WorldWideScience

Sample records for observational study shows

  1. Cefepime shows good efficacy and no antibiotic resistance in pneumonia caused by Serratia marcescens and Proteus mirabilis - an observational study.

    Science.gov (United States)

    Yayan, Josef; Ghebremedhin, Beniam; Rasche, Kurt

    2016-03-23

    Many antibiotics have no effect on Gram-positive and Gram-negative microbes, which necessitates the prescription of broad-spectrum antimicrobial agents that can lead to increased risk of antibiotic resistance. These pathogens constitute a further threat because they are also resistant to numerous beta-lactam antibiotics, as well as other antibiotic groups. This study retrospectively investigates antimicrobial resistance in hospitalized patients suffering from pneumonia triggered by Gram-negative Serratia marcescens or Proteus mirabilis. The demographic and clinical data analyzed in this study were obtained from the clinical databank of the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, for inpatients presenting with pneumonia triggered by S. marcescens or P. mirabilis from 2004 to 2014. An antibiogram was conducted for the antibiotics utilized as part of the management of patients with pneumonia triggered by these two pathogens. Pneumonia was caused by Gram-negative bacteria in 115 patients during the study period from January 1, 2004, to August 12, 2014. Of these, 43 (37.4 %) hospitalized patients [26 males (60.5 %, 95 % CI 45.9 %-75.1 %) and 17 females (39.5 %, 95 % CI 24.9 %-54.1 %)] with mean age of 66.2 ± 13.4 years had pneumonia triggered by S. marcescens, while 20 (17.4 %) patients [14 males (70 %, 95 % CI 49.9 %-90.1 %) and 6 females (30 %, 95 % CI 9.9 %-50.1 %)] with a mean age of 64.6 ± 12.8 years had pneumonia caused by P. mirabilis. S. marcescens showed an increased antibiotic resistance to ampicillin (100 %), ampicillin-sulbactam (100 %), and cefuroxime (100 %). P. mirabilis had a high resistance to tetracycline (100 %) and ampicillin (55 %). S. marcescens (P < 0.0001) and P. mirabilis (P = 0.0003) demonstrated no resistance to cefepime in these patients with pneumonia. S. marcescens and P. mirabilis were resistant to several commonly used antimicrobial agents, but showed no resistance to

  2. Genome-wide meta-analysis of observational studies shows common genetic variants associated with macronutrient intake

    NARCIS (Netherlands)

    T. Tanaka (Toshiko); J.S. Ngwa; F.J.A. van Rooij (Frank); M.C. Zillikens (Carola); M.K. Wojczynski (Mary ); A.C. Frazier-Wood (Alexis); D.K. Houston (Denise); S. Kanoni (Stavroula); R.N. Lemaitre (Rozenn ); J. Luan; V. Mikkilä (Vera); F. Renström (Frida); E. Sonestedt (Emily); J.H. Zhao (Jing Hua); A.Y. Chu (Audrey); L. Qi (Lu); D.I. Chasman (Daniel); M.C. De Oliveira Otto (Marcia); E.J. Dhurandhar (Emily); M.F. Feitosa (Mary Furlan); I. Johansson (Ingegerd); K-T. Khaw (Kay-Tee); K. Lohman (Kurt); A. Manichaikul (Ani); N.M. McKeown (Nicola ); D. Mozaffarian (Dariush); A.B. Singleton (Andrew); K. Stirrups (Kathy); J. Viikari (Jorma); Z. Ye (Zheng); S. Bandinelli (Stefania); I.E. Barroso (Inês); P. Deloukas (Panagiotis); N.G. Forouhi (Nita); A. Hofman (Albert); Y. Liu (YongMei); L.-P. Lyytikäinen (Leo-Pekka); K.E. North (Kari); M. Dimitriou (Maria); G. Hallmans (Göran); M. Kähönen (Mika); C. Langenberg (Claudia); J.M. Ordovas (Jose); A.G. Uitterlinden (André); F.B. Hu (Frank); I.-P. Kalafati (Ioanna-Panagiota); O. Raitakari (Olli); O.H. Franco (Oscar); A. Johnson (Anthony); V. Emilsson (Valur); J.A. Schrack (Jennifer); R.D. Semba; D.S. Siscovick (David); D.K. Arnett (Donna); I.B. Borecki (Ingrid); P.W. Franks (Paul); S.B. Kritchevsky (Stephen); R.J.F. Loos (Ruth); M. Orho-Melander (Marju); J.I. Rotter (Jerome); N.J. Wareham (Nick); J.C.M. Witteman (Jacqueline); L. Ferrucci (Luigi); G.V. Dedoussis (George); L.A. Cupples (Adrienne); J.A. Nettleton (Jennifer )

    2013-01-01

    textabstractBackground: Macronutrient intake varies substantially between individuals, and there is evidence that this variation is partly accounted for by genetic variants. Objective: The objective of the study was to identify common genetic variants that are associated with macronutrient intake.

  3. High-Resolution Observations of a Filament showing Activated Barb

    Science.gov (United States)

    Joshi, Anand; Martin, Sara F.; Mathew, Shibu; Srivastava, Nandita

    2012-07-01

    Analysis of a filament showing an activated barb using observations from the Dutch Open Telescope (DOT) on 2010 August 20 are presented. The DOT takes Doppler images in Hα, among other wavelengths, in a region about 110 × 110 arcsec^{2} in area, at a cadence of 30~seconds. The offline image restoration technique of speckle reconstruction is applied to obtain diffraction limited images. The filament developed a new barb in 10~minutes, which disappeared within the next 35~minutes. Such a rapid formation and disappearance of a filament barb is unusual, and has not been reported earlier. Line-of-sight velocity maps were constructed from the Doppler images of the target filament. We observe flows in the filament spine towards the barb location prior to its formation, and flows in the barb towards the spine during its disappearance. Photospheric magnetograms from Heliospheric Magnetic Imager on board the Solar Dynamics Observatory, at a cadence of 45~seconds, were used to determine the changes in magnetic flux in the region surrounding the barb location. The variation of magnetic flux in this duration supports the view that barbs are rooted in minor magnetic polarity. Our analysis shows that barbs can be short-lived and formation and disappearance of the barb was associated with cancellation of magnetic flux.

  4. Herbarium specimens, photographs, and field observations show Philadelphia area plants are responding to climate change.

    Science.gov (United States)

    Panchen, Zoe A; Primack, Richard B; Anisko, Tomasz; Lyons, Robert E

    2012-04-01

    The global climate is changing rapidly and is expected to continue changing in coming decades. Studying changes in plant flowering times during a historical period of warming temperatures gives us a way to examine the impacts of climate change and allows us to predict further changes in coming decades. The Greater Philadelphia region has a long and rich history of botanical study and documentation, with abundant herbarium specimens, field observations, and botanical photographs from the mid-1800s onward. These extensive records also provide an opportunity to validate methodologies employed by other climate change researchers at a different biogeographical area and with a different group of species. Data for 2539 flowering records from 1840 to 2010 were assessed to examine changes in flowering response over time and in relation to monthly minimum temperatures of 28 Piedmont species native to the Greater Philadelphia region. Regression analysis of the date of flowering with year or with temperature showed that, on average, the Greater Philadelphia species studied are flowering 16 d earlier over the 170-yr period and 2.7 d earlier per 1°C rise in monthly minimum temperature. Of the species studied, woody plants with short flowering duration are the best indicators of a warming climate. For monthly minimum temperatures, temperatures 1 or 2 mo prior to flowering are most significantly correlated with flowering time. Studies combining herbarium specimens, photographs, and field observations are an effective method for detecting the effects of climate change on flowering times.

  5. A Prospective Observational Study

    African Journals Online (AJOL)

    Methods: This was a prospective, questionnaire-based observational study. Printed questionnaires were distributed to the visitors of medical, surgical and neurosurgical ICU patients to determine awareness of basic infection control practices among visitors to an ICU. All the ICU staff, including nurses, doctors, consultant ...

  6. Spatial Heterodyne Observation of Water (SHOW) from a high altitude aircraft

    Science.gov (United States)

    Bourassa, A. E.; Langille, J.; Solheim, B.; Degenstein, D. A.; Letros, D.; Lloyd, N. D.; Loewen, P.

    2017-12-01

    The Spatial Heterodyne Observations of Water instrument (SHOW) is limb-sounding satellite prototype that is being developed in collaboration between the University of Saskatchewan, York University, the Canadian Space Agency and ABB. The SHOW instrument combines a field-widened SHS with an imaging system to observe limb-scattered sunlight in a vibrational band of water (1363 nm - 1366 nm). Currently, the instrument has been optimized for deployment on NASA's ER-2 aircraft. Flying at an altitude of 70, 000 ft the ER-2 configuration and SHOW viewing geometry provides high spatial resolution (limb-measurements of water vapor in the Upper troposphere and lower stratosphere region. During an observation campaign from July 15 - July 22, the SHOW instrument performed 10 hours of observations from the ER-2. This paper describes the SHOW measurement technique and presents the preliminary analysis and results from these flights. These observations are used to validate the SHOW measurement technique and demonstrate the sampling capabilities of the instrument.

  7. Direct observation during surgery shows preservation of cerebral microcirculation in patients with traumatic brain injury

    NARCIS (Netherlands)

    Pérez-Bárcena, Jon; Romay, Eduardo; Llompart-Pou, Juan Antonio; Ibáñez, Javier; Brell, Marta; Llinás, Pedro; González, Elsa; Merenda, Amedeo; Ince, Can; Bullock, Ross

    2015-01-01

    To describe the alterations of the cortical microcirculation of the brain (blood flow and vessel density) in TBI patients who and compare them with a control group. Prospective and observational study in a third-level university hospital. Cortical microcirculation in the brain was directly observed

  8. STS-39 Earth observation of Earth's limb at sunset shows atmospheric layers

    Science.gov (United States)

    1991-01-01

    STS-39 Earth observation taken aboard Discovery, Orbiter Vehicle (OV) 103, shows the Earth's limb at sunset with numerous atmospheric scattering layers highlighted. The layers consist of fine particles suspended in very stable layers of the atmosphere. The layers act as a prism for the sunlight.

  9. Army Study Shows Decline In Behavioral Health Stigma

    Science.gov (United States)

    2012-01-01

    Army Study Shows Decline in Behavioral Health Stigma By Rob McIlvaine Army News Service WASHINGTON, Jan. 20, 2012 - A newly released Army study on...conference yesterday. The three-year study outlines the problem of suicide in the Army and related issues of substance abuse, spouse abuse and child abuse...REPORT TYPE 3. DATES COVERED 00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Army Study Shows Decline In Behavioral Health Stigma 5a. CONTRACT

  10. This research is to study the factors which influence the business success of small business ‘processed rotan’. The data employed in the study are primary data within the period of July to August 2013, 30 research observations through census method. Method of analysis used in the study is multiple linear regressions. The results of analysis showed that the factors of labor, innovation and promotion have positive and significant influence on the business success of small business ‘processed rotan’ simultaneously. The analysis also showed that partially labor has positive and significant influence on the business success, yet innovation and promotion have insignificant and positive influence on the business success.

    OpenAIRE

    Nasution, Inggrita Gusti Sari; Muchtar, Yasmin Chairunnisa

    2013-01-01

    This research is to study the factors which influence the business success of small business ‘processed rotan’. The data employed in the study are primary data within the period of July to August 2013, 30 research observations through census method. Method of analysis used in the study is multiple linear regressions. The results of analysis showed that the factors of labor, innovation and promotion have positive and significant influence on the business success of small busine...

  11. Satellite-derived SIF and CO2 Observations Show Coherent Responses to Interannual Climate Variations

    Science.gov (United States)

    Butterfield, Z.; Hogikyan, A.; Kulawik, S. S.; Keppel-Aleks, G.

    2017-12-01

    Gross primary production (GPP) is the single largest carbon flux in the Earth system, but its sensitivity to changes in climate is subject to significant uncertainty. Satellite measurements of solar-induced chlorophyll fluorescence (SIF) offer insight into spatial and temporal patterns in GPP at a global scale and, combined with other satellite-derived datasets, provide unprecedented opportunity to explore interactions between atmospheric CO2, GPP, and climate variability. To explore potential drivers of GPP in the Northern Hemisphere (NH), we compare monthly-averaged SIF data from the Global Ozone Monitoring Experiment 2 (GOME-2) with observed anomalies in temperature (T; CRU-TS), liquid water equivalent (LWE) from the Gravity Recovery and Climate Experiment (GRACE), and photosynthetically active radiation (PAR; CERES SYN1deg). Using observations from 2007 through 2015 for several NH regions, we calculate month-specific sensitivities of SIF to variability in T, LWE, and PAR. These sensitivities provide insight into the seasonal progression of how productivity is affected by climate variability and can be used to effectively model the observed SIF signal. In general, we find that high temperatures are beneficial to productivity in the spring, but detrimental in the summer. The influences of PAR and LWE are more heterogeneous between regions; for example, higher LWE in North American temperate forest leads to decreased springtime productivity, while exhibiting a contrasting effect in water-limited regions. Lastly, we assess the influence of variations in terrestrial productivity on atmospheric carbon using a new lower tropospheric CO2 product derived from the Greenhouse Gases Observing Satellite (GOSAT). Together, these data shed light on the drivers of interannual variability in the annual cycle of NH atmospheric CO2, and may provide improved constraints on projections of long-term carbon cycle responses to climate change.

  12. What do the data show? Fostering physical intuition with ClimateBits and NASA Earth Observations

    Science.gov (United States)

    Schollaert Uz, S.; Ward, K.

    2017-12-01

    Through data visualizations using global satellite imagery available in NASA Earth Observations (NEO), we explain Earth science concepts (e.g. albedo, urban heat island effect, phytoplankton). We also provide examples of ways to explore the satellite data in NEO within a new blog series. This is an ideal tool for scientists and non-scientists alike who want to quickly check satellite imagery for large scale features or patterns. NEO analysis requires no software or plug-ins; only a browser and an internet connection. You can even check imagery and perform simple analyses from your smart phone. NEO can be used to create graphics for presentations and papers or as a first step before acquiring data for more rigorous analysis. NEO has potential application to easily explore large scale environmental and climate patterns that impact operations and infrastructure. This is something we are currently exploring with end user groups.

  13. Case Study Shows Disconnect on Civic Journalism's Role

    OpenAIRE

    Tully, M.; Harmsen, S.; Singer, J.; Ekdale, B.

    2017-01-01

    This in-depth case study examines attempts to transform a traditional newsroom to one oriented around civic journalism principles, offering a unique look at the resistance toward those principles even in a digital environment that facilitates new audience relationships. Civic journalism emphasizes understanding and addressing community concerns from a citizen perspective. This study finds that journalists still struggle to integrate citizens’ contributions into newsroom practice in meaningful...

  14. Oklahoma Cherokee formation study shows benefits of gas tax credits

    International Nuclear Information System (INIS)

    Stanley, B.J.; Cline, S.B.

    1994-01-01

    To no one's surprise, the administration's recently released energy initiative package does not advocate the use of tax incentives such as the Internal Revenue Code Sec. 29 (tight sand gas) credit that expired Dec. 31, 1992. This is unfortunate since tax credits do stimulate drilling, as the authors' recent study of Oklahoma's Pennsylvanian age Cherokee formation demonstrates. Within this 783,000 acre study area, more than 130 additional wells were drilled between 1991--92 because of tax credit incentives. And such tax credits also increase total federal tax revenues by causing wells to be drilled that would not have been drilled or accelerating the drilling of wells, thereby increasing taxable revenue. In short, tax credits create a win-win situation: they stimulate commerce, increase tax revenues, reduce the outflow of capital to foreign petroleum projects, and add to the nation's natural gas reserve, which is beneficial for national security, balance of payments, the environment, and gas market development. The paper discusses the study assumptions, study results, and the tax credit policy

  15. Distracted Biking: An Observational Study.

    Science.gov (United States)

    Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J

    2016-01-01

    Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured.

  16. The Alberta smoke plume observation study

    Directory of Open Access Journals (Sweden)

    K. Anderson

    2018-02-01

    Full Text Available A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS. Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018 at http://cwfis.cfs.nrcan.gc.ca/datamart.

  17. The Alberta smoke plume observation study

    Science.gov (United States)

    Anderson, Kerry; Pankratz, Al; Mooney, Curtis; Fleetham, Kelly

    2018-02-01

    A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS). Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018) at http://cwfis.cfs.nrcan.gc.ca/datamart.

  18. Observational Study of Travelers' Diarrhea.

    Science.gov (United States)

    Meuris

    1995-03-01

    Background: European air travelers returning from Algeria, Egypt, Mexico, Morocco, and Tunisia were interviewed about their experience of travelers' diseases upon arrival in Brussels. Diarrhea was mentioned by 37% of the adults and 27% of the children. These subjects were questioned about the types of measures taken, type and duration of drug treatment (if any), and about duration of diarrhea and side effects experienced. Methods: Final analysis was performed based on 2160 interviews. The largest proportion of diarrhea was reported in the age group 15-24 years (46%). Results: The majority of the 2160 subjects had opted for drug treatment (81%): 927 subjects for loperamide alone, 235 for loperamide in combination with nifuroxazide, and 178 for nifuroxazide alone. Other drugs had been used less frequently. The median time to recovery was 2.4 days with loperamide compared to 3.2 days with nifuroxazide and to 3.4 days for the no-treatment group. Conclusions: A stratification of the results by severity of the diarrhea suggests a rank of antidiarrheal potency as follows: loperamide > nifuroxazide > no-drug treatment. The side effect with the highest incidence was constipation (2.4% with loperamide). (J Travel Med 2:11-15, 1995) Travelers' diarrhea is usually defined as the passage of at least three unformed stools per day or any number of such stools when accompanied by fever, abdominal cramping, or vomiting. The definition may be broadened to include more trivial bowel disturbance.1,2 The duration of this self-limited disease generally is 3 to 5 days. Medical intervention aims at shortening the duration of disease, thus allowing the sufferer to resume his or her usual activities at an early stage. A shortened period of recovery to physical well-being has obvious favorable economic implications if the traveler is on business and may help the maintenance of a desired level of quality of life while a traveler is on holiday. An observational study of various medical

  19. Science Studies from Archived Observations

    Science.gov (United States)

    Armstrong, T. P.; Manweiler, J. W.; Patterson, J. D.

    2008-12-01

    Goals for spaceflight investigations include the discovery and characterization of physical features of the in- situ and remote environment. Abundant successes of flight investigations are easily documented. Prudent scientific practice dictates that to the maximum extent possible, observations should be well-characterized, reliably catalogued, and knowledgeably interpreted. This is especially true of data sets used in the publication of results in the reviewed literature. Typical scientific standards include making primary data numbers available to other investigators for replicated study. While NASA's contracts with investigators have required that data be submitted to agency official archives, the details, completeness (especially of ancillary and metadata) and forms differ from investigation to investigation and project to project. After several generations of improvements and refinements, modern computing and communications technology makes it possible to link multiple data sets at multiple locations through a unified data model. Virtual Observatories provide the overall organizational structures and SPASE-compliant XML defines the data granules that can be located. Proofs of the feasibility and value of this latest approach remain to be seen, but its ultimate goal of improving archival research using flight-derived data sets appears to depend on user acceptance and efficient use of the VxO resources. Criteria based on the authors experience in science derived from archival sources follow: 1. Interfaces and tools must be easy to learn, easy to use, and reliable. 2. Data numbers must be promptly downloadable in plain text. 3. Data must be available in or readily converted to physical units using calibrations and algorithms easily traceable as part of the search. Knowledge about (or heritage of) specific data items present in the science literature must be associated with the search for that item. 4. Data items must be trustworthy, having quoted uncertainties and

  20. UFOs: Observations, Studies and Extrapolations

    CERN Document Server

    Baer, T; Barnes, M J; Bartmann, W; Bracco, C; Carlier, E; Cerutti, F; Dehning, B; Ducimetière, L; Ferrari, A; Ferro-Luzzi, M; Garrel, N; Gerardin, A; Goddard, B; Holzer, E B; Jackson, S; Jimenez, J M; Kain, V; Zimmermann, F; Lechner, A; Mertens, V; Misiowiec, M; Nebot Del Busto, E; Morón Ballester, R; Norderhaug Drosdal, L; Nordt, A; Papotti, G; Redaelli, S; Uythoven, J; Velghe, B; Vlachoudis, V; Wenninger, J; Zamantzas, C; Zerlauth, M; Fuster Martinez, N

    2012-01-01

    UFOs (“ Unidentified Falling Objects”) could be one of the major performance limitations for nominal LHC operation. Therefore, in 2011, the diagnostics for UFO events were significantly improved, dedicated experiments and measurements in the LHC and in the laboratory were made and complemented by FLUKA simulations and theoretical studies. The state of knowledge is summarized and extrapolations for LHC operation in 2012 and beyond are presented. Mitigation strategies are proposed and related tests and measures for 2012 are specified.

  1. Title: Studies on drug switchability showed heterogeneity in methodological approaches: a scoping review.

    Science.gov (United States)

    Belleudi, Valeria; Trotta, Francesco; Vecchi, Simona; Amato, Laura; Addis, Antonio; Davoli, Marina

    2018-05-16

    Several drugs share the same therapeutic indication, including those undergoing patent expiration. Concerns on the interchangeability are frequent in clinical practice, challenging the evaluation of switchability through observational research. To conduct a scoping review of observational studies on drug switchability to identify methodological strategies adopted to deal with bias and confounding. We searched PubMed, EMBASE, and Web of Science (updated 1/31/2017) to identify studies evaluating switchability in terms of effectiveness/safety outcomes or compliance. Three reviewers independently screened studies extracting all characteristics. Strategies to address confounding, particularly, previous drug use and switching reasons were considered. All findings were summarized in descriptive analyses. Thirty-two studies, published in the last 10 years, met the inclusion criteria. Epilepsy, cardiovascular and rheumatology were the most frequently represented clinical areas. 75% of the studies reported data on effectiveness/safety outcomes. The most frequent study design was cohort (65.6%) followed by case-control (21.9%) and self-controlled (12.5%). Case-control and case-crossover studies showed homogeneous methodological strategies to deal with bias and confounding. Among cohort studies, the confounding associated with previous drug use was addressed introducing variables in multivariate model (47.3%) or selecting only adherent patients (14.3%). Around 30% of cohort studies did not report reasons for switching. In the remaining 70%, clinical parameters or previous occurrence of outcomes were measured to identify switching connected with lack of effectiveness or adverse events. This study represents a starting point for researchers and administrators who are approaching the investigation and assessment of issues related to interchangeability of drugs. Copyright © 2018. Published by Elsevier Inc.

  2. Gun Shows and Gun Violence: Fatally Flawed Study Yields Misleading Results

    Science.gov (United States)

    Hemenway, David; Webster, Daniel; Pierce, Glenn; Braga, Anthony A.

    2010-01-01

    A widely publicized but unpublished study of the relationship between gun shows and gun violence is being cited in debates about the regulation of gun shows and gun commerce. We believe the study is fatally flawed. A working paper entitled “The Effect of Gun Shows on Gun-Related Deaths: Evidence from California and Texas” outlined this study, which found no association between gun shows and gun-related deaths. We believe the study reflects a limited understanding of gun shows and gun markets and is not statistically powered to detect even an implausibly large effect of gun shows on gun violence. In addition, the research contains serious ascertainment and classification errors, produces results that are sensitive to minor specification changes in key variables and in some cases have no face validity, and is contradicted by 1 of its own authors’ prior research. The study should not be used as evidence in formulating gun policy. PMID:20724672

  3. AECL's excavation stability study - summary of observations

    International Nuclear Information System (INIS)

    Read, R.S.; Chandler, N.A.

    1996-05-01

    The Excavation Stability Study (ESS) was conducted at the 420 Level of the Underground Research Laboratory (URL) to evaluate stability and the extent of excavation damage in tunnels as a function of tunnel geometry and orientation, geology, and excavation method. A series of ovaloid and circular openings were used to achieve different boundary stress levels and near-field stress distributions to assess the effect of tunnel geometry on damage development. Several of these openings had sections in both granite and granodiorite lithology, providing a comparison of damage in rock types with different strength characteristics. Damage around circular tunnels (one excavated by drill-and-blast, the other by mechanical means) was also investigated. The study.showed that mechanically stable openings can be excavated in the most adverse stress conditions at the 420 Level of the URL. In addition, it was shown that tunnel stability is sensitive to tunnel shape, variations in geology, and to some extent, the excavation method. Findings of the study are relevant in developing design criteria, and in assessing the feasibility of constructing large ovaloid openings in adverse stress conditions. This report summarizes the preliminary observations related to tunnel stability and excavation damage. (author). 8 refs., 7 tabs., 23 figs

  4. Observing Protein & Energy Nutrition (OPEN) Study

    Science.gov (United States)

    The Observing Protein and Energy Nutrition (OPEN) Study was designed to assess dietary measurement error by comparing results from self-reported dietary intake data with four dietary biomarkers: doubly labeled water and urinary nitrogen, sodium, and potassium.

  5. STRengthening analytical thinking for observational studies

    DEFF Research Database (Denmark)

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G.

    2014-01-01

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, ma...

  6. Theoretical and observational studies of stellar activity

    International Nuclear Information System (INIS)

    Schmitt, J.H.M.M.

    1984-01-01

    In the theoretical part of this thesis, doubly-diffusive MHD instabilities are studied as a means of breaking up a diffuse magnetic field at the bottom of the solar convection zone. The analysis is linear and local, and assumes short meridional wavelengths; the effects of rotation and diffusion of vorticity, magnetic fields and heat are included. Results show that the instability depends sensitively on the temperature stratification, but rather insensitively on the assumed magnetic field configuration; instability time scales considerably less than the solar cycle period can be easily obtained. In the observational part of the thesis, results are reported of a survey of the x-ray emission of stars with shallow connection zones to study the onset of convection and dynamo activity along the main sequence. Complications arising from stellar multiplicity are discussed extensively; it is demonstrated that binaries have statistically higher x-ray luminosities; and it is shown that physical parameters can only be deduced from single stars. It is further shown that the x-ray luminosities of stars with spectral type in the color range 0.1 less than or equal to B. V less than or equal to 0.5 increase rapidly, whereas stars with B. V approx. 0.0 appear to have no intrinsic x-ray emission at presently detectable levels

  7. Century Scale Evaporation Trend: An Observational Study

    Science.gov (United States)

    Bounoui, Lahouari

    2012-01-01

    Several climate models with different complexity indicate that under increased CO2 forcing, runoff would increase faster than precipitation overland. However, observations over large U.S watersheds indicate otherwise. This inconsistency between models and observations suggests that there may be important feedbacks between climate and land surface unaccounted for in the present generation of models. We have analyzed century-scale observed annual runoff and precipitation time-series over several United States Geological Survey hydrological units covering large forested regions of the Eastern United States not affected by irrigation. Both time-series exhibit a positive long-term trend; however, in contrast to model results, these historic data records show that the rate of precipitation increases at roughly double the rate of runoff increase. We considered several hydrological processes to close the water budget and found that none of these processes acting alone could account for the total water excess generated by the observed difference between precipitation and runoff. We conclude that evaporation has increased over the period of observations and show that the increasing trend in precipitation minus runoff is correlated to observed increase in vegetation density based on the longest available global satellite record. The increase in vegetation density has important implications for climate; it slows but does not alleviate the projected warming associated with greenhouse gases emission.

  8. Analysis of allergen immunotherapy studies shows increased clinical efficacy in highly symptomatic patients

    DEFF Research Database (Denmark)

    Howarth, P; Malling, Hans-Jørgen; Molimard, M

    2011-01-01

    them. Thus, clinical studies of AIT can neither establish baseline symptom levels nor limit the enrolment of patients to those with the most severe symptoms. Allergen immunotherapy treatment effects are therefore diluted by patients with low symptoms for a particular pollen season. The objective...... tertiles). The difference observed in the average score in each tertile in active vs placebo-treated patients was assessed. This allowed an estimation of the efficacy that could be achieved in patients from sites where symptoms were high during the pollen season. Results:  An increased treatment effect...... of this analysis was to assess the effect possible to achieve with AIT in the groups of patients presenting the most severe allergic symptoms. Methods:  Study centres were grouped into tertiles categorized according to symptom severity scores observed in the placebo patients in each centre (low, middle and high...

  9. An observational study on oesophageal variceal endoscopic ...

    African Journals Online (AJOL)

    An observational study on oesophageal variceal endoscopic injection sclerotherapy in patients with portal hypertension seen at the Centre for Clinical Research, ... The report concludes that variceal injection sclerotherapy is a useful method of treating oesophageal varices and can be performed on an out patient basis.

  10. Magnetism reflectometer study shows LiF layers improve efficiency in spin valve devices

    Energy Technology Data Exchange (ETDEWEB)

    Bardoel, Agatha A [ORNL; Lauter, Valeria [ORNL; Szulczewski, Greg J [ORNL

    2012-01-01

    New, more efficient materials for spin valves - a device used in magnetic sensors, random access memories, and hard disk drives - may be on the way based on research using the magnetism reflectometer at Oak Ridge National Laboratory (ORNL). Spin valve devices work by means of two or more conducting magnetic material layers that alternate their electrical resistance depending on the layers alignment. Giant magnetoresistance is a quantum mechanical effect first observed in thin film structures about 20 years ago. The effect is observed as a significant change in electrical resistance, depending on whether the magnetization of adjacent ferromagnetic layers is in a parallel or an antiparallel magnetic alignment. 'What we are doing here is developing new materials. The search for new materials suitable for injecting and transferring carriers with a preferential spin orientation is most important for the development of spintronics,' said Valeria Lauter, lead instrument scientist on the magnetism reflectometer at the Spallation Neutron Source (SNS), who collaborated on the experiment. The researchers discovered that the conductivity of such materials is improved when an organic polymer semiconductor layer is placed between the magnetic materials. Organic semiconductors are now the material of choice for future spin valve devices because they preserve spin coherence over longer times and distances than conventional semiconductors. While research into spin valves has been ongoing, research into organic semiconductors is recent. Previous research has shown that a 'conductivity mismatch' exists in spin valve systems in which ferromagnetic metal electrodes interface with such organic semiconductors as Alq3 ({pi}-conjugated molecule tris(8-hydroxy-quinoline) aluminium). This mismatch limits the efficient injection of the electrons from the electrodes at the interface with the semiconductor material. However, lithium fluoride (LiF), commonly used in light

  11. Radiance Assimilation Shows Promise for Snowpack Characterization: A 1-D Case Study

    Science.gov (United States)

    Durand, Michael; Kim, Edward; Margulis, Steve

    2008-01-01

    We demonstrate an ensemble-based radiometric data assimilation (DA) methodology for estimating snow depth and snow grain size using ground-based passive microwave (PM) observations at 18.7 and 36.5 GHz collected during the NASA CLPX-1, March 2003, Colorado, USA. A land surface model was used to develop a prior estimate of the snowpack states, and a radiative transfer model was used to relate the modeled states to the observations. Snow depth bias was -53.3 cm prior to the assimilation, and -7.3 cm after the assimilation. Snow depth estimated by a non-DA-based retrieval algorithm using the same PM data had a bias of -18.3 cm. The sensitivity of the assimilation scheme to the grain size uncertainty was evaluated; over the range of grain size uncertainty tested, the posterior snow depth estimate bias ranges from -2.99 cm to -9.85 cm, which is uniformly better than both the prior and retrieval estimates. This study demonstrates the potential applicability of radiometric DA at larger scales.

  12. Contesting the "Nature" Of Conformity: what Milgram and Zimbardo's studies really show.

    Directory of Open Access Journals (Sweden)

    S Alexander Haslam

    Full Text Available Understanding of the psychology of tyranny is dominated by classic studies from the 1960s and 1970s: Milgram's research on obedience to authority and Zimbardo's Stanford Prison Experiment. Supporting popular notions of the banality of evil, this research has been taken to show that people conform passively and unthinkingly to both the instructions and the roles that authorities provide, however malevolent these may be. Recently, though, this consensus has been challenged by empirical work informed by social identity theorizing. This suggests that individuals' willingness to follow authorities is conditional on identification with the authority in question and an associated belief that the authority is right.

  13. The NOAA Satellite Observing System Architecture Study

    Science.gov (United States)

    Volz, Stephen; Maier, Mark; Di Pietro, David

    2016-01-01

    NOAA is beginning a study, the NOAA Satellite Observing System Architecture (NSOSA) study, to plan for the future operational environmental satellite system that will follow GOES and JPSS, beginning about 2030. This is an opportunity to design a modern architecture with no pre-conceived notions regarding instruments, platforms, orbits, etc. The NSOSA study will develop and evaluate architecture alternatives to include partner and commercial alternatives that are likely to become available. The objectives will include both functional needs and strategic characteristics (e.g., flexibility, responsiveness, sustainability). Part of this study is the Space Platform Requirements Working Group (SPRWG), which is being commissioned by NESDIS. The SPRWG is charged to assess new or existing user needs and to provide relative priorities for observational needs in the context of the future architecture. SPRWG results will serve as input to the process for new foundational (Level 0 and Level 1) requirements for the next generation of NOAA satellites that follow the GOES-R, JPSS, DSCOVR, Jason-3, and COSMIC-2 missions.

  14. Spatial Heterodyne Observations of Water (SHOW) vapour in the upper troposphere and lower stratosphere from a high altitude aircraft: Modelling and sensitivity analysis

    Science.gov (United States)

    Langille, J. A.; Letros, D.; Zawada, D.; Bourassa, A.; Degenstein, D.; Solheim, B.

    2018-04-01

    A spatial heterodyne spectrometer (SHS) has been developed to measure the vertical distribution of water vapour in the upper troposphere and the lower stratosphere with a high vertical resolution (∼500 m). The Spatial Heterodyne Observations of Water (SHOW) instrument combines an imaging system with a monolithic field-widened SHS to observe limb scattered sunlight in a vibrational band of water (1363 nm-1366 nm). The instrument has been optimized for observations from NASA's ER-2 aircraft as a proof-of-concept for a future low earth orbit satellite deployment. A robust model has been developed to simulate SHOW ER-2 limb measurements and retrievals. This paper presents the simulation of the SHOW ER-2 limb measurements along a hypothetical flight track and examines the sensitivity of the measurement and retrieval approach. Water vapour fields from an Environment and Climate Change Canada forecast model are used to represent realistic spatial variability along the flight path. High spectral resolution limb scattered radiances are simulated using the SASKTRAN radiative transfer model. It is shown that the SHOW instrument onboard the ER-2 is capable of resolving the water vapour variability in the UTLS from approximately 12 km - 18 km with ±1 ppm accuracy. Vertical resolutions between 500 m and 1 km are feasible. The along track sampling capability of the instrument is also discussed.

  15. A multicenter study of using carbon nanoparticles to show sentinel lymph nodes in early gastric cancer.

    Science.gov (United States)

    Yan, Jun; Zheng, Xiaoling; Liu, Zhangyuanzhu; Yu, Jiang; Deng, Zhenwei; Xue, Fangqing; Zheng, Yu; Chen, Feng; Shi, Hong; Chen, Gang; Lu, Jianping; Cai, Lisheng; Cai, Mingzhi; Xiang, Gao; Hong, Yunfeng; Chen, Wenbo; Li, Guoxin

    2016-04-01

    Lymph node metastasis occurs in approximately 10% of early gastric cancer. Preoperative or intra-operative identification of lymph node metastasis in early gastric cancer is crucial for surgical planning. The purpose of this study was to evaluate the feasibility of using carbon nanoparticles to show sentinel lymph nodes (SLNs) in early gastric cancer. A multicenter study was performed between July 2012 and November 2014. Ninety-one patients with early gastric cancer identified by preoperative endoscopic ultrasonography were recruited. One milliliter carbon nanoparticles suspension, which is approved by Chinese Food and Drug Administration, was endoscopically injected into the submucosal layer at four points around the site of the primary tumor 6-12 h before surgery. Laparoscopic radical resection with D2 lymphadenectomy was performed. SLNs were defined as nodes that were black-dyed by carbon nanoparticles in greater omentum and lesser omentum near gastric cancer. Lymph node status and SLNs accuracy were confirmed by pathological analysis. All patients had black-dyed SLNs lying in greater omentum and/or lesser omentum. SLNs were easily found under laparoscopy. The mean number of SLNs was 4 (range 1-9). Carbon nanoparticles were around cancer in specimen. After pathological analysis, 10 patients (10.99%) had lymph node metastasis in 91 patients with early gastric cancer. SLNs were positive in 9 cases and negative in 82 cases. In pathology, carbon nanoparticles were seen in lymphatic vessels, lymphoid sinus, and macrophages in SLNs. When SLNs were positive, cancer cells were seen in lymph nodes. The sensitivity, specificity, and accuracy of black-dyed SLNs in early gastric cancers were 90, 100, and 98.9 %, respectively. No patient had any side effects of carbon nanoparticles in this study. It is feasible to use carbon nanoparticles to show SLNs in early gastric cancer. Carbon nanoparticles suspension is safe for submucosal injection.

  16. Material rhetoric: spreading stones and showing bones in the study of prehistory.

    Science.gov (United States)

    Van Reybrouck, David; de Bont, Raf; Rock, Jan

    2009-06-01

    Since the linguistic turn, the role of rhetoric in the circulation and the popular representation of knowledge has been widely accepted in science studies. This article aims to analyze not a textual form of scientific rhetoric, but the crucial role of materiality in scientific debates. It introduces the concept of material rhetoric to understand the promotional regimes in which material objects play an essential argumentative role. It analyzes the phenomenon by looking at two students of prehistory from nineteenth-century Belgium. In the study of human prehistory and evolution, material data are either fairly abundant stone tools or very scarce fossil bones. These two types of material data stand for two different strategies in material rhetoric. In this article, the first strategy is exemplified by Aimé Rutot, who gathered great masses of eoliths (crudely chipped stones which he believed to be prehistoric tools). The second strategy is typified by the example of Julien Fraipont, who based his scientific career on only two Neanderthal skeletons. Rutot sent his "artifacts" to a very wide audience, while Fraipont showed his skeletons to only a few selected scholars. Unlike Rutot, however, Fraipont was able to monitor his audience's interpretation of the finds by means of personal contacts. What an archaeologist gains in reach, he or she apparently loses in control. In this article we argue that only those scholars who find the right balance between the extremes of reach and control will prove to be successful.

  17. A cross-sectional study of Tritrichomonas foetus infection among healthy cats at shows in Norway

    Directory of Open Access Journals (Sweden)

    Nødtvedt Ane

    2011-06-01

    Full Text Available Abstract Background In recent years, the protozoan Tritrichomonas foetus has been recognised as an important cause of chronic large-bowel diarrhoea in purebred cats in many countries, including Norway. The aim of this cross-sectional study was to determine the proportion of animals with T. foetus infection among clinically healthy cats in Norway and to assess different risk factors for T. foetus infection, such as age, sex, former history of gastrointestinal symptoms and concurrent infections with Giardia duodenalis and Cryptosporidium sp. Methods The sample population consisted of 52 cats participating in three cat shows in Norway in 2009. Samples were examined for motile T. foetus by microscopy, after culturing and for T. foetus-DNA by species-specific nested PCR, as well as for Giardia cysts and Cryptosporidium oocysts by immunofluorescent antibody test (IFAT. Results By PCR, T. foetus-DNA was demonstrated in the faeces of 11 (21% of the 52 cats tested. DNA-sequencing of five positive samples yielded 100% identity with previous isolates of T. foetus from cats. Only one sample was positive for T. foetus by microscopy. By IFAT, four samples were positive for Giardia cysts and one for Cryptosporidium oocysts, none of which was co-infected with T. foetus. No significant associations were found between the presence of T. foetus and the various risk factors examined. Conclusions T. foetus was found to be a common parasite in clinically healthy cats in Norway.

  18. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies

    DEFF Research Database (Denmark)

    Elm, E. von; Altman, D.G.; Egger, M.

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed...... recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists...... and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case...

  19. Cadmium in Salix. A study to show the capacity of Salix to remove cadmium from farmland

    International Nuclear Information System (INIS)

    Oestman, G.

    1994-01-01

    The aim of this report has been to show the ability of Salix to take up cadmium and how the uptake varies between different types of soil. The information that the results are based on has been obtained from analyses of soil and Salix. The samples were taken at five sites in the district around Lake Maelaren. Two or three stands were taken at each place. The factors studied were the pH, the organic matter content, and the concentration of cadmium in the soil. Salix has a good ability, relative to other crops, to remove cadmium from arable land. The cadmium uptake is 35 times higher with Salix than with straw or energy grass. Salix uptake of cadmium varies between 3 and 14% of the cadmium content in the soil that is accessible to plants. The present annual increase of cadmium in arable land is 1 g/ha, whereas the removal in a Salix plantation is 21 g Cd/ha, yr at an annual growth of 10 tonnes DM. If the Cd uptake is the same each year, then a total of 420 g Cd/ha is removed when Salix is grown over a 20-year period. This is a very large part of the topsoil's total cadmium content, which is 550 g/ha on average in Sweden. The investigation reveals no clear relationship between the Cd concentration in Salix and the concentration of Cd in the soil, the organic matter content or the pH. 22 refs, 4 figs, 2 tabs

  20. Complement activation in leprosy: a retrospective study shows elevated circulating terminal complement complex in reactional leprosy.

    Science.gov (United States)

    Bahia El Idrissi, N; Hakobyan, S; Ramaglia, V; Geluk, A; Morgan, B Paul; Das, P Kumar; Baas, F

    2016-06-01

    Mycobacterium leprae infection gives rise to the immunologically and histopathologically classified spectrum of leprosy. At present, several tools for the stratification of patients are based on acquired immunity markers. However, the role of innate immunity, particularly the complement system, is largely unexplored. The present retrospective study was undertaken to explore whether the systemic levels of complement activation components and regulators can stratify leprosy patients, particularly in reference to the reactional state of the disease. Serum samples from two cohorts were analysed. The cohort from Bangladesh included multi-bacillary (MB) patients with (n = 12) or without (n = 46) reaction (R) at intake and endemic controls (n = 20). The cohort from Ethiopia included pauci-bacillary (PB) (n = 7) and MB (n = 23) patients without reaction and MB (n = 15) patients with reaction. The results showed that the activation products terminal complement complex (TCC) (P ≤ 0·01), C4d (P ≤ 0·05) and iC3b (P ≤ 0·05) were specifically elevated in Bangladeshi patients with reaction at intake compared to endemic controls. In addition, levels of the regulator clusterin (P ≤ 0·001 without R; P < 0·05 with R) were also elevated in MB patients, irrespective of a reaction. Similar analysis of the Ethiopian cohort confirmed that, irrespective of a reaction, serum TCC levels were increased significantly in patients with reactions compared to patients without reactions (P ≤ 0·05). Our findings suggests that serum TCC levels may prove to be a valuable tool in diagnosing patients at risk of developing reactions. © 2016 British Society for Immunology.

  1. Late onset rheumatoid arthritis an observational study.

    Science.gov (United States)

    Rexhepi, Sylejman; Rexhepi, Mjellma; Sahatçiu-Meka, Vjollca; Rexhepi, Blerta; Bahtiri, Elton; Mahmutaj, Vigan

    Rheumatoid arthritis (RA) may have an onset at older age. The onset of the disease at the age of 60 and over is called late-onset rheumatoid arthritis (LORA). The aim of this study was to analyze the clinical, laboratory, radiological, and treatment characteristics of patients with LORA compared to those with early-onset RA (EaORA), provided that all the patients had an approximately equal duration of the disease. This is an observational single-center study, which involved 120 patients with an established diagnosis of RA, of which 60 patients had LORA, and 60 patients EaORA. The disease activity, measured by the Disease Activity Score 28 (DAS28-ESR), was significantly higher in the LORA group compared to the EaORA group (p0.05), while the number of patients positive for anti-citrullinated protein antibody (ACPA) was signifi cantly greater in the EaORA group (p<0.05). The values of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly higher in the LORA than in the EaORA group. Hemoglobin levels were lower in the LORA group (11.96±1.64 g/dL) than in the EaORA group (12.18±1.56 g/dL). The most used disease-modifying antirheumatic drugs (DMARDs) were methotrexate and sulfasalazine, while biological drugs were not used. In conclusion, based on the results of our study, LORA has some features that distinguish it from EaORA, such as higher disease activity, more frequent involvement of large joints, and more pronounced structural damage. This should be taken in account in clinical practice, especially regarding treatment choices.

  2. Studying the Effect of a Competitive Game Show in a Learning by Teaching Environment

    Science.gov (United States)

    Matsuda, Noboru; Yarzebinski, Evelyn; Keiser, Victoria; Raizada, Rohan; Stylianides, Gabriel J.; Koedinger, Kenneth R.

    2013-01-01

    In this paper we investigate how competition among tutees in the context of learning by teaching affects tutors' engagement as well as tutor learning. We conducted this investigation by incorporating a competitive Game Show feature into an online learning environment where students learn to solve algebraic equations by teaching a synthetic…

  3. Sauerbraten, Rotkappchen und Goethe: The Quiz Show as an Introduction to German Studies.

    Science.gov (United States)

    White, Diane

    1980-01-01

    Proposes an adaptation of the quiz-show format for classroom use, discussing a set of rules and sample questions designed for beginning and intermediate German students. Presents questions based on German life and culture which are especially selected to encourage participation from students majoring in subjects other than German. (MES)

  4. Multicenter observational prehospital resuscitation on helicopter study.

    Science.gov (United States)

    Holcomb, John B; Swartz, Michael D; DeSantis, Stacia M; Greene, Thomas J; Fox, Erin E; Stein, Deborah M; Bulger, Eileen M; Kerby, Jeffrey D; Goodman, Michael; Schreiber, Martin A; Zielinski, Martin D; O'Keeffe, Terence; Inaba, Kenji; Tomasek, Jeffrey S; Podbielski, Jeanette M; Appana, Savitri N; Yi, Misung; Wade, Charles E

    2017-07-01

    Earlier use of in-hospital plasma, platelets, and red blood cells (RBCs) has improved survival in trauma patients with severe hemorrhage. Retrospective studies have associated improved early survival with prehospital blood product transfusion (PHT). We hypothesized that PHT of plasma and/or RBCs would result in improved survival after injury in patients transported by helicopter. Adult trauma patients transported by helicopter from the scene to nine Level 1 trauma centers were prospectively observed from January to November 2015. Five helicopter systems had plasma and/or RBCs, whereas the other four helicopter systems used only crystalloid resuscitation. All patients meeting predetermined high-risk criteria were analyzed. Patients receiving PHT were compared with patients not receiving PHT. Our primary analysis compared mortality at 3 hours, 24 hours, and 30 days, using logistic regression to adjust for confounders and site heterogeneity to model patients who were matched on propensity scores. Twenty-five thousand one hundred eighteen trauma patients were admitted, 2,341 (9%) were transported by helicopter, of which 1,058 (45%) met the highest-risk criteria. Five hundred eighty-five of 1,058 patients were flown on helicopters carrying blood products. In the systems with blood available, prehospital median systolic blood pressure (125 vs 128) and Glasgow Coma Scale (7 vs 14) was significantly lower, whereas median Injury Severity Score was significantly higher (21 vs 14). Unadjusted mortality was significantly higher in the systems with blood products available, at 3 hours (8.4% vs 3.6%), 24 hours (12.6% vs 8.9%), and 30 days (19.3% vs 13.3%). Twenty-four percent of eligible patients received a PHT. A median of 1 unit of RBCs and plasma were transfused prehospital. Of patients receiving PHT, 24% received only plasma, 7% received only RBCs, and 69% received both. In the propensity score matching analysis (n = 109), PHT was not significantly associated with mortality

  5. Consent for pediatric anesthesia: an observational study.

    Science.gov (United States)

    Lagana, Zoe; Foster, Andrew; Bibbo, Adriana; Dowling, Kate; Cyna, Allan M

    2012-08-01

    Informed consent prior to anesthesia is an important part of the pediatric pre-anesthetic consultation. This study aimed to observe and identify the number and nature of the anesthesia risks considered and communicated to parents/guardians and children during the pediatric informed consent process on the day of elective surgery. A convenience sample of anesthetists had their pre-anesthesia consultations voice recorded, prior to elective surgery, during a 4-month period at the largest tertiary referral centre for pediatric care in South Australia. A data collection form was used to note baseline demographic data, and voice recording transcripts were independently documented by two researchers and subsequently compared for accuracy regarding the number and nature of risks discussed. Of the 96 voice recordings, 91 (92%) were suitable for the analysis. The five most commonly discussed risks were as follows: nausea and vomiting (36%); sore throat (35%); allergy (29%); hypoxia (25%); and emergence delirium (19%). Twenty-seven pre-anesthetic consultations (30%) were found to have had no discussion of anesthetic risk at all while a further 23 consultations (26%) incorporated general statements inferring that anesthesia carried risks, but with no elaboration about their nature, ramifications or incidence. The median number of risks (IQR) specifically mentioned per consultation was higher, 3 (1) vs 1 (1), P anesthesia experience odds ratio 0.34, 95% CI [0.13, 0.87], P = 0.025. The pediatric anesthesia risk discussion is very variable. Trainees tend to discuss more specific risks than consultants and a patient's previous experience of anesthesia was associated with a more limited discussion of anesthesia risk. © 2011 Blackwell Publishing Ltd.

  6. Excessive users of violent video games do not show emotional desensitization: an fMRI study.

    Science.gov (United States)

    Szycik, Gregor R; Mohammadi, Bahram; Hake, Maria; Kneer, Jonas; Samii, Amir; Münte, Thomas F; Te Wildt, Bert T

    2017-06-01

    Playing violent video games have been linked to long-term emotional desensitization. We hypothesized that desensitization effects in excessive users of violent video games should lead to decreased brain activations to highly salient emotional pictures in emotional sensitivity brain regions. Twenty-eight male adult subjects showing excessive long-term use of violent video games and age and education matched control participants were examined in two experiments using standardized emotional pictures of positive, negative and neutral valence. No group differences were revealed even at reduced statistical thresholds which speaks against desensitization of emotion sensitive brain regions as a result of excessive use of violent video games.

  7. A case study of lightning attachment to flat ground showing multiple unconnected upward leaders

    Science.gov (United States)

    Cummins, Kenneth L.; Krider, E. Philip; Olbinski, Mike; Holle, Ronald L.

    2018-04-01

    On 10 July 2015, a cloud-to-ground (CG) lightning flash that produced two ground terminations was photographed from inside the safety of a truck in southern New Mexico. An analysis of archived NLDN data verified that this was a two-stroke flash, and a close-up view of the first stroke shows that it also initiated at least 12 unconnected, upward leaders (or "streamers") near the ground termination. No unconnected upward leaders were seen near the second ground attachment. After combining an analysis of the photograph with information provided by the NLDN, we infer that the first stroke was of negative (normal) polarity, had modest peak current, and struck about 460 m (± 24%) from the camera. Attachment occurred when an upward-propagating positive leader reached an inferred height of about 21 m above local ground. The second stroke struck ground about 740 m from the camera, and the height of its attachment leader is estimated to be 15 m. The estimated lengths of the unconnected upward leaders in the two-dimensional (2-D) plane of the first stroke range from 2 to 8 m, and all appear to be located within 15 m (2-D) of the main ground termination, with 24% uncertainty. Many of the unconnected upward leaders (inferred to be positive) exhibit multiple upward branches, and most of those branches have upward-directed forks or splits at their ends. This is the first report showing such extensive branching for positive upward leaders in natural lightning strikes to ground. None of the upward leaders can be seen to emanate from the tops of tall, isolated, or pointed objects on the ground, but they likely begin on small plants and rocks, or flat ground. In terms of lightning safety, this photo demonstrates that numerous upward leaders can be produced near a lightning strike point and have the potential to damage or cause injury at more than one specific point on the ground.

  8. New study shows normally helpful natural bacteria may also trigger lupus | Center for Cancer Research

    Science.gov (United States)

    CCR scientists have discovered that a protein produced by bacteria that naturally inhabit our bodies may trigger the autoimmune disease lupus. The results of the study could unveil an entirely new set of drug targets for treating lupus and other autoimmune diseases. Read more…

  9. Older Adults Show Deficits in Retrieving and Decoding Associative Mediators Generated at Study

    Science.gov (United States)

    Hertzog, Christopher; Fulton, Erika K.; Mandviwala, Lulua; Dunlosky, John

    2013-01-01

    We instructed the use of mediators to encode paired-associate items, and then measured both cued recall of targets and mediators. Older adults (n = 49) and younger adults (n = 57) studied a mixed list of concrete and abstract noun pairs under instructions to either generate a sentence or an image to form a new association between normatively…

  10. Study of medication-free children with Tourette syndrome do not show imaging abnormalities

    DEFF Research Database (Denmark)

    Jeppesen, Signe Søndergaard; Debes, Nanette Mol; Simonsen, Helle Juhl

    2014-01-01

    BACKGROUND: Imaging studies of patients with Tourette's syndrome (TS) across different cohorts have shown alterations in gray and white matter in areas associated with the cortico-striato-thalamic-cortical (CSTC) pathways; however, no consistent findings have subsequently established a clear...

  11. Affiliation, joint venture or PSO? Case studies show why provider strategies differ.

    Science.gov (United States)

    1998-03-01

    Joint venture, affiliation or PSO? Here are three case studies of providers who chose different paths under Medicare risk, plus some key questions you'll want to ask of your own provider organization. Learn from these examples so you'll make the best contracting decisions.

  12. Material Rhetoric: Spreading Stones and Showing Bones in the Study of Prehistory

    NARCIS (Netherlands)

    Van Reybrouck, D.; de Bont, R.; Rock, J.

    2009-01-01

    Since the linguistic turn, the role of rhetoric in the circulation and the popular representation of knowledge has been widely accepted in science studies. This article aims to analyze not a textual form of scientific rhetoric, but the crucial role of materiality in scientific debates. It introduces

  13. A morphometric CT study of Down's syndrome showing small posterior fossa and calcification of basal ganglia

    International Nuclear Information System (INIS)

    Ieshima, A.; Yoshino, K.; Takashima, S.; Takeshita, K.; Kisa, T.

    1984-01-01

    We report characteristic and morphometric changes of cranial computed tomography (CT) with increasing age in 56 patients with Down's syndrome aged from 0 month to 37 years. Patients were compared with 142 normal controls aged 0 to 59 years. Width of ventricles, Sylvian fissures, posterior fossa, pons and cisterna magna were measured on CT. The incidences of the cavum septi pellucidi, cavum vergae and cavum veli interpositi and high density in the basal ganglia were examined. There was high incidence (10.7%) of bilateral calcification of basal ganglia in Down's syndrome, although that of pineal body and choroid plexus calcification was similar in Down's syndrome and controls. Basal ganglia calcification is more frequently seen in young Down's syndrome and may be related to the premature aging characteristic of Down's syndrome. The CT in Down's syndrome showed relatively small posterior fossa, small cerebellum, small brain stem and relatively large Sylvian fissures in those under one year of age. There was a high frequency of midline cava and large cisterna magna. There were no significant atrophic changes on CT except after the fifth decade comparing with controls. (orig.)

  14. 'Show me the money': financial incentives increase chlamydia screening rates among tertiary students: a pilot study.

    Science.gov (United States)

    Currie, Marian J; Schmidt, Matthias; Davis, Belinda K; Baynes, Anne M; O'Keefe, Elissa J; Bavinton, Tim P; McNiven, Michelle; Martin, Sarah J; Bowden, Francis J

    2010-03-01

    We hypothesise that text-messaging and financial incentives would increase tertiary student participation in chlamydia screening. A cross-sectional study was conducted over two phases on eight tertiary campuses during 2007. During Phase 1 (6 months) study activities were advertised through student organisations and media. Education and screening were offered during a range of student activities. During Phase 2 (4 days) education and screening were offered via text messages. Non-financial incentives were offered during Phase 1 and a $10 cash incentive was offered during Phase 2. Rates of specimens provided by students and the direct costs incurred during each phase were compared. 2786 students attended the 31 activities conducted in Phase 1. Of these, 627 students (22.5%) provided urine specimens for chlamydia testing. During Phase 2, the dissemination of 866 text messages resulted in urine specimens from 392 students (45.3%). Costs per test were AUD $175.11 in Phase 1 and AUD $27.13 in Phase 2. Compared with more labour intensive (and therefore more expensive) screening activities conducted over a 6-month period, offering a small financial incentive to tertiary students through text messaging over a 4-day period significantly increased participation in on-campus chlamydia screening. This model could readily be applied to other populations to increase participation in chlamydia screening.

  15. Functional behavior of the anomalous magnetic relaxation observed in melt-textured YBa_2Cu_3O_7_-_δ samples showing the paramagnetic Meissner effect

    International Nuclear Information System (INIS)

    Dias, F.T.; Vieira, V.N.; Garcia, E.L.; Wolff-Fabris, F.; Kampert, E.; Gouvêa, C.P.; Schaf, J.; Obradors, X.; Puig, T.; Roa, J.J.

    2016-01-01

    Highlights: • Paramagnetic Meissner effect observed up to 5T in FCC and FCW measurements. • Time effects evidenced by irreversibilities between FCC and FCW measurements. • Strong time effects causing an anomalous paramagnetic relaxation. • Paramagnetic relaxation governed by different flux dynamics in different intervals. • An interpretative analysis to identify the flux dynamics in the relaxation process. - Abstract: We have studied the functional behavior of the field-cooled (FC) magnetic relaxation observed in melt-textured YBa_2Cu_3O_7_-_δ (Y123) samples with 30 wt% of Y_2Ba_1Cu_1O_5 (Y211) phase, in order to investigate anomalous paramagnetic moments observed during the experiments. FC magnetic relaxation experiments were performed under controlled conditions, such as cooling rate and temperature. Magnetic fields up to 5T were applied parallel to the ab plane and along the c-axis. Our results are associated with the paramagnetic Meissner effect (PME), characterized by positive moments during FC experiments, and related to the magnetic flux compression into the samples. After different attempts our experimental data could be adequately fitted by an exponential decay function with different relaxation times. We discuss our results suggesting the existence of different and preferential flux dynamics governing the anomalous FC paramagnetic relaxation in different time intervals. This work is one of the first attempts to interpret this controversial effect in a simple analysis of the pinning mechanisms and flux dynamics acting during the time evolution of the magnetic moment. However, the results may be useful to develop models to explain this interesting and still misunderstood feature of the paramagnetic Meissner effect.

  16. Feasibility Study on the Development of Index that Shows Social and Cultural Acceptance of Nuclear Power

    International Nuclear Information System (INIS)

    Cho, SeongKyung; Choi, Seungho; Yoon, Hana; Song, Jiyeon

    2015-01-01

    In this context, it is necessary to manage and develop an index that can measure the level of public acceptance by establishing the terms of social/cultural public acceptance of nuclear power in a practical manner and by identifying influential factors of public acceptance. Developing an index itself is not intended to increase the public acceptance of nuclear power. This study intends to contribute to determining energy policy acceptable to the public by estimating the level of potential social conflicts related to nuclear power policies with eligible evaluation criteria on social/cultural acceptance and by reducing relevant social costs. Key conclusions and proposal of this research are as follows. First, the influential factors of acceptance are reliability of nuclear safety, risk perception of nuclear power and beneficial perception of nuclear power. Among them, reliability of nuclear safety appears to have the most influence. In addition, benefit perception of nuclear power at the social level is significantly higher than that at the individual level. However, in relation to risk perception, a gap between experts and the public is found as nuclear industry premises that accident does not occur while the public premises that accident may occur

  17. Feasibility Study on the Development of Index that Shows Social and Cultural Acceptance of Nuclear Power

    Energy Technology Data Exchange (ETDEWEB)

    Cho, SeongKyung [Bangmok College of General Education at Myongji Univ., Yongin (Korea, Republic of); Choi, Seungho; Yoon, Hana; Song, Jiyeon [Domo Brodeur, Seoul (Korea, Republic of)

    2015-05-15

    In this context, it is necessary to manage and develop an index that can measure the level of public acceptance by establishing the terms of social/cultural public acceptance of nuclear power in a practical manner and by identifying influential factors of public acceptance. Developing an index itself is not intended to increase the public acceptance of nuclear power. This study intends to contribute to determining energy policy acceptable to the public by estimating the level of potential social conflicts related to nuclear power policies with eligible evaluation criteria on social/cultural acceptance and by reducing relevant social costs. Key conclusions and proposal of this research are as follows. First, the influential factors of acceptance are reliability of nuclear safety, risk perception of nuclear power and beneficial perception of nuclear power. Among them, reliability of nuclear safety appears to have the most influence. In addition, benefit perception of nuclear power at the social level is significantly higher than that at the individual level. However, in relation to risk perception, a gap between experts and the public is found as nuclear industry premises that accident does not occur while the public premises that accident may occur.

  18. Observational study of Herbig-Haro nebulae

    International Nuclear Information System (INIS)

    Brugel, E.W.

    1981-01-01

    Spectrophotometric data have been obtained for twelve Herbig-Haro nebulae with the multichannel spectrometer on the Mt. Palomar 5.08 meter telescope and with the image intensified dissector scanner on the Kitt Peak 2.13 meter telescope. Energy distributions of the continuous spectra of the Herbig-Haro objects H-H 1 (NW), H-H 2A, H-H 2G, H-H 2H, H-H 24A and H-H 32 have been determined in the wavelength range 3300 to 8000A. The signal-to-noise ratio has been improved in comparison to an earlier attempt to measure the continuum in H-H 1 and H-H 2H. Reddening corrections are based on Miller's [SII] method. The [FeII] emission line spectra have also been utilized as a secondary method for determining the interstellar reddening. In all continua the flux F/sub lambda/ increases rapidly with decreasing wavelength after the small scale structure has been averaged out. A power law interpolation F/sub lambda/ proportional lambda/sup -n/ demonstrates that for all observed H-H objects n lies in the range between 2.04 (H-H 2A, H-H 2H) and 2.92 (H-H 32). The relation of these results to recent I.U.E. observations of H-H 1 is discussed. It is also found that the ratio of the total optical continuum flux to Hβ flux is almost the same for all observed H-H objects with the sole exception of H-H 24A in which the continuum is considerably stronger than in other objects. This fact leads to difficulties in the usual dust scattering hypothesis for the interpretation of H-H continua. It is argued, if these energy distributions are really due to dust scattering in stellar continua as has been usually assumed, the original source must be a hot object and cannot be a T Tauri star.An interpretation in terms of transition radiation (as suggested by Gurzadyan) does not seem to be possible because the observed rise of F/sub lambda/ towards the ultraviolet is too steep

  19. Geomagnetic Observations for Main Field Studies

    DEFF Research Database (Denmark)

    Matzka, Jürgen; Chulliat, A.; Mandea, M.

    2010-01-01

    Direct measurements of the geomagnetic field have been made for more than 400 years, beginning with individual determinations of the angle between geographic and magnetic North. This was followed by the start of continuous time series of full vector measurements at geomagnetic observatories...... and the beginning of geomagnetic repeat stations surveys in the 19th century. In the second half of the 20th century, true global coverage with geomagnetic field measurements was accomplished by magnetometer payloads on low-Earth-orbiting satellites. This article describes the procedures and instruments...... for magnetic field measurements on ground and in space and covers geomagnetic observatories, repeat stations, automatic observatories, satellites and historic observations. Special emphasis is laid on the global network of geomagnetic observatories....

  20. The new worlds observer: The astrophysics strategic mission concept study

    Directory of Open Access Journals (Sweden)

    Cash W.

    2011-07-01

    Full Text Available We present some results of the Astrophysics Strategic Mission Concept Study for the New Worlds Observer (NWO. We show that the use of starshades is the most effective and affordable path to mapping and understanding our neighboring planetary systems, to opening the search for life outside our solar system, while serving the needs of the greater astronomy community. A starshade-based mission can be implemented immediately with a near term program of technology demonstration.

  1. Complicated Intra-Abdominal Infections Observational European study (CIAO Study

    Directory of Open Access Journals (Sweden)

    Sartelli Massimo

    2011-12-01

    Full Text Available Abstract Complicated intra-abdominal infections are frequently associated with poor prognoses and high morbidity and mortality rates. Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. In order to describe the clinical, microbiological, and management-related profiles of both community-acquired and healthcare-acquired complicated intra-abdominal infections (IAIs, the World Society of Emergency Surgery (WSES, in collaboration with the Surgical Infections Society of Europe (SIS-E and other prominent European surgical societies, has designed the CIAO study. The CIAO study is a multicenter, observational study and will be carried out in various surgical departments throughout Europe. The study will include patients undergoing surgery or interventional drainage for complicated IAI.

  2. Management of rheumatic chorea: an observational study

    Directory of Open Access Journals (Sweden)

    Araújo Alexandra Prufer de Queiroz Campos

    2002-01-01

    Full Text Available BACKGROUND: Rheumatic chorea (RC has recently been linked to an antibody-mediated immune mechanism. OBJECTIVE/METHOD: To verify if this knowledge reflected in management changes we conceived a descriptive study. RESULTS: The medical charts of 20 children (13 females aged 6 to 12 years (mean 8 years, diagnosed as RC from June 1996 to June 1999, were reviewed. All patients received some medical treatment. Haloperidol was the most prescribed medication (15 patients - 75 %. Sulpiride, diazepam and valproate were also used as symptomatic treatment. Imune-modulating therapy with prednisone was prescribed for seven children. The shortest course of chorea (16 days occurred in a patient treated with prednisone. CONCLUSION: Prednisone has been prescribed for rheumatic chorea besides the traditional symptomatic approach. A great variety of antichoreic drugs are being employed.

  3. [Therapeutic failure in scabies: An observational study].

    Science.gov (United States)

    De Sainte Marie, B; Mallet, S; Gaudy-Marqueste, C; Baumstarck, K; Bentaleb, N; Loundou, A; Hesse, S; Monestier, S; Grob, J-J; Richard, M-A

    2016-01-01

    Several sources suggest an escalation of scabies in France. To describe a population of patients continuing to present with scabies despite multiple treatments in order to identify factors associated with persistence of infection. A descriptive cross-sectional study in adults and children consulting for persistent scabies despite at least one previous treatment. A standardized questionnaire explored potential sources of treatment failure. Thirty-one patients were analyzed. Initial symptoms were noted to have started between two and 52 weeks earlier (mean: 19 weeks). The mean number of prior consultations with a general practitioner was 3.1 (0-10) and 1.7 with a dermatologist (0-7). The mean number of patients per household was 3.5 (1-9). At least one dose of oral ivermectin (maximum of 6 doses per household) was prescribed for 84 % of patients (29 % of whom were not fasted at the time). Further, 74 % of patients received at least one local application of esdepallethrin and piperonyl butoxide (maximum: 5 courses), four received benzyl benzoate and two received permethrin; however, 58 % did not reapply the substance after hand washing. All households bought the prescribed treatments despite the costs. Close contacts of patients were treated in 58 % of households. Decontamination of bedding and clothing was carried out properly in 90 % of households. Persistence of infection appears to be linked to: (1) insufficient treatment of close contacts; (2) absence of a second treatment between days 7 and 14; (3) insufficient efficacy of the available treatments, doubtless due to multiple factors (intrinsic resistance of Sarcoptes, failure to repeat treatment, poor explanation of methods for dosing and application, and oral intake of treatments). Access to non-reimbursed treatments was not identified as a problem and decontamination of bedding and clothing was correctly performed in most cases. Though certain fundamental aspects of scabies treatment must be better

  4. 177Lu-immunotherapy of experimental peritoneal carcinomatosis shows comparable effectiveness to 213Bi-immunotherapy, but causes toxicity not observed with 213Bi

    International Nuclear Information System (INIS)

    Seidl, Christof; Zoeckler, Christine; Beck, Roswitha; Senekowitsch-Schmidtke, Reingard; Quintanilla-Martinez, Leticia; Bruchertseifer, Frank

    2011-01-01

    213 Bi-d9MAb-immunoconjugates targeting gastric cancer cells have effectively cured peritoneal carcinomatosis in a nude mouse model following intraperitoneal injection. Because the β-emitter 177 Lu has proven to be beneficial in targeted therapy, 177 Lu-d9MAb was investigated in this study in order to compare its therapeutic efficacy and toxicity with those of 213 Bi-d9MAb. Nude mice were inoculated intraperitoneally with HSC45-M2 gastric cancer cells expressing d9-E-cadherin and were treated intraperitoneally 1 or 8 days later with different activities of specific 177 Lu-d9MAb immunoconjugates targeting d9-E-cadherin or with nonspecific 177 Lu-d8MAb. Therapeutic efficacy was evaluated by monitoring survival for up to 250 days. For evaluation of toxicity, both biodistribution of 177 Lu-d9MAb and blood cell counts were determined at different time points and organs were examined histopathologically. Treatment with 177 Lu-immunoconjugates (1.85, 7.4, 14.8 MBq) significantly prolonged survival. As expected, treatment on day 1 after tumour cell inoculation was more effective than treatment on day 8, and specific 177 Lu-d9MAb conjugates were superior to nonspecific 177 Lu-d8MAb. Treatment with 7.4 MBq of 177 Lu-d9MAb was most successful, with 90% of the animals surviving longer than 250 days. However, treatment with therapeutically effective activities of 177 Lu-d9MAb was not free of toxic side effects. In some animals lymphoblastic lymphoma, proliferative glomerulonephritis and hepatocarcinoma were seen but were not observed after treatment with 213 Bi-d9MAb at comparable therapeutic efficacy. The therapeutic efficacy of 177 Lu-d9MAb conjugates in peritoneal carcinomatosis is impaired by toxic side effects. Because previous therapy with 213 Bi-d9MAb revealed comparable therapeutic efficacy without toxicity it should be preferred for the treatment of peritoneal carcinomatosis. (orig.)

  5. Clinical and biomarker changes in premanifest Huntington disease show trial feasibility: a decade of the PREDICT-HD study

    Directory of Open Access Journals (Sweden)

    Jane S Paulsen

    2014-04-01

    Full Text Available There is growing consensus that intervention and treatment of Huntington disease (HD should occur at the earliest stage possible. Various early-intervention methods for this fatal neurodegenerative disease have been identified, but preventive clinical trials for HD are limited by a lack of knowledge of the natural history of the disease and a dearth of appropriate outcome measures. Objectives of the current study are to document the natural history of premanifest HD progression in the largest cohort ever studied and to develop a battery of imaging and clinical markers of premanifest HD progression that can be used as outcome measures in preventive clinical trials. PREDICT-HD is a 32-site, international, observational study of premanifest HD, with annual examination of 1013 participants with premanifest HD and 301 gene-expansion negative controls between 2001 and 2012. Findings document 39 variables representing imaging, motor, cognitive, functional, and psychiatric domains, showing different rates of decline between premanifest Huntington disease and controls. Required sample size and models of premanifest HD are presented to inform future design of clinical and preclinical research. Preventive clinical trials in premanifest HD with participants who have a medium or high probability of motor onset are calculated to be as resource-effective as those conducted in diagnosed HD and could interrupt disease seven to twelve years earlier. Methods and measures for preventive clinical trials in premanifest HD more than a dozen years from motor onset are also feasible. These findings represent the most thorough documentation of a clinical battery for experimental therapeutics in stages of premanifest HD, the time period for which effective intervention may provide the most positive possible outcome for patients and their families affected by this devastating disease.

  6. Observational study of outpatients with schizophrenia in the Middle ...

    African Journals Online (AJOL)

    Observational study of outpatients with schizophrenia in the Middle East and Africa — 3- and 6-month efficacy and safety results. The Intercontinental Schizophrenia Outpatient Health Outcomes Study.

  7. Parental behaviour in paediatric chronic pain: a qualitative observational study.

    Science.gov (United States)

    Dunford, Emma; Thompson, Miles; Gauntlett-Gilbert, Jeremy

    2014-10-01

    Parental behaviour appears to influence the adjustment of children with chronic pain. However, research in this area has failed to produce consistent evidence. Studies have tended to rely on self-report measures derived from adult pain populations. This qualitative, observational research provides descriptive data of parental behaviour in a clinical environment. A qualitative observational study was made of parents and adolescents in a physically stressful setting. Modified grounded theory was used to analyse verbal and non-verbal behaviours. Eight parent-adolescent dyads seeking treatment for chronic pain were videoed during physical exercise sessions. Verbal and non-verbal behaviours were recorded and transcribed. Four overarching categories emerged: 'monitoring', 'protecting', 'encouraging' and 'instructing'. These often had both verbal and non-verbal aspects. Within these categories, more precise behavioural groups were also identified. This research identifies categories of parental behaviour that were derived directly from observation, rather than imposed on the basis of results from different populations. Four categories of behaviour were derived, which clarify and extend dimensions used in existing self-report instruments. Careful description of parental behaviours showed features that past research has neglected, and highlighted potential drawbacks of apparently positive parental actions. © The Author(s) 2013.

  8. An observational study showed that explaining randomization using gambling-related metaphors and computer-agency descriptions impeded RCT recruitment.

    Science.gov (United States)

    Jepson, Marcus; Elliott, Daisy; Conefrey, Carmel; Wade, Julia; Rooshenas, Leila; Wilson, Caroline; Beard, David; Blazeby, Jane M; Birtle, Alison; Halliday, Alison; Stein, Rob; Donovan, Jenny L

    2018-03-02

    To explore how the concept of randomisation is described by clinicians and understood by patients in randomised clinical trials (RCTs), and how it contributes to patient understanding and recruitment. Qualitative analysis of seventy-three audio recordings of recruitment consultations from five, multi-centre, UK based RCTs with identified or anticipated recruitment difficulties. One in ten appointments did not include any mention of randomisation. Most included a description of the method or process of allocation. Descriptions often drew on gambling-related metaphors or similies, or referred to allocation by a computer. Where reference was made to a computer, some patients assumed that they would receive the treatment that was 'best for them'. Descriptions of the rationale for randomisation were rarely present, and often only came about as a consequence of patients questioning the reason for a random allocation. The methods and processes of randomisation were usually described by recruiters, but often without clarity, which could lead to patient misunderstanding. The rationale for randomisation was rarely mentioned. Recruiters should avoid problematic gambling metaphors and illusions of agency in their explanations, and instead focus on clearer descriptions of the rationale and method of randomisation to ensure patients are better informed about randomisation and RCT participation. Copyright © 2018. Published by Elsevier Inc.

  9. In-State and Interstate Associations Between Gun Shows and Firearm Deaths and Injuries: A Quasi-experimental Study.

    Science.gov (United States)

    Matthay, Ellicott C; Galin, Jessica; Rudolph, Kara E; Farkas, Kriszta; Wintemute, Garen J; Ahern, Jennifer

    2017-12-19

    Gun shows are an important source of firearms, but no adequately powered studies have examined whether they are associated with increases in firearm injuries. To determine whether gun shows are associated with short-term increases in local firearm injuries and whether this association differs by the state in which the gun show is held. Quasi-experimental. California. Persons in California within driving distance of gun shows. Gun shows in California and Nevada between 2005 and 2013 (n = 915 shows) and rates of firearm-related deaths, emergency department visits, and inpatient hospitalizations in California. Compared with the 2 weeks before, postshow firearm injury rates remained stable in regions near California gun shows but increased from 0.67 injuries (95% CI, 0.55 to 0.80 injuries) to 1.14 injuries (CI, 0.97 to 1.30 injuries) per 100 000 persons in regions near Nevada shows. After adjustment for seasonality and clustering, California shows were not associated with increases in local firearm injuries (rate ratio [RR], 0.99 [CI, 0.97 to 1.02]) but Nevada shows were associated with increased injuries in California (RR, 1.69 [CI, 1.16 to 2.45]). The pre-post difference was significantly higher for Nevada shows than California shows (ratio of RRs, 1.70 [CI, 1.17 to 2.47]). The Nevada association was driven by significant increases in firearm injuries from interpersonal violence (RR, 2.23 [CI, 1.01 to 4.89]) but corresponded to a small increase in absolute numbers. Nonfirearm injuries served as a negative control and were not associated with California or Nevada gun shows. Results were robust to sensitivity analyses. Firearm injuries were examined only in California, and gun show occurrence was not randomized. Gun shows in Nevada, but not California, were associated with local, short-term increases in firearm injuries in California. Differing associations for California versus Nevada gun shows may be due to California's stricter firearm regulations. National

  10. Yogurt and Diabetes: Overview of Recent Observational Studies.

    Science.gov (United States)

    Salas-Salvadó, Jordi; Guasch-Ferré, Marta; Díaz-López, Andrés; Babio, Nancy

    2017-07-01

    The effects of dairy consumption on the prevention of type 2 diabetes remain controversial and depend on the dairy subtype. Yogurt intake has received special attention because its association with health benefits is more consistent than that of other types of dairy products. In the present article, we review those observational studies that evaluated the association between yogurt consumption and type 2 diabetes. We also discuss the possible mechanisms involved in these associations. We found that 13 prospective studies evaluated the association between yogurt intake and type 2 diabetes, most of which showed an inverse association between the frequency of yogurt consumption and the risk of diabetes. In addition to the scientific evidence accumulated from individual prospective studies, several meta-analyses have shown that yogurt consumption has a potential role in diabetes prevention. The most recent analysis shows a 14% lower risk of type 2 diabetes when yogurt consumption was 80-125 g/d compared with no yogurt consumption. The intake of fermented dairy products, especially yogurt, has been inversely associated with variables of glucose metabolism. Yogurt may have probiotic effects that could modulate glucose metabolism. We conclude that yogurt consumption, in the context of a healthy dietary pattern, may reduce the risk of type 2 diabetes in healthy and older adults at high cardiovascular risk. Large-scale intervention studies and randomized clinical trials are warranted to determine if yogurt consumption has beneficial effects on insulin sensitivity and reduces the risk of type 2 diabetes. © 2017 American Society for Nutrition.

  11. How safe do teenagers behave on Facebook? An observational study.

    Science.gov (United States)

    Vanderhoven, Ellen; Schellens, Tammy; Valcke, Martin; Raes, Annelies

    2014-01-01

    The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13-18) to investigate (1) what kind of information teenagers post on their profile, (2) to what extent they protect this information using privacy-settings and (3) how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends' eyes only, but a lot of information is accessible on the friends-of-friends' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky) information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed.

  12. How safe do teenagers behave on Facebook? An observational study.

    Directory of Open Access Journals (Sweden)

    Ellen Vanderhoven

    Full Text Available The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13-18 to investigate (1 what kind of information teenagers post on their profile, (2 to what extent they protect this information using privacy-settings and (3 how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends' eyes only, but a lot of information is accessible on the friends-of-friends' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed.

  13. Palliative care team visits. Qualitative study through participant observation.

    Science.gov (United States)

    Alfaya Góngora, Maria Del Mar; Bueno Pernias, Maria José; Hueso Montoro, César; Guardia Mancilla, Plácido; Montoya Juárez, Rafael; García Caro, Maria Paz

    2016-03-30

    To describe the clinical encounters that occur when a palliative care team provides patient care and the features that influence these encounters and indicate whether they are favorable or unfavorable depending on the expectations and feelings of the various participants. A qualitative case study conducted via participant observation. A total of 12 observations of the meetings of palliative care teams with patients and families in different settings (home, hospital and consultation room) were performed. The visits were follow-up or first visits, either scheduled or on demand. Content analysis of the observation was performed. The analysis showed the normal follow-up activity of the palliative care unit that was focused on controlling symptoms, sharing information and providing advice on therapeutic regimens and care. The environment appeared to condition the patients' expressions and the type of patient relationship. Favorable clinical encounter conditions included kindness and gratitude. Unfavorable conditions were deterioration caused by approaching death, unrealistic family objectives and limited resources. Home visits from basic palliative care teams play an important role in patient and family well-being. The visits seem to focus on controlling symptoms and are conditioned by available resources.

  14. A comparative study of the effectiveness of "Star Show" vs. "Participatory Oriented Planetarium" lessons in a middle school Starlab setting

    Science.gov (United States)

    Platco, Nicholas L.., Jr.

    2005-06-01

    The purpose of this study was to compare the effectiveness of "Star Show" and the "Participatory Oriented Planetarium" (POP) instructional programs in a middle school Starlab setting. The Star Show is a planetarium program that relies heavily on an audiovisual/lecture format to impart information, while the POP method of instruction is an inquiry, activity-based approach to teaching astronomy. All Star Show and POP lessons were conducted in a Starlab planetarium. This study examined the effectiveness of the two methods on the attainment of astronomy knowledge, changes in student attitudes toward astronomy, retention of knowledge, and gender differences. A pilot study (N = 69) was conducted at a middle school near King of Prussia, Pennsylvania. The main study (N = 295) was conducted at a middle school near Reading, Pennsylvania. All students were pretested and posttested in both studies. The testing instruments included a 60-question paper-and-pencil content test and a 22-item Likert-style science attitude test. The content test was judged to be valid and reliable by a panel of science educators. The attitude test is a field-tested attitude survey developed by Michael Zeilik. The topics included in the Star Show and POP lessons were seasons, moon phases, eclipses, stars, and constellations. The Star Show programs used in this study are professionally prepared planetarium programs from Jeff Bowen Productions. Several planetarium educators who have been involved with planetarium training workshops throughout the United States developed the POP lessons used in this study. The Star Show was clearly the more effective method for improving student knowledge in both the pilot and main studies. Both methods were equally effective for improving student attitudes toward astronomy. The POP method was the more effective method of instruction when retention of knowledge was examined four weeks after the treatments ended. Gender did not have any significant effect on this study

  15. Concatenation of observed grasp phases with observer's distal movements: a behavioural and TMS study.

    Directory of Open Access Journals (Sweden)

    Elisa De Stefani

    Full Text Available The present study aimed at determining how actions executed by two conspecifics can be coordinated with each other, or more specifically, how the observation of different phases of a reaching-grasping action is temporary related to the execution of a movement of the observer. Participants observed postures of initial finger opening, maximal finger aperture, and final finger closing of grasp after observation of an initial hand posture. Then, they opened or closed their right thumb and index finger (experiments 1, 2 and 3. Response times decreased, whereas acceleration and velocity of actual finger movements increased when observing the two late phases of grasp. In addition, the results ruled out the possibility that this effect was due to salience of the visual stimulus when the hand was close to the target and confirmed an effect of even hand postures in addition to hand apparent motion due to the succession of initial hand posture and grasp phase. In experiments 4 and 5, the observation of grasp phases modulated even foot movements and pronunciation of syllables. Finally, in experiment 6, transcranial magnetic stimulation applied to primary motor cortex 300 ms post-stimulus induced an increase in hand motor evoked potentials of opponens pollicis muscle when observing the two late phases of grasp. These data suggest that the observation of grasp phases induced simulation which was stronger during observation of finger closing. This produced shorter response times, greater acceleration and velocity of the successive movement. In general, our data suggest best concatenation between two movements (one observed and the other executed when the observed (and simulated movement was to be accomplished. The mechanism joining the observation of a conspecific's action with our own movement may be precursor of social functions. It may be at the basis for interactions between conspecifics, and related to communication between individuals.

  16. Concatenation of observed grasp phases with observer's distal movements: a behavioural and TMS study.

    Science.gov (United States)

    De Stefani, Elisa; Innocenti, Alessandro; De Marco, Doriana; Gentilucci, Maurizio

    2013-01-01

    The present study aimed at determining how actions executed by two conspecifics can be coordinated with each other, or more specifically, how the observation of different phases of a reaching-grasping action is temporary related to the execution of a movement of the observer. Participants observed postures of initial finger opening, maximal finger aperture, and final finger closing of grasp after observation of an initial hand posture. Then, they opened or closed their right thumb and index finger (experiments 1, 2 and 3). Response times decreased, whereas acceleration and velocity of actual finger movements increased when observing the two late phases of grasp. In addition, the results ruled out the possibility that this effect was due to salience of the visual stimulus when the hand was close to the target and confirmed an effect of even hand postures in addition to hand apparent motion due to the succession of initial hand posture and grasp phase. In experiments 4 and 5, the observation of grasp phases modulated even foot movements and pronunciation of syllables. Finally, in experiment 6, transcranial magnetic stimulation applied to primary motor cortex 300 ms post-stimulus induced an increase in hand motor evoked potentials of opponens pollicis muscle when observing the two late phases of grasp. These data suggest that the observation of grasp phases induced simulation which was stronger during observation of finger closing. This produced shorter response times, greater acceleration and velocity of the successive movement. In general, our data suggest best concatenation between two movements (one observed and the other executed) when the observed (and simulated) movement was to be accomplished. The mechanism joining the observation of a conspecific's action with our own movement may be precursor of social functions. It may be at the basis for interactions between conspecifics, and related to communication between individuals.

  17. Mood Dimensions Show Distinct Within-Subject Associations With Non-exercise Activity in Adolescents: An Ambulatory Assessment Study

    Directory of Open Access Journals (Sweden)

    Elena D. Koch

    2018-03-01

    Full Text Available Physical activity is known to preserve both physical and mental health. However, the physical activity levels of a large proportion of adolescents are insufficient. This is critical, since physical activity levels in youth have been shown to translate into adulthood. Whereas in adult populations, mood has been supposed to be one important psychological factor that drives physical activity in everyday life, this issue has been poorly studied in adolescent populations. Ambulatory Assessment is the state-of-the-art approach to investigate how mood and non-exercise activity fluctuate within persons in everyday life. Through assessments in real time and real life, this method provides ecological validity, bypassing several limitations of traditional assessment methods (e.g., recall biases. To investigate whether mood is associated with non-exercise activity in adolescents, we equipped a community-based sample comprising 113 participants, aged 12–17 years, with GPS-triggered e-diaries querying for valence, energetic arousal, and calmness, and with accelerometers continuously measuring physical activity in their everyday lives for 1 week. We excluded all acceleration data due to participants' exercise activities and thereafter we parameterized non-exercise activity as the mean value across 10-min intervals of movement acceleration intensity following each e-diary prompt. We used multilevel analyses to compute the effects of the mood dimensions on non-exercise activity within 10-min intervals directly following each e-diary prompt. Additionally, we conducted explorative analyses of the time course of the effects, i.e., on different timeframes of non-exercise activity up to 300 min following the mood assessment. The results showed that valence (p < 0.001 and energetic arousal (p < 0.001 were positively associated with non-exercise activity within the 10 min interval, whereas calmness (p < 0.001 was negatively associated with non-exercise activity

  18. Evaluation of Multiclass Model Observers in PET LROC Studies

    Science.gov (United States)

    Gifford, H. C.; Kinahan, P. E.; Lartizien, C.; King, M. A.

    2007-02-01

    A localization ROC (LROC) study was conducted to evaluate nonprewhitening matched-filter (NPW) and channelized NPW (CNPW) versions of a multiclass model observer as predictors of human tumor-detection performance with PET images. Target localization is explicitly performed by these model observers. Tumors were placed in the liver, lungs, and background soft tissue of a mathematical phantom, and the data simulation modeled a full-3D acquisition mode. Reconstructions were performed with the FORE+AWOSEM algorithm. The LROC study measured observer performance with 2D images consisting of either coronal, sagittal, or transverse views of the same set of cases. Versions of the CNPW observer based on two previously published difference-of-Gaussian channel models demonstrated good quantitative agreement with human observers. One interpretation of these results treats the CNPW observer as a channelized Hotelling observer with implicit internal noise

  19. Stroke risk and NSAIDs: A systematic review of observational studies

    NARCIS (Netherlands)

    C. Varas-Lorenzo (Cristina); N. Riera-Guardia (Nuria); B. Calingaert (Brian); J. Castellsague (Jordi); A. Pariente (Antoine); L. Scotti (Lorenza); M.C.J.M. Sturkenboom (Miriam); S. Perez-Gutthann (Susana)

    2011-01-01

    textabstractAims: To perform a quantitative systematic review of observational studies on the risk of stroke associated with the use of individual NSAIDs. Methods and results: Searches were conducted using the Medline database within PubMed (1990-2008). Observational cohort or case-control studies

  20. Learning to observe mathematical learning in lesson studies

    DEFF Research Database (Denmark)

    Rasmussen, Klaus; Østergaard, Camilla Hellsten; Foss, Kristian Kildemoes

    2016-01-01

    This poster deals with lesson study (LS) in pre-service teacher education. In particular how to prepare for, carry out, and reflect upon, observations of pupil learning. Observation is of crucial importance to the lesson study process, and here we present a study of observation features which ena...... enable or hinder fruitful lesson study. While substantial research has been carried out in the general field of bserving pupils’ learning processes and teachers’ pedagogical practice, little is known about this in the particular setting of lesson study....

  1. An observational study on the relationship between plasma vitamin ...

    African Journals Online (AJOL)

    ARTICLE. An observational study on the relationship between plasma ... To study plasma vitamin C, oxidative stress, hyperglycaemia, endothelial dysfunction and outcome in septic shock. ..... with critical illness,[6,7,16] and excess losses of.

  2. Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

    Science.gov (United States)

    Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

    2017-06-01

    Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

  3. Case-Control Studies - An Efficient Observational Study Design

    NARCIS (Netherlands)

    van Stralen, Karlijn J.; Dekker, Friedo W.; Zoccali, Carmine; Jager, Kitty J.

    2010-01-01

    Case-control studies are an efficient research method for investigating risk factors of a disease. The method involves the comparison of the odds of exposure in a patient group with that of the odds of exposure in a control group. As only a minority of the population is included in the study, less

  4. Corneal permeability changes in dry eye disease: an observational study.

    Science.gov (United States)

    Fujitani, Kenji; Gadaria, Neha; Lee, Kyu-In; Barry, Brendan; Asbell, Penny

    2016-05-13

    Diagnostic tests for dry eye disease (DED), including ocular surface disease index (OSDI), tear breakup time (TBUT), corneal fluorescein staining, and lissamine staining, have great deal of variability. We investigated whether fluorophotometry correlated with previously established DED diagnostic tests and whether it could serve as a novel objective metric to evaluate DED. Dry eye patients who have had established signs or symptoms for at least 6 months were included in this observational study. Normal subjects with no symptoms of dry eyes served as controls. Each eye had a baseline fluorescein scan prior to any fluorescein dye. Fluorescein dye was then placed into both eyes, rinsed with saline solution, and scanned at 5, 10, 15, and 30 min. Patients were administered the following diagnostic tests to correlate with fluorophotometry: OSDI, TBUT, fluorescein, and lissamine. Standard protocols were used. P eyes from 25 patients (DED = 22 eyes, 11 patients; Normal = 28 eyes, 14 patients) were included. Baseline scans of the dry eye and control groups did not show any statistical difference (p = 0.84). Fluorescein concentration of DED and normal patients showed statistical significance at all time intervals (p eyes up to 30 min after fluorescein dye instillation. There may be an aspect of DED that is missed in the current regimen of DED tests and only captured with fluorophotometry. Adding fluorophotometry may be useful in screening, diagnosing, and monitoring patients with DED.

  5. Genotype-Phenotype Study of the Middle Gangetic Plain in India Shows Association of rs2470102 with Skin Pigmentation.

    Science.gov (United States)

    Mishra, Anshuman; Nizammuddin, Sheikh; Mallick, Chandana Basu; Singh, Sakshi; Prakash, Satya; Siddiqui, Niyamat Ali; Rai, Niraj; Carlus, S Justin; Sudhakar, Digumarthi V S; Tripathi, Vishnu P; Möls, Märt; Kim-Howard, Xana; Dewangan, Hemlata; Mishra, Abhishek; Reddy, Alla G; Roy, Biswajit; Pandey, Krishna; Chaubey, Gyaneshwer; Das, Pradeep; Nath, Swapan K; Singh, Lalji; Thangaraj, Kumarasamy

    2017-03-01

    Our understanding of the genetics of skin pigmentation has been largely skewed towards populations of European ancestry, imparting less attention to South Asian populations, who behold huge pigmentation diversity. Here, we investigate skin pigmentation variation in a cohort of 1,167 individuals in the Middle Gangetic Plain of the Indian subcontinent. Our data confirm the association of rs1426654 with skin pigmentation among South Asians, consistent with previous studies, and also show association for rs2470102 single nucleotide polymorphism. Our haplotype analyses further help us delineate the haplotype distribution across social categories and skin color. Taken together, our findings suggest that the social structure defined by the caste system in India has a profound influence on the skin pigmentation patterns of the subcontinent. In particular, social category and associated single nucleotide polymorphisms explain about 32% and 6.4%, respectively, of the total phenotypic variance. Phylogeography of the associated single nucleotide polymorphisms studied across 52 diverse populations of the Indian subcontinent shows wide presence of the derived alleles, although their frequencies vary across populations. Our results show that both polymorphisms (rs1426654 and rs2470102) play an important role in the skin pigmentation diversity of South Asians. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  6. An observational study of road safety around selected primary ...

    African Journals Online (AJOL)

    Materials and Methods: A multistage sampling technique was used to select 46 of the 74 schools in the study area. Some (11) of the selected schools were sited within the same premises and shared a common entrance; thus a total of 35 school premises were eventually observed. Trained research assistants observed the ...

  7. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)

    DEFF Research Database (Denmark)

    Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G

    2014-01-01

    Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical...... to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how...

  8. Reception of Talent Shows in Denmark: First Results from a Trans-National Audience Study of a Global Format Genre

    DEFF Research Database (Denmark)

    Jensen, Pia Majbritt

    This paper will discuss the methodology and present the preliminary findings of the Danish part of a trans-national, comparative audience study of the musical talent show genre undertaken in Denmark, Finland, Germany and Great Britain in Spring 2013. Within the international business model...... of format adaptation, the musical talent show genre has been particularly successful in crossing cultural borders. Formats such as Idols, X Factor and Voice have sold to a large variety of countries, covering all continents. Such global reach inevitably raises the question of the genre’s audience appeal......; to what degree its reach has to do with a universal appeal inherent in the genre and/or the innovative character of individual formats, and to what degree its global success is due to local broadcasters’ ability to successfully adapt the formats to local audience tastes. A consensus has developed...

  9. Social Phobia in an Italian region: do Italian studies show lower frequencies than community surveys conducted in other European countries?

    Directory of Open Access Journals (Sweden)

    Dell'Osso Liliana

    2004-10-01

    Full Text Available Abstract Background The lifetime prevalence of Social Phobia (SP in European countries other than Italy has been estimated to range from 3.5% to 16.0%. The aim of this study was to assess the frequency of SP in Sardinia (Italy in order to verify the evidence of a lower frequency of SP in Italy observed in previous studies (from 1.0% to 3.1%. Methods A randomised cross sample of 1040 subjects, living in Cagliari, in rural areas, and in a mining district in Sardinia were interviewed using a Simplified version of the Composite International Diagnostic Interview (CIDIS. Diagnoses were made according to the 10th International Classification of Diseases (ICD-10. Results Lifetime prevalence of SP was 2.2% (males: 1.5%, females: 2.8% whereas 6-month prevalence resulted in 1.5% (males: 0.9%, females: 2.1%. Mean age at onset was 16.2 ± 9.3 years. A statistically significant association was found with Depressive Episode, Dysthymia and Generalized Anxiety Disorder. Conclusions The study is consistent with findings reported in several previous studies of a lower prevalence of SP in Italy. Furthermore, the results confirm the fact that SP, due to its early onset, might constitute an ideal target for early treatment aimed at preventing both the accumulation of social disabilities and impairments caused by anxiety and avoidance behaviour, as well as the onset of more serious, associated complications in later stages of the illness.

  10. Splenic lesions observed in 71 splenectomized dogs: a retrospective study

    Directory of Open Access Journals (Sweden)

    Elisângela Olegário da Silva

    2016-10-01

    Full Text Available The spleen of dogs is frequently affected by disorders that vary from local and systemic origin. The difficulty in associating clinical and gross findings contributes for the choice of total splenectomy as the main treatment, leading to an impairment of the immune and hematopoietic functions. The aim of this study was to evaluate the pathological findings in the spleen of splenectomized dogs during 2008 to 2014 at a Veterinary Teaching Hospital. From the 71 cases analyzed, 97% (69/71 of the dogs were submitted to total splenectomy and 3% (2/71 to partial splenectomy. In 45 (63.4% of these cases, the histopathological diagnosis was non-neoplastic alterations; only 36.6% (26/71 had a splenic neoplasia. The main non-neoplastic lesions observed were nodular hyperplasia 24.4% (11/45, infarction 22.3% (10/45, and hematoma 20% (9/45. The most frequent tumors were hemangiosarcoma 50% (13/26, histiocytic sarcoma 23% (6/26, and lymphoma 11.5% (3/26. The clinical methods used to diagnose splenic lesions were ultrasonography 88% (63/71, radiography 2.8% (2/71 and exploratory laparotomy 4.2% (3/71. In 4.2% (3/71 the spleen changes were observed during the therapeutic ovariohysterectomy. The results of the present study showed a prevalence of benign disorders in the spleen of splenectomized dogs associated with a high incidence of total splenectomy performed, indicating a difficulty in recognizing the different lesions that can affect the spleen by the veterinarian medical.

  11. Reliability of radiographic observations recorded on a proforma measured using inter- and intra-observer variation: a preliminary study.

    Science.gov (United States)

    Saunders, M B; Gulabivala, K; Holt, R; Kahan, R S

    2000-05-01

    The aim of this preliminary study was to test the reliability of radiographic evaluation of features of endodontic interest using a newly devised data collection system. Twelve endodontic MSc postgraduate students and one specialist endodontist examined sample radiographs derived from a random selection of 42 patients seen previously on an Endodontic New Patient Clinic (EDI). Each student examined a random selection of 8-9 roots on periapical radiographs of single- and multirooted teeth, with and without previous root canal therapy and 3-4 dental panoramic tomograms (DPTs). A total of 100 roots were examined. A proforma was used to record observations on 67 radiographic features using predefined criteria. Intra-observer agreement was tested by asking the students to re-examine the radiographs. The principle investigator and the specialist endodontist examined the same radiographs and devised a Gold Standard using the same criteria. This was compared with the student assessments to determine inter-observer variation. The postgraduates then attended a revision session on the use of the form. Each student subsequently examined 8-9 different roots from the pool of radiographs. A further assessment of inter-observer variation was made by comparing these observations with the Gold Standard. Of the 67 radiographic features, only 25 had sufficient response to allow statistical analysis. Kappa values for intra- and inter-observer variation were estimated. These varied depending on the particular radiographic feature being assessed. Fifteen out of 25 intra-observer recordings showed 'good' or 'very good' Kappa agreement, but only three out of 25 inter-observer observations achieved 'good' or 'very good' values. Inter-observer variation was improved following the revision session with 16 out of 25 observations achieving 'good' or 'very good' Kappa agreement. Modification to the proforma, the criteria used, and training for radiographic assessment were considered necessary to

  12. Assessing validity of observational intervention studies - the Benchmarking Controlled Trials.

    Science.gov (United States)

    Malmivaara, Antti

    2016-09-01

    Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. To create and pilot test a checklist for appraising methodological validity of a BCT. The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies. Key messages Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies.

  13. Observational studies and the difficult quest for causality

    DEFF Research Database (Denmark)

    Lipsitch, Marc; Jha, Ayan; Simonsen, Lone

    2016-01-01

    be answered once the vaccine is in use, from observational studies. However, such studies are inherently at risk for bias. Using a causal framework and illustrating with examples, we review newer approaches to detecting and avoiding confounding and selection bias in three major classes of observational study...... design: cohort, case-control and ecological studies. Studies of influenza VE, especially in seniors, are an excellent demonstration of the challenges of detecting and reducing such bias, and so we use influenza VE as a running example. We take a fresh look at the time-trend studies often dismissed...... as 'ecological'. Such designs are the only observational study design that can measure the overall effect of a vaccination programme [indirect (herd) as well as direct effects], and are in fact already an important part of the evidence base for several vaccines currently in use. Despite the great strides towards...

  14. Pain in neurosurgically treated patients: A prospective observational study

    NARCIS (Netherlands)

    M. Klimek (Markus); J.F. Ubben (Johannes); J. Ammann (Jan); K. Borner (Katy); J. Klein (Jan); S.J.C. Verbrugge (Serge)

    2006-01-01

    textabstractObject. This is the first observational study to compare perioperative pain character and intensity in patients undergoing different types of elective neurosurgical procedures. Methods. A structured questionnaire was used to inquire about pain intensity, character, and management during

  15. On sensitivity value of pair-matched observational studies

    OpenAIRE

    Zhao, Qingyuan

    2017-01-01

    An observational study may be biased for estimating causal effects by failing to control for unmeasured confounders. This paper proposes a new quantity called the "sensitivity value", which is defined as the minimum strength of unmeasured confounders needed to change the qualitative conclusions of a naive analysis assuming no unmeasured confounder. We establish the asymptotic normality of the sensitivity value in pair-matched observational studies. The theoretical results are then used to app...

  16. Noise exposure in movie theaters: a preliminary study of sound levels during the showing of 25 films.

    Science.gov (United States)

    Warszawa, Anna; Sataloff, Robert T

    2010-09-01

    The harmful effects of noise exposure during leisure-time activities are beginning to receive some scrutiny. We conducted a preliminary study to investigate the noise levels during the showings of 25 different films. During each screening, various sound measurements were made with a dosimeter. The movies were classified on the basis of both their Motion Picture Association of America (MPAA) rating and their genre, and the size of the theater and the size of the audience were taken into consideration in the final analysis. Our findings suggest that the sound levels of many movies might be harmful to hearing, although we can draw no definitive conclusions. We did not discern any relationship between noise levels and either MPAA rating or genre. Further studies are recommended.

  17. Whole blood DNA aberrant methylation in pancreatic adenocarcinoma shows association with the course of the disease: a pilot study.

    Directory of Open Access Journals (Sweden)

    Albertas Dauksa

    Full Text Available Pancreatic tumors are usually diagnosed at an advanced stage in the progression of the disease, thus reducing the survival chances of the patients. Non-invasive early detection would greatly enhance therapy and survival rates. Toward this aim, we investigated in a pilot study the power of methylation changes in whole blood as predictive markers for the detection of pancreatic tumors. We investigated methylation levels at selected CpG sites in the CpG rich regions at the promoter regions of p16, RARbeta, TNFRSF10C, APC, ACIN1, DAPK1, 3OST2, BCL2 and CD44 in the blood of 30 pancreatic tumor patients and in the blood of 49 matching controls. In addition, we studied LINE-1 and Alu repeats using degenerate amplification approach as a surrogate marker for genome-wide methylation. The site-specific methylation measurements at selected CpG sites were done by the SIRPH method. Our results show that in the patient's blood, tumor suppressor genes were slightly but significantly higher methylated at several CpG sites, while repeats were slightly less methylated compared to control blood. This was found to be significantly associated with higher risk for pancreatic ductal adenocarcinoma. Additionally, high methylation levels at TNFRSCF10C were associated with positive perineural spread of tumor cells, while higher methylation levels of TNFRSF10C and ACIN1 were significantly associated with shorter survival. This pilot study shows that methylation changes in blood could provide a promising method for early detection of pancreatic tumors. However, larger studies must be carried out to explore the clinical usefulness of a whole blood methylation based test for non-invasive early detection of pancreatic tumors.

  18. A Pilot Study of Reasons and Risk Factors for "No-Shows" in a Pediatric Neurology Clinic.

    Science.gov (United States)

    Guzek, Lindsay M; Fadel, William F; Golomb, Meredith R

    2015-09-01

    Missed clinic appointments lead to decreased patient access, worse patient outcomes, and increased healthcare costs. The goal of this pilot study was to identify reasons for and risk factors associated with missed pediatric neurology outpatient appointments ("no-shows"). This was a prospective cohort study of patients scheduled for 1 week of clinic. Data on patient clinical and demographic information were collected by record review; data on reasons for missed appointments were collected by phone interviews. Univariate and multivariate analyses were conducted using chi-square tests and multiple logistic regression to assess risk factors for missed appointments. Fifty-nine (25%) of 236 scheduled patients were no-shows. Scheduling conflicts (25.9%) and forgetting (20.4%) were the most common reasons for missed appointments. When controlling for confounding factors in the logistic regression, Medicaid (odds ratio 2.36), distance from clinic, and time since appointment was scheduled were associated with missed appointments. Further work in this area is needed. © The Author(s) 2014.

  19. Necrotizing soft tissue infections - a multicentre, prospective observational study (INFECT)

    DEFF Research Database (Denmark)

    Madsen, M. B.; Skrede, S.; Bruun, T.

    2018-01-01

    these to patient-important outcomes. With this protocol and statistical analysis plan we describe the methods used to obtain data and the details of the planned analyses. Methods: The INFECT study is a multicentre, prospective observational cohort study. Patients with NSTIs are enrolled in five Scandinavian......Background: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating...

  20. Retrospective cohort study shows that the risks for retinopathy of prematurity included birth age and weight, medical conditions and treatment.

    Science.gov (United States)

    Ali, Aliaa A; Gomaa, Nancy A S; Awadein, Ahmed R; Al-Hayouti, Huda H; Hegazy, Ahmed I

    2017-12-01

    This study described the characteristics and risk factors of neonates who developed retinopathy of prematurity (ROP) and severe treatable ROP in two Egyptian neonatal intensive care units (NICUs). This retrospective cohort study comprised 108 preterm neonates who were screened for ROP after being admitted to the two NICUs run by Cairo University Hospital from June 2014 to May 2015. Patients were examined using digital fundus photography and indirect ophthalmoscopy was performed if ROP was detected. Retinopathy of prematurity occurred in 75 patients. Late-onset sepsis, ventilation and hypercapnia were independently associated with ROP. Patients who developed severe treatable ROP had a younger gestational age (GA) than patients who did not develop ROP or developed mild or moderate ROP (29 weeks, range 27-33 weeks versus 32 weeks, range 28-36 weeks, p = 0.002) and a lower birthweight (1200 g, range 980-1590 g versus 1460 g, range 770-2475 g, p = 0.029). The risk factors associated with severe treatable ROP included the duration of admission, the duration of incubator oxygen, late-onset sepsis, intraventricular haemorrhage, total parenteral nutrition and the duration of caffeine citrate therapy. This study showed that the risks for ROP were wide-ranging and included GA and weight, medical conditions and treatment. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  1. Pulp polyp - A periapical lesion: Radiographic observational study

    Directory of Open Access Journals (Sweden)

    Kandagal V Suresh

    2015-01-01

    Full Text Available Introduction: Pulp polyp (PP is a chronic hyperplastic condition resulting in formation of granulation tissue and proliferative mass. The radiographic appearance of PP has innumerable presentations. Diagnosing and treatment planning of periapical lesions, heavily relies on the radiographic changes surrounding the root structures. Objective: To evaluate different radiographic periapical changes in clinically detected PP patients. Materials and Methods: Patients reporting to Department of Oral Medicine and Radiology and who were clinically diagnosed with PP by an oral diagnostician were subjected to radiographic examination. Digital intraoral periapical radiographs of 50 patients with PP were taken. Various periapical changes in the digital radiographs were recorded by a skilled oral radiologist. The data obtained was subjected to statistical analysis using SPSS ver 17.0 and P-value was set at <0.05 as significant. Result: Periapical changes like periodontal space widening (PDLW, loss of lamina dura, periapical abscess, periapical granuloma, hypercementosis, condensing osteitis and root resorption were noted. Periodontal space widening was seen in all patients (100%, loss of lamina dura was noted in 72%, periapical rarefying osteitis in 56%, condensing osteitis in 8%, hypercementosis, periapical granuloma, and root resorption were seen in 4% of PP patients. Majority of PP were asymptomatic (66%. Pulp polyp was commonly seen in mandibular first molar followed by mandibular second molar and maxillary first molar. Statistically significant difference was noticed between periapical changes in PP patients (P value <0.0001. All PP patients showed definite periapical changes suggesting it to be a periapical lesion. Conclusion: Pulp polyp is confined to the pulpal portion of the tooth which, may or may not cause changes in periapical region. The results of the present study showed that majority of the PP patients were associated with definite periapical

  2. Following Musical Shows: A Study with Focal Groups on Satisfaction of Musical Concerts Regular Visitors and Socialization between Them

    Directory of Open Access Journals (Sweden)

    Lúmia Massa Garcia Pires

    2017-06-01

    Full Text Available This article aimed to identify which attributes impact more significantly on the satisfaction of concerts’ regular visitors and socialization between them when inserted in these kinds of events. Thus, we used a qualitative methodology, performing focus groups. Among the main results of this study, we found, regarding satisfaction of concerts’ visitors, the attributes that most influence the public are related to services - especially for beverage supply, cleaning of bathrooms and lines formed inside the event - organization, show infrastructure and performance artists. Furthermore, considering the socialization of the visitors, we found that most respondents often go to concerts together with other people, but some did not exclude the possibility to attend the concerts alone when it comes to a familiar artist.

  3. A Trans-National Audience Study of a Global Format Genre: Talent Shows in Denmark, Finland, Germany and Great Britain

    DEFF Research Database (Denmark)

    Jensen, Pia Majbritt; Esser, Andrea; Keinonen, Heidi

    This paper will discuss the methodology and present the preliminary findings of a trans-national, comparative audience study of the musical talent show genre undertaken in Denmark, Finland, Germany and Great Britain in early 2013. Within the international business model of selling and adapting...... continents (Zwaan & de Bruin 2012). Such global reach inevitably raises the question of the genre’s audience appeal, to what degree its reach has to do with a universal appeal inherent in the genre and/or the innovative character of individual formats (Armbruster and Mikos 2009), and to what degree...... the global success is due to local broadcasters’ ability to successfully adapt the format to local audience tastes. A few trans-national, comparative textual analyses of various adaptations of the same formats have been carried out to reveal the differences between adaptations (e.g. Mikos and Perotta 2012...

  4. Ethical Disputes and Public Service Televison. Case Study: Otvoreno Political Talk Show, Broadcasted on 21st of January, 2010

    Directory of Open Access Journals (Sweden)

    Gordana Škaljac Narančić

    2011-12-01

    Full Text Available Ratings of the television programs as well as commercial effects become crucial measures of the media success and journalists’ efficiency neglecting minimal ethical standards. The profit maximisation logic and mere survival in times of the economic crisis also has the impact on preserving the sensitive ethical standards. In this respect, the television, as the most influential medium, especially public television, has the biggest responsibility. Violation of the ethical norms on public television means that it does not fulfil its key role – the role of public service. In important cases of the violation of ethical rules, the lack of clear responses of the regulators is the other side of the problem. The case study in this text shows us how easy it is to turn to the contempt of the professional journalistic standards and, consequently, ethical norms. This leads us to think how difficult is today to remain professional and ethical in times of the tangible commercialism and sensationalism.

  5. Young adult smoking in peer groups: an experimental observational study.

    Science.gov (United States)

    Harakeh, Zeena; Vollebergh, Wilma A M

    2013-03-01

    The aim of this experimental observational study is to examine whether, in a group setting (same-sex triads), passive peer influence (imitation) in the context of homogeneous and heterogeneous (contradictory) behavior of peer models affects young adults' smoking behavior. An experiment was conducted among 48 daily-smoking college and university students aged 17-25. Participants had to complete a 30-min music task with two same-sex confederates. We tested the following three conditions: (a) neither of the confederates is smoking, (b) one confederate is smoking and the other is not, and (c) both confederates are smoking. The primary outcome tested was the total number of cigarettes smoked during the task. Students in the condition with two smoking peer models and in the condition with one smoking peer model and one nonsmoking peer model smoked significantly more cigarettes than those in the condition with two nonsmoking peer models. However, results for the condition with two smoking peer models did not differ significantly from the condition with one smoking peer model and one nonsmoking peer model. Our findings show that in a group setting, the impact of the homogeneity of smoking peers on young adults' smoking behavior is not greater than the impact of the heterogeneity of smoking and nonsmoking peers. This would suggest that the smoking peer in the group has a greater impact on the daily-smoking young adult, thus reducing or even eliminating the protective effect of the nonsmoking peer model.

  6. Exploring interprofessional, interagency multimorbidity care: case study based observational research

    Science.gov (United States)

    McKinlay, Eileen M.; Morgan, Sonya J.; Gray, Ben V.; Macdonald, Lindsay M.; Pullon, Susan R.H.

    2017-01-01

    Background The increase in multimorbidity or co-occurring chronic illnesses is a leading healthcare concern. Patients with multimorbidity require ongoing care from many different professionals and agencies, and often report a lack of integrated care. Objective To explore the daily help-seeking behaviours of patients with multimorbidity, including which health professionals they seek help from, how professionals work together, and perceptions and characteristics of effective interprofessional, interagency multimorbidity care. Design Using a case study observational research design, multiple data sources were assembled for four patients with multimorbidity, identified by two general practitioners in New Zealand. In this paper, two case studies are presented, including the recorded instances of contact and communication between patients and professionals, and between professionals. Professional interactions were categorized as consultation, coordination, or collaboration. Results The two case studies illustrated two female patients with likely similar educational levels, but with different profiles of multimorbidity, social circumstances, and personal capabilities, involving various professionals and agencies. Engagement between professionals showed varying levels of interaction and a lack of clarity about leadership or care coordination. The majority of interactions were one-to-one consultations and rarely involved coordination and collaboration. Patients were rarely included in communications between professionals. Conclusion Cases constructed from multiple data sources illustrate the complexity of day-to-day, interprofessional, interagency multimorbidity care. While consultation is the most frequent mode of professional interaction, targeted coordinated and collaborative interactions (including the patient) are highly effective activities. Greater attention should be given to developing and facilitating these interactions and determining who should lead them. PMID

  7. Complex mixtures of dissolved pesticides show potential aquatic toxicity in a synoptic study of Midwestern U.S. streams

    Science.gov (United States)

    Nowell, Lisa H.; Moran, Patrick W.; Schmidt, Travis S.; Norman, Julia E.; Nakagaki, Naomi; Shoda, Megan E.; Mahler, Barbara J.; Van Metre, Peter C.; Stone, Wesley W.; Sandstrom, Mark W.; Hladik, Michelle L.

    2018-01-01

    Aquatic organisms in streams are exposed to pesticide mixtures that vary in composition over time in response to changes in flow conditions, pesticide inputs to the stream, and pesticide fate and degradation within the stream. To characterize mixtures of dissolved-phase pesticides and degradates in Midwestern streams, a synoptic study was conducted at 100 streams during May–August 2013. In weekly water samples, 94 pesticides and 89 degradates were detected, with a median of 25 compounds detected per sample and 54 detected per site. In a screening-level assessment using aquatic-life benchmarks and the Pesticide Toxicity Index (PTI), potential effects on fish were unlikely in most streams. For invertebrates, potential chronic toxicity was predicted in 53% of streams, punctuated in 12% of streams by acutely toxic exposures. For aquatic plants, acute but likely reversible effects on biomass were predicted in 75% of streams, with potential longer-term effects on plant communities in 9% of streams. Relatively few pesticides in water—atrazine, acetochlor, metolachlor, imidacloprid, fipronil, organophosphate insecticides, and carbendazim—were predicted to be major contributors to potential toxicity. Agricultural streams had the highest potential for effects on plants, especially in May–June, corresponding to high spring-flush herbicide concentrations. Urban streams had higher detection frequencies and concentrations of insecticides and most fungicides than in agricultural streams, and higher potential for invertebrate toxicity, which peaked during July–August. Toxicity-screening predictions for invertebrates were supported by quantile regressions showing significant associations for the Benthic Invertebrate-PTI and imidacloprid concentrations with invertebrate community metrics for MSQA streams, and by mesocosm toxicity testing with imidacloprid showing effects on invertebrate communities at environmentally relevant concentrations. This study documents the most

  8. A multicenter study shows PTEN deletion is strongly associated with seminal vesicle involvement and extracapsular extension in localized prostate cancer.

    Science.gov (United States)

    Troyer, Dean A; Jamaspishvili, Tamara; Wei, Wei; Feng, Ziding; Good, Jennifer; Hawley, Sarah; Fazli, Ladan; McKenney, Jesse K; Simko, Jeff; Hurtado-Coll, Antonio; Carroll, Peter R; Gleave, Martin; Lance, Raymond; Lin, Daniel W; Nelson, Peter S; Thompson, Ian M; True, Lawrence D; Brooks, James D; Squire, Jeremy A

    2015-08-01

    Loss of the phosphatase and tensin homolog (PTEN) tumor suppressor gene is a promising marker of aggressive prostate cancer. Active surveillance and watchful waiting are increasingly recommended to patients with small tumors felt to be low risk, highlighting the difficulties of Gleason scoring in this setting. There is an urgent need for predictive biomarkers that can be rapidly deployed to aid in clinical decision-making. Our objectives were to assess the incidence and ability of PTEN alterations to predict aggressive disease in a multicenter study. We used recently developed probes optimized for sensitivity and specificity in a four-color FISH deletion assay to study the Canary Retrospective multicenter Prostate Cancer Tissue Microarray (TMA). This TMA was constructed specifically for biomarker validation from radical prostatectomy specimens, and is accompanied by detailed clinical information with long-term follow-up. In 612 prostate cancers, the overall rate of PTEN deletion was 112 (18.3%). Hemizygous PTEN losses were present in 55/612 (9.0%) of cancers, whereas homozygous PTEN deletion was observed in 57/612 (9.3%) of tumors. Significant associations were found between PTEN status and pathologic stage (P free survival (number of events = 189), pre-operative prostate specific antigen (PSA) (P free survival in multivariate models, as were seminal vesicle invasion, extracapsular extension, and Gleason score, and preoperative PSA. Furthermore, these data demonstrate that the assay can be readily introduced at first diagnosis in a cost effective manner analogous to the use of FISH for analysis of HER2/neu status in breast cancer. Combined with published research beginning 17 years ago, both the data and tools now exist to implement a PTEN assay in the clinic. © 2015 The Authors. The Prostate, published by Wiley Periodicals, Inc.

  9. Necrotizing soft tissue infections - a multicentre, prospective observational study (INFECT)

    NARCIS (Netherlands)

    Madsen, M.B.; Skrede, S.; Bruun, T.; Arnell, P.; Rosén, A.; Nekludov, M.; Karlsson, Y.; Bergey, F.; Saccenti, E.; Martins dos Santos, V.A.P.; Perner, A.; Norrby-Teglund, A.; Hyldegaard, O.

    2018-01-01

    Background: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating

  10. The social well-being of nurses shows a thirst for a holistic support: A qualitative study.

    Science.gov (United States)

    Mozaffari, Naser; Peyrovi, Hamid; Nayeri, Nahid Dehghan

    2015-01-01

    Social well-being is one of the important aspects of health. In fact, this is a reflection of experience in a social environment, indicating how social challenges are determined. In other words, social well-being is an explanation of people's perception and experience of being in a good situation, satisfaction with the structure, and social interaction. This qualitative study intended to explore nurses' experience of social well-being. Qualitative content analysis was used to conduct the study. Through purposive sampling, a total of 18 nurses with various clinical experiences participated in semi-structured interviews. The data were analysed using the five-step, qualitative content analysis introduced by Graneheim and Lundman. The main theme extracted from the data analysis was "thirst for a holistic support" in nurses. It consisted of two subthemes including internal support (family's support, colleague's support, and organizational support) and external support (society's support and media's support). Nurses' experiences in shaping their social well-being show that nurses need support in order to rebuild their social well-being. It is supported in partnership with the media, the community, health-related organizations, and by nurses and family. This improves job satisfaction, hope, motivation, commitment, and confidence so as to ultimately facilitate improvement of social well-being of nurses.

  11. spa Typing and Multilocus Sequence Typing Show Comparable Performance in a Macroepidemiologic Study of Staphylococcus aureus in the United States.

    Science.gov (United States)

    O'Hara, F Patrick; Suaya, Jose A; Ray, G Thomas; Baxter, Roger; Brown, Megan L; Mera, Robertino M; Close, Nicole M; Thomas, Elizabeth; Amrine-Madsen, Heather

    2016-01-01

    A number of molecular typing methods have been developed for characterization of Staphylococcus aureus isolates. The utility of these systems depends on the nature of the investigation for which they are used. We compared two commonly used methods of molecular typing, multilocus sequence typing (MLST) (and its clustering algorithm, Based Upon Related Sequence Type [BURST]) with the staphylococcal protein A (spa) typing (and its clustering algorithm, Based Upon Repeat Pattern [BURP]), to assess the utility of these methods for macroepidemiology and evolutionary studies of S. aureus in the United States. We typed a total of 366 clinical isolates of S. aureus by these methods and evaluated indices of diversity and concordance values. Our results show that, when combined with the BURP clustering algorithm to delineate clonal lineages, spa typing produces results that are highly comparable with those produced by MLST/BURST. Therefore, spa typing is appropriate for use in macroepidemiology and evolutionary studies and, given its lower implementation cost, this method appears to be more efficient. The findings are robust and are consistent across different settings, patient ages, and specimen sources. Our results also support a model in which the methicillin-resistant S. aureus (MRSA) population in the United States comprises two major lineages (USA300 and USA100), which each consist of closely related variants.

  12. Dyslexic children show short-term memory deficits in phonological storage and serial rehearsal: an fMRI study.

    Science.gov (United States)

    Beneventi, Harald; Tønnessen, Finn Egil; Ersland, Lars

    2009-01-01

    Dyslexia is primarily associated with a phonological processing deficit. However, the clinical manifestation also includes a reduced verbal working memory (WM) span. It is unclear whether this WM impairment is caused by the phonological deficit or a distinct WM deficit. The main aim of this study was to investigate neuronal activation related to phonological storage and rehearsal of serial order in WM in a sample of 13-year-old dyslexic children compared with age-matched nondyslexic children. A sequential verbal WM task with two tasks was used. In the Letter Probe task, the probe consisted of a single letter and the judgment was for the presence or absence of that letter in the prior sequence of six letters. In the Sequence Probe (SP) task, the probe consisted of all six letters and the judgment was for a match of their serial order with the temporal order in the prior sequence. Group analyses as well as single-subject analysis were performed with the statistical parametric mapping software SPM2. In the Letter Probe task, the dyslexic readers showed reduced activation in the left precentral gyrus (BA6) compared to control group. In the Sequence Probe task, the dyslexic readers showed reduced activation in the prefrontal cortex and the superior parietal cortex (BA7) compared to the control subjects. Our findings suggest that a verbal WM impairment in dyslexia involves an extended neural network including the prefrontal cortex and the superior parietal cortex. Reduced activation in the left BA6 in both the Letter Probe and Sequence Probe tasks may be caused by a deficit in phonological processing. However, reduced bilateral activation in the BA7 in the Sequence Probe task only could indicate a distinct working memory deficit in dyslexia associated with temporal order processing.

  13. A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

    Directory of Open Access Journals (Sweden)

    Dykes Anna-Karin

    2011-02-01

    Full Text Available Abstract Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1% met the protocol criteria for dystocia. Results Among the total cohort, 940 (35.4% women reported experience of violence, and among these, 66 (2.5% women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26 of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08, OR 0.90, 95% CI (0.54-1.50, respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96. Conclusions Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia.

  14. A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term.

    Science.gov (United States)

    Finnbogadóttir, Hafrún; Dejin-Karlsson, Elisabeth; Dykes, Anna-Karin

    2011-02-21

    Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1%) met the protocol criteria for dystocia. Among the total cohort, 940 (35.4%) women reported experience of violence, and among these, 66 (2.5%) women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26) of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08), OR 0.90, 95% CI (0.54-1.50), respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96). Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia.

  15. A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

    Science.gov (United States)

    2011-01-01

    Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1%) met the protocol criteria for dystocia. Results Among the total cohort, 940 (35.4%) women reported experience of violence, and among these, 66 (2.5%) women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26) of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08), OR 0.90, 95% CI (0.54-1.50), respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96). Conclusions Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia. PMID:21338523

  16. Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study.

    Directory of Open Access Journals (Sweden)

    Pascal H Colson

    Full Text Available To estimate the incidence of active bleeding after cardiac surgery (AB based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications.AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: "Low incidence" if incidence is lower and "High incidence" if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications.Among 4,904 patients, 129 experienced AB (2.6%, among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16% but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication.A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring early after surgery.

  17. Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study.

    Science.gov (United States)

    Colson, Pascal H; Gaudard, Philippe; Fellahi, Jean-Luc; Bertet, Héléna; Faucanie, Marie; Amour, Julien; Blanloeil, Yvonnick; Lanquetot, Hervé; Ouattara, Alexandre; Picot, Marie Christine

    2016-01-01

    To estimate the incidence of active bleeding after cardiac surgery (AB) based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications. AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration) were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: "Low incidence" if incidence is lower and "High incidence" if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications. Among 4,904 patients, 129 experienced AB (2.6%), among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16%) but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication. A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring early after surgery.

  18. Genome-wide association study identifies novel locus for neuroticism and shows polygenic association with Major Depressive Disorder

    Science.gov (United States)

    de Moor, Marleen H.M.; van den Berg, Stéphanie M.; Verweij, Karin J.H.; Krueger, Robert F.; Luciano, Michelle; Vasquez, Alejandro Arias; Matteson, Lindsay K.; Derringer, Jaime; Esko, Tõnu; Amin, Najaf; Gordon, Scott D.; Hansell, Narelle K.; Hart, Amy B.; Seppälä, Ilkka; Huffman, Jennifer E.; Konte, Bettina; Lahti, Jari; Lee, Minyoung; Miller, Mike; Nutile, Teresa; Tanaka, Toshiko; Teumer, Alexander; Viktorin, Alexander; Wedenoja, Juho; Abecasis, Goncalo R.; Adkins, Daniel E.; Agrawal, Arpana; Allik, Jüri; Appel, Katja; Bigdeli, Timothy B.; Busonero, Fabio; Campbell, Harry; Costa, Paul T.; Smith, George Davey; Davies, Gail; de Wit, Harriet; Ding, Jun; Engelhardt, Barbara E.; Eriksson, Johan G.; Fedko, Iryna O.; Ferrucci, Luigi; Franke, Barbara; Giegling, Ina; Grucza, Richard; Hartmann, Annette M.; Heath, Andrew C.; Heinonen, Kati; Henders, Anjali K.; Homuth, Georg; Hottenga, Jouke-Jan; Janzing, Joost; Jokela, Markus; Karlsson, Robert; Kemp, John P.; Kirkpatrick, Matthew G.; Latvala, Antti; Lehtimäki, Terho; Liewald, David C.; Madden, Pamela A.F.; Magri, Chiara; Magnusson, Patrik K.E.; Marten, Jonathan; Maschio, Andrea; Medland, Sarah E.; Mihailov, Evelin; Milaneschi, Yuri; Montgomery, Grant W.; Nauck, Matthias; Ouwens, Klaasjan G.; Palotie, Aarno; Pettersson, Erik; Polasek, Ozren; Qian, Yong; Pulkki-Råback, Laura; Raitakari, Olli T.; Realo, Anu; Rose, Richard J.; Ruggiero, Daniela; Schmidt, Carsten O.; Slutske, Wendy S.; Sorice, Rossella; Starr, John M.; Pourcain, Beate St; Sutin, Angelina R.; Timpson, Nicholas J.; Trochet, Holly; Vermeulen, Sita; Vuoksimaa, Eero; Widen, Elisabeth; Wouda, Jasper; Wright, Margaret J.; Zgaga, Lina; Scotland, Generation; Porteous, David; Minelli, Alessandra; Palmer, Abraham A.; Rujescu, Dan; Ciullo, Marina; Hayward, Caroline; Rudan, Igor; Metspalu, Andres; Kaprio, Jaakko; Deary, Ian J.; Räikkönen, Katri; Wilson, James F.; Keltikangas-Järvinen, Liisa; Bierut, Laura J.; Hettema, John M.; Grabe, Hans J.; van Duijn, Cornelia M.; Evans, David M.; Schlessinger, David; Pedersen, Nancy L.; Terracciano, Antonio; McGue, Matt; Penninx, Brenda W.J.H.; Martin, Nicholas G.; Boomsma, Dorret I.

    2015-01-01

    shows that neuroticism is influenced by many genetic variants of small effect that are either common or tagged by common variants. These genetic variants also influence MDD. Future studies should confirm the role of the MAGI1 locus for neuroticism, and further investigate the association of MAGI1 and the polygenic association to a range of other psychiatric disorders that are phenotypically correlated with neuroticism. PMID:25993607

  19. Characterization of fibromyalgia symptoms in patients 55-95 years old: a longitudinal study showing symptom persistence with suboptimal treatment.

    Science.gov (United States)

    Jacobson, Sandra A; Simpson, Rachel G; Lubahn, Cheri; Hu, Chengcheng; Belden, Christine M; Davis, Kathryn J; Nicholson, Lisa R; Long, Kathy E; Osredkar, Tracy; Lorton, Dianne

    2015-02-01

    Fibromyalgia (FM) has been understudied in the elderly population, a group with particular vulnerabilities to pain, reduced mobility, and sleep disruption. To characterize FM symptoms and treatments in a cohort of older subjects examined over time to determine the extent to which current, community-based treatment for older FM patients is in accord with published guidelines, and effective in reducing symptoms. A longitudinal, observational study of 51 subjects with FM (range 55-95 years) and 81 control subjects (58-95 years) performed at Banner Sun Health Research Institute in Sun City, AZ, USA. Serial history and examination data were obtained over a 6-year period. FM data included medical history, medications, physical examination, tender point examination, neuropsychological testing, sleep and pain ratings, the Physical Function Subscale of the Fibromyalgia Impact Questionnaire, and other standardized scales to evaluate depression and other psychiatric symptoms, and cognitive and functional impairment. Pain and stiffness that interfered with physical activity, sleep, and mood were reported by 80 % or more of subjects. Over time, pain involved an increasing number of body areas. Over half of subjects were treated with NSAIDs, one-quarter with opioids, and one-quarter with estrogen. Few were treated with dual-acting antidepressants or pregabalin. In this cohort of elders with suboptimally treated FM, substantial persistence of symptoms was seen over time. In general, recommended treatments were either not used or not tolerated. Age-appropriate treatments as well as education of primary care providers are needed to improve treatment of FM in the older population.

  20. Contribution of infrared observations to the study of supernovae remnants

    International Nuclear Information System (INIS)

    Douvion, Thomas

    2000-01-01

    This research thesis addresses the study of dust in young supernovae remnants observed in middle infrared, mainly by means of the ISOCAM instrument installed on the ISO satellite. The author first presents the supernovae physics and the studied young remnants, describes dusts and the main sites of formation and destruction, and outlines the difficulties and benefits of observations performed in the middle infrared. Then, the author reports acquired evidences related to the formation of dusts in supernovae, and the search for a millimetre emission by cold dust contained in regions which are not yet excited by the shock, in order to better assess the overall quantities created by supernovae. He reports the use of observations of dust and neon in Cassiopeia A to perform a diagnosis on the mixture of elements during the supernovae explosion [fr

  1. Space observations for global and regional studies of the biosphere

    Science.gov (United States)

    Cihlar, J.; Li, Z.; Chen, J.; Sellers, P.; Hall, F.

    1994-01-01

    The capability to make space-based measurements of Earth at high spatial and temporal resolutions, which would not otherwise be economically or practically feasible, became available just in time to contribute to scientific understanding of the interactive processes governing the total Earth system. Such understanding has now become essential in order to take practical steps which would counteract or mitigate the pervasive impact of the growing human population on the future habitability of the Earth. The paper reviews the rationale for using space observations for studies of climate and terrestrial ecosystems at global and regional scales, as well as the requirements for such observations for studies of climate and ecosystem dynamics. The present status of these developments is reported along with initiatives under way to advance the use of satellite observations for Earth system studies. The most important contribution of space observations is the provision of physical or biophysical parameters for models representing various components of the Earth system. Examples of such parameters are given for climatic and ecosystem studies.

  2. An observational study of defensible space in the neighbourhood park

    Science.gov (United States)

    Marzukhi, M. A.; Afiq, M. A.; Zaki, S. Ahmad; Ling, O. H. L.

    2018-02-01

    The planning of neighborhood park is important to provide space for interaction, leisure, and recreation among residents in any neighbourhood area. However, on an almost daily basis, newspapers report inappropriate incidents such as snatch theft, robbery and street attack that occurred in the neighborhood park. These cases reflect the significance of physical planning and design of neighborhood park that directly affect the safety and comfort of the users. Thus, this study attempts to engage with the defensible space concept in ensuring the security elements be applied in the planning of the recreational area. This study adopts a qualitative method form of research that is retrofitted to an observational study. The observational study is significant for revealing the condition of a neighbourhood park in the ‘real-world,’ in which direct observation is conducted on Taman Tasik Puchong Perdana. The observer focused on four elements or variables of defensible space concept including the provision of facilities in the neighborhood park, territoriality, surveillance, image and milieu. The findings revealed that the planning of Taman Tasik Puchong Perdana does not deliberate the defensible space elements, which may contribute to the crime activities in the park. In these circumstances, the planning of neighbourhood park needs to include proposals for the implementation of defensible space in response to the challenges underpinned by crime problems. Besides, the awareness among the residents needs to be emphasized with the support from local authorities and other organizations to manage and sustain the safety environment in the neighborhood park.

  3. Observing position and movements in hydrotherapy: a pilot study.

    Science.gov (United States)

    Stark, Mary Ann; Rudell, Barb; Haus, George

    2008-01-01

    To observe and describe the positions and movements women choose while immersed in water during the first stage of labor. Descriptive, observational pilot study. A rural community hospital that provided hydrotherapy in labor. Women (N = 7) who intended to use hydrotherapy in labor were recruited prenatally from a midwife-managed practice. For 15 minutes of each hour during the first stage of labor, position and movements of the participants were observed and recorded on a laptop computer. The observational tool was developed for this study from a review of the literature and interviews with nursing experts; 435 observations were recorded. Women were free to choose when and how long to use hydrotherapy and had no restriction on their positions and movements. Only 3 of the 7 participants labored in the tub. Women demonstrated a greater range of positions and movements in the tub than in bed, both throughout labor and during late first-stage labor (7-10 cm of dilatation). Women had more contractions and made more rhythmic movements while in the tub than in bed. Hydrotherapy may encourage upright positions and movements that facilitate labor progress and coping, helping women avoid unnecessary interventions.

  4. Microbiological Evaluation of Household Drinking Water Treatment in Rural China Shows Benefits of Electric Kettles: A Cross-Sectional Study

    Science.gov (United States)

    Cohen, Alasdair; Tao, Yong; Luo, Qing; Zhong, Gemei; Romm, Jeff; Colford, John M.; Ray, Isha

    2015-01-01

    Background In rural China ~607 million people drink boiled water, yet little is known about prevailing household water treatment (HWT) methods or their effectiveness. Boiling, the most common HWT method globally, is microbiologically effective, but household air pollution (HAP) from burning solid fuels causes cardiovascular and respiratory disease, and black carbon emissions exacerbate climate change. Boiled water is also easily re-contaminated. Our study was designed to identify the HWT methods used in rural China and to evaluate their effectiveness. Methods We used a geographically stratified cross-sectional design in rural Guangxi Province to collect survey data from 450 households in the summer of 2013. Household drinking water samples were collected and assayed for Thermotolerant Coliforms (TTC), and physicochemical analyses were conducted for village drinking water sources. In the winter of 2013–2104, we surveyed 120 additional households and used remote sensors to corroborate self-reported boiling data. Findings Our HWT prevalence estimates were: 27.1% boiling with electric kettles, 20.3% boiling with pots, 34.4% purchasing bottled water, and 18.2% drinking untreated water (for these analyses we treated bottled water as a HWT method). Households using electric kettles had the lowest concentrations of TTC (73% lower than households drinking untreated water). Multilevel mixed-effects regression analyses showed that electric kettles were associated with the largest Log10TTC reduction (-0.60, pwater (-0.45, pwater, electric kettle users also had the lowest risk of having TTC detected in their drinking water (risk ratio, RR = 0.49, 0.34–0.70, pwater users (RR = 0.70, 0.53–0.93, pwater access and reduce HAP exposure in rural China. PMID:26421716

  5. Microbiological Evaluation of Household Drinking Water Treatment in Rural China Shows Benefits of Electric Kettles: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Alasdair Cohen

    Full Text Available In rural China ~607 million people drink boiled water, yet little is known about prevailing household water treatment (HWT methods or their effectiveness. Boiling, the most common HWT method globally, is microbiologically effective, but household air pollution (HAP from burning solid fuels causes cardiovascular and respiratory disease, and black carbon emissions exacerbate climate change. Boiled water is also easily re-contaminated. Our study was designed to identify the HWT methods used in rural China and to evaluate their effectiveness.We used a geographically stratified cross-sectional design in rural Guangxi Province to collect survey data from 450 households in the summer of 2013. Household drinking water samples were collected and assayed for Thermotolerant Coliforms (TTC, and physicochemical analyses were conducted for village drinking water sources. In the winter of 2013-2104, we surveyed 120 additional households and used remote sensors to corroborate self-reported boiling data.Our HWT prevalence estimates were: 27.1% boiling with electric kettles, 20.3% boiling with pots, 34.4% purchasing bottled water, and 18.2% drinking untreated water (for these analyses we treated bottled water as a HWT method. Households using electric kettles had the lowest concentrations of TTC (73% lower than households drinking untreated water. Multilevel mixed-effects regression analyses showed that electric kettles were associated with the largest Log10TTC reduction (-0.60, p<0.001, followed by bottled water (-0.45, p<0.001 and pots (-0.44, p<0.01. Compared to households drinking untreated water, electric kettle users also had the lowest risk of having TTC detected in their drinking water (risk ratio, RR = 0.49, 0.34-0.70, p<0.001, followed by bottled water users (RR = 0.70, 0.53-0.93, p<0.05 and households boiling with pots (RR = 0.74, 0.54-1.02, p = 0.06.As far as we are aware, this is the first HWT-focused study in China, and the first to quantify the

  6. Observation and Study of Proton Aurora by using Scanning Photometer

    Science.gov (United States)

    Mochizuki, T.; Ono, T.; Kadokura, A.; Sato, N.

    2009-12-01

    The proton auroras have significant differences from electron auroras in their spectral shape. They show Doppler-shifted and broadened spectra: the spectra have Doppler-shifted (~0.5 nm shorter) peak and both bluewing (~2-4 nm) and redwing (~1.5 nm) extending. Energy spectra of precipitating protons have been estimated from this shape. Recently it is found that the intensity in the extent of the blue wing reflects more effectively by the change of the mean energy of precipitating protons than the shift of peak wavelength [Lanchester et al., 2003]. Another character of the H-beta aurora is that it is diffuse form because a proton becomes hydrogen atom due to a charge-exchange reaction with atmospheric constituent and then possible to move across the magnetic field line. By using a scanning photometer, the movement of the proton auroral belt and change of a spectrum shape associated with the variation of proton source region due to storm and substorm were reported, however, not discussed in detail yet [Deehr and Lummerzheim, 2001]. The purpose of this study is to obtain the detail characteristics of H-beta aurora for understanding of source region of energetic protons in the magnetosphere. For this purpose, a new meridian-scanning photometer (SPM) was installed at Husafell station in Iceland in last summer season and Syowa Station, Antarctica. It will contribute to investigate the distribution of energetic protons and plasma waves which cause the pitch angle scattering in the magnetosphere. The meridian-scanning photometer is able to observe at five wavelengths for H-beta emission. One channel is to measure the background level. By analyzing the data obtained by the SPM, the H-beta spectrum can be estimated by fitting a model function with it. Then it is possible to obtain distribution of precipitating protons in north-south direction. It is also possible to estimate an energy spectrum of precipitating proton, simultaneously. The instrumental parameters of the SPM is

  7. Solar energetic particles: observational studies and magnetohydrodynamic simulation

    International Nuclear Information System (INIS)

    Masson, S.

    2010-10-01

    Solar activity manifests itself through highly dynamical events, such as flares and coronal mass ejections, which result in energy release by magnetic reconnection. This thesis focuses on two manifestations of this energy release: solar energetic particles and dynamics of magnetic reconnection. The first part of my work consists in the detailed temporal analysis of several electromagnetic signatures, produced by energetic particles in the solar atmosphere, with respect to the energetic particle flux at Earth. Using multi-instrument observations, I highlighted that particles can be accelerated by the flare to relativistic energies during a specific episode of acceleration in the impulsive phase. This showed that particles traveled a longer path length than the theoretical length generally assumed. Using in-situ measurements of magnetic field and plasma, I identified the interplanetary magnetic field for 10 particle events, and performing a velocity dispersion analysis I obtained the interplanetary length traveled by particles. I showed that the magnetic structure of the interplanetary medium play a crucial role in the association of the particle flux at Earth and the acceleration signatures of particles at the Sun. The second part of my work focuses on the dynamics of magnetic reconnection. Observationally, the best evidence for magnetic reconnection is the appearance of brightnesses at the solar surface. Performing the first data-driven 3 dimensional magneto-hydrodynamic (MHD) simulation of an observed event, I discovered that the evolution of brightnesses can be explained by the succession of two different reconnection regimes, induced by a new topological association where null-point separatrix lines are embedded in quasi-separatrix layers. This new topological association induces a change of field line connectivity, but also a continuous reconnection process, leading to an apparent slipping motion of reconnected field lines. From a MHD simulation I showed that

  8. Boys with Oppositional Defiant Disorder/Conduct Disorder Show Impaired Adaptation During Stress: An Executive Functioning Study.

    Science.gov (United States)

    Schoorl, Jantiene; van Rijn, Sophie; de Wied, Minet; van Goozen, Stephanie; Swaab, Hanna

    2018-04-01

    Evidence for problems in executive functioning (EF) in children with oppositional defiant disorder/conduct disorder (ODD/CD) is mixed and the impact stress may have on EF is understudied. Working memory, sustained attention, inhibition and cognitive flexibility of boys with ODD/CD (n = 65) and non-clinical controls (n = 32) were examined under typical and stressful test conditions. Boys with ODD/CD showed impaired working memory under typical testing conditions, and impairments in working memory and sustained attention under stressful conditions. In contrast to controls, performance on sustained attention, cognitive flexibility and inhibition was less influenced by stress in boys with ODD/CD. These results suggest that boys with ODD/CD show impairments in adaptation to the environment whereas typically developing boys show adaptive changes in EF.

  9. Female emotional eaters show abnormalities in consummatory and anticipatory food reward: a functional magnetic resonance imaging study.

    Science.gov (United States)

    Bohon, Cara; Stice, Eric; Spoor, Sonja

    2009-04-01

    To test the hypothesis that emotional eaters show greater neural activation in response to food intake and anticipated food intake than nonemotional eaters and whether these differences are amplified during a negative versus neutral mood state. Female emotional eaters and nonemotional eaters (N = 21) underwent functional magnetic resonance imaging (fMRI) during receipt and anticipated receipt of chocolate milkshake and a tasteless control solution while in a negative and neutral mood. Emotional eaters showed greater activation in the parahippocampal gyrus and anterior cingulate (ACC) in response to anticipated receipt of milkshake and greater activation in the pallidum, thalamus, and ACC in response to receipt of milkshake during a negative relative to a neutral mood. In contrast, nonemotional eaters showed decreased activation in reward regions during a negative versus a neutral mood. Results suggest that emotional eating is related to increased anticipatory and consummatory food reward, but only during negative mood. (c) 2008 by Wiley Periodicals, Inc.

  10. Folic Acid Supplementation and Preterm Birth: Results from Observational Studies

    Directory of Open Access Journals (Sweden)

    Elena Mantovani

    2014-01-01

    Full Text Available Introduction. Folic acid (FA supplementation is recommended worldwide in the periconceptional period for the prevention of neural tube defects. Due to its involvement in a number of cellular processes, its role in other pregnancy outcomes such as miscarriage, recurrent miscarriage, low birth weight, preterm birth (PTB, preeclampsia, abruptio placentae, and stillbirth has been investigated. PTB is a leading cause of perinatal mortality and morbidity; therefore its association with FA supplementation is of major interest. The analysis of a small number of randomized clinical trials (RCTs has not found a beneficial role of FA in reducing the rate of PTBs. Aim of the Study. The aim of this review was to examine the results from recent observational studies about the effect of FA supplementation on PTB. Materials and Methods. We carried out a search on Medline and by manual search of the observational studies from 2009 onwards that analyzed the rate of PTB in patients who received supplementation with FA before and/or throughout pregnancy. Results. The results from recent observational studies suggest a slight reduction of PTBs that is not consistent with the results from RCTs. Further research is needed to better understand the role of FA supplementation before and during pregnancy in PTB.

  11. Comprehensive study of observables in Compton scattering on the nucleon

    Science.gov (United States)

    Grießhammer, Harald W.; McGovern, Judith A.; Phillips, Daniel R.

    2018-03-01

    We present an analysis of 13 observables in Compton scattering on the proton. Cross sections, asymmetries with polarised beam and/or targets, and polarisation-transfer observables are investigated for energies up to the Δ(1232) resonance to determine their sensitivity to the proton's dipole scalar and spin polarisabilities. The Chiral Effective Field Theory Compton amplitude we use is complete at N4LO, O(e2δ4), for photon energies ω˜ m_{π}, and so has an accuracy of a few per cent there. At photon energies in the resonance region, it is complete at NLO, O(e2δ0), and so its accuracy there is about 20%. We find that for energies from pion-production threshold to about 250 MeV, multiple asymmetries have significant sensitivity to presently ill-determined combinations of proton spin polarisabilities. We also argue that the broad outcomes of this analysis will be replicated in complementary theoretical approaches, e.g., dispersion relations. Finally, we show that below the pion-production threshold, 6 observables suffice to reconstruct the Compton amplitude, and above it 11 are required. Although not necessary for polarisability extractions, this opens the possibility to perform "complete" Compton-scattering experiments. An interactive Mathematica notebook, including results for the neutron, is available from judith.mcgovern@manchester.ac.uk.

  12. Observed Orbit Effects during Long Range Beam-Beam Studies

    CERN Document Server

    Alemany, R; Buffat, X; Calaga, R; Fitterer, M; Giachino, R; Hemelsoet, GH; Herr, W; Papotti, G; Pieloni, T; Poyer, M; Schaumann, M; Trad, G; Wollmann, D

    2012-01-01

    Possible limitations due to long range beam-beam effects at the LHC have been studied and are presented in this note. With a larger number of bunches and collisions in all interaction points, the crossing angles were reduced to enhance long range beam-beam effects. The analysis of the effects on the dynamic aperture and losses are documented in [1]. This note concentrates on the bunch-by-bunch orbit effects observed during the experiment.

  13. Strategies GeoCape Intelligent Observation Studies @ GSFC

    Science.gov (United States)

    Cappelaere, Pat; Frye, Stu; Moe, Karen; Mandl, Dan; LeMoigne, Jacqueline; Flatley, Tom; Geist, Alessandro

    2015-01-01

    This presentation provides information a summary of the tradeoff studies conducted for GeoCape by the GSFC team in terms of how to optimize GeoCape observation efficiency. Tradeoffs include total ground scheduling with simple priorities, ground scheduling with cloud forecast, ground scheduling with sub-area forecast, onboard scheduling with onboard cloud detection and smart onboard scheduling and onboard image processing. The tradeoffs considered optimzing cost, downlink bandwidth and total number of images acquired.

  14. Folic acid supplementation and preterm birth: results from observational studies.

    Science.gov (United States)

    Mantovani, Elena; Filippini, Francesca; Bortolus, Renata; Franchi, Massimo

    2014-01-01

    Folic acid (FA) supplementation is recommended worldwide in the periconceptional period for the prevention of neural tube defects. Due to its involvement in a number of cellular processes, its role in other pregnancy outcomes such as miscarriage, recurrent miscarriage, low birth weight, preterm birth (PTB), preeclampsia, abruptio placentae, and stillbirth has been investigated. PTB is a leading cause of perinatal mortality and morbidity; therefore its association with FA supplementation is of major interest. The analysis of a small number of randomized clinical trials (RCTs) has not found a beneficial role of FA in reducing the rate of PTBs. The aim of this review was to examine the results from recent observational studies about the effect of FA supplementation on PTB. We carried out a search on Medline and by manual search of the observational studies from 2009 onwards that analyzed the rate of PTB in patients who received supplementation with FA before and/or throughout pregnancy. The results from recent observational studies suggest a slight reduction of PTBs that is not consistent with the results from RCTs. Further research is needed to better understand the role of FA supplementation before and during pregnancy in PTB.

  15. A foundational observation method for studying design situations

    DEFF Research Database (Denmark)

    Cash, Philip; Hicks, Ben; Culley, Steve

    2015-01-01

    Observational studies of designers play an important role in engineering design research, yet there is currently no accepted standard approach for comparing, combining, or contrasting studies. Consequentially, reuse, reanalysis, replication, and aggregation of data are limited and the potential...... that covers capture, coding, and analysis. The capture step defines overall and situational context as well as multiple capture streams, generating a broad data-set that can be examined from multiple perspectives. The coding step employs a multi-level approach that seeks to minimise workload while describing...

  16. Using data mining techniques to characterize participation in observational studies.

    Science.gov (United States)

    Linden, Ariel; Yarnold, Paul R

    2016-12-01

    Data mining techniques are gaining in popularity among health researchers for an array of purposes, such as improving diagnostic accuracy, identifying high-risk patients and extracting concepts from unstructured data. In this paper, we describe how these techniques can be applied to another area in the health research domain: identifying characteristics of individuals who do and do not choose to participate in observational studies. In contrast to randomized studies where individuals have no control over their treatment assignment, participants in observational studies self-select into the treatment arm and therefore have the potential to differ in their characteristics from those who elect not to participate. These differences may explain part, or all, of the difference in the observed outcome, making it crucial to assess whether there is differential participation based on observed characteristics. As compared to traditional approaches to this assessment, data mining offers a more precise understanding of these differences. To describe and illustrate the application of data mining in this domain, we use data from a primary care-based medical home pilot programme and compare the performance of commonly used classification approaches - logistic regression, support vector machines, random forests and classification tree analysis (CTA) - in correctly classifying participants and non-participants. We find that CTA is substantially more accurate than the other models. Moreover, unlike the other models, CTA offers transparency in its computational approach, ease of interpretation via the decision rules produced and provides statistical results familiar to health researchers. Beyond their application to research, data mining techniques could help administrators to identify new candidates for participation who may most benefit from the intervention. © 2016 John Wiley & Sons, Ltd.

  17. Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study

    Directory of Open Access Journals (Sweden)

    Alexandre Alanio

    2017-08-01

    Our study showed the wide population diversity across Europe, with evidence of local clusters of patients harbouring a given genotype. These data suggest a specific association between genotype and underlying disease, with evidence of a different natural history of PCP in HIV patients and renal transplant recipients.

  18. Swedish and American studies show that initiatives to decrease maternal obesity could play a key role in reducing preterm birth.

    Science.gov (United States)

    Gould, Jeffrey B; Mayo, Jonathan; Shaw, Gary M; Stevenson, David K

    2014-06-01

    Maternal obesity is a major source of preventable perinatal morbidity, but studies of the relationship between obesity and preterm birth have been inconsistent. This review looks at two major studies covering just under 3.5 million births, from California, USA, and Sweden. Inconsistent findings in previous studies appear to stem from the complex relationship between obesity and preterm birth. Initiatives to decrease maternal obesity represent an important strategy in reducing preterm birth. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  19. Laboratory, Epidemiological, and Human Intervention Studies Show That Tea (Camellia sinensis) May Be Useful in the Prevention of Obesity12

    OpenAIRE

    Grove, Kimberly A.; Lambert, Joshua D.

    2010-01-01

    Tea (Camellia sinensis, Theaceae) and tea polyphenols have been studied for the prevention of chronic diseases, including obesity. Obesity currently affects >20% of adults in the United States and is a risk factor for chronic diseases such as type II diabetes, cardiovascular disease, and cancer. Given this increasing public health concern, the use of dietary agents for the prevention of obesity would be of tremendous benefit. Whereas many laboratory studies have demonstrated the potential eff...

  20. Honored Teacher Shows Commitment.

    Science.gov (United States)

    Ratte, Kathy

    1987-01-01

    Part of the acceptance speech of the 1985 National Council for the Social Studies Teacher of the Year, this article describes the censorship experience of this honored social studies teacher. The incident involved the showing of a videotape version of the feature film entitled "The Seduction of Joe Tynan." (JDH)

  1. Observations of radiographer communication: An exploratory study using Transactional Analysis

    International Nuclear Information System (INIS)

    Booth, Lisa A.; Manning, David J.

    2006-01-01

    Purpose: Communication in medical imaging is a neglected area of research, despite the necessity for good communication if optimum diagnostic images are to be achieved. Methods: The present study has investigated the styles of communication used in medical imaging, using an approach known as Transactional Analysis. This approach has been demonstrated previously as having reliability and validity, using observations and supporting interviews with medical imaging staff, along with inter-rater observations of radiographer-patient interactions. Results: The results indicate that Transactional Analysis can be used effectively for identifying and naming interaction events in diagnostic radiography, with diagnostic radiographers using five styles of communication. Conclusion: Radiographers tend to use Parental styles of communicating; these styles are commonly associated with a practitioner-centred approach to dealing with patients which often result in non-adherence

  2. Show your best self(ie) : An exploratory study on selfie-related motivations and behavior in emerging adulthood

    NARCIS (Netherlands)

    Bij de Vaate, Anna J.D.(Nadia); Veldhuis, Jolanda; Alleva, Jessica M.; Konijn, Elly A.; van Hugten, Charlotte H.M.

    2018-01-01

    Although self-presentation has been studied for decades, social networking sites (SNS) such as Facebook have produced novel opportunities for visual online self-presentation. Posting selfies is currently a popular mode of consciously constructing visual online self-presentations, yet most prior

  3. Study shows aspirin reduces the risk and recurrence of prostate cancer in African-American men | Center for Cancer Research

    Science.gov (United States)

    African-American men who take a daily dose of aspirin experience a significantly lower risk of developing advanced prostate cancer – the aggressive and deadly form of the disease – than African-American men who do not regularly use aspirin, according to a study from the Center for Cancer Research (CCR) Laboratory of Human Carcinogenesis. Learn more...

  4. Prospective cohort study showing persistent HSV-2 shedding in women with genital herpes 2 years after acquisition.

    Science.gov (United States)

    Ramchandani, Meena; Selke, Stacy; Magaret, Amalia; Barnum, Gail; Huang, Meei-Li Wu; Corey, Lawrence; Wald, Anna

    2017-11-25

    Herpes simplex virus type 2 (HSV-2) is a prevalent infection with great variability in clinical and virological manifestations among individuals. This prospective cohort study aims to evaluate the natural history of HSV-2 reactivation in the genital area in the same group of women over time. Eighteen immunocompetent HSV-2 seropositive women were evaluated for viral shedding for 70 consecutive days within a median of 8 months (range 1-24 months) of HSV-2 acquisition and again approximately 2.5 years later from the original study. Participants obtained daily swabs of genital secretions for HSV PCR and recorded genital symptoms. The viral shedding rate was 29% during the initial study and 19% in the follow-up study (32% reduction, P=0.019). Subclinical shedding rate also decreased from 24% to 13% (37% reduction, P=0.032), as did the rate of days with genital lesions from 22% to 15% (33% reduction, P=0.24). The mean copy number during viral shedding remained unchanged over time at 4.8 log 10 c/mL (SD=2.0 and 1.6 during each study, respectively, P=0.33). Women with high viral shedding rates in the past were likely to continue to have high shedding rates (r=0.63, P=0.005). Despite some reduction, high viral shedding rates persist in women with genital HSV-2 greater than 2 years after acquisition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. An observational study of sea breeze characteristics over Kalpakkam Coast

    International Nuclear Information System (INIS)

    Mohan, Manju; Mishra, M.K.

    2005-01-01

    An observational study of the sea breeze characteristics has been carried out at Kalpakkam, India which lies on the East coast of Southern Indian peninsula about 700 m inland from the sea, the Bay of Bengal. There are clear and significant changes in the surface meteorological parameters at the onset and during sea-breeze phenomenon in the coastal areas. Hourly averaged measurements from a 30 m tall micrometeorological tower were used to study the sea-breeze characteristics at the above site. In this study, based on detailed analysis of the data on-set criteria of the sea breeze is characterized by increase in relative humidity at least by 5%, fall in temperature by equal or greater than 0.5 K and increase in wind speed with respect to previous hour record. The present study is also compared with the earlier studies in relation to sea breeze carried out at Chennai located approximately 80 km North from Kalpakkam and the differences between these studies are discussed. The comparison of sea breeze characteristics of the present study with those from earlier studies that were carried out more than half a century back also reflects the changes due to urbanization and other development activities as well as resulting climatic impacts. (author)

  6. An Observational Study of the Mesoscale Mistral Dynamics

    Science.gov (United States)

    Guenard, Vincent; Drobinski, Philippe; Caccia, Jean-Luc; Campistron, Bernard; Bench, Bruno

    2005-05-01

    We investigate the mesoscale dynamics of the mistral through the wind profiler observations of the MAP (autumn 1999) and ESCOMPTE (summer 2001) field campaigns. We show that the mistral wind field can dramatically change on a time scale less than 3 hours. Transitions from a deep to a shallow mistral are often observed at any season when the lower layers are stable. The variability, mainly attributed in summer to the mistral/land-sea breeze interactions on a 10-km scale, is highlighted by observations from the wind profiler network set up during ESCOMPTE. The interpretations of the dynamical mistral structure are performed through comparisons with existing basic theories. The linear theory of R. B. Smith [ Advances in Geophysics, Vol. 31, 1989, Academic Press, 1-41] and the shallow water theory [Schär, C. and Smith, R. B.: 1993a, J. Atmos. Sci. 50, 1373-1400] give some complementary explanations for the deep-to-shallow transition especially for the MAP mistral event. The wave breaking process induces a low-level jet (LLJ) downstream of the Alps that degenerates into a mountain wake, which in turn provokes the cessation of the mistral downstream of the Alps. Both theories indicate that the flow splits around the Alps and results in a persistent LLJ at the exit of the Rhône valley. The LLJ is strengthened by the channelling effect of the Rhône valley that is more efficient for north-easterly than northerly upstream winds despite the north-south valley axis. Summer moderate and weak mistral episodes are influenced by land-sea breezes and convection over land that induce a very complex interaction that cannot be accurately described by the previous theories.

  7. Oilsands for the USA : while environmental groups ask for a shutdown, new study shows significant resulting economic benefits in America

    International Nuclear Information System (INIS)

    Cook, D.L.

    2010-01-01

    The United States is beginning to appreciate the value of having massive oil sands resources located in relatively close proximity to their northern border. This article discussed a recent study conducted by the Canadian Energy Research Institute (CERI) to assess the impact of Canada's oil sands development on the economy of the United States. The study forecasted that the demand for oil sands-related goods and services from American companies will continue to increase as the industry expands. The top national-level goods and services impacts will be derived from increases in manufacturing; finance; insurance; real estate; and professional, scientific, and technical services. Accommodation and food services in the United States will also benefit from the growth of the oil sands industry. The United States may not risk pushing ahead with strict carbon-cutting legislation targeting the oil sands when policy-makers consider the potential impacts of Canada selling its resources to China. 1 fig.

  8. A conceptual framework for evaluating data suitability for observational studies.

    Science.gov (United States)

    Shang, Ning; Weng, Chunhua; Hripcsak, George

    2017-09-08

    To contribute a conceptual framework for evaluating data suitability to satisfy the research needs of observational studies. Suitability considerations were derived from a systematic literature review on researchers' common data needs in observational studies and a scoping review on frequent clinical database design considerations, and were harmonized to construct a suitability conceptual framework using a bottom-up approach. The relationships among the suitability categories are explored from the perspective of 4 facets of data: intrinsic, contextual, representational, and accessible. A web-based national survey of domain experts was conducted to validate the framework. Data suitability for observational studies hinges on the following key categories: Explicitness of Policy and Data Governance, Relevance, Availability of Descriptive Metadata and Provenance Documentation, Usability, and Quality. We describe 16 measures and 33 sub-measures. The survey uncovered the relevance of all categories, with a 5-point Likert importance score of 3.9 ± 1.0 for Explicitness of Policy and Data Governance, 4.1 ± 1.0 for Relevance, 3.9 ± 0.9 for Availability of Descriptive Metadata and Provenance Documentation, 4.2 ± 1.0 for Usability, and 4.0 ± 0.9 for Quality. The suitability framework evaluates a clinical data source's fitness for research use. Its construction reflects both researchers' points of view and data custodians' design features. The feedback from domain experts rated Usability, Relevance, and Quality categories as the most important considerations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  9. A Statistical Study of Interplanetary Type II Bursts: STEREO Observations

    Science.gov (United States)

    Krupar, V.; Eastwood, J. P.; Magdalenic, J.; Gopalswamy, N.; Kruparova, O.; Szabo, A.

    2017-12-01

    Coronal mass ejections (CMEs) are the primary cause of the most severe and disruptive space weather events such as solar energetic particle (SEP) events and geomagnetic storms at Earth. Interplanetary type II bursts are generated via the plasma emission mechanism by energetic electrons accelerated at CME-driven shock waves and hence identify CMEs that potentially cause space weather impact. As CMEs propagate outward from the Sun, radio emissions are generated at progressively at lower frequencies corresponding to a decreasing ambient solar wind plasma density. We have performed a statistical study of 153 interplanetary type II bursts observed by the two STEREO spacecraft between March 2008 and August 2014. These events have been correlated with manually-identified CMEs contained in the Heliospheric Cataloguing, Analysis and Techniques Service (HELCATS) catalogue. Our results confirm that faster CMEs are more likely to produce interplanetary type II radio bursts. We have compared observed frequency drifts with white-light observations to estimate angular deviations of type II burst propagation directions from radial. We have found that interplanetary type II bursts preferably arise from CME flanks. Finally, we discuss a visibility of radio emissions in relation to the CME propagation direction.

  10. Serum YKL-40 and gestational diabetes - an observational cohort study

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; Johansen, Julia S; Christiansen, Ib J

    2016-01-01

    To examine serum YKL-40 in women developing gestational diabetes mellitus (GDM). In the present large observational cohort study of 1179 pregnant women, we determined serum YKL-40 four times during pregnancy (at gestational age 12, 20, 25, and 32 weeks). Pregnancy outcome was obtained from medical...... records. Sixty-eight women (5.8%) developed GDM. Serum YKL-40 increased from gestational age (GA) 12 weeks and the following weeks in the women who developed GDM and was independent of BMI, parity, and maternal age (OR = 2.69, 95% CI: 1.45-5.00, p = 0.002). No association was found between serum YKL-40...

  11. Nursing praxis, compassionate caring and interpersonal relations: an observational study.

    Science.gov (United States)

    Fry, Margaret; MacGregor, Casimir; Ruperto, Kate; Jarrett, Kate; Wheeler, Janet; Fong, Jacqueline; Fetchet, Wendy

    2013-05-01

    The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests, treat and manage a range of patient conditions. The CIN role is focused on the waiting room and to 'communicate the wait', initiate diagnostics or treatment and follow-up for waiting room patients. We aim to explore what emergency nurses' do in their extended practice role in observable everyday life in the emergency department (ED). The paper argues that compassionate caring is a core nursing skill that supports CIN interpersonal relations, despite the role's highly clinical nature. Sixteen non-participant observations were undertaken in three EDs in New South Wales, Australia. Nurses were eligible for inclusion if they had two years of emergency experience and had worked in the CIN role for more than one year. All CIN's that were observed were highly experienced with a minimum three year ED experience. The CIN observations revealed how compassionate caring was utilised by CIN's to quickly build a therapeutic relationship with patients and colleagues, and helped to facilitate core communication and interpersonal skills. While the CIN role was viewed as extended practice, the role relied heavily on compassionate care to support interpersonal relationships and to actualise extended practice care. The study supports the contribution made by emergency nurses and demonstrates how compassionate caring is central to nursing praxis. This paper also demonstrates that the CIN role utilises a complex mix between advanced clinical skills and compassion that supports interpersonal and therapeutic relationships. Further research is needed to understand how compassionate care can be optimised within nursing praxis and the duty of care between nurses and patients, nurses and other health care professionals so that future healthcare goals can be realised. Copyright © 2013 College of Emergency Nursing Australasia Ltd. All rights reserved.

  12. Heart transplant centers with multidisciplinary team show a higher level of chronic illness management - Findings from the International BRIGHT Study.

    Science.gov (United States)

    Cajita, Maan Isabella; Baumgartner, Eva; Berben, Lut; Denhaerynck, Kris; Helmy, Remon; Schönfeld, Sandra; Berger, Gabriele; Vetter, Christine; Dobbels, Fabienne; Russell, Cynthia L; De Geest, Sabina

    The objectives of this study were to: (1) explore the proportion of HTx centers that have a multidisciplinary team and (2) assess the relationship between multidisciplinarity and the level of chronic illness management (CIM). The International Society for Heart and Lung Transplantation (ISHLT) recommends a multidisciplinary approach in heart transplant (HTx) follow-up care but little is known regarding the proportion of HTx centers that meet this recommendation and the impact on patient care. HTx centers with a multidisciplinary team may offer higher levels of CIM, a care model that has the potential to improve outcomes after HTx. We conducted a secondary analysis of the BRIGHT study, a cross-sectional study in 11 countries. Multidisciplinarity in the 36 HTx centers was assessed through HTx director reports and was defined as having a team that was composed of physician(s), nurse(s), and another healthcare professional (either a social worker, psychiatrist, psychologist, pharmacist, dietician, physical therapist, or occupational therapist). CIM was assessed with the Patient Assessment of Chronic Illness Care (PACIC). Multiple linear regression assessed the relationship between multidisciplinarity and the level of CIM. Twenty-nine (80.6%) of the HTx centers had a multidisciplinary team. Furthermore, multidisciplinarity was significantly associated with higher levels of CIM (β = 5.2, P = 0.042). Majority of the HTx centers follows the ISHLT recommendation for a multidisciplinary approach. Multidisciplinarity was associated with CIM and point toward a structural factor that needs to be in place for moving toward CIM. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Technological aspects of hospital communication challenges: an observational study.

    Science.gov (United States)

    Popovici, Ilinca; Morita, Plinio P; Doran, Diane; Lapinsky, Stephen; Morra, Dante; Shier, Ashleigh; Wu, Robert; Cafazzo, Joseph A

    2015-06-01

    To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety. This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital. At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution. N/A. N/A. The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers. The issues listed should be considered in the design of new technology for hospital communications. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  14. Population-based study shows improved postnatal growth in preterm very-low-birthweight infants between 1995 and 2010.

    Science.gov (United States)

    Ofek Shlomai, Noa; Reichman, Brian; Lerner-Geva, Liat; Boyko, Valentina; Bar-Oz, Benjamin

    2014-05-01

    To assess whether the postnatal growth of preterm very-low-birthweight (VLBW) infants, as determined by measures of postnatal growth failure (PNGF), improved during the period 1995-2010 and to evaluate postnatal growth by gestational age (GA) and intrauterine growth groups. The study was based on the Israel national VLBW infant database and comprised 13 531 VLBW infants of 24-32 weeks' GA, discharged at a postmenstrual age of ≤40 weeks. Z-scores were determined for weight at birth and discharge. Severe and mild PNGF was defined as a decrease >2 and 1-2 z-scores, respectively. Three time periods were considered: 1995-2000, 2001-2005 and 2006-2010. Multinomial logistic regression was used to assess the independent effect of time period on PNGF. Severe PNGF decreased from 11.7% in 1995-2000 to 7.2% in 2001-2005 and 5.2% in 2006-2010. Infants born in 2006-2010 had sixfold lower odds for severe PNGF than babies born in 1995-2000 (adjusted odds ratio 0.17, 95% confidence interval 0.14-0.21) and

  15. Ohio study shows that insurance coverage is critical for children with special health care needs as they transition to adulthood.

    Science.gov (United States)

    Goudie, Anthony; Carle, Adam C

    2011-12-01

    Nearly 30 percent of young adults with special health care needs in Ohio lack health insurance, compared to 5 percent of the state's children with special health care needs. As children with such needs become too old for Medicaid or insurance through their parents' employer, they face great challenges in obtaining insurance. Lack of insurance is highly predictive of unmet needs, which in turn are predictive of costly hospital-based encounters. Young adults with special health care needs who are uninsured are more than twice as likely as their peers with insurance to forgo filling prescriptions and getting care and to have problems getting care. Even after insurance status is accounted for, young adults with special health care needs are more likely than children with such needs to not fill prescriptions because of cost and to delay or forgo needed care. This study demonstrates that continuous and adequate health insurance is vital to the continued well-being of children with special health care needs as they transition to young adulthood.

  16. Questionnaire-based study showed that neonatal chest radiographs could be reliably interpreted using the WhatsApp messaging application.

    Science.gov (United States)

    Gross, Itai; Langer, Yshia; Pasternak, Yehonatan; Abu Ahmad, Wiessam; Eventov-Friedman, Smadar; Koplewitz, Benjamin Z

    2018-06-11

    We surveyed whether clinicians used the WhatsApp messaging application to view neonatal chest radiographs and asked a sub-sample to compare them with computer screen viewings. The study was conducted at three university-affiliated medical centres in Israel from June-December 2016. Questionnaires on using smartphones for professional purposes were completed by 68/71 paediatric residents and 20/28 neonatologists. In addition, 11 neonatologists viewed 20 chest radiographs on a computer screen followed by a smartphone and 10 viewed the same radiographs in the opposite order, separated by a washout period of two months. After another two months, five from each group viewed the same radiographs on a computer screen. Different interpretations between viewing modes were assessed. Most respondents used WhatsApp to send chest radiographs for consultation: 82% of the paediatric residents and 80% of the neonatologists. The mean number of inconsistencies in diagnosis was 3.7/20 between two computer views and 2.9/20 between computer and smartphone views (p=0.88) and the disease severity means were 3.7/20 and 2.85/20, respectively (p=0.94). Neonatologists using WhatsApp only determined umbilical line placement in 80% of cases. WhatsApp was reliable for preliminary interpretation of neonatal chest radiographs, but caution was needed when assessing umbilical lines. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Treatment of Crohn's disease with cannabis: an observational study.

    Science.gov (United States)

    Naftali, Timna; Lev, Lihi Bar; Yablecovitch, Doron; Yablekovitz, Doron; Half, Elisabeth; Konikoff, Fred M

    2011-08-01

    The marijuana plant cannabis is known to have therapeutic effects, including improvement of inflammatory processes. However, no report of patients using cannabis for Crohn's disease (CD) was ever published. To describe the effects of cannabis use in patients suffering from CD. In this retrospective observational study we examined disease activity, use of medication, need for surgery, and hospitalization before and after cannabis use in 30 patients (26 males) with CD. Disease activity was assessed by the Harvey Bradshaw index for Crohn's disease. Of the 30 patients 21 improved significantly after treatment with cannabis. The average Harvey Bradshaw index improved from 14 +/- 6.7 to 7 +/- 4.7 (P disease in humans. The results indicate that cannabis may have a positive effect on disease activity, as reflected by reduction in disease activity index and in the need for other drugs and surgery. Prospective placebo-controlled studies are warranted to fully evaluate the efficacy and side effects of cannabis in CD.

  18. A single qualitative study can show same findings as years of quantitative research: Obstructive sleep apnoea as an example

    Directory of Open Access Journals (Sweden)

    Howard Tandeter

    2016-06-01

    Full Text Available Background Many years of quantitative research led to our present knowledge of the symptoms and associated features (S&AF of the obstructive sleep apnoea (OSA syndrome. Aims 1. To prove that a qualitative research approach may identify symptoms and associated features of OSA in less time/effort than that used in a quantitative approach; 2. To describe the experience of patients with OSA and the effects of the syndrome on their quality of life and that of their spouses and families (issues that quantitative methods fail to recognize. Methods We used a narrative inquiry methodology (qualitative research. The sample was selected using the “snowball sampling technique". The sample included 10 patients with moderate to severe OSA who had good adherence to CPAP and significant clinical improvement after treatment, and 3 of the patient’s spouses. Results The following issues were identified: A long pre-diagnosis phase of OSA (20 years in one of the patients; Characteristic S&AF of the syndrome as experienced by patients and their spouses; The need for increased awareness of both the public and the medical establishment in regards to this disorder; Premature ejaculation (not reported previously and nightmares (non-conclusive in the literature were identified and improved with CPAP therapy. Conclusion With the use of quantitative research methods it took decades to discover things that we found in one simple qualitative study. We therefore urge scientists to use more often these qualitative methods when looking for S&AF of diseases and syndromes.

  19. Talk Show Science.

    Science.gov (United States)

    Moore, Mitzi Ruth

    1992-01-01

    Proposes having students perform skits in which they play the roles of the science concepts they are trying to understand. Provides the dialog for a skit in which hot and cold gas molecules are interviewed on a talk show to study how these properties affect wind, rain, and other weather phenomena. (MDH)

  20. Assessing the completeness of reporting of observational studies in Colombian Journal of Anesthesiology. Cross sectional study

    NARCIS (Netherlands)

    Bravo-Peña, M. (Mary); Barona-Fong, L. (Luis); Campo-López, J. (Julio); Arroyave, Y. (Yeni); J.A. Calvache (Jose Andres)

    2017-01-01

    textabstractIntroduction The STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology), consisting of 22 points, was published in 2007 with the aim of improving the reporting of observational research. Objective To determine the completeness of reporting of

  1. Prospective Observational Study on acute Appendicitis Worldwide (POSAW).

    Science.gov (United States)

    Sartelli, Massimo; Baiocchi, Gian L; Di Saverio, Salomone; Ferrara, Francesco; Labricciosa, Francesco M; Ansaloni, Luca; Coccolini, Federico; Vijayan, Deepak; Abbas, Ashraf; Abongwa, Hariscine K; Agboola, John; Ahmed, Adamu; Akhmeteli, Lali; Akkapulu, Nezih; Akkucuk, Seckin; Altintoprak, Fatih; Andreiev, Aurelia L; Anyfantakis, Dimitrios; Atanasov, Boiko; Bala, Miklosh; Balalis, Dimitrios; Baraket, Oussama; Bellanova, Giovanni; Beltran, Marcelo; Melo, Renato Bessa; Bini, Roberto; Bouliaris, Konstantinos; Brunelli, Daniele; Castillo, Adrian; Catani, Marco; Che Jusoh, Asri; Chichom-Mefire, Alain; Cocorullo, Gianfranco; Coimbra, Raul; Colak, Elif; Costa, Silvia; Das, Koray; Delibegovic, Samir; Demetrashvili, Zaza; Di Carlo, Isidoro; Kiseleva, Nadezda; El Zalabany, Tamer; Faro, Mario; Ferreira, Margarida; Fraga, Gustavo P; Gachabayov, Mahir; Ghnnam, Wagih M; Giménez Maurel, Teresa; Gkiokas, Georgios; Gomes, Carlos A; Griffiths, Ewen; Guner, Ali; Gupta, Sanjay; Hecker, Andreas; Hirano, Elcio S; Hodonou, Adrien; Hutan, Martin; Ioannidis, Orestis; Isik, Arda; Ivakhov, Georgy; Jain, Sumita; Jokubauskas, Mantas; Karamarkovic, Aleksandar; Kauhanen, Saila; Kaushik, Robin; Kavalakat, Alfie; Kenig, Jakub; Khokha, Vladimir; Khor, Desmond; Kim, Dennis; Kim, Jae I; Kong, Victor; Lasithiotakis, Konstantinos; Leão, Pedro; Leon, Miguel; Litvin, Andrey; Lohsiriwat, Varut; López-Tomassetti Fernandez, Eudaldo; Lostoridis, Eftychios; Maciel, James; Major, Piotr; Dimova, Ana; Manatakis, Dimitrios; Marinis, Athanasio; Martinez-Perez, Aleix; Marwah, Sanjay; McFarlane, Michael; Mesina, Cristian; Pędziwiatr, Michał; Michalopoulos, Nickos; Misiakos, Evangelos; Mohamedahmed, Ali; Moldovanu, Radu; Montori, Giulia; Mysore Narayana, Raghuveer; Negoi, Ionut; Nikolopoulos, Ioannis; Novelli, Giuseppe; Novikovs, Viktors; Olaoye, Iyiade; Omari, Abdelkarim; Ordoñez, Carlos A; Ouadii, Mouaqit; Ozkan, Zeynep; Pal, Ajay; Palini, Gian M; Partecke, Lars I; Pata, Francesco; Pędziwiatr, Michał; Pereira Júnior, Gerson A; Pintar, Tadeja; Pisarska, Magdalena; Ploneda-Valencia, Cesar F; Pouggouras, Konstantinos; Prabhu, Vinod; Ramakrishnapillai, Padmakumar; Regimbeau, Jean-Marc; Reitz, Marianne; Rios-Cruz, Daniel; Saar, Sten; Sakakushev, Boris; Seretis, Charalampos; Sazhin, Alexander; Shelat, Vishal; Skrovina, Matej; Smirnov, Dmitry; Spyropoulos, Charalampos; Strzałka, Marcin; Talving, Peep; Teixeira Gonsaga, Ricardo A; Theobald, George; Tomadze, Gia; Torba, Myftar; Tranà, Cristian; Ulrych, Jan; Uzunoğlu, Mustafa Y; Vasilescu, Alin; Occhionorelli, Savino; Venara, Aurélien; Vereczkei, Andras; Vettoretto, Nereo; Vlad, Nutu; Walędziak, Maciej; Yilmaz, Tonguç U; Yuan, Kuo-Ching; Yunfeng, Cui; Zilinskas, Justas; Grelpois, Gérard; Catena, Fausto

    2018-01-01

    Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.

  2. Change in neck circumference after shoulder arthroscopy: An observational study

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2015-01-01

    Full Text Available Background and Aims: Shoulder arthroscopy requires fluid irrigation, which causes soft-tissue oedema around chest, neck, and arm intraoperatively, leading to postoperative airway complications. We decided to study the incidence of increase in the neck circumference in shoulder arthroscopy and its effects on the airway. Methods: We studied 32 cases of shoulder arthroscopies over a period of 1-year, performed under general anaesthesia with interscalene block. The neck circumference of patients before and after the procedure was measured along with other parameters. The endotracheal tube cuff was deflated at the end of surgery to determine air leak around the tube. The negative leak test suggested airway oedema. Results: Thirty out of 32 patients showed positive air leak test. The average change in neck circumference was 1.17 ± 1.16 cm and all could be extubated uneventfully. Two showed negative leak test with an increase in neck circumference by 4.5 and 6.4 cm and were not extubated. Multiple regression analysis for risk factors showed intraoperative hypertension as a single predictor for an increase in neck circumference. Conclusion: Change in the neck circumference beyond 4 cm may suggest airway compromise and below 4 cm, airway compromise is unlikely even in the presence of extensive soft-tissue oedema around the shoulder, upper arm and chest.

  3. The comparison of two analgesic regimes after ambulatory surgery: an observational study

    NARCIS (Netherlands)

    Worp, F. van der; Stapel, J.T.; Lako, S.J.; Hendriks, J.C.M.; Vissers, K.C.P.; Steegers, M.A.H.

    2014-01-01

    INTRODUCTION: Over the past 15 years, the number of ambulatory surgical procedures worldwide has increased continuously. Studies show that 30% to 40% of the patients experience moderate-to-severe pain in the first 48 hours. The objective of this observational study is to compare the percentage of

  4. Subclinical Hypothyroidism: A Prospective Observational Study from Southern India.

    Science.gov (United States)

    Sridhar, Mathrubootham; Mahadevan, Shriraam; Vishwanathan, Latha; Subbarayan, Anbezhil

    2018-03-15

    To assess the natural history and progression of subclinical hypothyroidism and to study factors which help predict evolution of subclinical hypothyroidism into overt hypothyroidism. Longitudinal study in 40 children (2-16 yrs) presenting with subclinical hypothyroidism in a tertiary care unit in Chennai, India. Patients showing evidence of overt hypothyroidism or thyroid stimulating hormone ≥15 mIU/mL during follow-up were started on thyroxine. Others were followed up with 3-monthly thyroid function tests up to one year. At the end of our study period 3 (7.5%) were overtly hypothyroid, 16 (40%) remained as subclinical hypothyroid, and 21 (52.5%) became euthyroid. Evidence of auto- immunity at baseline was a significant (Phypothyroidism. Subclinical hypothyroidism in children, with thyroid stimulating hormone upto 15 mIU/L and irrespective of thyroid autoimmunity, needs only periodic clinical and biochemical follow up. Thyroid autoimmunity may point to an increased probability of progression to overt hypothyroidism.

  5. Beyond the traditional definition of breakthrough pain: an observational study.

    Science.gov (United States)

    Gatti, Antonio; Gentili, Marta; Iorno, Vittorio; Mammucari, Massimo; Tufaro, Giuseppe; Lazzari, Marzia; Sabato, Alessandro Fabrizio

    2013-03-01

    Breakthrough pain (BTP) is traditionally defined as a transitory pain flare in opioid-treated patients with chronic background pain. This definition has, however, been challenged in recent years. This study aimed to analyze BTP prevalence in different pain conditions. This was a prospective, non-interventional, observational study conducted from June to September 2011 in two Italian pain treatment reference centres. Consecutive patients aged >18 years with oncological or non-oncological pain were eligible for this study; background pain was acute/ subacute (3 months). The characteristics of pain were evaluated by means of a structured interview by physicians, and patients were asked to complete a dedicated clinical study form. The following outcomes were assessed: chronic pain duration (in patients with chronic pain), BTP prevalence, and number and severity of daily BTP episodes. All outcomes were assessed in four populations of patients with: (a) chronic oncological pain; (b) chronic non-oncological pain; (c) non-chronic oncological pain; (d) non-chronic non-oncological pain. The correlation between BTP and gender was also investigated. Of 1,270 patients with chronic pain, 1,086 had non-oncological pain (85.5%). Most patients (68.6%) with non-oncological pain were female (P = 0.001). Pain duration was significantly longer in non-oncological pain versus oncological pain groups (P = 0.002). BTP prevalence was lower in non-oncological patients (P definition. BTP frequency and severity is similar in oncological and non-oncological pain.

  6. Warfarin and fibrinolysis - a challenging combination: an observational cohort study

    Directory of Open Access Journals (Sweden)

    Luurila Harri

    2011-04-01

    Full Text Available Abstract Background Patients presenting with ST-segment elevation myocardial infarction (STEMI frequently use warfarin. Fibrinolytic agents and warfarin both increase bleeding risk, but only a few studies have been published concerning the bleeding risk of warfarin-prescribed patients receiving fibrinolysis. The objective of this study was to define the prevalence for intracranial haemorrhage (ICH or major bleeding in patients on warfarin treatment receiving pre-hospital fibrinolysis. Methods This was an observational cohort study. Data for this retrospective case series were collected in Helsinki Emergency Medical Service catchment area from 1.1.1997 to 30.6.2010. All warfarin patients with suspected ST-segment elevation myocardial infarction (STEMI, who received pre-hospital fibrinolysis, were included. Bleeding complications were detected from Medical Records and classified as ICH, major or minor bleeding. Results Thirty-six warfarin patients received fibrinolysis during the study period. Fourteen patients had bleeding complications. One (3%, 95% CI 0-15% patient had ICH, six (17%, 95% CI 7-32% had major and seven (19%, 95% CI 9-35% had minor bleeding. The only fatal bleeding occurred in a patient with ICH. Patients' age, fibrinolytic agent used or aspirin use did not predispose to bleeding complications. High International Normalized Ratio (INR seemed to predispose to bleedings with values over 3, but no statistically significant difference was found. Conclusions Bleedings occur frequently in warfarin patients treated with fibrinolysis in the real world setting, but they are rarely fatal.

  7. An observational study of foot lifts asymmetry during obstacle avoidance

    Directory of Open Access Journals (Sweden)

    Ujjawal Singh Tomar

    2012-01-01

    Full Text Available Background: Specific information regarding obstacle-clearance strategies used by community-dwelling young and elderly is scant in the literature, and physical barriers encountered in real-life situations have not been used in most of the studies. Aim: The aim of this study is to determine foot lift asymmetry during obstacle avoidance in young and elderly subjects. Settings and Design: This was an observational study. Materials and Methods: Thirty elderly and 30 young individuals were taken for the study. All the subjects were evaluated using different scales and foot lift asymmetry was measured on a walkway using three obstacles of different heights. Results: The mean and standard deviation (SD value of the asymmetric index of the young was 3.25±0.28 and the mean and SD value of the asymmetric index of the elderly was 3.53±0.47. The asymmetric index of the elderly population was found to be higher than that of the younger population. Conclusion: The asymmetric index of the elderly population was found to be higher than that of the younger population, though it is not clinically significant.

  8. Intrauterine temperature during intrapartum amnioinfusion: a prospective observational study.

    Science.gov (United States)

    Tomlinson, T M; Schaecher, C; Sadovsky, Y; Gross, G

    2012-07-01

    To determine the influence of routine intrapartum amnioinfusion (AI) on intrauterine temperature. Prospective observational study. Maternity unit, Barnes Jewish Hospital, St Louis, MO, USA. Forty women with singleton gestations and an indication for intrapartum intrauterine pressure catheter placement. Using a temperature probe, we digitally recorded intrauterine temperature every 10 minutes during labour. Amnioinfusion was administered according to a standard protocol using saline equilibrated to the ambient temperature. Mean intrauterine temperature during labour. Participants were monitored for a mean of 280 minutes (range 20-820). A total of 164 intrauterine temperature readings in the AI cohort were compared with 797 control measurements. When compared with controls, we observed a lower intrauterine temperature in the AI cohort (36.4 versus 37.4°C, P<0.01). More measurements in the AI cohort were recorded in the presence of intrapartum fever (40% versus 30%). A subgroup analysis of measurements recorded in afebrile parturients revealed an even greater effect of AI (1.5°C decrease, 37.3 versus 35.8°C, P<0.01). Routine intrapartum AI using saline equilibrated to a mean ambient temperature of 25.0°C reduces intrauterine temperature and may thereby affect fetal core temperature. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  9. [Assessment of Urinary Incontinence in Pregnancy and Postpartum: Observational Study].

    Science.gov (United States)

    Rocha, Juliana; Brandão, Pedro; Melo, Anabela; Torres, Silvia; Mota, Lurdes; Costa, Fernanda

    2017-08-31

    The urinary incontinence can affect up to 50% of women at some stage of their lives, particularly during pregnancy and postpartum. This study was designed in order to identify and assess the prevalence and risk factors for urinary incontinence during the third trimester of pregnancy and three months postpartum. Observational and cross-sectional study. The population of the study was composed of 268 women who delivered and were admitted to the Centro Hospitalar Tâmega e Sousa in the years 2013 and 2014, and who agreed to participate in this study. Postpartum women were asked to fill out a questionnaire adapted from the International Consultation on Incontinence Questionnaire - Short Form, for urinary incontinence research in the third trimester of pregnancy. Three months after delivery, they were contacted by telephone and asked to answer the same questions about the urinary incontinence postpartum. Of the 268 women interviewed, 31 were excluded from the study, taking into account the defined inclusion and exclusion criteria. In total (n = 237), 51.89% of women included in the study, reported the occurrence of urinary incontinence during pregnancy. The prevalence of urinary incontinence in pregnancy by parity (primiparous versus multiparous) was statistically significant (p = 0.006). At postpartum (n = 237), 28.69% of women with urinary incontinence had vaginal delivery and 5.91% of women underwent cesarean delivery (p = 0.001). In these group of women with postpartum urinary incontinence (n = 82), 31.69% have had urinary incontinence only in the postpartum and 68.31% of women have had symptoms during pregnancy (p urinary incontinence in pregnancy and the respective decrease in postpartum. Multiparity and occurrence of urinary incontinence in pregnancy appear as potential risk factors in the emergence of the urinary incontinence.

  10. Nursing diagnoses in patients with chronic venous ulcer: observational study

    Directory of Open Access Journals (Sweden)

    Glycia de Almeida Nogueira

    2015-06-01

    Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients.  Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.

  11. Radiology workstation for mammography: preliminary observations, eyetracker studies, and design

    Science.gov (United States)

    Beard, David V.; Johnston, Richard E.; Pisano, Etta D.; Hemminger, Bradley M.; Pizer, Stephen M.

    1991-07-01

    For the last four years, the UNC FilmPlane project has focused on constructing a radiology workstation facilitating CT interpretations equivalent to those with film and viewbox. Interpretation of multiple CT studies was originally chosen because handling such large numbers of images was considered to be one of the most difficult tasks that could be performed with a workstation. The authors extend the FilmPlane design to address mammography. The high resolution and contrast demands coupled with the number of images often cross- compared make mammography a difficult challenge for the workstation designer. This paper presents the results of preliminary work with workstation interpretation of mammography. Background material is presented to justify why the authors believe electronic mammographic workstations could improve health care delivery. The results of several observation sessions and a preliminary eyetracker study of multiple-study mammography interpretations are described. Finally, tentative conclusions of what a mammographic workstation might look like and how it would meet clinical demand to be effective are presented.

  12. Observational studies of X-ray binary systems

    International Nuclear Information System (INIS)

    Klis, M. van der.

    1983-01-01

    The subject of Chapter 1 is theoretical. The other chapters, Ch. 2 to 6, contain original observational data and efforts towards their interpretation. Of these, Ch. 3, 4 and 5 deal with massive X-ray binaries, Ch. 6 with low-mass systems and Ch. 2 with Cygnus X-3, which we have not yet been able to assign to any of these two classes. The X-ray observations described were made with the COS-B satellite. Work based on UV and optical observations is described in Ch. 5. The UV observations were made with the IUE satellite, the optical observations at several ground-based observatories. (Auth.)

  13. Gamblers Anonymous in Israel: a participant observation study of a self-help group.

    Science.gov (United States)

    Cromer, G

    1978-10-01

    This participant observation study of the first Gamblers Anonymous group in Israel is designed to show (1) the ways in which the group helps it members rehabilitate themselves, (2) the three stages through which they must go in order to ensure success, and (3) the reason why some participants fail to do so. The article concludes with a number of observations concerning the extent of gambling in Israel and the different ways that should be developed for dealing with the problem.

  14. Satellite Observation Systems for Polar Climate Change Studies

    Science.gov (United States)

    Comiso, Josefino C.

    2012-01-01

    The key observational tools for detecting large scale changes of various parameters in the polar regions have been satellite sensors. The sensors include passive and active satellite systems in the visible, infrared and microwave frequencies. The monitoring started with Tiros and Nimbus research satellites series in the 1970s but during the period, not much data was stored digitally because of limitations and cost of the needed storage systems. Continuous global data came about starting with the launch of ocean color, passive microwave, and thermal infrared sensors on board Nimbus-7 and Synthetic Aperture Radar, Radar Altimeter and Scatterometer on board SeaSat satellite both launched in 1978. The Nimbus-7 lasted longer than expected and provided about 9 years of useful data while SeaSat quit working after 3 months but provided very useful data that became the baseline for follow-up systems with similar capabilities. Over the years, many new sensors were launched, some from Japan Aeronautics and Space Agency (JAXA), some from the European Space Agency (ESA) and more recently, from RuSSia, China, Korea, Canada and India. For polar studies, among the most useful sensors has been the passive microwave sensor which provides day/night and almost all weather observation of the surface. The sensor provide sea surface temperature, precipitation, wind, water vapor and sea ice concentration data that have been very useful in monitoring the climate of the region. More than 30 years of such data are now available, starting with the Scanning Multichannel Microwave Radiometer (SMMR) on board the Nimbus-7, the Special Scanning Microwave/Imager (SSM/I) on board a Defense Meteorological Satellite Program (DMSP) and the Advanced Microwave Scanning Radiometer on board the EOS/ Aqua satellite. The techniques that have been developed to derive geophysical parameters from data provided by these and other sensors and associated instrumental and algorithm errors and validation techniques

  15. Oral implications of the vegan diet: observational study.

    Science.gov (United States)

    Laffranchi, L; Zotti, F; Bonetti, S; Dalessandri, D; Fontana, P

    2010-01-01

    The aim of this study was to investigate oral changes in subjects who have assumed a vegan diet for a long time (at least 18 months), that is to say, a diet completely lacking in meat and animal derivatives. A sample of 15 subjects was analyzed, all from northern Italy and aged 24 to 60 year, composed of 11 men and 4 women who had been following a vegan diet for a minimum of 18 months to a maximum of 20 years. In parallel with the study sample, a control group (15 subjects) with the same criteria of age, sex, and place of origin all following an omnivorous diet was chosen. The sample answered a questionnaire that investigated their eating habits, the frequency with which they eat meals, the main foodstuffs assumed, oral hygiene habits, and any painful symptomatology of the teeth or more general problems in the oral cavity. The sample was then subject to objective examination in which the saliva pH was measured and the teeth were checked for demineralization of the enamel, white spots, and caries (using KaVo DIAGNOdent) with particular attention being paid to the localization of these lesions, and lastly, sounding was carried out to detect any osseous defects and periodontal pockets. The study revealed greater incidence of demineralization and white spots in the vegan subjects compared to the omnivorous ones localized at the neck of the teeth and on the vestibular surfaces of dental elements (with the exception of the lower anterior group). The saliva pH, more acid in the omnivorous patients, ranged between four and six. Changes in oral conditions in both groups of subjects were observed. In order to research into the cause-effect relationship of the vegan diet on the oral cavity effectively, the sample needs to be studied for a longer period of time and the results re-evaluated.

  16. Estimation of Skin to Subarachnoid Space Depth: An Observational Study.

    Science.gov (United States)

    Hazarika, Rajib; Choudhury, Dipika; Nath, Sangeeta; Parua, Samit

    2016-10-01

    In a patient, the skin to Subarachnoid Space Depth (SSD) varies considerably at different levels of the spinal cord. It also varies from patient to patient at the same vertebral level as per age, sex and Body Mass Index (BMI). Estimation of the skin to SSD reduces complications related to spinal anaesthesia. To measure the skin to SSD in the Indian population and to find a formula for predicting this depth. Three hundred adult patients belonging to American Society of Anaesthesiologist class I and II, undergoing surgery using spinal anaesthesia in various surgical specialities of Gauhati Medical College were selected by systemic sampling for this prospective, observational study. Patients were divided into three groups: Group M containing male patients, Group F containing non-pregnant female patients, and Group PF containing pregnant female's patients. SSD was measured after performing lumbar puncture. The relationship between SSD and patient characteristics were studied, correlated and statistical analysis was used to find a formula for predicting the skin to SSD. Statistical analysis was done using Statistical Package for Social Sciences (SPSS 21.0, Chicago, IL, USA). One-way ANOVA with post-hoc(Bonferroni correction factor) analysis was applied to compare the three groups. Multivariate analysis was done for the covariates followed by a multivariate regression analysis to evaluate the covariates influencing SSD for each group separately. Mean SSD was 4.37±0.31cm in the overall population. SSD in adult males was 4.49±0.19cm which was significantly longer than that observed in female's 4.18±0.39cm which was comparable with SSD in parturient 4.43±0.19 cm. The formula for predicting the skin to SSD in the male population was 1.718+0.077×BMI+0.632×Height, in nonpregnant female population was 1.828+0.077×BMI+0.018×Height+0.007×Age and 0.748+0.209×BMI+4.703×Height-0.054×weight in parturient females, respectively. Skin to SSD correlated with the BMI in all

  17. Observational Study on Safety of Prehospital BLS CPAP in Dyspnea.

    Science.gov (United States)

    Sahu, Novneet; Matthews, Patrick; Groner, Kathryn; Papas, Mia A; Megargel, Ross

    2017-12-01

    Introduction Continuous positive airway pressure (CPAP) improves outcomes in patients with respiratory distress. Additional benefits are seen with CPAP application in the prehospital setting. Theoretical safety concerns regarding Basic Life Support (BLS) providers using CPAP exist. In Delaware's (USA) two-tiered Emergency Medical Service (EMS) system, BLS often arrives before Advanced Life Support (ALS). Hypothesis This study fills a gap in literature by evaluating the safety of CPAP applied by BLS prior to ALS arrival. This was a retrospective, observational study using Quality Assurance (QA) data collected from October 2009 through December 2012 throughout a state BLS CPAP pilot program; CPAP training was provided to BLS providers prior to participation. Collected data include pulse-oximetry (spO2), respiratory rate (RR), heart rate (HR), skin color, and Glasgow Coma Score (GCS) before and after CPAP application. Pre-CPAP and post-CPAP values were compared using McNemar's and t-tests. Advanced practitioners evaluated whether CPAP was correctly applied and monitored and whether the patient condition was "improved," "unchanged," or "worsened." Seventy-four patients received CPAP by BLS; CPAP was correctly indicated and applied for all 74 patients. Respiratory status and CPAP were appropriately monitored and documented in the majority of cases (98.6%). A total of 89.2% of patients improved and 4.1% worsened; CPAP significantly reduced the proportion of patients with SpO224, and cyanosis (PCPAP (mean difference [MD]=0.17; 95% CI, -0.49 to 0.83; P=.59). The HR decreased from 115.7 (SD=53) to 105.1 (SD=37) after CPAP (MD=-10.9; 95% CI, -3.2 to -18.6; PCPAP (MD=17.8; 95% CI, 14.2-21.5; PCPAP was indicated, to apply it correctly, and to appropriately monitor the status of these patients. The majority of patients who received CPAP by BLS providers had improvement in their clinical status and vital signs. The findings suggest that CPAP can be safely used by BLS providers

  18. Southeast Atmosphere Studies: learning from model-observation syntheses

    Directory of Open Access Journals (Sweden)

    J. Mao

    2018-02-01

    Full Text Available Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales.This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and

  19. [Pregnancy-Associated Breast Cancer: An analytical observational study].

    Science.gov (United States)

    Baulies, Sonia; Cusidó, Maite; Tresserra, Francisco; Rodríguez, Ignacio; Ubeda, Belén; Ara, Carmen; Fábregas, Rafael

    2014-03-04

    Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy and up to one year postpartum. A retrospective, analytical, observational study comparing 56 cases of breast cancer and pregnancy (PABC) diagnosed 1976-2008 with 73 patients with breast cancer not associated with pregnancy (non-PABC) was performed. Demographic data, prognostic factors, treatment and survival were reviewed and compared. The prevalence of PABC in our center is 8.3/10,000. The highest frequency (62%) appeared during the postpartum period. The stages are higher in PABC, being 31.3% advanced (EIII and EIV) in PABC versus 13.3% in non-PABC (P < .05). Regarding prognostic factors, 27.3% in PABC had a tumoral grade 3 versus 15.8% of non-PABC. Among women with PABC, 33.3% had negative estrogen receptors, 48.7% negative progesterone receptors and 34.5% positive Her2Neu compared with 22.2, 24.1 and 31%, respectively of non-PABC patients. Finally, positive lymph nodes were found in 52.8% of PABC, versus 33.8% non-PABC (P < .05). Overall and disease-free survival rate at 5 years for PABC was 63.7 and 74.2%, respectively. The poorer survival observed is possibly due to the presence of adverse prognostic features such as lymph node metastases, negative hormone receptors, tumoral grade iii, as well as a delay in diagnosis with a higher rate of advanced stages. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  20. Southeast Atmosphere Studies: learning from model-observation syntheses

    Science.gov (United States)

    Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; McNeill, V. Faye; Tsigaridis, Kostas; McDonald, Brian C.; Warneke, Carsten; Guenther, Alex; Alvarado, Matthew J.; de Gouw, Joost; Mickley, Loretta J.; Leibensperger, Eric M.; Mathur, Rohit; Nolte, Christopher G.; Portmann, Robert W.; Unger, Nadine; Tosca, Mika; Horowitz, Larry W.

    2018-02-01

    Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales.This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we

  1. Study of Rayleigh-Love coupling from Spatial Gradient Observation

    Science.gov (United States)

    Lin, C. J.; Hosseini, K.; Donner, S.; Vernon, F.; Wassermann, J. M.; Igel, H.

    2017-12-01

    We present a new method to study Rayleigh-Love coupling. Instead of using seismograms solely, where ground motion is recorded as function of time, we incorporate with rotation and strain, also called spatial gradient where ground is represented as function of distance. Seismic rotation and strain are intrinsic different observable wavefield so are helpful to indentify wave type and wave propagation. A Mw 7.5 earthquake on 29 March 2015 occurred in Kokopo, Papua New Guinea recorded by a dense seismic array at PFO, California are used to obtaint seismic spatial gradient. We firstly estimate time series of azimuthal direction and phase velocity of SH wave and Rayleigh wave by analyzing collocated seismograms and rotations. This result also compares with frequency wavenumber methods using a nearby ANZA seismic array. We find the direction of Rayleigh wave fits well with great-circle back azimuth during wave propagation, while the direction of Love wave deviates from that, especially when main energy of Rayleigh wave arrives. From the analysis of cross-correlation between areal strain and vertical rotation, it reveals that high coherence, either positive or negative, happens at the same time when Love wave deparate from great-circle path. We also find the observed azimuth of Love wave and polarized particle motion of Rayleigh wave fits well with the fast direction of Rayleigh wave, for the period of 50 secs. We conclude the cause of deviated azimuth of Love wave is due to Rayleigh-Love coupling, as surface wave propagates through the area with anisotropic structure.

  2. Safe medication management in specialized home healthcare - an observational study.

    Science.gov (United States)

    Lindblad, Marléne; Flink, Maria; Ekstedt, Mirjam

    2017-08-24

    Medication management is a complex, error-prone process. The aim of this study was to explore what constitutes the complexity of the medication management process (MMP) in specialized home healthcare and how healthcare professionals handle this complexity. The study is theoretically based in resilience engineering. Data were collected during the MMP at three specialized home healthcare units in Sweden using two strategies: observation of workplaces and shadowing RNs in everyday work, including interviews. Transcribed material was analysed using grounded theory. The MMP in home healthcare was dynamic and complex with unclear boundaries of responsibilities, inadequate information systems and fluctuating work conditions. Healthcare professionals adapted their everyday clinical work by sharing responsibility and simultaneously being authoritative and preserving patients' active participation, autonomy and integrity. To promote a safe MMP, healthcare professionals constantly re-prioritized goals, handled gaps in communication and information transmission at a distance by creating new bridging solutions. Trade-offs and workarounds were necessary elements, but also posed a threat to patient safety, as these interim solutions were not systematically evaluated or devised learning strategies. To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors. The healthcare professionals' strategies could be integrated in continuous learning, while preserving boundaries of safety, instead of being more or less interim solutions. Patients' and family caregivers' as active partners in the MMP may be an underestimated resource for a resilient home healthcare.

  3. Obesity in show cats.

    Science.gov (United States)

    Corbee, R J

    2014-12-01

    Obesity is an important disease with a high prevalence in cats. Because obesity is related to several other diseases, it is important to identify the population at risk. Several risk factors for obesity have been described in the literature. A higher incidence of obesity in certain cat breeds has been suggested. The aim of this study was to determine whether obesity occurs more often in certain breeds. The second aim was to relate the increased prevalence of obesity in certain breeds to the official standards of that breed. To this end, 268 cats of 22 different breeds investigated by determining their body condition score (BCS) on a nine-point scale by inspection and palpation, at two different cat shows. Overall, 45.5% of the show cats had a BCS > 5, and 4.5% of the show cats had a BCS > 7. There were significant differences between breeds, which could be related to the breed standards. Most overweight and obese cats were in the neutered group. It warrants firm discussions with breeders and cat show judges to come to different interpretations of the standards in order to prevent overweight conditions in certain breeds from being the standard of beauty. Neutering predisposes for obesity and requires early nutritional intervention to prevent obese conditions. Journal of Animal Physiology and Animal Nutrition © 2014 Blackwell Verlag GmbH.

  4. Coordinated Regional Benefit Studies of Coastal Ocean Observing Systems

    National Research Council Canada - National Science Library

    Kite-Powell, Hauke L; Colgan, Charles S; Luger, Michael; Wieand, Ken; Pulsipher, Allan; Pendleton, Linwood; Wellman, Katherine; Pelsoci, Tom

    2003-01-01

    .... The authors will first produce regional "inventories" of ocean observation user sectors, including information about the physical and economic scale of their activities, how products from improved...

  5. Temporomandibular disorders in burning mouth syndrome patients: an observational study.

    Science.gov (United States)

    Corsalini, Massimo; Di Venere, Daniela; Pettini, Francesco; Lauritano, Dorina; Petruzzi, Massimo

    2013-01-01

    Burning Mouth Syndrome (BMS) is a chronic disease characterized by absence of any lesions and burning of the oral mucosa associated to a sensation of dry mouth and/or taste alterations. The purpose of our study is to estimate signs and symptoms of Temporomandibular Disorders (TMD) in patients with BMS and to investigate for the existence of an association between BMS and TMD. Forty-four BMS patients were enrolled; BMS subtype was established according to the classification of Lamey. After a gnathological evaluation, according to the protocol of the European Academy of Craniomandibular Disorders, patients were classified by RDC/TMD criteria. The data were compared and analyzed using a chi-square test to describe the existence of an association between BMS and TMD. 65.9% the BMS patients showed disorders classified as primary signs and symptoms of TMD according to RDC / TMD criteria, and 72.7% showed parafunctional habits. The chi-square test revealed a statistically significant association (p = 0.035) between BMS and TMD. The data suggest that there is a possible relationship not yet well understood between BMS and TMD, may be for neurophatic alterations assumed for BMS that could be also engaged in TMD pathogenesis.

  6. ENZYMATIC CHANGES IN SNAKE ENVENOMATION- AN OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Sidharth Kapoor

    2017-06-01

    Full Text Available BACKGROUND Snakes are the most feared and the most worshipped living creatures on the earth. Snakes are called venomous when envenomation or human fatalities after their bite are known. Snakebite is an acute medical emergency faced by temperate and tropical regions with heavy rainfall and humid climate. The specific therapy for snakebite in India is still polyvalent ASV and clinical practice ASV is not recommended until the victim of snakebite presents either with the evidence of bite by a poisonous snake such as definite fang marks, swelling or pain at the bite site or with clinical or laboratory evidence of envenomation such as local and systemic bleeding. In some cases, institution of ASV may also be initiated on the identification of offending snake brought by the patient or attendants, but most of these are subjective matters and subject to fallacies. Also, that out of polyvalent and monovalent ASV available, since it is monovalent ASV, which is desirable due to its less side effects and more effectiveness, but its use warrants the identification of snake, which is practically not possible in every case and/or on the objective evidence of peripheral neurological signs and symptoms and haematological alterations, which may not be dependable in many cases. MATERIALS AND METHODS Snake envenomation is in fact a multifactorial stress phenomenon, which produces altered physiological states including death and one of the consequences of the stress phenomenon is generation of several lysosomal enzymes and formation of free radicals. Extensive data search on Medline has failed to show study of this type in any part of the world, so this study being taken up as a preliminary attempt to evaluate the pattern of enzymatic changes in snake envenomation. RESULTS The patients included in the study were be those coming to the Emergency Department of Government Medical College, Jammu, bitten by poisonous snakes during the period May 2003 to April 2004. The

  7. Observational study of drug-drug interactions in oncological inpatients

    Directory of Open Access Journals (Sweden)

    María Sacramento Díaz-Carrasco

    2018-01-01

    Full Text Available Objective: To determine the prevalence of potential clinically relevant drug- drug interactions in adult oncological inpatients, as well as to describe the most frequent interactions. A standard database was used. Method: An observational, transversal, and descriptive study including patients admitted to the Oncology Service of a reference hospital. All prescriptions were collected twice a week during a month. They were analysed using Lexicomp® database, recording all interactions classified with a level of risk: C, D or X. Results: A total of 1 850 drug-drug interactions were detected in 218 treatments. The prevalence of treatments with at least one clinically relevant interaction was 95%, being 94.5% for those at level C and 26.1% for levels D and X. The drugs most commonly involved in the interactions detected were opioid analgesics, antipsychotics (butyrophenones, benzodiazepines, pyrazolones, glucocorticoids and heparins, whereas interactions with antineoplastics were minimal, highlighting those related to paclitaxel and between metamizole and various antineoplastics. Conclusions: The prevalence of clinically relevant drug-drug interactions rate was very high, highlighting the high risk percentage of them related to level of risk X. Due to the frequency of onset and potential severity, highlighted the concomitant use of central nervous system depressants drugs with risk of respiratory depression, the risk of onset of anticholinergic symptoms when combining morphine or haloperidol with butylscopolamine, ipratropium bromide or dexchlorpheniramine and the multiple interactions involving metamizole.

  8. COLORECTAL CANCER IN YOUNG INDIVIDUALS: AN OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Mukesh Shanthilal

    2016-07-01

    Full Text Available INTRODUCTION Colorectal cancer is the third most common cancer which can be detected early by implementation of cancer screening. This has led to decline in colorectal cancer related morbidity and mortality in elderly patients. However, there is increase in the incidence of this cancer in young individuals. This study was undertaken to study the characteristics of young colorectal cancer patients. METHODS AND MATERIALS The study was conducted from 2014 to 2016. All colorectal cancer patients attending the Department of Oncology, who were less than or equal to 50 years of age were included. Patients’ demographic data as well as data regarding the colorectal cancer was collected. The data was entered into MS Excel worksheet and analysed using descriptive statistics. RESULTS This study included 28 patients with a median age of 40 years and equal sex distribution. History of smoking in 85.7% (12/14 and alcohol (moderate consumption in 64% (9/14 was present in male patients. There was no history of alcohol or smoking was present among female patients. However, tobacco chewing habit was present in 28% (4/14 of female patients. History of multiple sexual partners in 14% (4/28 of cases and 78% (22/28 were non-vegetarians. Nearly 85% (24/28 of patients presented with an advanced stage disease. The analysis showed involvement of left side of colon in 50% (14/28, rectum in 39% (11/28 and right side of colon in 11%(3/28. Except for two patients who were in stage - 1, all other patients received chemotherapy. CONCLUSION The incidence of colorectal cancer in young individuals is constantly rising. The reason for this increase is unclear and the relative contributions of genetic versus environmental factors remain relatively unexplored.

  9. External Validation of the HERNIAscore: An Observational Study.

    Science.gov (United States)

    Cherla, Deepa V; Moses, Maya L; Mueck, Krislynn M; Hannon, Craig; Ko, Tien C; Kao, Lillian S; Liang, Mike K

    2017-09-01

    The HERNIAscore is a ventral incisional hernia (VIH) risk assessment tool that uses only preoperative variables and predictable intraoperative variables. The aim of this study was to validate and modify, if needed, the HERNIAscore in an external dataset. This was a retrospective observational study of all patients undergoing resection for gastrointestinal malignancy from 2011 through 2015 at a safety-net hospital. The primary end point was clinical postoperative VIH. Patients were stratified into low-risk, medium-risk, and high-risk groups based on HERNIAscore. A revised HERNIAscore was calculated with the addition of earlier abdominal operation as a categorical variable. Cox regression of incisional hernia with stratification by risk class was performed. Incidence rates of clinical VIH formation within each risk class were also calculated. Two hundred and forty-seven patents were enrolled. On Cox regression, in addition to the 3 variables of the HERNIAscore (BMI, COPD, and incision length), earlier abdominal operation was also predictive of VIH. The revised HERNIAscore demonstrated improved predictive accuracy for clinical VIH. Although the original HERNIAscore effectively stratified the risk of an incisional radiographic VIH developing, the revised HERNIAscore provided a statistically significant stratification for both clinical and radiographic VIHs in this patient cohort. We have externally validated and improved the HERNIAscore. The revised HERNIAscore uses BMI, incision length, COPD, and earlier abdominal operation to predict risk of postoperative incisional hernia. Future research should assess methods to prevent incisional hernias in moderate-to-high risk patients. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  10. An observational study of disk-population globular clusters

    International Nuclear Information System (INIS)

    Armandroff, T.E.

    1988-01-01

    Integrated-light spectroscopy was obtained for twenty-seven globular clusters at the Ca II infrared triplet. Line strengths and radial velocities were measured from the spectra. For the well-studied clusters in the sample, the strength of the CA II lines is very well correlated with previous metallicity estimates obtained using a variety of techniques. The greatly reduced effect of interstellar extinction at these wavelengths compared to the blue region of the spectrum has permitted observations of some of the most heavily reddened clusters in the Galaxy. For several such clusters, the Ca II triplet metallicities are in poor agreement with metallicity estimates from infrared photometry by Malkan. Color-magnitude diagrams were constructed for six previously unstudied metal-rich globular clusters and for the well-studied cluster 47 Tuc. The V magnitudes of the horizontal branch stars in the six clusters are in poor agreement with previous estimates based on secondary methods. The horizontal branch morphologies and reddenings of the program clusters were also determined. Using the improved set of metallicities, radial velocities, and distance moduli, the spatial distribution, kinematics, and metallicity distribution of the Galactic globulars were analyzed. The revised data supports Zinn's conclusion that the metal-rich clusters form a highly flattened, rapidly rotating disk system, while the metal-poor clusters make up the familiar, spherically distributed, slowly rotating halo population. The scale height, metallicity distribution, and kinematics of the metal-rich globulars are in good agreement with those of the stellar thick disk. Luminosity functions were constructed, and no significant difference is found between disk and halo samples. Metallicity gradients seem to be present in the disk cluster system. The implications of these results for the formation and evol

  11. Sensitivity of dose-finding studies to observation errors.

    Science.gov (United States)

    Zohar, Sarah; O'Quigley, John

    2009-11-01

    The purpose of Phase I designs is to estimate the MTD (maximum tolerated dose, in practice a dose with some given acceptable rate of toxicity) while, at the same time, minimizing the number of patients treated at doses too far removed from the MTD. Our purpose here is to investigate the sensitivity of conclusions from dose-finding designs to recording or observation errors. Certain toxicities may go undetected and, conversely, certain non-toxicities may be incorrectly recorded as dose-limiting toxicities. Recording inaccuracies would be expected to have an influence on final and within trial recommendations and, in this paper, we study in greater depth this question. We focus, in particular on three designs used currently; the standard '3+3' design, the grouped up-and-down design [M. Gezmu, N. Flournoy, Group up-and-down designs for dose finding. Journal of Statistical Planning and Inference 2006; 136 (6): 1749-1764.] and the continual reassessment method (CRM, [J. O'Quigley, M. Pepe, L. Fisher, Continual reassessment method: a practical design for phase 1 clinical trials in cancer. Biometrics 1990; 46 (1): 33-48.]). A non-toxicity incorrectly recorded as a toxicity (error of first kind) has a greater influence in general than the converse (error of second kind). These results are illustrated via figures which suggest that the standard '3+3' design in particular is sensitive to errors of the second kind. Such errors can have a very important impact on drug development in that, if carried through to the Phase 2 and Phase 3 studies, we can significantly increase the probability of failure to detect efficacy as a result of having delivered an inadequate dose.

  12. Giant cell arteritis: a multicenter observational study in Brazil

    Directory of Open Access Journals (Sweden)

    Alexandre Wagner Silva de Souza

    2013-01-01

    Full Text Available OBJECTIVE: To describe demographic features, disease manifestations and therapy in patients with giant cell arteritis from referral centers in Brazil. METHODS: A retrospective cohort study was performed on 45 giant cell arteritis patients from three university hospitals in Brazil. Diagnoses were based on the American College of Rheumatology classification criteria for giant cell arteritis or temporal artery biopsy findings. RESULTS: Most patients were Caucasian, and females were slightly more predominant. The frequencies of disease manifestations were as follows: temporal headache in 82.2%, neuro-ophthalmologic manifestations in 68.9%, jaw claudication in 48.9%, systemic symptoms in 44.4%, polymyalgia rheumatica in 35.6% and extra-cranial vessel involvement in 17.8% of cases. Aortic aneurysms were observed in 6.6% of patients. A comparison between patients with biopsy-proven giant cell arteritis and those without temporal artery biopsies did not yield significant differences in disease manifestations. All patients were treated with oral prednisone, and intravenous methylprednisolone was administered to nearly half of the patients. Methotrexate was the most commonly used immunosuppressive agent, and low-dose aspirin was prescribed to the majority of patients. Relapses occurred in 28.9% of patients, and aspirin had a protective effect against relapses. Females had higher prevalences of polymyalgia rheumatica, systemic manifestations and jaw claudication, while permanent visual loss was more prevalent in men. CONCLUSIONS: Most of the clinical features of Brazilian giant cell arteritis patients were similar to those found in other studies, except for the high prevalence of neuro-ophthalmic manifestations and permanent blindness in the Brazilian patients. Aspirin had a protective effect on relapses.

  13. Endovascular control of haemorrhagic urological emergencies: an observational study

    Directory of Open Access Journals (Sweden)

    Thorpe Peter

    2006-09-01

    Full Text Available Abstract Background Transarterial embolisation (TAE is an effective method in control of haemorrhage irrespective of the nature of urological emergency. As the technique and technology have evolved, it is now possible to perform highly selective embolisation. The aim of this study was to critically appraise feasibility and efficacy of therapeutic TAE in control of haemorrhagic urological emergencies using selective and non-selective embolisation. Specifically, we aimed to assess the impact of timing of embolisation on the requirement of blood transfusion and long-term morphological and functional follow-up of embolised organs. Methods This is a single institutional observational study carried out between March 1992 and March 2006. Records of all patients who underwent selective and non-selective angioembolisation to control bleeding in urological emergencies were reviewed. Data on success rate, periprocedural complications, timing of embolisation, requirement of blood transfusion and the long-term morphological and functional outcomes of embolised organs was recorded. Results Fourteen patients underwent endovascular control of bleeding as a result of trauma, iatrogenic injury and spontaneous perinephric haemorrhage during a period of 14 years. All these patients would have required emergency open surgery without the option of embolisation procedure. The mean time between the first presentation and embolisation was 22 hours (range 30 minutes to 60 hours. Mean pre-embolisation transfusion requirement was 6.8 units (range 0–22 units. None of the patients with successful embolisation required post-procedural blood transfusion. Permanent haemostasis was achieved in all but one patient, who required emergency nephrectomy. There were no serious procedure related post-embolisation complications. Conclusion Endovascular control using transarterial angioembolisation is an effective method for managing haematuria or haemorrhage in urological emergencies

  14. [The aggression in SPDC: an observational study. Preliminary data].

    Science.gov (United States)

    Minutolo, Giuseppe; Cannavò, Dario; Petralia, Antonino; Gandolfo, Liliana; Palermo, Filippo; Aguglia, Eugenio

    2010-01-01

    In the different psychiatric disorders the aggression often leads to uncontrolled events, taking aspects of impulsiveness and irrationality. Our research proposes the assessment of socio-demographic and clinical characteristics of patients with a psychiatric disorder, who presented an aggressive event. The observational study was conducted on a sample of 50 patients (34 men and 16 women), hospitalized following the manifestation of an aggressive event. For each patient was provided an assessment of socio-demographic and clinical variables and a psychometric investigation through: the OAS, for the analysis of aggressive episodes; the BDHI, for the hostile behavior and attitudes; the BIS-11, for the impulsiveness and the BPRS for the psychopathological aspects. Among the socio-demographic features investigated, the highest correlation with aggressive behavior was related to the concomitant substance abuse, type of admission to psychiatric hospital and the male gender. The OAS has shown a greater propensity to directed-aggression in males with schizophrenia, and self-directed in females with major depression. The BPRS has shown a positive correlation between hetero-directed aggressive behavior and positive symptomatology, and between the self-directed and depression, risk of suicide, feelings of guilt and somatic concerns. The BDHI has indicated greater suspicion in women's group. The hypothesis that aggression is otherwise related to specific socio-demographic and clinical characteristics was confirmed by our study. The data suggest that early identification and assessment of potential risk factors involved in the genesis of aggressive episodes would allow the clinician to implement a better strategy for prevention and intervention.

  15. The G-spot: an observational MRI pilot study.

    Science.gov (United States)

    Maratos, Y K; Gombergh, R; Cornier, E; Minart, J P; Amoretti, N; Mpotsaris, A

    2016-08-01

    To identify a G-spot complex (GSC) in vivo in MRI examinations at 1.5 Tesla field strength. Observational study. Single centre. Twenty-one consecutive patients (January-March 2014). Imaging analysis of routine imaging protocols for usual medical indications with and without concomitant opacification of the vaginal cavity with inert ultrasound gel. The gel distends the otherwise collapsed vaginal walls, allowing for an improved discrimination of anatomic features. The macroscopic and histological results recently derived from the dissections of fresh cadavers by Ostrzenski et al. were translated into imaging characteristics to be expected in the respective MRI sequences (e.g. T1- and T2-weighted) in search of an in vivo correlate of the GSC. Age, menopause status, medical indication and diagnosis were co-variables. To analyse primarily whether MRI imaging is able to depict a distinct morphological entity in vivo matching the GSC, based on anatomical descriptions published recently. The elaboration of an appropriate MRI-imaging protocol was a secondary aim. A total of 21 studies were obtained. A GSC was identified within the anterior vaginal wall in 13/21 patients (62%). In all, 10/21 (48%) had vaginal gel opacification. We identified a GSC in 10/10 patients (100%) with opacification in all three planes of the T2 images. This was only true for 3/11 cases (27%) without opacification. There is evidence for an in vivo morphological correlate to the postmortem anatomical findings of a GSC described by Ostrzenski et al.; its visibility in MRI imaging can be significantly improved with vaginal opacification by ultrasound gel. Identification of G-spot by MRI with vaginal gel-opacification in 13/21 patients. © 2016 Royal College of Obstetricians and Gynaecologists.

  16. Fatal poisonings in Oslo: a one-year observational study.

    Science.gov (United States)

    Bjornaas, Mari A; Teige, Brita; Hovda, Knut E; Ekeberg, Oivind; Heyerdahl, Fridtjof; Jacobsen, Dag

    2010-06-06

    Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Fatal and non-fatal acute poisonings in subjects aged > or =16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. In Oslo, during the one-year period studied, 103 subjects aged > or =16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were

  17. Evaluating effectiveness and safety toward electronic cigarette among Malaysian vapers: One-month observational study

    Directory of Open Access Journals (Sweden)

    Azizur Rahman

    2016-01-01

    Conclusion: A month follow-up showed a good smoking cessation rate among Malaysian vapers mainly in single users, whereas less number of quitters but the high reduction in tobacco cigarette consumption observed in dual users without any harmful effects. Furthermore, extended period studies are warranted to confirm its long-term safety and effectiveness among different Malaysian population.

  18. VY Canis Majoris: Observational Studies of the Outflow

    Science.gov (United States)

    Harwit, M.

    2001-12-01

    A number of recent studies carried out with the Infrared Space Observatory, ISO, and the Submillimeter Wave Astronomy Satellite, SWAS, provide new information on the chemical composition of the dust and the geometry of the outflow. With ISO, we have obtained a near-, mid-, and far-infrared spectrum of VY CMa that shows the strong preponderance of amorphous, as contrasted to crystalline, silicates. The sharp spectral slope in the near-infrared suggests the presence also of iron grains. While an excellent theoretical fit to the data is obtained, we emphasize that this is far from unique. A resolution of ambiguities will require a self-consistent model that considers not only radiative transfer, but also plausible elemental abundances, laboratory studies of chemical condensation sequences, and gas dynamics. With SWAS we have obtained a high-resolution spectrum of the 557GHz ground state transition of ortho-water. The spectral profile enables us to rule out a number of outflow geometries proposed in the literature. With ISO we also obtained the intensities and velocity structure of several other spectral lines of water. Most of these lines must be optically thick but effectively thin, a circumstance that permits us to make use of recent gas-dynamic models to locate the radial position in the outflow where individual lines are emitted.

  19. Ambulatory laparoscopic minor hepatic surgery: Retrospective observational study.

    Science.gov (United States)

    Gaillard, M; Tranchart, H; Lainas, P; Tzanis, D; Franco, D; Dagher, I

    2015-11-01

    Over the last decade, laparoscopic hepatic surgery (LHS) has been increasingly performed throughout the world. Meanwhile, ambulatory surgery has been developed and implemented with the aims of improving patient satisfaction and reducing health care costs. The objective of this study was to report our preliminary experience with ambulatory minimally invasive LHS. Between 1999 and 2014, 172 patients underwent LHS at our institution, including 151 liver resections and 21 fenestrations of hepatic cysts. The consecutive series of highly selected patients who underwent ambulatory LHS were included in this study. Twenty patients underwent ambulatory LHS. Indications were liver cysts in 10 cases, liver angioma in 3 cases, focal nodular hyperplasia in 3 cases, and colorectal hepatic metastasis in 4 cases. The median operative time was 92 minutes (range: 50-240 minutes). The median blood loss was 35 mL (range: 20-150 mL). There were no postoperative complications or re-hospitalizations. All patients were hospitalized after surgery in our ambulatory surgery unit, and were discharged 5-7 hours after surgery. The median postoperative pain score at the time of discharge was 3 (visual analogue scale: 0-10; range: 0-4). The median quality-of-life score at the first postoperative visit was 8 (range: 6-10) and the median cosmetic satisfaction score was 8 (range: 7-10). This series shows that, in selected patients, ambulatory LHS is feasible and safe for minor hepatic procedures. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Southeast Atmosphere Studies: learning from model-observation syntheses

    Data.gov (United States)

    U.S. Environmental Protection Agency — Observed and modeled data shown in figure 2b-c. This dataset is associated with the following publication: Mao, J., A. Carlton, R. Cohen, W. Brune, S. Brown, G....

  1. Outcomes from massive paracetamol overdose: a retrospective observational study.

    Science.gov (United States)

    Marks, Daniel J B; Dargan, Paul I; Archer, John R H; Davies, Charlotte L; Dines, Alison M; Wood, David M; Greene, Shaun L

    2017-06-01

    This article is commented on by Bateman DN and Dear JW. Should we treat very large paracetamol overdose differently? Br J Clin Pharmacol 2017; 83: 1163-5. https://doi.org/10.1111/bcp.13279 AIMS: Treatment of paracetamol (acetaminophen) overdose with acetylcysteine is standardized, with dose determined only by patient weight. The validity of this approach for massive overdoses has been questioned. We systematically compared outcomes in massive and non-massive overdoses, to guide whether alternative treatment strategies should be considered, and whether the ratio between measured timed paracetamol concentrations (APAP pl ) and treatment nomogram thresholds at those time points (APAP t ) provides a useful assessment tool. This is a retrospective observational study of all patients (n = 545) between 2005 and 2013 admitted to a tertiary care toxicology service with acute non-staggered paracetamol overdose. Massive overdoses were defined as extrapolated 4-h plasma paracetamol concentrations >250 mg l -1 , or reported ingestions ≥30 g. Outcomes (liver injury, coagulopathy and kidney injury) were assessed in relation to reported dose and APAP pl :APAP t ratio (based on a treatment line through 100 mg l -1 at 4 h), and time to acetylcysteine. Ingestions of ≥30 g paracetamol correlated with higher peak serum aminotransferase (r = 0.212, P paracetamol overdose are at higher risk of organ injury, even when acetylcysteine is administered early. Enhanced therapeutic strategies should be considered in those who have an APAP pl :APAP t  ≥ 3. Novel biomarkers of incipient liver injury and abbreviated acetylcysteine regimens require validation in this patient cohort. © 2016 The British Pharmacological Society.

  2. Observing power blackouts from space - A disaster related study

    Science.gov (United States)

    Aubrecht, C.; Elvidge, C. D.; Ziskin, D.; Baugh, K. E.; Tuttle, B.; Erwin, E.; Kerle, N.

    2009-04-01

    world. Elvidge et al. (1998) first demonstrated that under certain conditions a detection of power outages is possible using OLS data. A standard procedure for visual detection of power outages has been developed. The procedure is based on identifying locations where consistently observed lighting is missing or reduced following a disaster event. Visible and thermal spectral bands of the event-related OLS data are compared to a recent cloud-free composite of nighttime lights by producing a color (RGB) composite image. For the cloud-free nighttime lights composite serving as reference information both monthly and annual composites can be used, depending on the respective availability and suitability of OLS data. The RGB color composite uses the reference lights as red (R), the current visible band as green (G) and the current thermal band as blue (B). The thermal band is typically inverted to make clouds appear bright. As clouds are typically colder than the surface of the Earth, in the thermal band higher values are observed on cloud-free areas, which thus appear brighter in standard visualization modes. The resulting color composite is visually interpreted to identify power outages, which show up as red lights on a dark (cloud-free) background. Red color stands for high values in the reference data (red band of the RGB composite) compared to low values in the event data (green and blue bands of the RGB composite), thus showing the disaster-related absence or reduction of lighting. Heavy cloud cover also obscures lights, resulting in red lights on a blue background. Yellow color in the RGB composite indicates areas where the lights are on, i.e. both red and green band (reference composite and visible band of the event image) feature high values with no cloud cover present (low values in the blue band). Under ideal conditions the presented procedure detects individual cities and towns where power has been lost or has been reduced. Conditions reducing or eliminating the

  3. Study of melt produced bodies observed at Henbury crater region

    International Nuclear Information System (INIS)

    Hopper, V.D.; Sewell, D.K.B.; Aitken, D.K.

    1989-01-01

    Spherical and non spherical bodies derived from target rock and meteorite components have been found in samples of soil in the Henbury crater region. From a study of the composition of these bodies, the compositions of the meteorite and the target rock, it has been possible to separate the bodies into three groups showing differing degrees of volatilization of various oxides. The composition of a number of the soil samples were measured using X-ray fluorescence. A selected number were then examined by a scanning electron microscope fitted with an energy dispersive X-ray analyzer. Where Ni was definitely identified, it was examined by an electron microprobe X-ray analyzer. A major finding was the depletion of SiO 2 in the production of both Group 1 and Group 3 bodies. Group 3 bodies are not volatilized to the same extent as Group 1. With no reference to the target rock , the general order of volatility appears to be Na 2 O>MgO>K 2 O>TiO 2 , SiO 2 and Al 2 O 3 , the significant change being the place of SiO2. 13 refs., 7 figs., 5 tabs

  4. Can headache impair intellectual abilities in children? An observational study

    Directory of Open Access Journals (Sweden)

    Esposito M

    2012-11-01

    analysis data showed that the children with migraine seemed to have lower perceptual organization than the children affected by tension-type headache.Conclusion: To our knowledge, studies on cognitive functioning in children affected by headache in the interictal phase are scarce, and our results suggest a new perspective in understanding of the neuropsychological aspects of young patients affected by headaches.Keywords: childhood headache, intelligence quotient, Weschler Intelligence Scale for Children Third Edition, intelligence, migraine

  5. Small-angle scattering studies show distinct conformations of calmodulin in its complexes with two peptides based on the regulatory domain of the catalytic subunit of phosphorylase kinase

    International Nuclear Information System (INIS)

    Trewhella, J.; Blumenthal, D.K.; Rokop, S.E.; Seeger, P.A.

    1990-01-01

    Small-angle X-ray and neutron scattering have been used to study the solution structures of calmodulin complexed with synthetic peptides corresponding to residues 342-366 and 301-326, designated PhK5 and PhK13, respectively, in the regulatory domain of the catalytic subunit of skeletal muscle phosphorylase kinase. The scattering data show that binding of PhK5 to calmodulin induces a dramatic contraction of calmodulin, similar to that previously observed when calmodulin is complexed with the calmodulin-binding domain peptide from rabbit skeletal muscle myosin light chain kinase. In contrast, calmodulin remains extended upon binding PhK13. In the presence of both peptides, calmodulin also remains extended. Apparently, the presence of PhK13 inhibits calmodulin from undergoing the PhK5-induced contraction. These data indicate that there is a fundamentally different type of calmodulin-target enzyme interaction in the case of the catalytic subunit of phosphorylase kinase compared with that for myosin light chain kinase

  6. Randomised study showed that recorded maternal voices reduced pain in preterm infants undergoing heel lance procedures in a neonatal intensive care unit.

    Science.gov (United States)

    Chirico, G; Cabano, R; Villa, G; Bigogno, A; Ardesi, M; Dioni, E

    2017-10-01

    Alleviating pain in neonates should be the goal of all caregivers. We evaluated whether recorded maternal voices were safe and effective in limiting pain in preterm infants undergoing heel lance procedures in the neonatal intensive care unit of an Italian children's hospital. This prospective, controlled study took place from December 2013 to December 2015. We enrolled 40 preterm infants, born at a 26-34 weeks of gestation, at a corrected gestational age 29-36 weeks and randomised them to listen or not listen to a recording of their mother's voice during a painful, routine heel lance for blood collection. Changes in the infants' Premature Infant Pain Profile, heart rate, oxygen saturation and blood pressure during the procedure were compared by analysis of variance. Possible side effects, of apnoea, bradycardia, seizures and vomiting, were also recorded. Both groups showed a marked increase in PIPP scores and decrease in oxygen saturation during the procedure, but infants in the treatment group had significantly lower PIPP scores (p = 0.00002) and lower decreases in oxygen saturation (p = 0.0283). No significant side effects were observed. Using recorded maternal voices to limit pain in preterm infants undergoing heel lance procedures appeared safe and effective. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  7. Functional behavior of the anomalous magnetic relaxation observed in melt-textured YBa{sub 2}Cu{sub 3}O{sub 7-δ} samples showing the paramagnetic Meissner effect

    Energy Technology Data Exchange (ETDEWEB)

    Dias, F.T., E-mail: fabio.dias@ufpel.edu.br [Instituto de Física e Matemática, Universidade Federal de Pelotas, Caixa Postal 354, 96010-900, Pelotas, Rio Grande do Sul (Brazil); Vieira, V.N.; Garcia, E.L. [Instituto de Física e Matemática, Universidade Federal de Pelotas, Caixa Postal 354, 96010-900, Pelotas, Rio Grande do Sul (Brazil); Wolff-Fabris, F.; Kampert, E. [Dresden High Magnetic Field Laboratory, Helmholtz-Zentrum Dresden-Rossendorf, 01314, Dresden (Germany); Gouvêa, C.P. [National Institute of Metrology, Quality and Technology (Inmetro), Material Metrology Division, 25250-020, Duque de Caxias, Rio de Janeiro (Brazil); Schaf, J. [Instituto de Física, Universidade Federal do Rio Grande do Sul, 91501-970, Porto Alegre, Rio Grande do Sul (Brazil); Obradors, X.; Puig, T. [Institut de Ciència de Materials de Barcelona, CSIC, Universitat Autònoma de Barcelona, 08193, Bellaterra (Spain); Roa, J.J. [Departamento de Ciencia de Materiales e Ingeniería Metalúrgica, Universitat Politècnica de Catalunya, 08028, Barcelona (Spain)

    2016-10-15

    Highlights: • Paramagnetic Meissner effect observed up to 5T in FCC and FCW measurements. • Time effects evidenced by irreversibilities between FCC and FCW measurements. • Strong time effects causing an anomalous paramagnetic relaxation. • Paramagnetic relaxation governed by different flux dynamics in different intervals. • An interpretative analysis to identify the flux dynamics in the relaxation process. - Abstract: We have studied the functional behavior of the field-cooled (FC) magnetic relaxation observed in melt-textured YBa{sub 2}Cu{sub 3}O{sub 7-δ} (Y123) samples with 30 wt% of Y{sub 2}Ba{sub 1}Cu{sub 1}O{sub 5} (Y211) phase, in order to investigate anomalous paramagnetic moments observed during the experiments. FC magnetic relaxation experiments were performed under controlled conditions, such as cooling rate and temperature. Magnetic fields up to 5T were applied parallel to the ab plane and along the c-axis. Our results are associated with the paramagnetic Meissner effect (PME), characterized by positive moments during FC experiments, and related to the magnetic flux compression into the samples. After different attempts our experimental data could be adequately fitted by an exponential decay function with different relaxation times. We discuss our results suggesting the existence of different and preferential flux dynamics governing the anomalous FC paramagnetic relaxation in different time intervals. This work is one of the first attempts to interpret this controversial effect in a simple analysis of the pinning mechanisms and flux dynamics acting during the time evolution of the magnetic moment. However, the results may be useful to develop models to explain this interesting and still misunderstood feature of the paramagnetic Meissner effect.

  8. Classroom Observation Practice in Career Schools: A Multiple Case Study

    Science.gov (United States)

    Withers, Marya G.

    2017-01-01

    Post-secondary career school educational leaders are charged with formulating sufficient, ongoing, and effective faculty development programming to ensure the delivery of quality education in their unique trade-expert led institutions. Classroom observations, which include substantive feedback exchanges from trained personnel are well documented…

  9. Study of observed microearthquakes at Masada Deep Borehole

    Science.gov (United States)

    Hofstetter, A.; Malin, P. E.

    2017-12-01

    Seismological measurements, conducted at great depths of several hundred of meters or even a few km, can provide useful information that one cannot get while conducting the measurements on the surface. We take advantage of Masada Deep borehole (MDBI), an abandoned oil well, for the installation of a seismometer at a large depth of 1,256 m (1,516 bsl). The station is located in the near vicinity of the East Masada fault, part of the Western Boundary Fault of the Dead Sea basin. We present seismic observations of microearthquakes which occurred along the Dead Sea fault (DSF). Many of them were not recorded by the Israel Seismic Network (ISN). The quiet site of the station has an obvious advantage in detection and identification of earthquakes and explosions. For example, the station detects about 30% more quarry explosions as compared to observations of the ISN. We demonstrate that borehole seismograms are clearer than the on-surface observations of nearby seismometer. We lowered the magnitude scale of observed events down to about M≈-3. Many of the earthquakes, sometimes clusters, occurred underneath the MDBI at depths of 10-25 km, having special signature. Using the cross-correlation technique we present several series of seismic activity either underneath the station or along the DSF. Frequency-magnitude relationship, known also as Gutenberg-Richter relationship, is somewhat higher than the determined value for the whole Dead Sea Fault.

  10. Mother-Father-Infant Interaction: A Naturalistic Observational Study.

    Science.gov (United States)

    Belsky, Jay

    1979-01-01

    Investigates infant preferences for interaction with mother v father, similarities and differences in maternal and paternal behavior, and the influence of a second parent's presence on parent-infant interaction. Families with infants 15 months of age were observed in their own homes. (Author/SS)

  11. Show-Bix &

    DEFF Research Database (Denmark)

    2014-01-01

    The anti-reenactment 'Show-Bix &' consists of 5 dias projectors, a dial phone, quintophonic sound, and interactive elements. A responsive interface will enable the Dias projectors to show copies of original dias slides from the Show-Bix piece ”March på Stedet”, 265 images in total. The copies are...

  12. Study of the Penetration Bias of ENVISAT Altimeter Observations over Antarctica in Comparison to ICESat Observations

    Directory of Open Access Journals (Sweden)

    Aurélie Michel

    2014-09-01

    Full Text Available The aim of this article is to characterize the penetration bias of the ENVIronmental SATellite (ENVISAT radar altimeter over the Antarctic ice sheet through comparison with the more accurate measurements of the Ice, Cloud and land Elevation Satellite (ICESat altimeter at crossover points. We studied the difference between ENVISAT and ICESat fluctuations over six years. We observed the same patterns between the leading edge width and the elevation difference. Both parameters are linked, and the major bias is due to the lengthening of the leading edge width due to the radar penetration. We show that the elevation difference between both altimeters and the leading edge width are linearly well-linked with a 0.8 Pearson correlation coefficient, whereas the slope effect over the coasts is difficult to analyze. When we analyze each crossover point temporal evolution locally, the linear correlation between the leading edge width and the elevation difference is between −0.6 and −1. Fitting a linear model between them, we find a reliability index greater than 0.7 for the Antarctic Plateau and Dronning Maud Land, which confirms that the penetration effect has a linear influence on the retrieved height. Moreover, we present results from SARAL/AltiKa (launched in February 2013 that confirm SARAL/AltiKa accuracy and the promising information it will provide.

  13. Case Study of Ion Beams Observed By Cluster At Perigee

    Science.gov (United States)

    Sergeev, V.; Sauvaud, J.-A.; Perigee Beam Team

    During substorms the short beams of ions in the keV-to-tens keV energy range are injected into the auroral flux tubes from the magnetotail (sometimes extending up to >100 keV energy) carrying the information on the source distance, scale-size and temporal history of plasma acceleration. We present observations with the CLUSTER crossing inward the auroral zone flux tubes at ~4Re distance near its perigee during the substorm activity on February 14, 2001. The ion beams cover the same region (poleward half) of the auroral oval where the low-energy ions are extracted from the ionosphere, and where the small-scale transient transverse Alfven waves are observed which carry predominantly the downward parallel Poynting flux into the ionosphere. The multiple beams were basically confirmed to be the transient effects, although some effects including the (spatial) velocity filter and the parallel electric fields (im- posed by quasineutrality requirement) may complicate the interpretation. The gener- ation region of ion beams is not limited to most poleward, newly-reconnected flux tubes; the beam generation region could extend across magnetic field inward by as much as >100km (if mapped to the ionosphere). Surprising variety of injection dis- tances observed nearly simultaneously (ranging between >60 Re and ~10 Re) have been inferred when using the full available energy and time resolution, with shorter injection distances be possibly associated with the flow braking process. The beam multiplicity often displays the apparent ~3 min quasiperiodicity inherent to the basic dissipation process, it was not yet explained by any substorm theory.

  14. Polysomy of chromosome 17 in breast cancer tumors showing an overexpression of ERBB2: a study of 175 cases using fluorescence in situ hybridization and immunohistochemistry

    International Nuclear Information System (INIS)

    Salido, Marta; Solé, Francesc; Tusquets, Ignasi; Corominas, Josep M; Suarez, Marta; Espinet, Blanca; Corzo, Cristina; Bellet, Meritxell; Fabregat, Xavier; Serrano, Sergi

    2005-01-01

    One of the most common genetic aberrations associated with breast cancer is the amplification and overexpression of the ERBB2 proto-oncogene located at chromosome 17, bands q12-21. The amplification/overexpression occurs in 25 to 30% of all breast cancers. In breast cancer, aneusomy of chromosome 17, either monosomy or polysomy, is frequently observed by conventional cytogenetics and fluorescence in situ hybridization (FISH). The aim of this study was to discover whether or not numerical aberrations on chromosome 17 have a correlation to the amplification or overexpression of the ERBB2 gene and to analyze their clinical implications in subgroups showing 2+ or 3+ positive scores by immunohistochemistry (IHC). We used FISH on a series of 175 formalin-fixed paraffin-embedded breast carcinomas to detect ERBB2 amplification, using a dual-probe system for the simultaneous enumeration of the ERBB2 gene and the centromeric region of chromosome 17, as well as using IHC to detect overexpression. We analyzed clinical and pathological variables in a subgroup of patients with 2+ and 3+ IHC scores (147 patients), to describe any differences in clinicopathological characteristics between polysomic and non-polysomic cases with the use of the χ 2 test. We found 13% of cases presenting polysomy, and three cases presented monosomy 17 (2%). According to the status of the ERBB2 gene, instances of polysomy 17 were more frequently observed in non-amplified cases than in FISH-amplified cases, suggesting that the mechanism for ERBB2 amplification is independent of polysomy 17. Polysomy 17 was detected in patients with 2+ and 3+ IHC scores. We found that nodal involvement was more frequent in polysomic than in non-polysomic cases (P = 0.046). The determination of the copy number of chromosome 17 should be incorporated into the assesment of ERBB2 status. It might also be helpful to differentiate a subgroup of breast cancer patients with polysomy of chromosome 17 and overexpression of ERBB2

  15. Astronomical Observations Astronomy and the Study of Deep Space

    CERN Document Server

    2010-01-01

    Our Search for knowledge about the universe has been remarkable, heartbreaking, fantastical, and inspiring, and this search is just beginning. Astronomical Observations is part of a 7 book series that takes readers through a virtual time warp of our discovery. From the nascent space programs of the 1960's to today's space tourism and the promise of distant planet colonization, readers will be transfixed. Throughout this journey of the mind, Earth-bound explorers gain keen insight into the celestial phenomena that have fascinated humans for centuries. Thrilling narratives about indefatigable sc

  16. Temporal sequence in observational studies to establish causality

    Directory of Open Access Journals (Sweden)

    Luis Carlos Silva Ayçaguer, PhD

    2014-05-01

    Full Text Available The article includes a brief summary on the scope of the notions of causality and risk and considers some operational difficulties that arise when dealing with problems associated with them. It underscores the vital importance of timing and its link with the most commonly used observational research designs that address causal relationships. The article describes in detail the need to record the order in which the relevant events occur and how to consider this in the analysis. A detailed example of errors that are usually incurred in and their effect is provided.

  17. Observational study of atmospheric surface layer and coastal weather in northern Qatar

    Science.gov (United States)

    Samanta, Dhrubajyoti; Sadr, Reza

    2016-04-01

    Atmospheric surface layer is the interaction medium between atmosphere and Earth's surface. Better understanding of its turbulence nature is essential in characterizing the local weather, climate variability and modeling of turbulent exchange processes. The importance of Middle East region, with its unique geographical, economical and weather condition is well recognized. However, high quality micrometeorological observational studies are rare in this region. Here we show experimental results from micrometeorological observations from an experimental site in the coastal region of Qatar during August-December 2015. Measurements of winds are obtained from three sonic anemometers installed on a 9 m tower placed at Al Ghariyah beach in northern Qatar (26.08 °N, 51.36 °E). Different surface layer characteristics is analyzed and compared with earlier studies in equivalent weather conditions. Monthly statistics of wind speed, wind direction, temperature, humidity and heat index are made from concurrent observations from sonic anemometer and weather station to explore variations with surface layer characteristics. The results also highlights potential impact of sea breeze circulation on local weather and atmospheric turbulence. The observed daily maximum temperature and heat index during morning period may be related to sea breeze circulations. Along with the operational micrometeorological observation system, a camera system and ultrasonic wave measurement system are installed recently in the site to study coastline development and nearshore wave dynamics. Overall, the complete observational set up is going to provide new insights about nearshore wind dynamics and wind-wave interaction in Qatar.

  18. Using direct clinical observation to assess the quality of cesarean delivery in Afghanistan: an exploratory study

    Science.gov (United States)

    2014-01-01

    Background As part of a National Emergency Obstetric and Newborn Care (EmONC) Needs Assessment, a special study was undertaken in July 2010 to examine the quality of cesarean deliveries in Afghanistan and examine the utility of direct clinical observation as an assessment method in low-resource settings. Methods This cross-sectional assessment of the quality of cesareans at 14 facilities in Afghanistan included a survey of surgeons regarding their routine cesarean practices, direct observation of 29 cesarean deliveries and comparison of observations with facility records for 34 additional cesareans conducted during the 3 days prior to the observation period at each facility. For both observed cases and record reviews, we assessed time intervals between specified points of care-arrival to the ward, first evaluation, detection of a complication, decision for cesarean, incision, and birth. Results All time intervals with the exception of “decision to skin incision” were longer in the record reviews than in observed cases. Prior cesarean was the most common primary indication for all cases. All mothers in both groups observed survived through one hour postpartum. Among newborns there were two stillbirths (7%) in observed births and seven (21%) record reviews. Although our sample is too small to show statistical significance, the difference is noteworthy. In six of the reviewed cesareans resulting in stillbirth, a fetal heart rate was recorded in the operating theater, although four were recorded as macerated. For the two fresh stillbirths, the cesarean surgeries were recorded as scheduled and not urgent. Conclusions Direct observation of cesarean deliveries enabled us to assess a number of preoperative, postoperative, and intraoperative procedures that are often not described in medical records in low resource settings. Comparison of observations with findings from provider interviews and facility records allowed us to infer whether observed practices were typical

  19. Direct observation, study and control of molecular super rotors

    Science.gov (United States)

    Korobenko, Aleksey; Milner, Alexander; Hepburn, John; Milner, Valery

    2014-05-01

    Extremely fast rotating molecules whose rotational energy is comparable with or exceeds the molecular bond strength are known as ``super rotors''. It has been speculated that super rotors may exhibit a number of unique properties, yet only indirect evidence of these molecular objects has been reported to date. We demonstrate the first direct observation of molecular super rotors by detecting coherent unidirectional molecular rotation with extreme frequencies exceeding 10 THz. The technique of an ``optical centrifuge'' is used to control the degree of rotational excitation in an ultra-broad range of rotational quantum numbers, reaching as high as N = 95 in oxygen and N = 60 in nitrogen. State-resolved detection enables us to determine the shape of the excited rotational wave packet and quantify the effect of centrifugal distortion on the rotational spectrum. Femtosecond time resolution reveals coherent rotational dynamics with increasing coherence times at higher angular momentum. We demonstrate that molecular super rotors can be created and observed in dense samples under normal conditions where the effects of ultrafast rotation on many-body interactions, inter-molecular collisions and chemical reactions can be readily explored.

  20. Observational study of food safety practices in retail deli departments.

    Science.gov (United States)

    Lubran, M B; Pouillot, R; Bohm, S; Calvey, E M; Meng, J; Dennis, S

    2010-10-01

    In order to improve the safety of refrigerated ready-to-eat food products prepared at retail deli departments, a better understanding of current practices in these establishments is needed. Food employees in deli departments at six chain and three independent retail establishments in Maryland and Virginia were observed, using notational analysis, as they prepared deli products for sale. The frequency of contact with objects and deli products before sale, hand washing and glove changing during preparation, and equipment, utensil, and surface cleaning and sanitizing was determined. Compliance with the U.S. Food and Drug Administration's 2005 model Food Code recommendations, which must be adopted by the individual state and local jurisdictions that are responsible for directly regulating retail establishments, was also assessed. Observations indicated there were a large number of actions for which hand washing was recommended at independent and chain stores (273 recommended of 1,098 total actions and 439 recommended of 3,073 total actions, respectively). Moreover, 67% (295 of 439) of the actions for which hand washing was recommended at the chain stores and 86% (235 of 273) of those at the independent stores resulted from employees touching non-food contact surfaces prior to handling ready-to-eat food. Compliance with hand washing recommendations was generally low and varied depending on store type with independent stores exhibiting lower compliance than chain stores (5 instances of compliance for 273 recommended actions and 73 instances of compliance for 439 recommended actions, respectively). Potential risk mitigation measures that may reduce the frequency of hand washing actions needed during ready-to-eat food preparation in retail deli departments are discussed. More research is needed to determine the impact of such measures on food safety.

  1. Communication Patterns and Stress in the Preschool: An Observational Study

    Science.gov (United States)

    Sjödin, Fredrik; Neely, Gregory

    2017-01-01

    The study included 12 preschool departments, with two teachers in six departments characterised by high levels of stress and burnout and two teachers in six departments characterised by low levels of stress and burnout. A total of 24 females with a mean age of 43.5 years participated in the study. The teachers rated stress, fatigue, work demands…

  2. Intraoperative performance and postoperative outcomes of microcoaxial phacoemulsification. Observational study.

    Science.gov (United States)

    Vasavada, Viraj; Vasavada, Vaishali; Raj, Shetal M; Vasavada, Abhay R

    2007-06-01

    To evaluate the intraoperative performance and postoperative outcomes after microcoaxial phacoemulsification. Iladevi Cataract & IOL Research Centre, Ahmedabad, India. A prospective observational case series comprised 84 eyes with age-related uncomplicated cataract having microcoaxial phacoemulsification through a 2.2 mm clear corneal incision by a standard surgical technique. Phacoemulsification parameters (Infiniti Vision System, Alcon) were microburst width, 30 ms; preset power, 50%; vacuum, 650 mm Hg; aspiration flow rate, 25 cc/minute. A single-piece Alcon AcrySof intraocular lens was implanted with the C cartridge (Alcon) cartridge. The incision was measured at the end of surgery. Observations included surgical time (from commencement of sculpting to end of epinucleus removal), cumulative dissipated energy (CDE), wound burns, intraoperative complications, postoperative increase in mean central corneal thickness (CCT) at 1 day and 1 month, mean % decrease in endothelial cell density (ECD), absolute mean change in coefficient of variation (cv) 3 months, and uncorrected visual acuity (UCVA) at 1 day. Data were analyzed using a 1-sample t test with 95% confidence intervals (CIs). The mean follow up was 3 months +/- 0.3 (SD). The mean incision size at the end of surgery was 2.3 +/- .09 mm; mean surgical time, 4.5 +/- 1.5 minutes; and mean CDE, 2.3 +/- 2.2 seconds. No wound burns or other intraoperative complications occurred. The postoperative CCT increased by a mean of 16 microm at 1 day (95% CI, 8-25; P = .66;) and by a mean of 3.14 microm at 1 month (95% CI, 2.26-4.05; P = .92). The ECD decreased by a mean of 5.8% (95% CI, 6.8-3.5; P = .82) and the mean coefficient of variation, by 3.3 (95% CI, 4.5-2.0; P = .65). At 1 day, the UCVA was 20/20 in 29% of cases, 20/20 to 20/40 in 58%, and 20/40 to 20/50 in 12%. Microcoaxial phacoemulsification was safely and effectively performed, achieving consistent and satisfactory postoperative outcomes.

  3. ADVERSE REACTIONS OF BLOOD DONATION: A PROSPECTIVE OBSERVATIONAL STUDY

    OpenAIRE

    Kandukuri Mahesh; Ravikanth; Chinthakindi; Shashi Kiran; Sudhir Kuma

    2014-01-01

    BACKGROUND: Voluntary donors normally tolerate blood donation very well as the history and preliminary examination is clear without any hidden history or facts related to the health status of the donor, occasionally, adverse reactions of variable severity may occur during or at the end of the collection. AIM: Aim of this study is to estimate and possibly avoid the cause of unwanted reactions. MATERIALS AND METHODS: This study is conducted over a period of three years, from ...

  4. [Observational study of craniofacial growth and development in Mexican children].

    Science.gov (United States)

    Fijikami, T K; Cedeño Pacheco, E

    1991-01-01

    The election of a investigation about craniofacial growing and development in Mexican children, was done due to a lack of national information in this rubric and as a fundamental part of the "growing and development in the scholastic" module of the Universidad Autónoma Metropolitana-Xochimilco, which work hypothesis was that "craniofacial growing and development in Mexican, 6 to 12 children in Xochimilco area are due to nutritional deficiency, second dentition eruption delay and dental maloclution "which was totality confirmed in a 100 Mexican facial characteristic children field work study, with cephalometric studies which permit to determine the craniofacial growing standard. This study was corroborated with a 40 children, 4 years later follow up.

  5. Musical Expression: An Observational Study of Instrumental Teaching

    Science.gov (United States)

    Karlsson, Jessika; Juslin, Patrik N.

    2008-01-01

    Research has shown that both music students and teachers think that expression is important. Yet, we know little about how expression is taught to students. Such knowledge is needed in order to enhance teaching of expression. The aim of this study was thus to explore the nature of instrumental music teaching in its natural context, with a focus on…

  6. Observation of Clouds Using the CSIR Transportable LIDAR: A Case Study over Durban, South Africa

    Directory of Open Access Journals (Sweden)

    Lerato Shikwambana

    2016-01-01

    Full Text Available The Council for Scientific and Industrial Research (CSIR transportable Light Detection And Ranging (LIDAR was used to collect data over Durban (29.9°S, 30.9°E during 20–23 November 2012. Aerosol measurements have been carried out in the past over Durban; however, no cloud measurements using LIDAR have ever been performed. Therefore, this study further motivates the continuation of LIDAR for atmospheric research over Durban. Low level clouds were observed on 20–22 November 2012 and high level clouds were observed on 23 November 2012. The low level cloud could be classified as stratocumulus clouds, whereas the high level clouds could be classified as cirrus clouds. Low level cloud layers showed high extinction coefficients values ranging between 0.0009 and 0.0044 m−1, whereas low extinction coefficients for high level clouds were observed at values ranging between 0.000001 and 0.000002 m−1. Optical depth showed a high variability for 20 and 21 November 2012. This indicates a change in the composition and/or thickness of the cloud. For 22 and 23 November 2012, almost similar values of optical depth were observed. Cloud-Aerosol LIDAR and Infrared Pathfinder Satellite Observations (CALIPSO revealed high level clouds while the CSIR LIDAR could not. However, the two instruments complement each other well to describe the cloudy condition.

  7. Talking with TV shows

    DEFF Research Database (Denmark)

    Sandvik, Kjetil; Laursen, Ditte

    2014-01-01

    User interaction with radio and television programmes is not a new thing. However, with new cross-media production concepts such as X Factor and Voice, this is changing dramatically. The second-screen logic of these productions encourages viewers, along with TV’s traditional one-way communication...... mode, to communicate on interactive (dialogue-enabling) devices such as laptops, smartphones and tablets. Using the TV show Voice as our example, this article shows how the technological and situational set-up of the production invites viewers to engage in new ways of interaction and communication...

  8. DNA fingerprinting validates seed dispersal curves from observational studies in the neotropical legume parkia.

    Science.gov (United States)

    Heymann, Eckhard W; Lüttmann, Kathrin; Michalczyk, Inga M; Saboya, Pedro Pablo Pinedo; Ziegenhagen, Birgit; Bialozyt, Ronald

    2012-01-01

    Determining the distances over which seeds are dispersed is a crucial component for examining spatial patterns of seed dispersal and their consequences for plant reproductive success and population structure. However, following the fate of individual seeds after removal from the source tree till deposition at a distant place is generally extremely difficult. Here we provide a comparison of observationally and genetically determined seed dispersal distances and dispersal curves in a Neotropical animal-plant system. In a field study on the dispersal of seeds of three Parkia (Fabaceae) species by two Neotropical primate species, Saguinus fuscicollis and Saguinus mystax, in Peruvian Amazonia, we observationally determined dispersal distances. These dispersal distances were then validated through DNA fingerprinting, by matching DNA from the maternally derived seed coat to DNA from potential source trees. We found that dispersal distances are strongly right-skewed, and that distributions obtained through observational and genetic methods and fitted distributions do not differ significantly from each other. Our study showed that seed dispersal distances can be reliably estimated through observational methods when a strict criterion for inclusion of seeds is observed. Furthermore, dispersal distances produced by the two primate species indicated that these primates fulfil one of the criteria for efficient seed dispersers. Finally, our study demonstrated that DNA extraction methods so far employed for temperate plant species can be successfully used for hard-seeded tropical plants.

  9. DNA Fingerprinting Validates Seed Dispersal Curves from Observational Studies in the Neotropical Legume Parkia

    Science.gov (United States)

    Heymann, Eckhard W.; Lüttmann, Kathrin; Michalczyk, Inga M.; Saboya, Pedro Pablo Pinedo; Ziegenhagen, Birgit; Bialozyt, Ronald

    2012-01-01

    Background Determining the distances over which seeds are dispersed is a crucial component for examining spatial patterns of seed dispersal and their consequences for plant reproductive success and population structure. However, following the fate of individual seeds after removal from the source tree till deposition at a distant place is generally extremely difficult. Here we provide a comparison of observationally and genetically determined seed dispersal distances and dispersal curves in a Neotropical animal-plant system. Methodology/Principal Findings In a field study on the dispersal of seeds of three Parkia (Fabaceae) species by two Neotropical primate species, Saguinus fuscicollis and Saguinus mystax, in Peruvian Amazonia, we observationally determined dispersal distances. These dispersal distances were then validated through DNA fingerprinting, by matching DNA from the maternally derived seed coat to DNA from potential source trees. We found that dispersal distances are strongly right-skewed, and that distributions obtained through observational and genetic methods and fitted distributions do not differ significantly from each other. Conclusions/Significance Our study showed that seed dispersal distances can be reliably estimated through observational methods when a strict criterion for inclusion of seeds is observed. Furthermore, dispersal distances produced by the two primate species indicated that these primates fulfil one of the criteria for efficient seed dispersers. Finally, our study demonstrated that DNA extraction methods so far employed for temperate plant species can be successfully used for hard-seeded tropical plants. PMID:22514748

  10. Harvesting Collective Trend Observations from Large Scale Study Trips

    DEFF Research Database (Denmark)

    Eriksen, Kaare; Ovesen, Nis

    2014-01-01

    To enhance industrial design students’ decoding and understanding of the technological possibilities and the diversity of needs and preferences in different cultures it is not unusual to arrange study trips where such students acquire a broader view to strengthen their professional skills and app...... numbers of students to the annual Milan Design Week and the Milan fair ‘I Saloni’ in Italy. The present paper describes and evaluates the method, the theory behind it, the practical execution of the trend registration, the results from the activities and future perspectives....... and approach, hence linking the design education and the design culture of the surrounding world. To improve the professional learning it is useful, though, to facilitate and organize the trips in a way that involves systematic data collection and reporting. This paper presents a method for facilitating study...

  11. Splenic lesions observed in 71 splenectomized dogs: a retrospective study

    OpenAIRE

    Elisângela Olegário da Silva; Giovana Wingeter Di Santis; Selwyn Arlington Headley; Ana Paula Frederico Rodrigues Loureiro Bracarense

    2016-01-01

    The spleen of dogs is frequently affected by disorders that vary from local and systemic origin. The difficulty in associating clinical and gross findings contributes for the choice of total splenectomy as the main treatment, leading to an impairment of the immune and hematopoietic functions. The aim of this study was to evaluate the pathological findings in the spleen of splenectomized dogs during 2008 to 2014 at a Veterinary Teaching Hospital. From the 71 cases analyzed, 97% (69/71) of the ...

  12. Quality of Life after Stapled Hemorrhoidopexy: A Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Pankaj Kumar Garg

    2013-01-01

    Full Text Available Objective. The objective of the study was to assess the change in quality of life (QOL of patients undergoing stapled hemorrhoidopexy (SH using WHO Quality of Life-BREF (WHOQOL-BREF questionnaire. Methods. The study sample comprised patients with symptomatic II, III, and IV degree hemorrhoids, undergoing SH. The patients were asked to complete WHOQOL-BREF questionnaire before and one month following the surgery. Result. There were 20 patients in the study group. The postoperative pain score measured by visual analogue scale at six hours postoperatively was at 24 hours. The items in the WHOQOL-BREF had high-internal consistency or reliability as shown by high Cronbach's alpha coefficient which was 0.82 and 0.90 for pre- and postoperative questionnaires. There was significant improvement in the overall perception of QOL and health, and in physical and psychological domains. There was modest improvement in environmental domain, while no change was noted in social domain. Conclusion. SH improved the quality of life of patients treated for hemorrhoids.

  13. Thermoacoustic CT of the breast: pilot study observations

    Science.gov (United States)

    Kruger, Robert A.; Kiser, William L., Jr.; Romilly, A. P.; Scmidt, Phyllis

    2001-06-01

    In order to assess the potential clinical utility of using thermoacoustic computer tomography (TCT) to image the breast, we conducted a retrospective pilot study of 78 patients. We recruited patients in three age groups (50 years). The study population was further segregated into normal and suspicious based on the results of the previous x-ray mammography and ultrasound. Image quality was evaluated qualitatively by consensus of two trained mammographers using a 4-point scale. The appearance of normal anatomy, cysts, benign disease and cancer was noted. Patients were also asked to rate the comfort of the TCT exam and to indicate a personal preference for x-ray mammography or TCT. Analysis of the data indicated that TCT image quality was dependent upon both patient age and breast density, improving with both increasing breast density and decreasing patient age. Fibrocystic disease was well seen, cysts appearing as areas of low RF absorption. Fibroadenomas did not demonstrate contrast enhancement with the exception of one patient with associated atypical hyperplasia. Cancer displayed higher RF absorption than surrounding tissues in 4/7 patients in whom cancer was confirmed, including one patient with a 7-mm ductal carcinoma in situ (DCIS).

  14. Gait Analysis of Symptomatic Flatfoot in Children: An Observational Study.

    Science.gov (United States)

    Kim, Ha Yong; Shin, Hyuck Soo; Ko, Jun Hyuck; Cha, Yong Han; Ahn, Jae Hoon; Hwang, Jae Yeon

    2017-09-01

    Flatfoot deformity is a lever arm disease that incurs kinetic inefficiency during gait. The purpose of this study was to measure the degree of kinetic inefficiency by comparing the gait analysis data of a flatfoot group with a normal control group. The patient group consisted of 26 children (21 males and 5 females) with symptomatic flatfoot. They were examined with gait analysis between May 2005 and February 2014. Exclusion criteria were patients with secondary flatfoot caused by neuromuscular disorders, tarsal coalition, vertical talus, or others. Patients' mean age was 9.5 years (range, 7 to 13 years). The gait analysis data of the study group and the normal control group were compared. The mean vertical ground reaction force (GRF) in the push-off phase was 0.99 for the patient group and 1.15 for the control group ( p push-off phase was 0.89 for the patient group and 1.27 for the control group ( p push-off phase was 1.38 for the patient group and 2.52 for the control group ( p push-off phase during gait. Symptomatic flatfeet had a moment inefficiency of 30% and power inefficiency of 45% during gait compared to feet with preserved medial longitudinal arches.

  15. Brucellosis in pregnant women from Pakistan: an observational study.

    Science.gov (United States)

    Ali, Shahzad; Akhter, Shamim; Neubauer, Heinrich; Scherag, André; Kesselmeier, Miriam; Melzer, Falk; Khan, Iahtasham; El-Adawy, Hosny; Azam, Asima; Qadeer, Saima; Ali, Qurban

    2016-09-02

    Brucella species occasionally cause spontaneous human abortion. Brucella can be transmitted commonly through the ingestion of raw milk or milk products. The objective of this study was to determine the sero-prevalence of and to identify potential risk factors for brucellosis in pregnant women from Rawalpindi, Pakistan. We conducted a cross-sectional study at the Gynecology Outdoor Patient department of the Benazir Bhutto Hospital, Rawalpindi, Pakistan from March to June 2013. Data related to potential risk factors and clinical history was collected by individual interviews on the blood sampling day. The 429 serum samples collected were initially screened by Rose Bengal Plate Agglutination test for the detection of Brucella antibodies. We applied standard descriptive statistics and logistic regression analyses. Twenty five (5.8 %; 95 % confidence interval (CI): 3.8 % -8.5 %) serum samples were found to be seropositive. Brucellosis-related clinical symptoms were recorded in various seropositive cases. Animal contact, raw milk consumption, having an abortion history and the experience of an intrauterine fetal death were associated with seropositivity for brucellosis in univariate analyses (all p Brucellosis is a serious threat for pregnant women and their unborn children in Pakistan. Pregnant women having brucellosis-related symptoms or previous history of abortions, miscarriages, intrauterine fetal death and other brucellosis-related manifestations should be screened for brucellosis - especially those exposed to animals given the increased risk - and medication should be administered according to state of the art.

  16. THE MANY FACES OF PNEUMOMEDIASTINUM: AN OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Narendra Kumar Narahari

    2016-06-01

    Full Text Available Pneumomediastinum is an uncommon condition which is defined by the presence of air in the mediastinum. It may result from a number of causes, but at times the underlying aetiology remains obscure. The present study aims to review the clinical and imaging features in patients who presented with pneumomediastinum alone or in association with other findings in order to establish the aetiological diagnosis. We report here, a series of cases with pneumomediastinum of various unusual aetiologies and also the clinical profile, predisposing factors and outcome of these patients along with the associated complications. METHODS We retrospectively reviewed the records of all patients who presented to the respiratory unit of our hospital with the diagnosis of pneumomediastinum over a period of 2 years from 2013-2015. The cases of pneumomediastinum resulting from trauma and iatrogenic causes were excluded from the study. RESULTS A total of six patients (4 males and 2 females with pneumomediastinum were identified during the study period after applying the exclusion criteria. The most common presenting symptom in these cases was shortness of breath followed by dry cough, chest pain and fever. Subcutaneous emphysema and Hamman sign was identified in one patient each. Of the six cases, preexisting lung disease was identified in 3 patients and these included connective tissue disease related interstitial lung disease in two cases and combined pulmonary fibrosis and emphysema in one case. In the remaining three cases, the causes of pneumomediastinum were Pneumocystis carinii pneumonia (PCP in HIV positive patient, pulmonary tuberculosis in another and spontaneous oesophageal perforation in the third. Coexisting pneumothorax was present in 3 out of 6 cases. The mean duration of hospital stay in these six patients was 8 days. No recurrence of pneumomediastinum was seen in any of the six patients during six months of followup. CONCLUSIONS Pneumomediastinum is a

  17. The energy show

    International Nuclear Information System (INIS)

    1988-01-01

    The Energy Show is a new look at the problems of world energy, where our supplies come from, now and in the future. The programme looks at how we need energy to maintain our standards of living. Energy supply is shown as the complicated set of problems it is - that Fossil Fuels are both raw materials and energy sources, that some 'alternatives' so readily suggested as practical options are in reality a long way from being effective. (author)

  18. Psychological harassment in the nursing workplace: an observational study.

    Science.gov (United States)

    Fornés, Joana; Cardoso, Meiremar; Castelló, Joana Maria; Gili, Margalida

    2011-06-01

    Psychological harassment in the workplace involves disrespectful or humiliating behavior to workers. Nurses make up one of the groups that are most exposed to these behaviors. This descriptive study investigated the most common types of psychological harassment in the nursing workplace and their relationship with sociodemographic variables among 285 nurses in Spain. Findings indicate differences in the prevalence of psychological harassment depending on the criterion that was used. Psychological harassment is positively correlated with a desire to abandon the profession and negatively with participation in decision making. The results suggest combining different measures to evaluate psychological harassment in the workplace and zero-tolerance polices for psychological abuse. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. UFOs in the LHC: Observations, studies and extrapolations

    CERN Document Server

    Baer, T; Cerutti, F; Ferrari, A; Garrel, N; Goddard, B; Holzer, EB; Jackson, S; Lechner, A; Mertens, V; Misiowiec, M; Nebot del Busto, E; Nordt, A; Uythoven, J; Vlachoudis, V; Wenninger, J; Zamantzas, C; Zimmermann, F; Fuster, N

    2012-01-01

    Unidentified falling objects (UFOs) are potentially a major luminosity limitation for nominal LHC operation. They are presumably micrometer sized dust particles which lead to fast beam losses when they interact with the beam. With large-scale increases and optimizations of the beam loss monitor (BLM) thresholds, their impact on LHC availability was mitigated from mid 2011 onwards. For higher beam energy and lower magnet quench limits, the problem is expected to be considerably worse, though. In 2011/12, the diagnostics for UFO events were significantly improved: dedicated experiments and measurements in the LHC and in the laboratory were made and complemented by FLUKA simulations and theoretical studies. The state of knowledge, extrapolations for nominal LHC operation and mitigation strategies are presented

  20. [Using consumer panels in public health observational studies].

    Science.gov (United States)

    Matilla-Santander, Nuria; Fu, Marcela; Ballbè, Montse; Lidón-Moyano, Cristina; Martín-Sánchez, Juan Carlos; Fernández, Esteve; Martínez-Sánchez, José M

    Consumer panels are a market research method useful for gathering information about low-frequency or difficult-access customers. The objective of this field-note is to explain our experience using this method in a cross-sectional public health study on the use of electronic cigarettes. After taking into account other non-probabilistic sampling techniques to obtain a huge sample of electronic-cigarette users (n=600), in the end we decided to use consumer panels (recruiters) because of the relative short duration of the field work and the high representativeness of the sample. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Aetiology of arthritis in hospitalised children: an observational study.

    Science.gov (United States)

    Aupiais, Camille; Ilharreborde, Brice; Doit, Catherine; Blachier, Audrey; Desmarest, Marie; Job-Deslandre, Chantal; Mazda, Keyvan; Faye, Albert; Bonacorsi, Stéphane; Alberti, Corinne; Lorrot, Mathie

    2015-08-01

    Arthritis in children has many causes and includes septic and viral arthritis, reactive arthritis and juvenile idiopathic arthritis (JIA). We aimed to describe the different types of arthritis among children hospitalised for a first episode of arthritis. Retrospective, descriptive case series study. A French tertiary care centre. Children under 16 years of age hospitalised for an arthritis episode between 1 January 2008 and 31 December 2009. Demographic and clinical features were compared with χ(2) or Fisher's exact tests and non-parametric tests. 173 children were hospitalised for a first episode of arthritis during the study period, with a male/female ratio of 1.14. The most frequent cause of hospitalisation was septic arthritis (43.4% of cases, 69.3% of which were due to Kingella kingae and 10.7% to Staphylococcus aureus). JIA was responsible for 8.1% of cases and arthritis without any definitive diagnosis for 40.4%. Median age at diagnosis was 2.7 years (IQR 0.3-14.6) and was lower in the septic arthritis group (1.5 years; 1.1-3.4) than in the JIA group (4.7 years; 2.5-10.9) (p<0.01). Septic arthritis involved a single joint in 97.3% of cases, while JIA involved four joints in 14.3% of cases and two to four joints in 28.6% of cases (p<0.01). Septic arthritis was the most frequent cause of arthritis in hospitalised children. Despite the increasing application of microbiological molecular methods to synovial fluid analysis, further measures are required to improve the diagnosis of arthritis of unknown cause. 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.

  2. Detection of lung cancer on the chest radiograph: a study on observer performance

    International Nuclear Information System (INIS)

    Quekel, Lorentz G.B.A.; Kessels, Alphons G.H.; Goei, Reginald; Engelshoven, Joseph M.A. van

    2001-01-01

    Study objectives: to study the validity and observers consistency in the detection of lung cancer on the chest radiograph. Materials and methods: the chest radiographs of 100 clinical cases were interpreted by 14 observers. The radiographs were obtained from 30 patients with initially missed but histopathologically proven non-small cell lung cancer (NSCLC), 35 patients with other cardiopulmonary diseases and 35 patients with no abnormalities. The observers consisted of ten experienced radiologists, two-experienced chest physicians and two residents in radiology. All observers were unaware of the study design. The validity and observer consistency was determined for each observer. Results: the mean sensitivity and specificity of the ten radiologists were 0.36 and 0.90. For the two chest physicians, the mean sensitivity and specificity were 0.29 and 0.96. For the two residents in radiology, mean sensitivity and specificity were 0.25 and 0.94. The mean interobserver kappa and mean intraobserver kappa for the radiologists were 0.38 and 0.54. For the two chest physicians, the mean interobserver kappa was 0.43, while the intraobserver kappa was 0.59. For the two residents in radiology, mean interobserver kappa was 0.35 and the intraobserver kappa was 0.42. There was no significant relation between the consistency parameters and validity parameters. The interobserver and intraobserver kappa values showed good correlation. Conclusion: the validity of the chest radiograph and observers consistency in the detection of nodular lung cancer varies widely. The level of experience is likely to influence the diagnostic performance

  3. How acquainting shows verbally

    DEFF Research Database (Denmark)

    Hermann, Jesper

    2004-01-01

    A central tenet of the integrational view of language and communication is an anchoring in the acting and integrating behaviour of the communicants themselves. In this way the integrational approach has a certain phenomenological slant. What happens when this approach is combined with a ¿psycholo...... to some of William James' classical psychological observations. 16...... of linguistic exertion¿ based upon the descriptions of the  stream of thought, and of conception (>acquainting) by William James? Text-examples taken from an internet site for dieters illustrate the combined James'ian & integrational approach in practice. Some of the examples are also specifically related......A central tenet of the integrational view of language and communication is an anchoring in the acting and integrating behaviour of the communicants themselves. In this way the integrational approach has a certain phenomenological slant. What happens when this approach is combined with a ¿psychology...

  4. A suggestion for quality assessment in systematic reviews of observational studies in nutritional epidemiology

    Directory of Open Access Journals (Sweden)

    Jong-Myon Bae

    2016-04-01

    Full Text Available OBJECTIVES: It is important to control the quality level of the observational studies in conducting meta-analyses. The Newcastle-Ottawa Scale (NOS is a representative tool used for this purpose. We investigated the relationship between high-quality (HQ defined using NOS and the results of subgroup analysis according to study design. METHODS: We selected systematic review studies with meta-analysis which performed a quality evaluation on observational studies of diet and cancer by NOS. HQ determinations and the distribution of study designs were examined. Subgroup analyses according to quality level as defined by the NOS were also extracted. Equivalence was evaluated based on the summary effect size (sES and 95% confidence intervals computed in the subgroup analysis. RESULTS: The meta-analysis results of the HQ and cohort groups were identical. The overall sES, which was obtained by combining the sES when equivalence was observed between the cohort and case-control groups, also showed equivalence. CONCLUSIONS: The results of this study suggest that it is more reasonable to control for quality level by performing subgroup analysis according to study design rather than by using HQ based on the NOS quality assessment tool.

  5. Overnight switching from oxcarbazepine to eslicarbazepine acetate: an observational study.

    Science.gov (United States)

    Schmid, E; Kuchukhidze, G; Kirschner, M; Leitinger, M; Höfler, J; Rohracher, A; Kalss, G; Wendling, A-S; Steinhoff, B J; Trinka, E

    2017-04-01

    There are clinical situations where it might be appropriate to switch patients from immediate-release oxcarbazepine (OXC) to eslicarbazepine acetate (ESL). We investigated the effects of transitioning patients overnight from OXC to ESL. A retrospective, single-center study was conducted in which patients with drug-resistant focal epilepsy on a stable dose of immediate-release OXC for at least 4 weeks were switched overnight to ESL. Patients were switched because they experienced persistent seizures with OXC but were unable to tolerate increased OXC dosing due to adverse events. Tolerability was assessed using the Adverse Events Profile (AEP), quality of life was assessed using the Quality of Life in Epilepsy Inventory 10 (QOLIE-10), and alertness was assessed as reaction time using a subtest of the Test Battery for Attention Performance version 2.3. Assessments were performed immediately prior to and 5 days after switching from OXC to ESL (days 0 and 5, respectively). The analysis included 21 patients (12 women, 9 men; mean age 36 years). After switching from OXC to ESL, there were significant improvements in mean scores for AEP (Peffects, quality of life, and alertness. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. The Reporting of Observational Research Studies in Dermatology Journals A Literature-Based Study

    NARCIS (Netherlands)

    Langan, Sinead; Schmitt, Jochen; Coenraads, Pieter-Jan; Svensson, Ake; von Elm, Erik; Williams, Hywel

    Objective: To assess the quality of reporting in observational studies in dermatology. Data Sources: Five dermatology journals-the Archives of Dermatology, the British Journal of Dermatology, the Journal of the American Academy of Dermatology, the Journal of Investigative Dermatology, and Acta

  7. Characterizing Suicide in Toronto: An Observational Study and Cluster Analysis

    Science.gov (United States)

    Sinyor, Mark; Schaffer, Ayal; Streiner, David L

    2014-01-01

    Objective: To determine whether people who have died from suicide in a large epidemiologic sample form clusters based on demographic, clinical, and psychosocial factors. Method: We conducted a coroner’s chart review for 2886 people who died in Toronto, Ontario, from 1998 to 2010, and whose death was ruled as suicide by the Office of the Chief Coroner of Ontario. A cluster analysis using known suicide risk factors was performed to determine whether suicide deaths separate into distinct groups. Clusters were compared according to person- and suicide-specific factors. Results: Five clusters emerged. Cluster 1 had the highest proportion of females and nonviolent methods, and all had depression and a past suicide attempt. Cluster 2 had the highest proportion of people with a recent stressor and violent suicide methods, and all were married. Cluster 3 had mostly males between the ages of 20 and 64, and all had either experienced recent stressors, suffered from mental illness, or had a history of substance abuse. Cluster 4 had the youngest people and the highest proportion of deaths by jumping from height, few were married, and nearly one-half had bipolar disorder or schizophrenia. Cluster 5 had all unmarried people with no prior suicide attempts, and were the least likely to have an identified mental illness and most likely to leave a suicide note. Conclusions: People who die from suicide assort into different patterns of demographic, clinical, and death-specific characteristics. Identifying and studying subgroups of suicides may advance our understanding of the heterogeneous nature of suicide and help to inform development of more targeted suicide prevention strategies. PMID:24444321

  8. Aortic replacement in aorto-occlusive disease: an observational study

    Directory of Open Access Journals (Sweden)

    Winter Richard K

    2008-10-01

    Full Text Available Abstract Background For many patients with aorto-occlusive disease, where stent deployment is not possible, surgery remains the only treatment option available. The aim of this study was to assess the results of aortic reconstruction surgery performed in patients with critical ischaemia. Methods All patients with critical ischaemia undergoing surgery during 1991–2004 were identified from a prospectively maintained database. Mortality data was verified against death certificate data. Demographic and clinical data were obtained from the clinical notes and the radiology database. Disease was classified as: type I – limited to aorta and common iliac arteries; type II – external iliac disease and type III combined aortic, iliac and infra-inguinal disease. Results 86 patients underwent aortic replacement surgery all of whom had critical ischaemia consisting of: type I (n = 16; type II (n = 37 and type III (n = 33. The 30-day mortality rate was 10.4%, the one-year patient survival was 80%, and the 1-year graft survival was 80%. At 2 years the actual patient survival was 73% and no additional graft losses were identified. All patients surviving 30 days reported excellent symptomatic relief. Early, complications occurred in 6 (7% patients: thrombosis within diseased superficial femoral arteries (n = 4; haemorrhage and subsequent death (n = 2. Ten (14% late complications (> 12 months occurred in the 69 surviving patients and included: anastomotic stenosis (n = 3; graft thrombosis (n = 4, graft infection (n = 3. Four patients developed claudication as a result of more distal disease in the presence of a patent graft, and 1 patient who continued smoking required an amputation for progressive distal disease. Conclusion Aortic reconstruction for patients with extensive aorto-occlussive disease provides long-standing symptomatic relief for the majority of patients. After the first year, there is continued patient attrition due to co

  9. Returning to work after laparoscopic myomectomy: a prospective observational study.

    Science.gov (United States)

    Huff, Keren O; Aref-Adib, Mehrnoosh; Magama, Zwelihle; Vlachodimitropoulou, Evangelia K; Oliver, Reeba; Odejinmi, Funlayo

    2018-01-01

    Laparoscopic myomectomy offers women many benefits over conventional open surgery, including an expedited recovery and return to employment. Our study evaluates the time taken for women to return to work after laparoscopic myomectomy and identifies factors prolonging recovery to > 8 weeks. We prospectively evaluated 94 women undergoing laparoscopic myomectomy by a single surgeon between January 2012 and March 2015. Women had standardized preoperative counseling and completed a validated return to work questionnaire 3 months postoperatively via telephone, post or in clinic. In all, 71/94 (75.5%) women completed the questionnaire. Results were analyzed comparing women who returned to work in ≤ 8 weeks [43/71 (60.6%)] with those who returned > 8 weeks postoperatively [28/71 (39.4%)]. A higher proportion of Asian and Caucasian women returned to work in ≤ 8 weeks (24/29) compared with black African and Caribbean women (19/42) (p = 0.003). Mean number of fibroids removed (2.59 and 5.75, respectively) was the only significantly differing factor between the two groups (p = 0.004). There was a significant difference in body mass index (BMI) and time to return to normal activity between the ≤ 8-week and > 8-week groups (p = 0.027, p = 0.011, respectively). Logistic regression analysis demonstrated that BMI and time to return to normal activity were the only factors prolonging recovery to > 8 weeks (p = 0.039, p = 0.015, respectively). Time to return to normal activity and BMI significantly influenced the time taken for women to work after laparoscopic myomectomy. Further data would support clinicians in counseling women appropriately and optimizing their postoperative return to employment. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  10. Effects of caffeine on the preterm brain: An observational study.

    Science.gov (United States)

    Dix, Laura M L; van Bel, Frank; Baerts, Willem; Lemmers, Petra M A

    2018-05-01

    Caffeine improves neurodevelopmental outcome of preterm infants. This study analyses the effects of caffeine on the neonatal brain. We hypothesized that caffeine has a neuroprotective effect through an increase in oxygen metabolism; reflected by increased cerebral oxygen extraction, electrical function, and perfusion. Preterm infants <32 weeks gestation (GA) receiving their primary dose caffeine-base (10 mg/kg) were included. Ten minutes of stable monitoring were selected before, during, and every hour up to 6 h after caffeine. Near-infrared spectroscopy monitored regional cerebral oxygenation (rScO 2 ) and extraction (FTOE). Amplitude-integrated electroencephalogram (aEEG) monitored minimum, mean and maximum amplitudes. Spontaneous activity transients (SAT) rate and the interval between SATs (ISI) were calculated. Mean arterial blood pressure (MABP), heart rate (HR) and arterial oxygen saturation (SaO 2 ) were monitored. Arterial pCO 2 's were collected before and 4 h after caffeine. Brain perfusion was assessed 1 h before and 3 h after caffeine by Doppler-measured resistance-index (RI), peak systolic velocity (PSV) and end-diastolic velocity (EDV), in the anterior cerebral artery (ACA) and internal carotid artery (ICA). Results were presented in mean ± SD. 34 infants, mean GA 28.8 ± 2.1 wk, were included. rScO 2 significantly decreased from 69 ± 11 to 63 ± 12 1 h after caffeine, and recovered at 6 h (66 ± 10). FTOE increased correspondingly. MABP and HR increased significantly. PSV in the ACA decreased slightly. Other Doppler variables, aEEG parameters, and SaO 2 were unaffected. Caffeine increases oxygen extraction, suggesting a (transient) stimulating effect on brain metabolism. However, no substantial changes were found in brain perfusion and in electrical brain activity. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Physical activity among hospitalized older adults - an observational study.

    Science.gov (United States)

    Evensen, Sigurd; Sletvold, Olav; Lydersen, Stian; Taraldsen, Kristin

    2017-05-16

    Low level of physical activity is common among hospitalized older adults and is associated with worse prognosis. The aim of this paper is to describe the pattern and level of physical activity in a group of hospitalized older adults and to identify factors associated with physical activity. We measured physical activity on day three after admission using accelerometer based activity monitors and time in upright position as outcome measure. We collected data of physical function (Short Physical Performance Battery, SPPB. 0-12), cognitive function (Mini Mental Status Examination, MMSE, 0-30 and diagnosis of cognitive impairment at discharge, yes/no), personal Activities of Daily Living (p-ADL, Barthel Index, BI, 0-20) and burden of disease (Cumulative Illness Rating Scale, CIRS, 0-56). We analyzed data using univariable and multivariable linear regression models, with time in upright position as dependent variable. We recorded physical activity in a consecutive sample of thirty-eight geriatric patients. Their (mean age 82.9 years, SD 6.3) mean time in upright position one day early after admission was 117.1 min (SD 90.1, n = 38). Mean SPPB score was 4.3 (SD 3.3, n = 34). Mean MMSE score was 19.3 (SD 5.3, n = 30), 73% had a diagnosis of cognitive impairment (n = 38). Mean BI score was 16.4 (SD 4.4, n = 36). Mean CIRS score was 17.0 (SD 4.2, n = 38). There was a significant association between SPPB score and time in upright position (p = 0.048): For each one unit increase in SPPB, the expected increase in upright time was 11.7 min. There was no significant association between age (p = 0.608), diagnosis of cognitive impairment (p = 0.794), p-ADL status (p = 0.127), CIRS score (p = 0.218) and time in upright position. The overall model fit was R 2 0.431. Participants' mean time in upright position one day early after admission was almost two hours, indicating a high level of physical activity compared to results from similar studies. Physical

  12. International Halley watch amateur observers' manual for scientific comet studies. Part 1: Methods

    Science.gov (United States)

    Edberg, S. J.

    1983-01-01

    The International Halley Watch is described as well as comets and observing techniques. Information on periodic Comet Halley's apparition for its 1986 perihelion passage is provided. Instructions are given for observation projects valuable to the International Halley Watch in six areas of study: (1) visual observations; (2) photography; (3) astrometry; (4) spectroscopic observations; (5) photoelectric photometry; and (6) meteor observations.

  13. Basal cortisol levels and metabolic syndrome: A systematic review and meta-analysis of observational studies.

    Science.gov (United States)

    Garcez, Anderson; Leite, Heloísa Marquardt; Weiderpass, Elisabete; Paniz, Vera Maria Vieira; Watte, Guilherme; Canuto, Raquel; Olinto, Maria Teresa Anselmo

    2018-05-17

    To perform a qualitative synthesis (systematic review) and quantitative analysis (meta-analysis) to summarize the evidence regarding the relationship between basal cortisol levels and metabolic syndrome (MetS) in adults. A systematic search was performed in the PubMed, Embase, and PsycINFO databases for observational studies on the association between basal cortisol levels and MetS. The quality of individual studies was assessed by the Newcastle-Ottawa score. A random effects model was used to report pooled quantitative results and the I 2 statistic was used to assess heterogeneity. Egger's and Begg's tests were used to evaluate publication bias. Twenty-six studies (19 cross-sectional and seven case-control) met the inclusion criteria for the systematic review. The majority was classified as having a low risk of bias and used established criteria for the diagnosis of MetS. Twenty-one studies provided data on basal cortisol levels as continuous values and were included in the meta-analysis; they comprised 35 analyses and 11,808 subjects. Pooled results showed no significant difference in basal cortisol levels between subjects with and without MetS (standardized mean difference [SMD] = 0.02, 95% confidence interval [CI]=-0.11 to 0.14). There was high heterogeneity between the studies when all comparisons were considered (I 2  = 83.1%;p meta-analysis of studies evaluating saliva samples showed no significantly lower basal cortisol levels among subjects with MetS (SMD=-0.18, 95% CI=-0.37 to 0.01), whereas those studies that evaluated serum samples (SMD = 0.11, 95% CI=-0.02 to 0.24) and urine samples (SMD = 0.73, 95% CI=-0.40 to 1.86) showed no significantly higher basal cortisol levels among subjects with MetS. In the subgroup and meta-regression analyses, a significant difference in basal cortisol levels was observed according to study design, population base, age, gender, cortisol level assessment method, and study quality. This systematic review

  14. Showing Value (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2009-06-01

    Full Text Available When Su Cleyle and I first decided to start Evidence Based Library and Information Practice, one of the things we agreed upon immediately was that the journal be open access. We knew that a major obstacle to librarians using the research literature was that they did not have access to the research literature. Although Su and I are both academic librarians who can access a wide variety of library and information literature from our institutions, we belong to a profession where not everyone has equal access to the research in our field. Without such access to our own body of literature, how can we ever hope for practitioners to use research evidence in their decision making? It would have been contradictory to the principles of evidence based library and information practice to do otherwise.One of the specific groups we thought could use such an open access venue for discovering research literature was school librarians. School librarians are often isolated and lacking access to the research literature that may help them prove to stakeholders the importance of their libraries and their role within schools. Certainly, school libraries have been in decline and the use of evidence to show value is needed. As Ken Haycock noted in his 2003 report, The Crisis in Canada’s School Libraries: The Case for Reform and Reinvestment, “Across the country, teacher-librarians are losing their jobs or being reassigned. Collections are becoming depleted owing to budget cuts. Some principals believe that in the age of the Internet and the classroom workstation, the school library is an artifact” (9. Within this context, school librarians are looking to our research literature for evidence of the impact that school library programs have on learning outcomes and student success. They are integrating that evidence into their practice, and reflecting upon what can be improved locally. They are focusing on students and showing the impact of school libraries and

  15. A Radical Sodium Reduction Policy is not Supported by Randomized Controlled Trials or Observational Studies

    DEFF Research Database (Denmark)

    Graudal, Niels

    2016-01-01

    Several health institutions recommend sodium intake be reduced to below 2,300 mg, which means that 6-7 billion individuals should alter their diet to accommodate. Such a radical recommendation should be based on solid evidence. However, this review reveals that (i) there are no randomized...... controlled trials (RCTs) allocating individuals to below 2,300 mg and measuring health outcomes; (ii) RCTs allocating risk groups such as obese prehypertensive individuals and hypertensive individuals down to (but not below) 2,300 mg show no effect of sodium reduction on all-cause mortality; (iii) RCTs...... allocating individuals to below 2,300 mg show a minimal effect on blood pressure in the healthy population (less than 1mm Hg) and significant increases in renin, aldosterone, noradrenalin cholesterol, and triglyceride; and (iv) observational studies show that sodium intakes below 2,645 and above 4,945 mg...

  16. Study on individual stochastic model of GNSS observations for precise kinematic applications

    Science.gov (United States)

    Próchniewicz, Dominik; Szpunar, Ryszard

    2015-04-01

    The proper definition of mathematical positioning model, which is defined by functional and stochastic models, is a prerequisite to obtain the optimal estimation of unknown parameters. Especially important in this definition is realistic modelling of stochastic properties of observations, which are more receiver-dependent and time-varying than deterministic relationships. This is particularly true with respect to precise kinematic applications which are characterized by weakening model strength. In this case, incorrect or simplified definition of stochastic model causes that the performance of ambiguity resolution and accuracy of position estimation can be limited. In this study we investigate the methods of describing the measurement noise of GNSS observations and its impact to derive precise kinematic positioning model. In particular stochastic modelling of individual components of the variance-covariance matrix of observation noise performed using observations from a very short baseline and laboratory GNSS signal generator, is analyzed. Experimental test results indicate that the utilizing the individual stochastic model of observations including elevation dependency and cross-correlation instead of assumption that raw measurements are independent with the same variance improves the performance of ambiguity resolution as well as rover positioning accuracy. This shows that the proposed stochastic assessment method could be a important part in complex calibration procedure of GNSS equipment.

  17. Tea consumption may decrease the risk of osteoporosis: an updated meta-analysis of observational studies.

    Science.gov (United States)

    Guo, Ming; Qu, Hua; Xu, Lin; Shi, Da-Zhuo

    2017-06-01

    Several epidemiological investigations have evaluated the correlation between tea consumption and risk of osteoporosis, but the results are inconsistent. Therefore, we conducted an updated meta-analysis of observational studies to assess this association. We searched for all relevant studies including cohort, cross-sectional, and case-control studies published from database inception to July 15, 2016, using MEDLINE EMBASE, and Cochrane Library. Polled odds ratios (ORs) were calculated using the random-effect model. Fourteen articles (16 studies) that examined 138523 patients were included in this meta-analysis. Seven studies concerning bone mineral density (BMD) showed an increase in BMD with tea consumption, including 4 cross-sectional studies (OR, 0.04, 95% confidence interval [CI], 0.01-0.08) and 3 cohort studies (OR, 0.01; 95% CI, 0.01-0.01). The remaining 9 studies concerning fracture, including 6 case-control studies and 3 cohort studies, showed no association between tea consumption and osteoporotic fracture (OR, 0.86; 95% CI, 0.74-1.01). This updated meta-analysis demonstrates that tea consumption could increase BMD, but the association with osteoporotic fracture requires further investigation. Together, the results highlight the need for future, high-quality-designed clinical trials on tea consumption and osteoporosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Correlations of Consumers, Leisure Motivation and Leisure Value with Leisure Benefits ─A Case Study on Taiwan International Orchid Show

    OpenAIRE

    Wu Yan

    2013-01-01

    This study aims to discuss the correlations of consumers’ Leisure Motivation and Leisure Value with Leisure Benefits. Leisure Motivation contains the dimensions of Intellectual Factor, Social Factor, Competence-Mastery, and Stimulus-Avoidance; and, Leisure Value covers Product Value, Service Value, and Experience Value. Visitors to Taiwan International Orchid Show are selected as the research samples for the questionnaire survey. Total 600 copies are distributed on site and 488 valid ones are...

  19. Night Shift Work and Risk of Depression: Meta-analysis of Observational Studies.

    Science.gov (United States)

    Lee, Aeyoung; Myung, Seung Kwon; Cho, Jung Jin; Jung, Yu Jin; Yoon, Jong Lull; Kim, Mee Young

    2017-07-01

    This study aimed to assess whether night shift work is associated with the risk of depression by using a meta-analysis of observational studies. We searched PubMed and EMBASE in August, 2016 to locate eligible studies and investigated the association between night shift work and the risk of depression, reporting outcome measures with adjusted odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs). In the meta-analysis of a total of 11 observational studies with 9 cross-sectional study, 1 longitudinal study, and 1 cohort study, night shift work was significantly associated with an increased risk of depression (OR/RR, 1.43; 95% CI, 1.24-1.64; I² = 78.0%). Also, subgroup meta-analyses by gender, night shift work duration, type of occupation, continent, and type of publication showed that night shift work was consistently associated with the increased risk of depression. The current meta-analysis suggests that night shift work is associated with the increased risk of depression. However, further large prospective cohort studies are needed to confirm this association. © 2017 The Korean Academy of Medical Sciences.

  20. An observational study of the initial management of hypothyroidism in France: the ORCHIDÉE study

    OpenAIRE

    Delemer, Brigitte; Aubert, Jean-Pierre; Nys, Pierre; Landron, Frédéric; Bouée, Stéphane

    2012-01-01

    Objective To document the initial management of hypothyroidism in France with respect to diagnostic setting, investigations, and therapeutic approach. Design Observational study of the management by primary care practitioners (PCPs) and endocrinologists of patients diagnosed with, and treated for, hypothyroidism during the enrollment period or the previous 6 months. Methods A representative sample of PCPs and endocrinologists enrolled up to five consecutive patients and reported sociodemograp...

  1. Boosting Memory by tDCS to Frontal or Parietal Brain Regions? A Study of the Enactment Effect Shows No Effects for Immediate and Delayed Recognition

    Directory of Open Access Journals (Sweden)

    Beat Meier

    2018-06-01

    Full Text Available Boosting memory with transcranial direct current stimulation (tDCS seems to be an elegant way to optimize learning. Here we tested whether tDCS to the left dorsolateral prefrontal cortex or to the left posterior parietal cortex would boost recognition memory in general and/or particularly for action phrases enacted at study. During study, 48 young adults either read or enacted simple action phrases. Memory for the action phrases was assessed after a retention interval of 45 min and again after 7-days to investigate the long-term consequences of brain stimulation. The results showed a robust enactment effect in both test sessions. Moreover, the decrease in performance was more pronounced for reading than for enacting the phrases at study. However, tDCS did not reveal any effect on subsequent recognition memory performance. We conclude that memory benefits of tDCS are not easily replicated. In contrast, enactment at study reliably boosts subsequent memory.

  2. Potential and limitations of multidecadal satellite soil moisture observations for selected climate model evaluation studies

    Directory of Open Access Journals (Sweden)

    A. Loew

    2013-09-01

    Full Text Available Soil moisture is an essential climate variable (ECV of major importance for land–atmosphere interactions and global hydrology. An appropriate representation of soil moisture dynamics in global climate models is therefore important. Recently, a first multidecadal, observation-based soil moisture dataset has become available that provides information on soil moisture dynamics from satellite observations (ECVSM, essential climate variable soil moisture. The present study investigates the potential and limitations of this new dataset for several applications in climate model evaluation. We compare soil moisture data from satellite observations, reanalysis and simulations from a state-of-the-art land surface model and analyze relationships between soil moisture and precipitation anomalies in the different dataset. Other potential applications like model parameter optimization or model initialization are not investigated in the present study. In a detailed regional study, we show that ECVSM is capable to capture well the interannual and intraannual soil moisture and precipitation dynamics in the Sahelian region. Current deficits of the new dataset are critically discussed and summarized at the end of the paper to provide guidance for an appropriate usage of the ECVSM dataset for climate studies.

  3. Prevalence of Recommendations Made Within Dental Research Articles Using Uncontrolled Intervention or Observational Study Designs.

    Science.gov (United States)

    Wilson, M K; Chestnutt, I G

    2016-03-01

    Evidence to inform clinical practice is reliant on research carried out using appropriate study design. The objectives of this work were to (i) identify the prevalence of articles reporting on human studies using uncontrolled intervention or observational research designs published in peer-reviewed dental journals and (ii) determine the nature of recommendations made by these articles. Six peer-reviewed dental journals were selected. Issues published in January to June 2013 were examined and the types of articles published categorized. Following pre-defined inclusion/exclusion criteria, human studies classified as using uncontrolled intervention or observational research designs were subject to detailed review by two independent investigators, to examine if they presented clinical, policy or research recommendations and if these recommendations were supported by the data presented. 52.9% (n = 156) of studies published during the time period met the inclusion criteria. Studies with uncontrolled intervention or observational research designs comprised a larger proportion of the primary research studies published in the journals with lower impact factors (73.3%; n = 107) compared to the high impact journals (38.9%; n = 49). Analysis showed that 60.9% (n = 95) of the included studies made recommendations for clinical practice/dental policy. In 28.2% (n = 44) of studies, the clinical/policy recommendations made were judged to not be fully supported by the data presented. Many studies published in the current dental literature, which are not considered to produce strong evidence, make recommendations for clinical practice or policy. There were some cases when the recommendations were not fully supported by the data presented. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Protective factors in patients aged over 65 with stroke treated by physiotherapy, showing cognitive impairment, in the Valencia Community. Protection Study in Older People (EPACV

    Directory of Open Access Journals (Sweden)

    Gil-Guillen Vicente

    2012-10-01

    Full Text Available Abstract Background Family function may have an influence on the mental health deterioration of the caregivers of dependent family members and it could have a varying importance on the care of dependents. Little attention has been paid to the preparation of minor stroke survivors for the recovery trajectory or the spouse for the caregiving role. Therefore, this study protocol intends to analyze the influence of family function on the protection of patients with stroke sequels needing physiotherapy in the family environment. Methods/Design This is an analytical observational design, prospective cohort study and using a qualitative methodology by means of data collected in the “interviews of life”. The study will be carried out by the Rehabilitation Service at Hospital of Elda in the Valencia Community. All patients that have been diagnosed with stroke and need physiotherapy treatment, having a dependency grade assigned and consent to participate in the study, will undergo a monitoring of one year in order to assess the predictive factors depending on the dependence of the people affected. Discussion Our research aims to analyze the perception of caregivers, their difficulties to work, and the influence of family function. Moreover, it aims to register the perception of the patients with stroke sequel over the care received and whether they feel protected in their family environment.

  5. Rhabdomyolysis in Ebola Virus Disease. Results of an Observational Study in a Treatment Center in Guinea.

    Science.gov (United States)

    Cournac, Jean Marie; Karkowski, Ludovic; Bordes, Julien; Aletti, Marc; Duron, Sandrine; Janvier, Frédéric; Foissaud, Vincent; Savini, Hélène; de Greslan, Thierry; Rousseau, Claire; Billhot, Magali; Gagnon, Nicolas; Mac Nab, Christine; Dubrous, Philippe; Moroge, Sophie; Broto, Helene; Cotte, Jean; Maugey, Nancy; Cordier, Pierre-Yves; Sagui, Emmanuel; Merens, Audrey; Rapp, Christophe; Quentin, Benoit; Granier, Hervé; Carmoi, Thierry; Cellarier, Gilles

    2016-01-01

    The pathogenesis of Ebola virus disease (EVD) remains unclear. The sporadic nature of Ebola outbreaks and their occurrence in resource-limited settings have precluded the acquisition of extensive clinical and laboratory data. Rhabdomyolysis during EVD has been suggested to occur in previous studies showing increased aspartate aminotransferase-alanine aminotransferase ratios, but, to date, has not been confirmed with creatine kinase (CK) assays. We performed an observational study of 38 patients admitted to an Ebola treatment center from January to April 2015. CK values from patients with confirmed EVD were compared with those in patients without confirmed EVD. A panel of other analyses were also performed. In patients with EVD, characteristics were compared between survivors and nonsurvivors. High levels of CK were more frequent in patients with EVD than in those without (P = .002), and rhabdomyolysis was more frequent (59% vs 19%, respectively; P = .03). CK levels >5000 U/L were observed in 36% of patients with EVD. Also in patients with EVD, fatal outcome was significantly associated with higher creatinine and bilirubin levels, international normalized ratio, and viral load. Rhabdomyolysis is a frequent disorder in EVD and seems to be more common than in other viral infections. It may contribute to the renal failure observed in nonsurviving patients. More studies are needed to determine the impact of rhabdomyolysis on EVD outcome. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  6. Time standards of nursing in Primary Health Care: an observational study

    Directory of Open Access Journals (Sweden)

    Daiana Bonfim

    2016-02-01

    Full Text Available Abstract OBJECTIVE To determine time standards for interventions and activities conducted by nursing professionals in Family Health Units (FHU in Brazil to substantiate the calculation of work force. METHOD This was an observational study carried out in 27 FHU, in 12 municipalities in 10 states, in 2013. In each unit, nursing professionals were observed every 10 minutes, for eight work hours, on five consecutive days via the work sampling technique. RESULTS A total of 32,613 observations were made, involving 47 nurses and 93 nursing technicians/assistants. Appointments were the main intervention carried out by nurses, with a mean time of 25.3 minutes, followed by record-keeping, which corresponded to 9.7%. On average, nursing technicians/assistants spent 6.3% of their time keeping records and 30.6 intervention minutes on immunization/vaccination control. CONCLUSION The study resulted in standard times of interventions carried out by the FHU nursing team, which can underpin the determination of nursing staff size and human resource policies. Furthermore, the study showed the panorama of interventions currently employed, allowing for the work process to be reviewed and optimized.

  7. Study of equatorial Kelvin waves using the MST radar and radiosonde observations

    Directory of Open Access Journals (Sweden)

    P. Kishore

    2005-06-01

    Full Text Available In this paper an attempt has been made to study equatorial Kelvin waves using a high power coherent VHF radar located at Gadanki (13.5° N, 79.2° E, a tropical station in the Indian sub-continent. Simultaneous radiosonde observations taken from a nearby meteorological station located in Chennai (13.04° N, 80.17° E were also used to see the coherence in the observed structures. These data sets were analyzed to study the mean winds and equatorial waves in the troposphere and lower stratosphere. Equatorial waves with different periodicities were identified. In the present study, particular attention has been given to the fast Kelvin wave (6.5-day and slow Kelvin wave (16-day. Mean zonal wind structures were similar at both locations. The fast Kelvin wave amplitudes were somewhat similar in both observations and the maximum amplitude is about 8m/s. The phase profiles indicated a slow downward progression. The slow Kelvin wave (16-day amplitudes shown by the radiosonde measurements are a little larger than the radar derived amplitudes. The phase profiles showed downward phase progression and it translates into a vertical wavelength of ~10-12km. The radar and radiosonde derived amplitudes of fast and slow Kelvin waves are larger at altitudes near the tropopause (15-17km, where the mean wind attains westward maximum.

  8. Periodontal disease and risk of chronic obstructive pulmonary disease: a meta-analysis of observational studies.

    Directory of Open Access Journals (Sweden)

    Xian-Tao Zeng

    Full Text Available BACKGROUND: Many epidemiological studies have found a positive association between periodontal disease (PD and risk of chronic obstructive pulmonary disease (COPD, but this association is varied and even contradictory among studies. We performed a meta-analysis to ascertain the relationship between PD and COPD. METHODS: PubMed and Embase database were searched up to January 10, 2012, for relevant observational studies on the association between PD and risk of COPD. Data from the studies selected were extracted and analyzed independently by two authors. The meta-analysis was performed using the Comprehensive Meta-Analysis software. RESULTS: Fourteen observational studies (one nested case-control, eight case-control, and five cross-sectional involving 3,988 COPD patients were yielded. Based on random-effects meta-analysis, a significant association between PD and COPD was identified (odds ratio = 2.08, 95% confidence interval = 1.48-2.91; P<0.001, with sensitivity analysis showing that the result was robust. Subgroups analyses according to study design, ethnicity, assessment of PD/COPD, and adjusted/unadjusted odds ratios also revealed a significant association. Publication bias was detected. CONCLUSIONS: Based on current evidence, PD is a significant and independent risk factor of COPD. However, whether a causal relationships exists remains unclear. Morever, we suggest performing randomized controlled trails to explore whether periodontal interventions are beneficial in regulating COPD pathogenesis and progression.

  9. Lower Risk of Death With SGLT2 Inhibitors in Observational Studies: Real or Bias?

    Science.gov (United States)

    Suissa, Samy

    2018-01-01

    Two recent observational studies reported a remarkably lower rate of all-cause death associated with sodium-glucose cotransporter 2 inhibitor (-SGLT2i) use in all patients with type 2 diabetes and not only those at increased cardiovascular risk. The >50% lower mortality rates reported in these studies are much greater than those found in the BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) and CANagliflozin cardioVascular Assessment Study (CANVAS) randomized trials. We show that these observational studies are affected by time-related biases, including immortal time bias and time-lag bias, which tend to exaggerate the benefits observed with a drug. The Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors (CVD-REAL) study, based on 166,033 users of SGLT2i and 1,226,221 users of other glucose-lowering drugs (oGLD) identified from health care databases of six countries, was affected by immortal time bias. Indeed, the immortal time between the first oGLD prescription and the first SGLT2i prescription was omitted from the analysis, which resulted in increasing the rate of death in the oGLD group and thus producing the appearance of a lower risk of death with SGLT2i use. The Swedish study compared 10,879 SGLT2i/dipeptidyl peptidase 4 inhibitor (DPP-4i) users with 10,879 matched insulin users. Such comparisons involving second-line therapies with a third-line therapy can introduce time-lag bias, as the patients may not be at the same stage of diabetes. This bias is compounded by the fact that the users of insulin had already started their insulin before cohort entry, unlike the new users of SGLT2i. Finally, the study also introduces immortal time bias with respect to the effects of SGLT2i relative to DPP-4i. In conclusion, the >50% lower rate of death with SGLT2i in type 2 diabetes reported by two recent observational studies is likely exaggerated by immortal time and time

  10. Histopathological studies show protective efficacy of Hippophae leaf extract against damage to jejunum in whole body 60Co-a-irradiated mice

    International Nuclear Information System (INIS)

    Gupta, Manish; Prasad, Jagdish; Madhu Bala

    2012-01-01

    Background: Ionizing radiation affect living tissue by causing majority of in vivo damage by free radical production. Earlier we reported that our preparation from Hippophae leaf offered survival benefit to >90% mice population which was whole body irradiated ( 60 Co-a-rays, 10 Gy). Objective: This study was planned to examine the protective effects of our drug (from Hippophae leaf) on ( 60 Co-a-ray induced oxidative damage and histopathological changes in jejunum. Methods: Around 2 months old adult male Strain 'A' mice were irradiated (10 Gy). Drug was administered intraperitoneally (-30 mm.). Histological parameters were studied after staining the sections with hematoxylin and eosin. Malondialdehyde formation (index of lipid peroxidation), alkaline phosphatase activity, and total thiol content were determined by biochemical techniques. The data was obtained at different time interval upto 30 days. Results: Biochemical studies showed that in comparison to the untreated controls, in the irradiated (10 Gy) mice, there was significant increase in the alkaline phosphatase activity and level of malondialdehyde whereas decrease in total thiol content within 2 days. Histological studies showed that whole body irradiation (10 Gy), damaged the jejunam crypt cells and decreased the villi height within 2 days. Intra-peritoneal administration of drug, 30 mm prior to irradiation, protected the crypt cells and villi height, countered the radiation induced increase in alkaline phosphatase activity and lipid peroxidation and values were comparable to the level of control in 30 days. Conclusions: These biochemical and histopathological studies suggested that our drug can offer effective radioprotection against the oxidative damage to jejunum in vivo. (author)

  11. Spinal Cord Stimulation (SCS) with Anatomically Guided (3D) Neural Targeting Shows Superior Chronic Axial Low Back Pain Relief Compared to Traditional SCS-LUMINA Study.

    Science.gov (United States)

    Veizi, Elias; Hayek, Salim M; North, James; Brent Chafin, T; Yearwood, Thomas L; Raso, Louis; Frey, Robert; Cairns, Kevin; Berg, Anthony; Brendel, John; Haider, Nameer; McCarty, Matthew; Vucetic, Henry; Sherman, Alden; Chen, Lilly; Mekel-Bobrov, Nitzan

    2017-08-01

    The aim of this study was to determine whether spinal cord stimulation (SCS) using 3D neural targeting provided sustained overall and low back pain relief in a broad routine clinical practice population. This was a multicenter, open-label observational study with an observational arm and retrospective analysis of a matched cohort. After IPG implantation, programming was done using a patient-specific, model-based algorithm to adjust for lead position (3D neural targeting) or previous generation software (traditional). Demographics, medical histories, SCS parameters, pain locations, pain intensities, disabilities, and safety data were collected for all patients. A total of 213 patients using 3D neural targeting were included, with a trial-to-implant ratio of 86%. Patients used seven different lead configurations, with 62% receiving 24 to 32 contacts, and a broad range of stimulation parameters utilizing a mean of 14.3 (±6.1) contacts. At 24 months postimplant, pain intensity decreased significantly from baseline (ΔNRS = 4.2, N = 169, P  pain subgroup (ΔNRS = 5.3, N = 91, P  low back pain also decreased significantly from baseline to 24 months (ΔNRS = 4.1, N = 70, P  pain responder rates of 51% (traditional SCS) and 74% (neural targeting SCS) and axial low back pain responder rates of 41% and 71% in the traditional SCS and neural targeting SCS cohorts, respectively. Lastly, complications occurred in a total of 33 of the 213 patients, with a 1.6% lead replacement rate and a 1.6% explant rate. Our results suggest that 3D neural targeting SCS and its associated hardware flexibility provide effective treatment for both chronic leg and chronic axial low back pain that is significantly superior to traditional SCS. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  12. CHEERS Results on Mrk 573: A Study of Deep Chandra Observations

    Science.gov (United States)

    Paggi, Alessandro; Wang, Junfeng; Fabbiano, Giuseppina; Elvis, Martin; Karovska, Margarita

    2012-09-01

    We present results on Mrk 573 obtained as part of the CHandra survey of Extended Emission-line Regions in nearby Seyfert galaxies (CHEERS). Previous studies showed that this source features a biconical emission in the soft X-ray band closely related to the narrow-line region as mapped by the [O III] emission line and the radio emission, though on a smaller scale; we investigate the properties of soft X-ray emission from this source with new deep Chandra observations. Making use of the subpixel resolution of the Chandra/ACIS image and point-spread function deconvolution, we resolve and study substructures in each ionizing cone. The two cone spectra are fitted with a photoionization model, showing a mildly photoionized phase diffused over the bicone. Thermal collisional gas at about ~1.1 keV and ~0.8 keV appears to be located between the nucleus and the "knots" resolved in radio observations, and between the "arcs" resolved in the optical images, respectively; this can be interpreted in terms of shock interaction with the host galactic plane. The nucleus shows a significant flux decrease across the observations indicating variability of the active galactic nucleus (AGN), with the nuclear region featuring a higher ionization parameter with respect to the bicone region. The long exposure allows us to find extended emission up to ~7 kpc from the nucleus along the bicone axis. Significant emission is also detected in the direction perpendicular to the ionizing cones, disagreeing with the fully obscuring torus prescribed in the AGN unified model and suggesting instead the presence of a clumpy structure.

  13. Cerebellar nuclei neurons show only small excitatory responses to optogenetic olivary stimulation in transgenic mice: in vivo and in vitro studies

    Directory of Open Access Journals (Sweden)

    Huo eLu

    2016-03-01

    Full Text Available To study the olivary input to the cerebellar nuclei (CN we used optogenetic stimulation in transgenic mice expressing channelrhodopsin-2 (ChR2 in olivary neurons. We obtained in vivo extracellular Purkinje cell (PC and CN recordings in anesthetized mice while stimulating the contralateral inferior olive (IO with a blue laser (single pulse, 10 - 50 ms duration. Peri-stimulus histograms were constructed to show the spike rate changes after optical stimulation. Among 29 CN neurons recorded, 15 showed a decrease in spike rate of variable strength and duration, and only 1 showed a transient spiking response. These results suggest that direct olivary input to CN neurons is usually overridden by stronger Purkinje cell inhibition triggered by climbing fiber responses. To further investigate the direct input from the climbing fiber collaterals we also conducted whole cell recordings in brain slices, where we used local stimulation with blue light. Due to the expression of ChR2 in Purkinje cell axons as well as the IO in our transgenic line, strong inhibitory responses could be readily triggered with optical stimulation (13 of 15 neurons. After blocking this inhibition with GABAzine, only in 5 of 13 CN neurons weak excitatory responses were revealed. Therefore our in vitro results support the in vivo findings that the excitatory input to CN neurons from climbing fiber collaterals in adult mice is masked by the inhibition under normal conditions.

  14. Evaluating learning and attitudes on tissue engineering: a study of children viewing animated digital dome shows detailing the biomedicine of tissue engineering.

    Science.gov (United States)

    Wilson, Anna C; Gonzalez, Laura L; Pollock, John A

    2012-03-01

    Informal science education creates opportunities for the general public to learn about complex health and science topics. Tissue engineering is a fast-growing field of medical science that combines advanced chemistries to create synthetic scaffolds, stem cells, and growth factors that individually or in combination can support the bodies own healing powers to remedy a range of maladies. Health literacy about this topic is increasingly important as our population ages and as treatments become more technologically advanced. We are using a science center planetarium as a projection space to engage and educate the public about the science and biomedical research that supports tissue engineering. The purpose of this study was to test the effectiveness of the films that we have produced for part of the science center planetarium demographic, specifically children ranging in age from 7 to 16 years. A two-group pre- and post-test design was used to compare children's learning and attitude changes in response to the two versions of the film. One version uses traditional voice-over narration; the other version uses dialog between two animated characters. The results of this study indicate that children demonstrated increases in knowledge of the topic with either film format, but preferred the animated character version. The percentage change in children's scores on the knowledge questions given before and after viewing the show exhibited an improvement from 23% correct to 61% correct on average. In addition, many of the things that the children reported liking were part of the design process of the art-science collaboration. Other results indicated that before viewing the shows 77% of the children had not even heard about tissue engineering and only 17% indicated that they were very interested in it, whereas after viewing the shows, 95% indicated that tissue engineering was a good idea. We also find that after viewing the show, 71% of the children reported that the show made

  15. Meta-GWAS Accuracy and Power (MetaGAP Calculator Shows that Hiding Heritability Is Partially Due to Imperfect Genetic Correlations across Studies.

    Directory of Open Access Journals (Sweden)

    Ronald de Vlaming

    2017-01-01

    Full Text Available Large-scale genome-wide association results are typically obtained from a fixed-effects meta-analysis of GWAS summary statistics from multiple studies spanning different regions and/or time periods. This approach averages the estimated effects of genetic variants across studies. In case genetic effects are heterogeneous across studies, the statistical power of a GWAS and the predictive accuracy of polygenic scores are attenuated, contributing to the so-called 'missing heritability'. Here, we describe the online Meta-GWAS Accuracy and Power (MetaGAP calculator (available at www.devlaming.eu which quantifies this attenuation based on a novel multi-study framework. By means of simulation studies, we show that under a wide range of genetic architectures, the statistical power and predictive accuracy provided by this calculator are accurate. We compare the predictions from the MetaGAP calculator with actual results obtained in the GWAS literature. Specifically, we use genomic-relatedness-matrix restricted maximum likelihood to estimate the SNP heritability and cross-study genetic correlation of height, BMI, years of education, and self-rated health in three large samples. These estimates are used as input parameters for the MetaGAP calculator. Results from the calculator suggest that cross-study heterogeneity has led to attenuation of statistical power and predictive accuracy in recent large-scale GWAS efforts on these traits (e.g., for years of education, we estimate a relative loss of 51-62% in the number of genome-wide significant loci and a relative loss in polygenic score R2 of 36-38%. Hence, cross-study heterogeneity contributes to the missing heritability.

  16. Long-Time Exposure to Violent Video Games Does Not Show Desensitization on Empathy for Pain: An fMRI Study.

    Science.gov (United States)

    Gao, Xuemei; Pan, Wei; Li, Chao; Weng, Lei; Yao, Mengyun; Chen, Antao

    2017-01-01

    As a typical form of empathy, empathy for pain refers to the perception and appraisal of others' pain, as well as the corresponding affective responses. Numerous studies investigated the factors affecting the empathy for pain, in which the exposure to violent video games (VVGs) could change players' empathic responses to painful situations. However, it remains unclear whether exposure to VVG influences the empathy for pain. In the present study, in terms of the exposure experience to VVG, two groups of participants (18 in VVG group, VG; 17 in non-VVG group, NG) were screened from nearly 200 video game experience questionnaires. And then, the functional magnetic resonance imaging data were recorded when they were viewing painful and non-painful stimuli. The results showed that the perception of others' pain were not significantly different in brain regions between groups, from which we could infer that the desensitization effect of VVGs was overrated.

  17. Long-Time Exposure to Violent Video Games Does Not Show Desensitization on Empathy for Pain: An fMRI Study

    Directory of Open Access Journals (Sweden)

    Xuemei Gao

    2017-05-01

    Full Text Available As a typical form of empathy, empathy for pain refers to the perception and appraisal of others’ pain, as well as the corresponding affective responses. Numerous studies investigated the factors affecting the empathy for pain, in which the exposure to violent video games (VVGs could change players’ empathic responses to painful situations. However, it remains unclear whether exposure to VVG influences the empathy for pain. In the present study, in terms of the exposure experience to VVG, two groups of participants (18 in VVG group, VG; 17 in non-VVG group, NG were screened from nearly 200 video game experience questionnaires. And then, the functional magnetic resonance imaging data were recorded when they were viewing painful and non-painful stimuli. The results showed that the perception of others’ pain were not significantly different in brain regions between groups, from which we could infer that the desensitization effect of VVGs was overrated.

  18. Long-Time Exposure to Violent Video Games Does Not Show Desensitization on Empathy for Pain: An fMRI Study

    Science.gov (United States)

    Gao, Xuemei; Pan, Wei; Li, Chao; Weng, Lei; Yao, Mengyun; Chen, Antao

    2017-01-01

    As a typical form of empathy, empathy for pain refers to the perception and appraisal of others’ pain, as well as the corresponding affective responses. Numerous studies investigated the factors affecting the empathy for pain, in which the exposure to violent video games (VVGs) could change players’ empathic responses to painful situations. However, it remains unclear whether exposure to VVG influences the empathy for pain. In the present study, in terms of the exposure experience to VVG, two groups of participants (18 in VVG group, VG; 17 in non-VVG group, NG) were screened from nearly 200 video game experience questionnaires. And then, the functional magnetic resonance imaging data were recorded when they were viewing painful and non-painful stimuli. The results showed that the perception of others’ pain were not significantly different in brain regions between groups, from which we could infer that the desensitization effect of VVGs was overrated. PMID:28512439

  19. Analyzing on Reality TV Show in the Perspective of Performance Study%电视真人秀节目的表演学解读

    Institute of Scientific and Technical Information of China (English)

    李绍元

    2012-01-01

    表演学为电视真人秀提供了一种新的研究视野和研究路径。在真人秀节目的表演学解读中,可以将自我呈现作为逻辑前设,把自我实现作为目标诉求,考察节目选手、主持、评委、观众、电视媒体乃至政府等主体的行为。分析真人秀表演的自我呈现、规范向度、审美旨趣和中介化问题。在这个意义上说,电视真人秀其实是一种表演范式,它既是一种审美表演(舞台表演),也是一种社会表演,还是一种媒介表演。%Performance study provides a new research field of vision and research path to the reality TV show. If we discuss reality TV show according to performance study,we will acquire the presentation of self as the logical presupposition,will set self-fulfillment as a target appeal,analyze the behavior of the players, the judges, the audience, the TV media and the government officials etc.,and research the presentation of self presentation, the standard dimension, the aesthetic objective and the mediated problems. In this sense, the reality TV show is actually a kind of performance model, which is not only a kind of aesthetic performance (stage performance), but also a kind social performance and media performance.

  20. Ionospheric and satellite observations for studying the dynamic behavior of typhoons and the detection of severe storms and tsunamis

    Science.gov (United States)

    Hung, R. J.; Smith, R. E.

    1978-01-01

    Atmospheric acoustic-gravity waves associated with severe thunderstorms, tornadoes, typhoons (hurricanes) and tsunamis can be studied through the coupling between the ionosphere and the troposphere. Reverse ray tracing computations of acoustic-gravity waves observed by an ionospheric Doppler sounder array show that wave sources are in the nearby storm systems and that the waves are excited prior to the storms. Results show that ionospheric observations, together with satellite observations, can contribute to the understanding of the dynamical behavior of typhoons, severe storms and tsunamis.

  1. Scintigraphy in the diagnosis of liver cancers. Study of 54 observations with anatomical confrontation

    International Nuclear Information System (INIS)

    Labro, R.D.A.

    1976-01-01

    This study attempts to judge the reliability of scintigraphy in the diagnosis of liver cancers. It concerns 54 observations with anatomical confrontation (laparoscopy, biopsy, laparotomy and/or autopsy). Technetium 99m scintigraphy gives a correct diagnosis in 81.5% of the cases, whether cirrhosis is present or not. Scintigraphy is only one stage in the investigation of neoplasic liver disease. This study shows that all too often it is practised alone since of 201 observations only 54 include another examination, and of these only 21 a laparoscopy. The simultaneous use of scintigraphy and laparoscopy eliminates false positives and reduces the percentage of false negatives from 7.5% to 4%. The two methods combined are therefore reliable to 96% (i.e. 96% of successful diagnosis in liver cancer tests. This work was performed with the techniques available in 1973. The quality of the scintigraphic image should be improved by technical progress in the form of new isotopic products, cameras with better definition and computerized data processing. With these new techniques it will certainly be possible to detect very small lacunae and to observe in more detail their diffusion in the liver parenchyma [fr

  2. 'Then I just showed her my arms . . .' Bodily sensations in moments of alienation related to self-injurious behaviour. A hermeneutic phenomenological study.

    Science.gov (United States)

    Schoppmann, S; Schröck, R; Schnepp, W; Büscher, A

    2007-09-01

    People committing self-injurious behaviour are often perceived as difficult patients; confronted with unhelpful reactions from nurses, the patients find themselves left alone in their distress. A connection between self-injurious behaviour and feelings of alienation is suggested in the literature. Alienation is described as a state in which the self is perceived as strange, machinelike and not in contact with its emotional and physical needs. On one hand, complex neuro-biological processes are seen as responsible for this; on the other hand, alienation is seen as a means of self-protection when one is exposed to a threatening or traumatic situation. Nursing interventions focus on the nurse-patient relationship and on the handling of self-injuries, but they tend to ignore the client's previous experience. Proceeding from the assumption that patients committing self-injurious behaviour are the experts on their own harm, the purpose of the present study is to get insight into their 'lived experience' and to contribute to the understanding of this vulnerable group. Adopting a hermeneutic phenomenological research perspective, methods of participant observation and qualitative interviewing were chosen to generate data. The database consists of 99 observational sequences, five interviews and a set of email texts written by a self-injuring woman. A thematic analysis as described by Van Manen was done. The main findings are that alienation is experienced in several stages, that nurses can detect early signs of an impending loss of control, and that self-injurious behaviour is an effective strategy to end a painful experience of alienation. Self-injurious behaviour is appropriately understood as a form of 'self-care'.

  3. Fast and slow readers of the Hebrew language show divergence in brain response ∼200 ms post stimulus: an ERP study.

    Directory of Open Access Journals (Sweden)

    Sebastian Peter Korinth

    Full Text Available Higher N170 amplitudes to words and to faces were recently reported for faster readers of German. Since the shallow German orthography allows phonological recoding of single letters, the reported speed advantages might have their origin in especially well-developed visual processing skills of faster readers. In contrast to German, adult readers of Hebrew are forced to process letter chunks up to whole words. This dependence on more complex visual processing might have created ceiling effects for this skill. Therefore, the current study examined whether also in the deep Hebrew orthography visual processing skills as reflected by N170 amplitudes explain reading speed differences. Forty university students, native speakers of Hebrew without reading impairments, accomplished a lexical decision task (i.e., deciding whether a visually presented stimulus represents a real or a pseudo word and a face decision task (i.e., deciding whether a face was presented complete or with missing facial features while their electroencephalogram was recorded from 64 scalp positions. In both tasks stronger event related potentials (ERPs were observed for faster readers in time windows at about 200 ms. Unlike in previous studies, ERP waveforms in relevant time windows did not correspond to N170 scalp topographies. The results support the notion of visual processing ability as an orthography independent marker of reading proficiency, which advances our understanding about regular and impaired reading development.

  4. A multievent study of broadband electrons observed by the DMSP satellites and their relation to red aurora observed at midlatitude stations

    International Nuclear Information System (INIS)

    Shiokawa, K.; Meng, C.; Reeves, G.D.; Rich, F.J.; Yumoto, K.

    1997-01-01

    Broadband electrons during magnetic storms are characterized by an unusually intense flux of precipitating electrons in the broadband energy range from 30 eV to 30 keV near the equatorward edge of the auroral oval (47 degree endash 66 degree magnetic latitude). Broadband electrons were first reported by Shiokawa et al. [1996]. In this paper, we report a multievent study of broadband electrons, using particle data obtained by the Defense Meteorological Satellite Program (DMSP) satellites during 23 magnetic storms from January 1989 through May 1992. Twelve broadband electron events are identified. Most of them are observed in the night sector, but some are observed in the morning sector. Particle data for successive polar passes of the DMSP multisatellites are used to show that broadband electrons generally last for less than 30 min and that for some events, they precipitate over a wide range of local times simultaneously. On the basis of a quantitative calculation of optical emissions from electrons in the neutral atmosphere, we conclude that broadband electrons are a possible cause of red auroras observed at midlatitude ground stations. We suggest that broadband electrons are associated with certain substorms during the main phase of magnetic storms. This conjecture comes from observations of H component positive bays and Pi 2 pulsations observed at low-latitude magnetic stations and from magnetic field variations observed at geosynchronous satellites. We conclude that the magnetospheric source of broadband electrons lies within the inner part of the plasma sheet. This conclusion is based on the facts that broadband electrons appear in latitudes where plasma sheet particles were observed before the event and that broadband electrons are observed poleward of the subauroral ion drifts, a position that corresponds to the inner edge of the injected particle layer during storms. (Abstract Truncated)

  5. Show what you know and deal with stress yourself: a qualitative interview study of medical interns' perceptions of stress and gender.

    Science.gov (United States)

    Verdonk, Petra; Räntzsch, Viktoria; de Vries, Remko; Houkes, Inge

    2014-05-17

    Medical students report high stress levels and in particular, the clinical phase is a demanding one. The field of medicine is still described as having a patriarchal culture which favors aspects like a physicians' perceived certainty and rationalism. Also, the Effort-Recovery Model explains stress as coming from a discrepancy between job demands, job control, and perceived work potential. Gendered differences in stress are reported, but not much is known about medical interns' perceptions of how gender plays in relation to stress. The aim of this study is to explore how medical interns experience and cope with stress, as well as how they reflect on the gendered aspects of stress. In order to do this, we have performed a qualitative study. In 2010-2011, semi-structured qualitative interviews were conducted with seventeen medical interns across all three years of the Masters programme (6 male, 11 female) at a Dutch medical school. The interview guide is based on gender theory, the Effort-Recovery Model, and empirical literature. Transcribed interviews have been analyzed thematically. First, stress mainly evolves from having to prove one's self and show off competencies and motivation ("Show What You Know…"). Second, interns seek own solutions for handling stress because it is not open for discussion (… "And Deal With Stress Yourself"). Patient encounters are a source of pride and satisfaction rather than a source of stress. But interns report having to present themselves as 'professional and self-confident', remaining silent about experiencing stress. Female students are perceived to have more stress and to study harder in order to live up to expectations. The implicit message interns hear is to remain silent about insecurities and stress, and, in particular, female students might face disadvantages. Students who feel less able to manifest the 'masculine protest' may benefit from a culture that embraces more collaborative styles, such as having open conversation

  6. Study of medium-scale traveling ionospheric disturbances (MSTID) with sounding rockets and ground observations

    Science.gov (United States)

    Yamamoto, Mamoru; Abe, Takumi; Kumamoto, Atsushi; Yokoyama, Tatsuhiro; Bernhardt, Paul; Watanabe, Shigeto; Yamamoto, Masa-yuki; Larsen, Miguel; Saito, Susumu; Tsugawa, Takuya; Ishisaka, Keigo; Iwagami, Naomoto; Nishioka, Michi; Kato, Tomohiro; Takahashi, Takao; Tanaka, Makoto; Mr

    Medium-scale traveling ionospheric disturbance (MSTID) is an interesting phenomenon in the F-region. The MSTID is frequent in summer nighttime over Japan, showing wave structures with wavelengths of 100-200 km, periodicity of about 1 hour, and propagation toward the southwest. The phenomena are observed by the total electron content (TEC) from GEONET, Japanese dense network of GPS receivers, and 630 nm airglow imagers as horizontal pattern. It was also measured as Spread-F events of ionograms or as field-aligned echoes of the MU radar. MSTID was, in the past, explained by Perkins instability (Perkins, 1973) while its low growth rate was a problem. Recently 3D simulation study by Yokoyama et al (2009) hypothesized a generation mechanism of the MSTID, which stands on electromagnetic E/F-region coupling of the ionosphere. The hypothesis is that the MSTID first grows with polarization electric fields from sporadic-E, then show spatial structures resembling to the Perkins instability. We recently conducted a observation campaign to check this hypothesis. We launched JASA ISAS sounding rockets S-310-42 and S-520-27 at 23:00 JST and 23:57JST on July 20, 2013 while an MSTID event was monitored in real-time by the GPS-TEC from GEONET. We found 1-5mV/m northeastward/eastward electric fields during the flight. Variation of electric fileds were associated with horizontal distribution of plasma density. Wind velocity was measured by the TME and Lithium releases from S-310-42 and S-520-27 rockets, respectively, showing southward wind near the sporadic-E layer heights. These results are consistent to the expected generation mechanism shown above. In the presentation we will discuss electric-field results and its relationship with plasma density variability together with preliminary results from the neutral-wind observations.

  7. The New Worlds Observer: An Optimal Path to Direct Study of Earth-like Planets

    Science.gov (United States)

    Cash, Webster C., Jr.; New Worlds Study Team

    2009-01-01

    Direct detection and spectroscopic study of the planets around the nearby stars is generally recognized as a prime goal of astronomy. The New Worlds Observer mission concept is being studied as an Astrophysics Strategic Mission Concept Study for this purpose. NWO features two spacecraft: a general purpose 4m telescope that operates from the UV to the Near IR, and a starshade, a flower-shaped occulter about 50m in diameter flying in alignment about 70,000km away. Our study shows this is the most effective way to map nearby planetary systems. In this poster we will show that NWO can return much more science than any of the competing approaches at any given price point. Images will show dust and debris down to a fraction of our zodiacal light level. Planets fainter than the Earth can be seen from the Habitable Zone outward, at distances up to 20pc. High throughput and low noise enable immediate follow-up spectroscopy of discovered planets. NWO can discover many more Earth-like planets than all competing approaches including astrometric, interferometric, and internal coronagraphic. Within hours of discovery, a high quality spectrum can determine the true nature of the exoplanet and open the search for biomarkers and life. Over half of the time will be spent with the starshade in transit to the next target. During those times the telescope will be available to for general astrophysics purposes. Operating from the ultraviolet to the near infrared, this will be a true HST follow-on. The study shows all needed technologies already exist. The cost scales primarily with telescope size. The mission is definitely within the financial and technical reach of NASA for the coming decade.

  8. Comparative Study Showing The Application Of Three Dimensional Oct And Ffa Correlation After Combined Bevacizumab/Laser And Triamcinolone/Laser In The Management Of Diabetic Macular Edema

    International Nuclear Information System (INIS)

    Helal, N.; Afahmoud, A.F.; Eliwa, T.F.; Omar, O.A.A.

    2012-01-01

    Purpose: to compare combined therapy by intravitreal triamicinolone acetonide and laser versus intravitreal bevacizumab and laser by three dimensional OCT in the management of diabetic macular edema regarding, the efficacy, duration of action, side effects, and complications of both regimens. Patients and methods: 40 eyes of 32 patients with type II diabetes mellitus, with clinically significant macular edema were enrolled into the study. They were divided equally into two groups, the first group was treated with intravitreal triamicinolone acetonide (4 mg/0.1 ml) followed 6 weeks later by focal Laser and the other group was treated by intravitreal bevacizumab (1.25 mg) followed 4 weeks later by focal Laser. Complete ophthalmological examination including BCVA, OCT and FFA were done preoperative and postoperative at 1, 3, 6, and 9 months. Results: the IVTA/Laser group showed an earlier improvement of BCVA by one line at the 3 month visit (p value 0.025 <0.05), compared to the IVA/Laser group that showed this change to be statistically significant at the 6 month visit (p value 0.048) with a one line improvement in BCVA. Regarding CMT and decrease of CMT than IVA/Laser although in both groups the improvement was transient, and relapses in both parameters occurred. There was a high incidence of cataract and steroid induced glaucoma in susceptible subjects in the IVTA/laser group than the IVA/Laser group. IVA/Laser may have a detrimental effect on FAZ integrity, and progression of the stage of diabetic retinopathy. Regarding mean change in CMT the IVTA/Laser has a stronger effect in reducing CMT, which is statistically significant at three months (p value <0.05). On the other hand IVA/Laser group, statistically significant change in mean CMT was at 1 month. Mean change in CMT between the 2 groups was not statistically significant throughout the study, although IVTA/Laser had a more powerful effect on the metric reduction of CMT, this difference was transient in both

  9. A comparative study of kalman filtering based observer and sliding mode observer for state of charge estimation

    Science.gov (United States)

    Ben Sassi, Hicham; Errahimi, Fatima; Es-Sbai, Najia; Alaoui, Chakib

    2018-05-01

    Nowadays, electric mobility is starting to define society and is becoming more and more irreplaceable and essential to daily activities. Safe and durable battery is of a great significance for this type of mobility, hence the increasing interest of research activity oriented to battery studies, in order to assure safe operating mode and to control the battery in case of any abnormal functioning conditions that could damage the battery if not properly managed. Lithium-ion technology is considered the most suitable existing technology for electrical storage, because of their interesting features such as their relatively long cycle life, lighter weight, their high energy density, However, there is a lot of work that is still needed to be done in order to assure safe operating lithium-ion batteries, starting with their internal status monitoring, cell balancing within a battery pack, and thermal management. Tasks that are accomplished by the battery management system (BMS) which uses the state of charge (SOC) as an indicator of the internal charge level of the battery, in order to avoid unpredicted system interruption. Since the state of charge is an inner state of a the battery which cannot be directly measured, a powerful estimation technique is inevitable, in this paper we investigate the performances of tow estimation strategies; kalman filtering based observers and sliding mode observers, both strategies are compared in terms of accuracy, design requirement, and overall performances.

  10. [Association between chronic periodontitis and hyperlipidemia: a Meta-analysis based on observational studies].

    Science.gov (United States)

    Lianhui, Yang; Meifei, Lian; Zhongyue, Hu; Yunzhi, Feng

    2017-08-01

    Objective The aim of this study is to evaluate the relationship between periodontitis and hyperlipidemia risks through Meta-analysis. Methods Two researchers conducted an electronic search on PubMed, Cochrane Library, Embase, CBM, CNKI, Wanfang and VIP databases established until July 2016 for observational studies on the association between periodontitis and hyperlipidemia. The language used was limited to Chinese and English. After data extraction and quality evaluation of included trials, Meta-analysis was conducted using the RevMan 5.3 software. The GRADE 3.6 software was used to evaluate the quality level of the evidence. Results Six case-control studies and one cohort study were included. The results of Meta-analysis showed that serum triglyceride (TG) in patients with periodontitis was significantly higher than that of the periodontal health group (MD=50.50, 95% confidence interval=39.57-61.42, Pchronic periodontitis were 4.73 times (OR=4.73, 95% confidence interval=2.74-8.17, Pperiodontal healthy patients. No significant difference was observed between the group with high-density lipoprotein cholesterol (HDL-C) and that with low density lipoprotein cholesterol (LDL-C). Conclusion Current evidence indicates that a correlation exists between chronic periodontitis and hyperlipidemia, and chronic periodontitis is an independent risk factor for hyperlipidemia, especially for TC and TG in serum.

  11. Meta-analysis of diffusion tensor imaging (DTI) studies shows altered fractional anisotropy occurring in distinct brain areas in association with depression

    LENUS (Irish Health Repository)

    Murphy, Melissa L

    2011-09-27

    Abstract Fractional anisotropy anomalies occurring in the white matter tracts in the brains of depressed patients may reflect microstructural changes underlying the pathophysiology of this disorder. We conducted a meta-analysis of fractional anisotropy abnormalities occurring in major depressive disorder using voxel-based diffusion tensor imaging studies. Using the Embase, PubMed and Google Scholar databases, 89 relevant data sets were identified, of which 7 (including 188 patients with major depressive disorder and 221 healthy controls) met our inclusion criteria. Authors were contacted to retrieve any additional data required. Coordinates were extracted from clusters of significant white matter fractional anisotropy differences between patients and controls. Relevant demographic, clinical and methodological variables were extracted from each study or obtained directly from authors. The meta-analysis was carried out using Signed Differential Mapping. Patients with depression showed decreased white matter fractional anisotropy values in the superior longitudinal fasciculus and increased fractional anisotropy values in the fronto-occipital fasciculus compared to controls. Using quartile and jackknife sensitivity analysis, we found that reduced fractional anisotropy in the left superior longitudinal fasciculus was very stable, with increases in the right fronto-occipital fasciculus driven by just one study. In conclusion, our meta-analysis revealed a significant reduction in fractional anisotropy values in the left superior longitudinal fasciculus, which may ultimately play an important role in the pathology of depression.

  12. Meta-analysis of diffusion tensor imaging studies shows altered fractional anisotropy occurring in distinct brain areas in association with depression.

    LENUS (Irish Health Repository)

    Murphy, Melissa L

    2011-09-01

    Fractional anisotropy anomalies occurring in the white matter tracts in the brains of depressed patients may reflect microstructural changes underlying the pathophysiology of this disorder. We conducted a meta-analysis of fractional anisotropy abnormalities occurring in major depressive disorder using voxel-based diffusion tensor imaging studies. Using the Embase, PubMed and Google Scholar databases, 89 relevant data sets were identified, of which 7 (including 188 patients with major depressive disorder and 221 healthy controls) met our inclusion criteria. Authors were contacted to retrieve any additional data required. Coordinates were extracted from clusters of significant white matter fractional anisotropy differences between patients and controls. Relevant demographic, clinical and methodological variables were extracted from each study or obtained directly from authors. The meta-analysis was carried out using Signed Differential Mapping. Patients with depression showed decreased white matter fractional anisotropy values in the superior longitudinal fasciculus and increased fractional anisotropy values in the fronto-occipital fasciculus compared to controls. Using quartile and jackknife sensitivity analysis, we found that reduced fractional anisotropy in the left superior longitudinal fasciculus was very stable, with increases in the right fronto-occipital fasciculus driven by just one study. In conclusion, our meta-analysis revealed a significant reduction in fractional anisotropy values in the left superior longitudinal fasciculus, which may ultimately play an important role in the pathology of depression.

  13. An observational study based on the interaction between the paediatric patient and radiographer

    International Nuclear Information System (INIS)

    Harding, J.; Davis, M.

    2015-01-01

    Background: The practice of paediatric radiography requires a completely different skill set to that of adult radiography. Often, obtaining a paediatric patient's cooperation is the most difficult aspect of the role. Ensuring that a child cooperates for the examination can make positioning easier, thereby potentially providing a more diagnostic image. Aim: The aim of this study was to observe the interaction between the paediatric patient and the radiographer and to uncover techniques used by the radiographer to help alleviate any fear or stress that the child might have had. Method: A direct observational method was conducted, after both the radiographer and the child's guardians provided full written consent. The actions of the radiographer and resultant reactions from the child were recorded on an observational checklist designed for paediatric examinations. Results: Seventy-nine patients aged between three months to fifteen years and thirteen radiographers with no specific paediatric training other than experience were observed. Examinations observed included lower limb, upper limb, pelvis, abdomen and chest projections. The data gathered were the result of radiographer actions when interacting with both happy and sad children. Conclusions: Successful methods of alleviating a child's fear and anxiety whilst in the X-ray room included the use of child friendly equipment such as colourful lead protection and posters on the wall, a simple explanation of what the equipment is before moving it, offering rewards such as stickers and praise and showing the child their image after the examination. When time was short and the workload was high, it was observed that radiographers were less likely to spend time calming the child down and instead were more focused on completing the examination as quickly as possible. - Highlights: • Seventy-nine patients and thirteen radiographers were observed in this study. • The use of child-friendly equipment and

  14. Task Equivalence for Model and Human-Observer Comparisons in SPECT Localization Studies

    Science.gov (United States)

    Sen, Anando; Kalantari, Faraz; Gifford, Howard C.

    2016-06-01

    While mathematical model observers are intended for efficient assessment of medical imaging systems, their findings should be relevant for human observers as the primary clinical end users. We have investigated whether pursuing equivalence between the model and human-observer tasks can help ensure this goal. A localization receiver operating characteristic (LROC) study tested prostate lesion detection in simulated In-111 SPECT imaging with anthropomorphic phantoms. The test images were 2D slices extracted from reconstructed volumes. The iterative ordered sets expectation-maximization (OSEM) reconstruction algorithm was used with Gaussian postsmoothing. Variations in the number of iterations and the level of postfiltering defined the test strategies in the study. Human-observer performance was compared with that of a visual-search (VS) observer, a scanning channelized Hotelling observer, and a scanning channelized nonprewhitening (CNPW) observer. These model observers were applied with precise information about the target regions of interest (ROIs). ROI knowledge was a study variable for the human observers. In one study format, the humans read the SPECT image alone. With a dual-modality format, the SPECT image was presented alongside an anatomical image slice extracted from the density map of the phantom. Performance was scored by area under the LROC curve. The human observers performed significantly better with the dual-modality format, and correlation with the model observers was also improved. Given the human-observer data from the SPECT study format, the Pearson correlation coefficients for the model observers were 0.58 (VS), -0.12 (CH), and -0.23 (CNPW). The respective coefficients based on the human-observer data from the dual-modality study were 0.72, 0.27, and -0.11. These results point towards the continued development of the VS observer for enhancing task equivalence in model-observer studies.

  15. What components of chronic care organisation relate to better primary care for coronary heart disease patients? An observational study.

    NARCIS (Netherlands)

    Lieshout, J. van; Frigola Capell, E.; Ludt, S.; Grol, R.P.T.M.; Wensing, M.J.P.

    2012-01-01

    OBJECTIVES: Cardiovascular risk management (CVRM) received by patients shows large variation across countries. In this study we explored the aspects of primary care organisation associated with key components of CVRM in coronary heart disease (CHD) patients. DESIGN: Observational study. SETTING: 273

  16. An observational study of the initial management of hypothyroidism in France: the ORCHIDÉE study

    Science.gov (United States)

    Delemer, Brigitte; Aubert, Jean-Pierre; Nys, Pierre; Landron, Frédéric; Bouée, Stéphane

    2012-01-01

    Objective To document the initial management of hypothyroidism in France with respect to diagnostic setting, investigations, and therapeutic approach. Design Observational study of the management by primary care practitioners (PCPs) and endocrinologists of patients diagnosed with, and treated for, hypothyroidism during the enrollment period or the previous 6 months. Methods A representative sample of PCPs and endocrinologists enrolled up to five consecutive patients and reported sociodemographic, clinical, therapeutic, and laboratory data. Data were submitted at baseline and at the first measurement of TSH after starting the treatment. Results The analysis population comprised 1255 patients (mean (s.d.) age 52.8 (16.3) years; 84% female). Hypothyroidism was suspected on clinical grounds in 77% of patients, with goiter in 16%. Autoimmune thyroiditis, supported by positive anti-thyroid antibodies, was the most frequent diagnosis (59%), followed by iatrogenic causes (28%), of which thyroidectomy was the most common. The median baseline TSH was 8.6 mIU/l, suggesting a high incidence of subclinical hypothyroidism. Imaging studies were requested in over 75% of patients, with ultrasound performed in 98% and scintigraphy performed in 19% of these patients. Both groups of physicians treated their patients almost exclusively with levothyroxine. Endocrinologists were more likely than PCPs to provide counseling on how to take medication correctly. Conclusions This observational study of a large cohort of patients with newly diagnosed hypothyroidism in France illustrates current practice and indicates some areas where physician education may be required to optimize adherence to guidelines and cost-effectiveness. PMID:23034782

  17. Variability of linezolid concentrations after standard dosing in critically ill patients: a prospective observational study

    Science.gov (United States)

    2014-01-01

    Introduction Severe infections in intensive care patients show high morbidity and mortality rates. Linezolid is an antimicrobial drug frequently used in critically ill patients. Recent data indicates that there might be high variability of linezolid serum concentrations in intensive care patients receiving standard doses. This study was aimed to evaluate whether standard dosing of linezolid leads to therapeutic serum concentrations in critically ill patients. Methods In this prospective observational study, 30 critically ill adult patients with suspected infections received standard dosing of 600 mg linezolid intravenously twice a day. Over 4 days, multiple serum samples were obtained from each patient, in order to determine the linezolid concentrations by liquid chromatography tandem mass spectrometry. Results A high variability of serum linezolid concentrations was observed (range of area under the linezolid concentration time curve over 24 hours (AUC24) 50.1 to 453.9 mg/L, median 143.3 mg*h/L; range of trough concentrations (Cmin) linezolid concentrations over 24 hours and at single time points (defined according to the literature as AUC24  400 mg*h/L and Cmin > 10 mg/L) were observed for 7 of the patients. Conclusions A high variability of linezolid serum concentrations with a substantial percentage of potentially subtherapeutic levels was observed in intensive care patients. The findings suggest that therapeutic drug monitoring of linezolid might be helpful for adequate dosing of linezolid in critically ill patients. Trial registration Clinicaltrials.gov NCT01793012. Registered 24 January 2013. PMID:25011656

  18. Study of Application for Excursion Observation Method in Primary School 2nd Grade Social Studies

    Directory of Open Access Journals (Sweden)

    Ahmet Ali GAZEL

    2014-04-01

    Full Text Available This study aims to investigate how field trips are conducted at 2nd grade of primary schools as a part of social studies course. Data for this research is compiled from 143 permanent Social Studies teachers working throughout 2011–2012 Education Year in the primary schools of central Kütahya and its districts. Data is compiled by using descriptive search model. In the research, after taking expert opinions, a measuring tool developed by the researcher is used. Data obtained from the research were transferred to computer, and analyses were made. In the analysis of the data, frequency and percentage values have been used to determine the distribution. Also a single factor variance analysis and t-test for independent samples have been used to determine the significance of difference between the variables. As a result of the research, it has been realized that insufficient importance is given to field trip method in Social Studies lessons. Most of the teachers using this method apply it in spring months. Teachers usually make use of field trips independent from unit/topic to increase the students’ motivation, and they generally use verbal expression in the class after tours. The biggest difficulty teachers encounter while using tour-observation method is the students’ undisciplined behavior.

  19. Serum Folate Shows an Inverse Association with Blood Pressure in a Cohort of Chinese Women of Childbearing Age: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Minxue Shen

    Full Text Available It has been reported that higher folate intake from food and supplementation is associated with decreased blood pressure (BP. The association between serum folate concentration and BP has been examined in few studies. We aim to examine the association between serum folate and BP levels in a cohort of young Chinese women.We used the baseline data from a pre-conception cohort of women of childbearing age in Liuyang, China, for this study. Demographic data were collected by structured interview. Serum folate concentration was measured by immunoassay, and homocysteine, blood glucose, triglyceride and total cholesterol were measured through standardized clinical procedures. Multiple linear regression and principal component regression model were applied in the analysis.A total of 1,532 healthy normotensive non-pregnant women were included in the final analysis. The mean concentration of serum folate was 7.5 ± 5.4 nmol/L and 55% of the women presented with folate deficiency (< 6.8 nmol/L. Multiple linear regression and principal component regression showed that serum folate levels were inversely associated with systolic and diastolic BP, after adjusting for demographic, anthropometric, and biochemical factors.Serum folate is inversely associated with BP in non-pregnant women of childbearing age with high prevalence of folate deficiency.

  20. Show what you know and deal with stress yourself: a qualitative interview study of medical interns’ perceptions of stress and gender

    Science.gov (United States)

    2014-01-01

    Background Medical students report high stress levels and in particular, the clinical phase is a demanding one. The field of medicine is still described as having a patriarchal culture which favors aspects like a physicians’ perceived certainty and rationalism. Also, the Effort-Recovery Model explains stress as coming from a discrepancy between job demands, job control, and perceived work potential. Gendered differences in stress are reported, but not much is known about medical interns’ perceptions of how gender plays in relation to stress. The aim of this study is to explore how medical interns experience and cope with stress, as well as how they reflect on the gendered aspects of stress. Methods In order to do this, we have performed a qualitative study. In 2010–2011, semi-structured qualitative interviews were conducted with seventeen medical interns across all three years of the Masters programme (6 male, 11 female) at a Dutch medical school. The interview guide is based on gender theory, the Effort-Recovery Model, and empirical literature. Transcribed interviews have been analyzed thematically. Results First, stress mainly evolves from having to prove one’s self and show off competencies and motivation (“Show What You Know…”). Second, interns seek own solutions for handling stress because it is not open for discussion (… “And Deal With Stress Yourself”). Patient encounters are a source of pride and satisfaction rather than a source of stress. But interns report having to present themselves as ‘professional and self-confident’, remaining silent about experiencing stress. Female students are perceived to have more stress and to study harder in order to live up to expectations. Conclusions The implicit message interns hear is to remain silent about insecurities and stress, and, in particular, female students might face disadvantages. Students who feel less able to manifest the ‘masculine protest’ may benefit from a culture that

  1. Use of Head Guards in AIBA Boxing Tournaments-A Cross-Sectional Observational Study.

    Science.gov (United States)

    Loosemore, Michael P; Butler, Charles F; Khadri, Abdelhamid; McDonagh, David; Patel, Vimal A; Bailes, Julian E

    2017-01-01

    This study looks at the changes in injuries after the implementation of a new rule by the International Boxing Association (AIBA) to remove head guards from its competitions. A cross-sectional observational study performed prospectively. This brief report examines the removal of head guards in 2 different ways. The first was to examine the stoppages due to blows to the head by comparing World Series Boxing (WSB), without head guards, to other AIBA competitions with head guards. Secondly, we examined the last 3 world championships: 2009 and 2011 (with head guards) and 2013 (without head guards). World Series Boxing and AIBA world championship boxing. Boxers from WSB and AIBA world championships. The information was recorded by ringside medical physicians. Stoppages per 10 000 rounds; stoppages per 1000 hours. Both studies show that the number of stoppages due to head blows was significantly decreased without head guards. The studies also showed that there was a notable increase in cuts. Removing head guards may reduce the already small risk of acute brain injury in amateur boxing.

  2. Study of ionospheric disturbances over the China mid- and low-latitude region with GPS observations

    Science.gov (United States)

    Ning, Yafei; Tang, Jun

    2018-01-01

    Ionospheric disturbances constitute the main restriction factor for precise positioning techniques based on global positioning system (GPS) measurements. Simultaneously, GPS observations are widely used to determine ionospheric disturbances with total electron content (TEC). In this paper, we present an analysis of ionospheric disturbances over China mid- and low-latitude area before and during the magnetic storm on 17 March 2015. The work analyses the variation of magnetic indices, the amplitude of ionospheric irregularities observed with four arrays of GPS stations and the influence of geomagnetic storm on GPS positioning. The results show that significant ionospheric TEC disturbances occurred between 10:30 and 12:00 UT during the main phase of the large storm, and the static position reliability for this period are little affected by these disturbances. It is observed that the positive and negative disturbances propagate southward along the meridian from mid-latitude to low-latitude regions. The propagation velocity is from about 200 to 700 m s-1 and the amplitude of ionospheric disturbances is from about 0.2 to 0.9 TECU min-1. Moreover, the position dilution of precession (PDOP) with static precise point positioning (PPP) on storm and quiet days is 1.8 and 0.9 cm, respectively. This study is based on the analysis of ionospheric variability with differential rate of vertical TEC (DROVT) and impact of ionospheric storm on positioning with technique of GPS PPP.

  3. Building Alliances with (In)Voluntary Clients: A Study Focused on Therapists' Observable Behaviors.

    Science.gov (United States)

    Sotero, Luciana; Cunha, Diana; da Silva, José Tomás; Escudero, Valentín; Relvas, Ana Paula

    2017-12-01

    This study aimed to compare therapists' observable behaviors to promote alliances with involuntary and voluntary clients during brief family therapy. The therapists' contributions to fostering alliances were rated in sessions 1 and 4 using videotapes of 29 families who were observed in brief therapy. Using the System for Observing Family Therapy Alliances, trained raters searched for specific therapist behaviors that contributed to or detracted from the four alliance dimensions: engagement in the therapeutic process, an emotional connection with the therapist, safety within the therapeutic system, and a shared sense of purpose within the family. The results showed that when working with involuntary clients, therapists presented more behaviors to foster the clients' engagement and to promote a shared sense of purpose within the family. However, in the fourth session, the therapists in both groups contributed to the alliance in similar ways. The results are discussed in terms of (a) the therapists' alliance-building behaviors, (b) the specificities of each client group, and (c) the implications for clinical practice, training, and research. © 2016 Family Process Institute.

  4. Order effect in a study on US voters’ preferences: quantum framework representation of the observables

    International Nuclear Information System (INIS)

    Khrennikova, Polina

    2014-01-01

    The US political system in the recent years has been mainly formed by a Divided Government, which is regarded as a consequence of ‘non-separability’ of voters’ preferences. The non- separability phenomenon emerges as a result of strong correlations that the voters establish between their preferences for the Congress and the White House contests. We investigate with help of the empirical data from the Smith et al (1999 J. Polit. Sci. 43 737–764) study what implications the upcoming information (encoded in the observables- questions) has on the non- separability emergence. We show that the informational context of the questions alters the preference frequencies that cannot be captured in a classical probabilistic framework. We attribute the changes to the incompatibility of observables C and P, which correspond to questions being asked. We embed our data in a quantum framework and model the voters’ mental state evolution as it is impacted by the operators, to show the non-commutativity of the transition probabilities as a result of the question order effect. (paper)

  5. Evaluation of team lifting on work demands, workload and workers' evaluation: an observational field study.

    Science.gov (United States)

    Visser, Steven; van der Molen, Henk F; Kuijer, P Paul F M; Hoozemans, Marco J M; Frings-Dresen, Monique H W

    2014-11-01

    The objective of this study was to assess differences in work demands, energetic workload and workers' discomfort and physical effort in two regularly observable workdays in ironwork; one where loads up to 50kg were handled with two persons manually (T50) and one where loads up to 100kg were handled manually with four persons (T100). Differences between these typical workdays were assessed with an observational within-subject field study of 10 ironworkers. No significant differences were found for work demands, energetic workload or discomfort between T50 and T100 workdays. During team lifts, load mass exceeded 25kg per person in 57% (T50 workday) and 68% (T100 workday) of the lifts. Seven ironworkers rated team lifting with two persons as less physically demanding compared with lifting with four persons. When loads heavier than 25kg are lifted manually with a team, regulations of the maximum mass weight are frequently violated. Loads heavier than 25kg are frequently lifted during concrete reinforcement work and should be lifted by a team of persons. However, the field study showed that loads above 25kg are most of the time not lifted with the appropriate number of workers. Therefore, loads heavier than 25kg should be lifted mechanically. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  6. Wound healing in pre-tibial injuries--an observation study.

    Science.gov (United States)

    McClelland, Heather M; Stephenson, John; Ousey, Karen J; Gillibrand, Warren P; Underwood, Paul

    2012-06-01

    Pre-tibial lacerations are complex wounds affecting a primarily aged population, with poor healing and a potentially significant impact on social well-being. Management of these wounds has changed little in 20 years, despite significant advances in wound care. A retrospective observational study was undertaken to observe current wound care practice and to assess the effect of various medical factors on wound healing time on 24 elderly patients throughout their wound journey. Wound length was found to be substantively and significantly associated with wound healing time, with a reduction in instantaneous healing rate of about 30% for every increase of 1 cm in wound length. Hence, longer wounds are associated with longer wound healing times. Prescription of several categories of drugs, including those for ischaemic heart disease (IHD), hypertension, respiratory disease or asthma; and the age of the patient were not significantly associated with wound healing times, although substantive significance could be inferred in the case of prescription for IHD and asthma. Despite the small sample size, this study identified a clear association between healing and length of wound. Neither the comorbidities nor prescriptions explored showed any significant association although some seem to be more prevalent in this patient group. The study also highlighted other issues that require further exploration including the social and economic impact of these wounds. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  7. Effectiveness of Vildagliptin in Clinical Practice: Pooled Analysis of Three Korean Observational Studies (the VICTORY Study

    Directory of Open Access Journals (Sweden)

    Sunghwan Suh

    2017-01-01

    Full Text Available The present observational study aimed to evaluate the clinical effectiveness of vildagliptin with metformin in Korean patients with type 2 diabetes mellitus (T2DM. Data were pooled from the vildagliptin postmarketing survey (PMS, the vildagliptin/metformin fixed drug combination (DC PMS, and a retrospective observational study of vildagliptin/metformin (fixed DC or free DC. The effectiveness endpoint was the proportion of patients who achieved a glycemic target (HbA1c of ≤7.0% at 24 weeks. In total, 4303 patients were included in the analysis; of these, 2087 patients were eligible. The mean patient age was 56.99 ± 11.25 years. Overall, 58.94% patients achieved an HbA1c target of ≤7.0% at 24 weeks. The glycemic target achievement rate was significantly greater in patients with baseline HbA1c < 7.5% versus ≥7.5% (84.64% versus 43.97%, receiving care at the hospital versus clinic (67.95% versus 52.33%, and receiving vildagliptin/metformin fixed DC versus free DC (70.69% versus 55.42%. Multivariate logistic regression analysis indicated that disease duration (P<0.0001, baseline HbA1c (P<0.0001, and DC type (P=0.0103 had significant effects on drug effectiveness. Vildagliptin plus metformin appeared as an effective treatment option for patients with T2DM in clinical practice settings in Korea.

  8. The New Worlds Observer: Direct Detection and Study of Exoplanets from the Habitable Zone Outward

    Science.gov (United States)

    Cash, Webster C.; New Worlds Study Team

    2009-01-01

    Direct detection and spectroscopic study of the planets around the nearby stars is generally recognized as a prime goal of astronomy. The New Worlds Observer mission concept is being studied as an Astrophysics Strategic Mission Concept Study for this purpose. NWO features two spacecraft: a general purpose 4m telescope that operates from the UV to the Near IR, and a starshade, a flower-shaped occulter about 50m in diameter flying in alignment about 70,000km away. Our study shows this is the most effective way to map nearby planetary systems. Images will show dust and debris down to a fraction of our zodiacal light level. Planets fainter than the Earth can be seen from the Habitable Zone outward, at distances up to 20pc. High throughput and low noise enable immediate follow-up spectroscopy of discovered planets. NWO can discover many more Earth-like planets than all competing approaches including astrometric, interferometric, and internal coronagraphic. Within hours of discovery, a high quality spectrum can determine the true nature of the exoplanet and open the search for biomarkers and life. Over half of the time will be spent with the starshade in transit to the next target. During those times the telescope will be available to for general astrophysics purposes. Operating from the ultraviolet to the near infrared, this will be a true HST follow-on. The study shows all needed technologies already exist. The cost scales primarily with telescope size. The mission is definitely within the financial and technical reach of NASA for the coming decade.

  9. A human intervention study with foods containing natural Ah-receptor agonists does not significantly show AhR-mediated effects as measured in blood cells and urine.

    Science.gov (United States)

    de Waard, Pim W J; Peijnenburg, Ad A C M; Baykus, Hakan; Aarts, Jac M M J G; Hoogenboom, Ron L A P; van Schooten, Frederik J; de Kok, Theo M C M

    2008-10-22

    Binding and activation of the aryl hydrocarbon receptor (AhR) is thought to be an essential step in the toxicity of the environmental pollutants dioxins and dioxin-like PCBs. However, also a number of natural compounds, referred to as NAhRAs (natural Ah-receptor agonists), which are present in, for example, fruits and vegetables, can bind and activate this receptor. To study their potential effects in humans, we first investigated the effect of the prototypical AhR agonist 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on gene expression in ex vivo exposed freshly isolated human lymphocytes, and compared the resulting gene expression profile with those caused by the well-known NAhRA indolo[3,2-b]carbazole (ICZ), originating from cruciferous vegetables, and by a hexane extract of NAhRA-containing grapefruit juice (GJE). Only ICZ induced a gene expression profile similar to TCDD in the lymphocytes, and both significantly up-regulated CYP1B1 and TIPARP (TCDD-inducible poly (ADP-ribose) polymerase) mRNA. Next, we performed a human intervention study with NAhRA-containing cruciferous vegetables and grapefruit juice. The expression of the prototypical AhR-responsive genes CYP1A1, CYP1B1 and NQO1 in whole blood cells and in freshly isolated lymphocytes was not significantly affected. Also enzyme activities of CYP1A2, CYP2A6, N-acetyltransferase 2 (NAT2) and xanthine oxidase (XO), as judged by caffeine metabolites in urine, were unaffected, except for a small down-regulation of NAT2 activity by grapefruit juice. Examination of blood plasma with DR CALUX showed a 12% increased AhR agonist activity 3 and 24 h after consumption of cruciferous vegetables, but did not show a significant effect of grapefruit juice consumption. We conclude that intake of NAhRAs from food may result in minor AhR-related effects measurable in human blood and urine.

  10. TRACING MOLECULAR GAS MASS IN EXTREME EXTRAGALACTIC ENVIRONMENTS: AN OBSERVATIONAL STUDY

    International Nuclear Information System (INIS)

    Zhu Ming; Papadopoulos, Padeli P.; Xilouris, Emmanuel M.; Kuno, Nario; Lisenfeld, Ute

    2009-01-01

    We present a new observational study of the 12 CO(1-0) line emission as an H 2 gas mass tracer under extreme conditions in extragalactic environments. Our approach is to study the full neutral interstellar medium (H 2 , H I, and dust) of two galaxies whose bulk interstellar medium (ISM) resides in environments that mark (and bracket) the excitation extremes of the ISM conditions found in infrared luminous galaxies, the starburst NGC 3310, and the quiescent spiral NGC 157. Our study maintains a robust statistical notion of the so-called X = N(H 2 )/I CO factor (i.e., a large ensemble of clouds is involved) while exploring its dependence on the very different average ISM conditions prevailing within these two systems. These are constrained by fully sampled 12 CO(3-2) and 12 CO(1-0) observations, at a matched beam resolution of half-power beam width ∼15'', obtained with the James Clerk Maxwell Telescope (JCMT) on Mauna Kea (Hawaii) and the 45 m telescope of the Nobeyama Radio Observatory in Japan, combined with sensitive 850 μm and 450 μm dust emission and H I interferometric images which allow a complete view of all the neutral ISM components. Complementary 12 CO(2-1) observations were obtained with the JCMT toward the center of the two galaxies. We found an X factor varying by a factor of 5 within the spiral galaxy NGC 157 and about two times lower than the Galactic value in NGC 3310. In addition, the dust emission spectrum in NGC 3310 shows a pronounced submillimeter 'excess'. We tried to fit this excess by a cold dust component but very low temperatures were required (T C ∼ 5-11 K) with a correspondingly low gas-to-dust mass ratio of ∼5-43. We furthermore show that it is not possible to maintain the large quantities of dust required at these low temperatures in this starburst galaxy. Instead, we conclude that the dust properties need to be different from Galactic dust in order to fit the submillimeter 'excess'. We show that the dust spectral energy

  11. The severe thunderstorm of 4 October 2007 in Mallorca: an observational study

    Directory of Open Access Journals (Sweden)

    C. Ramis

    2009-07-01

    Full Text Available During the afternoon of 4 October 2007, a thunderstorm swept across the Island of Mallorca from southwest to northeast. Strong straight-line winds (up to 30 m/s and heavy rain (rates up to 100 mm/h were registered accompanying the storm. Tornadoes with an estimated intensity of F2–F3 developed nearby the city of Palma, severely affecting industrial installations. One person was killed by the impact of heavy debris while more than 10 million € in damages were attributed to the event in the industrial area only. The observed evolution of temperature, humidity, wind and pressure, as well as the sequence of radar images, reveal that a squall line was initially organized over the sea and then moved north-eastwards at an estimated speed of around 80 km/h. This paper presents an analysis of the event from an observational point of view. The aim of the study is to contribute to the characterization of these rare events in the Western Mediterranean by analyzing the observational information available for this particular extreme event. The diagnosis is aimed at helping forecasters to identify this kind of organized deep convective events and being able to issue timely warnings. The synoptic scenario shows warm and moist advection at low levels over Balearics and an upper-level trough over mainland Spain. This situation is known to be prone to deep convection in Mediterranean Spain in autumn. Radiosonde ascents from Murcia and Palma show convective instability at mid levels that can conduce to develop convection if appropriate ascents occur. A plausible lifting mechanism to trigger convection is attributed to large amplitude gravity waves, registered as short-period pressure oscillations by surface barographs.

  12. Agomelatine in the treatment of depressive disorders in clinical practice: multicenter observational CHRONOS study

    Directory of Open Access Journals (Sweden)

    Ivanov SV

    2014-04-01

    Full Text Available Stanislav V Ivanov, Marina A Samushiya Department of “Borderline” Mental Pathology and Psychosomatic Disorders, Mental Health Research Center of the Russian Academy of Medical Science, Moscow, Russian Federation Background: CHRONOS was a large naturalistic study designed to evaluate the effectiveness and safety of agomelatine in the management of patients with major depression in routine clinical practice. Methods: Patients (n=6,276 with a moderate or severe major depressive episode without psychotic symptoms were treated initially as outpatients (80.2% or in psychiatric facilities (19.8% in 54 regions of the Russian Federation. Patients received a flexible-dosing regimen of agomelatine 25 mg or 50 mg once daily for 8 weeks, with frequent study visits (weeks 1, 2, 3, 4, 6, and 8. Results: Patients (mean age 44 years, 72.6% female showed progressive improvement on the 17-item Hamilton Rating Scale for Depression (HAMD-17 total score from 22±6.9 at baseline to 4.7±4.7 at week 8 (P<0.0001. The proportion of responders (HAMD-17 decrease of ≥50% was 90.1% and the proportion of remitters (HAMD-17 <7 was 79.1% at week 8. All individual HAMD-17 item scores improved rapidly, and the change relative to baseline was significant (P<0.0001 at week 1 and at each subsequent visit in all cases. There were corresponding rapid improvements in Clinical Global Impression Severity and Improvement scores. In the subgroup of patients with more severe illness (HAMD-17 ≥21 at baseline; n=3,478, the proportions of responders and remitters were 92.4% and 72.8%, respectively, at week 8. Conclusion: Agomelatine was effective and well tolerated in a large sample of depressed patients in an observational treatment setting, and showed a rapid onset of benefit across all HAMD-17 items. Keywords: agomelatine, antidepressant, Hamilton Rating Scale for Depression, major depressive disorder, observational study

  13. Admission interview scores are associated with clinical performance in an undergraduate physiotherapy course: an observational study.

    Science.gov (United States)

    Edgar, Susan; Mercer, Annette; Hamer, Peter

    2014-12-01

    The purpose of this study was to determine if there is an association between admission interview score and subsequent academic and clinical performance, in a four-year undergraduate physiotherapy course. Retrospective observational study. 141 physiotherapy students enrolled in two entry year groups. Individual student performance in all course units, practical examinations, clinical placements as well as year level and overall Grade Point Average. Predictor variables included admission interview scores, admission academic scores and demographic data (gender, age and entry level). Interview score demonstrated a significant association with performance in three of six clinical placements through the course. This association was stronger than for any other admission criterion although effect sizes were small to moderate. Further, it was the only admission score to have a significant association with overall Clinical Grade Point Average for the two year groups analysed (r=0.322). By contrast, academic scores on entry showed significant associations with all year level Grade Point Averages except Year 4, the clinical year. This is the first study to review the predictive validity of an admission interview for entry into a physiotherapy course in Australia. The results show that performance in this admission interview is associated with overall performance in clinical placements through the course, while academic admission scoring is not. These findings suggest that there is a role for both academic and non-academic selection processes for entry into physiotherapy. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  14. Risk Aversion in Game Shows

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten I.

    2008-01-01

    We review the use of behavior from television game shows to infer risk attitudes. These shows provide evidence when contestants are making decisions over very large stakes, and in a replicated, structured way. Inferences are generally confounded by the subjective assessment of skill in some games......, and the dynamic nature of the task in most games. We consider the game shows Card Sharks, Jeopardy!, Lingo, and finally Deal Or No Deal. We provide a detailed case study of the analyses of Deal Or No Deal, since it is suitable for inference about risk attitudes and has attracted considerable attention....

  15. Does Jatropha curcas L. show resistance to drought in the Sahelian zone of West Africa? A case study from Burkina Faso

    Science.gov (United States)

    Bayen, P.; Sop, T. K.; Lykke, A. M.; Thiombiano, A.

    2015-05-01

    Land degradation is an environmental problem which weakens agro-sylvo-pastoral productivity in sub-Saharan Africa. The most common manifestation of land degradation is the appearance of denuded land. We carried out an experiment to test the effect of three soil and water conservation techniques on survival and growth of Jatropha curcas seedlings transplanted onto two completely denuded lands in the Sahelian and Sudanian zones of Burkina Faso. We implemented an experimental design with three replicates per restoration technique. A total of 174 seedlings were planted in each study site. The results showed that the soil water content varied according to the restoration technique used (df = 2; F = 53.21; p curcas is unsuited to denuded land in the Sahelian zone. Most of the plants died in the Sahel between April and May, which is the peak of the dry season; this may be an indication that J. curcas may not be as drought-resistant as suggested by the prolific literature which has reported on diverse claims surrounding this plant.

  16. Observational studies in systematic [corrected] reviews of comparative effectiveness: AHRQ and the Effective Health Care Program.

    Science.gov (United States)

    Norris, Susan L; Atkins, David; Bruening, Wendy; Fox, Steven; Johnson, Eric; Kane, Robert; Morton, Sally C; Oremus, Mark; Ospina, Maria; Randhawa, Gurvaneet; Schoelles, Karen; Shekelle, Paul; Viswanathan, Meera

    2011-11-01

    Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews (CERs). The conceptual model and recommendations were developed using a consensus process by members of the methods workgroup of the Effective Health Care Program of the Agency for Healthcare Research and Quality. In considering whether to use observational studies in CERs for addressing beneficial effects, reviewers should answer two questions: (1) Are there gaps in the evidence from randomized controlled trials (RCTs)? (2) Will observational studies provide valid and useful information? The latter question involves the following: (a) refocusing the study questions on gaps in the evidence from RCTs, (b) assessing the risk of bias of the body of evidence of observational studies, and (c) assessing whether available observational studies address the gap review questions. Because it is unusual to find sufficient evidence from RCTs to answer all key questions concerning benefit or the balance of benefits and harms, comparative effectiveness reviewers should routinely assess the appropriateness of inclusion of observational studies for questions of benefit. Furthermore, reviewers should explicitly state the rationale for inclusion or exclusion of observational studies when conducting CERs. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Increased healing in diabetic toe ulcers in a multidisciplinary foot clinic-An observational cohort study.

    Science.gov (United States)

    Almdal, T; Nielsen, A Anker; Nielsen, K E; Jørgensen, M E; Rasmussen, A; Hangaard, S; Siersma, V; Holstein, P E

    2015-12-01

    To study toe ulcer healing in patients with diabetic foot ulcers attending a multidisciplinary foot clinic over a 10 years period. The study was retrospective, consecutive and observational during 2001 through 2011. The patients were treated according to the International Consensus on the Diabetic Foot. During the period the chiropodist staffing in the foot clinic was doubled; new offloading material and orthopedic foot corrections for recalcitrant ulcers were introduced. Healing was investigated in toe ulcers in Cox regression models. 2634 patients developed foot ulcers, of which 1461 developed toe ulcers; in 790 patients these were neuropathic, in 551 they were neuro-ischemic and in 120 they were critically ischemic. One-year healing rates increased in the period 2001-2011 from 75% to 91% for neuropathic toe ulcers and from 72% to 80% for neuro-ischemic toe ulcers, while no changes was observed for ischemic toe ulcers. Adjusted for changes in the patient population, the overall rate of healing for neuropathic and neuro-ischemic toe ulcers almost doubled (HR=1.95 [95% CI: 1.36-2.80]). The results show that the healing of toe ulcers improved. This outcome could not be explained by changes in the patient characteristics, but coincided with a number of improvements in organization and therapy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Dental Calculus Links Statistically to Angina Pectoris: 26-Year Observational Study.

    Science.gov (United States)

    Söder, Birgitta; Meurman, Jukka H; Söder, Per-Östen

    2016-01-01

    Dental infections, such as periodontitis, associate with atherosclerosis and its complications. We studied a cohort followed-up since 1985 for incidence of angina pectoris with the hypothesis that calculus accumulation, proxy for poor oral hygiene, links to this symptom. In our Swedish prospective cohort study of 1676 randomly selected subjects followed-up for 26 years. In 1985 all subjects underwent clinical oral examination and answered a questionnaire assessing background variables such as socio-economic status and pack-years of smoking. By using data from the Center of Epidemiology, Swedish National Board of Health and Welfare, Sweden we analyzed the association of oral health parameters with the prevalence of in-hospital verified angina pectoris classified according to the WHO International Classification of Diseases, using descriptive statistics and logistic regression analysis. Of the 1676 subjects, 51 (28 women/23 men) had been diagnosed with angina pectoris at a mean age of 59.8 ± 2.9 years. No difference was observed in age and gender between patients with angina pectoris and subjects without. Neither was there any difference in education level and smoking habits (in pack years), Gingival index and Plaque index between the groups. Angina pectoris patients had significantly more often their first maxillary molar tooth extracted (d. 16) than the other subjects (p = 0.02). Patients also showed significantly higher dental calculus index values than the subjects without angina pectoris (p = 0.01). Multiple regression analysis showed odds ratio 2.21 (95% confidence interval 1.17-4.17) in the association between high calculus index and angina pectoris (p = 0.015). Our study hypothesis was confirmed by showing for the first time that high dental calculus score indeed associated with the incidence of angina pectoris in this cohort study.

  19. Informing potential participants about research: observational study with an embedded randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Helen M Kirkby

    Full Text Available OBJECTIVES: To assess: 1 the feasibility of electronic information provision; 2 gather evidence on the topics and level of detail of information potential research participant's accessed; 3 to assess satisfaction and understanding. DESIGN: Observational study with an embedded randomised controlled trial. SETTING: Low risk intervention study based in primary care. PARTICIPANTS: White British & Irish, South Asian and African-Caribbean subjects aged between 40-74 years eligible for a blood pressure monitoring study. INTERVENTIONS: PDF copy of the standard paper participant information sheet (PDF-PIS and an electronic Interactive Information Sheet (IIS where participants could choose both the type and level of detail accessed. MAIN OUTCOME MEASURES: 1 Proportion of participants providing an email address and accessing electronic information 2 Willingness to participate in a recruitment clinic. 3 Type and depth of information accessed on the IIS. 4 Participant satisfaction and understanding. RESULTS: 1160 participants were eligible for the study. Of these, 276 (24% provided an active email address, of whom 84 did not respond to the email. 106 responded to the email but chose not to access any electronic information and were therefore ineligible for randomisation. 42 were randomised to receive the PDF-PIS and 44 to receive the IIS (with consent rates of 48% and 36%, respectively; odds ratio 0.6, 95% confidence interval 0.25 to 1.4. Electronic observation of information accessed by potential participants showed 41% chose to access no information and only 9% accessed the detail presented on the Research Ethics Committee approved participant information sheet before booking to attend a recruitment clinic for the intervention study. 63 of the 106 participants (59% who chose not to access any electronic information also booked an appointment. CONCLUSIONS: Current written information about research may not be read, emphasising the importance of the consent

  20. A study of solar preflare activity using two-dimensional radio and SMM-XRP observations

    Science.gov (United States)

    Kundu, M. R.; Gopalswamy, N.; Saba, J. L. R.; Schmelz, J. T. S.; Strong, K. T.

    1987-01-01

    A study of type III activity at meter-decameter wavelengths in the preflare phase of the February 3, 1986 flare is presented, using data obtained with the Clark Lake Multifrequency Radioheliograph. This activity is compared with similar type III burst activity during the impulsive phase, and it is found that there is a displacement of burst sources between the onset and end times of the activity. A comparison of this displacement at three frequencies suggests that the type III emitting electrons gain access progressively to diverging and different field lines relative to the initial field lines. The energetics of the type III emitting electrons are inferred from observations and compared with those of the associated hard X-ray emitting electrons. The soft X-ray data from SMM-XRP show enhanced emission measure, density, and temperature in the region associated with the preflare type III activity.

  1. [Smoking in the hospitality sector: an observational study in Barcelona (Spain), 2008].

    Science.gov (United States)

    Villalbí, Joan R; Baranda, Lucía; López, M José; Nebot, Manel

    2010-01-01

    To describe the actual presence of smoking in restaurant and hospitality premises after the smoking prevention act banning smoking in workplaces came into force in 2006, with wide exemptions in this sector. We performed an observational, descriptive study in Barcelona (Catalonia, Spain) in 2008 based on cluster sampling, with 1130 premises. The results were stratified by premise type. Up to 85.7% of food shops allowing consumption within their premises (bakeries, pastry shops...) ban smoking, as well as 85% of fast food establishments. Among restaurants, 40% are smoke-free or have separate smoking areas. Bar-cafés and café-restaurants (the most abundant premises) usually allow smoking. There are more smoke-free options in central districts and in shopping malls. Up to 75.4% of all premises allow smoking freely. These results show the limitations of the law. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. Excess mortality associated with hypopituitarism in adults: a meta-analysis of observational studies.

    Science.gov (United States)

    Pappachan, Joseph M; Raskauskiene, Diana; Kutty, V Raman; Clayton, Richard N

    2015-04-01

    Several previous observational studies showed an association between hypopituitarism and excess mortality. Reports on reduction of standard mortality ratio (SMR) with GH replacement have been published recently. This meta-analysis assessed studies reporting SMR to clarify mortality risk in hypopituitary adults and also the potential benefit conferred by GH replacement. A literature search was performed in Medline, Embase, and Cochrane library up to March 31, 2014. Studies with or without GH replacement reporting SMR with 95% confidence intervals (95% CI) were included. Patient characteristics, SMR data, and treatment outcomes were independently assessed by two authors, and with consensus from third author, studies were selected for analysis. Meta-analysis was performed in all studies together, and those without and with GH replacement separately, using the statistical package metafor in R. Six studies reporting a total of 19 153 hypopituiatary adults with a follow-up duration of more than 99,000 person years were analyzed. Hypopituitarism was associated with an overall excess mortality (weighted SMR, 1.99; 95% CI, 1.21-2.76) in adults. Female hypopituitary adults showed higher SMR compared with males (2.53 vs 1.71). Onset of hypopituitarism at a younger age was associated with higher SMR. GH replacement improved the mortality risk in hypopituitary adults that is comparable to the background population (SMR with GH replacement, 1.15; 95% CI, 1.05-1.24 vs SMR without GH, 2.40; 95% CI, 1.46-3.34). GH replacement conferred lower mortality benefit in hypopituitary women compared with men (SMR, 1.57; 95% CI, 1.38-1.77 vs 0.95; 95% CI, 0.85-1.06). There was a potential selection bias of benefit of GH replacement from a post-marketing data necessitating further evidence from long-term randomized controlled trials. Hypopituitarism may increase premature mortality in adults. Mortality benefit from GH replacement in hypopituitarism is less pronounced in women than men.

  3. Anodal Transcranial Direct Current Stimulation Shows Minimal, Measure-Specific Effects on Dynamic Postural Control in Young and Older Adults: A Double Blind, Sham-Controlled Study.

    Science.gov (United States)

    Craig, Chesney E; Doumas, Michail

    2017-01-01

    We investigated whether stimulating the cerebellum and primary motor cortex (M1) using transcranial direct current stimulation (tDCS) could affect postural control in young and older adults. tDCS was employed using a double-blind, sham-controlled design, in which young (aged 18-35) and older adults (aged 65+) were assessed over three sessions, one for each stimulatory condition-M1, cerebellar and sham. The effect of tDCS on postural control was assessed using a sway-referencing paradigm, which induced platform rotations in proportion to the participant's body sway, thus assessing sensory reweighting processes. Task difficulty was manipulated so that young adults experienced a support surface that was twice as compliant as that of older adults, in order to minimise baseline age differences in postural sway. Effects of tDCS on postural control were assessed during, immediately after and 30 minutes after tDCS. Additionally, the effect of tDCS on corticospinal excitability was measured by evaluating motor evoked potentials using transcranial magnetic stimulation immediately after and 30 minutes after tDCS. Minimal effects of tDCS on postural control were found in the eyes open condition only, and this was dependent on the measure assessed and age group. For young adults, stimulation had only offline effects, as cerebellar stimulation showed higher mean power frequency (MPF) of sway 30 minutes after stimulation. For older adults, both stimulation conditions delayed the increase in sway amplitude witnessed between blocks one and two until stimulation was no longer active. In conclusion, despite tDCS' growing popularity, we would caution researchers to consider carefully the type of measures assessed and the groups targeted in tDCS studies of postural control.

  4. A Microarray Study of Carpet-Shell Clam (Ruditapes decussatus Shows Common and Organ-Specific Growth-Related Gene Expression Differences in Gills and Digestive Gland

    Directory of Open Access Journals (Sweden)

    Carlos Saavedra

    2017-11-01

    Full Text Available Growth rate is one of the most important traits from the point of view of individual fitness and commercial production in mollusks, but its molecular and physiological basis is poorly known. We have studied differential gene expression related to differences in growth rate in adult individuals of the commercial marine clam Ruditapes decussatus. Gene expression in the gills and the digestive gland was analyzed in 5 fast-growing and five slow-growing animals by means of an oligonucleotide microarray containing 14,003 probes. A total of 356 differentially expressed genes (DEG were found. We tested the hypothesis that differential expression might be concentrated at the growth control gene core (GCGC, i.e., the set of genes that underlie the molecular mechanisms of genetic control of tissue and organ growth and body size, as demonstrated in model organisms. The GCGC includes the genes coding for enzymes of the insulin/insulin-like growth factor signaling pathway (IIS, enzymes of four additional signaling pathways (Raf/Ras/Mapk, Jnk, TOR, and Hippo, and transcription factors acting at the end of those pathways. Only two out of 97 GCGC genes present in the microarray showed differential expression, indicating a very little contribution of GCGC genes to growth-related differential gene expression. Forty eight DEGs were shared by both organs, with gene ontology (GO annotations corresponding to transcription regulation, RNA splicing, sugar metabolism, protein catabolism, immunity, defense against pathogens, and fatty acid biosynthesis. GO term enrichment tests indicated that genes related to growth regulation, development and morphogenesis, extracellular matrix proteins, and proteolysis were overrepresented in the gills. In the digestive gland overrepresented GO terms referred to gene expression control through chromatin rearrangement, RAS-related small GTPases, glucolysis, and energy metabolism. These analyses suggest a relevant role of, among others

  5. Studies Using an in Vitro Model Show Evidence of Involvement of Epithelial-Mesenchymal Transition of Human Endometrial Epithelial Cells in Human Embryo Implantation*

    Science.gov (United States)

    Uchida, Hiroshi; Maruyama, Tetsuo; Nishikawa-Uchida, Sayaka; Oda, Hideyuki; Miyazaki, Kaoru; Yamasaki, Akiko; Yoshimura, Yasunori

    2012-01-01

    Human embryo implantation is a critical multistep process consisting of embryo apposition/adhesion, followed by penetration and invasion. Through embryo penetration, the endometrial epithelial cell barrier is disrupted and remodeled by an unknown mechanism. We have previously developed an in vitro model for human embryo implantation employing the human choriocarcinoma cell line JAR and the human endometrial adenocarcinoma cell line Ishikawa. Using this model we have shown that stimulation with ovarian steroid hormones (17β-estradiol and progesterone, E2P4) and suberoylanilide hydroxamic acid (SAHA), a histone deacetylase inhibitor, enhances the attachment and adhesion of JAR spheroids to Ishikawa. In the present study we showed that the attachment and adhesion of JAR spheroids and treatment with E2P4 or SAHA individually induce the epithelial-mesenchymal transition (EMT) in Ishikawa cells. This was evident by up-regulation of N-cadherin and vimentin, a mesenchymal cell marker, and concomitant down-regulation of E-cadherin in Ishikawa cells. Stimulation with E2P4 or SAHA accelerated Ishikawa cell motility, increased JAR spheroid outgrowth, and enhanced the unique redistribution of N-cadherin, which was most prominent in proximity to the adhered spheroids. Moreover, an N-cadherin functional blocking antibody attenuated all events but not JAR spheroid adhesion. These results collectively provide evidence suggesting that E2P4- and implanting embryo-induced EMT of endometrial epithelial cells may play a pivotal role in the subsequent processes of human embryo implantation with functional control of N-cadherin. PMID:22174415

  6. Empty polyetheretherketone (PEEK) cages in anterior cervical diskectomy and fusion (ACDF) show slow radiographic fusion that reduces clinical improvement: results from the prospective multicenter "PIERCE-PEEK" study.

    Science.gov (United States)

    Suess, Olaf; Schomaker, Martin; Cabraja, Mario; Danne, Marco; Kombos, Theodoros; Hanna, Michael

    2017-01-01

    Anterior cervical diskectomy and fusion (ACDF) is a well-established surgical treatment for radiculopathy and myelopathy. Previous studies showed that empty PEEK cages have lower radiographic fusion rates, but the clinical relevance remains unclear. This paper's aim is to provide high-quality evidence on the outcomes of ACDF with empty PEEK cages and on the relevance of radiographic fusion for clinical outcomes. This large prospective multicenter clinical trial performed single-level ACDF with empty PEEK cages on patients with cervical radiculopathy or myelopathy. The main clinical outcomes were VAS (0-10) for pain and NDI (0-100) for functioning. Radiographic fusion was evaluated by two investigators for three different aspects. The median (range) improvement of the VAS pain score was: 3 (1-6) at 6 months, 3 (2-8) at 12 months, and 4 (2-8) at 18 months. The median (range) improvement of the NDI score was: 12 (2-34) at 6 months, 18 (4-46) at 12 months, and 22 (2-44) at 18 months. Complete radiographic fusion was reached by 126 patients (43%) at 6 months, 214 patients (73%) at 12 months, and 241 patients (83%) at 18 months. Radiographic fusion was a highly significant ( p  PEEK cages is slow and insufficient. Lack of complete radiographic fusion leads to less improvement of pain and disability. We recommend against using empty uncoated pure PEEK cages in ACDF. ISRCTN42774128. Retrospectively registered 14 April 2009.

  7. Synergy of Satellite-Surface Observations for Studying the Properties of Absorbing Aerosols in Asia

    Science.gov (United States)

    Tsay, Si-Chee

    2010-01-01

    , in major international research projects such as the Joint Aerosol Monsoon Experiment (JAM EX), a core element of the Asian Monsoon Years (AMY, 2008-2012). SMART-COMMIT deployments during 2008 AMY/JAMEX were conducted in northwestern China to characterize the properties of dust-laden aerosols and in the vicinity of Beijing for mega-city aerosols. In 2009, SMART-COMMIT also participated in the JAMEX/RAJO-MEGHA (Radiation, Aerosol Joint Observations-Monsoon Experiment in the Gangetic-Himalayan Area; Sanskrit for Dust-Cloud) to study the aerosol properties, solar absorption and the associated atmospheric warming, and the climatic impact of elevated aerosols during the pre-monsoon season in South Asia. We will show results from these field experiments, as well as discuss a new initiative of 7-SEAS (7 South East Asian Studies) to study the interaction of anthropogenic aerosols with regional meteorology, particularly with clouds.

  8. Period Study and Analyses of 2017 Observations of the Totally Eclipsing, Solar Type Binary, MT Camelopardalis

    Science.gov (United States)

    Faulkner, Danny R.; Samec, Ronald G.; Caton, Daniel B.

    2018-06-01

    We report here on a period study and the analysis of BVRcIc light curves (taken in 2017) of MT Cam (GSC03737-01085), which is a solar type (T ~ 5500K) eclipsing binary. D. Caton observed MT Cam on 05, 14, 15, 16, and 17, December 2017 with the 0.81-m reflector at Dark Sky Observatory. Six times of minimum light were calculated from four primary eclipses and two secondary eclipses:HJD I = 24 58092.4937±0.0002, 2458102.74600±0.0021, 2458104.5769±0.0002, 2458104.9434±0.0029HJD II = 2458103.6610±0.0001, 2458104.7607±0.0020,Six times of minimum light were also calculated from data taken by Terrell, Gross, and Cooney, in their 2016 and 2004 observations (reported in IBVS #6166; TGC, hereafter). In addition, six more times of minimum light were taken from the literature. From all 18 times of minimum light, we determined the following light elements:JD Hel Min I=2458102.7460(4) + 0.36613937(5) EWe found the orbital period was constant over the 14 years spanning all observations. We note that TGC found a slightly increasing period. However, our results were obtained from a period study rather than comparison of observations from only two epochs by the Wilson-Devinney (W-D) Program. A BVRcIc Johnson-Cousins filtered simultaneous W-D Program solution gives a mass ratio (0.3385±0.0014) very nearly the same as TGC’s (0.347±0.003), and a component temperature difference of only ~40 K. As with TGC, no spot was needed in the modeling. Our modeling (beginning with Binary Maker 3.0 fits) was done without prior knowledge of TGC’s. This shows the agreement achieved when independent analyses are done with the W-D code. The present observations were taken 1.8 years later than the last curves by TGC, so some variation is expected.The Roche Lobe fill-out of the binary is ~13% and the inclination is ~83.5 degrees. The system is a shallow contact W-type W UMa Binary, albeit, the amplitudes of the primary and secondary eclipse are very nearly identical. An eclipse duration of ~21

  9. Genome-wide transcriptome study in wheat identified candidate genes related to processing quality, majority of them showing interaction (quality x development) and having temporal and spatial distributions.

    Science.gov (United States)

    Singh, Anuradha; Mantri, Shrikant; Sharma, Monica; Chaudhury, Ashok; Tuli, Rakesh; Roy, Joy

    2014-01-16

    The cultivated bread wheat (Triticum aestivum L.) possesses unique flour quality, which can be processed into many end-use food products such as bread, pasta, chapatti (unleavened flat bread), biscuit, etc. The present wheat varieties require improvement in processing quality to meet the increasing demand of better quality food products. However, processing quality is very complex and controlled by many genes, which have not been completely explored. To identify the candidate genes whose expressions changed due to variation in processing quality and interaction (quality x development), genome-wide transcriptome studies were performed in two sets of diverse Indian wheat varieties differing for chapatti quality. It is also important to understand the temporal and spatial distributions of their expressions for designing tissue and growth specific functional genomics experiments. Gene-specific two-way ANOVA analysis of expression of about 55 K transcripts in two diverse sets of Indian wheat varieties for chapatti quality at three seed developmental stages identified 236 differentially expressed probe sets (10-fold). Out of 236, 110 probe sets were identified for chapatti quality. Many processing quality related key genes such as glutenin and gliadins, puroindolines, grain softness protein, alpha and beta amylases, proteases, were identified, and many other candidate genes related to cellular and molecular functions were also identified. The ANOVA analysis revealed that the expression of 56 of 110 probe sets was involved in interaction (quality x development). Majority of the probe sets showed differential expression at early stage of seed development i.e. temporal expression. Meta-analysis revealed that the majority of the genes expressed in one or a few growth stages indicating spatial distribution of their expressions. The differential expressions of a few candidate genes such as pre-alpha/beta-gliadin and gamma gliadin were validated by RT-PCR. Therefore, this study

  10. Genome-wide transcriptome study in wheat identified candidate genes related to processing quality, majority of them showing interaction (quality x development) and having temporal and spatial distributions

    Science.gov (United States)

    2014-01-01

    Background The cultivated bread wheat (Triticum aestivum L.) possesses unique flour quality, which can be processed into many end-use food products such as bread, pasta, chapatti (unleavened flat bread), biscuit, etc. The present wheat varieties require improvement in processing quality to meet the increasing demand of better quality food products. However, processing quality is very complex and controlled by many genes, which have not been completely explored. To identify the candidate genes whose expressions changed due to variation in processing quality and interaction (quality x development), genome-wide transcriptome studies were performed in two sets of diverse Indian wheat varieties differing for chapatti quality. It is also important to understand the temporal and spatial distributions of their expressions for designing tissue and growth specific functional genomics experiments. Results Gene-specific two-way ANOVA analysis of expression of about 55 K transcripts in two diverse sets of Indian wheat varieties for chapatti quality at three seed developmental stages identified 236 differentially expressed probe sets (10-fold). Out of 236, 110 probe sets were identified for chapatti quality. Many processing quality related key genes such as glutenin and gliadins, puroindolines, grain softness protein, alpha and beta amylases, proteases, were identified, and many other candidate genes related to cellular and molecular functions were also identified. The ANOVA analysis revealed that the expression of 56 of 110 probe sets was involved in interaction (quality x development). Majority of the probe sets showed differential expression at early stage of seed development i.e. temporal expression. Meta-analysis revealed that the majority of the genes expressed in one or a few growth stages indicating spatial distribution of their expressions. The differential expressions of a few candidate genes such as pre-alpha/beta-gliadin and gamma gliadin were validated by RT

  11. Multiple challenges of antibiotic use in a large hospital in Ethiopia - a ward-specific study showing high rates of hospital-acquired infections and ineffective prophylaxis.

    Science.gov (United States)

    Gutema, Girma; Håkonsen, Helle; Engidawork, Ephrem; Toverud, Else-Lydia

    2018-05-03

    This project aims to study the use of antibiotics in three clinical wards in the largest tertiary teaching hospital in Ethiopia for a period of 1 year. The specific aims were to assess the prevalence of patients on antibiotics, quantify the antibiotic consumption and identify the main indications of use. The material was all the medical charts (n = 2231) retrieved from three clinical wards (internal medicine, gynecology/obstetrics and surgery) in Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa between September 2013 and September 2014. Data collection was performed manually by four pharmacists. Each medical chart represented one patient. About 60% of the patients were admitted to internal medicine, 20% to each of the other two wards. The number of bed days (BD) was on average 16.5. Antibiotics for systemic use were prescribed to 73.7% of the patients (on average: 2.1 antibiotics/patient) of whom 86.6% got a third or fourth generation cephalosporin (mainly ceftriaxone). The average consumption of antibiotics was 81.6 DDD/100BD, varying from 91.8 in internal medicine and 71.6 in surgery to 47.6 in gynecology/obstetrics. The five most frequently occurring infections were pneumonia (26.6%), surgical site infections (21.5%), neutropenic fever (6.9%), sepsis (6.4%) and urinary tract infections (4.7%). About one fourth of the prescriptions were for prophylactic purposes. Hospital acquired infections occurred in 23.5% of the patients (353 cases of surgical site infection). The prescribing was based on empirical treatment and sensitivity testing was reported in only 3.8% of the cases. In the present study from three wards in the largest tertiary teaching hospital in Ethiopia, three out of four patients were prescribed antibiotics, primarily empirically. The mean antibiotic consumption was 81.6 DDD/100BD. Surgical site infections constituted a large burden of the infections treated in the hospital, despite extensive prescribing of prophylaxis. The findings show

  12. Development of Creative Behavior Observation Form: A Study on Validity and Reliability

    Science.gov (United States)

    Dere, Zeynep; Ömeroglu, Esra

    2018-01-01

    This study, Creative Behavior Observation Form was developed to assess creativity of the children. While the study group on the reliability and validity of Creative Behavior Observation Form was being developed, 257 children in total who were at the ages of 5-6 were used as samples with stratified sampling method. Content Validity Index (CVI) and…

  13. Malaria, sickle cell disease, HIV, and co-trimoxazole prophylaxis: An observational study

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    Ewurama D.A. Owusu

    2018-04-01

    Full Text Available Objectives: This observational study recorded the malaria and sickle cell disease (SCD profile of people living with HIV/AIDS (PLHA and determined whether prophylactic co-trimoxazole (CTX and the haemoglobin S (Hb S allele influenced malaria episodes. Methods: Sickling status, malaria episodes, and HIV type, as well as other data, were extracted retrospectively from the clinical records of 1001 patients attending the antiretroviral therapy clinic at Ridge Regional Hospital in Accra, Ghana between 2010 and 2015. Finger-prick capillary blood of returning patients (n = 501 was tested for the haemoglobin (Hb level and malaria, after information on malaria prevention methods was obtained through the administration of a questionnaire. Results: The use of insecticide-treated mosquito nets was low (22.8%. CTX prophylaxis showed no significant influence on the overall number of malaria episodes from 2010 to 2015; however, it did show a statistically significant relationship (p = 0.026 with the time elapsed since the last malaria episode. Even though 19% of participants possessed Hb S, it had no influence on malaria episodes. Conclusions: Hb S did not influence malaria in PLHA. Further studies in Hb SS and Hb SC are needed, as there are suggestions of increased frequency and severity of malaria. The impact of CTX prophylaxis on this cohort will be insightful. Keywords: Malaria, HIV, Sickle cell disease, Co-trimoxazole, Ghana

  14. Phase boundary in compatible and incompatible polymer blends studied by micro indentation test and microscopic observations

    International Nuclear Information System (INIS)

    Mina, M. F.; Akhtar, F.; Haque, M.E.

    2003-10-01

    The phase boundary of incompatible polymer blends such as poly (methyl methacrylate) (PMMA)/natural rubber (NR) and polyestyrene (PS)/NR as well as compatible blends such as PMMA/NR/epoxidizer NR (compatibilizer) and PS/NR/styrene-butadiene-styrene (SBS) block copolymer (compatibilizer) was studied by means of microhardness (H) technique and microscopy. Solution grown films of neat PMMA, PS and blended films of PMMA/NR, PS/NR, PMMA/NR/ENR and PS/NR/SBS were cast using a common solvent (toluene). While the neat PMMA and PS provide constant hardness values of 178 and 173 MPa, respectively, the binary (incompatible) and the ternary (compatible) blends show a conspicuous H-decrease (PMMA/NR=140 MPa, PS/NR=167 MPa, PMMA/NR/ENR=109 MPa and PS/NR/SBS=127 MPa). Scanning electron microscopy and optical microscopy reveal clear difference of the phase boundary of compatible (smooth boundary) and incompatible (sharp boundary) blends. Besides, the compatibilizer blends are characterised by the thinnest phase boundary (30 μm), which is found about 60 μm in the incompatible blends, showing a final hardness value that demonstrates the compatibilizer to be smoothly distributed in the interface between the two blend components. Results highlight that microindentation technique, in combination with microscopic observations, is a sensitive tool for studying the breadth and quality of the interphase boundary in non- or compatibilized polymer blends and other inhomogeneous materials. (author)

  15. Forest observational studies-an essential infrastructure for sustainable use of natural resources

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    XiuHai Zhao

    2014-04-01

    Full Text Available This contribution complements Forest Ecosystems’ Thematic Series on “Forest Observational Studies”. We provide essential clarification regarding the definition and purpose of long-term field studies, review some of the extensive literature and discuss different approaches to collecting field data. We also describe two newly established forest observational networks that serve to illustrate the scope and diversity of forest field studies. The first is a large-scale network of forest observational studies in prominent natural forest ecosystems in China. The second example demonstrates observational studies in mixed and uneven-aged pine-oak forests which are selectively managed by local communities in Mexico. We summarize the potential for analysing and modeling forest ecosystems within interdisciplinary projects and provide argumentation in favour of long-term institutional commitment to maintaining forest observational field studies.

  16. Relationship Between Serum Zinc Level and Metabolic Syndrome: A Meta-Analysis of Observational Studies.

    Science.gov (United States)

    Zhang, Yi; Zhang, Dian-Zhong

    2018-05-10

    This research sought to summarize the evidence regarding the relationship between serum zinc level and metabolic syndrome (MetS). The electronic databases of PubMed, Web of Science, and Embase were searched up to October 2017 for observational studies on the association between serum zinc level and MetS. The standard mean difference (SMD) and its corresponding 95% confidence interval (CI) of the serum zinc level for MetS versus control participants were calculated. In addition, the pooled odds ratio (OR) and relative risk (RR) of MetS for the highest versus lowest category of serum zinc level, as well as their corresponding 95% CI, were also calculated. A total of 11 observational studies (8 cross-sectional, 1 case-control, and 2 cohort studies) were included in this meta-analysis. The combined SMD demonstrated that the serum zinc level in MetS was higher than that in control participants (SMD = 0.11; 95% CI, 0.03-0.19; p = 0.009). Moreover, the overall multivariable-adjusted RR showed that the increased serum zinc level was associated with a higher risk of MetS (RR = 1.82; 95% CI, 1.33-2.50; p level and MetS (OR = 1.00; 95% CI, 0.99-1.01; p = 0.841). Although the serum zinc level in participants with MetS was significantly higher than that in control ones, the existing evidence was still insufficient to conclude a definite relationship between serum zinc level and MetS. More well-designed prospective cohort studies are needed to elaborate the concerned issues further.

  17. Observation of Interactions in Adolescent Group Therapy: A Mixed Methods Study

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    Eulàlia Arias-Pujol

    2017-07-01

    Full Text Available Group psychotherapy is a useful clinical practice for adolescents with mental health issues. Groups typically consist of young people of similar ages but with different personalities, and this results in a complex communication network. The goal of group psychoanalytic psychotherapy is to improve participants' mentalization abilities, facilitating interactions between peers and their therapist in a safe, containing environment. The main aim of this study was to analyze conversation turn-taking between a lead therapist, a co-therapist, and six adolescents over the course of 24 treatment sessions divided into four blocks over 8 months. We employed a mixed-methods design based on systematic observation, which we consider to be a mixed method itself, as the qualitative data collected in the initial observation phase is transformed into quantitative data and subsequently interpreted qualitatively with the aid of clinical vignettes. The observational methodology design was nomothetic, follow-up, and multidimensional. The choice of methodology is justified as we used an ad-hoc observation instrument combining a field format and a category system. Interobserver agreement was analyzed quantitatively by Cohen's kappa using the free QSEQ5 software program. Once we had confirmed the reliability of the data, these were analyzed by polar coordinate analysis, which is a powerful data reduction technique that provides a vector representation of relationships between categories. The results show significant relationships between the therapist and (1 the activation of turn-taking by the participants and the co-therapist and silence and (2 conversation-facilitating interventions and interventions designed to improve mentalization abilities. Detailed analysis of questions demonstrating interest in others showed how the communication changed from radial interactions stemming from the therapist at the beginning of therapy to circular interactions half way through

  18. Why is intracellular ice lethal? A microscopical study showing evidence of programmed cell death in cryo-exposed embryonic axes of recalcitrant seeds of Acer saccharinum.

    Science.gov (United States)

    Wesley-Smith, James; Walters, Christina; Pammenter, N W; Berjak, Patricia

    2015-05-01

    Conservation of the genetic diversity afforded by recalcitrant seeds is achieved by cryopreservation, in which excised embryonic axes (or, where possible, embryos) are treated and stored at temperatures lower than -180 °C using liquid nitrogen. It has previously been shown that intracellular ice forms in rapidly cooled embryonic axes of Acer saccharinum (silver maple) but this is not necessarily lethal when ice crystals are small. This study seeks to understand the nature and extent of damage from intracellular ice, and the course of recovery and regrowth in surviving tissues. Embryonic axes of A. saccharinum, not subjected to dehydration or cryoprotection treatments (water content was 1·9 g H2O g(-1) dry mass), were cooled to liquid nitrogen temperatures using two methods: plunging into nitrogen slush to achieve a cooling rate of 97 °C s(-1) or programmed cooling at 3·3 °C s(-1). Samples were thawed rapidly (177 °C s(-1)) and cell structure was examined microscopically immediately, and at intervals up to 72 h in vitro. Survival was assessed after 4 weeks in vitro. Axes were processed conventionally for optical microscopy and ultrastructural examination. Immediately following thaw after cryogenic exposure, cells from axes did not show signs of damage at an ultrastructural level. Signs that cells had been damaged were apparent after several hours of in vitro culture and appeared as autophagic decomposition. In surviving tissues, dead cells were sloughed off and pockets of living cells were the origin of regrowth. In roots, regrowth occurred from the ground meristem and procambium, not the distal meristem, which became lethally damaged. Regrowth of shoots occurred from isolated pockets of surviving cells of peripheral and pith meristems. The size of these pockets may determine the possibility for, the extent of and the vigour of regrowth. Autophagic degradation and ultimately autolysis of cells following cryo-exposure and formation of small

  19. Generalizability of causal inference in observational studies under retrospective convenience sampling.

    Science.gov (United States)

    Hu, Zonghui; Qin, Jing

    2018-05-20

    Many observational studies adopt what we call retrospective convenience sampling (RCS). With the sample size in each arm prespecified, RCS randomly selects subjects from the treatment-inclined subpopulation into the treatment arm and those from the control-inclined into the control arm. Samples in each arm are representative of the respective subpopulation, but the proportion of the 2 subpopulations is usually not preserved in the sample data. We show in this work that, under RCS, existing causal effect estimators actually estimate the treatment effect over the sample population instead of the underlying study population. We investigate how to correct existing methods for consistent estimation of the treatment effect over the underlying population. Although RCS is adopted in medical studies for ethical and cost-effective purposes, it also has a big advantage for statistical inference: When the tendency to receive treatment is low in a study population, treatment effect estimators under RCS, with proper correction, are more efficient than their parallels under random sampling. These properties are investigated both theoretically and through numerical demonstration. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  20. Health and social determinants and outcomes of home cooking: A systematic review of observational studies.

    Science.gov (United States)

    Mills, Susanna; White, Martin; Brown, Heather; Wrieden, Wendy; Kwasnicka, Dominika; Halligan, Joel; Robalino, Shannon; Adams, Jean

    2017-04-01

    Many dietary interventions assume a positive influence of home cooking on diet, health and social outcomes, but evidence remains inconsistent. We aimed to systematically review health and social determinants and outcomes of home cooking. Given the absence of a widely accepted, established definition, we defined home cooking as the actions required for preparing hot or cold foods at home, including combining, mixing and often heating ingredients. Nineteen electronic databases were searched for relevant literature. Peer-reviewed studies in English were included if they focussed mainly on home cooking, and presented post 19 th century observational or qualitative data on participants from high/very high human development index countries. Interventional study designs, which have previously been reviewed, were excluded. Themes were summarised using narrative synthesis. From 13,341 unique records, 38 studies - primarily cross-sectional in design - met the inclusion criteria. A conceptual model was developed, mapping determinants of home cooking to layers of influence including non-modifiable, individual, community and cultural factors. Key determinants included female gender, greater time availability and employment, close personal relationships, and culture and ethnic background. Putative outcomes were mostly at an individual level and focused on potential dietary benefits. Findings show that determinants of home cooking are more complex than simply possessing cooking skills, and that potential positive associations between cooking, diet and health require further confirmation. Current evidence is limited by reliance on cross-sectional studies and authors' conceptualisation of determinants and outcomes. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  1. Is sarcopenia associated with depression? A systematic review and meta-analysis of observational studies.

    Science.gov (United States)

    Chang, Ke-Vin; Hsu, Tsai-Hsuan; Wu, Wei-Ting; Huang, Kuo-Chin; Han, Der-Sheng

    2017-09-01

    to explore whether sarcopenia is associated with depression. electronic literature databases from PubMed, Scopus, Embase and Google Scholar were searched. A systematic review and meta-analysis of observational studies was conducted. community and outpatient clinic. people with and without diagnoses of sarcopenia. outcome measures of depression. about 15 articles were included, 5 of which were retrieved for narrative review. The crude odds ratios (ORs) between sarcopenia and depression were extracted from the remaining 10 studies, 6 of which also included adjusted ORs. Sarcopenia was associated with depression without adjusting covariates (crude OR, 1.640; 95% confidence interval (CI), 1.247-2.155). After adjusting for potential confounders such as age, gender, cognitive performance and physical activity, sarcopenia still demonstrated a significant positive association with depression (adjusted OR, 1.821; 95% CI, 1.160-2.859). A stratified analysis showed that the studies that used bioelectrical impedance analysis for measurement of body composition tended to have an elevated association between sarcopenia and depression compared with those that used dual-energy X-ray absorptiometry or equation estimation. sarcopenia was independently associated with depression. The causal relationship between the two clinical conditions requires future validation with cohort studies. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  2. Response of Treatment in Patients with Primary Headaches and Hypertension: A Prospective Observational Pilot Study

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    Abdullah Cüneyt Hocagil

    2018-03-01

    Full Text Available Objective: To determine the priority in the treatment of patients with primary headaches accompanied by high blood pressure. In our study, we investigated whether there was a relationship between the decline in headache after treatment and the change in the average arterial pressure. Materials and Methods: This prospective observational study was performed with 101 patients who were admitted to the hospital emergency department with primary headache accompanied by high blood pressure. After treatment, the decrease in the severity of headaches, mean arterial pressure, and percentage value for the drop of mean arterial pressure were calculated for all patients. Results: In the study, 25 (24.8% patients’ headache decreased 3 levels, 43 (42.6% patients’ headache decreased 2 levels, and 23 (22.8% patients’ headache decreased one level. The mean arterial pressure value at admission was 118.58±12.65 mmHg, and after treatment at the 30th minute decreased to 98.41±13.43 mmHg. Although there was a statistically significant (p0.05 drop in the mean arterial pressure value of the patients with one level decrease in headache severity after treatment. Conclusion: This study showed that when a primary headache, which is often associated with high blood pressure, was treated instead of treating high blood pressure as a secondary cause of headache, blood pressure decreased spontaneously

  3. Changes in the ocular surface: initial observations from a pilot study of diagnostic radiology technicians (radiographers)

    International Nuclear Information System (INIS)

    Guerdal, Canan; Aydin, Sevda; Sengoer, Tomris; Onmus, Hale; Oezarar, Muemtaz

    2002-01-01

    The purpose of this study was to evaluate the clinical and cytological changes in the ocular surface of radiology technicians (radiographers) exposed to diagnostic doses of radiation. The Schirmer, Rose Bengal staining and Tear-Break-Up-Time tear function tests were carried out following routine ophthalmic examination in 15 radiology technicians (group I) and 15 controls (group II). Impression cytology was performed by placing 5-mm-thick half-circular cellulose acetate filter paper in the upper and lower quadrants around the limbus. The cytological evaluation was made using the mapping technique. Significantly increased dry eye was detected in group I. In the impression cytology investigation, squamous metaplasia and intraepithelial lymphocytic infiltration was noted in all the group-I cases. A distinct change was observed between the regions showing squamous metaplasia and neigbouring normal epithelial cell structure. Dry eye and ocular surface cytological changes were observed in diagnostic radiology technicians. Routine ophthalmic evaluation of radiology technicians would be beneficial in detecting early cytological changes and dry eye. (orig.)

  4. Observational and numerical study of the Vardaris wind regime in northern Greece

    Science.gov (United States)

    Koletsis, I.; Giannaros, T. M.; Lagouvardos, K.; Kotroni, V.

    2016-05-01

    The Axios Valley, located in central-northern Greece, is surrounded by complex topography that plays a significant role in the modification of wind flow, both in terms of speed and direction. The characteristic wind regime of this valley is Vardaris, a northwesterly wind that prevails in this region, especially during the cold period of the year. Vardaris is well known for its consistent direction and high intensity, as well as for the effective advection of cold and dry air, often resulting to significant damages in local infrastructures and agriculture. A field campaign under the name AXIOS took place during the period from November 2007 through May 2008 in order to examine this particular wind flow. The analysis of the in situ observational data, which was funded by the research program THESPIA-KRIPIS, showed that topography plays a key role in intensifying Vardaris, generating gusts that approximated 30 m s- 1 during the experimental period. The air temperature and humidity fields were also found to be significantly influenced. In addition to the observational study, an intense Vardaris episode was simulated with the Weather Research and Forecasting (WRF) model at high horizontal resolution. Results revealed that the model was able to reproduce the favorable environmental conditions that lead to Vardaris occurrence, providing a useful insight on the physical mechanisms explaining its structure.

  5. Establishing a ultraviolet radiation observational network and enhancing the study on ultraviolet radiation

    Science.gov (United States)

    Bai, Jianhui; Wang, Gengchen

    2003-09-01

    On the basis of analyzing observational data on solar radiation, meteorological parameters, and total ozone amount for the period of January 1990 to December 1991 in the Beijing area, an empirical calculation method for ultraviolet radiation (UV) in clear sky is obtained. The results show that the calculated values agree well with the observed, with maximum relative bias of 6.2% and mean relative bias for 24 months of 1.9%. Good results are also obtained when this method is applied in Guangzhou and Mohe districts. The long-term variation of UV radiation in clear sky over the Beijing area from 1979 to 1998 is calculated, and the UV variation trends and causes are discussed: direct and indirect UV energy absorption by increasing pollutants in the troposphere may have caused the UV decrease in clear sky in the last 20 years. With the enhancement of people’s quality of life and awareness of health, it will be valuable and practical to provid UV forecasts for typical cities and rural areas. So, we should develop and enhance UV study in systematic monitoring, forecasting, and developing a good and feasible method for UV radiation reporting in China, especially for big cities.

  6. Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study

    Directory of Open Access Journals (Sweden)

    Massimo Cannas

    2014-11-01

    Full Text Available Background: The rates of cesarean deliveries have been increasing steadily in several European countries in recent decades, with Italy having the second-highest rate (38% in 2010, causing concern and debate about the appropriateness of many interventions. Moreover, some recent studies suggest that rates of common obstetric interventions are not homogeneous across hospitals, maybe not only because of patient case mix but also possibly because of different hospital practices and cultures. Thus, it is important to investigate whether the variation in rates of cesarean sections can be traced back to patient characteristics or whether it depends upon context variables at the hospital level. Objective and method: Using official hospital abstracts on deliveries that occurred in Sardinia over a two-year period, we implement multilevel logistic regression models in order to assess whether the observed differences in cesarean rates across hospitals can be justified by case-mix differences across hospitals. Results: The between-hospital variation in rates of cesarean delivery is estimated to be 0.388 in the model with only the intercept and 0.382 in the model controlling for the mother’s clinical and sociodemographic characteristics. Conclusions: The results show that taking into account the individual characteristics of delivered mothers is not enough to justify the observed variation across hospital rates, suggesting the important role of unobserved variables at the hospital level in determining cesarean section rates.

  7. An observational study of community health care nurses’ knowledge about delirium

    Directory of Open Access Journals (Sweden)

    Akrour R

    2017-03-01

    Full Text Available Rachid Akrour,1 Henk Verloo2 1Department of Geriatric Rehabilitation, Lausanne University Hospital, Lausanne, 2Department of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Sion, Switzerland Background: Early detection of delirium among home-dwelling older patients is a substantial challenge for home health care providers. Despite an abundance of literature, recent studies still describe a widespread lack of knowledge about delirium and its underdetection in all types of health care settings.Aims and objectives: This study aimed to assess the knowledge of community health care nurses (CHNs about delirium in the Switzerland’s French-speaking region.Methods: A cross-sectional observational study involving 75 CHNs was conducted between February and July 2015. Data were collected using an autoadministered questionnaire based on the study by Malenfant and Voyer, exploring theoretical knowledge of delirium and its detection using clinical vignette case studies. Outcomes were analyzed using descriptive statistics.
Results: Forty-eight CHNs participated in the study; nearly all of them (44; 94% selected the correct definition of delirium, and most (36; 78% knew its four principal diagnostic criteria. Only 16 (34% participants selected the confusion assessment method (CAM as the recommended best practice delirium detection tool. Only 19 (40% and 23 (49% participants were able to correctly identify hypoactive and hyperactive delirium, respectively, from the clinical vignette case studies. The average score of CHNs on the Malenfant and Voyer’s questionnaire was 12.7 (SD 3.2.Conclusion: Participants showed moderate-to-low knowledge about delirium. The study identified a lack of knowledge on how to recognize the signs and symptoms of delirium and the absence of suitable delirium detection tools. Keywords: delirium knowledge questionnaire, geriatric syndromes, delirium detection tools, clinical vignettes 

  8. Environmental Polychlorinated Biphenyl Exposure and Breast Cancer Risk: A Meta-Analysis of Observational Studies.

    Directory of Open Access Journals (Sweden)

    Jingwen Zhang

    Full Text Available Association between polychlorinated biphenyl (PCB exposure and breast cancer risk has been widely studied, but the results remain controversial. We performed a meta-analysis to evaluate the evidences from observational studies on PCB exposure and breast cancer risk.Relevant studies with data on internal PCB dose were identified from PubMed, EMBASE, CBM and CNKI databases through November 2014. Multivariable-adjusted odds ratio (OR with 95% confidence intervals (CIs were applied to assess the association between PCB exposure and breast cancer risk. Heterogeneity test, sensitivity analysis, subgroup analysis and publication bias test were also performed. To further explore the association between specific groups of PCB congeners and breast cancer, we examined the PCB congeners classified, according to their structural, biological and pharmacokinetics properties, as group I (potentially estrogenic, group II (potentially anti-estrogenic and immunotoxic, dioxin-like, and group III (phenobarbital, CYP1A and CYP2B inducers, biologically persistent.Of 660 studies screened, 25 studies which met criteria were selected, involving a total of 12866 participants (6088 cases and 6778 controls from eight countries. The results showed that the risk of breast cancer was associated with group II (OR = 1.23, 95% CI: 1.08-1.40 and group III (OR = 1.25, 95% CI: 1.09-1.43 PCBs, but not with group I (OR = 1.10, 95%CI: 0.97-1.24 PCBs or total PCB exposure (OR = 1.09, 95%CI: 0.97-1.22.Our meta-analysis based on the selected studies found group II and group III PCB exposure might contribute to the risk of breast cancer. More studies in developing countries with higher PCB levels are needed, as well as studies to explore the relationships between mixtures of organochlorine compounds and breast cancer risk.

  9. Distress in suspected lung cancer patients following rapid and standard diagnostic programs: a prospective observational study.

    Science.gov (United States)

    Brocken, Pepijn; van der Heijden, Erik H F M; Oud, Karen T M; Bootsma, Gerben; Groen, Harry J M; Donders, A Rogier T; Dekhuijzen, P N Richard; Prins, Judith B

    2015-04-01

    Timeliness may influence emotional distress during the diagnostic phase of suspected lung cancer patients. We performed a prospective observational study to compare distress and quality of life (QoL) in two medical centres with a Rapid Outpatient Diagnostic Program (RODP) and two using conventional Stepwise Diagnostic Approach (SDA) on the basis of trained nurse-led care. Outpatients with radiological suspicion of lung cancer completed the Hospital Anxiety and Depression Scale (HADS), European Organization for Research and Treatment of Cancer 30-item Quality of Life Questionnaire (QLQ-C30) and its 13-item Lung Cancer specific module (QLQ-LC13) upon first visit, 2 days later, thereafter weekly for 5 weeks and after 3 months. The 72 SDA patients and 121 RODP patients had a mean pre-diagnostic HADS-total score of 13.5 (SD 7.6); 63.4% had a score ≥10. Baseline QLQ-C30 global QoL was 61.6 (SD 22.7) exceeding reference values for lung cancer patients. Generalized least square models showed a significant centre by time interaction effect: during the first 6 weeks, HADS-total scores decreased in RODP patients (13.8-11.9) but sustained in SDA patients (13.1-13.6), whereas QoL showed no relevant changes. Times to diagnosis and discussion of therapy plan for RODP patients were 7 and 11 days shorter, respectively. Suspected lung cancer patients had high baseline distress levels. A decrease over time was found in RODP compared with SDA patients. QoL did not change relevantly. Albeit observational, these data indicate that patients experience less distress in rapid diagnostic programs than in stepwise diagnostic evaluation. Copyright © 2014 John Wiley & Sons, Ltd.

  10. Auditive stimulation therapy as an intervention in subacute and chronic tinnitus: a prospective observational study.

    Science.gov (United States)

    Kusatz, Martin; Ostermann, Thomas; Aldridge, David

    2005-01-01

    Tinnitus is a noise, a ringing, or a roaring sound in the affected ear and is becoming an increasingly serious problem for health care systems. Integrative treatment concepts are currently regarded as promising therapeutic approaches for managing tinnitus. The aim of this study was to present the results of auditive stimulation therapy, a program of music therapy developed specifically for tinnitus treatment. We collected data on outpatient treatment results from 155 tinnitus patients and evaluated them in a prospective observational study with three defined times of measurement (start, end, and 6 months after the end of treatment). Apart from anamnestic data and subjective evaluation of treatment, the major outcome parameter was the score of the tinnitus questionnaire. To evaluate effectiveness of the therapy, we calculated effect sizes (according to Cohen). Fifty-one percent of the patients were male, and the mean patient age was 49 years. Of the 155 patients, 137 (88%) were capable of gainful employment, which means that they fell in the age range between 18 and 65 years. The duration of tinnitus was more than 6 months for 80% of patients, and 43% had been suffering from tinnitus for more than 3 years. In general, all subscales of the tinnitus questionnaire showed highly significant changes (t-test, p observe a reduction to the level prior to treatment. The values for the effect sizes mostly ranged between medium (> 0.5) and high (> 0.8). Closer investigations indicated that a combination of music therapy and psychological training rendered the best effect sizes. This study demonstrated that music therapy is an effective integrated treatment approach and offers a way to make progress in tinnitus treatment.

  11. A 10-Day Developmental Voyage: Converging Evidence from Three Studies Showing that Self-Esteem May Be Elevated and Maintained without Negative Outcomes

    Science.gov (United States)

    Kafka, S.; Hunter, J. A.; Hayhurst, J.; Boyes, M.; Thomson, R. L.; Clarke, H.; Grocott, A. M.; Stringer, M.; O'Brien, K. S.

    2012-01-01

    Empirical evidence shows that educational experiences in the context of the outdoors lead to elevated self-esteem. Although elevated self-esteem is widely assumed to promote beneficial outcomes, recent evidence suggests that elevated self-esteem may also facilitate a variety of negative outcomes (i.e., increased prejudice, aggression, drug and…

  12. Leadership in the clinical workplace: what residents report to observe and supervisors report to display: an exploratory questionnaire study.

    Science.gov (United States)

    van der Wal, Martha A; Scheele, Fedde; Schönrock-Adema, Johanna; Jaarsma, A Debbie C; Cohen-Schotanus, Janke

    2015-11-02

    Within the current health care system, leadership is considered important for physicians. leadership is mostly self-taught, through observing and practicing. Does the practice environment offer residents enough opportunities to observe the supervisor leadership behaviours they have to learn? In the current study we investigate which leadership behaviours residents observe throughout their training, which behaviours supervisors report to display and whether residents and supervisors have a need for more formal training. We performed two questionnaire studies. Study 1: Residents (n = 117) answered questions about the extent to which they observed four basic and observable Situational Leadership behaviours in their supervisors. Study 2: Supervisors (n = 201) answered questions about the extent to which they perceived to display these Situational Leadership behaviours in medical practice. We asked both groups of participants whether they experienced a need for formal leadership training. One-third of the residents did not observe the four basic Situational Leadership behaviours. The same pattern was found among starting, intermediate and experienced residents. Moreover, not all supervisors showed these 4 leadership behaviours. Both supervisors and residents expressed a need for formal leadership training. Both findings together suggest that current practice does not offer residents enough opportunities to acquire these leadership behaviours by solely observing their supervisors. Moreover, residents and supervisors both express a need for more formal leadership training. More explicit attention should be paid to leadership development, for example by providing formal leadership training for supervisors and residents.

  13. A study on the characteristics of retrospective optimal interpolation using an Observing System Simulation Experiment

    Science.gov (United States)

    Kim, Shin-Woo; Noh, Nam-Kyu; Lim, Gyu-Ho

    2013-04-01

    This study presents the introduction of retrospective optimal interpolation (ROI) and its application with Weather Research and Forecasting model (WRF). Song et al. (2009) suggested ROI method which is an optimal interpolation (OI) that gradually assimilates observations over the analysis window for variance-minimum estimate of an atmospheric state at the initial time of the analysis window. The assimilation window of ROI algorithm is gradually increased, similar with that of the quasi-static variational assimilation (QSVA; Pires et al., 1996). Unlike QSVA method, however, ROI method assimilates the data at post analysis time using perturbation method (Verlaan and Heemink, 1997) without adjoint model. Song and Lim (2011) improved this method by incorporating eigen-decomposition and covariance inflation. The computational costs for ROI can be reduced due to the eigen-decomposition of background error covariance which can concentrate ROI analyses on the error variances of governing eigenmodes by transforming the control variables into eigenspace. A total energy norm is used for the normalization of each control variables. In this study, ROI method is applied to WRF model with Observing System Simulation Experiment (OSSE) to validate the algorithm and to investigate the capability. Horizontal wind, pressure, potential temperature, and water vapor mixing ratio are used for control variables and observations. Firstly, 1-profile assimilation experiment is performed. Subsequently, OSSE's are performed using the virtual observing system which consists of synop, ship, and sonde data. The difference between forecast errors with assimilation and without assimilation is obviously increased as time passed, which means the improvement of forecast error with the assimilation by ROI. The characteristics and strength/weakness of ROI method are also investigated by conducting the experiments with 3D-Var (3-dimensional variational) method and 4D-Var (4-dimensional variational) method

  14. Carotenoids and risk of fracture: a meta-analysis of observational studies.

    Science.gov (United States)

    Xu, Jiuhong; Song, Chunli; Song, Xiaochao; Zhang, Xi; Li, Xinli

    2017-01-10

    To quantify the association between dietary and circulating carotenoids and fracture risk, a meta-analysis was conducted by searching MEDLINE and EMBASE databases for eligible articles published before May 2016. Five prospective and 2 case-control studies with 140,265 participants and 4,324 cases were identified in our meta-analysis. Among which 5 studies assessed the association between dietary carotenoids levels and hip fracture risk, 2 studies focused on the association between circulating carotenoids levels and any fracture risk. A random-effects model was employed to summarize the risk estimations and their 95% confidence intervals (CIs). Hip fracture risk among participants with high dietary total carotenoids intake was 28% lower than that in participants with low dietary total carotenoids (OR: 0.72; 95% CI: 0.51, 1.01). A similar risk of hip fracture was found for β-carotene based on 5 studies, the summarized OR for high vs. low dietary β-carotene was 0.72 (95% CI: 0.54, 0.95). However, a significant between-study heterogeneity was found (total carotene: I2 = 59.4%, P = 0.06; β-carotene: I2 = 74.4%, P = 0.04). Other individual carotenoids did not show significant associations with hip fracture risk. Circulating carotene levels had no significant association with any fracture risk, the pooled OR (95% CI) was 0.83 (0.59, 1.17). Based on the evidence from observational studies, our meta-analysis supported the hypothesis that higher dietary total carotenoids or β-carotene intake might be potentially associated with a low risk of hip fracture, however, future well-designed prospective cohort studies and randomized controlled trials are warranted to specify the associations between carotenoids and fracture.

  15. SOSPES: SPIRIVA® observational study measuring SGRQ score in routine medical practice in Central and Eastern Europe

    Directory of Open Access Journals (Sweden)

    Fležar M

    2013-10-01

    Full Text Available Matjaž Fležar,1 Karina Jahnz-Rózyk,2 Gloria Enache,3 Tatiana Martynenko,4 Peter Kristufek,5 Sanda Škrinjaric-Cincar,6 Pavla Kadlecová,7 Goran Martinovic81University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia; 2Military Institute of Medicine, Department of Immunology and Allergology, Warsaw, Poland; 3Saint John Clinical Emergency Hospital, Bucharest, Romania; 4Municipal Medical Institution City Hospital, Barnaul, Russian Federation; 5SACCME, Slovak Medical University, Bratislava, Slovakia; 6Clinical Hospital Center, Osijek, Croatia; 7ADDS Sro, Jana Uhra, Brno, Czech Republic; 8Boehringer Ingelheim RCV GmbH and Co KG, Ingelheim, Vienna, AustriaPurpose: The long-acting inhaled anticholinergic agent, tiotropium, is recommended as first-line maintenance therapy for moderate to very severe Chronic Obstructive Pulmonary Disease (COPD to improve symptoms, exercise tolerance, health status, and to reduce exacerbations. Few studies have evaluated the therapeutic efficacy of tiotropium in patients in routine clinical conditions. The current study was designed to investigate the therapeutic efficacy of tiotropium delivered via the HandiHaler® device on the health status of patients with COPD with Global initiative for chronic Obstructive Lung Disease (GOLD disease classification 2–4 in six central and eastern European countries in a real-life clinical setting.Methods: The study was an open-label, prospective, uncontrolled, and single-arm surveillance study with three clinic visits during a 6-month observation period (baseline, and months 3 and 6. Health status was measured using the disease-specific St George's Respiratory Questionnaire (SGRQ. The primary efficacy endpoint was the mean change from baseline in SGRQ total score at the end of the 6-month observational period.Results: Patients treated with tiotropium 18 µg once daily showed statistically significant and clinically meaningful reduction (improvement of 21

  16. Evaluating the effectiveness of Neuro web design model in business websites (observational study

    Directory of Open Access Journals (Sweden)

    Boshra Sedghi Shamir

    2016-06-01

    Full Text Available By combining Neuromarketing، social psychology and e-commerce، a new area has been added to the world of consumer neuroscience named Nero web design. The practical Neuro business web design model consists of 67 applicable and implementable techniques in business websites and has been gathered in three sequential phases: attraction، message delivery، and reshaping with the aim of negotiating to the visitor’s brain to increase the conversion rate on a business website. Eight websites have been implemented to evaluate the effectiveness of this model: A simple website without using the model، a complete website (using all 67 techniques in the model، and six other websites that differentiate in reshaping groups. The unique and targeted visitors for each websites obtained through internet advertisements. They became 957 new visitors altogether. In the period of two months of observational studying، Website heat maps that track the mouse movements of visitors، showed that visitors attracted to all parts of the complete website homepage particularly order form module but not so for the simple website. This reflects the success of attraction phase of the model. The results showed that the conversion rate of each of the seven model websites as compared to simple website is greatly high and even more than the international average conversion rate.

  17. Feasibility study and technical proposal for long-term observations of bedrock stability with gps

    International Nuclear Information System (INIS)

    Ruizhi Chen; Kakkuri, J.

    1994-01-01

    In order to study the regional crustal deformation pattern in the territory of Finland, the Finnish Geodetic Institute is establishing the Finnish Permanent GPS Network, which is part of the Fennoscandian Permanent GPS Network. The Finnish GPS Network consists of a 12 stations located in different geological structures. The operation procedure of the network is described in the report. Feasibility study for monitoring the bedrock stability at local scale was performed. The study was carried out on the basis of an experiment on a baseline of 1041 metres. Twelve artificial movements ranging from 1 mm to 22 mm were generated with a precision-manufactured screw drive (with an accuracy of better than +-0.05 mm). The artificial movements were then detected with the GPS measurements. A preliminary analysis of the GPS data shows that the maximum difference between the GPS detected movements and the artificial movements is 0.9 mm with a standard deviation of +-0.46 mm. The observation time for reaching such accuracy is about 55 minutes. Three GPS networks were preliminarily designed for the radioactive waste disposal investigation sites of Olkiluoto, Kivetty and Romuvaara. Detailed research plan for achieving the best possible result from GPS measurements was proposed. (58 refs., 25 figs., 1 tab.)

  18. Safety of Intravenous Application of Mistletoe (Viscum album L. Preparations in Oncology: An Observational Study

    Directory of Open Access Journals (Sweden)

    Megan L. Steele

    2014-01-01

    Full Text Available Background. Traditional mistletoe therapy in cancer patients involves subcutaneous applications of Viscum album L. preparations, with doses slowly increasing based on patient responses. Intravenous infusion of high doses may improve therapeutic outcomes and is becoming more common. Little is known about the safety of this “off-label” application of mistletoe. Methods. An observational study was performed within the Network Oncology. Treatment with intravenous mistletoe applications is described. The frequency of adverse drug reactions (ADRs to intravenous mistletoe applications was calculated and compared to ADR data from a study on subcutaneous applications. Results. Of 475 cancer patients who received intravenous infusions of Helixor, Abnoba viscum, or Iscador mistletoe preparations, 22 patients (4.6% reported 32 ADRs of mild (59.4% or moderate severity (40.6%. No serious ADRs occurred. ADRs were more frequently reported to i.v. mistletoe administered alone (4.3%, versus prior to chemotherapy (1.6%. ADR frequency differed with respect to preparation type, with Iscador preparations showing a higher relative frequency, compared to Abnoba viscum and Helixor. Overall, patients were almost two times less likely to experience an ADR to intravenous compared to subcutaneous application of mistletoe. Conclusion. Intravenous mistletoe therapy was found to be safe and prospective studies for efficacy are recommended.

  19. Synergism between abdominal and pelvic floor muscles in healthy women: a systematic review of observational studies

    Directory of Open Access Journals (Sweden)

    Lia Ferla

    Full Text Available Abstract Introduction: The training of the pelvic floor muscles is widely used for treating pelvic floor dysfunctions, like urinary incontinence. During the training, abdominal contractions are avoided; however several studies support the use of the synergy between these muscle groups. Objective: Carrying out a systematic review of studies that seek to identify the presence of synergy between the muscles of the abdomen and the pelvic floor and its functionality in women without pelvic floor dysfunction. Methodology: To conduct the review, we have followed the recommendations proposed by the Cochrane Collaboration for systematic reviews. The literature search included the databases SCIELO, PEDro, MEDLINE, Cochrane CENTRAL and EMBASE, and manual research, the starting date of the databases until August 2013. We included cross observational studies with healthy women who were assessed to find the presence of synergy between the abdominal muscles and the pelvic floor. Results: We included 10 articles and they all showed the existence of synergy between the abdominal and pelvic floor muscles in healthy women in the supine, sitting and standing positions. Conclusion: Thus, we can conclude that there is synergy between the muscles of the abdomen and the pelvic floor in healthy women. Better understanding the behavior of these muscles and synergy may favor the development of strategies for the prevention and treatment of disorders of the female pelvic floor muscles.

  20. Inter-observer reliability assessments in time motion studies: the foundation for meaningful clinical workflow analysis.

    Science.gov (United States)

    Lopetegui, Marcelo A; Bai, Shasha; Yen, Po-Yin; Lai, Albert; Embi, Peter; Payne, Philip R O

    2013-01-01

    Understanding clinical workflow is critical for researchers and healthcare decision makers. Current workflow studies tend to oversimplify and underrepresent the complexity of clinical workflow. Continuous observation time motion studies (TMS) could enhance clinical workflow studies by providing rich quantitative data required for in-depth workflow analyses. However, methodological inconsistencies have been reported in continuous observation TMS, potentially reducing the validity of TMS' data and limiting their contribution to the general state of knowledge. We believe that a cornerstone in standardizing TMS is to ensure the reliability of the human observers. In this manuscript we review the approaches for inter-observer reliability assessment (IORA) in a representative sample of TMS focusing on clinical workflow. We found that IORA is an uncommon practice, inconsistently reported, and often uses methods that provide partial and overestimated measures of agreement. Since a comprehensive approach to IORA is yet to be proposed and validated, we provide initial recommendations for IORA reporting in continuous observation TMS.

  1. Observed Sensitivity during Family Interactions and Cumulative Risk: A Study of Multiple Dyads per Family

    Science.gov (United States)

    Browne, Dillon T.; Leckie, George; Prime, Heather; Perlman, Michal; Jenkins, Jennifer M.

    2016-01-01

    The present study sought to investigate the family, individual, and dyad-specific contributions to observed cognitive sensitivity during family interactions. Moreover, the influence of cumulative risk on sensitivity at the aforementioned levels of the family was examined. Mothers and 2 children per family were observed interacting in a round robin…

  2. Detailed Study of the Internal Structure of a Red-giant Star Observed with Kepler

    DEFF Research Database (Denmark)

    Di Mauro, M. P.; Ventura, R.; Cardini, D.

    2012-01-01

    We study the internal structure and evolutionary state of KIC 4351319, a red-giant star observed with the Kepler satellite. The use of 25 individual oscillation frequencies, together with the accurate atmospheric data provided by ground-based spectroscopic observations, allowed us to estimate the...

  3. A Classroom Observational Study of Qatar's Independent Schools: Instruction and School Reform

    Science.gov (United States)

    Palmer, Douglas J.; Sadiq, Hissa M.; Lynch, Patricia; Parker, Dawn; Viruru, Radhika; Knight, Stephanie; Waxman, Hersh; Alford, Beverly; Brown, Danielle Bairrington; Rollins, Kayla; Stillisano, Jacqueline; Abu-Tineh, Abdullah M. Hamdan; Nasser, Ramzi; Allen, Nancy; Al-Binali, Hessa; Ellili, Maha; Al-Kateeb, Haithem; Al-Kubaisi, Huda

    2016-01-01

    Qatar initiated a K-12 national educational reform in 2001. However, there is limited information on the instructional practices of the teachers in the reform schools. This project was an observational study of classrooms with a stratified random sample of the first six cohorts of reform schools. Specifically, 156 classrooms were observed in 29…

  4. An Observational Analysis of Coaching Behaviors for Career Development Event Teams: A Mixed Methods Study

    Science.gov (United States)

    Ball, Anna L.; Bowling, Amanda M.; Sharpless, Justin D.

    2016-01-01

    School Based Agricultural Education (SBAE) teachers can use coaching behaviors, along with their agricultural content knowledge to help their Career Development Event (CDE) teams succeed. This mixed methods, collective case study observed three SBAE teachers preparing multiple CDEs throughout the CDE season. The teachers observed had a previous…

  5. Long term observation on absolute lymphocyte counts in the adult health study sample, Hiroshima and Nagasaki

    International Nuclear Information System (INIS)

    Oesterle, S.N.; Norman, J.E. Jr.

    1980-01-01

    Total peripheral blood lymphocytes were evaluated by age and exposure status in the Adult Health Study population during three examination cycles between 1958 and 1972. No radiation effect was observed, but a significant drop in the absolute lymphocyte counts of those aged 70 years and over and a corresponding maximum for persons aged 50 - 59 was observed. (author)

  6. An Observation Capability Semantic-Associated Approach to the Selection of Remote Sensing Satellite Sensors: A Case Study of Flood Observations in the Jinsha River Basin.

    Science.gov (United States)

    Hu, Chuli; Li, Jie; Lin, Xin; Chen, Nengcheng; Yang, Chao

    2018-05-21

    Observation schedules depend upon the accurate understanding of a single sensor’s observation capability and the interrelated observation capability information on multiple sensors. The general ontologies for sensors and observations are abundant. However, few observation capability ontologies for satellite sensors are available, and no study has described the dynamic associations among the observation capabilities of multiple sensors used for integrated observational planning. This limitation results in a failure to realize effective sensor selection. This paper develops a sensor observation capability association (SOCA) ontology model that is resolved around the task-sensor-observation capability (TSOC) ontology pattern. The pattern is developed considering the stimulus-sensor-observation (SSO) ontology design pattern, which focuses on facilitating sensor selection for one observation task. The core aim of the SOCA ontology model is to achieve an observation capability semantic association. A prototype system called SemOCAssociation was developed, and an experiment was conducted for flood observations in the Jinsha River basin in China. The results of this experiment verified that the SOCA ontology based association method can help sensor planners intuitively and accurately make evidence-based sensor selection decisions for a given flood observation task, which facilitates efficient and effective observational planning for flood satellite sensors.

  7. An Observation Capability Semantic-Associated Approach to the Selection of Remote Sensing Satellite Sensors: A Case Study of Flood Observations in the Jinsha River Basin

    Directory of Open Access Journals (Sweden)

    Chuli Hu

    2018-05-01

    Full Text Available Observation schedules depend upon the accurate understanding of a single sensor’s observation capability and the interrelated observation capability information on multiple sensors. The general ontologies for sensors and observations are abundant. However, few observation capability ontologies for satellite sensors are available, and no study has described the dynamic associations among the observation capabilities of multiple sensors used for integrated observational planning. This limitation results in a failure to realize effective sensor selection. This paper develops a sensor observation capability association (SOCA ontology model that is resolved around the task-sensor-observation capability (TSOC ontology pattern. The pattern is developed considering the stimulus-sensor-observation (SSO ontology design pattern, which focuses on facilitating sensor selection for one observation task. The core aim of the SOCA ontology model is to achieve an observation capability semantic association. A prototype system called SemOCAssociation was developed, and an experiment was conducted for flood observations in the Jinsha River basin in China. The results of this experiment verified that the SOCA ontology based association method can help sensor planners intuitively and accurately make evidence-based sensor selection decisions for a given flood observation task, which facilitates efficient and effective observational planning for flood satellite sensors.

  8. Misuse of booster cushions - an observation study of children's performance during buckling up.

    Science.gov (United States)

    Osvalder, Anna-Lisa; Bohman, Katarina

    2008-10-01

    Booster cushions are effective tools to protect children from injuries in car crashes, but there remains a large amount of misuse. The aim of this study was to assess potential misuse of booster cushions in an observational laboratory study, and to identify whether booster cushion design, age or clothing had any effect. 130 Swedish children from the ages of 4-12 years participated. Each child buckled up on an integrated and on an aftermarket booster cushion in the rear seat. The older children also buckled up with seat belt only. Interviews, observations and body measurements were performed. Time to buckle up and amount of belt slack were registered. Photographs were taken to document misuse. Results showed that 77% failed to perform correct belt routing on the aftermarket cushion, independent of age, although they were familiar with this system. The misuse rate for the integrated cushion was only 4%. No misuse was found for seat belt only. Few children tightened the belt. The belt slack increased when wearing winter jackets. This indicates the importance of adding pretensioners to the rear seat. Sled tests with HIII&TNO 6y dummies were also performed for the most frequent misuse situations found. The main conclusion is that an integrated booster cushion has many advantages compared to an aftermarket cushion regarding both safety and comfort. It is easy and quick to handle, has few possibilities for misuse, has an intuitive design, the buckling up sequence is equal to buckling up with an ordinary seat belt, and younger children can buckle up correctly.

  9. Coronal structures and particle acceleration studies from radioelectric and optical observations

    International Nuclear Information System (INIS)

    Axisa, Francois.

    1974-01-01

    The problem of acceleration outside of and during eruptions is studied from the association of type III radioelectric jumps with the chromosphere activity observed in absorption and emission of the Hα line. In addition the mean corona structure is investigated from observation of the slowly variable metric wave component in connection with coronal filaments and jets, and by type III emission in relation to the eruptive sites of complex active regions. Most of the experimental material comes from observations made with the Nancay East-West radioheliograph, which works on 169 MHz and optical observations carried out at the Meudon Observatory on the chromosphere and on photosphere magnetic fields [fr

  10. Study of the Effects of Total Modulation Transfer Function Changes on Observer Performance Using Clinical Mammograms.

    Science.gov (United States)

    Bencomo, Jose Antonio Fagundez

    The main goal of this study was to relate physical changes in image quality measured by Modulation Transfer Function (MTF) to diagnostic accuracy. One Hundred and Fifty Kodak Min-R screen/film combination conventional craniocaudal mammograms obtained with the Pfizer Microfocus Mammographic system were selected from the files of the Department of Radiology, at M.D. Anderson Hospital and Tumor Institute. The mammograms included 88 cases with a variety of benign diagnosis and 62 cases with a variety of malignant biopsy diagnosis. The average age of the patient population was 55 years old. 70 cases presented calcifications with 30 cases having calcifications smaller than 0.5mm. 46 cases presented irregular bordered masses larger than 1 cm. 30 cases presented smooth bordered masses with 20 larger than 1 cm. Four separated copies of the original images were made each having a different change in the MTF using a defocusing technique whereby copies of the original were obtained by light exposure through different thicknesses (spacing) of transparent film base. The mammograms were randomized, and evaluated by three experienced mammographers for the degree of visibility of various anatomical breast structures and pathological lesions (masses and calicifications), subjective image quality, and mammographic interpretation. 3,000 separate evaluations were anayzed by several statistical techniques including Receiver Operating Characteristic curve analysis, McNemar test for differences between proportions and the Landis et al. method of agreement weighted kappa for ordinal categorical data. Results from the statistical analysis show: (1) There were no statistical significant differences in the diagnostic accuracy of the observers when diagnosing from mammograms with the same MTF. (2) There were no statistically significant differences in diagnostic accuracy for each observer when diagnosing from mammograms with the different MTF's used in the study. (3) There statistical

  11. What components of chronic care organisation relate to better primary care for coronary heart disease patients? An observational study.

    OpenAIRE

    Lieshout, J. van; Frigola Capell, E.; Ludt, S.; Grol, R.P.T.M.; Wensing, M.J.P.

    2012-01-01

    OBJECTIVES: Cardiovascular risk management (CVRM) received by patients shows large variation across countries. In this study we explored the aspects of primary care organisation associated with key components of CVRM in coronary heart disease (CHD) patients. DESIGN: Observational study. SETTING: 273 primary care practices in Austria, Belgium, England, Finland, France, Germany, The Netherlands, Slovenia, Switzerland and Spain. PARTICIPANTS: A random sample of 4563 CHD patients identified by co...

  12. Feasibility study for a first observation of coherent neutrino nucleus scattering using low-temperature detectors

    International Nuclear Information System (INIS)

    Guetlein, Achim

    2013-01-01

    Coherent Neutrino Nucleus Scattering (CNNS) is a neutral current process of the weak interaction. For low transferred momenta the neutrino scatters coherently off all nucleons leading to an enhanced cross section. However, because of the small resulting recoil energies (O(keV)) CNNS has not been observed experimentally so far. For the first observation of CNNS a strong neutrino source is needed. Thus, the expected count rates for solar neutrinos, supernova neutrinos, neutrinos generated by the decay of stopped π + particles at accelerators, and reactor neutrinos were calculated. Although an observation of CNNS could also be possible with other sources, the most promising neutrino sources are nuclear reactors with thermal powers between 2 and 4 GW. For an assumed energy threshold of 0.5 keV the target material with the largest count rate (∝10 kg -1 day -1 ) is sapphire. Thus, a low-temperature detector based on a 32 g sapphire crystal was designed and built to measure the background spectrum for energies below ∝10 keV. Although the energy threshold (∝1 keV) of this detector is too large for an observation of CNNS, the measured background spectrum can still be used for an investigation of the main background sources and the suppression of their events. For this investigation the simulated spectra of cosmic muons, ambient neutrons, and external gamma-rays are compared to the measured background spectrum. As a result, cosmic muons are the main contribution to the measured background spectrum. For a future experiment aiming at the observation of CNNS an array of 125 low-temperature detectors based on 32 g sapphire crystals is assumed. Background simulations of cosmic muons, ambient neutrons, and intrinsic radioactivity show that especially an efficient muon-veto system is crucial for a sufficient background suppression. To study the observation potential of this future experiment a distance of ∝ 40 m to a reactor core with a thermal power of ∝4 GW (neutrino

  13. A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals.

    Science.gov (United States)

    Al-Rawajfah, Omar M; Tubaishat, Ahmad

    2017-10-01

    The recognized international organizations on infection prevention recommend using an observational method as the gold standard procedure for assessing health care professional's compliance with standard infection control practices. However, observational studies are rarely used in Jordanian infection control studies. This study aimed to evaluate injection practices among nurses working in Jordanian governmental hospitals. A cross-sectional concealed observational design is used for this study. A convenience sampling technique was used to recruit a sample of nurses working in governmental hospitals in Jordan. Participants were unaware of the time and observer during the observation episode. A total of 384 nurses from 9 different hospitals participated in the study. A total of 835 injections events were observed, of which 73.9% were performed without handwashing, 64.5% without gloving, and 27.5% were followed by needle recapping. Handwashing rate was the lowest (18.9%) when injections were performed by beginner nurses. Subcutaneous injections were associated with the lowest rate (26.7%) of postinjection handwashing compared with other routes. This study demonstrates the need for focused and effective infection control educational programs in Jordanian hospitals. Future studies should consider exploring the whole infection control practices related to waste disposal and the roles of the infection control nurse in this process in Jordanian hospitals. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  14. New sub-family of lysozyme-like proteins shows no catalytic activity: crystallographic and biochemical study of STM3605 protein from Salmonella Typhimurium

    Energy Technology Data Exchange (ETDEWEB)

    Michalska, Karolina; Brown, Roslyn N.; Li, Hui; Jedrzejczak, Robert; Niemann, George; Heffron, Fred; Cort, John R.; Adkins, Joshua N.; Babnigg, Gyorgy; Joachimiak, Andrzej

    2013-03-01

    Phage viruses that infect prokaryotes integrate their genome into the host chromosome; thus, microbial genomes typically contain genetic remnants of both recent and ancient phage infections. Often phage genes occur in clusters of atypical G+C content that reflect integration of the foreign DNA. However, some phage genes occur in isolation without other phage gene neighbors, probably resulting from horizontal gene transfer. In these cases, the phage gene product is unlikely to function as a component of a mature phage particle, and instead may have been co-opted by the host for its own benefit. The product of one such gene from Salmonella enterica serovar Typhimurium, STM3605, encodes a protein with modest sequence similarity to phage-like lysozyme (N-acetylmuramidase) but appears to lack essential catalytic residues that are strictly conserved in all lysozymes. Close homologs in other bacteria share this characteristic. The structure of the STM3605 protein was characterized by X-ray crystallography, and functional assays showed that it is a stable, folded protein whose structure closely resembles lysozyme. However, this protein is unlikely to hydrolyze peptidoglycan. Instead, STM3605 is presumed to have evolved an alternative function because it shows some lytic activity and partitions to micelles.

  15. A palynological study of Polynesian and European effects on vegetation in Coromandel, New Zealand, showing the variability between four records from a single swamp

    International Nuclear Information System (INIS)

    Byrami, M.; Ogden, J.; Horrocks, M.; Deng, Y.; Shane, P.; Palmer, J.

    2002-01-01

    Seven cores were extracted from a river terrace swamp in the forested Kauaeranga valley, Coromandel Peninsula, New Zealand. High-resolution (c. 36-73 yr interval) pollen records were obtained from four of the cores and aged by radiocarbon dating and with stratigraphic reference to the 665 ± 15 14 C yr BP Kaharoa Tephra. The records span the last c. 1800 yr and show that the vegetation consisted of lowland podocarp-hardwood forest before deforestation by burning occurred. The pattern of deforestation at Kauaeranga, indicated by the abrupt dominance of Pteridium with concurrent increased charcoal, is typical of pollen records associated with early Polynesian settlement in New Zealand. Peaks of Pteridium and charcoal were also found in sediments deposited after European settlement. Different cores show marked palynological and stratigraphic differences relative to the Kaharoa Tephra, most importantly with regard to the timing of deforestation. Deforestation occurred close to the Kaharoa, at a calculated age of c. 750 BP in one core but well above the Kaharoa (c. 480 BP) in another. The stratigraphic unconformities between cores are attributed to variable fluvial processes causing an uneven deposition of sediments within the swamp. (author). 32 refs., 8 figs., 4 tabs

  16. Pre-LBA Anglo-Brazilian Amazonian Climate Observation Study (ABRACOS) Data

    Data.gov (United States)

    National Aeronautics and Space Administration — The data set presents the principal data from the Anglo-BRazilian Amazonian Climate Observation Study (ABRACOS) (Gash et al. 1996) and provides quality controlled...

  17. Pre-LBA Anglo-Brazilian Amazonian Climate Observation Study (ABRACOS) Data

    Data.gov (United States)

    National Aeronautics and Space Administration — ABSTRACT: The data set presents the principal data from the Anglo-BRazilian Amazonian Climate Observation Study (ABRACOS) (Gash et al. 1996) and provides quality...

  18. COGNOS : Care for People With Cognitive Dysfunction A National Observational Study

    NARCIS (Netherlands)

    Mets, Tony; De Deyn, Peter P.; Pals, Philippe; De Lepeleire, Jan; Vandewoude, Maurits; Ventura, Manfredi; Ivanoiu, Adrian; Albert, Adelin; Seghers, An-Katrien

    2013-01-01

    Care plans are intended to improve the independence and functioning of patients with cognitive dysfunction and support the caregivers involved. They are an integral part of the Belgian reimbursement procedure for cholinesterase inhibitors. This nationwide, multicenter, observational study examined

  19. Coagulation Profile in Patients with Different Etiologies for Cushing Syndrome: A Prospective Observational Study.

    Science.gov (United States)

    Tirosh, Amit; Lodish, Maya; Lyssikatos, Charalampos; Belyavskaya, Elena; Feelders, Richard A; Stratakis, Constantine A

    2017-05-01

    Previous studies reported a higher prevalence of venous-thromboembolic events among patients with Cushing disease (CD) compared to those with ACTH-independent Cushing syndrome (CS) from adrenal sources. The objective of the current study was to evaluate the coagulation profile of patients with CS from different etiologies. A prospective observational study was conducted at a clinical research center. The study included adult patients admitted for evaluation of suspected CS (n=85), that were divided into 3 groups: CD (n=22), ACTH-independent CS from an adrenal tumor/hyperplasia (adrenal CS, n=21), and a control group consisting of subjects with negative screening for CS (rule-out CS, n=42). Coagulation profiles were drawn before and 8.5±4.3 months after surgery (trans-sphenoidal or adrenalectomy, n=18), and included fibrinogen, Factor VIII (FVIII), von Willebrand factor antigen (vWF:Ag), plasminogen activator inhibitor-1 (PAI-1), antithrombin III (ATIII), Protein C (PC), Protein S (PS), α2-antiplasmin (α2AP), and aPTT measurements. Patients with CD had higher baseline mean cortisol levels, ATIII activity and vWF:Ag levels compared with adrenal CS. Differences in ATIII activity and vWF:Ag levels remained even after controlling for BMI, and ATIII after also controlling for 24-h urinary free cortisol collections. Our study showed for the first time the differences in coagulation profiles between various etiologies of CS. We assume that the higher cortisol burden among CD patients may explain the differences found in the coagulation profile as well as the higher risk for VTE compared with primary adrenal CS patients. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Investigation and studies on plant damage due to Tokyo photochemical smog. Part II. On the damage of petunia which showed the symptoms like injuries by pan (peroxyacetyl nitrate)

    Energy Technology Data Exchange (ETDEWEB)

    Terakado, K.

    1973-10-01

    Twice in the middle of June and in early Aug. 1972, petunia leaves were damaged by peroxyacetyl nitrate in Tokyo. The leaf damage, root activity, and pH and specific conductivity of the soil were studied. Similar plants were exposed experimentally to ozone for comparison. No damage was found on other types of plants in the same greenhouse, and different types of petunias were damaged to different degrees. The damage was studied by microscopy anbd by gross symptoms.

  1. Long-Time Exposure to Violent Video Games Does Not Show Desensitization on Empathy for Pain: An fMRI Study

    OpenAIRE

    Gao, Xuemei; Pan, Wei; Li, Chao; Weng, Lei; Yao, Mengyun; Chen, Antao

    2017-01-01

    As a typical form of empathy, empathy for pain refers to the perception and appraisal of others’ pain, as well as the corresponding affective responses. Numerous studies investigated the factors affecting the empathy for pain, in which the exposure to violent video games (VVGs) could change players’ empathic responses to painful situations. However, it remains unclear whether exposure to VVG influences the empathy for pain. In the present study, in terms of the exposure experience to VVG, two...

  2. Conifer Green Needle Complex in Patients with Precancerous Gastric Lesions: An Observational Pilot Study

    Directory of Open Access Journals (Sweden)

    Vladimir Bespalov

    2016-01-01

    Full Text Available Objectives. Helicobacter pylori infection is common and can lead to precancerous gastric lesions. Standard antibiotic therapy has a failure rate of more than 25% from antibiotic resistance. The primary aim of this observational pilot study was to test the feasibility of a large-scale clinical trial of Conifer Green Needle Complex (CGNC to treat precancerous gastric lesions. Secondary aims were to investigate H. pylori infection, stomach function, and histopathology of the gastric mucosa. Methods. A tablet form of CGNC (extracted from Pinus sylvestris and Picea abies (L Karst was prescribed to 26 patients with precancerous gastric lesions (two tablets, 100 mg CGNC/tablet, three times per day for six months. Another 24 patients received no treatment. Results. Compared with control patients, CGNC-treated patients showed total or partial regression (using the quantitative Rome III diagnostic criteria of dyspeptic symptoms (92.3%, p<0.0001, eradication of H. pylori infection (57.1%, p<0.03, a reduction in endoscopic signs of gastritis (92.3%, p<0.001, an increase of pepsinogen-pepsin in the gastric juice (57.7%, p<0.05, and total regression or reduction in the degree of intestinal metaplasia (46.2%, p<0.05 and lymphoplasmacytic infiltration (53.8%, p<0.05. Conclusions. This study justifies a randomised-controlled trial with CGNC in patients with atrophic gastritis.

  3. Effectiveness of an Internet-based preparation for psychosomatic treatment: Results of a controlled observational study.

    Science.gov (United States)

    Zimmer, Benjamin; Moessner, Markus; Wolf, Markus; Minarik, Carla; Kindermann, Sally; Bauer, Stephanie

    2015-11-01

    Patients often have to sustain long waiting periods between the time they first apply for psychotherapy and the actual uptake of the treatment. To support patients who are on a wait-list for inpatient psychosomatic treatment an Internet-based preparatory treatment (VORSTAT) was developed. In a randomized controlled trial, VORSTAT proved to increase treatment motivation prior to intake and to accelerate the accommodation phase at the beginning of inpatient treatment. No impact of VORSTAT on inpatient treatment outcome was found. The aim of the present study was to investigate the effectiveness of VORSTAT after implementing the service into routine care. A large naturalistic observational study comparing VORSTAT participants (N=911) against non-participants (N=1721) was conducted. Propensity scores were used to control for potential confounding variables due to the non-randomized group allocation. Reliable improvement of self-reported impairment achieved during inpatient treatment was used as outcome measure. VORSTAT participants showed higher rates of reliable improvement in physical impairment (50.8% vs. 44.9%), psychological impairment (41.2% vs. 29.9%), and social problems (22.3% vs. 15.2%). An Internet-based preparation for psychotherapy is an effective approach to improve outcome of inpatient psychosomatic treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. A second life for old data: Global patterns in pollution ecology revealed from published observational studies

    Energy Technology Data Exchange (ETDEWEB)

    Kozlov, Mikhail V., E-mail: mikoz@utu.fi [Section of Ecology, University of Turku, 20014 Turku (Finland); Zvereva, Elena L. [Section of Ecology, University of Turku, 20014 Turku (Finland)

    2011-05-15

    A synthesis of research on the responses of terrestrial biota (1095 effect sizes) to industrial pollution (206 point emission sources) was conducted to reveal regional and global patterns from small-scale observational studies. A meta-analysis, in combination with other statistical methods, showed that the effects of pollution depend on characteristics of the specific polluter (type, amount of emission, duration of impact on biota), the affected organism (trophic group, life history), the level at which the response was measured (organism, population, community), and the environment (biome, climate). In spite of high heterogeneity in responses, we have detected several general patterns. We suggest that the development of evolutionary adaptations to pollution is a common phenomenon and that the harmful effects of pollution on terrestrial ecosystems are likely to increase as the climate warms. We argue that community- and ecosystem-level responses to pollution should be explored directly, rather than deduced from organism-level studies. - Research synthesis demonstrated that the harmful effects of pollution on terrestrial ecosystems are likely to increase as the climate warms.

  5. A second life for old data: Global patterns in pollution ecology revealed from published observational studies

    International Nuclear Information System (INIS)

    Kozlov, Mikhail V.; Zvereva, Elena L.

    2011-01-01

    A synthesis of research on the responses of terrestrial biota (1095 effect sizes) to industrial pollution (206 point emission sources) was conducted to reveal regional and global patterns from small-scale observational studies. A meta-analysis, in combination with other statistical methods, showed that the effects of pollution depend on characteristics of the specific polluter (type, amount of emission, duration of impact on biota), the affected organism (trophic group, life history), the level at which the response was measured (organism, population, community), and the environment (biome, climate). In spite of high heterogeneity in responses, we have detected several general patterns. We suggest that the development of evolutionary adaptations to pollution is a common phenomenon and that the harmful effects of pollution on terrestrial ecosystems are likely to increase as the climate warms. We argue that community- and ecosystem-level responses to pollution should be explored directly, rather than deduced from organism-level studies. - Research synthesis demonstrated that the harmful effects of pollution on terrestrial ecosystems are likely to increase as the climate warms.

  6. Relaxation study of a paramagnetic ion by the observation of nuclear resonance signals

    International Nuclear Information System (INIS)

    Landesman, A.

    1960-01-01

    Dynamic polarization of protons in water containing the paramagnetic ion NO(SO 3 ) 2 was studied, both theoretically and experimentally, as a function of magnetic field. The enhancement of the proton polarization depends appreciably on the relaxation process of the electron spin and so enables us to decide which is the real relaxation process. We tried the two following processes: a) The electron spin is coupled with the nitrogen magnetic moment by hyperfine interaction; if this interaction has an anisotropic part, a relaxation process for the electronic spin will result through the Brownian motion of the ion. b) The relaxation of the electron spin takes place through spin-orbit coupling of the electron spin. Experimental results showed that the relaxation took place through the second process with the help of dynamic polarization we were able to study the relaxation of an electron spin in a liquid without using any electron resonance spectrometer, simply by observing the resonance of a nuclear spin coupled with the electron spin. Reprint of a paper published in Le Journal de Physique et le Radium, t. 20, p. 937-948, 1959 [fr

  7. Prospective observational study of adverse drug reactions to diclofenac in children

    Science.gov (United States)

    Standing, Joseph F; Ooi, Kuan; Keady, Simon; Howard, Richard F; Savage, Imogen; Wong, Ian C K

    2009-01-01

    AIM The aim of this study was to investigate the type of common (occurring in >1% of patients) adverse reactions caused by diclofenac when given to children for acute pain. METHODS A prospective observational study was undertaken on paediatric surgical patents aged ≤12 years at Great Ormond Street and University College London Hospitals. All adverse events were recorded, and causality assessment used to judge the likelihood of them being due to diclofenac. Prospective recruitment meant not all patients were prescribed diclofenac, allowing an analysis of utilization. Causality of all serious adverse events was reviewed by an expert panel. RESULTS Children prescribed diclofenac were significantly older, and stayed in hospital for shorter periods than those who were not. Diclofenac was not avoided in asthmatic patients. Data on 380 children showed they suffer similar types of nonserious adverse reactions to adults. The incidence (95% confidence interval) of rash was 0.8% (0.016, 2.3); minor central nervous system disturbance 0.5% (0.06, 1.9); rectal irritation with suppositories 0.3% (0.009, 1.9); and diarrhoea 0.3% (0.007, 1.5). No serious adverse event was judged to be caused by diclofenac, meaning the incidence of serious adverse reactions to diclofenac in children is Children given diclofenac for acute pain appeared to suffer similar types of adverse reactions to adults; the incidence of serious adverse reaction is <0.8%. PMID:19694745

  8. The value of postmortem computed tomography in paediatric natural cause of death: a Dutch observational study

    International Nuclear Information System (INIS)

    Rijn, Rick R. van; Beek, Erik J.; Nievelstein, Rutger-Jan A.; Putte, Elise M. van de; Teeuw, Arianne H.; Nikkels, Peter G.J.; Duijst, Wilma L.J.M.

    2017-01-01

    Postmortem CT is a relatively new field of interest within paediatric radiology. This paper focusses on its value in cases of unexpected natural death. We report on an observational Dutch study regarding the value of postmortem CT in children with an assumed natural unexpected death because postmortem CT is part of the Dutch NODO (additional investigations of cause of death) procedure. We included consecutive children who fulfilled criteria for the NODO procedure and were therefore referred to one of the centres for the procedure. Postmortem CT was performed in all cases and skeletal survey was performed in all children ages <5 years. The cause of death was defined in a consensus meeting. We included a total of 54 children (30 boys, median age 1.1 years, and 24 girls, median age 0.8 years). A definitive cause of death was established in 38 cases. In 7 cases the cause of death could be identified on postmortem CT. In 7 cases imaging findings were clinically relevant but did not lead to a cause of death. In the remaining 40 cases postmortem CT did not add to the diagnostic workup. Our study shows that in a group of children who unexpectedly died of an assumed natural cause of death and in whom a cause of death was found at autopsy, postmortem CT detected the cause of death in a minority of cases (12.9%). In the majority of cases (74.1%) postmortem CT did not add value in diagnosing the cause of death. (orig.)

  9. The value of postmortem computed tomography in paediatric natural cause of death: a Dutch observational study

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, Rick R. van [Academic Medical Centre Amsterdam, Department of Radiology, Emma Children' s Hospital, Amsterdam Zuid-Oost (Netherlands); Beek, Erik J.; Nievelstein, Rutger-Jan A. [University Medical Centre Utrecht, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Putte, Elise M. van de [University Medical Centre Utrecht, Department of Paediatrics, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Teeuw, Arianne H. [Academic Medical Center Amsterdam, Department of Paediatrics, Emma Children' s Hospital, Amsterdam (Netherlands); Nikkels, Peter G.J. [University Medical Centre Utrecht, Department of Pathology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Duijst, Wilma L.J.M. [Dutch Forensic Medical Association, Rotterdam (Netherlands); Collaboration: on behalf of the Dutch NODO Group

    2017-10-15

    Postmortem CT is a relatively new field of interest within paediatric radiology. This paper focusses on its value in cases of unexpected natural death. We report on an observational Dutch study regarding the value of postmortem CT in children with an assumed natural unexpected death because postmortem CT is part of the Dutch NODO (additional investigations of cause of death) procedure. We included consecutive children who fulfilled criteria for the NODO procedure and were therefore referred to one of the centres for the procedure. Postmortem CT was performed in all cases and skeletal survey was performed in all children ages <5 years. The cause of death was defined in a consensus meeting. We included a total of 54 children (30 boys, median age 1.1 years, and 24 girls, median age 0.8 years). A definitive cause of death was established in 38 cases. In 7 cases the cause of death could be identified on postmortem CT. In 7 cases imaging findings were clinically relevant but did not lead to a cause of death. In the remaining 40 cases postmortem CT did not add to the diagnostic workup. Our study shows that in a group of children who unexpectedly died of an assumed natural cause of death and in whom a cause of death was found at autopsy, postmortem CT detected the cause of death in a minority of cases (12.9%). In the majority of cases (74.1%) postmortem CT did not add value in diagnosing the cause of death. (orig.)

  10. Incidence and risk factors for delirium development in ICU patients - a prospective observational study.

    Science.gov (United States)

    Kanova, Marcela; Sklienka, Peter; Roman, Kula; Burda, Michal; Janoutova, Jana

    2017-06-01

    Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period. We evaluated the incidence of delirium and its predisposing and precipitating risk factors. All patients were assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU). Of the total of 332 patients with a median APACHE II (the Acute Physiology and Chronic Health Evaluation) score of 12, who were evaluated for delirium, 48 could not be assessed using CAM-ICU (47 due to prolonged coma, 1 due to language barriers). The incidence of delirium was 26.1%, with trauma and medical patients being more likely to develop delirium than surgical patients. Risk of delirium was significantly associated with age ≥ 65 years, and alcohol abuse in their anamnesis, with APACHE II score on admission, and with the use of sedatives and/or vasopressors. Delirious patients who remained in the ICU for a prolonged period showed a greater need for ventilator support and had a greater ICU-mortality.

  11. Diagnostic boundaries of autism disorder vs pervasive developmental disorder nos comparative observational study and literature review.

    Science.gov (United States)

    Carigi, Tiziana; Muratori, Filippo; Termine, Cristiano; Veggiotti, Pierangelo; Derhemi, Ledhina; Di Nardo, Roberta; Rossi, Giorgio; Balottin, Umberto

    2014-01-01

    Diagnosis of pervasive developmental disorders (PDDs), and above all diagnosis of the different PDD subtypes, is an ongoing challenge in psychopathology. Application of categorical criteria is complex and problematic in the clinical field where the boundaries dividing some of the PDD entities are blurred, creating particular problems for the clinician. A dimensional clinical approach, considering autistic symptom severity, level of functioning, developmental characteristics and symptoms other than the ones typically observed in autism, may be a more suitable approach in the clinical field and could provide the clinician treating these disorders with empirical guidance. To identify the clinical features that might differentiate the PDD subtypes, we conducted a comparative study in a clinical sample of children affected by autism disorder (AD) or pervasive developmental disorders not otherwise specified (PDD-NOS) and a mini critical review of the available literature addressing clinical and psychopathological differences between the two subtypes. The results of both our study and our literature review seem to show little support for the current PDD subtypes. In such a framework, the most significant element in clinical practice appears to be a deep knowledge of the characteristics of the individual in question. By adopting a broad and multi-faceted perspective, it becomes possible to define the most effective rehabilitation treatment. This applies particularly to the pharmacological treatment, since, to date, no specific therapies for PDDs are known and the choice of pharmacotherapy can be decided only on the basis of the patient's general profile and specific features.

  12. Carcinogenicity study of 3-monochloropropane-1, 2-diol (3-MCPD) administered by drinking water to B6C3F1 mice showed no carcinogenic potential.

    Science.gov (United States)

    Jeong, Jayoung; Han, Beom Seok; Cho, Wan-Seob; Choi, Mina; Ha, Chang-Su; Lee, Byoung-Seok; Kim, Yong-Bum; Son, Woo-Chan; Kim, Choong-Yong

    2010-09-01

    3-Monochloropropane-1, 2-diol (or 3-chloro-1,2-propanediol, 3-MCPD) is a well-known food processing contaminant found in a wide range of foods and ingredients. It has been classified as non-genotoxic carcinogen but its carcinogenic potential in the rodents has been controversial. The carcinogenicity to B6C3F1 mice by drinking water administration was assessed over a period of 104 weeks. Three groups, each comprising 50 male and 50 female mice received 3-MCPD at dosages of 30, 100 or 300 ppm up to Day 100 and 200 ppm onward (4.2, 14.3 and 33.0 mg/kg for males; 3.7, 12.2, and 31.0 mg/kg for females), were allocated. Survival was good, with at least 80% of males and 72% of females in each group surviving 104 weeks. Body weights and body weight gain were decreased in males and females receiving 200 ppm. Water and food consumptions of both sexes at 300/200 ppm were lowered. Emaciated or crouching position was observed for animals of both sexes exposed to 200 ppm. There were some differences in hematology and serum biochemistry compared with controls, although there was no histopathological evidence to support those changes. Histopathological examination did not reveal any neoplastic or non-neoplastic findings attributable to treatment with 3-MCPD. It is concluded that drinking water administration of 3-MCPD for 104 weeks revealed no evidence of carcinogenic potential.

  13. Patient characteristics associated with measurement of routine diabetes care: an observational study.

    Directory of Open Access Journals (Sweden)

    Arna L Van Doorn-Klomberg

    Full Text Available Non-modifiable patient characteristics, including age, gender, ethnicity as well as the occurrence of multi-morbidities, are associated with processes and outcomes of diabetes care. Information on these factors can be used in case mix adjustment of performance measures. However, the practical relevance of such adjustment is not clear. The aim of this study was to assess the strength of associations between patient factors and diabetes care processes and outcomes.We performed an observational study based on routinely collected data of 12,498 diabetes patients in 59 Dutch primary care practices. Data were collected on patient age, gender, whether the patient lived in a deprived area, body mass index and the co-occurrence of cardiovascular disease, chronic obstructive pulmonary disease, depression or anxiety. Outcomes included 6 dichotomous measures (3 process and 3 outcome related regarding glycosylated hemoglobin, systolic blood pressure and low density lipoprotein-cholesterol. We performed separate hierarchical logistic mixed model regression models for each of the outcome measures.Each of the process measure models showed moderate effect sizes, with pooled areas under the curve that varied between 0.66 and 0.76. The frequency of diabetes related consultations as a measure of patient compliance to treatment showed the strongest association with all process measures (odds ratios between 5.6 and 14.5. The effect sizes of the outcome measure models were considerably smaller than the process measure models, with pooled areas under the curve varying from 0.57 to 0.61.Several non-modifiable patient factors could be associated with processes and outcomes of diabetes care. However, associations were small. These results suggest that case-mix correction or stratification in assessing diabetes care has limited practical relevance.

  14. Site-directed mutagenesis and molecular modelling studies show the role of Asp82 and cysteines in rat acylase 1, a member of the M20 family

    International Nuclear Information System (INIS)

    Herga, Sameh; Brutus, Alexandre; Vitale, Rosa Maria; Miche, Helene; Perrier, Josette; Puigserver, Antoine; Scaloni, Andrea; Giardina, Thierry

    2005-01-01

    Acylase 1 from rat kidney catalyzes the hydrolysis of acyl-amino acids. Sequence alignment has shown that this enzyme belongs to the metalloprotein family M20. Site-directed mutagenesis experiments led to the identification of one functionally important amino acid residue located near one of the zinc coordinating residues, which play a critical role in the enzymatic activity. The D82N- and D82E-substituted forms showed no significant activity and very low activity, respectively, along with a loss of zinc coordination. Molecular modelling investigations indicated a putative role of D82 in ensuring a proper protonation of catalytic histidine. In addition, none of the five cysteine residues present in the rat kidney acylase 1 sequence seemed involved in the catalytic process: the loss of activity induced by the C294A substitution was probably due to a conformational change in the 3D structure

  15. FAKTOR YANG MEMPENGARUHI SIKAP AUDIENCE TERHADAP PRODUCT/BRAND PLACEMENT DALAM ACARA TV (STUDI KASUS INDONESIAN IDOL 2007 & MAMAMIA SHOW 2007

    Directory of Open Access Journals (Sweden)

    Leonid Julivan Rumambi

    2008-01-01

    Full Text Available Product/brand placement is not such a new matter in the marketing world, including in Indonesia in the last few years. These practice have been conducted at 1920 by cigarette's company in USA, while on the success story can be found on E.T (Extra-Terrestrial: the movie by 1982 presenting Reese's Pieces candy. Product/brand placement can be found widely in various medium starting from movies, TV shows, comics, games, video clip, etc. Today, various TV shows like 'Akademi Fantasi Indosiar (AFI', 'Indonesian Idol', 'Mamamia Show', 'Kontes Dangdut Indonesia (KDI', 'Empat Mata', 'Katakan Cinta', 'I-Gosip' & 'Cek & Ricek' are popular to advertise and become alternative medium for product / brand placement. In order to make the right decisions by conducting product/brand placement especially in TV shows, the company should know & understand several factors that influence audience attitude towards product/brand placement. Based on article entitled 'audience attitude towards product placement in movies: a case from Turkey' as a referred journal, the result of the research conducted have been formed four factors influencing attitude of audience toward product/brand placement. The four factors are 'attention', 'acceptance', 'reference' and 'ethics & regulation' with total variance explained equal to 53,53%. By conducting principal component factor analysis for this research, there are five factors influencing audience attitude toward product/brand placement formed with the total variance explained equal to 63,823 %. Three among other formed factors have several similar variables with the factor in the referred journal, while the two other factors compiled with only two variable/statement item for each. The percentage of each factor were 'acceptance' (18,923%, ethics & regulation (14,978%, attention (13,844%, reference (9,139% and interest (6,939%. The result of this research tried to conclude and give some input related with the final result of the main

  16. Association Between the Mediterranean Diet and Cancer Risk: A Review of Observational Studies

    NARCIS (Netherlands)

    Verberne, L.D.M.; Bach-Faig, A.; Buckland, G.; Serra-Majem, L.

    2010-01-01

    The aim of this article was to summarize the evidence concerning the association between Mediterranean dietary pattern and cancer risk in observational epidemiological studies. All the studies that met the following criteria were reviewed: human cohort and case-control studies that examined the

  17. User-friendly tools on handheld devices for observer performance study

    Science.gov (United States)

    Matsumoto, Takuya; Hara, Takeshi; Shiraishi, Junji; Fukuoka, Daisuke; Abe, Hiroyuki; Matsusako, Masaki; Yamada, Akira; Zhou, Xiangrong; Fujita, Hiroshi

    2012-02-01

    ROC studies require complex procedures to select cases from many data samples, and to set confidence levels in each selected case to generate ROC curves. In some observer performance studies, researchers have to develop software with specific graphical user interface (GUI) to obtain confidence levels from readers. Because ROC studies could be designed for various clinical situations, it is difficult task for preparing software corresponding to every ROC studies. In this work, we have developed software for recording confidence levels during observer studies on tiny personal handheld devices such as iPhone, iPod touch, and iPad. To confirm the functions of our software, three radiologists performed observer studies to detect lung nodules by using public database of chest radiograms published by Japan Society of Radiological Technology. The output in text format conformed to the format for the famous ROC kit from the University of Chicago. Times required for the reading each case was recorded very precisely.

  18. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement

    DEFF Research Database (Denmark)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias

    2014-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed...... recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists...... and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case...

  19. Nationwide individual record linkage study showed poor agreement of causes of death and hospital diagnoses at individual level but reasonable agreement at population level

    NARCIS (Netherlands)

    Klijs, Bart; Nusselder, Wilma J.; Mackenbach, Johan P.

    Objectives: To investigate to what extent underlying and multiple causes of death represent end-of-life morbidity in individuals and at population level. Study Design and Setting: Cause of death and national hospital data were individually linked for all deaths at the age of 50-84 years, in 2005 in

  20. Effects of Repetitive Transcranial Magnetic Stimulation in Performing Eye-Hand Integration Tasks: Four Preliminary Studies with Children Showing Low-Functioning Autism

    Science.gov (United States)

    Panerai, Simonetta; Tasca, Domenica; Lanuzza, Bartolo; Trubia, Grazia; Ferri, Raffaele; Musso, Sabrina; Alagona, Giovanna; Di Guardo, Giuseppe; Barone, Concetta; Gaglione, Maria P.; Elia, Maurizio

    2014-01-01

    This report, based on four studies with children with low-functioning autism, aimed at evaluating the effects of repetitive transcranial magnetic stimulation delivered on the left and right premotor cortices on eye-hand integration tasks; defining the long-lasting effects of high-frequency repetitive transcranial magnetic stimulation; and…

  1. Salivary cortisol differs with age and sex and shows inverse associations with WHR in Swedish women: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Lindblad Ulf

    2009-06-01

    Full Text Available Abstract Background Most studies on cortisol have focused on smaller, selected samples. We therefore aimed to sex-specifically study the diurnal cortisol pattern and explore its association with abdominal obesity in a large unselected population. Methods In 2001–2004, 1811 men and women (30–75 years were randomly selected from the Vara population, south-western Sweden (81% participation rate. Of these, 1671 subjects with full information on basal morning and evening salivary cortisol and anthropometric measurements were included in this cross-sectional study. Differences between groups were examined by general linear model and by logistic and linear regression analyses. Results Morning and Δ-cortisol (morning – evening cortisol were significantly higher in women than men. In both genders older age was significantly associated with higher levels of all cortisol measures, however, most consistently with evening cortisol. In women only, age-adjusted means of WHR were significantly lower in the highest compared to the lowest quartile of morning cortisol (p = 0.036 and Δ-cortisol (p Conclusion In summary, our findings of generally higher cortisol levels in women than men of all ages are novel and the stronger results seen for Δ-cortisol as opposed to morning cortisol in the association with WHR emphasise the need of studying cortisol variation intra-individually. To our knowledge, the associations in this study have never before been investigated in such a large population sample of both men and women. Our results therefore offer important knowledge on the descriptive characteristics of cortisol in relation to age and gender, and on the impact that associations previously seen between cortisol and abdominal obesity in smaller, selected samples have on a population level.

  2. [Registration of observational studies: it is time to comply with the Declaration of Helsinki requirement].

    Science.gov (United States)

    Dal-Ré, Rafael; Delgado, Miguel; Bolumar, Francisco

    2015-01-01

    Publication bias is a serious deficiency in the current system of disseminating the results of human research studies. Clinical investigators know that, from an ethical standpoint, they should prospectively register clinical trials in a public registry before starting them. In addition, it is believed that this approach will help to reduce publication bias. However, most studies conducted in humans are observational rather than experimental. It is estimated that less than 2% out of 2 million concluded or ongoing observational studies have been registered. The 2013 revision of the Declaration of Helsinki requires registration of any type of research study involving humans or identifiable samples or data. It is proposed that funding agencies, such as the Fondo de Investigaciones Sanitarias, as well as private companies, require preregistration of observational studies before providing funding. It is also proposed that Research Ethics Committees which, following Spanish regulation, have been using the Declaration as the framework for assessing the ethics of clinical trials with medicines since 1990, should follow the same provisions for the assessment of health-related observational studies: therefore, they should require prospective registration of studies before granting their final approval. This would allow observational study investigators to be educated in complying with an ethical requirement recently introduced in the most important ethical code for research involving humans. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. Effect of precipitation on clinic-diagnosed enteric infections in children in Rwanda: an observational study

    Directory of Open Access Journals (Sweden)

    Miles Kirby, PhD

    2018-05-01

    Full Text Available Background: Enteric infections are a major cause of morbidity and mortality in low-income and middle-income countries, particularly among children younger than 5 years. Climate change projections for Rwanda predict increases in average temperature, along with increases in total precipitation and frequency of extreme rainfall events. Previous research in Rwanda has found that extreme rainfall events increase the risk of contaminated drinking water, a substantial contributor to diarrhoea in this setting. Relatively little is known about the effect of precipitation on more severe clinic-diagnosed infections in rural, low-income settings such as Rwanda. In the context of a randomised controlled trial to assess the effect of a national environmental health campaign in Rwanda, we did a substudy to assess the effect of total and extreme rainfall on enteric infections in children younger than 5 years. Methods: For this observational study, we collected data from all government health facilities in Rusizi District, Western Province, for the year 2015. Patient data for children younger than 5 years from 150 study villages were extracted from paper-based registers. Gridded daily precipitation data were downloaded from the Tropical Applications of Meteorology using SATellite and ground based observations (TAMSAT rainfall dataset in addition to local weather station data. We modelled the effect of total rainfall (in mm and occurrence of an extreme rainfall event (95th percentile in the past 2 years on daily health facility visits for enteric symptoms (diarrhoea, gastroenteritis, or vomiting, using Poisson regression with a Newey-West estimator to adjust for serial autocorrelation. We examined total and extreme rainfall within the previous 1, 2, 3, and 4 weeks, controlling for weekend day because we observed a consistent reduction in case counts on weekends. Findings: Data were extracted from 46 facilities, with a study catchment area of approximately 12

  4. Observer-rated coping associated with borderline personality disorder: an exploratory study.

    Science.gov (United States)

    Kramer, Ueli

    2014-01-01

    Little is known about coping specificities, as operationalization of the concept of affect regulation, in borderline personality disorder (BPD). It is most important to take into account methodological criticisms addressed to the self-report questionnaire approach and to compare BPD coping specificities to the ones of neighbouring diagnostic categories, such as bipolar disorder (BD). The present exploratory study compared the coping profiles of N = 25 patients presenting BPD to those of N = 25 patients presenting BD and to those of N = 25 healthy controls. All participants underwent a clinical interview that was transcribed and rated using the Coping Patterns observer-rater system. Results partially confirmed study hypotheses and showed differences between BPD patients and healthy controls in all coping domains (competence, resources and autonomy), whereas the only coping domain presenting a BPD-specific lack of skills, compared with the BD patients, was autonomy, a set of coping strategies facing stress appraised as challenge. These coping processes were linked to general and BPD symptomatology. These results extend conclusions of earlier studies on affect regulation processes in BPD and bear important clinical implications, in the context of dialectical behavior therapy and other therapeutic approaches. Limitations of this exploratory study, such as the small sample size, are acknowledged. Coping can be reliably assessed in the narrative process in an non-structured interview frame. Patients with borderline personality disorder present with a specific lack of skills in affect regulation related to autonomy issues, compared to patients with bipolar disorder and healthy controls. Lack of skills in accommodation to distressing emotions in borderline personality disorder is related to symptom gravity and may be treated using radical acceptance strategies. Copyright © 2012 John Wiley & Sons, Ltd.

  5. Sharptooth catfish shows its metal: a case study of metal contamination at two impoundments in the Olifants River, Limpopo river system, South Africa.

    Science.gov (United States)

    Jooste, Antoinette; Marr, Sean M; Addo-Bediako, Abraham; Luus-Powell, Wilmien J

    2015-02-01

    Clarias gariepinus is increasing in importance as a global aquaculture species with a 100 fold increase in production over the past decade but this species still remains one of the most important wild harvested freshwater food fish throughout rural Africa. However, this species has been shown to accumulate metals from contaminated inland waters. In this paper, the metal concentrations in muscle tissue of C. gariepinus from two main-stem impoundments in the Olifants River, Limpopo Basin, were measured and a desktop risk assessment based on the US-EPA methodology completed to evaluate whether long-term consumption of C. gariepinus from these impoundments may pose a health risk to rural communities. Our results show that metals are accumulating in the muscle tissue of C. gariepinus and have appeared to have increased in the last two decades. Risk assessment generated Hazard quotients (HQ) greater than 1 indicate that long term consumption of fish from these impoundments may cause adverse health impacts. We found that lead (HQ=9), antimony (HQ=14), cobalt (HQ=2) and chromium (HQ=1) at one impoundment and lead (HQ=2) at the other impoundment were above acceptable levels for weekly consumption of 150 g C. gariepinus muscle tissue. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Spontaneous Brain Activity Did Not Show the Effect of Violent Video Games on Aggression: A Resting-State fMRI Study.

    Science.gov (United States)

    Pan, Wei; Gao, Xuemei; Shi, Shuo; Liu, Fuqu; Li, Chao

    2017-01-01

    A great many of empirical researches have proved that longtime exposure to violent video game can lead to a series of negative effects. Although research has focused on the neural basis of the correlation between violent video game and aggression, little is known whether the spontaneous brain activity is associated with violent video game exposure. To address this question, we measured the spontaneous brain activity using resting-state functional magnetic resonance imaging (fMRI). We used the amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF) to quantify spontaneous brain activity. The results showed there is no significant difference in ALFF, or fALFF, between violent video game group and the control part, indicating that long time exposure to violent video games won't significantly influence spontaneous brain activity, especially the core brain regions such as execution control, moral judgment and short-term memory. This implies the adverse impact of violent video games is exaggerated.

  7. Spontaneous Brain Activity Did Not Show the Effect of Violent Video Games on Aggression: A Resting-State fMRI Study

    Directory of Open Access Journals (Sweden)

    Wei Pan

    2018-01-01

    Full Text Available A great many of empirical researches have proved that longtime exposure to violent video game can lead to a series of negative effects. Although research has focused on the neural basis of the correlation between violent video game and aggression, little is known whether the spontaneous brain activity is associated with violent video game exposure. To address this question, we measured the spontaneous brain activity using resting-state functional magnetic resonance imaging (fMRI. We used the amplitude of low-frequency fluctuations (ALFF and fractional ALFF (fALFF to quantify spontaneous brain activity. The results showed there is no significant difference in ALFF, or fALFF, between violent video game group and the control part, indicating that long time exposure to violent video games won’t significantly influence spontaneous brain activity, especially the core brain regions such as execution control, moral judgment and short-term memory. This implies the adverse impact of violent video games is exaggerated.

  8. Spontaneous Brain Activity Did Not Show the Effect of Violent Video Games on Aggression: A Resting-State fMRI Study

    Science.gov (United States)

    Pan, Wei; Gao, Xuemei; Shi, Shuo; Liu, Fuqu; Li, Chao

    2018-01-01

    A great many of empirical researches have proved that longtime exposure to violent video game can lead to a series of negative effects. Although research has focused on the neural basis of the correlation between violent video game and aggression, little is known whether the spontaneous brain activity is associated with violent video game exposure. To address this question, we measured the spontaneous brain activity using resting-state functional magnetic resonance imaging (fMRI). We used the amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF) to quantify spontaneous brain activity. The results showed there is no significant difference in ALFF, or fALFF, between violent video game group and the control part, indicating that long time exposure to violent video games won’t significantly influence spontaneous brain activity, especially the core brain regions such as execution control, moral judgment and short-term memory. This implies the adverse impact of violent video games is exaggerated. PMID:29375416

  9. 24-hour aortic blood pressure variability showed a stronger association with carotid damage than 24-hour brachial blood pressure variability: The SAFAR study.

    Science.gov (United States)

    Yu, Shikai; Chi, Chen; Protogerou, Athanase D; Safar, Michel E; Blacher, Jacques; Argyris, Antonis A; Nasothimiou, Efthimia G; Sfikakis, Petros P; Papaioannou, Theodore G; Xu, Henry; Zhang, Yi; Xu, Yawei

    2018-03-01

    We aim to compare 24-hour aortic blood pressure variability (BPV) with brachial BPV in relation to carotid damage as estimated by carotid intima-media thickness (CIMT) and cross-sectional area (CCSA). Four hundred and forty five individuals received brachial and aortic 24-hour ambulatory BP monitoring with a validated device (Mobil-O-Graph). Systolic BPV was estimated by average real variability (ARV) and time-weighted standard deviation (wSD). In multiple logistic regression analysis, CIMT > 900 μm was significantly and independently associated with aortic ARV (OR = 1.38; 95% CI: 1.04-1.84), aortic wSD (OR = 1.65; 95% CI: 1.19-2.29) and brachial ARV (OR = 1.53; 95% CI: 1.07-2.18), but not with brachial wSD. CCSA > 90th percentile was significantly and independently associated with aortic ARV (OR = 1.50; 95% CI: 1.07-2.10) and wSD (OR = 1.70; 95% CI: 1.12-2.56), but not with brachial BPVs. In receiver operator characteristics curve analysis, aortic wSD identified CCSA > 90th percentile better than brachial wSD (AUC: 0.73 vs 0.68, P < .01). In conclusion, aortic 24-hour systolic BPV showed a slightly stronger association with carotid damage than brachial BPV. ©2018 Wiley Periodicals, Inc.

  10. Concatenation of Observed Grasp Phases with Observer’s Distal Movements: A Behavioural and TMS Study

    Science.gov (United States)

    De Stefani, Elisa; Innocenti, Alessandro; De Marco, Doriana; Gentilucci, Maurizio

    2013-01-01

    The present study aimed at determining how actions executed by two conspecifics can be coordinated with each other, or more specifically, how the observation of different phases of a reaching-grasping action is temporary related to the execution of a movement of the observer. Participants observed postures of initial finger opening, maximal finger aperture, and final finger closing of grasp after observation of an initial hand posture. Then, they opened or closed their right thumb and index finger (experiments 1, 2 and 3). Response times decreased, whereas acceleration and velocity of actual finger movements increased when observing the two late phases of grasp. In addition, the results ruled out the possibility that this effect was due to salience of the visual stimulus when the hand was close to the target and confirmed an effect of even hand postures in addition to hand apparent motion due to the succession of initial hand posture and grasp phase. In experiments 4 and 5, the observation of grasp phases modulated even foot movements and pronunciation of syllables. Finally, in experiment 6, transcranial magnetic stimulation applied to primary motor cortex 300 ms post-stimulus induced an increase in hand motor evoked potentials of opponens pollicis muscle when observing the two late phases of grasp. These data suggest that the observation of grasp phases induced simulation which was stronger during observation of finger closing. This produced shorter response times, greater acceleration and velocity of the successive movement. In general, our data suggest best concatenation between two movements (one observed and the other executed) when the observed (and simulated) movement was to be accomplished. The mechanism joining the observation of a conspecific’s action with our own movement may be precursor of social functions. It may be at the basis for interactions between conspecifics, and related to communication between individuals. PMID:24278395

  11. Show me how you walk and I tell you how you feel - a functional near-infrared spectroscopy study on emotion perception based on human gait.

    Science.gov (United States)

    Schneider, Sabrina; Christensen, Andrea; Häußinger, Florian B; Fallgatter, Andreas J; Giese, Martin A; Ehlis, Ann-Christine

    2014-01-15

    The ability to recognize and adequately interpret emotional states in others plays a fundamental role in regulating social interaction. Body language presents an essential element of nonverbal communication which is often perceived prior to mimic expression. However, the neural networks that underlie the processing of emotionally expressive body movement and body posture are poorly understood. 33 healthy subjects have been investigated using the optically based imaging method functional near-infrared spectroscopy (fNIRS) during the performance of a newly developed emotion discrimination paradigm consisting of faceless avatars expressing fearful, angry, sad, happy or neutral gait patterns. Participants were instructed to judge (a) the presented emotional state (emotion task) and (b) the observed walking speed of the respective avatar (speed task). We measured increases in cortical oxygenated haemoglobin (O2HB) in response to visual stimulation during emotion discrimination. These O2HB concentration changes were enhanced for negative emotions in contrast to neutral gait sequences in right occipito-temporal and left temporal and temporo-parietal brain regions. Moreover, fearful and angry bodies elicited higher activation increases during the emotion task compared to the speed task. Haemodynamic responses were correlated with a number of behavioural measures, whereby a positive relationship between emotion regulation strategy preference and O2HB concentration increases after sad walks was mediated by the ability to accurately categorize sad walks. Our results support the idea of a distributed brain network involved in the recognition of bodily emotion expression that comprises visual association areas as well as body/movement perception specific cortical regions that are also sensitive to emotion. This network is activated less when the emotion is not intentionally processed (i.e. during the speed task). Furthermore, activity of this perceptive network is, mediated by

  12. How often do German children and adolescents show signs of common mental health problems? Results from different methodological approaches – a cross-sectional study

    OpenAIRE

    Sauer, Kristin; Barkmann, Claus; Klasen, Fionna; Bullinger, Monika; Glaeske, Gerd; Ravens-Sieberer, Ulrike

    2014-01-01

    Background Child and adolescent mental health problems are ubiquitous and burdensome. Their impact on functional disability, the high rates of accompanying medical illnesses and the potential to last until adulthood make them a major public health issue. While methodological factors cause variability of the results from epidemiological studies, there is a lack of prevalence rates of mental health problems in children and adolescents according to ICD-10 criteria from nationally representative ...

  13. Seeing beyond monitors-Critical care nurses' multiple skills in patient observation: Descriptive qualitative study.

    Science.gov (United States)

    Alastalo, Mika; Salminen, Leena; Lakanmaa, Riitta-Liisa; Leino-Kilpi, Helena

    2017-10-01

    The aim of this study was to provide a comprehensive description of multiple skills in patient observation in critical care nursing. Data from semi-structured interviews were analysed using thematic analysis. Experienced critical care nurses (n=20) from three intensive care units in two university hospitals in Finland. Patient observation skills consist of: information gaining skills, information processing skills, decision-making skills and co-operation skills. The first three skills are integrated in the patient observation process, in which gaining information is a prerequisite for processing information that precedes making decisions. Co-operation has a special role as it occurs throughout the process. This study provided a comprehensive description of patient observation skills related to the three-phased patient observation process. The findings contribute to clarifying this part of the competence. The description of patient observation skills may be applied in both clinical practice and education as it may serve as a framework for orientation, ensuring clinical skills and designing learning environments. Based on this study, patient observation skills can be recommended to be included in critical care nursing education, orientation and as a part of critical care nurses' competence evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The Nord-Trøndelag Health Study shows increased prevalence of primary recurrent headaches among adolescents over a four-year period.

    Science.gov (United States)

    Jacobsena, Brit A; Dyb, Grete; Hagen, Knut; Stovner, Lars J; Holmen, Turid L; Zwart, John-Anker

    2017-12-29

    Objective Earlier epidemiological studies have shown that headaches are frequent among adolescents, especially girls. In particular, recurrent primary headache disorders such as migraine and tension-type headaches are common complaints in this age group. Headaches are increasingly being recognized as a significant health problem in adolescents and can lead to significant disabilities by affecting their lives, their school performance and their social lives. The aim of this study was to compare the prevalence of primary headaches among adolescents aged 16-20 years in Norway in two periods. Very few replicate studies have re-evaluated the prevalence of primary headaches in this age range and it is uncertain whether the prevalence is increasing. Methods Two cross-sectional, population-based studies were conducted in Norway from 1995 to 1997 (Young-HUNT 1) and from 1999 to 2001 (Young-HUNT 2). In Young-HUNT 1, 2594 adolescents in 2nd and 3rd grade in upper secondary school (aged 16-20 years) completed a comprehensive questionnaire including one question regarding headache during the last 12 months. In addition, 1730 of the students were interviewed about their headache complaints. In Young-HUNT 2, 2373 adolescents aged 16-20 years completed the same questionnaire and 1655 were interviewed in the same way as the earlier survey. The interviews were performed by trained nurses, and respondents were asked if they had experienced recurrent headache during the last year. If so, the headache was classified as migraine (MI), tensiontype headache (TTH) or non-classifiable headache (NCH). Headache frequency during the past year was recorded according to the following categories: Less than 1 day per month (less than monthly), 1-3 days per month (monthly), 1-5 days per week (weekly), or more than 5 days per week (daily). Results The participation rate was 88% in Young-HUNT 1 and 81% in Young-HUNT 2. The overall prevalence of having had headaches during the last 12 months did not

  15. The utility of observational studies in clinical decision making: lessons learned from statin trials.

    Science.gov (United States)

    Foody, JoAnne M; Mendys, Phillip M; Liu, Larry Z; Simpson, Ross J

    2010-05-01

    Contemporary clinical decision making is well supported by a wide variety of information sources, including clinical practice guidelines, position papers, and insights from randomized controlled trials (RCTs). Much of our fundamental understanding of cardiovascular risk factors is based on multiple observations from major epidemiologic studies, such as The Seven Country Studies and the US-based Framingham Heart Study. These studies provided the framework for the development of clinical practice guidelines, including the National Cholesterol Education Program Adult Treatment Panel series. The objective of this article is to highlight the value of observational studies as a complement to clinical trial data for clinical decision making in real-world practice. Although RCTs are still the benchmark for assessing clinical efficacy and safety of a specific therapeutic approach, they may be of limited utility to practitioners who must then adapt the lessons learned from the trial into the patient care environment. The use of well-structured observational studies can improve our understanding of the translation of clinical trials into clinical practice, as demonstrated here with the example of statins. Although such studies have their own limitations, improved techniques for design and analysis have reduced the impact of bias and confounders. The introduction of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines has provided more uniformity for such studies. When used together with RCTs, observational studies can enhance our understanding of effectiveness and utility in real-world clinical practice. In the examples of statin observational studies, the results suggest that relative effectiveness of different statins and potential impact of switching statins should be carefully considered in treating individual patients by practicing physicians.

  16. Assessing blood flow, microvasculature, erythema and redness in hypertrophic scars: A cross sectional study showing different features that require precise definitions.

    Science.gov (United States)

    Jaspers, M E H; Stekelenburg, C M; Simons, J M; Brouwer, K M; Vlig, M; van den Kerckhove, E; Middelkoop, E; van Zuijlen, P P M

    2017-08-01

    In hypertrophic scar assessment, laser Doppler imaging (LDI), colorimetry and subjective assessment (POSAS) can be used to evaluate blood flow, erythema and redness, respectively. In addition, the microvasculature (i.e. presence of microvessels) can be determined by immunohistochemistry. These measurement techniques are frequently used in clinical practice and/or in research to evaluate treatment response and monitor scar development. However, until now it has not been tested to what extent the outcomes of these techniques are associated, whilst the outcome terms are frequently used interchangeably or replaced by the umbrella term 'vascularization'. This is confusing, as every technique seems to measure a specific feature. Therefore, we evaluated the correlations of the four measurement techniques. We included 32 consecutive patients, aged ≥18 years, who underwent elective resection of a hypertrophic scar. Pre-operatively, we performed LDI (measuring blood flow), colorimetry (measuring erythema) and the POSAS (subjective redness) within the predefined scar area of interest (∼1.5cm). Subsequently, the scar was excised and the area of interest was sent for immunohistochemistry, to determine the presence of microvessels. Only a statistically significant correlation was found between erythema values (colorimetry) and subjective redness assessment (POSAS) (r=0.403, p=0.030). We found no correlations between the outcomes of LDI, immunohistochemistry and colorimetry. Blood flow, the presence of microvessels and erythema appear to be different hypertrophic scar features because they show an absence of correlation. Therefore, in the field of scar assessment, these outcome terms cannot be used interchangeably. In addition, we conclude that the term 'vascularization' does not seem appropriate to serve as an umbrella term. The use of precise definitions in research as well as in clinical practice is recommended. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  17. The perioperative surgical home (PSH): a comprehensive review of US and non-US studies shows predominantly positive quality and cost outcomes.

    Science.gov (United States)

    Kash, Bita A; Zhang, Yichen; Cline, Kayla M; Menser, Terri; Miller, Thomas R

    2014-12-01

    Policy Points: The perioperative surgical home (PSH) is complementary to the patient-centered medical home (PCMH) and defines methods for improving the patient experience and clinical outcomes, and controlling costs for the care of surgical patients. The PSH is a physician-led care delivery model that includes multi-specialty care teams and cost-efficient use of resources at all levels through a patient-centered, continuity of care delivery model with shared decision making. The PSH emphasizes "prehabilitation" of the patient before surgery, intraoperative optimization, improved return to function through follow-up, and effective transitions to home or post-acute care to reduce complications and readmissions. The evolving concept of more rigorously coordinated and integrated perioperative management, often referred to as the perioperative surgical home (PSH), parallels the well-known concept of a patient-centered medical home (PCMH), as they share a vision of improved clinical outcomes and reductions in cost of care through patient engagement and care coordination. Elements of the PSH and similar surgical care coordination models have been studied in the United States and other countries. This comprehensive review of peer-reviewed literature investigates the history and evolution of PSH and PSH-like models and summarizes the results of studies of PSH elements in the United States and in other countries. We reviewed more than 250 potentially relevant studies. At the conclusion of the selection process, our search had yielded a total of 152 peer-reviewed articles published between 1980 and 2013. The literature reports consistent and significant positive findings related to PSH initiatives. Both US and non-US studies stress the role of anesthesiologists in perioperative patient management. The PSH may have the greatest impact on preparing patients for surgery and ensuring their safe and effective transition to home or other postoperative rehabilitation. There appear

  18. An endemic of scabies in Kahuta, Azad Kashmir. The study shows a lack of awareness of scabies; mass treatment is needed.

    Science.gov (United States)

    Ali, Afaque

    2017-09-01

    The study was planned to find the awareness of scabies in the Forward Kahuta area of Azad Jammu and Kashmir, Pakistan. For this, a questionnaire related to scabies was distributed among the patients at different walk-in clinics in the region from June 2015 to May 2016. Of the 234 participants, 97(41.5%) were males and 137(58.5%) were females. All of them reported with itching, but 120(51.3%) of the participants didn't even know that itching may be due to scabies which was found in 157(67%) patients, and of them, 106(67.52%) knew that scabies was curable and preventable. Scabies was found in common school students (n=39(24.84%), farmers (n=32(2.38%) and laborers (n=31(19.74%). Due to poor awareness, a multi-dimensional approach is suggested to spread the awareness of skin diseases like scabies in the population under study and mass treatment of scabies in the area is recommended.

  19. Tianeptine, olanzapine and fluoxetine show similar restoring effects on stress induced molecular changes in mice brain: An FT-IR study

    Science.gov (United States)

    Türker-Kaya, Sevgi; Mutlu, Oğuz; Çelikyurt, İpek K.; Akar, Furuzan; Ulak, Güner

    2016-05-01

    Chronic stress which can cause a variety of disorders and illness ranging from metabolic and cardiovascular to mental leads to alterations in content, structure and dynamics of biomolecules in brain. The determination of stress-induced changes along with the effects of antidepressant treatment on these parameters might bring about more effective therapeutic strategies. In the present study, we investigated unpredictable chronic mild stress (UCMS)-induced changes in biomolecules in mouse brain and the restoring effects of tianeptine (TIA), olanzapine (OLZ) and fluoxetine (FLX) on these variations, by Fourier transform infrared (FT-IR) spectroscopy. The results revealed that chronic stress causes different membrane packing and an increase in lipid peroxidation, membrane fluidity. A significant increment for lipid/protein, Cdbnd O/lipid, CH3/lipid, CH2/lipid, PO-2/lipid, COO-/lipid and RNA/protein ratios but a significant decrease for lipid/protein ratios were also obtained. Additionally, altered protein secondary structure components were estimated, such as increment in random coils and beta structures. The administration of TIA, OLZ and FLX drugs restored these stress-induced variations except for alterations in protein structure and RNA/protein ratio. This may suggest that these drugs have similar restoring effects on the consequences of stress activity in brain, in spite of the differences in their action mechanisms. All findings might have importance in understanding molecular mechanisms underlying chronic stress and contribute to studies aimed for drug development.

  20. Hyperuricemia and risk of incident hypertension: a systematic review and meta-analysis of observational studies.

    Directory of Open Access Journals (Sweden)

    Ji Wang

    Full Text Available Observational studies of the relationship between hyperuricemia and the incidence of hypertension are controversial. We conducted a systematic review and meta-analysis to assess the association and consistency between uric acid levels and the risk of hypertension development.We searched MEDLINE, EMBASE, CBM (Chinese Biomedicine Database through September 2013 and reference lists of retrieved studies to identify cohort studies and nested case-control studies with uric acid levels as exposure and incident hypertension as outcome variables. Two reviewers independently extracted data and assessed study quality using Newcastle-Ottawa Scale. Extracted information included study design, population, definition of hyperuricemia and hypertension, number of incident hypertension, effect sizes, and adjusted confounders. Pooled relative risks (RRs and corresponding 95% confidence intervals (CIs for the association between hyperuricemia and risk of hypertension were calculated using a random-effects model.We included 25 studies with 97,824 participants assessing the association between uric acid and incident hypertension in our meta-analysis. The quality of included studies is moderate to high. Random-effects meta-analysis showed that hyperuricemia was associated with a higher risk of incident hypertension, regardless of whether the effect size was adjusted or not, whether the data were categorical or continuous as 1 SD/1 mg/dl increase in uric acid level (unadjusted: RR = 1.73, 95% CI 1.46∼2.06 for categorical data, RR = 1.22, 95% CI 1.03∼1.45 for a 1 SD increase; adjusted: RR = 1.48, 95% CI 1.33∼1.65 for categorical data, RR = 1.15, 95% CI 1.06∼1.26 for a 1 mg/dl increase, and the risk is consistent in subgroup analyses and have a dose-response relationship.Hyperuricemia may modestly increase the risk of hypertension incidence, consistent with a dose-response relationship.

  1. Seasonality shows evidence for polygenic architecture and genetic correlation with schizophrenia and bipolar disorder – a meta-analysis of genetic studies

    Science.gov (United States)

    Byrne, Enda M; Raheja, Uttam; Stephens, Sarah H.; Heath, Andrew C; Madden, Pamela AF; Vaswani, Dipika; Nijjar, Gagan V.; Ryan, Kathleen A.; Youssufi, Hassaan; Gehrman, Philip R; Shuldiner, Alan R; Martin, Nicholas G; Montgomery, Grant W; Wray, Naomi R; Nelson, Elliot C; Mitchell, Braxton D; Postolache, Teodor T

    2015-01-01

    Objective To test common genetic variants for association with seasonality (seasonal changes in mood and behavior) and to investigate whether there are shared genetic risk factors between psychiatric disorders and seasonality. Methods A meta-analysis of genome-wide association studies (GWAS) conducted in Australian and Amish populations in whom the Seasonal Pattern Assessment Questionnaire (SPAQ) had been administered. The total sample size was 4,156 individuals. Genetic risk scores based on results from prior large GWAS studies of bipolar disorder (BD), major depressive disorder (MDD), and schizophrenia (SCZ) were calculated to test for overlap in risk between psychiatric disorders and seasonality. Results The most significant association was with rs11825064 (p = 1.7 × 10−6, β = 0.64, S.E = 0.13), an intergenic SNP found on chromosome 11. The evidence for overlap in risk factors was strongest for SCZ and seasonality, with the SCZ genetic profile scores explaining 3% of the variance in log-transformed GSS. BD genetic profile scores were also significantly associated with seasonality, although at much weaker levels, and no evidence for overlap in risk was detected between MDD and seasonality. Conclusions Common SNPs of very large effect likely do not exist for seasonality in the populations examined. As expected, there was overlapping genetic risk factors for BD (but not MDD) with seasonality. Unexpectedly, the risk for SCZ and seasonality had the largest overlap, an unprecedented finding that requires replication in other populations, and has potential clinical implications considering overlapping cognitive deficits in seasonal affective disorders and SCZ PMID:25562672

  2. A randomized crossover clinical study showing that methylphenidate-SODAS improves attention-deficit/hyperactivity disorder symptoms in adolescents with substance use disorder

    Directory of Open Access Journals (Sweden)

    C.M. Szobot

    2008-03-01

    Full Text Available Our objective was to evaluate the effectiveness of a long-acting formulation of methylphenidate (MPH-SODAS on attention-deficit/hyperactivity disorder (ADHD symptoms in an outpatient sample of adolescents with ADHD and substance use disorders (SUD. Secondary goals were to evaluate the tolerability and impact on drug use of MPH-SODAS. This was a 6-week, single-blind, placebo-controlled crossover study assessing efficacy of escalated doses of MPH-SODAS on ADHD symptoms in 16 adolescents with ADHD/SUD. Participants were randomly allocated to either group A (weeks 1-3 on MPH-SODAS, weeks 4-6 on placebo or group B (reverse order. The primary outcome measures were the Swanson, Nolan and Pelham Scale, version IV (SNAP-IV and the Clinical Global Impression Scale (CGI. We also evaluated the adverse effects of MPH-SODAS using the Barkley Side Effect Rating Scale and subject reports of drug use during the study. The sample consisted of marijuana (N = 16; 100% and cocaine users (N = 7; 43.8%. Subjects had a significantly greater reduction in SNAP-IV and CGI scores (P < 0.001 for all analyses during MPH-SODAS treatment compared to placebo. No significant effects for period or sequence were found in analyses with the SNAP-IV and CGI scales. There was no significant effect on drug use. MPH-SODAS was well tolerated but was associated with more severe appetite reduction than placebo (P < 0.001. MPH-SODAS was more effective than placebo in reducing ADHD symptoms in a non-abstinent outpatient sample of adolescents with comorbid SUD. Randomized clinical trials, with larger samples and SUD intervention, are recommended.

  3. An Observational Study of Score Study Practices among Undergraduate Instrumental Music Education Majors

    Science.gov (United States)

    Silvey, Brian A.; Montemayor, Mark; Baumgartner, Christopher M.

    2017-01-01

    The purpose of this study was to investigate undergraduate instrumental music education majors' score study practices as they related to the effectiveness of their simulated conducting. Participants (N = 30) were video recorded in two sessions in which they completed a 20-min score study session and a simulated conducting performance. In the first…

  4. Magnetic clouds' structure in the magnetosheath as observed by Cluster and Geotail: four case studies

    Directory of Open Access Journals (Sweden)

    L. Turc

    2014-10-01

    Full Text Available Magnetic clouds (MCs are large-scale magnetic flux ropes ejected from the Sun into the interplanetary space. They play a central role in solar–terrestrial relations as they can efficiently drive magnetic activity in the near-Earth environment. Their impact on the Earth's magnetosphere is often attributed to the presence of southward magnetic fields inside the MC, as observed in the upstream solar wind. However, when they arrive in the vicinity of the Earth, MCs first encounter the bow shock, which is expected to modify their properties, including their magnetic field strength and direction. If these changes are significant, they can in turn affect the interaction of the MC with the magnetosphere. In this paper, we use data from the Cluster and Geotail spacecraft inside the magnetosheath and from the Advanced Composition Explorer (ACE upstream of the Earth's environment to investigate the impact of the bow shock's crossing on the magnetic structure of MCs. Through four example MCs, we show that the evolution of the MC's structure from the solar wind to the magnetosheath differs largely from one event to another. The smooth rotation of the MC can either be preserved inside the magnetosheath, be modified, i.e. the magnetic field still rotates slowly but at different angles, or even disappear. The alteration of the magnetic field orientation across the bow shock can vary with time during the MC's passage and with the location inside the magnetosheath. We examine the conditions encountered at the bow shock from direct observations, when Cluster or Geotail cross it, or indirectly by applying a magnetosheath model. We obtain a good agreement between the observed and modelled magnetic field direction and shock configuration, which varies from quasi-perpendicular to quasi-parallel in our study. We find that the variations in the angle between the magnetic fields in the solar wind and in the magnetosheath are anti-correlated with the variations in the

  5. Mortality in patients with diabetes mellitus and Addison's disease: a nationwide, matched, observational cohort study.

    Science.gov (United States)

    Chantzichristos, Dimitrios; Persson, Anders; Eliasson, Björn; Miftaraj, Mervete; Franzén, Stefan; Bergthorsdottir, Ragnhildur; Gudbjörnsdottir, Soffia; Svensson, Ann-Marie; Johannsson, Gudmundur

    2017-01-01

    Our hypothesis was that patients with diabetes mellitus obtain an additional risk of death if they develop Addison's disease (AD). Nationwide, matched, observational cohort study cross-referencing the Swedish National Diabetes Register with Inpatient, Cancer and Cause of Death Registers in patients with diabetes (type 1 and 2) and AD and matched controls with diabetes. Clinical characteristics at baseline, overall, and cause-specific mortality were assessed. The relative risk of death was assessed using a Cox proportional hazards regression model. Between January 1996 and December 2012, 226 patients with diabetes and AD were identified and matched with 1129 controls with diabetes. Median (interquartile range) follow-up was 5.9 (2.7-8.6) years. When patients with diabetes were diagnosed with AD, they had an increased frequency of diabetes complications, but both medical history of cancer and coronary heart disease did not differ compared with controls. Sixty-four of the 226 patients with diabetes and AD (28%) died, while 112 of the 1129 controls (10%) died. The estimated relative risk increase (hazard ratio) in overall mortality in the diabetes and AD group was 3.89 (95% confidence interval 2.84-5.32) compared with controls with diabetes. The most common cause of death was cardiovascular in both groups, but patients with diabetes and AD showed an increased death rate from diabetes complications, infectious diseases and unknown causes. Patients with the rare combination of diabetes and AD showed a markedly increased mortality and died more frequently from infections and unknown causes than patients with diabetes alone. Improved strategy for the management of this combination of metabolic disorders is needed. © 2017 European Society of Endocrinology.

  6. Designing virtual audiences for fear of public speaking training - an observation study on realistic nonverbal behavior.

    Science.gov (United States)

    Poeschl, Sandra; Doering, Nicola

    2012-01-01

    Virtual Reality technology offers great possibilities for Cognitive Behavioral Therapy of fear of public speaking: Clients can be exposed to virtual fear-triggering stimuli (exposure) and are able to role-play in virtual environments, training social skills to overcome their fear. Usually, prototypical audience behavior (neutral, social and anti-social) serves as stimulus in virtual training sessions, although there is significant lack of theoretical basis on typical audience behavior. The study presented deals with the design of a realistic virtual presentation scenario. An audience (consisting of n=18 men and women) in an undergraduate seminar was observed during three frontal lecture sessions. Behavior frequency of four nonverbal dimensions (eye contact, facial expression, gesture, and posture) was rated by means of a quantitative content analysis. Results show audience behavior patterns which seem to be typical in frontal lecture contexts, like friendly and neutral face expressions. Additionally, combined and even synchronized behavioral patterns between participants who sit next to each other (like turning to the neighbor and start talking) were registered. The gathered data serve as empirical design basis for a virtual audience to be used in virtual training applications that stimulate the experiences of the participants in a realistic manner, thereby improving the experienced presence in the training application.

  7. An observational study of implicit motor imagery using laterality recognition of the hand after stroke.

    Science.gov (United States)

    Amesz, Sarah; Tessari, Alessia; Ottoboni, Giovanni; Marsden, Jon

    2016-01-01

    To explore the relationship between laterality recognition after stroke and impairments in attention, 3D object rotation and functional ability. Observational cross-sectional study. Acute care teaching hospital. Thirty-two acute and sub-acute people with stroke and 36 healthy, age-matched controls. Laterality recognition, attention and mental rotation of objects. Within the stroke group, the relationship between laterality recognition and functional ability, neglect, hemianopia and dyspraxia were further explored. People with stroke were significantly less accurate (69% vs 80%) and showed delayed reaction times (3.0 vs 1.9 seconds) when determining the laterality of a pictured hand. Deficits either in accuracy or reaction times were seen in 53% of people with stroke. The accuracy of laterality recognition was associated with reduced functional ability (R(2) = 0.21), less accurate mental rotation of objects (R(2) = 0.20) and dyspraxia (p = 0.03). Implicit motor imagery is affected in a significant number of patients after stroke with these deficits related to lesions to the motor networks as well as other deficits seen after stroke. This research provides new insights into how laterality recognition is related to a number of other deficits after stroke, including the mental rotation of 3D objects, attention and dyspraxia. Further research is required to determine if treatment programmes can improve deficits in laterality recognition and impact functional outcomes after stroke.

  8. Mandatory Nap Times and Group Napping Patterns in Child Care: An Observational Study.

    Science.gov (United States)

    Staton, Sally L; Smith, Simon S; Hurst, Cameron; Pattinson, Cassandra L; Thorpe, Karen J

    2017-01-01

    Policy provision for naps is typical in child care settings, but there is variability in the practices employed. One practice that might modify children's early sleep patterns is the allocation of a mandatory nap time in which all children are required to lie on their beds without alternate activity permitted. There is currently limited evidence of the effects of such practices on children's napping patterns. This study examined the association between duration of mandatory nap times and group-level napping patterns in child care settings. Observations were undertaken in a community sample of 113 preschool rooms with a scheduled nap time (N = 2,114 children). Results showed that 83.5% of child care settings implemented a mandatory nap time (range = 15-145 min) while 14.2% provided alternate activities for children throughout the nap time period. Overall, 31% of children napped during nap times. Compared to rooms with ≤ 30 min of mandatory nap time, rooms with 31-60 min and > 60 min of mandatory nap time had a two-and-a-half and fourfold increase, respectively, in the proportion of children napping. Nap onset latency did not significantly differ across groups. Among preschool children, exposure to longer mandatory nap times in child care may increase incidence of napping.

  9. [Nursing students' satisfaction and perception of their first clinical placement: observational study].

    Science.gov (United States)

    Comparcini, Dania; Simonetti, Valentina; Tomietto, Marco; Galli, Francesco; Fiorani, Catia; Di Labio, Luisa; Cicolini, Giancarlo

    2014-01-01

    Clinical learning environments are defined as an interactive network of forces within the clinical context that influence students' learning outcomes. Nursing students' satisfaction could be strictly related to their learning outcomes. Aim. To analyze the first year nursing students' clinical learning experience and to identify the main determinants of students' satisfaction. The observational study was carried out in five Italian nursing degree courses. 420 students filled out the validated Italian version of the "Clinical Learning Environment and Supervision plus Nurse Teacher (CLES+T) scale" after the conclusion of their first clinical placement. The mean values of the main sub-dimensions of CLES+T varied from 4.02 (pedagogical atmosphere) to 3.30 (supervisory relationship). Students were mainly satisfied with their clinical placement, however the findings showed statistical significantly differences among the five nursing courses. The main determinants of the overall students' satisfaction are the nurse manager's leadership style and the integration between theoretical knowledge and everyday practice of nursing through the relationship among students, clinical tutors and nurse teacher. Our results may contribute to better understand nursing students' perception of their first clinical placement. However, further research are needed to evaluate which organizational factors and clinical training models may enhance the clinical learning experience.

  10. Many participants in inpatient rehabilitation can quantify their exercise dosage accurately: an observational study.

    Science.gov (United States)

    Scrivener, Katharine; Sherrington, Catherine; Schurr, Karl; Treacy, Daniel

    2011-01-01

    Are inpatients undergoing rehabilitation who appear able to count exercises able to quantify accurately the amount of exercise they undertake? Observational study. Inpatients in an aged care rehabilitation unit and a neurological rehabilitation unit, who appeared able to count their exercises during a 1-2 min observation by their treating physiotherapist. Participants were observed for 30 min by an external observer while they exercised in the physiotherapy gymnasium. Both the participants and the observer counted exercise repetitions with a hand-held tally counter and the two tallies were compared. Of the 60 people admitted for aged care rehabilitation during the study period, 49 (82%) were judged by their treating therapist to be able to count their own exercise repetitions accurately. Of the 30 people admitted for neurological rehabilitation during the study period, 20 (67%) were judged by their treating therapist to be able to count their repetitions accurately. Of the 69 people judged to be accurate, 40 underwent observation while exercising. There was excellent agreement between these participants' counts of their exercise repetitions and the observers' counts, ICC (3,1) of 0.99 (95% CI 0.98 to 0.99). Eleven participants (28%) were in complete agreement with the observer. A further 19 participants (48%) varied from the observer by less than 10%. Therapists were able to identify a group of rehabilitation participants who were accurate in counting their exercise repetitions. Counting of exercise repetitions by therapist-selected patients is a valid means of quantifying exercise dosage during inpatient rehabilitation. Copyright © 2011 Australian Physiotherapy Association. Published by .. All rights reserved.

  11. Challenges in translating end points from trials to observational cohort studies in oncology

    Directory of Open Access Journals (Sweden)

    Ording AG

    2016-06-01

    Full Text Available Anne Gulbech Ording,1 Deirdre Cronin-Fenton,1 Vera Ehrenstein,1 Timothy L Lash,1,2 John Acquavella,1 Mikael Rørth,1 Henrik Toft Sørensen1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA Abstract: Clinical trials are considered the gold standard for examining drug efficacy and for approval of new drugs. Medical databases and population surveillance registries are valuable resources for post-approval observational research, which are increasingly used in studies of benefits and risk of new cancer drugs. Here, we address the challenges in translating endpoints from oncology trials to observational studies. Registry-based cohort studies can investigate real-world safety issues – including previously unrecognized concerns – by examining rare endpoints or multiple endpoints at once. In contrast to clinical trials, observational cohort studies typically do not exclude real-world patients from clinical practice, such as old and frail patients with comorbidity. The observational cohort study complements the clinical trial by examining the effectiveness of interventions applied in clinical practice and by providing evidence on long-term clinical outcomes, which are often not feasible to study in a clinical trial. Various endpoints can be included in clinical trials, such as hard endpoints, soft endpoints, surrogate endpoints, and patient-reported endpoints. Each endpoint has it strengths and limitations for use in research studies. Endpoints used in oncology trials are often not applicable in observational cohort studies which are limited by the setting of standard clinical practice and by non-standardized endpoint determination. Observational studies can be more helpful moving research forward if they restrict focus to appropriate and valid endpoints. Keywords: endpoint determination, medical oncology

  12. SWAT use of gridded observations for simulating runoff - a Vietnam river basin study

    Science.gov (United States)

    Vu, M. T.; Raghavan, S. V.; Liong, S. Y.

    2012-08-01

    Many research studies that focus on basin hydrology have applied the SWAT model using station data to simulate runoff. But over regions lacking robust station data, there is a problem of applying the model to study the hydrological responses. For some countries and remote areas, the rainfall data availability might be a constraint due to many different reasons such as lacking of technology, war time and financial limitation that lead to difficulty in constructing the runoff data. To overcome such a limitation, this research study uses some of the available globally gridded high resolution precipitation datasets to simulate runoff. Five popular gridded observation precipitation datasets: (1) Asian Precipitation Highly Resolved Observational Data Integration Towards the Evaluation of Water Resources (APHRODITE), (2) Tropical Rainfall Measuring Mission (TRMM), (3) Precipitation Estimation from Remote Sensing Information using Artificial Neural Network (PERSIANN), (4) Global Precipitation Climatology Project (GPCP), (5) a modified version of Global Historical Climatology Network (GHCN2) and one reanalysis dataset, National Centers for Environment Prediction/National Center for Atmospheric Research (NCEP/NCAR) are used to simulate runoff over the Dak Bla river (a small tributary of the Mekong River) in Vietnam. Wherever possible, available station data are also used for comparison. Bilinear interpolation of these gridded datasets is used to input the precipitation data at the closest grid points to the station locations. Sensitivity Analysis and Auto-calibration are performed for the SWAT model. The Nash-Sutcliffe Efficiency (NSE) and Coefficient of Determination (R2) indices are used to benchmark the model performance. Results indicate that the APHRODITE dataset performed very well on a daily scale simulation of discharge having a good NSE of 0.54 and R2 of 0.55, when compared to the discharge simulation using station data (0.68 and 0.71). The GPCP proved to be the

  13. SWAT use of gridded observations for simulating runoff – a Vietnam river basin study

    Directory of Open Access Journals (Sweden)

    M. T. Vu

    2012-08-01

    Full Text Available Many research studies that focus on basin hydrology have applied the SWAT model using station data to simulate runoff. But over regions lacking robust station data, there is a problem of applying the model to study the hydrological responses. For some countries and remote areas, the rainfall data availability might be a constraint due to many different reasons such as lacking of technology, war time and financial limitation that lead to difficulty in constructing the runoff data. To overcome such a limitation, this research study uses some of the available globally gridded high resolution precipitation datasets to simulate runoff. Five popular gridded observation precipitation datasets: (1 Asian Precipitation Highly Resolved Observational Data Integration Towards the Evaluation of Water Resources (APHRODITE, (2 Tropical Rainfall Measuring Mission (TRMM, (3 Precipitation Estimation from Remote Sensing Information using Artificial Neural Network (PERSIANN, (4 Global Precipitation Climatology Project (GPCP, (5 a modified version of Global Historical Climatology Network (GHCN2 and one reanalysis dataset, National Centers for Environment Prediction/National Center for Atmospheric Research (NCEP/NCAR are used to simulate runoff over the Dak Bla river (a small tributary of the Mekong River in Vietnam. Wherever possible, available station data are also used for comparison. Bilinear interpolation of these gridded datasets is used to input the precipitation data at the closest grid points to the station locations. Sensitivity Analysis and Auto-calibration are performed for the SWAT model. The Nash-Sutcliffe Efficiency (NSE and Coefficient of Determination (R2 indices are used to benchmark the model performance. Results indicate that the APHRODITE dataset performed very well on a daily scale simulation of discharge having a good NSE of 0.54 and R2 of 0.55, when compared to the discharge simulation using station data (0

  14. Observation of Online Communities: A Discussion of Online and Offline Observer Roles in Studying Development, Cooperation and Coordination in an Open Source Software Environment

    Directory of Open Access Journals (Sweden)

    Sladjana V. Nørskov

    2011-09-01

    Full Text Available This paper addresses the application of observation to online settings with a special focus on observer roles. It draws on a study of online observation of a virtual community, i.e. an open source software (OSS community. The paper examines general and specific advantages and disadvantages of the observer roles in online settings by relating these roles to the same roles assumed in offline settings. The study suggests that under the right circumstances online and offline observation may benefit from being combined as they complement each other well. Quality issues and factors important to elicit trustworthy observational data from online study settings, such as OSS communities, are discussed. A proposition is made concerning how threats to credibility and transferability in relation to online observation (i.e. lack of richness and detail, risk of misunderstandings can be diminished, while maintaining the level of dependability (which is potentially high due to a greater degree of anonymity and "isolation" in online settings. The paper thus suggests that the less participative the researcher's online observer role is, the more s/he should consider introducing offline data collection techniques rather than adopting a more participative role in the observed online setting. This methodological discussion forms the basis for making a well-considered choice of online observer role rather than passively sliding into a role assigned by the setting. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs110358

  15. Sex-stratified Genome-wide Association Studies Including 270,000 Individuals Show Sexual Dimorphism in Genetic Loci for Anthropometric Traits

    Science.gov (United States)

    Jackson, Anne U.; Monda, Keri L.; Kilpeläinen, Tuomas O.; Esko, Tõnu; Mägi, Reedik; Li, Shengxu; Workalemahu, Tsegaselassie; Feitosa, Mary F.; Croteau-Chonka, Damien C.; Day, Felix R.; Fall, Tove; Ferreira, Teresa; Gustafsson, Stefan; Locke, Adam E.; Mathieson, Iain; Scherag, Andre; Vedantam, Sailaja; Wood, Andrew R.; Liang, Liming; Steinthorsdottir, Valgerdur; Thorleifsson, Gudmar; Dermitzakis, Emmanouil T.; Dimas, Antigone S.; Karpe, Fredrik; Min, Josine L.; Nicholson, George; Clegg, Deborah J.; Person, Thomas; Krohn, Jon P.; Bauer, Sabrina; Buechler, Christa; Eisinger, Kristina; Bonnefond, Amélie; Froguel, Philippe; Hottenga, Jouke-Jan; Prokopenko, Inga; Waite, Lindsay L.; Harris, Tamara B.; Smith, Albert Vernon; Shuldiner, Alan R.; McArdle, Wendy L.; Caulfield, Mark J.; Munroe, Patricia B.; Grönberg, Henrik; Chen, Yii-Der Ida; Li, Guo; Beckmann, Jacques S.; Johnson, Toby; Thorsteinsdottir, Unnur; Teder-Laving, Maris; Khaw, Kay-Tee; Wareham, Nicholas J.; Zhao, Jing Hua; Amin, Najaf; Oostra, Ben A.; Kraja, Aldi T.; Province, Michael A.; Cupples, L. Adrienne; Heard-Costa, Nancy L.; Kaprio, Jaakko; Ripatti, Samuli; Surakka, Ida; Collins, Francis S.; Saramies, Jouko; Tuomilehto, Jaakko; Jula, Antti; Salomaa, Veikko; Erdmann, Jeanette; Hengstenberg, Christian; Loley, Christina; Schunkert, Heribert; Lamina, Claudia; Wichmann, H. Erich; Albrecht, Eva; Gieger, Christian; Hicks, Andrew A.; Johansson, Åsa; Pramstaller, Peter P.; Kathiresan, Sekar; Speliotes, Elizabeth K.; Penninx, Brenda; Hartikainen, Anna-Liisa; Jarvelin, Marjo-Riitta; Gyllensten, Ulf; Boomsma, Dorret I.; Campbell, Harry; Wilson, James F.; Chanock, Stephen J.; Farrall, Martin; Goel, Anuj; Medina-Gomez, Carolina; Rivadeneira, Fernando; Estrada, Karol; Uitterlinden, André G.; Hofman, Albert; Zillikens, M. Carola; den Heijer, Martin; Kiemeney, Lambertus A.; Maschio, Andrea; Hall, Per; Tyrer, Jonathan; Teumer, Alexander; Völzke, Henry; Kovacs, Peter; Tönjes, Anke; Mangino, Massimo; Spector, Tim D.; Hayward, Caroline; Rudan, Igor; Hall, Alistair S.; Samani, Nilesh J.; Attwood, Antony Paul; Sambrook, Jennifer G.; Hung, Joseph; Palmer, Lyle J.; Lokki, Marja-Liisa; Sinisalo, Juha; Boucher, Gabrielle; Huikuri, Heikki; Lorentzon, Mattias; Ohlsson, Claes; Eklund, Niina; Eriksson, Johan G.; Barlassina, Cristina; Rivolta, Carlo; Nolte, Ilja M.; Snieder, Harold; Van der Klauw, Melanie M.; Van Vliet-Ostaptchouk, Jana V.; Gejman, Pablo V.; Shi, Jianxin; Jacobs, Kevin B.; Wang, Zhaoming; Bakker, Stephan J. L.; Mateo Leach, Irene; Navis, Gerjan; van der Harst, Pim; Martin, Nicholas G.; Medland, Sarah E.; Montgomery, Grant W.; Yang, Jian; Chasman, Daniel I.; Ridker, Paul M.; Rose, Lynda M.; Lehtimäki, Terho; Raitakari, Olli; Absher, Devin; Iribarren, Carlos; Basart, Hanneke; Hovingh, Kees G.; Hyppönen, Elina; Power, Chris; Anderson, Denise; Beilby, John P.; Hui, Jennie; Jolley, Jennifer; Sager, Hendrik; Bornstein, Stefan R.; Schwarz, Peter E. H.; Kristiansson, Kati; Perola, Markus; Lindström, Jaana; Swift, Amy J.; Uusitupa, Matti; Atalay, Mustafa; Lakka, Timo A.; Rauramaa, Rainer; Bolton, Jennifer L.; Fowkes, Gerry; Fraser, Ross M.; Price, Jackie F.; Fischer, Krista; KrjutÅ¡kov, Kaarel; Metspalu, Andres; Mihailov, Evelin; Langenberg, Claudia; Luan, Jian'an; Ong, Ken K.; Chines, Peter S.; Keinanen-Kiukaanniemi, Sirkka M.; Saaristo, Timo E.; Edkins, Sarah; Franks, Paul W.; Hallmans, Göran; Shungin, Dmitry; Morris, Andrew David; Palmer, Colin N. A.; Erbel, Raimund; Moebus, Susanne; Nöthen, Markus M.; Pechlivanis, Sonali; Hveem, Kristian; Narisu, Narisu; Hamsten, Anders; Humphries, Steve E.; Strawbridge, Rona J.; Tremoli, Elena; Grallert, Harald; Thorand, Barbara; Illig, Thomas; Koenig, Wolfgang; Müller-Nurasyid, Martina; Peters, Annette; Boehm, Bernhard O.; Kleber, Marcus E.; März, Winfried; Winkelmann, Bernhard R.; Kuusisto, Johanna; Laakso, Markku; Arveiler, Dominique; Cesana, Giancarlo; Kuulasmaa, Kari; Virtamo, Jarmo; Yarnell, John W. G.; Kuh, Diana; Wong, Andrew; Lind, Lars; de Faire, Ulf; Gigante, Bruna; Magnusson, Patrik K. E.; Pedersen, Nancy L.; Dedoussis, George; Dimitriou, Maria; Kolovou, Genovefa; Kanoni, Stavroula; Stirrups, Kathleen; Bonnycastle, Lori L.; Njølstad, Inger; Wilsgaard, Tom; Ganna, Andrea; Rehnberg, Emil; Hingorani, Aroon; Kivimaki, Mika; Kumari, Meena; Assimes, Themistocles L.; Barroso, Inês; Boehnke, Michael; Borecki, Ingrid B.; Deloukas, Panos; Fox, Caroline S.; Frayling, Timothy; Groop, Leif C.; Haritunians, Talin; Hunter, David; Ingelsson, Erik; Kaplan, Robert; Mohlke, Karen L.; O'Connell, Jeffrey R.; Schlessinger, David; Strachan, David P.; Stefansson, Kari; van Duijn, Cornelia M.; Abecasis, Gonçalo R.; McCarthy, Mark I.; Hirschhorn, Joel N.; Qi, Lu; Loos, Ruth J. F.; Lindgren, Cecilia M.; North, Kari E.; Heid, Iris M.

    2013-01-01

    Given the anthropometric differences between men and women and previous evidence of sex-difference in genetic effects, we conducted a genome-wide search for sexually dimorphic associations with height, weight, body mass index, waist circumference, hip circumference, and waist-to-hip-ratio (133,723 individuals) and took forward 348 SNPs into follow-up (additional 137,052 individuals) in a total of 94 studies. Seven loci displayed significant sex-difference (FDR<5%), including four previously established (near GRB14/COBLL1, LYPLAL1/SLC30A10, VEGFA, ADAMTS9) and three novel anthropometric trait loci (near MAP3K1, HSD17B4, PPARG), all of which were genome-wide significant in women (P<5×10−8), but not in men. Sex-differences were apparent only for waist phenotypes, not for height, weight, BMI, or hip circumference. Moreover, we found no evidence for genetic effects with opposite directions in men versus women. The PPARG locus is of specific interest due to its role in diabetes genetics and therapy. Our results demonstrate the value of sex-specific GWAS to unravel the sexually dimorphic genetic underpinning of complex traits. PMID:23754948

  16. Sex-stratified genome-wide association studies including 270,000 individuals show sexual dimorphism in genetic loci for anthropometric traits.

    Directory of Open Access Journals (Sweden)

    Joshua C Randall

    2013-06-01

    Full Text Available Given the anthropometric differences between men and women and previous evidence of sex-difference in genetic effects, we conducted a genome-wide search for sexually dimorphic associations with height, weight, body mass index, waist circumference, hip circumference, and waist-to-hip-ratio (133,723 individuals and took forward 348 SNPs into follow-up (additional 137,052 individuals in a total of 94 studies. Seven loci displayed significant sex-difference (FDR<5%, including four previously established (near GRB14/COBLL1, LYPLAL1/SLC30A10, VEGFA, ADAMTS9 and three novel anthropometric trait loci (near MAP3K1, HSD17B4, PPARG, all of which were genome-wide significant in women (P<5×10(-8, but not in men. Sex-differences were apparent only for waist phenotypes, not for height, weight, BMI, or hip circumference. Moreover, we found no evidence for genetic effects with opposite directions in men versus women. The PPARG locus is of specific interest due to its role in diabetes genetics and therapy. Our results demonstrate the value of sex-specific GWAS to unravel the sexually dimorphic genetic underpinning of complex traits.

  17. Service Failure and Recovery in a Public Setting: A Comparative Study of Target and Observing Customers

    OpenAIRE

    SEYED SHAHIN SHARIFI

    2017-01-01

    Previous research has examined the effect of service failure and recovery on target and the observing customers separately, with an emphasis on evaluations by target customers. It has been assumed that the reactions of those customers observing the recovery efforts would mirror those of target customers, or perhaps be even more favourable, given that they are not directly affected by the service failure. This research challenges this pre-conception. Through a series of experimental studies, t...

  18. Observation impact studies with the Mercator Ocean analysis and forecasting systems

    Science.gov (United States)

    Remy, E. D.; Le Traon, P. Y.; Lellouche, J. M.; Drevillon, M.; Turpin, V.; Benkiran, M.

    2016-02-01

    Mercator Ocean produces and delivers in real-time ocean analysis and forecasts on a daily basis. The quality of the analysis highly relies on the availability and quality of the assimilated observations.Tools are developed to estimate the impact of the present network and to help designing the future evolutions of the observing systems in the context of near real time production of ocean analysis and forecasts. OSE and OSSE are the main approaches used in this context. They allow the assessment of the efficiency of a given data set to constrain the ocean model circulation through the data assimilation process. Illustrations will mainly focus on the present and future evolution of the Argo observation network and altimetry constellation, including the potential impact of future SWOT data. Our systems show clear sensitivities to observation array changes, mainly depending on the specified observation error and regional dynamic. Impact on non observed variables can be important and are important to evaluate. Dedicated diagnostics has to be define to measure the improvements bring by each data set. Alternative approaches to OSE and OSSE are also explored: approximate computation of DFS will be presented and discussed. Limitations of each approach will be discussed in the context of real time operation.

  19. The epidemiology of hypernatraemia in hospitalised children in Lothian: a 10-year study showing differences between dehydration, osmoregulatory dysfunction and salt poisoning.

    Science.gov (United States)

    Forman, Sarah; Crofton, Patricia; Huang, Hian; Marshall, Tom; Fares, Katia; McIntosh, Neil

    2012-06-01

    The relative frequencies of the causes of hypernatraemia in children after the neonatal period are unknown. Salt poisoning and osmoregulatory dysfunction are extremely rare and potentially fatal. In this retrospective 10-year study, the incidence, causes and differential biochemistry of hypernatraemia in children is examined. Children with hypernatraemia (sodium ≥ 150 mmol/litre) aged >2 weeks to 17 years were identified from laboratory data of two paediatric departments serving the Lothian region of Scotland. A review of patient notes established time of onset and cause. Denominator data were available from the Scottish Health Service. On admission to hospital, 1 in 2288 children (1:1535 admitted as an emergency) had hypernatraemia. This is 1 in 30 563 Lothian children children admitted with 64 separate episodes (11 from a case of salt poisoning), the commonest cause was dehydration secondary to either gastroenteritis or systemic infection; 31% had an underlying chronic neurological disorder. A total of 177 further cases developed hypernatraemia after admission. The commonest causes were dehydration secondary to severe systemic infection and postoperative cardiac surgery. Urine sodium:creatinine ratio and fractional excretion of sodium were both much higher in the salt poisoning case than in a child with osmoregulatory dysfunction or children with simple dehydration. Hypernatraemia after 2 weeks of age is uncommon, and on admission is usually associated with dehydration. Salt poisoning and osmoregulatory dysfunction are rare but should be considered in cases of repeated hypernatraemia without obvious cause. Routine measurement of urea, creatinine and electrolytes on paired urine and plasma on admission will differentiate these rare causes.

  20. 78 FR 8152 - Proposed Collection; Comment Request: Women's Health Initiative Observational Study

    Science.gov (United States)

    2013-02-05

    ... Health Initiative (WHI) Observational Study. Type of Information Collection Request: Revision OMB 0925... causes of frailty, disability and death for postmenopausal women, namely, coronary heart disease, breast... providers. Type of Respondents: Study participants, next-of-kin, and physician's office staff. The annual...

  1. Dietary patterns are associated with disease risk among participants in the women's health initiative observational study

    Science.gov (United States)

    Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women’s Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infar...

  2. Coagulation Profile Dynamics in Pediatric Patients with Cushing Syndrome: A Prospective, Observational Comparative Study

    NARCIS (Netherlands)

    Birdwell, L. (Leah); M.B. Lodish (Maya Beth); Tirosh, A. (Amit); P. Chittiboina (Prashant); M. Keil (Mark); Lyssikatos, C. (Charlampos); Belyavskaya, E. (Elena); R.A. Feelders (Richard); C.A. Stratakis (Constantine)

    2016-01-01

    textabstractObjective To evaluate the association between Cushing syndrome and hypercoagulability in children. Study design A prospective, observational study was performed of 54 patients with Cushing syndrome, 15.1 ± 3.9 years, treated at the National Institutes of Health Clinical Center.

  3. Using and Experiencing the Academic Library: A Multisite Observational Study of Space and Place

    Science.gov (United States)

    May, Francine; Swabey, Alice

    2015-01-01

    This study examines how students are using academic library spaces and the role these spaces are playing in the campus community. Data were collected on five campuses (two community colleges, two undergraduate universities, and one technical institute) via observational seating sweeps and questionnaires. The study found remarkably similar usage…

  4. Falls in people with chronic obstructive pulmonary disease: An observational cohort study

    DEFF Research Database (Denmark)

    Roig, Marc; Eng, Janice J; MacIntyre, Donna L

    2011-01-01

    STUDY OBJECTIVE: To investigate incidence, risk factors and impact of falls on health related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). DESIGN: Observational cohort study. METHODS: Patients completed these questionnaires at baseline and at 6-months...

  5. Vitamin D insufficiency, preterm delivery and preeclampsia in women with type 1 diabetes - an observational study

    DEFF Research Database (Denmark)

    Vestgaard, Marianne; Secher, Anna L; Ringholm, Lene

    2017-01-01

    INTRODUCTION: The aim of this study was to evaluate whether vitamin D insufficiency is associated with preterm delivery and preeclampsia in women with type 1 diabetes. MATERIAL AND METHODS: An observational study of 198 pregnant women with type 1 diabetes. 25-Hydroxy-Vitamin D and HbA1c were meas...

  6. Predictors of switching from mania to depression in a large observational study across Europe (EMBLEM)

    NARCIS (Netherlands)

    Vieta, Eduard; Angst, Jules; Reed, Catherine; Bertsch, Jordan; Maria Haro, Josep

    Background: The risk of switching from mania to depression in bipolar disorder has been poorly studied. Large observational studies may be useful in identifying variables that predict switch to depression after mania and provide data on medication use and outcomes in "real world" patients. Method:

  7. Predictors of switching from mania to depression in a large observational study across Europe (EMBLEM)

    NARCIS (Netherlands)

    Vieta, Eduard; Angst, Jules; Reed, Catherine; Bertsch, Jordan; Maria Haro, Josep

    2009-01-01

    Background: The risk of switching from mania to depression in bipolar disorder has been poorly studied. Large observational studies may be useful in identifying variables that predict switch to depression after mania and provide data on medication use and outcomes in "real world" patients. Method:

  8. A prospective study of patients with brain MRI showing incidental t2 hyperintensities addressed as multiple sclerosis: a lot of work to do before treating.

    Science.gov (United States)

    Lebrun, Christine; Cohen, Mikael; Chaussenot, Annabelle; Mondot, Lydiane; Chanalet, Stephane

    2014-12-01

    With the development of magnetic resonance imaging (MRI) and publications about radiologically isolated syndrome (RIS), a lot of patients are referred to multiple sclerosis (MS) tertiary centers to confirm diagnosis of RIS or MS when brain T2 abnormalities are identified, whatever their characteristics. We evaluate prospectively the occurrence of RIS or MS and sensitivity, specificity and predictive value of McDonald criteria in diagnosis for patients presenting with incidental brain MRI T2 lesions. The authors ran standardized procedures on 220 consecutive patients addressed by general practitioners or neurologists to confirm RIS or MS diagnosis on brain MRI and give a therapeutic advice. All patients underwent neurological tests, extensive blood screening, cerebrospinal fluid (CSF) examination, visual evoked potential (VEP) and follow-up MRI after 3, 6, 12 and 24 months to consider dissemination in time and space. Patient characteristics were: 165 women and 55 men, mean age: 42.7 years old (23-59). The major symptom motivating MRI was headaches (39%), sensitive atypical manifestations or pain (12%), mood disorders (10%), transient visual symptoms (9%), fatigue (8%), hormonal screening (6%), vertigo (6%), cranial trauma (5%), and dummy run for clinical study (5%). After a structured analysis of T2 lesions, the suspected diagnosis was: inflammatory disease 45%, vascular 33%, non-pathological 19%, genetic 2%, and metabolic 1%. Extensive screening confirmed the proposed diagnosis in 97% of cases. Among all the 220 proposed RIS patients, only 35.4% fulfilled the 2010 McDonald criteria, and 8% can be categorized as RIS. Dissemination in time criteria was present for 82.7% of MS patients and 36% of RIS patients but none of the vascular or non-pathological T2 abnormalities. Even if RIS was initially suspected on MRI, only a third of the patients had an inflammatory disease. Most of the patients had either non-specific T2 lesions or a non-inflammatory disease. Others

  9. Cerebral perfusion characteristics show differences in younger versus older children with sickle cell anaemia: Results from a multiple-inflow-time arterial spin labelling study.

    Science.gov (United States)

    Kawadler, Jamie M; Hales, Patrick W; Barker, Simon; Cox, Timothy C S; Kirkham, Fenella J; Clark, Chris A

    2018-03-30

    Sickle cell anaemia (SCA) is associated with chronic anaemia and oxygen desaturation, which elevate cerebral blood flow (CBF) and increase the risk of neurocognitive complications. Arterial spin labelling (ASL) provides a methodology for measuring CBF non-invasively; however, ASL techniques using only a single inflow time are not sufficient to fully characterize abnormal haemodynamic behaviour in SCA. This study investigated haemodynamic parameters from a multi-inflow-time ASL acquisition in younger (8-12 years) and older (13-18 years) children with SCA with and without silent cerebral infarction (SCI+/-) (n = 20 and 19 respectively, 6 and 4 SCI+ respectively) and healthy controls (n = 9 and 7 respectively). Compared with controls, CBF was elevated globally in both groups of patients. In the younger SCA patients, blood oxygen content was negatively correlated with CBF in the middle and posterior cerebral artery territories and significantly positively correlated with bolus arrival time (BAT) in the anterior and middle cerebral artery territories. In older children, SCA patients had significantly shorter BAT than healthy controls and there was a significant negative correlation between CBF and oxygen content only in the territory of the posterior cerebral artery, with a trend for a correlation in the anterior cerebral artery but no relationship for the middle cerebral artery territory. In the younger group, SCI+ patients had significantly higher CBF in the posterior cerebral artery territory (SCI+ mean = 92.78 ml/100 g/min; SCI- mean = 72.71 ml/100 g/min; F = 4.28, p = 0.04), but this no longer reached significance when two children with abnormal transcranial Doppler and one with haemoglobin SC disease were excluded, and there were no significant differences between patients with and without SCI in the older children. With age, there appears to be increasing disparity between patients and controls in terms of the relationship between CBF and oxygen

  10. Satellite observed impacts of wildfires on regional atmosphere composition and shortwave radiative forcing: multiple cases study

    Science.gov (United States)

    Fu, Y.; Li, R.; Huang, J.; Bergeron, Y.; Fu, Y.

    2017-12-01

    Emissions of aerosols and trace gases from wildfires and the direct shortwave radiative forcing were studied using multi-satellite/sensor observations from Aqua Moderate-Resolution Imaging Spectroradiometer (MODIS), Aqua Atmospheric Infrared Sounder (AIRS), Aura Ozone Monitoring Instrument (OMI), and Aqua Cloud's and the Earth's Radiant Energy System (CERES). The selected cases occurred in Northeast of China (NEC), Siberia of Russia, California of America have dominant fuel types of cropland, mixed forest and needleleaf forest, respectively. The Fire radiative power (FRP) based emission coefficients (Ce) of aerosol, NOx (NO2+NO), formaldehyde (HCHO), and carbon monoxide (CO) showed significant differences from case to case. 1) the FRP of the cropland case in NEC is strongest, however, the Ce of aerosol is the lowest (20.51 ± 2.55 g MJ-1). The highest Ce of aerosol is 71.34 ± 13.24 g MJ-1 in the needleleaf fire case in California. 2) For NOx, the highest Ce existed in the cropland case in NEC (2.76 ± 0.25 g MJ-1), which is more than three times of those in the forest fires in Siberia and California. 3) The Ce of CO is 70.21±10.97 and 88.38±46.16 g MJ-1 in the forest fires in Western Siberia and California, which are about four times of that in cropland fire. 4) The variation of Ce of HCHO are relatively small among cases. Strong spatial correlations are found among aerosol optical depth (AOD), NOx, HCHO, and CO. The ratios of NOx to AOD, HCHO, and CO in the cropland case in NEC show much higher values than those in other cases. Although huge differences of emissions and composition ratios exist among cases, the direct shortwave (SW) radiative forcing efficiency (SWARFE) of smoke at the top of the atmosphere (TOA) are in good agreement, with the shortwave radiative forcing efficiencies values of 20.09 to 22.93 per unit AOD. Results in this study reveal noteworthy variations of the FRP-based emissions coefficient and relative chemical composition in the smoke

  11. Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study).

    Science.gov (United States)

    Guermazi, Ali; Niu, Jingbo; Hayashi, Daichi; Roemer, Frank W; Englund, Martin; Neogi, Tuhina; Aliabadi, Piran; McLennan, Christine E; Felson, David T

    2012-08-29

    To examine use of magnetic resonance imaging (MRI) of knees with no radiographic evidence of osteoarthritis to determine the prevalence of structural lesions associated with osteoarthritis and their relation to age, sex, and obesity. Population based observational study. Community cohort in Framingham, MA, United States (Framingham osteoarthritis study). 710 people aged >50 who had no radiographic evidence of knee osteoarthritis (Kellgren-Lawrence grade 0) and who underwent MRI of the knee. Prevalence of MRI findings that are suggestive of knee osteoarthritis (osteophytes, cartilage damage, bone marrow lesions, subchondral cysts, meniscal lesions, synovitis, attrition, and ligamentous lesions) in all participants and after stratification by age, sex, body mass index (BMI), and the presence or absence of knee pain. Pain was assessed by three different questions and also by WOMAC questionnaire. Of the 710 participants, 393 (55%) were women, 660 (93%) were white, and 206 (29%) had knee pain in the past month. The mean age was 62.3 years and mean BMI was 27.9. Prevalence of "any abnormality" was 89% (631/710) overall. Osteophytes were the most common abnormality among all participants (74%, 524/710), followed by cartilage damage (69%, 492/710) and bone marrow lesions (52%, 371/710). The higher the age, the higher the prevalence of all types of abnormalities detectable by MRI. There were no significant differences in the prevalence of any of the features between BMI groups. The prevalence of at least one type of pathology ("any abnormality") was high in both painful (90-97%, depending on pain definition) and painless (86-88%) knees. MRI shows lesions in the tibiofemoral joint in most middle aged and elderly people in whom knee radiographs do not show any features of osteoarthritis, regardless of pain.

  12. Magnetic resonance imaging for prostate bed radiotherapy planning: An inter- and intra-observer variability study

    International Nuclear Information System (INIS)

    Barkati, Maroie; Simard, Dany; Taussky, Daniel; Delouya, Guiula

    2016-01-01

    We assessed the inter- and intra-observer variability in contouring the prostate bed for radiation therapy planning using MRI compared with computed tomography (CT). We selected 15 patients with prior radical prostatectomy. All had CT and MRI simulation for planning purposes. Image fusions were done between CT and MRI. Three radiation oncologists with several years of experience in treating prostate cancer contoured the prostate bed first on CT and then on MRI. Before contouring, each radiation oncologist had to review the Radiation Therapy Oncology Group guidelines for postoperative external beam radiotherapy. The agreement between volumes was calculated using the Dice similarity coefficient (DSC). Analysis was done using the Matlab software. The DSC was compared using non-parametric statistical tests. Contouring on CT alone showed a statistically significant (P = 0.001) higher similarity between observers with a mean DSC of 0.76 (standard deviation ± 0.05) compared with contouring on MRI with a mean of 0.66 (standard deviation ± 0.05). Mean intra-observer variability between CT and MRI was 0.68, 0.75 and 0.78 for the three observers. The clinical target volume was 19 - 74% larger on CT than on MRI. The intra-observer difference in clinical target volume between CT and MRI was statistically significant in two observers and non-significant in the third one (P = 0.09). We found less inter-observer variability when contouring on CT than on MRI. Radiation Therapy Oncology Group contouring guidelines are based on anatomical landmarks readily visible on CT. These landmarks are more inter-observer dependent on MRI. Therefore, present contouring guidelines might not be applicable to MRI planning.

  13. The International Classification of Functioning, Disability and Health: a systematic review of observational studies.

    Science.gov (United States)

    Castaneda, Luciana; Bergmann, Anke; Bahia, Ligia

    2014-01-01

    To systematically review the use of the International Classification of Functioning, Disability and Health (ICF) in observational studies. This study is a systematic review of articles that use the ICF in observational studies. We took into account the observational design papers available in databases such as PubMed, Lilacs and SciELO, published in English and Portuguese from January 2001 to June 2011. We excluded those in which the samples did not comprise individuals, those about children and adolescents, and qualitative methodology articles. After reading the abstracts of 265 identified articles, 65 met the inclusion criteria. Of these, 18 were excluded. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) adapted Checklist, with 15 items needed for observational studies, was applied to the 47 remaining articles. Any paper that met 12 of these criteria was included in this systematic review. 29 articles were reviewed. Regarding the ICF application methodology, the checklist was used in 31% of the articles, the core set in 31% and the ICF categories in 31%. In the remaining 7%, it was not possible to define the applied methodology. In most papers (41%), qualifiers were used in their original format. As far as the area of knowledge is concerned, most of the studies were related to Rheumatology (24%) and Orthopedics (21%). Regarding the study design, 83% of the articles used cross-sectional studies. Results indicate a wide scientific production related to ICF over the past 10 years. Different areas of knowledge are involved in the debate on the improvement of information on morbidity. However, there are only a few quantitative epidemiological studies involving the use of ICF. Future studies are needed to improve data related to functioning and disability.

  14. Assessing validity of observational intervention studies – the Benchmarking Controlled Trials

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Abstract Background: Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. Aims: To create and pilot test a checklist for appraising methodological validity of a BCT. Methods: The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. Results: The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. Conclusions: The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies.Key messagesBenchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations.This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies.The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. PMID:27238631

  15. Terminal illness and the increased mortality risk of conventional antipsychotics in observational studies: a systematic review.

    Science.gov (United States)

    Luijendijk, Hendrika J; de Bruin, Niels C; Hulshof, Tessa A; Koolman, Xander

    2016-02-01

    Numerous large observational studies have shown an increased risk of mortality in elderly users of conventional antipsychotics. Health authorities have warned against use of these drugs. However, terminal illness is a potentially strong confounder of the observational findings. So, the objective of this study was to systematically assess whether terminal illness may have biased the observational association between conventional antipsychotics and risk of mortality in elderly patients. Studies were searched in PubMed, CINAHL, Embase, the references of selected studies and articles referring to selected studies (Web of Science). Inclusion criteria were (i) observational studies that estimated (ii) the risk of all-cause mortality in (iii) new elderly users of (iv) conventional antipsychotics compared with atypical antipsychotics or no use. Two investigators assessed the characteristics of the exposure and reference groups, main results, measured confounders and methods used to adjust for unmeasured confounders. We identified 21 studies. All studies were based on administrative medical and pharmaceutical databases. Sicker and older patients received conventional antipsychotics more often than new antipsychotics. The risk of dying was especially high in the first month of use, and when haloperidol was administered per injection or in high doses. Terminal illness was not measured in any study. Instrumental variables that were used were also confounded by terminal illness. We conclude that terminal illness has not been adjusted for in observational studies that reported an increased risk of mortality risk in elderly users of conventional antipsychotics. As the validity of the evidence is questionable, so is the warning based on it. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Student performance of the general physical examination in internal medicine: an observational study

    Science.gov (United States)

    2014-01-01

    Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

  17. Clinical and psychological repercussions of videolaparoscopic tubal ligation: observational, single cohort, retrospective study

    Directory of Open Access Journals (Sweden)

    Daniel Spadoto Dias

    Full Text Available CONTEXT AND OBJECTIVE: Tubal ligation is one of the most commonly used contraceptive methods worldwide. Since the controversy over the potential effects of tubal sterilization still continues, this study aimed to evaluate the clinical and psychological repercussions of videolaparoscopic tubal ligation.DESIGN AND SETTING: Observational, single cohort, retrospective study, conducted in a tertiary public hospital.METHODS: A questionnaire was applied to 130 women aged 21-46 years who underwent videolaparoscopic tubal ligation by means of tubal ring insertion or bipolar electrocoagulation and sectioning, between January 1999 and December 2007. Menstrual cycle interval, intensity and duration of bleeding, premenstrual symptoms, dysmenorrhea, dyspareunia, noncyclic pelvic pain and degree of sexual satisfaction were assessed in this questionnaire. Each woman served as her own control, and comparisons were made between before and after the surgical procedure and between the two techniques used.RESULTS: The clinical and psychological repercussions were significant, with increases in bleeding (P = 0.001, premenstrual symptoms (P < 0.001, dysmenorrhea (P = 0.019 and noncyclic pelvic pain (P = 0.001; and reductions in the number of sexual intercourse occurrences per week (P = 0.001 and in libido (P = 0.001. Women aged ≤ 35 years at the time of sterilization were more likely to develop menstrual abnormalities. The bipolar electrocoagulation method showed greater clinical and psychological repercussions.CONCLUSION: Regardless of the technique used, videolaparoscopic tubal ligation had repercussions consisting of increased menstrual flow and premenstrual symptoms, especially in women aged ≤ 35 years, and also had a negative influence on sexual activity.

  18. Vitamin D Intake and Risk of Type 1 Diabetes: A Meta-Analysis of Observational Studies

    Directory of Open Access Journals (Sweden)

    Li-Qiang Qin

    2013-09-01

    Full Text Available Vitamin D is suggested to have protective effects against type 1 diabetes. However, the results from observational studies have been inconsistent. We aimed to examine their association by conducting a meta-analysis of observational studies. Multiple databases were searched in June 2013 to identify relevant studies including both case-control and cohort studies. Either a fixed- or random-effects model was used to calculate the pooled risk estimate. We identified eight studies (two cohort studies and six case-control studies on vitamin D intake during early life and three studies (two cohort studies and one case-control study on maternal vitamin D intake during pregnancy. The pooled odds ratio for type 1 diabetes comparing vitamin D supplementation with non-supplementation during early life was 0.71 (95% confidence interval [CI], 0.51–0.98. Similar results were observed in the case-control subgroup analysis but not in the cohort subgroup analysis. The pooled odds ratio with maternal intake of vitamin D during pregnancy was 0.95 (95% CI, 0.66–1.36. In conclusion, vitamin D intake during early life may be associated with a reduced risk of type 1 diabetes. However, there was not enough evidence for an association between maternal intake of vitamin D and risk of type 1 diabetes in the offspring.

  19. The Gambian Bone and Muscle Ageing Study: Baseline Data from a Prospective Observational African Sub-Saharan Study

    Directory of Open Access Journals (Sweden)

    Ayse Zengin

    2017-08-01

    Full Text Available The Gambian Bone and Muscle Ageing Study is a prospective observational study investigating bone and muscle ageing in men and women from a poor, subsistence farming community of The Gambia, West Africa. Musculoskeletal diseases, including osteoporosis and sarcopenia, form a major part of the current global non-communicable disease burden. By 2050, the vast majority of the world’s ageing population will live in low- and middle-income countries with an estimated two-fold rise in osteoporotic fracture. The study design was to characterise change in bone and muscle outcomes and to identify possible preventative strategies for fracture and sarcopenia in the increasing ageing population. Men and women aged ≥40 years from the Kiang West region of The Gambia were recruited with stratified sampling by sex and age. Baseline measurements were completed in 488 participants in 2012 who were randomly assigned to follow-up between 1.5 and 2 years later. Follow-up measurements were performed on 465 participants approximately 1.7 years after baseline measurements. The data set comprises a wide range of measurements on bone, muscle strength, anthropometry, biochemistry, and dietary intake. Questionnaires were used to obtain information on health, lifestyle, musculoskeletal pain, and reproductive status. Baseline cross-sectional data show preliminary evidence for bone mineral density and muscle loss with age. Men had greater negative differences in total body lean mass with age than women following adjustments for body size. From peripheral quantitative computed tomography scans, greater negative associations between bone outcomes and age at the radius and tibia were shown in women than in men. Ultimately, the findings from The Gambian Bone and Muscle Ageing Study will contribute to the understanding of musculoskeletal health in a transitioning population and better characterise fracture and sarcopenia incidence in The Gambia with an aim to the

  20. Nurse staffing, medical staffing and mortality in Intensive Care: An observational study.

    Science.gov (United States)

    West, Elizabeth; Barron, David N; Harrison, David; Rafferty, Anne Marie; Rowan, Kathy; Sanderson, Colin

    2014-05-01

    To investigate whether the size of the workforce (nurses, doctors and support staff) has an impact on the survival chances of critically ill patients both in the intensive care unit (ICU) and in the hospital. Investigations of intensive care outcomes suggest that some of the variation in patient survival rates might be related to staffing levels and workload, but the evidence is still equivocal. Information about patients, including the outcome of care (whether the patient lived or died) came from the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme. An Audit Commission survey of ICUs conducted in 1998 gave information about staffing levels. The merged dataset had information on 65 ICUs and 38,168 patients. This is currently the best available dataset for testing the relationship between staffing and outcomes in UK ICUs. A cross-sectional, retrospective, risk adjusted observational study. Multivariable, multilevel logistic regression. ICU and in-hospital mortality. After controlling for patient characteristics and workload we found that higher numbers of nurses per bed (odds ratio: 0.90, 95% confidence interval: [0.83, 0.97]) and higher numbers of consultants (0.85, [0.76, 0.95]) were associated with higher survival rates. Further exploration revealed that the number of nurses had the greatest impact on patients at high risk of death (0.98, [0.96, 0.99]) whereas the effect of medical staffing was unchanged across the range of patient acuity (1.00, [0.97, 1.03]). No relationship between patient outcomes and the number of support staff (administrative, clerical, technical and scientific staff) was found. Distinguishing between direct care and supernumerary nurses and restricting the analysis to patients who had been in the unit for more than 8h made little difference to the results. Separate analysis of in-unit and in-hospital survival showed that the clinical workforce in intensive care had a greater impact on ICU mortality than on