. The maximum burnup value was also limited by the tested maximum burnup value which maintained the integrity of the pebble fuel. Parametric surveys were performed to obtain the optimized parameters used in this study, which are the fuel enrichment, per-pebble heavy metal (HM loading, and the average axial speed of the fuel. An optimum design with burnup value of 131.1 MWd/Kg-HM was achieved in this study which is much higher compare to the burnup of the reference design HTR-MODUL and a previously proposed OTTO-cycle PBR design. This optimum design uses 17% U-235 enrichment with 4 g HM-loading per fuel pebble

Prediabetes: A high-risk state for developing diabetes

Science.gov (United States)

Tabák, Adam G.; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J.; Kivimäki, Mika

2013-01-01

Summary Prediabetes (or “intermediate hyperglycaemia”), based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction, abnormalities that start before glucose changes are detectable. Observational evidence shows associations of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores could optimize the estimation of diabetes risk using non-invasive parameters and blood-based metabolic traits in addition to glycaemic values. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention with evidence of a 40%–70% relative risk reduction. Accumulating data also suggests potential benefits from pharmacotherapy. PMID:22683128

fMRI investigation of response inhibition, emotion, impulsivity, and clinical high-risk behaviour in adolescents

Directory of Open Access Journals (Sweden)

Matthew R G Brown

2015-09-01

Full Text Available High-risk behaviour in adolescents is associated with injury, mental health problems, and poor outcomes in later life. Improved understanding of the neurobiology of high-risk behaviour and impulsivity shows promise for informing clinical treatment and prevention as well as policy to better address high-risk behaviour. We recruited 21 adolescents (age 14-17 with a wide range of high-risk behaviour tendencies, including medically high-risk participants recruited from psychiatric clinics. Risk tendencies were assessed using the Adolescent Risk Behaviour Screen (ARBS. ARBS risk scores correlated highly (0.78 with impulsivity scores from the Barratt Impulsivity scale (BIS. Participants underwent 4.7 Tesla functional magnetic resonance imaging (fMRI while performing an emotional Go/NoGo task. This task presented an aversive or neutral distractor image simultaneously with each Go or NoGo stimulus. Risk behaviour and impulsivity tendencies exhibited similar but not identical associations with fMRI activation patterns in prefrontal brain regions. We interpret these results as reflecting differences in response inhibition, emotional stimulus processing, and emotion regulation in relation to participant risk behaviour tendencies and impulsivity levels. The results are consistent with high impulsivity playing an important role in determining high risk tendencies in this sample containing clinically high-risk adolescents.

fMRI investigation of response inhibition, emotion, impulsivity, and clinical high-risk behavior in adolescents.

Science.gov (United States)

Brown, Matthew R G; Benoit, James R A; Juhás, Michal; Dametto, Ericson; Tse, Tiffanie T; MacKay, Marnie; Sen, Bhaskar; Carroll, Alan M; Hodlevskyy, Oleksandr; Silverstone, Peter H; Dolcos, Florin; Dursun, Serdar M; Greenshaw, Andrew J

2015-01-01

High-risk behavior in adolescents is associated with injury, mental health problems, and poor outcomes in later life. Improved understanding of the neurobiology of high-risk behavior and impulsivity shows promise for informing clinical treatment and prevention as well as policy to better address high-risk behavior. We recruited 21 adolescents (age 14-17) with a wide range of high-risk behavior tendencies, including medically high-risk participants recruited from psychiatric clinics. Risk tendencies were assessed using the Adolescent Risk Behavior Screen (ARBS). ARBS risk scores correlated highly (0.78) with impulsivity scores from the Barratt Impulsivity scale (BIS). Participants underwent 4.7 Tesla functional magnetic resonance imaging (fMRI) while performing an emotional Go/NoGo task. This task presented an aversive or neutral distractor image simultaneously with each Go or NoGo stimulus. Risk behavior and impulsivity tendencies exhibited similar but not identical associations with fMRI activation patterns in prefrontal brain regions. We interpret these results as reflecting differences in response inhibition, emotional stimulus processing, and emotion regulation in relation to participant risk behavior tendencies and impulsivity levels. The results are consistent with high impulsivity playing an important role in determining high risk tendencies in this sample containing clinically high-risk adolescents.

High dose rate brachytherapy (HDRB) in prostate cancer - technique description and preliminary results

International Nuclear Information System (INIS)

Cordova Junior, Ardo Lotar; Salvajoli, Joao Victor; Pelizzon, Antonio CAssio Assis; Cecilio, Paulo Jose

1998-01-01

Describe the technique and preliminary results of high dose rate brachytherapy (HDRB) in localized prostate cancer. Subjects methods: Between March, 1997 and April, 1998, 26 patients were treated with external beam radiotherapy (45 to 50.4 Gy - 1.8 Gy per day) and implants (16 Gy in 2 days - twice a day). Median age was 68 years. The distribution by clinical stage was: 5 T1c, 9 T2a, 10 T2b and 2 T3a. Median initial PSA was 16 ng/ml. Results: With a median follow-up of 4 months, 85% of patients showed normal levels of PSA, with a median of 0.6 ng/ml, 60 to 90 days after treatment. Dysuria grades 1 and 2 and proctitis grade 1 were found in 11,3 and 5 patients, respectively. Conclusion: The method is safe, with acceptable early side effects. Longer follow-up is necessary before drawing any conclusions. (author)

Dronedarone in high-risk permanent atrial fibrillation

DEFF Research Database (Denmark)

Connolly, Stuart J; Camm, A John; Halperin, Jonathan L

2011-01-01

Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events...... in high-risk permanent atrial fibrillation....

Reproductive health education and sexual risk among high-risk female adolescents and young adults.

Science.gov (United States)

Ancheta, Rosedelia; Hynes, Colin; Shrier, Lydia A

2005-04-01

The objective of this study was to explore the associations of sources, content, and timing of reproductive health education with cognitive and behavioral sexual risk in a sample of high-risk female adolescents and young adults. Female adolescents and young adults (n=113, median age 17 years) receiving treatment for a sexually transmitted disease (STD) reported sources of reproductive health education, topics covered, and when first formal education occurred. Dependent variables included sexual risk knowledge; condom attitudes, negotiation skills, and use (consistent and at last sex); and number of sexual partners. Most participants reported receiving reproductive health education from both parental (80%) and formal sources (92%). Parents discussed the menstrual cycle (94%) more frequently than other sex education topics, while formal sources focused most on teaching about STDs (91%). Although median age of first formal instruction was 12 years, 26% of girls received their first formal education during or after the year they initiated coitus. Girls with a parental source of education and those receiving formal instruction on pregnancy reported greater ability to negotiate condom use. Girls who received education later in relation to the onset of sexual activity and those with a parental source of education reported more sexual partners. Early reproductive health education and education from both parental and formal sources is associated with reduced sexual risk among high-risk adolescent girls. Interestingly, receiving parental education is also associated with more sexual partners, suggesting that parental educational efforts may be reactive to their daughters' increasing sexual risk behavior. Future research should examine multiple sources of reproductive health education and the timing of education from these sources to enhance understanding the dynamic interactions between reproductive health education and adolescent sexual risk.

Mother-child interactions in depressed children and children at high risk and low risk for future depression.

Science.gov (United States)

Dietz, Laura J; Birmaher, Boris; Williamson, Douglas E; Silk, Jennifer S; Dahl, Ronald E; Axelson, David A; Ehmann, Mary; Ryan, Neal D

2008-05-01

To compare mother-child interactions and parenting styles in families of children with major depressive disorder, youths at high risk for depression, and healthy controls. Currently depressed (n = 43), high-risk (n = 28), and healthy control (n = 41) youths and their mothers engaged in a standardized videotaped problem-solving interaction. Measures of affect and behavior for both mothers and children were obtained, in addition to global measures of parenting. Depressed children demonstrated more negativity and less positivity in dyadic interactions than did children at high risk and control children. Mothers of depressed children were more disengaged than control mothers. Exploratory repeated-measures analyses in a subgroup of depressed children (n = 16) suggested mother-child interactions do not significantly change when children recover from depression. Children at high risk demonstrated less positivity in dyadic interactions than did controls. Mothers with a history of major depressive disorder and mothers with higher current depressive symptoms demonstrated patterns of disengagement and low control in interactions with children. Mother-child interactions in depressed youths are marked by maternal disengagement and low child positivity that may not improve when children recover. The bidirectional effects of maternal disengagement and low levels of child positivity may precede onset of major depressive disorder in children and serve as risk factors for recurrent depression in youths.

Preliminary Analysis of Aircraft Loss of Control Accidents: Worst Case Precursor Combinations and Temporal Sequencing

Science.gov (United States)

Belcastro, Christine M.; Groff, Loren; Newman, Richard L.; Foster, John V.; Crider, Dennis H.; Klyde, David H.; Huston, A. McCall

2014-01-01

Aircraft loss of control (LOC) is a leading cause of fatal accidents across all transport airplane and operational classes, and can result from a wide spectrum of hazards, often occurring in combination. Technologies developed for LOC prevention and recovery must therefore be effective under a wide variety of conditions and uncertainties, including multiple hazards, and their validation must provide a means of assessing system effectiveness and coverage of these hazards. This requires the definition of a comprehensive set of LOC test scenarios based on accident and incident data as well as future risks. This paper defines a comprehensive set of accidents and incidents over a recent 15 year period, and presents preliminary analysis results to identify worst-case combinations of causal and contributing factors (i.e., accident precursors) and how they sequence in time. Such analyses can provide insight in developing effective solutions for LOC, and form the basis for developing test scenarios that can be used in evaluating them. Preliminary findings based on the results of this paper indicate that system failures or malfunctions, crew actions or inactions, vehicle impairment conditions, and vehicle upsets contributed the most to accidents and fatalities, followed by inclement weather or atmospheric disturbances and poor visibility. Follow-on research will include finalizing the analysis through a team consensus process, defining future risks, and developing a comprehensive set of test scenarios with correlation to the accidents, incidents, and future risks. Since enhanced engineering simulations are required for batch and piloted evaluations under realistic LOC precursor conditions, these test scenarios can also serve as a high-level requirement for defining the engineering simulation enhancements needed for generating them.

Availability of high school extracurricular sports programs and high-risk behaviors.

Science.gov (United States)

Cohen, Deborah A; Taylor, Stephanie L; Zonta, Michela; Vestal, Katherine D; Schuster, Mark A

2007-02-01

The Surgeon General has called for an expansion of school-based extracurricular sports programs to address the obesity epidemic. However, little is known about the availability of and participation in high school extracurricular sports and how participation in these sports is related to high-risk behaviors. We surveyed Los Angeles County public high schools in 2002 to determine the number of extracurricular sports programs offered and the percentage of students participating in those programs. We used community data on rates of arrests, births, and sexually transmitted diseases (STDs) among youth to examine associations between risk behaviors and participation in sports programs. The average school offered 14 sports programs, and the average participation rate was 39% for boys and 30% for girls. Smaller schools and schools with higher percentages of disadvantaged students offered fewer programs. The average school offering 13 or fewer programs had 14% of its students participating, while the average school offering 16 or more programs had 31% of its students participating in sports. Controlling for area-level demographics, juvenile arrest rates and teen birth rates, but not STD rates, were lower in areas where schools offered more extracurricular sports. Opportunities for participation in high school extracurricular sports are limited. Future studies should test whether increased opportunities will increase physical activity and impact the increasing overweight problem in youths.

Exploration Health Risks: Probabilistic Risk Assessment

Science.gov (United States)

Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

2006-01-01

Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

Gut microbiota diversity and T1DM onset: Preliminary data of a case-control study

Directory of Open Access Journals (Sweden)

Deborah Traversi

2017-12-01

Full Text Available Type-1 diabetes incidence is increasing during the last decades. Recently, a role of microbiota alteration is proposed as pre-diabetic and diabetic risk factor. A bicentric case-control study is in progress in Northern Italy. Here preliminary results are shown. The microbiome clusterization showed a division between cases and controls even if fingerprint profiles are heterogenic. Methanobrevibacter smithii is highly present only in few patients. The diversity index and the microorganism sequenced in cases and controls, seems to be quite dissimilar. The conclusive results could show a significant predictive value for the bio-indicators evaluated. Keywords: Type 1 diabetes mellitus, Microbiota, Children, Methanobrevibacter smithii, qRT-PCR

Does Discrimination Explain High Risk of Depression among High-Income African American Men?

Science.gov (United States)

Assari, Shervin; Lankarani, Maryam Moghani; Caldwell, Cleopatra Howard

2018-04-19

Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES) are at an increased risk for having a major depressive episode (MDE). It is not known whether perceived discrimination (PD) explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL), 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status) were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI) was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.

Low- and high-testosterone individuals exhibit decreased aversion to economic risk.

Science.gov (United States)

Stanton, Steven J; Mullette-Gillman, O'Dhaniel A; McLaurin, R Edward; Kuhn, Cynthia M; LaBar, Kevin S; Platt, Michael L; Huettel, Scott A

2011-04-01

Testosterone is positively associated with risk-taking behavior in social domains (e.g., crime, physical aggression). However, the scant research linking testosterone to economic risk preferences presents inconsistent findings. We examined the relationship between endogenous testosterone and individuals' economic preferences (i.e., risk preference, ambiguity preference, and loss aversion) in a large sample (N = 298) of men and women. We found that endogenous testosterone levels have a significant U-shaped association with individuals' risk and ambiguity preferences, but not loss aversion. Specifically, individuals with low or high levels of testosterone (more than 1.5 SD from the mean for their gender) were risk and ambiguity neutral, whereas individuals with intermediate levels of testosterone were risk and ambiguity averse. This relationship was highly similar in men and women. In contrast to received wisdom regarding testosterone and risk, the present data provide the first robust evidence for a nonlinear association between economic preferences and levels of endogenous testosterone.

High risk behaviour near OPG dams and power stations : results from two surveys

Energy Technology Data Exchange (ETDEWEB)

Giesbrecht, N.; Schmidt, R.; Ialomiteanu, A. [Centre for Addiction and Mental Health, Toronto, ON (Canada)

2009-07-01

High risk behaviour near dams is not uncommon. This presentation discussed the results from 2 surveys on high risk behaviour near dams and power stations operated by Ontario Power Generation (OPG). The main components of the project were presented, with particular reference to analyses of recent literature on high-risk behaviour; interviews with OPG managers and staff in 4 regions; main survey of respondents from 4 regions; follow-up interviews with high-risk respondents; interviews with community members and contacts from recreational associations; and recommendations. Specific questions and results were provided from each survey. From the first survey, the characteristics of respondents that used OPG sites for recreation were identified. One hundred high risk respondents completed a follow-up interview. The survey showed that although high-risk behaviour is not uncommon, the main reason people use the facilities are for recreation and relaxation, and not for thrill seeking purposes. Recommendations stemming from the surveys included the need for definition of boundaries and delivery of messages via children, recreational associations, and law enforcement personnel. tabs., figs.

High prevalence of cardiometabolic risk factors in young employees of Information Technology industry.

Science.gov (United States)

Limaye, Tejas Y; Kulkarni, Ravindra L; Deokar, Manisha R; Kumaran, Kalyanaraman

2016-01-01

We assessed the burden of cardiometabolic risk factors in Information Technology (IT) employees as they are exposed to adverse lifestyle. In this cross-sectional study, health records were obtained from two IT industries in Pune. Prevalence of cardiometabolic risk factors [hyperglycemia, high blood pressure (BP), hypertriglyceridemia, high low-density lipoprotein (LDL)-cholesterol, low high-density lipoprotein (HDL)-cholesterol, and overweight/obesity] was determined using standard cutoffs. We also examined clustering of risk factors (≥two risk factors). Data were available on 1,350 of 5,800 employees (mean age: 33 ± 6 years, 78% men). Prevalence of diabetes and hypertension was 2.5% and 13.5%, respectively. Prevalence of prediabetes, borderline high BP, hypertriglyceridemia, high LDL-cholesterol, low HDL-cholesterol, and overweight/obesity was 6.5%, 20.3%, 21%, 22.1%, 70.1%, and 51.4%, respectively. Risk factor clustering was observed in 63.5% that increased with age (P < 0.001). Given the high burden of risk factors at relatively young age, spreading awareness and promoting healthy lifestyle through workplace interventions are warranted.

Place of surgery in high-risk tumours of the prostate

International Nuclear Information System (INIS)

Soulie, M.; Rozet, F.; Hennequin, C.; Salomon, L.

2010-01-01

Among the different options recommended for high-risk prostate cancer, radical prostatectomy is admitted as radiotherapy, but its role is still controversial in mono-therapy and difficult to evaluate in combined treatments. The results of clinical trials combining an external radiotherapy to a long-term androgen deprivation in locally advanced tumours sustain the principle of a multidisciplinary management in high-risk prostate cancer. The impact of surgery on the risk of progression and local recurrence is important in selected patients with low grade and small tumoral volume. Clinical and histological data associated to the MRI assessment remain essential and enhance the preoperative multidisciplinary decision, especially regarding nodal and distant metastases. Radical prostatectomy with an extended pelvic lymphadenectomy can be considered as a viable alternative to radiotherapy and hormonal therapy in these patients with a long life expectancy but presenting a high risk of local progression and a low risk of metastatic disease. Morbidity of the procedure is similar to radical prostatectomy for organ-confined tumours despite more erectile dysfunction due to non-sparing radical prostatectomy in most of cases. Oncological results from recent compiled series show 10- and 15-year specific survival rates around 85 and 75%, respectively, including adjuvant or salvage treatments with radiotherapy, androgen deprivation or chemotherapy. (authors)

Preliminary evaluation of alternative forms for immobilization of Hanford high-level defense wastes

International Nuclear Information System (INIS)

Schulz, W.W.; Beary, M.M.; Gallagher, S.A.; Higley, B.A.; Johnston, R.G.; Jungfleisch, F.M.; Kupfer, M.J.; Palmer, R.A.; Watrous, R.A.; Wolf, G.A.

1980-09-01

A preliminary evaluation of solid waste forms for immobilization of Hanford high-level radioactive defense wastes is presented. Nineteen different waste forms were evaluated and compared to determine their applicability and suitability for immobilization of Hanford salt cake, sludge, and residual liquid. This assessment was structured to address waste forms/processes for several different leave-retrieve long-term Hanford waste management alternatives which give rise to four different generic fractions: (1) sludge plus long-lived radionuclide concentrate from salt cake and residual liquid; (2) blended wastes (salt cake plus sludge plus residual liquid); (3) residual liquid; and (4) radionuclide concentrate from residual liquid. Waste forms were evaluated and ranked on the basis of weighted ratings of seven waste form and seven process characteristics. Borosilicate Glass waste forms, as marbles or monoliths, rank among the first three choices for fixation of all Hanford high-level wastes (HLW). Supergrout Concrete (akin to Oak Ridge National Laboratory Hydrofracture Process concrete) and Bitumen, low-temperature waste forms, rate high for bulk disposal immobilization of high-sodium blended wastes and residual liquid. Certain multi-barrier (e.g., Coated Ceramic) and ceramic (SYNROC Ceramic, Tailored Ceramics, and Supercalcine Ceramic) waste forms, along with Borosilicate Glass, are rated as the most satisfactory forms in which to incorporate sludges and associated radionuclide concentrates. The Sol-Gel process appears superior to other processes for manufacture of a generic ceramic waste form for fixation of Hanford sludge. Appropriate recommendations for further research and development work on top ranking waste forms are made

From the lab - Predicting Autism in High-Risk Infants | NIH MedlinePlus the Magazine

Science.gov (United States)

... High-Risk Infants Follow us Photo: iStock Predicting Autism in High-Risk Infants AN NIH-SUPPORTED STUDY ... high-risk, 6-month-old infants will develop autism spectrum disorder by age 2. Such a tool ...

Towards a comprehensive assessment and framework for low and high flow water risks

Science.gov (United States)

Motschmann, Alina; Huggel, Christian; Drenkhan, Fabian; León, Christian

2017-04-01

Driven by international organizations such as the Intergovernmental Panel on Climate Change (IPCC) the past years have seen a move from a vulnerability concept of climate change impacts towards a risk framework. Risk is now conceived at the intersection of climate-driven hazard and socioeconomic-driven vulnerability and exposure. The concept of risk so far has been mainly adopted for sudden-onset events. However, for slow-onset and cumulative climate change impacts such as changing water resources there is missing clarity and experience how to apply a risk framework. Research has hardly dealt with the challenge of how to integrate both low and high flow risks in a common framework. Comprehensive analyses of risks related to water resources considering climate change within multi-dimensional drivers across different scales are complex and often missing in climate-sensitive mountain regions where data scarcity and inconsistencies represent important limitations. Here we review existing vulnerability and risk assessments of low and high flow water conditions and identify critical conceptual and practical gaps. Based on this, we develop an integrated framework for low and high flow water risks which is applicable to both past and future conditions. The framework explicitly considers a water balance model simulating both water supply and demand on a daily basis. We test and apply this new framework in the highly glacierized Santa River catchment (SRC, Cordillera Blanca, Peru), representative for many developing mountain regions with both low and high flow water risks and poor data availability. In fact, in the SRC, both low and high flow hazards, such as droughts and floods, play a central role especially for agricultural, hydropower, domestic and mining use. During the dry season (austral winter) people are increasingly affected by water scarcity due to shrinking glaciers supplying melt water. On the other hand during the wet season (austral summer) high flow water

Preliminary risk analysis of an Hydrogen production plant using the reformed process of methane with vapor coupled to a high temperature nuclear reactor

International Nuclear Information System (INIS)

Flores y Flores, A.; Nelson E, P.F.; Francois L, J.L.

2004-01-01

It is necessary to identify the different types of dangers, as well as their causes, probabilities and consequences of the same ones, inside plants, industries and any process to classify the risks. This work is focused in particular to a study using the technical HAZOP (Hazard and Operability) for a plant of reformed of methane with vapor coupled to a nuclear reactor of the type HTTR (High Temperature Test Reactor), which is designed to be built in Japan. In particular in this study the interaction is analyzed between the nuclear reactor and the plant of reformed of methane with vapor. After knowing the possible causes of risk one it is built chart of results of HAZOP to have a better vision of the consequences of this faults toward the buildings and constructions, to people and the influence of the fault on each plant; for what there are proposed solutions to mitigate these consequences or to avoid them. The work is divided in three sections: a brief introduction about the technique of HAZOP; some important aspects of the plant of reformed of methane with vapor; and the construction of the chart of results of HAZOP. (Author)

Screening diagnostics of antivital experiences and propensity toward impulsive, autoagressive behavior in adolescents (preliminary results

Directory of Open Access Journals (Sweden)

Bannikov G.S.,

2014-08-01

Full Text Available Development of methods for revealing antivital experiences and propensity to autoaggressive behavior in educational institutions is one of the key steps in developing strategies for the primary prevention of suicidal behavior in adolescents. The purpose of this study was to develop an effective screening diagnostic package aimed at identifying antivital experiences and propensity to autoaggressive behavior. The survey methods we used were: Beck Hopelessness Scale, Russell Loneliness Scale, A.G. Shmelev Suicide Risk Questionnaire, PDQ-IV Borderline disorder and Narcissism scales. At the first stage we examined 750 minors aged 12-18 and identified risk group (85 people – 11.4%, which included adolescents with high levels of both individual scales, and their combination. At the second stage we examined 10 adolescents at risk. In 7 of them (70% were identified antivital, suicidal thoughts of passive or compulsive nature, signs of subjective and objective socio- psychological maladjustment. Our preliminary conclusion is that high levels of hopelessness and loneliness in adolescents are stable predictors of mental and emotional distress and psychosocial maladjustment in the period of psychological crises and decompensation of character accentuation of borderline and narcissistic types. These scales can be recommended for primary screening of antivital (depressive experiences and propensity to autoaggressive behavior in adolescents.

Studies of some risk factors for re-introduction and spread of highly ...

African Journals Online (AJOL)

High risk based poultry management and marketing procedures, inadequate poultry housing were areas of major concern in these states. Future high ... Key words: Risk factors, avian influenza, spread, Nigeria ... AJOL African Journals Online.

Social and Psychological Factors Related to Risk of Eating Disorders Among High School Girls.

Science.gov (United States)

Alfoukha, Marwa M; Hamdan-Mansour, Ayman M; Banihani, Manar Ali

2017-01-01

Prevalence of eating disorders (EDs) has increased among adolescents in Arabic and Western countries. The purposes are to identify the risk of ED and psychosocial correlates of risk of ED among high school girls in Jordan. The researchers employed a cross-sectional, correlational design using 799 high school girls from governmental and private schools in the central region of Jordan. The results indicate that prevalence of the risk of ED was 12%. The risk of ED had significant and positive correlation with body shape dissatisfaction, self-esteem, psychological distress, and pressure from family, peers, and media ( p self-esteem, negative peer pressure, and being young were significant predictors of the risk of EDs. Risk of ED is highly prevalent among high school girls, and school nurses need to adopt a model of care addressing the risk factors while caring for high school girls.

Applying the lessons of high risk industries to health care.

Science.gov (United States)

Hudson, P

2003-12-01

High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks.

KALIMER fuel system preliminary design description

International Nuclear Information System (INIS)

Hwang, Woan; Lee, B.O.; Nam, C.; Paek, S.K.

1998-10-01

This document provides general design concepts, design basis, preliminary design specification and design technologies which are needed for designing the fuel/non-fuel rods and assembly ducts of the KALIMER fuel system. The core of LMFBR consists of driver fuel assembly, blanket assembly, reflector assembly, shielding assembly, control assembly and GEM (Gas Expansion Module) as well as USS, dummy assembly, detector assembly. These core components must be designed to withstand the high temperature, high flux for a long irradiation exposure time. Due to the high temperature and high flux, irradiation creep and swelling as well as thermal-mechanical deformation are occurred at the fuel/non-fuel system and cause the deformations of materials and the geometric deflections at fuel/non-fuel rods, assembly ducts and components. In order to overcome these intricate phenomena through the engineering design, the design basis including theoretical analysis methodologies and design considerations, material characteristics of fuel system, and the specifications and drawings of fuel/non-fuel rods and assembly ducts, respectively, are presented. This document is preliminary design description which is produced in the conceptual design stage, and does not present the detailed and finalized design data which can be for the manufacturing. (author). 22 refs

High body mass index and cancer risk

DEFF Research Database (Denmark)

Benn, Marianne; Tybjærg-Hansen, Anne; Smith, George Davey

2016-01-01

of follow-up (range 0-37), 8002 developed non-skin cancer, 3347 non-melanoma skin cancer, 1396 lung cancer, 637 other smoking related cancers, 1203 colon cancer, 159 kidney cancer, 1402 breast cancer, 1062 prostate cancer, and 2804 other cancers. Participants were genotyped for five genetic variants...... with a BMI ≥ 30 versus 18.5-24.9 kg/m(2). Corresponding risk of breast cancer was 20 % (0-44 %) higher in postmenopausal women. BMI was not associated with risk of colon, kidney, other smoking related cancers, prostate cancer, or other cancers. In genetic analyses, carrying 7-10 versus 0-4 BMI increasing......High body mass index (BMI) has been associated with increased risk of some cancer. Whether these reflect causal associations is unknown. We examined this issue. Using a Mendelian randomisation approach, we studied 108,812 individuals from the general population. During a median of 4.7 years...

Sensation seeking in males involved in recreational high risk sports

OpenAIRE

M Guszkowska; A Bołdak

2010-01-01

The study examined sensation seeking intensity level in males involved in recreational high risk sports and investigated whether its level depends on type of sport practised. Additionally, in case of parachutists, sport experience of study participants were scrutinised with regard to its possible impact on the level of sensation seeking.The research involved 217 males aged 17 to 45, practising recreational high risk sports, namely: parachuting (n=98); wakeboarding (n=30); snowboarding (n=30);...

Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru

Science.gov (United States)

Konda, Kelika A.; Roberts, Chelsea P.; Maguiña, Jorge L.; Leon, Segundo R.; Clark, Jesse L.; Coates, Thomas J.; Caceres, Carlos F.; Klausner, Jeffrey D.

2016-01-01

Background Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. Methods Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02). Results Of 2,709 participants, 191 (7.05%) were RPR-reactive (median 1:8, range 1:1–1:1024) with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR) 3.84; P <0.001 and IR 8.15; P <0.001) and being MSM/TW (IR 6.48; P <0.001) were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001), not being in a stable partnership (IR 1.56, P = 0.035), higher number of sex partners (IR 3.01; P <0.001), unprotected sex in the past 3 months (IR 0.56; P = 0.003), HIV infection at baseline (IR 3.98; P <0.001) and incident HIV infection during the study period (IR 6.26; P = 0.003) were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR) 6.18; P <0.001), men reporting having sex with a man (aIR 4.63; P <0.001), and incident HIV infection (aIR 4.48; P = 0.008) were significantly associated

High Blood Pressure, Afib and Your Risk of Stroke

Science.gov (United States)

... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, AFib and Your Risk of Stroke Updated:Aug ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

Interpersonal conflict tactics and substance use among high-risk adolescents.

Science.gov (United States)

Unger, Jennifer B; Sussman, Steve; Dent, Clyde W

2003-07-01

Adolescents who use aggressive tactics to handle interpersonal conflicts may be at high risk for substance use, while adolescents who possess coping strategies to avoid or manage interpersonal conflict may be at lower risk for substance use. This study examined the association between interpersonal conflict tactics and substance use among 631 continuation high school students. Items from a modified Conflict Tactics Scale formed three factors: Physical Aggression, Nonphysical Aggression, and Nonaggression. Logistic regression analyses revealed that adolescents' ways of responding to interpersonal conflicts were associated with their substance use. Use of physical aggression was associated with a higher risk of cigarette, alcohol, marijuana, and other drug use. Use of nonphysical aggression was associated with a higher risk of cigarette and alcohol use. Use of nonaggressive conflict tactics was associated with a lower risk of cigarette use. Adolescents who respond to interpersonal conflicts in an aggressive manner, whether physical or verbal/psychological, may be at increased risk for substance use, while nonaggressive conflict management skills may be protective. Possibly, teaching adolescents nonaggressive techniques for handling interpersonal conflict may be a useful strategy for preventing both interpersonal violence and substance use.

Preliminary analysis of hydrogen risk caused by dust in ITER

International Nuclear Information System (INIS)

Cheng Kun; Tong Lili; Cao Xuewu

2012-01-01

A lot of dust will be generated during ITER operation,and hydrogen will be produced by the interaction of hot dust with water in the case of coolant ingress accident. The accumulated hydrogen will bring risk of combustion and explosion,which will damage the device. CFD method has been used to analyze the produced hydrogen in 'wet bypass' scenario, and come to the results that hydrogen will burn and explode at the beginning of the accident, different hydrogen risk will be brought by different coolant leakage, and hydrogen risk will be inert if the leakage is massive.Injecting CO 2 to inert the vacuum vessel has also been discussed, the risk of hydrogen will be suppressed by injecting CO 2 with a large rate at the beginning of accident. (authors)

Preliminary plan for case-control crash risk study

Science.gov (United States)

2002-01-31

The goal of the Federal Motor Carrier Safety Administration (FMCSA) is to reduce commercial vehicle-related fatalities and injuries. This is achieved through a thorough understanding of crash characteristics, precursors, and risk factors. This will h...

Improving the Output Power Stability of a High Concentration Photovoltaic System with Supercapacitors: A Preliminary Evaluation

Directory of Open Access Journals (Sweden)

Yu-Pei Huang

2015-01-01

Full Text Available The output power of a high concentration photovoltaic (HCPV system is very sensitive to fluctuating tracking errors and weather patterns. To help compensate this shortcoming, supercapacitors have been successfully incorporated into photovoltaic systems to improve their output power stability. This study examined the output power stability improvement of an HCPV module with a supercapacitor integrated into its circuit. Furthermore, the equivalent model of the experimental circuit is presented and analyzed. Experimental results suggest that integrating a supercapacitor into an HCPV module could improve its output power stability and further extend its acceptance angle. This paper provides preliminary data of the improvement and its evaluation method, which could be utilized for further improvements to an HCPV system.

Chronic kidney disease and bleeding risk in patients at high cardiovascular risk: a cohort study.

Science.gov (United States)

Ocak, G; Rookmaaker, M B; Algra, A; de Borst, G J; Doevendans, P A; Kappelle, L J; Verhaar, M C; Visseren, F L

2018-01-01

Essentials The association between chronic kidney disease and bleeding is unknown. We followed 10 347 subjects at high cardiovascular risk for bleeding events. Chronic kidney disease was associated with a 1.5-fold increased bleeding risk. Especially albuminuria rather than decreased kidney function was associated with bleeding events. Background There are indications that patients with chronic kidney disease have an increased bleeding risk. Objectives To investigate the association between chronic kidney disease and bleeding in patients at high cardiovascular risk. Methods We included 10 347 subjects referred to the University Medical Center Utrecht (the Netherlands) from September 1996 to February 2015 for an outpatient visit with classic risk factors for arterial disease or with symptomatic arterial disease (Second Manifestation of Arterial disease [SMART] cohort). Patients were staged according to the KDIGO guidelines, on the basis of estimated glomerular filtration rate (eGFR) and albuminuria, and were followed for the occurrence of major hemorrhagic events until March 2015. Hazard ratios (HRs) with 95% confidence intervals (CIs) for bleeding were calculated with Cox proportional hazards analyses. Results The incidence rate for bleeding in subjects with chronic kidney disease was 8.0 per 1000 person-years and that for subjects without chronic kidney disease was 3.5 per 1000 person-years. Patients with chronic kidney disease (n = 2443) had a 1.5-fold (95% CI 1.2-1.9) increased risk of bleeding as compared with subjects without chronic kidney disease (n = 7904) after adjustment. Subjects with an eGFR of Chronic kidney disease is a risk factor for bleeding in patients with classic risk factors for arterial disease or with symptomatic arterial disease, especially in the presence of albuminuria. © 2017 University Medical Center Utrecht. Journal of Thrombosis and Haemostasis © 2017 International Society on Thrombosis and Haemostasis.

Effects of Comprehensive, Multiple High-Risk Behaviors Prevention Program on High School Students

Science.gov (United States)

Collier, Crystal

2013-01-01

The purpose of this mixed methods study was to examine the effect of a multiple high-risk behaviors prevention program applied comprehensively throughout an entire school-system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The prevention program was created based upon the…

High risk for obstructive sleep apnea in patients with acute myocardial infarction

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Carla Renata Silva Andrechuk

2015-10-01

Full Text Available Objectives: to stratify the risk for obstructive sleep apnea in patients with acute myocardial infarction, treated at a public, tertiary, teaching hospital of the state of São Paulo, Brazil, and to identify related sociodemographic and clinical factors.Method: cross-sectional analytical study with 113 patients (mean age 59.57 years, 70.8% male. A specific questionnaire was used for the sociodemographic and clinical characterization and the Berlin Questionnaire for the stratification of the risk of obstructive sleep apnea syndrome.Results: the prevalence of high risk was 60.2% and the outcome of clinical worsening during hospitalization was more frequent among these patients. The factors related to high risk were body mass index over 30 kg/m2, arterial hypertension and waist circumference indicative of cardiovascular risk, while older age (60 years and over constituted a protective factor.Conclusion: considering the high prevalence of obstructive sleep apnea and its relation to clinical worsening, it is suggested that nurses should monitor, in their clinical practice, people at high risk for this syndrome, guiding control measures of modifiable factors and aiming to prevent the associated complications, including worsening of cardiovascular diseases.

High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck

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Michael J. Veness

2007-01-01

Full Text Available Nonmelanoma skin cancers (squamous cell and basal cell carcinomas occur at an epidemic rate in many countries with the worldwide incidence increasing. The sun-exposed head and neck are the most frequent sites for these cancers to arise and in most patients diagnosed with a cutaneous squamous cell carcinoma, local treatment is usually curative. However, a subset is diagnosed with a high-risk cutaneous squamous cell carcinoma. High-risk factors include size (> 2 cm, thickness/depth of invasion (> 4 mm, recurrent lesions, the presence of perineural invasion, location near the parotid gland, and immunosuppression. These patients have a higher risk (> 10–20% of developing metastases to regional lymph nodes (often parotid nodes, and in some cases also of experiencing local morbidity (perineural invasion, based on unfavourable primary lesion and patient factors. Despite treatment, many patients developing metastatic cutaneous squamous cell carcinoma experience mortality and morbidity usually as a consequence of uncontrolled metastatic nodal disease. It is therefore important that clinicians treating nonmelanoma skin cancers have an understanding and awareness of these high-risk patients. The aim of this article is to discuss the factors that define a high-risk patient and to present some of the issues pertinent to their management.

Screening for Behavioral Risk: Identification of High Risk Cut Scores within the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS)

Science.gov (United States)

Kilgus, Stephen P.; Taylor, Crystal N.; von der Embse, Nathaniel P.

2018-01-01

The purpose of this study was to support the identification of Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) cut scores that could be used to detect high-risk students. Teachers rated students across two time points (Time 1 n = 1,242 students; Time 2 n = 704) using the SAEBRS and the Behavioral and Emotional Screening System…

Qualitative risk assessment as a remediation management tool

International Nuclear Information System (INIS)

Knutson, D.E.

1991-01-01

The technique used to complete this thesis utilizes existing NRC and EPA guidance on health-based risk to qualitatively prioritize preliminary assessments and provide a tool for the direction and management of remediation activities. This method is intended as a decision making tool to aid in prioritizing the remediation effort and manage the remedial investigation and feasibility study (RI/FS) process. It is not a replacement for the RI/FS. The methodology for qualitative risk assessment utilizes data gathered in preliminary assessments and calculates the health-based hazards and consequences from contaminants found at each individual location. The health-based qualitative risk indicated that number-sign 6 fuel oil, carbon tetrachloride, depleted uranium, and enriched uranium were the contaminants of major concern, in that order. Plutonium ranked approximately sixth in the contaminant of concern priority. 38 refs., 1 fig., 9 tabs

Obstetric spinal hypotension: Preoperative risk factors and the ...

African Journals Online (AJOL)

Obstetric spinal hypotension: Preoperative risk factors and the development of a preliminary risk score – the PRAM score. ... We used empirical cut-point estimations in a logistic regression model to develop a scoring system for prediction of hypotension. Results. From 504 eligible patients, preoperative heart rate (odds ratio ...

Waste the waist: a pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk.

Science.gov (United States)

Greaves, Colin; Gillison, Fiona; Stathi, Afroditi; Bennett, Paul; Reddy, Prasuna; Dunbar, James; Perry, Rachel; Messom, Daniel; Chandler, Roger; Francis, Margaret; Davis, Mark; Green, Colin; Evans, Philip; Taylor, Gordon

2015-01-16

In the UK, thousands of people with high cardiovascular risk are being identified by a national risk-assessment programme (NHS Health Checks). Waste the Waist is an evidence-informed, theory-driven (modified Health Action Process Approach), group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. This pilot randomised controlled trial aimed to assess the feasibility of delivering the Waste the Waist intervention in UK primary care and of conducting a full-scale randomised controlled trial. We also conducted exploratory analyses of changes in weight. Patients aged 40-74 with a Body Mass Index of 28 or more and high cardiovascular risk were identified from risk-assessment data or from practice database searches. Participants were randomised, using an online computerised randomisation algorithm, to receive usual care and standardised information on cardiovascular risk and lifestyle (Controls) or nine sessions of the Waste the Waist programme (Intervention). Group allocation was concealed until the point of randomisation. Thereafter, the statistician, but not participants or data collectors were blinded to group allocation. Weight, physical activity (accelerometry) and cardiovascular risk markers (blood tests) were measured at 0, 4 and 12 months. 108 participants (22% of those approached) were recruited (55 intervention, 53 controls) from 6 practices and 89% provided data at both 4 and 12 months. Participants had a mean age of 65 and 70% were male. Intervention participants attended 72% of group sessions. Based on last observations carried forward, the intervention group did not lose significantly more weight than controls at 12 months, although the difference was significant when co-interventions and co-morbidities that could affect weight were taken into account (Mean Diff 2.6Kg. 95%CI: -4.8 to -0.3, p = 0.025). No significant differences were found in physical activity. The Waste the Waist

Prediabetes: a high-risk state for diabetes development.

Science.gov (United States)

Tabák, Adam G; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J; Kivimäki, Mika

2012-06-16

Prediabetes (intermediate hyperglycaemia) is a high-risk state for diabetes that is defined by glycaemic variables that are higher than normal, but lower than diabetes thresholds. 5-10% of people per year with prediabetes will progress to diabetes, with the same proportion converting back to normoglycaemia. Prevalence of prediabetes is increasing worldwide and experts have projected that more than 470 million people will have prediabetes by 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction-abnormalities that start before glucose changes are detectable. Observational evidence shows associations between prediabetes and early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores using non-invasive measures and blood-based metabolic traits, in addition to glycaemic values, could optimise estimation of diabetes risk. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention, with evidence of a 40-70% relative-risk reduction. Accumulating data also show potential benefits from pharmacotherapy. Copyright © 2012 Elsevier Ltd. All rights reserved.

Does Discrimination Explain High Risk of Depression among High-Income African American Men?

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Shervin Assari

2018-04-01

Full Text Available Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES are at an increased risk for having a major depressive episode (MDE. It is not known whether perceived discrimination (PD explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL, 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.

Estimating Worker Risk Levels Using Accident/Incident Data

Energy Technology Data Exchange (ETDEWEB)

Kenoyer, Judson L.; Stenner, Robert D.; Andrews, William B.; Scherpelz, Robert I.; Aaberg, Rosanne L.

2000-09-26

The purpose of the work described in this report was to identify methods that are currently being used in the Department of Energy (DOE) complex to identify and control hazards/risks in the workplace, evaluate them in terms of their effectiveness in reducing risk to the workers, and to develop a preliminary method that could be used to predict the relative risks to workers performing proposed tasks using some of the current methodology. This report describes some of the performance indicators (i.e., safety metrics) that are currently being used to track relative levels of workplace safety in the DOE complex, how these fit into an Integrated Safety Management (ISM) system, some strengths and weaknesses of using a statistically based set of indicators, and methods to evaluate them. Also discussed are methods used to reduce risk to the workers and some of the techniques that appear to be working in the process of establishing a condition of continuous improvement. The results of these methods will be used in future work involved with the determination of modifying factors for a more complex model. The preliminary method to predict the relative risk level to workers during an extended future time period is based on a currently used performance indicator that uses several factors tracked in the CAIRS. The relative risks for workers in a sample (but real) facility on the Hanford site are estimated for a time period of twenty years and are based on workforce predictions. This is the first step in developing a more complex model that will incorporate other modifying factors related to the workers, work environment and status of the ISM system to adjust the preliminary prediction.

Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries.

Science.gov (United States)

Andall-Brereton, Glennis; Brown, Eulynis; Slater, Sherian; Holder, Yvette; Luciani, Silvana; Lewis, Merle; Irons, Beryl

2017-06-08

To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study's results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.

Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries

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Glennis Andall-Brereton

2017-06-01

Full Text Available ABSTRACT Objective To characterize high-risk human papillomavirus (HPV infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. Methods Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1 a specimen for a Papanicolaou (Pap test and (2 a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace. High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. Results High-risk HPV was detected in 102 of 404 (25.2% in Saint Kitts and Nevis and in 109 of 368 (29.6% in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. Conclusions These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study’s results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.

Fatalities in high altitude mountaineering: a review of quantitative risk estimates.

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Weinbruch, Stephan; Nordby, Karl-Christian

2013-12-01

Quantitative estimates for mortality in high altitude mountaineering are reviewed. Special emphasis is placed on the heterogeneity of the risk estimates and on confounding. Crude estimates for mortality are on the order of 1/1000 to 40/1000 persons above base camp, for both expedition members and high altitude porters. High altitude porters have mostly a lower risk than expedition members (risk ratio for all Nepalese peaks requiring an expedition permit: 0.73; 95 % confidence interval 0.59-0.89). The summit bid is generally the most dangerous part of an expedition for members, whereas most high altitude porters die during route preparation. On 8000 m peaks, the mortality during descent from summit varies between 4/1000 and 134/1000 summiteers (members plus porters). The risk estimates are confounded by human and environmental factors. Information on confounding by gender and age is contradictory and requires further work. There are indications for safety segregation of men and women, with women being more risk averse than men. Citizenship appears to be a significant confounder. Prior high altitude mountaineering experience in Nepal has no protective effect. Commercial expeditions in the Nepalese Himalayas have a lower mortality than traditional expeditions, though after controlling for confounding, the difference is not statistically significant. The overall mortality is increasing with increasing peak altitude for expedition members but not for high altitude porters. In the Nepalese Himalayas and in Alaska, a significant decrease of mortality with calendar year was observed. A few suggestions for further work are made at the end of the article.

Lung transplantation for high-risk patients with idiopathic pulmonary fibrosis.

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De Oliveira, Nilto C; Julliard, Walker; Osaki, Satoru; Maloney, James D; Cornwell, Richard D; Sonetti, David A; Meyer, Keith C

2016-10-07

Survival for patients with idiopathic pulmonary fibrosis (IPF) and high lung allocation score (LAS) values may be significantly reduced in comparison to those with lower LAS values. To evaluate outcomes for high-risk IPF patients as defined by LAS values ≥46 (N=42) versus recipients with LAS values pulmonary complications was increased for the higher LAS group versus recipients with LAS <46, 30-day mortality and actuarial survival did not differ between the two cohorts. Although lung transplantation in patients with IPF and high LAS values is associated with increased risk of early post-transplant complications, long-term post-transplant survival for our high-LAS cohort was equivalent to that for the lower LAS recipients.

Influence of Comorbidity on the Risk of Mortality in Men With Unfavorable-Risk Prostate Cancer Undergoing High-Dose Radiation Therapy Alone

Energy Technology Data Exchange (ETDEWEB)

Huynh, Mai Anh, E-mail: mahuynh@lroc.harvard.edu [Harvard Radiation Oncology Program, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Chen, Ming-Hui; Wu, Jing [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Braccioforte, Michelle H.; Moran, Brian J. [Prostate Cancer Foundation of Chicago, Westmont, Illinois (United States); D' Amico, Anthony V. [Department of Radiation Oncology, Brigham and Women' s Hospital–Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

2016-07-15

Purpose: To explore whether a subgroup of men with unfavorable-risk prostate cancer (PC) exists in whom high-dose radiation therapy (RT) alone is sufficient to avoid excess PC death due to competing risk from cardiometabolic comorbidity. Methods and Materials: This was a cohort study of 7399 men in whom comorbidity (including congestive heart failure, diabetes mellitus, or myocardial infarction) was assessed and recorded with T1-3NxM0 PC treated with brachytherapy with or without neoadjuvant RT, October 1997 to May 2013 at a single providing institution. Cox and competing risks regression analyses were used to assess whether men with unfavorable–intermediate/high-risk versus favorable–intermediate/low-risk PC were at increased risk of PC-specific, all-cause, or other-cause mortality (PCSM, ACM, OCM), adjusting for number of comorbidities, age at and year of brachytherapy, RT use, and an RT treatment propensity score. Results: After a median follow-up of 7.7 years, 935 men died: 80 of PC and 855 of other causes. Among men with no comorbidity, PCSM risk (adjusted hazard ratio [AHR] 2.74 [95% confidence interval (CI) 1.49-5.06], P=.001) and ACM risk (AHR 1.30 [95% CI 1.07-1.58], P=.007) were significantly increased in men with unfavorable–intermediate/high-risk PC versus favorable–intermediate/low-risk PC, with no difference in OCM (P=.07). Although PCSM risk was increased in men with 1 comorbidity (AHR 2.87 [95% CI 1.11-7.40], P=.029), ACM risk was not (AHR 1.03 [95% CI 0.78-1.36], P=.84). Neither PCSM risk (AHR 4.39 [95% CI 0.37-51.98], P=.24) or ACM risk (AHR 1.43 [95% CI 0.83-2.45], P=.20) was increased in men with 2 comorbidities. Conclusions: To minimize death from PC, high-dose RT alone may be sufficient treatment in men with 2 or more cardiometabolic comorbidities and unfavorable–intermediate- and high-risk PC.

A Risk Management Framework to Characterize Black Swan Risks: A Case Study of Lightning Effects on Insensitive High Explosives

Science.gov (United States)

Sanders, Gary A.

Effective and efficient risk management processes include the use of high fidelity modeling and simulation during the concept exploration phase as part of the technology and risk assessment activities, with testing and evaluation tasks occurring in later design development phases. However, some safety requirements and design architectures may be dominated by the low probability/high consequence "Black Swan" vulnerabilities that require very early testing to characterize and efficiently mitigate. Failure to address these unique risks has led to catastrophic systems failures including the space shuttle Challenger, Deepwater Horizon, Fukushima nuclear reactor, and Katrina dike failures. Discovering and addressing these risks later in the design and development process can be very costly or even lead to project cancellation. This paper examines the need for risk management process adoption of early hazard phenomenology testing to inform the technical risk assessment, requirements definition and conceptual design. A case study of the lightning design vulnerability of the insensitive high explosives being used in construction, mining, demolition, and defense industries will be presented to examine the impact of this vulnerability testing during the concept exploration phase of the design effort. While these insensitive high explosives are far less sensitive to accidental initiation by fire, impact, friction or even electrical stimuli, their full range of sensitivities have not been characterized and ensuring safe engineering design and operations during events such as lightning storms requires vulnerability testing during the risk assessment phase.

Risk mitigation strategy for the ITER electron cyclotron upper port launcher

International Nuclear Information System (INIS)

Goede, A.P.H.; Bongers, W.A.; Elzendoorn, B.S.Q.; Graswinckel, M.F.; Baar, M.R. de

2010-01-01

A basic requirement for ITER equipment to meet is a high level of reliability, because ITER operation time is precious and radioactive operation leaves limited scope for repair. In order to reduce the risk of failure during ITER operation an effective risk mitigation strategy is necessary. This paper presents such strategy for the ITER electron cyclotron upper port launcher (ECUPL). A preliminary ECUPL risk analysis identifies possible failure modes. A probabilistic risk assessment quantifies the risk of failure using a 4 x 4 impact-likelihood matrix. Impact is quantified through technical, cost and schedule elements. Likelihood depends on the risk mitigation strategy adopted. A cost benefit analysis determines the most cost effective risk mitigation strategy. An essential element in risk mitigation is the testing of equipment prior to installation on the ITER machine. This paper argues the need for low- and highpower millimetre wave tests carried out on the fully assembled ECUPL. It presents a conceptual design for a dedicated on-site test bed that can handle 2 of 8 microwave beams at 2 MW long pulse operation.

On risk assessment of high level radioactive waste disposal

International Nuclear Information System (INIS)

Smith, C.F.; Kastenberg, W.E.

1976-01-01

One of the major concerns with the continued growth of the nuclear power industry is the production of the high level radioactive wastes. The risks associated with the disposal of these wastes derives from the potential for release of radioactive materials into the environment. The development of a methodology for risk analysis is carried out. The methodology suggested involves the probabilistic analysis of a general accident consequence distribution. In this analysis, the frequency aspect of the distribution is treated separately from the normalized probability function. In the final stage of the analysis, the frequency and probability characteristics of the distribution are recombined to provide an estimate of the risk. The characterization of the radioactive source term is accomplished using the ORIGEN computer code. Calculations are carried out for various reactor types and fuel cycles, and the overall waste hazard for a projected 35 year nuclear power program is determined. An index of relative nuclide hazard appropriate to problems involving the management of high level radioactive wastes is developed. As an illustration of the methodology, risk analyses are made for two proposed methods for waste management: extraterrestrial disposal and interim surface storage. The results of these analyses indicate that, within the assumptions used, the risks of these management schemes are small compared with natural background radiation doses. (Auth.)

Communicating about risk: strategies for situations where public concern is high but the risk is low

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Claire Hooker

2017-02-01

Full Text Available In this article, we summarise research that identifies best practice for communicating about hazards where the risk is low but public concern is high. We apply Peter Sandman’s ‘risk = hazard + outrage’ formulation to these risks, and review factors associated with the amplification of risk signals. We discuss the structures that determine the success of risk communication strategies, such as the capacity for early communication to ‘capture’ the dominant representation of risk issues, the importance of communicating uncertainty, and the usefulness of engaging with communities. We argue that, when facing trade-offs in probable outcomes from communication, it is always best to choose strategies that maintain or build trust, even at the cost of initial overreactions. We discuss these features of successful risk communication in relation to a range of specific examples, particularly opposition to community water fluoridation, Ebola, and routine childhood immunisation.

Distinct evolutionary mechanisms for genomic imbalances in high-risk and low-risk neuroblastomas

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Gisselsson David

2007-09-01

Full Text Available Abstract Background Neuroblastoma (NB is the most common extracranial solid tumour of childhood. Several genomic imbalances correlate to prognosis in NB, with structural rearrangements, including gene amplification, in a near-diploid setting typically signifying high-risk tumours and numerical changes in a near-triploid setting signifying low-risk tumours. Little is known about the temporal sequence in which these imbalances occur during the carcinogenic process. Methods We have reconstructed the appearance of cytogenetic imbalances in 270 NBs by first grouping tumours and imbalances through principal component analysis and then using the number of imbalances in each tumour as an indicator of evolutionary progression. Results Tumours clustered in four sub-groups, dominated respectively by (1 gene amplification in double minute chromosomes and few other aberrations, (2 gene amplification and loss of 1p sequences, (3 loss of 1p and other structural aberrations including gain of 17q, and (4 whole-chromosome gains and losses. Temporal analysis showed that the structural changes in groups 1–3 were acquired in a step-wise fashion, with loss of 1p sequences and the emergence of double minute chromosomes as the earliest cytogenetic events. In contrast, the gains and losses of whole chromosomes in group 4 occurred through multiple simultaneous events leading to a near-triploid chromosome number. Conclusion The finding of different temporal patterns for the acquisition of genomic imbalances in high-risk and low-risk NBs lends strong support to the hypothesis that these tumours are biologically diverse entities, evolving through distinct genetic mechanisms.

Foot length measurements of newborns of high and low risk pregnancies

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Ana Karina Marques Salge

Full Text Available Abstract OBJECTIVE Comparing foot length measurements of newborns in high and low risk pregnancies at a public hospital in Goiânia, GO, Brazil. METHOD A cross-sectional study carried out between April, 2013 and May, 2015, with a sample consisting of 180 newborns; 106 infants of women from high-risk pregnancies and 74 of women from low-risk pregnancies. Data were descriptively analyzed. Foot length measurement was performed using a stiff transparent plastic ruler, graduated in millimeters. The length of both feet was measured from the tip of the hallux (big toe to the end of the heel. RESULTS A statistically significant relationship was found between the foot length and newborn’s weight, between the cephalic and thoracic perimeters in the high-risk group and between the cephalic perimeter in the control group. CONCLUSION There is a need for creating cut-off points to identify newborns with intrauterine growth disorders using foot length.

Perceptions of risk from workers in high risk industries with work related musculoskeletal disorders.

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Hunter, D; Silverstein, B

2014-01-01

Work-related musculoskeletal disorders (WMSDs) remain a major occupational health problem, despite decades of research, outreach, and intervention. The aim of this study is to promote early identification and prevention of WMSDs by developing education and outreach materials grounded in interview data collected from workers that have recently filed for workers compensation (WC) for WMSDs. We conducted semi-structured telephone interviews with WC claimants (n=66) from high risk industries identified through the use of a Prevention Index (PI) in Washington state with WMSDs of the back, shoulder, hand/wrist, or knee. Perceptions regarding the degree of exposure to WMSD risk factors, the social construction of pain, and the potential to implement injury-prevention measures varied widely. Many workers dismissed their injuries as the result of "fluke" or "freak" occurrences and framed their exposure to risk factors for WMSDs as either inevitable or "just part of the job." Workers in high-risk industries for WMSDs described their work conditions in ways that suggested: (1) a lack of awareness of the potential for developing a WMSD, (2) a view of work-related pain as normal, and/or (3) a pattern of self-blame for WMSD onset. A paradigm that either asserts the inevitability of WMSDs or dismisses potential control measures presents both a significant barrier to injury prevention efforts as well as a major opportunity for future occupational health research.

A risk score to predict type 2 diabetes mellitus in an elderly Spanish Mediterranean population at high cardiovascular risk.

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Marta Guasch-Ferré

Full Text Available INTRODUCTION: To develop and test a diabetes risk score to predict incident diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. MATERIALS AND METHODS: A diabetes risk score was derived from a subset of 1381 nondiabetic individuals from three centres of the PREDIMED study (derivation sample. Multivariate Cox regression model ß-coefficients were used to weigh each risk factor. PREDIMED-personal Score included body-mass-index, smoking status, family history of type 2 diabetes, alcohol consumption and hypertension as categorical variables; PREDIMED-clinical Score included also high blood glucose. We tested the predictive capability of these scores in the DE-PLAN-CAT cohort (validation sample. The discrimination of Finnish Diabetes Risk Score (FINDRISC, German Diabetes Risk Score (GDRS and our scores was assessed with the area under curve (AUC. RESULTS: The PREDIMED-clinical Score varied from 0 to 14 points. In the subset of the PREDIMED study, 155 individuals developed diabetes during the 4.75-years follow-up. The PREDIMED-clinical score at a cutoff of ≥6 had sensitivity of 72.2%, and specificity of 72.5%, whereas AUC was 0.78. The AUC of the PREDIMED-clinical Score was 0.66 in the validation sample (sensitivity = 85.4%; specificity = 26.6%, and was significantly higher than the FINDRISC and the GDRS in both the derivation and validation samples. DISCUSSION: We identified classical risk factors for diabetes and developed the PREDIMED-clinical Score to determine those individuals at high risk of developing diabetes in elderly individuals at high cardiovascular risk. The predictive capability of the PREDIMED-clinical Score was significantly higher than the FINDRISC and GDRS, and also used fewer items in the questionnaire.

Preliminary Monthly Climatological Summaries

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National Oceanic and Atmospheric Administration, Department of Commerce — Preliminary Local Climatological Data, recorded since 1970 on Weather Burean Form 1030 and then National Weather Service Form F-6. The preliminary climate data pages...

Is the Population Detected by Screening in China Truly at High Risk of Stroke?

Science.gov (United States)

Wang, Yuan; Wang, Jing; Cheng, Juan; Liang, Xuan; Li, Xin; Lu, Wenli

2018-04-09

The Chinese Stroke Screening and Prevention Project (CSSPP) considers patients with 3 or more risk factors to be at high risk of stroke, and does not quantitatively assess the risk for stroke. However, to detect high-risk groups more efficiently, a health risk appraisal (HRA) model should be used to assess individual risk of stroke. The odds ratios for the 8 risk factors for stroke were pooled and the data were used to develop an HRA model to predict individuals' risks of developing stroke in the next 5 years. The Chinese screening project and HRA screening strategies were then compared. We assessed 4196 Chinese individuals who received checkups in 2015. The average 5-year risk of stroke was 5.81‰, with men being at higher risk of stroke than women over that period. The average 5-year risk of stroke also increased with the number of risk factors. 932 individuals (22.2%) were identified as being at high risk of stroke according to CSSPP, whereas 318 individuals with fewer than 3 risk factors were considered being at low risk despite having a 5-year risk of stroke greater than 4.0% by our assessment. Notably, among patients with hypertension and diabetes who were classified as being at low risk of stroke by the CSSPP, the HRA recognized 15.9% and 14.3% as being at high risk of stroke, respectively. All 8 major risk factors affect stroke risk differently, and the efficiency of clustering these risk factors might be improved by considering the relative risk of each factor with an HRA model. Copyright © 2018. Published by Elsevier Inc.

Ownership of High-Risk ("Vicious") Dogs as a Marker for Deviant Behaviors: Implications for Risk Assessment

Science.gov (United States)

Barnes, Jaclyn E.; Boat, Barbara W.; Putnam, Frank W.; Dates, Harold F.; Mahlman, Andrew R.

2006-01-01

This study examined the association between ownership of high-risk ("vicious") dogs and the presence of deviant behaviors in the owners as indicated by court convictions. We also explored whether two characteristics of dog ownership (abiding licensing laws and choice of breed) could be useful areas of inquiry when assessing risk status…

Job insecurity and risk of diabetes

DEFF Research Database (Denmark)

Ferrie, Jane E.; Virtanen, Marianna; Jokela, Markus

2016-01-01

participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. We calculated study-specific estimates of the association between job insecurity reported at baseline and incident diabetes over the follow-up period. We pooled the estimates in a meta-analysis to produce a summary...... risk estimate. Results: The 19 studies involved 140 825 participants from Australia, Europe and the United States, with a mean follow-up of 9.4 years and 3954 incident cases of diabetes. In the preliminary analysis adjusted for age and sex, high job insecurity was associated with an increased risk...... of incident diabetes compared with low job insecurity (adjusted odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09–1.30). In the multivariable-adjusted analysis restricted to 15 studies with baseline data for all covariates (age, sex, socioeconomic status, obesity, physical activity, alcohol and smoking...

Radiation and risk in physics education

International Nuclear Information System (INIS)

Eijkelhof, H.M.C.

1990-01-01

The study reported in this thesis deals with physics education, particularly with the teaching and learning of radioactivity and ionizing radiation. It is a follow up of earlier research and development work in the Dutch Physics Curriculum Development Project (PLON) on a unit called Ionizing Radiation. The central theme of this unit was the acceptability of the risks of ionizing radiation. Preliminary evaluation of the effectiveness of the PLON-unit showed that pupils appear to have lay-ideas which seem to be resistant to change. In this study the nature and persistence of these lay-ideas have been explored and a set of recommendations have been developed for writing curriculum materials and for teaching strategies, for physics lessons in secondary high school, in order to promote thoughtful risk analysis and assessment as regards applications of ionizing radiation. (H.W.). 225 refs.; 3 figs.; 41 tabs

Incidence of infective endocarditis among patients considered at high risk

DEFF Research Database (Denmark)

Østergaard, Lauge; Valeur, Nana; Ihlemann, Nikolaj

2018-01-01

Aims: Patients with prior infective endocarditis (IE), a prosthetic heart valve, or a cyanotic congenital heart disease (CHD) are considered to be at high risk of IE by guidelines. However, knowledge is sparse on the relative risk of IE between these three groups and compared controls. Methods...

Level of anxiety in parents of high-risk premature twins.

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Zanardo, V; Freato, F; Cereda, C

1998-01-01

We attempted to define parental anxiety in a population of parents of high-risk premature twins (mean birth weight 1,493 +/- 227 kg; mean gestational age 33 +/- 3.5 weeks), admitted to III level NICU. We specifically examined the following factors; gestational age of the twins, whether or not the twins had ventilatory support, pulmonary sequelae, major malformations or intra-ventricular hemorrhage, parental gender and highest level of education obtained by the parent. In the immediate pre-discharge period and a month later, a questionnaire (State-Trait Anxiety Inventory) was given to all parents of premature twins presenting for the discharge. The parents of 30 twins entered the study twice, at the discharge of their first twin (mean postnatal age 40 +/- 32 days), and one month later. They included 15 mothers and 11 fathers, aged 33 +/- 5.5 and 33 +/- 4.2 years, and at the second evaluation 11 mothers and 10 fathers, respectively. As case-controls we examined parental anxiety of fifteen consecutive singleton high-risk prematures, with equal gestational age, discharged immediately after. Our results indicate that the parents of high-risk twin and singleton prematures present an elevated, lasting state-trait anxiety level. Pre- and post-discharge parental anxiety is more elevated (not significant) in twinning with respect to the prematurity alone. When assessed separately by parental gender, in both these groups an increased (not significant) anxiety was persistently found in the mothers. We recommend that, although neonatologists generally define the discharge of the high-risk premature based upon the acquired stabilization of vital parameters, they pay special attention to the twin group we have identified which is at increased risk for predischarge parental anxiety.

Building-related symptoms among U.S. office workers and risks factors for moisture and contamination: Preliminary analyses of U.S. EPA BASE Data

Energy Technology Data Exchange (ETDEWEB)

Mendell, Mark J.; Cozen, Myrna

2002-09-01

dirty cooling coils were associated with a nonsignificant increase in lower respiratory symptoms. These preliminary findings suggest that some factors that indicate risks for moisture or contamination in office buildings may have adverse effects on respiratory or neurologic health of office workers. More refined analyses are underway that will include these risk factors in simultaneous multivariate models along with additional risk factors that may be confounders, such as ventilation rate and indoor temperature. Future analyses will also use more refined metrics for both health outcomes and environmental risks, as well as assess risk in susceptible sub-groups.

Cognitive and behavioural dispositions in offspring at high risk for alcoholism.

Science.gov (United States)

Kumar, Rajesh; Kumar, Keshav Janakiprasad; Benegal, Vivek

2018-05-15

Offspring with family history of alcoholism are considered to be at high risk for alcoholism. The present study sought to expand our understanding of cognitive and behavioural dispositions associated with executive control and self-regulation in alcohol naïve offspring with and without family history of alcoholism. Sample comprised of alcohol naive offspring in two groups: (i) at high risk (n = 34) and (ii) at low risk for alcoholism (n = 34). Both groups were matched on age (+/-1 year), education (+/-1 year) and gender. Measures used were: Mini-International Neuropsychiatric Interview, Family Interview for Genetic Studies, Socio-demographic Data Sheet, Annett's Handedness Questionnaire, Barratt's Impulsiveness Scale-version 11, Digit Span Test, Spatial Span Test, Tower of London, Wisconsin Card Sorting Test, Iowa Gambling Task (IGT) and Game of Dice Task (GDT). Results showed that alcohol naive offspring at high risk for alcoholism reported significantly high impulsivity and demonstrated significant differences on executive functions and decision making tasks. Correlation analysis revealed that high impulsivity was significantly associated with poor performance on explicit decision making task (GDT) and executive function task (WCST). There was no significant correlation between two decision making tasks (IGT and GDT) in both groups and performance on IGT was not significantly associated with impulsivity and executive functions. The present study indicates cognitive and behavioural dispositions in alcohol naive offspring at high risk for alcoholism and support the sub-optimal balance between reflective and impulsive system responsible for addiction. Furthermore, present study supports separability between two different types of decision making tasks. Copyright © 2018. Published by Elsevier B.V.

Low mortality rates after endovascular aortic repair expand use to high-risk patients.

Science.gov (United States)

Adkar, Shaunak S; Turner, Megan C; Leraas, Harold J; Gilmore, Brian F; Nag, Uttara; Turley, Ryan S; Shortell, Cynthia K; Mureebe, Leila

2018-02-01

The 2010 endovascular aneurysm repair (EVAR) trial 2 (EVAR 2) reported that patients with comorbidity profiles rendering them unfit for open aneurysm repair who underwent EVAR did not experience a survival advantage compared with those who did not undergo intervention. These patients experienced a 30-day mortality of 7.3%, whereas reports from similar cohorts reported far lower mortality rates. The primary objective of our study was to compare the incidence of 30-day mortality in low- and high-risk patients undergoing EVAR in a contemporary data set, using patient risk stratification criteria from EVAR 2. Secondarily, we sought to identify risk factors associated with a disproportionate contribution to 30-day mortality risk. Data were obtained from the 2005 to 2013 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use Data Files (N = 24,813). Patients were included in the high-risk cohort with the presence of renal, respiratory, or cardiac preoperative criteria alone or in combination. Renal impairment criteria were defined as dialysis and creatinine concentration >2.26 mg/dL. Respiratory impairment criteria included history of chronic obstructive pulmonary disease and preoperative ventilator support. Cardiac impairment criteria included history of myocardial infarction, congestive heart failure, angina, and prior coronary intervention. Patient and procedural characteristics and 30-day postoperative outcomes were compared using Pearson χ 2 tests for categorical variables and Wilcoxon rank sum tests for continuous variables. Among 24,813 patients undergoing EVAR, 12,043 (48%) patients were characterized as high risk (at least one impairment criterion); 12,770 (52%) patients were stratified as low risk. The 30-day mortality rate was 1.9% in the high-risk cohort compared with the 7.3% reported by EVAR 2, and it was higher in the high-risk cohort compared with the low-risk cohort (1.9% vs 0.9%; P < .001). Whereas the

Low Molecular Weight Heparin Improves Endothelial Function in Pregnant Women at High Risk of Preeclampsia.

Science.gov (United States)

McLaughlin, Kelsey; Baczyk, Dora; Potts, Audrey; Hladunewich, Michelle; Parker, John D; Kingdom, John C P

2017-01-01

Low molecular weight heparin (LMWH) has been investigated for the prevention of severe preeclampsia, although the mechanisms of action are unknown. The objective of this study was to investigate the cardiovascular effects of LMWH in pregnant women at high risk of preeclampsia. Pregnant women at high risk of preeclampsia (n=25) and low-risk pregnant controls (n=20) at 22 to 26 weeks' gestation underwent baseline cardiovascular assessments. High-risk women were then randomized to LMWH or saline placebo (30 mg IV bolus and 1 mg/kg subcutaneous dose). Cardiovascular function was assessed 1 and 3 hours post randomization. The in vitro endothelial effects of patient serum and exogenous LMWH on human umbilical venous endothelial cells were determined. High-risk women demonstrated a reduced cardiac output, high resistance hemodynamic profile with impaired radial artery flow-mediated dilation compared with controls. LMWH increased flow-mediated dilation in high-risk women 3 hours after randomization compared with baseline and increased plasma levels of placental growth factor, soluble fms-like tyrosine kinase-1, and myeloperoxidase. Serum from high-risk women impaired endothelial cell angiogenesis and increased PlGF-1 and PlGF-2 transcription compared with serum from low-risk controls. Coexposure of high-risk serum with LMWH improved the in vitro angiogenic response such that it was equivalent to that of low-risk serum and promoted placental growth factor secretion. LMWH improves maternal endothelial function in pregnant women at high risk of developing preeclampsia, possibly mediated through increased placental growth factor bioavailability. © 2016 American Heart Association, Inc.

What is the optimal management of high risk, clinically localized prostate cancer?

Science.gov (United States)

Eastham, James A; Evans, Christopher P; Zietman, Anthony

2010-01-01

To summarize the presentations and debate regarding the optimal treatment of localized high-risk prostate cancer as presented at the 2009 Spring Meeting of the Society of Urologic Oncology. The debate was centered on presentations arguing for radical prostatectomy (RP) or radiotherapy as the optimal treatment for this condition. The meeting presentations are summarized by their respective presenters herein. Dr. James Eastham presents the varied definitions for "high-risk" prostate cancer as strongly influencing which patients end up in this cohort. Based upon this, between 3% and 38% of patients with high-risk features could be defined as "high-risk". Despite that, these men do not have a uniformly poor prognosis after RP, and attention to surgical principles as outlined improve outcomes. Disease-specific survival at 12 years is excellent and up to one-half of these men may not need adjuvant or salvage therapies, depending on their specific disease characteristics. Adjuvant or salvage radiotherapies improve outcomes and are part of a sequential approach to treating these patients. Dr. Anthony Zietman presented radiotherapy as the gold-standard based upon large, randomized clinical trials of intermediate- and high-risk prostate cancer patients. Compared with androgen deprivation alone, the addition of radiotherapy provided a 12% cancer-specific survival advantage and 10% overall survival advantage. Dose escalation seems to confer further improvements in cancer control without significant escalation of toxicities, with more data forthcoming. There are no randomized trials comparing RP to radiotherapy for any risk category. In high-risk prostate cancer patients, both approaches have potential benefits and cumulative toxicities that must be matched to disease characteristics and patient expectations in selecting a treatment course. Copyright (c) 2010 Elsevier Inc. All rights reserved.

High serum alanine aminotransferase is associated with the risk of colorectal adenoma in Korean men.

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Moon, Chang Mo; Yun, Kyung Eun; Ryu, Seungho; Chang, Yoosoo; Park, Dong Il

2017-07-01

An elevated alanine aminotransferase (ALT) is frequently observed in subjects with metabolic syndrome, which is associated with the risk of colorectal adenoma (CRA). However, the relationship between ALT and CRA remains unclear. Therefore, we aimed to investigate whether high serum ALT is associated with the risk of CRA in a metabolically healthy population. We conducted this cross-sectional study in 27,717 asymptomatic Korean adults who underwent a health checkup. Subjects were categorized as adenoma-free, hyperplastic polyp, low-risk adenoma, or high-risk adenoma. High-risk adenoma was defined as three or more adenomas, any adenoma ≥ 10 mm, or adenoma with high-grade dysplasia or villous features. Among all participants, 10.3% and 1.5% of cases were categorized as low-risk and high-risk adenoma, respectively. In multivariate analyses adjusting for age, sex, body mass index, smoking habits, alcohol intake, regular exercise, aspirin and analgesics use, family history of colon cancer, education level, fatty liver, high-sensitivity C reactive protein, homeostasis model assessment of insulin resistance, total cholesterol, and triglyceride, an increase in ALT was positively associated with the prevalence of low-risk and high-risk adenoma (P for trend = 0.029 and 0.027, respectively). The highest quartile group of ALT level showed a significantly increased prevalence in low-risk (odds ratio, 1.17) and high-risk adenoma (odds ratio, 1.48) groups compared with the lowest quartile group. This phenomenon persisted in the subgroup analysis in men, but not in women. In the asymptomatic healthy population, high serum ALT is significantly associated with the risk of CRA. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Dosimetric impact of mixed-energy volumetric modulated arc therapy plans for high-risk prostate cancer

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Shyam Pokharel

2013-10-01

Full Text Available Purpose: This study investigated the dosimetric impact of mixing low and high energy treatment plans for prostate cancer treated with volumetric modulated arc therapy (VMAT technique in the form of RapidArc.Methods: A cohort of 12 prostate cases involving proximal seminal vesicles and lymph nodes was selected for this retrospective study. For each prostate case, the single-energy plans (SEPs and mixed-energy plans (MEPs were generated.  First, the SEPs were created using 6 mega-voltage (MV energy for both the primary and boost plans. Second, the MEPs were created using 16 MV energy for the primary plan and 6 MV energy for the boost plan. The primary and boost MEPs used identical beam parameters and same dose optimization values as in the primary and boost SEPs for the corresponding case. The dosimetric parameters from the composite plans (SEPs and MEPs were evaluated. Results: The dose to the target volume was slightly higher (on average <1% in the SEPs than in the MEPs. The conformity index (CI and homogeneity index (HI values between the SEPs and MEPs were comparable. The dose to rectum and bladder was always higher in the SEPs (average difference up to 3.7% for the rectum and up to 8.4% for the bladder than in the MEPs. The mean dose to femoral heads was higher by about 0.8% (on average in the MEPs than in the SEPs. The number of monitor units and integral dose were higher in the SEPs compared to the MEPs by average differences of 9.1% and 5.5%, respectively.Conclusion: The preliminary results from this study suggest that use of mixed-energy VMAT plan for high-risk prostate cancer could potentially reduce the integral dose and minimize the dose to rectum and bladder, but for the higher femoral head dose.-----------------------------------------------Cite this article as:Pokharel S. Dosimetric impact of mixed-energy volumetric modulated arc therapy plans for high-risk prostate cancer. Int J Cancer Ther Oncol 2013;1(1:01011.DOI: http

High-dose vitamin B6 decreases homocysteine serum levels in patients with schizophrenia and schizoaffective disorders: a preliminary study.

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Miodownik, Chanoch; Lerner, Vladimir; Vishne, Tali; Sela, Ben-Ami; Levine, Joseph

2007-01-01

Vitamin B6 plays an essential role in the normal functioning of the central nervous system. Normal homocysteine (Hcy) serum level is maintained by remethylation of Hcy to methionine by enzymes that require folic acid and vitamin B12 and by catabolism to cysteine by a vitamin B6-dependent enzyme. These findings may be consistent with the hypothesis that the vitamin B6 status may influence plasma Hcy levels. The aims of this preliminary study were (1) to determine whether a correlation exists between Hcy and vitamin B6 levels in patients with schizophrenia and schizoaffective disorders and (2) to investigate whether treatment with high-dose vitamin B6 may reduce Hcy levels in these patients. In this preliminary study, we enrolled 11 patients with schizophrenia or schizoaffective disorders (7 men and 4 women; mean age +/- SD, 50 +/- 12 years) receiving high doses of vitamin B6 treatment (1200 mg/d) for 12 weeks. Blood samples for the assessment of pyridoxal-5-phosphate and Hcy serum levels were obtained at baseline and after 12 weeks of treatment. Age was significantly positively correlated with Hcy levels at baseline (r = 0.392, P = 0.004). All other parameters, including diagnosis, disease duration, and pyridoxal-5-phosphate serum level, were not correlated with Hcy serum levels at baseline. After vitamin B6 treatment, Hcy serum levels significantly decreased (14.2 +/- 3.4 vs. 11.8 +/- 2.0 micromol/L, respectively, t = 2.679, P = 0.023); this decrease being statistically significant in men but not in women. High doses of vitamin B6 lead to a decrease in Hcy serum level in male patients with schizophrenia or schizoaffective disorder.

Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population

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Karvounis Charalambos

2009-07-01

Full Text Available Abstract Background The percentage of hypertrophic cardiomyopathy (HCM patients who are in high risk for Sudden Death (SD constitutes only a minority of all HCM population but the incidence of SD in this subset is high (at least 5% annually. The identification of this small but important proportion of high risk HCM patients has been the clue in the clinical evaluation of these patients. Methods Our study cohort consisted from 123 patients with HCM who are currently followed up in our Institution. Five clinical risk factors were assessed: a family history of premature SD, unexplained syncope, Non Sustained Ventricular Tachycardia (NSVT on 24-h ECG monitoring, Abnormal Blood Pressure Response (ABPR during upright exercise testing and Maximum left ventricular Wall Thickness (MWT ≥30 mm. The purpose of our study was the identification of high risk HCM patients coming from Northern Greece. Results Fifteen patients (12.2% of the whole cohort had MWT ≥ 30 mm, 30 patients (24.4% had an ABPR to exercise, 17 patients (13.8% had episodes of NSVT in 24-h Holter monitoring, 17 patients (13.8% suffered from syncope, and 8 patients (6.5% had a positive family history of premature SD. Data analysis revealed that 74 patients (60.1% had none risk factor. Twenty four patients (19.5% had 1 risk factor, 17 patients (13.8% had 2 risk factors, 4 patients (3.25% had 3 risk factors, and 4 patients (3.25% had 4 risk factors, while none patient had 5 risk factors. Twenty five patients (20.3% had 2 or more risk factors. Conclusion This study for the first time confirms that, although a 60% of patients with HCM coming from a regional Greek population are in low risk for SD, a substantial proportion (almost 20% carries a high risk for SD justifying prophylactic therapy with amiodaron or ICD implantation.

Core Competencies and the Prevention of High-Risk Sexual Behavior

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Charles, Vignetta Eugenia; Blum, Robert Wm.

2008-01-01

Adolescent sexual risk-taking behavior has numerous individual, family, community, and societal consequences. In an effort to contribute to the research and propose new directions, this chapter applies the core competencies framework to the prevention of high-risk sexual behavior. It describes the magnitude of the problem, summarizes explanatory…

Persistence and reappearance of high-risk human papillomavirus after conization

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Gosvig, Camilla Flarup; Huusom, Lene Drasbek; Andersen, Klaus Kaae

2013-01-01

Women with early cervical cancer or intraepithelial neoplasia grades 2 and 3 (CIN2+) are treated by conization; however, they still have a higher risk for subsequent CIN2+ than the general female population. Persistence of high-risk (HR) human papillomavirus (HPV) is a key factor in the development...

Evaluation methodology for flood damage reduction by preliminary water release from hydroelectric dams

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Ando, T.; Kawasaki, A.; Koike, T.

2017-12-01

IPCC AR5 (2014) reported that rainfall in the middle latitudes of the Northern Hemisphere has been increasing since 1901, and it is claimed that warmer climate will increase the risk of floods. In contrast, world water demand is forecasted to exceed a sustainable supply by 40 percent by 2030. In order to avoid this expectable water shortage, securing new water resources has become an utmost challenge. However, flood risk prevention and the secure of water resources are contradictory. To solve this problem, we can use existing hydroelectric dams not only as energy resources but also for flood control. However, in case of Japan, hydroelectric dams take no responsibility for it, and benefits have not been discussed accrued by controlling flood by hydroelectric dams, namely by using preliminary water release from them. Therefore, our paper proposes methodology for assessing those benefits. This methodology has three stages as shown in Fig. 1. First, RRI model is used to model flood events, taking account of the probability of rainfall. Second, flood damage is calculated using assets in inundation areas multiplied by the inundation depths generated by that RRI model. Third, the losses stemming from preliminary water release are calculated, and adding them to flood damage, overall losses are calculated. We can evaluate the benefits by changing the volume of preliminary release. As a result, shown in Fig. 2, the use of hydroelectric dams to control flooding creates 20 billion Yen benefits, in the probability of three-day-ahead rainfall prediction of the assumed maximum rainfall in Oi River, in the Shizuoka Pref. of Japan. As the third priority in the Sendai Framework for Disaster Risk Reduction 2015-2030, `investing in disaster risk reduction for resilience - public and private investment in disaster risk prevention and reduction through structural and non-structural measures' was adopted. The accuracy of rainfall prediction is the key factor in maximizing the benefits

Social and financial resources and high-risk alcohol consumption among older adults.

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Moos, Rudolf H; Brennan, Penny L; Schutte, Kathleen K; Moos, Bernice S

2010-04-01

This study examined long-term mutual predictive associations between social and financial resources and high-risk alcohol consumption in later life. A sample of 55- to 65-year-old older adults (n = 719) was surveyed at baseline and 10 years and 20 years later. At each contact point, participants completed an inventory that assessed social and financial resources and alcohol consumption. Over the 20-year interval, there was evidence of both social causation and social selection processes in relation to high-risk alcohol consumption. In support of a social causation perspective, higher levels of some social resources, such as participation in social activities, friends' approval of drinking, quality of relationship with spouse, and financial resources, were associated with a subsequent increased likelihood of high-risk alcohol consumption. Conversely, indicating the presence of social selection, high-risk alcohol consumption was associated with subsequent higher levels of friends' approval of drinking and quality of the spousal relationship, but lower quality of relationships with extended family members. These findings reflect mutual influence processes in which older adults' social resources and high-risk alcohol consumption can alter each other. Older adults may benefit from information about how social factors can affect their drinking habits; accordingly, information about social causation effects could be used to guide effective prevention and intervention efforts aimed at reducing the risk that late-life social factors may amplify their excessive alcohol consumption.

Management of high-risk Myeloma: an evidence-based review of treatment strategies.

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Lehners, Nicola; Hayden, Patrick J; Goldschmidt, Hartmut; Raab, Marc-Steffen

2016-08-01

Despite the progress made in the treatment of patients with multiple myeloma over recent decades, a significant cohort with high-risk disease as defined by specific clinical and genetic criteria continue to respond poorly to standard treatment. These patients represent a particular challenge to the treating physician and require early identification as well as personalized treatment strategies. In this review, we discuss the prognostic impact of adverse clinical, radiological and genetic factors, evaluate available scoring systems and highlight key aspects of the therapeutic management of high-risk myeloma. MEDLINE and recent scientific meetings' databases were searched for the keywords 'high-risk' and 'multiple myeloma' and relevant studies relating to both diagnostic and therapeutic approaches were identified. Expert commentary: A case is made for intensive induction using combinations of novel agents, early high-dose therapy supported by autologous stem cell transplantation and the widespread use of maintenance therapies. Novel therapeutic options, especially in the field of immunotherapy, are currently explored in clinical trials and have the potential to further improve outcomes for patients with high-risk multiple myeloma.

Can we avoid high levels of dose escalation for high-risk prostate cancer in the setting of androgen deprivation?

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Shakespeare, Thomas P; Wilcox, Shea W; Aherne, Noel J

2016-01-01

Both dose-escalated external beam radiotherapy (DE-EBRT) and androgen deprivation therapy (ADT) improve outcomes in patients with high-risk prostate cancer. However, there is little evidence specifically evaluating DE-EBRT for patients with high-risk prostate cancer receiving ADT, particularly for EBRT doses >74 Gy. We aimed to determine whether DE-EBRT >74 Gy improves outcomes for patients with high-risk prostate cancer receiving long-term ADT. Patients with high-risk prostate cancer were treated on an institutional protocol prescribing 3-6 months neoadjuvant ADT and DE-EBRT, followed by 2 years of adjuvant ADT. Between 2006 and 2012, EBRT doses were escalated from 74 Gy to 76 Gy and then to 78 Gy. We interrogated our electronic medical record to identify these patients and analyzed our results by comparing dose levels. In all, 479 patients were treated with a 68-month median follow-up. The 5-year biochemical disease-free survivals for the 74 Gy, 76 Gy, and 78 Gy groups were 87.8%, 86.9%, and 91.6%, respectively. The metastasis-free survivals were 95.5%, 94.5%, and 93.9%, respectively, and the prostate cancer-specific survivals were 100%, 94.4%, and 98.1%, respectively. Dose escalation had no impact on any outcome in either univariate or multivariate analysis. There was no benefit of DE-EBRT >74 Gy in our cohort of high-risk prostate patients treated with long-term ADT. As dose escalation has higher risks of radiotherapy-induced toxicity, it may be feasible to omit dose escalation beyond 74 Gy in this group of patients. Randomized studies evaluating dose escalation for high-risk patients receiving ADT should be considered.

Risk factors for high blood pressure in women attending menopause clinics in Italy.

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2006-01-10

We analysed risk factors for high blood pressure (BP) among women around menopause. Eligible women were consecutively attending first-level outpatient menopause clinics in Italy for general counseling or treatment of menopausal symptoms. During the visit BP was measured three times. The mean of second and third of the three diastolic BP values for women was >90mm of mercury and/or reporting any current pharmacological treatment for high BP were considered hypertensive. Out of 45,204 women who entered the study with information on blood pressure, 12,150 had high BP. The odds ratios (OR) of high BP increased with age: in comparison with women aged or =58, respectively. Women with high BP were less educated than those without (OR education >12 versus 26. In comparison with women reporting no regular physical activity, the multivariate OR of high BP was 0.93 (95% CI, 0.87-0.99) for women reporting regular activity. In comparison with peri-menopausal women, post-menopausal women were at increased risk (OR 1.14, 95% CI, 1.03-1.24) and the risk tended to increase with age at menopause. Current use of hormonal replacement therapy (HRT) was associated with a lower risk of high BP (OR 0.88, 95% CI, 0.84-0.94). This large cross-sectional study suggests that, after taking into account the effect of age, post-menopausal women are at greater risk of high BP, but current HRT use slightly lowers the risk. Other determinants of high BP were low level of education, overweight, and low level of physical activity.

[Risk groups in travel to tropical countries within the frame of mass tourism].

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van der Linde, F; Steffen, R; Schwarzenbach, F H

1977-01-01

More than 10,000 tourists returning from tropical countries have been asked about health problems during their stay abroad. Preliminary results from the first 5,550 questionnaires indicate that 74,8% had complaints of any kind concerning their health and 13,6% can be considered as having been ill. The frequency of complaints and illness in relation to different variables is shown and the possibility of definition of high risk groups is being discussed.

Theory of Mind Impairments in Youth at Clinical High Risk of Psychosis.

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Zhang, TianHong; Tang, YingYing; Cui, HuiRu; Lu, Xi; Xu, LiHua; Liu, XiaoHua; Li, HuiJun; Chow, Annabelle; Du, YaSong; Li, ChunBo; Jiang, KaiDa; Xiao, ZePing; Wang, JiJun

2016-01-01

The normal maturational processes of theory of mind (ToM) capacity are ongoing during adolescence and even early adulthood. However, research has shown that ToM ability also declines among adults suffering from prodromal psychotic experiences. The goal of this study was to investigate the characteristics of ToM performance in youth with clinical high risk (CHR) of psychosis. The Reading Mind in Eyes Task (RMET), including own-race and other-race eyes, was administered to 40 CHR youth; 42 age-, gender-, and education-matched healthy controls (HCs); and 62 adult patients with schizophrenia (SZ). Nine-month follow-up data were collected from 31 CHR subjects, of whom 7 (22.6%) had made the transition to psychosis. CHR youth showed significant impairment in RMET performance compared to HC youth but performed better than did SZ patients. Moreover, they were significantly slower than were HC youth in responding to the RMET, with a response time similar to that of SZ patients. In particular, they had significantly poorer accuracy in interpreting positive and neutral eye expressions compared to the HC group, but not in interpreting negative eye expressions. Preliminary follow-up data showed a trend toward significance (p = 0.079) for RMET performance between those who transitioned to psychosis and those who did not. Our findings illustrate that deficits in ToM capacity, specifically the ability to interpret people's mental state from eye expressions, occur early on in prodromal psychosis in youth. Early interventions for CHR youth focusing on ToM enhancement may halt progress toward psychosis.

A Proactive Approach to High Risk Delirium Patients Undergoing Total Joint Arthroplasty.

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Duque, Andres F; Post, Zachary D; Orozco, Fabio R; Lutz, Rex W; Ong, Alvin C

2018-04-01

Delirium is a common complication among elderly patients undergoing total joint arthroplasty (TJA). Its incidence has been reported from 4% to 53%. The Centers for Medicare and Medicaid Services consider delirium following TJA a "never-event." The purpose of this study is to evaluate a simple perioperative protocol used to identify delirium risk patients and prevent its incidence following TJA. Our group developed a protocol to identify and prevent delirium in patients undergoing TJA. All patients were screened and scored in the preoperative assessment, on criteria such as age, history of forgetfulness, history of agitation or visual hallucinations, history of falls, history of postoperative confusion, and inability to perform higher brain functions. Patients were scored on performance in a simple mental examination. The patients were classified as low, medium, or high risk. Patients who were identified as high risk were enrolled in a delirium avoidance protocol that minimized narcotics and emphasized nursing involvement and fluids administration. Five of 7659 (0.065%) consecutive TJA patients from 2010 to 2015 developed delirium. A total of 422 patients were identified as high risk. All 5 patients who suffered delirium were within the high risk group. No low or medium risk patients suffered a delirium complication. Three (0.039%) patients suffered drug-induced delirium, 1 (0.013%) had delirium related to alcohol withdrawal, and 1 (0.013%) had delirium after a systemic infection. This protocol is effective in identifying patients at high delirium risk and diminishing the incidence of this complication by utilizing a simple screening tool and perioperative protocol. Copyright © 2017 Elsevier Inc. All rights reserved.

Common approach of risks analysis