WorldWideScience

Sample records for prevention opportunity subgroup

  1. Pollution prevention opportunity assessments at Hanford

    Energy Technology Data Exchange (ETDEWEB)

    Betsch, M.D., Westinghouse Hanford

    1996-06-26

    The Pollution Prevention Opportunity Assessment (PPOA) is a pro- active way to look at a waste generating activity and identify opportunities to minimize wastes through a cost benefit analysis. Hanford`s PPOA process is based upon the graded approach developed by the Kansas City Plant. Hanford further streamlined the process while building in more flexibility for the individual users. One of the most challenging aspects for implementing the PPOA process at Hanford is one overall mission which is environmental restoration, Now that the facilities are no longer in production, each has a different non- routine activity making it difficult to quantify the inputs and outputs of the activity under consideration.

  2. Opportunity Knocks: HIV Prevention in Primary Care.

    Science.gov (United States)

    Thrun, Mark W

    2014-06-01

    Expansions in health care coverage, a comprehensive framework for HIV prevention and care, electronic medical records, and novel HIV prevention modalities create a current opportunity to change the trajectory of the HIV epidemic in the United States. HIV is increasingly disproportionately found in populations historically at higher risk, including gay men and other men who have sex with men, transgender women, injection drug users, and persons of color. This underscores the need for providers to identify persons at higher risk for HIV and assure the provision of screening and prevention services. In turn, universal screening for HIV-testing every adolescent and adult at least once in their lifetime-will increasingly be necessary to find the infrequent cases of HIV in lower risk populations. In both these domains, primary care providers will play a unique role in complementing traditional providers of HIV prevention and care services by increasing the proportion of their patients who have been screened for HIV, opening dialogues around sexual health, including asking about sexual orientation and gender identity, and prescribing antivirals as pre- and postexposure prophylaxis for their non-HIV-infected patients. Primary care providers must understand and embrace their importance along the HIV prevention and care continuum.

  3. Preventing radiological terrorism - opportunities and challenges

    International Nuclear Information System (INIS)

    Barlow, Maegon E.

    2016-01-01

    The Office of Radiological Security (ORS), within the U.S. Department of Energy's National Nuclear Security Administration, enhances global security by preventing high activity radioactive materials from use in acts of terrorism. This is a challenging task considering that high activity radiological materials are ubiquitous, constantly moving and mostly found in operational civil facilities. The implementation of the ORS mission is based on a three pillar strategy - protect, remove and reduce. ORS works both domestically and internationally with government authorities, law enforcement, and businesses to protect radioactive sources used for vital medical, research, and commercial purposes, remove and dispose of disused radioactive sources, and reduce the global reliance on radioactive sources through the promotion of viable non-isotopic alternative technologies. ORS has active engagement in all 50 States and in over 80 countries. This presentation will provide an overview of ORS protect, remove, and reduce strategy, as well as security challenges and opportunities

  4. Pollution prevention opportunity assessments, a training and resource guide

    Energy Technology Data Exchange (ETDEWEB)

    VALERO, O.J.

    1998-11-03

    The intention of the ''Pollution Prevention Opportunity Assessment Training and Resource Guide'' is to help Hanford waste generators identify ways to reduce waste through the Pollution Prevention Opportunity Assessment (P20A) process. This document presents pollution prevention tools and provides a step-by-step approach for conducting assessments.

  5. Opportunities and costs for preventing vertebrate extinctions.

    Science.gov (United States)

    Conde, Dalia A; Colchero, Fernando; Güneralp, Burak; Gusset, Markus; Skolnik, Ben; Parr, Michael; Byers, Onnie; Johnson, Kevin; Young, Glyn; Flesness, Nate; Possingham, Hugh; Fa, John E

    2015-03-16

    Despite an increase in policy and management responses to the global biodiversity crisis, implementation of the 20 Aichi Biodiversity Targets still shows insufficient progress [1]. These targets, strategic goals defined by the United Nations Convention on Biological Diversity (CBD), address major causes of biodiversity loss in part by establishing protected areas (Target 11) and preventing species extinctions (Target 12). To achieve this, increased interventions will be required for a large number of sites and species. The Alliance for Zero Extinction (AZE) [2], a consortium of conservation-oriented organisations that aims to protect Critically Endangered and Endangered species restricted to single sites, has identified 920 species of mammals, birds, amphibians, reptiles, conifers and reef-building corals in 588 'trigger' sites [3]. These are arguably the most irreplaceable category of important biodiversity conservation sites. Protected area coverage of AZE sites is a key indicator of progress towards Target 11 [1]. Moreover, effective conservation of AZE sites is essential to achieve Target 12, as the loss of any of these sites would certainly result in the global extinction of at least one species [2]. However, averting human-induced species extinctions within AZE sites requires enhanced planning tools to increase the chances of success [3]. Here, we assess the potential for ensuring the long-term conservation of AZE vertebrate species (157 mammals, 165 birds, 17 reptiles and 502 amphibians) by calculating a conservation opportunity index (COI) for each species. The COI encompasses a set of measurable indicators that quantify the possibility of achieving successful conservation of a species in its natural habitat (COIh) and by establishing insurance populations in zoos (COIc). Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. For whom does it work? Subgroup differences in the effects of a school-based universal prevention program

    NARCIS (Netherlands)

    Spilt, J.L.; Koot, H.M.; van Lier, P.A.C.

    2013-01-01

    This study examined subgroup differences in the effectiveness of a universal classroom-based preventive intervention. The Good Behavior Game (GBG) was delivered in Grade 1 and 2 in a randomized controlled trial including 759 students. Changes in externalizing and internalizing problems were modeled

  7. Prevention of diabetes with Mediterranean diets: a subgroup analysis of a randomized trial.

    Science.gov (United States)

    Salas-Salvadó, Jordi; Bulló, Mònica; Estruch, Ramón; Ros, Emilio; Covas, Maria-Isabel; Ibarrola-Jurado, Núria; Corella, Dolores; Arós, Fernando; Gómez-Gracia, Enrique; Ruiz-Gutiérrez, Valentina; Romaguera, Dora; Lapetra, José; Lamuela-Raventós, Rosa Maria; Serra-Majem, Lluís; Pintó, Xavier; Basora, Josep; Muñoz, Miguel Angel; Sorlí, José V; Martínez-González, Miguel A

    2014-01-07

    Interventions promoting weight loss can reduce the incidence of type 2 diabetes mellitus. Whether dietary changes without calorie restriction also protect from diabetes has not been evaluated. To assess the efficacy of Mediterranean diets for the primary prevention of diabetes in the Prevención con Dieta Mediterránea trial, from October 2003 to December 2010 (median follow-up, 4.1 years). Subgroup analysis of a multicenter, randomized trial. (Current Controlled Trials: ISRCTN35739639) SETTING: Primary care centers in Spain. Men and women without diabetes (3541 patients aged 55 to 80 years) at high cardiovascular risk. Participants were randomly assigned and stratified by site, sex, and age but not diabetes status to receive 1 of 3 diets: Mediterranean diet supplemented with extra-virgin olive oil (EVOO), Mediterranean diet supplemented with nuts, or a control diet (advice on a low-fat diet). No intervention to increase physical activity or lose weight was included. Incidence of new-onset type 2 diabetes mellitus (prespecified secondary outcome). During follow-up, 80, 92, and 101 new-onset cases of diabetes occurred in the Mediterranean diet supplemented with EVOO, Mediterranean diet supplemented with mixed nuts, and control diet groups, respectively, corresponding to rates of 16.0, 18.7, and 23.6 cases per 1000 person-years. Multivariate-adjusted hazard ratios were 0.60 (95% CI, 0.43 to 0.85) for the Mediterranean diet supplemented with EVOO and 0.82 (CI, 0.61 to 1.10) for the Mediterranean diet supplemented with nuts compared with the control diet. Randomization was not stratified by diabetes status. Withdrawals were greater in the control group. A Mediterranean diet enriched with EVOO but without energy restrictions reduced diabetes risk among persons with high cardiovascular risk. Instituto de Salud Carlos III.

  8. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT - GEOCHEMISTRY LABORATORY AT SANDIA NATIONAL LABORATORIES

    Science.gov (United States)

    These reports summarize pollution prevention opportunity assessments conducted jointly by EPA and DOE at the Geochemistry Laboratory and the Manufacturing and Fabrication Repair Laboratory at the Department of Energy's Sandia National Laboratories facility in Albuquerque, New Mex...

  9. Future opportunities in preventing cisplatin induced ototoxicity

    NARCIS (Netherlands)

    van den Berg, J. H.; Beijnen, J. H.; Balm, A. J. M.; Schellens, J. H. M.

    2006-01-01

    Cisplatin is one of the most commonly used cytotoxic agents. Ototoxicity is an important and dose-limiting side-effect of cisplatin therapy. It is believed that cisplatin suppresses the formation of endogenous anti-oxidants that normally prevent the inner ear against reactive oxygen species (ROS).

  10. Pollution prevention and waste minimization opportunity assessment in environmental restoration

    International Nuclear Information System (INIS)

    Roybal, J.A.; Willison, C.P.

    1997-01-01

    The Environmental Restoration (ER) Project at Sandia National Laboratories implicitly subscribed to the philosophy of pollution prevention and waste minimization. As a result of a Department of Energy (DOE) offer, Pollution Prevention Opportunity Assessments (PPOA) were conducted at two ER sites and a decontamination and Demolition (D and D) site. The purpose of one of the PPOAs was to identify pollution prevention (P2) opportunities during environmental remediation at the Classified Waste Landfill located at Sandia National Laboratories, New Mexico (SNL/NM). The remediation activities at this site are scheduled to begin in the fall of 1997. The PPOA included presentations by the team members, a tour of the site, and a brainstorming session to list the waste streams, identify P2 opportunities and rank them in order of priority. Twenty-five P2 opportunities were identified during the brainstorming session of which twenty-two opportunities were selected for further investigation. Those twenty-two opportunities are discussed in this paper. A cost benefit analysis was performed for each P2 opportunity based on the estimated waste volume, feasibility, and cost. Pollution Prevention by Design (P2D) was incorporated into the PPOA to introduce waste minimization techniques that can be used during the planning phase of restoration projects

  11. Preventing Family Problems: Troubling Trends and Promising Opportunities.

    Science.gov (United States)

    Tiesel, Judy Watson; Olson, David H.

    1992-01-01

    Presents family professional with overview that highlights challenges and opportunities in the field by describing several troubling trends in family life (divorce, teenage pregnancy, domestic abuse/violence, poverty), growing diversity and complexity among families in the United States, and the importance of prevention. Emphasizes prevention,…

  12. HIV prevention for Black women: structural barriers and opportunities.

    Science.gov (United States)

    Newman, Peter A; Williams, Charmaine C; Massaquoi, Notisha; Brown, Marsha; Logie, Carmen

    2008-08-01

    Black women bear a disproportionate burden of HIV/AIDS in North America. The purpose of this investigation was to explore Black Canadian women's perspectives on HIV risk and prevention. Four 90-minute focus groups (n=26) and six key informant interviews were conducted in Toronto with Black women of African and Caribbean descent and low socioeconomic status. Data analysis revealed a number of potent barriers to existing HIV preventive interventions: stigma, cultural disconnections, lack of engagement of Black religious institutions, and multiple intersecting forms of discrimination. Recommended HIV prevention opportunities included the Black church, mainstreaming, health care providers, and ethno-specific agencies. HIV prevention strategies for North American Black women, rather than focusing on HIV and individual risk behaviors, may benefit from a primary focus on social and structural factors (e.g., promoting gender equality, economic opportunity, women-controlled prevention technologies and combating racism in health care) thereby integrating HIV prevention into the larger context of community health and survival.

  13. Pollution Prevention Opportunity Assessment for the SNL/NM cafeterias.

    Energy Technology Data Exchange (ETDEWEB)

    McCord, Samuel Adam

    2005-12-01

    This Pollution Prevention Opportunity Assessment (PPOA) was conducted for the two Sandia National Laboratories/New Mexico cafeteria facilities between May and August 2005. The primary purpose of this PPOA is to assess waste and resource reduction opportunities and issue Pollution Prevention (P2) recommendations for Sandia's food service facilities. This PPOA contains recommendations for energy, water and resource reduction, as well as material substitution based upon environmentally preferable purchasing. Division 3000 has requested the PPOA report as part of the Division's compliance effort to implement the Environmental Management System (EMS) per DOE Order 450.1. This report contains a summary of the information collected and analyses performed with recommended options for implementation. The SNL/NM P2 Group will work with Division 3000 and the respective cafeteria facilities to implement these options.

  14. Pollution prevention opportunity assessments. Guidance for the Hanford Site

    International Nuclear Information System (INIS)

    Engel, J.A.

    1994-10-01

    The purpose of this document is to provide help to you, Hanford waste generators, in finding ways to reduce waste through Pollution Prevention (P2) and Pollution Prevention Opportunity Assessments (P2OAs). It is based on guidance from other sites, and serves to compliment the Hanford-specific training on P2OAs offered by the Pollution Prevention group at Westinghouse Hanford Company (WHC). The chapters of this document include help on how to choose major waste generating activities, how to conduct a P2OA, how to get results, and how to show progress. There is also a chapter on special situations and problems your facility may encounter. This first chapter tells you why you should consider conducting P2OAs and why they may be required

  15. Effectiveness of "shifting boundaries" teen dating violence prevention program for subgroups of middle school students.

    Science.gov (United States)

    Taylor, Bruce G; Mumford, Elizabeth A; Stein, Nan D

    2015-02-01

    We examine whether the Shifting Boundaries (SB) intervention, a primary intervention to prevent youth dating violence and sexual harassment (DV/H), is differentially effective for girls compared with boys or for youth with a history of DV/H experiences. We randomly assigned SB to 30 public middle schools in New York City, enrolling 117 sixth and seventh grade classes to receive a classroom, building, combined, or neither intervention. The SB classroom intervention included six sessions emphasizing the laws/consequences of DV/H, establishing boundaries and safe relationships. The SB schoolwide/building intervention included the use of school-based restraining orders, greater faculty/security presence in unsafe "hot spots" mapped by students, and posters to increase DV/H awareness and reporting. Student surveys were implemented at baseline, immediately after intervention, and 6 months after intervention. At 6 months after intervention, the SB building-level intervention was associated with significant reductions in the frequency of sexual harassment (SH) perpetration and victimization; the prevalence and frequency of sexual dating violence victimization; and the frequency of total dating violence victimization and perpetration. We also had one anomalous finding that the interventions were associated with an increase in the prevalence of SH victimization. These results were consistent for girls and boys, and those with or without a history of DV/H, with the one exception for those exposed to the SB building condition who had earlier reported perpetrating SH had a significantly lower frequency of perpetrating SH at the follow-up than those without such a history. SB can provide effective universal prevention of middle school DV/H experiences, regardless of students' prior exposure histories, and for boys and girls. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Social Entrepreneurship for Obesity Prevention: What Are the Opportunities?

    Science.gov (United States)

    Smith, Tosha Woods; Calancie, Larissa; Ammerman, Alice

    2015-09-01

    In recent years, social entrepreneurship has emerged as a new field to address social and public health challenges. Social entrepreneurship, which harnesses traditional business practices and market forces to address social challenges, may produce solutions that are more cost-effective and sustainable than those produced by governmental and nonprofit sectors. In this paper, we discuss whether and how social entrepreneurship can be harnessed for obesity prevention by defining and briefly reviewing the rise of social entrepreneurship in the USA, outlining the threat that obesity poses to US society and offering some examples of how social ventures are addressing the problem of obesity. Additional untapped opportunities are also discussed and recommendations given for how social entrepreneurship might impact obesity prevention in the future.

  17. Health care providers' missed opportunities for preventing femicide.

    Science.gov (United States)

    Sharps, P W; Koziol-McLain, J; Campbell, J; McFarlane, J; Sachs, C; Xu, X

    2001-11-01

    Homicide of women (femicide) by intimate partners is the most serious form of violence against women. The purpose of this analysis of a larger multisite study was to describe health care use in the year prior to murder of women by their intimate partner in order to identify opportunities for intervention to prevent femicide. A sample of femicide cases was identified from police or medical examiner records. Participants (n = 311) were proxy informants (most often female family members) of victims of intimate partner femicide from 11 U.S. cities. Information about prior domestic abuse and use of health care and other helping agencies for victims and perpetrators was obtained during structured telephone interviews. Most victims had been abused by their partners (66%) and had used health care agencies for either injury or physical or mental health problems (41%). Among women who had been pregnant during the relationship, 23% were beaten by partners during pregnancy. Among perpetrators with fair or poor physical health, 53% had contact with physicians and 15% with fair or poor mental health had seen a doctor about their mental health problem. Among perpetrators with substance problems, 5.4% had used alcohol treatment programs and 5.7% had used drug treatment programs. Frequent contacts with helping agencies by victims and perpetrators represent opportunities for the prevention of femicide by health care providers. Copyright 2001 American Health Foundation and Academic Press.

  18. Opportunities and Challenges for Nutritional Proteomics in Cancer Prevention12

    Science.gov (United States)

    Romagnolo, Donato F.; Milner, John A.

    2012-01-01

    Knowledge gaps persist about the efficacy of cancer prevention strategies based on dietary food components. Adaptations to nutrient supply are executed through tuning of multiple protein networks that include transcription factors, histones, modifying enzymes, translation factors, membrane and nuclear receptors, and secreted proteins. However, the simultaneous quantitative and qualitative measurement of all proteins that regulate cancer processes is not practical using traditional protein methodologies. Proteomics offers an attractive opportunity to fill this knowledge gap and unravel the effects of dietary components on protein networks that impinge on cancer. The articles presented in this supplement are from talks proffered in the “Nutrition Proteomics and Cancer Prevention” session at the American Institute for Cancer Research Annual Research Conference on Food, Nutrition, Physical Activity and Cancer held in Washington, DC on October 21 and 22, 2010. Recent advances in MS technologies suggest that studies in nutrition and cancer prevention may benefit from the adoption of proteomic tools to elucidate the impact on biological processes that govern the transition from normal to malignant phenotype; to identify protein changes that determine both positive and negative responses to food components; to assess how protein networks mediate dose-, time-, and tissue-dependent responses to food components; and, finally, for predicting responders and nonresponders. However, both the limited accessibility to proteomic technologies and research funding appear to be hampering the routine adoption of proteomic tools in nutrition and cancer prevention research. PMID:22649262

  19. Opportunities for the Primary Prevention of Obesity during Infancy

    Science.gov (United States)

    Paul, Ian M.; Bartok, Cynthia J.; Downs, Danielle S.; Stifter, Cynthia A.; Ventura, Alison K.; Birch, Leann L.

    2009-01-01

    Many parents, grandparents, and clinicians have associated a baby’s ability to eat and gain weight as a sign of good health, and clinicians typically only call significant attention to infant growth if a baby is failing to thrive or showing severe excesses in growth. Recent evidence, however, has suggested that pediatric healthcare providers should pay closer attention to growth patterns during infancy. Both higher weight and upward crossing of major percentile lines on the weight-for-age growth chart during infancy have long term health consequences, and are associated with overweight and obesity later in life. Clinicians should utilize the numerous available opportunities to discuss healthy growth and growth charts during health maintenance visits in the first two years after birth. Further, providers should instruct parents on strategies to promote healthy behaviors that can have long lasting obesity preventive effects. PMID:19968945

  20. Pollution prevention opportunity assessment benchmarking: Recommendations for Hanford

    Energy Technology Data Exchange (ETDEWEB)

    Engel, J.A.

    1994-05-01

    Pollution Prevention Opportunity Assessments (P2OAs) are an important first step in any pollution prevention program. While P2OAs have been and are being conducted at Hanford, there exists no standard guidance, training, tracking, or systematic approach to identifying and addressing the most important waste streams. The purpose of this paper then is to serve as a guide to the Pollution Prevention group at Westinghouse Hanford in developing and implementing P2OAs at Hanford. By searching the literature and benchmarks other sites and agencies, the best elements from those programs can be incorporated and pitfalls more easily avoided. This search began with the 1988 document that introduces P2OAs (then called Process Waste Assessments, PWAS) by the Environmental Protection Agency. This important document presented the basic framework of P20A features which appeared in almost all later programs. Major Department of Energy programs were also examined, with particular attention to the Defense Programs P20A method of a graded approach, as presented at the Kansas City Plant. The graded approach is a system of conducting P2OAs of varying levels of detail depending on the size and importance of the waste stream. Finally, private industry programs were examined briefly. While all the benchmarked programs had excellent features, it was determined that the size and mission of Hanford precluded lifting any one program for use. Thus, a series of recommendations were made, based on the literature review, in order to begin an extensive program of P2OAs at Hanford. These recommendations are in the areas of: facility Pollution Prevention teams, P20A scope and methodology, guidance documents, training for facilities (and management), technical and informational support, tracking and measuring success, and incentives.

  1. Cost-effectiveness of aspirin treatment in the primary prevention of cardiovascular disease events in subgroups based on age, gender, and varying cardiovascular risk

    NARCIS (Netherlands)

    Greving, J.P.; Buskens, E.; Koffijberg, H.; Algra, A.

    2008-01-01

    Background-Aspirin is effective for the primary prevention of cardiovascular events, but it remains unclear for which subgroups of individuals aspirin is beneficial. We assessed the cost-effectiveness of aspirin separately for men and women of different ages with various levels of cardiovascular

  2. Cost-effectiveness of aspirin treatment in the primary prevention of cardiovascular disease events in subgroups based on age, gender, and varying cardiovascular risk

    NARCIS (Netherlands)

    Greving, Jacoba P.; Buskens, Erik; Koffijberg, Hendrik; Algra, Ale

    2008-01-01

    BACKGROUND - Aspirin is effective for the primary prevention of cardiovascular events, but it remains unclear for which subgroups of individuals aspirin is beneficial. We assessed the cost-effectiveness of aspirin separately for men and women of different ages with various levels of cardiovascular

  3. Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska

    Directory of Open Access Journals (Sweden)

    Kathryn Hohman-Billmeier

    2016-12-01

    Full Text Available In 2010, Alaska Department of Health and Social Services (DHSS received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 14–19 instead of the original curriculum intended age range of 12–14. Cultural and approach adaptations were included as well. After 4 years of implementation and data collection, the sample was too small to provide statistically significant results. The lack of findings gave no information about the modification, nor any explanation of how the curriculum was received, or reasons for the small sample. This paper reports on a case study follow-up to the RCT to better understand outcome and implementation results. For this study, researchers reviewed project documents and interviewed peer educators, state and local staff, and evaluators. Three themes emerged from the data: (a the professional growth of peer educators and development of peer education, (b difficulties resulting from curriculum content, especially for subpopulations of sexually active youth, youth identified as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual, pregnant, and parenting youth and (c the appropriateness of an RCT with subpopulations of at-risk youth. Three recommendations emerged from the case study. First, including as many stakeholders as possible in the program and evaluation design phases is essential, and must be supported by appropriate funding streams and training. Second, there must be recognition of the multiple small subpopulations found in Alaska when adapting programs designed for a larger and more homogeneous population. Third, RCTs may not be appropriate for all population subgroups.

  4. Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska.

    Science.gov (United States)

    Hohman-Billmeier, Kathryn; Nye, Margaret; Martin, Stephanie

    2016-01-01

    In 2010, Alaska Department of Health and Social Services (DHSS) received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT) to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 14-19 instead of the original curriculum intended age range of 12-14. Cultural and approach adaptations were included as well. After 4 years of implementation and data collection, the sample was too small to provide statistically significant results. The lack of findings gave no information about the modification, nor any explanation of how the curriculum was received, or reasons for the small sample. This paper reports on a case study follow-up to the RCT to better understand outcome and implementation results. For this study, researchers reviewed project documents and interviewed peer educators, state and local staff, and evaluators. Three themes emerged from the data: (a) the professional growth of peer educators and development of peer education, (b) difficulties resulting from curriculum content, especially for subpopulations of sexually active youth, youth identified as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual, pregnant, and parenting youth and (c) the appropriateness of an RCT with subpopulations of at-risk youth. Three recommendations emerged from the case study. First, including as many stakeholders as possible in the program and evaluation design phases is essential, and must be supported by appropriate funding streams and training. Second, there must be recognition of the multiple small subpopulations found in Alaska when adapting programs designed for a larger and more homogeneous population. Third, RCTs may not be appropriate for all population subgroups.

  5. Pollution prevention opportunity assessment: Foundation of pollution prevention for waste management

    International Nuclear Information System (INIS)

    Damewood, R.W.

    1994-01-01

    The objective of this paper is to promote the Pollution Prevention Opportunity Assessment (PPOA) technique as a fundamental of pollution prevention for waste management. All key elements of an effective PPOA program are presented. These key elements include impacts of environmental laws on pollution prevention, PPOA concepts and overview, waste minimization opportunities assessment, reporting and monitoring waste minimization progress, and PPOA program implementation. As environmental laws evolve the focus is shifting from end-of-pipe pollution control to front-end source reduction. Waste minimization was mistakenly interpreted to mean the reduction of hazardous waste after generation in the past. The Pollution Prevention Act of 1990 has clearly defined its requirement on resource reduction. Waste reduction can be viewed as a criterion to assess all industrial processes and operations. The fundamental approach of PPOA focuses on a mass balance concept. This concept deals with tracking of chemicals from the point of purchase, through storage, utilization in the process, and waste generation at the end of process. In other words, PPOA is a technique to analyze this input/output process. By applying PPOA techniques, the framework of applicable compliance requirements to the current operation process is established. Furthermore, documentation of PPOA itself can meet as documentation requirements for environmental compliance. In general, the PPOA process consists of two phases. The first phase involves input and output process description and waste characterization. The second phase is an opportunities assessment for waste minimization from input/output waste characterization. These two phases are explained in detail in the paper

  6. STD Prevention Policies in the United States: Evidence and Opportunities

    OpenAIRE

    Leichliter, Jami S.; Seiler, Naomi; Wohlfeiler, Dan

    2016-01-01

    Policies are an important part of public health interventions, including in the area of STD prevention. Similar to other tools used in public health, policies are often evaluated to determine their usefulness. Therefore, we conducted a non-systematic review of policy evidence for sexually transmitted disease prevention. Our review considers assessments or evaluations of STD prevention-specific policies, health care system policies, and other, broader policies that have the potential to impact...

  7. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT - MANUFACTURING AND FABRICATION REPAIR LABORATORY AT SANDIA NATIONAL LABORATORIES

    Science.gov (United States)

    These reports summarize pollution prevention opportunity assessments conducted jointly by EPA and DOE at the Geochemistry Laboratory and the Manufacturing and Fabrication Repair Laboratory at the Department of Energy's Sandia National Laboratories facility in Albuquerque, New Mex...

  8. Effluent generation by the dairy industry: preventive attitudes and opportunities

    Directory of Open Access Journals (Sweden)

    V. B. Brião

    2007-12-01

    Full Text Available Work aimed to identify the effluent is generating areas in a dairy company for purpose of changing concept pollution prevention. methodology consisted measuring volumes and collecting samples effluents production sectors. analysis was conducted by sector, order those which generated excessive amounts effluents. results show that dry products (powdered milk powdered whey are greatest generators BOD, nitrogen phosphorus, while fluid form (UHT milk, formulated UHT, pasteurized cream butter produced large quantities oils grease. solids recovery, waste segregation water reuse can be applied with saving potential as much R$ 28,000 ($ 11,200 per month only raw materials also environmental gains in pollution prevention.

  9. The growing prevalence of kidney stones and opportunities for prevention.

    Science.gov (United States)

    Richman, Katherine; O'Bell, John; Pareek, Gyan

    2014-12-02

    The prevalence of kidney stones is climbing in the United States. Several investigators have demonstrated an association between metabolic syndrome and kidney stones and some have proposed a causal link. Risk factors for nephrolithiasis can be identified with a 24-hour urine collection and preventive measures can be customized to meet the needs of individual patients. Dietary and pharmacologic interventions are available to address urinary risk factors such as inadequate urine volume, hypercalcuria, hyperoxaluria, hyperuricosuria and hypocitraturia. Given that morbidity and healthcare costs associated with nephrolithiasis are on the rise, deterring stone formation is increasingly important. Multidisciplinary clinics that foster collaboration between urologists, nephrologists and dieticians offer patients effective prevention and treatment strategies.

  10. Use of Six Sigma for eliminating missed opportunities for prevention services.

    Science.gov (United States)

    Gittner, LisaAnn S; Husaini, Baqar A; Hull, Pamela C; Emerson, Janice S; Tropez-Sims, Suzanne; Reece, Michelle C; Zoorob, Roger; Levine, Robert S

    2015-01-01

    Delivery of primary care preventative services can be significantly increased utilizing Six Sigma methods. Missed preventative service opportunities were compared in the study clinic with the community clinic in the same practice. The study clinic had 100% preventative services, compared with only 16.3% in the community clinic. Preventative services can be enhanced to Six Sigma quality when the nurse executive and medical staff agree on a single standard of nursing care executed via standing orders.

  11. Youth Voice and HIV Prevention: Discursive Opportunities, Limitations and Productive Impossibilities

    Science.gov (United States)

    Gacoin, Andree

    2010-01-01

    This paper draws on engagements with "voice" in youth studies and "student voice" work in order to interrogate the limits and opportunities of the call to "youth voice" in HIV prevention discourses. Building on the limitations and opportunities within the debates of the "who", "what" and "how" of speaking and the construction of the youth subject,…

  12. World Report on Child Injury Prevention: Opportunity for scaling ...

    African Journals Online (AJOL)

    Unintentional injuries accounted for almost 90% of these child injury deaths. Beyond these fatalities, there are several thousand children who have survived with varying degrees of disability. While many prevention programmes have been shown to be effective, much more awareness and political commitment is needed in ...

  13. missed opportunities for intermittent preventive treatment for malaria ...

    African Journals Online (AJOL)

    Background: Malaria is of global health concern particularly among pregnant women. Nigeria contributes largely to global burden but coverage of. Intermittent Preventive Treatment of malaria in pregnancy using. Sulphadoxine pyrimethamine ..... awareness campaigns at sensitizing the community about the dangers of ...

  14. Nutritional Science Funding Opportunities | Division of Cancer Prevention

    Science.gov (United States)

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  15. Preventing neural tube defects in Europe : A missed opportunity

    NARCIS (Netherlands)

    Busby, A; Armstrong, B; Dolk, H; Armstrong, N; Haeusler, M; Berghold, A; Gillerot, Y; Baguette, A; Gjerga, R; Barisic, [No Value; Christiansen, M; Goujard, J; Steinbicker, [No Value; Rosch, C; McDonnell, R; Scarano, G; Calzolari, E; Neville, A; Cocchi, G; Bianca, S; Gatt, M; De Walle, H; Braz, P; Latos-Bielenska, A; Gener, B; Portillor, [No Value; Addor, MC; Abramsky, L; Ritvanen, A; Robert-Gnansia, E; Daltveit, AK; Aneren, G; Olars, B; Edwards, G

    2005-01-01

    Each year, more than 4500 pregnancies in the European Union are affected by neural tube defects (NTD). Unambiguous evidence of the effectiveness of peri conceptional folic acid in preventing the majority of neural tube defects has been available since 1991. We report on trends in the total

  16. Community Safety and Crime Prevention Partnerships: Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Patrick Sheperdson

    2014-04-01

    Full Text Available In many jurisdictions around the world, community safety and crime prevention activity is supported by interagency committees. In the Australian state of New South Wales (NSW, local government Community Safety Officers (CSOs lead, support or participate in a range of interagency and ‘whole of government’ networks, most of which were established to support central NSW state government crime prevention and community safety initiatives. Research was conducted with the aim of exploring the CSOs’ experience of the ‘whole of government’ partnerships established to support community safety and crime prevention in NSW.[i] The findings support international research which suggests that central-local partnerships are inhibited by different agendas, responsibilities and power dynamics across different levels of government. Some of the key contextual challenges for this work include concerns about costs shifting from State to local government and about shifting State government priorities; barriers to funding and to accessing crime (and other data; and various administrative burdens. Consequently, we argued that there is a need for formal engagement and negotiation between, on the one hand, State government agencies that steer NSW crime prevention and, on the other, community safety policy initiatives and local government. Such engagement could help overcome the perception, indeed the reality, that shifting and dumping costs and responsibilities to local government is creating a range of burdens for CSOs. [i] The authors thank the NSW Local Government Community Safety and Crime Prevention Network and the individual local government CSOs who kindly assisted and contributed to this research.

  17. Preventing sports injuries: opportunities for intervention in youth athletics.

    Science.gov (United States)

    Weaver, Nancy L; Marshall, Stephen W; Miller, Mark D

    2002-03-01

    Participation in youth sports has steadily grown over the past 30 years and continues to rise. During the 1998-1999 school year over 360,000 collegiate athletes and almost 6.5 million high school athletes participated in sports. This expansion has been accompanied by an increased awareness of the injury problem associated with participation in youth sports. Estimates are that one-third of high school athletes will sustain an injury during a sports season serious enough to result in time lost from participation. While there may always be some risk associated with sports participation, health professionals can actively encourage injury prevention. In this paper, we describe the benefits of sport participation, the injury problem associated with sports, injury prevention frameworks, and conclude by discussing the changing role of the team physician in youth sports.

  18. Opportunities for Improving Cancer Prevention at Federally Qualified Health Centers

    OpenAIRE

    Allen, Claire L.; Harris, Jeffrey R.; Hannon, Peggy A.; Parrish, Amanda T.; Hammerback, Kristen; Craft, John; Gray, Bruce

    2013-01-01

    As the Affordable Care Act unfolds, federally qualified health centers (FQHCs) will likely experience an influx of newly insured, low-income patients at disparate risk for cancer. Cancer-focused organizations are seeking to collaborate with FQHCs and the Primary Care Associations (PCAs) that serve them, to prevent cancer and reduce disparities. To guide this collaboration, we conducted 21 interviews with representatives from PCAs and FQHCs across four western states. We asked about: FQHC prio...

  19. NEW PREVENTION OPPORTUNITIES OF INFECTIOUS DISEASES. VACCINATION AGAINST ROTAVIRUS

    Directory of Open Access Journals (Sweden)

    T. A. Grechukha

    2013-01-01

    Full Text Available The article covers the problem of the burden of rotavirus disease. Rotavirus infection is the leading cause of mortality among children under 5 years of age and is a major problem for a public healthcare. The world is actively engaged in the prevention of rotavirus infection since 2005. There is a lot of data on the efficacy and safety of this vaccine. Different foreign investigations have shown the herd immunity of the vaccine. The authors present data about the effectiveness and safety of vaccines, established during clinical studies of the foreign scientists.

  20. Cancer Nanotechnology: Opportunities for Prevention, Diagnosis, and Therapy.

    Science.gov (United States)

    Zeineldin, Reema; Syoufjy, Joan

    2017-01-01

    Nanotechnological innovations over the last 16 years have brought about the potential to revolutionize specific therapeutic drug delivery to cancer tissue without affecting normal tissues. In addition, there are new nanotechnology-based platforms for diagnosis of cancers and for theranostics, i.e., integrating diagnosis with therapy and follow-up of effectiveness of therapy. This chapter presents an overview of these nanotechnology-based advancements in the areas of prevention, diagnosis, therapy, and theranostics for cancer. In addition, we stress the need to educate bio- and medical students in the field of nanotechnology.

  1. Cancer burden in Africa and opportunities for prevention.

    Science.gov (United States)

    Jemal, Ahmedin; Bray, Freddie; Forman, David; O'Brien, Meg; Ferlay, Jacques; Center, Melissa; Parkin, D Maxwell

    2012-09-15

    Cancer is an emerging public health problem in Africa. About 715,000 new cancer cases and 542,000 cancer deaths occurred in 2008 on the continent, with these numbers expected to double in the next 20 years simply because of the aging and growth of the population. Furthermore, cancers such as lung, female breast, and prostate cancers are diagnosed at much higher frequencies than in the past because of changes in lifestyle factors and detection practices associated with urbanization and economic development. Breast cancer in women and prostate cancer in men have now become the most commonly diagnosed cancers in many Sub-Saharan African countries, replacing cervical and liver cancers. In most African countries, cancer control programs and the provision of early detection and treatment services are limited despite this increasing burden. This paper reviews the current patterns of cancer in Africa and the opportunities for reducing the burden through the application of resource level interventions, including implementation of vaccinations for liver and cervical cancers, tobacco control policies for smoking-related cancers, and low-tech early detection methods for cervical cancer, as well as pain relief at the palliative stage of cancer. Copyright © 2012 American Cancer Society.

  2. The physician's unique role in preventing violence: a neglected opportunity?

    Directory of Open Access Journals (Sweden)

    Umhau John C

    2012-11-01

    Full Text Available Abstract Background Episodes of explosive rage and violence comprise a symptom complex which can have a devastating effect on a person's life. In the community this behavior is seen as workplace violence, domestic abuse and road rage, while in the clinical setting, this behavior is rarely mentioned by patients, despite evidence that it can signify an important biological disorder that may afflict more than three percent of the population. Discussion Patients are often reluctant to seek help for episodic attacks of rage, especially attacks which are accompanied by physical violence. Although, in the past, clinicians have had few treatment options to offer, recent neuroscience advances have created new possibilities to understand and help patients with this neglected problem. No formal medical guidelines for treating violence exist; however, many patients can be helped by diagnosis, referral and treatment. Treatment can include pharmaceuticals and nutrients, as well as referral for anger management or behavioral therapy. Summary The astute clinician has an opportunity to positively impact an important problem through the diagnosis and treatment of patients with symptoms of intermittent explosive disorder.

  3. Preneoplastic prostate lesions: an opportunity for prostate cancer prevention.

    Science.gov (United States)

    Nelson, W G; De Marzo, A M; Deweese, T L; Lin, X; Brooks, J D; Putzi, M J; Nelson, C P; Groopman, J D; Kensler, T W

    2001-12-01

    Environmental factors, especially the diet, play a prominent role in the epidemic of prostate cancer (PCA), in the United States. Many candidate dietary components have been proposed to influence human prostatic carcinogenesis, including fat, calories, fruits and vegetables, anti-oxidants, and various micronutrients, but the specific roles dietary agents play in promoting or preventing PCA remain controversial. We have collected evidence to suggest that GSTP1, the gene encoding the pi-class glutathione S-transferase (GST), may serve a "caretaker" function for prostatic cells. Although GSTP1 can be detected in normal prostatic epithelium, in almost all PCA cases, PCA cells fail to express GSTP1 polypeptides, and lack of GSTP1 expression most often appears to be the result of somatic "CpG island" DNA methylation changes. Loss of GSTP1 function also appears to be characteristic of prostatic epithelial neoplasia (PIN) lesions, thought to represent PCA precursors. We have recently learned that a new candidate early PCA precursor lesion, proliferative inflammatory atrophy (PIA), characterized by proliferating prostatic cells juxtaposed to inflammatory cells, contains epithelial cells that express high levels of GSTP1. These findings have formed the basis for a new model of prostatic carcinogenesis, in which prostatic cells in PIA lesions, subjected to a barrage of inflammatory oxidants, induce GSTP1 expression as a defense against oxidative genome damage. When cells with defective GSTP1 genes appear amongst the PIA cells, such cells become vulnerable to oxidants and electrophiles that inflict genome damage that tends to promote neoplastic transformation to PIN and PCA cells. Subsequently, PIN and PCA cells with defective GSTPI genes remain vulnerable to similar stresses tending to promote malignant progression. This new model for prostatic carcinogenesis has implications for the design of new prostate cancer prevention strategies. Rational prevention approaches might

  4. A computer based system for prioritizing pollution prevention opportunity assessments at SNL/NM

    International Nuclear Information System (INIS)

    Custer, M.S.; Leishman, N.L.; Walsh, M.L.; Nelson, J.D.; Davis, R.L.; Bueno, N.C.

    1996-01-01

    Prioritizing waste generators is necessary to determine which are the best candidates for Pollution Prevention Opportunity Assessments (PPOAs). This paper describes the Sandia National Laboratories/New Mexico (SNL/NM) PPOA Ranking System. The system uses a multimedia approach that considers hazardous and radioactive waste disposal data, and hazardous chemical usage data (from which air emissions are extrapolated). Pollution prevention information is included, from the SNL Pollution Prevention Opportunities database that identifies waste streams that have readily apparent pollution prevention opportunities. The system also considers the relative costs of waste management and the chargeback fees paid for waste generation. From these data, organizations are ranked with an algorithm developed in Microsoft Access trademark on a personal computer. The concept could readily be transferred to other facilities needing to decide where to perform PPOAs

  5. Understanding Challenges and Opportunities of Preventive Blood Pressure Self-Monitoring at Home

    DEFF Research Database (Denmark)

    Grönvall, Erik; Verdezoto, Nervo

    2013-01-01

    methods to understand existing challenges and uncover opportunities of self-monitoring technologies to support preventive healthcare activities among older adults. Emerging challenges from our study were: rule complexity for self-measuring, reliability of measurements, interpretation, understanding...... to support people’s preventive self-monitoring needs compared with existing solutions. Furthermore, supporting the active and informed citizen can improve older adult’s care abilities, awareness and activation towards preventive care....

  6. Rivaroxaban versus warfarin in Japanese patients with nonvalvular atrial fibrillation for the secondary prevention of stroke: a subgroup analysis of J-ROCKET AF.

    Science.gov (United States)

    Tanahashi, Norio; Hori, Masatsugu; Matsumoto, Masayasu; Momomura, Shin-ichi; Uchiyama, Shinichiro; Goto, Shinya; Izumi, Tohru; Koretsune, Yukihiro; Kajikawa, Mariko; Kato, Masaharu; Ueda, Hitoshi; Iwamoto, Kazuya; Tajiri, Masahiro

    2013-11-01

    The overall analysis of the rivaroxaban versus warfarin in Japanese patients with atrial fibrillation (J-ROCKET AF) trial revealed that rivaroxaban was not inferior to warfarin with respect to the primary safety outcome. In addition, there was a strong trend for a reduction in the rate of stroke/systemic embolism with rivaroxaban compared with warfarin. In this subanalysis of the J-ROCKET AF trial, we investigated the consistency of safety and efficacy profile of rivaroxaban versus warfarin among the subgroups of patients with previous stroke, transient ischemic attack, or non-central nervous system systemic embolism (secondary prevention group) and those without (primary prevention group). Patients in the secondary prevention group were 63.6% of the overall population of J-ROCKET AF. In the secondary prevention group, the rate of the principal safety outcome (% per year) was 17.02 in rivaroxaban-treated patients and 18.26 in warfarin-treated patients (hazard ratio [HR] 0.95; 95% confidence interval [CI] 0.70-1.29), while the rate of the primary efficacy endpoint was 1.66 in rivaroxaban-treated patients and 3.25 in warfarin-treated patients (HR 0.51; 95% CI 0.23-1.14). There were no significant interactions in the principal safety and the primary efficacy endpoints of rivaroxaban compared to warfarin between the primary and secondary prevention groups (P=.090 and .776 for both interactions, respectively). The safety and efficacy profile of rivaroxaban compared with warfarin was consistent among patients in the primary prevention group and those in the secondary prevention group. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  7. Opportunities provision for preventing youth gang involvement for children and young people (7-16).

    Science.gov (United States)

    Fisher, H; Montgomery, P; Gardner, F E M

    2008-04-16

    Youth gangs have long been studied in the United States and interest elsewhere is increasing. Many studies document a robust and consistent relationship between gang membership and elevated delinquency. One theory of gang involvement, drawing on anomie and strain theories, proposes that the gang provides a means of fulfilling the economic needs of youth excluded from legitimate labour markets. Opportunities provision is a gang prevention strategy based on this theory and the principle that providing youth with educational and employment opportunities may reduce gang involvement. Common techniques within opportunities provision include tutoring, remedial education, job training, and job placement. To determine the effectiveness of opportunities provision for preventing youth gang involvement for children and young people aged 7 to 16. Electronic searches were conducted of ASSIA, CINAHL, CJA, Cochrane Library, Dissertations Abstracts, EMBASE, ERIC, IBSS, LILACs, LexisNexis Butterworths, MEDLINE, NCJR Service Abstracts Database, PsycINFO, and Sociological Abstracts, to April 2007. Reviewers contacted relevant organisations, individuals and list-servs and searched pertinent websites and reference lists. All randomised controlled trials or quasi-randomised controlled trials of interventions that have opportunities provision as the majority component, delivered to children and youths aged 7 to 16 not involved in a gang, compared to any other or no intervention. Searches yielded 2,696 unduplicated citations. 2,676 were excluded based on title and abstract. Two were excluded based on personal communication with study authors. Full-text reports for 18 citations were retrieved. 16 were excluded because they were not evaluations, did not address a gang prevention programme, did not include gang-related outcomes, did not include opportunities provision intervention components, or presented preliminary findings for outcomes reported in another citation. The remaining two

  8. Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin in prevention of preterm preeclampsia in subgroups of women according to their characteristics and medical and obstetrical history.

    Science.gov (United States)

    Poon, Liona C; Wright, David; Rolnik, Daniel L; Syngelaki, Argyro; Delgado, Juan Luis; Tsokaki, Theodora; Leipold, Gergo; Akolekar, Ranjit; Shearing, Siobhan; De Stefani, Luciana; Jani, Jacques C; Plasencia, Walter; Evangelinakis, Nikolaos; Gonzalez-Vanegas, Otilia; Persico, Nicola; Nicolaides, Kypros H

    2017-11-01

    The Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention trial demonstrated that in women who were at high risk for preterm preeclampsia with delivery at aspirin administration from 11 to 14 until 36 weeks' gestation was associated with a significant reduction in the incidence of preterm preeclampsia (odds ratio 0.38; 95% confidence interval, 0.20 to 0.74; P=0.004). We sought to examine whether there are differences in the effect of aspirin on the incidence of preterm preeclampsia in the Aspirin for Evidence-Based Preeclampsia Prevention trial in subgroups defined according to maternal characteristics and medical and obstetrical history. This was a secondary analysis of data from the Aspirin for Evidence-Based Preeclampsia Prevention trial. Subgroup analysis was performed to assess evidence of differences in the effect of aspirin on incidence of preterm preeclampsia in subgroups defined by maternal age (aspirin effect in subgroups defined according to maternal characteristics and obstetrical history. In participants with chronic hypertension preterm preeclampsia occurred in 10.2% (5/49) in the aspirin group and 8.2% (5/61) in the placebo group (adjusted odds ratio, 1.29; 95% confidence interval, 0.33-5.12). The respective values in those without chronic hypertension were 1.1% (8/749) in the aspirin group and 3.9% (30/761) in the placebo group (adjusted odds ratio, 0.27; 95% confidence interval, 0.12-0.60). In all participants with adherence of ≥90% the adjusted odds ratio in the aspirin group was 0.24 (95% confidence interval, 0.09-0.65); in the subgroup with chronic hypertension it was 2.06 (95% confidence interval, 0.40-10.71); and in those without chronic hypertension it was 0.05 (95% confidence interval, 0.01-0.41). For the complete data set the test of interaction was not significant at the 5% level (P = .055), but in those with adherence ≥90%, after adjustment for multiple comparisons

  9. Polygenic Risk Score Identifies Subgroup With Higher Burden of Atherosclerosis and Greater Relative Benefit From Statin Therapy in the Primary Prevention Setting.

    Science.gov (United States)

    Natarajan, Pradeep; Young, Robin; Stitziel, Nathan O; Padmanabhan, Sandosh; Baber, Usman; Mehran, Roxana; Sartori, Samantha; Fuster, Valentin; Reilly, Dermot F; Butterworth, Adam; Rader, Daniel J; Ford, Ian; Sattar, Naveed; Kathiresan, Sekar

    2017-05-30

    Relative risk reduction with statin therapy has been consistent across nearly all subgroups studied to date. However, in analyses of 2 randomized controlled primary prevention trials (ASCOT [Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm] and JUPITER [Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin]), statin therapy led to a greater relative risk reduction among a subgroup at high genetic risk. Here, we aimed to confirm this observation in a third primary prevention randomized controlled trial. In addition, we assessed whether those at high genetic risk had a greater burden of subclinical coronary atherosclerosis. We studied participants from a randomized controlled trial of primary prevention with statin therapy (WOSCOPS [West of Scotland Coronary Prevention Study]; n=4910) and 2 observational cohort studies (CARDIA [Coronary Artery Risk Development in Young Adults] and BioImage; n=1154 and 4392, respectively). For each participant, we calculated a polygenic risk score derived from up to 57 common DNA sequence variants previously associated with coronary heart disease. We compared the relative efficacy of statin therapy in those at high genetic risk (top quintile of polygenic risk score) versus all others (WOSCOPS), as well as the association between the polygenic risk score and coronary artery calcification (CARDIA) and carotid artery plaque burden (BioImage). Among WOSCOPS trial participants at high genetic risk, statin therapy was associated with a relative risk reduction of 44% (95% confidence interval [CI], 22-60; P statin therapy was 3.6% (95% CI, 2.0-5.1) among those in the high genetic risk group and 1.3% (95% CI, 0.6-1.9) in all others. Each 1-SD increase in the polygenic risk score was associated with 1.32-fold (95% CI, 1.04-1.68) greater likelihood of having coronary artery calcification and 9.7% higher (95% CI, 2.2-17.8) burden of carotid plaque. Those at high genetic risk have a greater

  10. Pollution prevention opportunity assessment approach, training, and technical assistance for DOE contractors

    Energy Technology Data Exchange (ETDEWEB)

    Pemberton, S.

    1997-03-01

    One of the tools used in a successful pollution prevention program is a pollution prevention opportunity assessment (PPOA). PPOAs can be used to identify the nature and amounts of waste and energy usage from processes and projects within a site`s operations, identify the opportunities that exist for pollution prevention and energy conservation, and then evaluate those opportunities for feasible implementation. The purpose of this project is to share the Kansas City Plant`s (KCP`s) PPOA methodology and experience with other DOE personnel and DOE contractors. This consisted of three major activities in FY96: (1) completing the PPOA training module specific to Environmental Restoration activities; (2) providing PPOA training and technical assistance to interested DOE personnel and DOE contractors, and (3) implementing and maintaining the DOE-wide PPOA database. This report documents the FY96 efforts, lessons learned, and future plans for all of the PPOA-related activities.

  11. Pollution prevention opportunity assessment for Sandia National Laboratories/California recycling programs.

    Energy Technology Data Exchange (ETDEWEB)

    Wrons, Ralph Jordan; Vetter, Douglas Walter

    2007-07-01

    This Pollution Prevention Opportunity Assessment (PPOA) was conducted for the Sandia National Laboratories/California (SNL/CA) Environmental Management Department between May 2006 and March 2007, to evaluate the current site-wide recycling program for potential opportunities to improve the efficiency of the program. This report contains a summary of the information collected and analyses performed with recommended options for implementation. The SNL/NM Pollution Prevention (P2) staff worked with the SNL/CA P2 Staff to arrive at these options.

  12. Sexually Transmitted Disease Prevention Policies in the United States: Evidence and Opportunities.

    Science.gov (United States)

    Leichliter, Jami S; Seiler, Naomi; Wohlfeiler, Dan

    2016-02-01

    Policies are an important part of public health interventions, including in the area of sexually transmitted disease (STD) prevention. Similar to other tools used in public health, policies are often evaluated to determine their usefulness. Therefore, we conducted a nonsystematic review of policy evidence for STD prevention. Our review considers assessments or evaluations of STD prevention-specific policies, health care system policies, and other, broader policies that have the potential to impact STD prevention through social determinants of health. We also describe potential policy opportunity in these areas. It should be noted that we found gaps in policy evidence for some areas; thus, additional research would be useful for public health policy interventions for STD prevention.

  13. Oak Ridge K-25 Site chlorinated solvent pollution prevention opportunity assessment

    International Nuclear Information System (INIS)

    1994-08-01

    A pollution prevention opportunity assessment (PPOA) was conducted at the Oak Ridge K-25 Site to identify opportunities to reduce and better manage the use of chlorinated solvents. At the K-25 Site, 67 control areas were examined for their potential use of chlorinated solvents. Of these areas, 27 were found to be using (1) chlorinated solvents for cleaning, degreasing, and lubricating; (2) laboratory standards and solvents; and (3) test medium. Current management practices encourage the identification and use of nonhazardous chemicals, including the use of chlorinated solvents. The main pollution prevention principles are source reduction and recycling, and a number of pollution prevention options based on these principles were identified and evaluated as part of this chlorinated solvent PPOA. Source reduction options evaluated for the K-25 Site include the substitution of chlorinated solvents with nonchlorinated solvents. Recycling was identified for those areas that would benefit most from the reuse of the chlorinated solvents in use. The pollution prevention options that offer the greatest opportunity for success at the K-25 Site are the implementation of substitutes at the 10 control areas using chlorinated solvents for cleaning, degreasing, and lubrication. A change in the process may be all that is needed to eliminate the use of a chlorinated solvent. Once a decision is made to implement a substitution, the information should be communicated to all shops and laboratories. Another option to consider is the installation of recycling units to recycle the large amounts of methylene chloride used in the analytical sampling procedure

  14. Oak Ridge K-25 Site chlorinated solvent pollution prevention opportunity assessment

    Energy Technology Data Exchange (ETDEWEB)

    1994-08-01

    A pollution prevention opportunity assessment (PPOA) was conducted at the Oak Ridge K-25 Site to identify opportunities to reduce and better manage the use of chlorinated solvents. At the K-25 Site, 67 control areas were examined for their potential use of chlorinated solvents. Of these areas, 27 were found to be using (1) chlorinated solvents for cleaning, degreasing, and lubricating; (2) laboratory standards and solvents; and (3) test medium. Current management practices encourage the identification and use of nonhazardous chemicals, including the use of chlorinated solvents. The main pollution prevention principles are source reduction and recycling, and a number of pollution prevention options based on these principles were identified and evaluated as part of this chlorinated solvent PPOA. Source reduction options evaluated for the K-25 Site include the substitution of chlorinated solvents with nonchlorinated solvents. Recycling was identified for those areas that would benefit most from the reuse of the chlorinated solvents in use. The pollution prevention options that offer the greatest opportunity for success at the K-25 Site are the implementation of substitutes at the 10 control areas using chlorinated solvents for cleaning, degreasing, and lubrication. A change in the process may be all that is needed to eliminate the use of a chlorinated solvent. Once a decision is made to implement a substitution, the information should be communicated to all shops and laboratories. Another option to consider is the installation of recycling units to recycle the large amounts of methylene chloride used in the analytical sampling procedure.

  15. Aspirin for Primary Prevention of Cardiovascular Events: Meta-Analysis of Randomized Controlled Trials and Subgroup Analysis by Sex and Diabetes Status

    Science.gov (United States)

    Zhang, Yan; Chen, Sijing; Yang, Wei; Bao, Wei; Rong, Ying; Yu, Xuefeng; Hu, Frank B.; Liu, Liegang

    2014-01-01

    Objective To evaluate the benefits and harms of aspirin for the primary prevention of CVD and determine whether the effects vary by sex and diabetes status. Methods We searched Medline, Embase, and Cochrane databases for randomized controlled trials comparing the effects of aspirin with placebo or control in people with no pre-existing CVD. Two investigators independently extracted data and assessed the study quality. Analyses were performed using Stata version 12. Results Fourteen trials (107,686 participants) were eligible. Aspirin was associated with reductions in major cardiovascular events (risk ratio, 0.90; 95% confidence interval, 0.85–0.95), myocardial infarction (0.86; 0.75–0.93), ischemic stroke (0.86; 0.75–0.98) and all-cause mortality (0.94; 0.89–0.99). There were also increases in hemorrhagic stroke (1.34; 1.01–1.79) and major bleeding (1.55; 1.35–1.78) with aspirin. The number needed to treat to prevent 1 major cardiovascular event over a mean follow-up of 6.8 years was 284. By comparison, the numbers needed to harm to cause 1 major bleeding is 299. In subgroup analyses, pooled results demonstrated a reduction in myocardial infarction among men (0.71; 0.59–0.85) and ischemic stroke among women (0.77; 0.63–0.93). Aspirin use was associated with a reduction (0.65; 0.51–0.82) in myocardial infarction among diabetic men. In meta-regression analyses, the results suggested that aspirin therapy might be associated with a decrease in stroke among diabetic women and a decrease in MI among diabetic men and risk reductions achieved with low doses (75 mg/day) were as large as those obtained with higher doses (650 mg/day). Conclusions The use of low-dose aspirin was beneficial for primary prevention of CVD and the decision regarding an aspirin regimen should be made on an individual patient basis. The effects of aspirin therapy varied by sex and diabetes status. A clear benefit of aspirin in the primary prevention of CVD in people with diabetes

  16. Pollution prevention opportunity assessment approach, training, and technical assistance for DOE contractors. FY 1995 report

    Energy Technology Data Exchange (ETDEWEB)

    Pemberton, S.

    1996-02-01

    The Department of Energy and its contractors are faced with environmental concerns and large waste management costs. Federal legislation and DOE Orders require sites to develop waste minimization/pollution prevention programs. In response to these requirements, the Kansas City Plant developed a pollution prevention tool called a pollution prevention opportunity assessment (PPOA). Pilot assessments resulted in the development of a graded approach to reduce the amount of effort required for activities that utilized nonhazardous and/or low-volume waste streams. The project`s objectives in FY95 were to validate DOE`s PPOA Graded Approach methodology, provide PPOA training and technical assistance to interested DOE personnel and DOE contractors, enhance the methodology with energy analysis and tools for environmental restoration activities, implement a DOE-wide PPOA database, and provide support to DOE EM-334 in the completion of a report which estimates the future potential for pollution prevention and waste minimization in the DOE complex.

  17. Pollution prevention opportunity assessment approach, training, and technical assistance for DOE contractors. FY 1995 report

    International Nuclear Information System (INIS)

    Pemberton, S.

    1996-02-01

    The Department of Energy and its contractors are faced with environmental concerns and large waste management costs. Federal legislation and DOE Orders require sites to develop waste minimization/pollution prevention programs. In response to these requirements, the Kansas City Plant developed a pollution prevention tool called a pollution prevention opportunity assessment (PPOA). Pilot assessments resulted in the development of a graded approach to reduce the amount of effort required for activities that utilized nonhazardous and/or low-volume waste streams. The project's objectives in FY95 were to validate DOE's PPOA Graded Approach methodology, provide PPOA training and technical assistance to interested DOE personnel and DOE contractors, enhance the methodology with energy analysis and tools for environmental restoration activities, implement a DOE-wide PPOA database, and provide support to DOE EM-334 in the completion of a report which estimates the future potential for pollution prevention and waste minimization in the DOE complex

  18. Opportunities and supporting activities to promote preventive maintenance of NPPs in Japan

    International Nuclear Information System (INIS)

    Sanada, A.; Shinkawa, T.; Sakurada, M.

    1998-01-01

    With increase of the number of NPPs and operation history, enhancement of the safety regulation is becoming important for such long-operated NPPs. Centering on the comprehensive preventive maintenance, periodic safety reviews by utilities and its review and evaluation by MITI are in progress. The first reviews have not revealed essential and critical indications to be newly implemented. This means that the most of activities to secure reliability and safety have been done steadily. The present paper addresses the mechanism of on-going preventive maintenance and its essential elements: opportunities to identify issues and problems, and supporting activities to promote decision-makings on feedback, upgrading and modernization of NPPs. (author)

  19. Opportunities for Prevention: Assessing Where Low-Income Patients Seek Care for Preventable Coronary Artery Disease.

    Science.gov (United States)

    Klaiman, Tamar A; Valdmanis, Vivian G; Bernet, Patrick; Moises, James

    2015-10-01

    The Affordable Care Act has many aspects that are aimed at improving health care for all Americans, including mandated insurance coverage for individuals, as well as required community health needs assessments (CHNAs), and reporting of investments in community benefit by nonprofit hospitals in order to maintain tax exemptions. Although millions of Americans have gained access to health insurance, many--often the most vulnerable--remain uninsured, and will continue to depend on hospital community benefits for care. Understanding where patients go for care can assist hospitals and communities to develop their CHNA and implementation plans in order to focus resources where the need for prevention is greatest. This study evaluated patient care-seeking behavior among patients with coronary artery disease (CAD) in Florida in 2008--analyzed in 2013--to assess whether low-income patients accessed specific safety net hospitals for treatment or received care from hospitals that were geographically closer to their residence. This study found evidence that low-income patients went to hospitals that treated more low-income patients, regardless of where they lived. The findings demonstrate that hospitals-especially public safety net hospitals with a tradition of treating low-income patients suffering from CAD-should focus prevention activities where low-income patients reside.

  20. Access to Difficult-to-reach Population Subgroups: A Family Midwife Based Home Visiting Service for Implementing Nutrition-related Preventive Activities - A Mixed Methods Explorative Study

    Directory of Open Access Journals (Sweden)

    Helena Walz

    2015-08-01

    Full Text Available Health and social inequality are tightly linked and still pose an important public health problem. However, vulnerable and disadvantaged populations are difficult to reach for health-related interventions. Given the long-lasting effects of an adverse, particular nutrition-related, intrauterine and neonatal environment on health development (perinatal programming, an early and easy access is essential for sustainable interventions. The goal of this explorative study was therefore to elucidate whether an existing access of family midwives (FMs to families in need of support could be an option to implement effective public health and nutrition interventions. To that end three research objectives were formulated: (1 to determine whether a discernible impact of home visits by FMs can be described; (2 to identify subgroups among these families in need of more specific interventions; (3 to determine how relevant nutrition-related topics are for both FMs and the supported families. For addressing these objectives a mixed methods design was used: Routine documentation data from 295 families visited by a family midwife (FM were analyzed (secondary analysis, and structured expert interviews with FMs were conducted and analyzed. Study reporting followed the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology statement. Based on the FMs reports, a significant improvement (p < 0.001 regarding psycho-social variables could be determined after the home visits. Single mothers, however, seemed to benefit less from the FMs service compared to their counterparts (p = 0.015. Nutritional counseling was demanded by 89% of the families during the home visits. In addition, nutrition-related topics were reported in the interviews to be of high interest to both families and the FMs. Based on the obtained results it is concluded that FMs home visits offer a promising access to vulnerable and disadvantaged families for implementing nutrition

  1. A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research

    Science.gov (United States)

    Crowley, Max; Jones, Damon

    2017-01-01

    Investing in strategies that aim to build a more nurturing society offers tremendous opportunities for the field of prevention science. Yet, scientists struggle to consistently take their research beyond effectiveness evaluations and actually value the impact of preventive strategies. Ultimately, it is clear that convincing policymakers to make meaningful investments in children and youth will require estimates of the fiscal impact of such strategies across public service systems. The framework offered here values such investments. First, we review current public spending on children and families. Then, we describe how to quantify and monetize the impact of preventive interventions. This includes a new measurement strategy for assessing multi-system service utilization and a price list for key service provision from public education, social services, criminal justice, healthcare, and tax systems. PMID:28247294

  2. Child Sexual Abuse Prevention Opportunities: Parenting, Programs, and the Reduction of Risk.

    Science.gov (United States)

    Rudolph, Julia; Zimmer-Gembeck, Melanie J; Shanley, Dianne C; Hawkins, Russell

    2018-02-01

    To date, child sexual abuse (CSA) prevention has relied largely on child-focused education, teaching children how to identify, avoid, and disclose sexual abuse. The purpose of this article is to explore how prevention opportunities can include parents in new and innovative ways. We propose that parents can play a significant role as protectors of their children via two pathways: (i) directly, through the strong external barriers afforded by parent supervision, monitoring, and involvement; and (ii) indirectly, by promoting their children's self-efficacy, competence, well-being, and self-esteem, which the balance of evidence suggests will help them become less likely targets for abuse and more able to respond appropriately and disclose abuse if it occurs. In this article, we first describe why teaching young children about CSA protective behaviors might not be sufficient for prevention. We then narratively review the existing research on parents and prevention and the parenting and family circumstances that may increase a child's risk of experiencing sexual abuse. Finally, we make a number of recommendations for future approaches to prevention that may better inform and involve parents and other adult protectors in preventing CSA.

  3. The stable subgroup graph

    Directory of Open Access Journals (Sweden)

    Behnaz Tolue

    2018-07-01

    Full Text Available In this paper we introduce stable subgroup graph associated to the group $G$. It is a graph with vertex set all subgroups of $G$ and two distinct subgroups $H_1$ and $H_2$ are adjacent if $St_{G}(H_1\\cap H_2\

  4. Health screening to identify opportunities to improve preventive medicine in cats and dogs.

    Science.gov (United States)

    Diez, M; Picavet, P; Ricci, R; Dequenne, M; Renard, M; Bongartz, A; Farnir, F

    2015-07-01

    To describe the results of a prevention campaign in terms of participation and pet health status and to identify opportunities to improve preventive medicine in cats and dogs. An awareness campaign was designed to highlight the role of veterinarians and emphasise the benefits of a veterinary visit. Owners were invited to make an appointment for a free pet health check in a voluntarily participating veterinary clinic. Observations recorded by the veterinarians were entered in a database and subsequently analysed using simple descriptive statistics. A total of 5305 completed health check forms were analysed. The percentages of overweight and obese dogs and cats were 34 and 36%, respectively; this was the most common finding, followed by dental calculus (31% in dogs, 21% in cats). In total 67% of cats did not undergo flea control and 59% were not vaccinated. Opportunities for increased quality of care are numerous given the high percentage of intact, unvaccinated or non-permanently identified pets and the low level of worm and flea control. Animal health should benefit from preventive measures, and improved management can be undertaken after early detection of diseases. © 2015 British Small Animal Veterinary Association.

  5. Backcasting to identify food waste prevention and mitigation opportunities for infant feeding in maternity services.

    Science.gov (United States)

    Ryan-Fogarty, Yvonne; Becker, Genevieve; Moles, Richard; O'Regan, Bernadette

    2017-03-01

    Food waste in hospitals is of major concern for two reasons: one, healthcare needs to move toward preventative and demand led models for sustainability and two, food system sustainability needs to seek preventative measures such as diet adaptation and waste prevention. The impact of breast-milk substitute use on health services are well established in literature in terms of healthcare implications, cost and resourcing, however as a food demand and waste management issue little has been published to date. This paper presents the use of a desk based backcasting method to analyse food waste prevention, mitigation and management options within the Irish Maternity Service. Best practice in healthcare provision and waste management regulations are used to frame solutions. Strategic problem orientation revealed that 61% of the volume of ready to use breast-milk substitutes purchased by maternity services remains unconsumed and ends up as waste. Thirteen viable strategies to prevent and manage this waste were identified. Significant opportunities exist to prevent waste and also decrease food demand leading to both positive health and environmental outcomes. Backcasting methods display great promise in delivering food waste management strategies in healthcare settings, especially where evidenced best practice policies exist to inform solution forming processes. In terms of food waste prevention and management, difficulties arise in distinguishing between demand reduction, waste prevention and waste reduction measures under the current Waste Management Hierarchy definitions. Ultimately demand reduction at source requires prioritisation, a strategy which is complimentary to health policy on infant feeding. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Type 2 diabetes, related conditions, in relation and dementia: an opportunity for prevention?

    Science.gov (United States)

    Luchsinger, José A

    2010-01-01

    This manuscript provides a comprehensive review of the epidemiologic evidence linking type 2 diabetes (T2D) and its precursor conditions, elevated adiposity and hyperinsulinemia, to dementia. The mechanisms relating these conditions to dementia may be vascular and non-vascular. Elevated adiposity in middle age is related to a higher risk of dementia but the data on this association in old age is conflicting. Several studies have shown that hyperinsulinemia, a consequence of higher adiposity and insulin resistance, is also related to a higher risk of dementia, including late onset Alzheimer's disease (LOAD). Studies have consistently shown a relation of T2D with higher dementia risk, but the associations are stronger for vascular dementia compared to LOAD. A large proportion of the world population may be at increased risk of dementia given the trends for increasing prevalence of overweight, obesity, hyperinsulinemia, and T2D. However, these associations may present a unique opportunity for prevention and treatment of dementia. There are several known modalities that are effective in the prevention and T2D and the reduction of hyperinsulinemia including lifestyle interventions, metformin, thiazolideniodones, and acarbose. Several studies in the prevention and treatment of T2D are currently measuring cognitive outcomes and will provide information on whether T2D treatment and prevention can prevent cognitive decline and dementia.

  7. Behavior change in a lifestyle intervention for type 2 diabetes prevention in Dutch primary care: opportunities for intervention content

    NARCIS (Netherlands)

    Vermunt, P.W.A.; Milder, I.E.J.; Wielaard, F.; Baan, C.A.; Schelfhout, J.D.M.; Westert, G.P.; van Oers, J.A.M.

    2013-01-01

    Background Despite the favorable effects of behavior change interventions on diabetes risk, lifestyle modification is a complicated process. In this study we therefore investigated opportunities for refining a lifestyle intervention for type 2 diabetes prevention, based on participant perceptions of

  8. Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape.

    Science.gov (United States)

    Brown, Graham; Leonard, William; Lyons, Anthony; Power, Jennifer; Sander, Dirk; McColl, William; Johnson, Ronald; James, Cary; Hodson, Matthew; Carman, Marina

    2017-02-01

    Improvements in biomedical technologies, combined with changing social attitudes to sexual minorities, provide new opportunities for HIV prevention among gay and other men who have sex with men (GMSM). The potential of these new biomedical technologies (biotechnologies) to reduce HIV transmission and the impact of HIV among GMSM will depend, in part, on the degree to which they challenge prejudicial attitudes, practices and stigma directed against gay men and people living with HIV (PLHIV). At the structural level, stigma regarding gay men and HIV can influence the scale-up of new biotechnologies and negatively affect GMSM's access to and use of these technologies. At the personal level, stigma can affect individual gay men's sense of value and confidence as they negotiate serodiscordant relationships or access services. This paper argues that maximising the benefits of new biomedical technologies depends on reducing stigma directed at sexual minorities and people living with HIV and promoting positive social changes towards and within GMSM communities. HIV research, policy and programs will need to invest in: (1) responding to structural and institutional stigma; (2) health promotion and health services that recognise and work to address the impact of stigma on GMSM's incorporation of new HIV prevention biotechnologies; (3) enhanced mobilisation and participation of GMSM and PLHIV in new approaches to HIV prevention; and (4) expanded approaches to research and evaluation in stigma reduction and its relationship with HIV prevention. The HIV response must become bolder in resourcing, designing and evaluating programs that interact with and influence stigma at multiple levels, including structural-level stigma.

  9. Newspaper media reporting of motor vehicle crashes in Singapore: an opportunity lost for injury prevention education?

    Science.gov (United States)

    Heng, Kenneth W J; Vasu, Alicia

    2010-06-01

    Newspaper media advocacy can help steer public attention away from motor vehicle crash (MVC) injuries as a personal problem to that of a social and public health issue. If used properly, newspaper media is potentially a powerful mass educator on MVC prevention. However, there is often a conflict of interest in which newspapers, in an attempt to boost readership and revenue, may over-emphasize and sensationalize the human-interest aspect of an MVC story. The aim of this study is to examine newspaper articles of MVCs in Singapore to assess how our newspaper media coverage portray MVCs and identify factors that mitigate injury and educate the public on injury prevention measures. Details of the MVC were extracted from 12 months of newspaper coverage in Singapore. Two independent coders were used to establish inter-rater reliability. From 1 January to 31 December 2007, 201 articles about MVCs were published. About 74.1% of articles assigned blame to a particular road user, negligence on either road user was implied in 56.7% of articles, and road safety messages were mentioned in 8% of the articles. The mainstream communication tone used was positive for law enforcement (71.1%) and neutral towards injury prevention or road safety messages (89.1%). Newspaper media reporting of MVCs in Singapore generally does not include injury prevention messages or highlight injury-mitigating measures. This is a lost opportunity for public education. Collaboration between public health practitioners and newspaper media is required to address this issue.

  10. Full report: Assessment and opportunity identification of energy efficient pollution prevention technologies and processes

    Energy Technology Data Exchange (ETDEWEB)

    1994-11-01

    US industry produces about 12 billion tons of waste a year, or two-thirds of the waste generated in the US. The costs of handling and disposing of these wastes are significant, estimated to be between $25 and $43 billion in 1991, and represent an increase of 66% since 1986. US industry also uses about one-third of all energy consumed in the nation, which adds to the environmental burden. Industrial wastes affect the environmental well-being of the nation and, because of their growing costs, the competitive abilities of US industry. As part of a national effort to reduce industrial wastes, the US Congress passed the Energy Policy Act (EPAct, P.L. 102-486). Section 2108, subsections (b) and (c), of EPAct requires the Department of Energy (DOE) to identify opportunities to demonstrate energy efficient pollution prevention technologies and processes; to assess their availability and the energy, environmental, and cost effects of such technologies; and to report the results. Work for this report clearly pointed to two things, that there is insufficient data on wastes and that there is great breadth and diversity in the US industrial sector. This report identifies: information currently available on industrial sector waste streams, opportunities for demonstration of energy efficient pollution prevention technologies in two industries that produce significant amounts of waste--chemicals and petroleum, characteristics of waste reducing and energy saving technologies identifiable in the public literature, and potential barriers to adoption of waste reducing technologies by industry.

  11. The congruence subgroup problem

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    The group SL(2, Z) of 2 × 2 integral matrices of determinant 1 is a group that crops up in different contexts in mathematics. Its structure is understood. The group has a natural family of normal subgroups (of finite index). If I ⊂ Z is a proper non-zero ideal, the subgroup {g ∈ SL(2, Z)|g ≡ 1(modI)} is a subgroup of finite index ...

  12. Finite groups all of whose minimal subgroups are NE∗ -subgroups

    Indian Academy of Sciences (India)

    subgroups are classified. Keywords. NE-subgroup; NE∗-subgroup; the generalized fitting subgroup; saturated formation. 2010 Mathematics Subject Classification. 20D10, 20D20. 1. Introduction. All groups considered will be finite. We use conventional ...

  13. New Business Structures Creating Organizational Opportunities and Challenges for Work Disability Prevention.

    Science.gov (United States)

    Ekberg, Kerstin; Pransky, Glenn S; Besen, Elyssa; Fassier, Jean-Baptise; Feuerstein, Michael; Munir, Fehmidah; Blanck, Peter

    2016-12-01

    Purpose Flexible work arrangements are growing in order to develop resource-efficient production and because of advanced technologies, new societal values, changing demographics, and globalization. The article aims to illustrate the emerging challenges and opportunities for work disability prevention efforts among workers in alternate work arrangements. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability," held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a roundtable discussion with experts having direct employer experience. Results Both worker and employer perspectives were considered, and four common alternate work arrangements were identified: (a) temporary and contingent employment; (b) small workplaces; (c) virtual work/telework; and (d) lone workers. There was sparse available research of return-to-work (RTW) and workplace disability management strategies with regard to alternate work patterns. Limited research findings and a review of the grey literature suggested that regulations and guidelines concerning disabled workers are often ambiguous, leading to unsatisfactory protection. At the workplace level, there was a lack of research evidence on how flexible work arrangements could be handled or leveraged to support RTW and prevent disability. Potential negative consequences of this lack of organizational guidance and information are higher costs for employers and insurers and feelings of job insecurity, lack of social support and integration, or work intensification for disabled workers. Conclusions Future studies of RTW and workplace disability prevention

  14. The opioid epidemic is an historic opportunity to improve both prevention and treatment.

    Science.gov (United States)

    DuPont, Robert L

    2018-04-01

    The current narrative describing the national opioid epidemic as the result of overprescribing opioid pain medicines fails to capture the full dimensions of the problem and leads to inadequate and even confounding solutions. Overlooked is the fact that polysubstance use is nearly ubiquitous among overdose deaths, demonstrating that the opioid overdose death problem is bigger than opioids. The foundation of the nation's opioid overdose crisis - and the totality of the nation's drug epidemic - is widespread recreational pharmacology, the use of drugs for fun or "self-medication." The national focus on opioid overdose deaths provides important new opportunities in both prevention and treatment to make fundamental changes to the way that substance use disorders and related problems are understood and managed. The first-ever US Surgeon General's report on addiction provides a starting point for systemic changes in the nation's approach to preventing, treating and managing substance use disorders as serious, chronic diseases. New prevention efforts need to encourage youth to grow to adulthood not using alcohol, nicotine, marijuana or other drugs for reasons of health. New addiction treatment efforts need to focus on achieving long-term recovery including no use of alcohol, marijuana and other drugs. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Epidemiological transition of colorectal cancer in developing countries: environmental factors, molecular pathways, and opportunities for prevention.

    Science.gov (United States)

    Bishehsari, Faraz; Mahdavinia, Mahboobeh; Vacca, Michele; Malekzadeh, Reza; Mariani-Costantini, Renato

    2014-05-28

    Colorectal cancer (CRC) is one of the leading causes of cancer and cancer-related mortality worldwide. The disease has been traditionally a major health problem in industrial countries, however the CRC rates are increasing in the developing countries that are undergoing economic growth. Several environmental risk factors, mainly changes in diet and life style, have been suggested to underlie the rise of CRC in these populations. Diet and lifestyle impinge on nuclear receptors, on the intestinal microbiota and on crucial molecular pathways that are implicated in intestinal carcinogenesis. In this respect, the epidemiological transition in several regions of the world offers a unique opportunity to better understand CRC carcinogenesis by studying the disease phenotypes and their environmental and molecular associations in different populations. The data from these studies may have important implications for the global prevention and treatment of CRC.

  16. [Biological safety of nanomaterials: the opportunity and challenge of preventive medicine].

    Science.gov (United States)

    Zhao, Yuliang

    2015-09-01

    Nanotechnology, as a newly arisen technology, does not only benefit people, but also become one of the inevitable threats to public health due to the widely application of nanomaterials. The safety evaluation of nanomaterials has become one of the hottest research topics in the 21st century, which provides opportunities and challenges in the field of preventive medicine once in a blue moon. Although the history of development in the safety assessment of nanomaterials is just over twenty years, the achievements could not be underestimated. This paper summarized the research of nano biological, predicted the directions for future research, and proposed several recommendations, based on which, we hope it can promote the sustainable development safety in China.

  17. Opportunities During Early Life for Cancer Prevention: Highlights From a Series of Virtual Meetings With Experts

    Science.gov (United States)

    Holman, Dawn M.; Buchanan, Natasha D.

    2018-01-01

    Compelling evidence suggests that early life exposures can affect lifetime cancer risk. In 2014, the Centers for Disease Control and Prevention’s (CDC’s) Cancer Prevention Across the Lifespan Workgroup hosted a series of virtual meetings with select experts to discuss the state of the evidence linking factors during the prenatal period and early childhood to subsequent risk of both pediatric and adult cancers. In this article, we present the results from a qualitative analysis of the meeting transcripts and summarize themes that emerged from our discussions with meeting participants. Themes included the state of the evidence linking early life factors to cancer risk, research gaps and challenges, the level of evidence needed to support taking public health action, and the challenges of communicating complex, and sometimes conflicting, scientific findings to the public. Opportunities for collaboration among public health agencies and other stakeholders were identified during these discussions. Potential next steps for the CDC and its partners included advancing and building upon epidemiology and surveillance work, developing and using evidence from multiple sources to inform decision-making, disseminating and communicating research findings in a clear and effective way, and expanding collaborations with grantees and other partners. As the science on early life factors and cancer risk continues to evolve, there are opportunities for collaboration to translate science into actionable public health practice. PMID:27940972

  18. Radon testing in rapid access lung clinics: an opportunity for secondary prevention.

    Science.gov (United States)

    Smyth, R; Long, S; Wiseman, E; Sharpe, D; Breen, D; O'Regan, A

    2017-05-01

    Radon is a naturally occurring radioactive gas and a level 1 carcinogen. It acts synergistically with cigarette smoke to cause lung cancer. In Ireland, radon is estimated to be associated with 13 % of all lung cancers. Rapid access lung cancer clinics (RALC's) were established in the UK and Ireland to improve lung cancer management outcomes. There has been no attempt to date to provide advice on household radon exposure assessments in this setting. We performed a prospective feasibility study of radon assessment in our RALC to test the hypothesis that patients would avail of this service and that it would provide an opportunity for secondary prevention in at risk persons. We investigated household radon levels in consecutive patients who were newly referred with symptoms of lung cancer to the RALC in Galway University Hospital, Ireland over a 6-month period. Of 50 patients enrolled, 42 returned valid results. Overall 21 % of patients had radon levels recorded above the national reference level. Only 5 % of patients were aware of the association between radon gas and lung cancer. Smokers were significantly less likely to engage fully in radon testing. The development of RALC's offers a novel opportunity to integrate the concepts of radon exposure, cigarette smoking and the development of lung cancer, and to reinforce this message in the minds of at risk patients.

  19. Windows of opportunity for physical activity in the prevention of obesity.

    Science.gov (United States)

    Street, S J; Wells, J C K; Hills, A P

    2015-10-01

    Tackling increasing rates of obesity is likely to be a defining feature of health care over the next several decades. Adult obesity is a persistent and treatment-resistant problem. Consequently, an emerging theme in the literature is to commence prevention efforts earlier in the developmental time course. This view is based primarily on epidemiological data demonstrating a link between traits manifesting early during development and increased obesity risk in adulthood. Physical activity is a perennial factor in discussions of obesity prevention. However, the optimal timing and type of physical activity interventions to commence remains unclear. Critical developmental windows of plasticity may afford time-limited opportunities to shape body composition across the life course; however, physical activity has not been explicitly considered in these discussions. Although animal models suggest that physical activity commenced earlier in development has differential effects on obesity onset compared to physical activity commenced in adulthood, human research is lacking. In this conceptual review, we consider physical activity during critical developmental periods as a way to mitigate obesity risk later in life. © 2015 World Obesity.

  20. Antibacterial Peptides: Opportunities for the Prevention and Treatment of Dental Caries.

    Science.gov (United States)

    Pepperney, Adam; Chikindas, Michael L

    2011-06-01

    Dental caries is a multifactorial disease that is a growing and costly global health concern. The onset of disease is a consequence of an ecological imbalance within the dental plaque biofilm that favors specific acidogenic and aciduric caries pathogens, namely Streptococcus mutans and Streptococcus sobrinus. It is now recognized by the scientific and medical community that it is neither possible nor desirable to totally eliminate dental plaque. Conversely, the chemical biocides most commonly used for caries prevention and treatment indiscriminately attack all plaque microorganisms. These treatments also suffer from other drawbacks such as bad taste, irritability, and staining. Furthermore, the public demand for safe and natural personal hygiene products continues to rise. Therefore, there are opportunities that exist to develop new strategies for the treatment of this disease. As an alternative to conventional antibiotics, antibacterial peptides have been explored greatly over the last three decades for many different therapeutic uses. There are currently tens of hundreds of antibacterial peptides characterized across the evolutionary spectrum, and among these, many demonstrate physical and/or biological properties that may be suitable for a more targeted approach to the selective control or elimination of putative caries pathogens. Additionally, many peptides, such as nisin, are odorless, colorless, and tasteless and do not cause irritation or staining. This review focuses on antibacterial peptides for their potential role in the treatment and prevention of dental caries and suggests candidates that need to be explored further. Practical considerations for the development of antibacterial peptides as oral treatments are also discussed.

  1. Pollution prevention opportunity assessment for the K-25 Site Steam Plant -- Level 3

    International Nuclear Information System (INIS)

    1995-09-01

    A Level 3 pollution prevention opportunity assessment (PPOA) was performed for the K-1501 Steam Plant at the K-25 Site. The primary objective was to identify and evaluate pollution prevention (P2) options to reduce the quantities of each waste stream generated by the Steam Plant. For each of the waste streams, P2 options were evaluated to first reduce the quantity of waste generated and second to recycle the waste. This report provides a process description of the facility; identification, evaluation, and recommendations of P2 options; an implementation schedule with funding sources; and conclusions. Largely for economic reasons, only 3 of the 14 P2 options are being recommended for implementation. All are source reduction options. When implemented, these three options are estimated to reduce the annual generation of waste by 658,412 kg and will result in a cost savings of approximately $29,232/year for the K-25 Site. The recommended options are to: install a flue gas return System in Boiler 7; reduce steam loss from traps; and increase lapse time between rinses. The four boilers currently in operation at the Steam Plant use natural gas or fuel oil as fuel sources

  2. Herding interactions as an opportunity to prevent extreme events in financial markets

    Science.gov (United States)

    Kononovicius, Aleksejus; Gontis, Vygintas

    2015-07-01

    A characteristic feature of complex systems in general is a tight coupling between their constituent parts. In complex socio-economic systems this kind of behavior leads to self-organization, which may be both desirable (e.g. social cooperation) and undesirable (e.g. mass panic, financial "bubbles" or "crashes"). Abundance of the empirical data as well as general insights into the trading behavior enables the creation of simple agent-based models reproducing sophisticated statistical features of the financial markets. In this contribution we consider a possibility to prevent self-organized extreme events in financial market modeling its behavior using agent-based herding model, which reproduces main stylized facts of the financial markets. We show that introduction of agents with predefined fundamentalist trading behavior helps to significantly reduce the probability of the extreme price fluctuations events. We also investigate random trading, which was previously found to be promising extreme event prevention strategy, and find that its impact on the market has to be considered among other opportunities to stabilize the markets.

  3. Finite groups all of whose minimal subgroups are NE∗ -subgroups

    Indian Academy of Sciences (India)

    subgroup of G if there exists a subnormal subgroup T of G such that G = HT and H ∩ T is a. NE-subgroup of G. In this article, we investigate the structure of G under the assump- tion that subgroups of prime order are NE∗-subgroups of G. The finite ...

  4. Metabolic vitamin B12 deficiency: a missed opportunity to prevent dementia and stroke.

    Science.gov (United States)

    Spence, J David

    2016-02-01

    The purpose of this narrative review is to highlight insights into the importance and frequency of metabolic vitamin B12 (B12) deficiency, reasons why it is commonly missed, and reasons for the widespread but mistaken belief that treatment of B12 deficiency does not prevent stroke or improve cognitive function. Metabolic B12 deficiency is common, being present in 10%-40% of the population; is frequently missed; is easily treated; and contributes importantly to cognitive decline and stroke in older people. Measuring serum B12 alone is not sufficient for diagnosis; it is necessary to measure holotranscobalamin or functional markers of B12 adequacy such as methylmalonic acid or plasma total homocysteine. B-vitamin therapy with cyanocobalamin reduces the risk of stroke in patients with normal renal function but is harmful (perhaps because of thiocyanate accumulation from cyanide in cyanocobalamin) in patients with renal impairment. Methylcobalamin may be preferable in renal impairment. B12 therapy slowed gray matter atrophy and cognitive decline in the Homocysteine and B Vitamins in Cognitive Impairment Trial. Undiagnosed metabolic B12 deficiency may be an important missed opportunity for prevention of dementia and stroke; in patients with metabolic B12 deficiency, it would be prudent to offer inexpensive and nontoxic supplements of oral B12, preferably methylcobalamin or hydroxycobalamin. Future research is needed to distinguish the effects of thiocyanate from cyanocobalamin on hydrogen sulfide, and effects of treatment with methylcobalamin on cognitive function and stroke, particularly in patients with renal failure. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

    Directory of Open Access Journals (Sweden)

    James Coyle

    2012-06-01

    Full Text Available Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP, a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  6. Pollution prevention opportunity assessment for the SNL/California waste management facilities

    International Nuclear Information System (INIS)

    Braye, S.; Phillips, N.M.

    1995-01-01

    SNL/California's waste management facilities, Bldgs. 961 and 962-2, generate a secondary stream of hazardous and radioactive waste. This waste stream is generated mainly during the processing and handling of hazardous, radioactive, and mixed wastes (primary waste stream), which are generated by the laboratories, and when cleaning up spills. The secondary waste stream begins with the removal of a generator's hazardous, radioactive, and mixed waste from specified collection areas. The waste stream ends when the containers of processed waste are loaded for shipment off-site. The total amount of secondary hazardous waste generated in the waste management facilities from January 1993 to July 1994 was 1,160.6 kg. The total amount of secondary radioactive waste generated during the same period was 1,528.8 kg (with an activity of 0.070 mCi). Mixed waste usually is not generated in the secondary waste stream. This pollution prevention opportunity assessment (PPOA) was conducted using the graded approach methodology developed by the Department of Energy (DOE) PPOA task group. The original method was modified to accommodate the needs of Sandia's site-specific processes. The options generated for potential hazardous waste minimization, cost savings, and environmental health and safety were the result of a waste minimization team effort. The results of the team efforts are summarized

  7. Home and community care services: a major opportunity for preventive health care

    Directory of Open Access Journals (Sweden)

    Lujic Sanja

    2010-05-01

    Full Text Available Abstract Background In Australia, the Home and Community Care (HACC program provides services in the community to frail elderly living at home and their carers. Surprisingly little is known about the health of people who use these services. In this study we sought to describe health-related factors associated with use of HACC services, and to identify potential opportunities for targeting preventive services to those at high risk. Methods We obtained questionnaire data from the 45 and Up Study for 103,041 men and women aged 45 years and over, sampled from the general population of New South Wales, Australia in 2006-2007, and linked this with administrative data about HACC service use. We compared the characteristics of HACC clients and non-clients according to a range of variables from the 45 and Up Study questionnaire, and estimated crude and adjusted relative risks for HACC use with generalized linear models. Results 4,978 (4.8% participants used HACC services in the year prior to completing the questionnaire. Increasing age, female sex, lower pre-tax household income, not having a partner, not being in paid work, Indigenous background and living in a regional or remote location were strongly associated with HACC use. Overseas-born people and those speaking languages other than English at home were significantly less likely to use HACC services. People who were underweight, obese, sedentary, who reported falling in the past year, who were current smokers, or who ate little fruit or vegetables were significantly more likely to use HACC services. HACC service use increased with decreasing levels of physical functioning, higher levels of psychological distress, and poorer self-ratings of health, eyesight and memory. HACC clients were more likely to report chronic health conditions, in particular diabetes, stroke, Parkinson's disease, anxiety and depression, cancer, heart attack or angina, blood clotting problems, asthma and osteoarthritis

  8. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT OF THE UNITED STATES ARMY CORPS OF ENGINEERS GARRISON DAM HYDRO- ELECTRIC POWERPLANT - RIVERDALE, NORTH DAKOTA

    Science.gov (United States)

    The report describes the results of pollution prevention opportunity assessments conducted at a representative U.S. Army Corps of Engineers civil works dam and hydroelectric power plant. ecommended methods for reducing pollution resulting primarily from the operation of these fac...

  9. Qualitative assessment of HIV prevention challenges and opportunities among Latino immigrant men in a new receiving city.

    Science.gov (United States)

    Dolwick Grieb, Suzanne M; Desir, Fidel; Flores-Miller, Alejandra; Page, Kathleen

    2015-02-01

    Changing demographics in new receiving communities contributes to a lag time between the arrival of new immigrants and the development of appropriate services. This scarcity of services can exacerbate existing disparities in health conditions such as HIV, which disproportionately affects Latinos. Focus groups were conducted in Baltimore with 59 Latino men who had immigrated to the U.S. within the past 10 years to explore the challenges and opportunities to accessing HIV testing and preventative services. Transcripts were analyzed through a modified thematic constant comparison approach. Four thematic categories emerged: information about HIV, HIV fear and stigma, barriers to accessing healthcare, and opportunities for intervention approaches. Information and communication technology provides an opportunity to improve access to HIV testing and prevention services. Individualized interventions, though, must be disseminated in collaboration with community-, structural-, and policy-level interventions that address HIV risk, HIV/AIDS stigma, and healthcare access among Latino immigrants.

  10. Subgroups Among Opiate Addicts

    Science.gov (United States)

    Berzins, Juris I.; And Others

    1974-01-01

    The principal objective of the present investigation was to delineate homogeneous MMPI profile subgroups (types) through multivariate clustering procedures and to compare the derived (replicable) types on measures of the components of "sociopathy" as well as on other psychometric devices. (Author)

  11. Molecular subgroups of medulloblastoma

    OpenAIRE

    Northcott, Paul A; Dubuc, Adrian M; Pfister, Stefan; Taylor, Michael D

    2012-01-01

    Recent efforts at stratifying medulloblastomas based on their molecular features have revolutionized our understanding of this morbidity. Collective efforts by multiple independent groups have subdivided medulloblastoma from a single disease into four distinct molecular subgroups characterized by disparate transcriptional signatures, mutational spectra, copy number profiles and, most importantly, clinical features. We present a summary of recent studies that have contributed to our understand...

  12. In a subgroup of high-risk Asians, telmisartan was non-inferior to ramipril and better tolerated in the prevention of cardiovascular events.

    Directory of Open Access Journals (Sweden)

    Antonio L Dans

    2010-12-01

    in ethnic subgroups can help assess applicability of results to specific populations.ClinicalTrials.gov NCT00153101.

  13. Social network characteristics and HIV vulnerability among transgender persons in San Salvador: identifying opportunities for HIV prevention strategies.

    Science.gov (United States)

    Barrington, Clare; Wejnert, Cyprian; Guardado, Maria Elena; Nieto, Ana Isabel; Bailey, Gabriela Paz

    2012-01-01

    The purpose of this study is to improve understanding of HIV vulnerability and opportunities for HIV prevention within the social networks of male-to-female transgender persons in San Salvador, El Salvador. We compare HIV prevalence and behavioral data from a sample of gay-identified men who have sex with men (MSM) (n = 279), heterosexual or bisexual identified MSM (n = 229) and transgender persons (n = 67) recruited using Respondent Driven Sampling. Transgender persons consistently reported higher rates of HIV risk behavior than the rest of the study population and were significantly more likely to be involved in sex work. While transgender persons reported the highest rates of exposure to HIV educational activities they had the lowest levels of HIV-related knowledge. Transgender respondents' social networks were homophilous and efficient at recruiting other transgender persons. Findings suggest that transgender social networks could provide an effective and culturally relevant opportunity for HIV prevention efforts in this vulnerable population.

  14. [Subgroups of fibromyalgia].

    Science.gov (United States)

    Müller, W; Schneider, M; Joos, T; Hsu, H Y; Stratz, T

    2007-10-01

    As has been shown by a number of working groups, primary fibromyalgia syndrome does not represent a single clinical entity. It is possible to distinguish between a subgroup with high pain sensitivity and no associated psychiatric condition, a second subgroup characterized by depression and concomitant pain symptoms associated with fibromyalgia syndrome, and a third group with somatoform pain disorder of the fibromyalgia type. Bland inflammatory processes must be considered as the cause in the first group, while depression is the underlying reason for the development of pain in the second group. In the third group, serious previous or still existing psychological problems or also insufficient coping with illness symptoms must be regarded as the reason for pain chronification. Group 1 benefits from a blocking of the 5-HT3 receptors by means of tropisetron, for example. This not only affects pain chronification but also the inflammatory process itself. Group 2 needs antidepressant treatment, whereas the focus should be on psychotherapy is group 3. Groups 1 and 2 will also profit from multimodal physical treatment programs; to a certain extent this applies to group 3 as well. So-called mixed types require a combination of therapeutic measures.

  15. Opportunities for AIDS prevention in a rural state in criminal justice and drug treatment settings.

    Science.gov (United States)

    Farabee, D; Leukefeld, C G

    1999-01-01

    This study examined the likelihood that drug users would receive HIV/ AIDS prevention information and supplies (e.g., condoms and bleach) in the rural state of Kentucky. Despite evidence of high HIV risk among criminal justice and substance-using populations, incarceration and substance-user treatment were only minimally associated with prior HIV prevention exposure or HIV testing. These data strongly support the use of criminal justice and treatment settings to provide AIDS prevention interventions for the high-risk drug-using populations they serve, and to target HIV prevention services in rural as well as urban areas.

  16. State practitioner insights into local public health challenges and opportunities in obesity prevention: a qualitative study.

    Science.gov (United States)

    Stamatakis, Katherine A; Lewis, Moira; Khoong, Elaine C; Lasee, Claire

    2014-03-13

    The extent of obesity prevention activities conducted by local health departments (LHDs) varies widely. The purpose of this qualitative study was to characterize how state obesity prevention program directors perceived the role of LHDs in obesity prevention and factors that impact LHDs' success in obesity prevention. From June 2011 through August 2011, we conducted 28 semistructured interviews with directors of federally funded obesity prevention programs at 22 state and regional health departments. Interviews were transcribed verbatim, coded, and analyzed to identify recurring themes and key quotations. Main themes focused on the roles of LHDs in local policy and environmental change and on the barriers and facilitators to LHD success. The role LHDs play in obesity prevention varied across states but generally reflected governance structure (decentralized vs centralized). Barriers to local prevention efforts included competing priorities, lack of local capacity, siloed public health structures, and a lack of local engagement in policy and environmental change. Structures and processes that facilitated prevention were having state support (eg, resources, technical assistance), dedicated staff, strong communication networks, and a robust community health assessment and planning process. These findings provide insight into successful strategies state and local practitioners are using to implement innovative (and evidence-informed) community-based interventions. The change in the nature of obesity prevention requires a rethinking of the state-local relationship, especially in centralized states.

  17. Integrated prevention of obesity and eating disorders: barriers, developments and opportunities.

    Science.gov (United States)

    Sánchez-Carracedo, David; Neumark-Sztainer, Dianne; López-Guimerà, Gemma

    2012-12-01

    The serious consequences of obesity and eating disorders (ED), difficulties encountered in treatment and the high prevalence of these conditions are important reasons to develop efforts aimed at their prevention. The implementation of integrated interventions aimed at preventing risk factors for both obesity and ED constitutes a very exciting development. In the present paper we discuss and review the main reasons for an integrated approach to the spectrum of eating- and weight-related problems, which include anorexia nervosa, bulimia nervosa, anorexic and bulimic behaviours, unhealthy dieting practices, body dissatisfaction, binge-eating disorder, overweight and obesity. Given differences between the fields with regard to current perspectives and objectives, key barriers to an integrated approach to prevention are discussed. In order to show the possibilities of development of this approach, we review the main contributions made to date in the fields of both obesity and ED prevention. In particular, environmental approaches in the prevention of obesity and ED are reviewed, given their potential for preventing a broad spectrum of eating- and weight-related problems. Furthermore, several examples of initiatives that have utilized an integrated approach to prevention are discussed. Narrative review. We recommend a scenario in which the two fields share knowledge to enhance the difficult work of preventing and treating both ED and obesity.

  18. Missed Opportunities to Keep Children Safe? National Survey of Injury Prevention Activities of Children's Centres

    Science.gov (United States)

    Watson, Michael Craig; Mulvaney, Caroline; Timblin, Clare; Stewart, Jane; Coupland, Carol A.; Deave, Toity; Hayes, Mike; Kendrick, Denise

    2016-01-01

    Objective: To ascertain the activities undertaken by children's centres to prevent unintentional injuries in the under-fives and, in particular, the prevention of falls, poisoning and scalds. Design: A questionnaire was posted to managers of 851 children's centres, using stratified cluster sampling. The questionnaire included questions on injury…

  19. Opportunities for Pharmacists and Student Pharmacists to Provide Clinical Preventive Services

    Directory of Open Access Journals (Sweden)

    Natalie A. DiPietro Mager

    2017-01-01

    Full Text Available Pharmacists and student pharmacists can play an important role in providing clinical preventive services as specified by the United States Preventive Services Task Force (USPSTF. The USPSTF guidelines provide evidence-based recommendations about clinical preventive services for the general population. The purpose of this paper is to provide information to pharmacists and student pharmacists developing and implementing preventive health care services. Examples of successful pharmacy-based programs are also provided. Pharmacists and student pharmacists can provide preventive health care interventions by conducting screenings, providing education, and making referrals. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Idea Paper

  20. Encouraging employees to speak up to prevent infections: Opportunities to leverage quality improvement and care management processes.

    Science.gov (United States)

    Robbins, Julie; McAlearney, Ann Scheck

    2016-11-01

    Central line-associated bloodstream infections (CLABSIs) are associated with increased morbidity, mortality, and cost for U.S. hospitals, but many infections are preventable. Employees' willingness to speak up about errors or opportunities for improvement has been associated with a stronger safety culture in hospitals. However, the link between organizations' efforts to promote speaking up and prevent CLABSIs has not been studied. This exploratory, qualitative study included interviews with 158 key informants, including hospital executives, managers, and staff employees, in 6 hospitals that participated in the federally funded On the CUSP-Stop BSI initiative. Verbatim transcripts were analyzed to examine whether and how speaking up was addressed in CLABSI prevention efforts. Hospitals implementing evidence-based practices for CLABSI prevention facilitated employees' improvement-oriented speaking up by leveraging quality improvement and care management processes. Leader behavior, employee training, and error reporting systems also facilitated speaking up. Although the focus of this study was on CLABSI prevention, broader organizational practices to improve patient safety were salient in creating a nonpunitive, highly inclusive environment in which employees felt comfortable speaking up. These findings provide insight into the factors that may support speaking up to foster a safety culture and prevent health care-associated infection at unit and organization levels. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Biomass accident investigations – missed opportunities for learning and accident prevention

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess

    2017-01-01

    selected serious accidents involving biogas and wood pellets in Denmark and argues that such opportunities for learning were missed because accident investigations were superficial, follow-up incomplete and information sharing absent. In one particularly distressing case, a facility saw a repeat accident...

  2. Reports of Sub-Groups

    Science.gov (United States)

    Indian Journal of Adult Education, 1975

    1975-01-01

    Sub-group proceedings at the 28th all-India Adult Education Conference held in October, 1975, are summarized. Sub-groups discussed the theme "non-formal education" as it applies to one of five population groups: school drop-outs, youth, women, farmers, and industrial workers. The sixth sub-group considered policy and financing for…

  3. Incorporating Couples-Based Approaches into HIV Prevention for Gay and Bisexual Men: Opportunities and Challenges

    Science.gov (United States)

    Mizuno, Yuko; Smith, Dawn K.; Grabbe, Kristina; Courtenay-Quirk, Cari; Tomlinson, Hank; Mermin, Jonathan

    2016-01-01

    Thirty years after the beginning of the HIV epidemic, gay, bisexual, and other men who have sex with men (collectively called MSM) bear a disproportionate burden of HIV in the United States and continue to acquire a distressingly high number and proportion of new infections. Historically, HIV prevention for MSM has been focused on individual-level behavior change, rarely intervening with MSM as part of a couple. Yet, an estimated 33–67% of HIV infections among MSM are acquired from primary sexual partners, suggesting that work with MSM as couples could be an important contributor to prevention. Given the emergence of high impact combination HIV prevention, it is timely to consider how work with the broad variety of male couples can improve both personal and community health. Couples HIV testing and counseling for MSM is an important advance for identifying men who are unaware that they are HIV-positive, identifying HIV-discordant couples, and supporting men who want to learn their HIV status with their partner. Once men know their HIV status, new advances in biomedical prevention, which can dramatically reduce risk of HIV transmission or acquisition, allow men to make prevention decisions that can protect themselves and their partners. This paper highlights the present-day challenges and benefits of using a couples-based approach with MSM in the era of combination prevention to increase knowledge of HIV status, increase identification of HIV discordant couples to improve targeting prevention services, and support mutual disclosure of HIV status. PMID:24233328

  4. Development of a method to evaluate the technical and environmental feasibility of particular pollution prevention opportunities.

    Science.gov (United States)

    2000-06-01

    The Virginia Department of Transportation (VDOT) is obligated by House Joint Resolution 453 passed in 1995 by Virginia's General Assembly to develop and implement a pollution prevention (P2) program. The primary purpose of this study was to develop a...

  5. Role of editors and journals in detecting and preventing scientific misconduct: strengths, weaknesses, opportunities, and threats.

    Science.gov (United States)

    Marusic, Ana; Katavic, Vedran; Marusic, Matko

    2007-09-01

    Scientific journals have a central place in protecting research integrity because published articles are the most visible documentation of research. We used SWOT analysis to audit (S)trengths and (W)eaknesses as internal and (O)pportunities and (T)hreats as external factors affecting journals' responsibility in addressing research integrity issues. Strengths include editorial independence, authority and expertise, power to formulate editorial policies, and responsibility for the integrity of published records. Weaknesses stem from having no mandate for legal action, reluctance to get involved, and lack of training. Opportunities for editors are new technologies for detecting misconduct, policies by editorial organization or national institutions, and greater transparency of published research. Editors face threats from the lack of legal regulation and culture of research integrity in academic communities, lack of support from stakeholders in scientific publishing, and different pressures. Journal editors cannot be the policing force of the scientific community but they should actively ensure the integrity of the scientific record.

  6. Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.

    Science.gov (United States)

    Salvy, S-J; de la Haye, K; Galama, T; Goran, M I

    2017-02-01

    Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. © 2016 World Obesity Federation.

  7. Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

    Science.gov (United States)

    Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

    2016-01-01

    Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

  8. The health profile of professional soccer players: future opportunities for injury prevention.

    Science.gov (United States)

    Volpi, Piero; Taioli, Emanuela

    2012-12-01

    Injuries are a major adverse event during a soccer player's career; they require medical and surgical treatment and rehabilitation and thus may interrupt the player's activity, often with severe physical and psychological sequel. Specialists have tried to identify the risk factors for injuries, in an attempt to discover predictors that could be prevented and or eliminated before the injury occurs, but the results are scarce. This article reviews the epidemiology of the frequency and occurrence of injuries in Italian soccer players, reports a list of preventable risk factors that are associated with injuries, and identifies preventable risk factors. We have identified personal factors (age, previous traumatic events, physical and biological characteristics of the player, life style habits such as smoking, alcohol, and diet, changes in physical-athletic aspects of the players, such as increased muscle strength, and use of medications) as possible risk factors for injuries. However, environmental factors such as changes in training techniques, field composition, and shoes structure may also have a major influence. This summary indicates that appropriate preventive measures can be undertaken to prevent injuries in professional soccer players. Professionals who are in close contacts with the players should be informed of the predictors of injuries and should be trained to intervene and plan appropriate preventive measures.

  9. Opportunities to Reduce Overuse of Antibiotics for Perinatal Group B Streptococcal Disease Prevention and Management of Preterm Premature Rupture of Membranes

    Directory of Open Access Journals (Sweden)

    Stephanie Schrag

    2005-01-01

    Full Text Available Objective: To identify opportunities to reduce overuse of antibiotics for prevention of perinatal group B streptococcal (GBS disease and management of preterm premature rupture of membranes (pPROM.

  10. Opportunity for collaboration: a conceptual model of success in tobacco control and cancer prevention.

    Science.gov (United States)

    Stillman, Frances A; Schmitt, Carol L; Rosas, Scott R

    2012-01-01

    Collaborations between cancer prevention and tobacco control programs can leverage scarce resources to address noncommunicable diseases globally, but barriers to cooperation and actual collaboration are substantial. To foster collaboration between cancer prevention and tobacco control programs, the Global Health Partnership conducted research to identify similarities and differences in how the 2 programs viewed program success. Using concept mapping, cancer prevention and tobacco control experts generated statements describing the components of a successful cancer prevention or tobacco control program and 33 participants sorted and rated the final 99 statements. Multidimensional scaling analysis with a 2-dimensional solution was used to identify an 8-cluster conceptual map of program success. We calculated Pearson correlation coefficients for all 99 statements to compare the item-level ratings of both groups and used t tests to compare the mean importance of ratings assigned to each cluster. Eight major clusters of success were identified: 1) advocacy and persuasion, 2) building sustainability, 3) partnerships, 4) readiness and support, 5) program management fundamentals, 6) monitoring and evaluation, 7) utilization of evidence, and 8) implementation. We found no significant difference between the maps created by the 2 groups and only 1 mean difference for the importance ratings for 1 of the clusters: cancer prevention experts rated partnerships as more important to program success than did tobacco control experts. Our findings are consistent with those of research documenting the necessary components of successful programs and the similarities between cancer prevention and tobacco control. Both programs value the same strategies to address a common risk factor: tobacco use. Identifying common ground between these 2 research and practice communities can benefit future collaborations at the local, state, tribal, national, and international levels, and inform the

  11. Pollution prevention opportunity assessment for the K-25 Site Toxic Substances Control Act Incinerator Operations, Level III

    International Nuclear Information System (INIS)

    1995-09-01

    A Level III pollution prevention opportunity assessment (PPOA) was performed for the Oak Ridge K-25 Site Toxic Substances Control Act (TSCA) Incinerator to evaluate pollution prevention (P2) options for various waste streams: The main objective of this study was to identify and evaluate options to reduce the quantities of each waste stream generated by the TSCA Incinerator operations to realize significant environmental and/or economic benefits from P2. For each of the waste streams, P2 options were evaluated following the US Environmental Protection Agency (EPA) hierarchy to (1) reduce the quantity of waste generated, (2) recycle the waste, and/or (3) use alternate waste treatment or segregation methods. This report provides process descriptions, identification and evaluation of P2 options, and final recommendations

  12. The Hospital Management of Fatal Self-Poisoning in Industrialized Countries: An Opportunity for Suicide Prevention?

    Science.gov (United States)

    Kapur, Navneet; Turnbull, Pauline; Hawton, Keith; Simkin, Sue; Mackway-Jones, Kevin; Gunnell, David

    2006-01-01

    Suicide by self-poisoning is a prevalent cause of death worldwide. A substantial proportion of individuals who poison themselves come into contact with medical services before they die. Our focus in the current study was the medical management of drug self-poisoning in industrialized countries and its possible contribution to suicide prevention.…

  13. Breaking the Cycle of Teenage Pregnancy: Prevention Opportunities Focusing on the Younger Sisters of Teen Mothers.

    Science.gov (United States)

    East, Patricia L.

    1998-01-01

    Describes an under-recognized target population for adolescent pregnancy prevention: the younger sisters of childbearing teens. Data from several studies highlight several potential prepregnancy-risk characteristics that are particularly present in this group. These young women have disproportionately higher rates of early pregnancy and…

  14. Substance Use: Determinants and Opportunities for Prevention in the Family and School Context

    Science.gov (United States)

    Kleinjan, Marloes; Engels, Rutger C. M. E.

    2014-01-01

    During adolescence, teenagers try a range of risk behaviors including smoking, drinking, and the use of soft drugs. Because substance use contributes to an unhealthy lifestyle of teenagers on the short term and can lead to serious health problems on the longer term, prevention in this target group is important. This chapter provides an overview of…

  15. Schools and the Community Alcohol, Tobacco, and Other Drug Environment: Opportunities for Prevention

    Science.gov (United States)

    Pacific Institute for Research and Evaluation, 2013

    2013-01-01

    Schools have long been central to community-based alcohol, tobacco, and other drug (ATOD) prevention programs. Yet research consistently shows that school programs have only a marginal effect on student substance use and community ATOD problems. Schools are only one of the many influences on young people, and even the best curriculum will fail if…

  16. Opportunities for Environmental Crime: A Test of Situational Crime Prevention Theory

    NARCIS (Netherlands)

    Huisman, W.; van Erp, J.

    2013-01-01

    Recently, Situational Crime Prevention Theory (SCPT) has been proposed as an alternative to offender-based theories of white-collar crime. This paper uses the results of a cross-case analysis of 23 criminal investigations of environmental crime in the Netherlands to explore the fruitfulness of SCPT

  17. Opportunities for cost-effective prevention of late-life depression: An epidemiological approach.

    NARCIS (Netherlands)

    Smit, H.F.E.; Ederveen, A.; Cuijpers, P.; Deeg, D.J.H.; Beekman, A.T.F.

    2006-01-01

    Context: Clinically relevant late-life depression has a prevalence of 16% and is associated with substantial societal costs through its disease burden and unfavorable prognosis. From the public health perspective, depression prevention may be an attractive, if not imperative, means to generate

  18. "Whole-of-Community" Obesity Prevention: A Review of Challenges and Opportunities in Multilevel, Multicomponent Interventions.

    Science.gov (United States)

    Ewart-Pierce, Ella; Mejía Ruiz, María José; Gittelsohn, Joel

    2016-09-01

    The causes of obesity worldwide are complex and multilevel, including changing food environments, physical activity levels, policies, and food production systems. This intricate context requires multilevel and multicomponent (MLMC) interventions to improve health outcomes. We conducted a literature review of MLMC interventions for obesity prevention and mitigation; 14 studies meeting search criteria were identified. We found examples of successes in preventing obesity, reducing overweight, improving healthful behaviors, and enhancing some psychosocial indicators. Of eight studies that reported health and behavioral results, five showed no significant impact and three showed reductions in obesity. Four studies showed significant improvement in dietary behavior, and five reported significant desirable effects in physical activity or screen time. Five studies reported psychosocial impacts, and three of these showed significant improvements. MLMC approaches show promising results, particularly when they are able to integrate components at the policy, community, and interpersonal levels.

  19. Planning for pre-exposure prophylaxis to prevent HIV transmission: challenges and opportunities

    Science.gov (United States)

    2010-01-01

    There are currently several ongoing or planned trials evaluating the efficacy of pre-exposure prophylaxis (PrEP) as a preventative approach to reducing the transmission of HIV. PrEP may prove ineffective, demonstrate partial efficacy, or show high efficacy and have the potential to reduce HIV infection in a significant way. However, in addition to the trial results, it is important that issues related to delivery, implementation and further research are also discussed. As a part of the ongoing discussion, in June 2009, the Bill & Melinda Gates Foundation sponsored a Planning for PrEP conference with stakeholders to review expected trial results, outline responsible educational approaches, and develop potential delivery and implementation strategies. The conference reinforced the need for continued and sustained dialogue to identify where PrEP implementation may fit best within an integrated HIV prevention package. This paper identifies the key action points that emerged from the Planning for PrEP meeting. PMID:20624303

  20. Disease Prevention: An Opportunity to Expand Edible Plant-Based Vaccines?

    OpenAIRE

    Christopher Concha; Raúl Cañas; Johan Macuer; María José Torres; Andrés A. Herrada; Fabiola Jamett; Cristian Ibáñez

    2017-01-01

    The lethality of infectious diseases has decreased due to the implementation of crucial sanitary procedures such as vaccination. However, the resurgence of pathogenic diseases in different parts of the world has revealed the importance of identifying novel, rapid, and concrete solutions for control and prevention. Edible vaccines pose an interesting alternative that could overcome some of the constraints of traditional vaccines. The term ?edible vaccine? refers to the use of edible parts of a...

  1. Challenges and opportunities in international molecular cancer prevention research: An ASPO Molecular Epidemiology and the Environment and International Cancer Prevention Interest Groups Report.

    Science.gov (United States)

    Epplein, Meira; Bostick, Roberd M; Mu, Lina; Ogino, Shuji; Braithwaite, Dejana; Kanetsky, Peter A

    2014-11-01

    The International Agency for Research on Cancer estimates that over half of the new cancer cases and almost two-thirds of the cancer deaths in 2012 occurred in low and middle income countries. To discuss the challenges and opportunities to reducing the burden of cancer worldwide, the Molecular Epidemiology and the Environment and the International Issues in Cancer Special Interest Groups joined forces to hold a session during the 38th Annual Meeting of the American Society of Preventive Oncology (March 2014, Arlington, Virginia). The session highlighted three topics of particular interest to molecular cancer prevention researchers working internationally, specifically: 1) biomarkers in cancer research; 2) environmental exposures and cancer; and 3) molecular pathological epidemiology. A major factor for successful collaboration illuminated during the discussion was the need for strong, committed, and reliable international partners. A key element of establishing such relationships is to thoroughly involve individual international collaborators in the development of the research question; engaged international collaborators are particularly motivated to champion and shepherd the project through all necessary steps, including issues relating to institutional review boards, political sensitivity, laboratory-based assays, and tumor subtyping. Also essential is allotting time for the building, maintaining, and investing in such relationships so that successful international collaborations may take root and bloom. While there are many challenges inherent to international molecular cancer research, the opportunities for furthering the science and prevention of cancer worldwide are great, particularly at this time of increasing cancer incidence and prevalence in low and middle income countries. ©2014 American Association for Cancer Research.

  2. Lifestyle changes and the risk of developing endometrial and ovarian cancers: opportunities for prevention and management

    Directory of Open Access Journals (Sweden)

    Beavis AL

    2016-05-01

    Full Text Available Anna L Beavis,1,* Anna Jo Bodurtha Smith,2,* Amanda Nickles Fader1 1Department of Gynecology and Obstetrics, The Kelly Gynecologic Oncology Service, Johns Hopkins Medicine, Baltimore, MD, 2Harvard Medical School, Boston, MA, USA *These authors contributed equally to this work Abstract: Modifiable lifestyle factors, such as obesity, lack of physical activity, and smoking, contribute greatly to cancer and chronic disease morbidity and mortality worldwide. This review appraises recent evidence on modifiable lifestyle factors in the prevention of endometrial cancer (EC and ovarian cancer (OC as well as new evidence for lifestyle management of EC and OC survivors. For EC, obesity continues to be the strongest risk factor, while new evidence suggests that physical activity, oral contraceptive pills, and bariatric surgery may be protective against EC. Other medications, such as metformin and nonsteroidal anti-inflammatory drugs, may be protective, and interventional research is ongoing. For OC, we find increasing evidence to support the hypothesis that obesity and hormone replacement therapy increase the risk of developing OC. Oral contraceptive pills are protective against OC but are underutilized. Dietary factors such as the Mediterranean diet and alcohol consumption do not seem to affect the risk of either OC or EC. For EC and OC survivors, physical activity and weight loss are associated with improved quality of life. Small interventional trials show promise in increasing physical activity and weight maintenance for EC and OC survivors, although the impact on long-term health, including cancer recurrence and overall mortality, is unknown. Women’s health providers should integrate counseling about these modifiable lifestyle factors into both the discussion of prevention for all women and the management of survivors of gynecologic cancers. Keywords: lifestyle, prevention, endometrial cancer, ovarian cancer, gynecologic cancer, obesity

  3. Contribution of Mendelian disorders to common chronic disease: opportunities for recognition, intervention, and prevention.

    Science.gov (United States)

    Scheuner, Maren T; Yoon, Paula W; Khoury, Muin J

    2004-02-15

    Recognizing Mendelian disorders should improve health care for persons with strong familial risks for common chronic diseases. The Online Mendelian Inheritance in Man (OMIM) database was reviewed to identify Mendelian disorders featuring 17 common chronic diseases, including 9 cardiovascular conditions, diabetes, and 7 common cancers. Mendelian disorders were selected if any one of the 17 diseases was reported in more than two families manifesting in adulthood. Patterns of chronic diseases and modes of inheritance associated with these Mendelian disorders are described. The GeneTests/Reviews database and other websites were reviewed to determine availability of genetic testing and management and prevention recommendations for the selected disorders. Of 2,592 (OMIM) entries reviewed, 188 Mendelian disorders were selected. Most (67.7%) are autosomal dominant disorders. Almost half (45.8%) feature combinations of the chronic diseases under study. At least one gene is known for 68.8% of the selected disorders, and clinical genetic testing is available for 55% of disorders. Guidelines for management and prevention are available for 33.9% of these, ranging from recommendations for supportive care to guidelines for managing affected persons and screening relatives. Significant clinical heterogeneity exists for Mendelian disorders that might present as strong family histories of common chronic diseases. Recognition of the different combinations of diseases within a pedigree, including mode of inheritance and heritable disease risk factors, facilitates diagnosis of these Mendelian disorders. Genetic testing is available for most disorders, which can further clarify the genetic risk, and for some, recommendations for management and prevention are available. However, evidence-based guidelines are needed. Copyright 2004 Wiley-Liss, Inc.

  4. Braden Scale cumulative score versus subscale scores: are we missing opportunities for pressure ulcer prevention?

    Science.gov (United States)

    Gadd, Molly M

    2014-01-01

    Hospital-acquired pressure ulcer incidence rates continue to rise in the United States in the acute care setting despite efforts to extinguish them, and pressure ulcers are a nursing-sensitive quality indicator. The Braden Scale for Predicting Pressure Sore Risk instrument has been shown to be a valid and reliable instrument for assessing pressure ulcer risk. This case study represented 1 patient out of a chart audit that reviewed 20 patients with confirmed hospital-acquired pressure ulcers. The goal of the audit was to determine whether these ulcers might be avoided if preventive interventions based on Braden subscale scores versus the cumulative score were implemented. This case study describes a patient who, deemed at low risk for pressure ulcer development based on cumulative Braden Scale, may have benefited from interventions based on the subscale scores of sensory perception, activity, and mobility. Further research is needed to determine whether interventions based on subscales may be effective for preventing pressure ulcers when compared to a protocol based exclusively on the cumulative score.

  5. Symposium report: the prevention of obesity and NCDs: challenges and opportunities for governments.

    Science.gov (United States)

    Lobstein, Tim; Brinsden, Hannah

    2014-08-01

    This paper is written as a briefing document with the aim of providing support to policy-makers and government officials tackling obesity and related non-communicable diseases. It is based on a symposium Obesity and non-communicable diseases: Learning from international experiences convened by the International Association for the Study of Obesity (now the World Obesity Federation) and its policy section, the International Obesity TaskForce (now World Obesity - Policy and Prevention). The symposium discussed a wide range of proposals to tackle the consumption of unhealthy food products, including interventions in the market through fiscal policies and marketing restrictions, measures to strengthen public health legislation and measures to limit agri-food company lobbying activities. It recognized the need for government leadership and action in order to reduce preventable deaths while improving economic performance and identified a need for governments to take a systems wide approach to tackling obesity and to work with civil society, especially to monitor the drivers of disease and to hold all stakeholders accountable for progress. © 2014 The Authors. obesity reviews © 2014 World Obesity.

  6. Ovarian cancer: the Fallopian tube as the site of origin and opportunities for prevention

    Directory of Open Access Journals (Sweden)

    Sophia HL George, PhD

    2016-05-01

    Full Text Available High-grade serous carcinoma is the most common and aggressive histotype of epithelial ovarian cancer, and it is the predominant histotype associated with hereditary breast and ovarian cancer syndrome (HBOC. Mutations in BRCA1 and BRCA2 are responsible for most of the known causes of HBOC, while mutations in mismatch repair genes and several genes of moderate penetrance are responsible for the remaining known hereditary risk. Women with a history of familial ovarian cancer or with known germline mutations in highly penetrant genes are offered the option risk-reducing surgery, which involves the removal of the ovaries and fallopian tubes (salpingo-oophorectomy. Growing evidence now supports the fallopian tube epithelia as an etiological site for the development of HGSC and consequently, salpingectomy alone is emerging as a prophylactic option. This review discusses the site of origin of epithelial ovarian cancer, the rationale for risk-reducing salpingectomy in the high-risk population and opportunities for salpingectomy in the low-risk population.

  7. Targeting Obesity for the Prevention of Chronic Cardiovascular Disease Through Gut Microbiota-Herb Interactions: An Opportunity for Traditional Herbs.

    Science.gov (United States)

    Chen, Feng; Jiang, Jun; Tian, Dan-Dan; Wen, Qi; Li, Yong-Hui; Zhang, Jun-Qing; Cheng, Chen; Wang, Tengfei

    2017-01-01

    Cardiovascular disease still remains the primary cause of death worldwide and obesity is becoming recognized as one of the most critical contributing risk factors. The increased prevalence of obesity casts a cloud over the global health and the whole societies and will still be burdened in the future. Therefore, prevention and therapy of obesity is a beneficial strategy for the prevention of chronic cardiovascular disease. Numerous studies have demonstrated that gut microbiota takes part in human health and disease including obesity. Traditional herbs hold great potential to improve people's health and wellness, particularly in the area of chronic inflammatory diseases although the mechanisms of action remain poorly understood. Emerging explorations of gut microbiotaherb interactions provide a potential to revolutionize the way we view herbal therapeutics. This review summarizes the experimental studies performed on animals and humans regarding the gut microbiota-herb interactions targeting obesity. This review also discusses the opportunity of herbs with potent activities but low oral bioavailability conundrum for prevention and therapy for obesity and related cardiovascular disease. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  8. Missing opportunities for preventing unwanted pregnancy: a qualitative study of emergency contraception.

    Science.gov (United States)

    Maharaj, Pranitha; Rogan, Michael

    2011-04-01

    High levels of unplanned pregnancy among young people are a huge public health problem in South Africa. However, use of emergency contraception (EC) remains low. Studies suggest that providers constitute an important link to increasing access to EC use. The aim of the study was to provide greater insights into the attitudes of providers towards EC in order to better understand factors influencing uptake. The study drew upon 30 in-depth interviews with providers at private and public health facilities in Durban, South Africa. The results of the study highlight several barriers to the provision of EC in both public and private health facilities. The cost of EC products in commercial pharmacies is likely to be a major barrier to use for many women. In addition, providers in both public and private facilities are often reluctant to provide EC over the counter because they feel that the use of EC is likely to discourage regular use of contraception and increase the risk of unprotected sexual intercourse and, as a result, contribute to the spread of HIV/AIDS in South Africa. In addition, they reported that they do not have an opportunity to counsel women about EC because of time constraints. Providers in both the public and private sectors also demonstrated a level of uncertainty about the clinical effects of EC pills and on the regulations surrounding their provision. Despite relatively progressive legislation on EC provision and the widespread availability of EC products in South Africa, providers in pharmacies, family planning clinics and public health clinics need more training on EC provision. Interventions should aim to educate health providers on both the clinical and social aspects of EC provision.

  9. A retrospective 7-years study of aluminum phosphide poisoning in Tehran: opportunities for prevention.

    Science.gov (United States)

    Shadnia, S; Sasanian, G; Allami, P; Hosseini, A; Ranjbar, A; Amini-Shirazi, N; Abdollahi, M

    2009-04-01

    The objective of this study was to survey aluminum phosphide (AIP) poisoning in a referral poisoning hospital in Tehran servicing an estimation of 10,000,000 populations. Records of all patients admitted and hospitalized during a period of 7 years from January 2000 to January 2007 were collected and analyzed according to gender, age, cause of intoxication, amount of AIP consumed, route of exposure, time between exposure and onset of treatment, signs and symptoms of intoxication at admission, therapeutic intervention, laboratory tests, and outcome. During the studied years, 471 patients were admitted to the hospital with AIP poisoning; 50% of them were men. The overall case fatality ratio was 31%. The mean age was 27.1 years, and most of the patients were between 20 and 40 years old. Self-poisoning was observed in 93% of cases. The average ingested dose was 5.1 g, and most of the patients (73%) consumed 1-3 tablets of AIP. A wide range of symptoms and signs was seen on admission, but the most common one was cardiovascular manifestations (78.12%). The majority (65%) of patients were from Tehran. Poisoning in spring and winter (34% and 24%, respectively) was more common than other seasons. Gastric decontamination with potassium permanganate, and administration of calcium gluconate, magnesium sulfate, sodium bicarbonate, and charcoal were considered for most of the patients. Mean arterial blood pH was 7.23 and bicarbonate concentration was 12.7 mEq/L. One-hundred percent of patients with blood pH or= 7.35 survived. Electrocardiogram (EKG) abnormalities were noted in 65.6% of cases. There was a significant difference between survival and non-survival according to pH, HCO(3) concentration, and EKG abnormality. Even without an increase in resources, there appears to be significant opportunities for reducing mortality by better medical management and further restrictions on the AIP tablets usage. Arterial blood pH seems to be a prognostic factor for the outcome of AIP

  10. Cross Sectional Study Evaluating Routine Contact Investigation in Addis Ababa, Ethiopia: A Missed Opportunity to Prevent Tuberculosis in Children.

    Science.gov (United States)

    Assefa, Dawit; Klinkenberg, Eveline; Yosef, Genet

    2015-01-01

    The 2013 global roadmap for childhood tuberculosis calls for countries to implement contact screening and provide preventive therapy to children younger than 5 years. Therefore, this study designed to evaluate the implementation status of child contact screening and management in the health facilities of Addis Ababa, Ethiopia. Smear positive TB patients living with children attending daily observed treatment at the TB clinic and health care workers providing service were approached to address the study objective. Structured questionnaires were administered to smear positive index cases living with children whether they were requested to bring children age five year and below for TB screening and to health care providers in HIV, TB and child health clinics to assess their knowledge and practice on contact screening and management. Double data entry and analysis was done using EpiData software 3.1. In 27 health centres, 688 smear-positive index tuberculosis patients were approached of whom 203 (29.5%) reported to have children five years and below in their household. A total of 48 (23.6%) index cases had been requested by the health care workers to bring their children for tuberculosis screening and 45 (93.8%) had complied with this request. Of 230 children living with index smear positive tuberculosis patient, 152 (66.1%) were not screened for tuberculosis, 78 (33.9%) children screened, 2 had tuberculosis, 76 screened negative of which 3 (3.8%) received preventive treatment. None of the health care workers indicated to routinely record and report on child contact management. Household child contact screening and preventive intervention was sub-optimal in Addis Ababa. An important opportunity lost to prevent tuberculosis in young children. Training of health care workers, availing simple symptom based screening tool, and proper documentation could improve implementation.

  11. Global epidemiology of serogroup B meningococcal disease and opportunities for prevention with novel recombinant protein vaccines.

    Science.gov (United States)

    Villena, Rodolfo; Safadi, Marco Aurelio P; Valenzuela, María Teresa; Torres, Juan P; Finn, Adam; O'Ryan, Miguel

    2018-04-18

    Meningococcal disease (MD) is a major cause of meningitis and sepsis worldwide, with a high case fatality rate and frequent sequelae. Neisseria meningitidis serogroups A, B, C, W, X and Y are responsible for most of these life-threatening infections, and its unpredictable epidemiology can cause outbreaks in communities, with significant health, social and economic impact. Currently, serogroup B is the main cause of MD in Europe and North America and one of the most prevalent serogroups in Latin America. Mass vaccination strategies using polysaccharide vaccines have been deployed since the 1970s and the use of conjugate vaccines has controlled endemic and epidemic disease caused by serogroups A, C, W and Y and more recently serogroup B using geographically-specific outer membrane vesicle based vaccines. Two novel protein-based vaccines are a significant addition to our armamentarium against N. meningitidis as they provide broad coverage against highly diverse strains in serogroup B and other groups. Early safety, effectiveness and impact data of these vaccines are encouraging. These novel serogroup B vaccines should be actively considered for individuals at increased risk of disease and to control serogroup B outbreaks occurring in institutions or specific regions, as they are likely to save lives and prevent severe sequelae. Incorporation into national programs will require thorough country-specific analysis.

  12. Disease Prevention: An Opportunity to Expand Edible Plant-Based Vaccines?

    Science.gov (United States)

    Concha, Christopher; Cañas, Raúl; Macuer, Johan; Torres, María José; Herrada, Andrés A.; Jamett, Fabiola; Ibáñez, Cristian

    2017-01-01

    The lethality of infectious diseases has decreased due to the implementation of crucial sanitary procedures such as vaccination. However, the resurgence of pathogenic diseases in different parts of the world has revealed the importance of identifying novel, rapid, and concrete solutions for control and prevention. Edible vaccines pose an interesting alternative that could overcome some of the constraints of traditional vaccines. The term “edible vaccine” refers to the use of edible parts of a plant that has been genetically modified to produce specific components of a particular pathogen to generate protection against a disease. The aim of this review is to present and critically examine “edible vaccines” as an option for global immunization against pathogenic diseases and their outbreaks and to discuss the necessary steps for their production and control and the list of plants that may already be used as edible vaccines. Additionally, this review discusses the required standards and ethical regulations as well as the advantages and disadvantages associated with this powerful biotechnology tool. PMID:28556800

  13. Disease Prevention: An Opportunity to Expand Edible Plant-Based Vaccines?

    Directory of Open Access Journals (Sweden)

    Christopher Concha

    2017-05-01

    Full Text Available The lethality of infectious diseases has decreased due to the implementation of crucial sanitary procedures such as vaccination. However, the resurgence of pathogenic diseases in different parts of the world has revealed the importance of identifying novel, rapid, and concrete solutions for control and prevention. Edible vaccines pose an interesting alternative that could overcome some of the constraints of traditional vaccines. The term “edible vaccine” refers to the use of edible parts of a plant that has been genetically modified to produce specific components of a particular pathogen to generate protection against a disease. The aim of this review is to present and critically examine “edible vaccines” as an option for global immunization against pathogenic diseases and their outbreaks and to discuss the necessary steps for their production and control and the list of plants that may already be used as edible vaccines. Additionally, this review discusses the required standards and ethical regulations as well as the advantages and disadvantages associated with this powerful biotechnology tool.

  14. Stroke in Latin America: Burden of Disease and Opportunities for Prevention.

    Science.gov (United States)

    Avezum, Álvaro; Costa-Filho, Francisco F; Pieri, Alexandre; Martins, Sheila O; Marin-Neto, José A

    2015-12-01

    The epidemiological transition in Latin America toward older urban dwelling adults has led to the rise in cardiovascular risk factors and an increase in morbidity and mortality rates related to both stroke and myocardial infarction. As a result, there is an immediate need for effective actions resulting in better detection and control of cardiovascular risk factors that will ultimately reduce cardiovascular disease burden. Data from case-control studies have identified the following risk factors associated with stroke: hypertension; smoking; abdominal obesity; diet; physical activity; diabetes; alcohol intake; psychosocial factors; cardiac causes; and dyslipidemia. In addition to its high mortality, patients who survive after a stroke present quite frequently with marked physical and functional disability. Because stroke is the leading cause of death in most Latin American countries and also because it is a clearly preventable cause of death and disability, simple, affordable, and efficient strategies must be urgently implemented in Latin America. Copyright © 2015 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  15. Early life opportunities for prevention of diabetes in low and middle income countries

    Directory of Open Access Journals (Sweden)

    Hanson Mark A

    2012-11-01

    Full Text Available Abstract Background The global burden of diabetes and other non-communicable diseases is rising dramatically worldwide and is causing a double poor health burden in low- and middle-income countries. Early life influences play an important part in this scenario because maternal lifestyle and conditions such as gestational diabetes and obesity affect the risk of diabetes in the next generation. This indicates important periods during the lifecourse when interventions could have powerful affects in reducing incidence of non-communicable diseases. However, interventions to promote diet and lifestyle in prospective parents before conception have not received sufficient attention, especially in low- and middle-income countries undergoing socio-economic transition. Discussion Interventions to produce weight loss in adults or to reduce weight gain in pregnancy have had limited success and might be too late to produce the largest effects on the health of the child and his/her later risk of non-communicable diseases. A very important factor in the prevention of the developmental component of diabetes risk is the physiological state in which the parents enter pregnancy. We argue that the most promising strategy to improve prospective parents’ body composition and lifestyle is the promotion of health literacy in adolescents. Multiple but integrated forms of community-based interventions that focus on nutrition, physical activity, family planning, breastfeeding and infant feeding practices are needed. They need to address the wider social economic context in which adolescents live and to be linked with existing public health programmes in sexual and reproductive health and maternal and child health initiatives. Summary Interventions aimed at ensuring a healthy body composition, diet and lifestyle before pregnancy offer a most effective solution in many settings, especially in low- and middle-income countries undergoing socio-economic transition. Preparing

  16. High Rates of Tuberculosis and Opportunities for Prevention among International Students in the United States.

    Science.gov (United States)

    Collins, Jeffrey M; Reves, Randall R; Belknap, Robert W

    2016-04-01

    Foreign-born persons traveling on a student visa are not currently screened for tuberculosis on entry into the United States, despite residing in the United States for up to several years. To characterize the risk of tuberculosis in international students entering the United States and to identify strategies for early diagnosis and prevention in this population. Data were collected in 18 tuberculosis control jurisdictions in the United States. A cohort of 1,268 foreign-born patients of known visa status, diagnosed with active tuberculosis between 2004 and 2007, was used for analysis. Incidence rates were estimated on the basis of immigration data from study jurisdictions. Tuberculosis was diagnosed in 46 student residents, providing an annual estimate of 308 cases nationally. The estimated tuberculosis case rate in student residents was 48.1 cases per 100,000 person-years (95% confidence interval, 35.6-64.8), more than twice that of the general foreign-born population. Students identified by tuberculosis screening programs were more likely to be diagnosed within 6 months of U.S. arrival (75 vs. 6%; P < 0.001), and those with pulmonary disease were less likely to have a positive sputum smear for acid-fast bacilli compared with those not screened (18 vs. 63%; P = 0.05). In unscreened students, 71% were diagnosed more than 1 year after U.S. arrival and only 6% were previously treated for latent tuberculosis infection. The tuberculosis case rate in foreign-born students is significantly higher than in other foreign-born individuals. Screening this group after arrival to the United States is an effective strategy for earlier diagnosis of active tuberculosis.

  17. Inadequate knowledge of immunization guidelines: a missed opportunity for preventing infection in immunocompromised IBD patients.

    Science.gov (United States)

    Yeung, James H; Goodman, Karen J; Fedorak, Richard N

    2012-01-01

    Immunosuppressive agents, used commonly to treat inflammatory bowel disease (IBD), are associated with an increased risk of infections, including those preventable by immunization. This study aimed to describe physician and patient values and knowledge regarding immunization and immunization histories. In all, 167 IBD patients and 43 gastroenterologists completed mail-out questionnaires. Patients were asked 15 questions about their immunization histories and attitudes towards immunization. Gastroenterologists were asked nine questions about immunization for the immunocompromised host. The questionnaire return rate was 45.7% (43/94) for gastroenterologists and 25.2% (167/661) for patients. Only 14.3% (6/42) of gastroenterologists reported taking an immunization history from most or all of their patients. Only 5.4% (9/167) of patients recalled being asked by their gastroenterologist whether their immunizations were up to date, and just 0.6% (1/164) recalled being asked for a detailed immunization history. Overall, 21.7% (35/161) of patients had refused to be immunized in the past; 18.6% (8/43) of gastroenterologists did not know if up-to-date immunizations were important prior to starting immunosuppressive therapy. Of note, 23.1% (9/39) of gastroenterologists and 46.7% (35/161) of patients did not know whether live vaccines should be avoided by those in the immunosuppressed state, and 42.9% (18/43) of gastroenterologists acknowledged they did not know which specific immunizations should be avoided for immunosuppressed patients. Gastroenterologists have limited knowledge of their IBD patients' immunization status and rarely take an adequate immunization history. Substantial proportions of IBD patients and gastroenterologists lack adequate knowledge of established immunization guidelines prior to initiation of immunosuppressive therapy. Copyright © 2011 Crohn's & Crohn's & Colitis Foundation of America, Inc.

  18. From genome-wide association studies to Mendelian randomization: Novel opportunities for understanding cardiovascular disease causality, pathogenesis, prevention, and treatment.

    Science.gov (United States)

    Benn, Marianne; Nordestgaard, Børge G

    2018-02-19

    The Mendelian randomization approach is an epidemiologic study design incorporating genetic information into traditional epidemiologic studies to infer causality of biomarkers, risk factors, or lifestyle factors on disease risk. Mendelian randomization studies often draw on novel information generated in genome-wide association studies on causal associations between genetic variants and a risk factor or lifestyle factor. Such information can then be used in a largely unconfounded study design free of reverse causation to understand if and how risk factors and lifestyle factors cause cardiovascular disease. If causation is demonstrated, an opportunity for prevention of disease is identified; importantly however, before prevention or treatment can be implemented, randomized intervention trials altering risk factor levels or improving deleterious lifestyle factors needs to document reductions in cardiovascular disease in a safe and side-effect sparse manner. Documentation of causality can also inform on potential drug targets, more likely to be successful than prior approaches often relying on animal or cell studies mainly.The present review summarizes the history and background of Mendelian randomization, the study design, assumptions for using the design, and the most common caveats, followed by a discussion on advantages and disadvantages of different types of Mendelian randomization studies using one or more samples and different levels of information on study participants. The review also provides an overview of results on many of the risk factors and lifestyle factors for cardiovascular disease examined to date using the Mendelian randomization study design.

  19. Cytogenetic prognostication within medulloblastoma subgroups.

    Science.gov (United States)

    Shih, David J H; Northcott, Paul A; Remke, Marc; Korshunov, Andrey; Ramaswamy, Vijay; Kool, Marcel; Luu, Betty; Yao, Yuan; Wang, Xin; Dubuc, Adrian M; Garzia, Livia; Peacock, John; Mack, Stephen C; Wu, Xiaochong; Rolider, Adi; Morrissy, A Sorana; Cavalli, Florence M G; Jones, David T W; Zitterbart, Karel; Faria, Claudia C; Schüller, Ulrich; Kren, Leos; Kumabe, Toshihiro; Tominaga, Teiji; Shin Ra, Young; Garami, Miklós; Hauser, Peter; Chan, Jennifer A; Robinson, Shenandoah; Bognár, László; Klekner, Almos; Saad, Ali G; Liau, Linda M; Albrecht, Steffen; Fontebasso, Adam; Cinalli, Giuseppe; De Antonellis, Pasqualino; Zollo, Massimo; Cooper, Michael K; Thompson, Reid C; Bailey, Simon; Lindsey, Janet C; Di Rocco, Concezio; Massimi, Luca; Michiels, Erna M C; Scherer, Stephen W; Phillips, Joanna J; Gupta, Nalin; Fan, Xing; Muraszko, Karin M; Vibhakar, Rajeev; Eberhart, Charles G; Fouladi, Maryam; Lach, Boleslaw; Jung, Shin; Wechsler-Reya, Robert J; Fèvre-Montange, Michelle; Jouvet, Anne; Jabado, Nada; Pollack, Ian F; Weiss, William A; Lee, Ji-Yeoun; Cho, Byung-Kyu; Kim, Seung-Ki; Wang, Kyu-Chang; Leonard, Jeffrey R; Rubin, Joshua B; de Torres, Carmen; Lavarino, Cinzia; Mora, Jaume; Cho, Yoon-Jae; Tabori, Uri; Olson, James M; Gajjar, Amar; Packer, Roger J; Rutkowski, Stefan; Pomeroy, Scott L; French, Pim J; Kloosterhof, Nanne K; Kros, Johan M; Van Meir, Erwin G; Clifford, Steven C; Bourdeaut, Franck; Delattre, Olivier; Doz, François F; Hawkins, Cynthia E; Malkin, David; Grajkowska, Wieslawa A; Perek-Polnik, Marta; Bouffet, Eric; Rutka, James T; Pfister, Stefan M; Taylor, Michael D

    2014-03-20

    Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication. Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models. Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas. Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials.

  20. Cytogenetic Prognostication Within Medulloblastoma Subgroups

    Science.gov (United States)

    Shih, David J.H.; Northcott, Paul A.; Remke, Marc; Korshunov, Andrey; Ramaswamy, Vijay; Kool, Marcel; Luu, Betty; Yao, Yuan; Wang, Xin; Dubuc, Adrian M.; Garzia, Livia; Peacock, John; Mack, Stephen C.; Wu, Xiaochong; Rolider, Adi; Morrissy, A. Sorana; Cavalli, Florence M.G.; Jones, David T.W.; Zitterbart, Karel; Faria, Claudia C.; Schüller, Ulrich; Kren, Leos; Kumabe, Toshihiro; Tominaga, Teiji; Shin Ra, Young; Garami, Miklós; Hauser, Peter; Chan, Jennifer A.; Robinson, Shenandoah; Bognár, László; Klekner, Almos; Saad, Ali G.; Liau, Linda M.; Albrecht, Steffen; Fontebasso, Adam; Cinalli, Giuseppe; De Antonellis, Pasqualino; Zollo, Massimo; Cooper, Michael K.; Thompson, Reid C.; Bailey, Simon; Lindsey, Janet C.; Di Rocco, Concezio; Massimi, Luca; Michiels, Erna M.C.; Scherer, Stephen W.; Phillips, Joanna J.; Gupta, Nalin; Fan, Xing; Muraszko, Karin M.; Vibhakar, Rajeev; Eberhart, Charles G.; Fouladi, Maryam; Lach, Boleslaw; Jung, Shin; Wechsler-Reya, Robert J.; Fèvre-Montange, Michelle; Jouvet, Anne; Jabado, Nada; Pollack, Ian F.; Weiss, William A.; Lee, Ji-Yeoun; Cho, Byung-Kyu; Kim, Seung-Ki; Wang, Kyu-Chang; Leonard, Jeffrey R.; Rubin, Joshua B.; de Torres, Carmen; Lavarino, Cinzia; Mora, Jaume; Cho, Yoon-Jae; Tabori, Uri; Olson, James M.; Gajjar, Amar; Packer, Roger J.; Rutkowski, Stefan; Pomeroy, Scott L.; French, Pim J.; Kloosterhof, Nanne K.; Kros, Johan M.; Van Meir, Erwin G.; Clifford, Steven C.; Bourdeaut, Franck; Delattre, Olivier; Doz, François F.; Hawkins, Cynthia E.; Malkin, David; Grajkowska, Wieslawa A.; Perek-Polnik, Marta; Bouffet, Eric; Rutka, James T.; Pfister, Stefan M.; Taylor, Michael D.

    2014-01-01

    Purpose Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication. Patients and Methods Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models. Results Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas. Conclusion Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials. PMID

  1. Risk factors for secondary substance use disorders in people with childhood and adolescent-onset bipolar disorder: opportunities for prevention.

    Science.gov (United States)

    Kenneson, Aileen; Funderburk, Jennifer S; Maisto, Stephen A

    2013-07-01

    Compared to other mental illnesses, bipolar disorder is associated with a disproportionately high rate of substance use disorders (SUDs), and the co-occurrence is associated with significant morbidity and mortality. Early diagnosis of primary bipolar disorder may provide opportunities for SUD prevention, but little is known about the risk factors for secondary SUD among individuals with bipolar disorder. The purposes of this study were to describe the population of people with childhood and adolescent-onset primary bipolar disorder, and to identify risk factors for secondary SUD in this population. Using data collected from the National Comorbidity Survey Replication study, we identified 158 individuals with childhood-onset (bipolar disorder (I, II or subthreshold). Survival analysis was used to identify risk factors for SUD. Compared to adolescent-onset, people with childhood-onset bipolar disorder had increased likelihoods of attention deficit hyperactivity disorder (ADHD) (adjusted odds ratio=2.81) and suicide attempt (aOR=3.61). Males were more likely than females to develop SUD, and did so at a faster rate. Hazard ratios of risk factors for SUD were: lifetime oppositional defiant disorder (2.048), any lifetime anxiety disorder (3.077), adolescent-onset bipolar disorder (1.653), and suicide attempt (15.424). SUD was not predicted by bipolar disorder type, family history of bipolar disorder, hospitalization for a mood episode, ADHD or conduct disorder. As clinicians struggle to help individuals with bipolar disorder, this study provides information that might be useful in identifying individuals at higher risk for SUD. Future research can examine whether targeting these risk factors may help prevent secondary SUD. Published by Elsevier Inc.

  2. Estimating the effect of the red card in soccer: when to commit an offense in exchange for preventing a goal opportunity

    Czech Academy of Sciences Publication Activity Database

    Vecer, J.; Kopřiva, František; Ichiba, T.

    2009-01-01

    Roč. 5, č. 1 (2009), s. 1-18 ISSN 1559-0410 R&D Projects: GA MŠk LC542 Institutional research plan: CEZ:AV0Z70850503 Keywords : red card in soccer * preventing a goal opportunity Subject RIV: AH - Economics http://www.bepress.com/jqas/vol5/iss1/8

  3. Identification of atopic dermatitis subgroups in children from two longitudinal birth cohorts

    NARCIS (Netherlands)

    Paternoster, Lavinia; Savenije, Olga E M; Heron, Jon; Evans, David M; Vonk, Judith M; Brunekreef, Bert; Wijga, Alet H; Henderson, A John; Koppelman, Gerard H; Brown, Sara J

    2017-01-01

    BACKGROUND: Atopic dermatitis (AD) is a prevalent disease with variable natural history. Longitudinal birth cohort studies provide an opportunity to define subgroups based on disease trajectories, which may represent different genetic and environmental pathomechanisms. OBJECTIVE: To investigate the

  4. Finite groups all of whose minimal subgroups are NE-subgroups

    Indian Academy of Sciences (India)

    Logo of the Indian Academy of Sciences. Indian Academy of Sciences ... In this article, we investigate the structure of under the assumption that subgroups of prime order are *-subgroups of . The finite groups, all of whose minimal subgroups of the generalized Fitting subgroup are *-subgroups are classified.

  5. Fall Prevention Self-Assessments Via Mobile 3D Visualization Technologies: Community Dwelling Older Adults' Perceptions of Opportunities and Challenges.

    Science.gov (United States)

    Hamm, Julian; Money, Arthur; Atwal, Anita

    2017-06-19

    In the field of occupational therapy, the assistive equipment provision process (AEPP) is a prominent preventive strategy used to promote independent living and to identify and alleviate fall risk factors via the provision of assistive equipment within the home environment. Current practice involves the use of paper-based forms that include 2D measurement guidance diagrams that aim to communicate the precise points and dimensions that must be measured in order to make AEPP assessments. There are, however, issues such as "poor fit" of equipment due to inaccurate measurements taken and recorded, resulting in more than 50% of equipment installed within the home being abandoned by patients. This paper presents a novel 3D measurement aid prototype (3D-MAP) that provides enhanced measurement and assessment guidance to patients via the use of 3D visualization technologies. The purpose of this study was to explore the perceptions of older adults with regard to the barriers and opportunities of using the 3D-MAP application as a tool that enables patient self-delivery of the AEPP. Thirty-three community-dwelling older adults participated in interactive sessions with a bespoke 3D-MAP application utilizing the retrospective think-aloud protocol and semistructured focus group discussions. The system usability scale (SUS) questionnaire was used to evaluate the application's usability. Thematic template analysis was carried out on the SUS item discussions, think-aloud, and semistructured focus group data. The quantitative SUS results revealed that the application may be described as having "marginal-high" and "good" levels of usability, along with strong agreement with items relating to the usability (P=.004) and learnability (Passessment (SA). The application was seen as a useful tool to enhance visualization of measurement guidance and also to promote independent living, ownership of care, and potentially reduce waiting times. Several design and functionality recommendations

  6. The impact of subgroup type and subgroup configurational properties on work team performance.

    Science.gov (United States)

    Carton, Andrew M; Cummings, Jonathon N

    2013-09-01

    Scholars have invoked subgroups in a number of theories related to teams, yet certain tensions in the literature remain unresolved. In this article, we address 2 of these tensions, both relating to how subgroups are configured in work teams: (a) whether teams perform better with a greater number of subgroups and (b) whether teams perform better when they have imbalanced subgroups (majorities and minorities are present) or balanced subgroups (subgroups are of equal size). We predict that the impact of the number and balance of subgroups depends on the type of subgroup-whether subgroups are formed according to social identity (i.e., identity-based subgroups) or information processing (i.e., knowledge-based subgroups). We first propose that teams are more adversely affected by 2 identity-based subgroups than by any other number, yet the uniquely negative impact of a 2-subgroup configuration is not apparent for knowledge-based subgroups. Instead, a larger number of knowledge-based subgroups is beneficial for performance, such that 2 subgroups is worse for performance when compared with 3 or more subgroups but better for performance when compared with no subgroups or 1 subgroup. Second, we argue that teams perform better when identity-based subgroups are imbalanced yet knowledge-based subgroups are balanced. We also suggest that there are interactive effects between the number and balance of subgroups-however, the nature of this interaction depends on the type of subgroup. To test these predictions, we developed and validated an algorithm that measures the configurational properties of subgroups in organizational work teams. Results of a field study of 326 work teams from a multinational organization support our predictions. PsycINFO Database Record (c) 2013 APA, all rights reserved

  7. Subgroup Achievement and Gap Trends: Massachusetts, 2010

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    This paper profiles the student subgroup achievement and gap trends in Massachusetts for 2010. In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Massachusetts showed across-the-board gains--improvements in both reading and math at the basic, proficient and advanced levels for all racial/ethnic subgroups, low…

  8. Subgroup Achievement and Gap Trends: Kentucky, 2010

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    This paper profiles the student subgroup achievement and gap trends in Kentucky for 2010. In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Kentucky showed mostly gains in both reading and math at the basic, proficient, and advanced levels for racial/ethnic subgroups, low income students, and boys and girls.…

  9. ∗-supplemented subgroups of finite groups

    Indian Academy of Sciences (India)

    complemented in G. In 1998, Ballester-Bolinches and Pedraza-Aguilera [2] introduced. S-quasinormally embedded ... concept of M-supplemented subgroups and characterized the structure of finite groups by ... A subgroup H of a group G is said to be M∗-supplemented in G if there exists a subgroup. K of G such that G = HK ...

  10. Subgroup Achievement and Gap Trends: Nevada, 2010

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    This paper profiles the student subgroup achievement and gap trends in Nevada for 2010. In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Nevada showed across-the-board gains--improvements in both reading and math at the basic, proficient and advanced levels for all racial/ethnic subgroups, low income…

  11. Rethinking school-based health centers as complex adaptive systems: maximizing opportunities for the prevention of teen pregnancy and sexually transmitted infections.

    Science.gov (United States)

    Daley, Alison Moriarty

    2012-01-01

    This article examines school-based health centers (SBHCs) as complex adaptive systems, the current gaps that exist in contraceptive access, and the potential to maximize this community resource in teen pregnancy and sexually transmitted infection (STI) prevention efforts. Adolescent pregnancy is a major public health challenge for the United States. Existing community resources need to be considered for their potential to impact teen pregnancy and STI prevention efforts. SBHCs are one such community resource to be leveraged in these efforts. They offer adolescent-friendly primary care services and are responsive to the diverse needs of the adolescents utilizing them. However, current restrictions on contraceptive availability limit the ability of SBHCs to maximize opportunities for comprehensive reproductive care and create missed opportunities for pregnancy and STI prevention. A clinical case explores the current models of health care services related to contraceptive care provided in SBHCs and the ability to meet or miss the needs of an adolescent seeking reproductive care in a SBHC.

  12. Research methods for subgrouping low back pain

    DEFF Research Database (Denmark)

    Kent, Peter; Keating, Jennifer L; Leboeuf-Yde, Charlotte

    2010-01-01

    important distinctions in their treatment needs or prognoses. Due to a proliferation of research methods and variability in how subgrouping results are interpreted, it is timely to open discussion regarding a conceptual framework for the research designs and statistical methods available for subgrouping...... studies (a method framework). The aims of this debate article are: (1) to present a method framework to inform the design and evaluation of subgrouping research in low back pain, (2) to describe method options when investigating prognostic effects or subgroup treatment effects, and (3) to discuss...... the strengths and limitations of research methods suitable for the hypothesis-setting phase of subgroup studies....

  13. Primary prevention of neural-tube defects and some other congenital abnormalities by folic acid and multivitamins: history, missed opportunity and tasks

    Science.gov (United States)

    Bártfai, Zoltán; Bánhidy, Ferenc

    2011-01-01

    The history of intervention trials of periconception folic acid with multivitamin and folic acid supplementation in women has shown a recent breakthrough in the primary prevention of structural birth defects, namely neural-tube defects and some other congenital abnormalities. Recently, some studies have demonstrated the efficacy of this new method in reducing congenital abnormalities with specific origin; for example, in the offspring of diabetic and epileptic mothers, and in pregnancy with high fever. The benefits and drawbacks of four possible uses of periconception folate/folic acid and multivitamin supplementation are discussed: we believe there has been a missed opportunity to implement this preventive approach in medical practice. The four methods are as follows: (i) dietary intake of folate and other vitamins, (ii) periconception folic acid/multivitamin supplementation, (iii) food fortification with folic acid, and (iv) the combination of oral contraceptives with 6S-5-methytetrahydrofolate (‘folate’). PMID:25083211

  14. Fires in refugee and displaced persons settlements: the current situation and opportunities to improve fire prevention and control

    Science.gov (United States)

    Kazerooni, Yasaman; Gyedu, Adam; Burnham, Gilbert; Nwomeh, Benedict; Charles, Anthony; Mishra, Brijesh; Kuah, Solomon S; Kushner, Adam L; Stewart, Barclay T

    2015-01-01

    Introduction We aimed to describe the burden of fires in displaced persons settlements and identify interventions/innovations that might address gaps in current humanitarian guidelines. Methods We performed a systematic review of: i) academic and non-academic literature databases; and ii) guidelines from leading humanitarian agencies/initiatives regarding fire prevention/control. Results Of the 1,521 records retrieved, 131 reports described settlement fires in 31 hosting countries since 1990. These incidents resulted in 487 deaths, 790 burn injuries, displacement of 382,486 individuals and destruction of 50,509 shelters. There was a 25-fold increase in the rate of settlement fires from 1990 to 2015 (0.002 to 0.051 per 100,000 refugees, respectively). Only 4 of the 15 leading humanitarian agencies provided recommendations about fire prevention/control strategies. Potentially useful interventions/innovations included safer stoves (e.g. solar cookers) and fire retardant shelter materials. Conclusion The large and increasing number of fires in displaced persons settlements highlights the need to redress gaps in humanitarian fire prevention/control guidelines. The way forward includes: i) developing consensus among aid agencies regarding fire prevention/control strategies; ii) evaluating the impact of interventions/innovations on the burden of fires; and iii) engaging agencies in a broader discussion about protecting camp residents from armed groups. PMID:26818955

  15. Cross Sectional Study Evaluating Routine Contact Investigation in Addis Ababa, Ethiopia: A Missed Opportunity to Prevent Tuberculosis in Children

    NARCIS (Netherlands)

    Assefa, Dawit; Klinkenberg, Eveline; Yosef, Genet

    2015-01-01

    The 2013 global roadmap for childhood tuberculosis calls for countries to implement contact screening and provide preventive therapy to children younger than 5 years. Therefore, this study designed to evaluate the implementation status of child contact screening and management in the health

  16. Macro-Level Approaches to HIV Prevention among Ethnic Minority Youth: State of the Science, Opportunities, and Challenges

    Science.gov (United States)

    Prado, Guillermo; Lightfoot, Marguerita; Brown, C. Hendricks

    2013-01-01

    The HIV epidemic continues to disproportionately affect ethnic minority youth. These disconcerting health disparities indicate that although existing HIV preventive strategies for ethnic minority youth have been efficacious, they have not significantly reduced the impact of the epidemic in this population. Macro-level interventions, such as…

  17. An environmental assessment strategy for the identification of pollution prevention opportunities in the southern Urals Region of Russia

    International Nuclear Information System (INIS)

    Gonzalez, M.A.; Ott, R.L.

    1993-01-01

    The serious environmental problems of the South Urals Region of Russia have been broadly described in a report coauthored by Russian weapons scientists. The importance of taking the first steps to prevent further environmental damage and adverse public health effects has been recognized by the international scientific community. Scientists at the Lawrence Livermore National Laboratory have initiated a project to assist the Russians in their pollution prevention efforts. The specific objectives of this project are to: (1) conduct a pragmatic survey of the industrial and governmental pollution sources in a limited geographic region of the South Urals and (2) identify the priorities for pollution prevention and for food and water supply improvements at distribution points. The emphasis is on preventing adverse impacts to human health and improving industrial productivity. This project focuses on immediate pollution problems resulting from current operations and their solutions, not on long-term research related to the large-scale cleanup of legacy wastes. The project emphasizes near-term cost effective solutions to prevent pollution while longer term research aimed at contamination from past practices is pursued by other scientists. The project is being conducted in collaboration with environmental and physical scientists from institutes associated with the Ural Branch of the Russian Academy of Sciences; government officials at the national, regional, and local levels; and non-governmental Russian environmental groups. A broad cross section of Russian technical, political, and environmental abilities and interests is mandatory. This cross section will ensure the technical quality, the political acceptability, and the popular credibility of the project results to the affected Russians in the South Urals. Progress on this project is presented in this paper

  18. Prevention

    Science.gov (United States)

    ... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  19. Environmental and risk screening for prioritizing pollution prevention opportunities in the U.S. printed wiring board manufacturing industry.

    Science.gov (United States)

    Lam, Carl W; Lim, Seong-Rin; Schoenung, Julie M

    2011-05-15

    Modern manufacturing of printed wiring boards (PWBs) involves extensive use of various hazardous chemicals in different manufacturing steps such as board preparation, circuit design transfer, etching and plating processes. Two complementary environmental screening methods developed by the U.S. EPA, namely: (i) the Tool for the Reduction and Assessment of Chemical and Other Environmental Impacts (TRACI) and (ii) Risk-Screening Environmental Indicators (RSEI), are used to quantify geographic and chemical environmental impacts in the U.S. PWB manufacturing industry based on Toxics Release Inventory (TRI) data. Although the release weight percentages of industrial chemicals such as methanol, glycol ethers and dimethylformamide comprise the larger fraction of reported air and water emissions, results indicate that lead, copper and their compounds' releases correspond to the highest environmental impact from toxicity potentials and risk-screening scores. Combining these results with further knowledge of PWB manufacturing, select alternative chemical processes and materials for pollution prevention are discussed. Examples of effective pollution prevention options in the PWB industry include spent etchant recovery technologies, and process and material substitutions. In addition, geographic assessment of environmental burden highlights states where promotion of pollution prevention strategies and emissions regulations can have the greatest effect to curb the PWB industry's toxic release impacts. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Caffeine for Apnea of Prematurity trial: benefits may vary in subgroups

    NARCIS (Netherlands)

    Davis, Peter G.; Schmidt, Barbara; Roberts, Robin S.; Doyle, Lex W.; Asztalos, Elizabeth; Haslam, Ross; Sinha, Sunil; Tin, Win; Schmidt, B.; D'Ilario, J.; Cairnie, J.; Dix, J.; Adams, B.; Faber, B.; Callanan, K.; Davis, N.; Duff, J.; Ford, G.; Golec, L.; Lacy, M.; Hohn, D.; Barnett, C.; Goodchildt, L.; Lontis, R.; Fraser, S.; Keng, J.; Saunders, K.; Opie, G.; Kelly, E.; Bairam, A.; Ferland, S.; Laperriere, L.; Bélanger, S.; St Amand, P.; Blayney, M.; Davis, D.; Frank, J.; Lemyre, L.; Solimano, A.; Singh, A.; Chalmers, M.; Ramsay, K.; Synnes, A.; Whitfield, M.; Rogers, M.; Tomlinson, J.; Offringa, M.; Nuytemans, D.; Vermeulen, E.; Kok, J.; van Wassenaer, A.; Arnon, S.; Chalaf, A.; Regev, R.; Netter, I.; Ohlsson, A.; Nesbitt, K.; O'Brien, K.; Hamilton, A. M.; Sankaran, K.; Morgan, S.; Proctor, P.; LaCorte, M.; LeBlanc, P.; Braithwaite, A.; Golan, A.; Barabi, T.; Goldstein, E.; Reynolds, G.; Dromgool, B.; Meskell, S.; McMillan, D.; Schaab, D.; Spellen, L.; Sauve, R.; Christianson, H.; Anseeuw-Deeks, D.; Alvaro, R.; Chiu, A.; Porter, C.; Turner, G.; Moddemann, D.; Granke, N.; Penner, K.; Mulder, T.; Ghys, A.; van der Hoeven, M.; Clarke, M.; Parfitt, J.; MacLean, H.; Nwaesei, C.; Kuhn, L.; Ryan, H.; Saunders, C.; Schulze, A.; Pudenz, P.; Muller, M.; Lagercrantz, H.; Bhiladvala, M.; Legneval, L.; Herlenius, E.; Matthew, D.; Amos, W.; Tulsiani, S.; Tan-Dy, C.; Turner, M.; Shinwell, E.; Levine, R.; Juster-Reicher, A.; Barrington, K.; Kokkotis, T.; Khairy, M.; Grier, P.; Vachon, J.; Tin, W.; Fritz, S.; Walti, H.; Royer, D.; Halliday, H.; Millar, D.; Berry, A.; Mayes, C.; Cummings, C.; Fahnenstich, H.; Philipp, K.; Tillmann, B.; Weber, P.; Canning, R.; Wariyar, U.; Embleton, N.; Bucher, H.-U.; Fauchere, J.-C.; Pfister, R.; Launoy, V.; Huppi, P.; Poets, C.; Urschitz-Duprat, P.; Davis, P.; Doyle, L. W.; Gent, M.; Fraser, W.; Hey, E.; Perlman, M.; Thorpe, K.; Gray, S.; Roberts, R. S.; Chambers, C.; Costantini, L.; McGean, L.; Scapinello, L.

    2010-01-01

    OBJECTIVE: To determine whether the benefits of caffeine vary in three subgroups of 2006 participants in the Caffeine for Apnea of Prematurity (CAP) trial. STUDY DESIGN: Post-hoc subgroup analyses were performed on the basis of: (1) indication for commencement of study drug: treat apnea, prevent

  1. Nutritional risk and the metabolic syndrome in women: opportunities for preventive intervention from the Framingham Nutrition Study.

    Science.gov (United States)

    Millen, Barbara E; Pencina, Michael J; Kimokoti, Ruth W; Zhu, Lei; Meigs, James B; Ordovas, Jose M; D'Agostino, Ralph B

    2006-08-01

    Diet is recognized as a key factor in the cause and management of the metabolic syndrome (MetS). However, policies to guide preventive clinical nutrition interventions of the condition are limited. We examined the relation between dietary quality and incident MetS in adult women and identified foci for preventive nutrition interventions. This was a prospective study of 300 healthy women (aged 30-69 y) in the Framingham Offspring-Spouse study who were free of MetS risk factors at baseline. The development of individual MetS traits and overall MetS status during 12 y of follow-up were compared in women by tertile of nutritional risk, based on intake of 19 nutrients. Multivariate logistic regression models considered age, smoking, physical activity, and menopausal status. Baseline age-adjusted mean nutrient intake and ischemic heart disease risk profiles differed by tertile of nutritional risk. Women with higher nutritional risk profiles consumed more dietary lipids (total, saturated, and monounsaturated fats) and alcohol and less fiber and micronutrients; they had higher cigarette use and waist circumferences. Compared with women with the lowest nutritional risk, those in the highest tertile had a 2- to 3-fold risk of the development of abdominal obesity and overall MetS during 12 y of follow-up [odds ratio: 2.3 (95% CI: 1.2, 4.3) and 3.0 (95% CI: 1.2, 7.6), respectively]. Higher composite nutritional risk predicts the development of abdominal obesity and MetS during long-term follow-up in healthy women, independent of lifestyle and ischemic heart disease risk factors. Preventive nutrition interventions for obesity and MetS risk reduction should focus on the overall nutritional quality of women's dietary profiles.

  2. Mechanisms of team-sport-related brain injuries in children 5 to 19 years old: opportunities for prevention.

    Science.gov (United States)

    Cusimano, Michael D; Cho, Newton; Amin, Khizer; Shirazi, Mariam; McFaull, Steven R; Do, Minh T; Wong, Matthew C; Russell, Kelly

    2013-01-01

    There is a gap in knowledge about the mechanisms of sports-related brain injuries. The objective of this study was to determine the mechanisms of brain injuries among children and youth participating in team sports. We conducted a retrospective case series of brain injuries suffered by children participating in team sports. The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database was searched for brain injury cases among 5-19 year-olds playing ice hockey, soccer, American football (football), basketball, baseball, or rugby between 1990 and 2009. Mechanisms of injury were classified as "struck by player," "struck by object," "struck by sport implement," "struck surface," and "other." A descriptive analysis was performed. There were 12,799 brain injuries related to six team sports (16.2% of all brain injuries registered in CHIRPP). Males represented 81% of injuries and the mean age was 13.2 years. Ice hockey accounted for the greatest number of brain injuries (44.3%), followed by soccer (19.0%) and football (12.9%). In ice hockey, rugby, and basketball, striking another player was the most common injury mechanism. Football, basketball, and soccer also demonstrated high proportions of injuries due to contact with an object (e.g., post) among younger players. In baseball, a common mechanism in the 5-9 year-old group was being hit with a bat as a result of standing too close to the batter (26.1% males, 28.3% females). Many sports-related brain injury mechanisms are preventable. The results suggest that further efforts aimed at universal rule changes, safer playing environments, and the education of coaches, players, and parents should be targeted in maximizing prevention of sport-related brain injury using a multifaceted approach.

  3. Mechanisms of team-sport-related brain injuries in children 5 to 19 years old: opportunities for prevention.

    Directory of Open Access Journals (Sweden)

    Michael D Cusimano

    Full Text Available There is a gap in knowledge about the mechanisms of sports-related brain injuries. The objective of this study was to determine the mechanisms of brain injuries among children and youth participating in team sports.We conducted a retrospective case series of brain injuries suffered by children participating in team sports. The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP database was searched for brain injury cases among 5-19 year-olds playing ice hockey, soccer, American football (football, basketball, baseball, or rugby between 1990 and 2009. Mechanisms of injury were classified as "struck by player," "struck by object," "struck by sport implement," "struck surface," and "other." A descriptive analysis was performed.There were 12,799 brain injuries related to six team sports (16.2% of all brain injuries registered in CHIRPP. Males represented 81% of injuries and the mean age was 13.2 years. Ice hockey accounted for the greatest number of brain injuries (44.3%, followed by soccer (19.0% and football (12.9%. In ice hockey, rugby, and basketball, striking another player was the most common injury mechanism. Football, basketball, and soccer also demonstrated high proportions of injuries due to contact with an object (e.g., post among younger players. In baseball, a common mechanism in the 5-9 year-old group was being hit with a bat as a result of standing too close to the batter (26.1% males, 28.3% females.Many sports-related brain injury mechanisms are preventable. The results suggest that further efforts aimed at universal rule changes, safer playing environments, and the education of coaches, players, and parents should be targeted in maximizing prevention of sport-related brain injury using a multifaceted approach.

  4. Risk threshold for starting low dose aspirin in pregnancy to prevent preeclampsia: an opportunity at a low cost.

    Directory of Open Access Journals (Sweden)

    Emily Bartsch

    Full Text Available Preeclampsia (PE increases maternal and perinatal morbidity and mortality. Based on a multitude of data from randomized clinical trials, clinical practice guidelines endorse using ASA to prevent PE in women who are "at risk." However, data are lacking about the level of absolute risk to warrant starting ASA prophylaxis.We present two approaches for objectively determining the minimum absolute risk for PE at which ASA prophylaxis is justified. The first is a new approach-the minimum control event rate (CERmin. The second approach uses a pre-existing concept-the minimum event rate for treatment (MERT. Here we show how the CERmin is derived, and then use the CERmin and the MERT to guide us to a reasonable risk threshold for starting a woman on ASA prophylaxis against PE based on clinical risk assessment. We suggest that eligible women need not be at "high risk" for preeclampsia to warrant ASA, but rather at some modestly elevated absolute risk of 6-10%.Given its very low cost, its widespread availability, ease of administration and its safety profile, ASA is a highly attractive agent for the prevention of maternal and perinatal morbidity worldwide.

  5. High prevalence of missed opportunities for secondary fracture prevention in a regional general hospital setting in Singapore.

    Science.gov (United States)

    Gani, Linsey; Reddy, Saripalli K; Alsuwaigh, Rayan; Khoo, Joan; King, Thomas F J

    2017-12-01

    This study aims at assessing the gap in secondary fracture prevention at a regional general hospital setting in Singapore. Male patients have significantly lower rate of being investigated and treated for osteoporosis than their female counterparts. Vitamin D deficiency is prevalent in our population. Secondary fracture prevention services are not routine in Singapore; we seek to assess the treatment gap that exists in the lack of diagnosis and treatment of osteoporosis in fragility fracture patients. We performed a retrospective analysis of all admissions for fragility fractures between December 2013 and December 2014. Demographic data, rates of BMD performance, serum vitamin D investigation and calcium and vitamin D supplementation as well as antiresorptive initiation 1 year post admission were analysed. There were 125 fragility fractures in patients below 65 and 615 fractures in older patients. There was a slightly higher proportion of males in the younger population, whereas females predominated in the older population. Median vitamin D levels were low in both younger (19.1 μg/L) and older (22.0 μg/L) groups, but supplementation was lower in younger patients (4.8 versus 16.6%, p = 0.003). Rate of BMD performance was lower in younger patients (34.4 versus 64.6%, p Singapore. Male osteoporosis remains inadequately investigated and treated in both age groups.

  6. [Prevention and control of substance abuse in the workplace: a new and significant opportunity for the occupational physician].

    Science.gov (United States)

    Riboldi, L; Porru, S; Feltrin, G; Latocca, R; Bonzini, M; Bordini, L; Ferrario, M M

    2009-01-01

    Substance abuse is nowadays a recurrent theme in the daily practice of occupational physicians (OP), mainly owing to recent legislation prescribing mandatory assessments for workers performing job tasks involving danger to third parties. While some degree of bureaucracy is inevitable and legislation seems to be inclined towards deterrence, it is recommended to take advantage of the opportunities offered for practical interventions which, in accordance with science and ethics, the OP can carry out in the workplace. Risk assessment, health surveillance, fitness for work, health promotion and cooperation in management issues are the areas of intervention required for the OP to fully accomplish his role in the practice of modern occupational health. We propose specific activities for the OP so as to highlight roles and obligations, based on available scientific evidence and established codes of ethics. Lastly, we wish to emphasize the overall role of the OP in taking on responsibilities shared jointly with all the parties and in the approach to the substance abuse problem in all workplaces with the ultimate goal of acting for the benefit of workers, enterprises and society in general.

  7. Subgroup Achievement and Gap Trends: Delaware

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Delaware students showed consistent gains in math at the basic, proficient, and advanced levels for racial/ethnic subgroups, low income students, and boys and girls. There were mixed results in reading. Achievement gaps narrowed in both reading and math in…

  8. Subgroup Achievement and Gap Trends: Maine

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Maine students had across-the-board gains. There were improvements in both reading and math at the basic, proficient and advanced levels for the subgroups large enough to count, which were white students, low income students, and boys and girls. Results on…

  9. Subgroup Achievement and Gap Trends: Illinois

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Illinois students showed mostly gains in both reading and math at the basic, proficient, and advanced levels for racial/ethnic subgroups, low income students, and boys and girls. There was mixed progress made in narrowing achievement gaps in reading and math…

  10. Subgroup Achievement and Gap Trends: Florida

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Florida students showed gains almost across the board in both reading and math at the basic, proficient, and advanced levels for racial/ethnic subgroups, low income students, and boys and girls. Progress has been made in narrowing achievement gaps in both…

  11. Are we missing an opportunity for cancer prevention? Human papillomavirus vaccination for survivors of pediatric and young adult cancers.

    Science.gov (United States)

    Temkin, Sarah M; Seibel, Nita L

    2015-10-01

    Survivors of pediatric and young adult cancers remain at risk for subsequent diseases, including those related to human papillomavirus (HPV) infection. Prevention of HPV acquisition through vaccination has become possible over the last decade. HPV vaccines have been shown to be safe and effective, yet rates of vaccination among childhood cancer survivors have remained low. Multiple factors, including stronger advocacy for this intervention from providers, could potentially increase vaccination and lead to lower HPV disease burdens for childhood cancer survivors. Health care providers for survivors of pediatric and adolescent cancers should prioritize counseling for HPV vaccination at follow-up visits. Cancer 2015;121:3435-43. © 2015 American Cancer Society. © 2015 American Cancer Society.

  12. Shooting gallery attendance among IDUs in Tijuana and Ciudad Juarez, Mexico: correlates, prevention opportunities, and the role of the environment.

    Science.gov (United States)

    Philbin, Morgan; Pollini, Robin A; Ramos, Rebecca; Lozada, Remedios; Brouwer, Kimberly C; Ramos, Maria Elena; Firestone-Cruz, Michelle; Case, Patricia; Strathdee, Steffanie A

    2008-07-01

    We identified factors associated with shooting gallery attendance among injection drug users (IDUs) in two Mexico-US border cities. IDUs in Tijuana (n=222) and Ciudad Juarez (n=205), Mexico, who were >or=18 years and injected illicit drugs in the last month were recruited using respondent-driven sampling (RDS). An interviewer-administered survey collected sociodemographic and behavioral data. Logistic regression was used to examine correlates of shooting gallery attendance in each of the two cities. Homelessness and being arrested for syringe possession--both structural level factors--were associated with shooting gallery use in both cities. In Ciudad Juarez, younger age and having overdosed were also associated with shooting gallery use. Our study highlights the need for structural interventions that mitigate homelessness among IDUs and facilitate changes in law enforcement practices associated with shooting gallery use. Harm reduction interventions based within shooting galleries should also be considered to prevent transmission of blood-borne pathogens among IDUs.

  13. Opportunities for prevention and intervention with young children: lessons from the Canadian incidence study of reported child abuse and neglect

    Directory of Open Access Journals (Sweden)

    Fallon Barbara

    2013-02-01

    Full Text Available Abstract Background The most effective way to provide support to caregivers with infants in order to promote good health, social, emotional and developmental outcomes is the subject of numerous debates in the literature. In Canada, each province adopts a different approach which range from universal to targeted programs. Nonetheless, each year a group of vulnerable infants is identified to the child welfare system with concerns about their well-being and safety. This study examines maltreatment-related investigations in Canada involving children under the age of one year to identify which factors determine service provision at the conclusion of the investigation. Methods A secondary analysis of the Canadian Incidence Study of Reported Child Abuse and Neglect CIS-2008 (PHAC, 2010 dataset was conducted. Multivariate analyses were conducted to understand the profile of investigations involving infants (n=1,203 and which predictors were significant in the decision to transfer a case to ongoing services at the conclusion of the investigation. Logistic Regression and Classification and Regression Trees (CART were conducted to examine the relationship between the outcome and predictors. Results The results suggest that there are three main sources that refer infants to the Canadian child welfare system: hospital, police, and non-professionals. Infant maltreatment-related investigations involve young caregivers who struggle with poverty, single-parenthood, drug/solvent and alcohol abuse, mental health issues, lack of social supports, and intimate partner violence. Across the three referral sources, primary caregiver risk factors are the strongest predictor of the decision to transfer a case to ongoing services. Conclusions Multivariate analyses indicate that the presence of infant concerns does not predict ongoing service provision, except when the infant is identified with positive toxicology at birth. The opportunity for early intervention and the

  14. Background-cross-section-dependent subgroup parameters

    CERN Document Server

    Yamamoto, T

    2003-01-01

    A new set of subgroup parameters was derived that can reproduce the self-shielded cross section against a wide range of background cross sections. The subgroup parameters are expressed with a rational equation which numerator and denominator are expressed as the expansion series of background cross section, so that the background cross section dependence is exactly taken into account in the parameters. The advantage of the new subgroup parameters is that they can reproduce the self-shielded effect not only by group basis but also by subgroup basis. Then an adaptive method is also proposed which uses fitting procedure to evaluate the background-cross-section-dependence of the parameters. One of the simple fitting formula was able to reproduce the self-shielded subgroup cross section by less than 1% error from the precise evaluation. (author)

  15. Interpretation of Subgroup Effects in Published Trials

    DEFF Research Database (Denmark)

    Hancock, Mark J; Kjær, Per; Korsholm, Lars

    2013-01-01

    that report on treatment effect modifiers (subgroups) for specific physical therapy interventions. The key messages are: (1) point estimates of treatment modifier effect size (interaction effect) and their confidence intervals can be calculated using group-level data when individual patient-level data...... are not available; (2) interaction effects do not define the total effect size of the intervention in the subgroup but rather how much more effective it is in the subgroup than in those not in the subgroup; (3) recommendations regarding the use of an intervention in a subgroup need to consider the size...... and direction of the main effect and the interaction effect; and (4) rather than simply judging whether a treatment modifier effect is clinically important based only on the interaction effect size, a better criterion is to determine whether the combined effect of the interaction effect and main effect makes...

  16. Challenges and opportunities for controlling and preventing animal diseases in developing countries through gene-based technologies

    International Nuclear Information System (INIS)

    Crowther, J.R.; Jeggo, M.H.

    2005-01-01

    Polymerase Chain Reaction (PCR) technology allows scientist to amplify, copy, identify, characterize and manipulate genes in a relatively simple way. Exploitation of the technology to devise new products and translate these to the commercial sector has been remarkable. Molecular technologies are not difficult to establish and use, and can appear to offer developing countries many opportunities. However, developing countries should look in a different way at the apparent advantages offered. Whilst molecular biological science appears to offer solutions to many problems, there are a number of drawbacks. This desire to adopt the latest technology often overrides any considerations of the use of more conventional technologies to address needs. The conventional, and often more practical, methods already provide many specific tools in the disease control area. Changing the technology can also deflect critical resources into the molecular field in terms of laboratory funding and training. This may cause redundancy of staff, limit further development in conventional techniques, and polarize scientists into the older (less glossy) and newer (molecular) camps. Animal disease diagnosis still primarily utilizes conventional techniques such as Enzyme Linked Immunosorbent Assay (ELISA). This will not change drastically in developing countries, but developments will combine such methods with more discriminatory molecular techniques, and a balanced and parallel development is needed. An understanding of the use and possible advantages of the various technologies is required by both scientists and policy-makers in developing nations. Vaccines based on molecular science could have a real impact in developing countries, but 'vaccinology' needs to examine both the animal (immunology of target species) and the disease agent itself. This is a research-based science and, as such, is expensive, with no surety of success. Developing countries should exploit links with developed countries

  17. Tuberculosis and mass gatherings-opportunities for defining burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage.

    Science.gov (United States)

    Zumla, Alimuddin; Saeed, Abdulaziz Bin; Alotaibi, Badriah; Yezli, Saber; Dar, Osman; Bieh, Kingsley; Bates, Matthew; Tayeb, Tamara; Mwaba, Peter; Shafi, Shuja; McCloskey, Brian; Petersen, Eskild; Azhar, Esam I

    2016-06-01

    Tuberculosis (TB) is now the most common infectious cause of death worldwide. In 2014, an estimated 9.6 million people developed active TB. There were an estimated three million people with active TB including 360000 with multidrug-resistant TB (MDR-TB) who were not diagnosed, and such people continue to fuel TB transmission in the community. Accurate data on the actual burden of TB and the transmission risk associated with mass gatherings are scarce and unreliable due to the small numbers studied and methodological issues. Every year, an estimated 10 million pilgrims from 184 countries travel to the Kingdom of Saudi Arabia (KSA) to perform the Hajj and Umrah pilgrimages. A large majority of pilgrims come from high TB burden and MDR-TB endemic areas and thus many may have undiagnosed active TB, sub-clinical TB, and latent TB infection. The Hajj pilgrimage provides unique opportunities for the KSA and the 184 countries from which pilgrims originate, to conduct high quality priority research studies on TB under the remit of the Global Centre for Mass Gatherings Medicine. Research opportunities are discussed, including those related to the definition of the TB burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage. The associated data are required to develop international recommendations and guidelines for TB management and control at mass gathering events. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Research opportunities related to establishing standards for tobacco products under the Family Smoking Prevention and Tobacco Control Act.

    Science.gov (United States)

    Hecht, Stephen S

    2012-01-01

    This paper was written in response to a request from the U.S. National Cancer Institute. The goal is to discuss some research directions related to establishing tobacco product standards under the Family Smoking Prevention and Tobacco Control Act, which empowers the U.S. Food and Drug Administration to regulate tobacco products. Potential research related to tobacco product ingredients, nicotine, and harmful or potentially harmful constituents of tobacco products is discussed. Ingredients, which are additives, require less attention than nicotine and harmful or potentially harmful constituents. With respect to nicotine, the threshold level in tobacco products below which dependent users will be able to freely stop using the product if they choose to do so is a very important question. Harmful and potentially harmful constituents include various toxicants and carcinogens. An updated list of 72 carcinogens in cigarette smoke is presented. A crucial question is the appropriate levels of toxicants and carcinogens in tobacco products. The use of carcinogen and toxicant biomarkers to determine these levels is discussed. The need to establish regulatory standards for added ingredients, nicotine, and other tobacco and tobacco smoke constituents leads to many interesting and potentially highly significant research questions, which urgently need to be addressed.

  19. Suicide in Illinois, 2005-2010: A reflection of patterns and risks by age groups and opportunities for targeted prevention.

    Science.gov (United States)

    McLone, Suzanne G; Loharikar, Anagha; Sheehan, Karen; Mason, Maryann

    2016-10-01

    Suicide accounts for two thirds of all deaths from intentional or violence-related injury and is a leading cause of death in the United States. Patterns of suicide have been well described among high-risk groups, but few studies have compared the circumstances related to suicides across all age groups. We sought to understand the epidemiology of suicide cases in Illinois and to characterize the risks and patterns for suicide among different age groups. We used suicide data collected from the Illinois Violent Death Reporting System to assess demographics, method of suicide, circumstances, and mental health status among different age groups. Between 2005 and 2010, 3,016 suicides were reported; 692 (23%) were female, and the median age (n = 3,013) was 45 years (range, 10-98 years). The most common method/weapon types were hanging/strangulation (33%), firearm (32%) and poisoning (21%). Hanging was more common (74%) among young people aged 10 to 19 years, while firearm use was more common among elderly persons age 65 years and older (55%). The percentage of victims within an age group experiencing a crisis within two weeks before committing suicide was highest among 10- to 14-year-olds, while the risk factor of having a family member or friend die in the past 5 years was highest among older victims. The final analysis demonstrated age-related trends in suicide in Illinois, suggesting prevention programs should tailor services by age. Epidemiologic study, level IV.

  20. Shooting Gallery Attendance among IDUs in Tijuana and Ciudad Juarez, Mexico: Correlates, Prevention Opportunities, and the Role of the Environment

    Science.gov (United States)

    Philbin, Morgan; Pollini, Robin A.; Ramos, Rebecca; Lozada, Remedios; Brouwer, Kimberly C.; Ramos, Maria Elena; Firestone-Cruz, Michelle; Case, Patricia; Strathdee, Steffanie A.

    2009-01-01

    We identified factors associated with shooting gallery attendance among injection drug users (IDUs) in two Mexico–US border cities. IDUs in Tijuana (n = 222) and Ciudad Juarez (n = 205), Mexico, who were ≥18 years and injected illicit drugs in the last month were recruited using respondent-driven sampling (RDS). An interviewer-administered survey collected sociodemographic and behavioral data. Logistic regression was used to examine correlates of shooting gallery attendance in each of the two cities. Homelessness and being arrested for syringe possession—both structural level factors—were associated with shooting gallery use in both cities. In Ciudad Juarez, younger age and having overdosed were also associated with shooting gallery use. Our study highlights the need for structural interventions that mitigate homelessness among IDUs and facilitate changes in law enforcement practices associated with shooting gallery use. Harm reduction interventions based within shooting galleries should also be considered to prevent transmission of blood-borne pathogens among IDUs. PMID:18369723

  1. Regional trade and the nutrition transition: opportunities to strengthen NCD prevention policy in the Southern African Development Community.

    Science.gov (United States)

    Thow, Anne Marie; Sanders, David; Drury, Eliza; Puoane, Thandi; Chowdhury, Syeda N; Tsolekile, Lungiswa; Negin, Joel

    2015-01-01

    Addressing diet-related non-communicable diseases (NCDs) will require a multisectoral policy approach that includes the food supply and trade, but implementing effective policies has proved challenging. The Southern African Development Community (SADC) has experienced significant trade and economic liberalization over the past decade; at the same time, the nutrition transition has progressed rapidly in the region. This analysis considers the relationship between regional trade liberalization and changes in the food environment associated with poor diets and NCDs, with the aim of identifying feasible and proactive policy responses to support healthy diets. Changes in trade and investment policy for the SADC were documented and compared with time-series graphs of import data for soft drinks and snack foods to assess changes in imports and source country in relation to trade and investment liberalization. Our analysis focuses on regional trade flows. Diets and the burden of disease in the SADC have changed since the 1990s in parallel with trade and investment liberalization. Imports of soft drinks increased by 76% into SADC countries between 1995 and 2010, and processed snack foods by 83%. South Africa acts as a regional trade and investment hub; it is the major source of imports and investment related to these products into other SADC countries. At the same time, imports of processed foods and soft drinks from outside the region - largely from Asia and the Middle East - are increasing at a dramatic rate with soft drink imports growing by almost 1,200% and processed snack foods by 750%. There is significant intra-regional trade in products associated with the nutrition transition; however, growing extra-regional trade means that countries face new pressures in implementing strong policies to prevent the increasing burden of diet-related NCDs. Implementation of a regional nutrition policy framework could complement the SADC's ongoing commitment to regional trade policy.

  2. [Preventing lower limb amputations in patients suffering from diabetic foot syndrome and peripheral vascular disease - opportunities and limitations].

    Science.gov (United States)

    Schirmer, S; Ritter, R G; Rice, A; Frerichs, O; Wehage, I C; Fansa, H

    2011-12-01

    The number of patients suffering from a diabetic foot syndrome is increasing. In many cases large plantar or heel defects can only be reconstructed by using a free flap. The free parascapular flap is an alternative to free muscle flaps in the reconstruction of plantar or heel defects. Donor site morbidity is low. Autologous bypass reconstruction or an angioplasty can increase extremity perfusion. PATIENTS AND OPERATIONS: 52 patients with a diabetic foot syndrome have been reconstructed since 2007. 23 of them required a free tissue transfer. On average these patients were 68.7 years of age. A parascapular flap was used in 15 cases, a latissimus dorsi flap with a skin graft in 4 cases, a gracilis muscle flap with a skin graft in 3 cases. In one case a free instep flap of the contralateral foot, which had to be amputated, was used. In 13 cases the flap was anastomosed to the autologous bypass, in one case an AV loop was used. 22 flaps healed primarily. Only 1 patient was not able to walk at discharge. There was one flap loss. 4 patients required an amputation later on due to bypass failure or infection. 2 patients died due to cardiac arrest at the rehabilitation clinic. If the correct indication is met, free flaps can prevent diabetes-derived amputations of the lower limb. The parascapular flap can be used for plantar and heel defects. Flap harvesting is quick due to the constant vascular anatomy. The donor site morbidity is low. Reconstruction requires revascularisation in an interdisciplinary setting including vascular surgeons and radiologists. Limb salvage reduces mortality and improves quality of life. Revascularisation and reconstruction should best be done in a single surgical procedure. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Missed Opportunities along the Prevention of Mother-to-Child Transmission Services Cascade in South Africa: Uptake, Determinants, and Attributable Risk (the SAPMTCTE.

    Directory of Open Access Journals (Sweden)

    Selamawit Woldesenbet

    Full Text Available We examined uptake of prevention of mother-to-child HIV transmission (PMTCT services, predictors of missed opportunities, and infant HIV transmission attributable to missed opportunities along the PMTCT cascade across South Africa.A cross-sectional survey was conducted among 4-8 week old infants receiving first immunisations in 580 nationally representative public health facilities in 2010. This included maternal interviews and testing infants' dried blood spots for HIV. A weighted analysis was performed to assess uptake of antenatal and perinatal PMTCT services along the PMTCT cascade (namely: maternal HIV testing, CD4 count test/result, and receiving maternal and infant antiretroviral treatment and predictors of dropout. The population attributable fraction associated with dropouts at each service point are estimated.Of 9,803 mothers included, 31.7% were HIV-positive as identified by reactive infant antibody tests. Of these 80.4% received some form of maternal and infant antiretroviral treatment. More than a third (34.9% of mothers dropped out from one or more steps in the PMTCT service cascade. In a multivariable analysis, the following characteristics were associated with increased dropout from the PMTCT cascade: adolescent (<20 years mothers, low socioeconomic score, low education level, primiparous mothers, delayed first antenatal visit, homebirth, and non-disclosure of HIV status. Adolescent mothers were twice (adjusted odds ratio: 2.2, 95% confidence interval: 1.5-3.3 as likely to be unaware of their HIV-positive status and had a significantly higher rate (85.2% of unplanned pregnancies compared to adults aged ≥20 years (55.5%, p = 0.0001. A third (33.8% of infant HIV infections were attributable to dropout in one or more steps in the cascade.A third of transmissions attributable to missed opportunities of PMTCT services can be prevented by optimizing the uptake of PMTCT services. Identified risk factors for low PMTCT service uptake

  4. Identification of subgroups among fibromyalgia patients

    Directory of Open Access Journals (Sweden)

    D. Chaleil

    2012-09-01

    Full Text Available This paper presents some hypotheses concerning the identification of homogeneous subgroups among fibromyalgia (FM patients in order to improve the management of the disease. It also reviews the available literature about this subject. Three methods for subgrouping are discussed according to clinical features, biomarkers, and gait analysis. Clinical subgrouping based on cluster analysis has been used for the identification of homogeneous subgroups of patients and, more recently, homogeneous clinical features. So far, longitudinal studies using clinical subgroups to direct treatment and predict outcome are still required. Biomarkers in FM, which is a neurobiological disease, are of promising interest, nevertheless currently, none of them can be used to subgroup FM patients. Due to the fact that cortical and subcortical mechanisms of gait control share some cognitive functions which are involved in FM, gait markers have been proposed to evaluate and to subgroup FM patients, in clinical settings. Three out of 4 core FM symptoms are linked to gait markers. Kinesia measured by means of cranio-caudal power is correlated to pain, and could be proposed to assess pain behavior (kinesiophobia. Stride frequency, which is linked to physical component, allows the identification of a hyperkinetic subgroup. Moreover, SF has been correlated to fatigue during the 6 minute walking test. Stride regularity, which expresses the unsteadiness of gait, is correlated to cognitive dysfunction in FM. Decreased stride regularity allows the recognition of a homogeneous subgroup characterized by an increased anxiety and depression, and decreased cognitive functions. These results need further studies to be validated and so used in the daily clinical practice.

  5. Identification of subgroups among fibromyalgia patients.

    Science.gov (United States)

    Auvinet, B; Chaleil, D

    2012-09-28

    This paper presents some hypotheses concerning the identification of homogeneous subgroups among fibromyalgia (FM) patients in order to improve the management of the disease. It also reviews the available literature about this subject. Three methods for subgrouping are discussed according to clinical features, biomarkers, and gait analysis. Clinical subgrouping based on cluster analysis has been used for the identification of homogeneous subgroups of patients and, more recently, homogeneous clinical features. So far, longitudinal studies using clinical subgroups to direct treatment and predict outcome are still required. Biomarkers in FM, which is a neurobiological disease, are of promising interest, nevertheless currently, none of them can be used to subgroup FM patients. Due to the fact that cortical and subcortical mechanisms of gait control share some cognitive functions which are involved in FM, gait markers have been proposed to evaluate and to subgroup FM patients, in clinical settings. Three out of 4 core FM symptoms are linked to gait markers. Kinesia measured by means of cranio-caudal power is correlated to pain, and could be proposed to assess pain behavior (kinesiophobia). Stride frequency, which is linked to physical component, allows the identification of a hyperkinetic subgroup. Moreover, SF has been correlated to fatigue during the 6 minute walking test. Stride regularity, which expresses the unsteadiness of gait, is correlated to cognitive dysfunction in FM. Decreased stride regularity allows the recognition of a homogeneous subgroup characterized by an increased anxiety and depression, and decreased cognitive functions. These results need further studies to be validated and so used in the daily clinical practice.

  6. Prevention

    Science.gov (United States)

    ... Contact Aging & Health A to Z Find a Geriatrics Healthcare Professional Medications & Older Adults Making Your Wishes ... Prevention Hearing Loss Heart Attack High Blood Pressure Nutrition Osteoporosis Shingles Skin Cancer Related News Quitting Smoking, ...

  7. SUBGR: A Program to Generate Subgroup Data for the Subgroup Resonance Self-Shielding Calculation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kang Seog [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-06-06

    The Subgroup Data Generation (SUBGR) program generates subgroup data, including levels and weights from the resonance self-shielded cross section table as a function of background cross section. Depending on the nuclide and the energy range, these subgroup data can be generated by (a) narrow resonance approximation, (b) pointwise flux calculations for homogeneous media; and (c) pointwise flux calculations for heterogeneous lattice cells. The latter two options are performed by the AMPX module IRFFACTOR. These subgroup data are to be used in the Consortium for Advanced Simulation of Light Water Reactors (CASL) neutronic simulator MPACT, for which the primary resonance self-shielding method is the subgroup method.

  8. APF530 versus ondansetron, each in a guideline-recommended three-drug regimen, for the prevention of chemotherapy-induced nausea and vomiting due to anthracycline plus cyclophosphamide–based highly emetogenic chemotherapy regimens: a post hoc subgroup analysis of the Phase III randomized MAGIC trial

    Directory of Open Access Journals (Sweden)

    Schnadig ID

    2017-05-01

    Full Text Available Ian D Schnadig1, Richy Agajanian2, Christopher Dakhil3, Nashat Gabrail4, Jeffrey Vacirca5, Charles Taylor6, Sharon Wilks7, Eduardo Braun8, Michael C Mosier9, Robert B Geller10, Lee Schwartzberg11, Nicholas Vogelzang12 1Compass Oncology, US Oncology Research, Tualatin, OR, 2The Oncology Institute of Hope and Innovation, Whittier, CA, 3Cancer Center of Kansas, Wichita, KS, 4Gabrail Cancer Center, Canton, OH, 5North Shore Hematology Oncology, East Setauket, NY, 6Tulsa Cancer Institute, Tulsa, OK, 7Cancer Care Centers of South Texas, San Antonio, TX, 8Michiana Hematology Oncology, Westville, IN, 9Biostatistics, EMB Statistical Solutions, LLC, Overland Park, KS, 10Medical Affairs, Heron Therapeutics, Inc., San Diego, CA, 11West Cancer Center, Germantown, TN, 12Comprehensive Cancer Centers of Nevada, Las Vegas, NV, USA Background: APF530, a novel extended-release granisetron injection, was superior to ondansetron in a guideline-recommended three-drug regimen in preventing delayed-phase chemotherapy-induced nausea and vomiting (CINV among patients receiving highly emetogenic chemotherapy (HEC in the double-blind Phase III Modified Absorption of Granisetron In the prevention of CINV (MAGIC trial.Patients and methods: This MAGIC post hoc analysis evaluated CINV prevention efficacy and safety of APF530 versus ondansetron, each with fosaprepitant and dexamethasone, in patient subgroup receiving an anthracycline plus cyclophosphamide (AC regimen. Patients were randomized 1:1 to APF530 500 mg subcutaneously (granisetron 10 mg or ondansetron 0.15 mg/kg intravenously (IV (≤16 mg; stratification was by planned cisplatin ≥50 mg/m2 (yes/no. Patients were to receive fosaprepitant 150 mg IV and dexamethasone 12 mg IV on day 1, then dexamethasone 8 mg orally once daily on day 2 and twice daily on days 3 and 4. Patients were mostly younger females (APF530 arm, mean age 54.1 years, female, 99.3%; ondansetron arm, 53.8 years, female 98.3%. The primary

  9. ∗-supplemented subgroups of finite groups

    Indian Academy of Sciences (India)

    As we all know, the study of groups in which some primary subgroups satisfy a certain embedding property is one of the .... G ∈ F. The converse also holds, in the case where F = U. Lemma 2.10 Let G be a finite ..... Case I. F = U. If every Sylow 2-subgroup of G is cyclic, then G is 2-nilpotent by Burn- side theorem. Hence G is ...

  10. A New subgroup method for resonance calculation

    International Nuclear Information System (INIS)

    Milosevic, M.

    1997-01-01

    In the current work, a generalization of the subgroup resonance treatment was derived to account for the space and energy dependence of the resonant absorption inside the fuel rod of a heterogenous lattice. This paper describes the basic principles and algorithms used in the proposed subgroup method. The method is validated for interference effects in a homogenous uranium-plutonium mixture, and for spatial resonance interference in a realistic fuel dissolver benchmark problem. (author)

  11. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  12. Neurocognitive features in subgroups of bipolar disorder

    Science.gov (United States)

    Aminoff, Sofie Ragnhild; Hellvin, Tone; Lagerberg, Trine Vik; Berg, Akiah Ottesen; Andreassen, Ole A; Melle, Ingrid

    2013-01-01

    Objective To examine which subgroups of DSM-IV bipolar disorder (BD) [BD type I (BD-I) or BD type II (BD-II), and subgroups based on history of psychosis, presenting polarity, and age at onset] differentiate best regarding neurocognitive measures. Methods A total of 199 patients with BD were characterized by clinical and neurocognitive features. The distribution of subgroups in this sample was: BD-I, 64% and BD-II, 36%; 60% had a history of psychosis; 57% had depression as the presenting polarity; 61% had an early onset of BD, 25% had a mid onset, and 14% had a late onset. We used multivariate regression analyses to assess relationships between neurocognitive variables and clinical subgroups. Results Both BD-I diagnosis and elevated presenting polarity were related to impairments in verbal memory, with elevated presenting polarity explaining more of the variance in this cognitive domain (22.5%). History of psychosis and BD-I diagnosis were both related to impairment in semantic fluency, with history of psychosis explaining more of the variance (11.6%). Conclusion Poor performance in verbal memory appears to be associated with an elevated presenting polarity, and poor performance in semantic fluency appears to be associated with a lifetime history of psychosis. PMID:23521608

  13. Molecular subgrouping of Wolbachia and bacteriophage WO ...

    Indian Academy of Sciences (India)

    2011-12-16

    Dec 16, 2011 ... in insect pests of rice, insect pest of sericulture, Wuchere- .... USA). The size of the PCR product was determined using. 3-kb and 1-kb ladder (GeNei, Bangalore, India). Subgrouping of Wolbachia. Samples that were positive for super group A were typed ... tigate the phage diversity by phylogenetic analysis.

  14. ELECTROPHEROTYPES AND SUBGROUPS OF GROUP A ...

    African Journals Online (AJOL)

    Background: It is estimated that about 600 000 children die annually as a result of severe dehydrating diarrhea caused by rotaviruses. The virus is a double stranded RNA (dsRNA) virus with 11 segments. Group A rotaviruses show a characteristic 4-2-3-2 pattern following electrophoresis. The VP6 subgroups, I and II exist.

  15. On Preferential sylow fuzzy subgroups | Makamba | Quaestiones ...

    African Journals Online (AJOL)

    In this paper, for a prime p, we propose some plausible denitions for the notion of Sylow fuzzy p-subgroup of a nite group. We derive a number of results for nite fuzzy groups using one of the proposed denitions. We also discuss some of the relationships between various proposed denitions for suitability, including the crisp ...

  16. A Seroprevalence Study of Hepatitis B and C Virus Infections in a Hospitalized Population in Romania, an Opportunity for a Better National Prevention and Control Strategy.

    Science.gov (United States)

    Popovici, Odette; Molnar, Geza B; Popovici, Florin; Janţă, Denisa; Pistol, Adriana; Azoicăi, Doina

    2016-03-01

    The most recent prevalence data for hepatitis B virus (HBV) infection in Romania came from an ESEN 2 study (2002), and from a Romanian population-based study performed in 2008. Most of the previous studies were regional and performed in specific groups (blood donors, pregnant women, institutionalized people, etc) and had limited representativeness at the national level, both for HBV and hepatitis C virus (HCV) infection. The scarcity of prevalence data for HBV and HCV infection coming from the routine surveillance was also considered. The aim of our study was to obtain overall and age group specific estimates of the prevalence of HBV and HCV infections markers in Romania, in order to recommend evidence-based public health interventions. The main outcome was the proportion of persons with HBV, HCV and HBV+HCV infection markers, overall and by age group and gender. Our seroprevalence study ensured national representativeness for the targeted hospitalized population. A prospective collection of serum samples in hospital laboratories was completed between September and November 2013, using a systematic sampling. The study respected the confidentiality of personal data. We calculated the sample size using EpiInfo7 and used Z test - Two-tailed probability for statistical significance. The overall prevalence data estimated in our study were HBc Ab 28%, HBs Ag 4.2%, HBs Ab regardless of titer 64.1%, HBs Ab in titer of at least 10 mUI/ml and negative HBc Ab 17.5%; HCV Ab 5.6%; HBc Ab and HCV Ab 2.8%, as markers of double infection. The overall prevalence data estimated in our study for HBs Ag (4.2%) and HCV Ab (5.6%) correspond to a medium endemicity based on the WHO criteria. The estimated prevalence of HBV and HCV infection markers in the study population should represent an opportunity for a better national prevention and control strategy.

  17. Suicidal ideation and behaviour among persons seeking HIV testing in peri-urban areas of Cape Town, South Africa: a lost opportunity for suicide prevention.

    Science.gov (United States)

    Bantjes, Jason; Kagee, Ashraf; Saal, Wylene

    2017-07-01

    Suicidal ideation and behaviour (SIB) are among the psychiatric sequela of HIV/AIDS. Few studies have however examined the prevalence and correlates of SIB among persons seeking HIV testing. We set out to document the prevalence and correlates of SIB among people seeking HIV testing in peri-urban areas of Cape Town, South Africa (SA). A cross-sectional research design was used to recruit a sample (n = 500) of individuals seeking HIV testing. Self-report measures were used to assess two-week prevalence of SIB as well as life-time prevalence of suicide attempt. A structured clinical interview was used to assess common mental disorders (CMDs). Regression analysis was used to determine if CMD and socio-demographic variables predicted suicidal ideation. The mean age of the sample was 36 years, 51.6% were female and 46.6% were unemployed. The two-week prevalence of suicidal ideation was 24.27% while the two-week prevalence of suicide attempt and suicide plans was 2.8%. Suicidal ideation was not associated with age, gender, employment status, family income or household food insecurity. CMDs were significantly associated with suicidal ideation; individuals with depressive disorders were approximately 5.5 times more likely to report suicidal ideation, while those with generalised anxiety disorder, trauma-related disorders and alcohol use disorder were approximately 7, 4.7 and 2.8 times more likely to report suicidal ideation, respectively. Results suggest that persons seeking HIV testing may be a well-delineated group of persons at risk of suicide in this region of SA. Contact with the health care system during HIV testing provides an opportunity for targeted suicide prevention interventions in what appears to be a high risk group.

  18. A Note on TI-Subgroups of Finite Groups

    Indian Academy of Sciences (India)

    A subgroup of a finite group is called a TI-subgroup if H ∩ H x = 1 or for any x ∈ G . In this short note, the finite groups all of whose nonabelian subgroups are TI-subgroups are classified. Author Affiliations. Jiakuan Lu1 Linna Pang1. Department of Mathematics, Guangxi Normal University, Guangxi, Guilin 541004, ...

  19. A note on TI-subgroups of finite groups

    Indian Academy of Sciences (India)

    A subgroup of a finite group is called a TI-subgroup if H ∩ H x = 1 or for any x ∈ G . In this short note, the finite groups all of whose nonabelian subgroups are TI-subgroups are classified. Author Affiliations. Jiakuan Lu1 Linna Pang1. Department of Mathematics, Guangxi Normal University, Guangxi, Guilin 541004, ...

  20. Effects of Healthy Families New York on the promotion of maternal parenting competencies and the prevention of harsh parenting.

    Science.gov (United States)

    Rodriguez, M L; Dumont, K; Mitchell-Herzfeld, S D; Walden, N J; Greene, R

    2010-10-01

    This paper examines the effectiveness of the Healthy Families New York (HFNY) home visiting program in promoting parenting competencies and preventing maladaptive parenting behaviors in mothers at risk for child abuse and neglect. The study used microlevel observational assessments of mother-child interactions in the third wave of a randomized controlled trial to evaluate whether mothers who received home visiting services were more likely to exhibit positive parenting and less likely to display negative parenting behaviors than those who did not receive these services. Women were randomly assigned during pregnancy or shortly after the birth of the target child to an intervention group that was offered home visiting services or a control group that was given referrals to other services. At Year 3, 522 mother and child pairs were systematically observed while they interacted in semistructured tasks presenting varied parenting challenges. The study also sought to replicate a finding from Year 2, which revealed that program effects on harsh parenting were stronger among young, first-time mothers who were randomly assigned during pregnancy (the High Prevention Opportunity subgroup) than among the other mothers (the Limited Prevention Opportunity subgroup). Results indicate that HFNY was effective in fostering positive parenting, such as maternal responsivity and cognitive engagement. With respect to negative parenting, HFNY mothers in the High Prevention Opportunity subgroup were less likely than their counterparts in the control group to use harsh parenting, while no differences were detected for the Limited Prevention Opportunity subgroup. HFNY was successful in promoting positive parenting among mothers at risk for child abuse and neglect, which may reflect the program's strength-based approach. The replication of the High Prevention Opportunity subgroup as a moderator of program effects on harsh parenting further suggests that HFNY may be more useful for preventing

  1. MPACT Subgroup Self-Shielding Efficiency Improvements

    International Nuclear Information System (INIS)

    Stimpson, Shane; Liu, Yuxuan; Collins, Benjamin S.; Clarno, Kevin T.

    2016-01-01

    Recent developments to improve the efficiency of the MOC solvers in MPACT have yielded effective kernels that loop over several energy groups at once, rather that looping over one group at a time. These kernels have produced roughly a 2x speedup on the MOC sweeping time during eigenvalue calculation. However, the self-shielding subgroup calculation had not been reevaluated to take advantage of these new kernels, which typically requires substantial solve time. The improvements covered in this report start by integrating the multigroup kernel concepts into the subgroup calculation, which are then used as the basis for further extensions. The next improvement that is covered is what is currently being termed as ''Lumped Parameter MOC''. Because the subgroup calculation is a purely fixed source problem and multiple sweeps are performed only to update the boundary angular fluxes, the sweep procedure can be condensed to allow for the instantaneous propagation of the flux across a spatial domain, without the need to sweep along all segments in a ray. Once the boundary angular fluxes are considered to be converged, an additional sweep that will tally the scalar flux is completed. The last improvement that is investigated is the possible reduction of the number of azimuthal angles per octant in the shielding sweep. Typically 16 azimuthal angles per octant are used for self-shielding and eigenvalue calculations, but it is possible that the self-shielding sweeps are less sensitive to the number of angles than the full eigenvalue calculation.

  2. Opportunity Design

    DEFF Research Database (Denmark)

    Løwe Nielsen, Suna; Lassen, Astrid Heidemann; Nielsen, Louise Møller

    2013-01-01

    Entrepreneurship is about transforming novel ideas into future business, but it requires an entrepreneurial opportunity to be exploited via an effective strategic and organizational design. While the entrepreneurship literature says much about how to implement and organize new opportunities...... in a market setting (the back-end of entrepreneurial processes), it pays less attention to how entrepreneurs purposely design opportunities (the front-end of entrepreneurial processes). Drawing on methods and processes from the creative design literature, the paper introduces a framework of “opportunity...... design”. The framework explains how opportunities intentionally and pro-actively can be designed from methods and processes of moving-in and moving-out. An illustrative case of opportunity design within the area of sustainable energy and electric cars is presented to link the theoretical discussion...

  3. The ergodic theory of lattice subgroups

    CERN Document Server

    Gorodnik, Alexander

    2010-01-01

    The results established in this book constitute a new departure in ergodic theory and a significant expansion of its scope. Traditional ergodic theorems focused on amenable groups, and relied on the existence of an asymptotically invariant sequence in the group, the resulting maximal inequalities based on covering arguments, and the transference principle. Here, Alexander Gorodnik and Amos Nevo develop a systematic general approach to the proof of ergodic theorems for a large class of non-amenable locally compact groups and their lattice subgroups. Simple general conditions on the spectral theory of the group and the regularity of the averaging sets are formulated, which suffice to guarantee convergence to the ergodic mean

  4. Treatment implications of posterior fossa ependymoma subgroups.

    Science.gov (United States)

    Ramaswamy, Vijay; Taylor, Michael D

    2016-11-15

    Posterior fossa ependymoma comprises two distinct molecular entities, ependymoma_posterior fossa A (EPN_PFA) and ependymoma_posterior fossa B (EPN_PFB), with differentiable gene expression profiles. As yet, the response of the two entities to treatment is unclear. To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment, we studied a cohort of 820 patients with molecularly profiled, clinically annotated posterior fossa ependymomas. We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA, which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis" in the Journal of Clinical Oncology. Patients with incompletely resected EPN_PFA tumors had a very poor outcome despite receiving adjuvant radiation therapy, whereas a substantial proportion of patients with EPN_PFB tumors can be cured with surgery alone.

  5. Myasthenia gravis: subgroup classification and therapeutic strategies.

    Science.gov (United States)

    Gilhus, Nils Erik; Verschuuren, Jan J

    2015-10-01

    Myasthenia gravis is an autoimmune disease that is characterised by muscle weakness and fatigue, is B-cell mediated, and is associated with antibodies directed against the acetylcholine receptor, muscle-specific kinase (MUSK), lipoprotein-related protein 4 (LRP4), or agrin in the postsynaptic membrane at the neuromuscular junction. Patients with myasthenia gravis should be classified into subgroups to help with therapeutic decisions and prognosis. Subgroups based on serum antibodies and clinical features include early-onset, late-onset, thymoma, MUSK, LRP4, antibody-negative, and ocular forms of myasthenia gravis. Agrin-associated myasthenia gravis might emerge as a new entity. The prognosis is good with optimum symptomatic, immunosuppressive, and supportive treatment. Pyridostigmine is the preferred symptomatic treatment, and for patients who do not adequately respond to symptomatic therapy, corticosteroids, azathioprine, and thymectomy are first-line immunosuppressive treatments. Additional immunomodulatory drugs are emerging, but therapeutic decisions are hampered by the scarcity of controlled studies. Long-term drug treatment is essential for most patients and must be tailored to the particular form of myasthenia gravis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Religious subgroups influencing vaccination coverage in the Dutch Bible belt: an ecological study

    NARCIS (Netherlands)

    Ruijs, W.L.M.; Hautvast, J.L.A.; van der Velden, K.; de Vos, S.; Knippenberg, H.; Hulscher, M.E.J.L.

    2011-01-01

    Background The Netherlands has experienced epidemics of vaccine preventable diseases largely confined to the Bible belt, an area where -among others- orthodox protestant groups are living. Lacking information on the vaccination coverage in this minority, and its various subgroups, control of vaccine

  7. Religious subgroups influencing vaccination coverage in the Dutch Bible belt: an ecological study

    NARCIS (Netherlands)

    Ruijs, W.L.M.; Hautvast, J.L.A.; Velden, K. van der; Vos, S. de; Knippenberg, H.; Hulscher, M.E.J.L.

    2011-01-01

    BACKGROUND: The Netherlands has experienced epidemics of vaccine preventable diseases largely confined to the Bible belt, an area where -among others- orthodox protestant groups are living. Lacking information on the vaccination coverage in this minority, and its various subgroups, control of

  8. Religious subgroups influencing vaccination coverage in the Dutch Bible belt: an ecological study

    NARCIS (Netherlands)

    Ruijs, W.L.M.; Hautvast, J.L.A.; van der Velden, K.; de Vos, S.; Knippenberg, H.; Hulscher, M.E.J.L.; Ruijs, W.L.M.

    2012-01-01

    Background - The Netherlands has experienced epidemics of vaccine preventable diseases largely confined to the Bible belt, an area where -among others- orthodox Protestant groups are living. Lacking information on the vaccination coverage in this minority, and its various subgroups, control of

  9. Subgrouping the autism "spectrum": reflections on DSM-5.

    Directory of Open Access Journals (Sweden)

    Meng-Chuan Lai

    Full Text Available DSM-5 has moved autism from the level of subgroups ("apples and oranges" to the prototypical level ("fruit". But making progress in research, and ultimately improving clinical practice, will require identifying subgroups within the autism spectrum.

  10. Additive subgroups of topological vector spaces

    CERN Document Server

    Banaszczyk, Wojciech

    1991-01-01

    The Pontryagin-van Kampen duality theorem and the Bochner theorem on positive-definite functions are known to be true for certain abelian topological groups that are not locally compact. The book sets out to present in a systematic way the existing material. It is based on the original notion of a nuclear group, which includes LCA groups and nuclear locally convex spaces together with their additive subgroups, quotient groups and products. For (metrizable, complete) nuclear groups one obtains analogues of the Pontryagin duality theorem, of the Bochner theorem and of the Lévy-Steinitz theorem on rearrangement of series (an answer to an old question of S. Ulam). The book is written in the language of functional analysis. The methods used are taken mainly from geometry of numbers, geometry of Banach spaces and topological algebra. The reader is expected only to know the basics of functional analysis and abstract harmonic analysis.

  11. Effectiveness of lifestyle intervention in subgroups of obese infertile women : a subgroup analysis of a RCT

    NARCIS (Netherlands)

    van Oers, A. M.; Groen, H.; Mutsaerts, M. A. Q.; Burggraaff, J. M.; Kuchenbecker, W. K. H.; Perquin, D. A. M.; Koks, C. A. M.; van Golde, R.; Kaaijk, E. M.; Schierbeek, J. M.; Oosterhuis, G. J. E.; Broekmans, F. J.; Vogel, N. E. A.; Land, J. A.; Mol, B. W. J.; Hoek, A.

    2016-01-01

    STUDY QUESTION: Do age, ovulatory status, severity of obesity and body fat distribution affect the effectiveness of lifestyle intervention in obese infertile women? SUMMARY ANSWER: We did not identify a subgroup in which lifestyle intervention increased the healthy live birth rate however it did

  12. Sexual and Gender Minority Youth Suicide: Understanding Subgroup Differences to Inform Interventions.

    Science.gov (United States)

    O'Brien, Kimberly H McManama; Putney, Jennifer M; Hebert, Nicholas W; Falk, Amy M; Aguinaldo, Laika D

    2016-08-01

    Sexual and gender minority (SGM) youth are disproportionately affected by suicide-related thoughts and behaviors relative to their heterosexual and/or non-transgender peers. Theory and empirical evidence suggest that there are unique factors that contribute to this elevated risk, with distinguishable differences among SGM subgroups. Although SGM youth suicide prevention research is in its nascence, initial findings indicate that interventions which focus on family support and acceptance may be beneficial. It is critical that we develop and test tailored interventions for SGM youth at risk for suicide, with specific attention to subgroup differences and reductions in suicide-related thoughts and behaviors as outcomes.

  13. Being innovative regarding the sensitive question of accidents in mountain sports : prevention opportunities provided by experience feedback methods applied to accident and near-miss sequences

    OpenAIRE

    Vanpoulle, Maud

    2017-01-01

    Les carnets du LabEx ITEM; The effectiveness of sport accidents prevention is often considered in terms of communication strategies, in relation with the good enunciation, the correct reception, and ideally, the appropriation of prevention messages and safe methods by participants. The accuracy of these strategies depends on thorough knowledge of accident frequencies, of typical circumstances and risk factors, and of the origins of accident sequences (Bahr & Krosshaug, 2005; Rasmussen & Svedu...

  14. Pre-Cancer Atlas (PCA) and Other Human Tumor Atlas Network (HTAN) Funding Opportunity Announcements (FOAs) Released | Division of Cancer Prevention

    Science.gov (United States)

    There are 3 new funding opportunity announcements about the Pre-Cancer Atlas associated with the Beau Biden Cancer MoonshotSM Initiative that are intended to accelerate cancer research. The purpose of the FOAs is to promote research that results in a comprehensive view of the dynamic, multidimensional tumor ecosystem and is a direct response to the Moonshot Blue Ribbon Panel recommendation to generate human tumor atlases. |

  15. Community voices: barriers and opportunities for programmes to successfully prevent vertical transmission of HIV identified through consultations among people living with HIV.

    Science.gov (United States)

    Anderson, Ginna; Caswell, Georgina; Edwards, Olive; Hsieh, Amy; Hull, Beri; Mallouris, Christoforos; Mason, Naisiadet; Nöstlinger, Christiana

    2012-07-11

    In 2010, two global networks of people living with HIV, the International Community of Women Living with HIV (ICW Global) and the Global Network of People living with HIV (GNP+) were invited to review a draft strategic framework for the global scale up of prevention of vertical transmission (PVT) through the primary prevention of HIV and the prevention of unintended pregnancies among women living with HIV. In order to ensure recommendations were based on expressed needs of people living with HIV, GNP+ and ICW Global undertook a consultation amongst people living with HIV which highlighted both facilitators and barriers to prevention services. This commentary summarizes the results of that consultation. The consultation was comprised of an online consultation (moderated chat-forum with 36 participants from 16 countries), an anonymous online e-survey (601 respondents from 58 countries), and focus-group discussions with people living with HIV in Jamaica (27 participants). The consultation highlighted the discrepancies across regions with respect to access to essential packages of PVT services. However, the consultation participants also identified common barriers to access, including a lack of trustworthy sources of information, service providers' attitudes, and gender-based violence. In addition, participant responses revealed common facilitators of access, including quality counselling on reproductive choices, male involvement, and decentralized services. The consultation provided some understanding and insight into the participants' experiences with and recommendations for PVT strategies. Participants agreed that successful, comprehensive PVT programming require greater efforts to both prevent primary HIV infection among young women and girls and, in particular, targeted efforts to ensure that women living with HIV and their partners are supported to avoid unintended pregnancies and to have safe, healthy pregnancies instead. In addition to providing the insights

  16. Challenges and emerging opportunities for the HIV prevention, treatment and care cascade in men who have sex with men in Asia Pacific.

    Science.gov (United States)

    van Griensven, Frits; Guadamuz, Thomas E; de Lind van Wijngaarden, Jan Willem; Phanuphak, Nittaya; Solomon, Sunil Suhas; Lo, Ying-Ru

    2017-08-01

    In Asia Pacific, most countries have expanded HIV treatment guidelines to include all those with HIV infection and adopted antiretroviral treatment for prevention (TFP) as a blanket strategy for HIV control. Although the overall epidemic development associated with this focus is positive, the HIV epidemic in men who have sex with men (MSM) is continuing unperturbed without any signs of decline or reversal. This raises doubt about whether TFP as a blanket HIV prevention policy is the right approach. This paper reviews currently available biomedical HIV prevention strategies, national HIV prevention policies and guidelines from selected countries and published data on the HIV cascade in MSM. No evidence for efficacy of TFP in protecting MSM from HIV infection was found. The rationale for this approach is based on assumptions about biological plausibility and external validity of latency-based efficacy found in heterosexual couples. This is different from the route and timing of HIV transmission in MSM. New HIV infections in MSM principally occur in chains of acutely HIV-infected highly sexually active young men, in whom acquisition and transmission are correlated in space and time. By the time TFP renders its effects, most new HIV infections in MSM will have already occurred. On a global level, less than 6% of all reports regarding the HIV care cascade from 1990 to 2016 included MSM, and only 2.3% concerned MSM in low/middle-income countries. Only one report originated from Asia Pacific. Generally, HIV cascade data in MSM show a sobering picture of TFP in engaging and retaining MSM along the continuum. Widening the cascade with a preventive extension, including pre-exposure prophylaxis, the first proven efficacious and only biomedical HIV prevention strategy in MSM, will be instrumental in achieving HIV epidemic control in this group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  17. Report of the Production and Delivery Subgroup

    Energy Technology Data Exchange (ETDEWEB)

    Glass, R; Zalesky, R

    2004-11-01

    The Production and Delivery Subgroup was tasked with evaluating the various options that could be used for hydrogen production and delivery in terms of availability/industry readiness, technical and economic barriers, and environmental considerations. Hydrogen can be produced using a variety of feedstocks and conversion technologies. The feedstock options include water, natural gas, coal, petroleum, methanol, ethanol, biomass, and organic waste streams. Ultimately, using these domestic resources we will be able to produce all the hydrogen we will need for the complete conversion of our transportation infrastructure. The various conversion technologies include electrolysis, reforming (principally of natural gas, but also ethanol and methanol), photobiological and photoelectrochemical, biofermentation, pyrolysis and gasification of biomass and coal, high temperature thermochemical, and catalytic membranes. All of these production technologies are being actively researched by DOE's Office of Hydrogen, Fuel Cells and Infrastructure Technologies (HFCIT); and other offices within DOE support work that complements the HFCIT Program activities. In addition, private industry is also dedicating significant resources to these efforts. In establishing the California Hydrogen Highway Network (CA H2 Net) we must utilize both distributed (that is, hydrogen that is produced at the point of use) as well as centralized production of hydrogen. Because of technical and economic barriers, most of the technologies for hydrogen production listed above will not become practical for either mode of hydrogen production in large quantities until at least the 2015-2030 timeframe. In the near term, that is, the transitional period between now and 2010 when we will establish a widely available hydrogen fueling infrastructure in California, the distributed production options of reforming and electrolysis will play the dominant role. In addition, production of hydrogen at centralized plants

  18. Missed therapeutic and prevention opportunities in women with BRCA-mutated epithelial ovarian cancer and their families due to low referral rates for genetic counseling and BRCA testing: A review of the literature.

    Science.gov (United States)

    Hoskins, Paul J; Gotlieb, Walter H

    2017-11-01

    Answer questions and earn CME/CNE Fifteen percent of women with epithelial ovarian cancer have inherited mutations in the BRCA breast cancer susceptibility genes. Knowledge of her BRCA status has value both for the woman and for her family. A therapeutic benefit exists for the woman with cancer, because a new family of oral drugs, the poly ADP-ribose polymerase (PARP) inhibitors, has recently been approved, and these drugs have the greatest efficacy in women who carry the mutation. For her family, there is the potential to prevent ovarian cancer in those carrying the mutation by using risk-reducing surgery. Such surgery significantly reduces the chance of developing this, for the most part, incurable cancer. Despite these potential benefits, referral rates for genetic counseling and subsequent BRCA testing are low, ranging from 10% to 30%, indicating that these therapeutic and prevention opportunities are being missed. The authors have reviewed the relevant available literature. Topics discussed are BRCA and its relation to ovarian cancer, the rates of referral for genetic counseling/BRCA testing, reasons for these low rates, potential strategies to improve on those rates, lack of effectiveness of current screening strategies, the pros and cons of risk-reducing surgery, other prevention options, and the role and value of PARP inhibitors. CA Cancer J Clin 2017;67:493-506. © 2017 American Cancer Society. © 2017 American Cancer Society.

  19. Subgroup Achievement and Gap Trends: District of Columbia

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    The District's demographics are such that achievement trends could only be determined for African American, male and female, and low income subgroups. In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Washington, DC students showed gains in both reading and math at the basic, proficient, and advanced levels…

  20. Germ cell tumours in neonates and infants: a distinct subgroup?

    NARCIS (Netherlands)

    Veltman, I.M.; Schepens, M.T.M.; Looijenga, L.H.J.; Strong, L.C.; Geurts van Kessel, A.H.M.

    2003-01-01

    Human germ cell tumours (GCTs) constitute a heterogeneous group of tumours that can be classified into four major subgroups. One of these subgroups encompasses (immature) teratomas and yolk sac tumours of patients under the age of 5 years. In this paper we review the various clinical, histological

  1. electropherotypes and subgroups of group a rotaviruses circulating ...

    African Journals Online (AJOL)

    Emmanuel Ameh

    Group A rotaviruses show a characteristic 4-2-3-2 pattern following electrophoresis. The VP6 subgroups, I and II exist. This work was carried out to study the prevalence of rotavirus infection among children 0-5 years with diarrhea in Kano, and to determine the circulating subgroups and electropherotypes and of the rotavirus ...

  2. Finite Groups with Given Quantitative Non-Nilpotent Subgroups II

    DEFF Research Database (Denmark)

    Shi, Jiangtao; Zhang, Cui

    2014-01-01

    As an extension of Shi and Zhang's 2011 article [4], we prove that any finite group having at most 23 non-normal non-nilpotent proper subgroups is solvable except for G ≅ A 5 or SL(2, 5), and any finite group having at most three conjugacy classes of non-normal non-nilpotent proper subgroups...

  3. Identifying subgroups of patients using latent class analysis

    DEFF Research Database (Denmark)

    Nielsen, Anne Mølgaard; Kent, Peter; Hestbæk, Lise

    2017-01-01

    BACKGROUND: Heterogeneity in patients with low back pain (LBP) is well recognised and different approaches to subgrouping have been proposed. Latent Class Analysis (LCA) is a statistical technique that is increasingly being used to identify subgroups based on patient characteristics. However...

  4. Application of a fall screening algorithm stratified fall risk but missed preventive opportunities in community-dwelling older adults: a prospective study.

    Science.gov (United States)

    Muir, Susan W; Berg, Katherine; Chesworth, Bert; Klar, Neil; Speechley, Mark

    2010-01-01

    Evaluate the ability of the American and British Geriatrics Society fall prevention guideline's screening algorithm to identify and stratify future fall risk in community-dwelling older adults. Prospective cohort of community-dwelling older adults (n = 117) aged 65 to 90 years. Fall history, balance, and gait measured during a comprehensive geriatric assessment at baseline. Falls data were collected monthly for 1 year. The outcomes of any fall and any injurious fall were evaluated. The algorithm stratified participants into 4 hierarchal risk categories. Fall risk was 33% and 68% for the "no intervention" and "comprehensive fall evaluation required" groups respectively. The relative risk estimate for falling comparing participants in the 2 intervention groups was 2.08 (95% CI 1.42-3.05) for any fall and 2.60 (95% Cl 1.53-4.42) for any injurious fall. Prognostic accuracy values were: sensitivity of 0.50 (95% Cl 0.36-0.64) and specificity of 0.82 (95% CI 0.70-0.90) for any fall; and sensitivity of 0.56 (95% CI 0.38-0.72) and specificity of 0.78 (95% Cl 0.67-0.86) for any injurious fall. The algorithm was able to identify and stratify fall risk for each fall outcome, though the values of prognostic accuracy demonstrate moderate clinical utility. The recommendations of fall evaluation for individuals in the highest risk groups appear supported though the recommendation of no intervention in the lowest risk groups may not address their needs for fall prevention interventions. Further evaluation of the algorithm is recommended to refine the identification of fall risk in community-dwelling older adults.

  5. Municipal opportunities

    International Nuclear Information System (INIS)

    Cousens, D.; Chuddy, B.; Gleeson, A.; Leckie, D.; Wahl, K.; McGarry, D.

    1997-01-01

    The panel discussing market opportunities for municipal electric companies was moderated by Markham Mayor Don Cousens. He expressed himself in favour of deregulation and was optimistic about the benefits it will bring to municipal electric utilities and their customers. Barry Chuddy, General Manager of Business Development for TransAlta Energy discussed the advantages of recent cogeneration and district energy for municipal utilities in Ontario and Quebec, and expressed his support for incentive-based regulation based on a level playing field, competitive generation, and a reasonable charge for stranded assets. Toronto City Councillor Dan Leckie described cogeneration and district energy as a tremendous opportunity to reduce the cost of doing business in the city core through local job creation and by keeping money in the local economy. Karl Wahl, General Manager of Hydro Mississauga expressed optimism that the government will move expeditiously toward competition, choice and lower-cost supply. David McGarry, President of Elecsar Engineering of Sarnia spoke about the significant job creating potential that deregulation will bring to the electrical industry. He cited several examples from Ontario and British Columbia

  6. Multiplicity-adjusted semiparametric benefiting subgroup identification in clinical trials.

    Science.gov (United States)

    Schnell, Patrick M; Müller, Peter; Tang, Qi; Carlin, Bradley P

    2018-02-01

    Background A recent focus in the health sciences has been the development of personalized medicine, which includes determining the population for which a given treatment is effective. Due to limited data, identifying the true benefiting population is a challenging task. To tackle this difficulty, the credible subgroups approach provides a pair of bounding subgroups for the true benefiting subgroup, constructed so that one is contained by the benefiting subgroup while the other contains the benefiting subgroup with high probability. However, the method has so far only been developed for parametric linear models. Methods In this article, we develop the details required to follow the credible subgroups approach in more realistic settings by considering nonlinear and semiparametric regression models, supported for regulatory science by conditional power simulations. We also present an improved multiple testing approach using a step-down procedure. We evaluate our approach via simulations and apply it to data from four trials of Alzheimer's disease treatments carried out by AbbVie. Results Semiparametric modeling yields credible subgroups that are more robust to violations of linear treatment effect assumptions, and careful choice of the population of interest as well as the step-down multiple testing procedure result in a higher rate of detection of benefiting types of patients. The approach allows us to identify types of patients that benefit from treatment in the Alzheimer's disease trials. Conclusion Attempts to identify benefiting subgroups of patients in clinical trials are often met with skepticism due to a lack of multiplicity control and unrealistically restrictive assumptions. Our proposed approach merges two techniques, credible subgroups, and semiparametric regression, which avoids these problems and makes benefiting subgroup identification practical and reliable.

  7. Molecular subgroups of medulloblastoma identification using noninvasive magnetic resonance spectroscopy.

    Science.gov (United States)

    Blüml, Stefan; Margol, Ashley S; Sposto, Richard; Kennedy, Rebekah J; Robison, Nathan J; Vali, Marzieh; Hung, Long T; Muthugounder, Sakunthala; Finlay, Jonathan L; Erdreich-Epstein, Anat; Gilles, Floyd H; Judkins, Alexander R; Krieger, Mark D; Dhall, Girish; Nelson, Marvin D; Asgharzadeh, Shahab

    2016-01-01

    Medulloblastomas in children can be categorized into 4 molecular subgroups with differing clinical characteristics, such that subgroup determination aids in prognostication and risk-adaptive treatment strategies. Magnetic resonance spectroscopy (MRS) is a widely available, noninvasive tool that is used to determine the metabolic characteristics of tumors and provide diagnostic information without the need for tumor tissue. In this study, we investigated the hypothesis that metabolite concentrations measured by MRS would differ between molecular subgroups of medulloblastoma and allow accurate subgroup determination. MRS was used to measure metabolites in medulloblastomas across molecular subgroups (SHH = 12, Groups 3/4 = 17, WNT = 1). Levels of 14 metabolites were analyzed to determine those that were the most discriminant for medulloblastoma subgroups in order to construct a multivariable classifier for distinguishing between combined Group 3/4 and SHH tumors. Medulloblastomas across molecular subgroups revealed distinct spectral features. Group 3 and Group 4 tumors demonstrated metabolic profiles with readily detectable taurine, lower levels of lipids, and high levels of creatine. SHH tumors showed prominent choline and lipid with low levels of creatine and little or no evidence of taurine. A 5-metabolite subgroup classifier inclusive of creatine, myo-inositol, taurine, aspartate, and lipid 13a was developed that could discriminate between Group 3/4 and SHH medulloblastomas with excellent accuracy (cross-validated area under the curve [AUC] = 0.88). The data show that medulloblastomas of Group 3/4 differ metabolically as measured using MRS when compared with SHH molecular subgroups. MRS is a useful and accurate tool to determine medulloblastoma molecular subgroups. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. [Private companies: an opportunity for hepatitis B virus (HBV) prevention and care in Ivory Coast in the wake of HIV/AIDS?].

    Science.gov (United States)

    Bekelynck, A

    2015-02-01

    /AIDS epidemic in Ivory Coast, as relayed by other public and private actors. In the HBV context, private companies can only be a vector for the development of a two tier healthcare system. Therefore, the lack of a strong international commitment prevents public and private local initiatives to generalize HBV prevention and treatment.

  9. Direct investigations of supersymmetry: subgroup summary report

    Energy Technology Data Exchange (ETDEWEB)

    Stephen P Martin et al.

    2003-01-02

    A recurring element of the discussions in the Snowmass study is that there is a need and opportunity for improved theoretical tools in preparation for the discovery of Supersymmetry (SUSY). In order to be competitive with mass measurements at the LHC and a linear collider (LC), predictions of sparticle and Higgs masses from given model parameters need to be improved by an order of magnitude in some cases. There is also room for growth and improvement in (Monte Carlo) SUSY event generators. It seems injudicious to discuss priorities in the field of direct SUSY detection independently of having established directly the existence and mass of the Higgs since it is the particle that led to the founding of SUSY models. But under the hypothesis that a light Higgs exists with mass compatible with SUSY, then they should discuss such priorities. As outlined in section III in the context of the flavor-respecting minimal supersymmetric standard model (MSSM), there is no fundamental symmetry to tie, e.g., squark masses to slepton masses, or the gluino mass to the chargino mass or the chargino mass to the neutralino mass. However, models such as mSUGRA do lead to such relationships and LHC studies show that the heaviest super-partners, the squarks and the gluino should be observable for masses up to about 2.5 TeV at the LHC in such models. Depending on the actual decay chains, some other superpartners may be identifiable in the cascade decays of the quarks and the gluino. On the other hand a LC with CM energy of 1 TeV could comprehensively explore and discover superpartners with masses less than 0.5 TeV largely independently of their nature (neutral, charged, strong, electroweak) and decay modes. In most supersymmetric models, the chargino and neutralino and often the sleptons are much lighter than the squarks and gluino. A VLHC could extend the mass reach for squarks and the gluino but would not necessarily add much value if these had already been seen at the LHC. In summary

  10. Programmes for the prevention of parent-to-child transmission of HIV in Papua New Guinea: Health system challenges and opportunities.

    Science.gov (United States)

    Tynan, Anna; Vallely, Lisa; Kupul, Martha; Neo, Ruthy; Fiya, Voletta; Worth, Heather; Kariwiga, Grace; Mola, Glen D L; Kaldor, John; Kelly-Hanku, Angela

    2017-09-27

    Prevention of parent-to-child transmission (PPTCT) of HIV is a highly complex package of interventions, which spans services in both maternal and child health programmes. In Papua New Guinea (PNG), a commitment to ensure that all pregnant women and their partners have access to the full range of PPTCT interventions exists; however, efforts to increase access and utilisation of PPTCT remain far from optimal. The aim of this paper is to examine health care worker (HCW) perception of health system factors impacting on the performance of PPTCT programmes. Sixteen interviews were undertaken with HCWs involved in the PPTCT programme. Application of the WHO 6 building blocks of a health system was applied, and further thematic analysis was conducted on the data with assistance from the analysis software NVivo. Broken equipment, problems with access to medication and supplies, and poorly supported workforce were reported as barriers for implementing a successful PPTCT programme. The absence of central coordination of this complex, multistaged programme was also recognised as a key issue. The study findings highlight an important need for investment in appropriately trained and supported HCWs and integration of services at each stage of the PPTCT programme. Lessons from the PPTCT experience in PNG may inform policy discussions and considerations in other similar contexts. Copyright © 2017 John Wiley & Sons, Ltd.

  11. On solvable spherical subgroups of semisimple algebraic groups (report version)

    OpenAIRE

    Avdeev, Roman

    2010-01-01

    A new approach to classification of solvable spherical subgroups of semisimple algebraic groups is considered. This approach is completely different from the known approach by D. Luna and provides an explicit classification.

  12. The central subgroup of the nonabelian tensor square of Bieberbach ...

    African Journals Online (AJOL)

    A Bieberbach group with point group C2 xC2 is a free torsion crystallographic group. A central subgroup of a nonabelian tensor square of a group G, denoted by ∇(G) is a normal subgroup generated by generator g⊗g for all g∈G and essentially depends on the abelianization of the group. In this paper, the formula of the ...

  13. Opportunity-based age replacement: exponentially distributed times between opportunities

    NARCIS (Netherlands)

    R. Dekker (Rommert); M.C. Dijkstra (Matthijs)

    1992-01-01

    textabstractThis article gives a full analysis of a component-replacement model in which preventive replacements are only possible at maintenance opportunities. These oppertunities arise according to a Poisson process, independently of failures of the component. Conditions for the existence of a

  14. Preventing Youth Violence: Opportunities for Action

    Science.gov (United States)

    David-Ferdon, Corinne; Simon, Thomas R.

    2014-01-01

    All forms of violence, including youth violence, suicidal behavior, child maltreatment, sexual violence, intimate partner violence, and elder abuse, negatively affect the health and well-being of this country. Youth violence, in particular, is a significant public health problem. Many young people and communities view the grim facts about youth…

  15. Cigarette package design: opportunities for disease prevention.

    Science.gov (United States)

    Difranza, J R; Clark, D M; Pollay, R W

    2002-06-15

    To learn how cigarette packages are designed and to determine to what extent cigarette packages are designed to target children. A computer search was made of all Internet websites that post tobacco industry documents using the search terms: packaging, package design, package study, box design, logo, trademark and design study. All documents were retrieved electronically and analyzed by the first author for recurrent themes. Cigarette manufacturers devote a great deal of attention and expense to package design because it is central to their efforts to create brand images. Colors, graphic elements, proportioning, texture, materials and typography are tested and used in various combinations to create the desired product and user images. Designs help to create the perceived product attributes and project a personality image of the user with the intent of fulfilling the psychological needs of the targeted type of smoker. The communication of these images and attributes is conducted through conscious and subliminal processes. Extensive testing is conducted using a variety of qualitative and quantitative research techniques. The promotion of tobacco products through appealing imagery cannot be stopped without regulating the package design. The same marketing research techniques used by the tobacco companies can be used to design generic packaging and more effective warning labels targeted at specific consumers.

  16. Cigarette package design: opportunities for disease prevention

    Directory of Open Access Journals (Sweden)

    Pollay RW

    2003-01-01

    Full Text Available Abstract Objective To learn how cigarette packages are designed and to determine to what extent cigarette packages are designed to target children. Methods A computer search was made of all Internet websites that post tobacco industry documents using the search terms: packaging, package design, package study, box design, logo, trademark and design study. All documents were retrieved electronically and analyzed by the first author for recurrent themes. Data Synthesis Cigarette manufacturers devote a great deal of attention and expense to package design because it is central to their efforts to create brand images. Colors, graphic elements, proportioning, texture, materials and typography are tested and used in various combinations to create the desired product and user images. Designs help to create the perceived product attributes and project a personality image of the user with the intent of fulfilling the psychological needs of the targeted type of smoker. The communication of these images and attributes is conducted through conscious and subliminal processes. Extensive testing is conducted using a variety of qualitative and quantitative research techniques. Conclusion The promotion of tobacco products through appealing imagery cannot be stopped without regulating the package design. The same marketing research techniques used by the tobacco companies can be used to design generic packaging and more effective warning labels targeted at specific consumers.

  17. Opportunities and costs for preventing vertebrate extinctions

    DEFF Research Database (Denmark)

    Conde, Dalia Amor; Colchero, Fernando; Güneralp, Burak

    2015-01-01

    Despite an increase in policy and management responses to the global biodiversity crisis, implementation of the 20 Aichi Biodiversity Targets still shows insufficient progress [1] . These targets, strategic goals defined by the United Nations Convention on Biological Diversity (CBD), address majo...

  18. Cluster analysis of clinical data identifies fibromyalgia subgroups.

    Directory of Open Access Journals (Sweden)

    Elisa Docampo

    Full Text Available INTRODUCTION: Fibromyalgia (FM is mainly characterized by widespread pain and multiple accompanying symptoms, which hinder FM assessment and management. In order to reduce FM heterogeneity we classified clinical data into simplified dimensions that were used to define FM subgroups. MATERIAL AND METHODS: 48 variables were evaluated in 1,446 Spanish FM cases fulfilling 1990 ACR FM criteria. A partitioning analysis was performed to find groups of variables similar to each other. Similarities between variables were identified and the variables were grouped into dimensions. This was performed in a subset of 559 patients, and cross-validated in the remaining 887 patients. For each sample and dimension, a composite index was obtained based on the weights of the variables included in the dimension. Finally, a clustering procedure was applied to the indexes, resulting in FM subgroups. RESULTS: VARIABLES CLUSTERED INTO THREE INDEPENDENT DIMENSIONS: "symptomatology", "comorbidities" and "clinical scales". Only the two first dimensions were considered for the construction of FM subgroups. Resulting scores classified FM samples into three subgroups: low symptomatology and comorbidities (Cluster 1, high symptomatology and comorbidities (Cluster 2, and high symptomatology but low comorbidities (Cluster 3, showing differences in measures of disease severity. CONCLUSIONS: We have identified three subgroups of FM samples in a large cohort of FM by clustering clinical data. Our analysis stresses the importance of family and personal history of FM comorbidities. Also, the resulting patient clusters could indicate different forms of the disease, relevant to future research, and might have an impact on clinical assessment.

  19. Subgroup analysis in burnout: relations between fatigue, anxiety and depression

    Directory of Open Access Journals (Sweden)

    Arno eVan Dam

    2016-02-01

    Full Text Available Several authors have suggested that burned out patients do not form a homogeneous group and that subgroups should be considered. The identification of these subgroups may contribute to a better understanding of the burnout construct and lead to more specific therapeutic interventions. Subgroup analysis may also help clarify whether burnout is a distinct entity and whether subgroups of burnout overlap with other disorders such as depression and chronic fatigue syndrome. In a group of 113 clinically-diagnosed burned out patients, levels of fatigue, depression and anxiety were assessed. In order to identify possible subgroups, we performed a two-step cluster analysis. The analysis revealed two clusters that differed from one another in terms of symptom severity on the three aforementioned measures. Depression appeared to be the strongest predictor of group membership. These results are considered in the light of the scientific debate on whether burnout can be distinguished from depression and whether burnout subtyping is useful. Finally, implications for clinical practice and future research are discussed.

  20. Genetically meaningful phenotypic subgroups in autism spectrum disorders.

    Science.gov (United States)

    Veatch, O J; Veenstra-Vanderweele, J; Potter, M; Pericak-Vance, M A; Haines, J L

    2014-03-01

    Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with strong evidence for genetic susceptibility. However, the effect sizes for implicated chromosomal loci are small, hard to replicate and current evidence does not explain the majority of the estimated heritability. Phenotypic heterogeneity could be one phenomenon complicating identification of genetic factors. We used data from the Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule, Vineland Adaptive Behavior Scales, head circumferences, and ages at exams as classifying variables to identify more clinically similar subgroups of individuals with ASD. We identified two distinct subgroups of cases within the Autism Genetic Resource Exchange dataset, primarily defined by the overall severity of evaluated traits. In addition, there was significant familial clustering within subgroups (odds ratio, OR ≈ 1.38-1.42, P definition that should increase power to detect genetic factors influencing risk for ASD. © 2013 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

  1. Prospective effects of hearing status on loneliness and depression in older persons: identification of subgroups.

    Science.gov (United States)

    Pronk, Marieke; Deeg, Dorly J H; Smits, Cas; van Tilburg, Theo G; Kuik, Dirk J; Festen, Joost M; Kramer, Sophia E

    2011-12-01

    To determine the possible longitudinal relationships between hearing status and depression, and hearing status and loneliness in the older population. Multiple linear regression analyses were used to assess the associations between baseline hearing and 4-year follow-up of depression, social loneliness, and emotional loneliness. Hearing was measured both by self-report and a speech-in-noise test. Each model was corrected for age, gender, hearing aid use, baseline wellbeing, and relevant confounders. Subgroup effects were tested using interaction terms. We used data from two waves of the Longitudinal Aging Study Amsterdam (2001-02 and 2005-06, ages 63-93). Sample sizes were 996 (self-report (SR) analyses) and 830 (speech-in-noise test (SNT) analyses). Both hearing measures showed significant adverse associations with both loneliness measures (p loneliness model) and men (SR and SNT-emotional loneliness model). No significant effects appeared for depression. We found significant adverse effects of poor hearing on emotional and social loneliness for specific subgroups of older persons. Future research should confirm the subgroup effects and may contribute to the development of tailored prevention and intervention programs.

  2. Personality does not distinguish people with fibromyalgia but identifies subgroups of patients.

    Science.gov (United States)

    Torres, Xavier; Bailles, Eva; Valdes, Manuel; Gutierrez, Fernando; Peri, Josep-Maria; Arias, Anna; Gomez, Emili; Collado, Antonio

    2013-01-01

    The objectives were to compare the personality of fibromyalgia (FM) patients with other chronic painful and nonpainful disorders considering the confusion due to psychopathology and to assess the clustering of FM patients according to their personality profile. Differences in the NEO Five-Factor Inventory between FM, non-FM chronic pain and drug-resistant epileptic patients were assessed including the confounding effect of demographics and psychopathological status by multivariate regression analysis. Clustering of FM patients was assessed by two-step cluster analysis. Differences in clinical severity and psychosocial problems between subgroups and their outcome 6 months after multidisciplinary treatment were assessed. The final sample comprised 874 patients. Once the effect of confounding variables was considered, clinically nonsignificant differences in personality were observed between groups. FM patients could, however, be grouped into two clusters. Cluster 1 was characterized by higher neuroticism and lower extraversion and showed a worse pretreatment clinical state including more psychosocial problems. In spite of having reached a wider general improvement at 6-month follow-up, Cluster 1 patients remained more anxious and depressed. Identifying personality-based subgroups of FM might allow implementing specific preventive strategies. FM treatment might be optimized by increasing medication compliance, improving therapeutic alliance and testing different therapeutic options and treatment sequencing for each personality subgroup. © 2013.

  3. Polymorphisms at the ABO locus in subgroup A individuals.

    Science.gov (United States)

    Olsson, M L; Chester, M A

    1996-04-01

    The common ABO allele sequences are known, but little or no genetic information is available on the rare but important A subgroups. Blood group ABO polymorphism was analyzed in genomic DNA from 45 rare subgroup A individuals by sequence-specific primer polymerase chain reaction and amplified fragment length polymorphism investigating exons VI and VII in the ABO genes. These methods are used to detect specific mutations only, and not all changes that might be present can be detected. ABO genotypes discriminating six alleles (A1, A2, B, O1, O1var, and O2) were determined. The C-->T substitution at nucleotide position 467 (C467T) is not restricted to A2 and cis-AB individuals, but was found also in some A subgroups. Detection of the functionally more relevant C1060-single-point deletion in A2 was accomplished by a novel sequence-specific primer polymerase chain reaction approach. A 100-percent correlation between the C467T and the C1060-mutations was found. Fifteen of 17 samples showing the T646A mutation (described earlier in one case of Ax) showed a positive correlation with the C771T mutation in a frequently occurring O1var allele. The two exceptions were defined serologically as Ax. Indications have been found of an evolutionary relationship between A1 alleles and Ael and A3 subgroups as well as between A2 alleles and Aend and Aweak subgroups. Genetic heterogeneity within the Ax and Aint subgroups was also seen.

  4. Subgroups of some Fuchsian groups defined by two linear congruences

    Science.gov (United States)

    Yayenie, Omer

    In this article we define a new family of subgroups of Fuchsian groups H(√{m}) , for a squarefree positive integer m , and calculate their index in H(√{m}) and their parabolic class number. Moreover, we will show that the index of these subgroups is closely related to the solvability of a quadratic congruence x2≡ m(mod n) and the number of inequivalent solutions of a quadratic congruence x2≡ 1(mod n) . Finally, we will show that the results obtained by Yilmaz and Keskin [Acta Math. Sin 25 (2005), 215-222] are immediate corollaries of one of the main theorems of this article.

  5. Identities on maximal subgroups of GLn(D)

    International Nuclear Information System (INIS)

    Kiani, D.; Mahdavi-Hezavehi, M.

    2002-04-01

    Let D be a division ring with centre F. Assume that M is a maximal subgroup of GL n (D), n≥1 such that Z(M) is algebraic over F. Group identities on M and polynomial identities on the F-linear hull F[M] are investigated. It is shown that if F[M] is a PI-algebra, then [D:F] n (D) and M is a maximal subgroup of N. If M satisfies a group identity, it is shown that M is abelian-by-finite. (author)

  6. Caffeine for Apnea of Prematurity trial: benefits may vary in subgroups.

    Science.gov (United States)

    Davis, Peter G; Schmidt, Barbara; Roberts, Robin S; Doyle, Lex W; Asztalos, Elizabeth; Haslam, Ross; Sinha, Sunil; Tin, Win

    2010-03-01

    To determine whether the benefits of caffeine vary in three subgroups of 2006 participants in the Caffeine for Apnea of Prematurity (CAP) trial. Post-hoc subgroup analyses were performed on the basis of: (1) indication for commencement of study drug: treat apnea, prevent apnea, or facilitate extubation; (2) positive pressure ventilation (PPV) at randomization: endotracheal tube (ETT), noninvasive ventilation, or none; and (3) timing of commencement of study drug: early or late (3 days). Outcomes assessed were those showing treatment effects in the original analyses. We investigated the consistency of caffeine effects by using regression models that incorporated treatment/subgroup factor interactions. There was little evidence of a differential treatment effect of caffeine in subgroups defined by the clinical indication for starting study drug. The size and direction of the caffeine effect on death or disability differed depending on PPV at randomization (P = .03). Odds ratios (95% CI) were: no support, 1.32 (0.81-2.14); noninvasive support, 0.73 (0.52-1.03); and ETT, 0.73 (0.57-0.94). Adjustment for baseline factors strengthened this effect (P = .02). Starting caffeine early resulted in larger reductions in days of respiratory support. Postmenstrual age at time of discontinuing PPV was shorter with earlier treatment (P = .01). Mean differences (95% CI) were: early, 1.35 weeks (0.90-1.81); and late 0.55 weeks (-0.11-0.99). Adjustment for baseline factors weakened this effect (P = .03). There is evidence of variable beneficial effects of caffeine. Infants receiving respiratory support appeared to derive more neurodevelopmental benefits from caffeine than infants not receiving support. Earlier initiation of caffeine may be associated with a greater reduction in time on ventilation. Copyright 2010 Mosby, Inc. All rights reserved.

  7. The effect of active video games by ethnicity, sex and fitness: subgroup analysis from a randomised controlled trial.

    Science.gov (United States)

    Foley, Louise; Jiang, Yannan; Ni Mhurchu, Cliona; Jull, Andrew; Prapavessis, Harry; Rodgers, Anthony; Maddison, Ralph

    2014-04-03

    The prevention and treatment of childhood obesity is a key public health challenge. However, certain groups within populations have markedly different risk profiles for obesity and related health behaviours. Well-designed subgroup analysis can identify potential differential effects of obesity interventions, which may be important for reducing health inequalities. The study aim was to evaluate the consistency of the effects of active video games across important subgroups in a randomised controlled trial (RCT). A two-arm, parallel RCT was conducted in overweight or obese children (n=322; aged 10-14 years) to determine the effect of active video games on body composition. Statistically significant overall treatment effects favouring the intervention group were found for body mass index, body mass index z-score and percentage body fat at 24 weeks. For these outcomes, pre-specified subgroup analyses were conducted among important baseline demographic (ethnicity, sex) and prognostic (cardiovascular fitness) groups. No statistically significant interaction effects were found between the treatment and subgroup terms in the main regression model (p=0.36 to 0.93), indicating a consistent treatment effect across these groups. Preliminary evidence suggests an active video games intervention had a consistent positive effect on body composition among important subgroups. This may support the use of these games as a pragmatic public health intervention to displace sedentary behaviour with physical activity in young people.

  8. Adhikari SD Zero-sum problems with subgroup weights 259 ...

    Indian Academy of Sciences (India)

    AUTHOR INDEX. Adhikari S D. Zero-sum problems with subgroup weights. 259. Alaeiyan Mehdi. Semisymmetric cubic graphs of order. 16p2. 19. Alexandru V. On the Iwasawa algebra associated to a normal element of Cp. 45. Alzer Horst. Integral inequalities for self-reciprocal polynomials. 131. Ambily A A see Adhikari S D.

  9. Minnesota Multiphasic Personality Inventory Profiles Among Subgroups of Unwed Mothers

    Science.gov (United States)

    Horn, Joseph M.; Turner, Robert Gerald

    1976-01-01

    To identify replicable homogeneous subgroups among three samples of unwed mothers a multivariate clustering technique was employed to analyze the Minnesota Multiphasic Personality Inventory (MMPI) responses of unwed mothers giving up their babies for adoption (Ns=122 and 127) and unwed mothers keeping their babies (N=47). Three personality…

  10. On Subgroups of Non-Commutative General Rhotrix Group ...

    African Journals Online (AJOL)

    On Subgroups of Non-Commutative General Rhotrix Group. A Mohammed, UE Okon. Abstract. This paper considers the pair (GRn(F),o) consisting of the set of all invertible rhotrices of size n over an arbitrary field F; and together with the binary operation of row-column based method for rhotrix multiplication; 'o' , in order to ...

  11. Single-Phase Mail Survey Design for Rare Population Subgroups

    Science.gov (United States)

    Brick, J. Michael; Andrews, William R.; Mathiowetz, Nancy A.

    2016-01-01

    Although using random digit dialing (RDD) telephone samples was the preferred method for conducting surveys of households for many years, declining response and coverage rates have led researchers to explore alternative approaches. The use of address-based sampling (ABS) has been examined for sampling the general population and subgroups, most…

  12. On approximation of Lie groups by discrete subgroups

    Indian Academy of Sciences (India)

    voila.fr; salah.suissi@yahoo.fr. MS received 11 August 2012; revised 27 January 2013. Abstract. A locally compact group G is said to be approximated by discrete sub- groups (in the sense of Tôyama) if there is a sequence of discrete subgroups ...

  13. electropherotypes and subgroups of group a rotaviruses circulating ...

    African Journals Online (AJOL)

    Emmanuel Ameh

    diarrhea caused by rotaviruses. The virus is a double stranded RNA (dsRNA) virus with 11 segments. Group A rotaviruses show a characteristic 4-2-3-2 pattern following electrophoresis. The VP6 subgroups, I and II exist. This work was carried out to study the prevalence of rotavirus infection among children 0-5 years with ...

  14. Notes on discrete subgroups of Möbius transformations

    Indian Academy of Sciences (India)

    Notes on discrete subgroups of Möbius transformations. HUA WANG1, YUEPING JIANG2 and WENSHENG CAO3. 1Department of Mathematics, Changsha University of Science and Technology,. Changsha, Hunan 410076, People's Republic of China. 2Department of Applied Mathematics, Hunan University, Changsha ...

  15. On approximation of Lie groups by discrete subgroups

    Indian Academy of Sciences (India)

    2016-08-26

    Aug 26, 2016 ... The notion of approximation of Lie groups by discrete subgroups was introduced by Tôyama in Kodai Math. Sem. Rep. 1 (1949) 36–37 and investigated in detail by Kuranishi in Nagoya Math. J. 2 (1951) 63–71. It is known as a theorem of Tôyama that any connected Lie group approximated by discrete ...

  16. Practical Algorithms for Subgroup Detection in Covert Networks

    DEFF Research Database (Denmark)

    Memon, Nasrullah; Wiil, Uffe Kock; Qureshi, Pir Abdul Rasool

    2010-01-01

    In this paper, we present algorithms for subgroup detection and demonstrated them with a real-time case study of USS Cole bombing terrorist network. The algorithms are demonstrated in an application by a prototype system. The system finds associations between terrorist and terrorist organisations...

  17. Upper bounds for reversible circuits based on Young subgroups

    DEFF Research Database (Denmark)

    Abdessaied, Nabila; Soeken, Mathias; Thomsen, Michael Kirkedal

    2014-01-01

    We present tighter upper bounds on the number of Toffoli gates needed in reversible circuits. Both multiple controlled Toffoli gates and mixed polarity Toffoli gates have been considered for this purpose. The calculation of the bounds is based on a synthesis approach based on Young subgroups...

  18. Avian metapneumovirus subgroup C infection in chickens, China.

    Science.gov (United States)

    Wei, Li; Zhu, Shanshan; Yan, Xv; Wang, Jing; Zhang, Chunyan; Liu, Shuhang; She, Ruiping; Hu, Fengjiao; Quan, Rong; Liu, Jue

    2013-07-01

    Avian metapneumovirus causes acute respiratory tract infection and reductions in egg production in various avian species. We isolated and characterized an increasingly prevalent avian metapneumovirus subgroup C strain from meat-type commercial chickens with severe respiratory signs in China. Culling of infected flocks could lead to economic consequences.

  19. Avian Metapneumovirus Subgroup C Infection in Chickens, China

    OpenAIRE

    Wei, Li; Zhu, Shanshan; Yan, Xv; Wang, Jing; Zhang, Chunyan; Liu, Shuhang; She, Ruiping; Hu, Fengjiao; Quan, Rong; Liu, Jue

    2013-01-01

    Avian metapneumovirus causes acute respiratory tract infection and reductions in egg production in various avian species. We isolated and characterized an increasingly prevalent avian metapneumovirus subgroup C strain from meat-type commercial chickens with severe respiratory signs in China. Culling of infected flocks could lead to economic consequences.

  20. A note on TI-subgroups of finite groups

    Indian Academy of Sciences (India)

    and LINNA PANG. Department of Mathematics, Guangxi Normal University, Guangxi, Guilin 541004,. People's Republic of China. ∗Author to whom correspondence should be addressed. E-mail: jklu@mailbox.gxnu.edu.cn. MS received 27 November 2010; revised 29 August 2011. Abstract. A subgroup H of a finite group G ...

  1. Notes on discrete subgroups of Möbius transformations

    Indian Academy of Sciences (India)

    Abstract. Jørgensen's inequality gives a necessary condition for a nonelementary two generator subgroup of SL(2, C) to be discrete. By embedding SL(2, C) into. ˆU(1, 1; H), we obtain a new type of Jørgensen's inequality, which is in terms of the coefficients of involved isometries. We provide an example to show that this ...

  2. Characteristic properties of large subgroups in primary abelian groups

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    Current address: 13, General Kutuzov Street, Block 7, Floor 2, Flat 4, 4003 Plovdiv,. Bulgaria. E-mail: pvdanchev@yahoo.com. MS received 27 May 2002; revised 19 May 2004. Abstract. Suppose G is an arbitrary additively written primary abelian group with a fixed large subgroup L. It is shown that G is (a) summable; ...

  3. Post hoc subgroups in clinical trials: Anathema or analytics?

    Science.gov (United States)

    Weisberg, Herbert I; Pontes, Victor P

    2015-08-01

    There is currently much interest in generating more individualized estimates of treatment effects. However, traditional statistical methods are not well suited to this task. Post hoc subgroup analyses of clinical trials are fraught with methodological problems. We suggest that the alternative research paradigm of predictive analytics, widely used in many business contexts, can be adapted to help. We compare the statistical and analytics perspectives and suggest that predictive modeling should often replace subgroup analysis. We then introduce a new approach, cadit modeling, that can be useful to identify and test individualized causal effects. The cadit technique is particularly useful in the context of selecting from among a large number of potential predictors. We describe a new variable-selection algorithm that has been applied in conjunction with cadit. The cadit approach is illustrated through a reanalysis of data from the Randomized Aldactone Evaluation Study trial, which studied the efficacy of spironolactone in heart-failure patients. The trial was successful, but a serious adverse effect (hyperkalemia) was subsequently discovered. Our reanalysis suggests that it may be possible to predict the degree of hyperkalemia based on a logistic model and to identify a subgroup in which the effect is negligible. Cadit modeling is a promising alternative to subgroup analyses. Cadit regression is relatively straightforward to implement, generates results that are easy to present and explain, and can mesh straightforwardly with many variable-selection algorithms. © The Author(s) 2015.

  4. Non-meagre subgroups of reals disjoint with meagre sets

    Czech Academy of Sciences Publication Activity Database

    Kostana, Ziemowit

    2018-01-01

    Roč. 241, June (2018), s. 11-19 ISSN 0166-8641 Institutional support: RVO:67985840 Keywords : algebraic sum * Baire property * non-meaurable subgroup Subject RIV: BA - General Mathematics OBOR OECD: Pure mathematics Impact factor: 0.377, year: 2016 https://www.sciencedirect.com/science/ article /pii/S0166864118300567

  5. Non-meagre subgroups of reals disjoint with meagre sets

    Czech Academy of Sciences Publication Activity Database

    Kostana, Ziemowit

    2018-01-01

    Roč. 241, June (2018), s. 11-19 ISSN 0166-8641 Institutional support: RVO:67985840 Keywords : algebraic sum * Baire property * non-meaurable subgroup Subject RIV: BA - General Mathematics OBOR OECD: Pure mathematics Impact factor: 0.377, year: 2016 https://www. science direct.com/ science /article/pii/S0166864118300567

  6. Cluster Analysis of Clinical Data Identifies Fibromyalgia Subgroups

    Science.gov (United States)

    Docampo, Elisa; Collado, Antonio; Escaramís, Geòrgia; Carbonell, Jordi; Rivera, Javier; Vidal, Javier; Alegre, José

    2013-01-01

    Introduction Fibromyalgia (FM) is mainly characterized by widespread pain and multiple accompanying symptoms, which hinder FM assessment and management. In order to reduce FM heterogeneity we classified clinical data into simplified dimensions that were used to define FM subgroups. Material and Methods 48 variables were evaluated in 1,446 Spanish FM cases fulfilling 1990 ACR FM criteria. A partitioning analysis was performed to find groups of variables similar to each other. Similarities between variables were identified and the variables were grouped into dimensions. This was performed in a subset of 559 patients, and cross-validated in the remaining 887 patients. For each sample and dimension, a composite index was obtained based on the weights of the variables included in the dimension. Finally, a clustering procedure was applied to the indexes, resulting in FM subgroups. Results Variables clustered into three independent dimensions: “symptomatology”, “comorbidities” and “clinical scales”. Only the two first dimensions were considered for the construction of FM subgroups. Resulting scores classified FM samples into three subgroups: low symptomatology and comorbidities (Cluster 1), high symptomatology and comorbidities (Cluster 2), and high symptomatology but low comorbidities (Cluster 3), showing differences in measures of disease severity. Conclusions We have identified three subgroups of FM samples in a large cohort of FM by clustering clinical data. Our analysis stresses the importance of family and personal history of FM comorbidities. Also, the resulting patient clusters could indicate different forms of the disease, relevant to future research, and might have an impact on clinical assessment. PMID:24098674

  7. Clinical implications of medulloblastoma subgroups: incidence of CSF diversion surgery.

    Science.gov (United States)

    Schneider, Christian; Ramaswamy, Vijay; Kulkarni, Abhaya V; Rutka, James T; Remke, Marc; Tabori, Uri; Hawkins, Cynthia; Bouffet, Eric; Taylor, Michael D

    2015-03-01

    While medulloblastoma was initially thought to comprise a single homogeneous entity, it is now accepted that it in fact comprises 4 discrete subgroups, each with its own distinct demographics, clinical presentation, transcriptomics, genetics, and outcome. Hydrocephalus is a common complication of medulloblastoma and not infrequently requires CSF diversion. The authors report the incidence of CSF diversion surgery in each of the subgroups of medulloblastoma (Wnt, Shh, Group 3, and Group 4). The medical and imaging records for patients who underwent surgery for medulloblastoma at The Hospital for Sick Children were retrospectively reviewed. The primary outcome was the requirement for CSF diversion surgery either before or within 60 days of tumor resection. The modified Canadian Preoperative Prediction Rule for Hydrocephalus (mCPPRH) was compared among subgroups. Of 143 medulloblastoma patients, treated from 1991 to 2013, sufficient data were available for 130 patients (15 with Wnt, 30 with Shh, 30 with Group 3, and 55 with Group 4 medulloblastomas). Of these, 28 patients (22%) ultimately underwent CSF diversion surgery: 0% with Wnt, 29% with Shh, 29% with Group 3, and 43% with Group 4 tumors. Patients in the Wnt subgroup had a lower incidence of CSF diversion than all other patients combined (p = 0.04). Wnt patients had a lower mCPPRH score (lower risk of CSF diversion, p = 0.045), were older, had smaller ventricles at diagnosis, and had no leptomeningeal metastases. The overall rate of CSF diversion surgery for Shh, Group 3, and Group 4 medulloblastomas is around 30%, but no patients in the present series with a Wnt medulloblastoma required shunting. The low incidence of hydrocephalus in patients with Wnt medulloblastoma likely reflects both host factors (age) and disease factors (lack of metastases). The absence of hydrocephalus in patients with Wnt medulloblastomas likely contributes to their excellent rate of survival and may also contribute to a higher quality

  8. Differences in Psychosocial Predictors of Obesity Among LGBT Subgroups.

    Science.gov (United States)

    Warren, Jacob C; Smalley, K Bryant; Barefoot, K Nikki

    2016-08-01

    The purpose of the current study was to examine the overall presence of and differences in rates of overweight/obesity among a large, nationally diverse sample of lesbian, gay, bisexual, transgender (LGBT)-identified individuals (i.e., cisgender lesbians, cisgender gay men, cisgender bisexual women, cisgender bisexual men, transgender women, and transgender men) and to identify specific psychosocial predictors of obesity within each of the six LGBT subgroups. A total of 2702 LGBT-identified participants participated in the online study. Participants completed a series of demographic questions (including weight and height) and the Depression Anxiety Stress Scale 21. The percentage of participants who were overweight/obese did not differ significantly across LGBT subgroups, with 61.1% of the total sample being overweight/obese. However, the percentage of participants who self-reported body mass indexes in the obese range differed significantly across the six LGBT subgroups, with the highest prevalence in transgender men (46.0%). In addition, the predictors of obesity varied by subgroup, with age a significant predictor for cisgender lesbians, cisgender gay men, and cisgender bisexual women, relationship status for cisgender bisexual women, employment status for both cisgender gay men and cisgender bisexual women, education level for cisgender lesbians, and depression, anxiety, and stress for cisgender gay men. None of the examined psychosocial factors emerged as predictors of obesity for cisgender bisexual men, transgender women, or transgender men. These findings suggest that there are substantial variations in the presence and predictors of obesity across LGBT subgroups that support the need for culturally tailored healthy weight promotion efforts within the LGBT community.

  9. Differences in knowledge, attitudes, beliefs, and perceived risks regarding colorectal cancer screening among Chinese, Korean, and Vietnamese sub-groups.

    Science.gov (United States)

    Le, T Domi; Carney, Patricia A; Lee-Lin, Frances; Mori, Motomi; Chen, Zunqiu; Leung, Holden; Lau, Christine; Lieberman, David A

    2014-04-01

    Asian ethnic subgroups are often treated as a single demographic group in studies looking at cancer screening and health disparities. To evaluate knowledge and health beliefs associated with colorectal cancer (CRC) and CRC screening among Chinese, Korean, and Vietnamese subgroups, a survey assessed participants' demographic characteristics, healthcare utilization, knowledge, beliefs, attitudes associated with CRC and CRC screening. Exploratory factor analysis identified six factors accounting >60 % of the total variance in beliefs and attitudes. Cronbach's alpha coefficients assessed internal consistency. Differences among Asian subgroups were assessed using a Chi square, Fisher's exact, or Kruskal-Wallis test. Pearson's correlation coefficient assessed an association among factors. 654 participants enrolled: 238 Chinese, 217 Korean, and 199 Vietnamese. Statistically significant differences existed in demographic and health care provider characteristics, knowledge, and attitude/belief variables regarding CRC. These included knowledge of CRC screening modalities, reluctance to discuss cancer, belief that cancer is preventable by diet and lifestyle, and intention to undergo CRC screening. Chinese subjects were more likely to use Eastern medicine (52 % Chinese, 25 % Korean, 27 % Vietnamese; p Korean subjects were less likely to see herbs as a form of cancer prevention (34 % Chinese, 20 % Korean, 35 % Vietnamese; p Korean, 80 % Vietnamese; p < 0.0001). Important differences exist in knowledge, attitudes, and health beliefs among Asian subgroups. Understanding these differences will enable clinicians to deliver tailored, effective health messages to improve CRC screening and other health behaviors.

  10. Prevention of cardiovascular disease guided by total risk estimations - challenges and opportunities for practical implementation: highlights of a CardioVascular Clinical Trialists (CVCT) Workshop of the ESC Working Group on CardioVascular Pharmacology and Drug Therapy.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2011-11-03

    This paper presents a summary of the potential practical and economic barriers to implementation of primary prevention of cardiovascular disease guided by total cardiovascular risk estimations in the general population. It also reviews various possible solutions to overcome these barriers. The report is based on discussion among experts in the area at a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy that took place in September 2009. It includes a review of the evidence in favour of the \\'treat-to-target\\' paradigm, as well as potential difficulties with this approach, including the multiple pathological processes present in high-risk patients that may not be adequately addressed by this strategy. The risk-guided therapy approach requires careful definitions of cardiovascular risk and consideration of clinical endpoints as well as the differences between trial and \\'real-world\\' populations. Cost-effectiveness presents another issue in scenarios of finite healthcare resources, as does the difficulty of documenting guideline uptake and effectiveness in the primary care setting, where early modification of risk factors may be more beneficial than later attempts to manage established disease. The key to guideline implementation is to improve the quality of risk assessment and demonstrate the association between risk factors, intervention, and reduced event rates. In the future, this may be made possible by means of automated data entry and various other measures. In conclusion, opportunities exist to increase guideline implementation in the primary care setting, with potential benefits for both the general population and healthcare resources.

  11. Standard model group, QCD subgroup - dynamics isolating and testing the elementary QCD subprocess

    International Nuclear Information System (INIS)

    Tannenbaum, M.J.

    1982-01-01

    QCD to an experimentalist is the theory of interactions of quarks and gluons. Experimentalists like QCD because QCD is analogous to QED. Thus, following Drell and others who have for many years studied the validity of QED, one has a ready-made menu for tests of QCD. There are the static and long distance tests. These topics are covered by Peter LePage in the static properties group. In this report, dynamic and short distance tests of QCD will be discussed, primarily via reactions with large transverse momenta. This report is an introduction and overview of the subject, to serve as a framework for other reports from the subgroup. In the last two sections, the author has taken the opportunity to discuss his own ideas and opinions

  12. Human rotavirus subgroups and severity of associated diarrhoea in Ghana.

    Science.gov (United States)

    Armah, George E.; Hori, Hiroki; Anyanful, Akwasi; Addo, Julius A.; Commey, Joseph O.; Kamiya, Hitoshi; Nkrumah, Francis K.

    1995-11-01

    In a 12 month study of children with acute diarrhoea seeking medical care in 2 hospitals in Accra, Ghana, 16.3% were found to be infected with human rotaviruses (HRV). Vomiting and diarrhoea were the main symptoms observed. HRV infection was frequently associated with severe diarrhoea. Vomiting was however less frequent in HRV associated diarrhoea than in non HRV diarrhoea. No significant association was observed between the severity of dehydration and HRV infection. Subgroup II HRV was the predominant subgroup identified with the dominant serotypes being HRV serotypes 1 and 4. Poly-acrylamide gel electrophoresis of HRV RNAs isolated from 40 positive stool samples revealed the existence of 7 distinct electrophoretic migration patterns in the study population.

  13. Discrete neurocognitive subgroups in fully or partially remitted bipolar disorder

    DEFF Research Database (Denmark)

    Jensen, Johan Høy; Knorr, Ulla; Vinberg, Maj

    2016-01-01

    controls. Hierarchical cluster analysis was conducted to determine whether there are discrete neurocognitive subgroups in bipolar disorder. The pattern of the cognitive deficits and the characteristics of patients in these neurocognitive subgroups were examined with analyses of covariance and least......BACKGROUND: Neurocognitive impairment in remitted patients with bipolar disorder contributes to functional disabilities. However, the pattern and impact of these deficits are unclear. METHODS: We pooled data from 193 fully or partially remitted patients with bipolar disorder and 110 healthy...... was cross-sectional which limits inferences regarding the causality of the findings. CONCLUSION: Globally and selectively impaired bipolar disorder patients displayed more functional disabilities than those who were cognitively intact. The present findings highlight a clinical need to systematically screen...

  14. Subgroup discovery in data sets with multi-dimensional responses

    OpenAIRE

    Umek, Lan; Zupan, Blaž

    2015-01-01

    Most of the present subgroup discovery approaches aim at finding subsets of attribute-value data with unusual distribution of a single output variable. In general, real-life problems may be described with richer, multi-dimensional descriptions of the outcome. The discovery task in such domains is to find subsets of data instances with similar outcome description that are separable from the rest of the instances in the input space. We have developed a technique that directly addresses this pro...

  15. Supercharacters and pattern subgroups in the upper triangular groups

    OpenAIRE

    Le, Tung

    2010-01-01

    Let $U_n(q)$ denote the upper triangular group of degree $n$ over the finite field $\\F_q$ with $q$ elements. It is known that irreducible constituents of supercharacters partition the set of all irreducible characters $\\Irr(U_n(q)).$ In this paper we present a correspondence between supercharacters and pattern subgroups of the form $U_k(q)\\cap {}^wU_k(q)$ where $w$ is a monomial matrix in $GL_k(q)$ for some $k

  16. Neurocognitive performance as an endophenotype for mood disorder subgroups.

    Science.gov (United States)

    Merikangas, Alison K; Cui, Lihong; Calkins, Monica E; Moore, Tyler M; Gur, Ruben C; Gur, Raquel E; Merikangas, Kathleen R

    2017-06-01

    There is growing evidence that neurocognitive function may be an endophenotype for mood disorders. The goal of this study is to examine the specificity and familiality of neurocognitive functioning across the full range of mood disorder subgroups, including Bipolar I (BP-I), Bipolar II (BP-II), Major Depressive Disorders (MDD), and controls in a community-based family study. A total of 310 participants from 137 families with mood spectrum disorders (n=151) and controls (n=159) completed the University of Pennsylvania's Computerized Neurocognitive Battery (CNB) that assessed the accuracy and speed of task performance across five domains. Mixed effects regression models tested association and familiality. Compared to those without mood disorders, participants with BP-I had increased accuracy in complex cognition, while participants with MDD were more accurate in emotion recognition. There was also a significant familial association for accuracy of complex cognition. Mood disorder subgroups did not differ in performance speed in any of the domains. The small number of BP-I cases, and family size limited the statistical power of these analyses, and the cross-sectional assessment of neurocognitive function precluded our ability to determine whether performance precedes or post dates onset of disorder. This is one of the few community-based family studies of potential neurocognitive endophenotypes that includes the full range of mood disorder subgroups. There were few differences in neurocognitive function except enhanced accuracy in specific domains among those with BP-I and MDD. The differential findings across specific mood disorder subgroups substantiate their heterogeneity in other biologic and endophenotypic domains. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Mondzish: a new subgroup of Lolo-Burmese

    OpenAIRE

    Andrew Hsiu

    2014-01-01

    Abstract The Mondzish languages were recently identified by Ziwo Lama (2012) as a coherent subgroup of Lolo-Burmese, and its most divergent branch as well. They are spoken primarily in Wenshan Prefecture, Yunnan Province, southwestern China. However, Lama (2012) only identified two lects, Maang and Mondzi, as Mondzish languages, and did not classify many other nearby lects that I am convinced are also Mondzish. Here, I will demonstrate that these other lects display the lexical and phonol...

  18. Characteristic properties of large subgroups in primary abelian groups

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    1. Introduction. The main purpose of this article is to study the relations between the structures of primary abelian groups and their ..... Case 2. γ − 2 exists. Let Gγ −1 be a direct summand of Gγ . We remark, in connection with Case 1, that any pγ −1. -high subgroup of Gγ is isomorphic to Gγ −1. As far as Case 2 is concerned, ...

  19. Measuring the speed of aging across population subgroups.

    Science.gov (United States)

    Sanderson, Warren C; Scherbov, Sergei

    2014-01-01

    People in different subgroups age at different rates. Surveys containing biomarkers can be used to assess these subgroup differences. We illustrate this using hand-grip strength to produce an easily interpretable, physical-based measure that allows us to compare characteristic-based ages across educational subgroups in the United States. Hand-grip strength has been shown to be a good predictor of future mortality and morbidity, and therefore a useful indicator of population aging. Data from the Health and Retirement Survey (HRS) were used. Two education subgroups were distinguished, those with less than a high school diploma and those with more education. Regressions on hand-grip strength were run for each sex and race using age and education, their interactions and other covariates as independent variables. Ages of identical mean hand-grip strength across education groups were compared for people in the age range 60 to 80. The hand-grip strength of 65 year old white males with less education was the equivalent to that of 69.6 (68.2, 70.9) year old white men with more education, indicating that the more educated men had aged more slowly. This is a constant characteristic age, as defined in the Sanderson and Scherbov article "The characteristics approach to the measurement of population aging" published 2013 in Population and Development Review. Sixty-five year old white females with less education had the same average hand-grip strength as 69.4 (68.2, 70.7) year old white women with more education. African-American women at ages 60 and 65 with more education also aged more slowly than their less educated counterparts. African American men with more education aged at about the same rate as those with less education. This paper expands the toolkit of those interested in population aging by showing how survey data can be used to measure the differential extent of aging across subpopulations.

  20. Structural divergence between the two subgroups of P5 ATPases

    DEFF Research Database (Denmark)

    Sørensen, Danny Mollerup; Buch-Pedersen, Morten Jeppe; Palmgren, Michael Broberg

    2010-01-01

    Evolution of P5 type ATPases marks the origin of eukaryotes but still they remain the least characterized pumps in the superfamily of P-type ATPases. Phylogenetic analysis of available sequences suggests that P5 ATPases should be divided into at least two subgroups, P5A and P5B. P5A ATPases have....... Together these findings indicate that P5A and P5B ATPases are structurally and functionally different....

  1. A note on TI-subgroups of finite groups

    Indian Academy of Sciences (India)

    A kernel and a complement of a quasi-Frobenius group G are the preimages of a kernel and a complement of the Frobenius group G/Z(G), respectively. Lemma 1.2 [1]. A group G is quasi-Frobenius if and only if G possesses a noncentral subgroup H such that H ∩ Hg ≤ Z(G) for all g ∈ G − H. In this case, H is a comple-.

  2. Effect of duloxetine in patients with fibromyalgia: tiredness subgroups

    OpenAIRE

    Bradley, Laurence A; Bennett, Robert; Russell, Irwin J; Wohlreich, Madelaine M; Chappell, Amy S; Wang, Fujun; D'Souza, Deborah N; Moldofsky, Harvey

    2010-01-01

    Introduction This study tested the hypothesis that baseline ratings of fatigue/tiredness would be negatively associated with the efficacy of duloxetine on measures of pain and functional ability in patients with fibromyalgia. Methods A post hoc analysis of pooled data from 4 double-blind, placebo-controlled studies of duloxetine in fibromyalgia was performed. The fibromyalgia impact questionnaire (FIQ) tiredness item score (0 to 10 scale) was used to define tiredness subgroups. Patients were ...

  3. Effect of duloxetine in patients with fibromyalgia: tiredness subgroups.

    Science.gov (United States)

    Bradley, Laurence A; Bennett, Robert; Russell, Irwin J; Wohlreich, Madelaine M; Chappell, Amy S; Wang, Fujun; D'Souza, Deborah N; Moldofsky, Harvey

    2010-01-01

    This study tested the hypothesis that baseline ratings of fatigue/tiredness would be negatively associated with the efficacy of duloxetine on measures of pain and functional ability in patients with fibromyalgia. A post hoc analysis of pooled data from 4 double-blind, placebo-controlled studies of duloxetine in fibromyalgia was performed. The fibromyalgia impact questionnaire (FIQ) tiredness item score (0 to 10 scale) was used to define tiredness subgroups. Patients were stratified into 3 subgroups: mild (0 to 3), moderate (4 to 6), and severe (7 to 10) tiredness. Analysis of covariance models and logistic regressions were used to test treatment-by-tiredness subgroup interactions. Data from the first 3 months are included in this post hoc analysis (duloxetine N = 797, placebo N = 535). At baseline, the distribution of tiredness severity in the duloxetine and placebo groups respectively was 3.64% and 3.75% mild, 16.71% and 15.57% moderate, and 79.65% and 80.68% severe. Rates of clinically significant (≥30% and ≥50%) improvement in brief pain inventory (BPI) average pain were similar across the tiredness subgroups. Tiredness severity at baseline was not negatively associated with the effects of duloxetine on patients' reports of functional ability using the FIQ total score, FIQ measures of physical impairment, interference with work, pain, stiffness, and depression and the medical outcomes study short form-36 (SF-36). Studies of duloxetine in fibromyalgia have demonstrated clinically significant improvements in pain and functional ability (FIQ, SF-36). This post hoc analysis of data shows that the efficacy of duloxetine among patients with fibromyalgia does not vary as a function of baseline ratings of fatigue/tiredness.

  4. A generalized Frattini subgroup of a finite group

    Directory of Open Access Journals (Sweden)

    Prabir Bhattacharya

    1989-01-01

    Full Text Available For a finite group G and an arbitrary prime p, let SP(G denote the intersection of all maximal subgroups M of G such that [G:M] is both composite and not divisible by p; if no such M exists we set SP(G = G. Some properties of G are considered involving SP(G. In particular, we obtain a characterization of G when each M in the definition of SP(G is nilpotent.

  5. A 6-gene signature identifies four molecular subgroups of neuroblastoma

    Directory of Open Access Journals (Sweden)

    Kogner Per

    2011-04-01

    Full Text Available Abstract Background There are currently three postulated genomic subtypes of the childhood tumour neuroblastoma (NB; Type 1, Type 2A, and Type 2B. The most aggressive forms of NB are characterized by amplification of the oncogene MYCN (MNA and low expression of the favourable marker NTRK1. Recently, mutations or high expression of the familial predisposition gene Anaplastic Lymphoma Kinase (ALK was associated to unfavourable biology of sporadic NB. Also, various other genes have been linked to NB pathogenesis. Results The present study explores subgroup discrimination by gene expression profiling using three published microarray studies on NB (47 samples. Four distinct clusters were identified by Principal Components Analysis (PCA in two separate data sets, which could be verified by an unsupervised hierarchical clustering in a third independent data set (101 NB samples using a set of 74 discriminative genes. The expression signature of six NB-associated genes ALK, BIRC5, CCND1, MYCN, NTRK1, and PHOX2B, significantly discriminated the four clusters (p ALK, BIRC5, and PHOX2B, and was significantly associated with higher tumour stage, poor outcome and poor survival compared to the Type 1-corresponding favourable group (INSS stage 4 and/or dead of disease, p Conclusions Based on expression profiling we have identified four molecular subgroups of neuroblastoma, which can be distinguished by a 6-gene signature. The fourth subgroup has not been described elsewhere, and efforts are currently made to further investigate this group's specific characteristics.

  6. How can latent trajectories of back pain be translated into defined subgroups?

    DEFF Research Database (Denmark)

    Kongsted, Alice; Hestbæk, Lise; Kent, Peter

    2017-01-01

    descriptive definitions, as a way to apply the same definitions of mutually exclusive subgroups across populations. In this study, we investigated if the course trajectories of two LBP cohorts fitted with previously suggested trajectory subgroup definitions, how distinctly different these subgroups were......, and if the subgroup definitions matched with LCA-derived patterns. METHODS: Weekly measures of LBP intensity and frequency during 1 year were available from two clinical cohorts. We applied definitions of 16 possible trajectory subgroups to these observations and calculated the prevalence of the subgroups...... LBP than 'episodic LBP' subgroups. CONCLUSION: Previously suggested definitions of LBP trajectory subgroups could be readily applied to patients' observed data resulting in subgroups that matched well with LCA-derived trajectory patterns. We suggest that the number of trajectory subgroups can...

  7. Gambaran Populasi Golongan Darah Subgroup A (A1, A2 di PMI Kulon Progo

    Directory of Open Access Journals (Sweden)

    Hieronymus Rayi Prasetya

    2017-08-01

    Full Text Available Subgroup A1 and A2 are the most important in the blood group A. Subgroup A1 has the A antigen more than A2 subgroup, the A2 subgroup can cause misidentification of blood group due to poor A antigen and genetic variation possessed. Misidentification of the blood group will increase the risk of transfusion reactions. This research aims to describe the A1 and A2 subgroup population in Kulon Progo district. This study was conducted with a cross sectional sampling technique. The sample in this study were taken from donors of blood group A in Kulon Progo Red Cross. Identification of A1 and A2 subgroup is done by using lectin (Dolichos biflorus extract. The result of the examination of 53 samples showed that 96,2% was A1 subgroup and 3,8% was A2 subgroup. Key words : Subgroup A1, Subgroup A2, Population, Kulon Progo

  8. Religious subgroups influencing vaccination coverage in the Dutch Bible belt: an ecological study

    Directory of Open Access Journals (Sweden)

    Knippenberg Hans

    2011-02-01

    Full Text Available Abstract Background The Netherlands has experienced epidemics of vaccine preventable diseases largely confined to the Bible belt, an area where -among others- orthodox protestant groups are living. Lacking information on the vaccination coverage in this minority, and its various subgroups, control of vaccine preventable diseases is focused on the geographical area of the Bible belt. However, the adequacy of this strategy is questionable. This study assesses the influence of presence of various orthodox protestant subgroups (orthodox protestant denominations, OPDs on municipal vaccination coverage in the Bible belt. Methods We performed an ecological study at municipality level. Data on number of inhabitants, urbanization level, socio-economical status, immigration and vaccination coverage were obtained from national databases. As religion is not registered in the Netherlands, membership numbers of the OPDs had to be obtained from church year books and via church offices. For all municipalities in the Netherlands, the effect of presence or absence of OPDs on vaccination coverage was assessed by comparing mean vaccination coverage. For municipalities where OPDs were present, the effect of each of them (measured as membership ratio, the number of members proportional to total number of inhabitants on vaccination coverage was assessed by bivariate correlation and multiple regression analysis in a model containing the determinants immigration, socio-economical status and urbanization as well. Results Mean vaccination coverage (93.5% ± 4.7 in municipalities with OPDs (n = 135 was significantly lower (p Conclusion As variance in municipal vaccination coverage in the Bible belt is largely explained by membership ratios of the various OPDs, control of vaccine preventable diseases should be focused on these specific risk groups. In current policy part of the orthodox protestant risk group is missed.

  9. Subgroup Analysis of Trials Is Rarely Easy (SATIRE): a study protocol for a systematic review to characterize the analysis, reporting, and claim of subgroup effects in randomized trials.

    Science.gov (United States)

    Sun, Xin; Briel, Matthias; Busse, Jason W; Akl, Elie A; You, John J; Mejza, Filip; Bala, Malgorzata; Diaz-Granados, Natalia; Bassler, Dirk; Mertz, Dominik; Srinathan, Sadeesh K; Vandvik, Per Olav; Malaga, German; Alshurafa, Mohamed; Dahm, Philipp; Alonso-Coello, Pablo; Heels-Ansdell, Diane M; Bhatnagar, Neera; Johnston, Bradley C; Wang, Li; Walter, Stephen D; Altman, Douglas G; Guyatt, Gordon H

    2009-11-09

    Subgroup analyses in randomized trials examine whether effects of interventions differ between subgroups of study populations according to characteristics of patients or interventions. However, findings from subgroup analyses may be misleading, potentially resulting in suboptimal clinical and health decision making. Few studies have investigated the reporting and conduct of subgroup analyses and a number of important questions remain unanswered. The objectives of this study are: 1) to describe the reporting of subgroup analyses and claims of subgroup effects in randomized controlled trials, 2) to assess study characteristics associated with reporting of subgroup analyses and with claims of subgroup effects, and 3) to examine the analysis, and interpretation of subgroup effects for each study's primary outcome. We will conduct a systematic review of 464 randomized controlled human trials published in 2007 in the 118 Core Clinical Journals defined by the National Library of Medicine. We will randomly select journal articles, stratified in a 1:1 ratio by higher impact versus lower impact journals. According to 2007 ISI total citations, we consider the New England Journal of Medicine, JAMA, Lancet, Annals of Internal Medicine, and BMJ as higher impact journals. Teams of two reviewers will independently screen full texts of reports for eligibility, and abstract data, using standardized, pilot-tested extraction forms. We will conduct univariable and multivariable logistic regression analyses to examine the association of pre-specified study characteristics with reporting of subgroup analyses and with claims of subgroup effects for the primary and any other outcomes. A clear understanding of subgroup analyses, as currently conducted and reported in published randomized controlled trials, will reveal both strengths and weaknesses of this practice. Our findings will contribute to a set of recommendations to optimize the conduct and reporting of subgroup analyses, and claim

  10. Subgroup Analysis of Trials Is Rarely Easy (SATIRE: a study protocol for a systematic review to characterize the analysis, reporting, and claim of subgroup effects in randomized trials

    Directory of Open Access Journals (Sweden)

    Malaga German

    2009-11-01

    Full Text Available Abstract Background Subgroup analyses in randomized trials examine whether effects of interventions differ between subgroups of study populations according to characteristics of patients or interventions. However, findings from subgroup analyses may be misleading, potentially resulting in suboptimal clinical and health decision making. Few studies have investigated the reporting and conduct of subgroup analyses and a number of important questions remain unanswered. The objectives of this study are: 1 to describe the reporting of subgroup analyses and claims of subgroup effects in randomized controlled trials, 2 to assess study characteristics associated with reporting of subgroup analyses and with claims of subgroup effects, and 3 to examine the analysis, and interpretation of subgroup effects for each study's primary outcome. Methods We will conduct a systematic review of 464 randomized controlled human trials published in 2007 in the 118 Core Clinical Journals defined by the National Library of Medicine. We will randomly select journal articles, stratified in a 1:1 ratio by higher impact versus lower impact journals. According to 2007 ISI total citations, we consider the New England Journal of Medicine, JAMA, Lancet, Annals of Internal Medicine, and BMJ as higher impact journals. Teams of two reviewers will independently screen full texts of reports for eligibility, and abstract data, using standardized, pilot-tested extraction forms. We will conduct univariable and multivariable logistic regression analyses to examine the association of pre-specified study characteristics with reporting of subgroup analyses and with claims of subgroup effects for the primary and any other outcomes. Discussion A clear understanding of subgroup analyses, as currently conducted and reported in published randomized controlled trials, will reveal both strengths and weaknesses of this practice. Our findings will contribute to a set of recommendations to optimize

  11. Heterogeneity in national U.S. mortality trends within heart disease subgroups, 2000-2015.

    Science.gov (United States)

    Sidney, Stephen; Quesenberry, Charles P; Jaffe, Marc G; Sorel, Michael; Go, Alan S; Rana, Jamal S

    2017-07-18

    The long-term downward national U.S. trend in heart disease-related mortality slowed substantially during 2011-2014 before turning upward in 2015. Examining mortality trends in the major subgroups of heart disease may provide insight into potentially more targeted and effective prevention and treatment approaches to promote favorable trajectories. We examined national trends between 2000 and 2015 in mortality attributed to major heart disease subgroups including ischemic heart disease, heart failure, and all other types of heart disease. Using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (WONDER) data system, we determined national trends in age-standardized mortality rates attributed to ischemic heart disease, heart failure, and other heart diseases from January 1, 2000, to December 31, 2011, and from January 1, 2011, to December 31, 2015. Annual rate of changes in mortality attributed to ischemic heart disease, heart failure, and other heart diseases for 2000-2011 and 2011-2015 were compared. Death attributed to ischemic heart disease declined from 2000 to 2015, but the rate of decline slowed from 4.96% (95% confidence interval 4.77%-5.15%) for 2000-2011 to 2.66% (2.00%-3.31%) for 2011-2015. In contrast, death attributed to heart failure and all other causes of heart disease declined from 2000 to 2011 at annual rates of 1.94% (1.77%-2.11%) and 0.64% (0.44%-0.82%) respectively, but increased from 2011 to 2015 at annual rates of 3.73% (3.21% 4.26%) and 1.89% (1.33-2.46%). Differences in 2000-2011 and 2011-2015 decline rates were statistically significant for all 3 endpoints overall, by sex, and all race/ethnicity groups except Asian/Pacific Islanders (heart failure only significant) and American Indian/Alaskan Natives. While the long-term decline in death attributed to heart disease slowed between 2011 and 2014 nationally before turning upward in 2015, heterogeneity existed in the trajectories attributed to

  12. A 6-gene signature identifies four molecular subgroups of neuroblastoma

    LENUS (Irish Health Repository)

    Abel, Frida

    2011-04-14

    Abstract Background There are currently three postulated genomic subtypes of the childhood tumour neuroblastoma (NB); Type 1, Type 2A, and Type 2B. The most aggressive forms of NB are characterized by amplification of the oncogene MYCN (MNA) and low expression of the favourable marker NTRK1. Recently, mutations or high expression of the familial predisposition gene Anaplastic Lymphoma Kinase (ALK) was associated to unfavourable biology of sporadic NB. Also, various other genes have been linked to NB pathogenesis. Results The present study explores subgroup discrimination by gene expression profiling using three published microarray studies on NB (47 samples). Four distinct clusters were identified by Principal Components Analysis (PCA) in two separate data sets, which could be verified by an unsupervised hierarchical clustering in a third independent data set (101 NB samples) using a set of 74 discriminative genes. The expression signature of six NB-associated genes ALK, BIRC5, CCND1, MYCN, NTRK1, and PHOX2B, significantly discriminated the four clusters (p < 0.05, one-way ANOVA test). PCA clusters p1, p2, and p3 were found to correspond well to the postulated subtypes 1, 2A, and 2B, respectively. Remarkably, a fourth novel cluster was detected in all three independent data sets. This cluster comprised mainly 11q-deleted MNA-negative tumours with low expression of ALK, BIRC5, and PHOX2B, and was significantly associated with higher tumour stage, poor outcome and poor survival compared to the Type 1-corresponding favourable group (INSS stage 4 and\\/or dead of disease, p < 0.05, Fisher\\'s exact test). Conclusions Based on expression profiling we have identified four molecular subgroups of neuroblastoma, which can be distinguished by a 6-gene signature. The fourth subgroup has not been described elsewhere, and efforts are currently made to further investigate this group\\'s specific characteristics.

  13. Electroencephalographic characterization of subgroups of children with learning disorders.

    Directory of Open Access Journals (Sweden)

    Milene Roca-Stappung

    Full Text Available Electroencephalographic alterations have been reported in subjects with learning disorders, but there is no consensus on what characterizes their electroencephalogram findings. Our objective was to determine if there were subgroups within a group of scholars with not otherwise specified learning disorders and if they had specific electroencephalographic patterns. Eighty-five subjects (31 female, 8-11 years who scored low in at least two subscales -reading, writing and arithmetic- of the Infant Neuropsychological Evaluation were included. Electroencephalograms were recorded in 19 leads during rest with eyes closed; absolute power was obtained every 0.39 Hz. Three subgroups were formed according to children's performance: Group 1 (G1, higher scores than Group 2 in reading speed and reading and writing accuracy, Group 2 (G2, better performance than G1 in composition and Group 3 (G3, lower scores than Groups 1 and 2 in the three subscales. G3 had higher absolute power in frequencies in the delta and theta range at left frontotemporal sites than G1 and G2. G2 had higher absolute power within alpha frequencies than G3 and G1 at the left occipital site. G3 had higher absolute power in frequencies in the beta range than G1 in parietotemporal areas and than G2 in left frontopolar and temporal sites. G1 had higher absolute power within beta frequencies than G2 in the left frontopolar site. G3 had lower gamma absolute power values than the other groups in the left hemisphere, and gamma activity was higher in G1 than in G2 in frontopolar and temporal areas. This group of children with learning disorders is very heterogeneous. Three subgroups were found with different cognitive profiles, as well as a different electroencephalographic pattern. It is important to consider these differences when planning interventions for children with learning disorders.

  14. Practical Algorithms for Subgroup Detection in Covert Networks

    DEFF Research Database (Denmark)

    Memon, Nasrullah; Wiil, Uffe Kock; Qureshi, Pir Abdul Rasool

    2010-01-01

    and is capable of determining links between terrorism plots occurred in the past, their affiliation with terrorist camps, travel record, funds transfer, etc. The findings are represented by a network in the form of an Attributed Relational Graph (ARG). Paths from a node to any other node in the network indicate...... the relationships between individuals and organisations. The system also provides assistance to law enforcement agencies, indicating when the capture of a specific terrorist will more likely destabilise the terrorist network. In this paper, we discuss the important application area related to subgroups...

  15. Rewriting the Opportunity Theory

    DEFF Research Database (Denmark)

    Korsgaard, Steffen T.

    The aim of this paper is to further the discussion of opportunity theory by discussing its ontological and epistemological underpinnings, which have been neglected in previous discussions. The idea that opportunities have an objective component is critically examined drawing on insights from social...... constructionism. It is argued that opportunity theory needs to be rewritten....

  16. Opportunity Cost: A Reexamination

    Science.gov (United States)

    Parkin, Michael

    2016-01-01

    Is opportunity cost an ambiguous and arbitrary concept or a simple, straightforward, and fruitful one? This reexamination of opportunity cost addresses this question, and shows that opportunity cost is an ambiguous concept because "two" definitions are in widespread use. One of the definitions is indeed simple, fruitful, and one that…

  17. Characterisation of asthma subgroups associated with circulating YKL-40 levels.

    Science.gov (United States)

    Gomez, Jose L; Yan, Xiting; Holm, Carole T; Grant, Nicole; Liu, Qing; Cohn, Lauren; Nezgovorova, Vera; Meyers, Deborah A; Bleecker, Eugene R; Crisafi, Gina M; Jarjour, Nizar N; Rogers, Linda; Reibman, Joan; Chupp, Geoffrey L

    2017-10-01

    The chitinase-like protein YKL-40 mediates airway inflammation and serum levels are associated with asthma severity. However, asthma phenotypes associated with YKL-40 levels have not been precisely defined.We conducted an unsupervised cluster analysis of asthma patients treated at the Yale Center for Asthma and Airways Disease (n=156) to identify subgroups according to YKL-40 level. The resulting YKL-40 clusters were cross-validated in cohorts from the Severe Asthma Research Programme (n=167) and the New York University/Bellevue Asthma Repository (n=341). A sputum transcriptome analysis revealed molecular pathways associated with YKL-40 subgroups.Four YKL-40 clusters (C1-C4) were identified. C3 and C4 had high serum YKL-40 levels compared with C1 and C2. C3 was associated with earlier onset and longer duration of disease, severe airflow obstruction, and near-fatal asthma exacerbations. C4 had the highest serum YKL-40 levels, adult onset and less airflow obstruction, but frequent exacerbations. An airway transcriptome analysis in C3 and C4 showed activation of non-type 2 inflammatory pathways.Elevated serum YKL-40 levels were associated with two distinct clinical asthma phenotypes: one with irreversible airway obstruction and another with severe exacerbations. The YKL-40 clusters are potentially useful for identification of individuals with severe or exacerbation-prone asthma. Copyright ©ERS 2017.

  18. Post polio syndrome: fatigued patients a specific subgroup?

    Science.gov (United States)

    Östlund, Gunilla; Wahlin, Åke; Sunnerhagen, Katharina S; Borg, Kristian

    2011-01-01

    To examine the characteristics of fatigued and non-fatigued post-polio patients and to define potential subgroups across the fatigue continuum. Multi-centre study. A total of 143 post-polio patients were subdivided on the basis of percentile distribution into a fatigue group, a intermediate group, and a non-fatigue group, using the Multi Fatigue Inventory 20 general fatigue ratings. Data on background, quality of life, fatigue and pain were collected. Descriptive statistics and correlations in each group and analysis of variance and χ2 for group comparisons were performed. Non-linear regressions were employed to evaluate differences in the strength of associations between physical and mental fatigue, on the one hand, and vitality on the other. The fatigued group was younger, had shorter polio duration, more pain, higher body mass index, lower quality of life and was more physically and mentally fatigued. A higher proportion of this group had contracted polio after 1956 and was under 65 years of age. Mental fatigue had a relatively higher explanatory value than physical fatigue for differences in vitality in the fatigued group, whereas reversed patterns were seen in the other groups. Fatigued post-polio patients can be considered as a subgroup.

  19. The science achievement of various subgroups on alternative assessment formats

    Science.gov (United States)

    Lawrenz, Frances; Huffman, Douglas; Welch, Wayne

    2001-05-01

    The purpose of this study was to examine the science achievement outcomes for different subgroups of students using different assessment formats. A nationally representative sample of approximately 3,500 ninth grade science students from 13 high schools throughout the United States completed a series of science assessments designed to measure their level of achievement on the national science education standards. All of the schools were using a curriculum designed to meet the standards. The assessments included a multiple-choice test, a written open-ended test, a hands-on lab skills test, and a hands-on full investigation. The results show that the student outcomes on the different assessment formats are more highly correlated for higher achieving students than for lower achieving students. Patterns for different cultural groups also vary by assessment format. There were no differences found for sex. The results support the notion that different assessment formats assess different competencies and that the achievement of students from different subgroups varies by assessment format.

  20. Characterization and subgrouping of Campylobacter concisus strains using protein profiles, conventional biochemical testing and antibiotic susceptibility

    DEFF Research Database (Denmark)

    Aabenhus, Rune Munck; Permin, Henrik; Andersen, Leif P

    2005-01-01

    To characterize and subgroup clinical strains of Campylobacter concisus isolated from patients with gastrointestinal disease.......To characterize and subgroup clinical strains of Campylobacter concisus isolated from patients with gastrointestinal disease....

  1. Evaluation of Evidence of Statistical Support and Corroboration of Subgroup Claims in Randomized Clinical Trials.

    Science.gov (United States)

    Wallach, Joshua D; Sullivan, Patrick G; Trepanowski, John F; Sainani, Kristin L; Steyerberg, Ewout W; Ioannidis, John P A

    2017-04-01

    Many published randomized clinical trials (RCTs) make claims for subgroup differences. To evaluate how often subgroup claims reported in the abstracts of RCTs are actually supported by statistical evidence (P SATIRE) articles and Discontinuation of Randomized Trials (DISCO) articles. We used Scopus (updated July 2016) to search for English-language articles citing each of the eligible index articles with at least 1 subgroup finding in the abstract. Articles with a subgroup claim in the abstract with or without evidence of statistical heterogeneity (P < .05 from an interaction test) in the text and articles attempting to corroborate the subgroup findings. Study characteristics of trials with at least 1 subgroup claim in the abstract were recorded. Two reviewers extracted the data necessary to calculate subgroup-level effect sizes, standard errors, and the P values for interaction. For individual RCTs and meta-analyses that attempted to corroborate the subgroup findings from the index articles, trial characteristics were extracted. Cochran Q test was used to reevaluate heterogeneity with the data from all available trials. The number of subgroup claims in the abstracts of RCTs, the number of subgroup claims in the abstracts of RCTs with statistical support (subgroup findings), and the number of subgroup findings corroborated by subsequent RCTs and meta-analyses. Sixty-four eligible RCTs made a total of 117 subgroup claims in their abstracts. Of these 117 claims, only 46 (39.3%) in 33 articles had evidence of statistically significant heterogeneity from a test for interaction. In addition, out of these 46 subgroup findings, only 16 (34.8%) ensured balance between randomization groups within the subgroups (eg, through stratified randomization), 13 (28.3%) entailed a prespecified subgroup analysis, and 1 (2.2%) was adjusted for multiple testing. Only 5 (10.9%) of the 46 subgroup findings had at least 1 subsequent pure corroboration attempt by a meta-analysis or an

  2. Subgrouping Poor Readers on the Basis of Individual Differences in Reading-Related Abilities

    OpenAIRE

    Catts, Hugh W.; Hogan, Tiffany; Fey, Marc E.

    2003-01-01

    The present study investigated the use of the Reading Component Model to subgroup poor readers. A large sample of poor readers was identified in second grade and subgrouped on the basis of relative strengths and weaknesses in word recognition and listening comprehension. Although homogeneous subgroups were not identified, poor readers could be classified into four subgroups that differed significantly in reading-related abilities. Further analyses showed that poor readers' strengths and weakn...

  3. Cumulative subgroup analysis to reduce waste in clinical research for individualised medicine.

    Science.gov (United States)

    Song, Fujian; Bachmann, Max O

    2016-12-15

    Although subgroup analyses in clinical trials may provide evidence for individualised medicine, their conduct and interpretation remain controversial. Subgroup effect can be defined as the difference in treatment effect across patient subgroups. Cumulative subgroup analysis refers to a series of repeated pooling of subgroup effects after adding data from each of related trials chronologically, to investigate the accumulating evidence for subgroup effects. We illustrated the clinical relevance of cumulative subgroup analysis in two case studies using data from published individual patient data (IPD) meta-analyses. Computer simulations were also conducted to examine the statistical properties of cumulative subgroup analysis. In case study 1, an IPD meta-analysis of 10 randomised trials (RCTs) on beta blockers for heart failure reported significant interaction of treatment effects with baseline rhythm. Cumulative subgroup analysis could have detected the subgroup effect 15 years earlier, with five fewer trials and 71% less patients, than the IPD meta-analysis which first reported it. Case study 2 involved an IPD meta-analysis of 11 RCTs on treatments for pulmonary arterial hypertension that reported significant subgroup effect by aetiology. Cumulative subgroup analysis could have detected the subgroup effect 6 years earlier, with three fewer trials and 40% less patients than the IPD meta-analysis. Computer simulations have indicated that cumulative subgroup analysis increases the statistical power and is not associated with inflated false positives. To reduce waste of research data, subgroup analyses in clinical trials should be more widely conducted and adequately reported so that cumulative subgroup analyses could be timely performed to inform clinical practice and further research.

  4. Upgrading the safety toolkit: Initiatives of the accident analysis subgroup

    International Nuclear Information System (INIS)

    O'Kula, K.R.; Chung, D.Y.

    1999-01-01

    Since its inception, the Accident Analysis Subgroup (AAS) of the Energy Facility Contractors Group (EFCOG) has been a leading organization promoting development and application of appropriate methodologies for safety analysis of US Department of Energy (DOE) installations. The AAS, one of seven chartered by the EFCOG Safety Analysis Working Group, has performed an oversight function and provided direction to several technical groups. These efforts have been instrumental toward formal evaluation of computer models, improving the pedigree on high-use computer models, and development of the user-friendly Accident Analysis Guidebook (AAG). All of these improvements have improved the analytical toolkit for best complying with DOE orders and standards shaping safety analysis reports (SARs) and related documentation. Major support for these objectives has been through DOE/DP-45

  5. Eighth Negotiators' Standing Sub-Group and related meetings

    International Nuclear Information System (INIS)

    Rager, J.-P.

    2003-01-01

    The Max-Planck-Institute for Plasma Physics (IPP) at Garching near Munich was the venue for the eighth meeting of the ITER Negotiators' Standing Sub-Group (NSSG-8) and a number of related meetings over an intensive nine day period of work from 14 to 22 May 2003. The European Union hosted the meeting, which was also attended by delegations from Canada, China, Japan, the Russian Federation (RF) and the USA. This was the first time at the NSSG for the Chinese and US delegations, following their accession to the ITER Negotiations at the previous Negotiators' meeting (N-8) (see ITER ITA Newsletter No. 1, February 2003). Over the course of four days the Working Groups met, at times in parallel sessions, to make progress in their respective topic areas. The work of each group was led by a rapporteur, who subsequently presented the group's findings and recommendations to the NSSG as a whole for consideration and guidance

  6. Pain Drawings Improve Subgrouping of Low Back Pain Patients.

    Science.gov (United States)

    Hüllemann, Philipp; Keller, Thomas; Kabelitz, Maria; Freynhagen, Rainer; Tölle, Thomas; Baron, Ralf

    2017-03-01

    Subgrouping of low back pain (LBP) patients may be improved when pain drawings are combined with the painDETECT (PD-Q) questionnaire. We hypothesized that (1) different LBP subgroups determined by their pain radiation show different clinical patterns and (2) the occurrence of neuropathic symptoms depends on pain radiation. A total of 19,263 acute ( 3 months) LBP patients were allocated prospectively into 4 groups based on the location of pain drawings on a manikin and compared regarding neuropathic pain components, functionality, depression, pain intensity, and surgical interventions. All items were investigated at baseline and follow-up visits. Group I was composed of patients with axial LBP without radiating pain; group II, LBP with radiation into the thigh; group III, LBP with radiation into the shank; and group IV, LBP with radiation into the feet. Side-dependent pain radiation was assessed additionally. Depression, functionality, and pain intensity showed no clinically relevant differences, whereas PD-Q scores and the probability to rate positive for neuropathic pain increased with more distally radiating pain. Surgery and medication intake were most frequent in group IV. Follow-up analyses showed that only axial LBP became more neuropathic, whereas pain intensity decreased over time. Radicular patterns of pain drawings in LBP patients indicate severe pain conditions with the most neuropathic components, while axial LBP has the fewest. For the categorization of LBP, pain drawings help explain the underlying mechanism of pain, which might further improve mechanism-based treatment when used in clinical routines and research. © 2016 World Institute of Pain.

  7. Qualitative interaction trees: A tool to identify qualitative treatment-subgroup interactions

    NARCIS (Netherlands)

    Dusseldorp, E.; Mechelen, I. van

    2014-01-01

    When two alternative treatments (A and B) are available, some subgroup of patients may display a better outcome with treatment A than with B, whereas for another subgroup, the reverse may be true. If this is the case, a qualitative (i.e., disordinal) treatment-subgroup interaction is present. Such

  8. Are there distinct cognitive and motivational sub-groups of children with ADHD?

    DEFF Research Database (Denmark)

    Lambek, Rikke; Sonuga-Barke, Edmund; Tannock, Rosemary

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is proposed to be a neuropsychologically heterogeneous disorder that encompasses two distinct sub-groups, one with executive function (EF) deficits and one with delay aversion (DA). However, such claims have often been based on studies that have...... to be dissociable constructs; they do not yield distinct sub-groups when sub-grouping is...

  9. 26 CFR 1.1502-93 - Consolidated section 382 limitation (or subgroup section 382 limitation).

    Science.gov (United States)

    2010-04-01

    ...(c). (b) Value of the loss group (or loss subgroup)—(1) Stock value immediately before ownership... loss subgroup) is the value, immediately before the ownership change, of the stock of each member...), capital contributions between members of the loss group (or loss subgroup) (or a contribution of stock to...

  10. Representing and Counting the Subgroups of the Group Zm×Zn

    Directory of Open Access Journals (Sweden)

    Mario Hampejs

    2014-01-01

    Full Text Available We deduce a simple representation and the invariant factor decompositions of the subgroups of the group Zm×Zn, where m and n are arbitrary positive integers. We obtain formulas for the total number of subgroups and the number of subgroups of a given order.

  11. Hunting the Opportunity

    DEFF Research Database (Denmark)

    Nielsen, Suna Løwe; Christensen, Poul Rind; Heidemann Lassen, Astrid

    2017-01-01

    This paper bring together the two research fields of design and entrepreneurship in order to stimulate new knowledge on opportunity creation. A shared theoretical framework on new opportunity creation that illustrates that design and entrepreneurship can advantageously complement each other in th...... in the opportunity design process. Practical insights into the robustness of the framework are provided by a short illustrative case on electric cars....

  12. Gambaran Populasi Golongan Darah Subgroup A (A1, A2) di PMI Kulon Progo

    OpenAIRE

    Hieronymus Rayi Prasetya; Bambang Heru Budianto; Hernayanti Hernayanti

    2017-01-01

    Subgroup A1 and A2 are the most important in the blood group A. Subgroup A1 has the A antigen more than A2 subgroup, the A2 subgroup can cause misidentification of blood group due to poor A antigen and genetic variation possessed. Misidentification of the blood group will increase the risk of transfusion reactions. This research aims to describe the A1 and A2 subgroup population in Kulon Progo district. This study was conducted with a cross sectional sampling technique. The sample in this stu...

  13. Opportunity identification competence

    NARCIS (Netherlands)

    Baggen, Yvette

    2017-01-01

    Opportunities and their identification are of significant importance for competitiveness in today’s complex and turbulent business environment because they serve as a key influencing factor for new value-creation. Opportunity identification (OI) is interesting not only from the perspective of

  14. Seizing Political Opportunity

    DEFF Research Database (Denmark)

    Citi, Manuele; Justesen, Mogens Kamp

    2016-01-01

    Political actors need to be nimble and respond to the opportunity to reform old policies and initiate new ones. The article looks at how the European Commission takes advantage of politically opportune moments (the ‘gridlock interval’) in the European Parliament to put forward new legislation...

  15. Opportunity identification competence

    NARCIS (Netherlands)

    Baggen, Yvette

    2017-01-01

    Opportunities and their identification are of significant importance for competitiveness in today’s complex and turbulent business environment because they serve as a key influencing factor for new value-creation. Opportunity identification (OI) is interesting not only from the perspective of new

  16. Religious subgroups influencing vaccination coverage in the Dutch Bible belt: an ecological study.

    Science.gov (United States)

    Ruijs, Wilhelmina L M; Hautvast, Jeannine L A; van der Velden, Koos; de Vos, Sjoerd; Knippenberg, Hans; Hulscher, Marlies E J L

    2011-02-14

    The Netherlands has experienced epidemics of vaccine preventable diseases largely confined to the Bible belt, an area where -among others- orthodox protestant groups are living. Lacking information on the vaccination coverage in this minority, and its various subgroups, control of vaccine preventable diseases is focused on the geographical area of the Bible belt. However, the adequacy of this strategy is questionable. This study assesses the influence of presence of various orthodox protestant subgroups (orthodox protestant denominations, OPDs) on municipal vaccination coverage in the Bible belt. We performed an ecological study at municipality level. Data on number of inhabitants, urbanization level, socio-economical status, immigration and vaccination coverage were obtained from national databases. As religion is not registered in the Netherlands, membership numbers of the OPDs had to be obtained from church year books and via church offices. For all municipalities in the Netherlands, the effect of presence or absence of OPDs on vaccination coverage was assessed by comparing mean vaccination coverage. For municipalities where OPDs were present, the effect of each of them (measured as membership ratio, the number of members proportional to total number of inhabitants) on vaccination coverage was assessed by bivariate correlation and multiple regression analysis in a model containing the determinants immigration, socio-economical status and urbanization as well. Mean vaccination coverage (93.5% ± 4.7) in municipalities with OPDs (n = 135) was significantly lower (p < 0.001) than in 297 municipalities without OPDs (96.9% ± 2.1). Multiple regression analyses showed that in municipalities with OPDs 84% of the variance in vaccination coverage was explained by the presence of these OPDs. Immigration had a significant, but small explanatory effect as well. Membership ratios of all OPDs were negatively related to vaccination coverage; this relationship was strongest for

  17. Equal opportunities in diversity

    CERN Multimedia

    Laëtitia Pedroso

    2010-01-01

    Promoting equal opportunities at CERN and advising the Director-General on all related matters is the task of the Equal Opportunities Officer, Doris Chromek-Burckhart, and Tim Smith, chair of the Equal Opportunities Advisory Panel. Changes are being introduced: in future, the focus of their work will be broadened to cover all aspects of diversity promotion.   The term "equal opportunities" has always been broader in scope than the equal treatment of men and women but this is what it has traditionally been confined to in practice. "We wanted to change how people see our mission", explains Doris Chromek-Burckhart. The word "diversity" has much wider connotations than "equal opportunities" and makes it clearer that we are also dealing with differences in nationality, religion, age, culture and physical ability”. Getting away from the old clichés is vital to ensuring equal treatment for everyone. The diversit...

  18. Subgroup analyses in randomised controlled trials: cohort study on trial protocols and journal publications.

    Science.gov (United States)

    Kasenda, Benjamin; Schandelmaier, Stefan; Sun, Xin; von Elm, Erik; You, John; Blümle, Anette; Tomonaga, Yuki; Saccilotto, Ramon; Amstutz, Alain; Bengough, Theresa; Meerpohl, Joerg J; Stegert, Mihaela; Olu, Kelechi K; Tikkinen, Kari A O; Neumann, Ignacio; Carrasco-Labra, Alonso; Faulhaber, Markus; Mulla, Sohail M; Mertz, Dominik; Akl, Elie A; Bassler, Dirk; Busse, Jason W; Ferreira-González, Ignacio; Lamontagne, Francois; Nordmann, Alain; Gloy, Viktoria; Raatz, Heike; Moja, Lorenzo; Rosenthal, Rachel; Ebrahim, Shanil; Vandvik, Per O; Johnston, Bradley C; Walter, Martin A; Burnand, Bernard; Schwenkglenks, Matthias; Hemkens, Lars G; Bucher, Heiner C; Guyatt, Gordon H; Briel, Matthias

    2014-07-16

    To investigate the planning of subgroup analyses in protocols of randomised controlled trials and the agreement with corresponding full journal publications. Cohort of protocols of randomised controlled trial and subsequent full journal publications. Six research ethics committees in Switzerland, Germany, and Canada. 894 protocols of randomised controlled trial involving patients approved by participating research ethics committees between 2000 and 2003 and 515 subsequent full journal publications. Of 894 protocols of randomised controlled trials, 252 (28.2%) included one or more planned subgroup analyses. Of those, 17 (6.7%) provided a clear hypothesis for at least one subgroup analysis, 10 (4.0%) anticipated the direction of a subgroup effect, and 87 (34.5%) planned a statistical test for interaction. Industry sponsored trials more often planned subgroup analyses compared with investigator sponsored trials (195/551 (35.4%) v 57/343 (16.6%), P<0.001). Of 515 identified journal publications, 246 (47.8%) reported at least one subgroup analysis. In 81 (32.9%) of the 246 publications reporting subgroup analyses, authors stated that subgroup analyses were prespecified, but this was not supported by 28 (34.6%) corresponding protocols. In 86 publications, authors claimed a subgroup effect, but only 36 (41.9%) corresponding protocols reported a planned subgroup analysis. Subgroup analyses are insufficiently described in the protocols of randomised controlled trials submitted to research ethics committees, and investigators rarely specify the anticipated direction of subgroup effects. More than one third of statements in publications of randomised controlled trials about subgroup prespecification had no documentation in the corresponding protocols. Definitive judgments regarding credibility of claimed subgroup effects are not possible without access to protocols and analysis plans of randomised controlled trials. © The DISCO study group 2014.

  19. Subgroup differences in having a usual source of health care among working-age adults with and without disabilities.

    Science.gov (United States)

    Dobbertin, Konrad; Horner-Johnson, Willi; Lee, Jae Chul; Andresen, Elena M

    2015-04-01

    Having a usual source of health care is positively associated with regular health maintenance visits and receipt of preventive services. People with disabilities are, overall, more likely than those without disabilities to have a usual source of care (USC). However, the population of people with disabilities is quite heterogenous, and some segments of the population may have less access to a USC than others. To determine whether there are significant subgroup differences in having a USC within the U.S. population of working-age adults with disabilities, and to compare adults with and without disabilities while controlling for other subgroup differences. We analyzed Medical Expenditure Panel Survey annual data files from 2002 to 2008. We performed both bivariate and multivariate logistic regression analyses to examine the relationship of sociodemographic and disability subgroup variables with having a USC. Within the disability population, individuals who were younger; male; Black, Hispanic, or other (non-White) race; less educated; of lower income; or uninsured for part or all of the year were significantly less likely to have a USC. These differences mirrored those among adults without disabilities. When controlling for these differences, people with physical, hearing, or multiple disabilities had greater odds of having a USC than people without disabilities, but those with vision or cognitive limitations did not differ significantly from the non-disabled referent group. Disparities among people with and without disabilities are similar, underscoring the need for attention to disparities within the disability population. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. A bias-corrected net reclassification improvement for clinical subgroups.

    Science.gov (United States)

    Paynter, Nina P; Cook, Nancy R

    2013-02-01

    Comparing prediction models using reclassification within subgroups at intermediate risk is often of clinical interest. To demonstrate a method for obtaining an unbiased estimate for the Net Reclassification Improvement (NRI) evaluated only on a subset, the clinical NRI. and Setting. We derived the expected value of the clinical NRI under the null hypothesis using the same principles as the overall NRI. We then conducted a simulation study based on a logistic model with a known predictor and a potential predictor, varying the effects of the known and potential predictors to test the performance of our bias-corrected clinical NRI measure. Finally, data from the Women's Health Study, a prospective cohort of 24 171 female health professionals, were used as an example of the proposed method. Our bias-corrected estimate is shown to have a mean of zero in the null case under a range of simulated parameters and, unlike the naïve estimate, to be unbiased. We also provide 2 methods for obtaining a variance estimate, both with reasonable type 1 errors. Our proposed method is an improvement over currently used methods of calculating the clinical NRI and is recommended to reduce overly optimistic results.

  1. Topography and Volcanology of the Huangtsuishan Volcano Subgroup, Northern Taiwan

    Directory of Open Access Journals (Sweden)

    Yu-Ming Lai

    2010-01-01

    Full Text Available Combining the shaded relief topography model and the slope map from the Digital Terrain Model (DTM images, toporaphical map, field occurrences and petrography, the volcanic sequences of the Huangtsuishan Volcano Subgroup (HVS can be constructed. Two types of volcanic centers can be identified in this area. One is the Tachienhou volcanic dome, which may be located in the center of an older caldera. The other is the Huangtsui composite volcano, which is composed of interbedding lava flows and pyroclastic deposits with a volcanic crater named the Huangtsui pond at the summit. Eight lava plateaus radiated from Mts. Huangtsui and Tachienhou to the north and the east can be distinguished based on the DTM images. The volcanic deposits are comprised of four lithofacies, the lava flows, pyroclastic breccias, tuffs and lahars on the base of field occurrences. At least thirteen layers of lava flow, named the H1 to H13 can be recognized in the HVS and can be reconstructed and categorized into four stages. An old and large volcano erupted lava flows to form the products of stages one and two, then collapsed to form a caldera with a dome for the third stage. The latest stage of lava flow was poured out from the Huangtsui volcano, which formed a crater at the summit.

  2. Hispanic Subgroups, Acculturation, and Substance Abuse Treatment Outcomes

    Science.gov (United States)

    Chartier, Karen G.; Carmody, Tom; Akhtar, Maleeha; Stebbins, Mary B.; Walters, Scott T.; Warden, Diane

    2015-01-01

    This study explored Hispanic subgroup differences in substance use treatment outcomes, and the relationship of acculturation characteristics to these outcomes. Data were from a multisite randomized clinical trial of motivational enhancement therapy versus treatment as usual in a sample of Spanish-speaking substance abusers. Participants were Cuban American (n=34), Mexican American (n=209), Puerto Rican (n=78), and other Hispanic American (n=54). Results suggested that Cuban Americans and individuals with more connection to Hispanic culture had lower treatment retention. Hispanics born in the U.S and those who spoke English at home had a lower percentage of days abstinent during weeks 5-16, although Puerto Ricans born in the U.S. and Cuban Americans living more years in the U.S. had a higher percentage of days abstinent in weeks 1-4 and 5-16, respectively. Results may inform future hypothesis-driven studies in larger Hispanic treatment seeking samples of the relationship between acculturation and treatment outcome. PMID:26362001

  3. Office of Equal Opportunity Programs

    Science.gov (United States)

    Chin, Jennifer L.

    2004-01-01

    The NASA Glenn Office of Equal Opportunity Programs works to provide quality service for all programs and/or to assist the Center in becoming a model workplace. During the summer of 2004, I worked with Deborah Cotleur along with other staff members to create and modify customer satisfaction surveys. This office aims to assist in developing a model workplace by providing functions as a change agent to the center by serving as an advisor to management to ensure equity throughout the Center. In addition, the office serves as a mediator for the Center in addressing issues and concerns. Lastly, the office provides assistance to employees to enable attainment of personal and organizational goals. The Office of Equal Opportunities is a staff office which reports and provides advice to the Center Director and Executive Leadership, implements laws, regulations, and presidential executive orders, and provides center wide leadership and assistance to NASA GRC employees. Some of the major responsibilities of the office include working with the discrimination complaints program, special emphasis programs (advisory groups), management support, monitoring and evaluation, contract compliance, and community outreach. During my internship in this office, my main objective was to create four customer satisfaction surveys based on EO retreats, EO observances, EO advisory boards, and EO mediation/counseling. I created these surveys after conducting research on past events and surveys as well as similar survey research created and conducted by other NASA centers, program for EO Advisory group members, leadership training sessions for supervisors, preventing sexual harassment training sessions, and observance events. I also conducted research on the style and format from feedback surveys from the Marshall Equal Opportunity website, the Goddard website, and the main NASA website. Using the material from the Office of Equal Opportunity Programs at Glenn Research Center along with my

  4. Equal Opportunities Questionnaire

    CERN Multimedia

    2007-01-01

    The initiative to promote Equal Opportunities at CERN started in 1993. The first Equal Opportunities Officer was appointed in 1996 followed by the creation of the Equal Opportunities Advisory Panel in 1998. Initially the concern was mainly the fair treatment of women in the work-place. Today the emphasis has evolved to ensuring that diversity is used to increase creativity and productivity in the work-place. In order to ensure that all aspects of Equal Opportunities and Diversity are covered, CERN’s Equal Opportunities team has prepared a survey to obtain your input. Your answers are confidential and will only be used for generating statistics. The questionnaire is on-line and can be accessed via: https://espace.cern.ch/EOQ. We hope that you will take a few minutes of your time to give your input and would be grateful if you could reply before 15/10/07. For further information about Equal Opportunities at CERN see: http://cern.ch/equal-opportunities The Equal Opportuni...

  5. Equal Opportunities Questionnaire

    CERN Multimedia

    2007-01-01

    The initiative to promote Equal Opportunities at CERN started in 1993. The first Equal Opportunities Officer was appointed in 1996, which was followed by the creation of the Equal Opportunities Advisory Panel in 1998. Initially the concern was mainly the fair treatment of women in the work-place. Today the emphasis has evolved to ensuring that diversity is used to increase creativity and productivity in the work-place. In order to ensure that all aspects of Equal Opportunities and Diversity are covered, CERN’s Equal Opportunities team has prepared a survey to obtain your input. Your answers are confidential and will only be used for generating statistics. The questionnaire is on-line and can be accessed via: https://espace.cern.ch/EOQ. We hope that you will take a few minutes of your time to give your input and would be grateful if you could reply before 15/10/07. For further information about Equal Opportunities at CERN see: http://cern.ch/equal-opportunities The Equa...

  6. Are the mentally ill homeless a distinct homeless subgroup?

    Science.gov (United States)

    North, C S; Smith, E M; Pollio, D E; Spitznagel, E L

    1996-09-01

    The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is

  7. Crisis -- A Leadership Opportunity

    National Research Council Canada - National Science Library

    Braden, Victor; Cooper, II, Justin; Klingele, Michael; Powell, John P; Robbins, Michael G

    2005-01-01

    .... A leader who is "tuned-in" to the signals of impending crisis and understands how to harness the urgency brought on by the situation can minimize the potential dangers and maximize the resulting opportunities...

  8. Opportunity identification competence

    OpenAIRE

    Baggen, Yvette

    2017-01-01

    Opportunities and their identification are of significant importance for competitiveness in today’s complex and turbulent business environment because they serve as a key influencing factor for new value-creation. Opportunity identification (OI) is interesting not only from the perspective of new business start-ups, but also from the perspective of employees in existing organisations. Each entrepreneurial process starts with an imagined, rudimentary idea in the mind of an individual. Th...

  9. All IncP-1 plasmid subgroups, including the novel e subgroup, are prevalent in the influent of a Danish wastewater treatment plant

    DEFF Research Database (Denmark)

    Bahl, Martin Iain; Burmølle, Mette; Meisner, Annelein

    2009-01-01

    The presence and diversity of IncP-1 plasmids in the influent of a Danish wastewater treatment plant was studied by PCR amplification of the trfA gene in community DNA followed by sequencing. Three sets of PCR primers were designed to amplify a 281 bp fragment of trfA from all currently sequenced...... IncP-1 plasmids. A neighbor-joining tree, based on a multiple alignment of 72 obtained sequences together with homologous sequences of previously published IncP-1 plasmids, revealed that all established subgroups of IncP-1 plasmids, a, ß, ¿ and d, were present in the wastewater treatment plant...... influent. Also sequences representing the recently described fifth subgroup, the e subgroup, were detected in the wastewater. Thus, these results confirm the presence of at least five phylogenetically distinct subgroups of IncP-1 plasmids and represent the first time that sequences associated with plasmids...

  10. Identifying Subgroups of Tinnitus Using Novel Resting State fMRI Biomarkers and Cluster Analysis

    Science.gov (United States)

    2017-10-13

    applied to the resting-state data to identify tinnitus subgroups within the patient population and pair them with specific behavioral ...and behavioral data  Specific Aim 2: Determine tinnitus subgroups using automated cluster analysis of resting state data and associate the subgroups...data analysis and clustering method previously developed to apply to current tinnitus data set o Percentage of completion at end of Year 2 (24 months

  11. On finite groups whose every proper normal subgroup is a union of ...

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    Moreover, if N is a minimal normal subgroup of G, then. N ⊆ Z(Op(G)), where p is a prime factor of |G|. If N is not a minimal normal subgroup of G, then N contains a complete normal subgroup N1, where N1 is an elementary abelian group with order pa and we have: (a) N = N1Q has order paq and every element of N has ...

  12. Data-Driven Subgroups in Depression Derived from Directed Functional Connectivity Paths at Rest.

    Science.gov (United States)

    Price, Rebecca B; Gates, Kathleen; Kraynak, Thomas E; Thase, Michael E; Siegle, Greg J

    2017-12-01

    Depressed patients show abnormalities in brain connectivity at rest, including hyperconnectivity within the default mode network (DMN). However, there is well-known heterogeneity in the clinical presentation of depression that is overlooked when averaging connectivity data. We used data-driven parsing of neural connectivity to reveal subgroups among 80 depressed patients completing resting state fMRI. Directed functional connectivity paths (eg, region A influences region B) within a depression-relevant network were characterized using Group Iterative Multiple Model Estimation, a method shown to accurately recover the direction and presence of connectivity paths in individual participants. Individuals were clustered using community detection on neural connectivity estimates. Subgroups were compared on network features and on clinical and biological/demographic characteristics that influence depression prognosis. Two subgroups emerged. Subgroup A, containing 71% of the patients, showed a typical pattern of connectivity across DMN nodes, as previously reported in depressed patients on average. Subgroup B exhibited an atypical connectivity profile lacking DMN connectivity, with increased dorsal anterior cingulate-driven connectivity paths. Subgroup B members had an over-representation of females (87% of Subgroup B vs 65% of Subgroup A; χ 2 =3.89, p=0.049), comorbid anxiety diagnoses (42.9% of Subgroup B vs 17.5% of Subgroup A; χ 2 =5.34, p=.02), and highly recurrent depression (63.2% of Subgroup B vs 31.8% of Subgroup A; χ 2 =5.38, p=.02). Neural connectivity-based categorization revealed an atypical pattern of connectivity in a depressed patient subset that would be overlooked in group comparisons of depressed and healthy participants, and tracks with clinically relevant phenotypes including anxious depression and episodic recurrence. Data-driven parsing suggests heterogeneous substrates of depression; ideally, future work building on these findings will inform

  13. Estimating subgroup effects using the propensity score method: a practical application in outcomes research.

    Science.gov (United States)

    Eeren, Hester V; Spreeuwenberg, Marieke D; Bartak, Anna; de Rooij, Mark; Busschbach, Jan J V

    2015-04-01

    Our aim was to demonstrate the feasibility of the univariate and generalized propensity score (PS) method in subgroup analysis of outcomes research. First, to estimate subgroup effects, we tested the performance of 2 different PS methods, using Monte Carlo simulations: (1) the univariate PS with additional adjustment on the subgroup; and (2) the generalized PS, estimated by crossing the treatment options with a subgroup variable. The subgroup effects were estimated in a linear regression model using the 2 PS adjustments. We further explored whether the subgroup variable should be included in the univariate PS. Second, the 2 methods were compared using data from a large effectiveness study on psychotherapy in personality disorders. Using these data we tested the differences between short-term and long-term treatment, with the severity of patients' problems defining the subgroups of interest. The Monte Carlo simulations showed minor differences between both PS methods, with the bias and mean squared error overall marginally lower for the generalized PS. When considering the univariate PS, the subgroup variable can be excluded from the PS estimation and only adjusted for in the outcome equation. When applied to the psychotherapy data, the univariate and generalized PS estimations gave similar results. The results support the use of the generalized PS as a feasible method, compared with the univariate PS, to find certain subgroup effects in nonrandomized outcomes research.

  14. Industrial opportunities - offshore

    International Nuclear Information System (INIS)

    Gerrits, D.J.

    1998-01-01

    Industrial opportunities available in the Canadian offshore petroleum industry are discussed. Oil has been produced offshore from Nova Scotia since 1992, and offshore from Newfoundland since 1997. Special needs that must be addressed in offshore operations in eastern Canada such as the cold North Atlantic environment, isolation, logistics, safety, and quality assurance, are examined. The most obvious opportunities lie with the designing, building and installing the facilities needed to extract oil and gas from beneath the sea floor and transport it to market. However, there are also opportunities in designing and fabricating clothing, customized food containers and other equipment for offshore needs. Short term opportunities also exist in the decommissioning of depleted production fields and their facilities. One of the greatest obstacles facing new entrants into the offshore oil and gas industry is the lack of a track record. To meet this challenge, the ability to seek out partners to pursue local and international opportunities through joint ventures, strategic alliances and technology sharing partnering arrangements is of great importance. It may be the difference between success and failure. 6 figs

  15. Thirty-Day Inpatient Readmissions for Asian American and Pacific Islander Subgroups Compared With Whites.

    Science.gov (United States)

    Sentell, Tetine; Ahn, Hyeong Jun; Miyamura, Jill; Taira, Deborah A

    2018-02-01

    Asian and Pacific Islander (API) 30-day potentially preventable readmissions (PPRs) are understudied. Hawaii Health Information Corporation data from 2007-2012 statewide adult hospitalizations ( N = 495,910) were used to compare API subgroup and White PPRs. Eight percent of hospitalizations were PPRs. Seventy-two percent of other Pacific Islanders, 60% of Native Hawaiians, and 52% of Whites with a PPR were 18 to 64 years, compared with 22% of Chinese and 21% of Japanese. In multivariable models including payer, hospital, discharge year, residence location, and comorbidity, PPR disparities existed for some API subpopulations 65+ years, including Native Hawaiian men (odds ratio [OR] = 1.14; 95% confidence interval [CI] = 1.04-1.24), Filipino men (OR = 1.19; 95% CI = 1.04-1.38), and other Pacific Islander men (OR = 1.30; 95% CI = 1.19-1.43) and women (OR = 1.23; 95% CI = 1.02-1.51) compared with Whites, while many API groups 18 to 64 years had significantly lower PPR odds. Distinct PPR characteristics across API subpopulations and age groups can inform policy and practice. Further research should determine why elderly API have higher PPR rates, while nonelderly rates are lower.

  16. Etiological Subgroups of Small-for-Gestational-Age: Differential Neurodevelopmental Outcomes.

    Directory of Open Access Journals (Sweden)

    Xiuhong Li

    Full Text Available It remains unclear why substantial variations in neurodevelopmental outcomes exist within small-for-gestational-age (SGA children. We prospectively compared 5-y neurodevelopmental outcomes across SGA etiological subgroups.Children born SGA (N = 1050 from U.S. Early Childhood Longitudinal Study-Birth Cohort (2001-2007 was divided into etiological subgroups by each of 7 well-established prenatal risk factors. We fit linear regression models to compare 5-y reading, math, gross motor and fine motor scores across SGA subgroups, adjusting for socio-demographic confounders.Compared to singleton SGA subgroup, multiple-birth SGA subgroup had lower mean reading (adjusted mean difference, -4.08 [95% confidence interval, -6.10, -2.06] and math (-2.22 [-3.61, -0.84] scores. These disadvantages in reading and math existed only among multiple-birth SGA subgroup without ovulation stimulation (reading, -4.50 [-6.64, -2.36]; math, -2.91 [-4.37, -1.44], but not among those with ovulation stimulation (reading, -2.33 [-6.24, 1.57]; math 0.63 [-1.86, 3.12]. Compared to singleton SGA subgroup without maternal smoking and inadequate gestational weight gain, singleton SGA subgroup with co-occurrence of maternal smoking and inadequate gestational weight gain (GWG had lower mean reading (-4.81 [-8.50, -1.12] and math (-2.95 [-5.51, -0.38] scores. These differences were not mediated by Apgar score.Multiple-birth SGA subgroups (vs. singleton SGA or singleton SGA subgroup with co-occurrence of smoking and inadequate GWG (vs. singleton SGA subgroup without maternal smoking and inadequate gestational weight gain have poorer cognitive development up to 5 y.

  17. Opportunities in Neutron Science

    Science.gov (United States)

    Fernandez-Baca, Jaime

    2010-03-01

    National Laboratories often have unique facilities that cannot be normally found at universities, and that provide unique opportunities to perform research using world class instrumentation in collaboration with teams of experts. This synergy of expertise and world-class facilities also offers unique opportunities for mentoring and training of students in settings different from the university environment. In this talk I will discuss the opportunities of scientific research, mentoring and training at the Spallation Neutron Source (SNS) and the High Flux Isotope Reactor (HFIR) at Oak Ridge National Laboratory. The SNS is the world's most intense pulsed accelerator-based neutron source, the HFIR is the highest flux reactor-based neutron source for condensed matter research in the United States, the combination of these provides neutron scattering capabilities unavailable anywhere else in the world. The SNS and the HFIR at ORNL are funded by the Division of Scientific User Facilities, Office of Basic Energy Sciences, US. Department of Energy.

  18. Links and opportunities

    Science.gov (United States)

    1999-09-01

    At the end of June a new website was launched to enable young people to get involved with the UK's national Foresight programme and to help shape the future. `School of the Future - Young people with Foresight' will provide young people with the means to contribute to the national programme which develops scenarios of the future, looking at possible needs, opportunities or threats and deciding what should be done now to make sure these challenges can be met. The site can be found at www.asset.org.uk and it will be run by the Association for Schools' Science, Engineering and Technology (ASSET). The latest round of Foresight began in April and panels are taking a look at the aging population, crime prevention, built environment and transport, aerospace and systems, energy and the natural environment, information, communications and media, materials and sustainable development, amongst other topics. Information about Foresight activities and events can be obtained from the Office of Science and Technology or the Foresight Knowledge pool at www.foresight.gov.uk. The pool will act as a unique and freely accessible electronic library of views and information about the future that young people will be able to draw on for assistance and reference material. Futher assistance for students will also be on offer from museums and art galleries from now on, thanks to additional funding which has been made available over the next three years. Forty museums and galleries will share up to #2.5m for projects intended to improve students' literacy, numeracy and science skills as well as their understanding of history and art. Examples of the imaginative projects which have been put forward include use of the large collection of steam engines at the Museum of Science and Industry in Manchester to assist boys' science and literacy skills. The Museum of London will be working with over 2000 schools in the South East to provide materials for the schools' own mini-museums on the Romans

  19. Career opportunities in oncology.

    Science.gov (United States)

    Farrow, L

    Oncology nursing offers nurses a wide range of opportunities. Nurses need a wide range of skills in order to care for patients who may have acute oncological illnesses or require palliative care. The nature of the nurse/patient relationship can be intense. Nurses generally find this enhances job satisfaction. The pressures exerted on nurses working in oncology can be immense. Oncology nursing is rewarding but very demanding and therefore the nurse has to be resourceful. Early career planning is advisable to take advantage of the opportunities that are currently available.

  20. Raiding Opportunities and Unemployment

    DEFF Research Database (Denmark)

    Tranæs, Torben

    2001-01-01

    This article studies the impact of raiding opportunities in a labor market in which worker abilities differ. Recruiting firms can either raid an elsewhere-employed worker of known ability by bidding up his wage or go through costly search to find a good worker among the unemployed. In equilibrium......, all types of workers experience unemployment, high-ability workers involuntarily. The raiding opportunities give rise to involuntary unemployment without changing the basic properties of the competitive model and thus suggest new implications of various institutional parameters on unemployment...

  1. Opportunity's Empty Nest

    Science.gov (United States)

    2004-01-01

    This image taken by the panoramic camera onboard the Mars Exploration Rover Opportunity shows the rover's now-empty lander, the Challenger Memorial Station, at Meridiani Planum, Mars. The image was acquired on the 24th martian day, or sol, of Opportunity's mission at approximately 13:00 Local Solar Time. This is a mosaic image consisting of 12 color images acquired with the camera's red, green and blue filters. The color balance has been set to approximate the colors that a human eye would see.

  2. Raiding Opportunities and Unemployment

    DEFF Research Database (Denmark)

    Tranæs, Torben

    2001-01-01

    , all types of workers experience unemployment, high-ability workers involuntarily. The raiding opportunities give rise to involuntary unemployment without changing the basic properties of the competitive model and thus suggest new implications of various institutional parameters on unemployment......This article studies the impact of raiding opportunities in a labor market in which worker abilities differ. Recruiting firms can either raid an elsewhere-employed worker of known ability by bidding up his wage or go through costly search to find a good worker among the unemployed. In equilibrium...

  3. Finite groups with the set of the number of subgroups of possible ...

    Indian Academy of Sciences (India)

    Throughout this paper, groups mentioned are finite and p is a prime. An important topic in the group theory is to investigate the number of subgroups of possible order, and con- versely it is also an important subject to determine the structure of a finite group by considering the number of its subgroups of possible orders.

  4. Finite groups with the set of the number of subgroups of possible ...

    Indian Academy of Sciences (India)

    Finite group; the number of subgroups of possible order. 1. Introduction. Throughout this paper, groups mentioned are finite and p is a prime. An important topic in the group theory is to investigate the number of subgroups of possible order, and con- versely it is also an important subject to determine the structure of a finite ...

  5. On s-semipermutable subgroups of finite groups and p-nilpotency

    Indian Academy of Sciences (India)

    Srinivasan [10] showed that a group. G is supersolvable if all maximal subgroups of every Sylow subgroup of G are normal. Later, several authors obtain the same conclusion if normality is replaced by some weaker normality (see [8]). In this paper, we obtain some new characterizations of p-nilpotent groups and generalize.

  6. Clinimetrics corner: choosing appropriate study designs for particular questions about treatment subgroups

    DEFF Research Database (Denmark)

    Kent, Peter; Hancock, Mark; Petersen, Ditte H.D

    2010-01-01

    Background: Many clinicians and researchers believe that there are subgroups of people with spinal pain who respond differently to treatment and have different prognoses. There has been considerable interest in this topic recently. However, problems occur when conclusions about subgroups are made...

  7. Measuring English Language Workplace Proficiency across Subgroups: Using CFA Models to Validate Test Score Interpretation

    Science.gov (United States)

    Yoo, Hanwook; Manna, Venessa F.

    2017-01-01

    This study assessed the factor structure of the Test of English for International Communication (TOEIC®) Listening and Reading test, and its invariance across subgroups of test-takers. The subgroups were defined by (a) gender, (b) age, (c) employment status, (d) time spent studying English, and (e) having lived in a country where English is the…

  8. Making Students Visible: Comparing Different Student Subgroup Sizes for Accountability. Policy Memo 16-2

    Science.gov (United States)

    Hough, Heather; Witte, Joe

    2016-01-01

    With the passage of the Every Student Succeeds Act (ESSA) of 2015, California state policymakers are tasked with determining the subgroup threshold for school-level reporting. To inform this decision, this policy brief explores the implications of utilizing various subgroup sizes using data from the CORE Districts. The authors find that the 20+…

  9. Level of evidence for promising subgroup findings in an overall non-significant trial

    NARCIS (Netherlands)

    Tanniou, Julien; van der Tweel, Ingeborg|info:eu-repo/dai/nl/262684438; Teerenstra, S.; Roes, Kit C.B.|info:eu-repo/dai/nl/115147020

    2016-01-01

    In drug development and drug licensing, it sometimes occurs that a new drug does not demonstrate effectiveness for the full study population, but there appears to be benefit in a relevant, pre-defined subgroup. This raises the question, how strong the evidence from such a subgroup is, and which

  10. Conditions for Effective Application of Analysis of Symmetrically-Predicted Endogenous Subgroups

    Science.gov (United States)

    Peck, Laura R.

    2015-01-01

    Several analytic strategies exist for opening up the "black box" to reveal more about what drives policy and program impacts. This article focuses on one of these strategies: the Analysis of Symmetrically-Predicted Endogenous Subgroups (ASPES). ASPES uses exogenous baseline data to identify endogenously-defined subgroups, keeping the…

  11. Subgroup analyses in confirmatory clinical trials: time to be specific about their purposes

    Directory of Open Access Journals (Sweden)

    Julien Tanniou

    2016-02-01

    Full Text Available Abstract Background It is well recognized that treatment effects may not be homogeneous across the study population. Subgroup analyses constitute a fundamental step in the assessment of evidence from confirmatory (Phase III clinical trials, where conclusions for the overall study population might not hold. Subgroup analyses can have different and distinct purposes, requiring specific design and analysis solutions. It is relevant to evaluate methodological developments in subgroup analyses against these purposes to guide health care professionals and regulators as well as to identify gaps in current methodology. Methods We defined four purposes for subgroup analyses: (1 Investigate the consistency of treatment effects across subgroups of clinical importance, (2 Explore the treatment effect across different subgroups within an overall non-significant trial, (3 Evaluate safety profiles limited to one or a few subgroup(s, (4 Establish efficacy in the targeted subgroup when included in a confirmatory testing strategy of a single trial. We reviewed the methodology in line with this “purpose-based” framework. The review covered papers published between January 2005 and April 2015 and aimed to classify them in none, one or more of the aforementioned purposes. Results In total 1857 potentially eligible papers were identified. Forty-eight papers were selected and 20 additional relevant papers were identified from their references, leading to 68 papers in total. Nineteen were dedicated to purpose 1, 16 to purpose 4, one to purpose 2 and none to purpose 3. Seven papers were dedicated to more than one purpose, the 25 remaining could not be classified unambiguously. Purposes of the methods were often not specifically indicated, methods for subgroup analysis for safety purposes were almost absent and a multitude of diverse methods were developed for purpose (1. Conclusions It is important that researchers developing methodology for subgroup analysis

  12. A Newborn Case of “c” Subgroup Mismatch Presenting with Severe Hemolysis and Anemia

    Directory of Open Access Journals (Sweden)

    Ezgi Yangın Ergon

    2017-12-01

    Full Text Available Hemolysis and jaundice related to Rh incompatibility in the neonatal period has decreased substantially due to the widespread use of anti-D gammaglobulin in recent years. Nevertheless, the rate of subgroup mismatch in the etiology of hemolytic diseases of the newborn has increased significantly. In this article an 8-day-old newborn infant with “c” subgroup incompatibility and presenting with severe anemia, in whom hemolysis could be controlled with intravenous immunoglobulin infusion and subgroup appropriate blood transfusion, has been presented. Scientific studies have demonstrated that the hemolytic disease of patients who don’t have major blood group incompatibility but carry anti-C antibodies can be rather serious. Therefore, subgroup mismatch should always be kept in mind for newborns presenting with severe hemolytic anemia, and transfusion or if necessary exchange transfusion should be provided with subgroup matched blood products.

  13. Opportunity Turns 40

    Science.gov (United States)

    Muccio, Maria; Pierre-Vil, Samienta

    2016-01-01

    The New England Educational Opportunity Association (NEOA) drew more than 250 TRIO and college access professionals to its 40th annual conference in Massachusetts earlier this spring. NEOA's mission is to advocate for access to and success in postsecondary education for low-income individuals, "first-generation" college students, and…

  14. Opportunity Cost: A Reply

    Science.gov (United States)

    Parkin, Michael

    2016-01-01

    The author's objective for this reply in reexamining opportunity cost was to draw attention to two conflicting definitions of the concept in current use and to argue the case for dropping one of them. The comments of Daniel Arce, Rod O'Donnell, and Daniel Stone might be read as demonstration that the author has failed on both counts. Such a…

  15. Obesity Prevention and Screening.

    Science.gov (United States)

    Mackey, Eleanor R; Olson, Alexandra; DiFazio, Marc; Cassidy, Omni

    2016-03-01

    Obesity is widespread, associated with several physical and psychosocial comorbidities, and is difficult to treat. Prevention of obesity across the lifespan is critical to improving the health of individuals and society. Screening and prevention efforts in primary care are an important step in addressing the obesity epidemic. Each period of human development is associated with unique risks, challenges, and opportunities for prevention and intervention. Screening tools for overweight/obesity, although imperfect, are quick and easy to administer. Screening should be conducted at every primary care visit and tracked longitudinally. Screening tools and cutoffs for overweight and obesity vary by age group. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Nutrition and Cancer Prevention Research Practicum | Division of Cancer Prevention

    Science.gov (United States)

    The Nutritional Science Research Group in the Division of Cancer Prevention at the National Cancer Institute, National Institutes of Health and the Department of Nutrition at the Clinical Center, National Institutes of Health are offering a one week educational opportunity in "Nutrition and Cancer Prevention Research" for individuals with a sustained commitment to nutrition

  17. Subgrouping of risky behaviors among Iranian college students: a latent class analysis

    Directory of Open Access Journals (Sweden)

    Safiri S

    2016-07-01

    also estimated. Three latent classes were determined: 1 low risk; 2 cigarette and hookah smoker; and 3 high risk. It is worth mentioning that 3.7% of males and 0.4% of females were in the high risk group.Conclusion: Subgrouping of college students showed that a considerable percentage of them, especially males, were classified into the high risk and cigarette and hookah smoker groups. Appropriate preventive measures that consider multiple different risky behaviors simultaneously are needed for this part of the population. Keywords: alcohol drinking, sexual behavior, latent class analysis, risk behaviors, drug abuse, substance abuse

  18. Physical activity prescription: a critical opportunity to address a modifiable risk factor for the prevention and management of chronic disease: a position statement by the Canadian Academy of Sport and Exercise Medicine.

    Science.gov (United States)

    Thornton, Jane S; Frémont, Pierre; Khan, Karim; Poirier, Paul; Fowles, Jonathon; Wells, Greg D; Frankovich, Renata J

    2016-09-01

    Non-communicable disease is a leading threat to global health. Physical inactivity is a large contributor to this problem; in fact, the WHO ranks it as the fourth leading risk factor for overall morbidity and mortality worldwide. In Canada, at least 4 of 5 adults do not meet the Canadian Physical Activity Guidelines of 150 min of moderate-to-vigorous physical activity per week. Physicians play an important role in the dissemination of physical activity (PA) recommendations to a broad segment of the population, as over 80% of Canadians visit their doctors every year and prefer to get health information directly from them. Unfortunately, most physicians do not regularly assess or prescribe PA as part of routine care, and even when discussed, few provide specific recommendations. PA prescription has the potential to be an important therapeutic agent for all ages in primary, secondary and tertiary prevention of chronic disease. Sport and exercise medicine (SEM) physicians are particularly well suited for this role and should collaborate with their primary care colleagues for optimal patient care. The purpose of this Canadian Academy and Sport and Exercise Medicine position statement is to provide an evidence-based, best practices summary to better equip SEM and primary care physicians to prescribe PA and exercise, specifically for the prevention and management of non-communicable disease. This will be achieved by addressing common questions and perceived barriers in the field.Author note This position statement has been endorsed by the following nine sport medicine societies: Australasian College of Sports and Exercise Physicians (ACSEP), American Medical Society for Sports Medicine (AMSSM), British Association of Sports and Exercise Medicine (BASEM), European College of Sport & Exercise Physicians (ECOSEP), Norsk forening for idrettsmedisin og fysisk aktivite (NIMF), South African Sports Medicine Association (SASMA), Schweizerische Gesellschaft für Sportmedizin

  19. Opportunities for tuberculosis diagnosis and prevention among persons living with HIV: a cross-sectional study of policies and practices at four large Ryan White Program-Funded HIV clinics.

    Directory of Open Access Journals (Sweden)

    Lisa Pascopella

    Full Text Available OBJECTIVE: We describe the frequency and attributes of tuberculosis testing and treatment at four publicly-funded HIV clinics. METHODS: We abstracted medical records from a random sample of 600 HIV-infected patients having at least one clinic visit in 2009 at four clinics in New York and Los Angeles Metropolitan Statistical areas. We described testing and treatment for tuberculosis infection (TBI, 2008-2010, and estimated adjusted odds ratios (aORs. We interviewed key informants and described clinic policies and practices. RESULTS: Of 600 patients, 500 were eligible for testing, and 393 (79% were tested 2008-2010; 107 (21% did not receive at least one tuberculin skin test or interferon gamma release assay. Results were positive in 20 (5% patients, negative in 357 (91%, and unknown in 16 (4%. Fourteen (70% of 20 patients with TBI initiated treatment at the clinics; only three were documented to have completed treatment. Three hundred twenty three (54% patients had chest radiography, 346 (58% had tuberculosis symptom screening, and three had tuberculosis disease (117 per 100,000 person-years, 95% confidence interval (CI = 101-165. Adjusting for site, non-Hispanic ethnicity (aOR = 4.9, 95% CI = 2.6-9.5, and employment (aOR = 1.9, 95% CI = 1.0-3.4 were associated with TBI testing; female gender (aOR = 2.0, 95% CI = 1.4-3.3, non-black race (aOR = 1.7, 95% CI = 1.3-2.5, and unemployment (aOR = 1.5, 95% CI = 1.1-2.1 were associated with chest radiography. Clinics evaluated TBI testing performance annually and identified challenges to TB prevention. CONCLUSIONS: Study clinics routinely tested patients for TBI, but did not always document treatment. In a population with a high TB rate, ensuring treatment of TBI may enhance TB prevention.

  20. Choking Prevention

    Science.gov (United States)

    ... Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & Prevention Safety and Prevention Immunizations At Home ...

  1. Collaborative Approaches and Policy Opportunities for Accelerated Progress toward Effective Disease Prevention, Care, and Control: Using the Case of Poverty Diseases to Explore Universal Access to Affordable Health Care

    Directory of Open Access Journals (Sweden)

    Samia Laokri

    2017-08-01

    health-care silos.ConclusionDespite a large political commitment and mobilization efforts from funding, the global development goal of financial protection for health—newly adopted in TB control as no TB-affected household experiencing catastrophic expenditure—may remain aspirational. To enhance effective access to care for all, innovative opportunities in patient-centered and collaborative practices must be taken. Further research is greatly needed to optimize the use of locally relevant knowledge, networks, and technologies.

  2. Collaborative Approaches and Policy Opportunities for Accelerated Progress toward Effective Disease Prevention, Care, and Control: Using the Case of Poverty Diseases to Explore Universal Access to Affordable Health Care.

    Science.gov (United States)

    Laokri, Samia

    2017-01-01

    commitment and mobilization efforts from funding, the global development goal of financial protection for health-newly adopted in TB control as no TB-affected household experiencing catastrophic expenditure-may remain aspirational. To enhance effective access to care for all, innovative opportunities in patient-centered and collaborative practices must be taken. Further research is greatly needed to optimize the use of locally relevant knowledge, networks, and technologies.

  3. Non-communicable diseases – harnessing the current opportunities

    DEFF Research Database (Denmark)

    Sørensen, Jane Brandt; Demaio, Alessandro Rhyll; Østergaard, Lise Rosendal

    2012-01-01

    Non-communicable diseases (NCDs) receive growing attention, which brings a unique opportunity to utilise solutions available to address them. These diseases are largely preventable; proven, cost-effective interventions are available; and when NCDs have emerged, means exist to treat them, prevent...

  4. Four Distinct Subgroups of Self-Injurious Behavior among Chinese Adolescents: Findings from a Latent Class Analysis.

    Directory of Open Access Journals (Sweden)

    Xiuhong Xin

    Full Text Available Self-injurious behavior (SIB among adolescents is an important public health issue worldwide. It is still uncertain whether homogeneous subgroups of SIB can be identified and whether constellations of SIBs can co-occur due to the high heterogeneity of these behaviors. In this study, a cross-sectional study was conducted on a large school-based sample and latent class analysis was performed (n = 10,069, mean age = 15 years to identify SIB classes based on 11 indicators falling under direct SIB (DSIB, indirect SIB (ISIB, and suicide attempts (SAs. Social and psychological characteristics of each subgroup were examined after controlling for age and gender. Results showed that a four-class model best fit the data and each class had a distinct pattern of co-occurrence of SIBs and external measures. Class 4 (the baseline/normative group, 65.3% had a low probability of SIB. Class 3 (severe SIB group, 3.9% had a high probability of SIB and the poorest social and psychological status. Class 1 (DSIB+SA group, 14.2% had similar scores for external variables compared to class 3, and included a majority of girls [odds ratio (OR = 1.94]. Class 2 (ISIB group, 16.6% displayed moderate endorsement of ISIB items, and had a majority of boys and older adolescents (OR = 1.51. These findings suggest that SIB is a heterogeneous entity, but it may be best explained by four homogenous subgroups that display quantitative and qualitative differences. Findings in this study will improve our understanding on SIB and may facilitate the prevention and treatment of SIB.

  5. Treatment with triple combination of atorvastatin, perindopril, and amlodipine in patients with stable coronary artery disease: A subgroup analysis from the PAPA-CAD study.

    Science.gov (United States)

    Dézsi, Csaba András

    2018-01-01

    Background In patients with stable coronary artery disease, aspirin, a statin, and an angiotensin-converting enzyme inhibitor are recommended as first-line agents for secondary prevention. Subgroup analyses of the previously published Hungarian Perindopril plus Amlodipine in PAtients with Coronary Artery Disease (PAPA-CAD) non-interventional trial demonstrated that the addition of the metabolically beneficial, fixed combination of perindopril + amlodipine to atorvastatin further improves the patient's lipid profile. Methods The PAPA-CAD study, a 6-month open-label, prospective, multicenter, observational/non-interventional survey evaluated data accumulated from patients with hypertensive patients with stable coronary artery disease. The herein-reported subgroup analysis was conducted using the findings from those 1130 patients, who were taking atorvastatin in addition to the fixed combination of perindopril + amlodipine at the time of all four study visits (i.e., at baseline and 1, 3, and 6 months later). Results In the subgroup of patients taking atorvastatin as an add-on agent, 82.5% reached the target blood pressure of 140/90 mmHg compared with 78.8% of those not taking a statin. The addition of atorvastatin to the fixed combination of perindopril + amlodipine resulted in further significant improvements of key metabolic parameters. Conclusion This subgroup analysis confirmed that favorable synergism exists among perindopril, amlodipine, and atorvastatin.

  6. Patterns of subgrouping and spatial affiliation in a community of mantled howling monkeys (Alouatta palliata).

    Science.gov (United States)

    Bezanson, Michelle; Garber, Paul A; Murphy, John T; Premo, L S

    2008-03-01

    Studies of social affiliation and social spacing offer important insight into the dynamics of subgroup formation and social strategies in living primates. Among the 11 species in the genus Alouatta, mantled howlers (A. palliata) are the only species to consistently form large, stable social groups composed of several adult males and several adult females. In this study, we examine patterns of subgrouping, activity, and partner preferences in a troop of 26-29 wild mantled howling monkeys (including 12-13 marked individuals) inhabiting Isla de Ometepe, Nicaragua. During two study seasons in 2000 and 2001, we simultaneously monitored the size, composition, and activities of individuals in two to three different subgroups. A half-weight association index was used to calculate partner preferences and patterns of spatial association. Results indicate that our howler study troop fragmented into subgroups of 1-20 with subgroups averaging five and six individuals. Subgroup size and membership reflected individual patterns of social affiliation and social tolerance, and in general remained consistent across activities and from year to year. We also found evidence of cliques or social networks of three to four individuals embedded within larger subgroups. A small number of adult males appeared to play an important social role as the nucleus of clique formation. We argue that the persistence of strong male-male and male-female partner preferences in mantled howlers helps to explain the stability of relatively large multimale-multifemale groups.

  7. Differential pharmacotherapy for subgroups of fibromyalgia patients with specific consideration of 5-HT3 receptor antagonists.

    Science.gov (United States)

    Seidel, Matthias F; Müller, Wolfgang

    2011-06-01

    The fibromyalgia syndrome (FMS) has a prevalence of about 2% and is characterized by generalized musculoskeletal pain, reduced pain threshold and autonomic and functional symptoms. It is a multifactorial syndrome with four different subgroups exhibiting pathophysiological and psychiatric findings. No precise treatment strategy is currently available for the different FMS subgroups. This article reviews the evidence for treatment options for the different FMS subgroups. Therapy for the first subgroup of primary FMS, with high levels of pain but no psychopathological alterations, is targeted at nociceptors expressing serotonin (5-hydroxytryptamine-3; 5-HT3) receptors with 5-HT3 receptor antagonists. The second and third subgroups are characterized by depressive syndromes with a major indication for antidepressants. The fourth subgroup with psychosomatic syndromes requires psychotherapeutic treatment. Secondary FMS is similar to the primary syndromes but is triggered by a variety of other diseases and frequently responds to 5-HT3 receptor antagonist treatment. Different classes of drug, such as pregabalin, must be tested for efficacy and tolerance. FMS treatment strategies should be tailored after the identification of individual FMS subgroups. Although several groups of drug have been studied extensively, 5-HT3 receptor antagonists are most effective in patients without psychopathological alterations.

  8. User Frustrations as Opportunities

    Directory of Open Access Journals (Sweden)

    Michael Weiss

    2012-04-01

    Full Text Available User frustrations are an excellent source of new product ideas. Starting with this observation, this article describes an approach that entrepreneurs can use to discover business opportunities. Opportunity discovery starts with a problem that the user has, but may not be able to articulate. User-centered design techniques can help elicit those latent needs. The entrepreneur should then try to understand how users are solving their problem today, before proposing a solution that draws on the unique skills and technical capabilities available to the entrepreneur. Finally, an in-depth understanding of the user allows the entrepreneur to hone in on the points of difference and resonance that are the foundation of a strong customer value proposition.

  9. Hot business - cool opportunities

    International Nuclear Information System (INIS)

    Fraser, M.

    1997-01-01

    A new role for the deregulated electric utilities in the energy services market or performance contracting markets was discussed. It was argued that in view of the long tradition of close customer contact, distribution utilities are in a good position to leverage their relationship with their customers to expand the range of products and services that the ''utility'' provides to them. Real time pricing, energy services, HVAC maintenance and operation are just some of the areas where the distribution utility''s linkage to customers could be used to good advantage. Some case histories, and a list of potential product and service opportunities in the commercial/industrial and residential sectors were provided. Some of the potential pitfalls were also identified for utilities that wish to pursue these opportunities. These pitfalls included legal, marketing, risk management and funding issues

  10. Propane: North American opportunities

    International Nuclear Information System (INIS)

    Dempsey, C.

    1992-01-01

    Opportunities for expanding the propane market in North America are discussed. The goal of change should be to enhance client satisfaction and loyalty. The current customer base is largely comprised of pick-up trucks, vans and buses in commercial fleet service, police and similar fleet service and privately owned vehicles. Opportunities for the expansion of propane exist due to: vehicles being kept and lasting longer, allowing a longer pay-back time; exhaust emission standards becoming more stringent; the possible introduction of emission standards for substances currently not controlled; and properly combusted CO 2 emissions that are at least 12% lower than gasoline. The continuing development of engine fuel management systems, application of extensive road/highway experience, matching supply and refuelling infrastructure to consumer demands, application in air quality non-attainment areas, and original equipment manufacturer, government and industry cooperation are discussed. 8 figs

  11. Migration and intervening opportunities.

    Science.gov (United States)

    Denslow, D A; Eaton, P J

    1984-10-01

    An analysis of factors affecting migration is presented. The authors "extend the investigation of the roles of information, intervening opportunities, and psychic costs by focussing on differences in migrant destinations with respect to the deterring effect of distance. [They develop] a reservation-wage model of migration which implies that the distance effect is weaker for high-wage destinations and stronger for low-wage destinations." The model is tested using data for Brazil, Japan, Mexico, the United States, and Venezuela. excerpt

  12. Crisis -- A Leadership Opportunity

    Science.gov (United States)

    2005-04-01

    recognized the great value in understanding crisis theory and the leadership strategies to employ during these situations. Additionally, we discovered...ed.: 50. Mitroff, Ian I. Crisis leadership : Planning for the Unthinkable. Hoboken: Wiley, 2004. Murphy, P. (1996). "Chaos Theory as a Model...Crisis–A Leadership Opportunity COL Victor Braden, ARNG CAPT Justin Cooper II, USN COL Michael Klingele, USA Lt Col John P

  13. Equal Opportunities Advisory Panel

    CERN Multimedia

    HR Department

    2006-01-01

    At its meeting on 7 December 2006, the Standing Concertation Committee took note of the appointment of four new members of the Panel: Wisla Carena, Pierre Charrue, Sue Foffano and Markus Nordberg. The present composition of the Panel (appointed ad personam) is as follows: Tiziano Camporesi (Chairperson), Wisla Carena, Pierre Charrue, Sue Foffano, Josi Schinzel (Equal Opportunities Officer), Markus Nordberg, Christine Petit-Jean-Genaz et Elena Wildner. Human Resources Department Tel. 74480

  14. Opportunities for innovation

    International Nuclear Information System (INIS)

    Broaddus, J.A.

    1991-01-01

    Actual results have shown that the Construction Industry Institute (CII) offers significant opportunities for improvement in cost, schedule, and quality on most projects, and in particular, on large projects. This paper reviews the state of the construction industry, discusses how its problems are being addressed by CII, and addresses potential opportunities through the application of CII research products. CII is meeting the challenge of the industry. Just like the challenge of Department of Energy's Super Conducting Super Collider. With $1.2 billion worth of construction to be constructed during the 90s, the opportunities for innovation appear to be great. Every effort should be made while the projects are still on the high part of cost influence curve to use modern management methods and approaches to executing its work. Proper attention to all the inputs to project design is absolutely essential. Scope definition and control techniques have been developed by CII which can be used. Work packaging for the most efficient execution of engineering and construction are available as well. Approaches, incentives, and contracting strategies have also been researched by CII. Constructability programs virtually always guarantee a savings of at least 10 percent. Partnership arrangements can reduce the size of overhead for all participants in the process and eliminate the typical adversarial climates which tend to predominate on a construction project. SSC Laboratories and the PB-MK team have the opportunity to take the initiative now to make the 21st Century SSC a construction project which is executed in the 21st Century manner

  15. Generators for the em>l>-torsion subgroup of Jacobians of Genus Two Curves

    DEFF Research Database (Denmark)

    Ravnshøj, Christian Robenhagen

    2008-01-01

    We give an explicit description of the matrix representation of the Frobenius endomorphism on the Jacobian of a genus two curve on the subgroup of l-torsion points. By using this description, we can describe the matrix representation of the Weil-pairing on the subgroup of l-torsion points explici...... explicitly. Finally, the explicit description of the Weil-pairing provides us with an efficient, probabilistic algorithm to find generators of the subgroup of l-torsion points on the Jacobian of a genus two curve....

  16. Debate: Subgroup analyses in clinical trials: fun to look at - but don't believe them!

    Directory of Open Access Journals (Sweden)

    Sleight Peter

    2000-07-01

    Full Text Available Abstract Analysis of subgroup results in a clinical trial is surprisingly unreliable, even in a large trial. This is the result of a combination of reduced statistical power, increased variance and the play of chance. Reliance on such analyses is likely to be more erroneous, and hence harmful, than application of the overall proportional (or relative result in the whole trial to the estimate of absolute risk in that subgroup. Plausible explanations can usually be found for effects that are, in reality, simply due to the play of chance. When clinicians believe such subgroup analyses, there is a real danger of harm to the individual patient.

  17. Predictors of Prevention Failure in College Students Participating in Two Indicated Depression Prevention Programs

    OpenAIRE

    Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L.; Otero, Patricia

    2014-01-01

    The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were ...

  18. Antibody Prevalence and Factors Associated with Exposure to Orientia tsutsugamushi in Different Aboriginal Subgroups in West Malaysia

    Science.gov (United States)

    Tay, Sun Tee; Mohamed Zan, Hafizatul Anis; Lim, Yvonne A. L.; Ngui, Romano

    2013-01-01

    Background Limited data is available on the current status of scrub typhus infection in the aboriginal population in Malaysia. This study was aimed to provide recent data on the degree of exposure of 280 individuals from seven aboriginal subgroups to Orientia tsutsugamushi (causative agent of scrub typhus) in West Malaysia. The environment, socioeconomic and behavioural risk factors associated with the disease were also investigated. Methods/Findings The antibody prevalence to O. tsutsugamushi ranged from 0 to 36.4% in seven subgroups, with high prevalence rates noted in subgroups involved in agricultural activity and the lowest prevalence rates noted in subgroups whose main occupations were associated to fishing. Univariate analysis indicated populations with age above 18 years (OR = 1.15, 95% CI = 1.02–1.30, P = 0.015), working (OR = 1.99, 95% CI = 1.01–3.92, P = 0.044), working at agriculture area (OR = 1.18, 95% CI = 0.98–1.42, P = 0.031), receiving household income less than US$ 166.7 (RM500) per month (OR = 2.43, 95% CI = 1.16–5.11, P = 0.016) and having close contact with animal pets (OR = 4.06, 95% CI = 1.20–13.76, P = 0.016) are significantly associated with exposure to O. tsutsugamushi. Multivariate analysis confirms that participants who are above 18 years old, receiving household income less than US$ 166.7 (RM500) per month and having close contact with animal pets are 3.6 times (95% CI = 1.81–7.03, Ppopulation in Malaysia. Awareness about the disease and education on the preventive measures are important in reducing the risk of acquiring scrub typhus in the population studied. PMID:23936576

  19. Discrete subgroups of adolescents diagnosed with borderline personality disorder: a latent class analysis of personality features.

    Science.gov (United States)

    Ramos, Vera; Canta, Guilherme; de Castro, Filipa; Leal, Isabel

    2014-08-01

    Research suggests that borderline personality disorder (BPD) can be diagnosed in adolescents and is marked by considerable heterogeneity. This study aimed to identify personality features characterizing adolescents with BPD and possible meaningful patterns of heterogeneity that could lead to personality subgroups. The authors analyzed data on 60 adolescents, ages 15 to 18 years, who met DSM criteria for a BPD diagnosis. The authors used latent class analysis (LCA) to identify subgroups based on the personality pattern scales from the Millon Adolescent Clinical Inventory (MACI). LCA indicated that the best-fitting solution was a two-class model, identifying two discrete subgroups of BPD adolescents that were described as internalizing and externalizing. The subgroups were then compared on clinical and sociodemographic variables, measures of personality dimensions, DSM BPD criteria, and perception of attachment styles. Adolescents with a BPD diagnosis constitute a heterogeneous group and vary meaningfully on personality features that can have clinical implications for treatment.

  20. Arbitrary geometry resonance calculation using subgroup method and method of characteristics

    International Nuclear Information System (INIS)

    Cao, Liangzhi; Wu, Hongchun; Liu, Qingjie; Chen, Qichang

    2011-01-01

    Complex design of the nuclear reactor fuel assembly has proposed new challenges to the resonance calculation method. In this study, a subgroup resonance calculation method for two-dimensional arbitrary geometry is studied. The subgroup method is extended to arbitrary geometry fuel assembly by using the two-dimensional arbitrary geometry neutron transport calculation method of characteristics (MOC). Spatially dependent group averaged cross-sections are obtained by weighing the subgroup cross-section with subgroup flux spectrum. In addition to the great adaptability in geometry, this method has advantages in treating multiple resonant regions with complex resonant materials as well. Therefore, it is possible to calculate the spatially dependent resonance cross section of arbitrary geometry fuel assembly by one step. (author)

  1. Team negotiation: social, epistemic, economic, and psychological consequences of subgroup conflict.

    Science.gov (United States)

    Halevy, Nir

    2008-12-01

    Large collectives (e.g., organizations, political parties, nations) are seldom unitary players. Rather, they consist of different subgroups that often have conflicting interests. Nonetheless, negotiation research consistently regards negotiating teams, who represent these collectives, as monolithic parties with uniform interests. This article integrates concepts from social psychology, management, political science, and behavioral game theory to explore the effects of subgroup conflict on team negotiation. Specifically, the present research introduced a conflict of interests within negotiating teams and investigated how this internal conflict affects the outcome of the negotiation between teams. An experiment with 80 four-person teams found that conflict between subgroups had a detrimental effect on the performance of negotiating teams. This research also employed a recent model of motivated information processing in groups to investigate possible processes underlying the effect of subgroup conflict on team negotiation.

  2. Incidence and follow-up of Braunwald subgroups in unstable angina pectoris

    NARCIS (Netherlands)

    A.J.M. van Miltenburg-van Zijl (Addy); M.L. Simoons (Maarten); R.J. Veerhoek (Rinus); P.M.M. Bossuyt (Patrick)

    1995-01-01

    textabstractObjectives. This study was performed to establish the prognosis of patients with unstable angina within the subgroups of the Braunwald classification. Background. Among many classifications of unstable angina, the Braunwald classification is frequently used. However, the incidence

  3. Personalised caregiver support: effectiveness of psychosocial interventions in subgroups of caregivers of people with dementia

    NARCIS (Netherlands)

    van Mierlo, L.D.; Meiland, F.J.M.; van der Roest, H.G.; Dröes, R.M.

    2012-01-01

    Objective Insight into the characteristics of caregivers for whom psychosocial interventions are effective is important for care practice. Until now no systematic reviews were conducted into the effectiveness of psychosocial interventions for caregiver subgroups. Methods To gain insight into this

  4. General considerations for SSC scintillator calorimeters (For the scintillator general subgroup)

    International Nuclear Information System (INIS)

    Nodulman, L.

    1989-01-01

    The Scintillator Calorimetry group divided into three subgroups: a conventional uranium and plate design ala ZEUS, fiber design, and a group on general considerations. The considerations of the third group are reported here on geometrical and technical issues. 1 fig

  5. Latent class analysis derived subgroups of low back pain patients - do they have prognostic capacity?

    DEFF Research Database (Denmark)

    Mølgaard Nielsen, Anne; Hestbaek, Lise; Vach, Werner

    2017-01-01

    . Previously, we developed two novel suggestions for subgrouping patients with low back pain based on Latent Class Analysis of patient baseline characteristics (patient history and physical examination), which resulted in 7 subgroups when using a single-stage analysis, and 9 subgroups when using a two......-stage approach. However, their prognostic capacity was unexplored. This study (i) determined whether the subgrouping approaches were associated with the future outcomes of pain intensity, pain frequency and disability, (ii) assessed whether one of these two approaches was more strongly or more consistently...... than that of the comparator variables, except for participants' recovery beliefs and the domain-specific categorisations, but was still limited. The explained variance ranged from 4.3%-6.9% for pain intensity and from 6.8%-20.3% for disability, and highest at the 2 weeks follow-up. CONCLUSIONS: Latent...

  6. A Newborn Case of “c” Subgroup Mismatch Presenting with Severe Hemolysis and Anemia

    OpenAIRE

    Ezgi Yangın Ergon; Senem Alkan Özdemir; Rüya Çolak; Kıymet Çelik; Özgür Olukman; Şebnem Çalkavur

    2017-01-01

    Hemolysis and jaundice related to Rh incompatibility in the neonatal period has decreased substantially due to the widespread use of anti-D gammaglobulin in recent years. Nevertheless, the rate of subgroup mismatch in the etiology of hemolytic diseases of the newborn has increased significantly. In this article an 8-day-old newborn infant with “c” subgroup incompatibility and presenting with severe anemia, in whom hemolysis could be controlled with intravenous immunoglobulin infusion and subg...

  7. On s-semipermutable subgroups of finite groups and p-nilpotency

    Indian Academy of Sciences (India)

    Introduction. All groups considered in this paper are finite groups. Most of the notations are standard and can be found in [4] and [3]. Recall that a group H is said to be s-permutable (s-quasinormal) [6] in G if HP = PH for all Sylow subgroups P of G. A subgroup H of a group G is called s-semipermutable [2]. inGif it is ...

  8. On the normal subgroup with coprime G-conjugacy class sizes

    Indian Academy of Sciences (India)

    union of some conjugacy classes of a group G. So, it is interesting to explore the structure of the normal subgroup N if G-conjugacy class sizes of N are given, see [6,7,9]. Enlightened by [3] and [6,7,9], we are interested in the following question. Question. Let G be a group and let N be a normal subgroup of G. Suppose that ...

  9. Effects of hydroxyethyl starch in subgroups of patients with severe sepsis

    DEFF Research Database (Denmark)

    Müller, Rasmus G; Haase, Nicolai; Wetterslev, Jørn

    2013-01-01

    It has been speculated that certain subgroups of sepsis patients may benefit from treatment with hydroxyethyl starch (HES) 130/0.42, specifically in the earlier resuscitation of patients with more severely impaired circulation.......It has been speculated that certain subgroups of sepsis patients may benefit from treatment with hydroxyethyl starch (HES) 130/0.42, specifically in the earlier resuscitation of patients with more severely impaired circulation....

  10. Generating innovation opportunities:

    DEFF Research Database (Denmark)

    Kallio, Anne; Bergenholtz, Carsten

    2011-01-01

    This study examines how a company can generate innovation opportunities by exploring and absorbing customer knowledge. The exploration can be performed via an in-depth or broad search for resources beyond organisational boundaries. Salespeople are an essential channel for an in-depth search...... in relation to customers, since salespeople possess rich knowledge of the customers. In order to be useful, such knowledge has to be absorbed in the company. Most of the literature on absorptive capacity has focused on R&D, while less focus has been placed on studying the role of individuals...

  11. Frontier Aerospace Opportunities

    Science.gov (United States)

    Bushnell, Dennis M.

    2014-01-01

    Discussion and suggested applications of the many ongoing technology opportunities for aerospace products and missions, resulting in often revolutionary capabilities. The, at this point largely unexamined, plethora of possibilities going forward, a subset of which is discussed, could literally reinvent aerospace but requires triage of many possibilities. Such initial upfront homework would lengthen the Research and Development (R&D) time frame but could greatly enhance the affordability and performance of the evolved products and capabilities. Structural nanotubes and exotic energetics along with some unique systems approaches are particularly compelling.

  12. The value of heterogeneity for cost-effectiveness subgroup analysis: conceptual framework and application.

    Science.gov (United States)

    Espinoza, Manuel A; Manca, Andrea; Claxton, Karl; Sculpher, Mark J

    2014-11-01

    This article develops a general framework to guide the use of subgroup cost-effectiveness analysis for decision making in a collectively funded health system. In doing so, it addresses 2 key policy questions, namely, the identification and selection of subgroups, while distinguishing 2 sources of potential value associated with heterogeneity. These are 1) the value of revealing the factors associated with heterogeneity in costs and outcomes using existing evidence (static value) and 2) the value of acquiring further subgroup-related evidence to resolve the uncertainty given the current understanding of heterogeneity (dynamic value). Consideration of these 2 sources of value can guide subgroup-specific treatment decisions and inform whether further research should be conducted to resolve uncertainty to explain variability in costs and outcomes. We apply the proposed methods to a cost-effectiveness analysis for the management of patients with acute coronary syndrome. This study presents the expected net benefits under current and perfect information when subgroups are defined based on the use and combination of 6 binary covariates. The results of the case study confirm the theoretical expectations. As more subgroups are considered, the marginal net benefit gains obtained under the current information show diminishing marginal returns, and the expected value of perfect information shows a decreasing trend. We present a suggested algorithm that synthesizes the results to guide policy. © The Author(s) 2014.

  13. Progressive Amalgamation of Building Clusters for Map Generalization Based on Scaling Subgroups

    Directory of Open Access Journals (Sweden)

    Xianjin He

    2018-03-01

    Full Text Available Map generalization utilizes transformation operations to derive smaller-scale maps from larger-scale maps, and is a key procedure for the modelling and understanding of geographic space. Studies to date have largely applied a fixed tolerance to aggregate clustered buildings into a single object, resulting in the loss of details that meet cartographic constraints and may be of importance for users. This study aims to develop a method that amalgamates clustered buildings gradually without significant modification of geometry, while preserving the map details as much as possible under cartographic constraints. The amalgamation process consists of three key steps. First, individual buildings are grouped into distinct clusters by using the graph-based spatial clustering application with random forest (GSCARF method. Second, building clusters are decomposed into scaling subgroups according to homogeneity with regard to the mean distance of subgroups. Thus, hierarchies of building clusters can be derived based on scaling subgroups. Finally, an amalgamation operation is progressively performed from the bottom-level subgroups to the top-level subgroups using the maximum distance of each subgroup as the amalgamating tolerance instead of using a fixed tolerance. As a consequence of this step, generalized intermediate scaling results are available, which can form the multi-scale representation of buildings. The experimental results show that the proposed method can generate amalgams with correct details, statistical area balance and orthogonal shape while satisfying cartographic constraints (e.g., minimum distance and minimum area.

  14. Discovering subgroups using descriptive models of adverse outcomes in medical care.

    Science.gov (United States)

    Stiglic, Gregor; Kokol, P

    2012-01-01

    Hospital discharge databases store hundreds of thousands of patients. These datasets are usually used by health insurance companies to process claims from hospitals, but they also represent a rich source of information about the patterns of medical care. The proposed subgroup discovery method aims to improve the efficiency of detecting interpretable subgroups in data. Supervised descriptive rule discovery techniques can prove inefficient in cases when target class samples represent only an extremely small amount of all available samples. Our approach aims to balance the number of samples in target and control groups prior to subgroup discovery process. Additionally, we introduce some improvements to an existing subgroup discovery algorithm enhancing the user experience and making the descriptive data mining process and visualization of rules more user friendly. Instance-based subspace subgroup discovery introduced in this paper is demonstrated on hospital discharge data with focus on medical errors. In general, the number of patients with a recorded diagnosis related to a medical error is relatively small in comparison to patients where medical errors did not occur. The ability to produce comprehensible and simple models with high degree of confidence, support, and predictive power using the proposed method is demonstrated. This paper introduces a subspace subgroup discovery process that can be applied in all settings where a large number of samples with relatively small number of target class samples are present. The proposed method is implemented in Weka machine learning environment and is available at http://ri.fzv.uni-mb.si/ssd.

  15. Subgrouping patients with fibromyalgia according to the results of the Fibromyalgia Impact Questionnaire: a replication study.

    Science.gov (United States)

    Calandre, Elena P; Garcia-Carrillo, Jocelyne; Garcia-Leiva, Juan M; Rico-Villademoros, Fernando; Molina-Barea, Rocío; Rodriguez-Lopez, Carmen M

    2011-12-01

    Fibromyalgia is a complex and heterogeneous disease, and several attempts have been made in order to identify different subgroups of patients sharing a common symptomatology. The purpose of the present study has been to replicate a subgroup classification proposed by de Souza et al. based in the Fibromyalgia Impact Questionnaire (FIQ) in a large sample of patients with a cultural and clinical setting different from the original one. Four hundred twenty-one patients were classified, according to the results of the visual analog FIQ subscales in type I o type II subgroups. Demographic and clinical data, as well as results of scales assessing disease's severity, quality of life, sleep quality, anxiety and depression, were compared between the two groups. The profiles of type I and type II patients from our sample strikingly paralleled those of the original study, demonstrating the reproducibility of the classification. In our sample, 18.8% of the patients appertained to type I subgroup and 81.2% to type II subgroup. Patients from this later subgroup had higher comorbidity and received more drugs than those of the former. They were also more physically ill, with higher FIQ total scores and worse sleep quality, and more psychologically distressed, with higher levels of anxiety and depression and lower scores in the mental component summary of the Short-Form Health Questionnaire (SF-12). Our study shows that the proposed fibromyalgia classification is reliable and easy to perform and could be applied in further studies.

  16. Missed opportunities for congenital syphilis and HIV perinatal transmission prevention Oportunidades perdidas en la prevención de la sífilis congénita y de la transmisión vertical del HIV Oportunidades perdidas na prevenção da sífilis congênita e da transmissão vertical do HIV

    Directory of Open Access Journals (Sweden)

    Celeste Souza Rodrigues

    2008-10-01

    Full Text Available OBJECTIVE: To estimate the prevalence of missed opportunities for congenital syphilis and HIV prevention in pregnant women who had access to prenatal care and to assess factors associated to non-testing of these infections. METHODS: Cross-sectional study comprising a randomly selected sample of 2,145 puerperal women who were admitted in maternity hospitals for delivery or curettage and had attended at least one prenatal care visit, in Brazil between 1999 and 2000. No syphilis and/or anti-HIV testing during pregnancy was a marker for missed prevention opportunity. Women who were not tested for either or both were compared to those who had at least one syphilis and one anti-HIV testing performed during pregnancy (reference category. The prevalence of missed prevention opportunity was estimated for each category with 95% confidence intervals. Factors independently associated with missed prevention opportunity were assessed through multinomial logistic regression. RESULTS: The prevalence of missed prevention opportunity for syphilis or anti-HIV was 41.2% and 56.0%, respectively. The multivariate analysis showed that race/skin color (non-white, schooling (OBJETIVO: Estimar la prevalencia de oportunidad de pérdida de prevención de la sífilis y el HIV entre gestantes que tuvieron acceso al pre-natal y factores asociados con la no evaluación de estos agravios. MÉTODOS: Se realizó estudio transversal con muestra aleatoria de 2.145 puérperas de Brasil, 1999 y 2000 admitidas en maternidades para parto o curetaje y que habían realizado al menos una consulta de pre-natal. La no realización del examen de prueba para sífilis y/o anti-HIV durante el embarazo fue usada como marcador para oportunidad de pérdida de prevención. Las mujeres que realizaron sólo examen de sífilis o sólo examen de anti-HIV, o que no realizaron ninguno, fueron comparadas con las que realizaron los dos (categoría de referencia. La prevalencia de oportunidad de pérdida de

  17. Opportunity and obligation

    CERN Multimedia

    2012-01-01

    As anyone in the press or VIP offices can tell you, CERN is in the spotlight like never before. In the first two months of 2012, we welcomed some 56 VIP visits and 144 media visits on site. Not long ago, those were the kind of numbers we’d have had in six months, and 2012 is not a one-off.   Ever since CERN turned 50 in 2004, our visitor numbers have been growing, and that includes teachers and members of the public as well as VIPs and the media. It’s a sign of the explosion of interest around the world in our science, and to me it means two things. Firstly, it means that I owe everyone at CERN a vote of thanks, since I know that visits impinge on everyone’s time. I can assure you all, however, that it is time well spent. That’s because the second thing it tells me is that growing interest in CERN brings opportunity. Our current visibility gives the particle physics community the opportunity to drive science up the popular and political agendas, and it...

  18. Rape prevention

    Science.gov (United States)

    Date rape - prevention; Sexual assault - prevention ... Centers for Disease Control and Prevention website. Sexual assault and abuse and STDs. In: 2015 sexually transmitted diseases treatment guidelines 2015. www.cdc.gov/std/tg2015/sexual- ...

  19. Dengue Prevention

    Science.gov (United States)

    ... Address What's this? Submit What's this? Submit Button Prevention Recommend on Facebook Tweet Share Compartir This photograph ... medications to treat a dengue infection. This makes prevention the most important step, and prevention means avoiding ...

  20. Type 2 diabetes: identifying high risk Asian American subgroups in a clinical population.

    Science.gov (United States)

    Wang, Elsie J; Wong, Eric C; Dixit, Anjali A; Fortmann, Stephen P; Linde, Randolph B; Palaniappan, Latha P

    2011-08-01

    We compared the prevalence and treatment of type 2 diabetes across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and Non-Hispanic Whites (NHWs) in a Northern California healthcare system. A three-year, cross-sectional sample of patient electronic health records was accessed to compare diabetes prevalence in 21,816 Asian and 73,728 NHWs aged 35+ years. Diabetes was classified through ICD-9 codes, abnormal laboratory values, or use of oral anti-diabetic medication. Multivariate adjusted prevalence rates for each Asian subgroup, and adjusted odds ratios (OR) relative to NHWs, were compared. Age-adjusted prevalence ranged from 5.8% to 18.2% (women) and 8.1 to 25.3% (men). Age-adjusted ORs of Asian subgroups ranged 1.11-3.94 (women) and 1.14-4.56 (men). The odds of diabetes were significantly higher in Asian Indians (women OR 3.44, men OR 3.54) and Filipinos (women OR 3.94, men OR 4.56), compared to NHWs. Results for Asian Indians and Filipinos were similar with age-and-BMI adjustment. Treatment rates across subgroups were 59.7-82.0% (women) and 62.9-79.4% (men). Heterogeneity exists in the prevalence of diabetes across Asian subgroups, independent of obesity prevalence. Asian Indian and Filipino subgroups had particularly high prevalence of diabetes when compared to NHWs. Future studies should explore these clinically important differences among Asian subgroups. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. Divide and Conquer: Sub-Grouping of ASD Improves ASD Detection Based on Brain Morphometry.

    Science.gov (United States)

    Katuwal, Gajendra J; Baum, Stefi A; Cahill, Nathan D; Michael, Andrew M

    2016-01-01

    Low success (ASD) classification using brain morphometry from the large multi-site ABIDE dataset and inconsistent findings on brain morphometric abnormalities in ASD can be attributed to the ASD heterogeneity. In this study, we show that ASD brain morphometry is highly heterogeneous, and demonstrate that the heterogeneity can be mitigated and classification improved if autism severity (AS), verbal IQ (VIQ) and age are used with morphometric features. Morphometric features from structural MRIs (sMRIs) of 734 males (ASD: 361, controls: 373) of ABIDE were derived using FreeSurfer. Applying the Random Forest classifier, an AUC of 0.61 was achieved. Adding VIQ and age to morphometric features, AUC improved to 0.68. Sub-grouping the subjects by AS, VIQ and age improved the classification with the highest AUC of 0.8 in the moderate-AS sub-group (AS = 7-8). Matching subjects on age and/or VIQ in each sub-group further improved the classification with the highest AUC of 0.92 in the low AS sub-group (AS = 4-5). AUC decreased with AS and VIQ, and was the lowest in the mid-age sub-group (13-18 years). The important features were mainly from the frontal, temporal, ventricular, right hippocampal and left amygdala regions. However, they highly varied with AS, VIQ and age. The curvature and folding index features from frontal, temporal, lingual and insular regions were dominant in younger subjects suggesting their importance for early detection. When the experiments were repeated using the Gradient Boosting classifier similar results were obtained. Our findings suggest that identifying brain biomarkers in sub-groups of ASD can yield more robust and insightful results than searching across the whole spectrum. Further, it may allow identification of sub-group specific brain biomarkers that are optimized for early detection and monitoring, increasing the utility of sMRI as an important tool for early detection of ASD.

  2. Functional dyspepsia: relationship between clinical subgroups and Helicobacter pylori status in Western Turkey

    Directory of Open Access Journals (Sweden)

    Saruc M.

    2003-01-01

    Full Text Available The etiology of functional dyspepsia is not known. The objective of the present study was to determine the characteristics of functional dyspepsia in Western Turkey. We divided 900 patients with functional dyspepsia into three subgroups according to symptoms: ulcer-like (UL, 321 (35.6%, motility disorder-like (ML, 281 (31.2%, and the combination (C of these symptoms, 298 (33.1%. All patients were submitted to endoscopic evaluation, with two biopsies taken from the cardia and corpus, and four from the antrum of the stomach. All biopsy samples were studied for Helicobacter pylori (Hp density, chronic inflammation, activity, intestinal metaplasia, atrophy, and the presence of lymphoid aggregates by histological examination. One antral biopsy was used for the rapid urease test. Tissue cagA status was determined by PCR from an antral biopsy specimen by a random sampling method. We also determined the serum levels of tumor necrosis factor-alpha (TNF-alpha and gastrin by the same method. Data were analyzed statistically by the Kolmogorov-Smirnov test and by analysis of variance. Hp and cagA positivity was significantly higher in the UL subgroup than in the others. The patients in the ML subgroup had the lowest Hp and cagA positivity and Hp density. The ML subgroup also showed the lowest level of Hp-induced inflammation among all subgroups. The serum levels of TNF-alpha and gastrin did not reveal any difference between groups. Our findings show a poor association of Hp with the ML subgroup of functional dyspepsia, but a stronger association with the UL and C subgroups.

  3. Teleradiology: threat or opportunity?

    International Nuclear Information System (INIS)

    Jarvis, L.; Stanberry, B.

    2005-01-01

    The rapid advances in information technology and communication bandwidth have spawned an equally rapid development of clinical teleradiology. Current computer technology and communication capability allow easy transfer of diagnostic images, of any complexity, to any location in the world. This provides the opportunity to acquire swift primary and secondary diagnostic opinions from the remotest of locations, often at economically attractive rates, with the potential for easing the burden on hard-pressed departments of radiology. However, this comes at the potential cost of distancing the clinical radiologist from the patient, with consequent impact upon direct clinical care. As this technology advances across the world, it is vital that UK radiologists are familiar with the clinical implications, the medicolegal framework within which the field operates and the associated governance issues. This paper reviews current practice and discusses the associated risks

  4. International power opportunities

    International Nuclear Information System (INIS)

    Moon, A.

    1995-01-01

    Key factors in international development were discussed, using TransAlta Energy Corporation as an example. Trans-Alta is a company generating 4,500 MW of electricity from coal, hydro and natural gas. It has operating facilities in Canada, Argentina and New Zealand, including extensive coal mining interests in Canada. The climate for international opportunities in the energy field were judged to be very good in view of the projected requirement for some 900,000 MW of new power generation in different parts of the world by the year 2003. The five key factors identified for international power development were: (1) using core skills to add value, (2) have a long-term focus, (3) focus on specific countries and selected regions, (4) develop strong relationships with local partners, and (5) develop appropriate projects. 2 figs

  5. Opportunities within ASTERICS

    Science.gov (United States)

    van der Meer, Rob; Cimò, Giuseppe

    2016-04-01

    ASTERICS, The Astronomy ESFRI and Research Infrastructure Cluster project, brings together astronomers and astroparticle physicists of 22 institutes in Europe to help Europe's world-leading observatories work together to find common solutions to their Big Data challenges, their interoperability and scheduling, and their data access, searching for cross-cutting solutions with mutual and wide-ranging benefit to all concerned. ASTERICS is a four year project, funded through the European Union's Horizon 2020 Framework Programme. The facilities supported by ASTERICS include SKA, CTA, KM3NeT, E-ELT. ASTERICS aims to open up multi messenger astronomy to all scientists and the public through the Virtual Observatory and the citizen science work. I will draw a picture of the landscape in which ASTERICS operates and the possible interaction with the Very Large Volume Neutrino Telescope community. Attention will be given to emerging opportunities for the Neutrino community and how these can be recognised or created.

  6. Opportunities within ASTERICS

    Directory of Open Access Journals (Sweden)

    Meer Rob van der

    2016-01-01

    Full Text Available ASTERICS, The Astronomy ESFRI and Research Infrastructure Cluster project, brings together astronomers and astroparticle physicists of 22 institutes in Europe to help Europe's world-leading observatories work together to find common solutions to their Big Data challenges, their interoperability and scheduling, and their data access, searching for cross-cutting solutions with mutual and wide-ranging benefit to all concerned. ASTERICS is a four year project, funded through the European Union's Horizon 2020 Framework Programme. The facilities supported by ASTERICS include SKA, CTA, KM3NeT, E-ELT. ASTERICS aims to open up multi messenger astronomy to all scientists and the public through the Virtual Observatory and the citizen science work. I will draw a picture of the landscape in which ASTERICS operates and the possible interaction with the Very Large Volume Neutrino Telescope community. Attention will be given to emerging opportunities for the Neutrino community and how these can be recognised or created.

  7. Missed opportunities in crystallography.

    Science.gov (United States)

    Dauter, Zbigniew; Jaskolski, Mariusz

    2014-09-01

    Scrutinized from the perspective of time, the giants in the history of crystallography more than once missed a nearly obvious chance to make another great discovery, or went in the wrong direction. This review analyzes such missed opportunities focusing on macromolecular crystallographers (using Perutz, Pauling, Franklin as examples), although cases of particular historical (Kepler), methodological (Laue, Patterson) or structural (Pauling, Ramachandran) relevance are also described. Linus Pauling, in particular, is presented several times in different circumstances, as a man of vision, oversight, or even blindness. His example underscores the simple truth that also in science incessant creativity is inevitably connected with some probability of fault. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  8. Plague Prevention

    Science.gov (United States)

    ... Healthcare Professionals Clinicians Public Health Officials Veterinarians Prevention History of Plague Resources FAQ Prevention Recommend on Facebook Tweet Share Compartir Reduce rodent habitat around your ...

  9. Novel molecular subgroups for clinical classification and outcome prediction in childhood medulloblastoma: a cohort study.

    Science.gov (United States)

    Schwalbe, Edward C; Lindsey, Janet C; Nakjang, Sirintra; Crosier, Stephen; Smith, Amanda J; Hicks, Debbie; Rafiee, Gholamreza; Hill, Rebecca M; Iliasova, Alice; Stone, Thomas; Pizer, Barry; Michalski, Antony; Joshi, Abhijit; Wharton, Stephen B; Jacques, Thomas S; Bailey, Simon; Williamson, Daniel; Clifford, Steven C

    2017-07-01

    International consensus recognises four medulloblastoma molecular subgroups: WNT (MB WNT ), SHH (MB SHH ), group 3 (MB Grp3 ), and group 4 (MB Grp4 ), each defined by their characteristic genome-wide transcriptomic and DNA methylomic profiles. These subgroups have distinct clinicopathological and molecular features, and underpin current disease subclassification and initial subgroup-directed therapies that are underway in clinical trials. However, substantial biological heterogeneity and differences in survival are apparent within each subgroup, which remain to be resolved. We aimed to investigate whether additional molecular subgroups exist within childhood medulloblastoma and whether these could be used to improve disease subclassification and prognosis predictions. In this retrospective cohort study, we assessed 428 primary medulloblastoma samples collected from UK Children's Cancer and Leukaemia Group (CCLG) treatment centres (UK), collaborating European institutions, and the UKCCSG-SIOP-PNET3 European clinical trial. An independent validation cohort (n=276) of archival tumour samples was also analysed. We analysed samples from patients with childhood medulloblastoma who were aged 0-16 years at diagnosis, and had central review of pathology and comprehensive clinical data. We did comprehensive molecular profiling, including DNA methylation microarray analysis, and did unsupervised class discovery of test and validation cohorts to identify consensus primary molecular subgroups and characterise their clinical and biological significance. We modelled survival of patients aged 3-16 years in patients (n=215) who had craniospinal irradiation and had been treated with a curative intent. Seven robust and reproducible primary molecular subgroups of childhood medulloblastoma were identified. MB WNT remained unchanged and each remaining consensus subgroup was split in two. MB SHH was split into age-dependent subgroups corresponding to infant (Star for Harris, Action

  10. The interest of gait markers in the identification of subgroups among fibromyalgia patients

    Directory of Open Access Journals (Sweden)

    Auvinet Bernard

    2011-11-01

    Full Text Available Abstract Background Fibromyalgia (FM is a heterogeneous syndrome and its classification into subgroups calls for broad-based discussion. FM subgrouping, which aims to adapt treatment according to different subgroups, relies in part, on psychological and cognitive dysfunctions. Since motor control of gait is closely related to cognitive function, we hypothesized that gait markers could be of interest in the identification of FM patients' subgroups. This controlled study aimed at characterizing gait disorders in FM, and subgrouping FM patients according to gait markers such as stride frequency (SF, stride regularity (SR, and cranio-caudal power (CCP which measures kinesia. Methods A multicentre, observational open trial enrolled patients with primary FM (44.1 ± 8.1 y, and matched controls (44.1 ± 7.3 y. Outcome measurements and gait analyses were available for 52 pairs. A 3-step statistical analysis was carried out. A preliminary single blind analysis using k-means cluster was performed as an initial validation of gait markers. Then in order to quantify FM patients according to psychometric and gait variables an open descriptive analysis comparing patients and controls were made, and correlations between gait variables and main outcomes were calculated. Finally using cluster analysis, we described subgroups for each gait variable and looked for significant differences in self-reported assessments. Results SF was the most discriminating gait variable (73% of patients and controls. SF, SR, and CCP were different between patients and controls. There was a non-significant association between SF, FIQ and physical components from Short-Form 36 (p = 0.06. SR was correlated to FIQ (p = 0.01 and catastrophizing (p = 0.05 while CCP was correlated to pain (p = 0.01. The SF cluster identified 3 subgroups with a particular one characterized by normal SF, low pain, high activity and hyperkinesia. The SR cluster identified 2 distinct subgroups: the one with a

  11. The interest of gait markers in the identification of subgroups among fibromyalgia patients.

    Science.gov (United States)

    Auvinet, Bernard; Chaleil, Denis; Cabane, Jean; Dumolard, Anne; Hatron, Pierre; Juvin, Robert; Lanteri-Minet, Michel; Mainguy, Yves; Negre-Pages, Laurence; Pillard, Fabien; Riviere, Daniel; Maugars, Yves-Michel

    2011-11-11

    Fibromyalgia (FM) is a heterogeneous syndrome and its classification into subgroups calls for broad-based discussion. FM subgrouping, which aims to adapt treatment according to different subgroups, relies in part, on psychological and cognitive dysfunctions. Since motor control of gait is closely related to cognitive function, we hypothesized that gait markers could be of interest in the identification of FM patients' subgroups. This controlled study aimed at characterizing gait disorders in FM, and subgrouping FM patients according to gait markers such as stride frequency (SF), stride regularity (SR), and cranio-caudal power (CCP) which measures kinesia. A multicentre, observational open trial enrolled patients with primary FM (44.1 ± 8.1 y), and matched controls (44.1 ± 7.3 y). Outcome measurements and gait analyses were available for 52 pairs. A 3-step statistical analysis was carried out. A preliminary single blind analysis using k-means cluster was performed as an initial validation of gait markers. Then in order to quantify FM patients according to psychometric and gait variables an open descriptive analysis comparing patients and controls were made, and correlations between gait variables and main outcomes were calculated. Finally using cluster analysis, we described subgroups for each gait variable and looked for significant differences in self-reported assessments. SF was the most discriminating gait variable (73% of patients and controls). SF, SR, and CCP were different between patients and controls. There was a non-significant association between SF, FIQ and physical components from Short-Form 36 (p = 0.06). SR was correlated to FIQ (p = 0.01) and catastrophizing (p = 0.05) while CCP was correlated to pain (p = 0.01). The SF cluster identified 3 subgroups with a particular one characterized by normal SF, low pain, high activity and hyperkinesia. The SR cluster identified 2 distinct subgroups: the one with a reduced SR was distinguished by high FIQ

  12. The interest of gait markers in the identification of subgroups among fibromyalgia patients

    Science.gov (United States)

    2011-01-01

    Background Fibromyalgia (FM) is a heterogeneous syndrome and its classification into subgroups calls for broad-based discussion. FM subgrouping, which aims to adapt treatment according to different subgroups, relies in part, on psychological and cognitive dysfunctions. Since motor control of gait is closely related to cognitive function, we hypothesized that gait markers could be of interest in the identification of FM patients' subgroups. This controlled study aimed at characterizing gait disorders in FM, and subgrouping FM patients according to gait markers such as stride frequency (SF), stride regularity (SR), and cranio-caudal power (CCP) which measures kinesia. Methods A multicentre, observational open trial enrolled patients with primary FM (44.1 ± 8.1 y), and matched controls (44.1 ± 7.3 y). Outcome measurements and gait analyses were available for 52 pairs. A 3-step statistical analysis was carried out. A preliminary single blind analysis using k-means cluster was performed as an initial validation of gait markers. Then in order to quantify FM patients according to psychometric and gait variables an open descriptive analysis comparing patients and controls were made, and correlations between gait variables and main outcomes were calculated. Finally using cluster analysis, we described subgroups for each gait variable and looked for significant differences in self-reported assessments. Results SF was the most discriminating gait variable (73% of patients and controls). SF, SR, and CCP were different between patients and controls. There was a non-significant association between SF, FIQ and physical components from Short-Form 36 (p = 0.06). SR was correlated to FIQ (p = 0.01) and catastrophizing (p = 0.05) while CCP was correlated to pain (p = 0.01). The SF cluster identified 3 subgroups with a particular one characterized by normal SF, low pain, high activity and hyperkinesia. The SR cluster identified 2 distinct subgroups: the one with a reduced SR was

  13. ASSESSMENT OF POLLUTION PREVENTION OPPORTUNITIES FOR FIVE INDUSTRIES

    Science.gov (United States)

    The report summarizes the emissions inventory, market survey, product categorization, product characteristics, potential product reformulation, new product research, and alternate application methods for processes involved in printing, graphic arts, architectural and industrial m...

  14. [Vitamin D deficiency in childhood: an opportunity for prevention].

    Science.gov (United States)

    López-González, Desirée; Méndez-Sánchez, Lucía; Guagnelli, Miguel Ángel; Clark, Patricia

    The prevalence of vitamin D deficiency in the pediatric population has increased in recent years and continues to be underdiagnosed and undertreated. According to data from the "ENSANUT 2006" (National Health and Nutrition Survey), the prevalence of vitamin D deficiency in Mexico was 16% in children aged 2-12 years. Vitamin D plays a critical role in the formation and bone homeostasis and consequently on growth. Its deficiency is clearly associated with diseases such as rickets and osteomalacia, and it has been linked to other diseases such as obesity, metabolic syndrome, diabetes, cancer, respiratory infections and immune system disease. Specific risk groups have been described in the medical literature for vitamin D deficiency in which supplementation may offer a benefit. Currently, there is still controversy in defining the serum levels of proficiency and dose supplementation. In Mexico, the daily suggested intake of vitamin D is 5.6μg (224 IU), which is significantly lower than the recommendations in the U.S. and Europe (i.e., between 400 and 1000 IU/day). An increase in vitamin D deficiency has been reported in recent years. There is no consensus regarding the sufficiency levels of vitamin D. Cut-off values vary from 20 to 30ng/ml. Therefore, the objective of this review was to provide an overview of the problem in the pediatric population and to describe the groups at risk, as well as to analyze the current recommendations for vitamin D supplementation. Vitamin D deficiency was considered rare in Mexico according to the National Institute of Medical Science and Nutrition Salvador Zubirán. Lack of evidence did not help to establish the international recommended daily intake. Currently, vitamin D deficiency must be recognized as a health problem, worthy of attention and action. We suggest that prospective studies are carried out in our country where the relationship between serum vitamin D deficiency and poor bone mineralization will be established. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  15. Pet Dogs and Children's Health: Opportunities for Chronic Disease Prevention?

    Science.gov (United States)

    Gadomski, Anne M; Scribani, Melissa B; Krupa, Nicole; Jenkins, Paul; Nagykaldi, Zsolt; Olson, Ardis L

    2015-11-25

    Positive associations between having a pet dog and adult health outcomes have been documented; however, little evidence exists regarding the benefits of pet dogs for young children. This study investigates the hypothesis that pet dogs are positively associated with healthy weight and mental health among children. This cross-sectional study accrued a consecutive sample of children over 18 months in a pediatric primary care setting. The study enrolled 643 children (mean age, 6.7 years); 96% were white, 45% were female, 56% were privately insured, and 58% had pet dogs in the home. Before an annual visit, parents of children aged 4 to 10 years completed the DartScreen, a comprehensive Web-based health risk screener administered using an electronic tablet. The screener domains were child body mass index (BMI), physical activity, screen time, mental health, and pet-related questions. Children with and children without pet dogs did not differ in BMI (P = .80), screen time of 2 hours or less (P = 0.99), or physical activity (P = .07). A lower percentage of children with dogs (12%) met the clinical cut-off value of Screen for Child Anxiety and Related Disorders (SCARED-5) of 3 or more, compared with children without dogs (21%, P = .002). The mean SCARED-5 score was lower among children with dogs (1.13) compared with children without dogs (1.40; P = .01). This relationship was retained in multivariate analysis after controlling for several covariates. Having a pet dog in the home was associated with a decreased probability of childhood anxiety. Future studies need to establish whether this relationship is causal and, if so, how pet dogs alleviate childhood anxiety.

  16. Pollution prevention opportunity assessment for Building 922 solid office waste

    International Nuclear Information System (INIS)

    Phillips, N.M.

    1995-01-01

    Building 922 houses all of SNL/California's ES and H Departments: Health Protection, Environmental Protection, Safety, and Environmental Operations. It covers approximately 10,000 square feet and houses about 80 people. The office personnel generate nonhazardous solid office wastes in their daily activities. To determine the types and amounts of waste generated, a special PPOA sorting team sorted all of the trash collected from the building for a period of one-week (including paper and aluminum cans in the recycling bins). The team sorted the trash into major categories: paper, plastic, metals, glass, wet garbage, rest room waste, and miscellaneous materials. They then sorted it into subcategories within each major category. Rest room waste was collected but not sorted. The waste in each category was weighed separately. The total amount of trash collected during the week was approximately 168.8 kg (371.4 lbs). The results of this PPOA indicate that SNL/California is minimizing most nonhazardous office waste and reductions planned for the near future will add significantly to the minimization efforts

  17. Pollution prevention opportunity assessment for Building 922 solid office waste

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, N.M. [Sandia National Labs., Livermore, CA (United States). Environmental Protection Dept.

    1995-01-01

    Building 922 houses all of SNL/California`s ES and H Departments: Health Protection, Environmental Protection, Safety, and Environmental Operations. It covers approximately 10,000 square feet and houses about 80 people. The office personnel generate nonhazardous solid office wastes in their daily activities. To determine the types and amounts of waste generated, a special PPOA sorting team sorted all of the trash collected from the building for a period of one-week (including paper and aluminum cans in the recycling bins). The team sorted the trash into major categories: paper, plastic, metals, glass, wet garbage, rest room waste, and miscellaneous materials. They then sorted it into subcategories within each major category. Rest room waste was collected but not sorted. The waste in each category was weighed separately. The total amount of trash collected during the week was approximately 168.8 kg (371.4 lbs). The results of this PPOA indicate that SNL/California is minimizing most nonhazardous office waste and reductions planned for the near future will add significantly to the minimization efforts.

  18. Perimenopausal wrist fracture - An opportunity for prevention and ...

    African Journals Online (AJOL)

    Those identified were subjected to further review to establish rates of osteoporosis and/or hip fracture. Osteoporosis and/or hip fracture rates were also determined for a control population. Main outcome measures: Osteoporosis investigation and management rates in controls v, subjects who had experienced a previous ...

  19. New paradigms in cervical cancer prevention: opportunities and risks

    Directory of Open Access Journals (Sweden)

    Giorgi Rossi Paolo

    2008-12-01

    Full Text Available Testing for the DNA of high-risk types of papilloma virus (HPV is more sensitive than cytology in detecting pre-cancerous lesions. One of the main advantages will be the possibility of applying prolonged screening intervals. However adequate screening protocols (age of start and stop, screening intervals, management of HPV positive women need to be applied in order to avoid over-referral to colposcopy and over-treatment and to maintain sustainable costs. Further follow-up of running trials and research on molecular markers will better define these parameters. The new situation will require organised screening programmes with rigorous protocols and monitoring. This will be even more needed when women vaccinated for HPV 16 and 18 will be screened. Research on how to best screen vaccinated women is a priority. This paper proposes an overview of the plausible impact of new technologies in cervical cancer screening in the near future and in the vaccinated cohorts.

  20. Addressing sleep disturbances: An opportunity to prevent cardiometabolic disease?

    Science.gov (United States)

    GRANDNER, MICHAEL A.

    2014-01-01

    There is increasing awareness of the role of sleep disturbance as an important factor in health and disease. Although subclinical sleep disturbances (insufficient sleep duration or inadequate sleep quality) may be difficult to assess with conceptual and/or methodological clarity, this review attempts to summarize and synthesize these findings. First, the concept of sleep disturbance in a public health context is introduced, to provide context and rationale. Second, operational definitions of ‘cardiometabolic disease’ and ‘sleep disturbance’ are offered, to address many unclear operationalizations. Third, the extant literature is summarized regarding short or long sleep duration and/or insufficient sleep, insomnia and insomnia symptoms, general (non-specific sleep disturbances), circadian rhythm abnormalities that result in sleep disturbances, and, briefly, sleep-disordered breathing. Fourth, the review highlights the social/behavioural context of sleep, including discussions of sleep and race/ethnicity, socio-economic position, and other social/environmental factors, in order to place these findings in a social-environmental context relevant to public health. Fifth, the review highlights the issue of sleep as a domain of health behaviour and addresses issues regarding development of healthy sleep interventions. Finally, a research agenda of future directions is proposed. PMID:24892892

  1. Factors contributing to missed opportunities in the prevention of ...

    African Journals Online (AJOL)

    The tape recorder was used for capturing interviews and field notes captured cues. Tesch's eight steps coding process were used for data analysis. The researchers listened to the audiotapes and manually transcribed the themes, read the transcripts to understand and make meaning of ideas that emerged. The study found ...

  2. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice

    DEFF Research Database (Denmark)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-01-01

    Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe...... questionnaire and were examined according to a standardised protocol. Based on the clinical examination, patients were classified into diagnostic subgroups. After approximately 10 days, chiropractors reported whether they considered the subgroup had changed. The most frequent subgroups were reducible and partly...

  3. Breast Cancer Prevalence and Mortality among Hispanic Subgroups in the United States, 2009–2013

    Directory of Open Access Journals (Sweden)

    Bijou R. Hunt

    2016-01-01

    Full Text Available Background. This paper presents data on breast cancer prevalence and mortality among US Hispanics and Hispanic subgroups, including Cuban, Mexican, Puerto Rican, Central American, and South American. Methods. Five-year average annual female breast cancer prevalence and mortality rates for 2009–2013 were examined using data from the National Health Interview Survey (prevalence and the National Center for Health Statistics and the American Community Survey (mortality rates. Results. Overall breast cancer prevalence among US Hispanic women was 1.03%. Although the estimates varied slightly by Hispanic subgroup, these differences were not statistically significant. The breast cancer mortality rate for Hispanics overall was 17.71 per 100,000 women. Higher rates were observed among Cubans (17.89, Mexicans (18.78, and Puerto Ricans (19.04, and a lower rate was observed among Central and South Americans (10.15. With the exception of the rate for Cubans, all Hispanic subgroup rates were statistically significantly different from the overall Hispanic rate. Additionally, all Hispanic subgroups rates were statistically significantly higher than the Central and South American rate. Conclusion. The data reveal significant differences in mortality across Hispanic subgroups. These data enable public health officials to develop targeted interventions to help lower breast cancer mortality among the highest risk populations.

  4. Living-donor kidney transplant from a type a donor to a type a subgroup recipient.

    Science.gov (United States)

    Ueda, Norichika; Nishimura, Kenji; Yoshida, Yasuyuki; Hirai, Toshiaki; Kishikawa, Hidefumi; Ichikawa, Yasuji

    2015-04-01

    Type A subgroup is rare in Japan, and kidney transplant to a type A subgroup recipient is rare worldwide. A 65-year-old man presented for living-donor kidney transplant. Blood group testing showed that his wife (kidney donor) had blood group type A. The patient (recipient) had a type A subgroup because reverse blood grouping showed a weak reaction with A1 antigen. Further testing showed that the recipient had type A subgroup between Ax and Ael because adsorption elution experiments and flow cytometry showed a few A antigens that were not detected on forward grouping, and DNA analysis was not consistent with Ael. The patient was given a milder protocol for immunosuppressive preoperative therapy than typically used for ABO-incompatible kidney transplant; mycophenolate mofetil and prednisolone were started 3 weeks and cyclosporine 2 weeks before transplant, rituximab (100 mg) was given once, and double filtration plasmapheresis and plasma exchange were not used. Follow-up at 9 months after transplant showed stable clinical status and no allograft rejection. In summary, the present case showed that when type A subgroup recipient has low level of anti-A1 antibody and is receiving a kidney transplant from a blood type A donor, milder immunosuppressive preoperative therapy appears safe.

  5. Somatosensory nociceptive characteristics differentiate subgroups in people with chronic low back pain: a cluster analysis.

    Science.gov (United States)

    Rabey, Martin; Slater, Helen; OʼSullivan, Peter; Beales, Darren; Smith, Anne

    2015-10-01

    The objectives of this study were to explore the existence of subgroups in a cohort with chronic low back pain (n = 294) based on the results of multimodal sensory testing and profile subgroups on demographic, psychological, lifestyle, and general health factors. Bedside (2-point discrimination, brush, vibration and pinprick perception, temporal summation on repeated monofilament stimulation) and laboratory (mechanical detection threshold, pressure, heat and cold pain thresholds, conditioned pain modulation) sensory testing were examined at wrist and lumbar sites. Data were entered into principal component analysis, and 5 component scores were entered into latent class analysis. Three clusters, with different sensory characteristics, were derived. Cluster 1 (31.9%) was characterised by average to high temperature and pressure pain sensitivity. Cluster 2 (52.0%) was characterised by average to high pressure pain sensitivity. Cluster 3 (16.0%) was characterised by low temperature and pressure pain sensitivity. Temporal summation occurred significantly more frequently in cluster 1. Subgroups were profiled on pain intensity, disability, depression, anxiety, stress, life events, fear avoidance, catastrophizing, perception of the low back region, comorbidities, body mass index, multiple pain sites, sleep, and activity levels. Clusters 1 and 2 had a significantly greater proportion of female participants and higher depression and sleep disturbance scores than cluster 3. The proportion of participants undertaking Low back pain, therefore, does not appear to be homogeneous. Pain mechanisms relating to presentations of each subgroup were postulated. Future research may investigate prognoses and interventions tailored towards these subgroups.

  6. [Identification of subgroups with lower level of stroke knowledge using decision-tree analysis].

    Science.gov (United States)

    Kim, Hyun Kyung; Jeong, Seok Hee; Kang, Hyun Cheol

    2014-02-01

    This study was performed to explore levels of stroke knowledge and identify subgroups with lower levels of stroke knowledge among adults in Korea. A cross-sectional survey was used and data were collected in 2012. A national sample of 990 Koreans aged 20 to 74 years participated in this study. Knowledge of risk factors, warning signs, and first action for stroke were surveyed using face-to-face interviews. Descriptive statistics and decision tree analysis were performed using SPSS WIN 20.0 and Answer Tree 3.1. Mean score for stroke risk factor knowledge was 7.7 out of 10. The least recognized risk factor was diabetes and four subgroups with lower levels of knowledge were identified. Score for knowledge of stroke warning signs was 3.6 out of 6. The least recognized warning sign was sudden severe headache and six subgroups with lower levels of knowledge were identified. The first action for stroke was recognized by 65.7 percent of participants and four subgroups with lower levels of knowledge were identified. Multi-faceted education should be designed to improve stroke knowledge among Korean adults, particularly focusing on subgroups with lower levels of knowledge and less recognition of items in this study.

  7. Detecting treatment-subgroup interactions in clustered data with generalized linear mixed-effects model trees.

    Science.gov (United States)

    Fokkema, M; Smits, N; Zeileis, A; Hothorn, T; Kelderman, H

    2017-10-25

    Identification of subgroups of patients for whom treatment A is more effective than treatment B, and vice versa, is of key importance to the development of personalized medicine. Tree-based algorithms are helpful tools for the detection of such interactions, but none of the available algorithms allow for taking into account clustered or nested dataset structures, which are particularly common in psychological research. Therefore, we propose the generalized linear mixed-effects model tree (GLMM tree) algorithm, which allows for the detection of treatment-subgroup interactions, while accounting for the clustered structure of a dataset. The algorithm uses model-based recursive partitioning to detect treatment-subgroup interactions, and a GLMM to estimate the random-effects parameters. In a simulation study, GLMM trees show higher accuracy in recovering treatment-subgroup interactions, higher predictive accuracy, and lower type II error rates than linear-model-based recursive partitioning and mixed-effects regression trees. Also, GLMM trees show somewhat higher predictive accuracy than linear mixed-effects models with pre-specified interaction effects, on average. We illustrate the application of GLMM trees on an individual patient-level data meta-analysis on treatments for depression. We conclude that GLMM trees are a promising exploratory tool for the detection of treatment-subgroup interactions in clustered datasets.

  8. Biological and Molecular Characterization of Cucumber mosaic virus Subgroup II Isolate Causing Severe Mosaic in Cucumber.

    Science.gov (United States)

    Kumari, Reenu; Bhardwaj, Pooja; Singh, Lakhmir; Zaidi, Aijaz A; Hallan, Vipin

    2013-06-01

    Cucumber mosaic virus (CMV) has a wide host range causing severe damage in many important agricultural and ornamental crops. Earlier reports showed the prevalence of CMV subgroup I isolates in India. However, some recent reports point towards increasing incidence of subgroup II isolates in the country. The complete genome of a CMV isolate causing severe mosaic in cucumber was characterized and its phylogenetic analysis with other 21 CMV isolates reported worldwide clustered it with subgroup II strains. The genome comprised of RNA 1 (3,379 nucleotides), RNA 2 (3,038 nucleotides) and RNA 3 (2,206 nucleotides). The isolate showed highest homology with subgroup II isolates: 95.1-98.7, 87.7-98.0, and 85.4-97.1 % within RNA1, RNA2, and RNA3, respectively. RNA1 and RNA2 were closely related to the Japanese isolate while RNA3 clustered with an American isolate. Host range studies revealed that isolate showed severe mosaic symptoms on Nicotiana spp. and Cucumis spp. The isolate induced leaf deformation and mild filiform type symptoms in tomato. To best of our knowledge this is the first report of complete genome of CMV subgroup II isolate from India.

  9. Technology in Parkinson's disease: Challenges and opportunities.

    Science.gov (United States)

    Espay, Alberto J; Bonato, Paolo; Nahab, Fatta B; Maetzler, Walter; Dean, John M; Klucken, Jochen; Eskofier, Bjoern M; Merola, Aristide; Horak, Fay; Lang, Anthony E; Reilmann, Ralf; Giuffrida, Joe; Nieuwboer, Alice; Horne, Malcolm; Little, Max A; Litvan, Irene; Simuni, Tanya; Dorsey, E Ray; Burack, Michelle A; Kubota, Ken; Kamondi, Anita; Godinho, Catarina; Daneault, Jean-Francois; Mitsi, Georgia; Krinke, Lothar; Hausdorff, Jeffery M; Bloem, Bastiaan R; Papapetropoulos, Spyros

    2016-09-01

    The miniaturization, sophistication, proliferation, and accessibility of technologies are enabling the capture of more and previously inaccessible phenomena in Parkinson's disease (PD). However, more information has not translated into a greater understanding of disease complexity to satisfy diagnostic and therapeutic needs. Challenges include noncompatible technology platforms, the need for wide-scale and long-term deployment of sensor technology (among vulnerable elderly patients in particular), and the gap between the "big data" acquired with sensitive measurement technologies and their limited clinical application. Major opportunities could be realized if new technologies are developed as part of open-source and/or open-hardware platforms that enable multichannel data capture sensitive to the broad range of motor and nonmotor problems that characterize PD and are adaptable into self-adjusting, individualized treatment delivery systems. The International Parkinson and Movement Disorders Society Task Force on Technology is entrusted to convene engineers, clinicians, researchers, and patients to promote the development of integrated measurement and closed-loop therapeutic systems with high patient adherence that also serve to (1) encourage the adoption of clinico-pathophysiologic phenotyping and early detection of critical disease milestones, (2) enhance the tailoring of symptomatic therapy, (3) improve subgroup targeting of patients for future testing of disease-modifying treatments, and (4) identify objective biomarkers to improve the longitudinal tracking of impairments in clinical care and research. This article summarizes the work carried out by the task force toward identifying challenges and opportunities in the development of technologies with potential for improving the clinical management and the quality of life of individuals with PD. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder

  10. Technology in Parkinson disease: Challenges and Opportunities

    Science.gov (United States)

    Espay, Alberto J.; Bonato, Paolo; Nahab, Fatta; Maetzler, Walter; Dean, John M.; Klucken, Jochen; Eskofier, Bjoern M.; Merola, Aristide; Horak, Fay; Lang, Anthony E.; Reilmann, Ralf; Giuffrida, Joe; Nieuwboer, Alice; Horne, Malcolm; Little, Max A.; Litvan, Irene; Simuni, Tanya; Dorsey, E. Ray; Burack, Michelle A.; Kubota, Ken; Kamondi, Anita; Godinho, Catarina; Daneault, Jean-Francois; Mitsi, Georgia; Krinke, Lothar; Hausdorff, Jeffery M.; Bloem, Bastiaan R.; Papapetropoulos, Spyros

    2016-01-01

    The miniaturization, sophistication, proliferation, and accessibility of technologies are enabling the capturing of more and previously inaccessible phenomena in Parkinson disease (PD). However, more information has not translated into greater understanding of disease complexity to satisfy diagnostic and therapeutic needs. Challenges include non-compatible technology platforms, the need for wide-scale and long-term deployment of sensor technology (in particular among vulnerable elderly patients), and the gap between the “big data” acquired with sensitive measurement technologies and their limited clinical application. Major opportunities could be realized if new technologies are developed as part of open-source and/or open-hardware platforms enabling multi-channel data capture, sensitive to the broad range of motor and non-motor problems that characterize PD, and adaptable into self-adjusting, individualized treatment delivery systems. The International Parkinson and Movement Disorders Society Task Force on Technology is entrusted to convene engineers, clinicians, researchers, and patients to promote the development of integrated measurement and closed-loop therapeutic systems with high patient adherence that also serve to: 1) encourage the adoption of clinico-pathophysiologic phenotyping and early detection of critical disease milestones; 2) enhance tailoring of symptomatic therapy; 3) improve subgroup targeting of patients for future testing of disease modifying treatments; and 4) identify objective biomarkers to improve longitudinal tracking of impairments in clinical care and research. This article summarizes the work carried out by the Task Force toward identifying challenges and opportunities in the development of technologies with potential for improving the clinical management and quality of life of individuals with PD. PMID:27125836

  11. Learning Opportunities (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2009-12-01

    Full Text Available We’ve reached the end of another year of publication at EBLIP, my first at the helm as Editor‐in‐Chief, and four full years of publication since we began. This year was a busy one with several changes to the editorial team, the addition of more Editorial Advisors, and new evidence summary writers joining our team. Most importantly, the journal continues to grow and thrive, with more people than ever participating in its success. This year we added a new section called Using Evidence in Practice, and in this issue there are two articles in that section which provide practical examples of applying evidence in the workplace. Putting evidence into practice is what EBLIP is all about, so it is my hope that this new section makes the application of evidence based practice more concrete for readers. As we began working on issue 4.4, the Editorial Team decided that it would be a good idea to seek out an Editorial Intern to help with some of the tasks we never seem to get to, given that we are all volunteers. We see the internship as an opportunity to give a library and information studies student a chance to get involved with an open access journal and learn about publishing in library and information studies, which will hopefully benefit them as they begin their new career. The Editorial Intern will assist with marketing and promotion of the journal, soliciting potential manuscripts, and proofreading. They will also participate in all editorial meetings and general discussions. We anticipate that they will bring a wealth of enthusiasm and fresh ideas to our conversations so that EBLIP Editors can also continue to learn and grow by having a fresh set of eyes involved with our processes. It will certainly be a win‐win situation and a learning opportunity for all involved. We are pleased to announce that Andrea Baer has accepted the position of Editorial Intern and joined our team in mid‐November. Andrea is currently attending the University of

  12. KM: Problems and Opportunities

    International Nuclear Information System (INIS)

    Gulliford, J.

    2016-01-01

    Full text: The use of nuclear technology and materials for a wide range of industrial, scientific, medical and energy purposes creates a strong need to assure the availability of relevant skills to support their safe and effective use. Whatever the expected future of nuclear power in different countries, there remains a strong need to sustain a high level of nuclear scientific and engineering expertise in order to contribute to and inform a wide variety of policymaking, safety, technological, medical, and industrial activities. The current talent-base in nuclear technology and science has been built in these countries since the 1950s. The pioneering generation is now long retired and the generation they trained during the expansion period of nuclear technology is now also approaching retirement age. While many aspects of the knowledge accumulated during the pioneering period is well preserved through scientific research reports, design documentation and other publications, and reflected in university training programs, there is greater concern about how to sustain the practical science and technology skills and expertise that can only be obtained through challenging activities such as research and advanced technology development projects. The ageing of the general workforce in the nuclear industry, declining student enrolment in science and engineering programs, and the risk of losing accumulated knowledge and experience have drawn attention to the need for better management of nuclear knowledge. Significant effort needs to be made to maintain adequate skilled workforce and attract new employees for long-term sustainability. Addressing these challenges is very difficult for all but the largest and best-funded national programs. Even for these large programs, the opportunities are fleeting and the attractiveness of research project experiences can be mixed. Working together in an international context, countries can achieve a powerful solution to this situation by

  13. Eating disorder behavior and early maladaptive schemas in subgroups of eating disorders.

    Science.gov (United States)

    Unoka, Zsolt; Tölgyes, Tamás; Czobor, Pál; Simon, Lajos

    2010-06-01

    To examine relationship between Eating Disorder Behaviors (EDB) and Early Maladaptive Schemas (EMS) across eating disorder (ED) subgroups. EMS and ED behaviors were measured by Young Schema Questionnaire and Eating Behavior Severity Scale, respectively, among patients diagnosed with Restrictive or Binge/purging Anorexia, or bulimia nervosa. Canonical component analysis showed significant association between ED behaviors and EMSs. Canonical factor-pairs (EDB and EMS) revealed specific associations between certain patterns of EDBs, including binge-purging and physical exercise, and certain patterns of maladaptive cognitive schema, including Emotional deprivation, Abandonment, Enmeshments, Subjugation, and Emotional inhibition. ED subgroups significantly differred between the EMS and EDB canonical factors, respectively. Our findings indicate that EMS and EDB are associated, and that the factors that potentially mediate the association differ significantly among ED subgroups. These results are consistent with the notion that EMSs play a specific role in the development and maintenance of ED behaviors.

  14. Obesogenic environment - intervention opportunities.

    Science.gov (United States)

    Fisberg, Mauro; Maximino, Priscila; Kain, Juliana; Kovalskys, Irina

    2016-01-01

    To evaluate environmental obesogenic-related factors, such as physical activity in neighborhoods and schools, nutritional behavior, and intervention programs. Critical analysis of literature with personal point of view from infant obesity experts and political advisors for public intervention. Although obesity is a public health problem affecting several age groups, it is among children and adolescents that it plays a more important role, due to treatment complexity, high likelihood of persistence into adulthood, and association with other non-transmissible diseases while still in early age. Environment is a main component of the genesis and outcomes in the near future or long term. Modification of intake with high-density food, meal skipping, and high intake of saturated fat, sugar, and salt, associated to high levels of sedentarism are main causes of obesity. Intervention opportunities are related to modifications in political, environmental, and individual settings. School and physical activities in the educational environment are intertwined with nutrition intervention in continuous education. A critical review of some different scenarios in Latin American countries is presented. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  15. Research Opportunities with SIRTF

    Science.gov (United States)

    Bicay, M. D.

    2000-05-01

    The vast majority of observing time on the Space Infrared Telescope Facility (SIRTF), to be launched next year, will be available to the broad science community. A unique and innovative component of this community observing time is the Legacy Science Program, enabling investigators to conduct large and coherent science programs early in the mission, with data entering the public domain immediately upon processing at the SIRTF Science Center (SSC). The Legacy Science Call for Proposals (CP) is now open, and proposals are due on September 15, 2000. The first General Observer CP will be issued in late 2001, with proposals due four months after launch. Subsequent CPs will be issued by the SSC on an approximately annual basis. Archival research with SIRTF data will be possible within 6 months of launch, utilizing data from the First-Look Survey and from early Legacy Science observations. The author will provide an overview of the research opportunities available with SIRTF, the nominal schedule of CPs, and the anticipated plans for data analysis funding. Proposal submission procedures, and an introduction to planning and proposing tools and resources, will be provided. A description of the SIRTF observing modes and their corresponding SSC pipeline data products will also be presented.

  16. Household food insecurity as a determinant of overweight and obesity among low-income Hispanic subgroups: Data from the 2011-2012 California Health Interview Survey.

    Science.gov (United States)

    Smith, Teresa M; Colón-Ramos, Uriyoán; Pinard, Courtney A; Yaroch, Amy L

    2016-02-01

    An estimated 78% of Hispanics in the United States (US) are overweight or obese. Household food insecurity, a condition of limited or uncertain access to adequate food, has been associated with obesity rates among Hispanic adults in the US. However, the Hispanic group is multi-ethnic and therefore associations between obesity and food insecurity may not be constant across Hispanic country of origin subgroups. This study sought to determine if the association between obesity and food insecurity among Hispanics is modified by Hispanic ancestry across low-income (≤200% of poverty level) adults living in California. Data are from the cross-sectional 2011-12 California Health Interview Survey (n = 5498). Rates of overweight or obesity (BMI ≥ 25), Calfresh receipt (California's Supplemental Nutrition Assistance Program), and acculturation were examined for differences across subgroups. Weighted multiple logistic regressions examined if household food insecurity was significantly associated with overweight or obesity and modified by country of origin after controlling for age, education, marital status, country of birth (US vs. outside of US), language spoken at home, and Calfresh receipt (P groups, suggesting Hispanic subgroups behave differently in their association between food insecurity and obesity. By highlighting these factors, we can promote targeted obesity prevention interventions, which may contribute to more effective behavior change and reduced chronic disease risk in this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. A multi-locus approach to barcoding in the Anopheles strodei subgroup (Diptera: Culicidae).

    Science.gov (United States)

    Bourke, Brian Patrick; Oliveira, Tatiane Porangaba; Suesdek, Lincoln; Bergo, Eduardo Sterlino; Sallum, Maria Anice Mureb

    2013-04-19

    The ability to successfully identify and incriminate pathogen vectors is fundamental to effective pathogen control and management. This task is confounded by the existence of cryptic species complexes. Molecular markers can offer a highly effective means of species identification in such complexes and are routinely employed in the study of medical entomology. Here we evaluate a multi-locus system for the identification of potential malaria vectors in the Anopheles strodei subgroup. Larvae, pupae and adult mosquitoes (n = 61) from the An. strodei subgroup were collected from 21 localities in nine Brazilian states and sequenced for the COI, ITS2 and white gene. A Bayesian phylogenetic approach was used to describe the relationships in the Strodei Subgroup and the utility of COI and ITS2 barcodes was assessed using the neighbor joining tree and "best close match" approaches. Bayesian phylogenetic analysis of the COI, ITS2 and white gene found support for seven clades in the An. strodei subgroup. The COI and ITS2 barcodes were individually unsuccessful at resolving and identifying some species in the Subgroup. The COI barcode failed to resolve An. albertoi and An. strodei but successfully identified approximately 92% of all species queries, while the ITS2 barcode failed to resolve An. arthuri and successfully identified approximately 60% of all species queries. A multi-locus COI-ITS2 barcode, however, resolved all species in a neighbor joining tree and successfully identified all species queries using the "best close match" approach. Our study corroborates the existence of An. albertoi, An. CP Form and An. strodei in the An. strodei subgroup and identifies four species under An. arthuri informally named A-D herein. The use of a multi-locus barcode is proposed for species identification, which has potentially important utility for vector incrimination. Individuals previously found naturally infected with Plasmodium vivax in the southern Amazon basin and reported as An

  18. Effect of telmisartan on functional outcome, recurrence, and blood pressure in patients with acute mild ischemic stroke: a PRoFESS subgroup analysis

    DEFF Research Database (Denmark)

    Bath, Philip M W; Martin, Reneé H; Palesch, Yuko

    2009-01-01

    prevention trial assessed BP-lowering and antiplatelet strategies in 20 332 patients; 1360 were enrolled within 72 hours of ischemic stroke, with telmisartan (angiotensin receptor antagonist, 80 mg/d, n=647) vs placebo (n=713). For this nonprespecified subgroup analysis, the primary outcome was functional......, 1.40; 95% CI, 0.68-2.89; P=0.36) did not differ between the treatment groups. In comparison with placebo, telmisartan lowered BP (141/82 vs 135/78 mm Hg, difference 6 to 7 mm Hg and 2 to 4 mm Hg; P...

  19. The Importance of Risk and Subgroup Analysis of Nonparticipants in a Geriatric Intervention Study

    DEFF Research Database (Denmark)

    Rosted, Elizabeth; Poulsen, Ingrid; Hendriksen, Carsten

    2016-01-01

    () or die (). The largest subgroup of refusers described as “too ill” had the highest risk of readmission (OR = 3.00, 95% CI = 1.61–5.47, ) and of mortality within six months (OR = 3.50, 95% CI = 1.64–7.49, ). However, this seems not to have affected the results of our randomized study.  Conclusion: We...... recommend that intervention studies among older people or other fragile patient groups include analysis of relevant risk and subgroup analyses of refusers....

  20. Subgroup Discovery for Election Analysis: A Case Study in Descriptive Data Mining

    Science.gov (United States)

    Grosskreutz, Henrik; Boley, Mario; Krause-Traudes, Maike

    In this paper, we investigate the application of descriptive data mining techniques, namely subgroup discovery, for the purpose of the ad-hoc analysis of election results. Our inquiry is based on the 2009 German federal Bundestag election (restricted to the City of Cologne) and additional socio-economic information about Cologne's polling districts. The task is to describe relations between socio-economic variables and the votes in order to summarize interesting aspects of the voting behavior. Motivated by the specific challenges of election data analysis we propose novel quality functions and visualizations for subgroup discovery.

  1. Identification of a novel subgroup of Koala retrovirus from Koalas in Japanese zoos.

    Science.gov (United States)

    Shojima, Takayuki; Yoshikawa, Rokusuke; Hoshino, Shigeki; Shimode, Sayumi; Nakagawa, So; Ohata, Takuji; Nakaoka, Rie; Miyazawa, Takayuki

    2013-09-01

    We identified a new subgroup of koala retrovirus (KoRV), named KoRV-J, which utilizes thiamine transport protein 1 as a receptor instead of the Pit-1 receptor used by KoRV (KoRV-A). By subgroup-specific PCR, KoRV-J and KoRV-A were detected in 67.5 and 100% of koalas originating from koalas from northern Australia, respectively. Altogether, our results indicate that the invasion of the koala population by KoRV-J may have occurred more recently than invasion by KoRV-A.

  2. Objectives and tasks for sub-group B: Plutonium management and recycle

    International Nuclear Information System (INIS)

    1978-01-01

    The paper restates the prime objectives of Working Group 4 and explains that in order to accomplish their objectives two sub-groups (A and B) have been established. The Co-Chairmen suggested that sub group B take as their terms of reference those tasks remitted to them by Working Group 4 as a whole. The paper identifies and comments on 11 tasks into which the work of the sub-group is divided. The paper also includes a number of annexes giving the guidelines for data input to each task

  3. DIGITAL PAKISTAN: OPPORTUNITIES & CHALLENGES

    Directory of Open Access Journals (Sweden)

    Ghulam Muhammad Kundi

    2008-10-01

    Full Text Available IT has revolutionized the social and organizational life around the globe. Given the newness of IT as a technology, there is a lot of potential that needs to be explored. It is however, argued that as IT can revolutionize the economic development, by the same coin, although its mismanagement in adoption process can end up in problems or even straight failure of the technology at the business-end. This study was conducted with reference to opportunities and challenges in the IT adoption process in Pakistan. The aim of the study was to point out the barriers that are impeding the country’s computerization process in order to provide facts to the policy makers for smooth computerization. The primary data collected through structured questionnaires was analyzed and tested through correlation, regressions analysis and t-test. Out of 10 hypotheses, 3 were accepted while in the rest null hypotheses were not substantiated. Based on primary and secondary data analysis this study has found that all independent bureaucratic, political, education and social and cultural variables are mutually correlated and have significant impact on shaping and reshaping of IT in Pakistan, while the Pakistan IT policy is inconsistent, administrative machinery attitude is negative and non cooperative, procedures are cumbersome and implementation is weak and ineffective, not to mention the lack of IT knowledge on the bureaucratic side. The political environment is instable and law and order is worse which is discouraging the investment. Moreover, physical and legal infrastructure is insufficient and the country is lacking good quality IT professionals. IT organization alignment is another serious issue in Pakistan. However, government incentives and growing interest from the private sector indicate positive attitude towards computerization of the country.

  4. DIGITAL PAKISTAN: OPPORTUNITIES & CHALLENGES

    Directory of Open Access Journals (Sweden)

    Ghulam Muhammad Kundi

    2008-12-01

    Full Text Available ABSTRACT IT has revolutionized the social and organizational life around the globe. Given the newness of IT as a technology, there is a lot of potential that needs to be explored. It is however, argued that as IT can revolutionize the economic development, by the same coin, although its mismanagement in adoption process can end up in problems or even straight failure of the technology at the business-end. This study was conducted with reference to opportunities and challenges in the IT adoption process in Pakistan. The aim of the study was to point out the barriers that are impeding the country’s computerization process in order to provide facts to the policy makers for smooth computerization. The primary data collected through structured questionnaires was analyzed and tested through correlation, regressions analysis and t-test. Out of 10 hypotheses, 3 were accepted while in the rest null hypotheses were not substantiated. Based on primary and secondary data analysis this study has found that all independent bureaucratic, political, education and social and cultural variables are mutually correlated and have significant impact on shaping and reshaping of IT in Pakistan, while the Pakistan IT policy is inconsistent, administrative machinery attitude is negative and non cooperative, procedures are cumbersome and implementation is weak and ineffective, not to mention the lack of IT knowledge on the bureaucratic side. The political environment is instable and law and order is worse which is discouraging the investment. Moreover, physical and legal infrastructure is insufficient and the country is lacking good quality IT professionals. IT organization alignment is another serious issue in Pakistan. However, government incentives and growing interest from the private sector indicate positive attitude towards computerization of the country.

  5. Disordered eating in a Swedish community sample of adolescent girls: subgroups, stability, and associations with body esteem, deliberate self-harm and other difficulties.

    Science.gov (United States)

    Viborg, Njördur; Wångby-Lundh, Margit; Lundh, Lars-Gunnar; Wallin, Ulf; Johnsson, Per

    2018-01-01

    The developmental study of subtypes of disordered eating (DE) during adolescence may be relevant to understand the development of eating disorders. The purpose of the present study was to identify subgroups with different profiles of DE in a community sample of adolescent girls aged 13-15 years, and to study the stability of these profiles and subgroups over a one-year interval in order to find patterns that may need to be addressed in further research and prevention. Cluster analysis according to the LICUR procedure was performed on five aspects of DE, and the structural and individual stability of these clusters was analysed. The clusters were compared with regard to BMI, body esteem, deliberate self-harm, and other kinds of psychological difficulties. The analysis revealed six clusters (Multiple eating problems including purging, Multiple eating problems without purging, Social eating problems, Weight concerns, Fear of not being able to stop eating, and No eating problems) all of which had structurally stable profiles and five of which showed stability at the individual level. The more pronounced DE clusters (Multiple eating problems including/without purging) were consistently associated with higher levels of psychological difficulties and lower levels of body esteem. Furthermore, girls that reported purging reported engaging in self-harm to a larger extent. Subgroups of 13-15 year old girls show stable patterns of disordered eating that are associated with higher rates of psychological impairment and lower body esteem. The subgroup of girls who engage in purging also engage in more deliberate self-harm.

  6. Internalin profiling and multilocus sequence typing suggest four Listeria innocua subgroups with different evolutionary distances from Listeria monocytogenes.

    Science.gov (United States)

    Chen, Jianshun; Chen, Qiaomiao; Jiang, Lingli; Cheng, Changyong; Bai, Fan; Wang, Jun; Mo, Fan; Fang, Weihuan

    2010-03-31

    Ecological, biochemical and genetic resemblance as well as clear differences of virulence between L. monocytogenes and L. innocua make this bacterial clade attractive as a model to examine evolution of pathogenicity. This study was attempted to examine the population structure of L. innocua and the microevolution in the L. innocua-L. monocytogenes clade via profiling of 37 internalin genes and multilocus sequence typing based on the sequences of 9 unlinked genes gyrB, sigB, dapE, hisJ, ribC, purM, gap, tuf and betL. L. innocua was genetically monophyletic compared to L. monocytogenes, and comprised four subgroups. Subgroups A and B correlated with internalin types 1 and 3 (except the strain 0063 belonging to subgroup C) and internalin types 2 and 4 respectively. The majority of L. innocua strains belonged to these two subgroups. Subgroup A harbored a whole set of L. monocytogenes-L. innocua common and L. innocua-specific internalin genes, and displayed higher recombination rates than those of subgroup B, including the relative frequency of occurrence of recombination versus mutation (rho/theta) and the relative effect of recombination versus point mutation (r/m). Subgroup A also exhibited a significantly smaller exterior/interior branch length ratio than expected under the coalescent model, suggesting a recent expansion of its population size. The phylogram based on the analysis with correction for recombination revealed that the time to the most recent common ancestor (TMRCA) of L. innocua subgroups A and B were similar. Additionally, subgroup D, which correlated with internalin type 5, branched off from the other three subgroups. All L. innocua strains lacked seventeen virulence genes found in L. monocytogenes (except for the subgroup D strain L43 harboring inlJ and two subgroup B strains bearing bsh) and were nonpathogenic to mice. L. innocua represents a young species descending from L. monocytogenes and comprises four subgroups: two major subgroups A and B

  7. Internalin profiling and multilocus sequence typing suggest four Listeria innocua subgroups with different evolutionary distances from Listeria monocytogenes

    Directory of Open Access Journals (Sweden)

    Wang Jun

    2010-03-01

    Full Text Available Abstract Background Ecological, biochemical and genetic resemblance as well as clear differences of virulence between L. monocytogenes and L. innocua make this bacterial clade attractive as a model to examine evolution of pathogenicity. This study was attempted to examine the population structure of L. innocua and the microevolution in the L. innocua-L. monocytogenes clade via profiling of 37 internalin genes and multilocus sequence typing based on the sequences of 9 unlinked genes gyrB, sigB, dapE, hisJ, ribC, purM, gap, tuf and betL. Results L. innocua was genetically monophyletic compared to L. monocytogenes, and comprised four subgroups. Subgroups A and B correlated with internalin types 1 and 3 (except the strain 0063 belonging to subgroup C and internalin types 2 and 4 respectively. The majority of L. innocua strains belonged to these two subgroups. Subgroup A harbored a whole set of L. monocytogenes-L. innocua common and L. innocua-specific internalin genes, and displayed higher recombination rates than those of subgroup B, including the relative frequency of occurrence of recombination versus mutation (ρ/θ and the relative effect of recombination versus point mutation (r/m. Subgroup A also exhibited a significantly smaller exterior/interior branch length ratio than expected under the coalescent model, suggesting a recent expansion of its population size. The phylogram based on the analysis with correction for recombination revealed that the time to the most recent common ancestor (TMRCA of L. innocua subgroups A and B were similar. Additionally, subgroup D, which correlated with internalin type 5, branched off from the other three subgroups. All L. innocua strains lacked seventeen virulence genes found in L. monocytogenes (except for the subgroup D strain L43 harboring inlJ and two subgroup B strains bearing bsh and were nonpathogenic to mice. Conclusions L. innocua represents a young species descending from L. monocytogenes and

  8. Preventing crime by people with schizophrenic disorders: the role of psychiatric services.

    Science.gov (United States)

    Hodgins, S; Müller-Isberner, R

    2004-09-01

    Knowledge of when and how to implement treatments to prevent criminal offending among people with schizophrenia is urgently needed. To identify opportunities for interventions to prevent offending among men with schizophrenic disorders by tracking their histories of offending and admissions to hospital. We examined 232 men with schizophrenic disorders discharged from forensic and general psychiatric hospitals. Data were collected from participants, family members and official records. More than three-quarters (77.8%) of the forensic patients had previously been admitted to general psychiatric services; 24.3% of the general psychiatric patients had a criminal record. Offences had been committed by 39.8% of the forensic patients and 10.8% of the general psychiatric patients before their first admission to general psychiatry, and after their first admission these 59 patients committed 195 non-violent and 59 violent offences. Subsequently, 49 of them committed serious violent offences that led to forensic hospital admission. The offenders were distinguished by a pervasive and stable pattern of antisocial behaviour evident from at least mid-adolescence. General psychiatry requires resources in order to prevent criminal offending among a subgroup of patients with schizophrenic disorders.

  9. Streptococcus pneumoniae PspC Subgroup Prevalence in Invasive Disease and Differences in Contribution to Complement Evasion.

    Science.gov (United States)

    van der Maten, Erika; van den Broek, Bryan; de Jonge, Marien I; Rensen, Kim J W; Eleveld, Marc J; Zomer, Aldert L; Cremers, Amelieke J H; Ferwerda, Gerben; de Groot, Ronald; Langereis, Jeroen D; van der Flier, Michiel

    2018-04-01

    The pneumococcal capsular serotype is an important determinant of complement resistance and invasive disease potential, but other virulence factors have also been found to contribute. Pneumococcal surface protein C (PspC), a highly variable virulence protein that binds complement factor H to evade C3 opsonization, is divided into two subgroups: choline-bound subgroup I and LPxTG-anchored subgroup II. The prevalence of different PspC subgroups in invasive pneumococcal disease (IPD) and functional differences in complement evasion are unknown. The prevalence of PspC subgroups in IPD isolates was determined in a collection of 349 sequenced strains of Streptococcus pneumoniae isolated from adult patients. pspC deletion mutants and isogenic pspC switch mutants were constructed to study differences in factor H binding and complement evasion in relation to capsule thickness. Subgroup I pspC was far more prevalent in IPD isolates than subgroup II pspC The presence of capsule was associated with a greater ability of bound factor H to reduce complement opsonization. Pneumococcal subgroup I PspC bound significantly more factor H and showed more effective complement evasion than subgroup II PspC in isogenic encapsulated pneumococci. We conclude that variation in the PspC subgroups, independent of capsule serotypes, affects pneumococcal factor H binding and its ability to evade complement deposition. Copyright © 2018 American Society for Microbiology.

  10. CGH and OCC Announce a New, Two-Year Funding Opportunity for NCI-designated Cancer Centers

    Science.gov (United States)

    CGH and OCC announce a new funding opportunity available from CGH for cancer prevention and control (CPC) researchers at NCI-designated cancer centers: Administrative Supplements to Promote Cancer Prevention and Control Research in Low and Middle Income Countries.

  11. Research handbook on entrepreneurial opportunities

    DEFF Research Database (Denmark)

    With a wide-ranging set of contributions, this book provides a compilation of cutting-edge original research in the field of entrepreneurial opportunities. The book reopens the subject from diverse perspectives focusing on theories and approaches to entrepreneurial opportunities. The book has bee...

  12. Oilseeds business opportunities in Ethiopia

    NARCIS (Netherlands)

    Wijnands, J.H.M.; Biersteker, J.; Hiel, R.

    2007-01-01

    In this study the business opportunities for Dutch companies in the Ethiopian oilseeds sector are explored. Opportunities for setting up sustainable export chains should mutually benefit Dutch companies as well as the Ethiopian oilseeds sector in particular and the Ethiopian society in general.

  13. Contents of Stereotypes toward Woman Subgroups: An Investigation in the Framework of Stereotype Content Model

    Directory of Open Access Journals (Sweden)

    Timucin Aktan

    2016-12-01

    Full Text Available The aim of the study was to investigate the stereotype contents toward woman subgroups and relate these contents to social-structural predictors and sexism. In this respect, 119 university students were recruited for the first study and they were asked to rate 10 woman subgroups in terms of their competence and warmth, and their status and competitiveness. Participants' level of sexism was also measured using ambivalent sexism scale. The findings of the first study revealed that competence and warmth were the two fundamental dimensions of the stereotype contents, these stereotypes could be depicted in three clusters, the content of many women stereotypes were mixed, and status was linked to competence and competition was related to lack of warmth. Besides replicating the main hypotheses of stereotype content model, the findings supported its two basic assumptions, i.e. negative stereotypes are not necessary to reveal stereotype clusters and personal stereotypes are more open to motivational concerns. Finally, sexism was related only with competition, but not with stereotype contents. Since, high competent / high warm cluster was not observed in the first study, the number of woman subgroups was increased in the second study. Thus, 86 university students were asked to rate 18 women subgroups on the scales used in the first study. Results replicated the findings of the first study, supporting the main hypothesis of stereotype content model. The findings of the studies were discussed in the light of relevant literature.

  14. Young People with Harmful Sexual Behaviour: Do Those with Learning Disabilities Form a Distinct Subgroup?

    Science.gov (United States)

    Almond, Louise; Giles, Susan

    2008-01-01

    The study examines 102 young people with Learning Disabilities (n = 51) and without a learning disability (NLD; n = 51) to explore ways in which LD young people with harmful sexual behaviours (HSB) should be recognized as a subgroup requiring specialized treatment and intervention. Throughout this comparison of perpetrator, victim and abuse…

  15. On finite groups whose every proper normal subgroup is a union of ...

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    Department of Mathematics and Mathematical Sciences Foundation, St. Stephen's. College, Delhi 110 007, India. E-mail: ashrafi@kashanu.ac.ir; geetha venkat@ststephens.edu. MS received 19 June 2002; revised 26 March 2004. Abstract. Let G be a finite group and A be a normal subgroup of G. We denote by ncc(A) the ...

  16. Testing Measurement Invariance of the Students' Affective Characteristics Model across Gender Sub-Groups

    Science.gov (United States)

    Demir, Ergül

    2017-01-01

    In this study, the aim was to construct a significant structural measurement model comparing students' affective characteristics with their mathematic achievement. According to this model, the aim was to test the measurement invariances between gender sub-groups hierarchically. This study was conducted as basic and descriptive research. Secondary…

  17. [Errors in detection of subgroups in the ABO blood group system].

    Science.gov (United States)

    Sato, C; Maeda, H

    1997-09-01

    In the ABO blood group system, several subgroups have been described based on: 1) the difference of reactivities of the red cells with anti-A, anti-B, anti-A1, and anti-H, 2) the presence or absence of anti-A, anti-B, anti-A1, anti-H, and anti-HI in serum, and 3) the presence of A, B, H substances in the saliva of ABH secretors. Subgroups of A are more frequent in Caucasians than in Japanese, while those of B are more frequent in Japanese. Both the red cell typing (testing red cells for A and B antigens) and serum typing (testing the antibodies in the serum against red cells of known ABO groups) are important to identify and not to overlook these ABO subgroups. When transfusion is required in individuals with these subgroups, compatible blood products must be selected according to the presence or absence of antibodies active at 37 degrees C.

  18. High School Graduation Rates across English Learner Student Subgroups in Arizona. REL 2017-205

    Science.gov (United States)

    Huang, Min; Haas, Eric; Zhu, Niufeng; Tran, Loan

    2016-01-01

    Recent studies have documented differences in academic achievement between current and former English learner students. These differences validate calls for more focused analyses of achievement across English learner student subgroups. Specifically, there is interest in examining variation in academic success based on the amount of time a student…

  19. Subgroup analyses of maraviroc in previously treated R5 HIV-1 infection

    NARCIS (Netherlands)

    Fätkenheuer, Gerd; Nelson, Mark; Lazzarin, Adriano; Konourina, Irina; Hoepelman, Andy I. M.; Lampiris, Harry; Hirschel, Bernard; Tebas, Pablo; Raffi, François; Trottier, Benoit; Bellos, Nicholaos; Saag, Michael; Cooper, David A.; Westby, Mike; Tawadrous, Margaret; Sullivan, John F.; Ridgway, Caroline; Dunne, Michael W.; Felstead, Steve; Mayer, Howard; van der Ryst, Elna; Angel, Jonathan; Conway, Brian; Gough, Kevin A.; Lalonde, Richard G.; Laplante, Francois; Leblanc, Roger P.; Montaner, Julio S. G.; Rachlis, Anita R.; Romanowski, Barbara; Rosser, Stuart J.; Rubinstein, Ethan; Shafran, Stephen David; Smaill, Fiona; Tremblay, Cecile; Trottier, Sylvie; Tsoukas, Christos; Walmsley, Sharon Lynn; Voskanian, Alen; Akil, Bisher; Arduino, Roberto Claudio; Asmuth, David; Beatty, George William; Becker, Stephen Lawrence; Bellos, Nicholaos C.; Blue, Sky Robert; Bolan, Robert Key; Brand, John D.; Burnazian, George Ghazaros; Burnside, Alfred F.; Campbell, Thomas B.; Campo, Rafael E.; Casey, Kathleen King; Cimoch, Paul Joseph; Cohen, Calvin J.; Coodley, Gregg Oscar; Corales, Roberto B.; DeJesus, Edwin; Diaz, Leslie E.; Drusano, George L.; Ernst, Jerome A.; Feinberg, Judith E.; Feldman, Lawrence Edward; Fine, Steven M.; Flamm, Jason Andrew; Follansbee, Stephen Eliot; Fralich, Todd Allen; Gallant, Emanuel; Godofsky, Eliot Warren; Green, Gary; Greiger-Zanlungo, Paula Rosa; Gripshover, Barbara Marie; Groger, Richard K.; Gulick, Roy; Hardy, William David; Hassler, Shawn K.; Haubrich, Richard Harold; Hauptman, Stephen P.; Henry, David Holden; Henry, William Keith; Hernandez, Jose Norberto; Hicks, Charles Byron; Horberg, Michael Alan; Jemsek, Joseph G.; Kelly, Allan Rowan; Kinder, Clifford A.; Klein, Daniel Benjamin; Kogelman, Laura; Lalezari, Jacob Paul; LaMarca, Anthony; Lampiris, Harry William; Leibowitz, Matthew; Leider, Jason Mark; Lennox, Jeffrey Lloyd; Liporace, Ralph; Martin, Harold Luther; Martinez-Bejar, Lucia M.; Martorell, Claudia; McGowan, Joseph P.; Mildvan, Donna; Miles, Steven; Mitsuyasu, Ronald Takeshi; Morales-Ramirez, Javier Osvaldo; Morris, Anne B.; Mounzer, Karam Chucri; Myers, Robert Anderson; Nadler, Jeffrey P.; Pearce, Daniel; Pierone, Gerald; Rashbaum, Bruce Stephen; Ravishankar, Jayashree; Redfield, Robert Ray; Reichman, Richard Craig; Robbins, William Jay; Roberts, Stockton Edward; Rodriguez, Jorge E.; Sathasivam, Kunthavi; Sax, Paul Edward; Schwartz, Lawrence E.; Segal-Maurer, Sorana; Sension, Michael Grant; Sepulveda-Arzola, Gladys E.; Skolnik, Paul Richard; Sloan, Louis Marshall; Smith, Robert P.; Sosman, James Michael; Stapleton, Jack Thomas; Steigbigel, Roy; Steinhart, Corklin R.; Sweet, Donna Elaine; Swindells, Susan; Thompson, Melanie Ann; Sisneros, Silver; Towner, William James; Gordon, Peter; Hawkins, Trevor N.; Wheeler, David Allen; Williams, Sally; Wilcox, Dean; Williams, Steven; Wills, Todd Stephen; Wohlfeiler, Michael Bruce; Wright, David; Xavier, Angela; Yangco, Bienvenido Gamulo; Zingman, Barry Stephen; Zorrilla, Carmen D.; Allworth, Anthony M.; Bloch, Mark T.; Bodsworth, Neil J.; Chuah, John; Cooper, David; Doong, Nicholas; Dwyer, Dominic; Gold, Julian; Hoy, Jennifer Frances; Moore, Richard J.; Roth, Norman J.; Workman, Cassy; Clumeck, Nathan; Dellot, Patricia; Goffard, Jean Christophe; Moutschen, Michel; Vandercam, Bernard C.; Vogelaers, Dirk; Bentata, Michele; Cotte, Laurent; Delfraissy, Jean-Francois; Durant, Jacques; Girard, Pierre-Marie; Hocqueloux, Laurent; Landman, Roland; Lafeuillade, Alain; Martin, Isabelle Poizot; Molina, Jean-Michel; Pialoux, Gilles; Piketty, Christophe; Raffi, Francois; Reynes, Jacques; Verdon, Renaud; Arasteh, Keikawus; Bogner, Johannes Richard; Brockmeyer, Norbert H.; Esser, Stefan; Goebel, Frank-Detlef; Harrer, Thomas; Kern, Peter; Knechten, Heribert; van Lunzen, Jan; Mueller, Markus; Mutz, Antonius; Oette, Mark; Plettenberg, Andreas; Rockstroh, Juergen; Rump, Jorg-Andres; Schmidt, Reinhold E.; Schneider, Lothar; Schuster, Dieter; Staszewski, Schlomo; Stellbrink, Hans-Juergen; Trein, Andreas; Weitner, Lutwinus; Aiuti, Fernando; Bassetti, Dante; Di Biagio, Antonio; Caramello, Pietro; Carosi, Giampiero; Esposito, Roberto; Leoncini, Francesco; Manconi, Paolo Emilio; Mazzotta, Francesco; Montella, Francesco; Raise, Enzo; Vullo, Vicenzo; Hoepelman, Ilja Mohandas; Perenboom, Rosalinde Maria; Prins, J. M.; Richter, Clemens; van der Ende, Marchina Elisabeth; Beniowski, Marek; Boron-Kaczmarska, Anna; Flisiak, Robert; Halota, Waldemar; Horban, Andrzej; Mach, Tomasz; Smiatacz, Tomasz; Lozano de Leon, Fernando; Viciana Fernandez, Pompeyo; Rubio Garcia, Rafael; Gatell Artigas, Jose Josep; Gonzalez Garcia, Juan Julian; Gutierrez, Felix; Gonzalez Lahoz, Juan; Iribarren Loyarte, Jose; Moreno, Santiago; Pulido Ortega, Federico; Domingo Pedrol, Pere; Rivero, Antonio; Clotet, Bonaventura; Sarria, Cristina; Gisslen, Magnus; Flamholc, Leo; Karlsson, Anders; Battegay, Manuel; Bernasconi, Enos; Cavassini, Matthias; Drechsler, Henning; Opravil, Milos; Vernazza, Pietro; Easterbrook, Philippa Jane; Fisher, Martin; Hay, Philip; Johnson, Margaret A.; Leen, Clifford L.; Nelson, Mark R.; Ong, Edmund; Weber, Jonathan N.; White, David J.; Wilkins, Edmund; Wiselka, Martin; Alvarez-Jacinto, Ana Maria; Antoniskis, Diana; Atkinson, Barbara A.; Berger, Daniel S.; Blick, Gary; Brenna, Robert Owen; Burack, Jeffrey Howard; Church, L. W. Preston; Clay, Patrick G.; Cook, Paul Peniston; Creticos, Catherine Maria; Daly, Patrick William; Feleke, Getachew; File, Thomas Mc Donald; Galpin, Jeffrey Eliot; Green, Stephen Lloyd; Haas, Frances Fae; Hanna, Barbara J.; Hsiao, Chiu-Bin; Hsu, Ricky K.; Jones, Robert S.; Kadlecik, Peter; Kalayjian, Robert Charles; Keller, Robert H.; Kerkar, Shubha; Koirala, Janak; Lai, Leon Liang-Yu; Lalla-Reddy, Sujata; Macarthur, Rodger David; Malanoski, Gregory John; Markowitz, Norman Peter; McLeroth, Patrick L.; McMeeking, Alexander A.; Miljkovic, Goran; Montana, John Buscemi; Nixon, Daniel Edward; Norris, Dorece G.; Penico, Jesse Pullen; Perez-Limonte, Leonel; Posorske, Lynette H.; Prelutsky, David James; Riddell, James; Rodwick, Barry Michael; Ruane, Peter Jerome; Sampson, James; Santiago, Steven; Seinfeld, Amy; Sharp, Victoria Lee; Shebib, Zaher; Tanner, Mark Leslie; Timpone, Joseph G.; Wade, Barbara H.; Wallach, Frances; Weinberg, Winkler; Zurawski, Christine

    2008-01-01

    BACKGROUND: We conducted subanalyses of the combined results of the Maraviroc versus Optimized Therapy in Viremic Antiretroviral Treatment-Experienced Patients (MOTIVATE) 1 and MOTIVATE 2 studies to better characterize the efficacy and safety of maraviroc in key subgroups of patients. METHODS: We

  20. Schizophrenic patients without neuropsychological deficits : subgroup, disease severity or cognitive compensation?

    NARCIS (Netherlands)

    Holthausen, EAE; Wiersma, D; Sitskoorn, MM; Hijman, R; Dingemans, PM; Schene, AH; van den Bosch, RJ

    2002-01-01

    Some schizophrenic patients do not show clinically relevant cognitive deficits. The question remains whether this represents the existence of an etiologically different subgroup, a general effect of disease severity or whether their cognitive deficits do not reach a clinical threshold due to a

  1. Subgroup differences in psychosocial factors relating to coronary heart disease in the UK South Asian population.

    Science.gov (United States)

    Williams, Emily D; Nazroo, James Y; Kooner, Jaspal S; Steptoe, Andrew

    2010-10-01

    To explore the differences in psychosocial risk factors related to coronary heart disease (CHD) between South Asian subgroups in the UK. South Asian people suffer significantly higher rates of CHD than other ethnic groups, but vulnerability varies between South Asian subgroups, in terms of both CHD rates and risk profiles. Psychosocial factors may contribute to the excess CHD propensity that is observed; however, subgroup heterogeneity in psychosocial disadvantage has not previously been systematically explored. With a cross-sectional design, 1065 healthy South Asian and 818 white men and women from West London, UK, completed psychosocial questionnaires. Psychosocial profiles were compared between South Asian religious groups and the white sample, using analyses of covariance and post hoc tests. Of the South Asian sample, 50.5% was Sikh, 28.0% was Hindu, and 15.8% was Muslim. Muslim participants were more socioeconomically deprived and experienced higher levels of chronic stress, including financial strain, low social cohesion, and racial discrimination, compared with other South Asian religious groups. In terms of health behaviors, Muslim men smoked more than Sikhs and Hindus, and Muslims also reported lower alcohol consumption and were less physically active than other groups. This study found that Muslims were exposed to more psychosocial and behavioral adversity than Sikhs and Hindus, and highlights the importance of investigating subgroup heterogeneity in South Asian CHD risk. Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.

  2. Discrete neurocognitive subgroups in fully or partially remitted bipolar disorder: Associations with functional abilities.

    Science.gov (United States)

    Jensen, Johan Høy; Knorr, Ulla; Vinberg, Maj; Kessing, Lars V; Miskowiak, Kamilla W

    2016-11-15

    Neurocognitive impairment in remitted patients with bipolar disorder contributes to functional disabilities. However, the pattern and impact of these deficits are unclear. We pooled data from 193 fully or partially remitted patients with bipolar disorder and 110 healthy controls. Hierarchical cluster analysis was conducted to determine whether there are discrete neurocognitive subgroups in bipolar disorder. The pattern of the cognitive deficits and the characteristics of patients in these neurocognitive subgroups were examined with analyses of covariance and least significance difference pairwise comparison. Three discrete neurocognitive subgroups were detected: one that was cognitively intact (46.1%), one that was selectively impaired with deficits in processing speed (32.6%), and one that was globally impaired across verbal learning, working memory, and executive skills (21.2%). The globally and selectively impaired subgroups were characterized by greater perceived stress and subjective cognitive complaints, poorer work and social adjustment, and reduced quality of life compared to patients who were cognitively intact. The study design was cross-sectional which limits inferences regarding the causality of the findings. Globally and selectively impaired bipolar disorder patients displayed more functional disabilities than those who were cognitively intact. The present findings highlight a clinical need to systematically screen for cognitive dysfunction in remitted bipolar disorder and to target residual cognitive dysfunction in future treatment strategies. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Identification and Characterization of Unique Subgroups of Chronic Pain Individuals with Dispositional Personality Traits

    Directory of Open Access Journals (Sweden)

    S. Mehta

    2016-01-01

    Full Text Available Objective. The current study attempted to identify and characterize distinct CP subgroups based on their level of dispositional personality traits. The secondary objective was to compare the difference among the subgroups in mood, coping, and disability. Methods. Individuals with chronic pain were assessed for demographic, psychosocial, and personality measures. A two-step cluster analysis was conducted in order to identify distinct subgroups of patients based on their level of personality traits. Differences in clinical outcomes were compared using the multivariate analysis of variance based on cluster membership. Results. In 229 participants, three clusters were formed. No significant difference was seen among the clusters on patient demographic factors including age, sex, relationship status, duration of pain, and pain intensity. Those with high levels of dispositional personality traits had greater levels of mood impairment compared to the other two groups (p<0.05. Significant difference in disability was seen between the subgroups. Conclusions. The study identified a high risk group of CP individuals whose level of personality traits significantly correlated with impaired mood and coping. Use of pharmacological treatment alone may not be successful in improving clinical outcomes among these individuals. Instead, a more comprehensive treatment involving psychological treatments may be important in managing the personality traits that interfere with recovery.

  4. Contribution of Dietary Supplements to Nutritional Adequacy by Socioeconomic Subgroups in Adults of the United States

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Blumberg

    2017-12-01

    Full Text Available Many Americans have inadequate intakes of several nutrients, and the Dietary Guidelines for Americans 2015–2020 identified vitamins A, C, D, and E, in addition to calcium, magnesium, iron, potassium, choline, and fiber as “underconsumed nutrients”. Based on nationally representative data on 10,698 adults from National Health and Nutrition Examination Surveys (NHANES, 2009–2012, assessments were made of socioeconomic differences, based on the Poverty Income Ratio (PIR, in terms of the association of dietary supplement use on nutrient intake and nutrient inadequacies. Compared to food alone, the use of any dietary supplement plus food was associated with significantly (p < 0.01 higher intakes of 15–16 of 19 nutrients examined in all socioeconomic groups; and significantly reduced rates of inadequacy for 10/17 nutrients in the subgroup PIR > 1.85 (not poor, but only 4–5/17 nutrients (calcium and vitamins A, C, D, E for the poor and nearly poor subgroups (PIR < 1.35 and PIR 1.35 to ≤1.85, respectively. An increased prevalence of intakes above the Tolerable Upper Intake Level (UL was seen for 3–9/13 nutrients, but all were less than 5% in the PIR subgroups. In conclusion, dietary supplement use was associated with an increased micronutrient intake, decreased inadequacies, and a slight increase in the prevalence of intakes above the UL, with greater benefits seen in the PIR > 1.85 subgroup.

  5. Perceived discrimination and chronic health in adults from nine ethnic subgroups in the USA.

    Science.gov (United States)

    Carlisle, Shauna K

    2015-01-01

    This comparative analysis examines the association between chronic cardiovascular, respiratory and pain conditions, race, ethnicity, nativity, length of residency, and perceived discrimination among three racial and nine ethnic subgroups of Asian Americans (Vietnamese, Filipino, and Chinese), Latino-American (Cuban, Portuguese, and Mexican), and Afro-Caribbean American (Haitian, Jamaican, and Trinidadian/Tobagonian) respondents. Analysis used weighted Collaborative Psychiatric Epidemiology Surveys-merged data from the National Latino and Asian American Study and the National Survey of American Life. Logistic regression analysis was conducted to determine which groups within the model were more likely to report perceived discrimination effects. Afro-Caribbean subgroups were more likely to report perceived discrimination than Asian American and Latino-American subgroups were. Logistic regression revealed a significant positive association with perceived discrimination and chronic pain only for Latino-American respondents. Significant differences in reports of perceived discrimination emerged by race and ethnicity. Caribbean respondents were more likely to report high levels of perceived discrimination; however, they showed fewer significant associations related to chronic health conditions compared to Asian Americans and Latino-Americans. Examination of perceived discrimination across ethnic subgroups reveals large variations in the relationship between chronic health and discrimination by race and ethnicity. Examining perceived discrimination by ethnicity may reveal more complex chronic health patterns masked by broader racial groupings.

  6. Are Young Dual Language Learners Homogeneous? Identifying Subgroups Using Latent Class Analysis

    Science.gov (United States)

    Kim, Do-Hong; Lambert, Richard G.; Burts, Diane C.

    2018-01-01

    Although dual language learners (DLLs) are linguistically, culturally, and socially diverse, researchers usually study them in aggregate and compare them to non-DLLs. The authors' purpose was to identify subgroups of preschool DLLs using latent class analysis. There were 7,361 DLLs and 69,457 non-DLLs. Results revealed three distinct classes.…

  7. Finite groups with the set of the number of subgroups of possible ...

    Indian Academy of Sciences (India)

    ... Refresher Courses · Symposia · Live Streaming. Home; Journals; Proceedings – Mathematical Sciences; Volume 123; Issue 4. Finite Groups with the Set of the Number of Subgroups of Possible Order Containing Exactly Two Elements. Yanheng Chen Guiyun Chen. Volume 123 Issue 4 November 2013 pp 491-498 ...

  8. Psychosocial and Friendship Characteristics of Bully/Victim Subgroups in Korean Primary School Children

    Science.gov (United States)

    Shin, Yoolim

    2010-01-01

    This study investigated psychosocial and friendship characteristics of Korean children who engaged in bully/victim subgroups among their peer groups. The participants were 605 elementary school students in Bucheon City, Korea. The participants completed a peer nomination inventory as well as loneliness and social anxiety scales. Friendship quality…

  9. Weinberg Angle Derivation from Discrete Subgroups of SU(2 and All That

    Directory of Open Access Journals (Sweden)

    Potter F.

    2015-01-01

    Full Text Available The Weinberg angle W of the Standard Model of leptons and quarks is derived from specific discrete (i.e., finite subgroups of the electroweak local gauge group SU(2 L U(1 Y . In addition, the cancellation of the triangle anomaly is achieved even when there are four quark families and three lepton families!

  10. Incidence and follow-up of Braunwald subgroups in unstable angina pectoris

    NARCIS (Netherlands)

    van Miltenburg-van Zijl, A. J.; Simoons, M. L.; Veerhoek, R. J.; Bossuyt, P. M.

    1995-01-01

    OBJECTIVES. This study was performed to establish the prognosis of patients with unstable angina within the subgroups of the Braunwald classification. BACKGROUND. Among many classifications of unstable angina, the Braunwald classification is frequently used. However, the incidence and risk for each

  11. Manual therapy in osteoarthritis of the hip: outcome in specific subgroups of patients.

    NARCIS (Netherlands)

    Hoeksma, H.L.; Dekker, J.; Ronday, H.K.; Breedveld, F.C.; Ende, C.H.M. van den

    2005-01-01

    OBJECTIVE: To investigate whether manual therapy has particular benefit in subgroups of patients defined on the basis of hip function, range of joint motion, pain and radiological deterioration. METHODS: The study was performed in the out-patient clinic of physical therapy of a large hospital. Data

  12. Clinical trials with nested subgroups: Analysis, sample size determination and internal pilot studies.

    Science.gov (United States)

    Placzek, Marius; Friede, Tim

    2017-01-01

    The importance of subgroup analyses has been increasing due to a growing interest in personalized medicine and targeted therapies. Considering designs with multiple nested subgroups and a continuous endpoint, we develop methods for the analysis and sample size determination. First, we consider the joint distribution of standardized test statistics that correspond to each (sub)population. We derive multivariate exact distributions where possible, providing approximations otherwise. Based on these results, we present sample size calculation procedures. Uncertainties about nuisance parameters which are needed for sample size calculations make the study prone to misspecifications. We discuss how a sample size review can be performed in order to make the study more robust. To this end, we implement an internal pilot study design where the variances and prevalences of the subgroups are reestimated in a blinded fashion and the sample size is recalculated accordingly. Simulations show that the procedures presented here do not inflate the type I error significantly and maintain the prespecified power as long as the sample size of the smallest subgroup is not too small. We pay special attention to the case of small sample sizes and attain a lower boundary for the size of the internal pilot study.

  13. Principal Stratification: A Tool for Understanding Variation in Program Effects across Endogenous Subgroups

    Science.gov (United States)

    Page, Lindsay C.; Feller, Avi; Grindal, Todd; Miratrix, Luke; Somers, Marie-Andree

    2015-01-01

    Increasingly, researchers are interested in questions regarding treatment-effect variation across partially or fully latent subgroups defined not by pretreatment characteristics but by postrandomization actions. One promising approach to address such questions is principal stratification. Under this framework, a researcher defines endogenous…

  14. Mortality prediction models for pediatric intensive care: comparison of overall and subgroup specific performance

    NARCIS (Netherlands)

    Visser, Idse H. E.; Hazelzet, Jan A.; Albers, Marcel J. I. J.; Verlaat, Carin W. M.; Hogenbirk, Karin; van Woensel, Job B.; van Heerde, Marc; van Waardenburg, Dick A.; Jansen, Nicolaas J. G.; Steyerberg, Ewout W.

    2013-01-01

    To validate paediatric index of mortality (PIM) and pediatric risk of mortality (PRISM) models within the overall population as well as in specific subgroups in pediatric intensive care units (PICUs). Variants of PIM and PRISM prediction models were compared with respect to calibration (agreement

  15. Mortality prediction models for pediatric intensive care : comparison of overall and subgroup specific performance

    NARCIS (Netherlands)

    Visser, Idse H. E.; Hazelzet, Jan A.; Albers, Marcel J. I. J.; Verlaat, Carin W. M.; Hogenbirk, Karin; van Woensel, Job B.; van Heerde, Marc; van Waardenburg, Dick A.; Jansen, Nicolaas J. G.; Steyerberg, Ewout W.

    To validate paediatric index of mortality (PIM) and pediatric risk of mortality (PRISM) models within the overall population as well as in specific subgroups in pediatric intensive care units (PICUs). Variants of PIM and PRISM prediction models were compared with respect to calibration (agreement

  16. Symmetries of quantum spaces. Subgroups and quotient spaces of quantum SU(2) and SO(3) groups

    International Nuclear Information System (INIS)

    Podles, P.

    1995-01-01

    We prove that each action of a compact matrix quantum group on a compact quantum space can be decomposed into irreducible representations of the group. We give the formula for the corresponding multiplicities in the case of the quotient quantum spaces. We describe the subgroups and the quotient spaces of quantum SU(2) and SO(3) groups. (orig.)

  17. Subgrouping of patients with oral lichen planus according to cytochrome P450 enzyme phenotype and genotype

    DEFF Research Database (Denmark)

    Kragelund, Camilla; Jensen, Siri Beier; Hansen, Claus

    2014-01-01

    Objective. This study aimed to determine if the activity of the environmentally influenced cytochrome P450 enzyme CYP1A2, alone or in combination with CYP2D6*4 genotype, discriminates subgroups of oral lichen planus (OLP) according to lifestyle factors and clinical manifestations. Study Design...

  18. Superstring motivated gauge models based on a rank six subgroup of E6

    International Nuclear Information System (INIS)

    Lazarides, G.; Panagiotakopoulos, C.; Shafi, Q.

    1987-01-01

    We discuss gauge models based on a superstring motivated rank six subgroup of E 6 . Lepton number is an accidental unbroken symmetry of the models which leads to an essential stable proton. One of the neutral gauge bosons couples to B-L and may have mass below a TeV. (orig.)

  19. New 16Sr subgroups and distinct SNP lineages among grapevine Bois noir phytoplasma populations

    Science.gov (United States)

    Bois noir (BN) is an insect-transmitted grapevine yellows disease caused by phytoplasmas belonging to the stolbur subgroup 16SrXII-A. In Italy, increasing prevalence of stolbur phytoplasma strains in vineyards suggests progressive spread of the disease and potential for heavy impacts on the wine in...

  20. Structural Mobility, Exchange Mobility and Subgroup Consistent Mobility Measurement – US–German Mobility Measurements Revisited

    OpenAIRE

    C. SCHLUTER; D. VAN DE GAER

    2008-01-01

    We formalize the concept of structural mobility and use the framework of subgroup consistent mobility measurement to derive a relative and an absolute measure of mobility that is increasing both in upward structural mobility and exchange mobility. In our empirical illustration, we contribute substantively to the ongoing debate about mobility rankings between the USA and Germany.

  1. Fit genotypes and escape variants of subgroup III Neisseria meningitidis during three pandemics of epidemic meningitis

    NARCIS (Netherlands)

    Zhu, P.; van der Ende, A.; Falush, D.; Brieske, N.; Morelli, G.; Linz, B.; Popovic, T.; Schuurman, I. G.; Adegbola, R. A.; Zurth, K.; Gagneux, S.; Platonov, A. E.; Riou, J. Y.; Caugant, D. A.; Nicolas, P.; Achtman, M.

    2001-01-01

    The genetic variability at six polymorphic loci was examined within a global collection of 502 isolates of subgroup III, serogroup A Neisseria meningitidis. Nine "genoclouds" were identified, consisting of genotypes that were isolated repeatedly plus 48 descendent genotypes that were isolated

  2. Identification of Neuroblastoma Subgroups Based on Three-Dimensional Telomere Organization

    Directory of Open Access Journals (Sweden)

    Alexandra Kuzyk

    2016-08-01

    Full Text Available Using 3D telomere quantitative fluorescence in situ hybridization, we determined the 3D telomere organization of 74 neuroblastoma tissue samples. Hierarchical cluster analysis of the measured telomere parameters identified three subgroups from our patient cohort. These subgroups have unique telomere profiles based on telomere length and nuclear architecture. Subgroups with higher levels of telomere dysfunction were comprised of tumors with greater numbers of telomeres, telomeric aggregates, and short telomeres (P < .0001. Tumors with greater telomere dysfunction were associated with unfavorable tumor characteristics (greater age at diagnosis, unfavorable histology, higher stage of disease, MYCN amplification, and higher MYCN expression and poor prognostic risk (P < .001. Subgroups with greater telomere dysfunction also had higher intratumor heterogeneity. MYCN overexpression in two neuroblastoma cell lines with constitutively low MYCN expression induced changes in their telomere profile that were consistent with increased telomere dysfunction; this illustrates a functional relationship between MYCN and 3D telomere organization. This study demonstrates the ability to classify neuroblastomas based on the level of telomere dysfunction, which is a novel approach for this cancer.

  3. Tallying Differences between Demographic Subgroups from Multiple Institutions: The Practical Utility of Nonparametric Analysis

    Science.gov (United States)

    Yorke, Mantz

    2017-01-01

    When analysing course-level data by subgroups based upon some demographic characteristics, the numbers in analytical cells are often too small to allow inferences to be drawn that might help in the enhancement of practices. However, relatively simple analyses can provide useful pointers. This article draws upon a study involving a partnership with…

  4. Clinical outcomes with rivaroxaban in patients transitioned from vitamin K antagonist therapy: a subgroup analysis of a randomized trial.

    Science.gov (United States)

    Mahaffey, Kenneth W; Wojdyla, Daniel; Hankey, Graeme J; White, Harvey D; Nessel, Christopher C; Piccini, Jonathan P; Patel, Manesh R; Berkowitz, Scott D; Becker, Richard C; Halperin, Jonathan L; Singer, Daniel E; Califf, Robert M; Fox, Keith A A; Breithardt, Günter; Hacke, Werner

    2013-06-18

    In ROCKET AF (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation), a large randomized, clinical trial, rivaroxaban was noninferior to warfarin in preventing stroke or systemic embolism in patients with atrial fibrillation. To determine the efficacy and safety of rivaroxaban compared with warfarin among vitamin K antagonist (VKA)-naive and VKA-experienced patients. Prespecified subgroup analysis. (ClinicalTrials.gov: NCT00403767). Global. 14,264 persons with atrial fibrillation. Interaction of the relative treatment effect of rivaroxaban and warfarin on stroke or systemic embolism among VKA-naive and VKA-experienced patients. Overall, 7897 (55.4%) patients were VKA-experienced and 6367 (44.6%) were VKA-naive. The effect of rivaroxaban versus warfarin on stroke or systemic embolism was consistent: Rates per 100 patient-years of follow-up were 2.32 versus 2.87 for VKA-naive patients (hazard ratio [HR], 0.81 [95% CI, 0.64 to 1.03]) and 1.98 versus 2.09 for VKA-experienced patients (HR, 0.94 [CI, 0.75 to 1.18]; interaction P = 0.36). During the first 7 days, rivaroxaban was associated with more bleeding than warfarin (HR in VKA-naive patients, 5.83 [CI, 3.25 to 10.44], and in VKA-experienced patients, 6.66 [CI, 3.83 to 11.58]; interaction P = 0.53). After 30 days, rivaroxaban was associated with less bleeding than warfarin in VKA-naive patients (HR, 0.84 [CI, 0.74 to 0.95]) and similar bleeding in VKA-experienced patients (HR, 1.06 [CI, 0.96 to 1.17]; interaction P = 0.003). The trial was not designed to detect differences in these subgroups. The efficacy of rivaroxaban in VKA-experienced and VKA-naive patients was similar to that of the overall trial. There were more bleeding events within 7 days of study drug initiation with rivaroxaban, but after 30 days, rivaroxaban was associated with less bleeding in VKA-naive patients and similar bleeding in VKA

  5. Opportunities of Continuing Adult Education

    Directory of Open Access Journals (Sweden)

    Lidija Ušeckienė

    2011-04-01

    , educational background, gender, and social status were surveyed. One of the major preconditions for the development of continuing adult education is the individual’s motivation to learn. It was ascertained that about three quarters (76 % of the respondents have learnt recently, the rest have not. The major factors that determine adults’ learning are increasing requirements in labour market, a need for self-development, expanding horizons and striving to gain more knowledge, have better career opportunities, consequently, improve welfare. The factors having least influence on adults’ learning are the opportunity of the transition to a new career and the possibility to interrelate with new people. It is important to analyse the reasons why adults do not learn. The most common reasons that prevent them from studies are as follows (in priority order: the lack of funds, it is difficult to combine work and studies, it is too late to learn, and it is difficult to combine studies and family matters. Hence, the reasons restricting the opportunities of continuing adult education are closely related to the research data. The respondents indicate the lack of funds for studies. This reflects the same funding problem that institutions organising and conducting adult education face. Therefore, financial possibilities in adult education are a sore problem not only to individuals, but to various organizations and the state as well. The respondents’ claim that it is difficult to combine work and studies reveals that employers are not concerned to encourage and organise employees’ learning; in the circumstances, such career givers’ policy is harmful both to employees and their education, and employers themselves as the quality of human resources comprises staff education, competences, skills, etc. The argument that it is too late to learn is rather abstract. It shows that people are not innovative; they are not interested in new developments and are rather indifferent to changing

  6. Lone Actors: Challenges and Opportunities for Countering Violent Extremism

    NARCIS (Netherlands)

    Spaaij, R.; Richman, A.; Sharan, Y.

    2015-01-01

    This paper explores some of the key challenges and opportunities concerning the prevention and control of lone actor terrorism. It is argued that lone actors do not operate in a social vacuum and that the interaction points between lone actors and their social environments can render lone actors

  7. Prevalence and reliability of treatment-based classification for subgrouping patients with low back pain.

    Science.gov (United States)

    de Oliveira, Isadora Orlando; de Vasconcelos, Rodrigo Antunes; Pilz, Bruna; Teixeira, Paulo Eduardo Portes; de Faria Ferreira, Eduarda; Mello, Wilson; Grossi, Débora Bevilaqua

    2018-02-01

    To observe the distribution of patients who presented with low back pain (LBP) and to determine the between therapists' interrater reliability of assessments in a private outpatient setting using treatment-based classification (TBC) subgroups. An observational and methodological study was conducted. Four hundred and twenty-nine patients (231 male; 198 female) presenting LBP symptoms and referred to conservative treatment were assessed by 13 physical therapists who conducted a 60-min examination process utilizing TBC subgroups. Interrater reliability analyses from six raters were assessed using Fleiss' kappa and previously recorded data ( n  = 30). In this study, 65.74% of patients were classified in only one subgroup, the most prevalent being stabilization (21.91%), followed by extension (15.38%), traction (11.89%), flexion (10.96%), manipulation (5.13%), and lateral shift (0.47%). Approximately 20.98% of patients were classified in two subgroups, where the most frequent overlaps were flexion + stabilization (7.46%), extension + stabilization (6.06%), flexion + traction (4.20%), extension + manipulation (1.86%), and 13.29% of patients were not classified in any TBC subgroup. Analysis of interrater reliability showed a kappa value of 0.62 and an overall agreement of 66% between raters. LBP is a heterogeneous clinical condition and several classification methods are proposed in the attempt to observe better outcomes for patients. Eighty-five percent of patients assessed were able to be classified when using the TBC assessment and reliability analysis showed a substantial agreement between raters. 2c.

  8. Comprehensive profiling of DNA methylation in colorectal cancer reveals subgroups with distinct clinicopathological and molecular features

    International Nuclear Information System (INIS)

    Ang, Pei Woon; Soong, Richie; Loh, Marie; Liem, Natalia; Lim, Pei Li; Grieu, Fabienne; Vaithilingam, Aparna; Platell, Cameron; Yong, Wei Peng; Iacopetta, Barry

    2010-01-01

    Most previous studies of the CpG island methylator phenotype (CIMP) in colorectal cancer (CRC) have been conducted on a relatively small numbers of CpG sites. In the present study we performed comprehensive DNA methylation profiling of CRC with the aim of characterizing CIMP subgroups. DNA methylation at 1,505 CpG sites in 807 cancer-related genes was evaluated using the Illumina GoldenGate ® methylation array in 28 normal colonic mucosa and 91 consecutive CRC samples. Methylation data was analyzed using unsupervised hierarchical clustering. CIMP subgroups were compared for various clinicopathological and molecular features including patient age, tumor site, microsatellite instability (MSI), methylation at a consensus panel of CpG islands and mutations in BRAF and KRAS. A total of 202 CpG sites were differentially methylated between tumor and normal tissue. Unsupervised hierarchical clustering of methylation data from these sites revealed the existence of three CRC subgroups referred to as CIMP-low (CIMP-L, 21% of cases), CIMP-mid (CIMP-M, 14%) and CIMP-high (CIMP-H, 65%). In comparison to CIMP-L tumors, CIMP-H tumors were more often located in the proximal colon and showed more frequent mutation of KRAS and BRAF (P < 0.001). Comprehensive DNA methylation profiling identified three CRC subgroups with distinctive clinicopathological and molecular features. This study suggests that both KRAS and BRAF mutations are involved with the CIMP-H pathway of CRC rather than with distinct CIMP subgroups

  9. Gestational weight gain and perinatal outcomes of subgroups of Asian-American women, Texas, 2009.

    Science.gov (United States)

    Cheng, Hsiu-Rong; Walker, Lorraine O; Brown, Adama; Lee, Ju-Young

    2015-01-01

    Asian-American subgroups are heterogeneous, but few studies had addressed differences on gestational weight gain (GWG) and perinatal outcomes related to GWG among this growing and diverse population. The purposes of this study were to examine whether Asian-American women are at higher risk of inadequate or excessive GWG and adverse perinatal outcomes than non-Hispanic White (NH-White) women, and to compare those risks among Asian-American subgroups. This retrospective study included all singleton births to NH-Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnam, and NH-White women documented in 2009 Texas birth certificate data (N = 150,674). Data were analyzed using the χ(2) test, t test, multinomial logistic regression, and binary logistic regression. Chinese women were the reference group in the comparisons among Asian subgroups. Asian women had a higher risk of inadequate GWG and gestational diabetes mellitus (GDM) than NH-White women. No difference in the odds of excessive GWG was found among Asian subgroups, although Japanese women had the highest risk of inadequate GWG. After adjusting for confounders, Korean women had the lowest risk of GDM (adjusted odds ratio [AOR], 0.49), whereas Filipino women and Asian Indian had the highest risks of gestational hypertension (AOR, 2.01 and 1.61), cesarean birth (AOR, 1.44 and 1.39), and low birth weight (AOR, 1.94 and 2.51) compared with Chinese women. These results support the heterogeneity of GWG and perinatal outcomes among Asian-American subgroups. The risks of adverse perinatal outcomes should be carefully evaluated separately among Asian-American subpopulations. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  10. Dietary and physical activity behaviors of New York City children from different ethnic minority subgroups.

    Science.gov (United States)

    Vangeepuram, Nita; Mervish, Nancy; Galvez, Maida P; Brenner, Barbara; Wolff, Mary S

    2012-01-01

    To examine racial/ethnic differences in diet and physical activity behaviors in ethnic minority New York City children. Cross-sectional data from a community-based study of 486 6- to 8-year-old children were used. Race/ethnicity was derived using a caregiver's report of child's race and Hispanic ancestry. Dietary intake was obtained by 24-hour diet recalls using the Nutrition Data System for Research. Physical activity was assessed with pedometers and caregiver interviews. We compared diet and activity measures across racial/ethnic subgroups using chi-square and analysis of variance tests. Multivariate analyses adjusted for age, gender, body mass index, and caregiver education (with breastfeeding history and total energy intake included in diet models). Participants (N = 486) were categorized as Mexican (29.4%), Dominican (8.4%), Puerto Rican (20.6%), other/mixed Hispanic (14.0%), or non-Hispanic black (27.6%). Obesity rates were lower in non-Hispanic blacks (18%) than in Hispanics (31%). Mexicans had the lowest obesity rates among Hispanic subgroups (25%), and Dominicans had the highest (39%). There were differences in mean daily servings of food groups, with Mexicans having healthier diets and Puerto Ricans and non-Hispanic Blacks having less healthy diets. Sedentary time was lower in Mexicans than in other groups in adjusted models. Examination of additional models, including home language, did not show significant differences in the estimates. Diet and activity behaviors varied across racial/ethnic subgroups. Specifically, Mexican children had healthier diets, the least amount of sedentary time, and the lowest rates of obesity among the Hispanic subgroups examined. Targeted interventions in ethnic subgroups may be warranted to address specific behaviors. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  11. The efficacy of natalizumab in patients with relapsing multiple sclerosis: subgroup analyses of AFFIRM and SENTINEL.

    LENUS (Irish Health Repository)

    Hutchinson, Michael

    2012-02-01

    The AFFIRM and SENTINEL studies showed that natalizumab was effective both as monotherapy and in combination with interferon beta (IFNbeta)-1a in patients with relapsing multiple sclerosis (MS). Further analyses of AFFIRM and SENTINEL data were conducted to determine the efficacy of natalizumab in prespecified patient subgroups according to baseline characteristics: relapse history 1 year before randomization (1, 2, > or = 3), Expanded Disability Status Scale score (< or = 3.5, > 3.5), number of T2 lesions (< 9, > or = 9), presence of gadolinium-enhancing (Gd+) lesions (0, > or = 1), age (< 40, > or = 40) and gender (male, female). A post hoc analysis was conducted to determine the efficacy of natalizumab in patients with highly active disease (i. e., > or = 2 relapses in the year before study entry and > or = 1 Gd+ lesion at study entry). In both AFFIRM and SENTINEL studies natalizumab reduced the annualized relapse rates across all subgroups (except the small subgroups with < 9 baseline T2 lesions) over 2 years. In AFFIRM, natalizumab significantly reduced the risk of sustained disability progression in most subgroups. In SENTINEL, natalizumab significantly reduced the risk of sustained disability progression in the following subgroups: > or = 9 T2 lesions at baseline, > or = 1 Gd+ lesions at baseline, female patients and patients < 40 years of age. Natalizumab reduced the risk of disability progression by 64 % and relapse rate by 81 % in treatment- naive patients with highly active disease and by 58 % and 76 %, respectively, in patients with highly active disease despite IFNbeta-1a treatment. These results indicate that natalizumab is effective in reducing disability progression and relapses in patients with relapsing MS, particularly in patients with highly active disease.

  12. Epidemiological and virological characteristics of 2 subgroups of hepatitis B virus genotype C.

    Science.gov (United States)

    Chan, Henry L Y; Tsui, Stephen K W; Tse, Chi-Hang; Ng, Eddie Y T; Au, Thomas C C; Yuen, Lilly; Bartholomeusz, Angeline; Leung, Kwong-Sak; Lee, Kin-Hong; Locarnini, Stephen; Sung, Joseph J Y

    2005-06-15

    We aimed to investigate the characteristics of hepatitis B virus (HBV) genotype C subgroups in Hong Kong and their relationship with HBV genotype C in other parts of Asia. Full-genome nucleotide sequences of 49 HBV genotype C isolates from Chinese patients with chronic hepatitis B were compared with the sequences of 69 HBV genotype C isolates and 12 non-genotype C isolates in the GenBank database. Phylogenetic analysis was performed to define the subgroups of HBV genotype C on the basis of >4% heterogeneity of the entire HBV genome. HBV in 80% of patients in Hong Kong belonged to a subgroup predominantly found in Southeast Asia (Vietnam, Thailand, Myanmar, and southern China) designated as HBV genotype "Cs," and HBV in the remaining 20% of patients belonged to another subgroup, predominantly found in the Far East (Korea, Japan, and northern China), designated as HBV genotype "Ce." Overall, the mean+/-SD nucleotide sequence difference between HBV genotype Cs and HBV genotype Ce was 4.2%+/-0.3%. When HBV genotype Cs and HBV genotype Ce were compared among patients in Hong Kong, HBV genotype Cs was associated with a higher tendency to develop basal core promoter mutations (80% vs. 50%; P=.14), a higher prevalence of C at nucleotide 1858 (95% vs. 0%; P<.001), and a lower prevalence of precore stop codon mutations (5% vs. 50%; P=.002). HBV genotype C can be differentiated into 2 subgroups--namely, genotype Ce and genotype Cs--that have different epidemiological distributions and virological characteristics.

  13. Preventing Addiction.

    Science.gov (United States)

    Moore, Susan Fordney

    The purpose of this paper is to provide the beginning counselor with an overview of prevention concepts. Prevention is a relatively new emphasis in community efforts to stem the rising costs of substance abuse and other high-risk behaviors. The paper discusses agent, host, and environmental prevention models and how they relate to causal theories…

  14. Crime Prevention through Environmental Design

    Science.gov (United States)

    Draper, Rick; Cadzow, Emma

    2004-01-01

    Applying CPTED (Crime Prevention Through Environmental Design) strategies to schools can significantly contribute to a safer learning environment by influencing the behaviour of students and visitors. CPTED has three overlapping primary concepts that are intended to reduce opportunities for crime as well as fear of crime: access control,…

  15. 4G/5G variant of plasminogen activator inhibitor-1 gene and severe pregnancy-induced hypertension: subgroup analyses of variants of angiotensinogen and endothelial nitric oxide synthase.

    Science.gov (United States)

    Kobashi, Gen; Ohta, Kaori; Yamada, Hideto; Hata, Akira; Minakami, Hisanori; Sakuragi, Noriaki; Tamashiro, Hiko; Fujimoto, Seiichiro

    2009-01-01

    Pregnancy-induced hypertension (PIH) is a common cause of perinatal mortality. It is believed to result from the interaction of several factors, including those related to the blood coagulation system. We performed genotyping and subgroup analyses to determine if the 4G/5G genotypes of the plasminogen activator inhibitor-1 gene (PAI-1) play a role in the pathogenesis of PIH, and to evaluate possible interactions of the PAI-1 polymorphisms with those of the angiotensinogen gene (AGT) and the endothelial nitric oxide synthase gene (NOS3). An association study of PAI-1 polymorphism, and subgroup analyses of common variants of AGT and NOS3, among 128 patients with PIH and 376 healthy pregnant controls. No significant differences were found between the cases and controls in the frequencies of allele 4G or the 4G/4G genotype. In subgroup analyses, after adjustment for multiple comparison, a significant association with the AGT TT genotype was found among women with the PAI-1 4G/4G genotype, and an association with the NOS3 GA+AA genotype was found among women with the 5G/5G or 4G/5G genotypes. Our findings suggest that there are at least 2 pathways in the pathogenesis of severe PIH. However, with respect to early prediction and prevention of severe PIH, although the PAI-1 4G/4G genotype alone was not a risk factor for severe PIH, the fact that PAI-1 genotypes are associated with varying risks for severe PIH suggests that PAI-1 genotyping of pregnant women, in combination with other tests, may be useful in the development of individualized measures that may prevent severe PIH.

  16. Characterisation: Challenges and Opportunities - A UK Perspective

    International Nuclear Information System (INIS)

    Emptage, Matthew; Loudon, David; Mcleod, Richard; Milburn, Helen

    2016-01-01

    Characterisation plays a very important role in the nuclear industry supporting: the development and implementation of decommissioning strategies/plans (and the optimisation of associated costs through reduction in technical risks); regulatory compliance demonstration; waste prevention/minimisation; evaluation and optimisation of worker radiation doses; and maintaining public confidence. Recognising these important drivers, the UK regulators are working with the UK Nuclear Decommissioning Authority (NDA) to undertake a review of characterisation practice in the UK nuclear (decommissioning) industry. The objective of the characterisation review is to understand the current characterisation challenges and to determine strategic and tactical opportunities (including sharing of standards and guidance, capabilities, learning from experience, good practice, research and development, training, quality assurance) to optimise characterisation practice. The work is being undertaken through review of nuclear operator's characterisation practice, with input from the NDA, the UK regulators, nuclear operators and representatives from the supply chain, and through consideration of good practice case studies. To support this, a catalogue of relevant national/international guidance documents is also be compiled. Finally a workshop with representatives from all parties has taken place to consider the findings and establish a common understanding of challenges and opportunities and to start to consider how they can be addressed. The review is establishing a collective (UK regulator's, NDA; nuclear operator's and supply chain) understanding of opportunities to improve characterisation practice in the UK. The characterisation review process is described and early results are presented and discussed. Subsequent work in 2016 will be required to prioritise the opportunities and to build a consensus to facilitate development and implementation of an improvement plan. The aim

  17. 78 FR 64505 - Board of Scientific Counselors, National Center for Injury Prevention and Control, (BSC, NCIPC)

    Science.gov (United States)

    2013-10-29

    ... Scientific Counselors, National Center for Injury Prevention and Control, (BSC, NCIPC) In accordance with... reviews progress toward injury prevention goals and provides evidence in injury prevention- related... matters, including the: (1) Review of extramural research concepts for funding opportunity announcements...

  18. Equal opportunities group. His mission : accelerating equal opportunities at CERN

    CERN Multimedia

    Patrice Loïez

    2000-01-01

    L. to r.: Michel Mayoud, Christine Petit-Jean-Genaz, the Equal Opportunities Officer Sudeshna Datta-Cockerill, Elena Wildner, Anne-Sylvie Cerne, Karl-Heinz Kissler, the Chairman John Ellis and Eva-Maria Groniger-Voss

  19. The Paradox of Equal Opportunities

    Directory of Open Access Journals (Sweden)

    Mitja Sardoč

    2014-06-01

    Full Text Available The basic assumption of the idea of equal opportunities is based on the assertion that all individuals competing for an advantaged social position should have equal opportunities, i.e., that each and every one of them should have fair opportunities to achieve a particular goal. Despite the fact that equal opportunities is one of the basic mechanisms for a just distribution of advantageous social positions, the idea of fair equality of opportunity remains divided between different competing political projects, e.g., egalitarian liberalism, libertarian political theory, multiculturalism, etc. This paper examines two basic dimensions of equal opportunities to which existing conceptions fail to offer a unanimous answer, i.e., a the issue of fairness and b the issue of the currency of fairness. The concluding part of this paper presents two basic paradoxes that determine both the direction of the discussion as well as the possible solutions to the achievement of fair equal opportunities as part of any process for competing for advantageous social positions.

  20. Palivizumab for immunoprophylaxis of respiratory syncytial virus (RSV) bronchiolitis in high-risk infants and young children: a systematic review and additional economic modelling of subgroup analyses.

    Science.gov (United States)

    Wang, D; Bayliss, S; Meads, C

    2011-01-01

    Respiratory syncytial virus (RSV) is a seasonal infectious disease, with epidemics occurring annually from October to March in the UK. It is a very common infection in infants and young children and can lead to hospitalisation, particularly in those who are premature or who have chronic lung disease (CLD) or congenital heart disease (CHD). Palivizumab (Synagis®, MedImmune) is a monoclonal antibody designed to provide passive immunity against RSV and thereby prevent or reduce the severity of RSV infection. It is licensed for the prevention of serious lower respiratory tract infection caused by RSV in children at high risk. While it is recognised that a policy of using palivizumab for all children who meet the licensed indication does not meet conventional UK standards of cost-effectiveness, most clinicians feel that its use is justified in some children. To use systematic review evidence to estimate the cost-effectiveness of immunoprophylaxis of RSV using palivizumab in different subgroups of children with or without CLD or CHD who are at high risk of serious morbidity from RSV infection. A systematic review of the literature and an economic evaluation was carried out. The bibliographic databases included the Cochrane Library [Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment (HTA)] and five other databases, from inception to 2009. Research registries of ongoing trials including Current Controlled Trials metaRegister, Clinical Trials.gov and the National Institute for Health Research Clinical Research Network Portfolio were also searched. Searches were conducted for prognostic and hospitalisation studies covering 1950-2009 (the original report searches conducted in 2007 covering the period 1950-2007 were rerun in August 2009 to cover the period 2007-9) and the database of all references from the original report was sifted to