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Sample records for incidence rates stratified

  1. Decreasing incidence rates of bacteremia

    DEFF Research Database (Denmark)

    Nielsen, Stig Lønberg; Pedersen, C; Jensen, T G

    2014-01-01

    BACKGROUND: Numerous studies have shown that the incidence rate of bacteremia has been increasing over time. However, few studies have distinguished between community-acquired, healthcare-associated and nosocomial bacteremia. METHODS: We conducted a population-based study among adults with first......-acquired, 50.0 for healthcare-associated and 66.7 for nosocomial bacteremia. During 2000-2008, the overall incidence rate decreased by 23.3% from 254.1 to 198.8 (3.3% annually, p ...) and the incidence rate of nosocomial bacteremia decreased by 28.9% from 82.2 to 56.0 (4.2% annually, p

  2. Age-adjusted cancer incidence rates by county and year, 1999-2009

    Data.gov (United States)

    California Environmental Health Tracking Program — This dataset contains age-adjusted incidence rates for 26 malignancy/age group/gender combinations for the years 1999-2009. These data are stratified by year and...

  3. Prostate cancer incidence rates in Africa.

    Science.gov (United States)

    Chu, Lisa W; Ritchey, Jamie; Devesa, Susan S; Quraishi, Sabah M; Zhang, Hongmei; Hsing, Ann W

    2011-01-01

    African American men have among the highest prostate cancer incidence rates in the world yet rates among their African counterparts are unclear. In this paper, we compared reported rates among black men of Sub-Saharan African descent using data from the International Agency for Research on Cancer (IARC) and the National Cancer Institute Surveillance, Epidemiology, and End Results Program for 1973-2007. Although population-based data in Africa are quite limited, the available data from IARC showed that rates among blacks were highest in the East (10.7-38.1 per 100,000 man-years, age-adjusted world standard) and lowest in the West (4.7-19.8). These rates were considerably lower than those of 80.0-195.3 observed among African Americans. Rates in Africa increased over time (1987-2002) and have been comparable to those for distant stage in African Americans. These patterns are likely due to differences between African and African American men in medical care access, screening, registry quality, genetic diversity, and Westernization. Incidence rates in Africa will likely continue to rise with improving economies and increasing Westernization, warranting the need for more high-quality population-based registration to monitor cancer incidence in Africa.

  4. Using age-stratified incidence data to examine the transmission consequences of pertussis vaccination

    Directory of Open Access Journals (Sweden)

    J.C. Blackwood

    2016-09-01

    Full Text Available Pertussis is a highly infectious respiratory disease that has been on the rise in many countries worldwide over the past several years. The drivers of this increase in pertussis incidence remain hotly debated, with a central and long-standing hypothesis that questions the ability of vaccines to eliminate pertussis transmission rather than simply modulate the severity of disease. In this paper, we present age-structured case notification data from all provinces of Thailand between 1981 and 2014, a period during which vaccine uptake rose substantially, permitting an evaluation of the transmission impacts of vaccination. Our analyses demonstrate decreases in incidence across all ages with increased vaccine uptake – an observation that is at odds with pertussis case notification data in a number of other countries. To explore whether these observations are consistent with a rise in herd immunity and a reduction in bacterial transmission, we analyze an age-structured model that incorporates contrasting hypotheses concerning the immunological and transmission consequences of vaccines. Our results lead us to conclude that the most parsimonious explanation for the combined reduction in incidence and the shift to older age groups in the Thailand data is vaccine-induced herd immunity.

  5. Management practices associated with the incidence rate of clinical mastitis.

    Science.gov (United States)

    Barkema, H W; Schukken, Y H; Lam, T J; Beiboer, M L; Benedictus, G; Brand, A

    1999-08-01

    Risk factors for the incidence rate of clinical mastitis were studied in 274 Dutch dairy herds. Variables that were associated with resistance to disease were the feeding, housing, and milking machine factors. Variables that were associated with exposure were grazing, combined housing of dry cows and heifers, and calving area hygiene. Postmilking teat disinfection in herds with a low bulk milk somatic cell count and years of practicing dry cow therapy were positively associated with the incidence rate of clinical mastitis. Herds with a low bulk milk somatic cell count and in which postmilking teat disinfection was not used had lower incidence rates of clinical mastitis than did other herds. The incidence rate of clinical mastitis caused by Escherichia coli was mostly related to housing conditions, hygiene, and machine milking. The incidence rate of clinical mastitis caused by Staphylococcus aureus was mostly related to factors associated with bulk milk somatic cell count and factors that might be due to cause and effect reversal. A strong positive correlation existed between the incidence rate of clinical mastitis caused by Streptococcus dysgalactiae and the incidence rate of clinical mastitis caused by Staph. aureus. The incidence rate of clinical mastitis caused by Streptococcus dysgalactiae was related to nutrition, milking technique, and machine milking. The incidence rate of clinical mastitis caused by Streptococcus uberis was associated with factors related to housing, nutrition, and machine milking.

  6. Gallbladder Cancer Incidence and Death Rates

    Science.gov (United States)

    ... Cancer Lung Cancer Survivors May Feel Blame Women’s Perceived and Actual Risk of Getting Cancer Colorectal Cancer ... cases) and death rates by sex, racial and ethnic group, age group, U.S. Census region, state, county-level ...

  7. Incidence Rate and Distribution of Common Cancers among Iranian Children

    Directory of Open Access Journals (Sweden)

    Salman Khazaei

    2017-01-01

    Full Text Available Background: Geographic differences in the incidence of cancers may suggest unique genetic or environmental exposures that impact the risk of acquiring cancer. This research aims to determine the incidence rate and geographical distribution of common cancers among Iranian children. Methods: In this ecological study, we extracted data that pertained to the incidence rate of common cancers among children from reports by the National Registry of Cancer and Disease Control and Prevention in 2008. A map of the cancer incidence rates was designed by using geographic information system. Results:The most common cancer sites among children were the hematology system, brain and central nervous system, and lymph nodes. The central provinces had the lowest cancer incidences. Conclusion: The considerable variation in incidence of childhood cancers in Iran suggests a possible potential environmental risk factor or genetic background related to this increased risk among children.

  8. Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates

    OpenAIRE

    Smink, Frédérique R. E.; van Hoeken, Daphne; Hoek, Hans W.

    2012-01-01

    Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increas...

  9. Incidence and frequency rates of childhood cancer in Namibia

    African Journals Online (AJOL)

    Objective. To estimate the extent of paediatric malignancy in an African country and to compare these findings wjth paediatric cancer rates in other countries. Design. A retrospective descriptive study which calculated incidence and frequency rates from the data obtained from a 6-year survey of childhood cancer in. Namibia.

  10. Incidence and mortality rates of colorectal cancer in Malaysia.

    Science.gov (United States)

    Abu Hassan, Muhammad Radzi; Ismail, Ibtisam; Mohd Suan, Mohd Azri; Ahmad, Faizah; Wan Khazim, Wan Khamizar; Othman, Zabedah; Mat Said, Rosaida; Tan, Wei Leong; Mohammed, Siti Rahmah Noor Syahireen; Soelar, Shahrul Aiman; Nik Mustapha, Nik Raihan

    2016-01-01

    This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity. The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05). CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.

  11. Incidence and mortality rates of colorectal cancer in Malaysia

    Directory of Open Access Journals (Sweden)

    Muhammad Radzi Abu Hassan

    2016-03-01

    Full Text Available OBJECTIVES This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC patients in Malaysia by sex and ethnicity. METHODS The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR was calculated as the proportion of CRC cases (incidence and deaths (mortality from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. RESULTS The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35, followed by the Malay (18.95, and Indian (17.55 ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively. The 2011 (44.7% CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46 than females (8.05. CONCLUSIONS CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.

  12. Incidence rate of clinical bovine mastitis in selected smallholder ...

    African Journals Online (AJOL)

    A study was conducted in Gondar town in six selected smallholder farms from. August 2005 to January 2006 for six months to measure incidence rate of clinical bovine mastitis. Monitoring was performed by animal attendants of each farm after training and supervision of the monitoring activities and collection of data.

  13. Epidemiology of Eating Disorders : Incidence, Prevalence and Mortality Rates

    NARCIS (Netherlands)

    Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.

    Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms

  14. Incidence rate of clinical bovine mastitis in selected smallholder ...

    African Journals Online (AJOL)

    A study was conducted in Gondar town in six selected smallholder farms from August 2005 to January 2006 for six months to measure incidence rate of clinical bovine mastitis. Monitoring was performed by animal attendants of each farm after training and supervision of the monitoring activities and collection of data was ...

  15. Incidence, 10-year recidivism rate and prognostic factors for cholesteatoma.

    Science.gov (United States)

    Britze, A; Møller, M L; Ovesen, T

    2017-04-01

    Cholesteatoma patients have a high risk of recurrence with complications, and knowledge exchange is a prerequisite for improving treatment. This study aimed to apply appropriate statistics to provide meaningful and transferable results from cholesteatoma surgery, to highlight independent prognostic factors, and to assess the incidence rate. Incidence rates were assessed for the district of Aarhus, Denmark. From 147 patients operated on mainly with canal wall up mastoidectomies for debuting cholesteatomas, 10-year Kaplan-Meier recidivism rates were calculated and independent prognostic factors for the recidivism were identified by Cox multivariate regression analyses. Incidence rate was 6.8 per 100 000 per year. The 10-year cumulative recidivism rate was 0.44 (95 per cent confidence interval, 0.37-0.53). Independent prognostic factors for the recidivism were: age below 15 years (hazard ratio = 2.2; p > z = 0.002), cholesteatoma localised to the mastoid (hazard ratio = 1.7; p > z = 0.04), stapes erosion (hazard ratio = 1.9; p > z = 0.02) and incus erosion (hazard ratio = 1.9; p > z = 0.04). The recidivism rate is influenced by several factors that are important to observe, both in the clinic and when comparing results from surgery.

  16. Incidence and vertical transmission rate of Neospora caninum in sheep.

    Science.gov (United States)

    Filho, Paulo César G A; Oliveira, Júnior M B; Andrade, Muller R; Silva, José G; Kim, Pomy C P; Almeida, Jonatas C; Porto, Wagnner J N; Mota, Rinaldo A

    2017-06-01

    The infection by Neospora caninum in sheep can lead to abortion and the birth of weak and debilitated lambs. The aim of this study was to assess the incidence of natural infection by Neospora caninum and the vertical transmission rate among sheep. A flock of 50 sheep was monitored for serum antibody titres against N. caninum and seroconversion over a period of six months using an indirect ELISA technique. The offspring of the herd was also investigated regarding anti-N. caninum antibodies to determine the vertical transmission rate through the indirect immunofluorescence technique. The initial and final prevalences of infection by N. caninum were 26.0% (13/50) and 72.0% (36/50), respectively, and the incidence of infection by N. caninum in the present study was 62.2% (23/37). The vertical transmission rate found was 15.4% (2/13). A high incidence of infection by N. caninum in sheep was observed, and this is the first report assessing the incidence of N. caninum among naturally infected sheep. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Epidemiology of eating disorders: incidence, prevalence and mortality rates.

    Science.gov (United States)

    Smink, Frédérique R E; van Hoeken, Daphne; Hoek, Hans W

    2012-08-01

    Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15-19 year old girls. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset. The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking. Compared with the other eating disorders, binge eating disorder is more common among males and older individuals.

  18. Migration and melanoma incidence rates among Washington state counties.

    Science.gov (United States)

    Chan, Victor; Thompson, Ian; Whitney, David; Switzer, Michael; Anderson, Amy D; Smits, Shelly

    2013-08-01

    The purpose of this study was to look for a possible explanation for the variation in the incidence rate of melanoma among counties in Washington state. We used data from the Washington State Cancer Registry (WSCR), the Cancer Center at PeaceHealth St. Joseph Hospital in Whatcom County, and the Surveillance, Epidemiology, and End Results registry to get information on melanoma incidence. Demographic and migration records were obtained from the US Census Bureau, the Washington State Department of Licensing (DOL), and the US Internal Revenue Service (IRS). A number of different analytic techniques were used to address our research question, including a multiple regression analysis, time trend comparisons, and an analysis of birthplace data of melanoma patients in Whatcom county. We found a significant association between migration rate from the Southwest (SW) USA and melanoma incidence (PWhatcom county, almost half of all residents were born outside of Washington state, but they accounted for about 70% of all melanoma cases. Our analyses suggest that migration from the SW is an important factor in explaining the variation in melanoma rate among counties in Washington.

  19. Incidence rate of anemia in inflammatory bowel diseases.

    Science.gov (United States)

    Atuğ, Özlen; Kani, Haluk Tarık; Banzragch, Munkhtsetseg; İmeryüz, Neşe; Akın, Hakan

    2016-03-01

    To determine the incidence rate and distribution of anemia types over time from an Inflammatory Bowel Disease (IBD) patient cohort spanning 18 years. Between January 1995 and November 2013, the University Hospital digital databases as well as hard copies of patients' files were reviewed retrospectively. IBD patients with at least one complete blood count (CBC) report were included in this study. We obtained 941 IBD patients' records; 375 (39.9%) patients were diagnosed with Crohn's disease (CD), and 566 (60.1%) patients had ulcerative colitis (UC). Anemia was detected in 548 (58.2%) patients. Female patients were more frequently anemic than male patients (68.4% vs. 49.7%, p=0.001). The frequency of anemia was slightly higher in patients with CD (62.1%) than in patients with UC (55.7%) (p=0.04). The incidence rate of anemia for the entire IBD patient cohort was calculated as 103.45 per 1,000 patient-years. The correlation between the age of the IBD disease and the presence of anemia exhibited a high correlation coefficient of Pearson's r=0.702. This is the first study to report the incidence rate of anemia (103.45 per 1,000 patient-years) in a long-term cohort of IBD patients.

  20. Cumulative incidence rates of the mucopolysaccharidoses in Germany.

    Science.gov (United States)

    Baehner, F; Schmiedeskamp, C; Krummenauer, F; Miebach, E; Bajbouj, M; Whybra, C; Kohlschütter, A; Kampmann, C; Beck, M

    2005-01-01

    In order to estimate the cumulative incidence rates of the mucopolysaccharidoses (MPS) in Germany, a retrospective epidemiological survey covering the period between 1980 and 1995 was implemented. Multiple ascertainment sources were used to identify affected patients. A prevalence of approximately 0.69 cases per 100,000 births was obtained for MPS I (Hurler phenotype). Within the study period, 4 patients with Hurler/Scheie phenotype and 7 cases with Scheie disease were detected. The cumulative incidence for MPS II (Hunter syndrome) was estimated as 0.64 cases per 100,000 births (1.3 cases per 100,000 male live births); that for MPS III (Sanfilippo syndrome types A, B and C) as 1.57 cases in 100,000 births; that for MPS IV A (Morquio syndrome) as 0.38 cases in 100,000; and that for MPS VI (Maroteaux-Lamy syndrome) as 0.23 cases per 100,000 births. Two cases of MPS IVB (beta-galactosidase deficiency) have been identified, but no patients with MPS VII or MPS IX. A relatively high number of patients with MPS IIIB, MPS IVA and MPS VI were of Turkish origin. The crude rate for all types of mucopolysaccharidoses is approximately 3.53 cases in 100,000 live births. The cumulative incidence pattern of MPS in Germany was compared with the corresponding rates among other industrial nations obtained from recent literature: the crude cumulative rates for all types of mucopolysaccharidoses (3.4-4.5 in 100,000 live births) were similar among all published populations; however, different frequencies of the various forms of MPS were observed.

  1. Modeling a SI epidemic with stochastic transmission: hyperbolic incidence rate.

    Science.gov (United States)

    Christen, Alejandra; Maulén-Yañez, M Angélica; González-Olivares, Eduardo; Curé, Michel

    2018-03-01

    In this paper a stochastic susceptible-infectious (SI) epidemic model is analysed, which is based on the model proposed by Roberts and Saha (Appl Math Lett 12: 37-41, 1999), considering a hyperbolic type nonlinear incidence rate. Assuming the proportion of infected population varies with time, our new model is described by an ordinary differential equation, which is analogous to the equation that describes the double Allee effect. The limit of the solution of this equation (deterministic model) is found when time tends to infinity. Then, the asymptotic behaviour of a stochastic fluctuation due to the environmental variation in the coefficient of disease transmission is studied. Thus a stochastic differential equation (SDE) is obtained and the existence of a unique solution is proved. Moreover, the SDE is analysed through the associated Fokker-Planck equation to obtain the invariant measure when the proportion of the infected population reaches steady state. An explicit expression for invariant measure is found and we study some of its properties. The long time behaviour of deterministic and stochastic models are compared by simulations. According to our knowledge this incidence rate has not been previously used for this type of epidemic models.

  2. A comparison of surveillance methods for small incidence rates

    Energy Technology Data Exchange (ETDEWEB)

    Sego, Landon H.; Woodall, William H.; Reynolds, Marion R.

    2008-05-15

    A number of methods have been proposed to detect an increasing shift in the incidence rate of a rare health event, such as a congenital malformation. Among these are the Sets method, two modifcations of the Sets method, and the CUSUM method based on the Poisson distribution. We consider the situation where data are observed as a sequence of Bernoulli trials and propose the Bernoulli CUSUM chart as a desirable method for the surveillance of rare health events. We compare the performance of the Sets method and its modifcations to the Bernoulli CUSUM chart under a wide variety of circumstances. Chart design parameters were chosen to satisfy a minimax criteria.We used the steady- state average run length to measure chart performance instead of the average run length which was used in nearly all previous comparisons involving the Sets method or its modifcations. Except in a very few instances, we found that the Bernoulli CUSUM chart has better steady-state average run length performance than the Sets method and its modifcations for the extensive number of cases considered.

  3. Minimal and maximal incidence rates of skin cancer in Caucasians estimated by use of sigmoidal UV dose-incidence curves.

    Science.gov (United States)

    Juzeniene, Asta; Grigalavicius, Mantas; Baturaite, Zivile; Moan, Johan

    2014-11-01

    Sigmoidal (S-shaped) dose-cancer incidence relationships are often observed in animal bioassays for carcinogenicity. Ultraviolet (UV) radiation is an established skin carcinogen. The aim of this study is to examine if S-shaped curves describe the relationship between solar UV doses and skin cancer incidences, and if such relationships can be used to estimate threshold levels of non-carcinogenic UV exposure, as well as maximal incidence rates. We studied the incidence rate-annual erythema-effective UV dose relationship for squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and cutaneous melanoma (CM) among different Caucasian populations in Europe, Australia and New Zealand. Our analysis indicates that S-shaped associations describe the data well (P skin cancer was absent. Avoidance of UV radiation has a potential to reduce the incidence of skin cancer in fair-skinned population. Copyright © 2014 Elsevier GmbH. All rights reserved.

  4. Segmented polynomials for incidence rate estimation from prevalence data.

    Science.gov (United States)

    Mahiané, Severin Guy; Laeyendecker, Oliver

    2017-01-30

    The study considers the problem of estimating incidence of a non remissible infection (or disease) with possibly differential mortality using data from a(several) cross-sectional prevalence survey(s). Fitting segmented polynomial models is proposed to estimate the incidence as a function of age, using the maximum likelihood method. The approach allows automatic search for optimal position of knots, and model selection is performed using the Akaike information criterion. The method is applied to simulated data and to estimate HIV incidence among men in Zimbabwe using data from both the NIMH Project Accept (HPTN 043) and Zimbabwe Demographic Health Surveys (2005-2006). Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  5. Tuberculosis incidence rates during 8 years of follow-up of an antiretroviral treatment cohort in South Africa: comparison with rates in the community.

    Directory of Open Access Journals (Sweden)

    Ankur Gupta

    Full Text Available Although antiretroviral therapy (ART is known to be associated with time-dependent reductions in tuberculosis (TB incidence, the long-term impact of ART on incidence remains imprecisely defined due to limited duration of follow-up and incomplete CD4 cell count recovery in existing studies. We determined TB incidence in a South African ART cohort with up to 8 years of follow-up and stratified rates according to CD4 cell count recovery. We compared these rates with those of HIV-uninfected individuals living in the same community.Prospectively collected clinical data on patients receiving ART in a community-based cohort in Cape Town were analysed. 1544 patients with a median follow-up of 5.0 years (IQR 2.4-5.8 were included in the analysis. 484 episodes of incident TB (73.6% culture-confirmed were diagnosed in 424 patients during 6506 person-years (PYs of follow-up. The TB incidence rate during the first year of ART was 12.4 (95% CI 10.8-14.4 cases/100PYs and decreased to 4.92 (95% CI 3.64-8.62 cases/100PYs between 5 and 8 years of ART. During person-time accrued within CD4 cell strata 0-100, 101-200, 201-300, 301-400, 401-500, 501-700 and ≥700 cells/µL, TB incidence rates (95% CI were 25.5 (21.6-30.3, 11.2 (9.4-13.5, 7.9 (6.4-9.7, 5.0 (3.9-6.6, 5.1 (3.8-6.8, 4.1 (3.1-5.4 and 2.7 (1.7-4.5 cases/100PYs, respectively. Overall, 75% (95% CI 70.9-78.8 of TB episodes were recurrent cases. Updated CD4 cell count and viral load measurements were independently associated with long-term TB risk. TB rates during person-time accrued in the highest CD4 cell count stratum (>700 cells/µL were 4.4-fold higher that the rate in HIV uninfected individuals living in the same community (2.7 versus 0.62 cases/100PYs; 95%CI 0.58-0.65.TB rates during long-term ART remained substantially greater than rates in the local HIV uninfected populations regardless of duration of ART or attainment of CD4 cell counts exceeding 700 cells/µL.

  6. Tuberculosis incidence rates during 8 years of follow-up of an antiretroviral treatment cohort in South Africa: comparison with rates in the community.

    Science.gov (United States)

    Gupta, Ankur; Wood, Robin; Kaplan, Richard; Bekker, Linda-Gail; Lawn, Stephen D

    2012-01-01

    Although antiretroviral therapy (ART) is known to be associated with time-dependent reductions in tuberculosis (TB) incidence, the long-term impact of ART on incidence remains imprecisely defined due to limited duration of follow-up and incomplete CD4 cell count recovery in existing studies. We determined TB incidence in a South African ART cohort with up to 8 years of follow-up and stratified rates according to CD4 cell count recovery. We compared these rates with those of HIV-uninfected individuals living in the same community. Prospectively collected clinical data on patients receiving ART in a community-based cohort in Cape Town were analysed. 1544 patients with a median follow-up of 5.0 years (IQR 2.4-5.8) were included in the analysis. 484 episodes of incident TB (73.6% culture-confirmed) were diagnosed in 424 patients during 6506 person-years (PYs) of follow-up. The TB incidence rate during the first year of ART was 12.4 (95% CI 10.8-14.4) cases/100PYs and decreased to 4.92 (95% CI 3.64-8.62) cases/100PYs between 5 and 8 years of ART. During person-time accrued within CD4 cell strata 0-100, 101-200, 201-300, 301-400, 401-500, 501-700 and ≥700 cells/µL, TB incidence rates (95% CI) were 25.5 (21.6-30.3), 11.2 (9.4-13.5), 7.9 (6.4-9.7), 5.0 (3.9-6.6), 5.1 (3.8-6.8), 4.1 (3.1-5.4) and 2.7 (1.7-4.5) cases/100PYs, respectively. Overall, 75% (95% CI 70.9-78.8) of TB episodes were recurrent cases. Updated CD4 cell count and viral load measurements were independently associated with long-term TB risk. TB rates during person-time accrued in the highest CD4 cell count stratum (>700 cells/µL) were 4.4-fold higher that the rate in HIV uninfected individuals living in the same community (2.7 versus 0.62 cases/100PYs; 95%CI 0.58-0.65). TB rates during long-term ART remained substantially greater than rates in the local HIV uninfected populations regardless of duration of ART or attainment of CD4 cell counts exceeding 700 cells/µL.

  7. The Incidence Rate of Inflammatory Bowel Disease in an Urban Area of Iran: A Developing Country

    OpenAIRE

    Zahedi, Mohammad Javad; Darvish Moghadam, Sodaif; Hayat Bakhsh Abbasi, Mehdi; Dehghani, Masood; Shafiei pour, Sara; Zydabady nejad, Hamideh; Broumand, Kiekam

    2014-01-01

    BACKGROUND The incidence of inflammatory bowel disease (IBD) varies among different societies. The aim of this study is to determine the incidence rate of IBD in Kerman, a city in Southeast Iran. METHODS All medical records that indicated a new diagnosis of ulcerative colitis (UC) or Crohn’s disease (CD) were retrieved from the gastrointestinal endoscopy and pathology departments of 12 centers from October 2011 to September 2012. RESULTS The incidence rate of UC in Kerman was estimated at 4.9...

  8. Work-related ill health in doctors working in Great Britain: incidence rates and trends.

    Science.gov (United States)

    Zhou, Anli Yue; Carder, Melanie; Gittins, Matthew; Agius, Raymond

    2017-11-01

    Background Doctors have a higher prevalence of mental ill health compared with other professional occupations but incidence rates are poorly studied. Aims To determine incidence rates and trends of work-related ill health (WRIH) and work-related mental ill health (WRMIH) in doctors compared with other professions in Great Britain. Method Incidence rates were calculated using an occupational physician reporting scheme from 2005-2010. Multilevel regression was use to study incidence rates from 2001 to 2014. Results Annual incidence rates for WRIH and WRIMH in doctors were 515 and 431 per 100 000 people employed, respectively. Higher incidence rates for WRIH and WRMIH were observed for ambulance staff and nurses, respectively. Doctors demonstrated an annual average incidence rates increase for WRIH and WRMIH, especially in women, whereas the other occupations demonstrated a decreasing or static trend. The difference in trends between the occupations was statistically significant. Conclusions WRIH and WRMIH incidence rate are increasing in doctors, especially in women, warranting further research. © The Royal College of Psychiatrists 2017.

  9. Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006

    Science.gov (United States)

    Kirkcaldy, Robert D.; Gift, Thomas L.; Owusu-Edusei, Kwame; Weinstock, Hillard S.

    2014-01-01

    Antimicrobial drug resistance can hinder gonorrhea prevention and control efforts. In this study, we analyzed historical ciprofloxacin resistance data and gonorrhea incidence data to examine the possible effect of antimicrobial drug resistance on gonorrhea incidence at the population level. We analyzed data from the Gonococcal Isolate Surveillance Project and city-level gonorrhea incidence rates from surveillance data for 17 cities during 1991–2006. We found a strong positive association between ciprofloxacin resistance and gonorrhea incidence rates at the city level during this period. Their association was consistent with predictions of mathematical models in which resistance to treatment can increase gonorrhea incidence rates through factors such as increased duration of infection. These findings highlight the possibility of future increases in gonorrhea incidence caused by emerging cephalosporin resistance. PMID:24655615

  10. Urological complications after radical hysterectomy: Incidence rates and predisposing factors

    Directory of Open Access Journals (Sweden)

    Likić-Lađević Ivana

    2007-01-01

    Full Text Available Bacground/Aim. Radical hysterectomy is a surgical approach for stage Ib and IIa of cervical cancer. The incidence of intraoperative injuries of the bladder during radical hysterectomy ranges from 0.4-3.7%. The ureter can be crushed, caught in sutures, transsected, obstructed by angulation, or ischemic by the stippling or periureteric fascia. Vesicovaginal and ureterovaginal fistuls are reported to develop in 0.9-2% of patients after radical abdominal hysterectomy. Fistulas usually become manifested or visible at speculum examination within 14 days following the surgery. The aim of this study was to establish the incidence and predisposing factor of urological complications after radical hysterectomy. Methods. The study included a total of 536 patients with invasive stage Ib to IIb cancer of the cervix uteri who had underwent radical hysterectomy. The special elements considered were: the patient’s age; the International Federation of Ginecology and Obstetrics (FIGO stage after pathohistology; duration of operation; the result of preoperative laboratory tests for diabetes, anemia, hypoproteinemia, or disorders of liver or kidney function; ASA status; postoperative surgical infection. Results. The average age of the patients with complications was 48.68 years. All patients with intraoperative ureteric and bladder injuries had statisticaly significant higher stage of disease and operation lasted more than in others without injury. We noticed 1.3% ureteral injuries and 1.49% bladder injuries, more than 50% of the patients with a previously mentioned injuries were operated on more than 3 hours. We found 2.61% vesicovaginal and 2.43% ureterovaginal fistuls. A total of 50% of the patients with bladder injury and vesicovaginal fistuls and 70% of the patients with ureterovaginal fistuls had diabetes mellitus. Postoperative infection of surgical site is a very important factor for the development of fistule. Half of the patients with vesicovaginal

  11. Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011

    Directory of Open Access Journals (Sweden)

    Yeerae Kim

    2015-02-01

    Full Text Available Stomach cancer is the second most common cancer in Eastern Asia, accounting for approximately 50% of all new cases of stomach cancer worldwide. Our objective was to compare the stomach cancer incidence rates of Asian Americans in Los Angeles with those of native Asians to assess the etiology of stomach cancer from 1988 to 2011. To examine these differences, Asian Americans (Korean, Japanese, Chinese, and Filipino Americans living in Los Angeles, California, USA and native Asians (from Korea, Japan, China, and the Philippines were selected for this study. Using the Cancer Incidence in Five Continents database, stomach cancer incidence rates were examined. Data from the National Cancer Registry of Korea were used for native Koreans. Between native countries, the incidence rates in Japan, China, the Philippines, and the US declined over time, but the incidence in Korea has remained constant. The incidences among Asian immigrants were lower than those among native Asians. The incidence rates of males were approximately 2 times higher than those among females in Asian countries were. The effect of immigration on stomach cancer incidence suggests that lifestyle factors are a significant determinant of stomach cancer risk. However, the incidence in Korea remains the highest of these countries

  12. Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011.

    Science.gov (United States)

    Kim, Yeerae; Park, Jinju; Nam, Byung-Ho; Ki, Moran

    2015-01-01

    Stomach cancer is the second most common cancer in Eastern Asia, accounting for approximately 50% of all new cases of stomach cancer worldwide. Our objective was to compare the stomach cancer incidence rates of Asian Americans in Los Angeles with those of native Asians to assess the etiology of stomach cancer from 1988 to 2011. To examine these differences, Asian Americans (Korean, Japanese, Chinese, and Filipino Americans living in Los Angeles, California, USA) and native Asians (from Korea, Japan, China, and the Philippines) were selected for this study. Using the Cancer Incidence in Five Continents database, stomach cancer incidence rates were examined. Data from the National Cancer Registry of Korea were used for native Koreans. Between native countries, the incidence rates in Japan, China, the Philippines, and the US declined over time, but the incidence in Korea has remained constant. The incidences among Asian immigrants were lower than those among native Asians. The incidence rates of males were approximately 2 times higher than those among females in Asian countries were. The effect of immigration on stomach cancer incidence suggests that lifestyle factors are a significant determinant of stomach cancer risk. However, the incidence in Korea remains the highest of these countries.

  13. Depression and unemployment incidence rate evolution in Portugal, 1995-2013: General Practitioner Sentinel Network data.

    Science.gov (United States)

    Rodrigues, Ana Paula; Sousa-Uva, Mafalda; Fonseca, Rita; Marques, Sara; Pina, Nuno; Matias-Dias, Carlos

    2017-11-17

    Quantify, for both genders, the correlation between the depression incidence rate and the unemployment rate in Portugal between 1995 and 2013. An ecological study was developed to correlate the evolution of the depression incidence rates estimated by the General Practitioner Sentinel Network and the annual unemployment rates provided by the National Statistical Institute in official publications. There was a positive correlation between the depression incidence rate and the unemployment rate in Portugal, which was significant only for males (R2 = 0.83, p = 0.04). For this gender, an increase of 37 new cases of depression per 100,000 inhabitants was estimated for each 1% increase in the unemployment rate between 1995 and 2013. Although the study design does not allow the establishment of a causal association between unemployment and depression, the results suggest that the evolution of unemployment in Portugal may have had a significant impact on the level of mental health of the Portuguese, especially among men.

  14. Daylight Savings Time Transitions and the Incidence Rate of Unipolar Depressive Episodes

    DEFF Research Database (Denmark)

    Hansen, Bertel Teilfeldt; Sønderskov, Kim Mannemar; Hageman, Ida

    2017-01-01

    : Using time series intervention analysis of nationwide data from the Danish Psychiatric Central Research Register from 1995 to 2012, we compared the observed trend in the incidence rate of hospital contacts for unipolar depressive episodes after the transitions to and from summer time to the predicted...... trend in the incidence rate. Results: The analyses were based on 185,419 hospital contacts for unipolar depression and showed that the transition from summer time to standard time were associated with an 11% increase (95% CI = 7%, 15%) in the incidence rate of unipolar depressive episodes......Background: Daylight savings time transitions affect approximately 1.6 billion people worldwide. Prior studies have documented associations between daylight savings time transitions and adverse health outcomes, but it remains unknown whether they also cause an increase in the incidence rate...

  15. Regional geographic variations in kidney cancer incidence rates in European countries.

    Science.gov (United States)

    Li, Peng; Znaor, Ariana; Holcatova, Ivana; Fabianova, Eleonora; Mates, Dana; Wozniak, Magdalena B; Ferlay, Jacques; Scelo, Ghislaine

    2015-06-01

    Marked unexplained national variations in incidence rates of kidney cancer have been observed for decades in Europe. To investigate geographic variations at the regional level and identify European regions with high incidence rates of kidney cancer. Regional- and national-level incidence data were extracted from the Cancer Incidence in Five Continents databases, local cancer registry databases, and local published reports. World population age-standardised rates (ASRs) were calculated for the periods 2003-2007 and 1988-1992. Rates by period and sex were compared using map visualisation. During 2003-2007, the highest ASR was found in the Plzen region, Czech Republic (31.4/100,000 person-years in men). Other regions of the Czech Republic had ASRs of 18.6-27.5/100,000 in men, with a tendency for higher rates in regions south of Prague. Surrounding regions, including eastern Germany and regions of Slovakia and Austria, had medium-to-high incidence rates (13.0-16.8/100,000 in men). Three other areas in Europe showed higher incidence rates in men compared with the rest of the continent: Lithuania, Estonia, Latvia, and Belarus (15.0-17.6/100,000); Iceland (13.5/100,000), and northern Italy (up to 16.0/100,000). Similar regional differences were observed among women, with rates approximately half of those observed in men in the same region. In general, these regional geographic variations remained stable over the periods 1988-1992 and 2003-2007, although higher incidence rates were detected in the Baltic countries in 2003-2007. Several European regions show particularly high rates of kidney cancer incidence. Large variations were observed within countries covered by national health-care systems, implying that overdetection is not the major factor. We present regional geographic variations in kidney cancer incidence rates in Europe. We highlight several regions with high incidence rates where further studies should be conducted for cancer control and prevention. Copyright

  16. Daylight Savings Time Transitions and the Incidence Rate of Unipolar Depressive Episodes.

    Science.gov (United States)

    Hansen, Bertel T; Sønderskov, Kim M; Hageman, Ida; Dinesen, Peter T; Østergaard, Søren D

    2017-05-01

    Daylight savings time transitions affect approximately 1.6 billion people worldwide. Prior studies have documented associations between daylight savings time transitions and adverse health outcomes, but it remains unknown whether they also cause an increase in the incidence rate of depressive episodes. This seems likely because daylight savings time transitions affect circadian rhythms, which are implicated in the etiology of depressive disorder. Therefore, we investigated the effects of daylight savings time transitions on the incidence rate of unipolar depressive episodes. Using time series intervention analysis of nationwide data from the Danish Psychiatric Central Research Register from 1995 to 2012, we compared the observed trend in the incidence rate of hospital contacts for unipolar depressive episodes after the transitions to and from summer time to the predicted trend in the incidence rate. The analyses were based on 185,419 hospital contacts for unipolar depression and showed that the transition from summer time to standard time were associated with an 11% increase (95% CI = 7%, 15%) in the incidence rate of unipolar depressive episodes that dissipated over approximately 10 weeks. The transition from standard time to summer time was not associated with a parallel change in the incidence rate of unipolar depressive episodes. This study shows that the transition from summer time to standard time was associated with an increase in the incidence rate of unipolar depressive episodes. Distress associated with the sudden advancement of sunset, marking the coming of a long period of short days, may explain this finding. See video abstract at, http://links.lww.com/EDE/B179.

  17. Gender-age interaction in incidence rates of childhood emotional disorders

    DEFF Research Database (Denmark)

    Wesselhoeft, R; Mortensen, P B; Mors, O

    2014-01-01

    .24-2.43) for boys and 3.77% (95% CI 3.64-3.90) for girls. The pre-pubertal male preponderance was also significant for depressive disorders (F32-F33, p = 0.00144) and anxiety disorders (F40-F42, F93, p separately. CONCLUSIONS: Emotional disorders seem to display a male preponderance before the age of 12...... were incidence rates and cumulative incidences for unipolar depressive disorder (ICD-10: F32-F33), anxiety disorders (ICD-10: F40-F42), and emotional disorders with onset specific to childhood (ICD-10: F93). RESULTS: Pre-pubertal incidence rates for depressive and anxiety disorders were higher for boys......BACKGROUND: The post-pubertal association of female gender with emotional disorder is a robust finding. However, studies exploring the association of gender and emotional disorders before puberty are few and present diverging results. The aim of this study was to present gender-specific incidence...

  18. Incidence and progression rates of age-related maculopathy: the Rotterdam Study

    NARCIS (Netherlands)

    J.J.M. Willemse-Assink (Jacqueline); R. van Leeuwen (Redmer); R.C.W. Wolfs (Roger); J.R. Vingerling (Hans); Th. Stijnen (Theo); P.T.V.M. de Jong (Paulus); C.C.W. Klaver (Caroline); A. Hofman (Albert)

    2001-01-01

    textabstractPURPOSE: To describe the incidence rate of age-related macular degeneration (AMD) and the progression rates of early stages of age-related maculopathy (ARM), and to study the hierarchy of fundus features that determine progression. METHODS: A group of 4953 subjects

  19. An update in international trends in incidence rates of thyroid cancer, 1973-2007.

    Science.gov (United States)

    James, Benjamin C; Mitchell, Janeil M; Jeon, Heedo D; Vasilottos, Nektarios; Grogan, Raymon H; Aschebrook-Kilfoy, Briseis

    2018-04-05

    Over the past several decades, there has been a reported increase in the incidence of thyroid cancer in many countries. We previously reported an increase in thyroid cancer incidence across continents between 1973 and 2002. Here, we provide an update on the international trends in thyroid cancer between 2003 and 2007. We examined thyroid cancer incidence data from the Cancer Incidence in Five Continents (CI5) database for the period between 1973 and 2007 from 24 populations in the Americas, Asia, Europe, Africa and Oceania, and report on the time trends as well as the distribution by histologic type and gender worldwide. The incidence of thyroid cancer increased during the period from 1998-2002 to 2003-2007 in the majority of populations examined, with the highest rates observed among women, most notably in Israel and the United States SEER registry, at over 14 per 100,000 people. This update suggests that incidence is rising in a similar fashion across all regions of the world. The histologic and gender distributions in the updated CI5 are consistent with the previous report. Our analysis of the published CI5 data illustrates that the incidence of thyroid cancer increased between 1998-2002 and 2003-2007 in most populations worldwide, and rising rates continue in all regions of the world.

  20. Prevalence and incidence rate of injuries in runners at a local athletic club in Cape Town

    Directory of Open Access Journals (Sweden)

    C. Hendricks

    2013-12-01

    Full Text Available People across the world are running on a daily basis to improvetheir health status. However, running can predispose an individual to injuryto the back and lower limb. Baseline data on prevalence, incidence rate ofinjury and aetiological factors associated with running injuries are neededby physiotherapists to develop and implement effective prevention programmesto allow optimal performance in runners. Thus, the purpose of this study wasto determine the prevalence and incidence of injuries in runners at a localathletic club.Methods: A prospective, non-experimental cohort study was conductedover a 16 week period. A sample of 50 runners completed a self-administeredquestionnaire and an injury report form recording injuries sustained during the 16 week study period. Injury prevalence andcumulative incidence was calculated as a proportion rate along with 95% confidence interval.Results: The prevalence rate of injuries was 32%. The incidence rate of injuries was 0.67 per 1000km run (95% CI: 0.41- 1.08.The most common anatomical sites for new injuries were the calf (20% and the knee (18%.Conclusions: The study found a moderate prevalence and incidence rate of injury in runners, thus the need for physiotherapyledinjury surveillance and prevention programmes have been highlighted.

  1. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women.

    Science.gov (United States)

    DeSantis, Carol E; Fedewa, Stacey A; Goding Sauer, Ann; Kramer, Joan L; Smith, Robert A; Jemal, Ahmedin

    2016-01-01

    In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including data on incidence, mortality, survival, and screening. Approximately 231,840 new cases of invasive breast cancer and 40,290 breast cancer deaths are expected to occur among US women in 2015. Breast cancer incidence rates increased among non-Hispanic black (black) and Asian/Pacific Islander women and were stable among non-Hispanic white (white), Hispanic, and American Indian/Alaska Native women from 2008 to 2012. Although white women have historically had higher incidence rates than black women, in 2012, the rates converged. Notably, during 2008 through 2012, incidence rates were significantly higher in black women compared with white women in 7 states, primarily located in the South. From 1989 to 2012, breast cancer death rates decreased by 36%, which translates to 249,000 breast cancer deaths averted in the United States over this period. This decrease in death rates was evident in all racial/ethnic groups except American Indians/Alaska Natives. However, the mortality disparity between black and white women nationwide has continued to widen; and, by 2012, death rates were 42% higher in black women than in white women. During 2003 through 2012, breast cancer death rates declined for white women in all 50 states; but, for black women, declines occurred in 27 of 30 states that had sufficient data to analyze trends. In 3 states (Mississippi, Oklahoma, and Wisconsin), breast cancer death rates in black women were stable during 2003 through 2012. Widening racial disparities in breast cancer mortality are likely to continue, at least in the short term, in view of the increasing trends in breast cancer incidence rates in black women. © 2015 American Cancer Society.

  2. Incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in Danish and Swedish children

    DEFF Research Database (Denmark)

    Henriksen, Lonny; Simonsen, Jacob; Haerskjold, Ann

    2015-01-01

    BACKGROUND: Several studies have shown that the prevalence of the frequent chronic conditions of atopic dermatitis, asthma, and allergy has increased substantially for reasons not fully understood. Atopic diseases affect quality of life in both children and their family members. OBJECTIVE: Using...... national registers, we sought to establish up-to-date incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in the Danish and Swedish child populations. METHODS: Children born in Denmark from 1997 to 2011 or born in Sweden from 2006 to 2010 participated in this cross......-national, population-based cohort study. Incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in the Danish and Swedish child cohorts were ascertained through disease-specific dispensed prescribed medication, specific hospital contacts, or both. RESULTS: In both countries the incidence rate...

  3. Cholesteatoma in Danish children - A national study of changes in the incidence rate over 34 years

    DEFF Research Database (Denmark)

    Djurhuus, Bjarki Ditlev; Skytthe, Axel; Christensen, Kaare

    2015-01-01

    was examined using Poisson regression analysis, while the cumulative incidence proportion was estimated using life-tables. RESULTS: A total of 5850 cases of surgically treated middle ear cholesteatoma distributed among 3874 children aged 0-15 years were identified. From 1977 to 2002 the age...... of 5.4% (95% CI 3.2-7.5%). Age-specific incidence rates were at maximum around the age of 9 years during the whole period. The estimated cumulative incidence proportion at age 16 years based on the 2010 age-specific incidence rates was 0.16% (95% CI 0.09-0.32%) compared with 0.20% (95% CI 0.11-0......-standardized incidence rates for first-time surgically treated middle ear cholesteatoma increased from 8 to 15 per 100,000 person-years with an estimated annual increase of 1.8% (95% confidence interval (CI) 1.3-2.2%). From 2002 to 2010 the rates decreased from 15 to 10 per 100,000 person-years with an annual decrease...

  4. The Icelandic and Nordic cervical screening programs: trends in incidence and mortality rates through 1995.

    Science.gov (United States)

    Sigurdsson, K

    1999-07-01

    The objective of cervical cancer screening is to lower the incidence and mortality rates of the disease. This study evaluates the effectiveness of cervical screening and the UICC and EC screening recommendations based on the Nordic screening experience. The study analyzes the features of the Icelandic and the Nordic screening programs and the observed trends in the incidence and mortality rates in these countries through 1995. Organized screening started in all the Nordic countries soon after 1960 and had nation-wide coverage in all these countries, except in Denmark (45% coverage in 1991), by around 1973 but in Norway screening was only spontaneous up to late in 1994. Up to 1985 the target age group and screening interval were most intensive in Iceland, followed by Finland, Sweden and Denmark. All countries except Finland lowered the lower age limit and intensified the screening intervals after 1985. Through the period 1986-1995 the reduction in both the mortality and the incidence rates was greatest in Iceland (mortality: 76% and incidence: 67%) and Finland (73% and 75%, respectively), intermediate in Sweden (60% and 55%, respectively) and Denmark (55% and 54%, respectively), and lowest in Norway (43% and 34%, respectively). The age-specific incidence in the 20-29 age group has been increasing since 1971 in all the Nordic countries, except in Finland, where the yearly registered age-specific incidence has been increasing in the targeted 30-54 age group since 1991. In Iceland screening has greatly affected the rate of all stages of squamous cell carcinoma, but not the rate of adeno- and adenosquamous carcinomas. In fact the rate of adenocarcinoma has been increasing. Organized screening is more effective than spontaneous screening in reducing the risk of cervical cancer. Although differences in environmental, biological and ethnic factors may call for different screening strategies, screening should preferably start soon after age 20 with a screening interval of 2

  5. Burden of type 2 diabetes in Mexico: past, current and future prevalence and incidence rates.

    Science.gov (United States)

    Meza, Rafael; Barrientos-Gutierrez, Tonatiuh; Rojas-Martinez, Rosalba; Reynoso-Noverón, Nancy; Palacio-Mejia, Lina Sofia; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

    2015-12-01

    Mexico diabetes prevalence has increased dramatically in recent years. However, no national incidence estimates exist, hampering the assessment of diabetes trends and precluding the development of burden of disease analyses to inform public health policy decision-making. Here we provide evidence regarding current magnitude of diabetes in Mexico and its future trends. We used data from the Mexico National Health and Nutrition Survey, and age-period-cohort models to estimate prevalence and incidence of self-reported diagnosed diabetes by age, sex, calendar-year (1960-2012), and birth-cohort (1920-1980). We project future rates under three alternative incidence scenarios using demographic projections of the Mexican population from 2010-2050 and a Multi-cohort Diabetes Markov Model. Adult (ages 20+) diagnosed diabetes prevalence in Mexico increased from 7% to 8.9% from 2006 to 2012. Diabetes prevalence increases with age, peaking around ages 65-68 to then decrease. Age-specific incidence follows similar patterns, but peaks around ages 57-59. We estimate that diagnosed diabetes incidence increased exponentially during 1960-2012, roughly doubling every 10 years. Projected rates under three age-specific incidence scenarios suggest diabetes prevalence among adults (ages 20+) may reach 13.7-22.5% by 2050, affecting 15-25 million individuals, with a lifetime risk of 1 in 3 to 1 in 2. Diabetes prevalence in Mexico will continue to increase even if current incidence rates remain unchanged. Continued implementation of policies to reduce obesity rates, increase physical activity, and improve population diet, in tandem with diabetes surveillance and other risk control measures is paramount to substantially reduce the burden of diabetes in Mexico. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Burden of Type 2 Diabetes in Mexico: Past, Current and Future Prevalence and Incidence Rates

    Science.gov (United States)

    Meza, Rafael; Barrientos-Gutierrez, Tonatiuh; Rojas-Martinez, Rosalba; Reynoso-Noverón, Nancy; Palacio-Mejia, Lina Sofia; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

    2015-01-01

    Introduction Mexico diabetes prevalence has increased dramatically in recent years. However, no national incidence estimates exist, hampering the assessment of diabetes trends and precluding the development of burden of disease analyses to inform public health policy decision-making. Here we provide evidence regarding current magnitude of diabetes in Mexico and its future trends. Methods We used data from the Mexico National Health and Nutrition Survey, and age-period-cohort models to estimate prevalence and incidence of self-reported diagnosed diabetes by age, sex, calendar-year (1960–2012), and birth-cohort (1920–1980). We project future rates under three alternative incidence scenarios using demographic projections of the Mexican population from 2010–2050 and a Multi-cohort Diabetes Markov Model. Results Adult (ages 20+) diagnosed diabetes prevalence in Mexico increased from 7% to 8.9% from 2006 to 2012. Diabetes prevalence increases with age, peaking around ages 65–68 to then decrease. Age-specific incidence follows similar patterns, but peaks around ages 57–59. We estimate that diagnosed diabetes incidence increased exponentially during 1960–2012, roughly doubling every 10 years. Projected rates under three age-specific incidence scenarios suggest diabetes prevalence among adults (ages 20+) may reach 13.7–22.5% by 2050, affecting 15–25 million individuals, with a lifetime risk of 1 in 3 to 1 in 2. Conclusions Diabetes prevalence in Mexico will continue to increase even if current incidence rates remain unchanged. Continued implementation of policies to reduce obesity rates, increase physical activity, and improve population diet, in tandem with diabetes surveillance and other risk control measures is paramount to substantially reduce the burden of diabetes in Mexico. PMID:26546108

  7. Environmental stratified flows

    CERN Document Server

    Armenio, Vincenzo

    2006-01-01

    The volume covers the theory of stratified flows, from basic concepts to recent developments in the area of environmental fluid mechanics. The state of art of numerical techniques suited for stratified flows is given. Results of very recent researches in the areas of environmental stratified flows are discussed with details. The topics are treated in four separate chapters. The volume gives a unified view of stratified turbulent flows, from small-scale mixing, to large-scale environmental phenomena, also including detailed discussion on interaction between turbulence and internal gravity waves. The book will serve as an important review tool for all the scientists involved in the investigation of small scale as well as geophysical stratified flows.

  8. Incidence rates of asthma, rhinitis and eczema symptoms and influential factors in young children in Sweden

    DEFF Research Database (Denmark)

    Larsson, M.; Hagerhed-Engman, L.; Sigsgaard, T.

    2008-01-01

    questionnaire based on an ISAAC protocol to all children in the age of 1-6 years. Five years later a follow-up questionnaire was sent to the children that were 1-3 years at baseline. In total, 4779 children (response rate = 73%) participated in both surveys and constitute the study population in this cohort...... period of breast-feeding. Allergic symptoms in parents were also a strong risk factor for incident asthma, as well as for rhinitis and eczema. Conclusion: When comparing incident rates of asthma between different studies it is important to realize that different definitions of the healthy baseline...

  9. Risk-adjusted melanoma skin cancer incidence rates in Whites (United States).

    Science.gov (United States)

    Merrill, Ray Martell

    2011-12-01

    The objective of this study was to obtain a better population-based measure of risk for melanoma skin cancer. A method has been previously proposed for estimating cancer incidence rates for data collected from the Surveillance, Epidemiology, and End Results (SEER) program. Unlike conventionally reported incidence rates in the USA, this method uses the first primary cancer and adjusts for population-based cancer prevalence to obtain a better measure of cancer risk. The study involves SEER data for white men and women. Conventional melanoma incidence rates overestimate risk for men, increasingly so from 3.3% in the age group of 30-39 years to 11.3% in the age group of 80 years and older. Overestimation in risk for women ranged from 3.3% in the age group of 30-39 years to 8.9% in the age group of 80 years and older. Overestimation of risk was more pronounced when both in-situ and malignant melanomas were considered. Increasing trends in conventional rates were slightly greater than trends in risk-adjusted incidence rates (RAIRs). In 2007, the estimated number of cases with malignant melanoma among the white population based on conventional cancer incidence rates is 37 636 (64 125 including in-situ cases) for men and 28 935 (49 361 including in-situ cases) for women. The estimated number of cases in the USA based on RAIRS is 34 652 [(7.9%); 55 413 (13.6%) including in-situ cases] for male and 27 178 [(6.1%); 44 467 (9.9%) including in-situ cases] for women. We concluded that RAIRs are a better measure of melanoma skin cancer risk and should be used for estimating the number of cancer patients in the USA.

  10. Incidence rate of lung cancer in urban Shijiazhuang in 2012 with prevention implication.

    Science.gov (United States)

    Wen, Denggui; Li, Shumei; Zhang, Min; Zhang, Nan; Wen, Xiaoduo; Yang, Yi; Fen, Cheng; Wang, Shijie; Shan, Baoen

    2016-03-01

    Pollution has been established as an environmental factor in the development of lung cancer; however, the incidence rate in Shijiazhuang, one of China's most heavily polluted cities, is unknown. As Chinese citizens are entitled to complete public medical insurance coverage, we estimated the lung cancer incidence rate among registered citizens of urban Shijiazhuang in 2012 using reimbursement records of first hospitalization. In Shijiazhuang, lung cancer was the most common cancer in men and the second most common cancer in women. The age standardized world incidence rate (ASRW) was 46.42 and 19.14/100 000, respectively, compared with 51.05 and 22.24/100 000, respectively, reported for 63 Chinese tumor registration cities in 2010 (the national level). However, age-specific rates for the 55-70 range in men and the 25-55 range in women were higher in Shijiazhuang than nationally. Compared with GLOBOCAN 2012 data, the lung cancer ASRW in Shijiazhuang was comparable to that of all industrialized countries (44.7 and 19.6/100 000), but higher than all developing countries (30.0 and 11.1/100 000), Japan (38.8 and 12.9/100 000), and Korea (45.5 and 16.2/100 000). The lung cancer incidence rate in Shijiazhuang matched the world's highest level in 2012. According to the experience of western countries, the incidence rate in China is expected to continue to rise over the next 40 years. Intervention is urgently required in order to reduce smoking prevalence by a third by 2025 and to take concrete legal action to reduce air pollution.

  11. Incidence of intervertebral disk degeneration-related diseases and associated mortality rates in dogs

    NARCIS (Netherlands)

    Bergknut, N.; Egenvall, A.; Hagman, R.; Gustas, P.; Hazewinkel, H.A.W.; Meij, B.P.; Lagerstedt, A.S.

    2012-01-01

    Abstract Journal of the American Veterinary Medical Association June 1, 2012, Vol. 240, No. 11, Pages 1300-1309 doi: 10.2460/javma.240.11.1300 Incidence of intervertebral disk degeneration–related diseases and associated mortality rates in dogs Niklas Bergknut, Dr med vet, PhD; Agneta Egenvall, Dr

  12. Extinction and Ergodic Property of Stochastic SIS Epidemic Model with Nonlinear Incidence Rate

    Directory of Open Access Journals (Sweden)

    Qixing Han

    2013-01-01

    Full Text Available We investigate a stochastic SIS model with nonlinear incidence rate. We show that there exists a unique nonnegative solution to the system, and condition for the infectious individuals I(t to be extinct is given. Moreover, we prove that the system has ergodic property. Finally, computer simulations are carried out to verify our results.

  13. Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009.

    LENUS (Irish Health Repository)

    Ali, Hala

    2016-12-20

    Oral cancer is a significant public health problem world-wide and exerts high economic, social, psychological, and physical burdens on patients, their families, and on their primary care providers. We set out to describe the changing trends in incidence and survival rates of oral cancer in Ireland between 1994 and 2009.

  14. Association Between Heart Rate at Rest and Incident Atrial Fibrillation (from the Copenhagen Electrocardiographic Study)

    DEFF Research Database (Denmark)

    Skov, Morten W; Bachmann, Troels N; Rasmussen, Peter V.

    2016-01-01

    Heart rate (HR) at rest is a well-known marker of cardiovascular morbidity and mortality. Results on the association between HR and incident atrial fibrillation (AF) have, however, been conflicting. Using digital electrocardiograms from 281,451 primary care patients, we aimed to describe...

  15. Monitoring viral incidence rates: tools for the implementation of European Union regulations

    NARCIS (Netherlands)

    Janssen, M. P.; Cator, E. A.; van der Poel, C. L.; Schaasberg, W. P.; Bonsel, G. J.; van Hout, B. A.

    2009-01-01

    BACKGROUND AND OBJECTIVES: European legislation requires manufacturers of plasma products to report epidemiological data on human immunodeficiency virus, hepatitis B virus and hepatitis C virus in donor populations. The incidence rates of such infections are directly related to the risk of infection

  16. Incidence rates and trends of hip/femur fractures in five European countries

    DEFF Research Database (Denmark)

    Requena, G; Abbing-Karahagopian, V; Huerta, C

    2014-01-01

    Hip fractures represent a major public health challenge worldwide. Multinational studies using a common methodology are scarce. We aimed to estimate the incidence rates (IRs) and trends of hip/femur fractures over the period 2003-2009 in five European countries. The study was performed using seve...

  17. Associations of Census-Tract Poverty with Subsite-Specific Colorectal Cancer Incidence Rates and Stage of Disease at Diagnosis in the United States

    Directory of Open Access Journals (Sweden)

    Kevin A. Henry

    2014-01-01

    Full Text Available Background. It remains unclear whether neighborhood poverty contributes to differences in subsite-specific colorectal cancer (CRC incidence. We examined associations between census-tract poverty and CRC incidence and stage by anatomic subsite and race/ethnicity. Methods. CRC cases diagnosed between 2005 and 2009 from 15 states and Los Angeles County (N=278,097 were assigned to 1 of 4 groups based on census-tract poverty. Age-adjusted and stage-specific CRC incidence rates (IRs and incidence rate ratios (IRRs were calculated. Analyses were stratified by subsite (proximal, distal, and rectum, sex, race/ethnicity, and poverty. Results. Compared to the lowest poverty areas, CRC IRs were significantly higher in the most impoverished areas for men (IRR = 1.14 95% CI 1.12–1.17 and women (IRR = 1.06 95% CI 1.05–1.08. Rate differences between high and low poverty were strongest for distal colon (male IRR = 1.24 95% CI 1.20–1.28; female IRR = 1.14 95% CI 1.10–1.18 and weakest for proximal colon. These rate differences were significant for non-Hispanic whites and blacks and for Asian/Pacific Islander men. Inverse associations between poverty and IRs of all CRC and proximal colon were found for Hispanics. Late-to-early stage CRC IRRs increased monotonically with increasing poverty for all race/ethnicity groups. Conclusion. There are differences in subsite-specific CRC incidence by poverty, but associations were moderated by race/ethnicity.

  18. Socioeconomic status and prostate cancer incidence and mortality rates among the diverse population of California

    OpenAIRE

    Cheng, Iona; Witte, John S.; McClure, Laura A.; Shema, Sarah J.; Cockburn, Myles G.; John, Esther M.; Clarke, Christina A.

    2009-01-01

    Background The racial/ethnic disparities in prostate cancer rates are well documented, with the highest incidence and mortality rates observed among African-Americans followed by non-Hispanic Whites, Hispanics, and Asian/Pacific Islanders. Whether socioeconomic status (SES) can account for these differences in risk has been investigated in previous studies, but with conflicting results. Furthermore, previous studies have focused primarily on the differences between African-Americans and non-H...

  19. Dynamic Behavior for an SIRS Model with Nonlinear Incidence Rate and Treatment

    Directory of Open Access Journals (Sweden)

    Junhong Li

    2013-01-01

    Full Text Available This paper considers an SIRS model with nonlinear incidence rate and treatment. It is assumed that susceptible and infectious individuals have constant immigration rates. We investigate the existence of equilibrium and prove the global asymptotical stable results of the endemic equilibrium. We then obtained that the model undergoes a Hopf bifurcation and existences a limit cycle. Some numerical simulations are given to illustrate the analytical results.

  20. Association of arsenic exposure with lung cancer incidence rates in the United States.

    Directory of Open Access Journals (Sweden)

    Joseph J Putila

    Full Text Available Although strong exposure to arsenic has been shown to be carcinogenic, its contribution to lung cancer incidence in the United States is not well characterized. We sought to determine if the low-level exposures to arsenic seen in the U.S. are associated with lung cancer incidence after controlling for possible confounders, and to assess the interaction with smoking behavior.Measurements of arsenic stream sediment and soil concentration obtained from the USGS National Geochemical Survey were combined, respectively, with 2008 BRFSS estimates on smoking prevalence and 2000 U.S. Census county level income to determine the effects of these factors on lung cancer incidence, as estimated from respective state-wide cancer registries and the SEER database. Poisson regression was used to determine the association between each variable and age-adjusted county-level lung cancer incidence. ANOVA was used to assess interaction effects between covariates.Sediment levels of arsenic were significantly associated with an increase in incident cases of lung cancer (P<0.0001. These effects persisted after controlling for smoking and income (P<0.0001. Across the U.S., exposure to arsenic may contribute to up to 5,297 lung cancer cases per year. There was also a significant interaction between arsenic exposure levels and smoking prevalence (P<0.05.Arsenic was significantly associated with lung cancer incidence rates in the U.S. after controlling for smoking and income, indicating that low-level exposure to arsenic is responsible for excess cancer cases in many parts of the U.S. Elevated county smoking prevalence strengthened the association between arsenic exposure and lung cancer incidence rate, an effect previously unseen on a population level.

  1. Sex differences in the association of cutaneous melanoma incidence rates and geographic ultraviolet light exposure.

    Science.gov (United States)

    Liu-Smith, Feng; Farhat, Ahmed Majid; Arce, Anthony; Ziogas, Argyrios; Taylor, Thomas; Wang, Zi; Yourk, Vandy; Liu, Jing; Wu, Jun; McEligot, Archana J; Anton-Culver, Hoda; Meyskens, Frank L

    2017-03-01

    Cutaneous melanoma (CM) incidence rates continue to increase, and the reasons are unknown. Previously, we reported a unique age-specific sex difference in melanoma that suggested additional causes other than solar ultraviolet (UV) radiation. This study attempted to understand whether and how UV radiation differentially impacts the CM incidence in men and women. CM data and daily UV index (UVI) from 31 cancer registries were collected for association analysis. A second dataset from 42 US states was used for validation. There was no association between log-transformed female CM rates and levels of UVI, but there was a significant association between male rates and UVI and a significant association between overall rates and UVI. The 5-year age-specific rate-UVI association levels (represented by Pearson's coefficient ρ) increased with age in men, but age-specific ρ levels remained low and unchanged in women. The significant rate-UVI association in men and nonassociation in women was validated in a population of white residents of the United States. Confounders, including temperature and latitude, are difficult to separate from UVI. Ambient UVI appears to be associated with melanoma incidence in males but not in females. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Toward a better understanding of the comparatively high prostate cancer incidence rates in Utah.

    Science.gov (United States)

    Merrill, Ray M; Hilton, Sterling C; Wiggins, Charles L; Sturgeon, Jared D

    2003-04-29

    This study assesses whether comparatively high prostate cancer incidence rates among white men in Utah represent higher rates among members of the Church of Jesus Christ of Latter-day Saints (LDS or Mormons), who comprise about 70% of the state's male population, and considers the potential influence screening has on these rates. Analyses are based on 14,693 histologically confirmed invasive prostate cancer cases among men aged 50 years and older identified through the Utah Cancer Registry between 1985 and 1999. Cancer records were linked to LDS Church membership records to determine LDS status. Poisson regression was used to derive rate ratios of LDS to nonLDS prostate cancer incidence, adjusted for age, disease stage, calendar time, and incidental detection. LDS men had a 31% (95% confidence interval, 26%-36%) higher incidence rate of prostate cancer than nonLDS men during the study period. Rates were consistently higher among LDS men over time (118% in 1985-88, 20% in 1989-92, 15% in 1993-1996, and 13% in 1997-99); age (13% in ages 50-59, 48% in ages 60-69, 28% in ages 70-79, and 16% in ages 80 and older); and stage (36% in local/regional and 17% in unstaged). An age- and stage-shift was observed for both LDS and nonLDS men, although more pronounced among LDS men. Comparatively high prostate cancer incidence rates among LDS men in Utah are explained, at least in part, by more aggressive screening among these men.

  3. A review of fatal accident incidence rate trends in fishing international

    DEFF Research Database (Denmark)

    Jensen, Olaf; Pétursdóttir, G; Abrahamsen, Annbjørg

    2014-01-01

    Background. Injury prevention in fishing is one of the most important occupational health challenges. The aim was to describe and compare internationally the trends of the fatal injury incidence rates and to discuss the impact of the implemented safety programs. Methods. The review is based...... on journal articles and reports from the maritime authorities in Poland, UK, Norway, Iceland, Denmark, US and Alaska and Canada. The original incidence rates were recalculated as per 1000 person-years for international comparison of the trends. Results. The risk of fatal accidents in fishing in the northern...... countries has been reduced by around 50% to an average of about 1 per 1000 person-years. Norway and Canada keep the lowest rates with around 0.5 and 0.25 per 1000 person-years. About half of the fatal injuries are related to vessel disasters and drowning. The safety programs seem to have good effects still...

  4. A nationwide survey of incidence rates and risk factors of inguinal hernia in preterm children.

    Science.gov (United States)

    Fu, Yu-Wei; Pan, Mei-Lien; Hsu, Yao-Jen; Chin, Tai-Wai

    2018-01-01

    Clinical observations showed a higher incidence rate of inguinal hernia (IH) in preterm infants. In this study, we calculated the incidence rate of preterm IH from the National Health Insurance Research Database (NHIRD) of Taiwan. From NHIRD, 92,308 subjects born in the year of 1997-2005 were randomly selected as the study cohort. The medical claims of these subjects from birth to 6th year of age were analyzed. Preterm births were defined using ICD code 765.1*. Risk factors such as birth weight, lung disorders, and ventilator supports before IH repairs were investigated. The risk of incarceration and bowel resection were also evaluated. From 92,308 subjects, 2560 preterm births were identified. IH was repaired in 231 preterm (9.02%) and 3650 term subjects (4.07%). Male (preterm 13.3% and non-preterm 6.3%) had more hernia repairs than female (preterm 3.8% and non-preterm 1.6%). The incidence rate of IH is 13.7% for those under 1500 g, 8.2% for those 1500-1999 g, 7.7% for those 2000-2499 g, and 6.3% for those above 2500 g. The incidence rate of IH in preterms with past history of lung disorders and ventilation supports is 8.7 and 13.6%, respectively. There was no significant difference in the incidences of incarceration and bowel resection between preterms and non-preterms. Birth weight under 2500 g is a significant risk factor for IH repairs. Other risk factors are male gender, past history of lung diseases, and ventilator supports.

  5. Colorectal cancer among Koreans living in South Korea versus California: incidence, mortality, and screening rates.

    Science.gov (United States)

    Ryu, So Yeon; Crespi, Catherine M; Maxwell, Annette E

    2014-08-01

    This study compared trends in colorectal cancer (CRC) incidence and mortality rates among Koreans in South Korea and Korean Americans and non-Hispanic whites in California between 1999 and 2009, and examined CRC screening rates and socio-demographic correlates of CRC screening in the two Korean populations. Age-standardized CRC incidence and mortality rates of Koreans in South Korea and Korean Americans and non-Hispanic whites in California for the years 1999-2009 were obtained from annual reports of cancer statistics and modeled using joinpoint regression. Using 2009 data from the Korean National Health and Nutrition Examination Survey and the California Health Interview Survey, we estimated and compared CRC screening rates and test modalities. We used multiple logistic regression to examine socio-demographic correlates of completion of CRC screening according to the guidelines among the two Korean populations. CRC incidence and mortality rates among South Koreans increased during 1999-2009 but more slowly during the late 2000s. In California, CRC incidence increased among Korean American females but decreased among non-Hispanic whites. About 37% of South Koreans and 60% of Korean Americans reported completion of CRC screening according to guidelines in 2009. Among South Koreans, married status, higher income, and private health insurance were associated with CRC screening, adjusting for other factors. Among Korean Americans, having health insurance was associated with CRC screening. Despite almost identical CRC screening guidelines in South Korea and the USA and substantially higher screening rates among Korean Americans as compared to South Koreans, disparities remain in both populations with respect to CRC statistics. Thus, efforts to promote primary and secondary prevention of CRC in both Korean populations are critically important in both countries.

  6. Prostate cancer trends in Latvia during 1990-2012: incidence, prevalence, mortality, and survival rates.

    Science.gov (United States)

    Plonis, Juris; Bokums, Kristaps; Cauce, Vinita; Miklasevics, Edvins; Vaganovs, Peteris; Irmejs, Arvids; Gardovskis, Janis; Vjaters, Egils

    2014-01-01

    Prostate cancer (PCa) is one of the most common form of cancer in males worldwide. One of the highest PCa-related mortality rates in the world is observed in Latvia. Our study included male patients diagnosed with PCa between 1990 and 2012. We analyzed incidence, prevalence and mortality trends using joinpoint analysis. Kaplan-Meier analysis was performed for 5-, 10-, 15- and 20-year overall survival and cancer-specific survival rates. A total of 14,083PCa patients with a mean age of initial PCa diagnosis being 70.1 (SD 8.6) was registered. The standardized incidence rates (per 100,000) increased from 18.9 in 1990 to 74.7 in 2012, while the standardized prevalence rates (per 100,000) increased from 69.9 in 1990 to 437.6 in 2012. Standardized PCa mortality rates (per 100,000) also rose from 13.2 in 1990 to 27.2 in 2006 followed by statistically insignificant decrease continuing up to 2012. The mean 5-year cancer-specific survival rates increased from 43.6% in 1990 to 70.7% in 2007, and the mean 10-year cancer-specific survival rates from 32.9% in 1990 to 40.5% in 2001. This study revealed that the incidence, prevalence and mortality rates increased between 1990 and 2012, and although the 5- and 10-year overall and cancer-specific survival rates improved over the reviewed period they still needed to get better. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  7. Characteristics, rates, and trends of melanoma incidence among Hispanics in the USA.

    Science.gov (United States)

    Garnett, Erin; Townsend, Julie; Steele, Brooke; Watson, Meg

    2016-05-01

    The purpose of this study is to describe the epidemiology of melanoma among Hispanics using data that cover nearly 100 % of the US population. The study used population-based cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology and End Results Program to examine melanoma incidence rates and trends among Hispanics by sex, age, race, histology, anatomic location, stage, and tumor thickness. From 2008 to 2012, 6,623 cases of melanoma were diagnosed among Hispanics. Rates were higher among males (4.6) than among females (4.0), but females younger than age 55 had higher rates than males. The most common histologic subtype was superficial spreading melanoma (23 %). Melanomas with poorer outcomes, such as nodular (NM) and acral lentiginous melanoma (ALM), were more common among males. Hispanic females had the highest proportion of melanoma on the lower limb and hip (33.7 %), while Hispanic males had the highest proportion on the trunk (29.9 %). Incidence rates for later-stage diagnosis and thicker tumors were significantly higher among Hispanic men than among women. Incidence rates decreased significantly during 2003-2012 (AAPC = -1.4). Clinicians and public health practitioners will need to reach the growing Hispanic population in the USA with strategies for primary prevention and early diagnosis of melanoma. Results suggest Hispanics and providers need education to increase awareness about the characteristics of melanoma among Hispanics, including types that occur on non-sun-exposed areas (ALM and NM). Skin cancer prevention and awareness interventions targeting Hispanics should be culturally relevant.

  8. Histologic Lung Cancer Incidence Rates and Trends vary by Race/Ethnicity and Residential County.

    Science.gov (United States)

    Houston, Keisha A; Mitchell, Khadijah A; King, Jessica; White, Arica; Ryan, Bríd M

    2018-01-19

    Lung cancer incidence is higher among NH blacks compared with NH white and Hispanic populations in the U.S. However, national cancer estimates may not always reflect the cancer burden in terms of disparities and incidence in small geographic areas, especially urban-rural disparities. Moreover, there is a gap in the literature regarding rural-urban disparities in terms of cancer histology. Using population-based cancer registry data-Surveillance, Epidemiology and End Results (SEER) and National Program of Cancer Registries (NPCR)-we present age-adjusted histologic rates and trends by race/ethnicity, and residential county location at the time of first cancer diagnosis. Rate ratios were calculated to examine racial/ethnic differences in rates. Annual percent change (APC) was calculated to measure changes in rates over time. We find that declines in squamous cell carcinoma (SCC) are occurring fastest in metropolitan counties, while rates of adenocarcinoma increased fastest in counties non-adjacent to metropolitan areas. Further, while NH black men have increased lung cancer incidence compared with NH white and Hispanic men in all geographic locations, we find that the degree of the disparity increases with increasing rurality of residence. Finally, we report that among women diagnosed at less than 55 years of age, the incidence of SCC and adenocarcinoma was higher for NH blacks compared with NH whites. Our results highlight disparities among NH blacks in non-adjacent rural areas. These findings may have significant impact for the implementation of smoking cessation and lung cancer screening programs. Copyright © 2018. Published by Elsevier Inc.

  9. Nuclear medicine incident reporting in Australia: control charts and notification rates inform quality improvement.

    Science.gov (United States)

    Larcos, G; Collins, L T; Georgiou, A; Westbrook, J I

    2015-06-01

    Australia has a statutory incident reporting system for radiopharmaceutical maladministrations, but additional research into registry data is required for the purpose of quality improvement in nuclear medicine. We (i) used control charts to identify factors contributing to special cause variation (indicating higher than expected rates) in maladministrations and (ii) evaluated the impact of heterogeneous notification criteria and extent of underreporting among jurisdictions and individual facilities, respectively. Anonymised summaries of Australian Radiation Incident Register reports permitted calculation of national monthly maladministration notification rates for 2007-2012 and preparation of control charts. Multivariate logistic regression assessed the association of population, insurance and regulatory characteristics with maladministration notifications in each Australian State and Territory. Maladministration notification rates from two facilities with familiarity of notification processes and commitment to radiation protection were compared with those elsewhere. Special cause variation occurred in only 3 months, but contributed to 21% of all incidents (42 of 197 patients), mainly because of 'clusters' of maladministrations (n = 24) arising from errors in bulk radiopharmaceutical dispensing. Maladministration notification rates varied significantly between jurisdictions (0 to 12.2 maladministrations per 100 000 procedures (P < 0.05)) and individual facilities (31.7 vs 5.8 per 100 000; χ(2) = 40; 1 degree of freedom, P < 0.001). Unexpected increases in maladministration notifications predominantly relate to incident 'clusters' affecting multiple patients. The bulk preparation of radiopharmaceuticals is a vulnerable process and merits additional safeguards. Maladministration notification rates in Australia are heterogeneous. Adopting uniform maladministration notification criteria among States and Territories and methods to overcome underreporting are

  10. The Impact of Changes to the Unemployment Rate on Australian Disability Income Insurance Claim Incidence

    Directory of Open Access Journals (Sweden)

    Gaurav Khemka

    2017-03-01

    Full Text Available We explore the extent to which claim incidence in Disability Income Insurance (DII is affected by changes in the unemployment rate in Australia. Using data from 1986 to 2001, we fit a hurdle model to explore the presence and magnitude of the effect of changes in unemployment rate on the incidence of DII claims, controlling for policy holder characteristics and seasonality. We find a clear positive association between unemployment and claim incidence, and we explore this further by gender, age, deferment period, and occupation. A multinomial logistic regression model is fitted to cause of claim data in order to explore the relationship further, and it is shown that the proportion of claims due to accident increases markedly with rising unemployment. The results suggest that during periods of rising unemployment, insurers may face increased claims from policy holders with shorter deferment periods for white-collar workers and for medium and heavy manual workers. Our findings indicate that moral hazard may have a material impact on DII claim incidence and insurer business in periods of declining economic conditions.

  11. Incidence and prevalence rates of diabetes mellitus in Taiwan: Analysis of the 2000–2009 Nationwide Health Insurance database

    Directory of Open Access Journals (Sweden)

    Yi-Der Jiang

    2012-11-01

    Conclusion: The incidence of diabetes, including type 1, remained stable over this 10-year period in Taiwan. However, the incidence rate in men aged 20–59 years was higher than that in age-matched women. With our nationwide database, subgroup analysis of DM incidence can be performed to refine our health policies for the prevention, screening, and treatment of diabetes mellitus.

  12. The effect of a workflow-based response system on hospital-wide voluntary incident reporting rates.

    Science.gov (United States)

    Wang, Szu-Chang; Li, Ying-Chun; Huang, Hung-Chi

    2013-02-01

    Hospital incident reporting systems are usually evaluated on their theoretical benefit to the hospital or increase in reporting rates alone. To evaluate a workflow-based response system on staff incident reporting rates. A prospective cohort study of incident reports made by staff members before (2006-2007) and after (2008-2009) the system was implemented on 1 January 2008 at a medical center in southern Taiwan. Pre-system and post-system data were based on 713 129 and 730 176 inpatient days and 160 692 and 168 850 emergency department visits. The addition of a workflow-based response system to a reporting system processing incident reports and intra-hospital responses. Voluntary incident reporting rates and distribution of incident severities. Inpatient reports [9.9 vs. 28.8 per 10 000 patient days; rate ratio (RR): 2.9, 95% confidence interval (CI): 2.7-3.2, P reports (5.9 vs. 19.2 per 10 000 visits, RR: 3.3, 95% CI: 2.6-4.1, P system reported incidents were more evenly distributed over five severity levels than pre-sytem incidents, moving more toward the very severe level (RR: 17.6, 95% CI: 8.4-37.0, P system to the hospital incident reporting system significantly increased hospital-wide voluntary incident report rates at all incident injury levels.

  13. Global stability of a network-based SIS epidemic model with a general nonlinear incidence rate.

    Science.gov (United States)

    Huang, Shouying; Jiang, Jifa

    2016-08-01

    In this paper, we develop and analyze an SIS epidemic model with a general nonlinear incidence rate, as well as degree-dependent birth and natural death, on heterogeneous networks. We analytically derive the epidemic threshold R0 which completely governs the disease dynamics: when R0 1, the disease is permanent. It is interesting that the threshold value R0 bears no relation to the functional form of the nonlinear incidence rate and degree-dependent birth. Furthermore, by applying an iteration scheme and the theory of cooperative system respectively, we obtain sufficient conditions under which the endemic equilibrium is globally asymptotically stable. Our results improve and generalize some known results. To illustrate the theoretical results, the corresponding numerical simulations are also given.

  14. Trends in the incidence rate, type and treatment of surgically verified endometriosis - a nationwide cohort study.

    Science.gov (United States)

    Saavalainen, Liisu; Tikka, Tuulia; But, Anna; Gissler, Mika; Haukka, Jari; Tiitinen, Aila; Härkki, Päivi; Heikinheimo, Oskari

    2018-01-01

    To study the trends in incidence rate, type and surgical treatment, and patient characteristics of surgically verified endometriosis during 1987-2012. This is a register-based cohort study. We identified women receiving their first diagnosis of endometriosis in surgery from the Finnish Hospital Discharge Register (FHDR). Quality of the FHDR records was assessed bidirectionally. The age-standardized incidence rates of the first surgically verified endometriosis was assessed by calendar year. The cohort comprises 49 956 women. The quality assessment suggested the FHDR data to be of good quality. The most common diagnosis, ovarian endometriosis (46%), was associated with highest median age 38.5 years (interquartile range 31.0-44.8) and the second most common diagnosis, peritoneal endometriosis (40%), with median age 34.9 years (28.6-41.7). Between 1987 and 2012, a decrease was observed in the median age, from 38.8 (32.3-43.6) to 34.0 (28.9-41.0) years, and in the age-standardized incidence rate from 116 [95% confidence interval (CI) 112-121] to 45 (42-48) per 100 000 women. The proportion of hysterectomy as a first surgical treatment decreased from 38 to 19%, whereas that of laparoscopy increased from 42 to 73% when comparing 1987-1995 with 1996-2012. This nationwide cohort of surgically verified endometriosis showed a decrease in the incidence rate and in the patient age at the time of first diagnosis, even though the proportion of laparoscopy has increased. The number of hysterectomies has decreased. These changes are likely to reflect the evolving diagnostics, increasing awareness of endometriosis, and effective use of medical treatment before surgery. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Brain Death in Children: Incidence, Donation Rates, and the Occurrence of Central Diabetes Insipidus

    Directory of Open Access Journals (Sweden)

    Yener Nazik

    2018-01-01

    Full Text Available Introduction: Brain death is currently defined as the loss of full brain function including the brainstem. The diagnosis and its subsequent management in the pediatric population are still controversial. The aim of this study was to define the demographic characteristics, clinical features and outcomes of patients with brain death and determine the incidence of brain death, donation rates and occurrence of central diabetes insipidus accompanying brain death in children.

  16. A class of stochastic delayed SIR epidemic models with generalized nonlinear incidence rate and temporary immunity

    Science.gov (United States)

    Fan, Kuangang; Zhang, Yan; Gao, Shujing; Wei, Xiang

    2017-09-01

    A class of SIR epidemic model with generalized nonlinear incidence rate is presented in this paper. Temporary immunity and stochastic perturbation are also considered. The existence and uniqueness of the global positive solution is achieved. Sufficient conditions guaranteeing the extinction and persistence of the epidemic disease are established. Moreover, the threshold behavior is discussed, and the threshold value R0 is obtained. We show that if R0 1, then the system remains permanent in the mean.

  17. New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate

    OpenAIRE

    Ho, An; Raja, Bronson; Waldhorn, Richard; Baez, Valentina; Mohammed, Idiris

    2017-01-01

    ABSTRACT Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors f...

  18. [Cesarean section incidence and vaginal birth success rate at term pregnancy after myomectomy].

    Science.gov (United States)

    Mekiňová, L; Janků, P; Filipinská, E; Kadlecová, J; Ventruba, P

    To compare the incidence of primary and acute cesarean section (CS) and to compare success rate of vaginal delivery. To determine the frequency of maternal complications and evaluation of post-partum condition of the newborn. Prospective, pilot, cohort study. Department of Gynecology and Obstetrics Masaryk University and University Hospital Brno. Analysis of patients with physiologically ongoing singleton pregnancy and term delivery, vertex presentation. Women from the study group (n = 67) underwent myomectomy because of symptomatic, solitary uterine fibroid. Women from the control group (n = 4079) had no history of myomectomy. Analysis was aimed at comparing the incidence of primary and acute CS and comparing success rate of vaginal delivery in both groups and determing the frequency of maternal complications and evaluation of post-partum condition of the newborn. A significantly higher incidence of primary cesarean section was observed in the study group with a history of myomectomy compared to the control group (n = 20, 29.9%; versus n = 396, 9.7 %, p cesarean section in both groups was recorded (n = 7, 10.4%; versus n = 570, 14.0%, p = 0.079). No statistically significant difference in the success of vaginal delivery in both groups was recorded (n = 40, 85.1%; versus n = 3113, 84.5%, p = 0.079). The excessive blood loss was the most frequent complication in both group (n = 9, 13.4%; versus n = 214, 5.2%, p = 0.057). No statistically significant difference in the incidence of uterine rupture and postpartum hysterectomy was recorded. No maternal or fetal death related to childbirth was observed. The history of myomectomy does not increase the incidence of acute cesarean section in the group of strictly selected patients suitable for vaginal birth and has no impact on the success of vaginal delivery. Careful management of labor is a prerequisite for a low risk of maternal complications and good perinatal outcomes.

  19. [Incidence rate of adverse reaction/event by Qingkailing injection: a Meta-analysis of single rate].

    Science.gov (United States)

    Ai, Chun-ling; Xie, Yan-ming; Li, Ming-quan; Wang, Lian-xin; Liao, Xing

    2015-12-01

    To systematically review the incidence rate of adverse drug reaction/event by Qingkailing injection. Such databases as the PubMed, EMbase, the Cochrane library, CNKI, VIP WanFang data and CBM were searched by computer from foundation to July 30, 2015. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and cross check data. Then, Meta-analysis was performed by using the R 3.2.0 software, subgroup sensitivity analysis was performed based on age, mode of medicine, observation time and research quality. Sixty-three studies involving 9,793 patients with Qingkailing injection were included, 367 cases of adverse reactions/events were reported in total. The incidence rate of adverse reaction in skin and mucosa group was 2% [95% CI (0.02; 0.03)]; the digestive system adverse reaction was 6% [95% CI(0.05; 0.07); the injection site adverse reaction was 4% [95% CI (0.02; 0.07)]. In the digestive system as the main types of adverse reactions/events, incidence of children and adults were 4.6% [0.021 1; 0.097 7] and 6.9% [0.053 5; 0.089 8], respectively. Adverse reactions to skin and mucous membrane damage as the main performance/event type, the observation time > 7 days and ≤ 7 days incidence of 3% [0.012 9; 0.068 3] and 1.9% [0.007 8; 0.046 1], respectively. Subgroup analysis showed that different types of adverse reactions, combination in the incidence of adverse reactions/events were higher than that of single drug, the difference was statistically significant (P reactions occur, and clinical rational drug use, such as combination, age and other fators, and the influence factors vary in different populations. Therefore, clinical doctors for children and the elderly use special care was required for a clear and open spirit injection, the implementation of individualized medication.

  20. Global stability and attractivity of a network-based SIS epidemic model with nonmonotone incidence rate

    Science.gov (United States)

    Wei, Xiaodan; Liu, Lijun; Zhou, Wenshu

    2017-03-01

    In this paper, we study the global stability and attractivity of the endemic equilibrium for a network-based SIS epidemic model with nonmonotone incidence rate. The model was introduced in Li (2015). We prove that the endemic equilibrium is globally asymptotically stable if α (a parameter of this model) is sufficiently large, and is globally attractive if the transmission rate λ satisfies λ/λc ∈(1 , 2 ] , where λc is the epidemic threshold. Some numerical experiments are also presented to illustrate the theoretical results.

  1. Lung cancer incidence after exposure of rats to low doses of radon: influence of dose rate

    International Nuclear Information System (INIS)

    Morlier, J.P.; Morin, M.; Monchaux, G.; Fritsch, P.; Lafuma, J.; Masse, R.; Chameaud, J.

    1994-01-01

    To study the effect on lung cancer incidence of a long exposure to low levels of radon, 500 male 3-months-old Sprague-Dawley rats, were exposed to a cumulative dose of 25 WLM of radon and its daughters, 6 hours a day, 5 days a week, during 18 months. Exposure conditions were controlled in order to maintain a defined PAEC: 42 x 10 6 J.m -3 (2 WL), in the range of domestic and environmental exposures. Animals were kept until they died or given euthanasia when moribund. Mean survival times were similar in both irradiated and control groups: 828 days (SD = 169) and 830 days (SD = 137), as well as lung cancer incidence, 0.60% at 25 WLM and 0.63% for controls. The incidence of lung lesions was compared statistically with controls and those previously obtained at cumulative exposures of 25 and 50 WLM delivered over a 4-6 month period, inducing a significant increase of lung cancer, 2.2% and 3.8% respectively. Such a comparison showed a decreased lung cancer incidence related to a decrease in the dose rate for low levels of radon exposure. (author)

  2. Lung cancer incidence after exposure of rats to low doses of radon: influence of dose rate

    Energy Technology Data Exchange (ETDEWEB)

    Morlier, J.P.; Morin, M.; Monchaux, G.; Fritsch, P.; Lafuma, J.; Masse, R. [CEA Centre d`Etudes Nucleaires de Fontenay-aux-Roses, 92 (France). Dept. de Protection Technique; Pineau, J.F. [ALGADE, Bessines (France); Chameaud, J. [Compagnie Generale des Matieres Nucleaires (COGEMA), 87 - Razes (France)

    1994-12-31

    To study the effect on lung cancer incidence of a long exposure to low levels of radon, 500 male 3-months-old Sprague-Dawley rats, were exposed to a cumulative dose of 25 WLM of radon and its daughters, 6 hours a day, 5 days a week, during 18 months. Exposure conditions were controlled in order to maintain a defined PAEC: 42 x 10{sup 6} J.m{sup -3} (2 WL), in the range of domestic and environmental exposures. Animals were kept until they died or given euthanasia when moribund. Mean survival times were similar in both irradiated and control groups: 828 days (SD = 169) and 830 days (SD = 137), as well as lung cancer incidence, 0.60% at 25 WLM and 0.63% for controls. The incidence of lung lesions was compared statistically with controls and those previously obtained at cumulative exposures of 25 and 50 WLM delivered over a 4-6 month period, inducing a significant increase of lung cancer, 2.2% and 3.8% respectively. Such a comparison showed a decreased lung cancer incidence related to a decrease in the dose rate for low levels of radon exposure. (author).

  3. The association between patient-reported incidents in hospitals and estimated rates of patient harm.

    Science.gov (United States)

    Bjertnaes, Oyvind; Deilkås, Ellen Tveter; Skudal, Kjersti Eeg; Iversen, Hilde Hestad; Bjerkan, Anne Mette

    2015-02-01

    The aim of this study was to test the association between the rates of patient-reported incidents and patient harm documented in the patient record. The study was a secondary analysis of two national hospital assessments conducted in 2011. Hospital services in Norway. The patient survey was a standard national patient-experience survey conducted at the hospital level for all 63 hospitals in Norway. The medical record review was performed by 47 Global Trigger Tools (GTTs) in all 19 hospital trusts and 4 private hospitals. The two data sets were matched at the unit level, yielding comparable patient experiences and GTT data for 7 departments, 16 hospitals and 11 hospital trusts. No intervention. The correlation at the unit level between the patient-reported incident in hospital instrument (PRIH-I) and estimated rates of patient harm from the GTT. The PRIH-I index was significantly correlated with all patient-reported experience indicators at the individual level, with estimates for all patient harm events (Categories E-I) at the unit level (r = 0.62, P < 0.01), and with estimates of more serious harm events in Categories F-I (r = 0.42, P < 0.05). Patient-reported incidents in hospitals, as measured by the PRIH-I, are strongly correlated with patient harm rates based on the GTT. This indicates that patient-reported incidents are related to patient safety, but more research is needed to confirm the usefulness of patient reporting in the evaluation of patient safety. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  4. Cancer incidence rates in the Kurdistan region/Iraq from 2007-2009.

    Science.gov (United States)

    Othman, Ramadhan T; Abdulljabar, Rezvan; Saeed, Abdullah; Kittani, Sarwar Sadiq; Sulaiman, Hushyar M; Mohammed, Sami A; Rashid, Rekawt M; Hussein, Nawfal R

    2011-01-01

    Cancer is a disease of gradual increase in incidence overall the world. Kurdistan Region in Iraq has been exposed to several carcinogenic hazards. There are few reports about the increased risk of cancer in different cities in Iraq. These reports did not cover Kurdistan region. The aim of this paper was to study cancer incidence and to identify possible risks of cancer in this region. Cancer registries from 9 hospitals in three cities of Kurdistan were used as a source of data. Information on these cases was subjected to careful verification regarding repetition, place of residence and other possible errors. Overall registered cases in 2007, 2008 and 2009 were 1444, 2081, 2356 respectively. 49% of registered cases were males and 51% were female. The Age Standardized Rate of cancer was 89.83/100 000 among male and 83.93/100 000 among female. The results showed major variation in incidence rates of different types of cancer in the three governorates of Kurdistan. Furthermore, there was evidence of increased risks of cancer in Kurdistan Region in Iraq. Hematological malignancies were the most common cancer among male (21.13% of all cancer in males) and second most common in female (18.8% of all cancer in female), only exceeded by breast cancer. To reach sound conclusions about extent and determinants of cancer in Kurdistan, enormous multi-spectrum efforts are now needed.

  5. Population-Based Incidence Rates of First-Ever Stroke in Central Vietnam.

    Science.gov (United States)

    Yamanashi, Hirotomo; Ngoc, Mai Quang; Huy, Tran Van; Suzuki, Motoi; Tsujino, Akira; Toizumi, Michiko; Takahashi, Kensuke; Thiem, Vu Dinh; Anh, Dang Duc; Anh, Nguyen Thi Hien; Tho, Le Huu; Maeda, Takahiro; Cox, Sharon E; Yoshida, Lay-Myint; Ariyoshi, Koya

    2016-01-01

    Stroke incidence data with methodologically acceptable design in Southeast Asia countries is limited. This study aimed to determine incidence of age-, sex- and subtype-specific first-ever stroke (FES) in Vietnam. We conducted a hospital-based retrospective study, targeting all stroke cases hospitalized at a solo-provider hospital in our study site of Nha Trang from January 2009 to December 2011 with International Classification of Diseases, 10th revision (ICD-10) codes I60-69. We calculated positive predictive values (PPVs) of each ICD-10-coded stroke by conducting a detailed case review of 190 randomly selected admissions with ICD-10 codes of I60-I69. These PPVs were then used to estimate annual incident stroke cases from the computerized database. National census data in 2009 was used as a denominator. 2,693 eligible admissions were recorded during the study period. The crude annual incidence rate of total FES was 90.2 per 100,000 population (95% CI 81.1-100.2). The age-adjusted incidence of FES was 115.7 (95% CI 95.9-139.1) when adjusted to the WHO world populations. Importantly, age-adjusted intracerebral hemorrhage was as much as one third of total FES: 36.9 (95% CI 26.1-51.0). We found a considerable proportion of FES in Vietnam to be attributable to intracerebral hemorrhage, which is as high or exceeding levels seen in high-income countries. A high prevalence of improperly treated hypertension in Vietnam may underlie the high prevalence of intracerebral hemorrhagic stroke in this population.

  6. Incidence rates of suicidal behaviors and treated depression in patients with and without psoriatic arthritis using the Clinical Practice Research Datalink.

    Science.gov (United States)

    Hagberg, Katrina Wilcox; Li, Lin; Peng, Michael; Shah, Kamal; Paris, Maria; Jick, Susan

    2016-09-01

    To estimate rates of suicidal behaviors and treated depression in patients with psoriatic arthritis (PsA) in comparison to non-PsA patients. Using the Clinical Practice Research Datalink, we conducted a cohort study of patients with PsA compared to non-PsA patients. Patients with codes for suicidal behaviors (ideation, attempts, and suicide) and treated depression (diagnosis plus anti-depressant prescription) recorded during follow-up were identified as cases. We estimated incidence rates (IRs) and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) for each outcome and stratified results in the PsA cohort by receipt of systemic PsA drugs. The rates of suicide ideation, attempt, and suicide were similar for PsA and non-PsA patients [IRR = 0.99 (95%CI: 0.67-1.47), IRR = 1.07 (95%CI: 0.86-1.34), and 0.34 (95%CI: 0.05-2.48), respectively] and rates of suicidal behaviors were slightly higher among PsA patients who received PsA drugs compared to those who did not. PsA patients had slightly higher rate of treated depression compared to non-PsA patients [IRR = 1.38 (95%CI: 1.27-1.49)] and were significantly higher in PsA patients who received drugs [IRR = 1.59 (95%CI: 1.35-1.86)]. Rate of depression was higher in patients with PsA compared to non-PsA patients. The rate of suicidal behaviors was similar between the two cohorts.

  7. Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008-2014.

    Science.gov (United States)

    Jones, Rachel K; Jerman, Jenna

    2017-12-01

    To assess the prevalence of abortion among population groups and changes in rates between 2008 and 2014. We used secondary data from the Abortion Patient Survey, the American Community Survey, and the National Survey of Family Growth to estimate abortion rates. We used information from the Abortion Patient Survey to estimate the lifetime incidence of abortion. Between 2008 and 2014, the abortion rate declined 25%, from 19.4 to 14.6 per 1000 women aged 15 to 44 years. The abortion rate for adolescents aged 15 to 19 years declined 46%, the largest of any group. Abortion rates declined for all racial and ethnic groups but were larger for non-White women than for non-Hispanic White women. Although the abortion rate decreased 26% for women with incomes less than 100% of the federal poverty level, this population had the highest abortion rate of all the groups examined: 36.6. If the 2014 age-specific abortion rates prevail, 24% of women aged 15 to 44 years in that year will have an abortion by age 45 years. The decline in abortion was not uniform across all population groups.

  8. Prevalence of human endogenous retroviral element associates with Hodgkin's lymphoma incidence rates

    Directory of Open Access Journals (Sweden)

    Wee Hong Woo

    2014-01-01

    Full Text Available Human endogenous retrovirus-H (HERV-H is implicated in leukaemias and lymphomas, but the precise molecular mechanism underlying HERV-mediated carcinogenesis remains unknown. We determined the prevalence of HERV-H in a cross-section of the Singapore population and explored the relationship between HERV-H positivity and incidence rates for Hodgkin's lymphoma in three major ethnic groups of Singapore. We observed that Malays were 1.11 times likely (95% CI=1.05–1.17; P<0.01, and Indians 1.12 times likely (95% CI=1.07–1.18; P<0.01 to be HERV-H positive when compared to Chinese. Interestingly, the incidence rates of Hodgkin's lymphoma for the three races positively correlated to the respective prevalence rate for HERV-H positivity (r=0.9921 for male; r=0.9801 for female, suggesting that viral inheritance in human may predispose certain racial origin unfavourably to malignancy.

  9. Data study of death rate and cancer incidence among Thule workers, 2005

    International Nuclear Information System (INIS)

    Juel, K.; Engholm, G.; Storm, H.

    2005-12-01

    January 21st, 1968, an American B52 bomber with nuclear weapons aboard crashed close to the Thule air-base in Greenland. In 1986 suspicions arose that there might be increased disease incidences and death rate among the employees at the base that were involved in the clearing operations. During 1986 - 1995, several health studies were made of the Thule workers. These studies of death rate, cancer, hospitalization, and fertility did not show any differences between the Thule workers from the clearing operations and those not involved in the clearing. The present study shows no difference in total death rate among the clearing workers compared to other workers. The same results were found for cancer mortality, circulatory diseases, pulmonary diseases, natural causes, and accidents. As the previous studies showed, the present study shows that there were a slightly less number of suicides among the clearing workers. The data analyses show with great certainty that the Thule workers as a group do not have a great excessive mortality or an increased cancer incidence caused by the aircraft crash. Thus, the present results fall in line with the previous investigations. (ln)

  10. Disease control of delay SEIR model with nonlinear incidence rate and vertical transmission.

    Science.gov (United States)

    Cheng, Yan; Pan, Qiuhui; He, Mingfeng

    2013-01-01

    The aim of this paper is to develop two delayed SEIR epidemic models with nonlinear incidence rate, continuous treatment, and impulsive vaccination for a class of epidemic with latent period and vertical transition. For continuous treatment, we obtain a basic reproductive number ℜ0 and prove the global stability by using the Lyapunov functional method. We obtain two thresholds ℜ* and ℜ∗ for impulsive vaccination and prove that if ℜ* 1, then the disease is permanent by using the comparison theorem of impulsive differential equation. Numerical simulations indicate that pulse vaccination strategy or a longer latent period will make the population size infected by a disease decrease.

  11. Suppression of stratified explosive interactions

    Energy Technology Data Exchange (ETDEWEB)

    Meeks, M.K.; Shamoun, B.I.; Bonazza, R.; Corradini, M.L. [Wisconsin Univ., Madison, WI (United States). Dept. of Nuclear Engineering and Engineering Physics

    1998-01-01

    Stratified Fuel-Coolant Interaction (FCI) experiments with Refrigerant-134a and water were performed in a large-scale system. Air was uniformly injected into the coolant pool to establish a pre-existing void which could suppress the explosion. Two competing effects due to the variation of the air flow rate seem to influence the intensity of the explosion in this geometrical configuration. At low flow rates, although the injected air increases the void fraction, the concurrent agitation and mixing increases the intensity of the interaction. At higher flow rates, the increase in void fraction tends to attenuate the propagated pressure wave generated by the explosion. Experimental results show a complete suppression of the vapor explosion at high rates of air injection, corresponding to an average void fraction of larger than 30%. (author)

  12. The End of the Hysterectomy Epidemic and Endometrial Cancer Incidence: What Are the Unintended Consequences of Declining Hysterectomy Rates?

    Science.gov (United States)

    Temkin, Sarah M; Minasian, Lori; Noone, Anne-Michelle

    2016-01-01

    Population-level cancer incidence rates are one measure to estimate the cancer burden. The goal is to provide information on trends to measure progress against cancer at the population level and identify emerging patterns signifying increased risk for additional research and intervention. Endometrial cancer is the most common of the gynecologic malignancies but capturing the incidence of disease among women at risk (i.e., women with a uterus) is challenging and not routinely published. Decreasing rates of hysterectomy increase the number of women at risk for disease, which should be reflected in the denominator of the incidence rate calculation. Furthermore, hysterectomy rates vary within the United States by multiple factors including geographic location, race, and ethnicity. Changing rates of hysterectomy are important to consider when looking at endometrial cancer trends. By correcting for hysterectomy when calculating incidence rates of cancers of the uterine corpus, many of the disparities that have been assumed for this disease are diminished.

  13. High Mortality Rate of Stomach Cancer Caused Not by High Incidence but Delays in Diagnosis in Aomori Prefecture, Japan

    OpenAIRE

    Matsuzaka, Masashi; Tanaka, Rina; Sasaki, Yoshihiro

    2016-01-01

    Background: There are substantial differences in the mortality rates of stomach cancer among the 47 prefectures in Japan, and Aomori prefecture is one of the most severely impacted. The aims of this study were to determine the incidence and mortality rates of stomach cancer in Aomori prefecture in comparison with Japan as a whole and cast light on reasons underlying variation. Methods: Data on stomach cancer cases were extracted from the Aomori Cancer Registry Database. Incidence rates for sp...

  14. Effect of Birth Cohort on Risk of Hip Fracture: Age-Specific Incidence Rates in the Framingham Study

    Science.gov (United States)

    Samelson, Elizabeth J.; Zhang, Yuqing; Kiel, Douglas P.; Hannan, Marian T.; Felson, David T.

    2002-01-01

    Objectives. This study examined the effect of birth cohort on incidence rates of hip fracture among women and men in the Framingham Study. Methods. Age-specific incidence rates of first hip fracture were presented according to tertile of year of birth for 5209 participants of the Framingham Study, a population-based cohort followed since 1948. Sex-specific incidence rate ratios were calculated by Cox regression to assess the relation between birth cohort and hip fracture incidence. Results. An increasing trend in hip fracture incidence rates was observed with year of birth for women (trend, P = .05) and men (trend, P = .03). Relative to those born from 1887 to 1900 (incidence rate ratio [IRR] = 1.0), age-specific incidence rates were greatest in the most recent birth cohort, born from 1911 to 1921 (IRR = 1.4 for women, IRR = 2.0 for men), and intermediate in those born from 1901 to 1910 (IRR = 1.2 for women, IRR = 1.5 for men). Conclusions. Results suggest risk of hip fracture is increasing for successive birth cohorts. Projections that fail to account for the increase in rates associated with birth cohort underestimate the future public health impact of hip fracture in the United States. PMID:11988460

  15. Mortality rate and cancer incidence among in uterus exposed A-bomb survivors

    International Nuclear Information System (INIS)

    Yoshimoto, Yasuhiko

    1992-01-01

    This paper summarises the outcome of follow-up surveys on mortality rate and cancer incidence among in uterus exposed A-bomb survivors. The subjects were 1791 A-bomb survivors, and 1534 (85.7%) of these came from Hiroshima. According to uterus absorption doses, these A-bomb survivors could be divided into the 0 Gy exposed group (n=772) and the ≥0.01 Gy (a mean, 0.302 Gy) exposed group (n=1019). The number of proximally exposed A-bomb survivors (2,000 m or less) was approximately 3 times larger in Hiroshima than in Nagasaki, probably due to various socioeconomical factors. When the mortality rate was examined according to uterus absorption doses, it was higher at infancy and at the age of 15-39 in the ≥0.60 Gy exposed group than the 0 Gy exposed group. For infants, it was 3 times higher in the ≥0.60 Gy exposed group than the 0 Gy exposed group. The 1950-1984 survey on cancer incidence among in uterus exposed A-bomb survivors have revealed that cancer incidence tended to increase among in uterus exposed A-bomb survivors with increasing uterus absorption doses in their mothers. Since A-bomb survivors aged 15 years or younger at the time of A-bombing are characterized by developing leukemia 5-10 years after A-bombing, leukemia is unlikely to be increased among in uterus exposed A-bomb survivors. (N.K.)

  16. Correlation Analysis of Cocoa Consumption Data with Worldwide Incidence Rates of Testicular Cancer and Hypospadias

    Directory of Open Access Journals (Sweden)

    Fabrizio Giannandrea

    2009-02-01

    Full Text Available The underlying reasons for the increasing occurrence of male reproductive diseases (MRD such as hypospadias, cryptorchidism, and testicular cancer (TC over the last decades are still unknown. It has been hypothesized that the risk of MRD is determined in utero and that pregnancy dietary intake could also affect MRD risk in the offspring. Various studies in animals reported that cocoa and theobromine, the main stimulant of cocoa, exert toxic effects on the testis, inducing testicular atrophy and impaired sperm quality. A correlation analysis was conducted to examine the possible role of cocoa consumption on the occurrence of selected MRD during the prenatal and early life period of cases. The incidence rates between 1998-2002 of TC in 18 countries obtained from Cancer Incidence in Five Continents were correlated with the average per-capita consumption of cocoa (kg/capita/year (FAOSTAT-Database in these countries from 1965 to 1980, i.e. the period corresponding to the early life of TC cases. In order to test the above correlation in the case of hypospadias, the mean prevalence at birth in 20 countries (1999-2003 with average per-capita consumption of cocoa in these countries in the same period corresponding to pregnancy were used. The consumption of cocoa in the period 1965–80, was most closely correlated with the incidence of TC in young adults (r=0.859; p<0.001. An analogous significant correlation was also observed between early cocoa consumption and the prevalence rates of hypospadias in the period 1999-2003 (r=0.760; p<0.001. Although the ecological approach used in this study cannot provide an answer on the causal relationship between consumption of cocoa in early life and TC and hypospadias, the results are suggestive and indicate the need of further analytic studies to investigate the role of individual exposure to cocoa, particularly during the prenatal and in early life of the patients.

  17. Descriptive Study of the Environmental Epidemiology of High Lung Cancer 
Incidence Rate in Qujing, Yunnan, China

    Directory of Open Access Journals (Sweden)

    Linlin ZHANG

    2012-03-01

    Full Text Available Background and objective Qujing, located in Southwest China, is an area with an extremely high lung cancer incidence. Combustion of coal has exposed local people to great health hazards. The aim of this study is to achieve a thorough understanding of the relationship between environmental pollution and the high incidence of lung cancer in Qujing, Yunnan Province, China. The results would provide a scientific basis and support for the etiology of lung cancer, as well as suggestions on improving the environmental conditions in the area. Methods A total of 280 rural villages were selected through stratified cluster random sampling. Environmental background and pollution were investigated, including details on fuel type, coking plant, metal smelting, and chemical plant, among others. Logistic regression analysis was used to analyze the investigated factors. Results Out of the total number of local villages studied, 78.1% of those with high incidence often use smoky coal and coking. On the other hand, 78.8% of the low-incidence areas use smokeless coal or wood. Logistic regression analysis indicated that the coal type used for everyday life was a main risk factor related to lung cancer (P<0.05. Using smoky and coking coals create an alarmingly high risk for developing lung cancer. Meanwhile, smokeless coals and wood seemed to have no significant relationship to the lung cancer incidence. Conclusion The fuel type used for everyday life is an important factor in the high incidence of lung cancer in Qujing. Evidently, the use of smoky coal and coke increased the incidence of lung cancer, whereas smokeless coal and wood seem to bring about the contrary.

  18. Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: An overview.

    Science.gov (United States)

    Alotaibi, Abdulellah; Perry, Lin; Gholizadeh, Leila; Al-Ganmi, Ali

    2017-12-01

    This study aimed to report on the trends in incidence and prevalence rates of diabetes mellitus in Saudi Arabia over the last 25 years (1990-2015). A descriptive review. A systematic search was conducted for English-language, peer reviewed publications of any research design via Medline, EBSCO, PubMed and Scopus from 1990 to 2015. Of 106 articles retrieved, after removal of duplicates and quality appraisal, 8 studies were included in the review and synthesised based on study characteristics, design and findings. Studies originated from Saudi Arabia and applied a variety of research designs and tools to diagnosis diabetes. Of the 8 included studies; three reported type 1 diabetes and five on type 2 diabetes. Overall, findings indicated that the incidence and prevalence rate of diabetes is rising particularly among females, older children/adolescent and in urban areas. Further development are required to assess the health intervention, polices, guidelines, self-management programs in Saudi Arabia. Copyright © 2017. Published by Elsevier Ltd.

  19. Cancer incidence and mortality rate in children of A-bomb survivors

    International Nuclear Information System (INIS)

    Yoshimoto, Yasuhiko

    1992-01-01

    The purpose of this paper is to summarize the previous findings of carcinogenesis and mortality rate in children born to A-bomb survivors. The Radiation Effects Research Foundation has collected 72,228 children born to A-bomb survivors from May 1946 through 1984. Of their parents, 31,159 parents had been exposed to significant doses (≥0.01 Sv), with a mean genital dose of 0.435 Sv. Among a hypothetic population of 100,000 children of A-bomb survivors exposed to an mean genital dose of 0.4 SV, radiation-induced diseases were considered to occur in only 250 children or less. An earlier large-scale survey during the period 1948-1956 has revealed an evidence of significant increase in stillborn, congenital malformation, and infantile death. In the 1946-1982 survey concerning carcinogenesis in 72,216 children of A-bomb survivors, cancer was found to be detected in 92 children, with no statistically significant increase in cancer risk with increasing radiation doses in their parents. The survey on mortality rate in 67,586 children of A-bomb survivors has revealed no evidence of significant increase in mortality rate from diseases, other than cancer, and in the incidence of lethal cancer. For A-bomb survivors, genetic doubling doses were considered to be 1 Sv or more. Further, when genetic doubling doses are calculated, the contribution rate of genital cell disturbance should be considered in the incidence of spontaneously induced disease. There is no supportive evidence of genetic effects of A-bomb radiation in children of A-bomb survivors; however, genetic effects of A-bomb radiation cannot be denied completely. Continuing survey is expected to be done for children of A-bomb survivors. (N.K.)

  20. Falling Plasmodium knowlesi Malaria Death Rate among Adults despite Rising Incidence, Sabah, Malaysia, 2010-2014.

    Science.gov (United States)

    Rajahram, Giri S; Barber, Bridget E; William, Timothy; Grigg, Matthew J; Menon, Jayaram; Yeo, Tsin W; Anstey, Nicholas M

    2016-01-01

    Deaths from Plasmodium knowlesi malaria have been linked to delayed parenteral treatment. In Malaysia, early intravenous artesunate is now recommended for all severe malaria cases. We describe P. knowlesi fatalities in Sabah, Malaysia, during 2012-2014 and report species-specific fatality rates based on 2010-2014 case notifications. Sixteen malaria-associated deaths (caused by PCR-confirmed P. knowlesi [7], P. falciparum [7], and P. vivax [1] and microscopy-diagnosed "P. malariae" [1]) were reported during 2012-2014. Six patients with severe P. knowlesi malaria received intravenous artesunate at hospital admission. For persons ≥15 years of age, overall fatality rates during 2010-2014 were 3.4, 4.2, and 1.0 deaths/1,000 P. knowlesi, P. falciparum, and P. vivax notifications, respectively; P. knowlesi-associated fatality rates fell from 9.2 to 1.6 deaths/1,000 notifications. No P. knowlesi-associated deaths occurred among children, despite 373 notified cases. Although P. knowlesi malaria incidence is rising, the notification-fatality rate has decreased, likely due to improved use of intravenous artesunate.

  1. Falling Plasmodium knowlesi Malaria Death Rate among Adults despite Rising Incidence, Sabah, Malaysia, 2010–2014

    Science.gov (United States)

    Rajahram, Giri S.; William, Timothy; Grigg, Matthew J.; Menon, Jayaram; Yeo, Tsin W.; Anstey, Nicholas M.

    2016-01-01

    Deaths from Plasmodium knowlesi malaria have been linked to delayed parenteral treatment. In Malaysia, early intravenous artesunate is now recommended for all severe malaria cases. We describe P. knowlesi fatalities in Sabah, Malaysia, during 2012–2014 and report species-specific fatality rates based on 2010–2014 case notifications. Sixteen malaria-associated deaths (caused by PCR-confirmed P. knowlesi [7], P. falciparum [7], and P. vivax [1] and microscopy-diagnosed “P. malariae” [1]) were reported during 2012–2014. Six patients with severe P. knowlesi malaria received intravenous artesunate at hospital admission. For persons >15 years of age, overall fatality rates during 2010–2014 were 3.4, 4.2, and 1.0 deaths/1,000 P. knowlesi, P. falciparum, and P. vivax notifications, respectively; P. knowlesi–associated fatality rates fell from 9.2 to1.6 deaths/1,000 notifications. No P. knowlesi–associated deaths occurred among children, despite 373 notified cases. Although P. knowlesi malaria incidence is rising, the notification-fatality rate has decreased, likely due to improved use of intravenous artesunate. PMID:26690736

  2. Tuberculosis Incidence and Case Notification Rates in Kosovo and the Balkans in 2012: Cross-country Comparison.

    Science.gov (United States)

    Kurhasani, Xhevat; Hafizi, Hasan; Toci, Ervin; Burazeri, Genc

    2014-02-01

    Tuberculosis (TB) continues to be a considerable burden especially for millions of young adults and disadvantaged people worldwide. The TB incidence and notification rates are good indicators of TB situation in a country. Our aim was to compare TB incidence and notification rates in Kosovo and in seven other Balkan countries. Retrospective epidemiologic analysis of published data on TB incidence and notification rates in eight Balkan countries in 2012. Notification rates were expressed per 100,000 inhabitants and were calculated based on the number of TB cases reported divided by the population of each country under analysis. The TB incidence in Kosovo (47/100,000) was considerably higher compared to its four neighboring countries: Albania (16/100,000), Macedonia, Montenegro (18/100,000) and Serbia (23/100,000). The TB notification rates in Kosovo and other countries closely mimicked the incidence rates in these countries. The exceptionally high TB incidence rate in Kosovo could be due to many factors including low health and medical-seeking behaviors of the local population, poverty and low education levels. Effective interventions should be adapted to the local context in order to increase the chances of success.

  3. Monthly Incidence Rates of Abusive Encounters for Canadian Family Physicians by Patients and Their Families

    Directory of Open Access Journals (Sweden)

    Baukje (Bo Miedema

    2010-01-01

    Full Text Available Objective. The goal of this study was to examine the monthly incidence rates of abusive encounters for family physicians in Canada. Methods. A 7-page cross-sectional survey. Results. Of the entire study sample (N=720, 29% of the physicians reported having experienced an abusive event in the last month by a patient or patient family member. Abusive incidents were classified as minor, major, or severe. Of the physician participants who reported having been abused, all reported having experienced a minor event, 26% a major, and 8% a severe event. Of the physicians who experienced an abusive event, 55% were not aware of any policies to protect them, 76% did not seek help, and 64% did not report the abusive event. Conclusion. Family physicians are subjected to significant amounts of abuse in their day-to-day practices. Few physicians are aware of workplace policies that could protect them, and fewer report abusive encounters. Physicians would benefit from increased awareness of institutional policies that can protect them against abusive patients and their families and from the development of a national policy.

  4. Chaos induced by breakup of waves in a spatial epidemic model with nonlinear incidence rate

    International Nuclear Information System (INIS)

    Sun, Gui-Quan; Jin, Zhen; Liu, Quan-Xing; Li, Li

    2008-01-01

    Spatial epidemiology is the study of spatial variation in disease risk or incidence, including the spatial patterns of the population. The spread of diseases in human populations can exhibit large scale patterns, underlining the need for spatially explicit approaches. In this paper, the spatiotemporal complexity of a spatial epidemic model with nonlinear incidence rate, which includes the behavioral changes and crowding effect of the infective individuals, is investigated. Based on both theoretical analysis and computer simulations, we find out when, under the parameters which can guarantee a stable limit cycle in the non-spatial model, spiral and target waves can emerge. Moreover, two different kinds of breakup of waves are shown. Specifically, the breakup of spiral waves is from the core and the breakup of target waves is from the far-field, and both kinds of waves become irregular patterns at last. Our results reveal that the spatiotemporal chaos is induced by the breakup of waves. The results obtained confirm that diffusion can form spiral waves, target waves or spatial chaos of high population density, which enrich the findings of spatiotemporal dynamics in the epidemic model

  5. Computational Modelling and Optimal Control of Ebola Virus Disease with non-Linear Incidence Rate

    Science.gov (United States)

    Takaidza, I.; Makinde, O. D.; Okosun, O. K.

    2017-03-01

    The 2014 Ebola outbreak in West Africa has exposed the need to connect modellers and those with relevant data as pivotal to better understanding of how the disease spreads and quantifying the effects of possible interventions. In this paper, we model and analyse the Ebola virus disease with non-linear incidence rate. The epidemic model created is used to describe how the Ebola virus could potentially evolve in a population. We perform an uncertainty analysis of the basic reproductive number R 0 to quantify its sensitivity to other disease-related parameters. We also analyse the sensitivity of the final epidemic size to the time control interventions (education, vaccination, quarantine and safe handling) and provide the cost effective combination of the interventions.

  6. The role of climate on Malaria Incidence Rate in four governorates of Yemen.

    Science.gov (United States)

    Al-Mansoob, M A K; Al-Mazzah, M M

    2005-08-01

    The aim of study was to investigate the role of climate on the Malaria Incidence Rates (MIR) in some regions in of Yemen. For such purpose, the monthly (MIR) were calculated from the records of the hospitals' laboratories and centers of the Malaria Rollback centers in the main cities of the governorates Hudeidah, Taiz, Sana'a and Hadramout for the period 1989-1998. The readings of the climatic factors (CF) particularly the average monthly temperature (T), relative humidity (RH), volume of rain fall (RF) and wind speed (WS) for the same period of time were also collected from different weather and climatic information resources. Descriptive statistics, simple linear regression and multiple linear regression techniques were used to analyse the relationship between MIR and CF. The analysis shows highly significant relationship between MIR and the CF in these regions of Yemen (p-value 0.001).

  7. An SIRS Epidemic Model with Vital Dynamics and a Ratio-Dependent Saturation Incidence Rate

    Directory of Open Access Journals (Sweden)

    Xinli Wang

    2015-01-01

    Full Text Available This paper presents an investigation on the dynamics of an epidemic model with vital dynamics and a nonlinear incidence rate of saturated mass action as a function of the ratio of the number of the infectives to that of the susceptibles. The stabilities of the disease-free equilibrium and the endemic equilibrium are first studied. Under the assumption of nonexistence of periodic solution, the global dynamics of the model is established: either the number of infective individuals tends to zero as time evolves or it produces bistability in which there is a region such that the disease will persist if the initial position lies in the region and disappears if the initial position lies outside this region. Computer simulation shows such results.

  8. Community-based incidence rate of cardiovascular disease and mortality in 50-75 year old adults.

    Science.gov (United States)

    López-Suárez, A; Bascuñana-Quirell, A; Elvira-González, J; Beltrán-Robles, M; Aboza-Lobatón, A; Solís-Díaz, R

    2013-01-01

    Updated information on the incidence of the principal cardiovascular diseases (CVD) and cardiovascular mortality is not available in Spain. We have studied the incidence rate of new cases of myocardial infarction, heart failure, stroke and cardiovascular mortality in the adult population in Sanlúcar de Barrameda (Spain). A community-based prospective follow-up study was conducted. The study enrolled 858 participants aged 50-75 years who were randomly selected from the population and followed-up for 5 years. Age and gender-adjusted incidence rates of cardiovascular disease and cardiovascular mortality were calculated, obtaining complete information for 855 participants. Prognostic risk factors of new cases of cardiovascular disease were obtained using Cox proportional hazard modeling. The community-based incidence rate of heart failure was 455/100.000 persons-year. The incidence of myocardial infarction, stroke and cardiovascular mortality (506, 216 and 225/100.000 persons-year, respectively) was also very elevated. Male gender, family history of early cardiovascular disease, diabetes, hypertension and sedentary life style were independent risk factors of cardiovascular disease. The community-based incidence rate of heart failure in Sanlúcar de Barrameda (Spain) is very high, and it is the first to be reported in Spain. The incidence of myocardial infarction is among the highest in Spain. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  9. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  10. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  11. A web tool for age-period-cohort analysis of cancer incidence and mortality rates.

    Science.gov (United States)

    Rosenberg, Philip S; Check, David P; Anderson, William F

    2014-11-01

    Age-period-cohort (APC) analysis can inform registry-based studies of cancer incidence and mortality, but concerns about statistical identifiability and interpretability, as well as the learning curves of statistical software packages, have limited its uptake. We implemented a panel of easy-to-interpret estimable APC functions and corresponding Wald tests in R code that can be accessed through a user-friendly Web tool. Input data for the Web tool consist of age-specific numbers of events and person-years over time, in the form of a rate matrix of paired columns. Output functions include model-based estimators of cross-sectional and longitudinal age-specific rates, period and cohort rate ratios that incorporate the overall annual percentage change (net drift), and estimators of the age-specific annual percentage change (local drifts). The Web tool includes built-in examples for teaching and demonstration. User data can be input from a Microsoft Excel worksheet or by uploading a comma-separated-value file. Model outputs can be saved in a variety of formats, including R and Excel. APC methodology can now be carried out through a freely available user-friendly Web tool. The tool can be accessed at http://analysistools.nci.nih.gov/apc/. The Web tool can help cancer surveillance researchers make important discoveries about emerging cancer trends and patterns. ©2014 American Association for Cancer Research.

  12. Stratified vapor generator

    Science.gov (United States)

    Bharathan, Desikan [Lakewood, CO; Hassani, Vahab [Golden, CO

    2008-05-20

    A stratified vapor generator (110) comprises a first heating section (H.sub.1) and a second heating section (H.sub.2). The first and second heating sections (H.sub.1, H.sub.2) are arranged so that the inlet of the second heating section (H.sub.2) is operatively associated with the outlet of the first heating section (H.sub.1). A moisture separator (126) having a vapor outlet (164) and a liquid outlet (144) is operatively associated with the outlet (124) of the second heating section (H.sub.2). A cooling section (C.sub.1) is operatively associated with the liquid outlet (144) of the moisture separator (126) and includes an outlet that is operatively associated with the inlet of the second heating section (H.sub.2).

  13. Low incidence rate of overt hypothyroidism compared with hyperthyroidism in an area with moderately low iodine intake

    DEFF Research Database (Denmark)

    Laurberg, P; Bülow Pedersen, I; Pedersen, K M

    1999-01-01

    In areas with relatively high iodine intake, the incidence rate of hypothyroidism is several-fold higher than that of hyperthyroidism. Recently, we found a similarly high prevalence rate of subclinical hypothyroidism compared with hyperthyroidism in a high iodine intake area, while a relatively low...... prevalence of subclinical hypothyroidism was observed in a low iodine intake area. In the present study we compared the incidence rate (newly diagnosed in primary care and at hospital) of overt hypothyroidism with that of hyperthyroidism in a well-defined geographical area in Jutland, Denmark, with an iodine...... intake around 60 microg/day. The number of personsxyears studied was 569,108. Data on hyperthyroidism have been published previously. The overall incidence of hypothyroidism was 13.5/100,000 per year (F/M 22.9/3.6), hyperthyroidism 38.7/100.000 per year (F/M 63.0/13.0). The incidence of hypothyroidism...

  14. Addition of 24-Hour Heart Rate Variability Parameters to the Cardiovascular Health Study Stroke Risk Score and Prediction of Incident Stroke: The Cardiovascular Health Study

    Science.gov (United States)

    Bodapati, Rohan K.; Kizer, Jorge R.; Kop, Willem J.; Kamel, Hooman; Stein, Phyllis K.

    2018-01-01

    Background Heart rate variability (HRV) characterizes cardiac autonomic functioning. The association of HRV with stroke is uncertain. We examined whether 24-hour HRV added predictive value to the Cardiovascular Health Study clinical stroke risk score (CHS-SCORE), previously developed at the baseline examination. Methods and Results N=884 stroke-free CHS participants (age 75.3 ± 4.6), with 24-hour Holters adequate for HRV analysis at the 1994–1995 examination, had 68 strokes over ≤8 year follow-up (median 7.3 [interquartile range 7.1–7.6] years). The value of adding HRV to the CHS-SCORE was assessed with stepwise Cox regression analysis. The CHS-SCORE predicted incident stroke (HR=1.06 per unit increment, P=0.005). Two HRV parameters, decreased coefficient of variance of NN intervals (CV%, P=0.031) and decreased power law slope (SLOPE, P=0.033) also entered the model, but these did not significantly improve the c-statistic (P=0.47). In a secondary analysis, dichotomization of CV% (LOWCV% ≤12.8%) was found to maximally stratify higher-risk participants after adjustment for CHS-SCORE. Similarly, dichotomizing SLOPE (LOWSLOPE <− 1.4) maximally stratified higher-risk participants. When these HRV categories were combined (eg, HIGHCV% with HIGHSLOPE), the c-statistic for the model with the CHS-SCORE and combined HRV categories was 0.68, significantly higher than 0.61 for the CHS-SCORE alone (P=0.02). Conclusions In this sample of older adults, 2 HRV parameters, CV% and power law slope, emerged as significantly associated with incident stroke when added to a validated clinical risk score. After each parameter was dichotomized based on its optimal cut point in this sample, their composite significantly improved prediction of incident stroke during ≤8-year follow-up. These findings will require validation in separate, larger cohorts. PMID:28396041

  15. Fruits and vegetables intake differentially affects estrogen receptor negative and positive breast cancer incidence rates.

    Science.gov (United States)

    Olsen, Anja; Tjønneland, Anne; Thomsen, Birthe L; Loft, Steffen; Stripp, Connie; Overvad, Kim; Møller, Susanne; Olsen, Jørgen H

    2003-07-01

    Despite intensive research, the evidence for a protective effect of fruits and vegetables on breast cancer risk remains inconclusive. Other risk factors for breast cancer seem to vary with the estrogen receptor status of the breast tumor, and it is thus possible that the inconsistent results regarding a preventive effect of fruits and vegetables are due to lack of controlling for estrogen receptor status. The objective of this study was to investigate the effect of fruit and vegetable intake on postmenopausal breast cancer and explore whether the estrogen receptor status of the tumor modifies this relation. Postmenopausal women (n = 23,798; aged 50-64 y) provided information about diet and established risk factors for breast cancer in the cohort "Diet, Cancer and Health." During follow-up, 425 cases were diagnosed with breast cancer. Associations between intake of fruits and vegetables and the breast cancer rate were analyzed using Cox's regression model. The association for all breast cancers was an incidence rate ratio (IRR) of 1.02 (95% CI, 0.98-1.06) per 100 g/d increment of total intake of fruits, vegetables and juice. For estrogen receptor-positive (ER(+)) breast cancer, a borderline significant increase in the rate was seen, IRR: 1.05 (95% CI, 1.00-1.10), whereas a preventive effect was seen for estrogen receptor-negative (ER(-)) breast cancers, IRR: 0.90 (95% CI, 0.81-0.99). In conclusion, we did not find the overall breast cancer rate to be associated with the intake of fruits and vegetables, but there seemed to be different effects for ER(+) and ER(-) breast cancer.

  16. The incidence rate of thyroid cancer among women in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001-2008.

    Science.gov (United States)

    Alghamdi, Ibrahim G; Hussain, Issam I; Alghamdi, Mohamed S; Dohal, Ahlam A; Almalki, Shaia S; El-Sheemy, Mohammed A

    2015-06-01

    This study provides a descriptive epidemiological data of thyroid cancer cases diagnosed from 2001 to 2008 among Saudi women, including the frequency and percentage of cases, the crude incidence rate (CIR) and the age-standardised incidence rate (ASIR) stratified by the region and year of diagnosis. This is a retrospective descriptive epidemiological analysis of all Saudi thyroid cancer cases recorded in the Saudi Cancer Registry (SCR) between January 2001 and December 2008. The statistical analyses were applied using descriptive statistics with the Statistical Package for the Social Sciences version 20.0. A total of 2,930 cases were recorded in the SCR between January 2001 and December 2008. The region of Riyadh in Saudi Arabia had the highest overall ASIR at 9.43 per 100,000 women, followed by Tabuk at 7.11 and eastern region at 6.5, while Jazan and Jouf had the lowest average ASIRs at 1.97 and at 2.72, respectively. The region of Qassim recorded the greatest changes of ASIR at 5.5 per 100,000 women from 2001 to 2008. There was a slight increase in the CIRs and ASIRs for thyroid cancer in Saudi Arabia between 2001 and 2008. Riyadh, Tabuk and eastern region were the highest overall ASIR in Saudi Arabia. While, Jazan and Hail had the lowest rates. Finally, the region of Qassim had the highest changes in CIR and ASIR from 2001 to 2008. Further analytical studies are needed to determine the potential risk factors of thyroid cancer disease among Saudi women.

  17. Incidence Rates of Clinical Mastitis among Canadian Holsteins Classified as High, Average, or Low Immune Responders

    Science.gov (United States)

    Miglior, Filippo; Mallard, Bonnie A.

    2013-01-01

    The objective of this study was to compare the incidence rate of clinical mastitis (IRCM) between cows classified as high, average, or low for antibody-mediated immune responses (AMIR) and cell-mediated immune responses (CMIR). In collaboration with the Canadian Bovine Mastitis Research Network, 458 lactating Holsteins from 41 herds were immunized with a type 1 and a type 2 test antigen to stimulate adaptive immune responses. A delayed-type hypersensitivity test to the type 1 test antigen was used as an indicator of CMIR, and serum antibody of the IgG1 isotype to the type 2 test antigen was used for AMIR determination. By using estimated breeding values for these traits, cows were classified as high, average, or low responders. The IRCM was calculated as the number of cases of mastitis experienced over the total time at risk throughout the 2-year study period. High-AMIR cows had an IRCM of 17.1 cases per 100 cow-years, which was significantly lower than average and low responders, with 27.9 and 30.7 cases per 100 cow-years, respectively. Low-AMIR cows tended to have the most severe mastitis. No differences in the IRCM were noted when cows were classified based on CMIR, likely due to the extracellular nature of mastitis-causing pathogens. The results of this study demonstrate the desirability of breeding dairy cattle for enhanced immune responses to decrease the incidence and severity of mastitis in the Canadian dairy industry. PMID:23175290

  18. Risk factors for breast cancer in a population with high incidence rates

    International Nuclear Information System (INIS)

    Wrensch, Margaret; Peskin-Mentzer, Roni; Quesenberry, Charles P Jr; Souders-Mason, Virginia; Spence, Linda; Suzuki, Marisa; Gould, Mary; Chew, Terri; Farren, Georgianna; Barlow, Janice; Belli, Flavia; Clarke, Christina; Erdmann, Christine A; Lee, Marion; Moghadassi, Michelle

    2003-01-01

    This report examines generally recognized breast cancer risk factors and years of residence in Marin County, California, an area with high breast cancer incidence and mortality rates. Eligible women who were residents of Marin County diagnosed with breast cancer in 1997–99 and women without breast cancer obtained through random digit dialing, frequency-matched by cases' age at diagnosis and ethnicity, participated in either full in-person or abbreviated telephone interviews. In multivariate analyses, 285 cases were statistically significantly more likely than 286 controls to report being premenopausal, never to have used birth control pills, a lower highest lifetime body mass index, four or more mammograms in 1990–94, beginning drinking after the age of 21, on average drinking two or more drinks per day, the highest quartile of pack-years of cigarette smoking and having been raised in an organized religion. Cases and controls did not significantly differ with regard to having a first-degree relative with breast cancer, a history of benign breast biopsy, previous radiation treatment, age at menarche, parity, use of hormone replacement therapy, age of first living in Marin County, or total years lived in Marin County. Results for several factors differed for women aged under 50 years or 50 years and over. Despite similar distributions of several known breast cancer risk factors, case-control differences in alcohol consumption suggest that risk in this high-risk population might be modifiable. Intensive study of this or other areas of similarly high incidence might reveal other important risk factors proximate to diagnosis

  19. Heart rate variability is enhanced in controls but not maladaptive perfectionists during brief mindfulness meditation following stress-induction: A stratified-randomized trial.

    Science.gov (United States)

    Azam, Muhammad Abid; Katz, Joel; Fashler, Samantha R; Changoor, Tina; Azargive, Saam; Ritvo, Paul

    2015-10-01

    Heart rate variability (HRV) is a vagal nerve-mediated biomarker of cardiac function used to investigate chronic illness, psychopathology, stress and, more recently, attention-regulation processes such as meditation. This study investigated HRV in relation to maladaptive perfectionism, a stress-related personality factor, and mindfulness meditation, a stress coping practice expected to elevate HRV, and thereby promote relaxation. Maladaptive perfectionists (n=21) and Controls (n=39) were exposed to a lab-based assessment in which HRV was measured during (1) a 5-minute baseline resting phase, (2) a 5-minute cognitive stress-induction phase, and (3) a post-stress phase. In the post-stress phase, participants were randomly assigned to a 10-minute audio-instructed mindfulness meditation condition or a 10-minute rest condition with audio-description of mindfulness meditation. Analyses revealed a significant elevation in HRV during meditation for Controls but not for Perfectionists. These results suggest that mindfulness meditation promotes relaxation following cognitive stress and that the perfectionist personality hinders relaxation possibly because of decreased cardiac vagal tone. The results are discussed in the context of developing psychophysiological models to advance therapeutic interventions for distressed populations. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Spatio-seasonal modeling of the incidence rate of malaria in Mozambique

    Directory of Open Access Journals (Sweden)

    Nhalungo Delino

    2008-10-01

    Full Text Available Abstract Background The objective was to study the seasonal effect on the spatial distribution of the incidence of malaria in children under 10 years old living in the Manhiça district, Mozambique. Methods The data of the clinical malaria incidence were obtained from a study of two cohorts of children followed from December 1996 to July 1999. The cases were obtained by the active detection method. Hierarchical Bayesian models were used to model the incidence of malaria, including spatial correlation nested to climatic season. The models were compared with the deviance information criterion. The age and gender of the children were also taken into account. Results The incidence of malaria is associated with age, period and climate season. The incidence presents a clear spatial pattern, with a higher incidence in the neighbourhoods situated in the north and northeast of the Manhiça area. The transmission of malaria is highest during the wet season but the spatial pattern of malaria does not differ from that during the dry season. Conclusion The incidence of malaria in Manhiça presents a spatial pattern which is independent of the seasonal climatic conditions. The climate modifies the incidence of malaria in the entire region but does not change the spatial pattern of the incidence of this disease. These findings may be useful for the planning of malaria control activities. These activities can be performed taking account that the neighbourhoods with more incidence of malaria do not change over the annual climate seasons.

  1. The stratified Boycott effect

    Science.gov (United States)

    Peacock, Tom; Blanchette, Francois; Bush, John W. M.

    2005-04-01

    We present the results of an experimental investigation of the flows generated by monodisperse particles settling at low Reynolds number in a stably stratified ambient with an inclined sidewall. In this configuration, upwelling beneath the inclined wall associated with the Boycott effect is opposed by the ambient density stratification. The evolution of the system is determined by the relative magnitudes of the container depth, h, and the neutral buoyancy height, hn = c0(ρp-ρf)/|dρ/dz|, where c0 is the particle concentration, ρp the particle density, ρf the mean fluid density and dρ/dz Boycott layer transports dense fluid from the bottom to the top of the system; subsequently, the upper clear layer of dense saline fluid is mixed by convection. For sufficiently strong stratification, h > hn, layering occurs. The lowermost layer is created by clear fluid transported from the base to its neutral buoyancy height, and has a vertical extent hn; subsequently, smaller overlying layers develop. Within each layer, convection erodes the initially linear density gradient, generating a step-like density profile throughout the system that persists after all the particles have settled. Particles are transported across the discrete density jumps between layers by plumes of particle-laden fluid.

  2. Elevated incidence rates of diabetes in Peru: report from PERUDIAB, a national urban population-based longitudinal study.

    Science.gov (United States)

    Seclen, Segundo Nicolas; Rosas, Moises Ernesto; Arias, Arturo Jaime; Medina, Cecilia Alexandra

    2017-01-01

    A recent report from a non-nationally representative, geographically diverse sample in four separate communities in Peru suggests an unusually high diabetes incidence. We aimed to estimate the national diabetes incidence rate using PERUDIAB, a probabilistic, national urban population-based longitudinal study. 662 subjects without diabetes, selected by multistage, cluster, random sampling of households, representing the 24 administrative and the 3 (coast, highlands and jungle) natural regions across the country, from both sexes, aged 25+ years at baseline, enrolled in 2010-2012, were followed for 3.8 years. New diabetes cases were defined as fasting blood glucose ≥126 mg/dL or on medical diabetes treatment. There were 49 cases of diabetes in 2408 person-years follow-up. The weighted cumulative incidence of diabetes was 7.2% while the weighted incidence rate was estimated at 19.5 (95% CI 13.9 to 28.3) new cases per 1000 person-years. Older age, obesity and technical or higher education were statistically associated with the incidence of diabetes. Our results confirm that the incidence of diabetes in Peru is among the highest reported globally. The fast economic growth in the last 20 years, high overweight and obesity rates may have triggered this phenomenon.

  3. Dynamics of a Delayed HIV-1 Infection Model with Saturation Incidence Rate and CTL Immune Response

    Science.gov (United States)

    Guo, Ting; Liu, Haihong; Xu, Chenglin; Yan, Fang

    2016-12-01

    In this paper, we investigate the dynamics of a five-dimensional virus model incorporating saturation incidence rate, CTL immune response and three time delays which represent the latent period, virus production period and immune response delay, respectively. We begin this model by proving the positivity and boundedness of the solutions. Our model admits three possible equilibrium solutions, namely the infection-free equilibrium E0, the infectious equilibrium without immune response E1 and the infectious equilibrium with immune response E2. Moreover, by analyzing corresponding characteristic equations, the local stability of each of the feasible equilibria and the existence of Hopf bifurcation at the equilibrium point E2 are established, respectively. Further, by using fluctuation lemma and suitable Lyapunov functionals, it is shown that E0 is globally asymptotically stable when the basic reproductive numbers for viral infection R0 is less than unity. When the basic reproductive numbers for immune response R1 is less than unity and R0 is greater than unity, the equilibrium point E1 is globally asymptotically stable. Finally, some numerical simulations are carried out for illustrating the theoretical results.

  4. Stratifying the Risk of Venous Thromboembolism in Otolaryngology

    Science.gov (United States)

    Shuman, Andrew G.; Hu, Hsou Mei; Pannucci, Christopher J.; Jackson, Christopher R.; Bradford, Carol R.; Bahl, Vinita

    2015-01-01

    Objective The consequences of perioperative venous thromboembolism (VTE) are devastating; identifying patients at risk is an essential step in reducing morbidity and mortality. The utility of perioperative VTE risk assessment in otolaryngology is unknown. This study was designed to risk-stratify a diverse population of otolaryngology patients for VTE events. Study Design Retrospective cohort study. Setting Single-institution academic tertiary care medical center. Subjects and Methods Adult patients presenting for otolaryngologic surgery requiring hospital admission from 2003 to 2010 who did not receive VTE chemoprophylaxis were included. The Caprini risk assessment was retrospectively scored via a validated method of electronic chart abstraction. Primary study variables were Caprini risk scores and the incidence of perioperative venous thromboembolic outcomes. Results A total of 2016 patients were identified. The overall 30-day rate of VTE was 1.3%. The incidence of VTE in patients with a Caprini risk score of 6 or less was 0.5%. For patients with scores of 7 or 8, the incidence was 2.4%. Patients with a Caprini risk score greater than 8 had an 18.3% incidence of VTE and were significantly more likely to develop a VTE when compared to patients with a Caprini risk score less than 8 (P otolaryngology patients for 30-day VTE events and allows otolaryngologists to identify patient subgroups who have a higher risk of VTE in the absence of chemoprophylaxis. PMID:22261490

  5. Incidence rates of occupational diseases in the Dutch construction sector, 2010-2014

    NARCIS (Netherlands)

    van der Molen, Henk F.; de Vries, Sanne C.; Stocks, S. Jill; Warning, Jan; Frings-Dresen, Monique H. W.

    2016-01-01

    To estimate incidence and trends in incidence of occupational diseases (ODs) in the Dutch construction sector. In a dynamic prospective cohort over a 5-year period (2010-2014), ODs assessed by occupational physicians (OPs) participating in a voluntary construction workers health surveillance (WHS)

  6. Incidence Rate of Community-Acquired Sepsis Among Hospitalized Acute Medical Patients-A Population-Based Survey

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Laursen, Christian B; Jensen, Thøger Gorm

    2015-01-01

    OBJECTIVE:: Sepsis is a frequent cause of admission, but incidence rates based on administrative data have previously produced large differences in estimates. The aim of the study was to estimate the incidence of community-acquired sepsis based on patients' symptoms and clinical findings at arrival...... to define the presence of systemic inflammatory response syndrome and organ dysfunction. MEASUREMENTS AND MAIN RESULTS:: Incidence rate of sepsis of any severity. Among 8,358 admissions to the medical emergency department, 1,713 patients presented with an incident admission of sepsis of any severity, median...... age 72 years (5-95%; range, 26-91 yr), 793 (46.3%) were men, 728 (42.5%) presented with a Charlson comorbidity index greater than 2,621 (36.3%) were admitted with sepsis, 1,071 (62.5%) with severe sepsis, and 21 (1.2%) with septic shock. Incidence rate was 731/100,000 person-years at risk (95% CI, 697...

  7. Survey on th incidence of homeless pulmonary tuberculosis infection rate through chest x-ray examination

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Shin, Sung Rae [Dept. of Nursing, Sahmyook University, Seoul (Korea, Republic of); Ryu, Young Hwan [Dept. of Radiology, Seoul Medical Center, Seoul (Korea, Republic of); Lim, Hwan Yeal [Dept. of Medical Business Administration, U1 University, Yeongdong (Korea, Republic of)

    2017-02-15

    This study, Seoul City shelter, you are trying to seek medical cooperation and cure rate increase proposal Yu fndings’s current situation and tuberculosis of homeless tuberculosis. Inspector, and has a total 591 people is targeted to implement an interview after acquiring utilization agreement in studies conducted chest X-ray photography. Of the interview questions, three or more protons, it is determined that the TB symptomatic conducted sputum examination, chest X-ray examination confrms the physician radiology, when sputum examination primarily chromatic fndings the double implemented and conducted by requesting the ship inspection also said inspection sputum acid-fast bacteria if it is true one, respectively. confrmed case result of checking whether there is a difference due to risk factors (Jb) at the chi square black, it was found that there is no statistically significant difference at 95% confidence level. (χ{sup 2}=0.276, p>0.05), suspected case (Ac, Ae) results of examining whether there is a difference due to risk factors in chi square black, that there is a statistically significant difference at 99% confidence level is I found (χ{sup 2}=9.414, p<0.01). The nature of the homeless tuberculosis screening and directed to the distance homeless specifc location are likely to evaluate the actual incidence low and aggressive or management needs, the rationale is allowed insufficient reality is. Through this research, future, for tuberculosis high risk tuberculosis patient, such as homeless to expand the tuberculosis screening of infectious tuberculosis patients in private medical institutions, and one-stop service that chest X-ray examination and sputum examination is carried out at the same time introduced immediately to prevent the inspection and examination, cure, and should establish a foundation that can be up to post administration.

  8. Survey on th incidence of homeless pulmonary tuberculosis infection rate through chest x-ray examination

    International Nuclear Information System (INIS)

    Kim, Mi Young; Shin, Sung Rae; Ryu, Young Hwan; Lim, Hwan Yeal

    2017-01-01

    This study, Seoul City shelter, you are trying to seek medical cooperation and cure rate increase proposal Yu fndings’s current situation and tuberculosis of homeless tuberculosis. Inspector, and has a total 591 people is targeted to implement an interview after acquiring utilization agreement in studies conducted chest X-ray photography. Of the interview questions, three or more protons, it is determined that the TB symptomatic conducted sputum examination, chest X-ray examination confrms the physician radiology, when sputum examination primarily chromatic fndings the double implemented and conducted by requesting the ship inspection also said inspection sputum acid-fast bacteria if it is true one, respectively. confrmed case result of checking whether there is a difference due to risk factors (Jb) at the chi square black, it was found that there is no statistically significant difference at 95% confidence level. (χ 2 =0.276, p>0.05), suspected case (Ac, Ae) results of examining whether there is a difference due to risk factors in chi square black, that there is a statistically significant difference at 99% confidence level is I found (χ 2 =9.414, p<0.01). The nature of the homeless tuberculosis screening and directed to the distance homeless specifc location are likely to evaluate the actual incidence low and aggressive or management needs, the rationale is allowed insufficient reality is. Through this research, future, for tuberculosis high risk tuberculosis patient, such as homeless to expand the tuberculosis screening of infectious tuberculosis patients in private medical institutions, and one-stop service that chest X-ray examination and sputum examination is carried out at the same time introduced immediately to prevent the inspection and examination, cure, and should establish a foundation that can be up to post administration

  9. Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status

    Directory of Open Access Journals (Sweden)

    Melani Carla

    2008-10-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Methods Seven regions were considered (overall population, 14.9 million over 3–6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare. Incidence rates of in-hospital cases of CTS were estimated based on 1 codified demographic, diagnostic and intervention data in obligatory discharge records from all Italian public/private hospitals, archived (according to residence on regional databases; 2 demographic general population data for each region. We compared (using the χscore test age-sex-specific rates between married, unmarried, divorced and widowed subsets of the general population. We calculated standardized incidence ratios (SIRs for married/unmarried men and women. Results Age-standardized incidence rates (per 100,000 person-years of in-hospital cases of CTS were 166 in women and 44 in men (106 overall. Married subjects of both sexes showed higher age-specific rates with respect to unmarried men/women. SIRs were calculated comparing married vs unmarried rates of both sexes: 1.59 (95% confidence interval [95% CI], 1.57–1.60 in women, and 1.42 (95% CI, 1.40–1.45 in men. As compared with married women/men, widows/widowers both showed 2–3-fold higher incidence peaks during the fourth decade of life (beyond 50 years of age, widowed subjects showed similar trends to unmarried counterparts. Conclusion This large population-based study illustrates distinct age-related trends in men and women, and also raises the question whether marital status could be associated with CTS in the general population.

  10. Incidence rates and risk factors of bipolar disorder in the general population: a population-based cohort study

    NARCIS (Netherlands)

    Kroon, Jojanneke S.; Wohlfarth, Tamar D.; Dieleman, Jeanne; Sutterland, Arjen L.; Storosum, Jitschak G.; Denys, Damiaan; de Haan, Lieuwe; Sturkenboom, Mirjam C. J. M.

    2013-01-01

    To estimate the incidence rates (IRs) of bipolar I and bipolar II disorders in the general population according to sociodemographic population characteristics. A cohort study (during the years 1996-2007) was conducted in a general practitioners research database with a longitudinal electronic record

  11. [Seasonality of rotavirus infection in Venezuela: relationship between monthly rotavirus incidence and rainfall rates].

    Science.gov (United States)

    González Chávez, Rosabel

    2015-09-01

    In general, it has been reported that rotavirus infection was detected year round in tropical countries. However, studies in Venezuela and Brazil suggest a seasonal behavior of the infection. On the other hand, some studies link infection with climatic variables such as rainfall. This study analyzes the pattern of behavior of the rotavirus infection in Carabobo-Venezuela (2001-2005), associates the seasonality of the infection with rainfall, and according to the seasonal pattern, estimates the age of greatest risk for infection. The analysis of the rotavirus temporal series and accumulated precipitation was performed with the software SPSS. The infection showed two periods: high incidence (November-April) and low incidence (May-October). Accumulated precipitation presents an opposite behavior. The highest frequency of events (73.8% 573/779) for those born in the period with a low incidence of the virus was recorded at an earlier age (mean age 6.5 +/- 2.0 months) when compared with those born in the station of high incidence (63.5% 568/870, mean age 11.7 +/- 2.2 months). Seasonality of the infection and the inverse relationship between virus incidence and rainfall was demonstrated. In addition, it was found that the period of birth determines the age and risk of infection. This information generated during the preaccine period will be helpful to measure the impact of the vaccine against the rotavirus.

  12. Incidence rates of enterovirus 71 infections in young children during a nationwide epidemic in Taiwan, 2008-09.

    Directory of Open Access Journals (Sweden)

    Min-Shi Lee

    Full Text Available OBJECTIVE: Enterovirus 71 (EV71 is causing life-threatening outbreaks in tropical Asia. In Taiwan and other tropical Asian countries, although nationwide EV71 epidemics occur cyclically, age-specific incidence rates of EV71 infections that are critical to estimate disease burden and design vaccine trials are not clear. A nationwide EV71 epidemic occurred in 2008-09 in Taiwan, which provided a unique opportunity to estimate age-specific incidence rates of EV71 infections. STUDY DESIGN: We prospectively recruited 749 healthy neonates and conducted follow-ups from June 2006 to December 2009. Sera were obtained from participants at 0, 6, 12, 24, and 36 months of age for measuring EV71 neutralizing antibody titers. If the participants developed suspected enterovirus illnesses, throat swabs were collected for virus isolation. RESULTS: We detected 28 EV71 infections including 20 symptomatic and 8 asymptomatic infections. Age-specific incidence rates of EV71 infection increased from 1.71 per 100 person-years at 0-6 months of age to 4.09, 5.74, and 4.97 per 100 person-years at 7-12, 13-24, and 25-36 months of age, respectively. Cumulative incidence rate was 15.15 per 100 persons by 36 months of age, respectively. CONCLUSIONS: Risk of EV71 infections in Taiwan increased after 6 months of age during EV71 epidemics. The cumulative incidence rate was 15% by 36 months of age, and 29% of EV71 infections were asymptomatic in young children.

  13. Estimating the incidence reporting rates of new influenza pandemics at an early stage using travel data from the source country.

    Science.gov (United States)

    Chong, K C; Fong, H F; Zee, C Y

    2014-05-01

    During the surveillance of influenza pandemics, underreported data are a public health challenge that complicates the understanding of pandemic threats and can undermine mitigation efforts. We propose a method to estimate incidence reporting rates at early stages of new influenza pandemics using 2009 pandemic H1N1 as an example. Routine surveillance data and statistics of travellers arriving from Mexico were used. Our method incorporates changes in reporting rates such as linearly increasing trends due to the enhanced surveillance. From our results, the reporting rate was estimated at 0·46% during early stages of the pandemic in Mexico. We estimated cumulative incidence in the Mexican population to be 0·7% compared to 0·003% reported by officials in Mexico at the end of April. This method could be useful in estimation of actual cases during new influenza pandemics for policy makers to better determine appropriate control measures.

  14. Increased Incidence of Campylobacter spp. Infection and High Rates among Children, Israel

    Science.gov (United States)

    Lerner, Larisa; Valinsky, Lea; Moran-Gilad, Jacob; Nissan, Israel; Agmon, Vered; Peretz, Chava

    2013-01-01

    During 1999–2010, the annual incidence of Campylobacter spp. infection in Israel increased from 31.04 to 90.99 cases/100,000 population, a yearly increase of 10.24%. Children 26-fold higher than for the 30–<50 age group. PMID:24188185

  15. Age-Specific Incidence Rates for Dementia and Alzheimer Disease in NIA-LOAD/NCRAD and EFIGA Families

    Science.gov (United States)

    Vardarajan, Badri N.; Faber, Kelley M.; Bird, Thomas D.; Bennett, David A.; Rosenberg, Roger; Boeve, Bradley F.; Graff-Radford, Neill R.; Goate, Alison M.; Farlow, Martin; Sweet, Robert A.; Lantigua, Rafael; Medrano, Martin Z.; Ottman, Ruth; Schaid, Daniel J.; Foroud, Tatiana M.; Mayeux, Richard

    2014-01-01

    IMPORTANCE Late-onset Alzheimer disease (LOAD), defined as onset of symptoms after age 65 years, is the most common form of dementia. Few reports investigate incidence rates in large family-based studies in which the participants were selected for family history of LOAD. OBJECTIVE To determine the incidence rates of dementia and LOAD in unaffected members in the National Institute on Aging Genetics Initiative for Late-Onset Alzheimer Disease/National Cell Repository for Alzheimer Disease (NIA-LOAD/NCRAD) and Estudio Familiar de Influencia Genetica en Alzheimer (EFIGA) family studies. DESIGN, SETTING, AND PARTICIPANTS Families with 2 or more affected siblings who had a clinical or pathological diagnosis of LOAD were recruited as a part of the NIA-LOAD/NCRAD Family Study. A cohort of Caribbean Hispanics with familial LOAD was recruited in a different study at the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain in New York and from clinics in the Dominican Republic as part of the EFIGA study. MAIN OUTCOMES AND MEASURES Age-specific incidence rates of LOAD were estimated in the unaffected family members in the NIA-LOAD/NCRAD and EFIGA data sets. We restricted analyses to families with follow-up and complete phenotype information, including 396 NIA-LOAD/NCRAD and 242 EFIGA families. Among the 943 at-risk family members in the NIA-LOAD/NCRAD families, 126 (13.4%) developed dementia, of whom 109 (86.5%) met criteria for LOAD. Among 683 at-risk family members in the EFIGA families, 174 (25.5%) developed dementia during the study period, of whom 145 (83.3%) had LOAD. RESULTS The annual incidence rates of dementia and LOAD in the NIA-LOAD/NCRAD families per person-year were 0.03 and 0.03, respectively, in participants aged 65 to 74 years; 0.07 and 0.06, respectively, in those aged 75 to 84 years; and 0.08 and 0.07, respectively, in those 85 years or older. Incidence rates in the EFIGA families were slightly higher, at 0.03 and 0.02, 0.06 and 0.05, 0

  16. Incidence rate of thyroid cancer in Neuquén (2001-2012).

    Science.gov (United States)

    Cohen Sabban, Marcos Alejandro; Palmero, Cintia; Bertrand, Beatriz; Aiello, Ana; Ghiglioni, Amalia; Mac Donell, Maria Celina; Croci, Cecilia; Cabaeiro, Patricia; Juvenal, Guillermo Juan

    2014-11-01

    During the past decades, an increasing incidence of thyroid cancer (TC) has been reported worldwide. In Argentina there is no national cancer registry, and its incidence has therefore not been established. The aim of our study was to determine the incidence of TC in the province of Neuquén and to compare it to that reported in the literature. The medical records of 229 patients admitted over a period of 12 years (2001 to 2012) were used for data analysis. Tumor size, age, sex, and histological type were evaluated. The study period was divided into four three-year periods, and differences in each of these features were analyzed. We found an incidence of 4.72/100,000 inhabitants/year, and almost all patients had papillary TC. TC was five times more common in females as compared to males (7.78 and 1.55 respectively). Mean tumor size was 22.2 ± 1.1 mm. Tumor size was significantly greater in men (31.8 ± 3.7 mm) than in women (20.4 ± 1.0 mm). When grouped by three-year periods, a higher number of cases was found in the last one (47, 49, 49 and 84 respectively). As regards tumor distribution by size, there was a significant decrease in mean tumor size in the fourth period and an increase in the proportion of tumors <10mm. We report an increase in TC incidence in the Argentinean province of Neuquén which is similar to the overall increase reported in the international literature. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

  17. Investigation of effect of blood pressure and heart rate changes in different positions (lying and sitting on hypotension incidence rate after spinal anesthesia in patients undergoing caesarean section

    Directory of Open Access Journals (Sweden)

    Nahid Manouchehrian

    2016-07-01

    Full Text Available Due to the relatively high prevalence of hypotension (20% -40% after spinal anesthesia as well as the adverse effects of hypotension on mother and baby, it is better to prevent hypotension as much as possible. Therefore, this study is aimed to determine the relationship between postural blood pressure and heart rate changes and hypotension incidence rate after spinal anesthesia in cesarean section.63 women aging18 to 45years old with fullterm pregnancy, who were candidate for caesarean section with spinal anesthesia, entered the study. Afterwards, the diastolic, systolic, and mean arterial pressures as well as the heart rate (pulse in different positions (sitting, lying, and left lateral were measured. After spinal anesthesia, the patients' blood pressure was measured and recorded every minute until the10thmin, then every 3 minute until the15thmin, and then every 5 minute until the end of cesarean section. Data analysis was performed using SPSS (ver. 19 software, descriptive statistics, one-way ANOVA, and post hoc Bonferroni test. In this study, the hypotension incidence rate was 30% and the orthostatic variation rate of the systolic blood pressure in more than half of the people was between 4.39 to 13.49psi, which showed the highest variation compared to the diastolic pressure, mean arterial blood pressure (or: mean arterial pressure [MAP], and heart(pulse. Considering the correlation coefficient of 0.27, the systolic blood pressure in the lateral position has the highest relationship with the incidence of hypotension. The postural systolic blood pressure changes in patients prior to the spinal anesthesia can be a predictive factor for the post-spinal hypotension incidence.

  18. Age-period cohort analysis of AIDS incidence rates in Rio de Janeiro, Brazil, 1985-2009.

    Science.gov (United States)

    Rodrigues, Cristina Pinheiro Nádia

    2013-11-26

    The long average incubation time from HIV infection to AIDS makes it difficult to estimate the recent tendencies of HIV from AIDS incidence data. The objective of this study was to investigate the effects of three temporal components in AIDS incidence in the state of Rio de Janeiro, Brazil - age, period, and cohort. Age-specific AIDS incidence rates per 100,000 from Rio de Janeiro (Brazil) were calculated for both sexes using five-year age classes from 1985 to 2009 based on reported data from the Notifiable Disease Information System of the Brazilian Ministry of Health and from census population counts. Multivariate negative binomial models were used to analyze the risk of AIDS by age, period, and birth cohort. From 1985 to 2009, AIDS incidence initially increased with age in each birth cohort and then decreased (except for individuals born from 1971-1979 to 1986-1994). High peaks in the rates in each birth cohort were detected in 1995-1999 for males and in 2000-2004 for females. Multivariate analysis showed the maximum risk of AIDS in the 30-34 age group and 1958-1962 birth cohort. Age, birth cohort, and period effects all may have influenced the AIDS incidence rates over the period investigated. From 1985 to 1999, comparison of the tendencies (by age) of the period with the birth cohort revealed opposing tendencies in individuals older than 29 years and in the youngest age groups (0 to 14 years). From 2000 to 2009, a strong age effect can be observed in both sexes. Consistent changes in period tendency curves suggest the occurrence of period effects. A reduction in the intensity of the risk of AIDS can be observed after 2000-2004.

  19. Breast cancer incidence following low-dose rate environmental exposure: Techa River Cohort, 1956–2004

    Science.gov (United States)

    Ostroumova, E; Preston, D L; Ron, E; Krestinina, L; Davis, F G; Kossenko, M; Akleyev, A

    2008-01-01

    In the 1950s, the Mayak nuclear weapons facility in Russia discharged liquid radioactive wastes into the Techa River causing exposure of riverside residents to protracted low-to-moderate doses of radiation. Almost 10 000 women received estimated doses to the stomach of up to 0.47 Gray (Gy) (mean dose=0.04 Gy) from external γ-exposure and 137Cs incorporation. We have been following this population for cancer incidence and mortality and as in the general Russian population, we found a significant temporal trend of breast cancer incidence. A significant linear radiation dose–response relationship was observed (P=0.01) with an estimated excess relative risk per Gray (ERR/Gy) of 5.00 (95% confidence interval (CI), 0.80, 12.76). We estimated that approximately 12% of the 109 observed cases could be attributed to radiation. PMID:19002173

  20. PSA-stratified detection rates for [68Ga]THP-PSMA, a novel probe for rapid kit-based 68Ga-labeling and PET imaging, in patients with biochemical recurrence after primary therapy for prostate cancer.

    Science.gov (United States)

    Derlin, Thorsten; Schmuck, Sebastian; Juhl, Cathleen; Zörgiebel, Johanna; Schneefeld, Sophie M; Walte, Almut C A; Hueper, Katja; von Klot, Christoph A; Henkenberens, Christoph; Christiansen, Hans; Thackeray, James T; Ross, Tobias L; Bengel, Frank M

    2018-01-07

    [ 68 Ga]Tris(hydroxypyridinone)(THP)-PSMA is a novel radiopharmaceutical for one-step kit-based radiolabelling, based on direct chelation of 68 Ga 3+ at low concentration, room temperature and over a wide pH range, using direct elution from a 68 Ge/ 68 Ga-generator. We evaluated the clinical detection rates of [ 68 Ga]THP-PSMA PET/CT in patients with biochemically recurrent prostate cancer after prostatectomy. Consecutive patients (n=99) referred for evaluation of biochemical relapse of prostate cancer by [ 68 Ga]THP-PSMA PET/CT were analyzed retrospectively. Patients underwent a standard whole-body PET/CT (1 h p.i.), followed by delayed (3 h p.i.) imaging of the abdomen. PSA-stratified cohorts of positive PET/CT results, standardized uptake values (SUVs) and target-to-background ratios (TBRs) were analyzed, and compared between standard and delayed imaging. At least one lesion suggestive of recurrent or metastatic prostate cancer was identified on PET images in 52 patients (52.5%). Detection rates of [ 68 Ga]THP-PSMA PET/CT increased with increasing PSA level: 94.1% for a PSA value of ≥10 ng/mL, 77.3% for a PSA value of 2 to PSA value of 1 to PSA value of 0.5 to PSA value of >0.2 to PSA value of 0.01 to 0.2 ng/mL. [ 68 Ga]THP-PSMA uptake (SUVs) in metastases decreased over time, whereas TBRs improved. Delayed imaging at 3 h p.i. exclusively identified pathologic findings in 2% of [ 68 Ga]THP-PSMA PET/CT scans. Detection rate was higher in patients with a Gleason score ≥8 (P=0.02) and in patients receiving androgen deprivation therapy (P=0.003). In this study, [ 68 Ga]THP-PSMA PET/CT showed suitable detection rates in patients with biochemical recurrence of prostate cancer and PSA levels ≥ 2 ng /mL. Detections rates were lower than in previous studies evaluating other PSMA ligands, though prospective direct radiotracer comparison studies are mandatory particularly in patients with low PSA levels to evaluate the relative performance of different PSMA ligands.

  1. Incidence rate and prevalence of major risk factors for ectopic pregnancy in the Pakistani population: mini-review

    Directory of Open Access Journals (Sweden)

    Sabira Sultana

    2015-05-01

    Full Text Available Ectopic pregnancy is the complication of pregnancy in which the product of conception implants outside the uterine cavity i.e. in the uterine tubes, cervix, ovaries and abdomen. It is lifethreatening emergency and a major cause of maternal morbidity and mortality. The incidence rate is 0.5%-1.5% of all pregnancies. Even though its incidence rate is drop off when compared with earlier decades, it is still the foremost causes of maternal morbidity and mortality in the first trimester of pregnancy, especially in developing countries. In Pakistan, it varies from 1:1 124 to 1:130 pregnancies. Risk factors associated to ectopic pregnancy are pelvic inflammatory disease, past history of miscarriages, age, parity, infertility, previous ectopic pregnancy, induction of ovulation and intrauterine device usage. The aim of this study is to review the published literature concerning the disease knowledge and major risk factors associated to ectopic pregnancy in Pakistan.

  2. Global Stability of Delayed Viral Infection Models with Nonlinear Antibody and CTL Immune Responses and General Incidence Rate

    OpenAIRE

    Miao, Hui; Teng, Zhidong; Li, Zhiming

    2016-01-01

    The dynamical behaviors for a five-dimensional viral infection model with three delays which describes the interactions of antibody, cytotoxic T-lymphocyte (CTL) immune responses, and nonlinear incidence rate are investigated. The threshold values for viral infection, antibody response, CTL immune response, CTL immune competition, and antibody competition, respectively, are established. Under certain assumptions, the threshold value conditions on the global stability of the infection-free, im...

  3. Incidence of atrial fibrillation in relation to changing heart rate over time in hypertensive patients: the LIFE study

    DEFF Research Database (Denmark)

    Okin, Peter M; Wachtell, Kristian; Kjeldsen, Sverre E

    2008-01-01

    Onset of atrial fibrillation (AF) has been linked to changes in autonomic tone, with increasing heart rate (HR) immediately before AF onset in some patients suggesting a possible role of acute increases in sympathetic activity in AF onset. Although losartan therapy and decreasing ECG left...... ventricular hypertrophy are associated with decreased AF incidence, the relationship of HR changes over time to development of AF has not been examined....

  4. Comparing geographic area-based and classical population-based incidence and prevalence rates, and their confidence intervals

    Directory of Open Access Journals (Sweden)

    Ding-Geng Chen

    2017-09-01

    Full Text Available To quantify the HIV epidemic, the classical population-based prevalence and incidence rates (P rates are the two most commonly used measures used for policy interventions. However, these P rates ignore the heterogeneity of the size of geographic region where the population resides. It is intuitive that with the same P rates, the likelihood for HIV can be much greater to spread in a population residing in a crowed small urban area than the same number of population residing in a large rural area. With this limitation, Chen and Wang (2017 proposed the geographic area-based rates (G rates to complement the classical P rates. They analyzed the 2000–2012 US data on new HIV infections and persons living with HIV and found, as compared with other methods, using G rates enables researchers to more quickly detect increases in HIV rates. This capacity to reveal increasing rates in a more efficient and timely manner is a crucial methodological contribution to HIV research. To enhance this newly proposed concept of G rates, this article presents a discussion of 3 areas for further development of this important concept: (1 analysis of global HIV epidemic data using the newly proposed G rates to capture the changes globally; (2 development of the associated population density-based rates (D rates to incorporate the heterogeneities from both geographical area and total population-at-risk; and (3 development of methods to calculate variances and confidence intervals for the P rates, G rates, and D rates to capture the variability of these indices.

  5. Influence of occupational safety management on the incidence rate of occupational accidents in the Spanish industrial and ornamental stone mining.

    Science.gov (United States)

    Sanmiquel, Lluís; Rossell, Josep M; Vintró, Carla; Freijo, Modesto

    2014-01-01

    Mines are hazardous and workers can suffer many types of accidents caused by fire, flood, explosion or collapse. Injury incidence rates in mining are considerably higher than those registered by other economic sectors. One of the main reasons for this high-level incidence rate is the existence of a large number of dangerous workplaces. This work analyzes the influence that occupational safety management had on the accidents that took place in Spanish mining of industrial and ornamental stone during the period 2007-2008. Primary data sources are: (a) Results from a statistical study of the occupational health and safety management practices of 71 quarries defined by a questionnaire of 41 items; and (b) Occupational accidents registered in the Spanish industrial and ornamental stone mining throughout the period 2007-2008. The obtained results indicate that workplaces with a low average score in the analysis of occupational safety management have a higher incidence rate of accidents. Studies on mining workplaces are very important to help detect occupational safety concerns. Results from this study help raise awareness and will encourage the adoption of appropriate measures to improve safety.

  6. Studies on Lyme disease incidence rates in selected groups of forestry workers in West Pomerania, 2005–2014

    Directory of Open Access Journals (Sweden)

    Tomasz Stawicki

    2017-04-01

    Full Text Available Background: The data collected by sanitary-epidemiological stations in 2005–2014 were analyzed to determine the incidence rates of borreliosis Lyme disease in the West Pomerania group of workers exposed to tick bites. Material and Methods: It was assumed that an adequate comparison of official epidemiological data with the data concerning the number of exposed people, is an indispensable condition for assessing properly the trend in Lyme disease incidence rates, concerning at the same time a real scale of occupational exposure. The study covered a selected group of forestry workers, i.e., white-collar staff employed in different units of the State Forests National Forest Holding with their seats in West Pomerania. The aim of the research was to process and analyze the data on workers employed in the forest sector and their positions, requested from district sanitary-epidemiological stations. Results: In the years concerned 282 cases of the occupational disease were recorded mainly in the groups of forest rangers, junior foresters and forest service inspectors. The values of the incidence factor exhibit high variability with the major share of cases recorded in the years 2008–2010 that accounted for 61.8% of the total occurrences concerned. The incidence in the years 2008, 2009 and 2010 amounted to 2418, 2828 and 2646 cases per 100 000 employees, respectively. Conclusions: The results show that previously published information about the incidence of Lyme disease in the agriculture, forestry and hunting sector, did not fully illustrate a real scale of occupational risk. Med Pr 2017;68(2:211–220

  7. Incidence Rate of Concomitant Systemic Diseases in the Aging Population with Postmenopausal Osteoporosis

    Directory of Open Access Journals (Sweden)

    Selçuk Sayılır

    2016-08-01

    Full Text Available Objective: To evaluate the concomitant systemic diseases with postmenopausal osteoporosis and to investigate the points to be considered in treatment approach of patients with osteoporosis. Materials and Methods: The study included 110 female patients admitted to our clinic and followed up after postmenopausal osteoporosis diagnosis. Besides the demographic data; the concomitant diseases of the patients such as hypertension, hypo-hyperthyroidism, diabetes mellitus, Alzheimer’s disease, malignancy, osteoarthritis, gastrointestinal system diseases, chronic obstructive pulmonary disease (COPD- asthma and depression were also recorded. Results: The mean age of the patients included in our study was 65.9±9.8 years. When the concomitant systemic diseases were examined; 40 patients had hypertension, 32 patients had osteoarthritis, 24 patients had gastrointestinal tract problems, 22 patients had thyroid disease, 21 patients had depression, 15 patients had hyperlipidemia, 12 patients had diabetes mellitus, 10 patients had COPD - asthma, 7 patients had cardiac diseases, 5 patients had malignancy and 2 patients had Alzheimer disease. Conclusion: Osteoporosis is a common disease in the geriatric population. As a chronic disease with an increasing incidence with aging; it can cause many health problems, prevalently pathological bone fractures, in our country and all over the world. Constitutively, prophylaxis of osteoporosis should be the first step. Because systemic diseases with increasing incidence with aging may affect the severity of osteoporosis and impair the treatment; it is important for both clinicians and the society to have sufficient information about osteoporosis.

  8. Acute Myocardial Infarction Population Incidence and Mortality Rates, and 28-day Case-fatality in Older Adults. The REGICOR Study.

    Science.gov (United States)

    Vázquez-Oliva, Gabriel; Zamora, Alberto; Ramos, Rafel; Marti, Ruth; Subirana, Isaac; Grau, María; R Degano, Irene; Marrugat, Jaume; Elosua, Roberto

    2017-11-21

    Our aims were to determine acute myocardial infarction (AMI) incidence and mortality rates, and population and in-hospital case-fatality in the population older than 74 years; variability in clinical characteristics and AMI management of hospitalized patients, and changes in the incidence and mortality rates, case-fatality, and management by age groups from 1996 to 1997 and 2007 to 2008. A population-based AMI registry in Girona (Catalonia, Spain) including individuals with suspected AMI older than 34 years. The incidence rate increased with age from 169 and 28 cases/100 000 per year in the group aged 35 to 64 years to 2306 and 1384 cases/100 000 per year in the group aged 85 to 94 years, in men and women, respectively. Population case-fatality also increased with age, from 19% in the group aged 35 to 64 years to 84% in the group aged 85 to 94 years. A lower population case-fatality was observed in the second period, mainly explained by a lower in-hospital case-fatality. The use of invasive procedures and effective drugs decreased with age but increased in the second period in all ages up to 84 years. Acute myocardial infarction incidence, mortality, and case-fatality increased exponentially with age. There is still a gap in the use of invasive procedures and effective drugs between younger and older patients. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  9. Compensation claims for occupational noise induced hearing loss between 1998 and 2008: yearly incidence rates and trends in older workers.

    Science.gov (United States)

    Radi, Samia; Benke, Geza; Schaafsma, Frederieke; Sim, Malcolm

    2016-04-01

    To estimate yearly incidence rates for occupational noise induced hearing loss (ONIHL) claims and to describe occupational factors in relation to age for incident cases in Victoria, Australia, between 1998 and 2008. All compensation claims lodged for deafness between 1 July 1998 and 30 June 2008 in the working population covered by the Victorian compensation scheme were analysed. Denominators were provided from 1999-2000 and incidence rates were expressed per 100,000 workers for each financial year. Overall, 81.2% of the 4,518 claims lodged were accepted. Successful claimants were predominantly males (96.5%) and claimants aged 56 to 65 years formed half the overall claims. The number of accepted claims was almost five times higher in 2007-08 than 1998-99. The highest rise was in claimants aged 56 years and above, particularly in those after retirement age. The number of claims and yearly incidence rates (IR) more than doubled over the period (240 claims and IR of 15.1 per 100,000 workers in 1999-2000 versus 669 claims and IR of 34.2 in 2007-08) with a sharp increase from 2004-05 to almost double within one single year and remained at high levels afterwards. The dramatic increase in eligible claims may reflect an increase in awareness of entitlements among workers eligible to make a successful claim. This awareness may be the result of increased opportunities for screening coinciding with changes in regulations. Older workers who worked in smaller workplaces may also be targeted by services providers as they combine occupational noise induced hearing loss (ONIHL) and presbycusis (hearing loss due to age), but this hypothesis needs further evaluation. © 2015 Public Health Association of Australia.

  10. Electromagnetic waves in stratified media

    CERN Document Server

    Wait, James R; Fock, V A; Wait, J R

    2013-01-01

    International Series of Monographs in Electromagnetic Waves, Volume 3: Electromagnetic Waves in Stratified Media provides information pertinent to the electromagnetic waves in media whose properties differ in one particular direction. This book discusses the important feature of the waves that enables communications at global distances. Organized into 13 chapters, this volume begins with an overview of the general analysis for the electromagnetic response of a plane stratified medium comprising of any number of parallel homogeneous layers. This text then explains the reflection of electromagne

  11. The incidence rate and mortality of malignant brain tumors after 10 years of intensive cell phone use in Taiwan.

    Science.gov (United States)

    Hsu, Min-Huei; Syed-Abdul, Shabbir; Scholl, Jeremiah; Jian, Wen-Shan; Lee, Peisan; Iqbal, Usman; Li, Yu-Chuan

    2013-11-01

    The issue of whether cell phone usage can contribute toward the development of brain tumors has recently been reignited with the International Agency for Research on Cancer classifying radiofrequency electromagnetic fields as 'possibly' carcinogenic to humans in a WHO report. To our knowledge, this is the largest study reporting on the incidence and mortality of malignant brain tumors after long-term use of the cell phone by more than 23 million users. A population-based study was carried out the numbers of cell phone users were collected from the official statistics provided by the National Communication Commission. According to National Cancer Registry, there were 4 incidences and 4 deaths due to malignant neoplasms in Taiwan during the period 2000-2009. The 10 years of observational data show that the intensive user rate of cell phones has had no significant effect on the incidence rate or on the mortality of malignant brain tumors in Taiwan. In conclusion, we do not detect any correlation between the morbidity/mortality of malignant brain tumors and cell phone use in Taiwan. We thus urge international agencies to publish only confirmatory reports with more applicable conclusions in public. This will help spare the public from unnecessary worries.

  12. Combined effects of family history of CVD and heart rate on ischemic stroke incidence among Inner Mongolians in China.

    Science.gov (United States)

    Zhou, Yipeng; Tian, Yunfan; Zhong, Chongke; Batu, Buren; Xu, Tian; Li, Hongmei; Zhang, Mingzhi; Wang, Aili; Zhang, Yonghong

    2016-05-01

    This study aimed to evaluate the combined effects of family history of cardiovascular diseases (FHCVD) and heart rate on ischemic stroke incidence among Inner Mongolians in China. A prospective cohort study was conducted among 2589 participants aged 20 years and older from Inner Mongolia, China. The participants were divided into four groups according to status of FHCVD and heart rate and followed up from June 2002 to July 2012. Cox proportional hazards models were used to evaluate the combined effects of FHCVD and heart rate on the incidence of ischemic stroke. A total of 76 ischemic stroke occurred during the follow-up period. The observed ischemic stroke cases tended to be older and male, and had higher prevalence of smoking, drinking, hypertension and FHCVD as well as higher systolic and diastolic blood pressures at baseline compared with those who did not experience ischemic stroke. Age- and gender-adjusted hazard ratio (95% confidence interval) of ischemic stroke in the participants with both FHCVD and heart rate ≥ 80 were 2.89 (1.51-5.53), compared with those without FHCVD and heart rate < 80. After multiple adjustment, the association between ischemic stroke risk and both FHCVD and heart rate ≥ 80 remained statistically significant (hazard ratio, 2.47; 95% confidence interval: 1.22-5.01). Our main finding that participants with both FHCVD and faster heart rate have the highest risk of ischemic stroke suggests that faster heart rate may increase the risk of ischemic stroke among people with FHCVD.

  13. Sports members' participation in assessment of incidence rate of injuries in five sports from records of hospital-based clinical treatment

    NARCIS (Netherlands)

    Kingma, J; ten Duis, HJ

    This study is about the incidence rate of sports injuries in five different types of sports, gymnastics, soccer, volleyball, hockey, and basketball, for which 5,154 patients were admitted to the Emergency Unit of the Groningen University Hospital during the period 1990 through 1994. Incidence rate

  14. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

    Science.gov (United States)

    2011-01-01

    Background Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should

  15. Risk factors and their combined effects on the incidence rate of subarachnoid hemorrhage--a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Miikka Korja

    Full Text Available BACKGROUND: Prospective studies on the risk factors for subarachnoid hemorrhage (SAH are limited. Moreover, the effect of risk factors on the incidence rates of SAH is not well known about. AIMS: In this study, we aimed to identify risk factors for SAH and characterize subgroups in a population with a high incidence of SAH. METHODS: After recording multiple potential risk factors for SAH at the time of enrollment, first ever SAH events between 1972 and 2009 were recorded through the nationwide Causes of Death Register and Hospital Discharge Register for the population-based cohort of 64 349 participants, who participated in the National FINRISK Study between 1972 and 2007 in Finland. RESULTS: During the follow-up time of 1.26 million person-years (median 17.9 years, range 0 to 37.9 years, 437 persons experienced fatal or non-fatal SAH. Crude SAH incidence was 34.8 (95% confidence interval: 31.7-38.2 per 100 000 person-years among ≥ 25-year-old persons. Female sex, high blood pressure values and current smoking were confirmed as risk factors for SAH. Previous myocardial infarction, history of premature stroke (any kind in mother and elevated cholesterol levels in men were identified as new risk factors for SAH. Depending on the combination of risk factors, SAH incidence varied between 8 and 171 per 100 000 person-years. CONCLUSIONS: New and previously reported risk factors appear to have a much stronger association with the incidence of SAH than is ordinarily seen in cardiovascular diseases. Risk factor assessments may facilitate the identification of high-risk persons who should be the focus of preventive interventions.

  16. Risk Factors and Their Combined Effects on the Incidence Rate of Subarachnoid Hemorrhage – A Population-Based Cohort Study

    Science.gov (United States)

    Korja, Miikka; Silventoinen, Karri; Laatikainen, Tiina; Jousilahti, Pekka; Salomaa, Veikko; Hernesniemi, Juha; Kaprio, Jaakko

    2013-01-01

    Background Prospective studies on the risk factors for subarachnoid hemorrhage (SAH) are limited. Moreover, the effect of risk factors on the incidence rates of SAH is not well known about. Aims In this study, we aimed to identify risk factors for SAH and characterize subgroups in a population with a high incidence of SAH. Methods After recording multiple potential risk factors for SAH at the time of enrolment, first ever SAH events between 1972 and 2009 were recorded through the nationwide Causes of Death Register and Hospital Discharge Register for the population-based cohort of 64 349 participants, who participated in the National FINRISK Study between 1972 and 2007 in Finland. Results During the follow-up time of 1.26 million person-years (median 17.9 years, range 0 to 37.9 years), 437 persons experienced fatal or non-fatal SAH. Crude SAH incidence was 34.8 (95% confidence interval: 31.7–38.2) per 100 000 person-years among ≥25-year-old persons. Female sex, high blood pressure values and current smoking were confirmed as risk factors for SAH. Previous myocardial infarction, history of premature stroke (any kind) in mother and elevated cholesterol levels in men were identified as new risk factors for SAH. Depending on the combination of risk factors, SAH incidence varied between 8 and 171 per 100 000 person-years. Conclusions New and previously reported risk factors appear to have a much stronger association with the incidence of SAH than is ordinarily seen in cardiovascular diseases. Risk factor assessments may facilitate the identification of high-risk persons who should be the focus of preventive interventions. PMID:24040058

  17. Reduced rate of human papillomavirus infection and genetic overtransmission of TP53 72C polymorphic variant lower cervical cancer incidence.

    Science.gov (United States)

    Alsbeih, Ghazi A; Al-Harbi, Najla M; Bin Judia, Sara S; Khoja, Hatim A; Shoukri, Mohamed M; Tulbah, Asma M

    2017-07-01

    Cervical cancer is a predominantly human papillomavirus (HPV)-driven disease worldwide. However, its incidence is unexplainably low in western Asia, including Saudi Arabia. Using this paradigm, we investigated the role of HPV infection rate and host genetic predisposition in TP53 G72C single nucleotide polymorphism (SNP) presumed to affect cancer incidence. Patients treated between 1990 and 2012 were reviewed, and a series of 232 invasive cervical cancer cases were studied and compared with 313 matched controls without cancer. SNP was genotyped by way of direct sequencing. HPV linear array analysis was used to detect and genotype HPV in tumor samples. The incidence of cervical cancer revealed bimodal peaks at 42.5 years, with a slighter rebound at 60.8 years. Among all cases, 77% were HPV-positive and 16 HPV genotypes were detected-mostly genotypes 16 (75%) and 18 (9%)-with no difference by age, histology, or geographical region. Although the TP53 G72C genotype was not associated with overall cervical cancer risk, it was significantly associated with HPV positivity (odds ratio, 0.57; 95% confidence interval, 0.36-0.90; P = .016). Furthermore, the variant C allele was significantly overtransmitted in the population (P Cervical cancer incidence displays bimodal curve peaking at a young age with secondary rebound at older age. The combination of relative low HPV infection and variant TP53 72C allele overtransmission provide a plausible explanation for the low incidence of cervical cancer in our population. Therefore, HPV screening and host SNP genotyping may provide more relevant biomarkers to gauge the risk of developing cervical cancer. Cancer 2017;123:2459-66. © 2017 American Cancer Society. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  18. Incidence and Mortality Rates and Clinical Characteristics of Type 1 Diabetes among Children and Young Adults in Cochabamba, Bolivia

    Directory of Open Access Journals (Sweden)

    Elizabeth Duarte Gómez

    2017-01-01

    Full Text Available Objectives. To determine incidence, mortality, and clinical status of youth with diabetes at the Centro Vivir con Diabetes, Cochabamba, Bolivia, with support from International Diabetes Federation Life for a Child Program. Methods. Incidence/mortality data analysis of all cases (<25 year (y diagnosed January 2005–February 2017 and cross-sectional data (December 2015. Results. Over 12.2 years, 144 cases with type 1 diabetes (T1D were diagnosed; 43.1% were male. Diagnosis age was 0.3–22.2 y; peak was 11-12 y. 11.1% were <5 y; 29.2%, 5–<10 y; 43.1%, 10–<15 y; 13.2%, 15–<20 y; and 3.5%, 20–<25 y. The youngest is being investigated for monogenic diabetes. Measured incidence in Cercado Province (Cochabamba Department was 2.2/100,000 children < 15 y/y, with ≈80% ascertainment, giving total incidence of 2.7/100,000 children < 15 y/y. Two had died. Crude mortality rate was 2.3/1000 patient years. Clinical data on 141 cases <35 y: mean/median HbA1c was 8.5/8.2% (69/62 mmol/mol, levels higher in adolescents. Three were on renal replacement therapy; four others had substantial renal impairment. Elevated BMI, triglycerides, and cholesterol were common: 19.1%, 18.3%, and 39.1%, respectively. Conclusions. Bolivia has low T1D incidence. Reasonable glycemic control is being achieved despite limited resources; however, some have serious complications and adverse cardiovascular risk factor profiles. Further attention is needed for complications.

  19. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

    Directory of Open Access Journals (Sweden)

    Sagebiel Daniel

    2011-01-01

    Full Text Available Abstract Background Tuberculosis (TB in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas

  20. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates.

    Science.gov (United States)

    Alvarez, Gonzalo G; Gushulak, Brian; Abu Rumman, Khaled; Altpeter, Ekkehardt; Chemtob, Daniel; Douglas, Paul; Erkens, Connie; Helbling, Peter; Hamilton, Ingrid; Jones, Jane; Matteelli, Alberto; Paty, Marie-Claire; Posey, Drew L; Sagebiel, Daniel; Slump, Erika; Tegnell, Anders; Valín, Elena Rodríguez; Winje, Brita Askeland; Ellis, Edward

    2011-01-04

    Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Descriptive study of immigration TB screening programs. 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should facilitate the development of improved

  1. Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer.

    Science.gov (United States)

    Rocha, Thiago Augusto Hernandes; Thomaz, Erika Bárbara Abreu Fonseca; da Silva, Núbia Cristina; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Barbosa, Allan Claudius Queiroz; Thumé, Elaine; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Vissoci, João Ricardo Nickenig; Staton, Catherine Ann; Facchini, Luiz Augusto

    2017-10-30

    Oral cancer is a potentially fatal disease, especially when diagnosed in advanced stages. In Brazil, the primary health care (PHC) system is responsible for promoting oral health in order to prevent oral diseases. However, there is insufficient evidence to assess whether actions of the PHC system have some effect on the morbidity and mortality from oral cancer. The purpose of this study was to analyze the effect of PHC structure and work processes on the incidence and mortality rates of oral cancer after adjusting for contextual variables. An ecological, longitudinal and analytical study was carried out. Data were obtained from different secondary data sources, including three surveys that were nationally representative of Brazilian PHC and carried out over the course of 10 years (2002-2012). Data were aggregated at the state level at different times. Oral cancer incidence and mortality rates, standardized by age and gender, served as the dependent variables. Covariables (sociodemographic, structure of basic health units, and work process in oral health) were entered in the regression models using a hierarchical approach based on a theoretical model. Analysis of mixed effects with random intercept model was also conducted (alpha = 5%). The oral cancer incidence rate was positively association with the proportion of of adults over 60 years (β = 0.59; p = 0.010) and adult smokers (β = 0.29; p = 0.010). The oral cancer related mortality rate was positively associated with the proportion of of adults over 60 years (β = 0.24; p oral cancer (β = 0.02; p = 0.002). Mortality was inversely associated with the coverage of primary care teams (β = -0.01; p work processes have been shown to help reduce the mortality rate of oral cancer, but not the incidence rate of the disease. We recommend expanding investments in PHC in order to prevent oral cancer related deaths.

  2. Ottawa-Carleton commuter cyclist on- and off-road incident rates.

    Science.gov (United States)

    Aultman-Hall, L; Hall, F L

    1998-01-01

    This analysis overcomes the known limitations of police and emergency room bicycle accident databases through use of a survey that asked cyclists to indicate their accident history as well as their regular commute route to work or school. By relating the route information of the 1604 respondents (52.5% of the distributed questionnaires) to facility attributes in a Geographic Information System, defensible estimates of travel exposure on roads, off-road paths and sidewalks were developed. The relative rates of collisions on the three different facility types were not statistically different from 1.0. The relative rates for falls and injuries suggest it is safest to cycle on-road followed by off-road paths and trails, and finally least safe on sidewalks. While there were no major injuries reported on sidewalks, the relative rate for these events on paths was greater than the rate for roads. The absolute event rates per bicycle kilometre were found to be between 10 and 41 times higher than similar rates for automobile travel. Results suggest a need to discourage sidewalk cycling, and to further investigate the safety of off-road paths/trails. The analysis also demonstrates the need for bicycle travel exposure information and the use of more than just collision databases for bicycle safety analysis.

  3. High incidence of hospitalisation due to infectious gastroenteritis in older people associated with poor self-rated health.

    Science.gov (United States)

    Chen, Yingxi; Liu, Bette C; Glass, Kathryn; Kirk, Martyn D

    2015-12-30

    To estimate the incidence and risk factors for gastroenteritis-related hospitalisations in older adults. Longitudinal cohort study. The 45 and Up Study is a large-scale Australian prospective study of adults aged ≥ 45 years (mean 62.7 years) at recruitment in 2006-2009. Self-reported demographic, health and dietary information at recruitment from 265,440 participants were linked to infectious gastroenteritis hospitalisation data. We estimated the incidence of hospitalisation for infectious gastroenteritis, and calculated HRs using Cox regression, adjusting for sociodemographic, health and behavioural variables, with age as the underlying time variable. There were 6077 incident infectious gastroenteritis admissions over 1,111,000 person-years. Incidence increased exponentially with increasing age; from 2.4 per 1000 (95% CI 2.2 to 2.5) in individuals aged 45-54 years to 9.5 per 1000 (95% CI 9.2 to 9.8) in those aged 65+ years. After adjustment, hospitalisation due to infectious gastroenteritis was significantly more common in those reporting use of proton pump inhibitors (HR 1.6, 95% CI 1.5 to 1.7), and those with poorer self-rated health (HR 4.2, 95% CI 3.6 to 4.9). Infectious gastroenteritis results in hospitalisation of approximately 1% of people ≥ 65 years old each year. Early recognition and supportive treatment of diarrhoea in older patients with poorer self-rated health may prevent subsequent hospitalisation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Investigating the impact of blood culture bundles on the incidence of blood culture contamination rates.

    Science.gov (United States)

    Murphy, Theresa; Maile, Deborah; Barsch, Tara; Jerdan, Florence

    2014-01-01

    Blood cultures are integral diagnostic procedures for identifying serious infections and selecting antimicrobials. Positive blood cultures are the initial step in attaining a conclusive diagnosis of sepsis. Relative risk is blood culture contamination, false-positive blood culture results, diagnostic error delays, treatment errors, excessive lab testing, and increased length of stay. A complicating issue is the increased use of central venous access devices (CVADs). The purpose of this descriptive, comparative study is to evaluate the effectiveness of blood culture bundles on blood cultures drawn through a CVAD and contamination rates. The study revealed a decrease in blood culture contamination rates by 61%.

  5. Trends in Lung Cancer Incidence Rates by Histological Type in 1975-2008: A Population-Based Study in Osaka, Japan.

    Science.gov (United States)

    Kinoshita, Fukuaki Lee; Ito, Yuri; Nakayama, Tomio

    2016-11-05

    Monitoring trends in lung cancer incidence and mortality is important for the evaluation of cancer control activities. We investigated recent trends in age-standardized incidence rates by histological type of lung cancer in Osaka, Japan. Cancer incidence data for 1975-2008 were obtained from the Osaka Cancer Registry. Lung cancer mortality data with population data in Osaka during 1975-2012 were obtained from vital statistics. We examined trends in age-standardized incidence and mortality rates for all histological types and age-standardized incidence rates by histological type and age group using a joinpoint regression model. The age-standardized incidence rate of lung cancer levelled off or slightly increased from 1975-2008, with an annual percentage change of 0.3% (95% confidence interval [CI], 0.1%-0.4%) for males and 1.1% (95% CI, 0.9%-1.3%) for females, and the mortality rate decreased by 0.9% (95% CI, 1.2%-0.7%) for males and 0.5% (95% CI, 0.8%-0.3%) for females. The incidence rates of squamous cell carcinoma (SQC) and small cell carcinoma (SMC) significantly decreased for both genders, whereas that of adenocarcinoma (ADC) significantly increased among almost all age groups in both genders. The incidence rates of SQC and SMC decreased with the decline in smoking prevalence, which probably explains the change in trends in the incidence rates of lung cancer from the mid-1980s. However, the reason for the increase in ADC remains unclear. Therefore, trends in incidence rates of lung cancer should be carefully monitored, especially for ADC, and the associations between ADC and its possible risk factors should be studied.

  6. Ecosystem metabolism in a stratified lake

    DEFF Research Database (Denmark)

    Stæhr, Peter A.; Christensen, Jesper P. A.; Batt, Ryan D.

    2012-01-01

    that integrates rates across the entire depth profile and includes DO exchange between depth layers driven by mixed-layer deepening and eddy diffusivity. During full mixing, NEP was close to zero throughout the water column, and GPP and R were reduced 2-10 times compared to stratified periods. When present....... Although air-water gas exchange rates differed among the three formulations of gas-transfer velocity, this had no significant effect on metabolic rates.......Seasonal changes in rates of gross primary production (GPP), net ecosystem production (NEP), and respiration (R) were determined from frequent automated profiles of dissolved oxygen (DO) and temperature in a clear-water polymictic lake. Metabolic rate calculations were made using a method...

  7. Incident rate and risk factors for tuberculosis among patients with type 2 diabetes: retrospective cohort study in Shanghai, China.

    Science.gov (United States)

    Qiu, Hanbo; Shi, Yan; Li, Yanyun; Shen, Xin; Li, Rui; Yang, Qundi; Pan, Qichao; Yan, Fei

    2017-07-01

    To examine the incident rate of tuberculosis (TB) and its associates among adults with type 2 diabetes in Shanghai, China. We conducted a retrospective cohort study among 170 399 patients with type 2 diabetes aged ≥18 years who were registered in Shanghai community-based diabetes management system between 2004 and 2009. Their TB status was tracked until 31 December 2014. Cox regression was performed to identify the risk factors for TB. We documented 785 new TB cases during 654 977 person-years of follow-up. The incident rate of TB was 224.20 (206.69, 243.16) per 100 000 person-years among men and 51.34 (44.75, 58.92) per 100 000 person-years among women. A 1-unit increase of BMI was associated with a risk reduction in 16% (P < 0.01) for men and a 14% (P < 0.01) reduction for women. TB cases were more likely to be insulin-dependent [men: hazard ratio = 2.13 (1.29, 3.53); women: 3.28 (1.28, 8.39)] and had a poor glucose level initially [men: 1.21 (1.15, 1.27); women: 1.27 (1.18, 1.37)]. The risk factor for TB specific to men was a young age at diagnosis of diabetes, and the protective factor specific to women was actively engaging in physical activity. TB incident rate among patients with type 2 diabetes was substantially higher among men than among women. The risk of TB was reversely associated with initial BMI. The severity of poor glucose control among patients with diabetes was also linearly associated with the risk of TB. © 2017 John Wiley & Sons Ltd.

  8. Candidemia: incidence rates, type of species, and risk factors at a tertiary care academic hospital in China.

    Science.gov (United States)

    Wu, Zengbin; Liu, Yingbin; Feng, Xiaobo; Liu, Ying; Wang, Shuyun; Zhu, Xiaodong; Chen, Qiqi; Pan, Shuming

    2014-05-01

    To investigate the incidence rates of candidemia in hospitalized patients and to identify differences in risk factors of patients with Candida albicans and non-C. albicans and with Candida guilliermondii and non-C. guilliermondii candidemia. Non-immunosuppressed, non-neutropenic inpatients with candidemia diagnosed after admission were included in this retrospective observational study at a tertiary academic hospital in China. During the study period (January 2009 to December 2011), 238 eligible patients had candidemia episodes with an incidence rate 5.4%. Of these patients, 29.8% had candidemia due to C. albicans, 27.7% due to C. parapsilosis, and 16.4% due to C. guilliermondii. Diabetes was a significant risk factor for patients with candidemia due to C. albicans (35.2%, 25/71) compared to candidemia due to non-C. albicans spp (13.2%, 22/167) (odds ratio (OR) 0.2792, 95% confidence interval (CI) 0.144-0.5412; p candidemia due to non-C. guilliermondii spp, preterm birth with low birth weight (OR 0.0887, 95% CI 0.0398-0.1977; p candidemia due to C. guilliermondii. Furthermore, compared to patients with candidemia due to C. albicans, patients with candidemia due to C. guilliermondii had markedly higher rates of central venous catheterization (85.9%, 61/71 vs. C. guilliermondii: 100%, 39/39; p = 0.013) and intravenous nutrition (89.7%, 35/39 vs. C. albicans: 42.2%, 30/71; p Candidemia due to C. albicans ranks first in incidence, and candidemia due to C. guilliermondii occurs in a significant proportion of our hospitalized patients. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. [Lung cancer in Avila province, Spain. Incidence rates, epidemiolgy of the year 2012 and trends in the last 20 years].

    Science.gov (United States)

    Hernández-Hernández, J R; Moreno de Vega-Herrero, M B; Iglesias-Heras, M; García-García, R; Hernández-Terciado, F; Celdrán-Gil, J

    2015-10-01

    To determine the extent of lung cancer in Alvila. Its incidence rates and significant epidemiological aspects of the year 2012 were recorded, and the results of each 5-year period (up to 20 years) were compared with those of known studies conducted using the same methodology. A prospective study was conducted on all patients diagnosed with lung cancer in the Province of Avila throughout the year 2012. A total of 81 patients were diagnosed, of whom 70 were males and 11 females, with a mean age of 72.1 years (range: 44-91), and was higher than that found in previous studies. This gave gross, and adjusted to the standard world population, incidence rates in 2012 of 80.99 and 31.23 per 100,000, respectively, in males, and 12.97 and 5.68 per 100,000, respectively in females. These rates are lower in both sexes than those found in Alvila in 2002. In 2012, 80.25% had been smokers (90% of males and 18.18% of the women), although, on diagnosis, 68.75% had quit smoking. A clinical-radiological diagnosis was made in 9 (11.1%), with a histocytological diagnosis in 72 (88.9%). The histological types were: adenocarcinomas in 37.5%; squamous in 33.3%; microcytic in 13.8%; undifferentiated non-small cell in 11.1%; large cell in 2.77%, and carcinoid in 1.38%. The most frequent treatments were chemotherapy (50.6%), symptomatic (23.4%), and surgery (12.3%). The incidence of lung cancer in Avila has decreased in both sexes in the last 10 years. In 2012, the patients have been older, the majority with adenocarcinoma histology, and receiving chemotherapy. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Effect of cardiovascular prevention strategies on incident coronary disease hospitalisation rates in Spain; an ecological time series analysis.

    Science.gov (United States)

    Medrano, María José; Alcalde-Cabero, Enrique; Ortíz, Cristina; Galán, Iñaki

    2014-02-17

    To assess the overall population impact of primary prevention strategies (promotion of healthy lifestyles, prevention of smoking and use of vascular risk drug therapy) of coronary disease in Spain. Ecological time series analysis, 1982-2009. All public and private hospitals in Spain. General population. Incident coronary disease hospitalisation as derived from official hospital discharge data. Annual hospitalisation rates were modelled according to nationwide use of statins, antihypertensive, antidiabetic and antiplatelet drugs, and prevalences of smoking, obesity and overweight. Additive generalised models and mixed Poisson regression models were used for the purpose, taking year as the random-effect variable and adjusting for age, sex, prevalence of vascular risk factors and the number of hospital beds in intensive and coronary care units. Across 28 years and 671.5 million person-years of observation, there were 2 986 834 hospitalisations due to coronary disease; of these, 1 441 980 (48.28%) were classified as incident. Hospitalisation rates increased from 1982 to 1996, with an inflection point in 1997 and a subsequent 52% decrease until 2009. Prevalences of smoking, obesity, overweight and use of vascular risk drug therapy were significantly associated with hospitalisation rates (pstress on excessive body weight prevention.

  11. Data study of death rate and cancer incidence among Thule workers, 2005; Registerundersoegelse af doedelighed og kraeftforekomst blandt Thulearbejdere, 2005

    Energy Technology Data Exchange (ETDEWEB)

    Juel, K. [Statens Insti. for Folkesundhed, Copenhagen (Denmark); Engholm, G.; Storm, H. [Kraeftens Bekaempelse, Copenhagen (Denmark)

    2005-12-01

    January 21st, 1968, an American B52 bomber with nuclear weapons aboard crashed close to the Thule air-base in Greenland. In 1986 suspicions arose that there might be increased disease incidences and death rate among the employees at the base that were involved in the clearing operations. During 1986 - 1995, several health studies were made of the Thule workers. These studies of death rate, cancer, hospitalization, and fertility did not show any differences between the Thule workers from the clearing operations and those not involved in the clearing. The present study shows no difference in total death rate among the clearing workers compared to other workers. The same results were found for cancer mortality, circulatory diseases, pulmonary diseases, natural causes, and accidents. As the previous studies showed, the present study shows that there were a slightly less number of suicides among the clearing workers. The data analyses show with great certainty that the Thule workers as a group do not have a great excessive mortality or an increased cancer incidence caused by the aircraft crash. Thus, the present results fall in line with the previous investigations. (ln)

  12. Estimating Incidence Rate of Hospital-Treated Self-Harm in Hong Kong Using Capture-Recapture Approach.

    Science.gov (United States)

    Leung Kwok, Chi; Yip, Paul S F

    2017-12-08

    A surveillance system for self-harm has not been established in Hong Kong. The existing data source has an unknown degree of underreporting, and therefore a capture-recapture method has been proposed to correct for the incompleteness. To assess the underestimation of the incidence of self-harm cases presenting to hospital in Hong Kong using a capture and recapture method. Two different yet overlapping hospital administrative datasets of self-harm were obtained from all public hospitals in Hong Kong. From 2002 to 2011, 59,473 distinct episodes involving 36,411 patients were identified. A capture-recapture model considering heterogeneous capture probabilities was applied to estimate the number of self-harm episodes. The estimated number of self-harm incidence was 79,923, equally shared by females and males. Cases of self-harm by females were more likely to be ascertained than those by males. The estimated annual incidence rate of self-harm in Hong Kong from 2002 to 2011 ranged from 96.4 in 2010 to 132.7 in 2002. The proposed method does not include patients who required no medical attention and those where the patient consulted private doctors. The capture-recapture model is a useful method for adjusting the underestimation of self-harm cases from existing databases when surveillance system is not available and to reveal some hidden patterns.

  13. Incidence Rates of Deliberate Self-Harm in Denmark 1994–2011

    DEFF Research Database (Denmark)

    Morthorst, Britt Reuter; Soegaard, Bodil; Nordentoft, Merete

    2016-01-01

    .  Method: A register study based on all individuals recorded with an episode of deliberate self-harm or probable deliberate selfharm in nationwide registers during 1994-2011.  Results: A substantial difference in the rates of deliberate self-harm and probable deliberate self-harm was noted for both genders.......8-157.5) in 2011. For a subgroup of younger women aged 15-24 years, an almost threefold increase was observed, IRR = 2.5 (95% CI = 2.4-2.7). The most frequently used method was self-poisoning.  Conclusion: The rates of deliberate self-harm and probable deliberate self-harm differed significantly. An increased...

  14. [Project to Reduce the Incidence Rate of Nasogastric Tube Slippage in the Rehabilitation Ward].

    Science.gov (United States)

    Chen, Chiu-Chu; Su, Wei-Ling; Li, Ai-Cheng; Lin, Hsin-Yi

    2015-06-01

    Nasogastric (NG) tubes are used for providing nutrition to patients who have difficulties swallowing. However, the difficult process of repeatedly inserting NG tubes may lead to gastric erosions. The rehabilitation ward in this study had an NG tube slippage rate of 2.26% in 2012, significantly higher than the same rate in 2011. A proposal was developed to design better techniques for nurses to perform NG tube insertions in order to decrease the rate of NG tube slippage. The following were identified as the major causes of NG tube slippage: (1) caretaker is unfamiliar with NG tube care instructions, (2) caretaker disengages NG tube constraints, and (3) improper rotation of patients or carelessness when turning patients. Therefore, the following solutions were proposed: (1) establish an NG tube safety standard operating procedure, (2) publish bilingual (English and Bahasa Indonesia) pamphlets providing instructions on the correct method of securing and placing the NG tubes, (3) make bilingual (English and Bahasa Indonesia) instructional videos showing the correct method for securing and placing the NG tubes, (4) fabricate a novel tube constraint tool (the constraint ball) that is easy to use, (5) install creative bedside NG tube warning signs, and (6) reinforce the importance of NG tube constraint and placement among caretakers. The NG tube slippage rate was reduced from 2.26% to 0.77%, and was maintained at 0.75% during the follow-up period. The caretaker assessment further showed 100% understanding of the implemented NG tube safety procedures. This proposal was established using literature research, problem identification, and creative problem solving to achieve an effective reduction in NG tube slippage as well as to enhance nursing quality.

  15. Dynamics of synthetic drugs transmission model with psychological addicts and general incidence rate

    Science.gov (United States)

    Ma, Mingju; Liu, Sanyang; Xiang, Hong; Li, Jun

    2018-02-01

    Synthetic drugs are replacing traditional ones and becoming the main popular ones gradually, which have given rise to serious social issues in recent years. In this paper, a synthetic drugs transmission model with psychological addicts and general contact rate is proposed. The local and global stabilities are decided by the basic reproduction number R0. By analyzing the sensitivity of parameters, we obtain that controlling psychological addiction is better than drugs treatment. These results are verified by numerical simulations.

  16. Gynecologic cancer mortality in Trinidad and Tobago and comparisons of mortality-to-incidence rate ratios across global regions

    Science.gov (United States)

    Llanos, Adana A. M.; Warner, Wayne A.; Luciani, Silvana; Lee, Tammy Y.; Bajracharya, Smriti; Slovacek, Simeon; Roach, Veronica; Lamont-Greene, Marjorie

    2018-01-01

    Purpose To examine the factors associated with gynecologic cancer mortality risks, to estimate the mortality-to-incidence rate ratios (MIR) in Trinidad and Tobago (TT), and to compare the MIRs to those of select countries. Methods Data on 3,915 incident gynecologic cancers reported to the National Cancer Registry of TT from 1 January 1995 to 31 December 2009 were analyzed using proportional hazards models to determine factors associated with mortality. MIRs for cervical, endometrial, and ovarian cancers were calculated using cancer registry data (TT), GLOBOCAN 2012 incidence data, and WHO Mortality Database 2012 data (WHO regions and select countries). Results Among the 3,915 incident gynecologic cancers diagnosed in TT during the study period, 1,795 (45.8%) were cervical, 1,259 (32.2%) were endometrial, and 861 (22.0%) were ovarian cancers. Older age, African ancestry, geographic residence, tumor stage, and treatment non-receipt were associated with increased gynecologic cancer mortality in TT. Compared to GLOBOCAN 2012 data, TT MIR estimates for cervical (0.49 vs. 0.53), endometrial (0.61 vs. 0.65), and ovarian cancers (0.32 vs. 0.48) were elevated. While the Caribbean region had intermediate gynecologic cancer MIRs, MIRs in TT were among the highest of the countries examined in the Caribbean region. Conclusions Given its status as a high-income economy, the relatively high gynecologic cancer MIRs observed in TT are striking. These findings highlight the urgent need for improved cancer surveillance, screening, and treatment for these (and other) cancers in this Caribbean nation. PMID:28917021

  17. Gynecologic cancer mortality in Trinidad and Tobago and comparisons of mortality-to-incidence rate ratios across global regions.

    Science.gov (United States)

    Llanos, Adana A M; Warner, Wayne A; Luciani, Silvana; Lee, Tammy Y; Bajracharya, Smriti; Slovacek, Simeon; Roach, Veronica; Lamont-Greene, Marjorie

    2017-11-01

    To examine the factors associated with gynecologic cancer mortality risks, to estimate the mortality-to-incidence rate ratios (MIR) in Trinidad and Tobago (TT), and to compare the MIRs to those of select countries. Data on 3,915 incident gynecologic cancers reported to the National Cancer Registry of TT from 1 January 1995 to 31 December 2009 were analyzed using proportional hazards models to determine factors associated with mortality. MIRs for cervical, endometrial, and ovarian cancers were calculated using cancer registry data (TT), GLOBOCAN 2012 incidence data, and WHO Mortality Database 2012 data (WHO regions and select countries). Among the 3,915 incident gynecologic cancers diagnosed in TT during the study period, 1,795 (45.8%) were cervical, 1,259 (32.2%) were endometrial, and 861 (22.0%) were ovarian cancers. Older age, African ancestry, geographic residence, tumor stage, and treatment non-receipt were associated with increased gynecologic cancer mortality in TT. Compared to GLOBOCAN 2012 data, TT MIR estimates for cervical (0.49 vs. 0.53), endometrial (0.61 vs. 0.65), and ovarian cancers (0.32 vs. 0.48) were elevated. While the Caribbean region had intermediate gynecologic cancer MIRs, MIRs in TT were among the highest of the countries examined in the Caribbean region. Given its status as a high-income economy, the relatively high gynecologic cancer MIRs observed in TT are striking. These findings highlight the urgent need for improved cancer surveillance, screening, and treatment for these (and other) cancers in this Caribbean nation.

  18. Repeat HIV Testing and Incident Rates among Individuals Attending Voluntary Counseling and Testing Clinics in Wuxi, China: A Retrospective Study.

    Science.gov (United States)

    Meng, Xiao Jun; Grulich, Andrew; Wang, Xu Wen; Yin, Han Lu; Gu, Jing; Zhang, Xuan; Gu, Jing; Zou, Hua Chun

    2018-01-01

    We aimed to elucidate the rates of repeat HIV testing and incident HIV diagnosis, and baseline CD4+ T cell count among individuals attending HIV voluntary counseling and testing (VCT) clinics in Wuxi, China. A repeat HIV testing within 12 months was recorded if individuals had their first test with negative results, during 2013-2014 and retested within 12 months. An incident HIV diagnosis was recorded if individuals had their first test with negative results, during 2013-2015 and had a subsequent positive result at any point by the end of 2015. Data on HIV testing and diagnosis among individuals attending 32 VCT clinics from 2013 to 2015 and HIV diagnosis from other clinical services in Wuxi, China, were retrieved. A multivariate logistic regression model was used to analyze factors associated with repeat HIV testing. Cox regression was used to evaluate factors associated with incident HIV diagnosis. From 2013 to 2014, 11,504 individuals tested HIV negative at their first recorded test, with 655 (5.7%) retesting within 12 months. Higher repeat HIV testing within 12 months was associated with male gender [adjusted odds ratio (aOR) = 1.7, 95% confidence interval (CI): 1.4-2.2], risk behaviors [commercial heterosexual behaviors (aOR = 1.4, CI: 1.1-1.6), male-male sexual behaviors (aOR = 3.7, CI: 2.7-4.9)], injection drug use (aOR = 9.9, CI: 6.5-15.1), and having taken HIV tests previously (aOR = 2.0, CI: 1.6-2.4). From 2013 to 2015, 1,088 individuals tested negative on HIV test at their visit and at ⋝ 2 subsequent tests; of them 30 had incident HIV diagnosis. The overall rate of incident HIV diagnosis among all VCT individuals was 1.6 (95% CI: 1.1-2.1) per 100 person-years. Incident HIV diagnosis was associated with male gender [adjusted hazard ratio (aHR) = 8.5, 95% CI: 1.9-38.1], attending hospital-based VCT clinics (aHR = 7.8, 95% CI: 1.1-58.3), and male-male sexual behavior (aHR = 8.4, 95% CI: 1.5-46.7). Individuals diagnosed at VCT clinics had higher CD4+ T

  19. The Stratified Legitimacy of Abortions.

    Science.gov (United States)

    Kimport, Katrina; Weitz, Tracy A; Freedman, Lori

    2016-12-01

    Roe v. Wade was heralded as an end to unequal access to abortion care in the United States. However, today, despite being common and safe, abortion is performed only selectively in hospitals and private practices. Drawing on 61 interviews with obstetrician-gynecologists in these settings, we examine how they determine which abortions to perform. We find that they distinguish between more and less legitimate abortions, producing a narrative of stratified legitimacy that privileges abortions for intended pregnancies, when the fetus is unhealthy, and when women perform normative gendered sexuality, including distress about the abortion, guilt about failure to contracept, and desire for motherhood. This stratified legitimacy can perpetuate socially-inflected inequality of access and normative gendered sexuality. Additionally, we argue that the practice by physicians of distinguishing among abortions can legitimate legislative practices that regulate and restrict some kinds of abortion, further constraining abortion access. © American Sociological Association 2016.

  20. A Multicountry Ecological Study of Cancer Incidence Rates in 2008 with Respect to Various Risk-Modifying Factors

    Directory of Open Access Journals (Sweden)

    William B. Grant

    2013-12-01

    Full Text Available Observational and ecological studies are generally used to determine the presence of effect of cancer risk-modifying factors. Researchers generally agree that environmental factors such as smoking, alcohol consumption, poor diet, lack of physical activity, and low serum 25-hdyroxyvitamin D levels are important cancer risk factors. This ecological study used age-adjusted incidence rates for 21 cancers for 157 countries (87 with high-quality data in 2008 with respect to dietary supply and other factors, including per capita gross domestic product, life expectancy, lung cancer incidence rate (an index for smoking, and latitude (an index for solar ultraviolet-B doses. The factors found to correlate strongly with multiple types of cancer were lung cancer (direct correlation with 12 types of cancer, energy derived from animal products (direct correlation with 12 types of cancer, inverse with two, latitude (direct correlation with six types, inverse correlation with three, and per capita gross national product (five types. Life expectancy and sweeteners directly correlated with three cancers, animal fat with two, and alcohol with one. Consumption of animal products correlated with cancer incidence with a lag time of 15–25 years. Types of cancer which correlated strongly with animal product consumption, tended to correlate weakly with latitude; this occurred for 11 cancers for the entire set of countries. Regression results were somewhat different for the 87 high-quality country data set and the 157-country set. Single-country ecological studies have inversely correlated nearly all of these cancers with solar ultraviolet-B doses. These results can provide guidance for prevention of cancer.

  1. Global stability analysis of two-strain epidemic model with bilinear and non-monotone incidence rates

    Science.gov (United States)

    Baba, Isa Abdullahi; Hincal, Evren

    2017-05-01

    In this article we studied an epidemic model consisting of two strains with different types of incidence rates; bilinear and non-monotone. The model consists of four equilibrium points: disease-free equilibrium, endemic with respect to strain 1, endemic with respect to strain 2, and endemic with respect to both strains. The global stability analysis of the equilibrium points was carried out through the use of Lyapunov functions. Two basic reproduction ratios R 1 0 and R 2 0 are found, and we have shown that if both are less than one, the disease dies out, and if both are greater than one epidemic occurs. Furthermore, epidemics occur with respect to any strain with a basic reproduction ratio greater than one and disease dies out with respect to any strain with a basic reproduction ratio less than one. It was also shown that any strain with highest basic reproduction ratio will automatically outperform the other strain, thereby eliminating it. Numerical simulations were carried out to support the analytic result and to show the effect of the parameter k in the non-monotone incidence rate, which describes the psychological effect of general public towards infection.

  2. [The Nordic cervical screening programmes through 1995. Evaluation of incidence and mortality rates, targeted age groups and screening intervals.].

    Science.gov (United States)

    Sigurdsson, K

    1999-11-01

    The objective of cervical cancer screening is to lower the incidence and mortality rates of the disease. The Nordic countries have a long experience in cervical cancer screening. Based on this experience this study evaluates the UICC and EC guidelines regarding the effectiveness of organized vs. spontaneous screening, targeted age groups and screening intervals. The study analyses the features of the Icelandic and the Nordic screening programmes and the observed trends in the incidence and mortality rates in these countries through 1995. It also analyses the trends for cytologic preinvasive lesions at first visit and at second and later visits after a normal test(s). The frequency of histologic lesions was calculated for the birth cohort 1920-1926 from the age of 60 and among women referred for colposcopic examination in 1994. Organized screening started in all the Nordic countries except Norway soon after 1960. Up to 1985 the target age group and screening interval were most intensive in Iceland. All countries intensified the screening intervals after 1985. The reduction in both the mortality and the incidence rates was greatest in Iceland and Finland, intermediate in Sweden and Denmark, and lowest in Norway but in that country organized screening started in 1994. The age-specific incidence in the 20-29 age group has been increasing since 1971 in all the Nordic countries, except in Finland. In Iceland screening has greatly affected the rate of all stages of squamous cell carcinoma, but not the rate of adeno-and adenosquamous carcinomas. The prevalence of preinvasive disease has increased significantly since 1980. The rate of moderate to high-grade cytologic changes begins increasing as early as at 20 years of age and moderate to high-grade histologic lesions start to accumulate at 24 to 36 months after a normal smear. The rate of these lesions decreases with the number of negative smears taken. Moderate to high-grade histologic lesions and invasive cancer are

  3. Bayesian stratified sampling to assess corpus utility

    Energy Technology Data Exchange (ETDEWEB)

    Hochberg, J.; Scovel, C.; Thomas, T.; Hall, S.

    1998-12-01

    This paper describes a method for asking statistical questions about a large text corpus. The authors exemplify the method by addressing the question, ``What percentage of Federal Register documents are real documents, of possible interest to a text researcher or analyst?`` They estimate an answer to this question by evaluating 200 documents selected from a corpus of 45,820 Federal Register documents. Bayesian analysis and stratified sampling are used to reduce the sampling uncertainty of the estimate from over 3,100 documents to fewer than 1,000. A possible application of the method is to establish baseline statistics used to estimate recall rates for information retrieval systems.

  4. A systematic review describing incidence rate and prevalence of dysvascular partial foot amputation; how both have changed over time and compare to transtibial amputation

    Directory of Open Access Journals (Sweden)

    Michael P Dillon

    2017-11-01

    Full Text Available Abstract Background Partial foot amputation (PFA is a common consequence of advanced peripheral vascular disease. Given the different ways incidence rate and prevalence data have been measured and reported, it is difficult to synthesize data and reconcile variation between studies. As such, there is uncertainty in whether the incidence rates and prevalence of PFA have increased over time compared to the decline in transtibial amputation (TTA. The aims of this systematic review were to describe the incidence rate and prevalence of dysvascular PFA over time, and how these compare to TTA. Method Databases (i.e., MEDLINE, EMBASE, psychINFO, AMED, CINAHL, ProQuest Nursing and Allied Health were searched using MeSH terms and keywords related to amputation level and incidence rate or prevalence. Original research published in English from 1 January 2000 to 31 December 2015 were independently appraised, and data extracted, by two reviewers. The McMaster Critical Review Forms were used to assess methodological quality and bias. Results were reported as narrative summaries given heterogeneity of the literature and included the weighted mean annual incidence rate and 95% confidence interval. Results Twenty two cohort studies met the inclusion criteria. Twenty one reported incidence rate data for some level of PFA; four also included a TTA cohort. One study reported prevalence data for a cohort with toe(s amputation. Samples were typically older, male and included people with diabetes among other comorbidities. Incidence rates were reported using a myriad of denominators and strata such as diabetes type or initial/recurrent amputation. Conclusion When appropriately grouped by denominator and strata, incidence rates were more homogenous than might be expected. Variation between studies did not necessarily reduce confidence in the conclusion; for example, incidence rate of PFA were many times larger in cohorts with diabetes (94.24 per 100,000 people with

  5. Placenta accreta: incidence and risk factors in an area with a particularly high rate of cesarean section.

    Science.gov (United States)

    Morlando, Maddalena; Sarno, Laura; Napolitano, Raffaele; Capone, Angela; Tessitore, Giovanni; Maruotti, Giuseppe M; Martinelli, Pasquale

    2013-04-01

    Placenta accreta is a rare and potentially life-threatening complication of pregnancy characterized by abnormal adherence of the placenta to the uterine wall. A previously scarred uterus or an abnormal site of placentation in the lower segment is a major risk factor. The aim of this study was to investigate the change in the incidence of placenta accreta and associated risk factors along four decades, from the 1970s to 2000s, in a tertiary south Italian center. We analyzed all cases of placenta accreta in a sample triennium for each decade. The incidence increased from 0.12% during the 1970s, to 0.31% during the 2000s. During the same period, cesarean section rates increased from 17 to 64%. Prior cesarean section was the only risk factor showing a significant concomitant rise. Our results reinforce cesarean section as the most significant predisposing condition for placenta accreta. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  6. Melanoma Incidence Rates in Active Duty Military Personnel Compared With a Population-Based Registry in the United States, 2000-2007

    Science.gov (United States)

    2014-03-01

    later in life, especially among those with fair skin pigmentation, light eye and hair color, and propensity to freckle.’*"^ Studies comparing melanoma ...Naval Health Research Center Melanoma Incidence Rates in Active-Duty Military Personnel Compared With A Population-based Registry in the United...San Diego, California 92106-3521 MILITARY MEDICINE, 179, 3:247, 2014 Melanoma Incidence Rates in Active Duty Military Personnel Compared With a

  7. The analysis of hyper-homocysteine incidence rate and multi-risk factors in 200 patients with cerebral stroke

    International Nuclear Information System (INIS)

    Ding Xiudong; Yang Jianghui; Huo Aimei; Wang Yan; Chu Yanchuang; Dong Mei

    2009-01-01

    To investigate the hyperhomocysteine incidence rate and clinical significance in 200 patients with cerebral stroke, the serum homocysteine, fibrinogen, C-reaction protein, cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol levels in 200 patients with cerebral stroke and 100 normal healthy controls were detected. The results showed that both serum homocysteine and plasma FIB levels in patients with cerebral infarction and intracerebral hemorrhage were significantly higher than those in controls (P 0.05). The hyper-homocysteinemia is an independent risk factor for cerebral stoke, and hyperhomocysteine may lead to the increase of Fibrinogen level, which is one of the important reasons for the high blood viscosity in the cerebral infarction patients. (authors)

  8. Global stability and Hopf bifurcation of a delayed computer virus propagation model with saturation incidence rate and temporary immunity

    Science.gov (United States)

    Dai, Yunxian; Lin, Yiping; Zhao, Huitao; Khalique, Chaudry Masood

    2016-06-01

    In this paper, a delayed computer virus propagation model with a saturation incidence rate and a time delay describing temporary immune period is proposed and its dynamical behaviors are studied. The threshold value ℜ0 is given to determine whether the virus dies out completely. By comparison arguments and iteration technique, sufficient conditions are obtained for the global asymptotic stabilities of the virus-free equilibrium and the virus equilibrium. Taking the delay as a parameter, local Hopf bifurcations are demonstrated. Furthermore, the direction of Hopf bifurcation and the stabilities of the bifurcating periodic solutions are determined by the normal form theory and the center manifold theorem for functional differential equations (FDEs). Finally, numerical simulations are carried out to illustrate the main theoretical results.

  9. Individual and Population Level Impact of Key HIV Risk Factors on HIV Incidence Rates in Durban, South Africa.

    Directory of Open Access Journals (Sweden)

    Gita Ramjee

    Full Text Available We aimed to estimate the individual and joint impact of age, marital status and diagnosis with sexually transmitted infections (STIs on HIV acquisition among young women at a population level in Durban, KwaZulu-Natal, South Africa. A total of 3,978 HIV seronegative women were recruited for four biomedical intervention trials from 2002-2009. Point and interval estimates of partial population attributable risk (PAR were used to quantify the proportion of HIV seroconversions which can be prevented if a combination of risk factors is eliminated from a target population. More than 70% of the observed HIV acquisitions were collectively attributed to the three risk factors: younger age (<25 years old, unmarried and not cohabiting with a stable/regular partner and diagnosis with STIs. Addressing these risks requires targeted structural, behavioural, biomedical and cultural interventions in order to impact on unacceptably high HIV incidence rates among young women and the population as a whole.

  10. Increased incidence rates of trauma and stressor related disorders in Denmark following the 9/11 attacks

    DEFF Research Database (Denmark)

    Hansen, Bertel Teilfeldt; Østergaard, Søren Dinesen; Sønderskov, Kim Mannemar

    2016-01-01

    The terrorist attacks that occurred on September 11, 2001 (hereafter referred to as 9/11) in the United States had a profound impact on the physical and mental health of Americans, but the effects beyond the United States are largely unknown. To understand the wider aftermath, we examined...... for other disorders. This is consistent with the prominent role of external stressors in the etiology of trauma- and stressor-related disorders. The results indicate that the effects of 9/11 on mental disorders extended across the Atlantic Ocean to Denmark. Thus, the impact of terrorist attacks on mental...... the consequences of the 9/11 attacks on mental disorders in the Kingdom of Denmark. Utilizing population data from the Danish Psychiatric Central Research Register from 1995 to 2012, we used a time-series intervention approach to estimate the change in the incidence rate of mental disorders after the 9/11 attacks...

  11. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2006-04-01

    Full Text Available Abstract Background We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. Results The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. Conclusion This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral.

  12. Free Falling in Stratified Fluids

    Science.gov (United States)

    Lam, Try; Vincent, Lionel; Kanso, Eva

    2017-11-01

    Leaves falling in air and discs falling in water are examples of unsteady descents due to complex interaction between gravitational and aerodynamic forces. Understanding these descent modes is relevant to many branches of engineering and science such as estimating the behavior of re-entry space vehicles to studying biomechanics of seed dispersion. For regularly shaped objects falling in homogenous fluids, the motion is relatively well understood. However, less is known about how density stratification of the fluid medium affects the falling behavior. Here, we experimentally investigate the descent of discs in both pure water and in stable linearly stratified fluids for Froude numbers Fr 1 and Reynolds numbers Re between 1000 -2000. We found that stable stratification (1) enhances the radial dispersion of the disc at landing, (2) increases the descent time, (3) decreases the inclination (or nutation) angle, and (4) decreases the fluttering amplitude while falling. We conclude by commenting on how the corresponding information can be used as a predictive model for objects free falling in stratified fluids.

  13. Stratified Medicine and Reimbursement Issues

    Directory of Open Access Journals (Sweden)

    Hans-Joerg eFugel

    2012-10-01

    Full Text Available Stratified Medicine (SM has the potential to target patient populations who will most benefit from a therapy while reducing unnecessary health interventions associated with side effects. The link between clinical biomarkers/diagnostics and therapies provides new opportunities for value creation to strengthen the value proposition to pricing and reimbursement (P&R authorities. However, the introduction of SM challenges current reimbursement schemes in many EU countries and the US as different P&R policies have been adopted for drugs and diagnostics. Also, there is a lack of a consistent process for value assessment of more complex diagnostics in these markets. New, innovative approaches and more flexible P&R systems are needed to reflect the added value of diagnostic tests and to stimulate investments in new technologies. Yet, the framework for access of diagnostic–based therapies still requires further development while setting the right incentives and appropriate align stakeholders interests when realizing long- term patient benefits. This article addresses the reimbursement challenges of SM approaches in several EU countries and the US outlining some options to overcome existing reimbursement barriers for stratified medicine.

  14. Head injuries in professional male football (soccer) over 13 years: 29% lower incidence rates after a rule change (red card).

    Science.gov (United States)

    Beaudouin, Florian; Aus der Fünten, Karen; Tröß, Tobias; Reinsberger, Claus; Meyer, Tim

    2017-06-23

    Absolute numbers of head injuries in football (soccer) are considerable because of its high popularity and the large number of players. In 2006 a rule was changed to reduce head injuries. Players were given a red card (sent off) for intentional elbow-head contact. To describe the head injury mechanism and examine the effect of the rule change. Based on continuously recorded data from the German football magazine "kicker", a database of all head injuries in the 1 st German Male Bundesliga was generated comprising seasons 2000/01-2012/13. Injury mechanisms were analysed from video recordings. Injury incidence rates (IR) and 95% confidence intervals (95% CI) as well as incidence rate ratios (IRR) to assess differences before and after the rule change were calculated. 356 head injuries were recorded (IR 2.22, 95% CI 2.00 to 2.46 per 1000 match hours). Contact with another player caused most head injuries, more specifically because of head-head (34%) or elbow-head (17%) contacts. After the rule change, head injuries were reduced by 29% (IRR 0.71, 95% CI 0.57 to 0.86, p=0.002). Lacerations/abrasions declined by 42% (95% CI 0.39 to 0.85), concussions by 29% (95% CI 0.46 to 1.09), contusions by 18% (95% CI 0.43 to 1.55) and facial fractures by 16% (95% CI 0.55 to 1.28). This rule change appeared to reduce the risk of head injuries in men's professional football. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Aflatoxin contamination of red chili pepper from Bolivia and Peru, countries with high gallbladder cancer incidence rates.

    Science.gov (United States)

    Asai, Takao; Tsuchiya, Yasuo; Okano, Kiyoshi; Piscoya, Alejandro; Nishi, Carlos Yoshito; Ikoma, Toshikazu; Oyama, Tomizo; Ikegami, Kikuo; Yamamoto, Masaharu

    2012-01-01

    Chilean red chili peppers contaminated with aflatoxins were reported in a previous study. If the development of gallbladder cancer (GBC) in Chile is associated with a high level of consumption of aflatoxin-contaminated red chili peppers, such peppers from other countries having a high GBC incidence rate may also be contaminated with aflatoxins. We aimed to determine whether this might be the case for red chili peppers from Bolivia and Peru. A total of 7 samples (3 from Bolivia, 4 from Peru) and 3 controls (2 from China, 1 from Japan) were evaluated. Aflatoxins were extracted with acetonitrile:water (9:1, v/v) and eluted through an immuno-affinity column. The concentrations of aflatoxins B1, B2, G1, and G2 were measured using high-performance liquid chromatography (HPLC), and then the detected aflatoxins were identified using HPLC-mass spectrometry. In some but not all of the samples from Bolivia and Peru, aflatoxin B1 or aflatoxins B1 and B2 were detected. In particular, aflatoxin B1 or total aflatoxin concentrations in a Bolivian samples were above the maximum levels for aflatoxins in spices proposed by the European Commission. Red chili peppers from Bolivia and Peru consumed by populations having high GBC incidence rates would appear to be contaminated with aflatoxins. These data suggest the possibility that a high level of consumption of aflatoxin-contaminated red chili peppers is related to the development of GBC, and the association between the two should be confirmed by a case-control study.

  16. First-Ever Stroke and Transient Ischemic Attack Incidence and 30-Day Case-Fatality Rates in a Population-Based Study in Argentina

    DEFF Research Database (Denmark)

    Bahit, M Cecilia; Coppola, Mariano L; Riccio, Patricia M

    2016-01-01

    BACKGROUND AND PURPOSE: Epidemiological data about stroke are scarce in low- and middle-income Latin-American countries. We investigated annual incidence of first-ever stroke and transient ischemic attack (TIA) and 30-day case-fatality rates in a population-based setting in Tandil, Argentina....... METHODS: We prospectively identified all first-ever stroke and TIA cases from overlapping sources between January 5, 2013, and April 30, 2015, in Tandil, Argentina. We calculated crude and standardized incidence rates. We estimated 30-day case-fatality rates. RESULTS: We identified 334 first-ever strokes.......1% (95% CI, 14.2-36.6) for intracerebral hemorrhage, and 1.9% (95% CI, 0.4-5.8) for TIA. CONCLUSIONS: This study provides the first prospective population-based stroke and TIA incidence and case-fatality estimate in Argentina. First-ever stroke incidence was lower than that reported in previous Latin...

  17. Time trends in lifetime incidence rates of first-time diagnosed anorexia nervosa and bulimia nervosa across 16 years in a Danish nationwide psychiatric registry study.

    Science.gov (United States)

    Steinhausen, Hans-Christoph; Jensen, Christina Mohr

    2015-11-01

    To study recent time trends in the incidence of diagnosed anorexia nervosa (AN) and bulimia nervosa (BN) based on nationwide psychiatric register data. The Danish Psychiatric Central Research Registry was used to identify the incidence of diagnosed cases with AN and BN at the ages of 4-65 years from 1995 to 2010. Age- and sex-adjusted incidence rates per 100,000 person-years were calculated and were adjusted for time trends in the total number of people diagnosed in psychiatry. Time trends were analyzed using JoinPoint regression analysis. A total of N = 5,902 persons had a first-time incidence of AN, and a total of N = 5,113 had first-time incidence of BN. Incidence rates increased for AN from 6.4 to 12.6 per 100,000 person-years, and for BN from 6.3 to 7.2 per 100,000 person-years. In 2010, the male-to-female ratio was 1:8 for AN, and 1:20 for BN. There was an earlier onset for AN than for BN, and age at incidence decreased during the observation period for AN but not for BN. A sizeable part of the increasing incidence rates for AN and in particular, the younger AN age groups, could be attributed to an increase in the total number of N = 249,607 persons with first-time diagnoses in psychiatry. Incidence rates had increased slightly for AN, but were stable for BN across 16 years in this nationwide study and to a large extent were reflective of a general increase in diagnosed mental disorders. © 2015 Wiley Periodicals, Inc.

  18. Incidence rates and risk factor analyses for owner reported vomiting and diarrhoea in Labrador Retrievers - findings from the Dogslife Cohort.

    Science.gov (United States)

    Pugh, Carys A; Bronsvoort, B Mark de C; Handel, Ian G; Querry, Damon; Rose, Erica; Summers, Kim M; Clements, Dylan N

    2017-05-01

    Dogslife collects data directly from owners of Labrador Retrievers across the UK including information regarding signs of illness irrespective of whether the signs precipitated a veterinary visit. In December 2015, the cohort comprised 6084 dogs aged up to six years and their owners had made 2687 and 2601 reports of diarrhoea and vomiting respectively. The co-occurrence of vomiting and diarrhoea with other signs was described and the frequencies and durations of the two signs were examined with reference to veterinary visitation. Age-specific illness rates were described and Cox Proportional Hazards models were used to estimate risk factors. Just 37% of diarrhoea reports were associated with a veterinary visit and the proportion was even lower for vomiting at 28%; indicating that studies of veterinary practice data miss the majority of signs of gastrointestinal upset. In terms of frequency and duration, diarrhoea typically needed to last two days before the dog would be taken to the vet but if the dog vomited at least every six hours, the owner would be more likely to take the dog to the vet after one day. The illness rates of both signs peaked when the dogs were aged between three and six months. There was also a seasonal pattern to the incidents with the lowest hazards for both in May. Diarrhoea incidents peaked in August-September each year but, while vomiting appeared to be higher in September, it peaked in February. Having another dog in the household was associated with a lower hazard for both vomiting and diarrhoea but having a cat was only associated with a reduced hazard of vomiting. In addition to the distinct seasonal patterns of reporting, there were clear differences in the geographic risks for the two signs. The hazard of diarrhoea was positively associated with human population density within Great Britain (according to home post code) whereas no significant geographical association was found with vomiting. This study is particularly relevant for dog

  19. Incidence and hospitalization rates of varicella and herpes zoster before varicella vaccine introduction: a baseline assessment of the shifting epidemiology of varicella disease.

    Science.gov (United States)

    Coplan, P; Black, S; Rojas, C; Shinefield, H; Ray, P; Lewis, E; Guess, H

    2001-07-01

    A 15-year postmarketing evaluation of the impact of varicella vaccine on the age distribution of varicella disease is being conducted at Kaiser Permanente Medical Care Program, Northern California (KPMCP). We report on a baseline assessment of the age-specific incidence and hospitalization rates of varicella and herpes zoster that was conducted before vaccine introduction. To assess the annual incidence of varicella, a telephone survey was conducted in a random sample of approximately 8,000 youths 5 to 19 years of age. The annual incidence of hospitalizations for varicella and herpes zoster in 1994 was assessed with the use of the computerized database at KPMCP. Varicella annual incidence was 10.3% in 5- to 9-year-olds, 1.9% in 10- to 14-year-olds and 1.2% in the 15- to 19-year age groups, respectively. Hospitalization rates among the entire KPMCP membership were 2.6 and 2.1 per 100,000 person years for varicella and zoster, respectively. Varicella incidence in the 15- to 19-year age group was higher among African-Americans than among Caucasians. Varicella rates were similar in the 5- to 9- and 10- to 14-year age groups to rates from other published studies conducted in 1972 to 1978, 1980 to 1988 and 1990 to 1992; however, the rate in 15- to 19-year-olds was 2 to 4 times higher than published rates in the same age category.

  20. Improvements to TRAC models of condensing stratified flow. Pt. 2

    International Nuclear Information System (INIS)

    Zhang, Q.; Leslie, D.C.; Hewitt, G.F.

    1991-03-01

    The Bankoff experiments of condensation in counter-current stratified flow have been simulated by TRAC-PF1/MOD1 and modified TRAC with Bankoff's own correlations of interfacial friction and interfacial heat transfer coefficient (HTC). Steam flow rate and liquid height have been evaluated. Both TRAC and Bankoff HTCs are strongly dependant on the liquid velocity which is related to the liquid height. The calculations show that Bankoff HTC is much better than the TRAC HTC in the prediction of the stream flow rate and is recommended to replace TRAC HTC in the condensing stratified flow. (author)

  1. Hospitalization Rate and Population-Based Incidence of Hospitalization for Community-Acquired Pneumonia Among Children in Suzhou, China.

    Science.gov (United States)

    Shan, Wei; Shi, Ting; Zhang, Xiyan; Xue, Jian; Wang, Yin; Yu, Jia; Huang, Yukai; Lin, Sheng; Zhao, Genming; Tian, Jianmei; Zhang, Tao

    2018-03-22

    Data on hospitalization burden of CAP in children is very limited in China. This study aimed to estimate the hospitalization rate and population-based incidence of hospitalization of CAP for children <15 years of age in Suzhou, China. This was a retrospective study of children hospitalized in Soochow University Affiliated Children's Hospital (SCH) from January 2010 to December 2014. Children who were residents of downtown Suzhou, 29 days to <15 years of age, with discharge diagnosis codes (ICD-10) including J09 to J18 and J20 to J22 were included. All-cause clinical community-acquired pneumonia (CCAP) and radiographically confirmed pneumonia (RCAP) were identified based on individual medical chart review. The hospitalization rate (HR) and population-based cumulative incidence of hospitalization (HI) were calculated. Among 184,734 children <15 years old admitted to SCH during the study period, 31,302 children were identified as having CCAP, and 24,218 (77.4%) children confirmed as having RCAP. CCAP hospitalization occurred year round and peaked during winter and early spring. The overall HRs for CCAP and RCAP were 189.0 (95%CI, 187.1-190.9) and 146.2 (95%CI, 144-148) per 1,000 hospitalizations respectively, and the HIs per 100,000 children annually were CCAP, 3,235.8 (95%CI, 3207.3-3264.2) and RCAP, 2,503.5 (95%CI, 2,478.3-2,528.6). For children <5 years old, the HR for CCAP was 248.4 (95%CI, 245.9-250.9) and RCAP 194.0 (95%CI, 191.4-196.3) per 1,000 hospitalizations; the HI for CCAP was 6,956.2 (95%CI: 6,892.8-7,019.6) and 5,431.9 (95%CI: 5,375.4-5,488.4) per 100,000 children for RCAP. The highest HR and HI were observed in children 29 days to <6 months old: HR for CCAP was 407.4 (95%CI: 400.9-413.9) per 1,000 hospitalizations and HI for CCAP was 11,203.7 (95%CI: 11,026.8-11,380.6) per 100,000 children annually. There is a considerable burden of CAP among children <15 years of age in Suzhou, particularly among children 29 days to <6 months of age and during winter

  2. PHOTOSPHERIC EMISSION FROM STRATIFIED JETS

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Hirotaka; Nagataki, Shigehiro; Ono, Masaomi; Lee, Shiu-Hang; Mao, Jirong [Astrophysical Big Bang Laboratory, RIKEN, Saitama 351-0198 (Japan); Yamada, Shoichi [Department of Science and Engineering, Waseda University, 3-4-1 Okubo, Shinjuku, Tokyo 169-8555 (Japan); Pe' er, Asaf [Institute for Theory and Computation, Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Mizuta, Akira [KEK Theory Center, Tsukuba 305-0801 (Japan); Harikae, Seiji, E-mail: hito@yukawa.kyoto-u.ac.jp [Quants Research Department, Financial Engineering Division, Mitsubishi UFJ Morgan Stanley Securities Co., Ltd., Mejirodai Bldg., 3-29-20 Mejirodai, Bunkyo-ku, Tokyo 112-8688 (Japan)

    2013-11-01

    We explore photospheric emissions from stratified two-component jets, wherein a highly relativistic spine outflow is surrounded by a wider and less relativistic sheath outflow. Thermal photons are injected in regions of high optical depth and propagated until the photons escape at the photosphere. Because of the presence of shear in velocity (Lorentz factor) at the boundary of the spine and sheath region, a fraction of the injected photons are accelerated using a Fermi-like acceleration mechanism such that a high-energy power-law tail is formed in the resultant spectrum. We show, in particular, that if a velocity shear with a considerable variance in the bulk Lorentz factor is present, the high-energy part of observed gamma-ray bursts (GRBs) photon spectrum can be explained by this photon acceleration mechanism. We also show that the accelerated photons might also account for the origin of the extra-hard power-law component above the bump of the thermal-like peak seen in some peculiar bursts (e.g., GRB 090510, 090902B, 090926A). We demonstrate that time-integrated spectra can also reproduce the low-energy spectrum of GRBs consistently using a multi-temperature effect when time evolution of the outflow is considered. Last, we show that the empirical E{sub p}-L{sub p} relation can be explained by differences in the outflow properties of individual sources.

  3. Economic Disparities and Syphilis Incidence in Massachusetts, 2001-2013.

    Science.gov (United States)

    Smock, Laura; Caten, Evan; Hsu, Katherine; DeMaria, Alfred

    We used area-level indicators of poverty to describe economic disparities in the incidence rate of infectious syphilis in Massachusetts to (1) determine whether methods developed in earlier AIDS analyses in Massachusetts could be applied to syphilis and (2) characterize syphilis trends during a time of increased rates of syphilis incidence. Using census tract data and population counts from the US Census Bureau and Massachusetts data on syphilis, we analyzed the incidence rate of syphilis infection from 2001 to 2013 by the poverty level of the census tract in which people with syphilis resided, stratified by age, sex, and race/ethnicity. The syphilis incidence rate increased in all census tract groups in Massachusetts from 2001 to 2013, and disparities in incidence rates by area poverty level persisted over time. The overall incidence rate of syphilis increased 6.9-fold from 2001 to 2013 in all census tract poverty-level groupings (from 1.5 to 10.3 per 100 000 population), but the rise in rate was especially high in the poorest census tracts (from 5.6 to 31.0 per 100 000 population) and among men (from 2.2 to 19.4 per 100 000 population). The highest syphilis incidence rate was among non-Hispanic black people. The largest changes in incidence rate occurred after 2010. One region had a disproportionate increase in incidence rates and a disproportionate impact on the statewide trend. Census tract poverty analyses can inform the targeting of interventions that make progress toward reducing disparities in rates of syphilis incidence possible.

  4. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology

    Directory of Open Access Journals (Sweden)

    El Saadi Ossama

    2004-04-01

    Full Text Available Abstract Background Understanding variations in the incidence of schizophrenia is a crucial step in unravelling the aetiology of this group of disorders. The aims of this review are to systematically identify studies related to the incidence of schizophrenia, to describe the key features of these studies, and to explore the distribution of rates derived from these studies. Methods Studies with original data related to the incidence of schizophrenia (published 1965–2001 were identified via searching electronic databases, reviewing citations and writing to authors. These studies were divided into core studies, migrant studies, cohort studies and studies based on Other Special Groups. Between- and within-study filters were applied in order to identify discrete rates. Cumulative plots of these rates were made and these distributions were compared when the underlying rates were sorted according to sex, urbanicity, migrant status and various methodological features. Results We identified 100 core studies, 24 migrant studies, 23 cohort studies and 14 studies based on Other Special Groups. These studies, which were drawn from 33 countries, generated a total of 1,458 rates. Based on discrete core data for persons (55 studies and 170 rates, the distribution of rates was asymmetric and had a median value (10%–90% quantile of 15.2 (7.7–43.0 per 100,000. The distribution of rates was significantly higher in males compared to females; the male/female rate ratio median (10%–90% quantile was 1.40 (0.9–2.4. Those studies conducted in urban versus mixed urban-rural catchment areas generated significantly higher rate distributions. The distribution of rates in migrants was significantly higher compared to native-born; the migrant/native-born rate ratio median (10%–90% quantile was 4.6 (1.0–12.8. Apart from the finding that older studies reported higher rates, other study features were not associated with significantly different rate distributions (e

  5. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology.

    Science.gov (United States)

    McGrath, John; Saha, Sukanta; Welham, Joy; El Saadi, Ossama; MacCauley, Clare; Chant, David

    2004-04-28

    Understanding variations in the incidence of schizophrenia is a crucial step in unravelling the aetiology of this group of disorders. The aims of this review are to systematically identify studies related to the incidence of schizophrenia, to describe the key features of these studies, and to explore the distribution of rates derived from these studies. Studies with original data related to the incidence of schizophrenia (published 1965-2001) were identified via searching electronic databases, reviewing citations and writing to authors. These studies were divided into core studies, migrant studies, cohort studies and studies based on Other Special Groups. Between- and within-study filters were applied in order to identify discrete rates. Cumulative plots of these rates were made and these distributions were compared when the underlying rates were sorted according to sex, urbanicity, migrant status and various methodological features. We identified 100 core studies, 24 migrant studies, 23 cohort studies and 14 studies based on Other Special Groups. These studies, which were drawn from 33 countries, generated a total of 1,458 rates. Based on discrete core data for persons (55 studies and 170 rates), the distribution of rates was asymmetric and had a median value (10%-90% quantile) of 15.2 (7.7-43.0) per 100,000. The distribution of rates was significantly higher in males compared to females; the male/female rate ratio median (10%-90% quantile) was 1.40 (0.9-2.4). Those studies conducted in urban versus mixed urban-rural catchment areas generated significantly higher rate distributions. The distribution of rates in migrants was significantly higher compared to native-born; the migrant/native-born rate ratio median (10%-90% quantile) was 4.6 (1.0-12.8). Apart from the finding that older studies reported higher rates, other study features were not associated with significantly different rate distributions (e.g. overall quality, methods related to case finding

  6. An evaluation of rabies vaccination rates among canines and felines involved in biting incidents within the Wellington-Dufferin-Guelph Public Health Department.

    Science.gov (United States)

    Bottoms, K; Trotz-Williams, L; Hutchison, S; MacLeod, J; Dixon, J; Berke, O; Poljak, Z

    2014-11-01

    The objectives of this study were to determine the rate of animal bite incidents occurring in the human population of a local health department, and to determine the proportion of these canines and felines that were not up to date on their rabies vaccination at the time the incident occurred. Data were obtained from animal bite incidents reported to Wellington-Dufferin-Guelph Public Health during 2010 and 2011. Descriptive statistics of 718 eligible reports revealed the average rate of animal biting was 1.55 bites per 1000 residents per year. Approximately 54% of these animals were vaccinated against rabies, 32% were not up to date with their rabies vaccination, and the remaining 14.5% were of unknown status. The unit of analysis was the municipality, and the four outcomes of interest were: (i) number of animal bite incidents per 1000 residents, (ii) number of dog bite incidents per 1000 residents, (iii) proportion of animals involved in bite incidents that were not up to date with their rabies vaccination, and (iv) proportion of dogs that were not up to date. Associations between the outcomes and selected demographic variables were investigated using regression analysis. The number of veterinary clinics per 10,000 residents, and whether the municipality was urban or rural were identified as significant predictors for the number of animal bites per 1000 residents, and the number of dog bites. There were no significant predictors for the proportion of unvaccinated animals or dogs. Spatial clustering and the location of spatial clusters were assessed using the empirical Bayes index and spatial scan test. This analysis identified five municipalities within the health department that have a high rate of biting incidents and a high proportion of animals that were not up to date on their rabies vaccination. Such municipalities are ideal for targeted educational campaigns regarding the importance of vaccination in pets. © 2014 Blackwell Verlag GmbH.

  7. Delayed heart rate recovery after exercise as a risk factor of incident type 2 diabetes mellitus after adjusting for glycometabolic parameters in men.

    Science.gov (United States)

    Yu, Tae Yang; Jee, Jae Hwan; Bae, Ji Cheol; Hong, Won-Jung; Jin, Sang-Man; Kim, Jae Hyeon; Lee, Moon-Kyu

    2016-10-15

    Some studies have reported that delayed heart rate recovery (HRR) after exercise is associated with incident type 2 diabetes mellitus (T2DM). This study aimed to investigate the longitudinal association of delayed HRR following a graded exercise treadmill test (GTX) with the development of T2DM including glucose-associated parameters as an adjusting factor in healthy Korean men. Analyses including fasting plasma glucose, HOMA-IR, HOMA-β, and HbA1c as confounding factors and known confounders were performed. HRR was calculated as peak heart rate minus heart rate after a 1-min rest (HRR 1). Cox proportional hazards model was used to quantify the independent association between HRR and incident T2DM. During 9082 person-years of follow-up between 2006 and 2012, there were 180 (10.1%) incident cases of T2DM. After adjustment for age, BMI, systolic BP, diastolic BP, smoking status, peak heart rate, peak oxygen uptake, TG, LDL-C, HDL-C, fasting plasma glucose, HOMA-IR, HOMA-β, and HbA1c, the hazard ratios (HRs) [95% confidence interval (CI)] of incident T2DM comparing the second and third tertiles to the first tertile of HRR 1 were 0.867 (0.609-1.235) and 0.624 (0.426-0.915), respectively (p for trend=0.017). As a continuous variable, in the fully-adjusted model, the HR (95% CI) of incident T2DM associated with each 1 beat increase in HRR 1 was 0.980 (0.960-1.000) (p=0.048). This study demonstrated that delayed HRR after exercise predicts incident T2DM in men, even after adjusting for fasting glucose, HOMA-IR, HOMA-β, and HbA1c. However, only HRR 1 had clinical significance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. The incidence rate of HIV type-1 drug resistance in patients on antiretroviral therapy: a nationwide population-based Danish cohort study 1999-2005

    DEFF Research Database (Denmark)

    Audelin, A.M.; Lohse, N.; Obel, N.

    2009-01-01

    BACKGROUND: Newer antiretroviral treatment regimens for HIV carry a lower risk of inducing drug resistance mutations. We estimated changes in incidence rates (IRs) of new mutations in HIV-infected individuals receiving highly active antiretroviral therapy (HAART). METHODS: Population-based data...

  9. Time Trends over 16 Years in Incidence-Rates of Autism Spectrum Disorders across the Lifespan Based on Nationwide Danish Register Data

    Science.gov (United States)

    Jensen, Christina Mohr; Steinhausen, Hans-Christoph; Lauritsen, Marlene Briciet

    2014-01-01

    This study investigated time trends and associated factors of incidence rates of diagnosed autism spectrum disorders (ASD) across the lifespan from 1995 to 2010, using data from the Danish Psychiatric Central Research Registry. First time diagnosis of childhood autism, atypical autism, Asperger's syndrome, or pervasive developmental…

  10. Convergence of decreasing male and increasing female incidence rates in major tobacco-related cancers in Europe in 1988-2010.

    Science.gov (United States)

    Lortet-Tieulent, Joannie; Renteria, Elisenda; Sharp, Linda; Weiderpass, Elisabete; Comber, Harry; Baas, Paul; Bray, Freddie; Coebergh, Jan Willem; Soerjomataram, Isabelle

    2015-06-01

    Smoking prevalence has been declining in men all over Europe, while the trend varies in European regions among women. To study the impact of past smoking prevalence, we present a comprehensive overview of the most recent trends in incidence, during 1988-2010, in 26 countries, of four of the major cancers in the respiratory and upper gastro-intestinal tract associated with tobacco smoking. Data from 47 population-based cancer registries for lung, laryngeal, oral cavity and pharyngeal, and oesophageal cancer cases were obtained from the newly developed data repository within the European Cancer Observatory (http://eco.iarc.fr/). Truncated age-standardised incidence rates (35-74 years) by calendar year, average annual percentage change in incidence over 1998-2007 were calculated. Smoking prevalence in selected countries was extracted from the Organisation for Economic Co-operation and Development and the World Health Organization databases. There remained great but changing variation in the incidence rates of tobacco-related cancers by European region. Generally, the high rates among men have been declining, while the lower rates among women are increasing, resulting in convergence of the rates. Female lung cancer rates were above male rates in Denmark, Iceland and Sweden (35-64 years). In lung and laryngeal cancers, where smoking is the main risk factor, rates were highest in central and eastern Europe, southern Europe and the Baltic countries. Despite a lowering of female smoking prevalence, female incidence rates of lung, laryngeal and oral cavity cancers increased in most parts of Europe, but were stable in the Baltic countries. Mixed trends emerged in oesophageal cancer, probably explained by differing risk factors for the two main histological subtypes. This data repository offers the opportunity to show the variety of incidence trends by sex among European countries. The diverse patterns of trends reflect varied exposure to risk factors. Given the heavy cancer

  11. Time trends in incidence rates of diagnosed attention-deficit/hyperactivity disorder across 16 years in a nationwide Danish registry study.

    Science.gov (United States)

    Mohr Jensen, Christina; Steinhausen, Hans-Christoph

    2015-03-01

    To investigate time trends in incidence rates of first-time diagnosed attention-deficit/hyperactivity disorder (ADHD) in a nationwide sample aged 4-65 years across 16 years and identify potential contributing factors to these time trends. Incidence rates of first-time diagnosed ADHD based on ICD-10 criteria in Danish psychiatric hospitals per 100,000 person years (PY) were calculated for the total population, the 2 sexes, and 4 age groups using data from the Danish Psychiatric Central Research Registry and annual census data. Time trends and the role of contributing factors were analyzed and identified using joinpoint regression procedures by calculating annual percent changes for the time period 1995-2010. A total of 20,281 patients were diagnosed with ADHD and incidence rates increased from 7.3 to 91.2 per 100,000 PY during the study period. Joinpoint analysis suggested that incidence rates for diagnosed ADHD rapidly increased from 1998 to 2002, peaked from 2002 to 2008, and slowed down from 2008 to 2010. Contributing factors to the observed time trends were a general increase in patients seen in psychiatry for any mental disorder and an increased awareness and recognition of ADHD in females, adolescents, and adults. These results provide empirical data needed in the public and professional debate often based on theoretical rather than empirical arguments. Results support the notion of increasing incidence rates of diagnosed ADHD and identify that contributing factors are a general increase in the number of patients assessed in psychiatry and an increased recognition of females, adolescents, and adults with ADHD. © Copyright 2015 Physicians Postgraduate Press, Inc.

  12. HIV and Hepatitis B and C incidence rates in US correctional populations and high risk groups: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Hook Edward W

    2010-12-01

    Full Text Available Abstract Background High Human Immunodeficiency Virus (HIV prevalence and high risk behaviors have been well documented within United States (US correctional systems. However, uncertainty remains regarding the extent to which placing people in prison or jail increases their risk of HIV infection, and regarding which inmate populations experience an increased incidence of HIV. Describing these dynamics more clearly is essential to understanding how inmates and former detainees may be a source for further spread of HIV to the general US population. Methods The authors conducted a systematic review and meta-analysis of studies describing HIV incidence in US correctional facility residents and, for comparison, in high risk groups for HIV infection, such as non-incarcerated intravenous drug users (IVDU and men who have sex with men (MSM in the US. HIV incidence rates were further compared with Hepatitis B and Hepatitis C Virus rates in these same populations. Results Thirty-six predominantly prospective cohort studies were included. Across all infection outcomes, continuously incarcerated inmates and treatment recruited IVDU showed the lowest incidence, while MSM and street recruited IVDU showed the highest. HIV incidence was highest among inmates released and re-incarcerated. Possible sources of heterogeneity identified among HIV studies were risk population and race. Conclusions Although important literature gaps were found, current evidence suggests that policies and interventions for HIV prevention in correctional populations should prioritize curtailing risk of infection during the post-release period. Future research should evaluate HIV incidence rates in inmate populations, accounting for proportion of high risk sub-groups.

  13. Typology and description of the endemic areas with a long-time biggest and smallest colorectal incidence rates in the Silesia voivodeship populations

    Directory of Open Access Journals (Sweden)

    Brunon Zemła

    2013-09-01

    Full Text Available Background: The colorectal cancers (C18–C21, by ICD – X revision = RJG, it a big social-clinical problem. The high level differentiation (dependent of particular countries and regions within them; for example: Silesia voivodeship common for frequency of incidence. Therefore an attempt looking for an endemic area with a longtime biggest and smallest incidence rates in the smaller population scale, what a make easy fight against cancers. Materials and methods: In the years 1999–2009 20682 persons were diagnosed for RJG. Basing on the data (as above and demographic data, the different type of rates were calculated. All statistic procedures were in detail described anywhere [4–6]. Results: In the years 1999– 2009, in Silesia voivodeship, 20 682 cases of RJG were diagnosed, i.e. 53.5% among males and 46.5% among females. Age-adjusted rate for the whole Silesia voivodeship is 31.4 per 100 thousands to men and 19.5/100 thousands to women. In comparison between two extremely periods (1999–2009 : 2006–2009, age – adjusted incidence rates among men increased about 2.9%, and among women decreased about 6.5%. The distribution of age-standardized colorectal cancer rates within Silesia voivodeship, in the years 1999–2009, taking into account 36 counties – was very unequal so among males and at the same among females. But the most important epidemiological problem was the endemic areas with significantly biggest incidence rates among males: towns on the law of county: Częstochowa, Katowice, Bielsko-Biała and counties: mikołowski and wodzisławski; among females the endemic areas of this type were Bielsko-Biała town and his county. Conclusions: 1 Within Silesia voivodeship were revealed the endemic areas at statistically significantly high or low (in a long-time then the overall incidence rate for the colorectal cancer among men and women. 2 The endemic areas with the biggest incidence colorectal rates (fig. 1D and 2D, it indications to

  14. Stratified turbulence diagnostics for high-Reynolds-number momentum wakes

    Science.gov (United States)

    Diamessis, Peter; Zhou, Qi

    2017-11-01

    We analyze a large-eddy simulation (LES) dataset of the turbulent wake behind a sphere of diameter D translating at speed U in a linearly stratified Boussinesq fluid with buoyancy frequency N. These simulations are performed at Reynolds numbers Re ≡ UD / ν ∈ { 5 ×103 , 105 , 4 ×105 } and various Froude numbers Fr ≡ 2 U /(ND) . The recently obtained data at Re = 4 ×105 , the highest Re attained so far in either simulation or laboratory, and Fr ∈ { 4 , 16 } enable us to systematically investigate the effects of Reynolds number on this prototypical localized stratified turbulent shear flow. Our analysis focuses on the time evolution of various diagnostics of stratified turbulence, such as the horizontal and vertical integral length scales, turbulent kinetic energy and its dissipation rate ɛ, and the local rate of shear between the spontaneously formed layers of vorticity within the larger-scale quasi-horizontal flow structures. This leads to a discussion of the transitions between distinct stratified flow regimes (Brethouwer et al. 2007) in the appropriately defined phase diagram, and we highlight the dynamical role of the Gibson number Gi = ɛ /(νN2) , and its dependence on the body-based Reynolds number Re . ONR Grants N00014-13-1-0665 and N00014-15-1-2513.

  15. Stratified Outcome Evaluation of Peritonitis

    African Journals Online (AJOL)

    Patients who complicated had a mean MPI of 26.9 compared to those who did not (22.8) (p=0.018). Morbidity rates increased with rising MPI scores (31% for .... Colon. 9. 12.9%. Pelvic. 5. 7.1%. Gastric. 5. 7.1%. Total. 70. 100.0%. The peritonitis was generalised, 2-3 quadrant and focal in 65.7%, 21.4% and 12.9% of cases ...

  16. The incidence rate of corpus uteri cancer among females in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001–2008

    Directory of Open Access Journals (Sweden)

    Alghamdi IG

    2014-01-01

    Full Text Available Ibrahim G Alghamdi,1 Issam I Hussain,1 Mohamed S Alghamdi,2 Mohamed A El-Sheemy1,3 1University of Lincoln, Brayford Pool, Lincoln, UK; 2Ministry of Health, General Directorate of Health Affairs, Al-Baha, Kingdom of Saudi Arabia; 3Research and Development, Lincoln Hospital, Lincolnshire Hospitals NHS Trust, Lincoln, UK Background: The present study reviews the epidemiological data on corpus uteri cancer among Saudi women, including its frequency, crude incidence rate, and age-standardized incidence rate (ASIR, adjusted by region and year of diagnosis. Methods: A retrospective, descriptive epidemiological analysis was conducted of all the corpus uteri cancer cases recorded in the Saudi Cancer Registry between January 2001 and December 2008. The statistical analyses were performed using descriptive statistics, analysis of variance, Poisson regression, and a simple linear model. Results: A total of 1,060 corpus uteri cancer cases were included. Women aged 60–74 years of age were most affected by the disease. The region of Riyadh in Saudi Arabia had the highest overall ASIR, at 4.4 cases per 100,000 female patients, followed by the eastern region, at 4.2, and Makkah, at 3.7. Jazan, Najran, and Qassim had the lowest average ASIRs, ranging from 0.8 to 1.4. A Poisson regression model using Jazan as the reference revealed that the corpus uteri cancer incidence rate ratio was significantly higher for the regions of Makkah, at 16.5 times (95% confidence interval [CI]: 8.0–23.0, followed by Riyadh, at 16.0 times (95% CI: 9.0–22.0, and the eastern region, at 9.9 times (95% CI: 5.6–17.6. The northern region experienced the highest changes in ASIRs of corpus uteri cancer among female Saudi patients between 2001 and 2008. Conclusion: There was a slight increase in the crude incidence rates and ASIRs for corpus uteri cancer in Saudi Arabia between 2001 and 2008. Older Saudi women were most affected by the disease. Riyadh, the eastern region, and Makkah

  17. Potential impact on HIV incidence of higher HIV testing rates and earlier antiretroviral therapy initiation in MSM

    DEFF Research Database (Denmark)

    Phillips, Andrew N; Cambiano, Valentina; Miners, Alec

    2015-01-01

    count 350/μl. We investigated what would be required to reduce HIV incidence in MSM to below 1 per 1000 person-years (i.e. new infections per year) by 2030, and whether this is likely to be cost-effective. METHODS: A dynamic, individual-based simulation model was calibrated to multiple data sources...

  18. Epidemiological study of paediatric germ cell tumours revealed the incidence and distribution that was expected, but a low mortality rate

    DEFF Research Database (Denmark)

    Evers, Madeline; Rechnitzer, Catherine; Graem, Niels

    2017-01-01

    Aim: Germ cell tumours (GCTs) are a rare heterogeneous tumour group derived from primordial germ cells, which can be benign or malignant and occur in the gonads or extragonadally. This study mapped the paediatric GCTs in Denmark from 1984 to 2013 to study the incidence and outcome. Methods: We id...

  19. Incidence rate of ovarian cancer cases in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001-2008.

    Science.gov (United States)

    Alghamdi, Ibrahim G; Hussain, Issam I; Alghamdi, Mohamed S; Alghamdi, Mansour M; Dohal, Ahlam A; El-Sheemy, Mohammed A

    2014-01-01

    This study provides descriptive epidemiological data, such as the percentage of cases diagnosed, crude incidence rate (CIR), and age-standardized incidence rate (ASIR) of ovarian cancer in Saudi Arabia from 2001-2008. A retrospective descriptive epidemiological analysis of all ovarian cancer cases recorded in the Saudi Cancer Registry (SCR) from January 2001-December 2008 was performed. The data were analyzed using descriptive statistics, analysis of variance tests, Poisson regression, and simple linear modeling. A total of 991 ovarian cancer cases were recorded in the SCR from January 2001-December 2008. The region of Riyadh had the highest overall ASIR at 3.3 cases per 100,000 women, followed by the Jouf and Asir regions at 3.13 and 2.96 cases per 100,000 women. However, Hail and Jazan had the lowest rates at 1.4 and 0.6 cases per 100,000 women, respectively. Compared to Jazan, the incidence rate ratio for the number of ovarian cancer cases was significantly higher (PSaudi Arabia at 4.52 (95% CI: 2.93-6.98). The predicted annual CIR and ASIR for ovarian cancer in Saudi Arabia could be defined by the equations 0.9 + (0.07× years) and 1.71 + (0.09× years), respectively. We observed a slight increase in the CIRs and ASIRs for ovarian cancer in Saudi Arabia from 2001-2008. Riyadh, Jouf, and Asir had the highest overall ASIR, while Jazan and Hail had the lowest rates. Makkah, Riyadh, and the eastern region of Saudi Arabia had the highest incidence rate ratio for the number of ovarian cancer cases. Further analytical studies are required to determine the potential risk factors of ovarian cancer among Saudi women.

  20. Comparison of annual percentage change in breast cancer incidence rate between Taiwan and the United States-A smoothed Lexis diagram approach.

    Science.gov (United States)

    Chien, Li-Hsin; Tseng, Tzu-Jui; Chen, Chung-Hsing; Jiang, Hsin-Fang; Tsai, Fang-Yu; Liu, Tsang-Wu; Hsiung, Chao A; Chang, I-Shou

    2017-07-01

    Recent studies compared the age effects and birth cohort effects on female invasive breast cancer (FIBC) incidence in Asian populations with those in the US white population. They were based on age-period-cohort model extrapolation and estimated annual percentage change (EAPC) in the age-standardized incidence rates (ASR). It is of interest to examine these results based on cohort-specific annual percentage change in rate (APCR) by age and without age-period-cohort model extrapolation. FIBC data (1991-2010) were obtained from the Taiwan Cancer Registry and the U.S. SEER 9 registries. APCR based on smoothed Lexis diagrams were constructed to study the age, period, and cohort effects on FIBC incidence. The patterns of age-specific rates by birth cohort are similar between Taiwan and the US. Given any age-at-diagnosis group, cohort-specific rates increased overtime in Taiwan but not in the US; cohort-specific APCR by age decreased with birth year in both Taiwan and the US but was always positive and large in Taiwan. Given a diagnosis year, APCR decreased as birth year increased in Taiwan but not in the US. In Taiwan, the proportion of APCR attributable to cohort effect was substantial and that due to case ascertainment was becoming smaller. Although our study shows that incidence rates of FIBC have increased rapidly in Taiwan, thereby confirming previous results, the rate of increase over time is slowing. Continued monitoring of APCR and further investigation of the cause of the APCR decrease in Taiwan are warranted. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  1. Mercury biogeochemical cycling in a stratified estuary

    Energy Technology Data Exchange (ETDEWEB)

    Mason, R.P.; Fitzgerald, W.F. (Univ. of Connecticut, Groton, CT (United States)); Hurley, J. (Wisconsin DNR, Fitchburg, WI (United States)); Hanson, A.K. Jr.; Donaghay, P.L.; Sieburth, J.M. (Univ. of Rhode Island, Narragansett, RI (United States))

    1993-09-01

    Total Hg in the permanently stratified Pettaquamscutt estuary was <25 pM throughout the water column, even in highly sulfidic bottom waters. Particulate Hg was typically >40% of the total Hg. Reactive Hg (Hg[sub R]) was generally <3 pM and decreased with depth, but there is Hg[sub R] even in the anoxic bottom waters. Elemental Hg (Hg[sup 0]) was highest in the mixed layer and below the detection limit at depth. Demethylation is not an important source of Hg[sup 0] in this estuary. Dimethylmercury was not detected. Monomethylmercury (MMHg) was near the detection limit in the mixed layer and increased rapidly in the low oxygen region. Dissolved MMHg correlated with bacteriochlorophyll pigments, suggesting that the microbial community plays an important role in MMHg production in the estuary. The overall distributions of dissolved and particulate Hg species result from the interaction with Fe and Mn redox cycling, particulate scavenging and sinking, and MMHg production in the pycnocline. The estimated rate of MMHg production from Hg[sub R] in the pycnocline region is 1.7% d[sup [minus]1]. Hg[sup 0] and MMHg are formed principally in the mixed layer and in the pycnocline region, respectively. Particulate scavenging is important, and sedimentation, methylation, and Hg[sup 0] production are the principal sinks for Hg[sub R].

  2. Improved patient selection by stratified surgical intervention

    DEFF Research Database (Denmark)

    Wang, Miao; Bünger, Cody E; Li, Haisheng

    2015-01-01

    BACKGROUND CONTEXT: Choosing the best surgical treatment for patients with spinal metastases remains a significant challenge for spine surgeons. There is currently no gold standard for surgical treatments. The Aarhus Spinal Metastases Algorithm (ASMA) was established to help surgeons choose...... the most appropriate surgical intervention for patients with spinal metastases. PURPOSE: The purpose of this study was to evaluate the clinical outcome of stratified surgical interventions based on the ASMA, which combines life expectancy and the anatomical classification of patients with spinal metastases...... survival times in the five surgical groups determined by the ASMA were 2.1 (TS 0-4, TC 1-7), 5.1 (TS 5-8, TC 1-7), 12.1 (TS 9-11, TC 1-7 or TS 12-15, TC 7), 26.0 (TS 12-15, TC 4-6), and 36.0 (TS 12-15, TC 1-3) months. The 30-day mortality rate was 7.5%. Postoperative neurological function was maintained...

  3. Effect of low-intensity low-dose rate irradiation on the incidence and the development of spontaneous leukosis in AKR mice

    International Nuclear Information System (INIS)

    Burlakova, E.B.; Erokhin, V.N.

    2001-01-01

    Development of spontaneous leukosis in AKR mice is accelerated by irradiation with low doses of 1.2-2.4 cGy and low dose rate 0.06 cGy/day. The leukoses incidence rate increases. Deaths of the animals from leukosis occurs earlier, shortening the average and maximum life-spans of the animals. The dynamics of changes in the mass of organs of the immune systems (thymus and spleen) shows extrema. The moment of reaching the extremum correlates with the maximum rate of animals' deaths [ru

  4. Analytic and geometric study of stratified spaces

    CERN Document Server

    Pflaum, Markus J

    2001-01-01

    The book provides an introduction to stratification theory leading the reader up to modern research topics in the field. The first part presents the basics of stratification theory, in particular the Whitney conditions and Mather's control theory, and introduces the notion of a smooth structure. Moreover, it explains how one can use smooth structures to transfer differential geometric and analytic methods from the arena of manifolds to stratified spaces. In the second part the methods established in the first part are applied to particular classes of stratified spaces like for example orbit spaces. Then a new de Rham theory for stratified spaces is established and finally the Hochschild (co)homology theory of smooth functions on certain classes of stratified spaces is studied. The book should be accessible to readers acquainted with the basics of topology, analysis and differential geometry.

  5. Stratified growth in Pseudomonas aeruginosa biofilms

    DEFF Research Database (Denmark)

    Werner, E.; Roe, F.; Bugnicourt, A.

    2004-01-01

    In this study, stratified patterns of protein synthesis and growth were demonstrated in Pseudomonas aeruginosa biofilms. Spatial patterns of protein synthetic activity inside biofilms were characterized by the use of two green fluorescent protein (GFP) reporter gene constructs. One construct...

  6. Trends in the incidence rate of device-associated infections in intensive care units after the establishment of the Korean Nosocomial Infections Surveillance System.

    Science.gov (United States)

    Choi, J Y; Kwak, Y G; Yoo, H; Lee, S-O; Kim, H B; Han, S H; Choi, H J; Kim, Y K; Kim, S R; Kim, T H; Lee, H; Chun, H K; Kim, J-S; Eun, B W; Kim, D W; Koo, H-S; Bae, G-R; Lee, K

    2015-09-01

    The effectiveness of continuous nationwide surveillance on healthcare-associated infections should be investigated in each country. To assess the rate of device-associated infections (DAIs) in intensive care units (ICUs) since the establishment of the Korean Nosocomial Infections Surveillance System (KONIS). Nationwide data were obtained on the incidence rate of DAI in ICUs reported to KONIS by all participating hospitals. The three major DAIs were studied: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CABSI), and catheter-associated urinary tract infection (CAUTI). The pooled and year-wise incidence rates (cases per 1000 device-days) of these DAIs were determined for the period 2006 and 2012. In addition, data from institutions that had participated in KONIS for at least three consecutive years were analysed separately. The number of ICUs participating in KONIS gradually increased from 76 in 2006 to 162 in 2012. Between 2006 and 2012, the incidence rate per 1000 device-days for VAP decreased significantly from 3.48 to 1.64 (F = 11, P Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. Magnetic resonance angiography and CT angiography of persistent primitive olfactory artery: Incidence and association rate with aneurysm in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Bo Ra; Yeo, Soo Hyun; Chang, Hyuk Won; Kim, Mi Jeong; Lee, Sung Moon; Kim, Ealmaan; Kim, Mi Kyung; Cho, Ho Chan; Kim, Hye Soon [Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2012-06-15

    Japanese data indicates an incidence of persistent primitive olfactory artery (PPOA) of 0.14%. We studied the incidence of PPOA and associated cerebral vascular variation or anomalies in Korea. We retrospectively reviewed cranial magnetic resonance angiography (MRA) and computed tomography angiography (CTA) images of a total of 9841 patients of our institution. The diagnostic criterion of PPOA is extreme anterioinferior course of the proximal anterior cerebral artery, with a hairpin turn of the lateral projection. We found 29 cases (0.29%) with PPOA. The PPOA location was on the left in 19 cases, bilateral in 3 cases, and on the right in 7 cases. An aneurysm was found at the hairpin turn in 2 patients. There were aneurysms in other sites in 3 cases. There were hypoplasia of anterior cerebral artery in 3 cases, and fenestration of intracranial artery in 1 case. In Korean populations, the incidence of PPOA found in MRA and CTA was twice as high as that shown in the previous Japanese data. Within Korea, left side laterality is more common than right side or bilalterality. Aneurysmal dilatations at the hairpin turning point and aneurysms at other sites were found, and other vascular variations were observed in several cases.

  8. Cholestasis sepsis at neonatology ward and neonatal Intensive Care Unit Cipto Mangunkusumo Hospital 2007 : incidence, mortality rate and associated risk factors

    Directory of Open Access Journals (Sweden)

    Kadim S. Bachtiar

    2008-06-01

    Full Text Available Cholestatic jaundice represents serious pathological condition. Septic-cholestasis is a kind of hepato-cellular cholestasis that occured during or after sepsis caused by biliary flow obstruction. This is a cohort study from February to June 2007 on neonatal sepsis patients at Neonatology ward Department of Child Health Faculty of Medicine University of Indonesia-Cipto Mangunkusumo General National Hospital. Aim of this study is to find out the incidence of intrahepatic cholestasis in neonatal sepsis, associated risk factors, and mortality rate in neonatal cholestasis-sepsis. From 138 neonatal sepsis patients, the incidence of intrahepatic cholestasis is 65.9%. None of the risk factors tested in this study showed statistically significant result. Mortality rate of neonatal cholestasis-sepsis is 52.8%. (Med J Indones 2008; 17: 107-13Keywords: cholestasis intrahepatic, neonatal sepsis, cholestasis sepsis, conjugated hyperbilirubinemia

  9. Prevalence, incidence rates and persistence of contact allergy and allergic contact dermatitis in The Odense Adolescence Cohort Study: a 15-year follow-up

    DEFF Research Database (Denmark)

    Mortz, C. G.; Bindslev-Jensen, C.; Andersen, Klaus Ejner

    2013-01-01

    BACKGROUND: A cohort of 1501 unselected 8th grade schoolchildren was established 15 years ago with the aim to follow the course of contact allergy and allergic contact dermatitis (ACD) from school age into adult life. To date no studies have evaluated incidence rates and persistence of contact al...... the most common contact allergen, and new sensitizations occurred despite the European Union nickel regulation. Fragrance mix I was a poor marker for history of eczematous skin reaction to perfumed products.......-phenylenediamine (1.1%). Most nickel reactions were persistent, and a significant number of new nickel sensitizations were found. Fragrance mix I reactions from adolescence could not be reproduced. CONCLUSIONS: From adolescence to adulthood the incidence rates of contact allergy and ACD were high. Nickel was still...

  10. Second primary pancreatic ductal carcinoma in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma: High cumulative incidence rates at 5 years after pancreatectomy.

    Science.gov (United States)

    Ishida, Jun; Toyama, Hirochika; Matsumoto, Ippei; Asari, Sadaki; Goto, Tadahiro; Terai, Sachio; Nanno, Yoshihide; Yamashita, Azusa; Mizumoto, Takuya; Ueda, Yuki; Kido, Masahiro; Ajiki, Tetsuo; Fukumoto, Takumi; Ku, Yonson

    2016-01-01

    The aim of this study was to determine the incidence rate and clinical features of second primary pancreatic ductal carcinoma (SPPDC) in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma (PDC). Data of patients undergoing R0 resection for PDC at a single high-volume center were reviewed. SPPDC was defined as a tumor in the remnant pancreas after R0 resection for PDC, and SPPDC met at least one of the following conditions: 1) the time interval between initial pancreatectomy and development of a new tumor was 3 years or more; 2) the new tumor was not located in contact with the pancreatic stump. We investigated the clinical features and treatment outcomes of patients with SPPDC. This study included 130 patients who underwent surgical resection for PDC between 2005 and 2014. Six (4.6%) patients developed SPPDC. The cumulative 3- and 5-year incidence rates were 3.1% and 17.7%, respectively. Four patients underwent remnant pancreatectomy for SPPDC. They were diagnosed with the disease in stage IIA or higher and developed recurrence within 6 months after remnant pancreatectomy. One patient received carbon ion radiotherapy and survived 45 months. One patient refused treatment and died 19 months after the diagnosis of SPPDC. The incidence rate of SPPDC is not negligible, and the cumulative 5-year incidence rate of SPPDC is markedly high. Post-operative surveillance of the remnant pancreas is critical for the early detection of SPPDC, even in long-term survivors after PDC resection. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  11. The effect of a change in mutation rate on the incidence of dominant and X-linked recessive disorders in man

    International Nuclear Information System (INIS)

    Childs, J.D.

    1981-01-01

    In order to assess the impact on man of a sustained change in mutation rate that might be caused by ionizing radiation or a chemical mutagen in the environment, it is important to determine the current incidence of genetic disease, the rate at which deleterious mutations arise and the number of generations that mutations persist before eliminated by selection. From these data it should be possible to estimate both the increase in genetic disease in the first generation following the increase in mutation rate, and the rate at which a new equilibrium between mutation and selection would occur. In this paper the results of a survey to determine birth frequency, mutation rate and reproductive fitness for each of the important dominant and X-linked recessive disorders are described. It is estimated that these disorders affect about 0.6% of live-born individuals, including 0.1% of live-borns who carry a newly-arising mutation. (orig.)

  12. Heart rate-based training intensity and its impact on injury incidence among elite-level professional soccer players.

    Science.gov (United States)

    Owen, Adam L; Forsyth, Jacky J; Wong, Del P; Dellal, Alexandre; Connelly, Sean P; Chamari, Karim

    2015-06-01

    Elite-level professional soccer players are suggested to have increased physical, technical, tactical, and psychological capabilities when compared with their subelite counterparts. Ensuring these players remain at the elite level generally involves training many different bodily systems to a high intensity or level within a short duration. This study aimed to examine whether an increase in training volume at high-intensity levels was related to injury incidence, or increased the odds of sustaining an injury. Training intensity was monitored through time spent in high-intensity (T-HI) and very high-intensity (T-VHI) zones of 85-injuries were recorded over 2 consecutive seasons. Twenty-three, elite professional male soccer players (mean ± SD age, 25.6 ± 4.6 years; stature, 181.8 ± 6.8 cm; and body mass, 79.3 ± 8.1 kg) were studied throughout the 2-years span of the investigation. The results showed a mean total injury incidence of 18.8 (95% confidence interval [CI], 14.7-22.9) injuries per 1,000 hours of exposure. Significant correlations were found between training volume at T-HI and injury incidence (r = 0.57, p = 0.005). Further analysis revealed how players achieving more time in the T-VHI zone during training increased the odds of sustaining a match injury (odds ratio = 1.87; 95% CI, 1.12-3.12, p = 0.02) but did not increase the odds of sustaining a training injury. Reducing the number of competitive match injuries among elite-level professional players may be possible if greater focus is placed on the training intensity and volume over a period of time ensuring the potential reduction of fatigue or overuse injuries. In addition, it is important to understand the optimal training load at which adaptation occurs without raising the risk of injury.

  13. Incidence of Second Malignancies in Prostate Cancer Patients Treated With Low-Dose-Rate Brachytherapy and Radical Prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, Sarah Nicole; Tyldesley, Scott [Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Hamm, Jeremy [Department of Population Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Jiang, Wei Ning [Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Keyes, Mira; Pickles, Tom [Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Lapointe, Vince [Department of Medical Physics, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Kahnamelli, Adam [Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); McKenzie, Michael [Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Miller, Stacy [Department of Radiation Oncology, British Columbia Cancer Agency–Centre for the North, Prince George, British Columbia (Canada); Morris, W. James, E-mail: jmorris@bccancer.bc.ca [Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada)

    2014-11-15

    Purpose: To compare the second malignancy incidence in prostate cancer patients treated with brachytherapy (BT) relative to radical prostatectomy (RP) and to compare both groups with the cancer incidence in the general population. Methods and Materials: From 1998 to 2010, 2418 patients were treated with Iodine 125 prostate BT monotherapy at the British Columbia Cancer Agency, and 4015 referred patients were treated with RP. Cancer incidence was compared with the age-matched general population using standardized incidence ratios (SIRs). Pelvic malignancies included invasive and noninvasive bladder cancer and rectal cancer. Cox multivariable analysis was performed with adjustment for covariates to determine whether treatment (RP vs BT) was associated with second malignancy risk. Results: The median age at BT was 66 years and at RP 62 years. The SIR comparing BT patients with the general population was 1.06 (95% confidence interval [CI] 0.91-1.22) for second malignancy and was 1.53 (95% CI 1.12-2.04) for pelvic malignancy. The SIR comparing RP patients with the general population was 1.11 (95% CI 0.98-1.25) for second malignancy and was 1.11 (95% CI 0.82-1.48) for pelvic malignancy. On multivariable analysis, older age (hazard ratio [HR] 1.05) and smoking (HR 1.65) were associated with increased second malignancy risk (P<.0001). Radical prostatectomy was not associated with a decreased second malignancy risk relative to BT (HR 0.90, P=.43), even when excluding patients who received postprostatectomy external beam radiation therapy (HR 1.13, P=.25). Older age (HR 1.09, P<.0001) and smoking (HR 2.17, P=.0009) were associated with increased pelvic malignancy risk. Radical prostatectomy was not associated with a decreased pelvic malignancy risk compared with BT (HR 0.57, P=.082), even when excluding postprostatectomy external beam radiation therapy patients (HR 0.87, P=.56). Conclusions: After adjustment for covariates, BT patients did not have an increased second

  14. Association between community socioeconomic factors, animal feeding operations, and campylobacteriosis incidence rates: Foodborne Diseases Active Surveillance Network (FoodNet), 2004-2010.

    Science.gov (United States)

    Rosenberg Goldstein, Rachel E; Cruz-Cano, Raul; Jiang, Chengsheng; Palmer, Amanda; Blythe, David; Ryan, Patricia; Hogan, Brenna; White, Benjamin; Dunn, John R; Libby, Tanya; Tobin-D'Angelo, Melissa; Huang, Jennifer Y; McGuire, Suzanne; Scherzinger, Karen; Lee, Mei-Ling Ting; Sapkota, Amy R

    2016-07-22

    Campylobacter is a leading cause of foodborne illness in the United States. Campylobacter infections have been associated with individual risk factors, such as the consumption of poultry and raw milk. Recently, a Maryland-based study identified community socioeconomic and environmental factors that are also associated with campylobacteriosis rates. However, no previous studies have evaluated the association between community risk factors and campylobacteriosis rates across multiple U.S. states. We obtained Campylobacter case data (2004-2010; n = 40,768) from the Foodborne Diseases Active Surveillance Network (FoodNet) and socioeconomic and environmental data from the 2010 Census of Population and Housing, the 2011 American Community Survey, and the 2007 U.S. Census of Agriculture. We linked data by zip code and derived incidence rate ratios using negative binomial regression models. Community socioeconomic and environmental factors were associated with both lower and higher campylobacteriosis rates. Zip codes with higher percentages of African Americans had lower rates of campylobacteriosis (incidence rate ratio [IRR]) = 0.972; 95 % confidence interval (CI) = 0.970,0.974). In Georgia, Maryland, and Tennessee, three leading broiler chicken producing states, zip codes with broiler operations had incidence rates that were 22 % (IRR = 1.22; 95 % CI = 1.03,1.43), 16 % (IRR = 1.16; 95 % CI = 0.99,1.37), and 35 % (IRR = 1.35; 95 % CI = 1.18,1.53) higher, respectively, than those of zip codes without broiler operations. In Minnesota and New York FoodNet counties, two top dairy producing areas, zip codes with dairy operations had significantly higher campylobacteriosis incidence rates (IRR = 1.37; 95 % CI = 1.22, 1.55; IRR = 1.19; 95 % CI = 1.04,1.36). Community socioeconomic and environmental factors are important to consider when evaluating the relationship between possible risk factors and Campylobacter infection.

  15. The role of persistent and incident major depression on rate of cognitive deterioration in newly diagnosed Alzheimer's disease patients.

    Science.gov (United States)

    Spalletta, Gianfranco; Caltagirone, Carlo; Girardi, Paolo; Gianni, Walter; Casini, Anna Rosa; Palmer, Katie

    2012-07-30

    Depression may potentially impair the clinical course of Alzheimer's disease (AD). Thus, the aim of this study was to investigate cognitive progression of AD patients with or without major depressive episode (MDE). In this 1-year longitudinal follow-up study conducted in three Italian memory clinics, 119 newly diagnosed probable AD patients of mild severity, who were not undergoing treatment with an acetyl-cholinesterase inhibitor (AChEI), and had not been treated with psychotropic drugs in the last 2 years, were included. Patients were assessed to investigate the effect of baseline and 1-year follow-up MDE (using modified DSM-IV diagnostic criteria for MDE in AD) on progression of global cognitive deterioration (using Mini-Mental State Examination (MMSE)), adjusted for confounding factors. Never being depressed was associated with a 3.1 (95%CI 1.0-10.1) increased risk of MMSE decline compared to recovered depression. Six times more patients with persistent depression had MMSE decline compared to patients with recovered depression. However, the largest odds (7.3; 95%CI 1.4-38.1) of cognitive decline was observed in patients who developed incident depression over follow-up. In conclusion, persistent or incident depression worsens cognitive outcome while no or recovered depression does not affect it in early AD patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Apparently-Different Clearance Rates from Cohort Studies of Mycoplasma genitalium Are Consistent after Accounting for Incidence of Infection, Recurrent Infection, and Study Design.

    Directory of Open Access Journals (Sweden)

    Timo Smieszek

    Full Text Available Mycoplasma genitalium is a potentially major cause of urethritis, cervicitis, pelvic inflammatory disease, infertility, and increased HIV risk. A better understanding of its natural history is crucial to informing control policy. Two extensive cohort studies (students in London, UK; Ugandan sex workers suggest very different clearance rates; we aimed to understand the reasons and obtain improved estimates by making maximal use of the data from the studies. As M. genitalium is a sexually-transmitted infectious disease, we developed a model for time-to-event analysis that incorporates the processes of (reinfection and clearance, and fitted to data from the two cohort studies to estimate incidence and clearance rates under different scenarios of sexual partnership dynamics and study design (including sample handling and associated test sensitivity. In the London students, the estimated clearance rate is 0.80 p.a. (mean duration 15 months, with incidence 1.31%-3.93% p.a. Without adjusting for study design, corresponding estimates from the Ugandan data are 3.44 p.a. (mean duration 3.5 months and 58% p.a. Apparent differences in clearance rates are probably mostly due to lower testing sensitivity in the Uganda study due to differences in sample handling, with 'true' clearance rates being similar, and adjusted incidence in Uganda being 28% p.a. Some differences are perhaps due to the sex workers having more-frequent antibiotic treatment, whilst reinfection within ongoing sexual partnerships might have caused some of the apparently-persistent infection in the London students. More information on partnership dynamics would inform more accurate estimates of natural-history parameters. Detailed studies in men are also required.

  17. Impact of changes in welfare legislation on the incidence of disability pension. A cohort study of construction workers.

    Science.gov (United States)

    Söderberg, Mia; Mannelqvist, Ruth; Järvholm, Bengt; Schiöler, Linus; Stattin, Mikael

    2018-01-01

    Study objectives were to investigate how changes in social insurance legislation influenced the incidence of disability pension. The study included 295,636 male construction workers who attended health examinations between 1971 and 1993, aged 20-60 years and without previous disability pension. Via the Swedish National Insurance Agency national register we identified 66,046 subjects who were granted disability pension up until 2010. The incidence rates were calculated and stratified according to age and diagnosis. The incidence rate of disability pension was fairly stable until the 1990s when large variations occurred, followed by a strong decreasing trend from the early 2000s to 2010. Trends in incidence rates, stratified by age and diagnosis, showed a consistent decrease in cardiovascular disease for all age groups. In subjects aged 30-49 years there was a high peak around 2003 for musculoskeletal diseases and psychiatric diseases. For the age group 50-59 years, musculoskeletal diagnosis, the most common cause of disability pension, had a sharp peak around 1993 and then a decreasing trend. In the 60-64 age group, the incidence rate for psychiatric diagnosis was stable, while incidence rates for musculoskeletal diagnosis varied during the 1990s. There are considerable variations in the incidence rate of disability pension over time, with different patterns depending on age and diagnosis. Changes in social insurance legislation, as well as in administration processes, seem to influence the variation.

  18. Trauma centers with higher rates of angiography have a lesser incidence of splenectomy in the management of blunt splenic injury.

    Science.gov (United States)

    Capecci, Louis M; Jeremitsky, Elan; Smith, R Stephen; Philp, Frances

    2015-10-01

    Nonoperative management (NOM) for blunt splenic injury (BSI) is well-established. Angiography (ANGIO) has been shown to improve success rates with NOM. Protocols for NOM are not standardized and vary widely between centers. We hypothesized that trauma centers that performed ANGIO at a greater rate would demonstrate decreased rates of splenectomy compared with trauma centers that used ANGIO less frequently. A large, multicenter, statewide database (Pennsylvania Trauma Systems Foundation) from 2007 to 2011 was used to generate the study cohort of patients with BSI (age ≥ 13). The cohort was divided into 2 populations based on admission to centers with high (≥13%) or low (Splenectomy rates were then compared between the 2 groups, and multivariable logistic regression for predictors of splenectomy (failed NOM) were also performed. The overall rate of splenectomy in the entire cohort was 21.0% (1,120 of 5,333 BSI patients). The high ANGIO group had a lesser rate of splenectoy compared with the low ANGIO group (19% vs 24%; P splenectomy compared with low ANGIO centers (odds ratio, 0.68; 95% CI 0.58-0.80; P splenectomy rates compared with centers with lesser rate of ANGIO. Inclusion of angiographic protocols for NOM of BSI should be considered strongly. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Trends in Breast Cancer Incidence Rates by Age and Stage at Diagnosis in Gharbiah, Egypt, over 10 Years (1999–2008

    Directory of Open Access Journals (Sweden)

    Kelly A. Hirko

    2013-01-01

    Full Text Available Background. This study was undertaken to evaluate trends in breast cancer incidence in Egypt from 1999 to 2008 and to make projections for breast cancer occurrence for the years 2009–2015. Patients and Methods. We utilized joinpoint regression and average annual percent change (AAPC measures with 95% confidence intervals (CI to describe the trends in breast cancer incidence rates from the Gharbiah Cancer Registry by age and stage at diagnosis and to estimate expected breast cancer caseloads for 2009–2015. Results. From 1999 to 2008, the AAPC in breast cancer incidence rates in Gharbiah significantly increased among women 50 years and older and among localized tumors (AAPC %, 95% CI, 3.1% to 8.0%. Our results predict a significant increase in breast cancer caseloads from 2009 to 2015 among women aged 30–39 (AAPC %, 95% CI, 0.9% to 1.1% and among women aged 40–49 years (AAPC %, 95% CI, 1.0% to 2.6%. Conclusion. These results have important implications for allocating limited resources, managing treatment needs, and exploring the consequences of prior interventions and/or changing risk factors in Egypt and other developing countries at the same stages of demographic and health transitions.

  20. A numerical study of laminar flames propagating in stratified mixtures

    Science.gov (United States)

    Zhang, Jiacheng

    Numerical simulations are carried out to study the structure and speed of laminar flames propagating in compositionally and thermally stratified fuel-air mixtures. The study is motivated by the need to understand the physics of flame propagation in stratified-charge engines and model it. The specific question of interest in this work is: how does the structure and speed of the flame in the stratified mixture differ from that of the flame in a corresponding homogeneous mixture at the same equivalence ratio, temperature, and pressure? The studies are carried out in hydrogen-air, methane-air, and n-heptane-air mixtures. A 30-species 184-step skeletal mechanism is employed for methane oxidation, a 9-species 21-step mechanism for hydrogen oxidation, and a 37-species 56-step skeletal mechanism for n-heptane oxidation. Flame speed and structure are compared with corresponding values for homogeneous mixtures. For compositionally stratified mixtures, as shown in prior experimental work, the numerical results suggest that when the flame propagates from a richer mixture to a leaner mixture, the flame speed is faster than the corresponding speed in the homogeneous mixture. This is caused by enhanced diffusion of heat and species from the richer mixture to the leaner mixture. In fact, the effects become more pronounced in leaner mixtures. Not surprisingly, the stratification gradient influences the results with shallower gradients showing less effect. The controlling role that diffusion plays is further assessed and confirmed by studying the effect of a unity Lewis number assumption in the hydrogen/air mixtures. Furthermore, the effect of stratification becomes less important when using methane or n-heptane as fuel. The laminar flame speed in a thermally stratified mixture is similar to the laminar flame speed in homogeneous mixture at corresponding unburned temperature. Theoretical analysis is performed and the ratio of extra thermal diffusion rate to flame heat release rate

  1. Implementing powered stretcher and load systems was a cost effective intervention to reduce the incidence rates of stretcher related injuries in a paramedic service.

    Science.gov (United States)

    Armstrong, Daniel P; Ferron, Richard; Taylor, Cindi; McLeod, Brent; Fletcher, Steve; MacPhee, Renée S; Fischer, Steven L

    2017-07-01

    Paramedic services are considering moving towards the use of powered stretcher and load systems to reduce stretcher related injuries, but cost is perceived as a barrier. This study compared injury incidence rates, days lost, and compensation costs between Niagara Emergency Medical Service (NEMS) and Hamilton Paramedic Service (HPS) pre- (four years) and post- (one year) implementation of powered stretcher and load systems in NEMS. Prior to the intervention stretcher related musculoskeletal disorder (MSD) incidence rates averaged 20.0 (±6.8) and 17.9 (±6.4) per 100 full time equivalent (FTE), in NEMS and HPS respectively. One-year post intervention rates decreased to 4.3 per 100 FTE in NEMS, a 78% reduction. Rates modestly increased to 24.6 per 100 FTE in HPS in same period. Cost-benefit analysis estimated that the added cost to purchase powered stretcher and load systems would be recovered within their expected 7-year service life due to the reduction in compensation costs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Effect of low 60Co dose rates on sister chromatid exchange incidence in the benthic worm. Neanthes arenaceodentata

    International Nuclear Information System (INIS)

    Harrison, F.L.; Rice, D.W. Jr.

    1981-01-01

    The usefulness of sister chromatid exchange (SCE) induction as a measure of low-level radiation effect was examined in a benthic marine worm, Neanthes arenaceodentata. Larvae were exposed to 60 Co radiation for 12 to 24 h at total doses ranging from 0.5 to 309 R and at dose rates from 0.04 to 13 R/h. Animals exposed at intermediate dose rates (0.5, 0.6, 1.25, 2.0, and 2.5 R/h) had SCE frequencies per chromosome about twice that of those receiving no radiation (controls), whereas those exposed at the higher dose rates (7.0 and 13 R/h) had SCE frequencies lower than the controls. Animals exposed at the lower dose rates (0.04 and 0.1 R/h) had lower SCE frequencies than those exposed at intermediate dose rates (and higher SCE frequencies than controls). The length of chromosome pair number one differed among metaphase spreads and was used as an index of chromosome condensation in a given metaphase. Because there is a possibility that chromosome morphology may affect the ability to resolve SCEs, morphology will be monitored in future studies. A preliminary experiment was performed to assess the effects of 2.2 and 11.5 R/h for 24 h on growth and development. Larvae observed at 6 and 17 d after irradiation did not have significantly different numbers of abnormal larvae or survival rates

  3. Maximal mixing rate in turbulent stably stratified Couette flow

    Science.gov (United States)

    Caulfield, C. P.; Kerswell, R. R.

    2001-11-01

    A rigorous upper bound on the long-time-averaged vertical buoyancy flux is derived from the Navier-Stokes equations for a Boussinesq fluid confined between two parallel horizontal plates a distance d apart, maintained at a constant statically stabilizing temperature difference Δ T and driven at a constant relative velocity Δ U. The upper bound on the volume and long-time-averaged vertical buoyancy flux \\cal B := limt arrow ∞ 1/t int^t0 g/ρ0 dtildet is \\cal B <= \\cal B_max=(1-16√2/Re) (Δ U)^3 /(64 √2d) where Re=Δ Ud/ν and ρ0 is some reference density. Significantly, \\cal B_max is independent of the bulk Richardson number of the flow and is achieved by an optimal solution with a mixing efficiency (or flux Richardson number) which approaches 0.5 as the Reynolds number becomes large. The time-averaged turbulent dissipation of kinetic energy and the time-averaged vertical buoyancy flux are then in equipartition for the optimising flow.

  4. Stably-stratified wall-bounded turbulence

    Science.gov (United States)

    Hadi Sichani, Pejman; Zonta, Francesco; Obabko, Aleksandr; Soldati, Alfredo

    2017-11-01

    Stably-stratified (bottom-up cooling) turbulent flows are encountered in a number of industrial applications, environmental processes and geophysical flows. Turbulent entrainment and mixing across density interfaces in terrestrial water bodies (oceans, lakes and rivers) and in industrial heat transfer equipments are just some important examples of stably-stratified flows. In this work we use Direct Numerical Simulation to investigate the fundamental physics of stably-stratified channel turbulence under Boussinesq and Non-Oberbeck-Boussinesq (NOB) conditions. Compared to the neutrally-buoyant case, in the stably-stratified case active turbulence survives only in the near-wall region and coexists with internal gravity waves (IGW) moving in the core region of the channel. This induces a general suppression of turbulence levels, momentum and buoyancy fluxes. Our results show also that NOB effects may be important when the flow is subject to large temperature gradients. The most striking feature observed in case of NOB conditions is the generation of a strong flow asymmetry with possible local flow laminarization in the near wall region.

  5. Investigations of fabric stratifiers for solar tanks

    DEFF Research Database (Denmark)

    Andersen, Elsa; Furbo, Simon; Fan, Jianhua

    2005-01-01

    water. In this paper investigations of a number of different fabric stratification pipes are presented and compared to a non flexible inlet stratifier. Additional, detailed investigations of the flow structure close to two fabric stratification pipes are presented for one set of operating conditions...

  6. Direct multiangle solution for poorly stratified atmospheres

    Science.gov (United States)

    Vladimir Kovalev; Cyle Wold; Alexander Petkov; Wei Min Hao

    2012-01-01

    The direct multiangle solution is considered, which allows improving the scanning lidar-data-inversion accuracy when the requirement of the horizontally stratified atmosphere is poorly met. The signal measured at zenith or close to zenith is used as a core source for extracting optical characteristics of the atmospheric aerosol loading. The multiangle signals are used...

  7. Incidence of Diabetes Mellitus Narrowly Correlates with Unemployment Rate during 2000–2012 in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Brož, J.; Brabec, Marek; Janíčková Žďárská, D.; Novotná, M.; Kvapil, M.

    č. 1 (2016), s. 86-87 ISSN 1210-7778 Institutional support: RVO:67985807 Keywords : diabetes mellitus * unemployment rate Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.682, year: 2016 http://apps.szu.cz/svi/cejph/show_en.php?kat=archiv/2016-1-13

  8. Incidence of atrial fibrillation in relation to changing heart rate over time in hypertensive patients: the LIFE study

    DEFF Research Database (Denmark)

    Okin, Peter M; Wachtell, Kristian; Kjeldsen, Sverre E

    2008-01-01

    Onset of atrial fibrillation (AF) has been linked to changes in autonomic tone, with increasing heart rate (HR) immediately before AF onset in some patients suggesting a possible role of acute increases in sympathetic activity in AF onset. Although losartan therapy and decreasing ECG left ventric...

  9. Cost-Effectiveness of Different Cervical Screening Strategies in Islamic Republic of Iran: A Middle-Income Country with a Low Incidence Rate of Cervical Cancer

    Science.gov (United States)

    Nahvijou, Azin; Daroudi, Rajabali; Tahmasebi, Mamak; Amouzegar Hashemi, Farnaz; Rezaei Hemami, Mohsen; Akbari Sari, Ali; Barati Marenani, Ahmad; Zendehdel, Kazem

    2016-01-01

    Objective Invasive cervical cancer (ICC) is the fourth most common cancer among women worldwide. Cervical screening programs have reduced the incidence and mortality rates of ICC. We studied the cost-effectiveness of different cervical screening strategies in the Islamic Republic of Iran, a Muslim country with a low incidence rate of ICC. Methods We constructed an 11-state Markov model, in which the parameters included regression and progression probabilities, test characteristics, costs, and utilities; these were extracted from primary data and the literature. Our strategies included Pap smear screening and human papillomavirus (HPV) DNA testing plus Pap smear triaging with different starting ages and screening intervals. Model outcomes included lifetime costs, life years gained, quality-adjusted life years (QALY), and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis was performed to examine the stability of the results. Results We found that the prevented mortalities for the 11 strategies compared with no screening varied from 26% to 64%. The most cost-effective strategy was HPV screening, starting at age 35 years and repeated every 10 years. The ICER of this strategy was $8,875 per QALY compared with no screening. We found that screening at 5-year intervals was also cost-effective based on GDP per capita in Iran. Conclusion We recommend organized cervical screening with HPV DNA testing for women in Iran, beginning at age 35 and repeated every 10 or 5 years. The results of this study could be generalized to other countries with low incidence rates of cervical cancer. PMID:27276093

  10. Comparative effect of partial root-zone drying and deficit irrigation on incidence of blossom-end rot in tomato under varied calcium rates

    DEFF Research Database (Denmark)

    Sun, Yanqi; Feng, Hao; Liu, Fulai

    2013-01-01

    This study investigated the comparative effects of reduced irrigation regimes—partial root-zone drying (PRD) and conventional deficit irrigation (DI)—on the incidence of blossom-end rot (BER) in tomato (Solanum lycopersicum L.) under three Ca-fertilization rates: 0, 100, and 200mg Ca kg–1 soil...... xylem sap abscisic acid concentration, lower stomatal conductance, and higher plant water status in the PRD in relation to the DI plants might have contributed to the increased fruit Ca uptake, and could have reduced BER development in tomato fruits. Therefore, under conditions with limited freshwater...

  11. Intravitreal injection analysis at the Bascom Palmer Eye Institute: evaluation of clinical indications for the treatment and incidence rates of endophthalmitis

    Directory of Open Access Journals (Sweden)

    Ludimila L Cavalcante

    2010-05-01

    Full Text Available Ludimila L Cavalcante, Milena L Cavalcante, Timothy G Murray, Michael M Vigoda, Yolanda Piña, Christina L Decatur, R Prince Davis, Lisa C Olmos, Amy C Schefler, Michael B Parrott, Kyle J Alliman, Harry W Flynn, Andrew A MoshfeghiBascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USAObjective: To report the incidence of endophthalmitis, in addition to its clinical and microbiological aspects, after intravitreal injection of vascular-targeting agents.Methods: A retrospective review of a consecutive series of 10,142 intravitreal injections of vascular targeting agents (bevacizumab, ranibizumab, triamcinolone acetonide, and preservative-free triamcinolone acetonide between June 1, 2007 and January 31, 2010, performed by a single service (TGM at the Bascom Palmer Eye Institute.Results: One case of clinically-suspected endophthalmitis was identified out of a total of 10,142 injections (0.009%, presenting within three days of injection of bevacizumab. The case was culture-positive for Staphylococcus epidermidis. Final visual acuity was 20/40 after pars plana vitrectomy surgery.Conclusions: In this series, the incidence of culture-positive endophthalmitis after intravitreal injection of vascular agents in an outpatient setting was very low. We believe that following a standardized injection protocol, adherence to sterile techniques and proper patient follow-up are determining factors for low incidence rates.Keywords: endophthalmitis, intravitreal injections, vascular targeting agents 

  12. Sex-specific incidence rates and risk factors of insulin resistance and β-cell dysfunction: a decade follow-up in a Middle Eastern population.

    Science.gov (United States)

    Derakhshan, A; Tohidi, M; Hajebrahimi, M A; Saadat, N; Azizi, F; Hadaegh, F

    2017-02-01

    To examine the incidence of and risk factors for insulin resistance and β-cell dysfunction in a representative Iranian population over a median follow-up of 9.2 years. In total, 3662 people (1528 men) without known diabetes with a baseline homeostasis model assessment of insulin resistance (HOMA-IR) level HOMA-IR HOMA-IR < 2.39 and HOMA-β ≥ 81.7 among women). The incidence rates of insulin resistance and β-cell dysfunction were 56.3 and 33.6/1000 person-years among men and 48.6 and 50.3/1000 person-years among women, respectively. Applying multivariable Cox regression in both sexes, fasting insulin, triglyceride/HDL cholesterol ratio and lower education were positive predictors of insulin resistance, whereas age was a negative predictor. Moreover, fasting plasma glucose, waist-to-height ratio, wrist circumference and lower hip circumference were significantly associated with incident insulin resistance only among women (all P < 0.05). Considering β-cell dysfunction in both sexes, age and fasting plasma glucose increased the risk, whereas 2-h post-challenge plasma glucose was a positive predictor only among men, and waist-to-height ratio and triglyceride/HDL cholesterol ratio were negative predictors only among women (all P < 0.05). Modifiable risk factors are related to the incidence of insulin resistance and β-cell dysfunction, which can be prevented with proper strategies although the difference between men and women should be taken into account. © 2016 Diabetes UK.

  13. Trends in primary total hip arthroplasty in Spain from 2001 to 2008: Evaluating changes in demographics, comorbidity, incidence rates, length of stay, costs and mortality

    Directory of Open Access Journals (Sweden)

    Jimenez-Trujillo Isabel

    2011-02-01

    Full Text Available Abstract Background Hip arthroplasties is one of the most frequent surgical procedures in Spain and are conducted mainly in elderly subjects. We aim to analyze changes in incidence, co-morbidity profile, length of hospital stay (LOHS, costs and in-hospital mortality (IHM of patients undergoing primary total hip arthroplasty (THA over an 8-year study period in Spain. Methods We selected all surgical admissions in individuals aged ≥40 years who had received a primary THA (ICD-9-CM procedure code 81.51 between 2001 and 2008 from the National Hospital Discharge Database. Age- and sex-specific incidence rates, LOHS, costs and IHM were estimated for each year. Co-morbidity was assessed using the Charlson comorbidity index. Multivariate analysis of time trends was conducted using Poisson regression. Logistic regression models were conducted to analyze IHM. Results We identified a total of 161,791 discharges of patients having undergone THA from 2001 to 2008. Overall crude incidence had increased from 99 to 105 THA per 100.000 inhabitants from 2001 to 2008 (p 2 and in 2008, the prevalence of 1-2 or >2 had increased to 20.4% and 1.1% respectively (p Conclusions The current study provides clear and valid data indicating increased incidence of primary THA in Spain from 2001 to 2008 with concomitant reductions in LOHS, slight reduction IHM, but a significant increase in cost per patient. The health profile of the patient undergoing a THA seems to be worsening in Spain.

  14. Incidence, prevalence and mortality rates of malaria in Ethiopia from 1990 to 2015: analysis of the global burden of diseases 2015.

    Science.gov (United States)

    Deribew, Amare; Dejene, Tariku; Kebede, Biruck; Tessema, Gizachew Assefa; Melaku, Yohannes Adama; Misganaw, Awoke; Gebre, Teshome; Hailu, Asrat; Biadgilign, Sibhatu; Amberbir, Alemayehu; Yirsaw, Biruck Desalegn; Abajobir, Amanuel Alemu; Shafi, Oumer; Abera, Semaw F; Negussu, Nebiyu; Mengistu, Belete; Amare, Azmeraw T; Mulugeta, Abate; Mengistu, Birhan; Tadesse, Zerihun; Sileshi, Mesfin; Cromwell, Elizabeth; Glenn, Scott D; Deribe, Kebede; Stanaway, Jeffrey D

    2017-07-04

    In Ethiopia there is no complete registration system to measure disease burden and risk factors accurately. In this study, the 2015 global burden of diseases, injuries and risk factors (GBD) data were used to analyse the incidence, prevalence and mortality rates of malaria in Ethiopia over the last 25 years. GBD 2015 used verbal autopsy surveys, reports, and published scientific articles to estimate the burden of malaria in Ethiopia. Age and gender-specific causes of death for malaria were estimated using cause of death ensemble modelling. The number of new cases of malaria declined from 2.8 million [95% uncertainty interval (UI) 1.4-4.5 million] in 1990 to 621,345 (95% UI 462,230-797,442) in 2015. Malaria caused an estimated 30,323 deaths (95% UI 11,533.3-61,215.3) in 1990 and 1561 deaths (95% UI 752.8-2660.5) in 2015, a 94.8% reduction over the 25 years. Age-standardized mortality rate of malaria has declined by 96.5% between 1990 and 2015 with an annual rate of change of 13.4%. Age-standardized malaria incidence rate among all ages and gender declined by 88.7% between 1990 and 2015. The number of disability-adjusted life years lost (DALY) due to malaria decreased from 2.2 million (95% UI 0.76-4.7 million) in 1990 to 0.18 million (95% UI 0.12-0.26 million) in 2015, with a total reduction 91.7%. Similarly, age-standardized DALY rate declined by 94.8% during the same period. Ethiopia has achieved a 50% reduction target of malaria of the millennium development goals. The country should strengthen its malaria control and treatment strategies to achieve the sustainable development goals.

  15. Background stratified Poisson regression analysis of cohort data.

    Science.gov (United States)

    Richardson, David B; Langholz, Bryan

    2012-03-01

    Background stratified Poisson regression is an approach that has been used in the analysis of data derived from a variety of epidemiologically important studies of radiation-exposed populations, including uranium miners, nuclear industry workers, and atomic bomb survivors. We describe a novel approach to fit Poisson regression models that adjust for a set of covariates through background stratification while directly estimating the radiation-disease association of primary interest. The approach makes use of an expression for the Poisson likelihood that treats the coefficients for stratum-specific indicator variables as 'nuisance' variables and avoids the need to explicitly estimate the coefficients for these stratum-specific parameters. Log-linear models, as well as other general relative rate models, are accommodated. This approach is illustrated using data from the Life Span Study of Japanese atomic bomb survivors and data from a study of underground uranium miners. The point estimate and confidence interval obtained from this 'conditional' regression approach are identical to the values obtained using unconditional Poisson regression with model terms for each background stratum. Moreover, it is shown that the proposed approach allows estimation of background stratified Poisson regression models of non-standard form, such as models that parameterize latency effects, as well as regression models in which the number of strata is large, thereby overcoming the limitations of previously available statistical software for fitting background stratified Poisson regression models.

  16. Background stratified Poisson regression analysis of cohort data

    International Nuclear Information System (INIS)

    Richardson, David B.; Langholz, Bryan

    2012-01-01

    Background stratified Poisson regression is an approach that has been used in the analysis of data derived from a variety of epidemiologically important studies of radiation-exposed populations, including uranium miners, nuclear industry workers, and atomic bomb survivors. We describe a novel approach to fit Poisson regression models that adjust for a set of covariates through background stratification while directly estimating the radiation-disease association of primary interest. The approach makes use of an expression for the Poisson likelihood that treats the coefficients for stratum-specific indicator variables as 'nuisance' variables and avoids the need to explicitly estimate the coefficients for these stratum-specific parameters. Log-linear models, as well as other general relative rate models, are accommodated. This approach is illustrated using data from the Life Span Study of Japanese atomic bomb survivors and data from a study of underground uranium miners. The point estimate and confidence interval obtained from this 'conditional' regression approach are identical to the values obtained using unconditional Poisson regression with model terms for each background stratum. Moreover, it is shown that the proposed approach allows estimation of background stratified Poisson regression models of non-standard form, such as models that parameterize latency effects, as well as regression models in which the number of strata is large, thereby overcoming the limitations of previously available statistical software for fitting background stratified Poisson regression models. (orig.)

  17. Background stratified Poisson regression analysis of cohort data

    Energy Technology Data Exchange (ETDEWEB)

    Richardson, David B. [University of North Carolina at Chapel Hill, Department of Epidemiology, School of Public Health, Chapel Hill, NC (United States); Langholz, Bryan [Keck School of Medicine, University of Southern California, Division of Biostatistics, Department of Preventive Medicine, Los Angeles, CA (United States)

    2012-03-15

    Background stratified Poisson regression is an approach that has been used in the analysis of data derived from a variety of epidemiologically important studies of radiation-exposed populations, including uranium miners, nuclear industry workers, and atomic bomb survivors. We describe a novel approach to fit Poisson regression models that adjust for a set of covariates through background stratification while directly estimating the radiation-disease association of primary interest. The approach makes use of an expression for the Poisson likelihood that treats the coefficients for stratum-specific indicator variables as 'nuisance' variables and avoids the need to explicitly estimate the coefficients for these stratum-specific parameters. Log-linear models, as well as other general relative rate models, are accommodated. This approach is illustrated using data from the Life Span Study of Japanese atomic bomb survivors and data from a study of underground uranium miners. The point estimate and confidence interval obtained from this 'conditional' regression approach are identical to the values obtained using unconditional Poisson regression with model terms for each background stratum. Moreover, it is shown that the proposed approach allows estimation of background stratified Poisson regression models of non-standard form, such as models that parameterize latency effects, as well as regression models in which the number of strata is large, thereby overcoming the limitations of previously available statistical software for fitting background stratified Poisson regression models. (orig.)

  18. County-level cumulative environmental quality associated with cancer incidence.

    Science.gov (United States)

    Jagai, Jyotsna S; Messer, Lynne C; Rappazzo, Kristen M; Gray, Christine L; Grabich, Shannon C; Lobdell, Danelle T

    2017-08-01

    Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains. The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status. Comparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incidence rate was positively associated with poor environmental quality overall (IRD, 38.55; 95% CI, 29.57-47.53) and for male (IRD, 32.60; 95% CI, 16.28-48.91) and female (IRD, 30.34; 95% CI, 20.47-40.21) subjects, indicating a potential increase in cancer incidence with decreasing environmental quality. Rural/urban stratified models demonstrated positive associations comparing the highest with the lowest quintiles for all strata, except the thinly populated/rural stratum and in the metropolitan/urbanized stratum. Prostate and breast cancer demonstrated the strongest positive associations with poor environmental quality. We observed strong positive associations between the EQI and all-site cancer incidence rates, and associations differed by rural/urban status and environmental domain. Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental

  19. Incidence rate and pattern of clinically relevant potential drug-drug interactions in a large outpatient population of a developing country.

    Science.gov (United States)

    Nabovati, Ehsan; Vakili-Arki, Hasan; Taherzadeh, Zhila; Saberi, Mohammad Reza; Abu-Hanna, Ameen; Eslami, Saeid

    2016-01-01

    The objective of this study was to determine incidence rate, type, and pattern of clinically relevant potential drug-drug interactions (pDDIs) in a large outpatient population of a developing country. A retrospective, descriptive cross-sectional study was conducted on outpatients' prescriptions in Khorasan Razavi province, Iran, over 12 months. A list of 25 clinically relevant DDIs, which are likely to occur in the outpatient setting, was used as the reference. Most frequent clinically relevant pDDIs, most common drugs contributing to the pDDIs, and the pattern of pDDIs for each medical specialty were determined. Descriptive statistics were used to report the results. In total, out of 8,169,142 prescriptions, 6,096 clinically relevant pDDIs were identified. The most common identified pDDIs were theophyllines-quinolones, warfarin-nonsteroidal anti-inflammatory drugs, benzodiazepines-azole antifungal agents, and anticoagulants-thyroid hormones. The most common drugs contributing to the identified pDDIs were ciprofloxacin, theophylline, warfarin, aminophylline, alprazolam, levothyroxine, and selegiline. While the incidence rate of clinically relevant pDDIs in prescriptions of general practitioners, internists, and cardiologists was the highest, the average pDDI incidence per 10,000 prescriptions of pulmonologists, infectious disease specialists, and cardiologists was highest. Although a small proportion of the analyzed prescriptions contained drug pairs with potential for clinically relevant DDIs, a significant number of outpatients have been exposed to the adverse effects associated with these interactions. It is recommended that in addition to training physicians and pharmacists, other effective interventions such as computerized alerting systems and electronic prescribing systems be designed and implemented.

  20. Incidence, causative factors and mortality rates of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in northern Italy: data from the REACT registry.

    Science.gov (United States)

    Diphoorn, Janouk; Cazzaniga, Simone; Gamba, Chiara; Schroeder, Jan; Citterio, Antonella; Rivolta, Alma Lisa; Vighi, Giuseppe Danilo; Naldi, Luigi

    2016-02-01

    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe cutaneous adverse drug reactions. We assessed incidence, drug exposure and mortality, analysing data obtained from the Lombardy Registry of Severe Cutaneous Reactions (REACT). Data were collected from hospitals in the Italian Lombardy region (9,502,272 people). A trained monitor was sent to the reporting hospital to collect data on drug exposure and clinical features. The algorithm for drug causality for epidermal necrolysis algorithm was applied to assess drug causality. Defined Daily Dose (DDD) was used to express drug consumption. From April 2009 to November 2014, 17 cases of TEN and 59 cases of SJS were collected. The overall incidence rate was 1.40 cases (95%CI, 1.12-1.76) per million people per year. A total of 15 cases died during hospitalization with a mortality rate of 16.9% for SJS and 29.4% for TEN. Overall, 55.4% of cases had a probable or very probable relation with drug exposure. In a total of five patients (6.6%), no causative drug for the reaction was identifiable. Allopurinol contributed to the highest number of cases (23 cases), while the highest incidence based on more than one case reported was observed for cotrimoxazole and lamotrigine, with 5.37 cases (95%CI, 2.09-13.80) and 3.54 (95%CI, 1.21-10.42) per 10 million DDD/year, respectively. We confirmed that SJS and TEN are rare adverse cutaneous reactions. As expected, mortality was influenced by the degree of skin detachment. The profile of drugs associated with the reactions was in agreement with data from other surveillance systems. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Rating

    OpenAIRE

    Karas, Vladimír

    2006-01-01

    Charakteristika ratingu. Dělení a druhy ratingu (rating emise × rating emitenta; dlouhodobý rating × krátkodobý rating; mezinárodní rating × lokální rating). Obecné požadavky kladené na rating. Proces tvorby ratingu. Vyžádaný rating. Nevyžádaný rating. Ratingový proces na bázi volně přístupných informací. Uplatňované ratingové systémy. Ratingová kriteria. Využití a interpretace ratingové známky. Funkce ratingu. Rating v souvislosti s BASEL II. Rating v souvislosti s hospodářskými krizemi....

  2. Incidence rate of Kaposi sarcoma in HIV-infected patients on antiretroviral therapy in Southern Africa: a prospective multi-cohort study

    Science.gov (United States)

    Rohner, Eliane; Valeri, Fabio; Maskew, Mhairi; Prozesky, Hans; Rabie, Helena; Garone, Daniela; Dickinson, Diana; Chimbetete, Cleophas; Lumano-Mulenga, Priscilla; Sikazwe, Izukanji; Wyss, Natascha; Clough-Gorr, Kerri M.; Egger, Matthias; Chi, Benjamin H.; Bohlius, Julia

    2014-01-01

    Background The risk of Kaposi sarcoma (KS) among HIV-infected persons on antiretroviral therapy (ART) is not well defined in resource-limited settings. We studied KS incidence rates and associated risk factors in children and adults on ART in Southern Africa. Methods We included patient data of six ART programs in Botswana, South Africa, Zambia, and Zimbabwe. We estimated KS incidence rates in patients on ART measuring time from 30 days after ART initiation to KS diagnosis, last follow-up visit, or death. We assessed risk factors (age, sex, calendar year, WHO stage, tuberculosis, and CD4 counts) using Cox models. Findings We analyzed data from 173,245 patients (61% female, 8% children aged 2 years after ART initiation). Male sex (adjusted hazard ratio [HR] 1.34; 95% CI 1.12–1.61), low current CD4 counts (≥500 cells/µL versus <50 cells/µL, adjusted HR 0.36; 95% CI 0.23–0.55) and age (5 to 9 years versus 30 to 39 years, adjusted HR 0.20; 95% CI 0.05–0.79) were relevant risk factors for developing KS. Interpretation Despite ART, KS risk in HIV-infected persons in Southern Africa remains high. Early HIV testing and maintaining high CD4 counts is needed to further reduce KS-related morbidity and mortality. PMID:25393941

  3. MC3D modelling of stratified explosion

    International Nuclear Information System (INIS)

    Picchi, S.; Berthoud, G.

    1999-01-01

    It is known that a steam explosion can occur in a stratified geometry and that the observed yields are lower than in the case of explosion in a premixture configuration. However, very few models are available to quantify the amount of melt which can be involved and the pressure peak that can be developed. In the stratified application of the MC3D code, mixing and fragmentation of the melt are explained by the growth of Kelvin Helmholtz instabilities due to the shear flow of the two phase coolant above the melt. Such a model is then used to recalculate the Frost-Ciccarelli tin-water experiment. Pressure peak, speed of propagation, bubble shape and erosion height are well reproduced as well as the influence of the inertial constraint (height of the water pool). (author)

  4. Inviscid incompressible limits of strongly stratified fluids

    Czech Academy of Sciences Publication Activity Database

    Feireisl, Eduard; Jin, B.J.; Novotný, A.

    2014-01-01

    Roč. 89, 3-4 (2014), s. 307-329 ISSN 0921-7134 R&D Projects: GA ČR GA201/09/0917 Institutional support: RVO:67985840 Keywords : compressible Navier-Stokes system * anelastic approximation * stratified fluid Subject RIV: BA - General Mathematics Impact factor: 0.528, year: 2014 http://iospress.metapress.com/content/d71255745tl50125/?p=969b60ae82634854ab8bd25505ce1f71&pi=3

  5. Turbulent Mixing in Stably Stratified Flows

    Science.gov (United States)

    2008-03-01

    Turbulent fluid motions are typically characterized by several features including randomness in both space and time, vorticity, an energy cascade ...drawback of this method is that the portion of the flow identified as a turbulent structure is dependent on the type of wavelet filter used (e.g., Haar ...the mesoscale variability of the atmosphere. J. Atmos. Sci., 40:749-761, 1983. E. Lindborg. The energy cascade in a strongly stratified fluid. J

  6. Large eddy simulation of stably stratified turbulence

    International Nuclear Information System (INIS)

    Shen Zhi; Zhang Zhaoshun; Cui Guixiang; Xu Chunxiao

    2011-01-01

    Stably stratified turbulence is a common phenomenon in atmosphere and ocean. In this paper the large eddy simulation is utilized for investigating homogeneous stably stratified turbulence numerically at Reynolds number Re = uL/v = 10 2 ∼10 3 and Froude number Fr = u/NL = 10 −2 ∼10 0 in which u is root mean square of velocity fluctuations, L is integral scale and N is Brunt-Vaïsälä frequency. Three sets of computation cases are designed with different initial conditions, namely isotropic turbulence, Taylor Green vortex and internal waves, to investigate the statistical properties from different origins. The computed horizontal and vertical energy spectra are consistent with observation in atmosphere and ocean when the composite parameter ReFr 2 is greater than O(1). It has also been found in this paper that the stratification turbulence can be developed under different initial velocity conditions and the internal wave energy is dominated in the developed stably stratified turbulence.

  7. Nitrogen transformations in stratified aquatic microbial ecosystems

    DEFF Research Database (Denmark)

    Revsbech, Niels Peter; Risgaard-Petersen, N.; Schramm, Andreas

    2006-01-01

    Abstract  New analytical methods such as advanced molecular techniques and microsensors have resulted in new insights about how nitrogen transformations in stratified microbial systems such as sediments and biofilms are regulated at a µm-mm scale. A large and ever-expanding knowledge base about n...... performing dissimilatory reduction of nitrate to ammonium have given new dimensions to the understanding of nitrogen cycling in nature, and the occurrence of these organisms and processes in stratified microbial communities will be described in detail.......Abstract  New analytical methods such as advanced molecular techniques and microsensors have resulted in new insights about how nitrogen transformations in stratified microbial systems such as sediments and biofilms are regulated at a µm-mm scale. A large and ever-expanding knowledge base about...... nitrogen fixation, nitrification, denitrification, and dissimilatory reduction of nitrate to ammonium, and about the microorganisms performing the processes, has been produced by use of these techniques. During the last decade the discovery of anammmox bacteria and migrating, nitrate accumulating bacteria...

  8. MRI-detection rate and incidence of lumbar bleeding sources in 190 patients with non-aneurysmal SAH.

    Directory of Open Access Journals (Sweden)

    Sepide Kashefiolasl

    Full Text Available Up to 15% of all spontaneous subarachnoid hemorrhages (SAH have a non-aneurysmal SAH (NASAH. The evaluation of SAH patients with negative digital subtraction angiography (DSA is sometimes a diagnostic challenge. Our goal in this study was to reassess the yield of standard MR-imaging of the complete spinal axis to rule out spinal bleeding sources in patients with NASAH.We retrospectively analyzed the spinal MRI findings in 190 patients with spontaneous NASAH, containing perimesencephalic (PM and non-perimesencephalic (NPM SAH, diagnosed by computer tomography (CT and/or lumbar puncture (LP, and negative 2nd DSA.190 NASAH patients were included in the study, divided into PM-SAH (n = 87; 46% and NPM-SAH (n = 103; 54%. Overall, 23 (22% patients had a CT negative SAH, diagnosed by positive LP. MR-imaging of the spinal axis detected two patients with lumbar ependymoma (n = 2; 1,05%. Both patients complained of radicular sciatic pain. The detection rate raised up to 25%, if only patients with radicular sciatic pain received an MRI.Routine radiological investigation of the complete spinal axis in NASAH patients is expensive and can not be recommended for standard procedure. However, patients with clinical signs of low-back/sciatic pain should be worked up for a spinal pathology.

  9. Incidence, hospital costs and in-hospital mortality rates of surgically treated patients with traumatic cranial epidural hematoma

    Directory of Open Access Journals (Sweden)

    Atci Ibrahim Burak

    2017-12-01

    Full Text Available Background: In this study, the patients who were operated in two clinics due to traumatic cranial epidural hematoma (EDH were assessed retrospectively and the factors that increase the costs were tried to be revealed through conducting cost analyses. Methods: The patients who were operated between 2010 and 2016 with the diagnosis of EDH were assessed in terms of age, sex, trauma etiology, Glasgow coma scale (GCS at admission, the period from trauma to hospital arrival, trauma-related injury in other organs, the localization of hematoma, the size of hematoma, length of stay in the intensive care unit (ICU, length of antibiotherapy administration, number of consultations conducted, total cost of in-hospital treatments of the patients and prognosis. Results: Distribution of GCS were, between 13-15 in 18 (36% patients, 9-13 in 23 (46% patients and 3-8 in 9 (18% patients. The reasons for emergency department admissions were fall from high in 29 (58% patients, assault in 11 (22% patients and motor vehicle accident in 10 (20% patients. The average cost per ICU stay was 2838 $ (range=343-20571 $. The average cost per surgical treatment was 314 $. ICU care was approximately 9 times more expensive than surgical treatment costs. The mortality rate of the study cohort was 14% (7 patients. Conclusion: The prolonged period of stay in the ICU, antibiotherapy and repeat head CTs increase the costs for patients who are surgically treated for EDH.

  10. Increasing incidence of skin disorders in children? A comparison between 1987 and 2001

    Directory of Open Access Journals (Sweden)

    van Suijlekom-Smit Lisette WA

    2006-03-01

    Full Text Available Abstract Background The increasing proportion of skin diseases encountered in general practice represents a substantial part of morbidity in children. Only limited information is available about the frequency of specific skin diseases. We aimed to compare incidence rates of skin diseases in children in general practice between 1987 and 2001. Methods We used data on all children aged 0–17 years derived from two consecutive surveys performed in Dutch general practice in 1987 and 2001. Both surveys concerned a longitudinal registration of GP consultations over 12 months. Each disease episode was coded according to the International Classification of Primary Care. Incidence rates of separate skin diseases were calculated by dividing all new episodes for each distinct ICPC code by the average study population at risk. Data were stratified for socio-demographic characteristics. Results The incidence rate of all skin diseases combined in general practice decreased between 1987 and 2001. Among infants the incidence rate increased. Girls presented more skin diseases to the GP. In the southern part of the Netherlands children consulted their GP more often for skin diseases compared to the northern part. Children of non-Western immigrants presented relatively more skin diseases to the GP. In general practice incidence rates of specific skin diseases such as impetigo, dermatophytosis and atopic dermatitis increased in 2001, whereas warts, contact dermatitis and skin injuries decreased. Conclusion The overall incidence rate of all skin diseases combined in general practice decreased whereas the incidence rates of bacterial, mycotic and atopic skin diseases increased.

  11. Age-specific bone tumour incidence rates are governed by stem cell exhaustion influencing the supply and demand of progenitor cells.

    Science.gov (United States)

    Richardson, Richard B

    2014-07-01

    Knudson's carcinogenic model, which simulates incidence rates for retinoblastoma, provides compelling evidence for a two-stage mutational process. However, for more complex cancers, existing multistage models are less convincing. To fill this gap, I hypothesize that neoplasms preferentially arise when stem cell exhaustion creates a short supply of progenitor cells at ages of high proliferative demand. To test this hypothesis, published datasets were employed to model the age distribution of osteochondroma, a benign lesion, and osteosarcoma, a malignant one. The supply of chondrogenic stem-like cells in femur growth plates of children and adolescents was evaluated and compared with the progenitor cell demand of longitudinal bone growth. Similarly, the supply of osteoprogenitor cells from birth to old age was compared with the demands of bone formation. Results show that progenitor cell demand-to-supply ratios are a good risk indicator, exhibiting similar trends to the unimodal and bimodal age distributions of osteochondroma and osteosarcoma, respectively. The hypothesis also helps explain Peto's paradox and the finding that taller individuals are more prone to cancers and have shorter lifespans. The hypothesis was tested, in the manner of Knudson, by its ability to convincingly explain and demonstrate, for the first time, a bone tumour's bimodal age-incidence curve. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

  12. [Causes of emergency dizziness stratified by etiology].

    Science.gov (United States)

    Qiao, Wenying; Liu, Jianguo; Zeng, Hong; Liu, Yugeng; Jia, Weihua; Wang, Honghong; Liu, Bo; Tan, Jing; Li, Changqing

    2014-06-03

    To explore the causes of emergency dizziness stratified to improve the diagnostic efficiency. A total of 1 857 cases of dizziness at our emergency department were collected and their etiologies stratified by age and gender. The top three diagnoses were benign paroxysmal positional vertigo (BPPV, 31.7%), hypertension (24.0%) and posterior circulation ischemia (PCI, 20.5%). Stratified by age, the main causes of dizziness included BPPV (n = 6), migraine-associated vertigo (n = 2), unknown cause (n = 1) for the group of vertigo (14.5%) and neurosis (7.3%) for 18-44 years; BPPV (36.8%), hypertension (22.4%) and migraine-associated vertigo (11.2%) for 45-59 years; hypertension (30.8%), PCI (29.8%) and BPPV (22.9%) for 60-74 years; PCI (30.7%), hypertension (28.6%) and BPPV (25.5%) for 75-92 years. BPPV, migraine and neurosis were more common in females while hypertension and PCI predominated in males (all P hypertension, neurosis and migraine showed the following significant demographic features: BPPV, PCI, hypertension, neurosis and migraine may be the main causes of dizziness. BPPV should be considered initially when vertigo was triggered repeatedly by positional change, especially for young and middle-aged women. And the other common causes of dizziness were migraine-associated vertigo, neurosis and Meniere's disease.Hypertension should be screened firstly in middle-aged and elderly patients presenting mainly with head heaviness and stretching. In elders with dizziness, BPPV is second in constituent ratio to PCI and hypertension.In middle-aged and elderly patients with dizziness, psychological factors should be considered and diagnosis and treatment should be offered timely.

  13. Increased Incidence Rate of Trauma- and Stressor-Related Disorders in Denmark After the September 11, 2001, Terrorist Attacks in the United States.

    Science.gov (United States)

    Hansen, Bertel T; Østergaard, Søren D; Sønderskov, Kim M; Dinesen, Peter T

    2016-10-01

    The terrorist attacks that occurred on September 11, 2001 (hereafter referred to as 9/11) in the United States had a profound impact on the physical and mental health of Americans, but the effects beyond the United States are largely unknown. To understand the wider aftermath, we examined the consequences of the 9/11 attacks on mental disorders in the Kingdom of Denmark. Utilizing population data from the Danish Psychiatric Central Research Register from 1995 to 2012, we used a time-series intervention approach to estimate the change in the incidence rate of mental disorders after the 9/11 attacks. Based on analyses of 1,448,250 contacts with psychiatric services, we found that the attacks were followed by an immediate 16% increase in the incidence rate of trauma- and stressor-related disorders. This surge dissipated approximately a year after 9/11. In contrast, no similar increases were found for other disorders. This is consistent with the prominent role of external stressors in the etiology of trauma- and stressor-related disorders. The results indicate that the effects of 9/11 on mental disorders extended across the Atlantic Ocean to Denmark. Thus, the impact of terrorist attacks on mental health is likely not limited to inhabitants of the country under attack; it also extends to people far away and without immediate relation to it. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Long-term course of Crohn's disease in Japan: Incidence of complications, cumulative rate of initial surgery, and risk factors at diagnosis for initial surgery.

    Science.gov (United States)

    Sato, Yuho; Matsui, Toshiyuki; Yano, Yutaka; Tsurumi, Kozue; Okado, Yuki; Matsushima, Yu; Koga, Akihiro; Takahashi, Haruhiko; Ninomiya, Kazeo; Ono, Yoichiro; Takatsu, Noritaka; Beppu, Takahiro; Nagahama, Takashi; Hisabe, Takashi; Takaki, Yasuhiro; Hirai, Fumihito; Yao, Kenshi; Higashi, Daijiro; Futami, Kitaro; Washio, Masakazu

    2015-12-01

    Intestinal complications of stenosis or fistula may occur during the course of Crohn's disease (CD), and surgery is performed in a fair number of patients. The risk factors for initial surgery in a Japanese hospital-based cohort of CD patients were evaluated. This study was a single-center, retrospective, cohort study. The subjects were 520 patients who underwent inpatient and outpatient treatment at our hospital, had a definitive diagnosis of CD, and no previous surgery. Three parameters were investigated: (i) cumulative incidence of stenosis and fistula; (ii) cumulative rate of initial surgery for each disease type; and (iii) risk factors at diagnosis for initial surgery. (i) Stenosis and fistula increased with time, with stenosis or fistula appearing in about half of the patients after 5 years. (ii) The cumulative rate of initial surgery was about 50% after 10 years. (iii) The patient factors at diagnosis of current smoker, upper gastrointestinal disease, stricturing, penetrating, moderate to severe stenosis of the jejunum, moderate to severe stenosis of the ileum, and moderate to severe stenosis of the terminal ileum were risk factors for initial surgery. Stenosis or fistula appeared in about half of the patients after 5 years from diagnosis. When upper gastrointestinal disease or complicated small intestinal lesions are seen at the time of diagnosis, the cumulative rate of initial surgery is significantly higher. © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  15. Abundance, biting behaviour and parous rate of anopheline mosquito species in relation to malaria incidence in gold-mining areas of southern Venezuela.

    Science.gov (United States)

    Moreno, J E; Rubio-Palis, Y; Páez, E; Pérez, E; Sánchez, V

    2007-12-01

    A longitudinal entomological and epidemiological study was conducted in five localities of southern Venezuela between January 1999 and April 2000 to determine the abundance, biting behaviour and parity of anopheline mosquitoes (Diptera: Culicidae) in relation to climate variables and malaria incidence. A total of 3685 female anopheline mosquitoes, representing six species, were collected. The most abundant species were Anopheles marajoara Galvão & Damasceno (60.7%) and Anopheles darlingi Root (35.1%), which together represented 95.8% of the total anophelines collected. Abundance and species distribution varied by locality. Malaria prevalence varied from 12.5 to 21.4 cases per 1000 population. Transmission occurred throughout the year; the annual parasite index (API) for the study period was 813.0 cases per 1000 population, with a range of 71.6-2492 per 1000 population, depending on locality. Plasmodium vivax (Grassi & Feletti) (Coccidia: Plasmodiidae) accounted for 78.6% of cases, Plasmodium falciparum (Welch) for 21.4% and mixed infections (Pv+Pf) for marajoara and An. darlingi were more abundant during the rainy season (April-September). There was no significant correlation (P > 0.05) between mosquito abundance and rainfall. Correlations between malaria incidence by parasite species and mosquito abundance were not significant (P > 0.05). Monthly parous rates were similar for An. marajoara and An. darlingi throughout the year, with two peaks that coincided with the dry-rainy transition period and the period of less rain. Peaks in the incidence of malaria cases were observed 1 month after major peaks in biting rates of parous anophelines. Anopheles darlingi engages in biting activity throughout the night, with two minor peaks at 23.00-00.00 hours and 03.00-04.00 hours. Anopheles marajoara has a different pattern, with a biting peak at 19.00-21.00 hours and 76.6% of biting occurring before midnight. Although both vectors bite indoors and outdoors, they showed a

  16. Decision tree analysis to stratify risk of de novo non-melanoma skin cancer following liver transplantation.

    Science.gov (United States)

    Tanaka, Tomohiro; Voigt, Michael D

    2018-03-01

    Non-melanoma skin cancer (NMSC) is the most common de novo malignancy in liver transplant (LT) recipients; it behaves more aggressively and it increases mortality. We used decision tree analysis to develop a tool to stratify and quantify risk of NMSC in LT recipients. We performed Cox regression analysis to identify which predictive variables to enter into the decision tree analysis. Data were from the Organ Procurement Transplant Network (OPTN) STAR files of September 2016 (n = 102984). NMSC developed in 4556 of the 105984 recipients, a mean of 5.6 years after transplant. The 5/10/20-year rates of NMSC were 2.9/6.3/13.5%, respectively. Cox regression identified male gender, Caucasian race, age, body mass index (BMI) at LT, and sirolimus use as key predictive or protective factors for NMSC. These factors were entered into a decision tree analysis. The final tree stratified non-Caucasians as low risk (0.8%), and Caucasian males > 47 years, BMI risk (7.3% cumulative incidence of NMSC). The predictions in the derivation set were almost identical to those in the validation set (r 2  = 0.971, p risk groups at 5/10/20 year was 0.5/1.2/3.3, 2.1/4.8/11.7 and 5.6/11.6/23.1% (p risk of developing NMSC in the long-term after LT.

  17. E25 stratified torch ignition engine emissions and combustion analysis

    International Nuclear Information System (INIS)

    Rodrigues Filho, Fernando Antonio; Baêta, José Guilherme Coelho; Teixeira, Alysson Fernandes; Valle, Ramón Molina; Fonseca de Souza, José Leôncio

    2016-01-01

    Highlights: • A stratified torch ignition (STI) engine was built and tested. • The STI engines was tested in a wide range of load and speed. • Significant reduction on emissions was achieved by means of the STI system. • Low cyclic variability characterized the lean combustion process of the torch ignition engine. • HC emission is the main drawback of the stratified torch ignition engine. - Abstract: Vehicular emissions significantly increase atmospheric air pollution and greenhouse gases (GHG). This fact associated with fast global vehicle fleet growth calls for prompt scientific community technological solutions in order to promote a significant reduction in vehicle fuel consumption and emissions, especially of fossil fuels to comply with future legislation. To meet this goal, a prototype stratified torch ignition (STI) engine was built from a commercial existing baseline engine. In this system, combustion starts in a pre-combustion chamber, where the pressure increase pushes the combustion jet flames through calibrated nozzles to be precisely targeted into the main chamber. These combustion jet flames are endowed with high thermal and kinetic energy, being able to generate a stable lean combustion process. The high kinetic and thermal energy of the combustion jet flame results from the load stratification. This is carried out through direct fuel injection in the pre-combustion chamber by means of a prototype gasoline direct injector (GDI) developed for a very low fuel flow rate. In this work the engine out-emissions of CO, NOx, HC and CO 2 of the STI engine are presented and a detailed analysis supported by the combustion parameters is conducted. The results obtained in this work show a significant decrease in the specific emissions of CO, NOx and CO 2 of the STI engine in comparison with the baseline engine. On the other hand, HC specific emission increased due to wall wetting from the fuel hitting in the pre-combustion chamber wall.

  18. Shock propagation and mixing though a stratified gas

    Science.gov (United States)

    Chacon, Fabian; Gamba, Mirko

    2017-11-01

    In this work, we investigate the characteristics of a shock wave propagating through a stratified gas. The objective is to understand the formation and evolution of the system of waves that results from the interaction, as well as the induced mixing. This work is motivated by understanding the shock-induced mixing and system of waves that arise by the interaction of a detonation wave with the fuel/air injection system in a rotating detonation engine. In these devices, one of the key limiting factors in achieving stable detonation and pressure gain is associated with the stratification induced by a non-uniform and incomplete mixing process. To investigate some of the fundamental aspects of the rapid distortion induced by a detonation wave on the non-uniform flow, we conduct a combined analytical and experimental analysis on a simplified and reduced problem. Experimentally, we consider a single row of injectors of regular spacing that generate a non-reacting turbulent non-uniform flow and are subject to an incident transverse normal shock. Different gasses and shock strengths are used to generate a range of density and velocity ratios that are comparable to what could be experienced through a detonation. Using Schlieren and PLIF imaging, the evolution of mixture fraction throughout the flowfield is investigated. The presence of instabilities and the formation of a system of reflected waves is observed and investigated. A variable property, 1-D, multi-isentropic method of characteristics model is constructed to theoretically investigate the shock propagation and interaction with the stratified flow. This work is supported by the DOE/UTSR program under project DE-FE0025315.

  19. Subcutaneous bortezomib in multiple myeloma patients induces similar therapeutic response rates as intravenous application but it does not reduce the incidence of peripheral neuropathy.

    Directory of Open Access Journals (Sweden)

    Jiri Minarik

    Full Text Available Subcutaneous (SC application of bortezomib has been recently introduced as a new application route in multiple myeloma (MM patients. We performed an analysis to compare the outcomes of bortezomib-based therapy in multiple myeloma (MM patients treated using either intravenous (IV or subcutaneous (SC route of administration.During January 2012 through December 2013, we performed a retrospective analysis of 446 patients with MM treated with bortezomib-based regimens (either once weekly - 63% or twice weekly - 27% in both, the first line setting, and in relapse, with separate analysis of patients undergoing autologous stem cell transplantation. We assessed the response rates and toxicity profiles in both, IV and SC route of bortezomib administration.The response rates in both IV and SC arm were similar with overall response rate 71.7% vs 70.7%, complete remissions in 13.9% vs 8.6%, very good partial remissions in 30.8% vs 34.5% and partial remissions in 27% vs 27.6%. The most frequent grade ≥ 3 toxicities were anemia, thrombocytopenia and neutropenia, with no significant differences between IV and SC group. There were no significant differences in the rate of peripheral neuropathy (PN. PN of any grade was present in 48% in the IV arm and in 41% in the SC arm. PN grade ≥ 2 was present in 20% vs 18% and PN grade ≥ 3 was present in 6% vs 4%.We conclude that subcutaneous application of bortezomib has similar therapeutic outcomes and toxicity profile as intravenous route of application. In our cohort there was no difference in the incidence of PN, suggesting that PN is dose dependent and might be reduced by lower intensity schemes rather than by the route of administration.

  20. Scattering by multiple parallel radially stratified infinite cylinders buried in a lossy half space.

    Science.gov (United States)

    Lee, Siu-Chun

    2013-07-01

    The theoretical solution for scattering by an arbitrary configuration of closely spaced parallel infinite cylinders buried in a lossy half space is presented in this paper. The refractive index and permeability of the half space and cylinders are complex in general. Each cylinder is radially stratified with a distinct complex refractive index and permeability. The incident radiation is an arbitrarily polarized plane wave propagating in the plane normal to the axes of the cylinders. Analytic solutions are derived for the electric and magnetic fields and the Poynting vector of backscattered radiation emerging from the half space. Numerical examples are presented to illustrate the application of the scattering solution to calculate backscattering from a lossy half space containing multiple homogeneous and radially stratified cylinders at various depths and different angles of incidence.

  1. The incidence rate of female breast cancer in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001–2008

    Science.gov (United States)

    Alghamdi, Ibrahim G; Hussain, Issam I; Alghamdi, Mohamed S; El-Sheemy, Mohamed A

    2013-01-01

    Background This study presents descriptive epidemiological data related to breast cancer cases diagnosed from 2001 to 2008 among Saudi women, including the frequency and percentage of cases, the crude incidence rate (CIR), and the age-standardized incidence rate (ASIR), adjusted by the region and year of diagnosis. Methods This is a retrospective descriptive epidemiological study of all Saudi female breast cancer cases from 2001 to 2008. The statistical analyses were conducted using descriptive statistics, a linear regression model, and analysis of variance with the Statistical Package for the Social Sciences version 20.0. Results A total of 6,922 female breast cancer cases were recorded in the Saudi Cancer Registry from 2001 to 2008. The highest overall percentages (38.6% and 31.2%) of female breast cancer cases were documented in women who were 30–44 and 45–59 years of age, respectively. The eastern region of Saudi Arabia had the highest overall ASIR, at 26.6 per 100,000 women, followed by Riyadh at 20.5 and Makkah at 19.4. Jazan, Baha, and Asir had the lowest average ASIRs, at 4.8, 6.1, and 7.3 per 100,000 women, respectively. The region of Jouf (24.2%; CIR 11.2, ASIR 17.2) had the highest changes in CIR and ASIR from 2001 to 2008. While Qassim, Jazan, and Tabuk recorded down-trending rates with negative values. Conclusion There was a significant increase in the CIRs and ASIRs for female breast cancer between 2001 and 2008. The majority of breast cancer cases occurred among younger women. The region of Jouf had the greatest significant differences of CIR and ASIR during 2001 to 2008. Jazan, Baha, and Najran had the lowest average CIRs and ASIRs of female breast cancer, whereas the linear trend upward is a concern in certain regions, such as the eastern region, Makkah, and Riyadh. However, further analytical epidemiological research is needed to identify the potential risk factors involved in the increase in the prevalence of breast cancer among Saudi women

  2. Cancer incidence in kidney transplant recipients: a study protocol

    International Nuclear Information System (INIS)

    Pita-Fernandez, Salvador; Valdes-Cañedo, Francisco; Pertega-Diaz, Sonia; Seoane-Pillado, Maria Teresa; Seijo-Bestilleiro, Rocio

    2009-01-01

    Different publications show an increased incidence of neoplasms in renal transplant patients. The objective of this study is to determine the incidence of cancer in the recipients of renal transplants performed in the A Coruña Hospital (Spain) during the period 1981–2007. During the study period 1967 kidney transplants were performed, corresponding to 1710 patients. Patients with neoplasms prior to the transplant will be excluded (n = 38). A follow-up study was carried out in order to estimate cancer incidence after transplantation. For each patient, information included donor and recipient characteristics, patients and graft survival and cancer incidence after transplantation. Incident cancer is considered as new cases of cancer after the transplant with anatomopathological confirmation. Their location will be classified according to the ICD-9. The analysis will be calculated using the indirect standardisation method. Age-adjusted cancer incidence rates in the Spanish general population will be obtained from the Carlos III Health Institute, the National Epidemiology Centre of the Ministry of Science and Technology. Crude first, second and third-year post-transplantation cancer incidence rates will be calculated for male and female recipients. The number of cases of cancer at each site will be calculated from data in the clinical records. The expected number of cancers will be calculated from data supplied by the Carlos III Health Institute. For each tumour location we will estimate the standardized incidence ratios (SIRs), using sex-specific cancer incidence rates, by dividing the incidence rate for the transplant patients by the rate of the general population. The 95% confidence intervals of the SIRs and their associated p-values will be calculated by assuming that the observed cancers follow a Poisson distribution. Stratified analysis will be performed to examine the variation in the SIRs with sex and length of follow-up. Competing risk survival analysis

  3. Sexual minority population density and incidence of lung, colorectal and female breast cancer in California.

    Science.gov (United States)

    Boehmer, Ulrike; Miao, Xiaopeng; Maxwell, Nancy I; Ozonoff, Al

    2014-03-26

    Risk factors for breast, colorectal, and lung cancer are known to be more common among lesbian, gay, and bisexual (LGB) individuals, suggesting they may be more likely to develop these cancers. Our objective was to determine differences in cancer incidence by sexual orientation, using sexual orientation data aggregated at the county level. Data on cancer incidence were obtained from the California Cancer Registry and data on sexual orientation were obtained from the California Health Interview Survey, from which a measure of age-specific LGB population density by county was calculated. Using multivariable Poisson regression models, the association between the age-race-stratified incident rate of breast, lung and colorectal cancer in each county and LGB population density was examined, with race, age group and poverty as covariates. Among men, bisexual population density was associated with lower incidence of lung cancer and with higher incidence of colorectal cancer. Among women, lesbian population density was associated with lower incidence of lung and colorectal cancer and with higher incidence of breast cancer; bisexual population density was associated with higher incidence of lung and colorectal cancer and with lower incidence of breast cancer. These study findings clearly document links between county-level LGB population density and cancer incidence, illuminating an important public health disparity.

  4. Thermal instability in a stratified plasma

    International Nuclear Information System (INIS)

    Hermanns, D.F.M.; Priest, E.R.

    1989-01-01

    The thermal instability mechansism has been studied in connection to observed coronal features, like, e.g. prominences or cool cores in loops. Although these features show a lot of structure, most studies concern the thermal instability in an uniform medium. In this paper, we investigate the thermal instability and the interaction between thermal modes and the slow magneto-acoustic subspectrum for a stratified plasma slab. We fomulate the relevant system of equations and give some straightforward properties of the linear spectrum of a non-uniform plasma slab, i.e. the existence of continuous parts in the spectrum. We present a numerical scheme with which we can investigate the linear spectrum for equilibrium states with stratification. The slow and thermal subspectra of a crude coronal model are given as a preliminary result. (author). 6 refs.; 1 fig

  5. Stratified scaffold design for engineering composite tissues.

    Science.gov (United States)

    Mosher, Christopher Z; Spalazzi, Jeffrey P; Lu, Helen H

    2015-08-01

    A significant challenge to orthopaedic soft tissue repair is the biological fixation of autologous or allogeneic grafts with bone, whereby the lack of functional integration between such grafts and host bone has limited the clinical success of anterior cruciate ligament (ACL) and other common soft tissue-based reconstructive grafts. The inability of current surgical reconstruction to restore the native fibrocartilaginous insertion between the ACL and the femur or tibia, which minimizes stress concentration and facilitates load transfer between the soft and hard tissues, compromises the long-term clinical functionality of these grafts. To enable integration, a stratified scaffold design that mimics the multiple tissue regions of the ACL interface (ligament-fibrocartilage-bone) represents a promising strategy for composite tissue formation. Moreover, distinct cellular organization and phase-specific matrix heterogeneity achieved through co- or tri-culture within the scaffold system can promote biomimetic multi-tissue regeneration. Here, we describe the methods for fabricating a tri-phasic scaffold intended for ligament-bone integration, as well as the tri-culture of fibroblasts, chondrocytes, and osteoblasts on the stratified scaffold for the formation of structurally contiguous and compositionally distinct regions of ligament, fibrocartilage and bone. The primary advantage of the tri-phasic scaffold is the recapitulation of the multi-tissue organization across the native interface through the layered design. Moreover, in addition to ease of fabrication, each scaffold phase is similar in polymer composition and therefore can be joined together by sintering, enabling the seamless integration of each region and avoiding delamination between scaffold layers. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Characteristics and comparison of colorectal cancer incidence in Beijing with other regions in the world

    Science.gov (United States)

    Li, Zhongmin; Yang, Lei; Du, Changzheng; Fang, Xuedong; Wang, Ning; Gu, Jin

    2017-01-01

    Background Population-based epidemiologic studies about colorectal cancer are lacking in China. This study aims to provide a basis for colorectal cancer screening and prevention, through analysis and comparisons the characteristics of the trends in colorectal cancer incidence in Beijing and selected representative regions. RESULTS The annual incidence rate in Beijing region increased significantly, from 9.40/100,000 in 1998 to 18.61/100,000 in 2012. The stratified rate showed that the incidence of distal colon adenocarcinoma increased substantially in men, especially in those aged > 75 years and residing in urban areas. Although the incidence rate in Beijing is still lower than in Shanghai, Jiashan, and Hong Kong in China, it is increasing rapidly. Further, the incidence rate in Beijing is lower than in New York, Oxford and Osaka, but higher than in Mumbai and Kyadondo. The incidence trend in Beijing is increasing especially in older groups, while in other regions such as New York, it is decreasing in these age groups. Materials and Methods Colorectal cancer incidence data were obtained from Beijing Cancer Registry and Cancer Incidence in Five Continents Plus database. All incidence rates were age-standardized according to Segi's world population. Incidence trends were characterized by calculating the annual percent changes using the Joinpoint Regression Program. Conclusions Compared with other regions, Beijing has a medium level of colorectal cancer incidence, however, it is increasing significantly. There are obvious differences in the cancer subsite, sex and age distributions between Beijing and other regions. Prevention and screening of colorectal cancer in Beijing should be strengthened. PMID:28445947

  7. Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki (Dept. of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan)), email: utsunomi@kumamoto-u.ac.jp; Awai, Kazuo (Dept. of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima Univ., Hiroshima (Japan)); Funama, Yoshinori (Dept. of Medical Physics, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan))

    2011-06-15

    Background Although pre-existing renal insufficiency (RI) is the most important risk factor for contrast-induced nephropathy (CIN), the background distribution of baseline renal function has not been investigated thoroughly in patients scheduled for contrast-enhanced CT. Purpose To investigate the incidence and severity of baseline RI evaluated by estimated glomerular filtration rates (eGFR) in patients who underwent contrast-enhanced CT at an academic center. Material and Methods A total of 6586 patients (3630 men and 2956 women; mean age 57.0 +- 11.9 years) who underwent contrast-enhanced CT between January and December 2008 were retrospectively studied. Of these, 829 had cardiovascular diseases (CVD), 5116 had oncologic diseases, 178 had diabetes mellitus (DM), and 1572 had chronic liver disease (CLD). The eGFR (mL/min/1.73 m2) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 < =eGFR < 90, 45 < =eGFR < 60, 30 < =eGFR < 45 and eGFR < 30, respectively. Results Of the 6586 patients, 1.6%, 3.7%, 13.7%, and 54.2% were judged to present with severe, moderate-b, moderate-a, and mild RI, respectively. While moderate-b-to-severe RI was recorded in 133 (3.2%) of 4161 patients aged 70 years or less, it was observed in 218 (9.0%) of the 2425 patients who were 71 years or older. Among the 829 CVD patients, 9.9% manifested moderate-b-to-severe- and 73.0% mild-to-moderate-a RI. The corresponding rates were 4.4% and 68.9% for oncologic disease, 16.9% and 61.2% for DM, and 4.8% and 71.5% for CLD patients. By univariate analysis, there was a significant association between moderate-b-to-severe RI and the advanced age, CVD, DM, and non-oncologic disease. Multivariate analysis showed that the advanced age, DM, and non-oncologic disease were statistically associated with moderate-b-to-severe RI. Conclusion The incidence of RI of eGFR < 45mL/min/1.73 m2 at baseline was high in patients with advanced age, CVD and DM and

  8. A study of stratified gas-liquid pipe flow

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, George W.

    2005-07-01

    This work includes both theoretical modelling and experimental observations which are relevant to the design of gas condensate transport lines. Multicomponent hydrocarbon gas mixtures are transported in pipes over long distances and at various inclinations. Under certain circumstances, the heavier hydrocarbon components and/or water vapour condense to form one or more liquid phases. Near the desired capacity, the liquid condensate and water is efficiently transported in the form of a stratified flow with a droplet field. During operating conditions however, the flow rate may be reduced allowing liquid accumulation which can create serious operational problems due to large amounts of excess liquid being expelled into the receiving facilities during production ramp-up or even in steady production in severe cases. In particular, liquid tends to accumulate in upward inclined sections due to insufficient drag on the liquid from the gas. To optimize the transport of gas condensates, a pipe diameters should be carefully chosen to account for varying flow rates and pressure levels which are determined through the knowledge of the multiphase flow present. It is desirable to have a reliable numerical simulation tool to predict liquid accumulation for various flow rates, pipe diameters and pressure levels which is not presently accounted for by industrial flow codes. A critical feature of the simulation code would include the ability to predict the transition from small liquid accumulation at high flow rates to large liquid accumulation at low flow rates. A semi-intermittent flow regime of roll waves alternating with a partly backward flowing liquid film has been observed experimentally to occur for a range of gas flow rates. Most of the liquid is transported in the roll waves. The roll wave regime is not well understood and requires fundamental modelling and experimental research. The lack of reliable models for this regime leads to inaccurate prediction of the onset of

  9. Parkinson's disease incidence: magnitude, comparability, time trends.

    Science.gov (United States)

    de Pedro-Cuesta, J; Stawiarz, L

    1991-11-01

    In this study, we reviewed incidence surveys of Parkinson's Disease (PD) from all over the world, published during the period 1945-1989, using reported quality criteria. In addition, we compared age-specific PD incidences from selected observations by stratified analysis. Crude incidences were described for 11 populations, and age-specific incidences for three of them: Iceland, Rochester (Minn, USA), and Turku (Finland). Effect modification by age was detected: a) by comparing incidences by age at diagnosis with incidence by age at clinical disease onset; and b) when only data on onset of disease was computed. For disease onsets, the incidences in Rochester for the period 1955-1966, and in Turku (Finland) during the interval 1968-1970, were lower than that in Iceland for the period 1958-1960: RR = 0.58 95% CI (0.41, 0.83), and RR = 0.67 95% CI (0.51, 0.87), respectively. For the Rochester population aged 40-69 years, a statistically significant 56% decrease in the incidences of Parkinsonism onsets during the period 1945-1966 was found. Validity problems in comparing PD incidences and the role of PD underdiagnosis were emphasized. We concluded that: a) stratified analysis is more suitable than standardization when comparing incidences for etiological purposes; b) the incidence of PD was highest in Iceland; and c) in Rochester, PD incidence under the age of 70 decreased with time.

  10. Incidence and mortality rates in breast, corpus uteri, and ovarian cancers in Poland (1980–2013: an analysis of population-based data in relation to socio-economic changes

    Directory of Open Access Journals (Sweden)

    Banas T

    2016-09-01

    Full Text Available Tomasz Banas,1 Grzegorz Juszczyk,2 Kazimierz Pitynski,1 Dorota Nieweglowska,1 Artur Ludwin,1 Aleksandra Czerw2 1Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, 2Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland Objectives: This study aimed to analyze incidence and mortality trends in breast cancer (BC, corpus uteri cancer (CUC, and ovarian cancer (OC in Poland in the context of sociodemographic changes.Materials and methods: Incidence and mortality data (1980–2013 were retrieved from the Polish National Cancer Registry, while socioeconomic data (1960–2013 were obtained from the World Bank. Age-standardized incidence and mortality rates were calculated by direct standardization, and join-point regression was performed to describe trends using the average annual percentage change (AAPC.Results: A significant decrease in birth and fertility rates and a large increase in gross domestic product were observed together with a decrease in the total mortality rate among women, as well as an increase in life expectancy for women. A large, significant increase in BC incidence was observed (AAPC1980–1990 2.14, AAPC1990–1996 4.71, AAPC1996–2013 2.21, with a small but significant decrease in mortality after a slight increase (AAPC1980–1994 0.52, AAPC1994–2013 −0.66. During the period 1980–2013, a significant increase in CUC incidence (AAPC1980–1994 3.7, AAPC1994–2013 1.93 was observed, with an initial mortality-rate reduction followed by a significant increase (AAPC1980–2006 −1.12, AAPC2006–2013 3.74. After the initial increase of both OC incidence and mortality from 1994, the incidence rate decreased significantly (AAPC1980–1994 2.98, AAPC1994–2013 −0.49, as did the mortality rate (AAPC1980–1994 0.52, AAPC1994–2013 −0.66.Conclusion: After 1994, a decrease in OC incidence was found, while the incidence of BC and CUC continued to increase. A reduction in

  11. Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT

    International Nuclear Information System (INIS)

    Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki; Awai, Kazuo; Funama, Yoshinori

    2011-01-01

    Background Although pre-existing renal insufficiency (RI) is the most important risk factor for contrast-induced nephropathy (CIN), the background distribution of baseline renal function has not been investigated thoroughly in patients scheduled for contrast-enhanced CT. Purpose To investigate the incidence and severity of baseline RI evaluated by estimated glomerular filtration rates (eGFR) in patients who underwent contrast-enhanced CT at an academic center. Material and Methods A total of 6586 patients (3630 men and 2956 women; mean age 57.0 ± 11.9 years) who underwent contrast-enhanced CT between January and December 2008 were retrospectively studied. Of these, 829 had cardiovascular diseases (CVD), 5116 had oncologic diseases, 178 had diabetes mellitus (DM), and 1572 had chronic liver disease (CLD). The eGFR (mL/min/1.73 m 2 ) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 2 at baseline was high in patients with advanced age, CVD and DM and in patients without oncologic disease

  12. Incidence rates and risk factors for owner-reported adverse events following vaccination of dogs that did or did not receive a Leptospira vaccine.

    Science.gov (United States)

    Yao, Peng Ju; Stephenson, Nicole; Foley, Janet E; Toussieng, Chuck R; Farver, Thomas B; Sykes, Jane E; Fleer, Katryna A

    2015-11-15

    To determine incidence rates (IRs) and potential risk factors for owner-reported adverse events (AEs) following vaccination of dogs that did or did not receive a Leptospira vaccine. Observational, retrospective cohort study. 130,557 dogs. Electronic records of mobile veterinary clinics from June 2012 to March 2013 were searched to identify dogs that received ≥ 1 vaccine in a given visit. Signalment data, vaccinations received, medications administered, and owner-reported clinical signs consistent with AEs that developed ≤ 5 days after vaccination were recorded. Associations between potential risk factors and owner-reported AEs were evaluated by logistic regression analysis. The IR/10,000 dogs for owner-reported postvaccination AEs was 26.3 (95% CI, 23.6 to 29.2), whereas that for dogs that received a Leptospira vaccine alone or with other vaccines was 53.0 (95% CI, 42.8 to 64.9). Significant factors for increasing or decreasing risk of AEs were as follows: receiving a Leptospira vaccine (adjusted OR, 2.13), age at vaccination 1 to dogs), and IRs for these events did not differ significantly between dogs vaccinated with or without a Leptospira component. The overall IR for owner-reported postvaccination AEs was low. Results suggested vaccination against Leptospira (an organism that can cause fatal disease) is safe in the majority of cases, slightly increasing the risk of owner-reported AEs but not associated with a significant increase in hypersensitivity reactions, compared with other vaccinations administered.

  13. Mixing in a stratified shear flow: Energetics and sampling

    Science.gov (United States)

    Ivey, G. N.; Koseff, J. R.; Briggs, D. A.; Ferziger, J. H.

    1993-01-01

    Direct numerical simulations of the time evolution of homogeneous stably stratified shear flows have been performed for Richardson numbers from 0 to 1 and for Prandtl numbers between 0.1 and 2. The results indicate that mixing efficiency R(sub f) varies with turbulent Froude number in a manner consistent with laboratory experiments performed with Prandtl numbers of 0.7 and 700. However, unlike the laboratory results, for a particular Froude number, the simulations do not show a clear dependence on the magnitude of R(sub f) on Pr. The observed maximum value of R(sub f) is 0.25. When averaged over vertical length scales of an order of magnitude greater than either the overturning or Ozmidov scales of the flow, the simulations indicate that the dissipation rate epsilon is only weakly lognormally distributed with an intermittency of about 0.01 whereas estimated values in the ocean are 3 to 7.

  14. The optimism trap: Migrants' educational choices in stratified education systems.

    Science.gov (United States)

    Tjaden, Jasper Dag; Hunkler, Christian

    2017-09-01

    Immigrant children's ambitious educational choices have often been linked to their families' high level of optimism and motivation for upward mobility. However, previous research has mostly neglected alternative explanations such as information asymmetries or anticipated discrimination. Moreover, immigrant children's higher dropout rates at the higher secondary and university level suggest that low performing migrant students could have benefitted more from pursuing less ambitious tracks, especially in countries that offer viable vocational alternatives. We examine ethnic minority's educational choices using a sample of academically low performing, lower secondary school students in Germany's highly stratified education system. We find that their families' optimism diverts migrant students from viable vocational alternatives. Information asymmetries and anticipated discrimination do not explain their high educational ambitions. While our findings further support the immigrant optimism hypothesis, we discuss how its effect may have different implications depending on the education system. Copyright © 2017. Published by Elsevier Inc.

  15. Investigations on flow reversal in stratified horizontal flow

    International Nuclear Information System (INIS)

    Staebler, T.; Meyer, L.; Schulenberg, T.; Laurien, E.

    2005-01-01

    The phenomena of flow reversal in stratified flows are investigated in a horizontal channel with application to the Emergency Core Cooling System (ECCS) in Pressurized Water Reactors (PWR). In case of a Loss-of-Coolant-Accident (LOCA), coolant can be injected through a secondary pipe within the feeding line of the primary circuit, the so called hot leg, counter-currently to the steam flow. It is essential that the coolant reaches the reactor core to prevent overheating. Due to high temperatures in such accident scenarios, steam is generated in the core, which escapes from the reactor vessel through the hot leg. In case of sufficiently high steam flow rates, only a reduced amount of coolant or even no coolant will be delivered to the reactor core. The WENKA test facility at the Institute for Nuclear and Energy Technologies (IKET) at Forschungszentrum Karlsruhe is capable to investigate the fluid dynamics of two-phase flows in such scenarios. Water and air flow counter-currently in a horizontal channel made of clear acrylic glass to allow full optical access. Flow rates of water and air can be varied independently within a wide range. Once flow reversal sets in, a strong hysteresis effect must be taken into account. This was quantified during the present investigations. Local experimental data are needed to expand appropriate models on flow reversal in horizontal two-phase flow and to include them into numerical codes. Investigations are carried out by means of Particle Image Velocimetry (PIV) to obtain local flow velocities without disturbing the flow. Due to the wavy character of the flow, strong reflections at the interfacial area must be taken into account. Using fluorescent particles and an optical filter allows eliminating the reflections and recording only the signals of the particles. The challenges in conducting local investigations in stratified wavy flows by applying optical measurement techniques are discussed. Results are presented and discussed allowing

  16. Classification of archaeologically stratified pumice by INAA

    International Nuclear Information System (INIS)

    Peltz, C.; Bichler, M.

    2001-01-01

    In the framework of the research program 'Synchronization of Civilization in the Eastern Mediterranean Region in the 2nd Millenium B.C.' instrumental neutron activation analysis (INAA) was used to determine 30 elements in pumice from archaeological excavations to reveal their specific volcanic origin. The widespread pumiceous products of several eruptions in the Aegean region were used as abrasive tools and were therefore popular trade objects. A remarkable quantity of pumice and pumiceous tephra (several km 3 ) was produced by the 'Minoan eruption' of Thera (Santorini), which is assumed to have happened between 1450 and 1650 B.C. Thus the discovery of the primary fallout of 'Minoan' tephra in archaeologically stratified locations can be used as a relative time mark. Additionally, pumice lumps used as abrasive can serve for dating by first appearance. Essential to an identification of the primary volcanic source is the knowledge that pumices from the Aegean region can easily be distinguished by their trace element distribution patterns, as previous work has shown. The elements Al, Ba, Ca, Ce, Co, Cr, Cs, Dy, Eu, Fe, Hf, K, La, Lu, Mn, Na, Nd, Rb, Sb, Sc, Sm, Ta, Tb, Th, Ti, U, V, Yb, Zn and Zr were determined in 16 samples of pumice lumps from excavations in Tell-el-Dab'a and Tell-el-Herr (Egypt). Two irradiation cycles and five measurement runs were applied. A reliable identification of the samples is achieved by comparing these results to the database compiled in previous studies. (author)

  17. Spiral arms in thermally stratified protoplanetary discs

    Science.gov (United States)

    Juhász, Attila; Rosotti, Giovanni P.

    2018-02-01

    Spiral arms have been observed in nearly a dozen protoplanetary discs in near-infrared scattered light and recently also in the submillimetre continuum. While one of the most compelling explanations is that they are driven by planetary or stellar companions, in all but one cases such companions have not yet been detected and there is even ambiguity on whether the planet should be located inside or outside the spirals. Here, we use 3D hydrodynamic simulations to study the morphology of spiral density waves launched by embedded planets taking into account the vertical temperature gradient, a natural consequence of stellar irradiation. Our simulations show that the pitch angle of the spirals in thermally stratified discs is the lowest in the disc mid-plane and increases towards the disc surface. We combine the hydrodynamic simulations with 3D radiative transfer calculations to predict that the pitch angle of planetary spirals observed in the near-infrared is higher than in the submillimetre. We also find that in both cases the spirals converge towards the planet. This provides a new powerful observational method to determine if the perturbing planet is inside or outside the spirals, as well as map the thermal stratification of the disc.

  18. Experimental study of unsteady thermally stratified flow

    International Nuclear Information System (INIS)

    Lee, Sang Jun; Chung, Myung Kyoon

    1985-01-01

    Unsteady thermally stratified flow caused by two-dimensional surface discharge of warm water into a oblong channel was investigated. Experimental study was focused on the rapidly developing thermal diffusion at small Richardson number. The basic objectives were to study the interfacial mixing between a flowing layer of warm water and an underlying body of cold water and to accumulate experimental data to test computational turbulence models. Mean velocity field measurements were carried out by using NMR-CT(Nuclear Magnetic Resonance-Computerized Tomography). It detects quantitative flow image of any desired section in any direction of flow in short time. Results show that at small Richardson number warm layer rapidly penetrates into the cold layer because of strong turbulent mixing and instability between the two layers. It is found that the transfer of heat across the interface is more vigorous than that of momentum. It is also proved that the NMR-CT technique is a very valuable tool to measure unsteady three dimensional flow field. (Author)

  19. Trends in breast cancer incidence rates by age and tumor characteristics of women in the city of Isfahan for the period 2001-2010: An application of joinpoint analysis

    Directory of Open Access Journals (Sweden)

    Mehdi Tazhibi

    2014-01-01

    Full Text Available Background: Cancer incidence trends use by health officials in order to program evaluations and development of cancer control strategies. The trends of cancer incidence have used to evaluate programs and develop the cancer control strategies. The aim of this study is to analyze changes of breast cancer incidence trends in Isfahan city using joinpoint regression models. Materials and Methods: The study was based on all cases of breast cancer reported among women residing in the city of Isfahan for the period 2001-2010. Age-standardized rates were calculated for each tumor characteristics, using the direct method. Joinpoint regression was used to provide estimated annual percentage change. Results: A plot of the age-specific rates of breast cancer showed an increase in all age groups from 30 to 69 years and sharp increase in the incidence of breast cancer confined to estrogen receptor-positive and progesterone receptor-positive tumors and the significant change (2003 by progesterone receptor− tumors. The analysis by tumor size and grade, incidence rates decreased for tumors >5 cm by 10.6% since 2006.7 and for poorly differentiated tumor by 26.1% since 2007.8. No decrease in incidence was observed for group of proportion of positive lymph nodes to lymph node surgery ≥25%. The proportion of positive lymph node to surgery node ≤25% (nonsignificant was upward. Conclusion: The trend of incidence rates with tumor size ≤2, well-differentiated tumor grade, moderately differentiated tumor grade, positive estrogen and progesterone hormone receptors was upward. The pattern of breast cancer can help to cancer prevention and prognosis, selecting the best type of surgery.

  20. Use of Boosted Protease Inhibitors Reduces Kaposi Sarcoma Incidence Among Male Veterans With HIV Infection

    Science.gov (United States)

    Kowalkowski, Marc A.; Kramer, Jennifer R.; Richardson, Peter R.; Suteria, Insia; Chiao, Elizabeth Y.

    2015-01-01

    Background. Kaposi sarcoma (KS) incidence has decreased since combination antiretroviral therapy (cART). However, effects of cART type and duration on KS remain difficult to interpret secondary to KS-associated immune reconstitution inflammatory syndrome (IRIS). Methods. We performed a retrospective study of Veterans Affairs Human Immunodeficiency Virus Clinical Case Registry data from 1985 to 2010. We analyzed the relationship between cART regimens and KS using multivariable Poisson regression, stratified or adjusted for timing around cART initiation. KS was identified by ≥1 inpatient or ≥2 outpatient International Classification of Diseases, Ninth Revision codes (176.0–9). Percent of cART on specific regimen and total duration on specific regimen were examined. Results. There were 341 KS cases among 25 529 HIV-infected male veterans (incidence rate = 2.02/1000 person-years). Stratified by years after starting cART, every additional 10% time on boosted protease inhibitors (BPIs) was associated with reduced KS incidence in the third year of cART (incidence rate ratio [IRR] = 0.79; 95% confidence interval [CI], .69–.90). Months on BPIs was associated with lower KS incidence (P = .02). KS incidence was lower at 12–23 (IRR = 0.47; 95% CI, .23–.95) and ≥36 (IRR = 0.14; 95% CI, .02–1.00) months on BPIs compared with <6 months. Longer duration on other regimens was not associated with decreased KS incidence. Conclusions. Lower KS incidence was observed with longer BPI use, after accounting for potential IRIS and other factors. Future research should evaluate newer cART regimens and long-term benefits of PI-based cART on KS in other cohorts and prospective studies. PMID:25586682

  1. The Values of Combined and Sub-Stratified Imaging Scores with Ultrasonography and Mammography in Breast Cancer Subtypes.

    Directory of Open Access Journals (Sweden)

    Tsun-Hou Chang

    Full Text Available The Breast Imaging Reporting and Data System (BI-RADS of Mammography (MG and Ultrasonography (US were equivalent to the "5-point score" and applied for combined and sub-stratified imaging assessments. This study evaluated the value of combined and sub-stratified imaging assessments with MG and US over breast cancer subtypes (BCS.Medical records of 5,037 cases having imaging-guided core biopsy, performed from 2009 to 2012, were retrospectively reviewed. This study selected 1,995 cases (1,457 benign and 538 invasive cancer having both MG and US before biopsy. These cases were categorized with the "5-point score" for their MG and US, and applied for combined and sub-stratified imaging assessments. Invasive cancers were classified on the basis of BCS, and correlated with combined and sub-stratified imaging assessments.These selected cases were evaluated by the "5-point score." MG, US, and combined and sub-stratified imaging assessments all revealed statistically significant (P < 0.001 incidence of malignancy. The sensitivity was increased in the combined imaging score (99.8%, and the specificity was increased in the sub-stratified combined score (75.4%. In the sub-stratified combined imaging assessment, all BCS can be classified with higher scores (abnormality hierarchy, and luminal B subtype showed the most salient result (hierarchy: higher, 95%; lower, 5%.Combined and sub-stratified imaging assessments can increase sensitivity and specificity of breast cancer diagnosis, respectively, and Luminal B subtype shows the best identification by sub-stratified combined imaging scoring.

  2. Nadir CD4+, religion, antiretroviral therapy, incidence of type 2 diabetes mellitus, and increasing rates of obesity among black Africans with HIV disease

    Directory of Open Access Journals (Sweden)

    Mbungu Fuele S

    2012-11-01

    Full Text Available Madone Mandina Ndona,1 Benjamin Longo-Mbenza,2 Roger Wumba,3 Barthelemy Tandu Umba,4 Baudouin Buassa-bu-Tsumbu,5 Marcel Mbula Mambimbi,1 Thaddée Odio Wobin,1 Simon Mbungu Fuele61Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo; 2Walter Sisulu University, Faculty of Health Sciences, Mthatha, Eastern Cape, South Africa; 3Tropical Medicine Department, Infectious and Parasitic Diseases, University Clinic of Kinshasa and University of Kinshasa, Kinshasa, Democratic Republic of Congo; 4Department of Gynecology, 5Department of Biochemistry, University of Kinshasa, Kinshasa, Democratic Republic of Congo; 6Biostatistics Unit of Lomo Medical Center and Heart of Africa Center of Cardiology, Kinshasa, Democratic Republic of CongoBackground: The purpose of this study was to determine the cross-sectional association between some sociodemographic factors and antiretroviral therapy (ART, as well as the incidence and predictors of type 2 diabetes mellitus among Central Africans with human immunodeficiency virus (HIV disease.Methods: This study had a cross-sectional design and was a prospective analysis of 102 patients with HIV disease (49 on ART versus 53 not on ART in Kinshasa, Democratic Republic of Congo, between 2004 and 2008. A Cox regression model was used to assess for any relationship between type 2 diabetes and exposure to combination ART without protease inhibitors, after adjusting for known risk factors for type 2 diabetes, nadir CD4 and CD8 levels, viral load, marital status, and religion.Results: Unexpectedly elevated rates of smoking, excess alcohol intake, and ART-related total, abdominal, and peripheral obesity were observed in our study group of HIV patients. At the end of follow-up, five patients were diagnosed with type 2 diabetes (incidence rate 4.9%, 9.8 per 1000 person-years. Univariate risk factors for type 2 diabetes were male gender (relative risk [RR] 1.1, 95% confidence interval [CI] 1

  3. ABDOMINAL CLOSURE WITH ANTI BACTERIAL COATED SUTURE MATERIALS AND ITS RELATION TO THE INCIDENCE OF POST OPERATIVE SUPERFICIAL SURGICAL SITE INFECTION RATES

    Directory of Open Access Journals (Sweden)

    Josephine Pudumai Selvi

    2017-07-01

    Full Text Available BACKGROUND Surgical site infection (SSI is an immense burden on healthcare resources even in the modern era of immaculate sterilization approaches and highly effective antibiotics. An estimated 234 million various surgical procedures, involving skin incisions requiring various types of wound closure techniques, are performed in the world, with the majority resulting in a wound healing by primary intention. Triclosan (5-chloro-2-(2, 4-dichlorophenoxy phenol is a broad-spectrum bactericidal agent that has been used for more than 40 years in various products, such as toothpaste and soaps. Higher concentrations of Triclosan work as a bactericide by attacking different structures in the bacterial cytoplasm and cell membrane. Use of Triclosan-coated sutures should theoretically result in the reduction of SSI. The aim of the study is to assess the abdominal closure with antibacterial coated suture materials and its relation to the incidence of post-operative superficial surgical site infection rates. MATERIALS AND METHODS The data will be collected from hospital records of surgery performed, post-operative daily progress notes and outpatient folders and telephonic conversations with patients after discharge. All patients undergoing laparotomy procedure for any cause. 100 patients divided as 50 in each group. RESULTS The positive outcome of infection (21.5% in patients using ordinary sutures was significantly differed with the positive outcome of infection (11.4% of Triclosan coated sutures. CONCLUSION In conclusion since there was a definite advantage inferred to the patients by using Triclosan coated polyglactin 910, it is the opinion of the researcher that Triclosan coated sutures has a role to play in reducing SSI in clean wounds and its use should be confined to areas where its application has proven benefits. However more studies should be done to clearly define its role and indications in surgery.

  4. Modelling of vapour explosion in stratified geometrie

    International Nuclear Information System (INIS)

    Picchi, St.

    1999-01-01

    When a hot liquid comes into contact with a colder volatile liquid, one can obtain in some conditions an explosive vaporization, told vapour explosion, whose consequences can be important on neighbouring structures. This explosion needs the intimate mixing and the fine fragmentation between the two liquids. In a stratified vapour explosion, these two liquids are initially superposed and separated by a vapor film. A triggering of the explosion can induce a propagation of this along the film. A study of experimental results and existent models has allowed to retain the following main points: - the explosion propagation is due to a pressure wave propagating through the medium; - the mixing is due to the development of Kelvin-Helmholtz instabilities induced by the shear velocity between the two liquids behind the pressure wave. The presence of the vapour in the volatile liquid explains experimental propagation velocity and the velocity difference between the two fluids at the pressure wave crossing. A first model has been proposed by Brayer in 1994 in order to describe the fragmentation and the mixing of the two fluids. Results of the author do not show explosion propagation. We have therefore built a new mixing-fragmentation model based on the atomization phenomenon that develops itself during the pressure wave crossing. We have also taken into account the transient aspect of the heat transfer between fuel drops and the volatile liquid, and elaborated a model of transient heat transfer. These two models have been introduced in a multi-components, thermal, hydraulic code, MC3D. Results of calculation show a qualitative and quantitative agreement with experimental results and confirm basic options of the model. (author)

  5. [Incidence and mortality of female breast cancer in China, 2014].

    Science.gov (United States)

    Li, H; Zheng, R S; Zhang, S W; Zeng, H M; Sun, K X; Xia, C F; Yang, Z X; Chen, W Q; He, J

    2018-03-23

    Objective: To estimate the incidence and mortality of female breast cancer in China based on the cancer registration data in 2014, collected by the National Central Cancer Registry (NCCR), and to provide support data for breast cancer prevention and control in China. Methods: There were 449 cancer registries submitting female breast cancer incidence and deaths data occurred in 2014 to NCCR. After evaluating the data quality, 339 registries' data were accepted for analysis and stratified by areas (urban/rural) and age group. Combined with data on national population in 2014, the nationwide incidence and mortality of female breast cancer were estimated. Chinese population census in 2000 and Segi's population were used for age-standardized incidence/mortality rates. Results: Qualified 339 cancer registries covered a total of 288 243 347 populations (144 061 915 in urban and 144 181 432 in rural areas) in 2014. The morphology verified cases (MV%) accounted for 87.42% and 0.59% of incident cases were identified through death certifications only (DCO%), with mortality to incidence ratio of 0.24. The estimates of new breast cancer cases were about 278 900 in China in 2014, accounting for 16.51% of all new cases in female. The crude incidence rate, age-standardized rate of incidence by Chinese standard population (ASRIC), and age-standardized rate of incidence by world standard population (ASRIW) of breast cancer were 41.82/100 000, 30.69/100 000, and 28.77/100 000, respectively, with a cumulative incidence rate (0-74 age years old) of 3.12%. The crude incidence rates and ASRIC in urban areas were 49.94 per 100 000 and 34.85 per 100 000, respectively, whereas those were 31.72 per 100 000 and 24.89 per 100 000 in rural areas. The estimates of breast cancer deaths were about 66 000 in China in 2014, accounting for 7.82% of all the cancer-related deaths in female. The crude mortality rate, age-standardized rate of mortality by Chinese standard population(ASRMC) and age

  6. Internal wave patterns in enclosed density-stratified and rotating fluids

    NARCIS (Netherlands)

    Manders, A.M.A.

    2003-01-01

    Stratified fluids support internal waves, which propagate obliquely through the fluid. The angle with respectto the stratification direction is contrained: it is purely determined by the wave frequency and the strength of the density stratification (internal gravity waves) or the rotation rate

  7. Longevity of Compositionally Stratified Layers in Ice Giants

    Science.gov (United States)

    Friedson, A. J.

    2017-12-01

    In the hydrogen-rich atmospheres of gas giants, a decrease with radius in the mixing ratio of a heavy species (e.g. He, CH4, H2O) has the potential to produce a density stratification that is convectively stable if the heavy species is sufficiently abundant. Formation of stable layers in the interiors of these planets has important implications for their internal structure, chemical mixing, dynamics, and thermal evolution, since vertical transport of heat and constituents in such layers is greatly reduced in comparison to that in convecting layers. Various processes have been suggested for creating compositionally stratified layers. In the interiors of Jupiter and Saturn, these include phase separation of He from metallic hydrogen and dissolution of dense core material into the surrounding metallic-H envelope. Condensation of methane and water has been proposed as a mechanism for producing stable zones in the atmospheres of Saturn and the ice giants. However, if a stably stratified layer is formed adjacent to an active region of convection, it may be susceptible to progressive erosion as the convection intrudes and entrains fluid into the unstable envelope. We discuss the principal factors that control the rate of entrainment and associated erosion and present a specific example concerning the longevity of stable layers formed by condensation of methane and water in Uranus and Neptune. We also consider whether the temporal variability of such layers may engender episodic behavior in the release of the internal heat of these planets. This research is supported by a grant from the NASA Solar System Workings Program.

  8. Experimental Observation of the Stratified Electrothermal Instability on Aluminum with Thickness Greater than a Skin Depth

    Energy Technology Data Exchange (ETDEWEB)

    Hutchinson, Trevor M. [Univ. of Nevada, Reno, NV (United States); Hutchinson, Trevor M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Awe, Thomas James [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bauer, Bruno S. [Univ. of Nevada, Reno, NV (United States); Yates, Kevin [Univ. of New Mexico, Albuquerque, NM (United States); Yu, Edmund p. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Yelton, William G. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Fuelling, Stephan [Univ. of Nevada, Reno, NV (United States)

    2017-07-01

    The first direct observation of the stratified electrothermal instability on the surface of thick metal is reported. Aluminum rods coated with 70 μm Parylene-N were driven to 1 MA in approximately 100 ns, with the metal thicker than the skin depth. The dielectric coating suppressed plasma formation, enabling persistent observation of discrete azimuthally-correlated stratified structures perpendicular to the current. Strata amplitudes grow rapidly, while their Fourier spectrum shifts toward longer wavelength. Assuming blackbody emission, radiometric calculations indicate strata are temperature perturbations that grow exponentially with rate γ = 0.04 ns -1 in 3000- 10,000 K aluminum.

  9. Incidence of fractures in patients with multiple sclerosis: the Danish National Health Registers

    DEFF Research Database (Denmark)

    Bazelier, M. T.; de Vries, F.; Bentzen, J.

    2012-01-01

    Background: Patients with multiple sclerosis (MS) are potentially at high risk of fracture due to falls and osteoporosis. Objective: To estimate incidence rates of fractures in MS patients, stratified by fracture type, sex and age, and to compare these rates with controls. Methods: The case...... population consisted of all patients with an accepted diagnosis of MS in the Danish MS Registry (1949-2007). Data were linked to the National Hospital Discharge Register (1977-2007). Patients with MS (n = 11,157) were 1: 6 matched by year of birth, gender, calendar time and region to persons without MS...

  10. Incidence and prevalence of episcleritis and scleritis in Northern California.

    Science.gov (United States)

    Honik, Grace; Wong, Ira G; Gritz, David C

    2013-12-01

    To evaluate the incidence and prevalence of episcleritis and scleritis in a large well-defined population in Northern California. Secondary analysis was performed on data from the Northern California Epidemiology of Uveitis Study. The patient database of a large regional health maintenance organization was searched for all patients who potentially experienced ocular inflammatory disease during the 12-month study period. Medical records were reviewed for all potential patients to confirm ocular inflammatory disease and specific diagnosis, establish the time of onset, and collect additional data. Age- and sex-stratified quarterly study population data were used to calculate incidence rates and prevalence ratios. After reviewing 2011 possible cases, 297 new-onset cases of episcleritis, 39 prior-onset cases of episcleritis, 25 new-onset cases of scleritis, and 8 prior-onset cases of scleritis were confirmed. For episcleritis, the overall incidence was 41.0 per 100,000 person-years and an annual prevalence ratio of 52.6 per 100,000. The overall incidence of scleritis was 3.4 per 100,000 person-years and an annual prevalence ratio of 5.2 per 100,000 persons. For both episcleritis and scleritis, there was a statistically significant increase in eye disease in older patients (P = 0.05 and episcleritis (P = 0.017). This study found that patients with scleritis were older than those with episcleritis and that women had higher rates of both episcleritis and scleritis compared with what men had.

  11. A criterion for the onset of slugging in horizontal stratified air-water countercurrent flow

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Moon-Hyun; Lee, Byung-Ryung; Kim, Yang-Seok [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)] [and others

    1995-09-01

    This paper presents an experimental and theoretical investigation of wave height and transition criterion from wavy to slug flow in horizontal air-water countercurrent stratified flow conditions. A theoretical formula for the wave height in a stratified wavy flow regime has been developed using the concept of total energy balance over a wave crest to consider the shear stress acting on the interface of two fluids. From the limiting condition of the formula for the wave height, a necessary criterion for transition from a stratified wavy flow to a slug flow has been derived. A series of experiments have been conducted changing the non-dimensional water depth and the flow rates of air in a horizontal pipe and a duct. Comparisons between the measured data and the predictions of the present theory show that the agreement is within {plus_minus}8%.

  12. Two-phase air-water stratified flow measurement using ultrasonic techniques

    International Nuclear Information System (INIS)

    Fan, Shiwei; Yan, Tinghu; Yeung, Hoi

    2014-01-01

    In this paper, a time resolved ultrasound system was developed for investigating two-phase air-water stratified flow. The hardware of the system includes a pulsed wave transducer, a pulser/receiver, and a digital oscilloscope. The time domain cross correlation method is used to calculate the velocity profile along ultrasonic beam. The system is able to provide velocities with spatial resolution of around 1mm and the temporal resolution of 200μs. Experiments were carried out on single phase water flow and two-phase air-water stratified flow. For single phase water flow, the flow rates from ultrasound system were compared with those from electromagnetic flow (EM) meter, which showed good agreement. Then, the experiments were conducted on two-phase air-water stratified flow and the results were given. Compared with liquid height measurement from conductance probe, it indicated that the measured velocities were explainable

  13. A criterion for the onset of slugging in horizontal stratified air-water countercurrent flow

    International Nuclear Information System (INIS)

    Chun, Moon-Hyun; Lee, Byung-Ryung; Kim, Yang-Seok

    1995-01-01

    This paper presents an experimental and theoretical investigation of wave height and transition criterion from wavy to slug flow in horizontal air-water countercurrent stratified flow conditions. A theoretical formula for the wave height in a stratified wavy flow regime has been developed using the concept of total energy balance over a wave crest to consider the shear stress acting on the interface of two fluids. From the limiting condition of the formula for the wave height, a necessary criterion for transition from a stratified wavy flow to a slug flow has been derived. A series of experiments have been conducted changing the non-dimensional water depth and the flow rates of air in a horizontal pipe and a duct. Comparisons between the measured data and the predictions of the present theory show that the agreement is within ±8%

  14. Gas slug ascent through rheologically stratified conduits

    Science.gov (United States)

    Capponi, Antonio; James, Mike R.; Lane, Steve J.

    2016-04-01

    Textural and petrological evidence has indicated the presence of viscous, degassed magma layers at the top of the conduit at Stromboli. This layer acts as a plug through which gas slugs burst and it is thought to have a role in controlling the eruptive dynamics. Here, we present the results of laboratory experiments which detail the range of slug flow configurations that can develop in a rheologically stratified conduit. A gas slug can burst (1) after being fully accommodated within the plug volume, (2) whilst its base is still in the underlying low-viscosity liquid or (3) within a low-viscosity layer dynamically emplaced above the plug during the slug ascent. We illustrate the relevance of the same flow configurations at volcanic-scale through a new experimentally-validated 1D model and 3D computational fluid dynamic simulations. Applied to Stromboli, our results show that gas volume, plug thickness, plug viscosity and conduit radius control the transition between each configuration; in contrast, the configuration distribution seems insensitive to the viscosity of magma beneath the plug, which acts mainly to deliver the slug into the plug. Each identified flow configuration encompasses a variety of processes including dynamic narrowing and widening of the conduit, generation of instabilities along the falling liquid film, transient blockages of the slug path and slug break-up. All these complexities, in turn, lead to variations in the slug overpressure, mirrored by changes in infrasonic signatures which are also associated to different eruptive styles. Acoustic amplitudes are strongly dependent on the flow configuration in which the slugs burst, with both acoustic peak amplitudes and waveform shapes reflecting different burst dynamics. When compared to infrasonic signals from Stromboli, the similarity between real signals and laboratory waveforms suggests that the burst of a slug through a plug may represent a viable first-order mechanism for the generation of

  15. Wheelchair incidents

    NARCIS (Netherlands)

    Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM

    2002-01-01

    This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with

  16. Epidemiological studies on disturbances of human fetal development in areas with various doses of natural background radiation. I. Relationship between incidences of Down's syndrome or visible malformation and gonad dose equivalent rate of natural background radiation

    International Nuclear Information System (INIS)

    Ujeno, Y.

    1985-01-01

    The relationship between environmental radiation to the gonads and incidences of Down's syndrome and visible malformation was analyzed using Kendall's rank correlation method. The subjects, studied during a 3-yr period (1979-1981), were inhabitants of 46 prefectures in Japan that had various dose rates of natural background ionizing radiation. Results showed that the natural background very low-dose radiation rate was not a predominant factor responsible for inducing Down's syndrome or other visible malformations

  17. Uma metodologia para estimar a incidência a partir de prevalências obtidas em Pesquisas Nacionais por Amostra de Domicílios: o exemplo da alfabetização A methodology to estimate incidence from prevalence rates in household surveys: the example of literacy

    Directory of Open Access Journals (Sweden)

    Greice Maria Silva da Conceição

    2008-06-01

    Full Text Available Conhecer a incidência de algum evento por idade e tempo é sem dúvida um dos maiores interesses da epidemiologia. Devido à relação matemática que existe entre as medidas de incidência e prevalência, alguns métodos foram desenvolvidos com o objetivo de obter a incidência a partir da prevalência. Este estudo descreve, de forma tutorial, um método que fornece estimativas de incidências por idade e tempo desde que existam prevalências repetidas de um evento, que a ocorrência do mesmo esteja relacionada à idade do indivíduo e que este possua características de uma doença crônica. O estudo foi realizado para a alfabetização da população brasileira, utilizando as prevalências por idade obtidas na Pesquisa Nacional por Amostra de Domicílios (PNAD 1981, 1985, 1989, 1992, 1995 e 2001, e permitiu recuperar as estimativas da incidência de alfabetização nas idades entre 5 e 20 anos entre os anos de 1960 a 2000. O método ajusta os parâmetros de incidência para idade e tempo com o auxílio de um modelo linear generalizado para dados categóricos e utiliza o algoritmo EM para obter os dados não observados.Age and time-specific incidence rates are highly relevant to epidemiologists. Due to the mathematical relationship between incidence and prevalence, several methods have been developed to obtain incidence based on prevalence. The present study didactically describes a method to estimate age and time incidence, based on: repeated measurements of prevalence for an event; events related to the individual's age; and events with the characteristics of a chronic disease. The method was used to analyze literacy in the Brazilian population, using prevalence by age obtained from the National Household Sample Survey (PNAD for 1981, 1985, 1989, 1992, 1995, and 2001, and allowed obtaining literacy incidence estimates for ages 5 to 20 years, for the years 1960 through 2001. The method adjusts incidence parameters for age and time with the

  18. Incidence Angle Effect of Energetic Carbon Ions on Deposition Rate, Topography, and Structure of Ultrathin Amorphous Carbon Films Deposited by Filtered Cathodic Vacuum Arc

    KAUST Repository

    Wang, N.

    2012-07-01

    The effect of the incidence angle of energetic carbon ions on the thickness, topography, and structure of ultrathin amorphous carbon (a-C) films synthesized by filtered cathodic vacuum arc (FCVA) was examined in the context of numerical and experimental results. The thickness of a-C films deposited at different incidence angles was investigated in the light of Monte Carlo simulations, and the calculated depth profiles were compared with those obtained from high-resolution transmission electron microscopy (TEM). The topography and structure of the a-C films were studied by atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS), respectively. The film thickness decreased with the increase of the incidence angle, while the surface roughness increased and the content of tetrahedral carbon hybridization (sp 3) decreased significantly with the increase of the incidence angle above 45° , measured from the surface normal. TEM, AFM, and XPS results indicate that the smoothest and thinnest a-C films with the highest content of sp 3 carbon bonding were produced for an incidence angle of 45°. The findings of this study have direct implications in ultrahigh-density magnetic recording, where ultrathin and smooth a-C films with high sp 3 contents are of critical importance. © 2012 IEEE.

  19. [Hyponatremia associated with SSRI/NRSI: Descriptive and comparative epidemiological study of the incidence rates of the notified cases from the data of the French National Pharmacovigilance Database and the French National Health Insurance].

    Science.gov (United States)

    Revol, R; Rault, C; Polard, E; Bellet, F; Guy, C

    2017-12-14

    Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are frequently prescribed. These antidepressants can potentially induce serious hyponatremia through the SIADH syndrome. That seems to concern all molecules of these classes but the individual risk of each molecule is not well known. The aims of the study were to compare the incidence rate of each molecule in order to identify the existence of molecules more at risk of inducing hyponatremia and to characterize a profile of patients at risk for hyponatremia during a treatment with a SSRI or a SNRI. The cases of hyponatremia under SSRI/SNRI were extracted from the French pharmacovigilance database (BPNV). The exposition to the different SSRIs/SNRIs in the French population was estimated from the French National Health Insurance database (SNIIRAM) using a sampled database (Echantillon Généralistes des Bénéficiaires). The study ran from 01/01/2011 to 31/12/2013. The primary study endpoint was the incidence rate of notifications of the hyponatremia cases in patients treated by SSRI/SNRI and recorded into the BNPV database, related to the average annual number of corresponding treatments initiated during the same period. The number of cases of hyponatremia included in the study was 169 for 3 749 800 adult patients initiating treatment. The incidence rate of cases was 1.64 for 100 000 persons per year (PY). The standardized incidence rates between the different molecules showed no difference except for duloxetine (2.79/100 000 PY p > 0.03). Identified risk factors were age, with a large increase of incidence rate from 75 years old (incidence 12.5 higher) and female gender. Comparison of the incidence rates from spontaneous reports indicates a greater risk of hyponatremia for duloxetine for 2011-2013. This result needs to be confirmed by other studies. The advanced age and female sex are risk factors, irrespective of the molecule. Copyright © 2017 L

  20. Concussion in field hockey: a retrospective analysis into the incidence rates, mechanisms, symptoms and recovery of concussive injuries sustained by elite field hockey players

    Science.gov (United States)

    Rossiter, Michael; Challis, Michael

    2017-01-01

    Objectives To identify the incidence and mechanisms of concussion in elite Field Hockey in different age groups and also the postconcussion symptoms and recovery times. Methods Data was collected retrospectively, for both training and matches, over a 12-month period from national level Field Hockey players across under-16, under-18, under-21, Development and Senior players. Mechanism of injury (including player role and field position), postconcussive symptoms and recovery times were recorded following a semistructured interview with each player. Additional information on training hours, matches and squad size were also recorded in order to calculate the incidence per 1000 match hours. Results Of the 28 recorded cases, only 11 could be included in the study. Women had the highest incidence of concussion, with the majority being in the under-21 age group. Overall incidence varied from 3/1000 match hours in training to 0.02/1000 match hours in matches, with an overall incidence of 0–0.02/1000 match hours across all age groups. The most common mechanism of injury was collision with another player, followed by impact from a stick or ball Midfield and attacking forwards sustained the highest incidence of concussion. None of the concussed athletes wore protective headgear (there were no cases of concussion in goal keepers) and all occurred in open play rather than a penalty corner (when protective headgear is often worn). Postconcussion headaches and difficulty concentrating were the most commonly reported postconcussion symptoms. Average recovery time and return-to-play was 2–4 weeks. Conclusions Due to the low numbers, only limited conclusions can be made, but it would appear that the risk of concussion in elite Field Hockey is low. As age and skill increases, the risk decreases. Postconcussion symptoms and average return-to-play times are similar to other sports. From this study, no conclusions can be made as to the role of protective headgear to reduce the risk

  1. Resource-stratified implementation of a community-based breast cancer management programme in Peru.

    Science.gov (United States)

    Duggan, Catherine; Dvaladze, Allison L; Tsu, Vivien; Jeronimo, Jose; Constant, Tara K Hayes; Romanoff, Anya; Scheel, John R; Patel, Shilpen; Gralow, Julie R; Anderson, Benjamin O

    2017-10-01

    Breast cancer incidence and mortality rates continue to rise in Peru, with related deaths projected to increase from 1208 in 2012, to 2054 in 2030. Despite improvements in national cancer control plans, various barriers to positive breast cancer outcomes remain. Multiorganisational stakeholder collaboration is needed for the development of functional, sustainable early diagnosis, treatment and supportive care programmes with the potential to achieve measurable outcomes. In 2011, PATH, the Peruvian Ministry of Health, the National Cancer Institute in Lima, and the Regional Cancer Institute in Trujillo collaborated to establish the Community-based Program for Breast Health, the aim of which was to improve breast health-care delivery in Peru. A four-step, resource-stratified implementation strategy was used to establish an effective community-based triage programme and a practical early diagnosis scheme within existing multilevel health-care infrastructure. The phased implementation model was initially developed by the Breast Cancer Initiative 2·5: a group of health and non-governmental organisations who collaborate to improve breast cancer outcomes. To date, the Community-based Program for Breast Health has successfully implemented steps 1, 2, and 3 of the Breast Cancer Initiative 2·5 model in Peru, with reports of increased awareness of breast cancer among women, improved capacity for early diagnosis among health workers, and the creation of stronger and more functional linkages between the primary levels (ie, local or community) and higher levels (ie, district, region, and national) of health care. The Community-based Program for Breast Health is a successful example of stakeholder and collaborator involvement-both internal and external to Peru-in the design and implementation of resource-appropriate interventions to increase breast health-care capacity in a middle-income Latin American country. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Convergence of decreasing male and increasing female incidence rates in major tobacco-related cancers in Europe in 1988-2010

    NARCIS (Netherlands)

    J.G.A. Lortet-Tieulent (Joannie); E. Renteria (Elisenda); L. Sharp (Linda); E. Weiderpass (Elisabete); H. Comber; P. Baas (Paul); F. Bray (Freddie); J.W.W. Coebergh (Jan Willem); I. Soerjomataram (Isabelle)

    2013-01-01

    textabstractIntroduction: Smoking prevalence has been declining in men all over Europe, while the trend varies in European regions among women. To study the impact of past smoking prevalence, we present a comprehensive overview of the most recent trends in incidence, during 1988-2010, in 26

  3. Increasing Incidence in Relapsing-Remitting MS and High Rates among Young Women in Finland: A Thirty-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Marja-Liisa Sumelahti

    2014-01-01

    Full Text Available Object. Gender and disease course specific incidences were studied in high- and medium-risk regions of MS in Finland. Methods. Age- and gender-specific incidences with 95% CIs were calculated in 10-year periods from 1981 to 2010. Poser diagnostic criteria were used and compared with the McDonald criteria from 2001 to 2010. Association between age and diagnostic delay over time was assessed by using the Kruskal-Wallis test. Results. 1419 (89% RRMS and 198 (11% PPMS cases were included. RRMS incidence increased with the female to male ratio (F/M from 4,2/105 (F/M 1.9 to 9,7 (2.3, while that of PPMS decreased from 1,2 (1.6 to 0,7 (1.2. The use of McDonald criteria did not change the conclusion. The decreasing diagnostic delay and age at diagnosis in RRMS were associated within the 10-year periods and contrasted those in PPMS. Increasing female risk in RRMS was observed in the high-risk region. Conclusion. Increasing RRMS incidence and high female ratios shown in each age group indicate gender-specific influences acting already from childhood. A more precise definition of the risk factors and their action in MS is needed to provide a better understanding of underlying pathological processes and a rationale for the development of new preventive and treatment strategies.

  4. Cancer incidence and mortality in China, 2013.

    Science.gov (United States)

    Chen, Wanqing; Zheng, Rongshou; Zhang, Siwei; Zeng, Hongmei; Xia, Changfa; Zuo, Tingting; Yang, Zhixun; Zou, Xiaonong; He, Jie

    2017-08-10

    National Central Cancer Registry of China (NCCRC) updated nationwide statistics of cancer incidence and mortality in China using population-based cancer registration data in 2013 from all available cancer registries. In 2016, 255 registries' data were qualified and included in this analysis. We estimated numbers of new cancer cases and deaths in China in 2013 using age-specific rates and corresponding national population stratified by area, sex, age group (0, 1-4, 5-9, 10-14…85+) and cancer type. The world Segi's population was applied for age-standardized rates. All rates were expressed per 100,000 person-year. A total of 3,682,000 new cancer cases and 2,229,300 cancer deaths were estimated in China in 2013. Cancers of lung, female breast, stomach, liver, colon-rectum and esophagus were the most common cancers, accounting for about half of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer were the five leading causes of cancer death, accounting for about 60% of all cancer deaths. The cancer patterns showed differences not only between male and female, but also among different geographic regions in China. For overall cancers, the age-standardized incidence rates were stable during the past decades in male, but significantly increased by 2.2% per year in female. Cancer poses a major threat to public health and the cancer burden keep raising in China. The annual updated cancer statistics can provide scientific basis for cancer prevention and control. Copyright © 2017. Published by Elsevier B.V.

  5. Personalized medicine for prevention: can risk stratified screening decrease colorectal cancer mortality at an acceptable cost?

    Science.gov (United States)

    Subramanian, Sujha; Bobashev, Georgiy; Morris, Robert J; Hoover, Sonja

    2017-04-01

    Tailored health care interventions are expected to transform clinical practice. The objective of this study was to develop an innovative model to assess the effectiveness, cost, and harms of risk stratified colorectal cancer screening. We updated a previously validated microsimulation model consisting of three interlinked components: risk assessment, natural history, and screening/treatment modules. We used data from representative national surveys and the literature to create a synthetic population that mimics the family history and genetic profile of the US population. We applied risk stratification based on published risk assessment tools to triage individuals into five risk categories: high, increased, medium, decreased, and low. On average, the incremental cost of risk stratified screening for colorectal cancer compared to the current approach at 60% and 80% compliance rates is $18,342 and $23,961 per life year gained. The harms in terms of false positives and perforations are consistently lower for personalized scenarios across all compliance rates. False positives are reduced by more than 47.0% and perforations by at least 9.9%. There is considerable uncertainty in the life years gained, but the reduction in harms remains stable under all scenarios. A key finding is that risk stratified screening can reduce harms at all levels of compliance. Therefore, selection of screening scenarios should include comprehensive comparisons of mortality, harms from screening, and cost. This study provides guidance for evaluating risk stratified cancer screening and further research is required to identify optimal implementation approaches in the real-world setting.

  6. Partially coherent light propagation in stratified media containing an optically thick anisotropic layer

    Science.gov (United States)

    Nichols, Shane M.; Arteaga, Oriol; Martin, Alexander T.; Kahr, Bart

    2017-11-01

    Methods used to compute the reflection or transmission Mueller matrix of stratified media assume light is a monochromatic plane wave, but measurements with spectroscopic devices invariably involve a finite distribution of wavelengths and incidence angles. Consequently, there can be stark disagreement between calculation and experiment, especially when the specimen includes a thick non-opaque layer. To accurately model specimens with a thick layer, it is sometimes necessary to explicitly include the coherence of the light in models. For anisotropic and/or optically active media, we distinguish between five regimes of coherence. Algebraic expressions valid for all regimes are given. Experimental data spanning multiple regimes is modeled.

  7. The stratified H-index makes scientific impact transparent

    DEFF Research Database (Denmark)

    Würtz, Morten; Schmidt, Morten

    2017-01-01

    The H-index is widely used to quantify and standardize researchers' scientific impact. However, the H-index does not account for the fact that co-authors rarely contribute equally to a paper. Accordingly, we propose the use of a stratified H-index to measure scientific impact. The stratified H......-index supplements the conventional H-index with three separate H-indices: one for first authorships, one for second authorships and one for last authorships. The stratified H-index takes scientific output, quality and individual author contribution into account....

  8. Incidence of anogenital warts in Germany: a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Mikolajczyk Rafael T

    2010-12-01

    Full Text Available Abstract Background Human papilloma virus (HPV types 6 and 11 account for 90 percent of anogenital warts (AGW. Assessment of a potential reduction of the incidence of AGW following introduction of HPV vaccines requires population-based incidence rates. The aim of this study was to estimate incidence rates of AGW in Germany, stratified by age, sex, and region. Additionally, the medical practitioner (gynaecologist, dermatologist, urologist etc. who made the initial diagnosis of AGW was assessed. Methods Retrospective cohort study in a population aged 10 to 79 years in a population-based healthcare insurance database. The database included more than 14 million insurance members from all over Germany during the years 2004-2006. A case of AGW was considered incident if a disease-free period of twelve months preceded the diagnosis. To assess regional variation, analyses were performed by federal state. Results The estimated incidence rate was 169.5/100,000 person-years for the German population aged 10 to 79 years. Most cases occurred in the 15 to 40 years age group. The incidence rate was higher and showed a peak at younger ages in females than in males. The highest incidence rates for both sexes were observed in the city-states Berlin, Hamburg and Bremen. In females, initial diagnosis of AGW was most frequently made by a gynaecologist (71.7%, whereas in males, AGW were most frequently diagnosed by a dermatologist (44.8% or urologist (25.1%. Conclusions Incidence of AGW in Germany is comparable with findings for other countries. As expected, most cases occurred in the younger age groups. The frequency of diagnoses of AGW differs between sexes and women and men receive treatment by doctors of different specialties.

  9. A situação do câncer de mama em Goiás, no Brasil e no mundo: tendências atuais para a incidência e a mortalidade Breast cancer in Goiás, in Brazil and in the World: current incidence and mortality rates

    Directory of Open Access Journals (Sweden)

    Régis Resende Paulinelli

    2003-03-01

    Full Text Available O câncer de mama apresenta elevada incidência e mortalidade em todo o mundo, representando um grave problema de saúde pública. A incidência dessa neoplasia vem aumentando nas últimas décadas, mesmo em áreas de tradicional baixa incidência, em grande parte devido às mudanças nos hábitos de vida e no perfil epidemiológico da população. Vários países desenvolvidos têm conseguido, apesar desse aumento na incidência, reduzir a sua mortalidade, através de um diagnóstico mais precoce e de um tratamento mais eficaz. Nesse artigo comentamos as tendências atuais para o câncer de mama em vários locais do mundo, de forma comparativa, bem como os possíveis fatores envolvidos nessas mudanças. Dispensamos particular atenção à situação do Brasil, e da cidade de Goiânia.Breast cancer has the highest incidence and mortality rates in the whole World, and is a severe public health issue. This type of neoplasia has been increasing in the last decades, even in areas of traditional low incidence in part due to changes in the lifestyle and epidemiological profile of the population. Various developed countries, notwithstanding this incidence increase, have succeeded to reduce mortality through early diagnosis and more efficacious treatment. This paper compares current breast cancer trend in various parts of World, as well as the possible factors involved in this change of pattern. Especial emphasis is placed on the problem in our country Brazil, and in our city, Goiânia.

  10. Stratifying risk in the prevention of recurrent variceal hemorrhage: Results of an individual patient meta-analysis.

    Science.gov (United States)

    Albillos, Agustín; Zamora, Javier; Martínez, Javier; Arroyo, David; Ahmad, Irfan; De-la-Peña, Joaquin; Garcia-Pagán, Juan-Carlos; Lo, Gin-Ho; Sarin, Shiv; Sharma, Barjesh; Abraldes, Juan G; Bosch, Jaime; Garcia-Tsao, Guadalupe

    2017-10-01

    Endoscopic variceal ligation plus beta-blockers (EVL+BB) is currently recommended for variceal rebleeding prophylaxis, a recommendation that extends to all patients with cirrhosis with previous variceal bleeding irrespective of prognostic stage. Individualizing patient care is relevant, and in published studies on variceal rebleeding prophylaxis, there is a lack of information regarding response to therapy by prognostic stage. This study aimed at comparing EVL plus BB with monotherapy (EVL or BB) on all-source rebleeding and mortality in patients with cirrhosis and previous variceal bleeding stratified by cirrhosis severity (Child A versus B/C) by means of individual time-to-event patient data meta-analysis from randomized controlled trials. The study used individual data on 389 patients from three trials comparing EVL plus BB versus BB and 416 patients from four trials comparing EVL plus BB versus EVL. Compared with BB alone, EVL plus BB reduced overall rebleeding in Child A (incidence rate ratio 0.40; 95% confidence interval, 0.18-0.89; P = 0.025) but not in Child B/C, without differences in mortality. The effect of EVL on rebleeding was different according to Child (P for interaction EVL, EVL plus BB reduced rebleeding in both Child A and B/C, with a significant reduction in mortality in Child B/C (incidence rate ratio 0.46; 95% confidence interval, 0.25-0.85; P = 0.013). Outcomes of therapies to prevent variceal rebleeding differ depending on cirrhosis severity: in patients with preserved liver function (Child A), combination therapy is recommended because it is more effective in preventing rebleeding, without modifying survival, while in patients with advanced liver failure (Child B/C), EVL alone carries an increased risk of rebleeding and death compared with combination therapy, underlining that BB is the key element of combination therapy. (Hepatology 2017;66:1219-1231). © 2017 by the American Association for the Study of Liver Diseases.

  11. Revisiting the concept of ‘chronic disease’ from the perspective of the episode of care model. Does the ratio of incidence to prevalence rate help us to define a problem as chronic?

    Directory of Open Access Journals (Sweden)

    Jean K Soler

    2013-12-01

    Full Text Available Background This is a study of the epidemiology of acute and chronic episodes of care (EoCs in the Transition Project in three countries. We studied the duration of EoCs for acute and chronic health problems and the relationship of incidence to prevalence rates for these EoCs.Method The Transition Project databases collect data on all elements of the doctor–patient encounter in family medicine. Family doctors code these elements using the International Classification of Primary Care.We used the data from three practice populations to study the duration of EoCs and the ratio of incidence to prevalence for common health problems.Results We found that chronic health problems tended to have proportionately longer duration EoCs, as expected, but also a lower incidence to prevalence rate ratio than acute health problems. Thus, the incidence to prevalence index could be used to define a chronic condition as one with a low ratio, below a defined threshold.Conclusions Chronic health problems tend to have longer duration EoCs, proportionately, across populations. This result is expected, but we found important similarities and differences which make defining a problem as chronic on the basis of time rather difficult. The ratio of incidence to prevalence rates has potential to categorise health problems into acute or chronic categories, at different ratio thresholds (such as 20, 30 or 50%. It seems to perform well in this study of three family practice populations, and is proposed to the scientific community for further evaluation.

  12. An 'epidemic' of multiple sclerosis and falling infection rates? Reflecting on comparisons made and the rising multiple sclerosis incidence in Bach's 2002 New England Journal of Medicine figure.

    Science.gov (United States)

    Tremlett, H; Lucas, R

    2018-01-01

    We set out to revisit and comment on the evidence surrounding a popular figure published in the New England Journal of Medicine (2002), which suggests that the incidence of immune-mediated diseases, including multiple sclerosis (MS), is increased by reduced exposure to infections. Commentary. We found that, to date (May 2017), this influential article has been cited >2000 times. However, on close investigation of the figure, we noticed some problems. Specifically, we observed several challenges inherent in using ecological data from disparate studies and countries to make conclusions surrounding the temporal patterns and relationships between diseases. For example, the figure depicts incidence data for MS based solely on a limited group of individuals with MS (n = 637; 455 women and 182 men) living within the region of Sassari on the island of Sardinia, known for its unique genealogy and risk of MS. However, the infectious-related data were based primarily on large population studies from the USA, with one derived from army recruits in France. We encourage the scientific community to apply rigorous, consistent methods in order to confirm or refute whether a strong, direct relationship does or does not exist between the incidence of MS and infectious diseases. Further, our article highlights a major knowledge gap that would benefit from a thorough review of the temporal trends related to MS incidence. Collation of this wide body of knowledge may provide a balanced understanding of this important topic and would best serve the progress of MS research. © 2017 EAN.

  13. Plume Splitting in a Two-layer Stratified Ambient Fluid

    Science.gov (United States)

    Ma, Yongxing; Flynn, Morris; Sutherland, Bruce

    2017-11-01

    A line-source plume descending into a two-layer stratified ambient fluid in a finite sized tank is studied experimentally. Although the total volume of ambient fluid is fixed, lower- and upper-layer fluids are respectively removed and added at a constant rate mimicking marine outfall through diffusers and natural and hybrid ventilated buildings. The influence of the plume on the ambient depends on the value of λ, defined as the ratio of the plume buoyancy to the buoyancy loss of the plume as it crosses the ambient interface. Similar to classical filling-box experiments, the plume can always reach the bottom of the tank if λ > 1 . By contrast, if λ < 1 , an intermediate layer eventually forms as a result of plume splitting. Eventually all of the plume fluid spreads within the intermediate layer. The starting time, tv, and the ending time, tt, of the transition process measured from experiments correlate with the value of λ. A three-layer ambient fluid is observed after transition, and the mean value of the measured densities of the intermediate layer fluid is well predicted using plume theory. Acknowledgments: Funding for this study was provided by NSERC.

  14. Clinical research in small genomically stratified patient populations.

    Science.gov (United States)

    Martin-Liberal, J; Rodon, J

    2017-07-01

    The paradigm of early drug development in cancer is shifting from 'histology-oriented' to 'molecularly oriented' clinical trials. This change can be attributed to the vast amount of tumour biology knowledge generated by large international research initiatives such as The Cancer Genome Atlas (TCGA) and the use of next generation sequencing (NGS) techniques developed in recent years. However, targeting infrequent molecular alterations entails a series of special challenges. The optimal molecular profiling method, the lack of standardised biological thresholds, inter- and intra-tumor heterogeneity, availability of enough tumour material, correct clinical trials design, attrition rate, logistics or costs are only some of the issues that need to be taken into consideration in clinical research in small genomically stratified patient populations. This article examines the most relevant challenges inherent to clinical research in these populations. Moreover, perspectives from the Academia point of view are reviewed as well as initiatives to be taken in forthcoming years. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Incidence of type 2 diabetes in Japan: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Atsushi Goto

    Full Text Available The definition of incident type 2 diabetes varies across studies; hence, the actual incidence of type 2 diabetes in Japan is unclear. Here, we reviewed the various definitions of incident type 2 diabetes used in previous epidemiologic studies and estimated the diabetes incidence rate in Japan.We searched for related literature in the MEDLINE, EMBASE, and Ichushi databases through September 2012. Two reviewers selected studies that evaluated incident type 2 diabetes in the Japanese population.From 1824 relevant articles, we included 33 studies with 386,803 participants. The follow-up period ranged from 2.3 to 14 years and the studies were initiated between 1980 and 2003. The random-effects model indicated that the pooled incidence rate of diabetes was 8.8 (95% confidence interval, 7.4-10.4 per 1000 person-years. We observed a high degree of heterogeneity in the results (I(2 = 99.2%; p < 0.001, with incidence rates ranging from 2.3 to 52.6 per 1000 person-years. Three studies based their definition of incident type 2 diabetes on self-reports only, 10 on laboratory data only, and 20 on self-reports and laboratory data. Compared with studies defining diabetes using laboratory data (n = 30; pooled incidence rate = 9.6; 95% confidence interval = 8.3-11.1, studies based on self-reports alone tended to show a lower incidence rate (n = 3; pooled incidence rate = 4.0; 95% confidence interval = 3.2-5.0; p for interaction < 0.001. However, stratified analyses could not entirely explain the heterogeneity in the results.Our systematic review and meta-analysis indicated the presence of a high degree of heterogeneity, which suggests that there is a considerable amount of uncertainty regarding the incidence of type 2 diabetes in Japan. They also suggested that laboratory data may be important for the accurate estimation of the incidence of type 2 diabetes.

  16. Incidents analysis

    International Nuclear Information System (INIS)

    Francois, P.

    1996-01-01

    We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs

  17. Medication incidents reported to an online incident reporting system.

    LENUS (Irish Health Repository)

    Alrwisan, Adel

    2011-01-15

    AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

  18. A review of recent developments on turbulent entrainment in stratified flows

    International Nuclear Information System (INIS)

    Cotel, Aline J

    2010-01-01

    Stratified interfaces are present in many geophysical flow situations, and transport across such an interface is an essential factor for correctly evaluating the physical processes taking place at many spatial and temporal scales in such flows. In order to accurately evaluate vertical and lateral transport occurring when a turbulent flow impinges on a stratified interface, the turbulent entrainment and vorticity generation mechanisms near the interface must be understood and quantified. Laboratory experiments were performed for three flow configurations: a vertical thermal, a sloping gravity current and a vertical turbulent jet with various tilt angles and precession speeds. All three flows impinged on an interface separating a two-layer stably stratified environment. The entrainment rate is quantified for each flow using laser-induced fluorescence and compared to predictions of Cotel and Breidenthal (1997 Appl. Sci. Res. 57 349-66). The possible applications of transport across stratified interfaces include the contribution of hydrothermal plumes to the global ocean energy budget, turbidity currents on the ocean floor, the design of lake de-stratification systems, modeling gas leaks from storage reservoirs, weather forecasting and global climate change.

  19. Experiments on one-phase thermally stratified flows in nuclear reactor pipe lines

    International Nuclear Information System (INIS)

    Rezende, Hugo Cesar; Navarro, Moyses Alberto; Jordao, Elizabete; Santos, Andre Augusto Campagnole dos

    2009-01-01

    The phenomenon of thermal stratified flows occurs when two different layers of the same liquid at different temperatures flow separately in horizontal pipes without appreciable mixing. This phenomenon was not considered in the design stage of most of the operating nuclear power plants, but in last two decades it has become apparent due to the temperature monitoring of piping systems. The occurrence of temperature differences of about 200 deg C have been found in a narrow band around the hot and cold water interface in components under stratified flows. Loadings due to thermal stratification affected the integrity of safety related piping systems. This paper presents the results of a range of experiments performed to simulate one phase thermally stratified flows in geometry and flow condition representing a nuclear reactor steam generator injection nozzle. They have the objective of studying the flow configurations and understanding the evolution of the thermal stratification process. The driving parameter considered to characterize flow under stratified regime due to difference in specific masses is the Froude number. Different Froude numbers, from 0.018 to 0.22, were obtained in different testes by setting injection cold water flow rates and hot water initial temperatures as planned in the test matrix. Results are presented showing the influence of Froude number on the hot and cold water interface position, temperature gradients and striping phenomenon. (author)

  20. A meta-analysis for the effect of prophylactic GTN on the incidence of post-ERCP pancreatitis and on the successful rate of cannulation of bile ducts

    Directory of Open Access Journals (Sweden)

    Wang Chun-hui

    2010-07-01

    Full Text Available Abstract Background Glyceryl trinitrate (GTN has been shown to be able to relax the sphincter of Oddi (SO both in animals and humans. Theoretically, the use of these compounds during and after endoscopic retrograde cholangiopancreatgraphy (ERCP could relax the biliary and pancreatic sphincters, facilitating cannulation of common bile duct (CBD during the procedure, or minimizing potential pancreatic outflow obstruction after the procedure. However, clinical trials evaluating the protective effect of GTN on the post-endoscopic retrograde cholangiopancreatgraphy pancreatitis (PEP have yielded inconclusive results. This meta-analysis is to systematically assess the effect of prophylactic administration of glyceryl trinitrate (GTN on the prevention of PEP and the effect on the cannulation of bile ducts. Methods By searching PubMed (1966 to September 2009, CENTRAL (Cochrane Controlled trials Register; issue 3, 2009 and EMBASE.com (1984 to September 2009, two independent reviewers systematically identified prospective randomized controlled trials (RCTs detecting the effect of prophylactic GTN on the incidence of PEP and on the cannulation of bile ducts. A meta-analysis of these clinical trials was then performed. Results There are 55/899(6.1% patients suffering PEP in the treatment group versus 95/915(10.4% patients in the placebo group. The overall pooled risk of PEP was significantly lower in the GTN group than in the placebo group (OR 0.56, 95% CI: 0.40 to 0.79, p = 0.001. Subgroup analyses suggested that GTN administered by the sublingual form (OR 0.34,95% CI:0.16 to 0.75, p = 0.007 is more effective than transdermal route(OR 0.64,95% CI:0.40 to 1.01, p = 0.05, and the protective effect of GTN was far more obvious in the centers with high incidence of PEP (OR 0.40, 95% CI:0.24 to 0.67, p = 0.0006 than those centers with a low incidence of PEP (OR 0.75, 95% CI: 0.47 to 1.20, p = 0.22. Additionally, the meta-analysis suggests that GTN was not

  1. Spatio-temporal distribution of Aedes aegypti (Diptera: Culicidae) mitochondrial lineages in cities with distinct dengue incidence rates suggests complex population dynamics of the dengue vector in Colombia.

    Science.gov (United States)

    Jaimes-Dueñez, Jeiczon; Arboleda, Sair; Triana-Chávez, Omar; Gómez-Palacio, Andrés

    2015-04-01

    Aedes aegypti is the primary vector of the four serotypes of dengue virus (DENV1-4), Chikungunya and yellow fever virus to humans. Previous population genetic studies have revealed a particular genetic structure among the vector populations in the Americas that suggests differences in the ability to transmit DENV. In Colombia, despite its high epidemiologic importance, the genetic population structure and the phylogeographic depiction of Ae. aegypti, as well as its relationship with the epidemiologic landscapes in cities with heterogeneous incidence levels, remains unknown. We conducted a spatiotemporal analysis with the aim of determining the genetic structure and phylogeography of Colombian populations of Ae. aegypti among cities with different eco-epidemiologic characteristics with regard to DENV. Mitochondrial cytochrome oxidase C subunit 1 (COI)--NADH dehydrogenase subunit 4 (ND4) genes were sequenced and analyzed from 341 adult mosquitoes collected during 2012 and 2013 in the Colombian cities of Bello, Riohacha and Villavicencio, which exhibit low, medium and high levels of incidence of DENV, respectively. The results demonstrated a low genetic differentiation over time and a high genetic structure between the cities due to changes in the frequency of two highly supported genetic groups. The phylogeographic analyses indicated that one group (associated with West African populations) was found in all the cities throughout the sampling while the second group (associated with East African populations) was found in all the samples from Bello and in only one sampling from Riohacha. Environmental factors such as the use of chemical insecticides showed a significant correlation with decreasing genetic diversity, indicating that environmental factors affect the population structure of Ae. aegypti across time and space in these cities. Our results suggest that two Ae. aegypti lineages are present in Colombia; one that is widespread and related to a West African

  2. Cancer Incidence in Egypt: Results of the National Population-Based Cancer Registry Program

    Directory of Open Access Journals (Sweden)

    Amal S. Ibrahim

    2014-01-01

    Full Text Available Background. This paper aims to present cancer incidence rates at national and regional level of Egypt, based upon results of National Cancer Registry Program (NCRP. Methods. NCRP stratified Egypt into 3 geographical strata: lower, middle, and upper. One governorate represented each region. Abstractors collected data from medical records of cancer centers, national tertiary care institutions, Health Insurance Organization, Government-Subsidized Treatment Program, and death records. Data entry was online. Incidence rates were calculated at a regional and a national level. Future projection up to 2050 was also calculated. Results. Age-standardized incidence rates per 100,000 were 166.6 (both sexes, 175.9 (males, and 157.0 (females. Commonest sites were liver (23.8%, breast (15.4%, and bladder (6.9% (both sexes: liver (33.6% and bladder (10.7% among men, and breast (32.0% and liver (13.5% among women. By 2050, a 3-fold increase in incident cancer relative to 2013 was estimated. Conclusion. These data are the only available cancer rates at national and regional levels of Egypt. The pattern of cancer indicated the increased burden of liver cancer. Breast cancer occupied the second rank. Study of rates of individual sites of cancer might help in giving clues for preventive programs.

  3. Mixed Convection Flow along a Stretching Cylinder in a Thermally Stratified Medium

    Directory of Open Access Journals (Sweden)

    Swati Mukhopadhyay

    2012-01-01

    Full Text Available An analysis for the axisymmetric laminar boundary layer mixed convection flow of a viscous and incompressible fluid towards a stretching cylinder immersed in a thermally stratified medium is presented in this paper. Similarity transformation is employed to convert the governing partial differential equations into highly nonlinear ordinary differential equations. Numerical solutions of these equations are obtained by a shooting method. It is found that the heat transfer rate at the surface is lower for flow in a thermally stratified medium compared to that of an unstratified medium. Moreover, both the skin friction coefficient and the heat transfer rate at the surface are larger for a cylinder compared to that for a flat plate.

  4. Experiments on the Microenvironment and Breathing of a Person in Isothermal and Stratified Surroundings

    DEFF Research Database (Denmark)

    Nielsen, Peter V.; Jensen, Rasmus Lund; Litewnicki, Michal

    2009-01-01

    This study investigates the characteristics of human exhalation. Experiments are performed on a breathing thermal manikin in a test room. The manikin is heated, and an artificial lung is used to generate varying air flows with specific flow rates and temperatures for breathing. Smoke visualisation...... is used to show the formation, movement and disappearance of the exhalation jets from both nose and mouth. The exhalation of breathing without ventilation in the room, and with stratified surroundings (displacement ventilation) is analysed....

  5. Incidence and survival of oropharyngeal cancer in Denmark

    DEFF Research Database (Denmark)

    Jensen, Jakob Schmidt; Jensen, David Hebbelstrup; Grønhøj, Christian

    2018-01-01

    ,000 in 2014 with an AAPC of 5.3. The 5-year RS increased significantly from 33.1% over the period 1980-1984 to 58.5% (25.4% points) over the period 2010-2014. With no significant difference stratified for gender. Tumors located at the palatine tonsils (n = 3333) and salivary gland OPC (n = 90) had...... 1980 to 2014. METHODS: This study included all patients registered in the nationwide Danish Cancer Registry over the period 1980-2014. The age-adjusted incidence rates (AAIR) per 100,000, annual percentage change (APC) and average annual percent change (AAPC) were evaluated. Five-year relative survival...

  6. Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003-2005: a population-based study from the Danish Crohn colitis database

    DEFF Research Database (Denmark)

    Vind, Ida; Riis, L; Jess, T

    2006-01-01

    incidence rates and patient characteristics in Copenhagen County and City. METHODS: All patients diagnosed with IBD during 2003-2005 were followed prospectively. Demographic and clinical characteristics, such as disease extent, extraintestinal manifestations, smoking habits, medical treatment, surgical...... interventions, cancer, and death, were registered. RESULTS: Five-hundred sixty-two patients were diagnosed with IBD, resulting in mean annual incidences of 8.6/10(5) for CD, 13.4/10(5) for UC, and 1.1/10(5) for IC. Time from onset to diagnosis was 8.3 months in CD and 4.5 months in UC patients. A family history...... of IBD, smoking, and extraintestinal manifestations was significantly more common in CD than in UC patients. Only 0.6% of UC patients had primary sclerosing cholangitis. In CD, old age at diagnosis was related to pure colonic disease, whereas children significantly more often had proximal and extensive...

  7. The comparative analysis of traumas and poisonings incidence and mortality rates from them at workers and men-employees, workers of the nuclear industry, participants in the rectification of the consequences of the accident at the Chernobyl Atomic Electri

    Directory of Open Access Journals (Sweden)

    Birukov A.P.

    2013-12-01

    Full Text Available The study aims the estimation of incidence of traumas and poisonings, and mortality from them at workers of the Russian nuclear industry, participants in the rectification of the consequences of the accident at the Chernobyl Atomic Electric Power Station, in view of their social structure. Material and methods. Carrying out this research, we used the information base of the Register of the persons exposed by radiation after the Chernobyl accident. There had been registered as of January, 1, 1998: liquidators of 1986-1987 years — 12882 people (men — 84,3%, liquidators of 1988-1990 years —2313 people (men — 88,3%. There had been presented parameters of case rate and mortality of men, separately workers and employees of the given cohort. Results. Lower level of traumas and poisonings incidence at employees had been revealed (2-2,4 times lower, than at the workers, the mortality of traumas and poisonings at employees were also 1,1-2,9 times lower (on the average — in 2,0 times is revealed. The alcoholism essentially raises a traumatism at liquidators. The traumatism above at the liquidators, suffering a chronic alcoholism, in 1,9-3,3 times. The distinctions in coefficients of the mortality from traumas and poisonings and the incidence by them for age groups of the men-liquidators were revealed. Conclusion. The essential difference in parameters of men-liquidators' health, workers of the nuclear industry, and workers shows that a social factor renders significant influence on health of a studied contingent of persons. Age features in many respects define value of parameters of incidence of traumas and poisonings and death rates from them a studied contingent. In radiation epidemiological researches it is necessary to consider biological and social factors necessarily.

  8. Cuban Ocular Toxoplasmosis Epidemiology Study (COTES): incidence and prevalence of ocular toxoplasmosis in Central Cuba.

    Science.gov (United States)

    Bustillo, Jorge L; Diaz, Jose D; Pacheco, Idarmes C; Gritz, David C

    2015-03-01

    Serological studies indicate that rates of ocular toxoplasmosis (OT) vary geographically, with higher rates in tropical regions. Little is known about population-based rates of active OT. We aimed to describe the epidemiology of OT in Central Cuba. This large-population, cross-sectional cohort study used a prospective database at a large regional referral centre in Central Cuba. The patient database was searched for all patients who presented with OT during the 12-month study period from 1 April 2011 to 31 March 2012. Inclusion criteria were the clinical diagnosis of OT, characterised by focal retinochoroidal inflammation and a response to therapy as expected. Gender-stratified and age-stratified study population data from the 2012 Cuban Census were used to calculate incidence rates and prevalence ratios. Among 279 identified patients with OT, 158 presented with active OT. Of these, 122 new-onset and 36 prior-onset cases were confirmed. Based on the total population in the Sancti Spiritus province (466,106 persons), the overall incidence of active OT was 26.2 per 100,000 person-years (95% CI 21.7 to 31.3) with an annual prevalence ratio of 33.9 per 100,000 persons (95% CI 28.8 to 39.6). The incidence of active OT was lowest in the oldest age group and highest in patients aged 25-44 years (4.5 and 42.1 per 100,000 person-years, respectively). This first report describing population-based rates of OT in the Cuban population highlights the importance of patient age as a likely risk factor for OT. Disease rates were found to be highest in females and young to middle-aged adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. PERBEDAAN LAJU KECEPATAN TERJADINYA HIPERTENSI MENURUT KONSUMSI NATRIUM [STUDI KOHORT PROSPEKTIF DI KOTA BOGOR, JAWA BARAT, INDONESIA] (THE INCIDENCE RATE DIFFERENCE OF HYPERTENSION ACCORDING TO SODIUM CONSUMPTION [A PROSPECTIVE COHORT STUDY IN BOGOR CIT

    Directory of Open Access Journals (Sweden)

    Ekowati Rahajeng

    2017-01-01

    Full Text Available ABSTRACTHypertension is one of the leading causes of death in the world.The amount of dietary of salt or sodium consumed is important determinant of hypertension. The purpose of analysis is to identify the differences between incidence rate of hypertension according to sodium cosumption.The study is part of a prospective cohort study of Non Communicable Diseases conducted since 2011, in Bogor City West Java, Indonesia. Data were collected by interview and blood pressure measurement. Event of hypertension was defined when in the 1-year of follow-up, participant had a high blood pressure in at least 2 of the 3 measurements. The consumption of sodium was collected through 24-hour dietary recall. The analysis conducted in 2561 participants were do not have hypertension, consist of 94 people with high sodium consumption and 2467 people with low sodium consumption . Data were analyzed by Life Table Survival to calculate the incidence rate of hypertension, with statistical test Wilcoxon (Gehan to determine incidence rate difference of hypertension according to risk factors. The incidence rate of hypertension in 4-years observations was 58 per 1000 person-year. Adjusted by age and gender, fat and sugar consumption, fruit and vegetable consumption, physical inactivity, and smoking(AHR 71 vs 22 per 1000 person-years, shown that the incidence rate of hypertension in people who consume high sodium, significantly faster than people who consume low-sodium. The incidence rate difference of hypertension between the high and low sodium consumption was 49 per 1,000 person-years.  ABSTRAK Hipertensi merupakan salah satu penyebab utama kematian di dunia. Jumlah garam atau natrium yang dikonsumsi merupakan determinan penting terjadinya hipertensi. Tujuan analisis ini untuk mengidentifikasi perbedaan laju kecepatan terjadinya hipertensi pada orang dewasa, menurut jumlah natrium yang dikonsumsi. Studi ini merupakan bagian dari Studi Kohort Penyakit Tidak Menular yang

  10. Suicidal ideation and suicide attempts in children and adolescents with bipolar disorder: a systematic review of prevalence and incidence rates, correlates, and targeted interventions.

    Science.gov (United States)

    Hauser, Marta; Galling, Britta; Correll, Christoph U

    2013-08-01

    Pediatric bipolar disorder (PBD) is associated with poor outcomes, including suicidal ideation (SI) and suicide attempt (SA). However, frequencies and risk factors of SI/SA and targeted intervention trials for SI/SA in PBD have not been reviewed systematically. We conducted a systematic PubMed review, searching for articles reporting on prevalences/incidences, correlates and intervention studies targeting SI/SA in PBD. Weighted means were calculated, followed by an exploratory meta-regression of SI and SA correlates. Fourteen studies (n = 1595), in which 52.1% of patients were male and the mean age was 14.4 years, reported data on SI/SA prevalence (N = 13, n = 1508) and/or correlates (N = 10, n = 1348) in PBD. Weighted mean prevalences were: past SI = 57.4%, past SA = 21.3%, current SI = 50.4%, and current SA = 25.5%; incidences (mean 42 months of follow-up) were: SI = 14.6% and SA = 14.7%. Regarding significant correlates, SI (N = 3) was associated with a higher percentage of Caucasian race, narrow (as opposed to broad) PBD phenotype, younger age, and higher quality of life than SA. Significant correlates of SA (N = 10) included female sex, older age, earlier illness onset, more severe/episodic PBD, mixed episodes, comorbid disorders, past self-injurious behavior/SI/SA, physical/sexual abuse, parental depression, family history of suicidality, and poor family functioning. Race, socioeconomic status, living situation, and life events were not clearly associated with SA. In a meta-regression analysis, bipolar I disorder and comorbid attention-deficit hyperactivity disorder were significantly associated with SA. Only one open label study targeting the reduction of SI/SA in PBD was identified. SI and SA are very common but under-investigated in PBD. Exploration of predictors and protective factors is imperative for the establishment of effective preventive and intervention strategies, which are urgently needed. © 2013 John Wiley & Sons A/S. Published by John Wiley

  11. Incidence, malignancy rates of diagnoses and cyto-histological correlations in the new Italian Reporting System for Thyroid Cytology: An institutional experience.

    Science.gov (United States)

    Straccia, P; Santoro, A; Rossi, E D; Brunelli, C; Mosseri, C; Musarra, T; Pontecorvi, A; Lombardi, C P; Fadda, G

    2017-12-01

    FNA biopsy is considered as the most accurate method for the selection of patients with thyroid nodules that need for surgery or for the wait and see management. The aim of the present study is to clarify the risk of malignancy for the cytological data classified according to the 2014 Italian reporting system. We report a retrospective analysis of 4043 patients in our institution's experience during the period April 2014 through December 2016 with the Italian reporting system for thyroid cytology. The diagnostic incidences of the 4043 cases were as follows: 9.8% TIR1; 1.3% TIR1C; 70% TIR2; 6.6% TIR3A; 4.5% TIR3B; 2.4% TIR4; 5.2% TIR5. A repeated aspiration was carried out in 68 out of 269 cases (25%) classified as TIR3A. A total of 407 cases with cytology underwent surgical resection. A malignant neoplasm was detected in 261 out of 407 (64%) cases. Regarding TIR3B, surgical excision was undertaken in 109 cases, which included 42 high-risk lesions and 67 Hürthle cell neoplasms. The risk of malignancy was significantly higher in the former compared to the latter (50% vs 9%; PReporting System concerning the mutual frequency of the diagnostic categories. The risk of malignancy is perfectly within the range of the estimated values. © 2017 John Wiley & Sons Ltd.

  12. Effect of turbulence and convection on melting of the ice shelves in stratified environment

    Science.gov (United States)

    Gayen, Bishakdatta; Mondal, Mainak; Griffiths, Ross

    2017-11-01

    We have performed high-resolution simulations to investigate the convective boundary layer when a wall of ice dissolves into stratified seawater under polar ocean conditions. Under the stratified ambient condition, melt water spreads out into the interior in a series of nearly horizontal layers due to double diffusive convection. The layer thickness depends on the ambient density gradient and the difference in density between the freezing point (interface temperature) and the ambient water temperature. For a small O(1) m hight box the layers are laminar and results for layer depth are in agreement with the experimental results. However, for significantly higher ice walls the layer scaling differs as a result of turbulent mixing. Stratification has a significant effect on melt rate which further helps in the shaping of ice-wall. The temperature and density structures found under Pine Island Glacier show several layers having a vertical scale that can also be explained by this study.

  13. Addition of 24 hour heart rate variability parameters to the cardiovascular health study stroke risk score and prediction of incident stroke : The cardiovascular health study

    NARCIS (Netherlands)

    Bodapati, R.K.; Kizer, J.R.; Kop, W.J.; Stein, P.K.

    2017-01-01

    Background Heart rate variability (HRV) characterizes cardiac autonomic functioning. The association of HRV with stroke is uncertain. We examined whether 24‐hour HRV added predictive value to the Cardiovascular Health Study clinical stroke risk score (CHS‐SCORE), previously developed at the baseline

  14. Suicide in Recent Onset Psychosis Revisited: Significant Reduction of Suicide Rate over the Last Two Decades - A Replication Study of a Dutch Incidence Cohort.

    Directory of Open Access Journals (Sweden)

    Stynke Castelein

    Full Text Available This study aims to compare the suicide risk over the past decade following recent onset psychosis to findings from the eighties and nineties in the same catchment area and to identify predictors of suicide in the context of the Psychosis Recent Onset Groningen-Survey (PROGR-S. A medical file search was carried out to determine the current status of all patients admitted between 2000 and 2009. The suicide rate was compared with a study executed in 1973-1988 in the same catchment area. Predictors of suicide were investigated using Cox regression. The status of 424 of the 614 patients was known in July 2014. Suicide occurred in 2.4% of patients with psychosis disorders (n = 10; mean follow-up 5.6 years; 6 out of 10 suicides took place within two years. Within two decades, the suicide rate dropped from 11% (follow-up 15 years, 8.5% after 5 years to 2.4%. The Standardized Mortality Rate (SMR of suicides compared with the general population was 41.6. A higher age was the only significant predictor for suicide. Neuroticism, living situation, disorganized and negative symptoms, and passive coping style all showed a trend for significance. A significant reduction in the suicide rate was found for people with psychosis over the past decades. Given the high SMR, suicide research should be given the highest priority. Identifying predictors may contribute to further reduction of suicide among patients with psychosis.

  15. Do neighborhood demographics, crime rates, and alcohol outlet density predict incidence, severity, and outcome of hospitalization for traumatic injury? A cross-sectional study of Dallas County, Texas, 2010.

    Science.gov (United States)

    Cook, Alan; Gonzalez, Jennifer Reingle; Balasubramanian, Bijal A

    2014-12-01

    Unintentional injury leads all other causes of death for those 1 to 45 years old. The expense of medical care for injured people is estimated to exceed $406 billion annually. Given this burden on the population, the Centers for Disease Control and Prevention consistently refers to injury prevention as a national priority. We postulated that exposure to crime and the density of alcohol outlets in one's neighborhood will be positively associated with the incidence of hospitalization for and mortality from traumatic injuries, independent of other neighborhood characteristics. We conducted a cross-sectional study with ecological and individual analyses. Patient-level data for traumatic injury, injury severity, and hospital mortality due to traumatic injury in 2010 were gathered from the Dallas-Fort Worth Hospital Council Foundation. Each case of traumatic injury or death was geospatially linked with neighborhood of origin information from the 2010 U.S. Census within Dallas County, Texas. This information was subsequently linked with crime data gathered from 20 local police departments and the Texas Alcoholic Beverage Commission alcohol outlet dataset. The crime data are the Part One crimes reported to the Federal Bureau of Investigation. The proportion of persons 65 years old or older was the strongest predictor of the incidence of hospitalization for traumatic injury (b = 12.64, 95% confidence interval (CI) 8.73 to 16.55). In turn, the incidence of traumatic injury most strongly predicted the severity of traumatic injury (b = 0.008, 95% CI 0.0003 - 0.0012). The tract-level unemployment rate was associated with a 5% increase in the odds of hospital mortality among hospitalized trauma patients. Several neighborhood characteristics were associated with the incidence, severity, and hospital mortality from traumatic injury. However, crime rates and alcohol outlet density carried no such association. Prevention efforts should focus on neighborhood characteristics such

  16. [Incidence and mortality of stomach cancer in China, 2013].

    Science.gov (United States)

    Zhang, S W; Yang, Z X; Zheng, R S; Zeng, H M; Chen, W Q; He, J

    2017-07-23

    Objective: To estimate the incidence and mortality of stomach cancer in China based on the cancer registration data in 2013, collected by the National Central Cancer Registry (NCCR). Methods: There were 347 cancer registries that submitted stomach cancer incidence and deaths occurred in 2013 to NCCR. After evaluating the data quality, 255 registries' data were accepted for analysis and stratified by areas (urban/rural), sex, and age group. Combined with data on national population in 2013, the nationwide incidence and mortality of stomach cancer were estimated. Chinese population census in 2000 and Segi's population were used for age-standardized incidence/mortality rates. Results: Qualified 255 cancer registries covered a total of 226 494 490 populations (111 595 772 in urban and 114 898 718 in rural areas). The percentage of cases morphologically verified and death certificate-only cases were 76.27% and 1.98%, respectively, and the mortality to incidence rate ratio was 0.72. It is estimated that there were 427 000 new cases for stomach cancer nationwide, with a crude incidence rate of 31.38 per 100 000 (42.85 per 100 000 in males, 19.33 per 100 000 in females). The age-standardized incidence rates by Chinese standard population (ASR China) and by world standard population (ASR world) were 21.40 per 100 000 and 21.32 per 100 000, respectively, with a cumulative incidence rate (0-74 age years old) of 2.66%. The crude and ASR China incidence rates of stomach cancer in urban areas were 27.80 per 100 000 and 18.48 per 100 000, respectively, whereas those were 35.54 per 100 000 and 24.93 per 100 000 in rural areas. It is estimated that there were 301 000 deaths for stomach cancer nationwide, with a crude mortality rate of 22.13 per 100 000 (29.85 per 100 000 in males, 14.03 per 100 000 in females). The ASR China and ASR world mortality rates were 14.68 per 100 000 and 14.54 per 100 000, respectively, with a cumulative mortality rate (0-74 years old) of 1.70%. The crude

  17. Incidence of the geometric parameters and of flow in the primary ventilation rate and of carbon monoxide emissions in burning atmospherics of medium and high pressure

    International Nuclear Information System (INIS)

    Amell A, Andres; Hernandez V, Jaime; Cortes T, Jaime

    2000-01-01

    In this kind of atmospheric burners, high-pressure gas supply and Venturi geometry guarantee a good primary air entrance for combustion. In this project we analyze the most important burner geometric parameters (outlet diameter, injection diameter and mixer geometry) and gas flux conditions (supply pressure) that have an influence over primary aeration rate. The results of this investigation will contribute with the methodology design improvement, focused to use this kind of burners in our country

  18. Magnetic Field in the Gravitationally Stratified Coronal Loops B. N. ...

    Indian Academy of Sciences (India)

    crucial especially in the magnetic field measurement of longer and long-lived coro- nal structures. The negligence of this factor causes a large amount of uncertainty in the estimation of magnetic field. This result is very important in keeping with the view of the evolution of kink waves in gravitationally stratified coronal loops.

  19. Profiling of poorly stratified atmospheres with scanning lidar

    Science.gov (United States)

    C. E. Wold; V. A. Kovalev; A. P. Petkov; W. M. Hao

    2012-01-01

    The direct multiangle solution may allow inversion of the scanning lidar data even when the requirement of the horizontally stratified atmosphere is poorly met. The solution is based on two principles: (1) The signal measured in zenith is the core source for extracting the information about the atmospheric aerosol loading, and (2) The multiangle signals are used as...

  20. The dynamics of small inertial particles in weakly stratified turbulence

    NARCIS (Netherlands)

    van Aartrijk, M.; Clercx, H.J.H.

    We present an overview of a numerical study on the small-scale dynamics and the large-scale dispersion of small inertial particles in stably stratified turbulence. Three types of particles are examined: fluid particles, light inertial particles (with particle-to-fluid density ratio 1Ͽp/Ͽf25) and

  1. Dispersion of (light) inertial particles in stratified turbulence

    NARCIS (Netherlands)

    van Aartrijk, M.; Clercx, H.J.H.; Armenio, Vincenzo; Geurts, Bernardus J.; Fröhlich, Jochen

    2010-01-01

    We present a brief overview of a numerical study of the dispersion of particles in stably stratified turbulence. Three types of particles arc examined: fluid particles, light inertial particles ($\\rho_p/\\rho_f = \\mathcal{O}(1)$) and heavy inertial particles ($\\rho_p/\\rho_f \\gg 1$). Stratification

  2. Economic Evaluation in Stratified Medicine : Methodological Issues and Challenges

    NARCIS (Netherlands)

    Fugel, Hans-Joerg; Nuijten, Mark; Postma, Maarten; Redekop, Ken

    2016-01-01

    Background: Stratified Medicine (SM) is becoming a practical reality with the targeting of medicines by using a biomarker or genetic-based diagnostic to identify the eligible patient sub-population. Like any healthcare intervention, SM interventions have costs and consequences that must be

  3. Economic evaluation in stratified medicine: Methodological issues and challenges

    NARCIS (Netherlands)

    Fugel, H.-J. (Hans-Joerg); M.J.C. Nuijten (Mark); M.J. Postma (Maarten); W.K. Redekop (Ken)

    2016-01-01

    textabstractBackground: Stratified Medicine (SM) is becoming a practical reality with the targeting of medicines by using a biomarker or genetic-based diagnostic to identify the eligible patient sub-population. Like any healthcare intervention, SM interventions have costs and consequences that must

  4. Stratified Outcome Evaluation of Peritonitis | Wabwire | Annals of ...

    African Journals Online (AJOL)

    Background: The heterogeneity of disease severity in peritonitis makes outcome prediction challenging. Risk evaluation in secondary peritonitis can direct treatment planning, predict outcomes and aid in the conduct of surgical audits. Objective: To determine the outcome of peritonitis in patients stratified according to ...

  5. Plane Stratified Flow in a Room Ventilated by Displacement Ventilation

    DEFF Research Database (Denmark)

    Nielsen, Peter Vilhelm; Nickel, J.; Baron, D. J. G.

    2004-01-01

    The air movement in the occupied zone of a room ventilated by displacement ventilation exists as a stratified flow along the floor. This flow can be radial or plane according to the number of wall-mounted diffusers and the room geometry. The paper addresses the situations where plane flow...

  6. On Internal Waves in a Density-Stratified Estuary

    NARCIS (Netherlands)

    Kranenburg, C.

    1991-01-01

    In this article some field observations, made in recent years, of internal wave motions in a density-stratified estuary are presented, In order to facilitate the appreciation of the results, and to make some quantitative comparisons, the relevant theory is also summarized. Furthermore, the origins

  7. Bacterial production, protozoan grazing, and mineralization in stratified Lake Vechten

    NARCIS (Netherlands)

    Bloem, J.

    1989-01-01

    The role of heterotrophic nanoflagellates (HNAN, size 2-20 μm) in grazing on bacteria and mineralization of organic matter in stratified Lake Vechten was studied.

    Quantitative effects of manipulation and fixation on HNAN were checked. Considerable losses were caused by

  8. On the Jeans Criterion of a Stratified Heat Conducting Gaseous ...

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... Home; Journals; Journal of Astrophysics and Astronomy; Volume 33; Issue 4. On the Jeans Criterion of a Stratified Heat Conducting Gaseous Medium in the Presence of Non-Uniform Rotation and Magnetic Field. Joginder S. Dhiman Rekha Dadwal. Volume 33 Issue 4 December 2012 pp 363-373 ...

  9. On the Jeans Criterion of a Stratified Heat Conducting Gaseous ...

    Indian Academy of Sciences (India)

    homogeneous stratified gaseous medium with finite thermal conductiv- ity and infinite electrical conductivity, in the presence of non-uniform rotation and magnetic field in the Chandrasekhar's frame of reference, is studied. It is found that the magnetic field, whether uniform or non- uniform, has no effect on the Jeans' criterion ...

  10. A structured e-content development framework using a stratified ...

    African Journals Online (AJOL)

    The paper discusses a stratified objectives-driven e-content structuring and deployment framework which is an iterative and intuitive approach to content structuring and sequencing. The model has been developed from experiences and insights gained over a four-stage content development training process involving ...

  11. Incidence of herpes zoster amongst adults varies by severity of immunosuppression.

    Science.gov (United States)

    Schröder, Carsten; Enders, Dirk; Schink, Tania; Riedel, Oliver

    2017-09-01

    We examined the incidence of herpes zoster in immunocompromised adults (≥18 years) with different severities of immunosuppression and assessed the prevalence of complications and of various kinds of healthcare resource utilisation. German claims data from more than ten million adults were used to calculate annual incidence rates of herpes zoster for the years 2006-2012 and to analyse the prevalence of complications, physician visits, hospitalisations, and antiviral and analgesic treatments using a cohort design. The analyses were stratified by age, sex, and severity of immunosuppression, defined by immunocompromising conditions and drug therapies. The incidence rate per 1000 person-years of herpes zoster was almost twice as high in immunocompromised patients (11.5 (95% confidence interval (CI): 11.4-11.6)) compared to immunocompetent subjects (5.9 (95% CI: 5.8-5.9)). The incidence rate was higher in highly immunocompromised patients (13.4 (95% CI: 13.2-13.6)) than in patients with a low severity of immunosuppression (10.0 (95% CI: 9.8-10.1)). These differences were observed for both sexes and in all age groups. Complications, outpatient physician visits, hospitalisations, and analgesic treatments occurred more frequently in immunocompromised patients as well. Our results show that immunocompromised individuals are affected by the disease in particular and that the burden of herpes zoster is highest in severely immunocompromised patients. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  12. Rate of ectasia and incidence of irregular topography in patients with unidentified preoperative risk factors undergoing femtosecond laser-assisted LASIK

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2013-12-01

    Full Text Available Majid Moshirfar,1 Jared G Smedley,2 Valliammai Muthappan,1 Allison Jarsted,3 Erik M Ostler1 1John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2College of Human Medicine, Michigan State University, Lansing, MI, USA; 3Department of Ophthalmology, State University of New York Upstate Medical University, Syracuse, NY, USA Purpose: To report the rate of postoperative ectasia after laser-assisted in situ keratomileusis (LASIK with femtosecond laser-assisted flap creation, in a population of patients with no identified preoperative risk factors. Methods: A retrospective case review of 1,992 eyes (1,364 patients treated between March 2007 and January 2009 was conducted, with a follow up of over 4 years. After identifying cases of ectasia, all the patient charts were examined retrospectively for preoperative findings suggestive of forme fruste keratoconus (FFKC. Results: Five eyes of four patients with post-LASIK ectasia were identified. All eyes passed preoperative screening and received bilateral LASIK. One of the five patients developed ectasia in both eyes. Three patients retrospectively revealed preoperative topography suggestive of FFKC, while one patient had no identifiable preoperative risk factors. Upon review of all the charts, a total 69 eyes, including four of the five eyes with ectasia, were retrospectively found to have topographies suggestive of FFKC. Conclusion: We identified four cases of post-LASIK ectasia that had risk factors for FFKC on reexamination of the chart and one case of post-LASIK ectasia with no identifiable preoperative risk factors. The most conservative screening recommendations would not have precluded this patient from LASIK. The rate of purely iatrogenic post-LASIK ectasia at our center was 0.05% (1/1,992, and the total rate of post-LASIK ectasia for our entire study was 0.25% (1/398. The rate of eyes with unrecognized preoperative FFKC that developed post-LASIK ectasia was 5.8% (1/17. Keywords

  13. Report of incidence and mortality in China cancer registries, 2009

    Science.gov (United States)

    Zheng, Rongshou; Zhang, Siwei; Zhao, Ping; Li, Guanglin; Wu, Lingyou; He, Jie

    2013-01-01

    Objective The National Central Cancer Registry (NCCR) collected cancer registration data in 2009 from local cancer registries in 2012, and analyzed to describe cancer incidence and mortality in China. Methods On basis of the criteria of data quality from NCCR, data submitted from 104 registries were checked and evaluated. There were 72 registries’ data qualified and accepted for cancer registry annual report in 2012. Descriptive analysis included incidence and mortality stratified by area (urban/rural), sex, age group and cancer site. The top 10 common cancers in different groups, proportion and cumulative rates were also calculated. Chinese population census in 1982 and Segi’s population were used for age-standardized incidence/mortality rates. Results All 72 cancer registries covered a total of 85,470,522 population (57,489,009 in urban and 27,981,513 in rural areas). The total new cancer incident cases and cancer deaths were 244,366 and 154,310, respectively. The morphology verified cases accounted for 67.23%, and 3.14% of incident cases only had information from death certifications. The crude incidence rate in Chinese cancer registration areas was 285.91/100,000 (males 317.97/100,000, females 253.09/100,000), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 146.87/100,000 and 191.72/100,000 with the cumulative incidence rate (0-74 age years old) of 22.08%. The cancer incidence and ASIRC were 303.39/100,000 and 150.31/100,000 in urban areas whereas in rural areas, they were 249.98/100,000 and 139.68/100,000, respectively. The cancer mortality in Chinese cancer registration areas was 180.54/100,000 (224.20/100,000 in males and 135.85/100,000 in females), age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 85.06/100,000 and 115.65/100,000, and the cumulative incidence rate (0-74 age years old) was 12.94%. The cancer mortality

  14. A mechanically enhanced hybrid nano-stratified barrier with a defect suppression mechanism for highly reliable flexible OLEDs.

    Science.gov (United States)

    Jeong, Eun Gyo; Kwon, Seonil; Han, Jun Hee; Im, Hyeon-Gyun; Bae, Byeong-Soo; Choi, Kyung Cheol

    2017-05-18

    Understanding the mechanical behaviors of encapsulation barriers under bending stress is important when fabricating flexible organic light-emitting diodes (FOLEDs). The enhanced mechanical characteristics of a nano-stratified barrier were analyzed based on a defect suppression mechanism, and then experimentally demonstrated. Following the Griffith model, naturally-occurring cracks, which were caused by Zn etching at the interface of the nano-stratified structure, can curb the propagation of defects. Cross-section images after bending tests provided remarkable evidence to support the existence of a defect suppression mechanism. Many visible cracks were found in a single Al 2 O 3 layer, but not in the nano-stratified structure, due to the mechanism. The nano-stratified structure also enhanced the barrier's physical properties by changing the crystalline phase of ZnO. In addition, experimental results demonstrated the effect of the mechanism in various ways. The nano-stratified barrier maintained a low water vapor transmission rate after 1000 iterations of a 1 cm bending radius test. Using this mechanically enhanced hybrid nano-stratified barrier, FOLEDs were successfully encapsulated without losing mechanical or electrical performance. Finally, comparative lifetime measurements were conducted to determine reliability. After 2000 hours of constant current driving and 1000 iterations with a 1 cm bending radius, the FOLEDs retained 52.37% of their initial luminance, which is comparable to glass-lid encapsulation, with 55.96% retention. Herein, we report a mechanically enhanced encapsulation technology for FOLEDs using a nano-stratified structure with a defect suppression mechanism.

  15. Lightning incidents in Mongolia

    Directory of Open Access Journals (Sweden)

    Myagmar Doljinsuren

    2015-11-01

    Full Text Available This is one of the first studies that has been conducted in Mongolia on the distribution of lightning incidents. The study covers a 10-year period from 2004 to 2013. The country records a human death rate of 15.4 deaths per 10 million people per year, which is much higher than that of many countries with similar isokeraunic level. The reason may be the low-grown vegetation observed in most rural areas of Mongolia, a surface topography, typical to steppe climate. We suggest modifications to Gomes–Kadir equation for such countries, as it predicts a much lower annual death rate for Mongolia. The lightning incidents spread over the period from May to August with the peak of the number of incidents occurring in July. The worst lightning affected region in the country is the central part. Compared with impacts of other convective disasters such as squalls, thunderstorms and hail, lightning stands as the second highest in the number of incidents, human deaths and animal deaths. Economic losses due to lightning is only about 1% of the total losses due to the four extreme weather phenomena. However, unless precautionary measures are not promoted among the public, this figure of losses may significantly increase with time as the country is undergoing rapid industrialization at present.

  16. Foodborne illness incidence rates and food safety risks for populations of low socioeconomic status and minority race/ethnicity: a review of the literature.

    Science.gov (United States)

    Quinlan, Jennifer J

    2013-08-15

    While foodborne illness is not traditionally tracked by race, ethnicity or income, analyses of reported cases have found increased rates of some foodborne illnesses among minority racial/ethnic populations. In some cases (Listeria, Yersinia) increased rates are due to unique food consumption patterns, in other cases (Salmonella, Shigella, Campylobacter) it is unclear why this health disparity exists. Research on safe food handling knowledge and behaviors among low income and minority consumers suggest that there may be a need to target safe food handling messages to these vulnerable populations. Another possibility is that these populations are receiving food that is less safe at the level of the retail outlet or foodservice facility. Research examining the quality and safety of food available at small markets in the food desert environment indicates that small corner markets face unique challenges which may affect the quality and potential safety of perishable food. Finally, a growing body of research has found that independent ethnic foodservice facilities may present increased risks for foodborne illness. This review of the literature will examine the current state of what is known about foodborne illness among, and food safety risks for, minority and low socioeconomic populations, with an emphasis on the United States and Europe.

  17. Foodborne Illness Incidence Rates and Food Safety Risks for Populations of Low Socioeconomic Status and Minority Race/Ethnicity: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Jennifer J. Quinlan

    2013-08-01

    Full Text Available While foodborne illness is not traditionally tracked by race, ethnicity or income, analyses of reported cases have found increased rates of some foodborne illnesses among minority racial/ethnic populations. In some cases (Listeria, Yersinia increased rates are due to unique food consumption patterns, in other cases (Salmonella, Shigella, Campylobacter it is unclear why this health disparity exists. Research on safe food handling knowledge and behaviors among low income and minority consumers suggest that there may be a need to target safe food handling messages to these vulnerable populations. Another possibility is that these populations are receiving food that is less safe at the level of the retail outlet or foodservice facility. Research examining the quality and safety of food available at small markets in the food desert environment indicates that small corner markets face unique challenges which may affect the quality and potential safety of perishable food. Finally, a growing body of research has found that independent ethnic foodservice facilities may present increased risks for foodborne illness. This review of the literature will examine the current state of what is known about foodborne illness among, and food safety risks for, minority and low socioeconomic populations, with an emphasis on the United States and Europe.

  18. Sleep disturbance at simulated altitude indicated by stratified respiratory disturbance index but not hypoxic ventilatory response.

    Science.gov (United States)

    Kinsman, Tahnee A; Townsend, Nathan E; Gore, Christopher J; Hahn, Allan G; Clark, Sally A; Aughey, Robert J; McKenna, Michael J; Hawley, John A; Chow, Chin-Moi

    2005-08-01

    At high altitudes, the clinically defined respiratory disturbance index (RDI) and high hypoxic ventilatory response (HVR) have been associated with diminished sleep quality. Increased RDI has also been observed in some athletes sleeping at simulated moderate altitude. In this study, we investigated relationships between the HVR of 14 trained male endurance cyclists with variable RDI and sleep quality responses to simulated moderate altitude. Blood oxygen saturation (SpO2%), heart rate, RDI, arousal rate, awakenings, sleep efficiency, rapid eye movement (REM) sleep, non-REM sleep stages 1, 2 and slow wave sleep as percentages of total sleep time (%TST) were measured for two nights at normoxia of 600 m and one night at a simulated altitude of 2,650 m. HVR and RDI were not significantly correlated with sleep stage, arousal rate or awakening response to nocturnal simulated altitude. SpO2 was inversely correlated with total RDI (r = -0.69, P = 0.004) at simulated altitude and with the change in arousal rate from normoxia (r = -0.65, P = 0.02). REM sleep response to simulated altitude correlated with the change, relative to normoxia, in arousal (r = -0.63, P = 0.04) and heart rate (r = -0.61, P = 0.04). When stratified, those athletes at altitude with RDI >20 h(-1) (n = 4) and those with sleep or arousal increase. However, the stratified RDI provides a basis for determining potential sleep disturbance in athletes at simulated moderate altitude.

  19. Survey of quality defects in market beef and dairy cows and bulls sold through livestock auction markets in the Western United States: I. Incidence rates.

    Science.gov (United States)

    Ahola, J K; Foster, H A; Vanoverbeke, D L; Jensen, K S; Wilson, R L; Glaze, J B; Fife, T E; Gray, C W; Nash, S A; Panting, R R; Rimbey, N R

    2011-05-01

    A survey was conducted to quantify incidence of Beef Quality Assurance (BQA)-related defects in market beef and dairy cows and bulls selling at auction during 2 seasons in 2008. Twenty-three BQA-related traits were evaluated by 9 trained personnel during sales at 10 livestock auction markets in Idaho (n = 5; beef and dairy), California, (n = 4; dairy only), and Utah (n = 1; beef and dairy). Overall, 18,949 unique lots (8,213 beef cows, 1,036 beef bulls, 9,177 dairy cows, and 523 dairy bulls,) consisting of 23,479 animals (9,299 beef cows, 1,091 beef bulls, 12,429 dairy cows, and 660 dairy bulls) were evaluated during 125 sales (64 spring, 61 fall) for dairy and 79 sales (40 spring, 39 fall) for beef. The majority of market beef cows and bulls (60.9 and 71.3%, respectively) were predominantly black-hided, and the Holstein hide pattern was observed in 95.4 and 93.6% of market dairy cows and bulls, respectively. Market cattle weighed 548 ± 103.6 kg (beef cows), 751 ± 176.1 kg (beef bulls), 658 ± 129.7 kg (dairy cows), and 731 ± 150.8 kg (dairy bulls). Most beef cows (79.6%) weighed 455 to 726 kg, and most beef bulls (73.8%) weighed 545 to 954 kg, respectively. Among market beef cattle, 16.0% of cows and 14.5% of bulls weighed less than 455 and 545 kg, respectively, and 63.7% of dairy cows and 81.5% of dairy bulls weighed 545 to 817 kg or 545 to 954 kg, respectively. However, 19.5% of dairy cows and 13.1% of dairy bulls weighed less than 545 kg. Mean BCS for beef cattle (9-point scale) was 4.7 ± 1.2 (cows) and 5.3 ± 0.9 (bulls), and for dairy cattle (5-point scale) was 2.6 ± 0.8 (cows) and 2.9 ± 0.6 (bulls). Some 16.5% of beef cows and 4.1% of beef bulls had a BCS of 1 to 3, whereas 34.8% of dairy cows and 10.4% of dairy bulls had a BCS of 2 or less. Emaciation (beef BCS = 1, dairy BCS = 1.0) or near-emaciation (beef BCS = 2, dairy BCS = 1.5) was observed in 13.3% of dairy cows and 3.9% of beef cows. Among beef cattle, 15.1% of cows and 15.4% of bulls were

  20. Effect of stratified inequality of blood flow on gas exchange in liquid-filled lungs.

    Science.gov (United States)

    West, J. B.; Maloney, J. E.; Castle, B. L.

    1972-01-01

    This investigation set out to answer two questions: (1) are the distal alveoli in the terminal lung units less well perfused than the proximal alveoli, i.e., is there stratification of blood flow; and (2) if so, does this enhance gas exchange in the presence of stratified inequality of ventilation. Excised dog lungs were ventilated with saline and perfused with blood. Following single inspirations of xenon 133 in saline and various periods of breath holding, the expired xenon concentration against volume was measured and it confirmed marked stratified inequality of ventilation under these conditions. By measuring the rate of depletion of xenon from alveoli during a period of blood flow, we showed that the alveoli which emptied at the end of expiration had 16% less blood flow than those exhaling earlier. However, by measuring the xenon concentration in pulmonary venous blood, we found that about 10% less tracer was transferred from the alveoli into the blood when the inspired xenon was stratified within the respiratory zone. Thus while stratification of blood flow was confirmed, it was shown to impair rather than enhance the efficiency of gas transfer.

  1. Turbulence Statistics of a Buoyant Jet in a Stratified Environment

    Science.gov (United States)

    McCleney, Amy Brooke

    Using non-intrusive optical diagnostics, turbulence statistics for a round, incompressible, buoyant, and vertical jet discharging freely into a stably linear stratified environment is studied and compared to a reference case of a neutrally buoyant jet in a uniform environment. This is part of a validation campaign for computational fluid dynamics (CFD). Buoyancy forces are known to significantly affect the jet evolution in a stratified environment. Despite their ubiquity in numerous natural and man-made flows, available data in these jets are limited, which constrain our understanding of the underlying physical processes. In particular, there is a dearth of velocity field data, which makes it challenging to validate numerical codes, currently used for modeling these important flows. Herein, jet near- and far-field behaviors are obtained with a combination of planar laser induced fluorescence (PLIF) and multi-scale time-resolved particle image velocimetry (TR-PIV) for Reynolds number up to 20,000. Deploying non-intrusive optical diagnostics in a variable density environment is challenging in liquids. The refractive index is strongly affected by the density, which introduces optical aberrations and occlusions that prevent the resolution of the flow. One solution consists of using index matched fluids with different densities. Here a pair of water solutions - isopropanol and NaCl - are identified that satisfy these requirements. In fact, they provide a density difference up to 5%, which is the largest reported for such fluid pairs. Additionally, by design, the kinematic viscosities of the solutions are identical. This greatly simplifies the analysis and subsequent simulations of the data. The spectral and temperature dependence of the solutions are fully characterized. In the near-field, shear layer roll-up is analyzed and characterized as a function of initial velocity profile. In the far-field, turbulence statistics are reported for two different scales, one

  2. Using the PDSA Cycle for the Evaluation of Pointing and Calling Implementation to Reduce the Rate of High-Alert Medication Administration Incidents in the United Christian Hospital of Hong Kong, China

    Directory of Open Access Journals (Sweden)

    Lap Fung Tsang

    2017-07-01

    Full Text Available Introduction: The present study aimed to adopt a Plan-do-Study-Act (PDSA cycle to monitor the implementation of Pointing and Calling (P&C in the United Christian Hospital of Hong Kong, China. Materials and Methods: A workgroup was formed to evaluate the approaches to apply P&C in high-alert medication administration using infusion and syringe devices. A series of promulgations and strategies were implemented to increase the probability of its success and sustainability. In addition, pretest and posttest evaluation was performed to monitor the incident rate associated with high-alert medication administration using infusion and syringe devices. Results:Over 100 briefing sessions were conducted in the hospital wards, and 145 senior managers, ward managers, and advanced practice nurses completed the training and assessment. In total, 217 questionnaires, which were scored based on a six-point Likert scale, were collected from 21 wards, with the response rate estimated at 26.53%. Moreover, an audit was performed to obtain 98.1-100% of the compliance rate of using the P&C for evaluation. Since June 2016, the incident rate due to inaccurate device setting decreased from 0.21 to 0.13 after the P&C implementation. Conclusion: According to the results, P&C is a simple method to facilitate the meticulous assessment of high-alert medication administration by nurses. It is recommended that further improvement be made in this regard in order to address the unidentified other areas. Of note, counter measures were proposed to strengthen P&C compliance.

  3. Exploring the role of wave drag in the stable stratified oceanic and atmospheric bottom boundary layer in the cnrs-toulouse (cnrm-game) large stratified water flume

    NARCIS (Netherlands)

    Kleczek, M.; Steeneveld, G.J.; Paci, A.; Calmer, R.; Belleudy, A.; Canonici, J.C.; Murguet, F.; Valette, V.

    2014-01-01

    This paper reports on a laboratory experiment in the CNRM-GAME (Toulouse) stratified water flume of a stably stratified boundary layer, in order to quantify the momentum transfer due to orographically induced gravity waves by gently undulating hills in a boundary layer flow. In a stratified fluid, a

  4. The incidence of and mortality from leukaemias in the UK: a general population-based study

    Directory of Open Access Journals (Sweden)

    McKeever Tricia

    2009-07-01

    Full Text Available Abstract Background The acute and chronic leukaemias constitute about 2.5% of all newly diagnosed malignancies and kill over 4000 people/year in the UK, yet there is little accurate up-to-date data on how the incidence of and mortality from leukaemias vary with socio-economic status in the UK. We aimed to quantify the incidence of and mortality from leukaemias in the UK and their variation with gender, age, year of diagnosis as well as socio-economic status. Methods All incident cases of leukaemia were identified in 'The Health Improvement Network' (THIN General Practice dataset. Crude incidence rates and incidence rate ratios (using Poisson Regression stratified by age, gender, year of diagnosis and socio-economic status were calculated. Median survival and hazard ratios for risk of death (using Cox regression were then calculated, and stratified in a similar manner. Results A total of 4162 cases of leukaemia were identified, 2314 (56% of whom were male. The overall incidence of leukaemia was 11.25 per 100 000 person-years. The age and gender distributions of ALL, AML, CLL and CML were similar to UK cancer registry data. The incidence of leukaemias was independent of socio-economic class. Median survival from leukaemia was 6.58 years and mortality increased with increasing age at diagnosis. The prognosis in AML was dismal and worsened with increasing socio-economic deprivation. For other leukaemias mortality was independent of socio-economic status. Conclusion This is the first general population study to describe the incidence of and mortality from leukaemias in the UK by socio-economic status. Similar mortality across socio-economic gradients in the leukaemias studied suggests equal access to and uptake of services. The exception to this was in AML, where poorer survival in AML patients from lower socio-economic classes may represent a class bias in treatment offered and/or greater co-morbidity in these patients, and warrants further

  5. Piezoelectricity induced defect modes for shear waves in a periodically stratified supperlattice

    Science.gov (United States)

    Piliposyan, Davit

    2018-01-01

    Properties of shear waves in a piezoelectric stratified periodic structure with a defect layer are studied for a superlattice with identical piezoelectric materials in a unit cell. Due to the electro-mechanical coupling in piezoelectric materials the structure exhibits defect modes in the superlattice with full transmission peaks both for full contact and electrically shorted interfaces. The results show an existence of one or two transmission peaks depending on the interfacial conditions. In the long wavelength region where coupling between electro-magnetic and elastic waves creates frequency band gaps the defect layer introduces one or two defect modes transmitting both electro-magnetic and elastic energies. Other parameters affecting the defect modes are the thickness of the defect layer, differences in refractive indexes and the magnitude of the angle of the incident wave. The results of the paper may be useful in the design of narrow band filters or multi-channel piezoelectric filters.

  6. Topography evolution in sputtered stratified media and in spatio-time variable ion flux conditions

    Energy Technology Data Exchange (ETDEWEB)

    Carter, G.; Nobes, M.J.; Lewis, G.W.; Cox, J.

    Earlier theoretical studies on the development of topography on solids sputtered by spatially uniform and spatially non-uniform ion fluxes are extended to a general treatment including spatially non-uniform (e.g. stratified) solids and time varying ion fluxes. It is shown that the former case is relevant to the sputter erosion of, for example, polycrystalline media, dislocated solids and surface contaminant protection situations. Predictions of feature development in these three cases is shown to correspond very well with experimental studies, and offers convincing explanation of the different etch pit elaboration processes, associated with dislocations, depending upon incident ion beam and rotated target situations and the relevance of the theory to practical situations of (1) substrate thinning and polishing and (2) controlled surface contour evolution are outlined. Some simulation studies with sand blasting, which is, in many ways, a macroscopic analogue of ion bombardment sputter erosion are presented also.

  7. Updated canine infection rates for Dirofilaria immitis in areas of Brazil previously identified as having a high incidence of heartworm-infected dogs.

    Science.gov (United States)

    Labarthe, Norma Vollmer; Paiva, Jonimar Pereira; Reifur, Larissa; Mendes-de-Almeida, Flavya; Merlo, Alexandre; Carvalho Pinto, Carlos Jose; Juliani, Paulo Sérgio; de Almeida, Maria Angela Ornelas; Alves, Leucio Câmara

    2014-11-07

    Canine heartworm infections were frequently diagnosed in Brazil before the new millennium. After the year 2000, the frequency of diagnosis showed a sharp decline; however, a few years later, new evidence indicated that the parasite was still present and that canine infection rates seemed to be increasing. Therefore, an updated survey of canine heartworm prevalence was conducted in several locations in south, southeast, and northeast Brazil. Dogs from 15 locations having previously reported a high prevalence of heartworm infection were included in the survey according to defined criteria, including the absence of treatment with a macrocyclic lactone for at least 1 year. Blood samples from 1531 dogs were evaluated by an in-clinic immunochromatography test kit (Witness® Heartworm, Zoetis, USA) for detection of Dirofilaria immitis antigen. At each location, epidemiologic data, including physical characteristics and clinical signs reported by owners or observed by veterinarians, were recorded on prepared forms for tabulation of results by location, clinical signs, and physical characteristics. The overall prevalence of canine heartworm infection was 23.1%, with evidence of heartworm-infected dogs detected in all 15 locations studied. There was a tendency for higher prevalence rates in environmentally protected areas, despite some locations having less-than-ideal environmental temperatures for survival of vector mosquitoes. Among physical characteristics, it was noted that dogs with predominantly white hair coats and residing in areas with a high (≥20%) prevalence of heartworm were less likely to have heartworm infection detected by a commercial heartworm antigen test kit than were dogs with other coat colors. In general, dogs older than 2 years were more frequently positive for D. immitis antigen than were younger dogs. Clinical signs of heartworm infections were rare or owners were unable to detect them, and could not be used for reliable prediction of the

  8. Risk factors for incident asthma and COPD in a cohort of young adults.

    Science.gov (United States)

    Traulsen, Lisbet Krogh; Baelum, Jesper; Halling, Anders; Thomsen, Gert; Thilsing, Trine; Sherson, David; Sigsgaard, Torben; Omland, Øyvind; Malling, Tine; Skadhauge, Lars Rauff

    2017-03-07

    The aim of the study was to describe potential shared risk factors for incident asthma and COPD in a population-based, 9-year follow-up study. From a cohort of 1191 individuals, aged 20-44, who participated in baseline survey including spirometry, bronchial challenge, and skin prick test (SPT) 742 subjects (62%) were reexamined at follow-up in 2012-2014. A total of 27 incident cases of asthma and 22 cases of COPD were identified at follow-up corresponding to an incidence rate of 5.8 (95% CI 3.9-8.4) and 3.5 (2.2-5.3) per 1000 person years, respectively. Among the identified COPD cases a total of 12 were Asthma-COPD Overlap Syndrome (ACOS). Atopy defined by positive SPT was a risk factor for asthma in males (OR 7.54; 95% CI 1.24-45.90), whereas risk factors in females were nasal allergy (3.81; 1.20-12.11), FEV 1 incident asthma and COPD were found. Despite low power when stratifying by sex risk factors for incident asthma and COPD emphasize considerable gender differences. © 2017 John Wiley & Sons Ltd.

  9. Stratifying the risk of lymph node metastasis in undifferentiated-type early gastric cancer

    Science.gov (United States)

    Asakawa, Yukiko; Ohtaka, Masahiko; Maekawa, Shinya; Fukasawa, Mitsuharu; Nakayama, Yasuhiro; Yamaguchi, Tatsuya; Inoue, Taisuke; Uetake, Tomoyoshi; Sakamoto, Minoru; Sato, Tadashi; Kawaguchi, Yoshihiko; Fujii, Hideki; Mochizuki, Kunio; Hada, Masao; Oyama, Toshio; Yasumura, Tomotaka; Omata, Kosaku; Nishiyama, Atsushi; Naito, Keiichi; Hata, Hideo; Haba, Yoshiaki; Miyata, Kazuyuki; Saitoh, Haruhisa; Yamadera, Yoichi; Miura, Kazuo; Kawaoi, Akira; Abe, Tohru; Tsunoda, Hajime; Honda, Yuji; Kurosaki, Masayuki; Enomoto, Nobuyuki

    2015-01-01

    AIM: To study how lymph node metastasis (LNM) risk is stratified in undifferentiated-type early gastric cancer (undiff-EGC) dependent on combinations of risk factors. METHODS: Five hundred and sixty-seven cases with undiff-EGC undergoing gastrectomy with lymphadenectomy were examined retrospectively. Using clinicopathological factors of patient age, location, size, an endoscopic macroscopic tumor form, ulceration, depth, histology, lymphatic involvement (LI) and venous involvement (VI), LNM risk was examined and stratified by conventional statistical analysis and data-mining analysis. RESULTS: LNM was positive in 44 of 567 cases (7.8%). Univariate analysis revealed > 2 cm, protrusion, submucosal (sm), mixed type, LI and VI as significant prognostic factors and > 2 cm and LI-positive were independent factors by multivariate analysis. In preoperatively evaluable factors excluding LVI, sm and > 2 cm were independent factors. According to the depth and size, cases were categorized into the low-risk group [m and ≤ 2 cm, 0% (LNM incidence)], the moderate-risk group (m and > 2 cm, 5.6%; and sm and ≤ 2 cm, 6.0%), and the high-risk group (sm and > 2 cm, 19.3%). On the other hand, LNM occurred in 1.4% in all LI-negative cases, greatly lower than 28.2% in all LI-positive cases, and LNM incidence was low in LI-negative cases even in the moderate- and high-risk groups. CONCLUSION: LNM-related factors in undiff-EGC were depth and size preoperatively while those were LI and size postoperatively. Among these factors, LI was the most significantly correlated factor. PMID:25759537

  10. Analysis of photonic band-gap structures in stratified medium

    DEFF Research Database (Denmark)

    Tong, Ming-Sze; Yinchao, Chen; Lu, Yilong

    2005-01-01

    Purpose - To demonstrate the flexibility and advantages of a non-uniform pseudo-spectral time domain (nu-PSTD) method through studies of the wave propagation characteristics on photonic band-gap (PBG) structures in stratified medium Design/methodology/approach - A nu-PSTD method is proposed...... in solving the Maxwell's equations numerically. It expands the temporal derivatives using the finite differences, while it adopts the Fourier transform (FT) properties to expand the spatial derivatives in Maxwell's equations. In addition, the method makes use of the chain-rule property in calculus together...... with the transformed space technique in order to make the algorithm flexible in terms of non-uniform spatial sampling. Findings - Through the studies of the wave propagation characteristics on PBG structures in stratified medium, it has been found that the proposed method retains excellent accuracy in the occasions...

  11. Identification of major planktonic sulfur oxidizers in stratified freshwater lake.

    Directory of Open Access Journals (Sweden)

    Hisaya Kojima

    Full Text Available Planktonic sulfur oxidizers are important constituents of ecosystems in stratified water bodies, and contribute to sulfide detoxification. In contrast to marine environments, taxonomic identities of major planktonic sulfur oxidizers in freshwater lakes still remain largely unknown. Bacterioplankton community structure was analyzed in a stratified freshwater lake, Lake Mizugaki in Japan. In the clone libraries of 16S rRNA gene, clones very closely related to a sulfur oxidizer isolated from this lake, Sulfuritalea hydrogenivorans, were detected in deep anoxic water, and occupied up to 12.5% in each library of different water depth. Assemblages of planktonic sulfur oxidizers were specifically analyzed by constructing clone libraries of genes involved in sulfur oxidation, aprA, dsrA, soxB and sqr. In the libraries, clones related to betaproteobacteria were detected with high frequencies, including the close relatives of Sulfuritalea hydrogenivorans.

  12. Insight into steam explosion in stratified melt-coolant configuration

    OpenAIRE

    Grishchenko, Dmitry; Konovalenko, Alexander; Karbojian, Aram; Kudinova, Valtyna; Bechta, Sevostian; Kudinov, Pavel

    2013-01-01

    Release of core melt from failed reactor vessel into a pool of water is adopted in several existing designs of light water reactors (LWRs) as an element of severe accident  mitigation  strategy.  When  vessel  breach  is  large  and  water  pool  is shallow,  released  corium  melt  can  reach  containment  floor  in  liquid  form  and spread under water creating a stratified configuration of melt covered by coolant. Steam  explosion  in  such  stratified  configuration  was  long  believed  ...

  13. Posttraumatic Stress Disorder After High-Dose-Rate Brachytherapy for Cervical Cancer With 2 Fractions in 1 Application Under Spinal/Epidural Anesthesia: Incidence and Risk Factors

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, Kathrin, E-mail: kathrin.kirchheiner@meduniwien.ac.at [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Czajka-Pepl, Agnieszka [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Ponocny-Seliger, Elisabeth [Department of Psychology, Sigmund Freud Private University Vienna, Vienna (Austria); Scharbert, Gisela; Wetzel, Léonore [Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Nout, Remi A. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Sturdza, Alina [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Dimopoulos, Johannes C. [Metropolitan Hospital, Athens (Greece); Dörr, Wolfgang; Pötter, Richard [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria)

    2014-06-01

    Purpose: To investigate the psychological consequences of high-dose-rate brachytherapy with 2 fractions in 1 application under spinal/epidural anesthesia in the treatment of locally advanced cervical cancer. Methods and Materials: In 50 patients with locally advanced cervical cancer, validated questionnaires were used for prospective assessment of acute and posttraumatic stress disorder (ASD/PTSD) (Impact of Event Scale–Revision), anxiety/depression (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Cervical Cancer 24), physical functioning (World Health Organization performance status), and pain (visual analogue scale), before and during treatment and 1 week and 3 months after treatment. Qualitative interviews were recorded in open format for content analysis. Results: Symptoms of ASD occurred in 30% of patients 1 week after treatment; and of PTSD in 41% 3 months after treatment in association with this specific brachytherapy procedure. Pretreatment predictive variables explain 82% of the variance of PTSD symptoms. Helpful experiences were the support of the treatment team, psychological support, and a positive attitude. Stressful factors were pain, organizational problems during treatment, and immobility between brachytherapy fractions. Conclusions: The specific brachytherapy procedure, as performed in the investigated mono-institutional setting with 2 fractions in 1 application under spinal/epidural anesthesia, bears a considerable risk of traumatization. The source of stress seems to be not the brachytherapy application itself but the maintenance of the applicator under epidural anesthesia in the time between fractions. Patients at risk may be identified before treatment, to offer targeted psycho-social support. The patients' open reports regarding helpful experiences are an encouraging feedback for the treatment team; the reported stressful

  14. Posttraumatic Stress Disorder After High-Dose-Rate Brachytherapy for Cervical Cancer With 2 Fractions in 1 Application Under Spinal/Epidural Anesthesia: Incidence and Risk Factors

    International Nuclear Information System (INIS)

    Kirchheiner, Kathrin; Czajka-Pepl, Agnieszka; Ponocny-Seliger, Elisabeth; Scharbert, Gisela; Wetzel, Léonore; Nout, Remi A.; Sturdza, Alina; Dimopoulos, Johannes C.; Dörr, Wolfgang; Pötter, Richard

    2014-01-01

    Purpose: To investigate the psychological consequences of high-dose-rate brachytherapy with 2 fractions in 1 application under spinal/epidural anesthesia in the treatment of locally advanced cervical cancer. Methods and Materials: In 50 patients with locally advanced cervical cancer, validated questionnaires were used for prospective assessment of acute and posttraumatic stress disorder (ASD/PTSD) (Impact of Event Scale–Revision), anxiety/depression (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Cervical Cancer 24), physical functioning (World Health Organization performance status), and pain (visual analogue scale), before and during treatment and 1 week and 3 months after treatment. Qualitative interviews were recorded in open format for content analysis. Results: Symptoms of ASD occurred in 30% of patients 1 week after treatment; and of PTSD in 41% 3 months after treatment in association with this specific brachytherapy procedure. Pretreatment predictive variables explain 82% of the variance of PTSD symptoms. Helpful experiences were the support of the treatment team, psychological support, and a positive attitude. Stressful factors were pain, organizational problems during treatment, and immobility between brachytherapy fractions. Conclusions: The specific brachytherapy procedure, as performed in the investigated mono-institutional setting with 2 fractions in 1 application under spinal/epidural anesthesia, bears a considerable risk of traumatization. The source of stress seems to be not the brachytherapy application itself but the maintenance of the applicator under epidural anesthesia in the time between fractions. Patients at risk may be identified before treatment, to offer targeted psycho-social support. The patients' open reports regarding helpful experiences are an encouraging feedback for the treatment team; the reported stressful

  15. Dust particle charge distribution in a stratified glow discharge

    Energy Technology Data Exchange (ETDEWEB)

    Sukhinin, Gennady I [Institute of Thermophysics, Siberian Branch, Russian Academy of Sciences, Lavrentyev Ave., 1, Novosibirsk 630090 (Russian Federation); Fedoseev, Alexander V [Institute of Thermophysics, Siberian Branch, Russian Academy of Sciences, Lavrentyev Ave., 1, Novosibirsk 630090 (Russian Federation); Ramazanov, Tlekkabul S [Institute of Experimental and Theoretical Physics, Al Farabi Kazakh National University, Tole Bi, 96a, Almaty 050012 (Kazakhstan); Dzhumagulova, Karlygash N [Institute of Experimental and Theoretical Physics, Al Farabi Kazakh National University, Tole Bi, 96a, Almaty 050012 (Kazakhstan); Amangaliyeva, Rauan Zh [Institute of Experimental and Theoretical Physics, Al Farabi Kazakh National University, Tole Bi, 96a, Almaty 050012 (Kazakhstan)

    2007-12-21

    The influence of a highly pronounced non-equilibrium characteristic of the electron energy distribution function in a stratified dc glow discharge on the process of dust particle charging in a complex plasma is taken into account for the first time. The calculated particle charge spatial distribution is essentially non-homogeneous and it can explain the vortex motion of particles at the periphery of a dusty cloud obtained in experiments.

  16. Indications for tonsillectomy stratified by the level of evidence

    OpenAIRE

    Windfuhr, Jochen P.

    2016-01-01

    Background: One of the most significant clinical trials, demonstrating the efficacy of tonsillectomy (TE) for recurrent throat infection in severely affected children, was published in 1984. This systematic review was undertaken to compile various indications for TE as suggested in the literature after 1984 and to stratify the papers according to the current concept of evidence-based medicine.Material and methods: A systematic Medline research was performed using the key word of "tonsillect...

  17. Economic Evaluation in Stratified Medicine: Methodological Issues and Challenges

    OpenAIRE

    Fugel, Hans-Joerg; Nuijten, Mark; Postma, Maarten; Redekop, Ken

    2016-01-01

    textabstractBackground: Stratified Medicine (SM) is becoming a practical reality with the targeting of medicines by using a biomarker or genetic-based diagnostic to identify the eligible patient sub-population. Like any healthcare intervention, SM interventions have costs and consequences that must be considered by reimbursement authorities with limited resources. Methodological standards and guidelines exist for economic evaluations in clinical pharmacology and are an important component for...

  18. Does a sheared flow stabilize inversely stratified fluid?

    DEFF Research Database (Denmark)

    Benilov, E.S.; Naulin, V.; Juul Rasmussen, J.

    2002-01-01

    with a monotonic profile (which were examined numerically). It turns out that virtually any deviation from the linear profiles examined by Kuo (1963) triggers off instability. This instability, however, is restricted either spectrally or spatially, which makes it different from the usual Rayleigh......-Taylor instability (in the absence of the flow, inversely stratified fluids are unstable at all points and all wavelengths). The conclusions of the paper are verified by simulation of the governing (nonlinear) equations. (C) 2002 American Institute of Physics....

  19. Community genomics among stratified microbial assemblages in the ocean's interior

    DEFF Research Database (Denmark)

    DeLong, Edward F; Preston, Christina M; Mincer, Tracy

    2006-01-01

    Microbial life predominates in the ocean, yet little is known about its genomic variability, especially along the depth continuum. We report here genomic analyses of planktonic microbial communities in the North Pacific Subtropical Gyre, from the ocean's surface to near-sea floor depths. Sequence......, and host-viral interactions. Comparative genomic analyses of stratified microbial communities have the potential to provide significant insight into higher-order community organization and dynamics....

  20. Incidence of haematological malignancies, Eastern Cape Province; South Africa, 2004-2013.

    Science.gov (United States)

    Oelofse, Diana; Truter, Ilse

    2018-04-01

    The incidence of haematological malignancies in Africa's rapidly urbanising populations is insufficiently explored. Reliable population-based cancer statistics, however, continues to be a scarce resource in Africa and tends to be urban biased with limited rural coverage. In addition, many haematological malignancies are regarded as rare cancers, a sub-group that often affects the young disproportionately and require advanced diagnostic services and facilities able to deliver costly sophisticated treatments. This study provides a first attempt to estimate the incidence of haematological malignancies among the Eastern Cape Province population of South Africa. Multiple public- and private sector data archives and resources were utilised to optimise the identification of incident cases, including clinical records; bone marrow; cytology; histology; flow cytometry and cytogenetic records. Crude incidence, age-and gender-standardised rates are presented and comparison made with existing national data and select data from other economically developed countries and global institutions. A total of 3603 incident cases were identified between 2004 and 2013. Mature lymphoid malignancies accounted for approximately 60% (n = 2153), myeloma/plasma cell neoplasms 13% (n = 465), acute leukaemia 17% (n = 596), chronic myeloid leukaemia 4% (n = 155) and other myeloproliferative neoplasms 6% (n = 234) when stratified according to conventional groups. Most subtypes increase with age, with male excess. Haematological malignancies in the Eastern Cape Province show disparities in gender and pathology-specific incidence patterns. The present study suggest that haematological malignancies are not uncommon in this region and the incidence rate of at least one rare subtype, APL, is comparable with some European populations. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Continuous Dependence on the Density for Stratified Steady Water Waves

    Science.gov (United States)

    Chen, Robin Ming; Walsh, Samuel

    2016-02-01

    There are two distinct regimes commonly used to model traveling waves in stratified water: continuous stratification, where the density is smooth throughout the fluid, and layer-wise continuous stratification, where the fluid consists of multiple immiscible strata. The former is the more physically accurate description, but the latter is frequently more amenable to analysis and computation. By the conservation of mass, the density is constant along the streamlines of the flow; the stratification can therefore be specified by prescribing the value of the density on each streamline. We call this the streamline density function. Our main result states that, for every smoothly stratified periodic traveling wave in a certain small-amplitude regime, there is an L ∞ neighborhood of its streamline density function such that, for any piecewise smooth streamline density function in that neighborhood, there is a corresponding traveling wave solution. Moreover, the mapping from streamline density function to wave is Lipschitz continuous in a certain function space framework. As this neighborhood includes piecewise smooth densities with arbitrarily many jump discontinues, this theorem provides a rigorous justification for the ubiquitous practice of approximating a smoothly stratified wave by a layered one. We also discuss some applications of this result to the study of the qualitative features of such waves.

  2. Sirolimus effects on cancer incidence after kidney transplantation: a meta-analysis.

    Science.gov (United States)

    Yanik, Elizabeth L; Siddiqui, Kulsoom; Engels, Eric A

    2015-09-01

    Sirolimus, an immunosuppressant option for kidney transplant recipients, may reduce cancer risk by interrupting the mammalian target of rapamycin pathway. However, studies of sirolimus and cancer incidence in kidney recipients have not been definitive, and have had limited ability to examine specific cancer types. The literature was systematically reviewed to identify randomized controlled trials (RCTs) and observational studies of kidney recipients that compared sirolimus users to sirolimus nonusers. Meta-analytic methods were used to obtain pooled estimates of the association between sirolimus use and incidence of total cancer and specific cancer types. Estimates were stratified by study type (RCT vs. observational) and use of cyclosporine (an immunosuppressant that affects DNA repair). Twenty RCTs and two observational studies were eligible for meta-analysis, including 39,039 kidney recipients overall. Sirolimus use was associated with lower overall cancer incidence (incidence rate ratio [IRR] = 0.71, 95% CI = 0.56-0.90), driven by a reduction in incidence of nonmelanoma skin cancer (NMSC, IRR = 0.49, 95% CI = 0.32-0.76). The protective effect of sirolimus on NMSC risk was most notable in studies comparing sirolimus against cyclosporine (IRR = 0.19, 95% CI = 0.04-0.84). After excluding NMSCs, there was no overall association between sirolimus and incidence of other cancers (IRR = 1.06, 95% CI = 0.69-1.63). However, sirolimus use had associations with lower kidney cancer incidence (IRR = 0.40, 95% CI = 0.20-0.81), and higher prostate cancer incidence (IRR = 1.85, 95% CI = 1.17-2.91). Among kidney recipients, sirolimus users have lower NMSC risk, which may be partly due to removal of cyclosporine. Sirolimus may also reduce kidney cancer risk but did not appear protective for other cancers, and it may actually increase prostate cancer risk. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  3. Stratified premedication strategy for the prevention of contrast media hypersensitivity in high-risk patients.

    Science.gov (United States)

    Lee, Suh-Young; Yang, Min Suk; Choi, Young-Hoon; Park, Chang Min; Park, Heung-Woo; Cho, Sang Heon; Kang, Hye-Ryun

    2017-03-01

    Although the severity of hypersensitivity reactions to iodinated contrast media varies, it is well correlated with the severity of recurrent reactions; however, prophylaxis protocols are not severity-stratified. To assess the outcomes of tailored prophylaxis according to the severity of hypersensitivity reactions to iodinated contrast media. Our premedication protocols were stratified based on the severity of previous reactions: (1) 4 mg of chlorpheniramine for mild reactions, (2) adding 40 mg of methylprednisolone for moderate reactions, and (3) adding multiple doses of 40 mg of methylprednisolone for severe index reactions. Cases of reexposure in patients with a history of hypersensitivity reactions were routinely monitored and mandatorily recorded. Among a total of 850 patients who underwent enhanced computed tomography after severity-tailored prophylaxis, breakthrough reactions occurred in 17.1%, but most breakthrough reactions (89.0%) were mild and did not require medical treatment. Additional corticosteroid use did not reduce the breakthrough reaction rate in cases with a mild index reaction (16.8% vs 17.2%, P = .70). However, underpremedication with a single dose of corticosteroid revealed significantly higher rates of breakthrough reaction than did double doses of corticosteroid in cases with a severe index reaction (55.6% vs 17.4%, P = .02). Changing the iodinated contrast media resulted in an additional reduction of the breakthrough reaction rate overall (14.9% vs 32.1%, P = .001). In a total severity-based stratified prophylaxis regimens and changing iodinated contrast media can be considered in patients with a history of previous hypersensitivity reaction to iodinated contrast media to reduce the risk of breakthrough reactions. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. [Report of Cancer Incidence and Mortality in China, 2014].

    Science.gov (United States)

    Chen, W Q; Li, H; Sun, K X; Zheng, R S; Zhang, S W; Zeng, H M; Zou, X N; Gu, X Y; He, J

    2018-01-23

    Objective: The registration data of local cancer registries in 2014 were collected by National Central Cancer Registry (NCCR)in 2017 to estimate the cancer incidence and mortality in China. Methods: The data submitted from 449 registries were checked and evaluated, and the data of 339 registries out of them were qualified and selected for the final analysis. Cancer incidence and mortality were stratified by area, gender, age group and cancer type, and combined with the population data of 2014 to estimate cancer incidence and mortality in China. The age composition of standard population of Chinese census in 2000 and Segi's population were used for age-standardized incidence and mortality in China and worldwide, respectively. Results: Total covered population of 339 cancer registries (129 in urban and 210 in rural) in 2014 were 288 243 347 (144 061 915 in urban and 144 181 432 in rural areas). The mortality verified cases (MV%) were 68.01%. Among them, 2.19% cases were identified through death certifications only (DCO%), and the mortality to incidence ratio was 0.61. There were about 3, 804, 000 new cases diagnosed as malignant cancer and 2, 296, 000 cases dead in 2014 in the whole country. The incidence rate was 278.07/100, 000 (males 301.67/100, 000, females 253.29/100, 000) in China, age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population were 190.63/100, 000 and 186.53/100, 000, respectively, and the cumulative incidence rate (0-74 age years old) was 21.58%. The cancer incidence and ASIRC in urban areas were 302.13/100, 000 and 196.58/100, 000, respectively, whereas in rural areas, those were 248.94/100, 000 and 182.64/100, 000, respectively. The cancer mortality in China was 167.89/100, 000 (207.24/100, 000 in males and 126.54/100, 000 in females), age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population were 106.98/100, 000 and 106.09/100, 000, respectively. And

  5. Interfacial shear stress in stratified flow in a horizontal rectangular duct

    Energy Technology Data Exchange (ETDEWEB)

    Lorencez, C.; Kawaji, M. [Univ. of Toronto (Canada); Murao, Y. [Tokushima Univ. (Japan)] [and others

    1995-09-01

    Interfacial shear stress has been experimentally examined for both cocurrent and countercurrent stratified wavy flows in a horizontal interfacial shear stress from the measurements were examined and the results have been compared with existing correlations. Some differences were found in the estimated interfacial shear stress from the measurements were examined and the results have been compared with existing correlations. Some differences were found in the estimated interfacial shear stress values at high gas flow rates which could be attributed to the assumptions and procedures involved in each method. The interfacial waves and secondary motions were also found to have significant effects on the accuracy of Reynolds stress and turbulence kinetic energy extrapolation methods.

  6. Effect of FLR correction on Rayleigh -Taylor instability of quantum and stratified plasma

    International Nuclear Information System (INIS)

    Sharma, P.K.; Tiwari, Anita; Argal, Shraddha; Chhajlani, R.K.

    2013-01-01

    The Rayleigh Taylor instability of stratified incompressible fluids is studied in presence of FLR Correction and quantum effects in bounded medium. The Quantum magneto hydrodynamic equations of the problem are solved by using normal mode analysis method. A dispersion relation is carried out for the case where plasma is bounded by two rigid planes z = 0 and z = h. The dispersion relation is obtained in dimensionless form to discuss the growth rate of Rayleigh Taylor instability in presence of FLR Correction and quantum effects. The stabilizing or destabilizing behavior of quantum effect and FLR correction on the Rayleigh Taylor instability is analyzed. (author)

  7. Performance and combustion characteristics of direct-injection stratified-charge rotary engines

    Science.gov (United States)

    Nguyen, Hung Lee

    1987-01-01

    Computer simulations of the direct-injection stratified-charge (DISC) Wankel engine have been used to calculate heat release rates and performance and efficiency characteristics of the 1007R engine. Engine pressure data have been used in a heat release analysis to study the effects of heat transfer, leakage, and crevice flows. Predicted engine performance data are compared with experimental test data over a range of engine speeds and loads. An examination of methods to improve the performance of the Wankel engine with faster combustion, reduced leakage, higher compression ratio, and turbocharging is presented.

  8. Calculation of periodic flows in a continuously stratified fluid

    Science.gov (United States)

    Vasiliev, A.

    2012-04-01

    Analytic theory of disturbances generated by an oscillating compact source in a viscous continuously stratified fluid was constructed. Exact solution of the internal waves generation problem was constructed taking into account diffusivity effects. This analysis is based on set of fundamental equations of incompressible flows. The linearized problem of periodic flows in a continuously stratified fluid, generated by an oscillating part of the inclined plane was solved by methods of singular perturbation theory. A rectangular or disc placed on a sloping plane and oscillating linearly in an arbitrary direction was selected as a source of disturbances. The solutions include regularly perturbed on dissipative component functions describing internal waves and a family of singularly perturbed functions. One of the functions from the singular components family has an analogue in a homogeneous fluid that is a periodic or Stokes' flow. Its thickness is defined by a universal micro scale depending on kinematics viscosity coefficient and a buoyancy frequency with a factor depending on the wave slope. Other singular perturbed functions are specific for stratified flows. Their thickness are defined the diffusion coefficient, kinematic viscosity and additional factor depending on geometry of the problem. Fields of fluid density, velocity, vorticity, pressure, energy density and flux as well as forces acting on the source are calculated for different types of the sources. It is shown that most effective source of waves is the bi-piston. Complete 3D problem is transformed in various limiting cases that are into 2D problem for source in stratified or homogeneous fluid and the Stokes problem for an oscillating infinite plane. The case of the "critical" angle that is equality of the emitting surface and the wave cone slope angles needs in separate investigations. In this case, the number of singular component is saved. Patterns of velocity and density fields were constructed and

  9. An Artificial Neural Network Stratifies the Risks of Reintervention and Mortality after Endovascular Aneurysm Repair; a Retrospective Observational study.

    Directory of Open Access Journals (Sweden)

    Alan Karthikesalingam

    Full Text Available Lifelong surveillance after endovascular repair (EVAR of abdominal aortic aneurysms (AAA is considered mandatory to detect potentially life-threatening endograft complications. A minority of patients require reintervention but cannot be predictively identified by existing methods. This study aimed to improve the prediction of endograft complications and mortality, through the application of machine-learning techniques.Patients undergoing EVAR at 2 centres were studied from 2004-2010. Pre-operative aneurysm morphology was quantified and endograft complications were recorded up to 5 years following surgery. An artificial neural networks (ANN approach was used to predict whether patients would be at low- or high-risk of endograft complications (aortic/limb or mortality. Centre 1 data were used for training and centre 2 data for validation. ANN performance was assessed by Kaplan-Meier analysis to compare the incidence of aortic complications, limb complications, and mortality; in patients predicted to be low-risk, versus those predicted to be high-risk.761 patients aged 75 +/- 7 years underwent EVAR. Mean follow-up was 36+/- 20 months. An ANN was created from morphological features including angulation/length/areas/diameters/volume/tortuosity of the aneurysm neck/sac/iliac segments. ANN models predicted endograft complications and mortality with excellent discrimination between a low-risk and high-risk group. In external validation, the 5-year rates of freedom from aortic complications, limb complications and mortality were 95.9% vs 67.9%; 99.3% vs 92.0%; and 87.9% vs 79.3% respectively (p<0.001.This study presents ANN models that stratify the 5-year risk of endograft complications or mortality using routinely available pre-operative data.

  10. Relationship of Self-Rated Health to Stroke Incidence and Mortality in Older Individuals with and without a History of Stroke: A Longitudinal Study of the MRC Cognitive Function and Ageing (CFAS) Population.

    Science.gov (United States)

    Mavaddat, Nahal; van der Linde, Rianne; Parker, Richard; Savva, George; Kinmonth, Ann Louise; Brayne, Carol; Mant, Jonathan

    2016-01-01

    Poor self-rated health (SRH) has been associated with increased risk of death and poor health outcomes even after adjusting for confounders. However its' relationship with disease-specific mortality and morbidity has been less studied. SRH may also be particularly predictive of health outcomes in those with pre-existing conditions. We studied whether SRH predicts new stroke in older people who have never had a stroke, or a recurrence in those with a prior history of stroke. MRC CFAS I is a multicentre cohort study of a population representative sample of people in their 65th year and older. A comprehensive interview at baseline included questions about presence of stroke, self-rated health and functional disability. Follow-up at 2 years included self-report of stroke and stroke death obtained from death certificates. Multiple logistical regression determined odds of stroke at 2 years adjusting for confounders including disability and health behaviours. Survival analysis was performed until June 2014 with follow-up for up to 13 years. 11,957 participants were included, of whom 11,181 (93.8%) had no history of stroke and 776 (6.2%) one or more previous strokes. Fewer with no history of stroke reported poor SRH than those with stroke (5 versus 21%). In those with no history of stroke, poor self-rated health predicted stroke incidence (OR 1.5 (1.1-1.9)), but not stroke mortality (OR 1.2 (0.8-1.9)) at 2 years nor for up to 13 years (OR 1.2(0.9-1.7)). In those with a history of stroke, self-rated health did not predict stroke incidence (OR 0.9(0.6-1.4)), stroke mortality (OR 1.1(0.5-2.5)), or survival (OR 1.1(0.6-2.1)). Poor self-rated health predicts risk of stroke at 2 years but not stroke mortality among the older population without a previous history of stroke. SRH may be helpful in predicting who may be at risk of developing a stroke in the near future.

  11. Incidence and composition of Ceratitid fruit flies in wild coffee ...

    African Journals Online (AJOL)

    Incidence and composition of fruit flies were studied at afromontane rainforests of southwestern Ethiopia: Yayu, Berhane-kontir and Bonga forest which are located in Illubabor, Benchi- Maji and Kefa zones, respectively. Based on ecological descriptions of forest coffee population, each forest locality was stratified into three ...

  12. Practice Guideline Summary: Sudden Unexpected Death in Epilepsy Incidence Rates and Risk Factors: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society

    Science.gov (United States)

    Harden, Cynthia; Tomson, Torbjörn; Gloss, David; Buchhalter, Jeffrey; Cross, J. Helen; Donner, Elizabeth; French, Jacqueline A.; Gil-Nagel, Anthony; Hesdorffer, Dale C.; Smithson, W. Henry; Spitz, Mark C.; Walczak, Thaddeus S.; Sander, Josemir W.; Ryvlin, Philippe

    2017-01-01

    Objective: To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified. Methods: Systematic review of evidence; modified Grading Recommendations Assessment, Development and Evaluation process for developing conclusions; recommendations developed by consensus. Results: Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0–17 years) is 0.22/1,000 patient-years (95% CI 0.16–0.31) (high confidence in evidence). SUDEP risk increases in adults to 1.2/1,000 patient-years (95% CI 0.64–2.32) (low confidence in evidence). The major risk factor for SUDEP is the occurrence of generalized tonic-clonic seizures (GTCS); the SUDEP risk increases in association with increasing frequency of GTCS occurrence (high confidence in evidence). Recommendations: Level B: Clinicians caring for young children with epilepsy should inform parents/guardians that in 1 year, SUDEP typically affects 1 in 4,500 children; therefore, 4,499 of 4,500 children will not be affected. Clinicians should inform adult patients with epilepsy that SUDEP typically affects 1 in 1,000 adults with epilepsy per year; therefore, annually 999 of 1,000 adults will not be affected. For persons with epilepsy who continue to experience GTCS, clinicians should continue to actively manage epilepsy therapies to reduce seizures and SUDEP risk while incorporating patient preferences and weighing the risks and benefits of any new approach. Clinicians should inform persons with epilepsy that seizure freedom, particularly freedom from GTCS, is strongly associated with decreased SUDEP risk. ABBREVIATIONS AAN: American Academy of Neurology AED: antiepileptic drug GTCS: generalized tonic-clonic seizures SUDEP: sudden unexpected death in epilepsy PMID:28684957

  13. The effect of periodontal therapy on the survival rate and incidence of complications of multirooted teeth with furcation involvement after an observation period of at least 5 years: a systematic review.

    Science.gov (United States)

    Huynh-Ba, Guy; Kuonen, Patrick; Hofer, Dominik; Schmid, Jürg; Lang, Niklaus P; Salvi, Giovanni E

    2009-02-01

    To systematically review the survival rate and incidence of complications of furcation-involved multirooted teeth following periodontal therapy after at least 5 years. Electronic and manual searches were performed up to and including January 2008. Publication selection, data extraction and validity assessment were performed independently by three reviewers. Twenty-two publications met the inclusion criteria. Because of the heterogeneity of the data, a meta-analysis could not be performed. The survival rate of molars treated non-surgically was >90% after 5-9 years. The corresponding values for the different surgical procedures were: Surgical therapy: 43.1% to 96%, observation period: 5-53 years. Tunnelling procedures: 42.9% to 92.9%, observation period: 5-8 years. Surgical resective procedures including amputation(s) and hemisections: 62% to 100%, observation period: 5-13 years. Guided tissue regeneration (GTR): 83.3% to 100%, observation period: 5-12 years. The most frequent complications included caries in the furcation area after tunnelling procedures and root fractures after root-resective procedures. Good long-term survival rates (up to 100%) of multirooted teeth with furcation involvement were obtained following various therapeutic approaches. Initial furcation involvement (Degree I) could be successfully managed by non-surgical mechanical debridement. Vertical root fractures and endodontic failures were the most frequent complications observed following resective procedures.

  14. Indications for tonsillectomy stratified by the level of evidence

    Science.gov (United States)

    Windfuhr, Jochen P.

    2016-01-01

    Background: One of the most significant clinical trials, demonstrating the efficacy of tonsillectomy (TE) for recurrent throat infection in severely affected children, was published in 1984. This systematic review was undertaken to compile various indications for TE as suggested in the literature after 1984 and to stratify the papers according to the current concept of evidence-based medicine. Material and methods: A systematic Medline research was performed using the key word of “tonsillectomy“ in combination with different filters such as “systematic reviews“, “meta-analysis“, “English“, “German“, and “from 1984/01/01 to 2015/05/31“. Further research was performed in the Cochrane Database of Systematic Reviews, National Guideline Clearinghouse, Guidelines International Network and BMJ Clinical Evidence using the same key word. Finally, data from the “Trip Database” were researched for “tonsillectomy” and “indication“ and “from: 1984 to: 2015“ in combination with either “systematic review“ or “meta-analysis“ or “metaanalysis”. Results: A total of 237 papers were retrieved but only 57 matched our inclusion criteria covering the following topics: peritonsillar abscess (3), guidelines (5), otitis media with effusion (5), psoriasis (3), PFAPA syndrome (6), evidence-based indications (5), renal diseases (7), sleep-related breathing disorders (11), and tonsillitis/pharyngitis (12), respectively. Conclusions: 1) The literature suggests, that TE is not indicated to treat otitis media with effusion. 2) It has been shown, that the PFAPA syndrome is self-limiting and responds well to steroid administration, at least in a considerable amount of children. The indication for TE therefore appears to be imbalanced but further research is required to clarify the value of surgery. 3) Abscesstonsillectomy as a routine is not justified and indicated only for cases not responding to other measures of treatment, evident complications

  15. Breast cancer incidence in Mongolia

    Science.gov (United States)

    Altantsetseg, Dalkhjav; Davaasambuu, Ganmaa; Rich-Edwards, Janet; Davaalkham, Dambadarjaa; Tretli, Steinar; Hoover, Robert N.; Frazier, A. Lindsay

    2013-01-01

    Purpose Data on international variation in breast cancer incidence may help to identify additional risk factors. Substantially lower breast cancer rates in Asia than in North America and Western Europe are established, but differences within Asia have been largely ignored despite heterogeneity in lifestyles and environments. Mongolia’s breast cancer experience is of interest because of its shared genetics but vastly different diet compared with other parts of Asia. Methods Age-standardized breast cancer incidence and mortality rates obtained from the International Association of Cancer Registries are presented for several Asian countries. Mongolian incidence rates obtained from its cancer registry describe incidence within the country. Results Breast cancer incidence in Mongolia (age standardized 8.0/100,000) is almost a third of rates in China (21.6/100,000), and over five times that of Japan (42.7/100,000) and Russia (43.2/100,000). Rates within Mongolia appear to have increased slightly over the last decade and are higher in urban than rural areas (annual percentage increase of age-standardized rates from 1998 to 2005 was 3.60 and 2.57%, respectively). The increase in breast cancer incidence with age plateaus at menopause, as in other Asian populations. Conclusions Mongolia’s low breast cancer incidence is of particular interest because of their unusual diet (primarily red meat and dairy) compared with other Asian countries. More intensive study of potential dietary, reproductive and lifestyle factors in Mongolia with comparison to other Asian populations may provide more clarity in what drives the international breast cancer rate differences. PMID:22543542

  16. Marked socioeconomic inequalities in hip fracture incidence rates during the Bone and Joint Decade (2000-2010) in Portugal: age and sex temporal trends in a population based study.

    Science.gov (United States)

    Oliveira, Carla Maria; Alves, Sandra Maria; Pina, Maria Fátima

    2016-08-01

    Socioeconomic factors may influence changes in hip fracture (HF) incidence over time. We analysed HF temporal trends during the Bone and Joint Decade in Portugal (BJD-Portugal), 2000-2010, by regional socioeconomic status (SES), sex and age. We selected registers of patients aged 50+ years with HF (International Classification of Diseases, V.9-Clinical Modification, ICD9-CM) caused by traumas of low/moderate energy, from the National Hospital Discharge Database. Annual time series of age-specific incidence rates were calculated by sex and regional SES (deprived, medium, affluent). Generalised additive models were fitted to identify shape/turning points in temporal trends. We selected 96 905 HF (77.3% in women). Women were older than men at admission (81.2±8.5 vs 78.2±10.1 years-old, ptrend (1.7%/year) only in affluent and increasing trends (3.3-3.4%/year) after 2006/2007 in medium and deprived was observed. For men, trends were stable or increased in almost all age/SES groups (only two decreasing periods). For the oldest women, all SES present similar trends: turning points around 2003 (initiating decreasing periods: 1.8-2.9%/year) and around 2007 (initiating increasing periods: 3.7-3.3%/year). There were SES-sex-age inequalities in temporal trends during BJD-Portugal: marked SES inequalities among women aged 65-79 years (a persistent, decreasing trend only in the affluent) vanished among the oldest women; the same was not observed in men, for them, there were almost no declining periods; women aged ≥80 years, presented increasing trends around 2007, as in most deprived/age/sex groups. Despite some successful periods of decreasing trends, incidence rates did not improve overall in almost all age groups and both sexes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Determination of the refractive index and thickness of a thin film embedded in a given stratified medium.

    Science.gov (United States)

    Chabrier, G; Goudonnet, J P; Vernier, P

    1989-07-15

    A thin film deposited on the plane face of a glass substrate or a thin film embedded in a known stratified medium can be characterized by nondestructive optical measurements: transmittance and reflectance for several angles of incidence with s and p polarization. We present here a graphic method for determining the complex refractive index and thickness for thin film optical characterization. Light entering into the medium through a prism or half-cylinder [attenuated total reflection (ATR)] extends the usable angles. Applications are made to very thin metallic films and dielectric films (SiO(x)).

  18. Direct contact condensation induced transition from stratified to slug flow

    International Nuclear Information System (INIS)

    Strubelj, Luka; Ezsoel, Gyoergy; Tiselj, Iztok

    2010-01-01

    Selected condensation-induced water hammer experiments performed on PMK-2 device were numerically modelled with three-dimensional two-fluid models of computer codes NEPTUNE C FD and CFX. Experimental setup consists of the horizontal pipe filled with the hot steam that is being slowly flooded with cold water. In most of the experimental cases, slow flooding of the pipe was abruptly interrupted by a strong slugging and water hammer, while in the selected experimental runs performed at higher initial pressures and temperatures that are analysed in the present work, the transition from the stratified into the slug flow was not accompanied by the water hammer pressure peak. That makes these cases more suitable tests for evaluation of the various condensation models in the horizontally stratified flows and puts them in the range of the available CFD (Computational Fluid Dynamics) codes. The key models for successful simulation appear to be the condensation model of the hot vapour on the cold liquid and the interfacial momentum transfer model. The surface renewal types of condensation correlations, developed for condensation in the stratified flows, were used in the simulations and were applied also in the regions of the slug flow. The 'large interface' model for inter-phase momentum transfer model was compared to the bubble drag model. The CFD simulations quantitatively captured the main phenomena of the experiments, while the stochastic nature of the particular condensation-induced water hammer experiments did not allow detailed prediction of the time and position of the slug formation in the pipe. We have clearly shown that even the selected experiments without water hammer present a tough test for the applied CFD codes, while modelling of the water hammer pressure peaks in two-phase flow, being a strongly compressible flow phenomena, is beyond the capability of the current CFD codes.

  19. Photonic Bandgaps in Mie Scattering by Concentrically Stratified Spheres

    Science.gov (United States)

    Smith, David D.; Fuller, Kirk A.; Curreri, Peter A.

    2002-01-01

    The Mie formulation for homogeneous spheres is generalized to handle core/shell systems and multiple concentric layers in a manner that exploits an analogy with stratified planar systems, thereby allowing concentric multi-layered structures to be treated as photonic bandgap materials. Representative results from a Mie code employing this analogy demonstrate that photonic bands are present for periodic concentric spheres, though not readily apparent in extinction spectra. Rather, the periodicity simply alters the scattering profile, enhancing the ratio of backscattering to forward scattering inside the bandgap, whereas modification of the interference structure is evident in extinction spectra in accordance with the optical theorem

  20. Analysis of photonic band-gap structures in stratified medium

    DEFF Research Database (Denmark)

    Tong, Ming-Sze; Yinchao, Chen; Lu, Yilong

    2005-01-01

    in solving the Maxwell's equations numerically. It expands the temporal derivatives using the finite differences, while it adopts the Fourier transform (FT) properties to expand the spatial derivatives in Maxwell's equations. In addition, the method makes use of the chain-rule property in calculus together...... in electromagnetic and microwave applications once the Maxwell's equations are appropriately modeled. Originality/value - The method validates its values and properties through extensive studies on regular and defective 1D PBG structures in stratified medium, and it can be further extended to solving more...

  1. Electromagnetic fields due to dipole antennas over stratified anisotropic media.

    Science.gov (United States)

    Kong, J. A.

    1972-01-01

    Solutions to the problem of radiation of dipole antennas in the presence of a stratified anisotropic media are facilitated by decomposing a general wave field into transverse magnetic (TM) and transverse electric (TE) modes. Employing the propagation matrices, wave amplitudes in any region are related to those in any other regions. The reflection coefficients, which embed all the information about the geometrical configuration and the physical constituents of the medium, are obtained in closed form. In view of the general formulation, various special cases are discussed.

  2. Fluid mixing in stratified gravity currents: the Prandtl mixing length.

    Science.gov (United States)

    Odier, P; Chen, J; Rivera, M K; Ecke, R E

    2009-04-03

    Shear-induced vertical mixing in a stratified flow is a key ingredient of thermohaline circulation. We experimentally determine the vertical flux of momentum and density of a forced gravity current using high-resolution velocity and density measurements. A constant eddy-viscosity model provides a poor description of the physics of mixing, but a Prandtl mixing length model relating momentum and density fluxes to mean velocity and density gradients works well. For the average gradient Richardson number Ri(g) approximately 0.08 and a Taylor Reynolds number Re(lambda) approximately 100, the mixing lengths are fairly constant, about the same magnitude, comparable to the turbulent shear length.

  3. Stratifying patients with peripheral neuropathic pain based on sensory profiles

    DEFF Research Database (Denmark)

    Vollert, Jan; Maier, Christoph; Attal, Nadine

    2017-01-01

    In a recent cluster analysis, it has been shown that patients with peripheral neuropathic pain can be grouped into 3 sensory phenotypes based on quantitative sensory testing profiles, which are mainly characterized by either sensory loss, intact sensory function and mild thermal hyperalgesia and...... populations that need to be screened to reach a subpopulation large enough to conduct a phenotype-stratified study. The most common phenotype in diabetic polyneuropathy was sensory loss (83%), followed by mechanical hyperalgesia (75%) and thermal hyperalgesia (34%, note that percentages are overlapping...

  4. Trichomonas vaginalis Incidence Associated with Hormonal Contraceptive Use and HIV Infection among Women in Rakai, Uganda

    Directory of Open Access Journals (Sweden)

    Heena Brahmbhatt

    2014-01-01

    Full Text Available Background. Data on the incidence of Trichomonas vaginalis and use of hormonal contraception (HC are limited. Methods. 2,374 sexually active women aged 15–49 years from cohort surveys in Rakai, Uganda, were included. Incidence of T. vaginalis was estimated per 100 person years (py and association between HC (DMPA, Norplant, and oral contraceptives and T. vaginalis infection was assessed by incidence rate ratios (IRR, using Poisson regression models. Results. At baseline, 34.9% had used HC in the last 12 months, 12.8% HIV+, 39.7% with high BV-scores (7–10, and 3.1% syphilis positive. The 12-month incidence of T. vaginalis was 2.4/100 py; CI (1.90, 3.25. When stratified by type of HC used, compared to women who did not use HC or condoms, incidence of T. vaginalis was significantly higher among users of Norplant (adj.IRR = 3.01, CI: 1.07–8.49 and significantly lower among DMPA users (adj.IRR = 0.55, CI: 0.30, 0.98 and women who discontinued HC use at follow-up (adj.IRR = 0.30, CI: 0.09, 0.99. HIV infection was associated with an increase in incidence of T. vaginalis (adj.IRR = 2.34, CI: 1.44, 3.78. Conclusions. Use of Norplant and being HIV+ significantly increased the risk of T. vaginalis, while use of DMPA and discontinuation of overall HC use were associated with a decreased incidence of T. vaginalis.

  5. Random forcing of geostrophic motion in rotating stratified turbulence

    Science.gov (United States)

    Waite, Michael L.

    2017-12-01

    Random forcing of geostrophic motion is a common approach in idealized simulations of rotating stratified turbulence. Such forcing represents the injection of energy into large-scale balanced motion, and the resulting breakdown of quasi-geostrophic turbulence into inertia-gravity waves and stratified turbulence can shed light on the turbulent cascade processes of the atmospheric mesoscale. White noise forcing is commonly employed, which excites all frequencies equally, including frequencies much higher than the natural frequencies of large-scale vortices. In this paper, the effects of these high frequencies in the forcing are investigated. Geostrophic motion is randomly forced with red noise over a range of decorrelation time scales τ, from a few time steps to twice the large-scale vortex time scale. It is found that short τ (i.e., nearly white noise) results in about 46% more gravity wave energy than longer τ, despite the fact that waves are not directly forced. We argue that this effect is due to wave-vortex interactions, through which the high frequencies in the forcing are able to excite waves at their natural frequencies. It is concluded that white noise forcing should be avoided, even if it is only applied to the geostrophic motion, when a careful investigation of spontaneous wave generation is needed.

  6. Analysis of a global random stratified sample of nurse legislation.

    Science.gov (United States)

    Benton, D C; Fernández-Fernández, M P; González-Jurado, M A; Beneit-Montesinos, J V

    2015-06-01

    To identify, compare and contrast the major component parts of heterogeneous stratified sample of nursing legislation. Nursing legislation varies from one jurisdiction to another. Up until now no research exists into whether the variations of such legislation are random or if variations are related to a set of key attributes. This mixed method study used a random stratified sample of legislation to map through documentary analysis the content of 14 nursing acts and then explored, using quantitative techniques, whether the material contained relates to a number of key attributes. These attributes include: legal tradition of the jurisdiction; model of regulation; administrative approach; area of the world; and the economic status of the jurisdiction. Twelve component parts of nursing legislation were identified. These were remarkably similar irrespective of attributes of interest. However, not all component parts were specified in the same level of detail and the manner by which the elements were addressed did vary. A number of potential relationships between the structure of the legislation and the key attributes of interest were identified. This study generated a comprehensive and integrated map of a global sample of nursing legislation. It provides a set of descriptors to be used to undertake further quantitative work and provides an important policy tool to facilitate dialogue between regulatory bodies. At the individual nurse level it offers insights that can help nurses pursue recognition of credentials across jurisdictions. © 2015 International Council of Nurses.

  7. Efficient Radiative Transfer for Dynamically Evolving Stratified Atmospheres

    Science.gov (United States)

    Judge, Philip G.

    2017-12-01

    We present a fast multi-level and multi-atom non-local thermodynamic equilibrium radiative transfer method for dynamically evolving stratified atmospheres, such as the solar atmosphere. The preconditioning method of Rybicki & Hummer (RH92) is adopted. But, pressed for the need of speed and stability, a “second-order escape probability” scheme is implemented within the framework of the RH92 method, in which frequency- and angle-integrals are carried out analytically. While minimizing the computational work needed, this comes at the expense of numerical accuracy. The iteration scheme is local, the formal solutions for the intensities are the only non-local component. At present the methods have been coded for vertical transport, applicable to atmospheres that are highly stratified. The probabilistic method seems adequately fast, stable, and sufficiently accurate for exploring dynamical interactions between the evolving MHD atmosphere and radiation using current computer hardware. Current 2D and 3D dynamics codes do not include this interaction as consistently as the current method does. The solutions generated may ultimately serve as initial conditions for dynamical calculations including full 3D radiative transfer. The National Center for Atmospheric Research is sponsored by the National Science Foundation.

  8. Wave modes in magnetic elements in a stratified atmosphere

    International Nuclear Information System (INIS)

    Wilson, P.R.

    1978-01-01

    The vibration modes of a magnetic flux element embedded in a compressible, gravitationally stratified atmosphere are considered. A local dispersion relation is first derived for a force-free field which decreases exponentially with height, and this is applied to a magnetic flux sheath lying within the local region. The sheath is embedded in an isothermal, gravitationally stratified plasma for which the standard dispersion relation applies globally.The velocity and pressure balance conditions across the interface restrict the possible vibration modes of the system. For the pulsation or varicose mode, a modified acoustic mode and a modified fast mode are obtained. The latter has a cutoff frequency which is greater than the acoustic cutoff and suggests that waves of shorter periods may occur in the presence of magnetic elements.For the sinuous or taut wire mode, complex solutions for the dispersion equation are obtained. For one of these the real part is large and negative, indicating that, within the limitations of a linear analysis, waves propagate with increasing amplitude. The possible significance of this is briefly discussed

  9. Designing Wood Supply Scenarios from Forest Inventories with Stratified Predictions

    Directory of Open Access Journals (Sweden)

    Philipp Kilham

    2018-02-01

    Full Text Available Forest growth and wood supply projections are increasingly used to estimate the future availability of woody biomass and the correlated effects on forests and climate. This research parameterizes an inventory-based business-as-usual wood supply scenario, with a focus on southwest Germany and the period 2002–2012 with a stratified prediction. First, the Classification and Regression Trees algorithm groups the inventory plots into strata with corresponding harvest probabilities. Second, Random Forest algorithms generate individual harvest probabilities for the plots of each stratum. Third, the plots with the highest individual probabilities are selected as harvested until the harvest probability of the stratum is fulfilled. Fourth, the harvested volume of these plots is predicted with a linear regression model trained on harvested plots only. To illustrate the pros and cons of this method, it is compared to a direct harvested volume prediction with linear regression, and a combination of logistic regression and linear regression. Direct harvested volume regression predicts comparable volume figures, but generates these volumes in a way that differs from business-as-usual. The logistic model achieves higher overall classification accuracies, but results in underestimations or overestimations of harvest shares for several subsets of the data. The stratified prediction method balances this shortcoming, and can be of general use for forest growth and timber supply projections from large-scale forest inventories.

  10. Beyond Genetics—Stratified and Personalised Medicines Using Multiple Parameters

    Directory of Open Access Journals (Sweden)

    Richard Peck

    2010-05-01

    Full Text Available Prescribers have been practicing stratified medicine for many years. Patient characteristics, usually non-genetic, including age, comorbidities and concomitant medications are taken into account when deciding which drug to prescribe. In addition, the majority of drugs require dose adjustments across patient subgroups, usually determined by non-genetic differences between the subgroups. Whilst pharmacogenetics hold promise for enhancing treatment stratification and even treatment individualisation, non-genetic factors will continue to be very important. Both non-genetic and genetic factors must be considered to improve understanding and quantification of the variability in treatment outcomes and to guide stratification and targeting of patient subgroups to the right drug and also to the right range of doses within that subgroup. Development of stratified medicines must consider non-genetic as well as genetic factors and, where appropriate, include stratification through optimising the dose for each patient or subgroup as well as by choosing the drug most likely to deliver efficacy to that patient or group.

  11. Crystallization of a compositionally stratified basal magma ocean

    Science.gov (United States)

    Laneuville, Matthieu; Hernlund, John; Labrosse, Stéphane; Guttenberg, Nicholas

    2018-03-01

    Earth's ∼3.45 billion year old magnetic field is regenerated by dynamo action in its convecting liquid metal outer core. However, convection induces an isentropic thermal gradient which, coupled with a high core thermal conductivity, results in rapid conducted heat loss. In the absence of implausibly high radioactivity or alternate sources of motion to drive the geodynamo, the Earth's early core had to be significantly hotter than the melting point of the lower mantle. While the existence of a dense convecting basal magma ocean (BMO) has been proposed to account for high early core temperatures, the requisite physical and chemical properties for a BMO remain controversial. Here we relax the assumption of a well-mixed convecting BMO and instead consider a BMO that is initially gravitationally stratified owing to processes such as mixing between metals and silicates at high temperatures in the core-mantle boundary region during Earth's accretion. Using coupled models of crystallization and heat transfer through a stratified BMO, we show that very high temperatures could have been trapped inside the early core, sequestering enough heat energy to run an ancient geodynamo on cooling power alone.

  12. A modified stratified model for the 3C 273 jet

    International Nuclear Information System (INIS)

    Liu Wenpo; Shen Zhiqiang

    2009-01-01

    We present a modified stratified jet model to interpret the observed spectral energy distributions of knots in the 3C 273 jet. Based on the hypothesis of the single index of the particle energy spectrum at injection and identical emission processes among all the knots, the observed difference of spectral shape among different 3C 273 knots can be understood as a manifestation of the deviation of the equivalent Doppler factor of stratified emission regions in an individual knot from a characteristic one. The summed spectral energy distributions of all ten knots in the 3C 273 jet can be well fitted by two components: a low-energy component (radio to optical) dominated by synchrotron radiation and a high-energy component (UV, X-ray and γ-ray) dominated by inverse Compton scattering of the cosmic microwave background. This gives a consistent spectral index of α = 0.88 (S v ∝ v -α ) and a characteristic Doppler factor of 7.4. Assuming the average of the summed spectrum as the characteristic spectrum of each knot in the 3C 273 jet, we further get a distribution of Doppler factors. We discuss the possible implications of these results for the physical properties in the 3C 273 jet. Future GeV observations with GLAST could separate the γ-ray emission of 3C 273 from the large scale jet and the small scale jet (i.e. the core) through measuring the GeV spectrum.

  13. STRESS DISTRIBUTION IN THE STRATIFIED MASS CONTAINING VERTICAL ALVEOLE

    Directory of Open Access Journals (Sweden)

    Bobileva Tatiana Nikolaevna

    2017-08-01

    Full Text Available Almost all subsurface rocks used as foundations for various types of structures are stratified. Such heterogeneity may cause specific behaviour of the materials under strain. Differential equations describing the behaviour of such materials contain rapidly fluctuating coefficients, in view of this, solution of such equations is more time-consuming when using today’s computers. The method of asymptotic averaging leads to getting homogeneous medium under study to averaged equations with fixed factors. The present article is concerned with stratified soil mass consisting of pair-wise alternative isotropic elastic layers. In the results of elastic modules averaging, the present soil mass with horizontal rock stratification is simulated by homogeneous transversal-isotropic half-space with isotropy plane perpendicular to the standing axis. Half-space is loosened by a vertical alveole of circular cross-section, and virgin ground is under its own weight. For horizontal parting planes of layers, the following two types of surface conditions are set: ideal contact and backlash without cleavage. For homogeneous transversal-isotropic half-space received with a vertical alveole, the analytical solution of S.G. Lekhnitsky, well known in scientific papers, is used. The author gives expressions for stress components and displacements in soil mass for different marginal conditions on the alveole surface. Such research problems arise when constructing and maintaining buildings and when composite materials are used.

  14. Energetics of stratified turbulent mixing at geophysical scales

    Science.gov (United States)

    Scotti, Alberto; Passaggia, Pierre-Yves; White, Brian

    2017-11-01

    Energy-based arguments provide a fundamental diagnostic tool in turbulent flows. In stratified incompressible flows, there are two reservoirs of energy, the kinetic and potential energy. However, the standard expression Ep = ρgZ for the latter is not convex, and thus, within an energetic framework based on this definition, turbulent fluctuations have zero potential energy, a rather unsatisfactorily state of affairs. The solution is to modify the definition of potential energy to include only the portion that is effectively available. This introduces the concept of Available Potential Energy (APE). In this talk, we approach the problem of APE using a general framework which recovers the standard buoyancy-only dependent formulation in non-rotating systems. Unlike the standard formulation, rotation can be included in a natural way, in which case the Available Energy depends both on the buoyancy and potential vorticity distribution. We will show results from experiments of stratified mixing at oceanic values of the Gibson number conducted in our large flume. The goal of this experiments is to shed some light on the controversy surrounding the relationship between the mixing efficiency and the Gibson number. Funded by NSF-OCE-1155558 and OCE-1736989.

  15. Tidally-forced flow in a rotating, stratified, shoaling basin

    Science.gov (United States)

    Winters, Kraig B.

    2015-06-01

    Baroclinic flow of a rotating, stratified fluid in a parabolic basin is computed in response to barotropic tidal forcing using the nonlinear, non-hydrostatic, Boussinesq equations of motion. The tidal forcing is derived from an imposed, boundary-enhanced free-surface deflection that advances cyclonically around a central amphidrome. The tidal forcing perturbs a shallow pycnocline, sloshing it up and down over the shoaling bottom. Nonlinearities in the near-shore internal tide produce an azimuthally independent 'set-up' of the isopycnals that in turn drives an approximately geostrophically balanced, cyclonic, near-shore, sub-surface jet. The sub-surface cyclonic jet is an example of a slowly evolving, nearly balanced flow that is excited and maintained solely by forcing in the fast, super-inertial frequency band. Baroclinic instability of the nearly balanced jet and subsequent interactions between eddies produce a weak transfer of energy back into the inertia-gravity band as swirling motions with super-inertial vorticity stir the stratified fluid and spontaneously emit waves. The sub-surface cyclonic jet is similar in many ways to the poleward flows observed along eastern ocean boundaries, particularly the California Undercurrent. It is conjectured that such currents may be driven by the surface tide rather than by winds and/or along-shore pressure gradients.

  16. Crenothrix are major methane consumers in stratified lakes.

    Science.gov (United States)

    Oswald, Kirsten; Graf, Jon S; Littmann, Sten; Tienken, Daniela; Brand, Andreas; Wehrli, Bernhard; Albertsen, Mads; Daims, Holger; Wagner, Michael; Kuypers, Marcel Mm; Schubert, Carsten J; Milucka, Jana

    2017-09-01

    Methane-oxidizing bacteria represent a major biological sink for methane and are thus Earth's natural protection against this potent greenhouse gas. Here we show that in two stratified freshwater lakes a substantial part of upward-diffusing methane was oxidized by filamentous gamma-proteobacteria related to Crenothrix polyspora. These filamentous bacteria have been known as contaminants of drinking water supplies since 1870, but their role in the environmental methane removal has remained unclear. While oxidizing methane, these organisms were assigned an 'unusual' methane monooxygenase (MMO), which was only distantly related to 'classical' MMO of gamma-proteobacterial methanotrophs. We now correct this assignment and show that Crenothrix encode a typical gamma-proteobacterial PmoA. Stable isotope labeling in combination swith single-cell imaging mass spectrometry revealed methane-dependent growth of the lacustrine Crenothrix with oxygen as well as under oxygen-deficient conditions. Crenothrix genomes encoded pathways for the respiration of oxygen as well as for the reduction of nitrate to N 2 O. The observed abundance and planktonic growth of Crenothrix suggest that these methanotrophs can act as a relevant biological sink for methane in stratified lakes and should be considered in the context of environmental removal of methane.

  17. Instability and mixing in interacting stratified shear layers

    Science.gov (United States)

    Joe, W. T.; Caulfield, C. P.

    2003-11-01

    Often in geophysical fluid flows, a stratified shear flow undergoes a transition to turbulence, leading to markedly enhanced mixing of the fluid parcels, and deceleration of the forcing shear flow. Such mixing events generically lead to the development of a layered density distribution, with deep layers of relatively well-mixed fluid separated by relatively thin interfaces of strong density gradient. There are certain circumstances in which re-intensification of the shear by the external forcing is initially localized in the vicinity of the strong density gradient interfaces. We consider numerically the behaviour of a simple example of such flows, where a relatively deep well-mixed layer is bordered by two thin interfaces of stronger density gradient, each of which is subject to a localized velocity shear. We find that the stability and subsequent behaviour of such flows are qualitatively and quantitatively dependent on the overall stratification. Sufficiently strongly stratified flows lead to Kelvin-Helmholtz instabilities and associated mixing events which remain localized in the vicinity of the interfaces, while weaker stratification allows for intense interaction across the interior well-mixed layer.

  18. Measuring mixing efficiency in experiments of strongly stratified turbulence

    Science.gov (United States)

    Augier, P.; Campagne, A.; Valran, T.; Calpe Linares, M.; Mohanan, A. V.; Micard, D.; Viboud, S.; Segalini, A.; Mordant, N.; Sommeria, J.; Lindborg, E.

    2017-12-01

    Oceanic and atmospheric models need better parameterization of the mixing efficiency. Therefore, we need to measure this quantity for flows representative of geophysical flows, both in terms of types of flows (with vortices and/or waves) and of dynamical regimes. In order to reach sufficiently large Reynolds number for strongly stratified flows, experiments for which salt is used to produce the stratification have to be carried out in a large rotating platform of at least 10-meter diameter.We present new experiments done in summer 2017 to study experimentally strongly stratified turbulence and mixing efficiency in the Coriolis platform. The flow is forced by a slow periodic movement of an array of large vertical or horizontal cylinders. The velocity field is measured by 3D-2C scanned horizontal particles image velocimetry (PIV) and 2D vertical PIV. Six density-temperature probes are used to measure vertical and horizontal profiles and signals at fixed positions.We will show how we rely heavily on open-science methods for this study. Our new results on the mixing efficiency will be presented and discussed in terms of mixing parameterization.

  19. Optimal energy growth in a stably stratified shear flow

    Science.gov (United States)

    Jose, Sharath; Roy, Anubhab; Bale, Rahul; Iyer, Krithika; Govindarajan, Rama

    2018-02-01

    Transient growth of perturbations by a linear non-modal evolution is studied here in a stably stratified bounded Couette flow. The density stratification is linear. Classical inviscid stability theory states that a parallel shear flow is stable to exponentially growing disturbances if the Richardson number (Ri) is greater than 1/4 everywhere in the flow. Experiments and numerical simulations at higher Ri show however that algebraically growing disturbances can lead to transient amplification. The complexity of a stably stratified shear flow stems from its ability to combine this transient amplification with propagating internal gravity waves (IGWs). The optimal perturbations associated with maximum energy amplification are numerically obtained at intermediate Reynolds numbers. It is shown that in this wall-bounded flow, the three-dimensional optimal perturbations are oblique, unlike in unstratified flow. A partitioning of energy into kinetic and potential helps in understanding the exchange of energies and how it modifies the transient growth. We show that the apportionment between potential and kinetic energy depends, in an interesting manner, on the Richardson number, and on time, as the transient growth proceeds from an optimal perturbation. The oft-quoted stabilizing role of stratification is also probed in the non-diffusive limit in the context of disturbance energy amplification.

  20. Review of the United States universal varicella vaccination program: Herpes zoster incidence rates, cost-effectiveness, and vaccine efficacy based primarily on the Antelope Valley Varicella Active Surveillance Project data

    Science.gov (United States)

    Goldman, G.S.; King, P.G.

    2013-01-01

    In a cooperative agreement starting January 1995, prior to the FDA's licensure of the varicella vaccine on March 17, the Centers for Disease Control and Prevention (CDC) funded the Los Angeles Department of Health Services’ Antelope Valley Varicella Active Surveillance Project (AV-VASP). Since only varicella case reports were gathered, baseline incidence data for herpes zoster (HZ) or shingles was lacking. Varicella case reports decreased 72%, from 2834 in 1995 to 836 in 2000 at which time approximately 50% of children under 10 years of age had been vaccinated. Starting in 2000, HZ surveillance was added to the project. By 2002, notable increases in HZ incidence rates were reported among both children and adults with a prior history of natural varicella. However, CDC authorities still claimed that no increase in HZ had occurred in any US surveillance site. The basic assumptions inherent to the varicella cost–benefit analysis ignored the significance of exogenous boosting caused by those shedding wild-type VZV. Also ignored was the morbidity associated with even rare serious events following varicella vaccination as well as the morbidity from increasing cases of HZ among adults. Vaccine efficacy declined below 80% in 2001. By 2006, because 20% of vaccinees were experiencing breakthrough varicella and vaccine-induced protection was waning, the CDC recommended a booster dose for children and, in 2007, a shingles vaccination was approved for adults aged 60 years and older. In the prelicensure era, 95% of adults experienced natural chickenpox (usually as children)—these cases were usually benign and resulted in long-term immunity. Varicella vaccination is less effective than the natural immunity that existed in prevaccine communities. Universal varicella vaccination has not proven to be cost-effective as increased HZ morbidity has disproportionately offset cost savings associated with reductions in varicella disease. Universal varicella vaccination has failed to

  1. Postoperative Complications of Total Joint Arthroplasty in Obese Patients Stratified by BMI.

    Science.gov (United States)

    Zusmanovich, Mikhail; Kester, Benjamin S; Schwarzkopf, Ran

    2018-03-01

    High body mass index (BMI) is associated with significant complications in patients undergoing total joint arthroplasty. Many studies have evaluated this trend, but few have looked at the rates of complications based on BMI as a continuous variable. The purpose of this study was to stratify obese patients into 3 BMI categories and evaluate their rates of complications and gauge whether transitioning from higher to lower BMI category lowers complication. Patients undergoing primary total joint arthroplasty were selected from the National Surgical Quality Improvement Program database from 2008-2015 and arranged into 3 groups based on BMI: O1 (BMI 30-34.9 kg/m 2 ), O2 (BMI 35-39.9 kg/m 2 ), and O3 (BMI >40 kg/m 2 ). Thirty-day complications were recorded and evaluated utilizing univariate and multivariate analyses stratified by BMI. A total of 268,663 patients were identified. Patients with a BMI >30 kg/m 2 had more infectious and medical complications compared with nonobese patients. Furthermore, there were increased complications as the BMI categories increased. Patients with a BMI >40 kg/m 2 (O3) had longer operating times, length of stay, higher rates of readmissions, reoperations, deep venous thrombosis, renal insufficiency, superficial infections, deep infections, and wound dehiscence. These trends were present when comparing the O2 with O1 category as well. We have demonstrated increased rates of medical and surgical complications in obese patients. Furthermore, we demonstrated a stepwise increase in complication rates when transitioning to higher BMI groups. Based on our data, we believe that preoperative counseling and interventions to decrease BMI should be explored before offering elective surgery to obese patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Strongly Stratified Turbulence Wakes and Mixing Produced by Fractal Wakes

    Science.gov (United States)

    Dimitrieva, Natalia; Redondo, Jose Manuel; Chashechkin, Yuli; Fraunie, Philippe; Velascos, David

    2017-04-01

    This paper describes Shliering and Shadowgraph experiments of the wake induced mixing produced by tranversing a vertical or horizontal fractal grid through the interfase between two miscible fluids at low Atwood and Reynolds numbers. This is a configuration design to models the mixing across isopycnals in stably-stratified flows in many environmental relevant situations (either in the atmosphere or in the ocean. The initial unstable stratification is characterized by a reduced gravity: g' = gΔρ ρ where g is gravity, Δρ being the initial density step and ρ the reference density. Here the Atwood number is A = g' _ 2 g . The topology of the fractal wake within the strong stratification, and the internal wave field produces both a turbulent cascade and a wave cascade, with frecuen parametric resonances, the envelope of the mixing front is found to follow a complex non steady 3rd order polinomial function with a maximum at about 4-5 Brunt-Vaisalla non-dimensional time scales: t/N δ = c1(t/N) + c2g Δρ ρ (t/N)2 -c3(t/N)3. Conductivity probes and Shliering and Shadowgraph visual techniques, including CIV with (Laser induced fluorescence and digitization of the light attenuation across the tank) are used in order to investigate the density gradients and the three-dimensionality of the expanding and contracting wake. Fractal analysis is also used in order to estimate the fastest and slowest growing wavelengths. The large scale structures are observed to increase in wave-length as the mixing progresses, and the processes involved in this increase in scale are also examined.Measurements of the pointwise and horizontally averaged concentrations confirm the picture obtained from past flow visualization studies. They show that the fluid passes through the mixing region with relatively small amounts of molecular mixing,and the molecular effects only dominate on longer time scales when the small scales have penetrated through the large scale structures. The Non

  3. Cancer incidence among waiters

    DEFF Research Database (Denmark)

    Reijula, Jere; Kjaerheim, Kristina; Lynge, Elsebeth

    2015-01-01

    AIMS: To study cancer risk patterns among waiters in the Nordic countries. METHODS: We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were...... diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population. RESULTS: The SIR of all cancers in waiters, in the five countries combined......, was 1.46 (95% CI 1.41-1.51) in men and 1.09 (1.07-1.11) in women. In male waiters, the SIR decreased from 1.79 (1.63-1.96) in 1961-1975, to 1.33 (1.26-1.40) in 1991-2005, but remained stable among women. The SIR among male waiters was highest for cancers in the pharynx (6.11; 95% CI 5.02-7.37), oral...

  4. Worldwide Incidence of Colorectal Cancer, Leukemia, and Lymphoma in Inflammatory Bowel Disease: An Updated Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Chelle L. Wheat

    2016-01-01

    Full Text Available Background/Aims. Inflammatory bowel disease (IBD is associated with an increased risk of colorectal cancer (CRC. In addition, there may be an association between leukemia and lymphoma and IBD. We conducted a systematic review and meta-analysis of the IBD literature to estimate the incidence of CRC, leukemia, and lymphoma in adult IBD patients. Methods. Studies were identified by a literature search of PubMed, Cochrane Library, Medline, Web of Science, Scopus, EMBASE, and ProQuest Dissertations and Theses. Pooled incidence rates (per 100,000 person-years [py] were calculated through use of a random effects model, unless substantial heterogeneity prevented pooling of estimates. Several stratified analyses and metaregression were performed to explore potential study heterogeneity and bias. Results. Thirty-six articles fulfilled the inclusion criteria. For CRC, the pooled incidence rate in CD was 53.3/100,000 py (95% CI 46.3–60.3/100,000. The incidence of leukemia was 1.5/100,000 py (95% CI −0.06–3.0/100,000 in IBD, 0.3/100,000 py (95% CI −1.0–1.6/100,000 in CD, and 13.0/100,000 py (95% CI 5.8–20.3/100,000 in UC. For lymphoma, the pooled incidence rate in CD was 0.8/100,000 py (95% CI −0.4–2.1/100,000. Substantial heterogeneity prevented the pooling of other incidence estimates. Conclusion. The incidence of CRC, leukemia, and lymphoma in IBD is low.

  5. Trends of Incidence and Risk Factors of Ventilator-Associated Pneumonia in Elderly Patients Admitted to French ICUs Between 2007 and 2014.

    Science.gov (United States)

    Dananché, Cédric; Vanhems, Philippe; Machut, Anaïs; Aupée, Martine; Bervas, Caroline; L'Hériteau, François; Lepape, Alain; Lucet, Jean-Christophe; Stoeckel, Vincent; Timsit, Jean-François; Berger-Carbonne, Anne; Savey, Anne; Bénet, Thomas

    2018-02-09

    To assess trends and risk factors of ventilator-associated pneumonia according to age, particularly in the elderly admitted to French ICUs between 2007 and 2014. Multicenter, prospective French national Healthcare-Associated Infection surveillance network of ICUs ("Réseau REA-Raisin"). Two-hundred fifty six ICUs in 246 settings in France. Included were all adult patients hospitalized greater than or equal to 48 hours in ICUs participating in the network. Ventilator-associated pneumonia surveillance over time. Overall and multidrug-resistant organism-related ventilator-associated pneumonia incidence rates were expressed per 1,000 intubation days at risk. Age was stratified into three groups: young (18-64 yr old), old (65-74 yr old), and very old (75+ yr old). Age-stratified multivariate mixed-effects Poisson regressions were undertaken to assess trends of ventilator-associated pneumonia incidence over time, with center as the random effect. Ventilator-associated pneumonia risk factors were also evaluated. Of 206,223 patients, 134,510 were intubated: 47.8% were young, 22.3% were old, and 29.9% were very old. Ventilator-associated pneumonia incidence was lower in the very old group compared with the young group (14.51; 95% CI, 16.95-17.70 vs 17.32; 95% CI, 16.95-17.70, respectively, p associated pneumonia incidence decreased selectively in the young and old groups over time (adjusted incidence rate ratios, 0.88; 95% CI, 0.82-0.94; p associated with ventilator-associated pneumonia in the three age groups, whereas antibiotics at admission was a protective factor. Scheduled surgical ICU and immunodeficiency were risk factors of ventilator-associated pneumonia in the old group (p = 0.003). Ventilator-associated pneumonia incidence is lower but did not decrease over time in very old patients compared with young patients.

  6. Constipation and Incident CKD.

    Science.gov (United States)

    Sumida, Keiichi; Molnar, Miklos Z; Potukuchi, Praveen K; Thomas, Fridtjof; Lu, Jun Ling; Matsushita, Kunihiro; Yamagata, Kunihiro; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P

    2017-04-01

    Constipation is one of the most prevalent conditions in primary care settings and increases the risk of cardiovascular disease, potentially through processes mediated by altered gut microbiota. However, little is known about the association of constipation with CKD. In a nationwide cohort of 3,504,732 United States veterans with an eGFR ≥60 ml/min per 1.73 m 2 , we examined the association of constipation status and severity (absent, mild, or moderate/severe), defined using diagnostic codes and laxative use, with incident CKD, incident ESRD, and change in eGFR in Cox models (for time-to-event analyses) and multinomial logistic regression models (for change in eGFR). Among patients, the mean (SD) age was 60.0 (14.1) years old; 93.2% of patients were men, and 24.7% were diabetic. After multivariable adjustments, compared with patients without constipation, patients with constipation had higher incidence rates of CKD (hazard ratio, 1.13; 95% confidence interval [95% CI], 1.11 to 1.14) and ESRD (hazard ratio, 1.09; 95% CI, 1.01 to 1.18) and faster eGFR decline (multinomial odds ratios for eGFR slope constipation associated with an incrementally higher risk for each renal outcome. In conclusion, constipation status and severity associate with higher risk of incident CKD and ESRD and with progressive eGFR decline, independent of known risk factors. Further studies should elucidate the underlying mechanisms. Copyright © 2017 by the American Society of Nephrology.

  7. Evaluating the Effectiveness of an Antimicrobial Stewardship Program on Reducing the Incidence Rate of Healthcare-Associated Clostridium difficile Infection: A Non-Randomized, Stepped Wedge, Single-Site, Observational Study.

    Directory of Open Access Journals (Sweden)

    Giulio DiDiodato

    Full Text Available The incidence rate of healthcare-associated Clostridium difficile infection (HA-CDI is estimated at 1 in 100 patients. Antibiotic exposure is the most consistently reported risk factor for HA-CDI. Strategies to reduce the risk of HA-CDI have focused on reducing antibiotic utilization. Prospective audit and feedback is a commonly used antimicrobial stewardship intervention (ASi. The impact of this ASi on risk of HA-CDI is equivocal. This study examines the effectiveness of a prospective audit and feedback ASi on reducing the risk of HA-CDI.Single-site, 339 bed community-hospital in Barrie, Ontario, Canada. Primary outcome is HA-CDI incidence rate. Daily prospective and audit ASi is the exposure variable. ASi implemented across 6 wards in a non-randomized, stepped wedge design. Criteria for ASi; any intravenous antibiotic use for ≥ 48 hrs, any oral fluoroquinolone or oral second generation cephalosporin use for ≥ 48 hrs, or any antimicrobial use for ≥ 5 days. HA-CDI cases and model covariates were aggregated by ward, year and month starting September 2008 and ending February 2016. Multi-level mixed effect negative binomial regression analysis was used to model the primary outcome, with intercept and slope coefficients for ward-level random effects estimated. Other covariates tested for inclusion in the final model were derived from previously published risk factors. Deviance residuals were used to assess the model's goodness-of-fit.The dataset included 486 observation periods, of which 350 were control periods and 136 were intervention periods. After accounting for all other model covariates, the estimated overall ASi incidence rate ratio (IRR was 0.48 (95% 0.30, 0.79. The ASi effect was independent of antimicrobial utilization. The ASi did not seem to reduce the risk of Clostridium difficile infection on the surgery wards (IRR 0.87, 95% CI 0.45, 1.69 compared to the medicine wards (IRR 0.42, 95% CI 0.28, 0.63. The ward-level burden of

  8. Cancer incidence and mortality in Hebei province, 2013

    Science.gov (United States)

    He, Yutong; Liang, Di; Li, Daojuan; Shi, Jin; Jin, Jing; Zhai, Jingbo; Wen, Denggui; Shan, Baoen

    2017-01-01

    Abstract To estimate the numbers of new cancer cases and deaths in Hebei province in 2013 and to investigate the real cancer burden in Hebei province to develop strategies for cancer prevention and control. Data on new cancer cases and deaths in 2013 were collected from 31 population-based cancer registries of Hebei province. All data were checked and evaluated based on data quality criteria from the “Chinese Guideline for Cancer Registration” and “Cancer Incidence in Five Continents Volume IX” by the International Agency for Research on Cancer/International Association of Cancer Registration (IARC/IACR). Qualified data from 21 registries were used for analysis after evaluation. Data analysis was stratified by areas (urban/rural), gender, age group, and cancer type. New cancer cases and deaths in Hebei province were estimated using age-specific rates and the corresponding provincial population. The 10 most common cancers in different groups and the cumulative rates were calculated. The Chinese population census in 2000 and the population of Segi were used for age-standardized incidence/mortality rates. The covered populations included 11, 185,626 people (5,709,393 in males and 5,476,233 in females) from 21 qualified cancer registries, accounting for 15.25% of Hebei provincial population. The major indicators of quality control, that is, the percentage of cases morphologically verified (MV%), percentage of cancer cases identified with a death certificate only (DCO%), and the mortality to incidence rate ratio (M/I), were 75.56%, 3.23%, and 0.65, respectively. In 2013, it was estimated that there were approximately 164,100 newly diagnosed cancer cases and 105,200 cancer deaths in Hebei province. The incidence rate of cancer was 225.36/100,000 (248.03/100,000 in males, 201.73/100,000 in females), and the age-standardized incidence rates by Chinese standard population (ASIRC) and the world standard population (ASIRW) were 182.81/100,000 and 181

  9. Produção de biomassa e rizomas e incidência de "Metsubure" em taro submetido a doses de potássio com e sem adição de cálcio Biomass accumulation, yield and "Metsubure" incidence in taro corms submitted to potassium rates, with and without calcium application

    Directory of Open Access Journals (Sweden)

    Francisco HF Pereira

    2006-03-01

    Full Text Available Avaliou-se o efeito de doses crescentes de potássio (K, em solo com e sem aplicação de cálcio (Ca, na produção de biomassa, produção de rizomas, teores de K e Ca e incidência de "Metsubure" em rizomas de taro. O experimento foi conduzido em vasos contendo 10 L de solo, em casa de vegetação, de 19/10/2002 a 20/07/2003, com o taro 'Chinês' (BGH 5928. Foram avaliadas cinco doses de K (0; 150; 300; 600 e 1.200 mg K2O kg-1 de solo, sem e com adição de Ca (0 e 232 mg Ca kg-1 de solo, dispostas no delineamento inteiramente casualizado, em esquema fatorial 5 x 2, com quatro repetições. Produções de biomassa e de rizomas apresentaram comportamento semelhante em resposta às doses de K, em presença e ausência da adição do Ca. Valores máximos de biomassa seca e produção de rizomas foram verificados com a adição de Ca nas doses de 794 e 760 mg K2O kg-1 de solo, respectivamente. Sob baixa dose de K, as massas secas de rizomas e totais, a produção de massa fresca e o número de rizomas-filho por planta foram maiores na ausência do que presença de Ca, sendo esse comportamento invertido a partir das doses de K2O de 85; 46; 202 e 578 mg kg-1 de solo, respectivamente. Na ausência da adição de Ca incrementos na dose de K promoveram redução da concentração de Ca nos rizomas-filho; a concentração de K nesses rizomas aumentou com o incremento na dose de K, independentemente da adição de Ca. Na ausência de adição de Ca e nas doses de 600 e 1.200 mg K2O kg-1 de solo constatou-se a incidência do sintoma de "Metsubure" em 6,56 e 9,84% dos rizomas-filho, respectivamente.The biomass accumulation (cormels and total plant dry weight, yield (fresh weight and number of cormels and "Metsubure" incidence in taro cormels was evaluated on plants submitted to distinct potassium (K fertilizer rates, with and without calcium (Ca application. The experiment was conduced in a glasshouse from 10/19/2002 to 07/20/2003, with the taro 'Chin

  10. Persistence of the Gender Gap and Low Employment of Female Workers in a Stratified Labor Market: Evidence from South Korea

    OpenAIRE

    Joonmo Cho; Jaeseong Lee

    2015-01-01

    The gender gap in working conditions has barely improved in South Korea where various measures for gender equality have been in place for a relatively long time. Furthermore, the female employment rate is also the lowest in OECD (Organization for Economic Cooperation and Development) countries. This study will evaluate the stratified structure of the labor market to identify the causes and will analyze changes in the gender employment distribution and mobility. This study conducted an empiric...

  11. Vortices in rotating and stratified flows: aspect ratio and sustainability

    Directory of Open Access Journals (Sweden)

    Le Gal P.

    2013-04-01

    Full Text Available In linear stratifications, vortices have a typical flat shape that appears to be not only a compromise between the rotation and the stratification of the background flow through their Coriolis parameter f and buoyancy frequency hbox{$ar{N}$} N̅ , but also involves the buoyancy frequency Nc within the vortices and their Rossby number Ro. We derive an analytical solution for the self-similar ellipsoidal shape of the vortices and the law for their aspect ratio. From this law, we show that long-lived vortices must necessary be either weakly stratified anticyclones or superstratified cyclones (which is less likely to occur. These predictions are experimentally and numerically verified and agree with published measurements for Jovian vortices and ocean meddies. This approach can be applied to a gaussian stratification to give good insights of the shape of vortices in protoplanetary disks and their sustainability.

  12. Nonlinear evolution of a layered stratified shear flow

    Science.gov (United States)

    Lee, V.; Caulfield, C. P.

    2001-10-01

    We investigate numerically and theoretically the nonlinear evolution of a parallel shear flow at moderate Reynolds number which has embedded within it a mixed layer of intermediate fluid. The two relatively thin strongly stratified density interfaces are centered on the edges of the shear layer. We are particularly interested in the development of primary and secondary instabilities. We present the results of a stability analysis which predicts that such flows may be unstable to stationary vortical disturbances which are a generalization of an inviscid instability first considered by G.I. Taylor. We investigate the behavior of these "Taylor billows" at finite amplitude through two-dimensional numerical simulations. We observe that the braid regions connecting adjacent primary Taylor billows are susceptible to secondary, inherently two-dimensional instabilities. We verify that these secondary instabilities, which take the form of small elliptical vortices, arise due to a local intensification of the spanwise vorticity in the braid region.

  13. The Risk-Stratified Osteoporosis Strategy Evaluation study (ROSE)

    DEFF Research Database (Denmark)

    Rubin, Katrine Hass; Holmberg, Teresa; Rothmann, Mette Juel

    2015-01-01

    The risk-stratified osteoporosis strategy evaluation study (ROSE) is a randomized prospective population-based study investigating the effectiveness of a two-step screening program for osteoporosis in women. This paper reports the study design and baseline characteristics of the study population....... 35,000 women aged 65-80 years were selected at random from the population in the Region of Southern Denmark and-before inclusion-randomized to either a screening group or a control group. As first step, a self-administered questionnaire regarding risk factors for osteoporosis based on FRAX......(®) was issued to both groups. As second step, subjects in the screening group with a 10-year probability of major osteoporotic fractures ≥15 % were offered a DXA scan. Patients diagnosed with osteoporosis from the DXA scan were advised to see their GP and discuss pharmaceutical treatment according to Danish...

  14. Internal combustion engine using premixed combustion of stratified charges

    Science.gov (United States)

    Marriott, Craig D [Rochester Hills, MI; Reitz, Rolf D [Madison, WI

    2003-12-30

    During a combustion cycle, a first stoichiometrically lean fuel charge is injected well prior to top dead center, preferably during the intake stroke. This first fuel charge is substantially mixed with the combustion chamber air during subsequent motion of the piston towards top dead center. A subsequent fuel charge is then injected prior to top dead center to create a stratified, locally richer mixture (but still leaner than stoichiometric) within the combustion chamber. The locally rich region within the combustion chamber has sufficient fuel density to autoignite, and its self-ignition serves to activate ignition for the lean mixture existing within the remainder of the combustion chamber. Because the mixture within the combustion chamber is overall premixed and relatively lean, NO.sub.x and soot production are significantly diminished.

  15. [Analysis of cancer incidence and mortality in elderly population in China, 2013].

    Science.gov (United States)

    Chen, W Q; Zheng, R S; Zhang, S W; Zeng, H M; Zou, X N; He, J

    2017-01-23

    Objective: To estimate the cancer incidence and mortality in elderly Chinese population in 2013 based on the data from local cancer registries submitted to National Central Cancer Registry (NCCR). Methods: Data from 255 cancer registries submitted to NCCR with qualified data after checked and evaluated, were selected for this estimation. Cancer incidence and mortality were stratified by areas, sex, age groups and cancer site, combined with population data of the year 2013 to estimate cancer epidemiology in older people in China. Chinese population census in 2000 and Segi's population were used for the estimation of age-standardized incidence/mortality rates. Results: All the 255 cancer registries (88 in urban and 167 in rural areas) were selected for this estimation, covered 37 407 728 elderly subjects, accounting for 17.73% of the entire national elderly population. It was estimated about 2 171.0 thousand new cancer cases in older people in China, accounting for 58.96% of all cancer incidence, with the crude incidence rate of 1 029.16/100 000 (1 297.96 per 100 000 in male, 777.18 per 100 000 in female), and the age-standardized incidence rate by Chinese standard population (ASIRC, 2000) was 1 019.25 per 100 000. It was estimated about 1 600.5 thousand deaths in older people in China, accounting for 67.70% of all cancer deaths, with the crude mortality of 758.72/100 000 (988.37 per 100 000 in males, 543.44 per 100 000 in females), and the age-standardized incidence rate by Chinese standard population (ASIRC, 2000) was 730.78 per 100 000. Lung cancer, stomach cancer, colorectal cancer, liver cancer and esophageal cancer were the most common cancers, accounting for about 67.70% of all cancer cases in China. Those cancers are also the most common cancers in China, accounting for about 73.45% of all cancer deaths. Conclusions: The cancer burden of elderly population in China is very serious. The major cancer incidence and mortality in urban and rural areas are similar

  16. Mitosis in circulating tumor cells stratifies highly aggressive breast carcinomas.

    Science.gov (United States)

    Adams, Daniel L; Adams, Diane K; Stefansson, Steingrimur; Haudenschild, Christian; Martin, Stuart S; Charpentier, Monica; Chumsri, Saranya; Cristofanilli, Massimo; Tang, Cha-Mei; Alpaugh, R Katherine

    2016-05-04

    Enumeration of circulating tumor cells (CTCs) isolated from the peripheral blood of breast cancer patients holds promise as a clinically relevant, minimally invasive diagnostic test. However, CTC utility has been limited as a prognostic indicator of survival by the inability to stratify patients beyond general enumeration. In comparison, histological biopsy examinations remain the standard method for confirming malignancy and grading malignant cells, allowing for cancer identification and then assessing patient cohorts for prognostic and predictive value. Typically, CTC identification relies on immunofluorescent staining assessed as absent/present, which is somewhat subjective and limited in its ability to characterize these cells. In contrast, the physical features used in histological cytology comprise the gold standard method used to identify and preliminarily characterize the cancer cells. Here, we superimpose the methods, cytologically subtyping CTCs labeled with immunohistochemical fluorescence stains to improve their prognostic value in relation to survival. In this single-blind prospective pilot study, we tracked 36 patients with late-stage breast cancer over 24 months to compare overall survival between simple CTC enumeration and subtyping mitotic CTCs. A power analysis (1-β = 0. 9, α = 0.05) determined that a pilot size of 30 patients was sufficient to stratify this patient cohort; 36 in total were enrolled. Our results confirmed that CTC number is a prognostic indicator of patient survival, with a hazard ratio 5.2, p = 0.005 (95 % CI 1.6-16.5). However, by simply subtyping the same population based on CTCs in cytological mitosis, the hazard ratio increased dramatically to 11.1, p cancer, (2) mitotic CTCs may significantly correlate with shortened overall survival, and (3) larger and more defined patient cohort studies are clearly called for based on this initial pilot study.

  17. Visualization periodic flows in a continuously stratified fluid.

    Science.gov (United States)

    Bardakov, R.; Vasiliev, A.

    2012-04-01

    To visualize the flow pattern of viscous continuously stratified fluid both experimental and computational methods were developed. Computational procedures were based on exact solutions of set of the fundamental equations. Solutions of the problems of flows producing by periodically oscillating disk (linear and torsion oscillations) were visualized with a high resolutions to distinguish small-scale the singular components on the background of strong internal waves. Numerical algorithm of visualization allows to represent both the scalar and vector fields, such as velocity, density, pressure, vorticity, stream function. The size of the source, buoyancy and oscillation frequency, kinematic viscosity of the medium effects were traced in 2D an 3D posing problems. Precision schlieren instrument was used to visualize the flow pattern produced by linear and torsion oscillations of strip and disk in a continuously stratified fluid. Uniform stratification was created by the continuous displacement method. The buoyancy period ranged from 7.5 to 14 s. In the experiments disks with diameters from 9 to 30 cm and a thickness of 1 mm to 10 mm were used. Different schlieren methods that are conventional vertical slit - Foucault knife, vertical slit - filament (Maksoutov's method) and horizontal slit - horizontal grating (natural "rainbow" schlieren method) help to produce supplementing flow patterns. Both internal wave beams and fine flow components were visualized in vicinity and far from the source. Intensity of high gradient envelopes increased proportionally the amplitude of the source. In domains of envelopes convergence isolated small scale vortices and extended mushroom like jets were formed. Experiments have shown that in the case of torsion oscillations pattern of currents is more complicated than in case of forced linear oscillations. Comparison with known theoretical model shows that nonlinear interactions between the regular and singular flow components must be taken

  18. Dynamics of mixed convective-stably-stratified fluids

    Science.gov (United States)

    Couston, L.-A.; Lecoanet, D.; Favier, B.; Le Bars, M.

    2017-09-01

    We study the dynamical regimes of a density-stratified fluid confined between isothermal no-slip top and bottom boundaries (at temperatures Tt and Tb) via direct numerical simulation. The thermal expansion coefficient of the fluid is temperature dependent and chosen such that the fluid density is maximum at the inversion temperature Tb>Ti>Tt . Thus, the lower layer of the fluid is convectively unstable while the upper layer is stably stratified. We show that the characteristics of the convection change significantly depending on the degree of stratification of the stable layer. For strong stable stratification, the convection zone coincides with the fraction of the fluid that is convectively unstable (i.e., where T >Ti ), and convective motions consist of rising and sinking plumes of large density anomaly, as is the case in canonical Rayleigh-Bénard convection; internal gravity waves are generated by turbulent fluctuations in the convective layer and propagate in the upper layer. For weak stable stratification, we demonstrate that a large fraction of the stable fluid (i.e., with temperature T phenomenological description of the transition between the regimes of plume-dominated and entrainment-dominated convection through analysis of the differences in the heat transfer mechanisms, kinetic energy density spectra, and probability density functions for different stratification strengths. Importantly, we find that the effect of the stable layer on the convection decreases only weakly with increasing stratification strength, meaning that the dynamics of the stable layer and convection should be studied self-consistently in a wide range of applications.

  19. [Incidence of fetal macrosomia among single live birth neonates and influencing factors in Xi' an, 2010-2013].

    Science.gov (United States)

    Zhang, Q; Bai, R H; Wang, L L; Dang, S N; Mi, B B; Yan, H

    2016-08-10

    To analyze the incidence and influencing factors on fetal macrosomia among single live birth neonates in Xi' an. A questionnaire survey was conducted among women at the childbearing age who were selected through multi stage stratified random sampling in Xi 'an during 2010-2013. All the childbearing aged women involved, were in pregnancy or having definite pregnancy outcomes. A total of 4 970 women at childbearing age and their infants were investigated. The overall incidence of fetal macrosomia weight among the single live birth neonates under study, was 9.7% during 2010-2013 (8.9% in 2010, 8.1% in 2011, 10.0% in 2012 and 10.1% in 2013, respectively). The incidence rates of fetal macrosomia appeared 10.5% in the central district and, 8.6% in the rural-urban area of Xi'an. There were statistically significant differences (Pmacrosomia. The incidence of fetal macrosomia in Xi' an was higher than the national figures. The incidence of fetal macrosomia was higher in the central district than in rural-urban area. Having male neonate, postmature birth, gestational diabetes, being multipara, drinking during pregnancy were the risk factors related to fetal macrosomia.

  20. Efeitos da associação propafenona - propofol na contratilidade miocárdica, freqüência cardíaca, fluxo coronariano e incidência de arritmia em corações isolados de ratos Effects of propafenone associated with propofol on myocardial contractility, heart rate, coronary flow, and the incidence of arrhythmia in isolated hearts of rats

    Directory of Open Access Journals (Sweden)

    Nilcéa Leal de Moraes Assis

    2004-01-01

    Full Text Available OBJETIVO: Estudar a influência da propafenona associada ao propofol na contratilidade miocárdica (dP/dt e freqüência cardíaca, fluxo coronariano e incidência de arritmia em corações isolados de ratos. MÉTODOS: Estudados 40 corações de ratos albinos anestesiados com éter sulfúrico, adaptados a sistema de perfusão, tipo Langendorff modificado, nutridos com solução de Krebs-Henseleit (K-H, (95% de O2, 5% de CO2, pH de 7,4±0,1, pressão de perfusão entre 90 e 100cm de água e temperatura de 37±0,5º C, obtidos registros de controle após período de estabilização e distribuídos em quatro grupos: I (controle, II (propafenona, na dose de 100mcg, III (propofol, na dose de 25mcg e IV (propafenona-propofol. RESULTADOS: Verificou-se diminuição (pOBJECTIVE: To study the influence of propafenone associated with propofol on myocardial contractility (dP/dt and heart rate, coronary flow, and the incidence of arrhythmia in isolated rat hearts. METHODS: Forty albino rats were anesthetized with sulfuric ether, a modified Langendorff method was performed, and the rats were fed with Krebs-Henseleit (K-H solution, (95% O2, 5% CO2, pH 7.4±0.1, perfusion pressure between 90 and 100cm of water, and temperature 37± 0.5ºC. Control records were obtained after a stabilization period and rats were distributed into the following 4 groups: I (control, II (100mcg propafenone, III (25mcg propofol, and IV (propafenone-propofol. RESULTS: A decrease (P<0.05 in the heart rate in groups II and IV was observed, with a greater decrease in group II. A decrease was noted in the dP/dt ratio (P< 0.05 in groups II and IV, during all periods. Group III experienced depression from the 1st to the 3rd minute. Coronary flow had a decrease (P<0.05 in all groups, compared with the control group, especially in group IV with a decrease from 14mL/min to 11mL/min. Arrhythmogenic effects of propafenone (pro-arrhythmia were verified in 50% of group II. In the association with

  1. FDTD Modelling of Electromagnetic waves in Stratified Medium ...

    African Journals Online (AJOL)

    The technique is an adaptation of the finite-difference time domain (FDTD) approach usually applied to model electromagnetic wave propagation. In this paper a simple 2D implementation of FDTD algorithm in mathematica environment is presented. Source implementation and the effect of conductivity on the incident field ...

  2. Stratified flows with variable density: mathematical modelling and numerical challenges.

    Science.gov (United States)

    Murillo, Javier; Navas-Montilla, Adrian

    2017-04-01

    Stratified flows appear in a wide variety of fundamental problems in hydrological and geophysical sciences. They may involve from hyperconcentrated floods carrying sediment causing collapse, landslides and debris flows, to suspended material in turbidity currents where turbulence is a key process. Also, in stratified flows variable horizontal density is present. Depending on the case, density varies according to the volumetric concentration of different components or species that can represent transported or suspended materials or soluble substances. Multilayer approaches based on the shallow water equations provide suitable models but are not free from difficulties when moving to the numerical resolution of the governing equations. Considering the variety of temporal and spatial scales, transfer of mass and energy among layers may strongly differ from one case to another. As a consequence, in order to provide accurate solutions, very high order methods of proved quality are demanded. Under these complex scenarios it is necessary to observe that the numerical solution provides the expected order of accuracy but also converges to the physically based solution, which is not an easy task. To this purpose, this work will focus in the use of Energy balanced augmented solvers, in particular, the Augmented Roe Flux ADER scheme. References: J. Murillo , P. García-Navarro, Wave Riemann description of friction terms in unsteady shallow flows: Application to water and mud/debris floods. J. Comput. Phys. 231 (2012) 1963-2001. J. Murillo B. Latorre, P. García-Navarro. A Riemann solver for unsteady computation of 2D shallow flows with variable density. J. Comput. Phys.231 (2012) 4775-4807. A. Navas-Montilla, J. Murillo, Energy balanced numerical schemes with very high order. The Augmented Roe Flux ADER scheme. Application to the shallow water equations, J. Comput. Phys. 290 (2015) 188-218. A. Navas-Montilla, J. Murillo, Asymptotically and exactly energy balanced augmented flux

  3. Deep silicon maxima in the stratified oligotrophic Mediterranean Sea

    Directory of Open Access Journals (Sweden)

    Y. Crombet

    2011-02-01

    Full Text Available The silicon biogeochemical cycle has been studied in the Mediterranean Sea during late summer/early autumn 1999 and summer 2008. The distribution of nutrients, particulate carbon and silicon, fucoxanthin (Fuco, and total chlorophyll-a (TChl-a were investigated along an eastward gradient of oligotrophy during two cruises (PROSOPE and BOUM encompassing the entire Mediterranean Sea during the stratified period. At both seasons, surface waters were depleted in nutrients and the nutriclines gradually deepened towards the East, the phosphacline being the deepest in the easternmost Levantine basin. Following the nutriclines, parallel deep maxima of biogenic silica (DSM, fucoxanthin (DFM and TChl-a (DCM were evidenced during both seasons with maximal concentrations of 0.45 μmol L−1 for BSi, 0.26 μg L−1 for Fuco, and 1.70 μg L−1 for TChl-a, all measured during summer. Contrary to the DCM which was a persistent feature in the Mediterranean Sea, the DSM and DFMs were observed in discrete areas of the Alboran Sea, the Algero-Provencal basin, the Ionian sea and the Levantine basin, indicating that diatoms were able to grow at depth and dominate the DCM under specific conditions. Diatom assemblages were dominated by Chaetoceros spp., Leptocylindrus spp., Pseudonitzschia spp. and the association between large centric diatoms (Hemiaulus hauckii and Rhizosolenia styliformis and the cyanobacterium Richelia intracellularis was observed at nearly all sites. The diatom's ability to grow at depth is commonly observed in other oligotrophic regions and could play a major role in ecosystem productivity and carbon export to depth. Contrary to the common view that Si and siliceous phytoplankton are not major components of the Mediterranean biogeochemistry, we suggest here that diatoms, by persisting at depth during the stratified period, could contribute to a

  4. Magnetoacoustic Waves in a Stratified Atmosphere with a Magnetic Null Point

    Energy Technology Data Exchange (ETDEWEB)

    Tarr, Lucas A.; Linton, Mark; Leake, James, E-mail: lucas.tarr.ctr@nrl.navy.mil [U.S. Naval Research Laboratory, 4555 Overlook Ave. SW, Washington, DC 20375 (United States)

    2017-03-01

    We perform nonlinear MHD simulations to study the propagation of magnetoacoustic waves from the photosphere to the low corona. We focus on a 2D system with a gravitationally stratified atmosphere and three photospheric concentrations of magnetic flux that produce a magnetic null point with a magnetic dome topology. We find that a single wavepacket introduced at the lower boundary splits into multiple secondary wavepackets. A portion of the packet refracts toward the null owing to the varying Alfvén speed. Waves incident on the equipartition contour surrounding the null, where the sound and Alfvén speeds coincide, partially transmit, reflect, and mode-convert between branches of the local dispersion relation. Approximately 15.5% of the wavepacket’s initial energy ( E {sub input}) converges on the null, mostly as a fast magnetoacoustic wave. Conversion is very efficient: 70% of the energy incident on the null is converted to slow modes propagating away from the null, 7% leaves as a fast wave, and the remaining 23% (0.036 E {sub input}) is locally dissipated. The acoustic energy leaving the null is strongly concentrated along field lines near each of the null’s four separatrices. The portion of the wavepacket that refracts toward the null, and the amount of current accumulation, depends on the vertical and horizontal wavenumbers and the centroid position of the wavepacket as it crosses the photosphere. Regions that refract toward or away from the null do not simply coincide with regions of open versus closed magnetic field or regions of particular field orientation. We also model wavepacket propagation using a WKB method and find that it agrees qualitatively, though not quantitatively, with the results of the numerical simulation.

  5. Evaluation of a Stratified National Breast Screening Program in the United Kingdom: An Early Model-Based Cost-Effectiveness Analysis.

    Science.gov (United States)

    Gray, Ewan; Donten, Anna; Karssemeijer, Nico; van Gils, Carla; Evans, D Gareth; Astley, Sue; Payne, Katherine

    2017-09-01

    To identify the incremental costs and consequences of stratified national breast screening programs (stratified NBSPs) and drivers of relative cost-effectiveness. A decision-analytic model (discrete event simulation) was conceptualized to represent four stratified NBSPs (risk 1, risk 2, masking [supplemental screening for women with higher breast density], and masking and risk 1) compared with the current UK NBSP and no screening. The model assumed a lifetime horizon, the health service perspective to identify costs (£, 2015), and measured consequences in quality-adjusted life-years (QALYs). Multiple data sources were used: systematic reviews of effectiveness and utility, published studies reporting costs, and cohort studies embedded in existing NBSPs. Model parameter uncertainty was assessed using probabilistic sensitivity analysis and one-way sensitivity analysis. The base-case analysis, supported by probabilistic sensitivity analysis, suggested that the risk stratified NBSPs (risk 1 and risk-2) were relatively cost-effective when compared with the current UK NBSP, with incremental cost-effectiveness ratios of £16,689 per QALY and £23,924 per QALY, respectively. Stratified NBSP including masking approaches (supplemental screening for women with higher breast density) was not a cost-effective alternative, with incremental cost-effectiveness ratios of £212,947 per QALY (masking) and £75,254 per QALY (risk 1 and masking). When compared with no screening, all stratified NBSPs could be considered cost-effective. Key drivers of cost-effectiveness were discount rate, natural history model parameters, mammographic sensitivity, and biopsy rates for recalled cases. A key assumption was that the risk model used in the stratification process was perfectly calibrated to the population. This early model-based cost-effectiveness analysis provides indicative evidence for decision makers to understand the key drivers of costs and QALYs for exemplar stratified NBSP. Copyright

  6. Redox stratified biofilms to support completely autotrophic nitrogen removal: Principles and results

    DEFF Research Database (Denmark)

    Pellicer i Nàcher, Carles; Smets, Barth F.

    liquid. If operated properly, MABRs yield compact and homogeneous redox-stratified biofilms capable of hosting side-by-side aerobic and anaerobic microbial communities. We have recently demonstrated that completely autotrophic nitrogen removal is feasible in MABRs at nitrogen removal rates as high as 5...... bacteria in compact reaction zones about 100 m thick separated by an intermediate zone with low or null metabolic activity. Both identified microbial communities showed a very low diversity and were dominated by halophilic and halotolerant Nitrosomonas sp. and Candidatus Brocadia anammoxidans....... The continuous and sustained inoculation of metabolically active anaerobic oxidizing bacteria from a biofilm reactor placed in the recirculation line of our MABRs showed to shorten considerably the onset of autotrophic nitrogen removal. However, the main hurdle keeping MABRs from attaining high removal...

  7. Fuel-air mixing and distribution in a direct-injection stratified-charge rotary engine

    Science.gov (United States)

    Abraham, J.; Bracco, F. V.

    1989-01-01

    A three-dimensional model for flows and combustion in reciprocating and rotary engines is applied to a direct-injection stratified-charge rotary engine to identify the main parameters that control its burning rate. It is concluded that the orientation of the six sprays of the main injector with respect to the air stream is important to enhance vaporization and the production of flammable mixture. In particular, no spray should be in the wake of any other spray. It was predicted that if such a condition is respected, the indicated efficiency would increase by some 6 percent at higher loads and 2 percent at lower loads. The computations led to the design of a new injector tip that has since yielded slightly better efficiency gains than predicted.

  8. Stratified patterns of divorce: Earnings, education, and gender

    Directory of Open Access Journals (Sweden)

    Amit Kaplan

    2015-05-01

    Full Text Available Background: Despite evidence that divorce has become more prevalent among weaker socioeconomic groups, knowledg