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  1. Validation of a prognostic index for Huntington's disease.

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    Long, Jeffrey D; Langbehn, Douglas R; Tabrizi, Sarah J; Landwehrmeyer, Bernhard G; Paulsen, Jane S; Warner, John; Sampaio, Cristina

    2017-02-01

    Characterizing progression in Huntington's disease is important for study the natural course and selecting appropriate participants for clinical trials. The aim was to develop a prognostic index for motor diagnosis in Huntington's disease and examine its predictive performance in external observational studies. The prediagnosis Neuro-biological Predictors of Huntington's Disease study (N = 945 gene-positive) was used to select a Cox regression model for computing a prognostic index. Cross-validation was used for selecting a model with good internal validity performance using the research sites as natural splits of the data set. Then, the external predictive performance was assessed using prediagnosis data from three additional observational studies, The Cooperative Huntington Observational Research Trial (N = 358), TRACK-HD (N = 118), and REGISTRY (N = 480). Model selection yielded a prognostic index computed as the weighted combination of the UHDRS total motor score, Symbol Digit Modalities Test, baseline age, and cytosine-adenine-guanine expansion. External predictive performance was very good for the first two of the three studies, with the third being a much more progressed cohort than the other studies. The databases were pooled and a final Cox regression model was estimated. The regression coefficients were scaled to produce the prognostic index for Huntington's disease, and a normed version, which is scaled relative to a 10-year 50% probability of motor diagnosis. The positive results of this comprehensive validity analysis provide evidence that the prognostic index is generally useful for predicting Huntington's disease progression in terms of risk of future motor diagnosis. The variables for the index are routinely collected in ongoing observational studies and the index can be used to identify cohorts for clinical trial recruitment. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  2. A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma

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    Hoster, Eva; Dreyling, Martin; Klapper, Wolfram; Gisselbrecht, Christian; van Hoof, Achiel; Kluin-Nelemans, Hanneke C.; Pfreundschuh, Michael; Reiser, Marcel; Metzner, Bernd; Einsele, Hermann; Peter, Norma; Jung, Wolfram; Woermann, Bernhard; Ludwig, Wolf-Dieter; Duehrsen, Ulrich; Eimermacher, Hartmut; Wandt, Hannes; Hasford, Joerg; Hiddemann, Wolfgang; Unterhalt, Michael

    2008-01-01

    There is no generally established prognostic index for patients with mantle cell lymphoma (MCL), because the International Prognostic Index (IPI) and Follicular Lymphoma International Prognostic Index (FLIPI) have been developed for diffuse large cell and follicular lymphoma patients, respectively.

  3. Prognostic significance of serum uric acid in outpatients with chronic heart failure is complex and related to body mass index: data from the IN-CHF Registry.

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    Baldasseroni, S; Urso, R; Maggioni, A P; Orso, F; Fabbri, G; Marchionni, N; Tavazzi, L

    2012-05-01

    In the field of cardiovascular diseases, elevated levels of serum uric acid (UA) reflect a marked activation of the xanthine oxidase pathway with increase in free radicals production; it is often associated with an inflammatory state, oxygen consumption and endothelial dysfunction. All these associations have been also confirmed in heart failure (HF) but the pathophysiological role of UA in this setting is not well understood. The aim of this study was to evaluate the prognostic role of UA in outpatients enrolled in the Italian Registry of Congestive Heart Failure (IN-CHF). All patients met the European Society of Cardiology (ESC) criteria for diagnosis of HF. We considered patients with complete clinical data and UA level available at the baseline and at 1-year follow-up. The study population was composed of 877 patients aged 63 ± 12 years. One-year mortality was 10.8% and dead patients had a higher level of UA than survivors (7.1 mg dl⁻¹ vs 6.6 mg dl⁻¹, p < 0.0207). In multivariable full model of analysis, UA did not result in an independent predictor of death in overall population, but only in patients with low body mass index (BMI) (≤22 kg m⁻²) (hazard ratio (HR): 2.38, 95% confidence interval (CI) 1.36-4.18). In this subgroup, a statistically significant gradual relationship between UA and survival was detected starting from values higher than 8 mg dl⁻¹. Elevated level of UA is not an independent predictor of mortality in chronic HF, but it markedly worsens outcome if associated with low level of BMI. This association is likely an indicator of chronic inflammatory and catabolic state. Copyright © 2010 Elsevier B.V. All rights reserved.

  4. Cell Proliferation Activity and Prognostic Index in Squamous Cell Lung Carcinoma

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    José Antonio Alvarez-Riesgo

    1998-01-01

    Full Text Available Flow Cytometry (FC has been incorporated into cancer research in relation to its prognostic value together with histological parameters and TNM stages. We have studied by means of FC the cell cycle of 132 samples from male patients with Squamous Cell Lung Carcinoma (SQCLC. All of the patients received curative surgery and the clinical follow-up was 60 months. The clinical and cytometric parameters were evaluated in order to predict the patients’ outcome. The presence of tumoural recurrence and the tumoural stage showed statistical significance associated with survival. The multivariant analysis reveals radiotherapy (p = 0.004 as protective variable and the high S-phase fraction (SPF (p = 0.001 and stage IIIA (p = 0.012 as risk factors. The SPF appears as an independent prognostic factor for overall survival time. We can build a prognostic index representative of different prognostic groups, which allows us to improve the individual monitoring of these patients.

  5. Improving the Prognostic Ability through Better Use of Standard Clinical Data - The Nottingham Prognostic Index as an Example.

    Directory of Open Access Journals (Sweden)

    Klaus-Jürgen Winzer

    Full Text Available Prognostic factors and prognostic models play a key role in medical research and patient management. The Nottingham Prognostic Index (NPI is a well-established prognostic classification scheme for patients with breast cancer. In a very simple way, it combines the information from tumor size, lymph node stage and tumor grade. For the resulting index cutpoints are proposed to classify it into three to six groups with different prognosis. As not all prognostic information from the three and other standard factors is used, we will consider improvement of the prognostic ability using suitable analysis approaches.Reanalyzing overall survival data of 1560 patients from a clinical database by using multivariable fractional polynomials and further modern statistical methods we illustrate suitable multivariable modelling and methods to derive and assess the prognostic ability of an index. Using a REMARK type profile we summarize relevant steps of the analysis. Adding the information from hormonal receptor status and using the full information from the three NPI components, specifically concerning the number of positive lymph nodes, an extended NPI with improved prognostic ability is derived.The prognostic ability of even one of the best established prognostic index in medicine can be improved by using suitable statistical methodology to extract the full information from standard clinical data. This extended version of the NPI can serve as a benchmark to assess the added value of new information, ranging from a new single clinical marker to a derived index from omics data. An established benchmark would also help to harmonize the statistical analyses of such studies and protect against the propagation of many false promises concerning the prognostic value of new measurements. Statistical methods used are generally available and can be used for similar analyses in other diseases.

  6. Bacterial brain abscesses: prognostic value of an imaging severity index

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    Demir, M.K. [Department of Radiology, Trakya University School of Medicine, Edirne (Turkey)]. E-mail: demirkemal@superonline.com; Hakan, T. [Department of Neurosurgery, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Kilicoglu, G. [Department of Radiology, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Ceran, N. [Department of Infectious Disease, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Berkman, M.Z. [Department of Neurosurgery, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Erdem, I. [Department of Infectious Disease, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Goektas, P. [Department of Infectious Disease, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey)

    2007-06-15

    Aim: To assess the correlation between imaging findings [computed tomography (CT) or magnetic resonance imaging (MRI)] and neurological status before and after the treatment of bacterial brain abscesses. Materials and methods: CT and MRI images of 96 patients with brain abscesses were retrospectively evaluated in terms of the number, location and size of lesions, and the presence and extent of perilesional oedema and midline shift. An imaging severity index (ISI) based on these different radiological parameters was calculated. Initial Glasgow Coma Scale (GCS) scores and ISI were assessed and the prognostic value of these two indices was calculated. The Pearson correlation test, Mann-Whitney test, Chi-square test, receiver-operating characteristic (ROC) analysis, together with comparison of ROC analyses and Fisher's exact test were used. Results: There was a negative correlation between ISI and the initial GCS values: ISI increased as the GCS score decreased, indicating an inverse relationship (r = -0.51, p < 0.0001). There was a significant difference between the ISI and GCS scores of patients with an adverse event compared with patients with good recovery. Outcome was significantly worse in patients with initial ISI over the calculated cut-off values of 8 points or GCS scores under the cut-off value of 13 points. Conclusion: ISI is a useful prognostic indicator for bacterial brain abscess patients and correlates strongly with the patient outcome for all parameters studied. ISI score had a better prognostic value than GCS.

  7. [Expression and prognostic significance of microenvironment related prognostic factors in patients with classical Hodgkin's lymphoma].

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    Wang, T T; Li, S X; Xia, B; Zhao, H F; Xu, W; Yang, H L; Wang, X F; Yu, Y; Sun, B C; Zhang, Y Z

    2017-05-16

    Objective: To observe the expression of three microenvironment related prognostic factors, i. e. programmed death 1 (PD-1), forkhead box protein 3(FOXP3) and colony-stimulating factor 1 receptor(CSF-1R) protein in classical Hodgkin's lymphoma (CHL) patients, and to explore the correlation between the protein expression and the prognosis of the patients. Methods: A total of 45 cases of CHL patients, who had been admitted to the Tianjin Medical University Cancer Institute and Hospital and Chinese PLA General Hospital from February 2005 to August 2010 were analyzed, including clinical features, prognostic factors, and treatment regimens. CHL patients' specimens were collected and the expression of PD-1, FOXP3, and CSF-1R proteins analyzed by immunohistochemical staining. Epstein-Barr virus encoded mRNA (EBER) was detected by in situ hybridization analysis. The relationship between the protein expression of PD-1, FOXP3 and CSF-1R and the patients' outcome was analyzed with clinical and follow-up data. Survival analysis was performed by Kaplan-Meier method, the Cox proportional hazard model was used to perform multivariate analysis. Results: In this cohort of 45 CHL patients, PD-1 positive was found in 7 cases (15.6%), FOXP3 high expression in 23 cases (51.1%), CSF-1R positive in 18 cases (40.0%). In the univariate analysis, the expression of FOXP3 and CSF-1R, International Prognostic Index (IPI) score, Ann Arbor stage and EBER were related with the patients' 5-year overall survival (OS); IPI score, the expression of FOXP3 and EBER were related with the patients' 5-year progress-free survival (PFS). Multivariate analysis indicated that CSF-1R protein expression was the independent prognostic factor affecting the patients' 5-year OS(HR: 8.918, P=0.020), and FOXP3 protein expression was the independent prognostic factor affecting the patients' 5-year PFS (HR: 0.122, PCSF-1R and EBV may be independent prognostic factors of CHL and this study may provide novel strategies

  8. The Practicability of a Novel Prognostic Index (PI) Model and Comparison with Nottingham Prognostic Index (NPI) in Stage I-III Breast Cancer Patients Undergoing Surgical Treatment.

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    Wen, Jiahuai; Ye, Feng; Li, Shuaijie; Huang, Xiaojia; Yang, Lu; Xiao, Xiangsheng; Xie, Xiaoming

    2015-01-01

    Previous studies have indicated the prognostic value of various laboratory parameters in cancer patients. This study was to establish a prognostic index (PI) model for breast cancer patients based on the potential prognostic factors. A retrospective study of 1661 breast cancer patients who underwent surgical treatment between January 2002 and December 2008 at Sun Yat-sen University Cancer Center was conducted. Multivariate analysis (Cox regression model) was performed to determine the independent prognostic factors and a prognostic index (PI) model was devised based on these factors. Survival analyses were used to estimate the prognostic value of PI, and the discriminatory ability of PI was compared with Nottingham Prognostic Index (NPI) by evaluating the area under the receiver operating characteristics curves (AUC). The mean survival time of all participants was 123.6 months. The preoperative globulin >30.0g/L, triglyceride >1.10mmol/L and fibrinogen >2.83g/L were identified as risk factors for shorter cancer-specific survival. The novel prognostic index model was established and enrolled patients were classified as low- (1168 patients, 70.3%), moderate- (410 patients, 24.7%) and high-risk groups (83 patients, 5.0%), respectively. Compared with the low-risk group, higher risks of poor clinical outcome were indicated in the moderate-risk group [Hazard ratio (HR): 1.513, 95% confidence interval (CI): 1.169-1.959, p = 0.002] and high-risk group (HR: 2.481, 95%CI: 1.653-3.724, p< 0.001). The prognostic index based on three laboratory parameters was a novel and practicable prognostic tool. It may serve as complement to help predict postoperative survival in breast cancer patients.

  9. Prognostic Nutritional Index Predicts Severe Complications, Recurrence, and Poor Prognosis in Patients With Colorectal Cancer Undergoing Primary Tumor Resection.

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    Tokunaga, Ryuma; Sakamoto, Yasuo; Nakagawa, Shigeki; Miyamoto, Yuji; Yoshida, Naoya; Oki, Eiji; Watanabe, Masayuki; Baba, Hideo

    2015-11-01

    The prognostic nutritional index is reportedly related to postoperative outcomes. The aim of this study was to elucidate the clinical importance of the prognostic nutritional index in patients with colorectal cancer who were undergoing primary tumor resection. This is a retrospective study from a single institution. This study was conducted at a colorectal surgery service in an academic teaching hospital. The 556 patients with colorectal cancer who were undergoing surgery between March 2005 and August 2014 were eligible for this study. The preoperative prognostic nutritional index was calculated. Classification and regression tree analysis was performed to determine the prognostic nutritional index cutoff value. The associations of the prognostic nutritional index status with clinicopathological factors and postoperative outcomes were examined using univariate and multivariate analyses. Classification and regression tree analysis demonstrated that 45.5 was the optimal cutoff value. The low status (≤45.5) was correlated with older age, low BMI, low estimated glomerular filtration rate, CEA positivity, carbohydrate antigen 19-9 positivity, preoperative chemotherapy, tumors invading muscular or deeper layers, distant metastasis, poor differentiation, severe postoperative complications, tumor recurrence, and poor survival. In multivariate analysis, the low status was an independent risk factor for severe postoperative complications (OR = 2.06 [95% CI, 1.22-3.50]; p = 0.007) and low overall survival (HR =3.98 [95% CI, 2.38-6.89]; p nutritional index status, not considering the postoperative host status. The preoperative prognostic nutritional index predicts severe complications, recurrence, and poor prognosis in patients with colorectal cancer who are undergoing primary tumor resection. Investigation of the nutritional and immunologic statuses using the prognostic nutritional index could be a useful clinical approach.

  10. Prognostic significance of the prognostic nutritional index in esophageal cancer patients undergoing neoadjuvant chemotherapy.

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    Nakatani, M; Migita, K; Matsumoto, S; Wakatsuki, K; Ito, M; Nakade, H; Kunishige, T; Kitano, M; Kanehiro, H

    2017-08-01

    Nutritional status is one of the most important issues faced by cancer patients. Several studies have shown that a low preoperative nutritional status is associated with a worse prognosis in patients with various types of cancer, including esophageal cancer (EC). Recently, neoadjuvant chemotherapy (NAC) and/or radiotherapy have been accepted as the standard treatment for resectable advanced EC. However, NAC has the potential to deteriorate the nutritional status of a patient. This study aimed to evaluate the prognostic significance of the nutritional status for EC patients who underwent NAC. We retrospectively reviewed 66 squamous cell EC patients who underwent NAC consisting of docetaxel, cisplatin, and 5-fluorouracil followed by subtotal esophagectomy at Nara Medical University Hospital between January 2009 and August 2015. To assess the patients' nutritional status, the prognostic nutritional index (PNI) before commencing NAC and prior to the operation was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count in the peripheral blood (per mm3). The cutoff value of the PNI was set at 45. A multivariable analysis was performed to identify prognostic factors for overall survival (OS) and relapse-free survival (RFS). The mean pre-NAC and preoperative PNI were 50.2 ± 5.7 and 48.1 ± 4.7, respectively (P = 0.005). The PNI decreased following NAC in 44 (66.7%) patients. Before initiating NAC, 9 (13.6%) patients had a low PNI, and 12 (18.2%) patients had a low PNI prior to the operation. The pre-NAC PNI and preoperative PNI were significantly associated with the OS (P = 0.013 and P = 0.004, respectively) and RFS (P = 0.036 and P = 0.005, respectively) rates. The multivariable analysis identified the preoperative PNI as an independent prognostic factor for poor OS and RFS, although the pre-NAC PNI was not an independent predictor. Our results suggest that the preoperative PNI is a useful marker for predicting the long-term outcomes of EC patients

  11. Prognostic nutritional index as a prognostic biomarker for survival in digestive system carcinomas.

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    Zhao, Yang; Xu, Peng; Kang, Huafeng; Lin, Shuai; Wang, Meng; Yang, Pengtao; Dai, Cong; Liu, Xinghan; Liu, Kang; Zheng, Yi; Dai, Zhijun

    2016-12-27

    The prognostic nutritional index (PNI) has been reported to correlate with the prognosis in patients with various malignancies. We performed a meta-analysis to determine the predictive potential of PNI in digestive system cancers. Twenty-three studies with a total of 7,384 patients suffering from digestive system carcinomas were involved in this meta-analysis. A lower PNI was significantly associated with the shorter overall survival (OS) [Hazard Ratio (HR) 1.83, 95% Confidence Interval (CI) 1.62-2.07], the poorer disease-free survival (DFS) (HR 1.85, 95% CI 1.19-2.89), and the higher rate of post-operative complications (HR 2.31, 95% CI 1.63-3.28). In conclusion, PNI was allowed to function as an efficient indicator for the prognosis of patients with digestive system carcinomas.

  12. Re-evaluation of Mannheim prognostic index in perforative peritonitis: prognostic role of advanced age. A prospective cohort study.

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    Neri, Alessandro; Marrelli, Daniele; Scheiterle, Maximilian; Di Mare, Giulio; Sforza, Simone; Roviello, Franco

    2015-01-01

    Peritonitis from perforation of abdominal viscera is associated with high mortality. In western countries individuals older than 65 years constitute a significant proportion of the population and intra abdominal infections are more challenging to manage in these aged patients. This prospective cohort study included 143 consecutive patients operated on for primary perforative peritonitis. The aim of the study was to assess the prognostic efficacy of Mannheim Peritonitis Index (MPI) in a population with a significant proportion of older patients and to substantiate advanced age as an independent prognostic factor. Patients' informations were collected both on hospitalization and after surgical exploration; severity of peritonitis was evaluated using the MPI. The prognostic value of MPI was compared to older age and other clinical variables. The intra-hospital mortality was 25.2%. According to the MPI score, the ROC curve identified 21 as cut-off value with a sensitivity of 86% and a specificity of 59% in predicting the risk of death. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis. In the subgroup of patients with MPI score≥21, the mortality rate was 46.4% for patients older than 80 years old and 38.3% for younger patients (p=0.07); in patients with MPI score<21, the mortality of those aged more than 80 years reached 33.3% compared to 3.4% for younger patients (p=0.001). Age older than 80 years is strongly related to major increase in mortality rates and should be taken into account together with the MPI score in planning the surgical approach and the post-operative care. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  13. Recurrent epithelial ovarian cancer: Validation and improvement of an established prognostic index

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    Gronlund, B; Christensen, Ib Jarle; Bülow-Lehnsby, A L

    2005-01-01

    OBJECTIVES: To validate and improve an established prognostic index in patients with recurrent ovarian cancer. METHODS: A Canadian three-covariate prognostic index (tumour grade at diagnosis, initial performance status, and time to relapse/primary progression (TRP)) was validated in a well...... available), 25.0 (22.1-33.6), 11.3 (8.5-12.9), and 5.2 (3.5-6.3) months, respectively. CONCLUSIONS: A novel prognostic model (the Copenhagen index) for patients with recurrent ovarian cancer is presented.......-defined cohort of comparable Danish patients. Potential parameters to be included in an improved prognostic index were revealed by univariate and multivariate analyses in the Danish validation group. RESULTS: The Canadian index validated in the Danish patient population (n=189) found a statistical significant...

  14. A prognostic index for locoregional recurrence after neoadjuvant chemotherapy.

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    Herrero-Vicent, C; Guerrero-Zotano, A; Gavilá-Gregori, J; Hernández-Blanquisett, A; Sandiego-Contreras, S; Samper-Hiraldo, J M; Guillem-Porta, V; Ruiz-Simón, A

    2016-01-01

    The appropriate selection criteria for breast-conserving surgery (BCS) or mastectomy after neoadjuvant chemotherapy (NAC) are poorly defined. The aim of this study is to analyse the incidence and prognostic factors for locoregional recurrence (LRR) in patients with breast cancer (BC) treated with NAC to develop a prognostic score to help with clinical decision-making. Using our retrospective maintained BC database, we identified 730 patients treated with NAC (327 patients treated with BCS and 403 patients treated with mastectomy) between 1998 and 2014. To identify variables associated with an increased LRR rate, we performed firstly Kaplan-Meier curves, with comparisons among groups using log-rank test, and then, significant variables were included in a multivariate analysis using Cox proportional hazards. The prognostic index was developed by assigning score 0 (favourable) or score 1 (unfavourable) for each significant variable of multivariate analysis and was created separately for patients with BCS and mastectomy. At a median follow-up of 72 months, the 6-year cumulative incidence of LRR was 7.2% ( ± 3%) for BCS and 7.9% ( ± 3%) for mastectomy. By univariate analysis, variables associated with an increased LRR were for BCS: HER2 positive, grade III, ductal carcinoma in situ (DCIS), No-pCR (ypTis, ypN0), and age < 40 years; and for mastectomy, HER2-positive, DCIS, No-pCR, and LVI. By multivariate analysis, variables associated with an increased LRR were for BCS: HER2 positive (HR: 11.1, p = 0.001), DCIS (HR: 3.1, p = 0.005), and age < 40 years (HR: 2.8, p = 0.02); and for mastectomy: HER2 positive (HR: 9.5, p = 0.03), DCIS (HR: 2.7, p = 0.01), No-pCR (HR: 11.4, p = 0.01), and age < 40 years (HR: 2.8, p = 0.006). The score stratified patients into three subsets with statistically different levels of risk for LRR. For BCS, the six-year LRR rates were 3%, 13%, and 33% for the low (score 0, n = 120), intermediate (score 1, n = 95) and high (score 2-3, n = 27) risk

  15. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: the updated BODE index and the ADO index.

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    Puhan, Milo A; Garcia-Aymerich, Judith; Frey, Martin; ter Riet, Gerben; Antó, Josep M; Agustí, Alvar G; Gómez, Federico P; Rodríguez-Roisín, Roberto; Moons, Karel G M; Kessels, Alphons G; Held, Ulrike

    2009-08-29

    The BODE index (including body-mass index, airflow obstruction, dyspnoea, and exercise capacity) was an important contribution to the prognostic assessment of patients with chronic obstructive pulmonary disease (COPD). However, no study has assessed whether the risk of mortality predicted by the BODE index matches the observed mortality in different populations. We assessed the calibration of the BODE index, updated it to improve its calibration, and developed and validated a simplified index for use in primary-care settings. We included 232 patients from the Swiss Barmelweid cohort with longstanding and severe COPD and 342 patients from the Spanish Phenotype and Course of COPD cohort study who had had their first hospital admission due to moderate-to-severe COPD. In both cohorts we compared the observed 3-year risk of all-cause mortality with the risk predicted by the BODE index. We then updated the BODE index and developed a simplified ADO index (including age, dyspnoea, and airflow obstruction) from the Swiss cohort, and validated both in the Spanish cohort. Calibration of the BODE index was poor, with relative underprediction of 3-year risk of mortality by 36% in the Swiss cohort (median predicted risk 21.7% [IQR 12.7-31.7] vs 34.1% observed risk; p=0.013) and relative overprediction by 39% in the Spanish cohort (16.7% [12.7-31.7] vs 12.0%; p=0.035). The 3-year risk of mortality predicted by both the updated BODE (median 10.7% [8.1-13.8]) and ADO indices (11.8% [9.1-14.3]) matched the observed mortality in the Spanish cohort well (p=0.99 and p=0.98, respectively). Both the updated BODE and ADO indices could lend support to the prognostic assessment of patients with COPD in specialised and primary-care settings. Such assessment enhances the targeting of treatments to individual patients. Swiss National Science Foundation; Klinik Barmelweid; Fondo de Investigación Sanitaria Ministry of Health, Spain; Agència d'Avaluació de Tecnologia i Recerca M

  16. Geriatric Nutritional Risk Index as a Prognostic Factor in Peritoneal Dialysis Patients

    OpenAIRE

    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2013-01-01

    ♦ Background: The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce.

  17. A prognostic index for locoregional recurrence after neoadjuvant chemotherapy

    OpenAIRE

    Herrero-Vicent, C; Guerrero-Zotano, A; Gavil?-Gregori, J; Hern?ndez-Blanquisett, A; Sandiego-Contreras, S; Samper-Hiraldo, JM; Guillem-Porta, V; Ruiz-Sim?n, A

    2016-01-01

    Background The appropriate selection criteria for breast-conserving surgery (BCS) or mastectomy after neoadjuvant chemotherapy (NAC) are poorly defined. The aim of this study is to analyse the incidence and prognostic factors for locoregional recurrence (LRR) in patients with breast cancer (BC) treated with NAC to develop a prognostic score to help with clinical decision-making. Materials and methods Using our retrospective maintained BC database, we identified 730 patients treated with NAC (...

  18. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease : the updated BODE index and the ADO index

    NARCIS (Netherlands)

    Puhan, Milo A.; Garcia-Aymerich, Judith; Frey, Martin; ter Riet, Gerben; Anto, Josep M.; Agusti, Alvar G.; Gomez, Federico P.; Rodriguez-Roisin, Roberto; Moons, Karel G. M.; Kessels, Alphons G.; Held, Ulrike

    2009-01-01

    Background The BODE index (including body-mass index, airflow obstruction, dyspnoea, and exercise capacity) was an important contribution to the prognostic assessment of patients with chronic obstructive pulmonary disease (COPD). However, no study has assessed whether the risk of mortality predicted

  19. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: the updated BODE index and the ADO index

    NARCIS (Netherlands)

    Puhan, Milo A.; Garcia-Aymerich, Judith; Frey, Martin; ter Riet, Gerben; Antó, Josep M.; Agustí, Alvar G.; Gómez, Federico P.; Rodríguez-Roisín, Roberto; Moons, Karel G. M.; Kessels, Alphons G.; Held, Ulrike

    2009-01-01

    Background The BODE index (including body-mass index, airflow obstruction, dyspnoea, and exercise capacity) was an important contribution to the prognostic assessment of patients with chronic obstructive pulmonary disease (COPD). However, no study has assessed whether the risk of mortality predicted

  20. Short-Term Prognostic Index for Breast Cancer: NPI or Lpi

    Directory of Open Access Journals (Sweden)

    V. Van Belle

    2011-01-01

    Full Text Available Axillary lymph node involvement is an important prognostic factor for breast cancer survival but is confounded by the number of nodes examined. We compare the performance of the log odds prognostic index (Lpi, using a ratio of the positive versus negative lymph nodes, with the Nottingham Prognostic Index (NPI for short-term breast cancer specific disease free survival. A total of 1818 operable breast cancer patients treated in the University Hospital of Leuven between 2000 and 2005 were included. The performance of the NPI and Lpi were compared on two levels: calibration and discrimination. The latter was evaluated using the concordance index (cindex, the number of patients in the extreme groups, and difference in event rates between these. The NPI had a significant higher cindex, but a significant lower percentage of patients in the extreme risk groups. After updating both indices, no significant differences between NPI and Lpi were noted.

  1. The Enhanced International Prognostic Index for Diffuse Large B-cell Lymphoma.

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    Yang, Yan; Wang, Lanlan; Ma, Yanna; Han, Tingting; Huang, Mei

    2017-05-01

    To explore the prognostic value of the enhanced International Prognostic Index (NCCN-IPI) for Asian patients with diffuse large B-cell lymphoma (DLBCL) treated in the rituximab era. We performed a retrospective analysis of 176 patients with newly diagnosed DLBCL. The estimated overall survival (OS) and progression-free survival (PFS) of the different risk groups were discriminated by the International Prognostic Index (IPI), the revised International Prognostic Index (R-IPI) and the NCCN-IPI. With a median follow-up of 18 months, at 3 years, the OS was 73% and the PFS was 65%. The 3-year OS for the 4 NCCN-IPI risk groups were 91% versus 80% versus 57% versus 45% (P < 0.001); the 3-year PFS were 77% versus 72% versus 56% versus 26% (P < 0.001). The 3-year OS of the 4 risk groups discriminated by the IPI ranged from 85-55% (P < 0.001); the 3-year PFS ranged from 81-41% (P < 0.001). The 3-year OS of the 3 distinct prognostic groups by the R-IPI ranged from 86-51% (P < 0.001); the 3-year PFS ranged from 86-47% (P < 0.001). The 3-year OS and PFS of the high-risk group according to the NCCN-IPI were lower than the IPI and R-IPI. Using the NCCN-IPI, the outcomes among the risk groups spanned a large range, and the survival of the high-risk group was significantly different from the high-intermediate risk group. The NCCN-IPI is a clinically useful prognostic index for patients with DLBCL treated in the rituximab era, especially for high-risk patients. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  2. Prognostic Nutritional Index and the Risk of Mortality in Patients With Acute Heart Failure.

    Science.gov (United States)

    Cheng, Yu-Lun; Sung, Shih-Hsien; Cheng, Hao-Min; Hsu, Pai-Feng; Guo, Chao-Yu; Yu, Wen-Chung; Chen, Chen-Huan

    2017-06-25

    Nutritional status has been related to clinical outcomes in patients with heart failure. We assessed the association between nutritional status, indexed by prognostic nutritional index (PNI), and survival in patients hospitalized for acute heart failure. A total of 1673 patients (age 76±13 years, 68% men) hospitalized for acute heart failure in a tertiary medical center were analyzed. PNI was calculated as 10×serum albumin (g/dL)+0.005×total lymphocyte count (per mm(3)). National Death Registry was linked to identify the clinical outcomes of all-cause and cardiovascular death. With increasing tertiles of PNI, age and N-terminal probrain natriuretic peptide decreased, and body mass index, estimated glomerular filtration rate, and hemoglobin increased. During a mean follow-up duration of 31.5 months, a higher PNI tertile was related to better survival free from all-cause and cardiovascular mortality in the total study population and in participants with either reduced or preserved left ventricular ejection fraction. After accounting for age, sex, estimated glomerular filtration rate, left ventricular ejection fraction, serum sodium level, and on-admission systolic blood pressure, PNI was independently associated with cardiovascular death and total mortality (hazard ratio per 1 SD of the natural logarithm of the PNI: 0.76 [95% CI, 0.66-0.87] and 0.79 [95% CI, 0.73-0.87], respectively). In subgroup analyses stratified by age, sex, left ventricular ejection fraction, body mass index, or estimated glomerular filtration rate, PNI was consistently related to mortality. PNI is independently associated with long-term survival in patients hospitalized for acute heart failure with either reduced or preserved left ventricular ejection fraction. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  3. USEFULNESS OF A NEW PROGNOSTIC INDEX FOR ALCOHOLIC HEPATITIS

    Directory of Open Access Journals (Sweden)

    Jazon Romilson de Souza ALMEIDA

    2015-03-01

    Full Text Available Background Alcoholic liver disease is a major cause of end-stage liver disease worldwide and severe forms of alcoholic hepatitis are associated with a high short-term mortality. Objectives To analyze the importance of age-bilirubin-INR-creatinine (ABIC score as an index of mortality and predictor for complications in patients with alcoholic hepatitis. To evaluate its correlation with those complications, with risk of death, as well as the scores model for end stage liver disease (MELD and Maddrey’s discriminat function. Methods A total of 46 medical records of patients who had been hospitalized with alcoholic hepatitis were assessed retrospectively with lab tests on admission and after seven days. Score calculations were carried out and analyzed as well. Results The scores showed positive reciprocal correlation and were associated with both hepatic encephalopathy and ascites. ABIC index, which was classified as high risk, presented as a risk factor for these complications and for death. In univariate logistic regression analysis of mortality, the ABIC index at hospital admission odds ratio was 19.27, whereas after 7 days, it was 41.29. The average survival of patients with ABIC of low and intermediate risk was 61.1 days, and for those with high risk, 26.2 days. Conclusions ABIC index is a predictor factor for complications such as ascites and hepatic encephalopathy, as well as for risk of death. Thus, it is a useful tool for clinical practice.

  4. The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a meta-analysis

    Science.gov (United States)

    2012-01-01

    Background Prognostic assessment is important for the management of patients with acute pulmonary embolism (APE). Pulmonary Embolism Severity Index (PESI) and simple PESI (sPESI) are new emerged prognostic assessment tools for APE. The aim of this meta-analysis is to assess the accuracy of the PESI and the sPESI to predict prognostic outcomes (all-cause and PE-related mortality, serious adverse events) in APE patients, and compare between these two PESIs. Methods MEDLINE and EMBASE database were searched up to June 2012 using the terms “Pulmonary Embolism Severity Index” and “pulmonary embolism”. Summary odds ratio (OR) with 95% confidence intervals (CIs) for prognostic outcomes in low risk PESI versus high risk PESI were calculated. Summary receiver operating characteristic curve (SROC) used to estimate overall predicting accuracies of prognostic outcomes. Results Twenty-one studies were included in this meta-analysis. The results showed low-risk PESI was significantly associated with lower all-cause mortality (OR 0.13; 95% CI 0.12 to 0.15), PE-related mortality (OR 0.09; 95% CI 0.05 to 0.17) and serious adverse events (OR 0.34; 95% CI 0.29 to 0.41), with no homogeneity across studies. In sPESI subgroup, the OR of all-cause mortality, PE-related mortality, and serious adverse events was 0.10 (95% CI 0.08 to 0.14), 0.09 (95% CI 0.03 to 0.26) and 0.40 (95% CI 0.31 to 0.51), respectively; while in PESI subgroup, the OR was 0.14 (95% CI 0.13 to 0.16), 0.09 (95% CI 0.04 to 0.21), and 0.30 (95% CI 0.23 to 0.38), respectively. For accuracy analysis, the pooled sensitivity, the pooled specificity, and the overall weighted AUC for PESI predicting all-cause mortality was 0.909 (95% CI: 0.900 to 0.916), 0.411 (95% CI: 0.407 to 0.415), and 0.7853±0.0058, respectively; for PE-related mortality, it was 0.953 (95% CI: 0.913 to 0.978), 0.374 (95% CI: 0.360 to 0.388), and 0.8218±0.0349, respectively; for serious adverse events, it was 0.821 (95% CI: 0.795 to 0.845), 0

  5. Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics has received considerable attention recently as an emerging sub-discipline within SHM. Prognosis is here strictly defined as “predicting the time at...

  6. Prognostic gene signature profiles of hepatitis C-related early-stage liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Anu Venkatesh

    2014-12-01

    Full Text Available The rate of hepatitis C virus (HCV related liver cirrhosis and subsequent cancer development is increasing and raising the risk of related mortality and morbidity. To address this issue, we aimed to develop a prognostic index that can be used to stratify patients for risk of disease progression. This index was developed in part by using a gene signature test implemented in a clinically applicable digital transcript counting platform (NanoString nCounter system. A cohort of 145 U.S. patients with HCV-related early-stage cirrhosis was analyzed by using the assay. This dataset (GEO accession number GPL17230 provides information of expression levels of the prognostic genes in the cohort.

  7. Body mass index (BMI) may be a prognostic factor for gastric cancer with peritoneal dissemination.

    Science.gov (United States)

    Chen, Shi; Nie, Run-Cong; OuYang, Li-Ying; Li, Yuan-Fang; Xiang, Jun; Zhou, Zhi-Wei; Chen, YingBo; Peng, JunSheng

    2017-02-23

    The aim of this study is to investigate whether body mass index (BMI) is a prognostic factor in gastric cancer patients with peritoneal dissemination. This is a retrospective study consisting of 518 patients with a histological diagnosis of gastric cancer with peritoneal dissemination seen at the Sixth Affiliated Hospital of Sun Yat-Sen University and Sun Yat-sen University Cancer Center between January 2010 and April 2014. Patients were followed until December 2015. Chi-square test and Kaplan-Meier survival analysis were used to compare the clinicopathological variables and prognosis. Univariate analyses showed that significant prognostic factors included palliative gastrectomy (p dissemination, especially in patients who received palliative chemotherapy. BMI is a prognostic factor for patients who have gastric cancer with peritoneal dissemination, especially in those who received palliative chemotherapy.

  8. Improved prognostic stratification using NCCN- and GELTAMO-international prognostic index in patients with diffuse large B-cell lymphoma.

    Science.gov (United States)

    Hong, Junshik; Kim, Seok Jin; Chang, Myung Hee; Kim, Jeong-A; Kwak, Jae-Yong; Kim, Jin Seok; Yoon, Dok Hyun; Lee, Won Sik; Do, Young Rok; Kang, Hye Jin; Eom, Hyeon-Seok; Park, Yong; Won, Jong-Ho; Mun, Yeung-Chul; Kim, Hyo Jung; Kwon, Jung Hye; Kong, Jee Hyun; Oh, Sung Yong; Lee, Sunah; Bae, Sung Hwa; Yang, Deok-Hwan; Jun, Hyun Jung; Lee, Ho Sup; Yun, Hwan Jung; Lee, Soon Il; Kim, Min Kyoung; Yi, Jun Ho; Lee, Jae Hoon; Kim, Won Seog; Suh, Cheolwon

    2017-11-03

    The National Comprehensive Cancer Network (NCCN)-International Prognostic Index (IPI) and GELTAMO (Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea)-IPI were developed to enable better risk prediction of patients with diffuse large B-cell lymphoma (DLBCL). The present study compared the effectiveness of risk prediction between IPI, NCCN-IPI, and GELTAMO-IPI in patients with DLBCL particularly in terms of determining high-risk patients. Among 439 patients who were enrolled to a prospective DLBCL cohort treated with R-CHOP immunochemotherapy, risk groups were classified according to the three IPIs and the prognostic significance of individual IPI factors and IPI models were analyzed and compared. All three IPI effectively separated the analyzed patients into four risk groups according to overall survival (OS). Estimated 5-year OS of patients classified as high-risk according to the IPI was 45.7%, suggesting that the IPI is limited in the selection of patients who are expected to have a poor outcome. In contrast, the 5-year OS of patients stratified as high-risk according to NCCN- and GELTAMO-IPI was 31.4% and 21.9%, respectively. The results indicate that NCCN- and GELTAMO-IPI are better than the IPI in predicting patients with poor prognosis, suggesting the superiority of enhanced, next-generation IPIs for DLBCL.

  9. Prognostic relevance of PCI-related myocardial infarction

    NARCIS (Netherlands)

    Woudstra, Pier; Grundeken, Maik J.; van de Hoef, Tim P.; Wallentin, Lars; Fox, Keith A.; de Winter, Robbert J.; Damman, Peter

    2013-01-01

    Procedure-related myocardial infarction (pMI) is directly associated with a coronary revascularization procedure, such as percutaneous coronary intervention (PCI) or CABG surgery. In contrast to spontaneous myocardial infarction (MI), the prognostic relevance of pMI is the subject of ongoing debate.

  10. Albumin-to-alkaline phosphatase ratio: a novel prognostic index for hepatocellular carcinoma.

    Science.gov (United States)

    Chan, Anthony W H; Chan, Stephen L; Mo, Frankie K F; Wong, Grace L H; Wong, Vincent W S; Cheung, Yue-Sun; Chan, Henry L Y; Yeo, Winnie; Lai, Paul B S; To, Ka-Fai

    2015-01-01

    Prognosis of patients with hepatocellular carcinoma (HCC) depends on both tumour extent and hepatic function reserve. Liver function test (LFT) is a basic routine blood test to evaluate hepatic function. We first analysed LFT components and their associated scores in a training cohort of 217 patients who underwent curative surgery to identify LFT parameters with high performance (discriminatory capacity, homogeneity, and monotonicity of gradient). We derived a novel index, albumin-to-alkaline phosphatase ratio (AAPR), which had the highest c-index (0.646) and χ(2) (24.774) among other liver biochemical parameters. The AAPR was an independent prognostic factor for overall and disease-free survival. The adjusted hazard ratio of death and tumour relapse was 2.36 (P = 0.002) and 1.85 (P = 0.010), respectively. The independent prognostic significance of AAPR on top of 5 commonly used and well established staging systems was further confirmed in 2 independent cohorts of patients receiving surgical resection (n = 256) and palliative therapy (n = 425). In summary, the AAPR is a novel index readily derived from a simple low-cost routine blood test and is an independent prognostic indicator for patients with HCC regardless of treatment options.

  11. Novel immunological and nutritional-based prognostic index for gastric cancer.

    Science.gov (United States)

    Sun, Kai-Yu; Xu, Jian-Bo; Chen, Shu-Ling; Yuan, Yu-Jie; Wu, Hui; Peng, Jian-Jun; Chen, Chuang-Qi; Guo, Pi; Hao, Yuan-Tao; He, Yu-Long

    2015-05-21

    To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio in gastric cancer. We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between 1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS). Propensity score analysis was performed to adjust variables to control for selection bias. Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring (hazard ratio, 1.668; 95% confidence interval: 1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage II-III disease (P = 0.019, P index in gastric cancer.

  12. Octogenarian patients with chronic obstructive pulmonary disease: Characteristics and usefulness of prognostic indexes.

    Science.gov (United States)

    Golpe, Rafael; Suárez-Valor, María; Veres-Racamonde, Alejandro; Cano-Jiménez, Esteban; Martín-Robles, Irene; Sanjuán-López, Pilar; Pérez-de-Llano, Luis

    2017-10-30

    Most studies on chronic obstructive pulmonary disease (COPD) exclude octogenarian patients. Therefore, the disease is not well characterized in this age group. The objective of this study is to analyze the clinical characteristics of octogenarian patients with COPD and the usefulness of the prognostic indexes used most frequently in this age group. Retrospective study of consecutive patients seen at a clinic between 2009 and 2017. The following variables were analyzed: lung function parameters, distribution of clinical phenotypes, income history, mortality, comorbidities and usefulness of the Charlson, BODEX, COTE and CODEX indexes to predict mortality. The sample comprised 698 patients, 82 aged (11.7%)≥80 years old. Mean follow-up time was 47.9±21.8 months. In octogenarian patients, the severity of the COPD, assessed by means of the FEV1% or BODEX index, was similar to that of younger patients, but dyspnea was worse in the elderly group. In these patients, the chronic bronchitis and frequent exacerbator phenotypes were the most frequent, whilst the emphysema phenotype was the least common. Octogenarians had a greater prevalence of cardiovascular comorbidities and renal diseases. Moreover, hospital admissions were more frequent and mortality was higher in these elderly patients. Most prognostic indexes were useful in predicting mortality in elderly patients. CODEX was the most useful index to predict mortality, both in octogenarian and younger patients. Octogenarian patients with COPD have differential characteristics which could imply the need for different therapeutic approaches. Prognostic indexes are useful for predicting mortality in this population. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. Onodera's prognostic nutritional index as a risk factor for mortality in peritoneal dialysis patients.

    Science.gov (United States)

    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2012-11-01

    The aim of this study was to evaluate the clinical relevance and usefulness of the Onodera's prognostic nutritional index (OPNI) as a prognostic and nutritional indicator in peritoneal dialysis (PD) patients. Patients were divided into 3 groups based on the initial OPNI score: group A (n = 186, 45). Group A was associated with a higher grade according to the Davies risk index than the other groups. Serum creatinine and albumin levels, total lymphocyte count, and fat mass increased with an increase in OPNI. According to the edema index, the correlation coefficient for OPNI was -0.284 and for serum albumin was -0.322. Similarly, according to the C-reactive protein (CRP), the correlation coefficient for OPNI was -0.117 and for serum albumin was -0.169. Multivariate analysis adjusted for age, Davies risk index, CRP, and edema index revealed that the hazard ratios for low OPNI, serum albumin, and CRP were 1.672 (P = 0.003), 1.308 (P = 0.130), and 1.349 (P = 0.083), respectively. Our results demonstrate that the OPNI is a simple method that can be used for predicting the nutritional status and clinical outcome in PD patients.

  14. A clinically based prognostic index for diffuse large B-cell lymphoma with a cut-off at 70 years of age significantly improves prognostic stratification

    DEFF Research Database (Denmark)

    Gang, Anne O.; Pedersen, Michael; d'Amore, Francesco

    2015-01-01

    subtypes. We applied IPI factors to a population-based rituximab-treated cohort of 1990 patients diagnosed 2000-2010 and explored new factors and the optimal prognostic age cut-off for DLBCL. Multivariate-analyses (MVA) confirmed the prognostic value of all IPI factors except the presence of > 1 extranodal...... lesion. The optimal age cut-off was 70 years. In a MVA of albumin, lymphocyte count, sex, immunoglobulin G, bulky disease, hemoglobin and B-symptoms, only albumin was prognostic. We propose: (1) a modified DLBCL prognostic index (DLBCL-PI) including: age (70 years), performance status (PS), lactate...... dehydrogenase (LDH), stage and albumin level, and (2) a separate age-adjusted DLBCL-PI for patients 1 extranodal lesion, however excluding stage....

  15. [Clinical application value of prognostic nutritional index for predicting survival in patients with advanced non-small cell lung cancer].

    Science.gov (United States)

    Xu, W J; Kang, Y M; Zhou, L; Chen, F F; Song, Y H; Zhang, C Q

    2017-02-23

    Objective: To explore the clinical application value of prognostic nutritional index(PNI) for predicting overall survival(OS) in patients with advanced non-small cell lung cancer (NSCLC). Methods: 123 patients with histologically confirmed non-small cell lung cancer were enrolled in this study, and their clinical and laboratory data were reviewed. The PNI was calculated as 10×serum albumin value+ 5×total lymphocyte countin peripheral blood.Univariate and multivariate analyses were used to identify the potential prognostic factors for advanced NSCLC. Results: PNI of the 123 NSCLC patients was 46.24±6.56. PNI was significantly associated with age, weight loss and pleural effusion (Prelationship with sex, smoking, hemoptysis, chest pain, dyspnea, histological type, clinical stage, and administration of chemotherapy (P>0.05). The median OS of the 123 patients was 19.5 months. The median OS in the higher PNI group (PNI≥46.24) and lower PNI group(PNI<46.24) were 25.2 months and 16.4 months, respectively.The 1-year survival rates were 80.6% and 63.9%, and 2-year survival rates were 54.8% and 19.6%, respectively (P<0.01). Univariate analysis showed that PNI, age, dyspnea, and weight loss were related to the OS of the advanced NSCLC patients (P<0.05). Multivariate analysis identified PNI as an independent prognostic factor for OS of advanced NSCLC (P<0.001). Conclusion: PNI can be easily calculated, and may be used as a relatively new prognostic indicator for advanced NSCLC in clinical practice.

  16. A combined pulmonary function and emphysema score prognostic index for staging in Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Boutou, Afroditi K; Nair, Arjun; Douraghi-Zadeh, Dariush; Sandhu, Ranbir; Hansell, David M; Wells, Athol U; Polkey, Michael I; Hopkinson, Nicholas S

    2014-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is characterized by high morbidity and mortality. Lung computed tomography parameters, individually or as part of a composite index, may provide more prognostic information than pulmonary function tests alone. To investigate the prognostic value of emphysema score and pulmonary artery measurements compared with lung function parameters in COPD and construct a prognostic index using a contingent staging approach. Predictors of mortality were assessed in COPD outpatients whose lung computed tomography, spirometry, lung volumes and gas transfer data were collected prospectively in a clinical database. Univariate and multivariate Cox proportional hazard analysis models with bootstrap techniques were used. 169 patients were included (59.8% male, 61.1 years old; Forced Expiratory Volume in 1 second % predicted: 40.5±19.2). 20.1% died; mean survival was 115.4 months. Age (HR = 1.098, 95% Cl = 1.04-1.252) and emphysema score (HR = 1.034, 95% CI = 1.007-1.07) were the only independent predictors of mortality. Pulmonary artery dimensions were not associated with survival. An emphysema score of 55% was chosen as the optimal threshold and 30% and 65% as suboptimals. Where emphysema score was between 30% and 65% (intermediate risk) the optimal lung volume threshold, a functional residual capacity of 210% predicted, was applied. This contingent staging approach separated patients with an intermediate risk based on emphysema score alone into high risk (Functional Residual Capacity ≥210% predicted) or low risk (Functional Residual Capacity Emphysema score-Functional Residual Capacity index might provide a better separation of high and low risk patients with COPD, than other individual predictors alone.

  17. Correlation analysis between molecular subtypes and Nottingham Prognostic Index in breast cancer.

    Science.gov (United States)

    Zhen, Hongchao; Yang, Liuting; Li, Li; Yu, Junxian; Zhao, Lei; Li, Yingying; Li, Qin

    2017-09-26

    Molecular subtypes and Nottingham Prognostic Index (NPI) are both prognostic models for breast cancer patients. We evaluated the association between molecular subtypes and NPI in 1042 breast cancer patients. The molecular subtypes indicating poorer prognosis were positively correlated to higher NPI (r = 0.138, P = 0.001). ER positive expression and PR high expression were positively correlated with NPI (r = 0.142, P = 0.001; r = 0.139, P = 0.001; respectively) and negatively correlated with histological grade (r = -0.233, P 5.40 were higher in the HER2 overexpression subtype, basal-like subtype, ER-, PR low/negative expression, and Ki67 high expression groups. The excellent consistence was observed between histological grade and molecular subtypes, ER, PR, Ki67. The difference of histological grade between the HER2 positive and negative group was statistically significant. In conclusion, there was closely association between molecular subtypes and NPI in breast cancer. For further comparing the prognostic significance of molecular subtypes and NPI, survival analyses should be performed on the same population in a large-scale prospective study.

  18. Dietary fat in relation to prognostic indicators in breast cancer.

    Science.gov (United States)

    Verreault, R; Brisson, J; Deschênes, L; Naud, F; Meyer, F; Bélanger, L

    1988-08-03

    The relation of diet, especially fat intake, to recognized prognostic indicators for breast cancer was investigated in 666 women with a newly diagnosed infiltrating breast carcinoma. Diet during the year preceding diagnosis was assessed by interview using a food frequency questionnaire covering the intake of 114 food items. Prognostic indicators included axillary node involvement at diagnosis, estrogen receptor status, and selected histologic features of the primary tumor such as nuclear grade, histologic grade, tubule formation, mitotic activity, and nuclear size of tumor cells. After adjustment for total energy intake, age, body weight, and tumor size at diagnosis, an increase in saturated fat intake was related to an increased frequency of node involvement at diagnosis among postmenopausal patients. In contrast, an elevation in polyunsaturated fat intake was related to a reduction of the percentage of patients with positive nodes at diagnosis. This relation was observed among both premenopausal and postmenopausal patients. Dietary fat was not related to the estrogen receptor status of tumors. No association was found between dietary habits and histologic features of the primary tumor. These data suggest that dietary fat may have an effect on the growth or spread of breast cancer during the preclinical phase of the disease and that this effect may vary according to the type of fat considered.

  19. A laboratory prognostic index model for patients with advanced non-small cell lung cancer.

    Directory of Open Access Journals (Sweden)

    Arife Ulas

    Full Text Available We aimed to establish a laboratory prognostic index (LPI in advanced non-small cell lung cancer (NSCLC patients based on hematologic and biochemical parameters and to analyze the predictive value of LPI on NSCLC survival.The study retrospectively reviewed 462 patients with advanced NSCLC diagnosed between 2000 and 2010 in a single institution. We developed an LPI that included serum levels of white blood cells (WBC, lactate dehydrogenase (LDH, albumin, calcium, and alkaline phosphatase (ALP, based on the results of a Cox regression analysis. The patients were classified into 3 LPI groups as follows: LPI 0: normal; LPI 1: one abnormal laboratory finding; and LPI 2: at least 2 abnormal laboratory findings.The median follow up period was 44 months; the median overall survival (OS and median progression-free survival (PFS were 11 and 6 months, respectively. A multivariate analysis revealed that the following could be used as independent prognostic factors: an Eastern Cooperative Oncology Group performance status score (ECOG PS ≥2, a high LDH level, serum albumin 10.5 g/dL, number of metastases>2, presence of liver metastases, malignant pleural effusion, or receiving chemotherapy ≥4 cycles. The 1-year OS rates according to LPI 0, LPI 1, and LPI 2 were 54%, 34%, and 17% (p<0.001, respectively and 6-month PFS rates were 44%, 27%, and 15% (p<0.001, respectively. The LPI was a significant predictor for OS (Hazard Ratio (HR: 1.41; 1.05-1.88, p<0.001 and PFS (HR: 1.48; 1.14-1.93, p<0.001.An LPI is an inexpensive, easily accessible and independent prognostic index for advanced NSCLC and may be helpful in making individualized treatment plans and predicting survival rates when combined with clinical parameters.

  20. Proliferation in Non-Hodgkin’S Lymphomas and Its Prognostic Value Related to Staging Parameters

    Directory of Open Access Journals (Sweden)

    Irene Lorand‐Metze

    2004-01-01

    Full Text Available In malignant lymphomas, cell kinetics has shown to be related with histologic type as well as with the clinical behaviour. The aim of our study was to investigate the relevance of cell proliferation parameters on overall survival in non‐Hodgkin's lymphomas as well as their relationship with prognostic factors such as International Prognostic Index (IPI. We performed DNA‐flow‐cytometry (S‐phase fraction and detection of DNA‐aneuploidy as well as cytologic examination and the AgNOR technique in material obtained by fine needle aspiration of lymph nodes at diagnosis. The majority of the patients were stage IV by Ann Arbor and intermediate risk by IPI (42/55. When analyzing all patients together, histologic type by the WHO classification, IPI and the presence of a DNA‐aneuploid clone could not separate well patients with a different survival. For all patients, univariate Cox analysis revealed S‐phase (SPF and AgNOR parameters to be of prognostic value. In the multivariate analysis, however, only SPF remained in the final model. Yet, when stratifying for DNA‐ploidy, only the total number of AgNORs/nucleus was an independent parameter. Looking only at the DNA‐diploid cases, the AgNOR pattern remained the most important parameter, whereas for the DNA‐aneuploid cases this was true for SPF. When studying patients with B large cell lymphoma separately, only DNA‐ploidy was a prognostic factor. In summary, cell kinetic parameters reveal important prognostic information in NHL patients. Furthermore, DNA‐aneuploidy seems to interfere with the analysis of the AgNOR pattern.

  1. Medulloblastoma: evaluation of proliferative index by monoclonal antibody Mib-1, its prognostic correlation and therapeutic implications

    Directory of Open Access Journals (Sweden)

    Ferrari Antonio Fernandes

    2003-01-01

    Full Text Available In the past few years, the monoclonal antibody MIB-1 has been used by researchers in order to retrospectively study paraffin imbibed tumor fragments. The medulloblastoma is the most common malignant central nervous system tumor in childhood. The objectives were: determination of the mean Mib-1 LI value from these patients, as well as the prognostic value of the method.This retrospective study represents an analysis of the cellular proliferation index of posterior fossa medulloblastomas collected from 22 patients at A.C. Camargo Hospital, from January 1990 to December 1999. The histopathological diagnosis was confirmed by H&E and proliferative index (LI was achived with Mib-1 which detects proliferating cells during G1, G2, S and M phases.The results demostrated that the mean Mib-1 was 30,1%, and ranged from 5,2% to 62,0%.In conclusion, this method has prognostic value, has to be used as routine for patients harboring medulloblastomas and the ones who have PI greater than the mean value found in this study, should be treated aggressively.

  2. An intelligent prognostic system for analyzing patients with paraquat poisoning using arterial blood gas indexes.

    Science.gov (United States)

    Hu, Lufeng; Lin, Feiyan; Li, Huaizhong; Tong, Changfei; Pan, Zhifang; Li, Jun; Chen, Huiling

    The arterial blood gas (ABG) test is used to assess gas exchange in the lung, and the acid-base level in the blood. However, it is still unclear whether or not ABG test indexes correlate with paraquat (PQ) poisoning. This study investigates the predictive value of ABG tests in prognosing patients with PQ poisoning; it also identifies the most significant indexes of the ABG test. An intelligent machine learning-based system was established to effectively give prognostic analysis of patients with PQ poisoning based on ABG indexes. In the proposed system, an enhanced support vector machine combined with a feature selection strategy was developed to predict the risk status from a pool of 103 patients (56 males and 47 females); of these, 52 subjects were deceased and 51 patients were alive. The proposed method was rigorously evaluated against the real-life dataset in terms of accuracy, sensitivity, and specificity. Additionally, the feature selection was investigated to identify correlating factors for the risk status. The results demonstrated that there were significant differences in ABG indexes between deceased and alive subjects (p-value <0.01). According to the feature selection, we found that the most important correlated indexes were associated with partial pressure of carbon dioxide (PCO2). This study discovered the relationship between ABG test and poisoning degree to provide a new avenue for prognosing PQ poisoning. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Geriatric Nutritional Risk Index as a prognostic factor in peritoneal dialysis patients.

    Science.gov (United States)

    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2013-01-01

    The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce. We reviewed the medical records at Yeungnam University Hospital in Korea to identify all adults (>18 years) who received PD; 486 patients were enrolled in the study. The initial low, middle, and high GNRI tertiles included 162, 166, and 158 patients respectively. Significant correlations were noted between the initial GNRI and body mass index, creatinine, albumin, arm circumference, fat mass index, and comorbidities. The cut-off value for the time-averaged GNRI over 1 year was 96.4, and the sensitivity and specificity for a diagnosis of a decline in lean mass were 77.1% and 40.0% respectively. A multivariate analysis adjusted for age, risk according to the Davies comorbidity index, and C-reactive protein showed that an low initial GNRI tertile was associated with mortality in PD patients. The GNRI is a simple method for predicting nutrition status and clinical outcome in PD patients.

  4. Prognostic index for chronic- and smoldering-type adult T-cell leukemia-lymphoma.

    Science.gov (United States)

    Katsuya, Hiroo; Shimokawa, Mototsugu; Ishitsuka, Kenji; Kawai, Kazuhiro; Amano, Masahiro; Utsunomiya, Atae; Hino, Ryosuke; Hanada, Shuichi; Jo, Tatsuro; Tsukasaki, Kunihiro; Moriuchi, Yukiyoshi; Sueoka, Eisaburo; Yoshida, Shinichiro; Suzushima, Hitoshi; Miyahara, Masaharu; Yamashita, Kiyoshi; Eto, Tetsuya; Suzumiya, Junji; Tamura, Kazuo

    2017-07-06

    Adult T-cell leukemia-lymphoma (ATL) has been divided into 4 clinical subtypes: acute, lymphoma, chronic, and smoldering. The aim of this study is to develop a novel prognostic index (PI) for chronic and smoldering ATL. We conducted a nationwide retrospective survey on ATL patients, and 248 fully eligible individuals were used in this analysis. In the univariate analysis, sex, performance status, log10 (soluble interleukin-2 receptor [sIL-2R]), neutrophils count, and lymphadenopathy showed values of P < .05 in training samples. A multivariate analysis was performed on these factors, and only log10 (sIL-2R) was identified as an independent prognostic factor in training samples. Using a regression coefficient of this variable, a prognostic model was formulated to identify different levels of risk: indolent ATL-PI (iATL-PI) = 1.51 × log10 (sIL-2R [U/mL]). The values calculated by iATL-PI were divided into 3 groups using a quartile point. In the validation sample, median survival times (MSTs) were 1.6 years, 5.5 years, and not reached for patients in the high-, intermediate-, and low-risk groups, respectively (P < .0001). To make the scoring system clinically practicable, we simplified iATL-PI according to trichotomizing sIL-2R at 1000 and 6000 U/mL, using a quartile point. Patients with more than 6000 U/mL sIL-2R were categorized into the high-risk group, less than and equal to 1000 U/mL into the low-risk group, and the others into the intermediate-risk group, and MSTs were 1.6 years, not reached, and 5.5 years, respectively (P < .0001). iATL-PI has potential as a novel tool for a risk-adapted therapeutic approach. © 2017 by The American Society of Hematology.

  5. Multicenter validation study of a prognostic index for portal vein tumor thrombosis in hepatocellular carcinoma.

    Science.gov (United States)

    Yu, Jeong Il; Yoon, Sang Min; Park, Hee Chul; Kim, Jong Hoon; Kim, Tae Hyun; Park, Joong-Won; Seong, Jinsil; Lee, Ik Jae; Jang, Hong Seok; Kay, Chul Seung; Kim, Chul Yong; Chie, Eui Kyu; Kim, Jin Hee; Kim, Mi-Sook; Choi, Young Min

    2014-10-01

    We previously reported on a staging system and prognostic index (PITH) for portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) patients treated with radiotherapy (RT) at a single institution. The aim of this study is to validate the PITH staging system using data from patients at other institutions and to compare it with other published staging systems. A total of 994 HCC patients with PVTT who were treated with RT between 1998 and 2011 by the Korean Radiation Oncology Group were analyzed retrospectively. All patients were staged using the Cancer of the Liver Italian Program (CLIP), Japanese Integrated Staging (JIS), Okuda, and PITH staging systems, and survival data were analyzed. The likelihood ratio, Akaike information criteria (AIC), time-dependent receiver operating characteristics, and prediction error curve analysis were used to determine discriminatory ability for comparison of staging systems. The median survival was 9.2 months. Compared with the other staging systems, the PITH score gave the highest values for likelihood ratio and lowest AIC values, demonstrating that PITH may be a better prognostic model. Although the values were not significant and differences were not exceptional, the PITH score showed slightly better performance with respect to time-dependent area under curve and integrated Brier score of prediction error curve. The PITH staging system was validated in this multicenter retrospective study and showed better stratification ability in HCC patients with PVTT than other systems.

  6. Validation, revision and extension of the Mantle Cell Lymphoma International Prognostic Index in a population-based setting.

    Science.gov (United States)

    van de Schans, Saskia A M; Janssen-Heijnen, Maryska L G; Nijziel, Marten R; Steyerberg, Ewout W; van Spronsen, Dick Johan

    2010-09-01

    The aim of this study was to validate the Mantle Cell Lymphoma International Prognostic Index in a population-based cohort and to study the relevance of its revisions. We analyzed data from 178 unselected patients with stage III or IV mantle cell lymphoma, registered between 1994 and 2006 in the Eindhoven Cancer Registry. Follow-up was completed up to January 1(st), 2008. Multiple imputations for missing covariates were used. Validity was assessed by comparing observed survival in our cohort with predicted survival according to the original Mantle cell lymphoma International Prognostic Index. A revised model was constructed with Cox regression analysis. Discrimination was assessed by a concordance statistic ('c'). The original Mantle cell lymphoma International Prognostic Index could stratify our cohort into three distinct risk groups based on Eastern Cooperative Group performance status, white blood cell count, lactate dehydrogenase level, and age, with the discrimination being nearly as good as in the original cohort (c 0.65 versus 0.63). A modified model including performance status in five categories (0/1/2/3/4) instead of two (0-1/2-4), the presence of B-symptoms (yes/no) and sex (male/female) in addition to the original variables resulted in a better prognostic index (c 0.75). The Mantle cell lymphoma International Prognostic Index is a valid tool for risk stratification, comparison of prognosis, and treatment decisions in an unselected Dutch population-based setting. Although the index can be significantly improved, external validation on an independent data set is warranted before broad application of the modified instrument could be recommended.

  7. Validation, revision and extension of the mantle cell lymphoma international prognostic index in a population-based setting

    NARCIS (Netherlands)

    S.A.M. van de Schans (Saskia); M.L.G. Janssen-Heijnen (Maryska); M.R. Nijzie (Marten); E.W. Steyerberg (Ewout); D.J. van Spronsen (Dick Johan)

    2010-01-01

    textabstractBackground The aim of this study was to validate the Mantle Cell Lymphoma International Prognostic Index in a population-based cohort and to study the relevance of its revisions. Design and Methods We analyzed data from 178 unselected patients with stage III or IV mantle cell lymphoma,

  8. [Leuko-glycemic index as an in-hospital prognostic marker in patients with ST-segment elevation myocardial infarction].

    Science.gov (United States)

    León-Aliz, Ebrey; Moreno-Martínez, Francisco L; Pérez-Fernández, Guillermo A; Vega-Fleites, Luis F; Rabassa-López-Calleja, Magda A

    2014-01-01

    Blood glucose and white blood cell count on admission have demonstrated prognostic significance in patients with myocardial infarction; leuko-glycemic index, a recently proposed marker, still lacks enough knowledge about its value. To evaluate the leuko-glycemic index as a prognostic marker in patients with ST-segment elevation myocardial infarction. A retrospective study was carried out in 128 patients with ST-segment elevation myocardial infarction, who were admitted between January 2009 and October 2010 in the Intensive Care Unit of the Hospital Dr. Celestino Hernández Robau. Clinical and laboratory data were collected, including glucose and white blood cell count on admission, from which we calculated the leuko-glycemic index and we evaluated its prognostic value. Patients who had a poor outcome such as death, major cardiac complications and failed-thrombolysis, showed higher values of leuko-glycemic index (Pglycemic index was an independent predictor after multivariate analysis. The leuko-glycemic index was associated with an increased occurrence of hospital complications, death and failed-thrombolysis; its pathological value was an independent predictor of in-hospital death and complications in the studied sample. Copyright © 2013 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  9. Prognostic value of brachioradialis muscle oxygen saturation index and vascular occlusion test in septic shock patients.

    Science.gov (United States)

    Marín-Corral, J; Claverias, L; Bodí, M; Pascual, S; Dubin, A; Gea, J; Rodriguez, A

    2016-05-01

    To compare rSO2 (muscle oxygen saturation index) static and dynamic variables obtained by NIRS (Near Infrared Spectroscopy) in brachioradialis muscle of septic shock patients and its prognostic implications. Prospective and observational study. Intensive care unit. Septic shock patients and healthy volunteers. The probe of a NIRS device (INVOS 5100) was placed on the brachioradialis muscle during a vascular occlusion test (VOT). Baseline, minimum and maximum rSO2 values, deoxygenation rate (DeOx), reoxygenation slope (ReOx) and delta value. Septic shock patients (n=35) had lower baseline rSO2 (63.8±12.2 vs. 69.3±3.3%, p<0.05), slower DeOx (-0.54±0.31 vs. -0.91±0.35%/s, p=0.001), slower ReOx (2.67±2.17 vs. 9.46±3.5%/s, p<0.001) and lower delta (3.25±5.71 vs. 15.1±3.9%, p<0.001) when compared to healthy subjects (n=20). Among septic shock patients, non-survivors showed lower baseline rSO2 (57.0±9.6 vs. 69.8±11.3%, p=0.001), lower minimum rSO2 (36.0±12.8 vs. 51.3±14.8%, p<0.01) and lower maximum rSO2 values (60.6±10.6 vs. 73.3±11.2%, p<0.01). Baseline rSO2 was a good mortality predictor (AUC 0.79; 95%CI: 0.63-0.94, p<0.01). Dynamic parameters obtained with VOT did not improve the results. Septic shock patients present an important alteration of microcirculation that can be evaluated by NIRS with prognostic implications. Monitoring microvascular reactivity in the brachioradialis muscle using VOT with our device does not seem to improve the prognostic value of baseline rSO2. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  10. Prognostic value of an increase in post-exercise ankle-brachial index.

    Science.gov (United States)

    Hammad, Tarek A; Hiatt, William R; Gornik, Heather L; Shishehbor, Mehdi H

    2017-06-01

    Prior studies have assessed the prognostic value of a decrease, not an increase, of the post-exercise ankle-brachial index (ABI) among patients with normal resting results. Thus, we sought to evaluate the prognostic significance of an increase in post-exercise ABI among these patients. From a single center vascular laboratory database between September 2005 and January 2010, we retrospectively identified 1437 consecutive patients with a normal resting ABI (1.00-1.40) and available post-exercise results. We classified them into group 1 (normal subjects; post-exercise ABI drop ⩽ 20%, 58%) and group 2 (post-exercise ABI increase, 42%) after excluding those with an ABI drop > 20% (peripheral artery disease) as they had known disease ( n=192). The primary outcome was to assess the risk of ischemic events, defined as a composite of unadjudicated death, stroke, or myocardial infraction (MACE). Associations between groups and outcomes were examined using multivariable Cox proportional hazard and propensity analyses. Both groups had similar prevalence of cardiovascular comorbidities. In unadjusted analysis, group 2 was more likely to have MACE ( p = 0.001). After adjusting for all baseline characteristics, an increase in post-exercise ABI compared to normal subjects was associated with a higher MACE (adjusted HR: 1.70, 95% CI: 1.14-2.53; p=0.009). This association stayed statistically significant after propensity matching (adjusted HR: 1.80, 95% CI: 1.17-2.76; p=0.007). This hypothesis-generating analysis showed that an increase in post-exercise ABI appears to identify a population with a higher risk for MACE. A prospective study of this association and mechanisms of risk should be conducted.

  11. Performance of the Multidimensional Geriatric Assessment and Multidimensional Prognostic Index in predicting negative outcomes in older adults with cancer.

    Science.gov (United States)

    Giantin, V; Falci, C; De Luca, E; Valentini, E; Iasevoli, M; Siviero, P; Maggi, S; Martella, B; Crepaldi, G; Monfardini, S; Manzato, E

    2018-01-01

    The Multidimensional Geriatric Assessment (MGA) is currently used for assessing geriatric oncological patients, but a new prognostic index - the Multidimensional Prognostic Index (MPI) - has a demonstrated prognostic value in cancer patients too. The present work was designed to compare the MPI and MGA as predictors of 12-month mortality. 160 patients ≥70 years old with locally-advanced or metastatic solid cancers consecutively joining our Geriatric Oncology Program were administered a Comprehensive Geriatric Assessment to calculate their MGA and MPI scores. Geriatric Clinic, Geriatric Surgery Clinic, Medical Oncology Unit, Padova Hospital, Italy. Using Cohen's Kappa coefficient, there was a poor concordance between the MPI and MGA. Severe MPI being associated with a higher mortality risk than Frail in the MGA. The ROC curves indicated that the MPI had a greater discriminatory power for 12-month mortality than the MGA. In our population of elderly cancer patients, the MPI performed better than the MGA in predicting mortality. Further evidence from larger prospective trials is needed to establish whether other geriatric scales, such as the GDS and CIRS-SI, could enhance the value of prognostic indexes applied to elderly cancer patients. © 2016 John Wiley & Sons Ltd.

  12. Prospective clarification of the utility of the palliative prognostic index for patients with advanced cancer in the home care setting.

    Science.gov (United States)

    Hamano, Jun; Kizawa, Yoshiyuki; Maeno, Takami; Nagaoka, Hiroka; Shima, Yasuo; Maeno, Tetsuhiro

    2014-12-01

    This study aimed to prospectively clarify the accuracy of the Palliative Prognostic Index (PPI) for advanced cancer patients in home care settings. The study included 66 advanced cancer patients who received home visiting services between April 2010 and June 2012, and who died at home or in the hospital. Using medical records from initial home visits, we prospectively calculated PPI scores along with sensitivity and specificity. For 3- and 6-week survival, prognostic prediction showed respective sensitivities of 60% and 70.6%, and specificities of 87.0% and 71.9%. The sensitivity of the PPI for advanced cancer patients in home care settings was lower than that reported for patients in palliative care units. Development of prognostic tools suitable for home care settings is needed. © The Author(s) 2013.

  13. The prognostic value of pre-operative serum tetranectin, CA-125 and a combined index in women with primary ovarian cancer

    DEFF Research Database (Denmark)

    Høgdall, Claus K; Nørgaard-Pedersen, Bent; Mogensen, Ole

    2002-01-01

    OBJECTIVE: To study the prognostic value of pre-operative serum tetranectin (TN), CA125 levels and a mathematical formula (Index1) in primary ovarian cancer. MATERIALS AND METHODS: The study group consisted of sixty-six patients with varying FIGO stages I-IV. The end-point was death from ovarian....../l (relative hazard for FIGO stages = 3.3 and for TN = 2.6). CONCLUSION: TN was a strong prognostic variable in patients with advanced ovarian cancer. To the contrary, CA125 was a strong prognostic factor in patients with a localised ovarian cancer and of no prognostic value in patients with advanced cancer...... cancer. Evaluation was by univariate life-tables analyses and the multivariate Cox analysis. In the Cox analyses, the variables were tested respectively in actual values and as dichotomy variables with different cut-off levels: 6.7, 7.3 and 8.2 mg/l for TN, 35, 65, 100 and 165 U/ml for CA125. RESULTS...

  14. The diet-related GHG index

    DEFF Research Database (Denmark)

    Lund, Thomas Bøker; Watson, David; Smed, Sinne

    2017-01-01

    The aim was to construct and validate a cost-efficient index to measure GHG emissions (GHGe) caused by Danish consumers’ diets to be employed in questionnaire-based surveys. The index was modelled on the basis of actual food purchase data from a panel of ordinary Danish households and a questionn......The aim was to construct and validate a cost-efficient index to measure GHG emissions (GHGe) caused by Danish consumers’ diets to be employed in questionnaire-based surveys. The index was modelled on the basis of actual food purchase data from a panel of ordinary Danish households......-efficient way to estimate diet-related GHG emissions of Danish consumers. Since the index is responsive to relevant socio-demographic and attitudinal factors, it can be utilised to monitor key attitudinal/habitual and socio-demographic drivers of change....

  15. Improved risk stratification by the integration of the revised international prognostic scoring system with the myelodysplastic syndromes comorbidity index.

    Science.gov (United States)

    van Spronsen, M F; Ossenkoppele, G J; Holman, R; van de Loosdrecht, A A

    2014-12-01

    Myelodysplastic syndromes (MDS) comprise bone marrow failure diseases with a diverse clinical outcome. For improved risk stratification, the International Prognostic Scoring System (IPSS) has recently been revised (IPSS-R). This single-centre study aimed to validate the IPSS-R and to evaluate prior prognostic scoring systems for MDS. We retrospectively analysed 363 patients diagnosed with MDS according to the FAB criteria between 2000 and 2012. The IPSS, MD Anderson Risk Model Score (MDAS), World Health Organisation (WHO)-classification based Prognostic Scoring System (WPSS), refined WPSS (WPSS-R), IPSS-R and MDS-Comorbidity Index (MDS-CI) were applied to 222 patients considered with primary MDS following the WHO criteria and their prognostic power was investigated. According to the IPSS-R, 18 (8%), 81 (37%), 50 (23%), 43 (19%) and 30 (13%) patients were classified as very low, low, intermediate, high and very high risk with, respectively, a median overall survival of 96 (95% Confidence interval (CI) not reached), 49 (95% CI 34-64), 22 (95% CI 0-49), 19 (95% CI 11-27) and 10 (95% CI 6-13) months (pMDS-CI refined the risk stratification of MDS patients stratified according to the IPSS-R. In conclusion, accounting for the disease status by means of the IPSS-R and comorbidity through the MDS-CI considerably improves the prognostic assessment in MDS patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Mannheim Peritonitis Index (MPI) and elderly population: prognostic evaluation in acute secondary peritonitis.

    Science.gov (United States)

    Salamone, G; Licari, L; Falco, N; Augello, G; Tutino, R; Campanella, S; Guercio, G; Gulotta, G

    2016-01-01

    Acute Secondary Peritonitis due to abdominal visceral perforation is characterized by high mortality and morbidity risk. Risk stratification allows prognosis prediction to adopt the best surgical treatment and clinical care support therapy. In Western countries elderly people represent a significant percentage of population Aim. Evaluation of Mannheim Peritonitis Index (MPI) and consideration upon old people. Retrospective study on 104 patients admitted and operated for "Acute Secondary Peritonitis due to visceral perforation". MPI was scored. In our study we want to demonstrate efficacy of MPI and the possibility to consider older age an independent prognostic factor. Mortality was 25.96%. Greatest sensitivity and specificity for the MPI score as a predictor of mortality was at the score of 20. MPI score of 22. Patients with MPI score 17-21 had 0.46 times lower risk of mortality compared to patients with MPI score >21. In the group of patients with MPI score of >20 the mortality rate was 48.5% for patients older than 80 years old and 12.1% for younger patients (p < 0.005); in the group with MPI score of < 20 mortality rate was respectively 8.4% and 1.4% (p < 0.005). Data confirm the accuracy of the test. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis.

  17. Prognosis Prediction for Postoperative Esophageal Cancer Patients Using Onodera's Prognostic Nutritional Index.

    Science.gov (United States)

    Matsumoto, Hideo; Okamoto, Yuko; Kawai, Akimasa; Ueno, Daisuke; Kubota, Hisako; Murakami, Haruaki; Higashida, Masaharu; Hirai, Toshihiro

    2017-01-01

    Preoperative nutritional status may impact surgical outcome and prognosis. We evaluated the predictive value of Onodera's prognostic nutritional index (O's-PNI) of surgical outcome following esophagectomy in esophageal cancer patients. In total, 144 patients undergoing esophagectomy for esophageal cancer from April 2010 to May 2015 were evaluated, retrospectively. Eighty-four patients were enrolled in this study. O's-PNIs were calculated before surgery, discharge, and 1, 2, and 6 mo after discharge. The relationship between O's-PNI and occurrence of complications as classified by the Clavien-Dindo (C-D) classification, length of hospital stay, and survival time was investigated. The mean O's-PNI for patients with complications of more than Grade 2 by the C-D classification was 37.4, which was significantly lower than that for Grades 0 or 1 (40.5, P = 0.0094). A negative correlation was obtained between O's-PNI and hospital stay length (P = 0.0006), whereas a positive correlation was obtained for O's-PNI at 6 mo postsurgery and overall survival (P = 0.0171, P = 0.0201). O's-PNI may represent a useful indicator of the occurrence of complications and length of hospital stay, and may influence overall survival at 6 mo postsurgery. Nutritional management during the perioperative period could therefore contribute to satisfactory outcomes following esophagectomy in esophageal cancer patients.

  18. An inflammation-based prognostic index predicts survival advantage after transarterial chemoembolization in hepatocellular carcinoma.

    Science.gov (United States)

    Pinato, David J; Sharma, Rohini

    2012-08-01

    Transarterial chemoembolization (TACE) is the preferred treatment for unresectable, intermediate-stage hepatocellular carcinoma (HCC). However, survival after TACE can be highly variable, suggesting the need for more accurate patient selection to improve therapeutic outcome. We have explored the prognostic ability of the blood neutrophil-to-lymphocyte ratio (NLR), a biomarker of systemic inflammation, as a predictor of survival after TACE. Fifty-four patients with a diagnosis of HCC eligible for TACE were selected. Clinicopathologic variables were collected, including demographics, tumor staging, liver functional reserve, and laboratory variables. Dynamic changes in the NLR before and after TACE were studied as predictors of survival using both a univariate and multivariate Cox regression model. Patients in whom the NLR remained stable or normalized after TACE showed a significant improvement in overall survival of 26 months compared with patients showing a persistently abnormal index (P = 0.006). Other predictors of survival on univariate analysis were Cancer of the Liver Italian Program score (P = 0.05), intrahepatic spread (P = 0.01), tumor diameter > 5 cm (P = 0.02), > 1 TACE (P = 0.01), alpha-fetoprotein ≥ 400 (P = 0.002), and radiologic response to TACE (P analysis. Changes in alpha-fetoprotein after treatment did not predict survival. Patients with a persistently increased NLR have a worse outcome after TACE. NLR is a simple and universally available stratifying biomarker that can help identify patients with a significant survival advantage after TACE. Copyright © 2012 Mosby, Inc. All rights reserved.

  19. Prognostic Value of the Nutritional Risk Index in Heart Transplant Recipients.

    Science.gov (United States)

    Barge-Caballero, Eduardo; García-López, Fernando; Marzoa-Rivas, Raquel; Barge-Caballero, Gonzalo; Couto-Mallón, David; Paniagua-Martín, María J; Solla-Buceta, Miguel; Velasco-Sierra, Carlos; Pita-Gutiérrez, Francisco; Herrera-Noreña, José M; Cuenca-Castillo, José J; Vázquez-Rodríguez, José Manuel; Crespo-Leiro, María G

    2017-08-01

    To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT). We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression. Mean NRI before HT was 100.9 ± 9.9. According to this parameter, the prevalence of severe nutritional risk (NRI nutritional risk (83.5 ≤ NRI nutritional risk (97.5 ≤ NRI risk of postoperative infection (adjusted OR, 0.97; 95%CI, 0.95-1.00; P = .027) and prolonged postoperative ventilator support (adjusted OR, 0.96; 95%CI, 0.94-0.98; P = .001). Patients at moderate or severe nutritional risk had significantly higher 1-year post-HT mortality (adjusted HR, 1.55; 95%CI, 1.22-1.97; P risk of postoperative complications and mortality after HT. Preoperative NRI determination may help to identify HT candidates who might benefit from nutritional intervention. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  20. Adding items that assess changes in activities of daily living does not improve the predictive accuracy of the Palliative Prognostic Index.

    Science.gov (United States)

    Hamano, Jun; Tokuda, Yasuharu; Kawagoe, Shohei; Shinjo, Takuya; Shirayama, Hiroto; Ozawa, Taketoshi; Shishido, Hideki; Otomo, Sen; Nagayama, Jun; Baba, Mika; Tei, Yo; Hiramoto, Shuji; Suga, Akihiko; Hisanaga, Takayuki; Ishihara, Tatsuhiko; Iwashita, Tomoyuki; Kaneishi, Keisuke; Kuriyama, Toshiyuki; Maeda, Takashi; Morita, Tatsuya

    2017-03-01

    Changes in activities of daily living in cancer patients may predict their survival. The Palliative Prognostic Index is a useful tool to evaluate cancer patients, and adding an item about activities of daily living changes might improve its predictive value. To clarify whether adding an item about activities of daily living changes improves the accuracy of Palliative Prognostic Index. Multicenter prospective cohort study. A total of 58 palliative care services in Japan. Patients aged >20 years diagnosed with locally extensive or metastatic cancer (including hematological neoplasms) who had been admitted to palliative care units, were receiving care by hospital-based palliative care teams, or were receiving home-based palliative care. Palliative care physicians recorded clinical variables at the first assessment and followed up patients 6 months later. A total of 2425 subjects were recruited and 2343 of these had analyzable data. The C-statistic of the original Palliative Prognostic Index was 0.801, and those of modified Palliative Prognostic Indices ranged from 0.793 to 0.805 at 3 weeks. For 6-week survival predictions, the C-statistic of the original Palliative Prognostic Index was 0.802, and those of modified Palliative Prognostic Indices ranged from 0.791 to 0.799. The weighted kappa of the original Palliative Prognostic Index was 0.510, and those of modified Palliative Prognostic Indices ranged from 0.484 to 0.508. Adding items about activities of daily living changes to the Palliative Prognostic Index did not improve prognostic value in advanced cancer patients.

  1. Blood pyrrole-protein adducts as a diagnostic and prognostic index in pyrrolizidine alkaloid-hepatic sinusoidal obstruction syndrome.

    Science.gov (United States)

    Gao, Hong; Ruan, Jianqing Q; Chen, Jie; Li, Na; Ke, Changqiang Q; Ye, Yang; Lin, Ge; Wang, Jiyao Y

    2015-01-01

    The diagnosis of hepatic sinusoidal obstruction syndrome (HSOS) induced by pyrrolizidine alkaloids is mainly based on clinical investigation. There is currently no prognostic index. This study evaluated the quantitative measurement of blood pyrrole-protein adducts (PPAs) as a diagnostic and prognostic index for pyrrolizidine alkaloid-induced HSOS. Suspected drug-induced liver injury patients were prospectively recruited. Blood PPAs were quantitatively measured using ultra-performance liquid chromatography-tandem mass spectrometry. Patients' age, sex, biochemistry test results, and a detailed drug history were recorded. The patients were divided into two groups, ie, those with HSOS induced by pyrrolizidine alkaloid-containing drugs and those with liver injury induced by drugs without pyrrolizidine alkaloids. The relationship between herb administration, clinical outcomes, blood sampling time, and blood PPA concentration in pyrrolizidine alkaloid-associated HSOS patients was analyzed using multiple linear regression analysis. Forty patients met the entry criteria, among whom 23 had pyrrolizidine alkaloid-associated HSOS and 17 had liver injury caused by drugs without pyrrolizidine alkaloids. Among the 23 patients with pyrrolizidine alkaloid-associated HSOS, ten recovered, four developed chronic disease, eight died, and one underwent liver transplantation within 6 months after onset. Blood PPAs were detectable in 24 of 40 patients with concentrations from 0.05 to 74.4 nM. Sensitivity and specificity of the test for diagnosis of pyrrolizidine alkaloid-associated HSOS were 100% (23/23) and 94.1% (23/24), respectively. The positive predictive value was 95.8% and the negative predictive value was 100%, whereas the positive likelihood ratio was 23.81. The level of blood PPAs in the severe group (died or received liver transplantation) was significantly higher than that in the recovery/chronicity group (P=0.004). Blood PPAs measured by ultra-performance liquid

  2. Confirmation of the mantle-cell lymphoma International Prognostic Index in randomized trials of the European Mantle-Cell Lymphoma Network

    DEFF Research Database (Denmark)

    Hoster, Eva; Klapper, Wolfram; Hermine, Olivier

    2014-01-01

    PURPOSE: Mantle-cell lymphoma (MCL) is a distinct B-cell lymphoma associated with poor outcome. In 2008, the MCL International Prognostic Index (MIPI) was developed as the first prognostic stratification tool specifically directed to patients with MCL. External validation was planned.......9) and 2.6 (2.0 to 3.3), respectively. MIPI was similarly prognostic for TTF. All four clinical baseline characteristics constituting the MIPI, age, performance status, lactate dehydrogenase level, and WBC count, were confirmed as independent prognostic factors for OS and TTF. The validity of MIPI...

  3. Complex karyotype in mantle cell lymphoma is a strong prognostic factor for the time to treatment and overall survival, independent of the MCL international prognostic index.

    Science.gov (United States)

    Sarkozy, Clémentine; Terré, Christine; Jardin, Fabrice; Radford, Isabelle; Roche-Lestienne, Catherine; Penther, Dominique; Bastard, Christian; Rigaudeau, Sophie; Pilorge, Sylvain; Morschhauser, Franck; Bouscary, Didier; Delarue, Richard; Farhat, Hassan; Rousselot, Philippe; Hermine, Olivier; Tilly, Hervé; Chevret, Sylvie; Castaigne, Sylvie

    2014-01-01

    Mantle cell lymphoma (MCL) is usually an aggressive disease. However, a few patients do have an "indolent" evolution (iMCL) defined by a long survival time without intensive therapy. Many studies highlight the prognostic role of additional genetic abnormalities, but these abnormalities are not routinely tested for and do not yet influence the treatment decision. We aimed to evaluate the prognostic impact of these additional abnormalities detected by conventional cytogenetic testing, as well as their relationships with the clinical characteristics and their value in identifying iMCL. All consecutive MCL cases diagnosed between 1995 and 2011 at four institutions were retrospectively selected on the basis of an informative karyotype with a t(11;14) translocation at the time of diagnosis. A total of 125 patients were included and followed for an actual median time of 35 months. The median overall survival (OS) and survival without treatment (TFS) were 73.7 and 1.3 months, respectively. In multivariable Cox models, a high mantle cell lymphoma international prognostic index score, a complex karyotype, and blastoid morphology were independently associated with a shortened OS. Spleen enlargement, nodal presentation, extra-hematological involvement, and complex karyotypes were associated with shorter TFS. A score based on these factors allowed for the identification of "indolent" patients (median TFS 107 months) from other patients (median TFS: 1 month). In conclusion, in this multicentric cohort of MCL patients, a complex karyotype was associated with a shorter survival time and allowed for the identification of iMCL at the time of diagnosis. Copyright © 2013 Wiley Periodicals, Inc.

  4. The preoperative alkaline phosphatase-to-platelet ratio index is an independent prognostic factor for hepatocellular carcinoma after hepatic resection.

    Science.gov (United States)

    Yu, Ya-Qun; Li, Jun; Liao, Yan; Chen, Qian; Liao, Wei-Jia; Huang, Jian

    2016-12-01

    A simple, inexpensive, and readily available prognostic index is highly needed to accurately predict the prognosis of hepatocellular carcinoma (HCC). This study aimed to develop a simple prognostic index using routine laboratory tests, alkaline phosphatase-to-platelet count ratio index (APPRI), to predict the likelihood of postoperative survival in HCC patients.A total of 246 patients with HCC undergoing curative resection were retrospectively analyzed. Cutoff point for APPRI was calculated using receiver operating characteristic curve analysis, and then the patients were divided into the low-APPRI group (APPRI ≤ 4.0) and the high-APPRI group (APPRI > 4.0). The influences of APPRI on disease-free survival (DFS) and overall survival (OS) were tested by the Kaplan-Meier method, and multivariate analysis using Cox regression. Elevated APPRI was associated with age, cirrhosis, and aspartate aminotransferase (AST) in HCC. Univariate analysis showed that APPRI > 4.0, tumor size >6 cm, multiple tumors, Barcelona-clinic liver cancer stages B to C, and AST > 40 U/L were significant predictors of worse DFS and OS. A multivariate analysis suggested that APPRI > 4.0 was an independent factor for DFS (hazard ratio [HR] = 1.689; 95% confidence interval [CI], 1.139-2.505; P = 0.009) and OS (HR = 1.664; 95% CI, 1.123-2.466; P = 0.011). Preoperative APPRI > 4.0 was a powerful prognostic predictor of adverse DFS and OS in HCC after surgery. The APPRI may be a promising prognostic marker for HCC after surgical resection.

  5. Ki67 index is an independent prognostic factor in epithelioid but not in non-epithelioid malignant pleural mesothelioma: a multicenter study.

    Science.gov (United States)

    Ghanim, B; Klikovits, T; Hoda, M A; Lang, G; Szirtes, I; Setinek, U; Rozsas, A; Renyi-Vamos, F; Laszlo, V; Grusch, M; Filipits, M; Scheed, A; Jakopovic, M; Samarzija, M; Brcic, L; Stancic-Rokotov, D; Kern, I; Rozman, A; Dekan, G; Klepetko, W; Berger, W; Glasz, T; Dome, B; Hegedus, B

    2015-03-03

    Estimating the prognosis in malignant pleural mesothelioma (MPM) remains challenging. Thus, the prognostic relevance of Ki67 was studied in MPM. Ki67 index was determined in a test cohort of 187 cases from three centres. The percentage of Ki67-positive tumour cells was correlated with clinical variables and overall survival (OS). The prognostic power of Ki67 index was compared with other prognostic factors and re-evaluated in an independent cohort (n=98). Patients with Ki67 higher than median (>15%) had significantly (P<0.001) shorter median OS (7.5 months) than those with low Ki67 (19.1 months). After multivariate survival analyses, Ki67 proved to be-beside histology and treatment-an independent prognostic marker in MPM (hazard ratio (HR): 2.1, P<0.001). Interestingly, Ki67 was prognostic exclusively in epithelioid (P<0.001) but not in non-epithelioid subtype. Furthermore, Ki67 index was significantly lower in post-chemotherapy samples when compared with chemo-naive cases. The prognostic power was comparable to other recently published prognostic factors (CRP, fibrinogen, neutrophil-to-leukocyte ratio (NLR) and nuclear grading score) and was recapitulated in the validation cohort (P=0.048). This multicentre study demonstrates that Ki67 is an independent and reproducible prognostic factor in epithelioid but not in non-epithelioid MPM and suggests that induction chemotherapy decreases the proliferative capacity of MPM.

  6. Blood pyrrole-protein adducts as a diagnostic and prognostic index in pyrrolizidine alkaloid-hepatic sinusoidal obstruction syndrome

    Directory of Open Access Journals (Sweden)

    Gao H

    2015-08-01

    Full Text Available Hong Gao,1,* Jianqing Q Ruan,2,* Jie Chen,1 Na Li,2 Changqiang Q Ke,3 Yang Ye,3–5 Ge Lin,2,4,5 Jiyao Y Wang1,61Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 2School of Biomedical Sciences, Chinese University of Hong Kong, Hong Kong; 3Shanghai Institute of Materia Medica, Shanghai, People’s Republic of China; 4Joint Research Laboratory for Promoting Globalization of Traditional Chinese Medicines, Shanghai Institute of Materia Medica, 5Chinese University of Hong Kong, Hong Kong; 6Center of Evidence-Based Medicine Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this work and share first authorship Background: The diagnosis of hepatic sinusoidal obstruction syndrome (HSOS induced by pyrrolizidine alkaloids is mainly based on clinical investigation. There is currently no prognostic index. This study evaluated the quantitative measurement of blood pyrrole-protein adducts (PPAs as a diagnostic and prognostic index for pyrrolizidine alkaloid-induced HSOS.Methods: Suspected drug-induced liver injury patients were prospectively recruited. Blood PPAs were quantitatively measured using ultra-performance liquid chromatography-tandem mass spectrometry. Patients’ age, sex, biochemistry test results, and a detailed drug history were recorded. The patients were divided into two groups, ie, those with HSOS induced by pyrrolizidine alkaloid-containing drugs and those with liver injury induced by drugs without pyrrolizidine alkaloids. The relationship between herb administration, clinical outcomes, blood sampling time, and blood PPA concentration in pyrrolizidine alkaloid-associated HSOS patients was analyzed using multiple linear regression analysis.Results: Forty patients met the entry criteria, among whom 23 had pyrrolizidine alkaloid-associated HSOS and 17 had liver injury caused by drugs without pyrrolizidine alkaloids. Among the 23

  7. A novel prognostic indicator for in-hospital and 4-year outcomes in patients with pulmonary embolism: TIMI risk index.

    Science.gov (United States)

    Keskin, Muhammed; Güvenç, Tolga Sinan; Hayıroğlu, Mert İlker; Kaya, Adnan; Tatlısu, Mustafa Adem; Avşar, Şahin; Öz, Ahmet; Keskin, Taha; Uzun, Ahmet Okan; Kozan, Ömer

    2017-10-01

    Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) was recently evaluated in patients with acute myocardial infarction and found as an important prognostic index. In the current study, we evaluated the prognostic value of TRI in patients with moderate-high and high risk pulmonary embolism (PE) who were treated with thrombolytic agents. We retrospectively evaluated the in-hospital and long-term (4-year) prognostic impact of TRI in a total number of 456 patients with moderate-high and high risk PE. Patients were stratified by quartiles (Q) of admission TRI. In-hospital analysis revealed significantly higher rates of in-hospital death for patients with TRI in Q4. After adjustment for confounding baseline variables, TRI in Q4 was associated with 2.8-fold hazard of in-hospital death. Upon multivariate analysis, admission TRI in Q4 vs. Q1-3 was associated with 3.1 fold hazard of 4-year mortality rate. TRI in Q4, as compared to Q1-3, was significantly predictive of short term and long-term outcomes in PE patients who treated with thrombolytic agents. Our data suggest TRI to be an independent, feasible, and cost-effective tool for rapid risk stratification in moderate-high and high risk PE patients who treated with thrombolytic agents. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Evaluation of an Optimal Cut-Off Point for the Ki-67 Index as a Prognostic Factor in Primary Breast Cancer: A Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Rumiko Tashima

    Full Text Available The Ki-67 index is an important biomarker for indicating the proliferation of cancer cells and is considered to be an effective prognostic factor for breast cancer. However, a standard cut-off point for the Ki-67 index has not yet been established. Therefore, the aim of this retrospective study was to determine an optimal cut-off point in order to establish it as a more accurate prognostic factor. Immunohistochemical analysis of the Ki-67 index was performed on 4329 patients with primary breast cancer from August 1987 to March 2012. Out of this sample, there were 3186 consecutive cases from September 1997 with simultaneous evaluations of ER, PgR and HER2 status. Cox's proportional hazard model was used to perform univariate and multivariate analyses of the factors related to OS. The hazard ratios (HR and the p values were then compared to determine the optimal cut-off point for the Ki-67 index. The median Ki-67 index value was 20.5% (mean value 26.2%. The univariate analysis revealed that there was a statistically significant negative correlation with DFS and OS and the multivariate analysis revealed that the Ki-67 index value was a significant factor for DFS and OS. The top seven cut-off points were then carefully chosen based on the results of the univariate analysis using the lowest p-values and the highest HR as the main selection criteria. The multivariate analysis of the factors for OS showed that the cut-off point of 20% had the highest HR in all of the cases. However, the cutoff point of 20% was only a significant factor for OS in the Luminal/HER2- subtype. There was no correlation between the Ki-67 index value and OS in any of the other subtypes. These data indicate that the optimal cut-off point of 20% is the most effective prognostic factor for Luminal/HER2- breast cancer.

  9. Prognostic significance of Ki67 proliferation index, HIF1 alpha index and microvascular density in patients with non-small cell lung cancer brain metastases

    Energy Technology Data Exchange (ETDEWEB)

    Berghoff, A.S. [Medical University of Vienna, Institute of Neurology, Vienna (Austria); Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Department of Medicine I, Vienna (Austria); Ilhan-Mutlu, A.; Preusser, M. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Department of Medicine I, Vienna (Austria); Woehrer, A.; Hainfellner, J.A. [Medical University of Vienna, Institute of Neurology, Vienna (Austria); Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Hackl, M. [Austrian National Cancer Registry, Statistics Austria, Vienna (Austria); Widhalm, G. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Department of Neurosurgery, Vienna (Austria); Dieckmann, K. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Department of Radiotherapy, Vienna (Austria); Melchardt, T. [Paracelsus Medical University Hospital Salzburg, Third Medical Department, Salzburg (Austria); Dome, B. [Medical University of Vienna, Department of Surgery, Vienna (Austria); Heinzl, H. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Center for Medical Statistics, Informatics, and Intelligent Systems, Vienna (Austria); Birner, P. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Institute of Clinical Pathology, Vienna (Austria)

    2014-07-15

    Survival upon diagnosis of brain metastases (BM) in patients with non-small cell lung cancer (NSCLC) is highly variable and established prognostic scores do not include tissue-based parameters. Patients who underwent neurosurgical resection as first-line therapy for newly diagnosed NSCLC BM were included. Microvascular density (MVD), Ki67 tumor cell proliferation index and hypoxia-inducible factor 1 alpha (HIF-1 alpha) index were determined by immunohistochemistry. NSCLC BM specimens from 230 patients (151 male, 79 female; median age 56 years; 199 nonsquamous histology) and 53/230 (23.0 %) matched primary tumor samples were available. Adjuvant whole-brain radiation therapy (WBRT) was given to 153/230 (66.5 %) patients after neurosurgical resection. MVD and HIF-1 alpha indices were significantly higher in BM than in matched primary tumors. In patients treated with adjuvant WBRT, low BM HIF-1 alpha expression was associated with favorable overall survival (OS), while among patients not treated with adjuvant WBRT, BM HIF-1 alpha expression did not correlate with OS. Low diagnosis-specific graded prognostic assessment score (DS-GPA), low Ki67 index, high MVD, low HIF-1 alpha index and administration of adjuvant WBRT were independently associated with favorable OS. Incorporation of tissue-based parameters into the commonly used DS-GPA allowed refined discrimination of prognostic subgroups. Ki67 index, MVD and HIF-1 alpha index have promising prognostic value in BM and should be validated in further studies. (orig.) [German] Die Ueberlebensprognose von Patienten mit zerebralen Metastasen eines nicht-kleinzelligen Lungenkarzinoms (NSCLC) ist sehr variabel. Bisher werden gewebsbasierte Parameter nicht in die prognostische Beurteilung inkludiert. Neurochirurgische Resektate zerebraler NSCLC-Metastasen wurden in dieser Studie untersucht. Die Gefaessdichte (''microvascular density'', MVD), der Ki67-Proliferationsindex sowie der HIF-1α-Index wurden mittels

  10. Proliferative activity (MIB-1 index) is an independent prognostic parameter in patients with high-grade soft tissue sarcomas of subtypes other than malignant fibrous histiocytomas

    DEFF Research Database (Denmark)

    Jensen, V; Sørensen, Flemming Brandt; Bentzen, S M

    1998-01-01

    . Univariate analysis identified patient age, tumour size, histological grade of malignancy, MIB-1 index and p53 accumulation as significant prognostic parameters. Multivariate Cox analysis, including tests for interaction terms between histological subtypes and MIB-1 index, showed independent prognostic....... The proliferative activity was assessed by use of the monoclonal antibody MIB-1 and evaluated in multiple, random systematic sampled fields of vision. The percentage of proliferating cells (the MIB-1 index) ranged between 1% and 85% (median 12%). A significant increase in mean MIB-1 index was seen with increasing...

  11. Prognostic immune-related gene models for breast cancer: a pooled analysis.

    Science.gov (United States)

    Zhao, Jianli; Wang, Ying; Lao, Zengding; Liang, Siting; Hou, Jingyi; Yu, Yunfang; Yao, Herui; You, Na; Chen, Kai

    2017-01-01

    Breast cancer, the most common cancer among women, is a clinically and biologically heterogeneous disease. Numerous prognostic tools have been proposed, including gene signatures. Unlike proliferation-related prognostic gene signatures, many immune-related gene signatures have emerged as principal biology-driven predictors of breast cancer. Diverse statistical methods and data sets were used for building these immune-related prognostic models, making it difficult to compare or use them in clinically meaningful ways. This study evaluated successfully published immune-related prognostic gene signatures through systematic validations of publicly available data sets. Eight prognostic models that were built upon immune-related gene signatures were evaluated. The performances of these models were compared and ranked in ten publicly available data sets, comprising a total of 2,449 breast cancer cases. Predictive accuracies were measured as concordance indices (C-indices). All tests of statistical significance were two-sided. Immune-related gene models performed better in estrogen receptor-negative (ER-) and lymph node-positive (LN+) breast cancer subtypes. The three top-ranked ER- breast cancer models achieved overall C-indices of 0.62-0.63. Two models predicted better than chance for ER+ breast cancer, with C-indices of 0.53 and 0.59, respectively. For LN+ breast cancer, four models showed predictive advantage, with C-indices between 0.56 and 0.61. Predicted prognostic values were positively correlated with ER status when evaluated using univariate analyses in most of the models under investigation. Multivariate analyses indicated that prognostic values of the three models were independent of known clinical prognostic factors. Collectively, these analyses provided a comprehensive evaluation of immune-related prognostic gene signatures. By synthesizing C-indices in multiple independent data sets, immune-related gene signatures were ranked for ER+, ER-, LN+, and LN- breast

  12. Beyond Body Mass Index. Is the Body Cell Mass Index (BCMI) a useful prognostic factor to describe nutritional, inflammation and muscle mass status in hospitalized elderly?: Body Cell Mass Index links in elderly.

    Science.gov (United States)

    Rondanelli, Mariangela; Talluri, Jacopo; Peroni, Gabriella; Donelli, Chiara; Guerriero, Fabio; Ferrini, Krizia; Riggi, Emilia; Sauta, Elisabetta; Perna, Simone; Guido, Davide

    2017-03-24

    The aim of this study was to establish the effectiveness of Body Cell Mass Index (BCMI) as a prognostic index of (mal)nutrition, inflammation and muscle mass status in the elderly. A cross-sectional observational study has been conducted on 114 elderly patients (80 women and 34 men), with mean age equal to 81.07 ± 6.18 years. We performed a multivariate regression model by Structural Equation Modelling (SEM) framework. We detected the effects over a Mini Nutritional Assessment (MNA) stratification, by performing a multi-group multivariate regression model (via SEM) in two MNA nutritional strata, less and bigger (or equal) than 17. BCMI had a significant effect on albumin (β = +0.062, P = 0.001), adjusting for the other predictors of the model as Body Mass Index (BMI), age, sex, fat mass and cognitive condition. An analogous result is maintained in MNAmass (FFM) (β = +0.480, P Index (SMI) (β = +0.265, P < 0.001), assessed by DXA. BCMI also returned suggestive evidences (0.05 < P < 0.10) for both the effect on FFM and on SMI in overall sample. The main result of this study is that the BCMI, compared to BMI, proved to be significantly related to an important marker as albumin in geriatric population. Then, assessing the BCMI could be a valuable, inexpensive, easy to perform tool to investigate the inflammation status of elderly patients. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  13. Prognostic value of a systemic inflammatory response index in metastatic renal cell carcinoma and construction of a predictive model

    Science.gov (United States)

    Li, Hongzhao; Chen, Luyao; Li, Xintao; Zhang, Yu; Xie, Yongpeng; Zhang, Xu

    2017-01-01

    Inflammation act as a crucial role in carcinogenesis and tumor progression. In this study, we aim to investigate the prognostic significance of systemic inflammatory biomarkers in metastatic renal cell carcinoma (mRCC) and develop a survival predictive model. One hundred and sixty-one mRCC patients who had undergone cytoreductive nephrectomy were enrolled from January 2006 to December 2013. We created a systemic inflammation response index (SIRI) basing on pretreatment hemoglobin and lymphocyte to monocyte ratio (LMR), and evaluated its associations with overall survival (OS) and clinicopathological features. Pretreatment hemoglobin and LMR both remained as independent factors adjusted for other markers of systemic inflammation responses and conventional clinicopathological parameters. A high SIRI seems to be an independent prognosis predictor of worse OS and was significantly correlated with aggressive tumor behaviors. Inclusion of the SIRI into a prognostic model including Fuhrman grade, histology, tumor necrosis and targeted therapy established a nomogram, which accurately predicted 1-year survival for mRCC patients. The SIRI seems to be a prognostic biomarker in mRCC patients. The proposed nomogram can be applied to predict OS of patients with mRCC after nephrectomy. PMID:28881716

  14. Calpain-1 Expression in Triple-Negative Breast Cancer: A Potential Prognostic Factor Independent of the Proliferative/Apoptotic Index

    Directory of Open Access Journals (Sweden)

    Shadia M. Al-Bahlani

    2017-01-01

    Full Text Available Triple-negative breast cancer (TNBC is an aggressive type of breast cancer in which calpain system plays an important role in its cellular processes including apoptosis and proliferation. Although such roles have been assessed in tumor pathogenesis, the correlation of its expression to the proliferating/apoptotic index has not been studied yet. Immunohistochemical staining of calpain-1 was performed on paraffin-embedded tissues to correlate its expression with clinicopathological variables and outcome. The proliferation activity was determined by calculating the percentage of cells expressing the Ki-67 antigen. The apoptotic index was assessed morphologically and biochemically using Haematoxylin & Eosin method and Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay, respectively. Calpain-1 was significantly expressed in TNBC tissues varying from low to high with a significant correlation to lymph node status but not with the other clinicopathological variables, suggesting its role as a prognostic factor. In addition, a positive correlation was found between both apoptotic counts assays (P<0.001, r=0.547 as well as with proliferation (P=0.045. Calpain-1 expression had no significant correlation with either proliferation (P=0.29 or apoptotic indices (P=0.071 and P=0.100. Determining calpain-1 expression may provide relevant prognostic value for TNBC cancer patients.

  15. Prognostic Impact of the Geriatric Nutritional Risk Index on Long-Term Outcomes in Patients Who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Hassan, Ahmed; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-06-01

    Malnutrition has been identified as an important predictor of poor clinical outcomes in patients with heart failure. The aim of this study is to examine the prognostic impact of nutritional status in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). The impact of nutrition, assessed using the geriatric nutritional risk index (GNRI) calculated by serum albumin and body mass index, was evaluated in 2,853 patients with CAD who underwent their first PCI between 2000 and 2011. Patients were assigned to tertiles based on their GNRI levels. The incidences of all-cause death and cardiac death were assessed. The median GNRI values were 101 (interquartile range 95 to 106). Lower GNRI levels were associated with older age and higher prevalence of acute coronary syndrome and chronic kidney disease. During the median follow-up period of 7.4 years, Kaplan-Meier curves showed ongoing divergence in rates of mortality among tertiles (GNRI nutritional status was associated with long-term clinical outcomes in CAD patients after PCI. Evaluation of GNRI carries important prognostic information and may guide the therapeutic approach to such patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Efficacy of NETDC (New England Trophoblastic Disease Center prognostic index score to predict gestational trophoblastic tumor from hydatidiform mole

    Directory of Open Access Journals (Sweden)

    Khrismawan Khrismawan

    2004-03-01

    Full Text Available A prospective longitudinal analytic study assessing the efficacy of NETDC (New England Trophoblastic Disease Center prognostic index score in predicting malignancy after hydatidiform mole had been performed. Of the parameter evaluated; age of patients, type of hydatidiform mole, uterine enlargement, serum hCG level, lutein cyst, and presence of complicating factors were significant risk factors for malignancy after hydatidiform mole were evacuated (p<0.032. The study were done on 50 women diagnosed with hydatidiform mole with 1 year observation (January 2001-December 2002 at the Department of Obstetrics and Gynecology, Mohammad Hoesin Hospital, Palembang. The results showed that the NETDC prognostic index score predicted malignancy in 50% of high risk group and 10% in low risk group (p<0.05. This showed a higher number than that found by the WHO (19%-30%. The risk for incidence of  malignancy after hydatidiform mole in the high risk group is 9.0 times higher compared to that of the low risk group (CI: 1.769-45.786. (Med J Indones 2004; 13: 40-6 Keywords: New England Trophoblastic Disease Center (NETDC, gestational trophoblastic tumor, hydatidiform mole, high and low risk

  17. Prognostic value of body mass index and waist circumference in patients with chronic heart failure (Spanish REDINSCOR Registry).

    Science.gov (United States)

    Puig, Teresa; Ferrero-Gregori, Andreu; Roig, Eulalia; Vazquez, Rafael; Gonzalez-Juanatey, Jose R; Pascual-Figal, Domingo; Delgado, Juan; Alonso-Pulpon, Luis; Borras, Xavier; Mendez, Ana; Cinca, Juan

    2014-02-01

    To analyze the association between higher body mass index and waist circumference, and the prognostic values of both indicators in total and cardiac mortality in patients with chronic heart failure. The study included 2254 patients who were followed up for 4 years. Obesity was classified as a body mass index ≥30 and overweight as a body mass index of 25.0-29.9. Central obesity was defined as waist circumference ≥88 cm for women and ≥102cm for men. Independent predictors of total and cardiac mortality were assessed in a multivariate Cox model adjusted for confounding variables. Obesity was present in 35% of patients, overweight in 43%, and central obesity in 60%. Body mass index and waist circumference were independent predictors of lower total mortality: hazard ratio=0.84 (P120cm. Mortality was significantly lower in patients with a high body mass index and waist circumference. The results also showed that this protection was lost when these indicators over a certain limit. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  18. Neuromagnetic index of hemispheric asymmetry prognosticating the outcome of sudden hearing loss.

    Science.gov (United States)

    Li, Lieber Po-Hung; Shiao, An-Suey; Chen, Kuang-Chao; Lee, Po-Lei; Niddam, David M; Chang, Shyue-Yih; Hsieh, Jen-Chuen

    2012-01-01

    The longitudinal relationship between central plastic changes and clinical presentations of peripheral hearing impairment remains unknown. Previously, we reported a unique plastic pattern of "healthy-side dominance" in acute unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). This study aimed to explore whether such hemispheric asymmetry bears any prognostic relevance to ISSNHL along the disease course. Using magnetoencephalography (MEG), inter-hemispheric differences in peak dipole amplitude and latency of N100m to monaural tones were evaluated in 21 controls and 21 ISSNHL patients at two stages: initial and fixed stage (1 month later). Dynamics/Prognostication of hemispheric asymmetry were assessed by the interplay between hearing level/hearing gain and ipsilateral/contralateral ratio (I/C) of N100m latency and amplitude. Healthy-side dominance of N100m amplitude was observed in ISSNHL initially. The pattern changed with disease process. There is a strong correlation between the hearing level at the fixed stage and initial I/C(amplitude) on affected-ear stimulation in ISSNHL. The optimal cut-off value with the best prognostication effect for the hearing improvement at the fixed stage was an initial I/C(latency) on affected-ear stimulation of 1.34 (between subgroups of complete and partial recovery) and an initial I/C(latency) on healthy-ear stimulation of 0.76 (between subgroups of partial and no recovery), respectively. This study suggested that a dynamic process of central auditory plasticity can be induced by peripheral lesions. The hemispheric asymmetry at the initial stage bears an excellent prognostic potential for the treatment outcomes and hearing level at the fixed stage in ISSNHL. Our study demonstrated that such brain signature of central auditory plasticity in terms of both N100m latency and amplitude at defined time can serve as a prognostication predictor for ISSNHL. Further studies are needed to explore the long-term temporal scenario

  19. Evaluation of body mass index as a prognostic factor in osteoarthrosis of the knee

    Directory of Open Access Journals (Sweden)

    Fabrício Bolpato Loures

    2016-08-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the relationship between patients' body mass index (BMI and the degree of radiographic severity of knee osteoarthrosis. METHOD: 117 patients with gonarthrosis were evaluated prospectively. The patients' BMI was calculated and their knee arthrosis was classified in accordance with the modified Ahlbäck criteria. Kruskal-Wallis analysis of variance (ANOVA was used to evaluate the relationship between these two variables. RESULTS: The group classified as Ahlbäck grade V had significantly higher BMI than the others. CONCLUSION: There is a direct relationship between BMI and the degree of radiographic severity of gonarthrosis. Obesity appears to be directly related to the progression of knee osteoarthrosis.

  20. Development of a cumulative psychosocial factor index for problematic recovery following work-related musculoskeletal injuries.

    Science.gov (United States)

    Wideman, Timothy H; Sullivan, Michael J L

    2012-01-01

    Psychosocial variables such as fear of movement, depression, and pain catastrophizing have been shown to be important prognostic factors for a wide range of pain-related outcomes. The potential for a cumulative relationship between different elevated psychosocial factors and problematic recovery following physical therapy has not been fully explored. The purpose of this study was to determine whether the level of risk for problematic recovery following work-related injuries is associated with the number of elevated psychosocial factors. This was a prospective cohort study. Two hundred two individuals with subacute, work-related musculoskeletal injuries completed a 7-week physical therapy intervention and participated in testing at treatment onset and 1 year later. An index of psychosocial risk was created from measures of fear of movement, depression, and pain catastrophizing. This index was used to predict the likelihood of experiencing problematic recovery in reference to pain intensity and return-to-work status at the 1-year follow-up. Logistic regression analysis revealed that the number of prognostic factors was a significant predictor of persistent pain and work disability at the 1-year follow-up. Chi-square analysis revealed that the risk for problematic recovery increased for patients with elevated levels on at least 1 psychosocial factor and was highest when patients had elevated scores on all 3 psychosocial factors. The physical therapy interventions used in this study were not standardized. This study did not include a specific measure for physical function. The number of elevated psychosocial factors present in the subacute phase of recovery has a cumulative effect on the level of risk for problematic recovery 1 year later. This research suggests that a cumulative prognostic factor index could be used in clinical settings to improve prognostic accuracy and to facilitate clinical decision making.

  1. The prognostic value of asymmetric laxity of the sacroiliac joints in pregnancy-related pelvic pain.

    NARCIS (Netherlands)

    Damen, L.; Buyruk, H.M.; Guler-Uysal, F.; Lotgering, F.K.; Snijders, C.J.; Stam, H.J.

    2002-01-01

    STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine the prognostic value of asymmetric laxity of the sacroiliac joints during pregnancy on pregnancy-related pelvic pain postpartum. SUMMARY OF BACKGROUND DATA: In a previous study, we observed a significant relation between asymmetric

  2. The prognostic value of clinical factors and cancer stem cell-related markers in gliomas

    DEFF Research Database (Denmark)

    Dahlrot, Rikke Hedegaard

    2014-01-01

    fluorescence-based automated quantitative image acquisition. The prognostic significance was subsequently investigated in relation to the observed clinical prognostic variables. We found that Musashi-1 was not prognostic in WHO grade II tumours, but in WHO grade III high levels of Musashi-1 were associated...... on experiences from clinical trials, with the risk that the results obtained are restricted to highly selected patients only. Moreover, these studies provided only little knowledge of the clinical behaviour of the tumours. For some time, it has been believed that somatic stem cells are responsible for self...... tumours. Moreover, CSCs have been suggested as the cause of resistance towards radiotherapy and chemotherapy. In gliomas, CSCs were originally identified by means of the expression of CD133, but other proteins have subsequently been suggested as CSC related. To improve patients' survival, further...

  3. Reward-related attentional bias and adolescent substance use: a prognostic relationship?

    Science.gov (United States)

    van Hemel-Ruiter, Madelon E; de Jong, Peter J; Ostafin, Brian D; Oldehinkel, Albertine J

    2015-01-01

    Current cognitive-motivational addiction theories propose that prioritizing appetitive, reward-related information (attentional bias) plays a vital role in substance abuse behavior. Previous cross-sectional research has shown that adolescent substance use is related to reward-related attentional biases. The present study was designed to extend these findings by testing whether these reward biases have predictive value for adolescent substance use at three-year follow-up. Participants (N = 657, mean age = 16.2 yrs at baseline) were a sub-sample of Tracking Adolescents' Individual Lives Survey (TRAILS), a large longitudinal community cohort study. We used a spatial orienting task as a behavioral index of appetitive-related attentional processes at baseline and a substance use questionnaire at both baseline and three years follow-up. Bivariate correlational analyses showed that enhanced attentional engagement with cues that predicted potential reward and nonpunishment was positively associated with substance use (alcohol, tobacco, and cannabis) three years later. However, reward bias was not predictive of changes in substance use. A post-hoc analysis in a selection of adolescents who started using illicit drugs (other than cannabis) in the follow-up period demonstrated that stronger baseline attentional engagement toward cues of nonpunishment was related to a higher level of illicit drug use three years later. The finding that reward bias was not predictive for the increase in substance use in adolescents who already started using substances at baseline, but did show prognostic value in adolescents who initiated drug use in between baseline and follow-up suggests that appetitive bias might be especially important in the initiation stages of adolescent substance use.

  4. Prognostic Factors and a New Prognostic Index Model for Children and Adolescents with Hodgkin’s Lymphoma Who Underwent Autologous Hematopoietic Stem Cell Transplantation: A Multicenter Study of the Turkish Pediatric Bone Marrow Transplantation Study

    Directory of Open Access Journals (Sweden)

    Vural Kesik

    2016-12-01

    Full Text Available Objective: The prognostic factors and a new childhood prognostic index after autologous hematopoietic stem cell transplantation (AHSCT in patients with relapsed/refractory Hodgkin’s lymphoma (HL were evaluated. Materials and Methods: The prognostic factors of 61 patients who underwent AHSCT between January 1990 and December 2014 were evaluated. In addition, the Age-Adjusted International Prognostic Index and the Childhood International Prognostic Index (CIPI were evaluated for their impact on prognosis. Results: The median age of the 61 patients was 14.8 years (minimummaximum: 5-20 years at the time of AHSCT. There were single relapses in 28 patients, ≥2 relapses in eight patients, and refractory disease in 25 patients. The chemosensitivity/chemorefractory ratio was 36/25. No pretransplant radiotherapy, no remission at the time of transplantation, posttransplant white blood cell count over 10x103/ μL, posttransplant positron emission tomography positivity at day 100, and serum albumin of <2.5 g/dL at diagnosis were correlated with progression-free survival. No remission at the time of transplantation, bone marrow positivity at diagnosis, and relapse after AHSCT were significant parameters for overall survival. Conclusion: The major factors affecting the progression-free and overall survival were clearly demonstrated. A CIPI that uses a lactate dehydrogenase level of 500 IU/L worked well for estimating the prognosis. We recommend AHSCT at first complete remission for relapsed cases, and it should also be taken into consideration for patients with high prognostic scores at diagnosis.

  5. [Using the CRIB as an early prognostic index for very low birthweight infants, treated in neonatal intensive care unites].

    Science.gov (United States)

    Vakrilova, L; Emilova, Z; Slŭncheva, B; Kalaĭdzhieva, M; Pramatarova, T; Iarŭkova, N

    2007-01-01

    The illness severity by admission in NICU reflects the intensity of the therapy, the prognosis for the newborn and the hospital costs. Using the CRIB (Clinical Risk Index for Babies) as an objective and easy method for measuring the illness severity in the first 12 h of life allows assessing the risk of death until discharge. To apply the CRIB for assessing the illness severity and to investigate its prognostic value for life and risk of permanent disabilities among very low birthweight (VLBW) and gestational age (VLGA) infants. The study includes the inborn babies in the Specialized Obstetrics & Gynaecology Hospital "Maichin dom" with birthweight 15. The infants with permanent disabilities were with significantly higher CRIB scores too: 11.7 / 11.4% among the infants with IVH III-IV compared to 6.2 / 5.2 without; 9.6 / 10.1 among infants with CLD compared to 5.7 /5.2 without; 10.1 / 10 among infants with ROP compared to 5.5 / 5.1 without. The CRIB score is useful and easy to apply early and objective prognostic criterion about the risk of in hospital death and permanent disabilities among VLBW newborns. It can be used as a basis for comparing the results of the different NICUs too.

  6. Prognostic factors related to recurrent low-back pain and sickness absence

    NARCIS (Netherlands)

    Heuvel, S.G. van den; Ariëns, G.A.M.; Boshuizen, H.C.; Hoogendoorn, W.E.; Bongers, P.M.

    2004-01-01

    This study aimed at determining the prognostic factors related to the recurrence of low-back pain and future sickness absence due to low-back pain. Data were used from a prospective cohort study in a working population with a three year follow-up period. They were collected with annual

  7. [The Association Française de Chirurgie (AFC) colorectal index: a reliable preoperative prognostic index in colorectal surgery].

    Science.gov (United States)

    Duval, H; Dumont, F; Vibert, E; Manaouil, D; Verhaeghe, P; Fuks, D; Bounicaud, D; Riboulot, M; Chatelain, D; Yzet, T; Mauvais, F; Lapôtre-Ledoux, B; Regimbeau, J-M

    2006-01-01

    Evaluation of outcome after colorectal surgery is always necessary. A new index which permits to appreciate preoperatively postoperative mortality after colorectal resection in colorectal cancer (CRC) and in diverticular disease has been published (i.e., Association Française de Chirurgie, AFC colorectal index). From November 2002 to July 2004, in-hospital mortality was analysed on 253 patients who underwent colic resection (N = 220, 87%) or rectal resection, with anastomosis (N = 175, 70%). Mortality was analysed according to emergency resection, neurological co morbidity, lost of weight more than 10% of weight, age older than 70 years. Mean age of patients was 63 +/- 18 years (17-92) (45% older than 70 years), 26% of patients were ASA >or= III, 35% underwent surgery in emergency, and 12% underwent laparoscopic surgery. One hundred and fifteen (45%) patients underwent surgery for CRC and 50 (20%), for diverticular disease and 11 patients underwent surgery for ischemic colitis. Overall mortality rate was 10% (N = 26), it was 19% in emergency surgery versus 5% after elective surgery. Global morbidity was 38%, percentage of anastomotic leak was 8% (N = 14/175), reoperation was necessary in 14%. The mean length of stay was 13 +/- 8 days. Ten percent of patients necessitated unplanned readmission. After surgery for CCR or diverticular disease. -i) overall mortality was 9% - ii) among patients who had 0, 1, 2, or 3 predictive risk factors of mortality; mortality was 0% , 5% 15% and 33%. After surgery for other aetiology than CCR or diverticular disease, among patients who had 0, 1, 2, or 3 predictive risk factors of mortality; mortality was 0%, 12% 36% and 25%. These results showed the reproducibility of the AFC colorectal index and its potential application in all aetiologies after colorectal surgery.

  8. Modified BODE indexes: Agreement between multidimensional prognostic systems based on oxygen uptake

    Directory of Open Access Journals (Sweden)

    José Luis Lopez-Campos

    2010-05-01

    Full Text Available José Luis Lopez-Campos, Pilar Cejudo, Eduardo Marquez, Francisco Ortega, Esther Quintana, Carmen Carmona, Emilia BarrotUnidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospitales Universitarios Virgen del Rocío, Seville, SpainAim: It has been recently shown that the original BODE index has a high degree of correlation with two modified BODE indexes using maximal oxygen uptake expressed either as mL/min/kg (mBODE or as the percentage predicted (mBODE%. In this study we investigated the agreement between the two modified BODE indexes (mBODE and mBODE% in patients with stable chronic obstructive pulmonary disease (COPD.Methods: A total of 169 patients with stable COPD were enrolled in this cross-sectional study. Differences between the two mBODE indexes were assessed using kappa coefficients and Bland-Altman plots. One out of every three patients underwent the six-minute walking test to investigate the agreement with the original BODE index.Results: Correlations between the two mBODE indexes with each other (r = 0.96, P < 0.001 and with the original BODE index (mBODE r = 0.88, P < 0.001; mBODE% r = 0.93, P < 0.001 were excellent. However, the two mBODE indexes were significantly different from each other (mBODE 5.27 ± 2.3 versus mBODE% 4.31 ± 2.5; P < 0.001. The kappa coefficients were significantly lower (entire study group k = 0.5, P < 0.001 for every GOLD stage. The mean difference between the two mBODE indexes was 0.8 ± 0.6 units. Differences with the original BODE were higher for the mBODE (1.8 ± 0.9 than for the mBODE% (0.6 ± 0.8.Conclusions: The new mBODE indexes are highly correlated but significantly different from each other. The differences between the novel indexes deserve further scrutiny.Keywords: BODE index, chronic obstructive pulmonary disease, exercise testing, multidimensional evaluation, oxygen uptake

  9. Evaluation of topographic index in relation to terrain roughness and ...

    Indian Academy of Sciences (India)

    are upslope area, topographic index, stream power index, radiation index .... flat areas. The effect of smoothening and dis- cretisation were closely related to local terrain characteristics. However, the assessment of the topographic index is very ...... case study of two protected areas in Himalayan foothills;. Biodiversity and ...

  10. Prognostic nutritional index serves as a predicative marker of survival and associates with systemic inflammatory response in metastatic intrahepatic cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Zhang C

    2016-10-01

    Full Text Available Chenyue Zhang,1,2 Haiyong Wang,1,3 Zhouyu Ning,1,2 Litao Xu,1,2 Liping Zhuang,1,2 Peng Wang,1,2 Zhiqiang Meng1,2 1Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 3Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, People’s Republic of China Objective: The significance of the prognostic nutritional index (PNI has been widely reported and confirmed in many types of cancers. However, few studies are available indicating its prognostic power in patients with intrahepatic cholangiocarcinoma (ICC. Thus, we investigated its relationship with overall survival (OS to evaluate its role in predicting survival in patients with ICC. Patients and methods: Between October 2011 and October 2015, 173 consecutive patients with pathologically confirmed locally advanced or metastatic ICC were enrolled. First, the correlations between PNI and clinical factors were analyzed among these patients. Next, univariate and multivariate analyses were conducted to evaluate the association between PNI and OS among these patients with ICC. In addition, the relationships between PNI and three typical systemic inflammatory response (SIR markers – the neutrophil/lymphocyte ratio (NLR, the platelet/lymphocyte ratio (PLR, and the lymphocyte/monocyte ratio (LMR – were also assessed. Results: A lower PNI was linked with a shorter OS in patients with ICC, as reflected obviously in the Kaplan–Meier analyses. The patients with ICC were divided into the locally advanced group and the metastatic group. Further analyses revealed that PNI is not associated with OS in the locally advanced group. However, in the subgroup of patients with metastatic ICC, a lower PNI significantly correlated with a worsened OS. The OS for patients with a low PNI is 5 months, whereas the OS is 10.17 months for patients with a high PNI. Multivariate analyses revealed

  11. Prognostic Value of Absolute versus Relative Rise of Blood ...

    African Journals Online (AJOL)

    maternal outcome than a relative rise in the systolic/diastolic blood pressure from mid pregnancy, which did not reach this absolute level. We conclude that in the Nigerian obstetric population, the practice of diagnosing pregnancy hypertension on ...

  12. Long-term prognostic value of a comprehensive assessment of cardiac magnetic resonance indexes after an ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Merlos, Pilar; López-Lereu, Maria P; Monmeneu, Jose V; Sanchis, Juan; Núñez, Julio; Bonanad, Clara; Valero, Ernesto; Miñana, Gema; Chaustre, Fabián; Gómez, Cristina; Oltra, Ricardo; Palacios, Lorena; Bosch, Maria J; Navarro, Vicente; Llácer, Angel; Chorro, Francisco J; Bodí, Vicente

    2013-08-01

    A variety of cardiac magnetic resonance indexes predict mid-term prognosis in ST-segment elevation myocardial infarction patients. The extent of transmural necrosis permits simple and accurate prediction of systolic recovery. However, its long-term prognostic value beyond a comprehensive clinical and cardiac magnetic resonance evaluation is unknown. We hypothesized that a simple semiquantitative assessment of the extent of transmural necrosis is the best resonance index to predict long-term outcome soon after a first ST-segment elevation myocardial infarction. One week after a first ST-segment elevation myocardial infarction we carried out a comprehensive quantification of several resonance parameters in 206 consecutive patients. A semiquantitative assessment (altered number of segments in the 17-segment model) of edema, baseline and post-dobutamine wall motion abnormalities, first pass perfusion, microvascular obstruction, and the extent of transmural necrosis was also performed. During follow-up (median 51 months), 29 patients suffered a major adverse cardiac event (8 cardiac deaths, 11 nonfatal myocardial infarctions, and 10 readmissions for heart failure). Major cardiac events were associated with more severely altered quantitative and semiquantitative resonance indexes. After a comprehensive multivariate adjustment, the extent of transmural necrosis was the only resonance index independently related to the major cardiac event rate (hazard ratio=1.34 [1.19-1.51] per each additional segment displaying>50% transmural necrosis, P<.001). A simple and non-time consuming semiquantitative analysis of the extent of transmural necrosis is the most powerful cardiac magnetic resonance index to predict long-term outcome soon after a first ST-segment elevation myocardial infarction. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  13. State of consciousness and ERP (event-related potential measures. Diagnostic and prognostic value of electrophysiology for disorders of consciousness

    Directory of Open Access Journals (Sweden)

    Michela Balconi

    2011-11-01

    Full Text Available Disorders of consciousness were amply studied in the recent years. At this regards new methodologies and technologies were applied to explore the diagnostic and prognostic criteria that may be applied to the patients. Specifically electrophysiological measures were used to verify the degree of awareness and responsiveness in coma, vegetative states (VS, minimal consciousness state (MC, and locked-in syndrome (LI. Recently, ERPs (event-related potentials were adopted to integrate the classical neuroimaging measures. Between the others, MMN (mismatch negativity and P300 deflections were found to represent a consistent index of the present state of consciousness and to be predictive of successive modifications of this state. Also frequency-based EEG measures, such as brain oscillations, were revealed to be relevant marker of consciousness and awareness, able to predict the future evolution of pathology.

  14. Phyllodes tumors of the breast: diagnosis, treatment and prognostic factors related to recurrence

    Science.gov (United States)

    Zhou, Zhi-Rui; Wang, Chen-Chen; Yang, Zhao-Zhi

    2016-01-01

    Phyllodes tumors of the breast are rare tumor types that consist of 0.3–1.0% in all breast tumors. The naming and classification of breast phyllodes tumor have been debated for years. Based on the classification criteria modified by WHO in 2003, this review mainly introduced the clinicopathologic characteristics, pre-operational diagnosis and the treatment of breast phyllodes tumors, and also summarized the prognostic factors related to tumor recurrence. PMID:28066617

  15. Prognostic value of body mass index before treatment for laryngeal squamous cell carcinoma.

    Science.gov (United States)

    Li, Zhao-Qu; Zou, Lan; Liu, Tian-Run; Yang, An-Kui

    2015-12-01

    Patients with head and neck cancer often suffer from malnutrition. This study aims to investigate the influence of body mass index (BMI) on the prognosis of laryngeal squamous cell carcinoma (LSCC). A total of 473 patients with LSCC initially treated at Sun Yat-sen University Cancer Center between January 2005 and July 2009 were retrospectively reviewed. Survival analysis was performed by the Kaplan-Meier method and Cox regression model. Low BMI before treatment was significantly associated with poor overall survival in patients with LSCC (Pnutritional status is favorable to improve survival in patients with LSCC.

  16. Development of an oncological-multidimensional prognostic index (Onco-MPI) for mortality prediction in older cancer patients.

    Science.gov (United States)

    Brunello, Antonella; Fontana, Andrea; Zafferri, Valeria; Panza, Francesco; Fiduccia, Pasquale; Basso, Umberto; Copetti, Massimiliano; Lonardi, Sara; Roma, Anna; Falci, Cristina; Monfardini, Silvio; Cella, Alberto; Pilotto, Alberto; Zagonel, Vittorina

    2016-05-01

    A multidimensional prognostic index (MPI) based on a comprehensive geriatric assessment (CGA) has been developed and validated in independent cohorts of older patients demonstrating good accuracy in predicting one-year mortality. The aim of this study was to develop a cancer-specific modified MPI (Onco-MPI) for mortality prediction in older cancer patients. We enrolled 658 new cancer subjects ≥70 years (mean age 77.1 years, 433 females, 65.8 %) attending oncological outpatient services from September 2004 to June 2011. The Onco-MPI was calculated according to a validated algorithm as a weighted linear combination of the following CGA domains: age, sex, basal and instrumental activities of daily living, Eastern Cooperative Oncology Group performance status, mini-mental state examination, body mass index, Cumulative Illness Rating Scale, number of drugs and the presence of caregiver. Cancer sites (breast 46.5 %, colorectal 21.3 %, lung 6.4 %, prostate 5.5 %, urinary tract 5.0 %, other 15.3 %) and cancer stages (I 37 %, II 22 %, III 19 %, IV 22 %) were also included in the model. All-cause mortality was recorded. Three grades of severity of the Onco-MPI score (low risk: 0.0-0.46, medium risk: 0.47-0.63, high risk: 0.64-1.0) were calculated using RECPAM method. Discriminatory power and calibration were assessed by estimating survival C-indices, along with 95 % confidence interval (CI) and the survival-based Hosmer-Lemeshow (HL) measures. One-year mortality incidence rate was 17.4 %. A significant difference in mortality rates was observed in Onco-MPI low risk compared to medium- and high-risk patients (2.1 vs. 17.7 vs. 80.8 %, p patients that can be useful for clinical decision making in this age group.

  17. Maximal amniotic fluid index as a prognostic factor in pregnancies complicated by polyhydramnios.

    Science.gov (United States)

    Pri-Paz, S; Khalek, N; Fuchs, K M; Simpson, L L

    2012-06-01

    Polyhydramnios is present in approximately 2% of pregnancies and has been associated with a variety of adverse pregnancy outcomes. Our aim was to evaluate the association between the maximal amniotic fluid index (AFI) and the frequency of specific adverse outcomes. This was a retrospective chart review of 524 singleton pregnancies diagnosed with polyhydramnios and delivered in a single tertiary referral center between 2003 and 2008. Polyhydramnios was defined as either AFI ≥ 25 cm or a maximum vertical pocket (MVP) ≥ 8 cm even in the presence of AFI polyhydramnios, as based on the maximal AFI (≥ 35 cm; n = 67), was associated with the highest rates of prenatally diagnosed congenital anomalies (79%), preterm delivery (46%), small-for-gestational-age neonate (16%), aneuploidy (13%) and perinatal mortality (27%). No significant association between degree of polyhydramnios and adverse outcome was demonstrated in cases of idiopathic polyhydramnios (n = 253). There is an association between the frequencies of a variety of adverse pregnancy outcomes and the severity of polyhydramnios as reflected by the maximal AFI. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  18. Prognostic factors for outcomes after whole-brain irradiation of brain metastases from relatively radioresistant tumors: a retrospective analysis

    NARCIS (Netherlands)

    Meyners, Thekla; Heisterkamp, Christine; Kueter, Jan-Dirk; Veninga, Theo; Stalpers, Lukas J. A.; Schild, Steven E.; Rades, Dirk

    2010-01-01

    This study investigated potential prognostic factors in patients treated with whole-brain irradiation (WBI) alone for brain metastases from relatively radioresistant tumors such as malignant melanoma, renal cell carcinoma, and colorectal cancer. Additionally, a potential benefit from escalating the

  19. Prognostic factors for outcomes after whole-brain irradiation of brain metastases from relatively radioresistant tumors: a retrospective analysis

    NARCIS (Netherlands)

    Meyners, T.; Heisterkamp, C.; Kueter, J.D.; Veninga, T.; Stalpers, L.J.A.; Schild, S.E.; Rades, D.

    2010-01-01

    Background: This study investigated potential prognostic factors in patients treated with whole-brain irradiation (WBI) alone for brain metastases from relatively radioresistant tumors such as malignant melanoma, renal cell carcinoma, and colorectal cancer. Additionally, a potential benefit from

  20. Preoperative prognostic nutritional index and nomogram predicting recurrence-free survival in patients with primary non-muscle-invasive bladder cancer without carcinoma in situ

    Directory of Open Access Journals (Sweden)

    Cui J

    2017-11-01

    Full Text Available Jianfeng Cui,1,* Shouzhen Chen,1,* Qiyu Bo,2 Shiyu Wang,1 Ning Zhang,1 Meng Yu,1 Wenfu Wang,1 Jie Han,3 Yaofeng Zhu,1 Benkang Shi1 1Department of Urology, 2Department of First Operating Room, Qilu Hospital of Shandong University, 3Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong University, Jinan, People’s Republic of China *These authors contributed equally to this work Background and objectives: Among the cancers of the urogenital system, bladder cancer is ranked second both in incidence and mortality, and hence, a more accurate estimate of the prognosis for individual patients with non-muscle-invasive bladder cancer (NMIBC is urgently needed. Prognostic nutritional index (PNI which is based on serum albumin levels and peripheral lymphocyte count has been confirmed to have prognostic value in various cancers. The aim of this study was to clarify the prognostic value of PNI in patients with NMIBC.Methods: Data of 329 patients with NMIBC were evaluated retrospectively. Recurrence-free survival (RFS was assessed using the Kaplan–Meier method, and the equivalences of survival curves were tested by log-rank tests. The univariate and multivariate analyses were performed using the Cox proportional hazards regression model. Discrimination of the nomogram was measured by the concordance index. A p-value of <0.05 was considered statistically significant.Results: In univariate analysis, age, tumor focality, tumor size, tumor grade, pathological T stage and preoperative PNI were significantly associated with RFS. Multivariate analysis identified PNI as an independent predictor of RFS in patients with NMIBC. According to these independent predictors, a nomogram for the prediction of recurrence was developed.Conclusion: PNI can be regarded as an independent prognostic factor for predicting RFS in NMIBC. The nomogram could be useful to improve personalized therapy for patients with NMIBC. Keywords: non

  1. Prognostic significance of ankle-brachial index, brachial-ankle pulse wave velocity, flow-mediated dilation, and nitroglycerin-mediated dilation in end-stage renal disease.

    Science.gov (United States)

    Morimoto, Satoshi; Yurugi, Takatomi; Aota, Yasuko; Sakuma, Takao; Jo, Fusakazu; Nishikawa, Mitsushige; Iwasaka, Toshiji; Maki, Kei

    2009-01-01

    Identifying patients at high risk of cardiovascular disease is important in managing patients undergoing hemodialysis. We evaluated a series of prognostic values: flow-mediated dilation (FMD) and nitrogen-mediated dilation (NMD), an index of endothelium-dependent and endothelium-independent function, respectively, ankle-brachial index (ABI), and brachial-ankle pulse wave velocity (baPWV) in patients undergoing chronic hemodialysis. A cohort of 199 patients was studied. At entry, these values were examined and the prognostic significances were investigated. In estimating the significance of baPWV, patients with ABI hemodialysis patients by means of ABI and baPWV but not FMD or NMD provides complementary information in identifying a high-risk population in these patients.

  2. Prognostic factors related to mortality in newborns with Bochdalek hernia: a case-control study.

    Science.gov (United States)

    Bracho-Blanchet, Eduardo; Esperante-Lozano, Sandro; Dávila-Pérez, Roberto; Reed-López Güereña, Francisco; Zalles-Vidal, Cristian; Nieto-Zermeño, Jaime

    2011-01-01

    Bochdalek hernia remains an entity carrying a high mortality. Because there are no published studies about prognostic factors for mortality in Bochdalek hernia in underdeveloped countries, we designed the present study. Our objective was to determine the prognostic factors related to mortality in Bochdalek hernia in countries such as Mexico. We designed a case (deceased)-control (alive) study during a 10-year period analyzing epidemiological and pre-, intra- and postoperative factors related to mortality. Our protocol is to operate when the patient is hemodynamically stable. We analyzed 11 cases and 38 controls. There was pulmonary hypertension in 65% of the patients. Associated anomalies were not related to mortality. Low Apgar score (p = 0.016), the need for high frequency ventilation (p = 0.003) or having postoperative complications (p = 0.025) were related to mortality with pulmonary hypertension being the main cause. Odds ratios showed that immediate intubation, preoperative pulmonary hypertension (p = 0.05) and the necessity for preoperative stabilization (p = 0.043) increased mortality risk by 1.5 times. Using preoperative high-frequency ventilation increased the risk nine times and, when needed postoperatively, increases the risk 11 times. Factors related to mortality were low Apgar score, immediate intubation, need for stabilization, postoperative complications and need for high-frequency ventilation.

  3. Relative index of inequality and slope index of inequality: a structured regression framework for estimation

    NARCIS (Netherlands)

    Moreno-Betancur, Margarita; Latouche, Aurélien; Menvielle, Gwenn; Kunst, Anton E.; Rey, Grégoire

    2015-01-01

    The relative index of inequality and the slope index of inequality are the two major indices used in epidemiologic studies for the measurement of socioeconomic inequalities in health. Yet the current definitions of these indices are not adapted to their main purpose, which is to provide summary

  4. Routine use of ancillary investigations in staging diffuse large B-cell lymphoma improves the International Prognostic Index (IPI).

    Science.gov (United States)

    Talaulikar, Dipti; Shadbolt, Bruce; Dahlstrom, Jane E; McDonald, Anne

    2009-11-22

    The International Prognostic Index (IPI) is used to determine prognosis in diffuse large B-cell lymphoma (DLBCL). One of the determinants of IPI is the stage of disease with bone marrow involvement being classified as stage IV. For the IPI, involvement on bone marrow is traditionally defined on the basis of histology with ancillary investigations used only in difficult cases to aid histological diagnosis. This study aimed to determine the effect of the routine use of flow cytometry, immunohistochemistry and molecular studies in bone marrow staging upon the IPI. Bone marrow trephines of 156 histologically proven DLBCL cases at initial diagnosis were assessed on routine histology, and immunohistochemistry using two T-cell markers (CD45RO and CD3), two B-cell markers (CD20 and CD79a) and kappa and lambda light chains. Raw flow cytometry data on all samples were reanalysed and reinterpreted blindly. DNA extracted from archived paraffin-embedded trephine biopsy samples was used for immunoglobulin heavy chain and light chain gene rearrangement analysis. Using immunophenotyping (flow cytometry and immunohistochemistry), 30 (19.2%) cases were upstaged to stage IV. A further 8 (5.1%) cases were upstaged using molecular studies. A change in IPI was noted in 18 cases (11.5%) on immunophenotyping alone, and 22 (14.1%) cases on immunophenotyping and molecular testing. Comparison of two revised IPI models, 1) using immunophenotyping alone, and 2) using immunophenotyping with molecular studies, was performed with baseline IPI using a Cox regression model. It showed that the revised IPI model using immunophenotyping provides the best differentiation between the IPI categories. Improved bone marrow staging using flow cytometry and immunohistochemistry improves the predictive value of the IPI in patients with DLBCL and should be performed routinely in all cases.

  5. Routine use of ancillary investigations in staging diffuse large B-cell lymphoma improves the International Prognostic Index (IPI

    Directory of Open Access Journals (Sweden)

    Shadbolt Bruce

    2009-11-01

    Full Text Available Abstract Background The International Prognostic Index (IPI is used to determine prognosis in diffuse large B-cell lymphoma (DLBCL. One of the determinants of IPI is the stage of disease with bone marrow involvement being classified as stage IV. For the IPI, involvement on bone marrow is traditionally defined on the basis of histology with ancillary investigations used only in difficult cases to aid histological diagnosis. This study aimed to determine the effect of the routine use of flow cytometry, immunohistochemistry and molecular studies in bone marrow staging upon the IPI. Results Bone marrow trephines of 156 histologically proven DLBCL cases at initial diagnosis were assessed on routine histology, and immunohistochemistry using two T-cell markers (CD45RO and CD3, two B-cell markers (CD20 and CD79a and kappa and lambda light chains. Raw flow cytometry data on all samples were reanalysed and reinterpreted blindly. DNA extracted from archived paraffin-embedded trephine biopsy samples was used for immunoglobulin heavy chain and light chain gene rearrangement analysis. Using immunophenotyping (flow cytometry and immunohistochemistry, 30 (19.2% cases were upstaged to stage IV. A further 8 (5.1% cases were upstaged using molecular studies. A change in IPI was noted in 18 cases (11.5% on immunophenotyping alone, and 22 (14.1% cases on immunophenotyping and molecular testing. Comparison of two revised IPI models, 1 using immunophenotyping alone, and 2 using immunophenotyping with molecular studies, was performed with baseline IPI using a Cox regression model. It showed that the revised IPI model using immunophenotyping provides the best differentiation between the IPI categories. Conclusion Improved bone marrow staging using flow cytometry and immunohistochemistry improves the predictive value of the IPI in patients with DLBCL and should be performed routinely in all cases.

  6. Comprehensive DNA methylation study identifies novel progression-related and prognostic markers for cutaneous melanoma.

    Science.gov (United States)

    Wouters, Jasper; Vizoso, Miguel; Martinez-Cardus, Anna; Carmona, F Javier; Govaere, Olivier; Laguna, Teresa; Joseph, Jesuchristopher; Dynoodt, Peter; Aura, Claudia; Foth, Mona; Cloots, Roy; van den Hurk, Karin; Balint, Balazs; Murphy, Ian G; McDermott, Enda W; Sheahan, Kieran; Jirström, Karin; Nodin, Bjorn; Mallya-Udupi, Girish; van den Oord, Joost J; Gallagher, William M; Esteller, Manel

    2017-06-05

    Cutaneous melanoma is the deadliest skin cancer, with an increasing incidence and mortality rate. Currently, staging of patients with primary melanoma is performed using histological biomarkers such as tumor thickness and ulceration. As disruption of the epigenomic landscape is recognized as a widespread feature inherent in tumor development and progression, we aimed to identify novel biomarkers providing additional clinical information over current factors using unbiased genome-wide DNA methylation analyses. We performed a comprehensive DNA methylation analysis during all progression stages of melanoma using Infinium HumanMethylation450 BeadChips on a discovery cohort of benign nevi (n = 14) and malignant melanoma from both primary (n = 33) and metastatic (n = 28) sites, integrating the DNA methylome with gene expression data. We validated the discovered biomarkers in three independent validation cohorts by pyrosequencing and immunohistochemistry. We identified and validated biomarkers for, and pathways involved in, melanoma development (e.g., HOXA9 DNA methylation) and tumor progression (e.g., TBC1D16 DNA methylation). In addition, we determined a prognostic signature with potential clinical applicability and validated PON3 DNA methylation and OVOL1 protein expression as biomarkers with prognostic information independent of tumor thickness and ulceration. Our data underscores the importance of epigenomic regulation in triggering metastatic dissemination through the inactivation of central cancer-related pathways. Inactivation of cell-adhesion and differentiation unleashes dissemination, and subsequent activation of inflammatory and immune system programs impairs anti-tumoral defense pathways. Moreover, we identify several markers of tumor development and progression previously unrelated to melanoma, and determined a prognostic signature with potential clinical utility.

  7. Secondary Cutaneous Diffuse Large B-cell Lymphoma has a Higher International Prognostic Index Score and Worse Prognosis Than Diffuse Large B-cell Lymphoma, Leg Type.

    Science.gov (United States)

    Lee, Woo Jin; Won, Kwang Hee; Won, Chong Hyun; Chang, Sung Eun; Choi, Jee Ho; Moon, Kee Chan; Park, Chan-Sik; Huh, Jooryung; Suh, Cheolwon; Lee, Mi Woo

    2016-02-01

    Diffuse large B-cell lymphoma (DLBCL) can be separated into 2 groups: nodal and extranodal disease. The aim of this study was to analyse the clinical features of skin lesions and survival outcomes of cutaneous DLBCL according to the primary tumour site. A total of 44 patients with cutaneous DLBCL were classified as primary cutaneous DLBCL, leg type or cutaneous DLBCL secondary to primary disease. Although skin lesion characteristics did not differ significantly between groups, extensive cutaneous lesions were more often observed in secondary cutaneous DLBCL compared with DLBCL, leg type. Secondary cutaneous DLBCL was more commonly associated with an advanced stage and higher International Prognostic Index score than DLBCL, leg type. DLBCL, leg type demonstrated a better survival outcome than secondary cutaneous DLBCL. The multiplicity of skin lesions and time-point of cutaneous involvement were associated with prognosis in secondary cutaneous DLBCL. Survival outcomes and prognostic factors differ depending on the primary tumour site of cutaneous DLBCL.

  8. The optimal cut-off value of the preoperative prognostic nutritional index for the survival differs according to the TNM stage in hepatocellular carcinoma.

    Science.gov (United States)

    Okamura, Yukiyasu; Sugiura, Teiichi; Ito, Takaaki; Yamamoto, Yusuke; Ashida, Ryo; Uesaka, Katsuhiko

    2017-08-01

    To establish the optimal cut-off value of the preoperative prognostic nutritional index (PNI) for prognosis according to the Tumor Node Metastasis (TNM) stage of hepatocellular carcinoma (HCC) after curative resection. This retrospective study reviewed the records of 375 patients. The optimal cut-off value of the PNI was established according to the TNM stage, and overall survival was compared between the low and high PNI groups. The optimal cut-off value of the PNI decreased with increasing TNM stage, with 52, 47, and 43 patients having stage I, II, and III HCC, respectively. A low preoperative PNI predicted a poorer overall survival than did a high PNI for stage I (P cut-off value for the PNI for prognosis differs among the TNM stages and that the preoperative PNI is a favorable prognostic factor for stage I HCC.

  9. Clinical characteristics, hospital outcome and prognostic factors of patients with ventilator-related pneumothorax.

    Science.gov (United States)

    Hsu, C-W; Sun, S-F; Lee, D L; Chu, K-A; Lin, H-S

    2014-01-01

    Mechanical ventilation is a common cause of iatrogenic pneumothorax in intensive care units (ICU). Most of the patients with ventilator-related pneumothorax (VRP) have underlying lung diseases and is associated with increased morbidity and mortality. The prognostic factors of VRP are not clear. The objective of this study was to find the possible prognostic factors. Analysis of retrospectively collected data of patients with pneumothorax induced by mechanical ventilation. Data were obtained concerning demographics, acute physiology and chronic health evaluation (APACHE) II score, organ failure, underlying diseases, interval between the start of mechanical ventilation and pneumothorax, arterial blood gas, respiratory parameters and patient outcomes. One hundred and twenty-four patients with VRP were included for analysis. The incidence rate of VRP was 0.4% (124/31,660), and the mortality rate was 77.4%. The patients with VRP had higher hospital mortality rate than that of mechanically ventilated patients without pneumothorax (77.4% vs. 13.7%, PVRP occurred in the early phase of mechanical ventilation, and 8.9% of the patients had a later episode of pneumothorax on the opposite lung. The interval between two episodes of VRP was short, at a median time of 2 days. Cox regression analysis showed that tension pneumothorax (P=0.001), PaO2/FiO2VRP patients with tension pneumothorax or PaO2/FiO2VRP patients with PaO2/FiO2≥200 mmHg.

  10. Recipient Related Prognostic Factors for Graft Survival after Kidney Transplantation. A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Alina Daciana ELEC

    2012-09-01

    Full Text Available Background and Aim. Advanced chronic kidney disease (CKD severely impairs life expectancy and quality of life in affected patients. Considering its benefits, renal transplantation currently represents the optimal treatment solution for end stage kidney disease patients. Pre-transplant assessment aims to maximize the graft and patient survival by identifying potential factors influencing the post-transplant outcome. The aim of this study has been to analyze recipient related prognostic factors bearing an impact on graft survival. Material and Methods. We analyzed the graft outcomes of 426 renal transplantations performed at the Clinical Institute of Urology and Renal Transplantation of Cluj-Napoca, between January 2004 and December 2008. Variables related to recipient and to potential donor/recipient prognostic factors were studied using univariate and multivariate analysis. Results. Graft survivals at 1, 3, 5 and 7 years were 94.01%, 88.37%, 82.51% and 78.10%, respectively. Chronic rejection (41.11% and death with a functioning graft (18.88% were the main causes of graft loss. In uni and multivariate analysis the recipient related variables found to influence the renal graft outcome were: peritoneal dialysis, pre transplant residual diuresis, grade I hypertension, severe iliac vessel atheromatosis, ischemic heart disease, stroke history, dyslipidemia and denutrition. The worst graft outcomes have been found for recipients on peritoneal dialysis, with anuria, hypotension, severe iliac atheromatosis, ischemic heart disease, stroke history, dyslipidemia and a poor nutritional status. Conclusion. The type of dialysis, the pre transplant residual diuresis, recipient arterial blood pressure, iliac vessel atheromatosis, ischemic heart disease, stroke history, dyslipidemia and denutrition significantly influence graft survival.

  11. A prognostic factor index for overall survival in patients receiving first-line chemotherapy for HER2-negative advanced breast cancer: an analysis of the ATHENA trial.

    Science.gov (United States)

    Llombart-Cussac, Antonio; Pivot, Xavier; Biganzoli, Laura; Cortes-Funes, Hernan; Pritchard, Kathleen I; Pierga, Jean-Yves; Smith, Ian; Thomssen, Christoph; Srock, Stefanie; Sampayo, Miguel; Cortes, Javier

    2014-10-01

    Evidence-based definitions of 'poor-prognosis' or 'aggressive' advanced breast cancer are lacking. We developed a prognostic factor index using data from 2203 patients treated with first-line chemotherapy plus bevacizumab for HER2-negative advanced breast cancer. The risk factors most closely associated with worse OS were: disease-free interval ≤24 months; liver metastases or ≥3 involved organ sites; prior anthracycline and/or taxane therapy; triple-negative breast cancer (TNBC); and performance status 2 or prior analgesic/corticosteroid treatment. Risk of death was increased threefold in patients with ≥3 versus ≤1 risk factors (hazard ratio 3.0 [95% CI 2.6-3.4; p < 0.001]; median 16.0 vs 38.8 months, respectively). This prognostic index may enable identification of patients with a poorer prognosis in whom more intensive systemic regimens may be appropriate. The index may also be considered in designing new trials, although it requires validation in other datasets before extrapolation to non-bevacizumab-containing therapy. ClinicalTrials.gov identifier: NCT00448591. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Prognostic value of the bone scan index using a computer-aided diagnosis system for bone scans in hormone-naive prostate cancer patients with bone metastases.

    Science.gov (United States)

    Miyoshi, Yasuhide; Yoneyama, Shuko; Kawahara, Takashi; Hattori, Yusuke; Teranishi, Jun-ichi; Kondo, Keiichi; Moriyama, Masatoshi; Takebayashi, Shigeo; Yokomizo, Yumiko; Yao, Masahiro; Uemura, Hiroji; Noguchi, Kazumi

    2016-02-19

    The bone scan index (BSI) using a computer-aided diagnosis system for bone scans is expected to be an objective and quantitative clinical tool for evaluating bone metastatic prostate cancer. This study aimed to evaluate the pretreatment BSI as a prognostic factor in hormone-naive prostate cancer patients with bone metastases. The study included 60 patients with hormone-naive, bone metastatic prostate cancer that was initially treated with combined androgen blockade therapy. The BONENAVI system was used for calculating the BSI. We evaluated the correlation between overall survival (OS) and pretreatment clinicopathological characteristics, including patients' age, initial prostate-specific antigen (PSA) value, Gleason scores, clinical TNM stage, and the BSI. Cox proportional hazards regression models were used for statistical analysis. The median follow-up duration was 21.4 months. Clinical or PSA progression occurred in 37 (61.7%) patients and 18 (30.0%) received docetaxel. Death occurred in 16 (26.7%) patients. Of these deaths, 15 (25.0%) were due to prostate cancer. The median OS was not reached. In multivariate analysis, age and the BSI were independent prognostic factors for OS. We evaluated the discriminatory ability of our models, including or excluding BSI by quantifying the C-index. The BSI improved the C-index from 0.751 to 0.801 for OS. Median OS was not reached in patients with a BSI ≤ 1.9 and median OS was 34.8 months in patients with a BSI >1.9 (p = 0.039). The pretreatment BSI and patients' age are independent prognostic factors for patients with hormone-naive, bone metastatic prostate cancer.

  13. Denotational World-indexed Logical Relations and Friends

    DEFF Research Database (Denmark)

    Thamsborg, Jacob Junker

    and solve the fundamental type-worlds circularity by metric-space theory. This approach scales to state-of-theart step-indexed techniques and permits unrestricted relational reasoning by the use of so-called Bohr relations. Along the way, we develop auxiliary theory; most notably a generalized version...

  14. Relative Greenness Index for assessing curing of grassland fuel

    NARCIS (Netherlands)

    Newnham, G.J.; Verbesselt, J.; Grant, I.F.; Anderson, S.A.J.

    2011-01-01

    Knowledge of the proportion of live and dead herbaceous fuel in grasslands is important in determining fire danger. This paper examines the Relative Greenness approach for quantifying these live and dead proportions. Relative Greenness places the Normalized Difference Vegetation Index (NDVI) in the

  15. Prognostic factors related to sequelae in childhood bacterial meningitis: Data from a Greek meningitis registry

    Directory of Open Access Journals (Sweden)

    Vasilopoulou Vasiliki A

    2011-08-01

    Full Text Available Abstract Background Bacterial meningitis (BM is a life-threatening disease, often related with serious complications and sequelae. Infants and children who survive bacterial meningitis often suffer neurological and other sequelae. Methods A total of 2,477 patients aged 1 month to 14 years old hospitalized in a Children's Hospital in Greece diagnosed with acute bacterial meningitis were collected through a Meningitis Registry, from 1974 to 2005. Clinical, laboratory and other parameters (sex, age, pathogen, duration of symptoms before and after admission were evaluated through univariate and multivariate analysis with regard to sequelae. Analysis of acute complications were also studied but not included in the final model. Results The rate of acute complications (arthritis and/or subdural effusion was estimated at 6.8% (152 out of 2,251 patients, 95%CI 5.8-7.9 while the rate of sequelae (severe hearing loss, ventriculitis, hydrocephalus or seizure disorder among survivors was estimated at 3.3% (73 out of 2,207 patients, 95%CI 2.6-4.2. Risk factors on admission associated with sequelae included seizures, absence of hemorrhagic rash, low CSF glucose, high CSF protein and the etiology of meningitis. A combination of significant prognostic factors including presence of seizures, low CSF glucose, high CSF protein, positive blood culture and absence of petechiae on admission presented an absolute risk of sequelae of 41.7% (95%CI 15.2-72.3. Conclusions A combination of prognostic factors of sequelae in childhood BM may be of value in selecting patients for more intensive therapy and in identifying possible candidates for new treatment strategies.

  16. Comparison of the prognostic value of liver biopsy and FIB-4 index in patients coinfected with HIV and hepatitis C virus.

    Science.gov (United States)

    Berenguer, Juan; Zamora, Francisco X; Aldámiz-Echevarría, Teresa; Von Wichmann, Miguel A; Crespo, Manel; López-Aldeguer, José; Carrero, Ana; Montes, Marisa; Quereda, Carmen; Téllez, María J; Galindo, María J; Sanz, José; Santos, Ignacio; Guardiola, Josep M; Barros, Carlos; Ortega, Enrique; Pulido, Federico; Rubio, Rafael; Mallolas, Josep; Tural, Cristina; Jusdado, Juan J; Pérez, Gloria; Díez, Cristina; Álvarez-Pellicer, Julio; Esteban, Herminia; Bellón, José M; González-García, Juan

    2015-03-15

    We compared the prognostic value of liver biopsy (LB) and FIB-4 index in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection. We studied patients from the Grupo de Estudio del SIDA 3603 study cohort, in whom fibrosis was evaluated at baseline using both LB (Metavir score) and FIB-4 index. We assessed overall death (OD) and liver-related events (LREs), defined as decompensation or hepatocellular carcinoma, whichever occurred first. We used receiver operating characteristic (ROC) curves to determine the ability of LB and FIB-4 to predict outcomes. We also assessed the association between advanced fibrosis-LB (F3 or greater) or FIB-4 (≥3.25)-and outcomes using multivariate Cox regression analysis. The study sample comprised 903 patients (328 with sustained virologic response [SVR]). Baseline fibrosis by LB was as follows: F0, n = 71; F1, n = 242; F2, n = 236; F3, n = 236; F4, n = 118. Fibrosis by FIB-4 was as follows: ≤1, n = 148; >1 to <3.25, n = 597; ≥3.25, n = 158. After a median follow-up of 62 months, there were 46 deaths and 71 LREs. The area under the ROC curves for OD/LREs was 0.648 and 0.742 for LB and FIB-4, respectively (P = .006). Similar results were found for patients without SVR and for OD and LREs separately. The adjusted hazard ratios of OD or LRE were 1.740 (95% confidence interval [CI], 1.119-2.7.06; P = .014) for advanced fibrosis assessed by LB and 3.896 (95% CI, 2.463-6.160; P < .001) assessed by FIB-4. FIB-4 outperformed LB as a predictor of OD and LRE. These findings are of relevance for clinical practice and research and call into question the role of LB as a gold standard for assessing prognosis in HIV/HCV coinfection. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. The prognostic influence of body mass index, resting energy expenditure and fasting blood glucose on postoperative patients with esophageal cancer.

    Science.gov (United States)

    Wu, Ning; Zhu, Yongjun; Kadel, Dhruba; Pang, Liewen; Chen, Gang; Chen, Zhiming

    2016-12-21

    Body mass index (BMI), resting energy expenditure (REE) and fasting blood glucose (FBG) are major preoperative assessments of patients' nutrition and metabolic state. The relations and effects of these indices on esophageal cancer patients' postoperative short-term and long-term outcomes remain controversial and unclear. We aimed to study the impact of BMI, REE and FBG in esophageal cancer patients undergoing esophagectomy. Three hundred and six esophageal cancer patients who underwent esophagectomy were observed retrospectively. Clinical characteristics, postoperative complications and survival analysis were compared among different BMI, REE and FBG groups. There were significant linear relationships between REE, BMI and FBG indices, patients with low BMI tended to have low REE (p cancer undergoing esophagectomy and preoperative evaluation of these indices help to determine the prognosis in these patients.

  18. Prognostic factors and visual outcome for fireworks-related burns during spring festival in South China.

    Science.gov (United States)

    Lin, Ying; Liang, Xuanwei; Liu, Xialin; Qu, Bo; Ni, Yao; Jiang, Shuhong; Liu, Yizhi

    2012-01-01

    The aim of this study was to evaluate the clinical features and the visual results of fireworks-related ocular burn injuries and to determine the prognostic factors. The authors conducted a prospective observational study of 53 eyes of 46 consecutive patients with fireworks-related ocular injury who visited Zhongshan Ophthalmic Center during the Spring Festival in Southern China. Eyes were graded using an ocular trauma classification system, which included age of the patient. Patients were followed up for a minimum of 5 months. Best-corrected visual acuity at the last follow-up was considered the final visual outcome. Data were analyzed with SPSS version 13.0 (SPSS, Inc., Chicago, IL). Results of statistical tests were considered statistically significant for P ocular injuries, 23 patients (50.0%) also had eyelid and/or facial burns. The most common initial anterior segment injuries were open-globe injuries (42, 79.3%), conjunctival burns (16, 30.2%), and foreign bodies (18, 34.0%). Others were traumatic cataract, lens subluxation and dislocation, and vitreous hemorrhage. Management after first aid included pars plana vitrectomy (9, 17.0%), aspiration of cataract (18, 34.0%), retinal reattachment (8, 15.1%), and enucleation. Amniotic membrane grafts were used in 11 patients (20.8%) with serious conjunctiva burns and corneal contusions and abrasions who were thought to have a good prognosis. Fireworks-related ocular injuries included a variety of clinical manifestations. Examinations such as B scan, optical coherence tomography, and ultrasound biomicroscopy helped to make a correct diagnosis and plan further treatment. Fireworks-related ocular injuries commonly affect young male subjects of Southern China. Visual outcomes were frequently poor and visually devastating. Laws should be passed to forbid the personal use of fireworks in China, and public education on the sale and use of fireworks should be increased.

  19. Diet compounds, glycemic index and obesity-related cardiac effects.

    Science.gov (United States)

    Diniz, Yeda S; Burneiko, Regina M; Seiva, Fabio R F; Almeida, Flávia Q A; Galhardi, Cristiano Machado; Filho, José Luiz V B Novelli; Mani, Fernanda; Novelli, Ethel L B

    2008-02-20

    Diet compounds may influence obesity-related cardiac oxidative stress and metabolic sifting. Carbohydrate-rich diet may be disadvantageous from fat-rich diet to cardiac tissue and glycemic index rather than lipid profile may predict the obesity-related cardiac effects. Male Wistar rats were divided into three groups (n=8/group): (C) receiving standard chow (3.0 kcal/g); (CRD) receiving carbohydrate-rich diet (4.0 kcal/g), and (FRD) receiving fat-rich diet (4.0 kcal/g). Rats were sacrificed after the oral glucose tolerance test (OGTT) at 60 days of dietary treatments. Lipid profile and oxidative stress parameters were determined in serum. Myocardial samples were used to determine oxidative stress, metabolic enzymes, glycogen and triacylglycerol. FRD rats showed higher final body weight and body mass index than CRD and C. Serum cholesterol and low-density lipoprotein were higher in FRD than in CRD, while triacylglycerol and oxidized low-density lipoprotein cholesterol were higher in CRD than in FRD. CRD rats had the highest myocardial lipid hydroperoxide and diminished superoxide dismutase and catalase activities. Myocardial glycogen was lower and triacylglycerol was higher in CRD than in C and FRD rats. Although FRD rats had depressed myocardial-reducing power, no significant changes were observed in myocardial energy metabolism. Myocardial beta-hydroxyacyl coenzyme-A dehydrogenase and citrate synthase, as well as the enhanced lactate dehydrogenase/citrate synthase ratio indicated that fatty acid degradation was decreased in CRD rats. Glycemic index was positively correlated with obesity-related cardiac effects. Isoenergetic carbohydrate-rich and fat-rich diets induced different degree of obesity and differently affected lipid profile. Carbohydrate-rich diet was deleterious relative to fat-rich diet in the heart enhancing lipoperoxidation and shifting the metabolic pathway for energy production. Glycemic index rather than dyslipidemic profile may predict the obesity

  20. A prognostic model of therapy-related myelodysplastic syndrome for predicting survival and transformation to acute myeloid leukemia.

    Science.gov (United States)

    Quintás-Cardama, Alfonso; Daver, Naval; Kim, Hawk; Dinardo, Courtney; Jabbour, Elias; Kadia, Tapan; Borthakur, Gautam; Pierce, Sherry; Shan, Jianqin; Cardenas-Turanzas, Marylou; Cortes, Jorge; Ravandi, Farhad; Wierda, William; Estrov, Zeev; Faderl, Stefan; Wei, Yue; Kantarjian, Hagop; Garcia-Manero, Guillermo

    2014-10-01

    We evaluated the characteristics of a cohort of patients with myelodysplastic syndrome (MDS) related to therapy (t-MDS) to create a prognostic model. We identified 281 patients with MDS who had received previous chemotherapy and/or radiotherapy for previous malignancy. Potential prognostic factors were determined using univariate and multivariate analyses. Multivariate Cox regression analysis identified 7 factors that independently predicted short survival in t-MDS: age ≥ 65 years (hazard ratio [HR], 1.63), Eastern Cooperative Oncology Group performance status 2-4 (HR, 1.86), poor cytogenetics (-7 and/or complex; HR, 2.47), World Health Organization MDS subtype (RARs or RAEB-1/2; HR, 1.92), hemoglobin (HR, 2.24), platelets (HR, 2.01), and transfusion dependency (HR, 1.59). These risk factors were used to create a prognostic model that segregated patients into 3 groups with distinct median overall survival: good (0-2 risk factors; 34 months), intermediate (3-4 risk factors; 12 months), and poor (5-7 risk factors; 5 months) (P < .001) and 1-year leukemia-free survival (96%, 84%, and 72%, respectively, P = .003). This model also identified distinct survival groups according to t-MDS therapy. In summary, we devised a prognostic model specifically for patients with t-MDS that predicted overall survival and leukemia-free survival. This model might facilitate the development of risk-adapted therapeutic strategies. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. The art versus science of predicting prognosis: can a prognostic index predict short-term mortality better than experienced nurses do?

    Science.gov (United States)

    Casarett, David J; Farrington, Sue; Craig, Teresa; Slattery, Julie; Harrold, Joan; Oldanie, Betty; Roy, Jason; Biehl, Richard; Teno, Joan

    2012-06-01

    To determine whether a prognostic index could predict one-week mortality more accurately than hospice nurses can. An electronic health record-based retrospective cohort study of 21,074 hospice patients was conducted in three hospice programs in the Southeast, Northeast, and Midwest United States. Model development used logistic regression with bootstrapped confidence intervals and multiple imputation to account for missing data. The main outcome measure was mortality within 7 days of hospice enrollment. A total of 21,074 patients were admitted to hospice between October 1, 2008 and May 31, 2011, and 5562 (26.4%) died within 7 days. An optimal predictive model included the Palliative Performance Scale (PPS) score, admission from a hospital, and gender. The model had a c-statistic of 0.86 in the training sample and 0.84 in the validation sample, which was greater than that of nurses' predictions (0.72). The index's performance was best for patients with pulmonary disease (0.89) and worst for patients with cancer and dementia (both 0.80). The index's predictions of mortality rates in each index category were within 5.0% of actual rates, whereas nurses underestimated mortality by up to 18.9%. Using the optimal index threshold (<3), the index's predictions had a better c-statistic (0.78 versus 0.72) and higher sensitivity (74.4% versus 47.8%) than did nurses' predictions but a lower specificity (80.6% versus 95.1%). Although nurses can often identify patients who will die within 7 days, a simple model based on available clinical information offers improved accuracy and could help to identify those patients who are at high risk for short-term mortality.

  2. Prognostic factors in patients with hepatitis B-related primary liver cancer treated with transcatheter arterial chemoembolization

    Directory of Open Access Journals (Sweden)

    YIN Hao

    2014-01-01

    Full Text Available ObjectiveTo analyze the prognostic factors in patients with hepatitis B-related primary liver cancer treated with transcatheter arterial chemoembolization (TACE and to provide a basis for properly selecting indications and treatment regimen in clinical practice. MethodsA total of 140 patients with hepatitis B-related primary liver cancer, who underwent TACE in our hospital from January to December 2010, were enrolled in this study. Follow-up was continued until December 2011 to observe the patients′ survival within 12 months after treatment. The Kaplan-Meier method and log-rank (Mantel-Cox test were used for univariate and multivariate analyses to identify the prognostic factors in patients with hepatitis B-related primary liver cancer treated with TACE. ResultsThe univariate analysis showed that age, portal vein metastasis, peritoneal metastasis, pleural metastasis, Child-Pugh classification, bilirubin, alanine aminotransferase, number of interventional therapies, and antiviral therapy were prognostic factors in patients with hepatitis B-related primary liver cancer treated with TACE. There was significant difference in 12-month survival curve between patients treated with TACE plus antiviral therapy and those who did not receive antiviral therapy (P<0.05. The multivariate analysis showed that portal vein metastasis (P=0.004, peritoneal metastasis (P=0.009, bilirubin level (P=0.017, antiviral therapy (P=0.000, and number of TACE therapies (P=0.000 were prognostic factors in patients with hepatitis B-related primary liver cancer treated with TACE. ConclusionPortal vein metastasis, peritoneal metastasis, and bilirubin level may be independent risk factors in patients with hepatitis B-related primary liver cancer treated with TACE, and antiviral therapy and number of interventional therapies may be protective factors for these patients.

  3. Modification of Simplified Pulmonary Embolism Severity Index and its Prognostic Value in Patients with Acute Pulmonary Embolism.

    Science.gov (United States)

    Ostovan, Mohammad Ali; Ghaffari, Samad; Pourafkari, Leili; Dehghani, Pooyan; Hajizadeh, Reza; Nadiri, Mehdi; Ghaffari, Mohammad Reza

    2016-02-01

    Various risk stratification systems have been used to predict the clinical outcome of patients with pulmonary embolism (PE). In this study we present a modification of the simplified Pulmonary Embolism Severity Index (S-PESI) score and evaluate its accuracy in predicting the outcome of these patients. Patients older than 18 years with documented PE were enrolled in this study. S-PESI was calculated in all patients. We added electrocardiographic evidence of right ventricular strain as a new criteria and replaced the O2 saturation of <90% in S-PESI score with PaO2 /PaCO2 ratio obtained from the arterial blood gas analysis as two newly modified criteria to define a modified form of S-PESI system (modified s-PESI). Patients were followed for about one year in outpatient clinics. Any deaths attributable to PE or for unknown reasons were considered as PE related. We defined Major Adverse Cardio-Pulmonary Events (MACPE) as sum of one-year mortality, need for thrombolysis and mechanical ventilation during index hospitalisation. Among 300 enrolled patients, in-hospital mortality occurred in 38 (12.7%) and one-year mortality in 73 (24.3%) patients. Considering a cut-off point of 3, modified s-PESI score had a lower sensitivity (49.3% vs. 89%) and higher specificity (79.4% vs. 37.7%) than S-PESI to predict one-year mortality. Area Under Curve (AUC) to predict MACPE was significantly higher for modified s-PESI (0.692 vs 0.730, P=0.012). The modified s-PESI is superior to S-PESI in predicting one-year outcome in patients with PE and can be used for more accurate risk stratification of these patients. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  4. Prognostic Significance of Bcl-2 and p53 Protein Expressions and Ki67 Proliferative Index in Diffuse Large B-cell Lymphoma

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    Betül Bolat Küçükzeybek

    2013-09-01

    Full Text Available Objective: Diffuse large B-cell lymphoma (DLBCL is a high-grade neoplasm that has heterogeneous properties in clinical, morphological, and immunophenotypic aspects. In the present study the effects of p53, Bcl-2, and Ki67 on prognosis and their relationships with clinical parameters were examined. Materials and Methods: Thirty-five patients who had been diagnosed with nodally located DLBCL at İzmir Atatürk Training and Research Hospital between January 1999 and June 2006 were included in the study. The Ann Arbor classification system was used to determine the stage of the patients. The patients were evaluated according to age, sex, stage, B symptoms, extranodal involvement, and lactate dehydrogenase (LDH level as well as immunohistochemically. P53 protein and Bcl-2 oncoprotein expressions and Ki67 proliferation index were assessed immunohistochemically. Results: High Bcl-2 expression was found in 9 patients (25.7%, high p53 expression was found in 10 patients (28.6%, and high Ki67 was observed in 23 patients (65.7%. There was no significant correlation between p53 expression, Bcl-2 expression, or Ki67 proliferation index and age, sex, stage, B symptoms, extranodal involvement, LDH level, and overall survival (p>0.05. We did not find a relationship among p53 expression, Bcl-2 expression, Ki67 proliferation index, and prognosis (p>0.05. There was no significant relationship between overall survival and age, sex, stage, B symptoms, extranodal involvement, or LDH level (p>0.05. Our results revealed that Bcl-2 and p53 protein expressions and Ki67 proliferation index have no effect on overall survival of patients with DLBCL. Conclusion: The prognostic importance of p53 and Bcl-2 protein expressions and Ki67 proliferation index in DLBCL, which has biological and clinical heterogeneity, can be understood in a large series of studies that have subclasses and immunohistochemical markers with optimal cut-off values.

  5. Dialysate bacterial endotoxin as a prognostic indicator of peritoneal dialysis related peritonitis.

    Science.gov (United States)

    Szeto, Cheuk-Chun; Lai, Ka-Bik; Chow, Kai-Ming; Kwan, Bonnie Ching-Ha; Law, Man-Ching; Pang, Wing-Fai; Ma, Terry King-Wing; Leung, Chi-Bon; Li, Philip Kam-Tao

    2016-12-01

    Peritonitis is the major complication of peritoneal dialysis (PD). The aim of our present study is to explore the prognostic value of endotoxin level in PD effluent for the prediction of treatment failure in PD-related peritonitis. We studied 325 peritonitis episodes in 223 patients. PD effluent (PDE) was collected every 5 days for endotoxin level and leukocyte count. Patients were followed for relapsing or recurrent peritonitis. We found 20 episodes (6.2%) had primary treatment failure; 41 (12.6%) developed relapsing, 19 (5.8%) had recurrent, and 22 (6.8%) had repeat episodes. Endotoxin was detectable in the PDE of 19 episodes (24.4%) caused by Gram negative organisms, 4 episodes (6.8%) of mixed bacterial growth, and none of the culture negative episodes or those by Gram positive organisms. For episodes caused by Gram negative bacteria, a detectable endotoxin level in PDE on day 5 had a sensitivity and specificity of 66.7% and 83.3%, respectively, for predicting primary treatment failure. In contrast, PDE leukocyte count > 1000 per mm3 on day 5 had a sensitivity and specificity of 88.9% and 89.1%, respectively; the addition of PDE endotoxin assay did not improve the sensitivity or specificity. We conclude that detectable endotoxin in PDE 5 days after antibiotic therapy might predict primary treatment failure in peritonitis episodes caused by Gram negative organisms. However, the sensitivity and specificity of PDE endotoxin assay was inferior to PDE leukocyte count. © 2016 Asian Pacific Society of Nephrology.

  6. Factor Structure of the Rorschach Prognostic Rating Scale and Its Relation to Therapeutic Outcome

    Science.gov (United States)

    Auerbach, Stephen M.; Edinger, Jack D.

    1976-01-01

    This study evaluated the factor structure of the Rorschach Prognostic Rating Scale (RPRS) in order to: (a) test the assumption that the RPRS represents a unitary response system and (b) determine the efficacy of employing population specific factor scores as predictors of therapy outcome. (Author/NG)

  7. Glasgow outcome scale at hospital discharge as a prognostic index in patients with severe traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Rosmari A.R.A. Oliveira

    2012-08-01

    Full Text Available OBJECTIVE: Evaluate the Glasgow outcome scale (GOS at discharge (GOS-HD as a prognostic indicator in patients with traumatic brain injury (TBI. METHOD: Retrospective data were collected of 45 patients, with Glasgow coma scale <8, age 25±10 years, 36 men, from medical records. Later, at home visit, two measures were scored: GOS-HD (according to information from family members and GOS LATE (12 months after TBI. RESULTS: At discharge, the ERG showed: vegetative state (VS in 2 (4%, severe disability (SD in 27 (60%, moderate disability (MD in 15 (33% and good recovery (GR in 1 (2%. After 12 months: death in 5 (11%, VS in 1 (2%, SD in 7 (16%, MD in 9 (20% and GR in 23 (51%. Variables associated with poor outcome were: worse GOS-HD (p=0.03, neurosurgical procedures (p=0.008 and the kind of brain injury (p=0.009. CONCLUSION: The GOS-HD was indicator of prognosis in patients with severe TBI.

  8. The prognostic value of tip-to-apex distance (TAD index in intertrochanteric fractures fixed by dynamic hip screw

    Directory of Open Access Journals (Sweden)

    Ali Sadighi

    2012-11-01

    Full Text Available Intertrochanteric fractures (ITFs are the most common type of fractures requiring surgical intervention. They also have the highest surgical mortality among orthopedic operations. Among the many different techniques used for fixation of this type of fracture, use of the Dynamic Hip Screw (DHS has gained wide acceptance. This current study was designed to assess positive predictive value of tip-to-apex distance (TAD index in the prognosis of patients treated with DHS. The study was designed according to a descriptive-analytic protocol, made up of 100 cases of ITFs caused by falling, treated in the Shohada Orthopedic Center, Tabriz, Iran. All patients underwent lateral and antero-posterior hip X-ray to measure TAD index. The cohort was followed for three months after DHS placement. Of a total of 100 cases (53 male, 47 female with a mean age of 76.7 years (range 29-100 years, 43% had grade 4, 29% grade 3, 21% grade 5, 5% grade 2 and 2% grade 6 osteoporosis. The screw position was postero-inferior in 57%, central in 40% and superior in 3% of patients. Minimum and maximum TAD index were 20 and 28 mm, respectively. Mean TAD was 23.5 mm. There were no post-operative complications in 84% of cases. Screw failure was the most common complication in the remaining 16% of patients. The study shows a statistically significant correlation between TAD index and cut-off rate in patients with intertrochanteric fractures of femoral bone treated by DHS. This validates the use of TAD index in determining the prognosis of patients treated by DHS.

  9. Using prognostic models in CLL to personalize approach to clinical care: Are we there yet?

    Science.gov (United States)

    Mina, Alain; Sandoval Sus, Jose; Sleiman, Elsa; Pinilla-Ibarz, Javier; Awan, Farrukh T; Kharfan-Dabaja, Mohamed A

    2017-10-28

    Four decades ago, two staging systems were developed to help stratify CLL into different prognostic categories. These systems, the Rai and the Binet staging, depended entirely on abnormal exam findings and evidence of anemia and thrombocytopenia. Better understanding of biologic, genetic, and molecular characteristics of CLL have contributed to better appreciating its clinical heterogeneity. New prognostic models, the GCLLSG prognostic index and the CLL-IPI, emerged. They incorporate biologic and genetic information related to CLL and are capable of predicting survival outcomes and cases anticipated to need therapy earlier in the disease course. Accordingly, these newer models are helping develop better informed surveillance strategies and ultimately tailor treatment intensity according to presence (or lack thereof) of certain prognostic markers. This represents a step towards personalizing care of CLL patients. We anticipate that as more prognostic factors continue to be identified, the GCLLSG prognostic index and CLL-IPI models will undergo further revisions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Role of bispectral index monitoring and burst suppression in prognostication following out-of-hospital cardiac arrest: a systematic review protocol.

    Science.gov (United States)

    Eveson, Leanne; Vizcaychipi, Marcela; Patil, Shashank

    2017-09-25

    Out-of-hospital cardiac arrest (OHCA) is associated with significant mortality or may have a poor neurological outcome. Various community-training programmes have improved practices like bystander cardiopulmonary resuscitation (CPR) and early defibrillation using automated external defibrillator (AED). Post-resuscitation care has also changed significantly in the millennium. Interventions like targeted temperature management (TTM), avoidance of hyperoxia and emergency cardiac catheterisation have given patients a chance of a better neurological outcome. Despite these timely interventions, it is still very difficult to predict neurological outcome. The European Resuscitation Council and European Society of Intensive Care Medicine (ERC-ESICM) published guidance in 2015 with a strong recommendation to delay prognostication for at least 72 h and with an emphasis to adapt a multimodal approach, which includes neurological examination, biomarkers, electroencephalogram (EEG) and radiological tests. These interventions not only have cost attached to them, but the unpredictability has a significant emotional impact on family members. Bispectral index (BIS) monitoring device acts on the principle of EEG and converts the waveform into an absolute number and also measures the burst suppression. We hypothesize that patients who have a low BIS value and high burst suppression within 24 h of presentation will have a poor neurological outcome. The primary objective of this review is to look at BIS monitor as a tool, which could help bring forward the timing of prognostication. Electronic databases will be systematically searched for randomised controlled trials and prospective or retrospective cohort studies with no language restrictions. The search will be supplemented with grey literature searches of thesis, dissertations and hand searching of relevant journals. Two independent reviewers will screen, select and perform analysis according to the Preferred Reporting Items for

  11. Population-based study of breast cancer in older women: prognostic factors of relative survival and predictors of treatment

    Directory of Open Access Journals (Sweden)

    Dialla Pegdwende

    2012-10-01

    Full Text Available Abstract Background A large proportion of women with breast cancer (BC are elderly. However, there is a lack of information regarding BC prognostic factors and care in this population. The aims of this study were to assess the prognostic factors of relative survival (RS among women with BC aged ≥ 75 years old and to identify the predictive factors of treatments administered to this population. Methods A population-based study was performed using data from the Cote d’Or breast and gynaecological cancer registry. Women aged 75 years and older with primary invasive BC and resident in Cote d’Or at the time of diagnosis made between January 1998 and December 2008 were retrospectively selected. Prognostic factors of RS were estimated in a generalized linear model with a Poisson error structure. RS rate for the whole population was given at 5 years. Logistic regression models were used to identify the predictors of the treatments administered. Results Six hundred and eighty-one women were included. Median age at diagnosis was 80. Comorbidities (p=0.02, pT stage (p=0.04, metastases (p= Conclusions Comorbid conditions adversely affect survival in older women with breast cancer. Moreover the results of this study showed that there are numerous predictors of the type of treatment administered, and that the most important were age and comorbidities.

  12. Increasing Body Mass Index Is Inversely Related to Groin Hernias.

    Science.gov (United States)

    Ravanbakhsh, Samine; Batech, Michael; Tejirian, Talar

    2015-10-01

    Few studies describe the relationship between obesity and groin hernias. Our objective was to investigate the correlation between body mass index (BMI) and groin hernias in a large population. Patients with the diagnosis of inguinal or femoral hernia with and without incarceration or strangulation were identified using the Kaiser Permanente Southern California regional database including 14 hospitals over a 7-year period. Patients were stratified by BMI. There were 47,950 patients with a diagnosis of a groin hernia--a prevalence of 2.28 per cent. Relative to normal BMI (20-24.9 kg/m(2)), lower BMI was associated with an increased risk for hernia diagnosis. With increasing BMI, the risk of incarceration or strangulation increased. Additionally, increasing age, male gender, white race, history of hernia, tobacco use history, alcohol use, and higher comorbidity index increased the chance of a groin hernia diagnosis. Complications were higher for women, patients with comorbidities, black race, and alcohol users. Our study is the largest to date correlating obesity and groin hernias in a diverse United States population. Obesity (BMI ≥ 30 kg/m(2)) is associated with a lower risk of groin hernia diagnosis, but an increased risk of complications. This inverse relationship may be due to limitations of physical exam in obese patients.

  13. Indian monsoon variability in relation to Regional Pressure Index

    Indian Academy of Sciences (India)

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

    Indian Institute of Tropical Meteorology, Pune 411 008, India. In this paper Regional Pressure Index (RPI) over the Indian region (20◦N–40◦N and ... zonal index cycle in Northern Hemisphere (NH) and Southern Hemisphere (SH). But in spite of these zonal indices the Regional Pressure Index. (RPI) may play quite a ...

  14. Diagnostic and prognostic values of the V-index, a novel ECG marker quantifying spatial heterogeneity of ventricular repolarization, in patients with symptoms suggestive of non-ST-elevation myocardial infarction.

    Science.gov (United States)

    Abächerli, Roger; Twerenbold, Raphael; Boeddinghaus, Jasper; Nestelberger, Thomas; Mächler, Patrick; Sassi, Roberto; Rivolta, Massimo W; Roonizi, Ebadollah Kheirati; Mainardi, Luca T; Kozhuharov, Nikola; Rubini Giménez, Maria; Wildi, Karin; Grimm, Karin; Sabti, Zaid; Hillinger, Petra; Puelacher, Christian; Strebel, Ivo; Cupa, Janosch; Badertscher, Patrick; Roux, Isabelle; Schmid, Ramun; Leber, Remo; Osswald, Stefan; Mueller, Christian; Reichlin, Tobias

    2017-06-01

    The V-index is an ECG marker quantifying spatial heterogeneity of ventricular repolarization. We prospectively assessed the diagnostic and prognostic values of the V-index in patients with suspected non-ST-elevation myocardial infarction (NSTEMI). We prospectively enrolled 497 patients presenting with suspected NSTEMI to the emergency department (ED). Digital 12-lead ECGs of five-minute duration were recorded at presentation. The V-index was automatically calculated in a blinded fashion. Patients with a QRS duration >120ms were ruled out from analysis. The final diagnosis was adjudicated by two independent cardiologists. The prognostic endpoint was all-cause mortality during 24months of follow-up. NSTEMI was the final diagnosis in 14% of patients. V-index levels were higher in patients with AMI compared to other causes of chest pain (median 23ms vs. 18ms, pV-index in addition to conventional ECG-criteria improved the diagnostic accuracy for the diagnosis of NSTEMI as quantified by area under the ROC curve from 0.66 to 0.73 (p=0.001) and the sensitivity of the ECG for AMI from 41% to 86% (pV-index (pV-index remained an independent predictor of death. The V-index, an ECG marker quantifying spatial heterogeneity of ventricular repolarization, significantly improves the accuracy and sensitivity of the ECG for the diagnosis of NSTEMI and independently predicts mortality during follow-up. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. PROGNOSTIC VALUE OF THE BASELINE VALUES OF SERUM TESTOSTERONE AND FREE ANDROGEN INDEX IN PATIENTS WITH PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    M. E. Grigoryev

    2012-01-01

    Full Text Available The growing incidence of prostate cancer (PC and its variable nature are an important problem today. PC is distinguished by its latent ability in many cases, which makes its screening difficult.Prostate-specific antigen (PSA is one of the most common tumor markers of PC, which are used for mass male screening. However, the detection rate of PC in men with normal PSA values is also very high. This promotes an active search for new markers and predictors of PC.The effect of androgens on hormonal carcinogenesis in the prostate suggests that the analysis of serum testosterone concentrations and free androgen index may be made in patients with low PSA levels in the early diagnosis and prognosis of PC.

  16. The quantification of fingerprint quality using a relative contrast index.

    Science.gov (United States)

    Humphreys, Jill D; Porter, Glenn; Bell, Michael

    2008-06-10

    Research into fingermark enhancement techniques has traditionally used visual comparisons and qualitative methods to assess their effectiveness based on the quality of the developed fingermark. However, with increasing research into the optimisation of these techniques the need for a quantitative evaluative method has arisen. Parameters for acceptable fingerprint quality are not well defined and generally encompass clear, sharp edges and high levels of contrast between the fingermark ridges and background material. Using these current parameters, a conclusive measurement of fingerprint quality and thus the effectiveness of development techniques cannot be achieved. This study presents a model through which an aspect of fingerprint quality can be objectively and impartially measured based on a relative contrast index, constructed through measuring the reflective intensity of the fingermark ridges against the background material. Using a fibre-optic spectrophotometer attached to a microscope with axial illumination, the intensity counts of the ridge detail and background material were measured and a logarithmic contrast index constructed. The microscope and spectrophotometer parameters were experimentally tested using a standard colour resolution chart with known reflective properties. The protocol was successfully applied to four sample groups: black inked fingerprints on white paper; latent fingermarks on white paper developed separately with ninhydrin and physical developer; and fingermarks in blood deposited on white tiles and enhanced with amido black. The contrast indices obtained quantitatively reflect the level of contrast and provide an indication of fingerprint quality through a numerical representation rather than previous qualitative methods. It has been suggested that the proposed method of fingerprint quantification may be viable for application in the forensic research arena as it allows the definitive measurement of contrast to aid the evaluation of

  17. Bounds and Inequalities Relating h-Index, g-Index, e-Index and Generalized Impact Factor: An Improvement over Existing Models

    Science.gov (United States)

    Abbas, Ash Mohammad

    2012-01-01

    In this paper, we describe some bounds and inequalities relating -index, -index, -index, and generalized impact factor. We derive the bounds and inequalities relating these indexing parameters from their basic definitions and without assuming any continuous model to be followed by any of them. We verify the theorems using citation data for five Price Medalists. We observe that the lower bound for -index given by Theorem 2, , comes out to be more accurate as compared to Schubert-Glanzel relation for a proportionality constant of , where is the number of citations and is the number of papers referenced. Also, the values of -index obtained using Theorem 2 outperform those obtained using Egghe-Liang-Rousseau power law model for the given citation data of Price Medalists. Further, we computed the values of upper bound on -index given by Theorem 3, , where denotes the value of -index. We observe that the upper bound on -index given by Theorem 3 is reasonably tight for the given citation record of Price Medalists. PMID:22496760

  18. Bounds and inequalities relating h-index, g-index, e-index and generalized impact factor: an improvement over existing models.

    Directory of Open Access Journals (Sweden)

    Ash Mohammad Abbas

    Full Text Available In this paper, we describe some bounds and inequalities relating h-index, g-index, e-index, and generalized impact factor. We derive the bounds and inequalities relating these indexing parameters from their basic definitions and without assuming any continuous model to be followed by any of them. We verify the theorems using citation data for five Price Medalists. We observe that the lower bound for h-index given by Theorem 2, [formula: see text], g ≥ 1, comes out to be more accurate as compared to Schubert-Glanzel relation h is proportional to C(2/3P(-1/3 for a proportionality constant of 1, where C is the number of citations and P is the number of papers referenced. Also, the values of h-index obtained using Theorem 2 outperform those obtained using Egghe-Liang-Rousseau power law model for the given citation data of Price Medalists. Further, we computed the values of upper bound on g-index given by Theorem 3, g ≤ (h + e, where e denotes the value of e-index. We observe that the upper bound on g-index given by Theorem 3 is reasonably tight for the given citation record of Price Medalists.

  19. Bounds and inequalities relating h-index, g-index, e-index and generalized impact factor: an improvement over existing models.

    Science.gov (United States)

    Abbas, Ash Mohammad

    2012-01-01

    In this paper, we describe some bounds and inequalities relating h-index, g-index, e-index, and generalized impact factor. We derive the bounds and inequalities relating these indexing parameters from their basic definitions and without assuming any continuous model to be followed by any of them. We verify the theorems using citation data for five Price Medalists. We observe that the lower bound for h-index given by Theorem 2, [formula: see text], g ≥ 1, comes out to be more accurate as compared to Schubert-Glanzel relation h is proportional to C(2/3)P(-1/3) for a proportionality constant of 1, where C is the number of citations and P is the number of papers referenced. Also, the values of h-index obtained using Theorem 2 outperform those obtained using Egghe-Liang-Rousseau power law model for the given citation data of Price Medalists. Further, we computed the values of upper bound on g-index given by Theorem 3, g ≤ (h + e), where e denotes the value of e-index. We observe that the upper bound on g-index given by Theorem 3 is reasonably tight for the given citation record of Price Medalists.

  20. A preoperative low nutritional prognostic index correlates with the incidence of incisional surgical site infections after bowel resection in patients with Crohn's disease.

    Science.gov (United States)

    Maeda, Kiyoshi; Nagahara, Hisashi; Shibutani, Masatsune; Otani, Hiroshi; Sakurai, Katsunobu; Toyokawa, Takahiro; Tanaka, Hiroaki; Kubo, Naoshi; Muguruma, Kazuya; Kamata, Noriko; Yamagami, Hirokazu; Hirakawa, Kosei

    2015-11-01

    The incidence of incisional surgical site infections (SSIs) is reported to be higher among patients with Crohn's disease (CD) than among those with colorectal cancer. It has also been reported that the preoperative nutritional and inflammatory status is associated with the frequency of postoperative complications. Onodera's prognostic nutritional index (OPNI) is a simple and useful parameter for determining the nutritional and inflammatory status. In the present study, we retrospectively investigated the correlation between the OPNI and the incidence of incisional SSI in patients with CD who had undergone bowel resection. A total of 177 CD patients who underwent abdominal surgery were enrolled. Various clinical factors and the OPNI values were evaluated to identify risk factors for incisional SSIs. The incidence of incisional SSIs was 19.8 %. A multivariate analysis indicated that the OPNI was an independent risk factor for incisional SSIs. The results of this retrospective study suggest that the OPNI is an independent risk factor for incisional SSIs in patients with a history of bowel resection for CD.

  1. Prognostic factors in acute mesenteric ischemia and evaluation with Mannheim Peritonitis Index and platelet-to-lymphocyte ratio.

    Science.gov (United States)

    Yılmaz, Eyüp Murat; Cartı, Erdem Barış

    2017-07-01

    Acute mesenteric ischemia (AMI) is a disease that has a very high mortality rate and for which the diagnosis is frequently delayed. The aim of the present study was to assess the predictive value of the Mannheim Peritonitis Index (MPI) and platelet-to-lymphocyte (P/L) ratio in the prognosis of AMI. The files of 34 patients diagnosed with AMI between September 2014 and April 2016 were retrospectively examined. The patients were divided into 2 groups based on survival. The parameters of MPI and P/L ratio, demographic data, and duration of hospitalization were recorded and compared. In all, 19 (55.9%) patients were male, and 15 (44.1%) were female. Total of 19 patients (55.9%) were discharged with a complete recovery, while 15 (44.1%) died. MPI mean value was 21.13±7.55 and 16.00±5.24 in those who died and survived, respectively (p=0.026). P/L ratio was 288.48±233.01 and 373.82±389.62 in those who survived and died, respectively (p=0.045). MPI and P/L ratio are simple and reliable methods to predict the prognosis of AMI.

  2. Multidimensional Geriatric Prognostic Index, Based on a Geriatric Assessment, for Long-Term Survival in Older Adults in Korea.

    Directory of Open Access Journals (Sweden)

    Hee-Won Jung

    Full Text Available The patient´s survival estimate is important for clinical decision-making, especially in frail patients with multimorbidities. We aimed to develop a multidimensional geriatric prognosis index (GPI for 3- and 5-year mortality in community-dwelling elderly and to validate the GPI in a separate hospital-based population. The GPI was constructed using data for 988 participants in the Korean Longitudinal Study on Health and Aging (KLoSHA and cross-validated with 1109 patients who underwent a geriatric assessment at the Seoul National University Bundang Hospital (SNUBH. The GPI, with a total possible score of 8, included age, gender, activities of daily living, instrumental activities of daily living, comorbidities, mood, cognitive function, and nutritional status. During the 5-year observation period, 179 KLoSHA participants (18.1% and 340 SNUBH patients (30.7% died. The c-indices for 3- and 5-year mortality were 0.78 and 0.80, respectively, in the KLoSHA group and 0.73 and 0.80, respectively, in the SNUBH group. Positive linear trends were observed for GPI scores and both 3- and 5-year mortality in both groups. In conclusions, using common components of a geriatric assessment, the GPI can stratify the risk of 3- and 5-year mortality in Korean elderly people both in the community and hospital.

  3. How are VIX and Stock Index ETF Related?

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); T-L. Hsieh (Tai-Lin); M.J. McAleer (Michael)

    2016-01-01

    textabstractAs stock market indexes are not tradeable, the importance and trading volume of Exchange Traded Funds (ETFs) cannot be understated. ETFs track and attempt to replicate the performance of a specific index. Numerous studies have demonstrated a strong relationship between the S&P500

  4. Prognostic significance of the complex "Visceral Adiposity Index" vs. simple anthropometric measures: Tehran lipid and glucose study.

    Science.gov (United States)

    Mohammadreza, Bozorgmanesh; Farzad, Hadaegh; Davoud, Khalili; Fereidoun Prof, Azizi Fereidoun

    2012-03-07

    Visceral adiposity index (VAI) has recently been suggested to be used as a surrogate of visceral adiposity. We examined if VAI could improve predictive performances for CVD of the Framingham's general CVD algorithm (a multivariate model incorporating established CVD risk factors). We compared the predictive abilities of the VAI with those of simple anthropometric measures i.e. BMI, waist-to-height ratio (WHtR) or waist-to-hip ratio (WHpR). In a nine-year population-based follow-up, 6,407 (2,778 men) participants, free of CVD at baseline, aged≥30 years were eligible for the current analysis. The risk of CVD was estimated by incorporating VAI, BMI, WHpR, and WHtR, one at a time, into multivariate accelerated failure time models. We documented 534 CVD events with the annual incidence rate (95%CIs) being 7.3 (6.4-8.3) among women and 13.0 (11.7-14.6) among men. Risk of future CVD increased with increasing levels of VAI among both men and women. VAI was associated with multivariate-adjusted increased risk of incident CVD among women. However, the magnitude of risk conferred by VAI was not significantly higher than those conferred by BMI, WHpR, or WHtR. Among men, after adjustment for established CVD risk factors, VAI was no longer associated with increased risk of CVD. VAI failed to add to the predictive ability of the Framingham general CVD algorithm. Using VAI instead of simple anthropometric measures may lead to loss of much information needed for predicting incident CVD.

  5. Delta neutrophil index as a promising prognostic marker of emergent surgical intervention for acute diverticulitis in the emergency department.

    Science.gov (United States)

    Kang, Hee Seung; Cha, Yong Sung; Park, Kyung Hye; Hwang, Sung Oh

    2017-01-01

    Early identification of patients with acute diverticulitis who require emergent surgical intervention in the emergency department (ED) is important to the physician. Although computed tomography (CT) has an important role in evaluating the severity of diverticulitis, its findings alone may not predict the need for emergent surgical intervention in all patients with acute diverticulitis in the ED. Serum inflammation markers may help to differentiate severity of acute diverticulitis and predict the need for surgical intervention in clinical practice. No information is currently available on the clinical usefulness of the delta neutrophil index (DNI), with respect to the prediction of emergent surgical intervention in patients with acute diverticulitis at the ED. This was a retrospective observational study of consecutive adult patients with acute diverticulitis confirmed by CT in the ED, between January 2014 and December 2016. Recruited patients were divided into two groups: emergent surgical intervention and no surgical intervention. The following laboratory serum parameters were examined in the ED: DNI value, C-reactive protein (CRP) levels, white blood cell count, neutrophil count, and neutrophil-to-lymphocyte ratio (NLR). The patients were also examined for the presence or absence of complications by CT. A total of 132 patients were finally included in the study, with the emergent surgical intervention group constituting 52 patients. The median DNI value, CRP levels, neutrophil count, and NLR were significantly higher in the emergent surgical intervention group than in the no surgical intervention group. The area under the curve for predicting emergent surgical intervention, using the DNI was significantly higher than that of CRP levels, neutrophil count, or NLR. Moreover, the combination of initial DNI and CT was most powerful diagnostic modality. DNI values measured at the ED combined with CT were good predictors for emergent surgical intervention in acute

  6. Delta neutrophil index as a promising prognostic marker of emergent surgical intervention for acute diverticulitis in the emergency department.

    Directory of Open Access Journals (Sweden)

    Hee Seung Kang

    Full Text Available Early identification of patients with acute diverticulitis who require emergent surgical intervention in the emergency department (ED is important to the physician. Although computed tomography (CT has an important role in evaluating the severity of diverticulitis, its findings alone may not predict the need for emergent surgical intervention in all patients with acute diverticulitis in the ED. Serum inflammation markers may help to differentiate severity of acute diverticulitis and predict the need for surgical intervention in clinical practice. No information is currently available on the clinical usefulness of the delta neutrophil index (DNI, with respect to the prediction of emergent surgical intervention in patients with acute diverticulitis at the ED.This was a retrospective observational study of consecutive adult patients with acute diverticulitis confirmed by CT in the ED, between January 2014 and December 2016. Recruited patients were divided into two groups: emergent surgical intervention and no surgical intervention. The following laboratory serum parameters were examined in the ED: DNI value, C-reactive protein (CRP levels, white blood cell count, neutrophil count, and neutrophil-to-lymphocyte ratio (NLR. The patients were also examined for the presence or absence of complications by CT.A total of 132 patients were finally included in the study, with the emergent surgical intervention group constituting 52 patients. The median DNI value, CRP levels, neutrophil count, and NLR were significantly higher in the emergent surgical intervention group than in the no surgical intervention group. The area under the curve for predicting emergent surgical intervention, using the DNI was significantly higher than that of CRP levels, neutrophil count, or NLR. Moreover, the combination of initial DNI and CT was most powerful diagnostic modality.DNI values measured at the ED combined with CT were good predictors for emergent surgical intervention

  7. Prognostic value of increased expression of RACO-1 in patients with hepatitis B-related hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Chen JY

    2017-02-01

    Full Text Available Jian-yao Chen,1 Li-ping Liu,2 Jiang-feng Xu3 1Department of Hepatobiliary Surgery, Shaoxing Second Hospital, Shaoxing, 2Department of Surgery, Zhuzhou Clinical Institute, Central South University School of Medicine, Zhuzhou, 3Department of Surgery, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China Abstract: RING domain AP-1 coactivator-1 (RACO-1 is a coactivator that links c-Jun to growth factor signaling and is essential for AP-1 function. This study aimed to investigate the expression and clinical significance of RACO-1 protein in hepatitis B virus (HBV-related hepatocellular carcinoma (HCC in China. A total of 136 tissue samples of HBV-related HCC were detected by immunohistochemistry (including 76 patients in training cohort and 60 patients in validation cohort. Correlation between RACO-1 expression and clinicopathologic features of HBV-related HCC was analyzed in both the cohorts. RACO-1 expression was significantly higher in HBV-related HCC tissues than in adjacent non-tumor liver tissues. All the patients were divided into two groups: the low expression group and the high expression group. RACO-1 expression was significantly related to vascular invasion (P=0.021, tumor numbers (P=0.046, International Union for Cancer Control/American Joint Committee on Cancer stage (P=0.006, cirrhosis (P=0.046, capsular (P=0.039, and Barcelona Clinic Liver Cancer stage (P=0.041 in training cohort. The validation cohort showed the same results. The high RACO-1 expression was the independent prognostic factor for HBV-related HCC patients in both training cohort and validation cohort. Our data implicate RACO-1 as a novel prognostic marker and a potential therapeutic target for HBV-related HCC. Keywords: RACO-1, hepatitis B, hepatocellular carcinoma, prognosis, BCLC stage, vascular invasion, cirrhosis, UICC/AJCC stage

  8. Tumor burden as the most important prognostic factor in early stage Hodgkin's disease. Relations to other prognostic factors and implications for choice of treatment

    DEFF Research Database (Denmark)

    Specht, L; Nordentoft, A M; Cold, Søren

    1988-01-01

    Two hundred ninety patients with Hodgkin's disease pathologic stage (PS) I or II were treated in the prospective randomized trial of the Danish National Hodgkin Study (see Appendix) with radiotherapy +/- adjuvant combination chemotherapy. The initial tumor burden of each patient was assessed......, combining tumor size of each involved region and number of regions involved. Multivariate analyses of prognostic factors including treatment, tumor burden, histologic subtype, pathologic stage, number of involved regions, mediastinal size, systemic symptoms, erythrocyte sedimentation rate (ESR), sex...

  9. Prognostic value of blood-biomarkers related to hypoxia, inflammation, immune response and tumour load in non-small cell lung cancer - A survival model with external validation.

    Science.gov (United States)

    Carvalho, Sara; Troost, Esther G C; Bons, Judith; Menheere, Paul; Lambin, Philippe; Oberije, Cary

    2016-06-01

    Improve the prognostic prediction of clinical variables for non-small cell lung cancer (NSCLC), by selecting from blood-biomarkers, non-invasively describing hypoxia, inflammation and tumour load. Model development and validation included 182 and 181 inoperable stage I-IIIB NSCLC patients treated radically with radiotherapy (55.2%) or chemo-radiotherapy (44.8%). Least absolute shrinkage and selection operator (LASSO), selected from blood-biomarkers related to hypoxia [osteopontin (OPN) and carbonic anhydrase IX (CA-IX)], inflammation [interleukin-6 (IL-6), IL-8, and C-reactive protein (CRP)], and tumour load [carcinoembryonic antigen (CEA), and cytokeratin fragment 21-1 (Cyfra 21-1)]. Sequent model extension selected from alpha-2-macroglobulin (α2M), serum interleukin-2 receptor (sIL2r), toll-like receptor 4 (TLR4), and vascular endothelial growth factor (VEGF). Discrimination was reported by concordance-index. OPN and Cyfra 21-1 (hazard ratios of 3.3 and 1.7) significantly improved a clinical model comprising gender, World Health Organization performance-status, forced expiratory volume in 1s, number of positive lymph node stations, and gross tumour volume, from a concordance-index of 0.66 to 0.70 (validation=0.62 and 0.66). Extension of the validated model yielded a concordance-index of 0.67, including α2M, sIL2r and VEGF (hazard ratios of 4.6, 3.1, and 1.4). Improvement of a clinical model including hypoxia and tumour load blood-biomarkers was validated. New immunological markers were associated with overall survival. Data and models can be found at www.cancerdata.org (http://dx.doi.org/10.17195/candat.2016.04.1) and www.predictcancer.org. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  10. Diagnostic and prognostic value of right ventricular strain in patients with pulmonary arterial hypertension and relatively preserved functional capacity studied with echocardiography and magnetic resonance.

    Science.gov (United States)

    da Costa Junior, Augusto Alberto; Ota-Arakaki, Jaquelina Sonoe; Ramos, Roberta Pulcheri; Uellendahl, Marly; Mancuso, Frederico José Neves; Gil, Manuel Adan; Fischer, Cláudio Henrique; Moises, Valdir Ambrosio; de Camargo Carvalho, Antonio Carlos; Campos, Orlando

    2017-01-01

    Right ventricular (RV) dysfunction harbingers adverse prognosis in pulmonary arterial hypertension (PAH). Although conventional two-dimensional echocardiography (2DE) is limited for RV systolic function quantitation, RV strain can be a useful tool. The diagnostic and prognostic impact of 2DE speckle-tracking RV longitudinal strain was evaluated, including other 2DE systolic indexes, in a group of PAH patients without severe impairment of functional capacity, chronic pulmonary thromboembolism or left ventricular dysfunction. Sixty-six group I PAH patients, 67 % NYHA functional class I or II (none in IV) were studied by 2DE to obtain: RV fractional area change, tricuspid annular plane systolic excursion, RV myocardial performance index, tissue Doppler tricuspid annulus systolic velocity. Global, free wall (RVFreeWSt) and septal RV longitudinal systolic strain were obtained. RV ejection fraction by cardiac magnetic resonance (CMR-RVEF) was also assessed. All patients were followed up to 3.9 years (mean 3.3 years). Combined endpoints were hospitalization for worsening PAH or cardiovascular death. Among all the 2DE indexes of RV systolic function, RVFreeWSt exhibited the best correlation with CMR-RVEF (r = 0.83; p < 0.005). Combined endpoints occurred in 15 (22.7 %) patients (6 hospitalizations and 9 deaths). Multivariate analysis identified RVFreeWSt ≤-14 % as the only 2DE independent variable associated with combined endpoints [HR 4.66 (1.25-17.37); p < 0.05]. We conclude that RVFreeWSt may be a suitable non-geometric 2DE surrogate of CMR-RVEF in PAH patients, constituting a powerful independent predictor of long-term outcome in this cohort with relatively preserved functional capacity.

  11. Incidence and prognostic factor of ethambutol-related optic neuropathy: 10-year experience in southern Taiwan

    Directory of Open Access Journals (Sweden)

    Shih-Chou Chen

    2015-07-01

    Full Text Available To investigate the incidence and prognostic factors of ethambutol-related optic neuropathy (EON in one medical center of southern Taiwan, a retrospective chart review study with 4803 newly diagnosed tuberculosis cases from January 2002 to July 2011 at one medical center hospital in southern Taiwan were reviewed. Of these patients, 1004 had ophthalmic records. Sixty-two cases (1.29% experienced visual impairment and were diagnosed as EON with mean visual acuity of 0.86 ± 0.69 by logMAR. Sixteen of the 62 patients had a follow-up time > 6 months. Of these, eight patients (50% showed visual improvement (an increase in visual acuity of ≥ 2 Snellen lines after ethambutol was discontinued. Another eight patients (50% showed no visual improvement. We analyzed multiple factors between the patients with and without visual improvement by logistic regression, including body weight, daily dose of ethambutol, duration of ethambutol use, cumulative dose of ethambutol, renal function, underlying disease of diabetes mellitus, hypertension, and initial visual acuity showed no statistically significant difference. In conclusion, the incidence of EON was 1.29%. Half of the patients showed visual improvement after discontinuation of ethambutol, and no obvious prognostic factors were found to facilitate the vision recovery. Ethambutol should be discontinued as soon as EON is suspected.

  12. Prognostic factors for outcomes after whole-brain irradiation of brain metastases from relatively radioresistant tumors: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Schild Steven E

    2010-10-01

    Full Text Available Abstract Background This study investigated potential prognostic factors in patients treated with whole-brain irradiation (WBI alone for brain metastases from relatively radioresistant tumors such as malignant melanoma, renal cell carcinoma, and colorectal cancer. Additionally, a potential benefit from escalating the radiation dose was investigated. Methods Data from 220 patients were retrospectively analyzed for overall survival and local control. Nine potential prognostic factors were evaluated: tumor type, WBI schedule, age, gender, Karnofsky performance score, number of brain metastases, extracerebral metastases, interval from diagnosis of cancer to WBI, and recursive partitioning analysis (RPA class. Results Survival rates at 6 and 12 months were 32% and 19%, respectively. In the multivariate analysis, WBI doses >30 Gy (p = 0.038, KPS ≥70 (p Conclusions Improved outcomes were associated with WBI doses >30 Gy, better performance status, fewer brain metastases, lack of extracerebral metastases, and lower RPA class. Patients receiving WBI alone appear to benefit from WBI doses >30 Gy. However, such a benefit is limited to RPA class 1 or 2 patients.

  13. Systematic review of prognostic roles of body mass index for patients undergoing lung cancer surgery: does the 'obesity paradox' really exist?

    Science.gov (United States)

    Li, Shuangjiang; Wang, Zhiqiang; Huang, Jian; Fan, Jun; Du, Heng; Liu, Lunxu; Che, Guowei

    2017-05-01

    The paradoxical benefit of obesity, the 'obesity paradox', has been recently identified in surgical populations. Our goal was to evaluate by a systematic review with meta-analysis the prognostic role of body mass index (BMI) and to identify whether the 'obesity paradox' exists in lung cancer surgery. Comprehensive literature retrieval was conducted in PubMed to identify the eligible articles. The odds ratios (OR) and hazard ratios (HR) with the corresponding 95% confidence intervals (CI) were used to synthesize in-hospital and long-term survival outcomes, respectively. The heterogeneity level and publication bias between studies were also estimated. Finally, 25 observational studies with 78 143 patients were included in this review. The pooled analyses showed a significantly better long-term survival rate in patients with higher BMI, but no significant benefit of increased BMI was found for in-hospital morbidity. The pooled analyses also showed that overall morbidity (OR: 0.84; 95% CI: 0.73-0.98; P  =   0.025) and in-hospital mortality (OR: 0.78; 95% CI: 0.63-0.98; P  =   0.031) were significantly decreased in obese patients. Obesity could be a strong predictor of the favourable long-term prognosis of lung cancer patients (HR: 0.69; 95% CI: 0.56-0.86; P  =   0.001). The robustness of these pooled estimates was strong. No publication bias was detected. In summary, obesity has favourable effects on in-hospital outcomes and long-term survival of surgical patients with lung cancer. The 'obesity paradox' does have the potential to exist in lung cancer surgery.

  14. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  15. ABO blood groups in relation to breast carcinoma incidence and associated prognostic factors in Moroccan women.

    Science.gov (United States)

    Zouine, S; Marnissi, F; Otmani, N; Bennani Othmani, M; El Wafi, M; Kojok, K; Zaid, Y; Tahiri Jouti, N; Habti, N

    2016-07-01

    The association between blood groups ABO and different types of diseases was established in several previous studies. Our aim was to seek the possible association between the ABO blood group and breast cancer-associated prognostic factors. The Chi-squared analytic test was used to compare phenotypic ABO distribution among Moroccan blood donors and 442 cases of women suffering from breast carcinoma with archived files in Maternity Ward of University Hospital C.H.U Ibn Rochd between 2008 and 2011. High incidence of breast carcinoma was observed in blood type B patients (p breast carcinomas overexpressing human epidermal growth factor receptor HER2 (p cancer at age over 70 years (p cancer among women younger than 35 years old. Blood type A and AB were associated with high incidence of lymph node metastasis (p breast carcinoma. Further follow-up studies are necessary to clarify the role of ABH antigens in the progression of breast carcinoma.

  16. Relation between body mass index percentile and muscle strength ...

    African Journals Online (AJOL)

    Noha Abdel Kader Abdel Kader Hasan

    2016-02-01

    Feb 1, 2016 ... time to fatigue to evaluate endurance time. The results: A significant distinction in muscle strength and endurance time among the obese, overweight groups comparing to the normal weight groups was identified. Additionally there was a positive correlation between muscle strength and body mass index ...

  17. Predictive performance of the visceral adiposity index for a visceral adiposity-related risk: Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Azizi Fereidoun

    2011-05-01

    Full Text Available Abstract Background Visceral adiposity index (VAI has recently been developed based on waist circumference, body mass index (BMI, triglycerides (TGs, and high-density lipoprotein cholesterol (HDL-C. We examined predictive performances for incident diabetes of the VAI per se and as compared to the metabolic syndrome (MetS and waist-to-height-ratio (WHtR. Methods Participants free of diabetes at baseline with at least one follow-up examination (5,964 were included for the current study. Weibull regression models were developed for interval-censored survival data. Absolute and relative integrated discriminatory improvement index (IDI and cut-point-based and cut-point-free net reclassification improvement index (NRI were used as measures of predictive ability for incident diabetes added by VAI, as compared to the MetS and WHtR. Results The annual incidence rate of diabetes was 0.85 per 1000 person. Mean VAI was 3.06 (95%CIs 2.99-3.13. Diabetes risk factors levels increased in stepwise fashion across VAI quintiles. Risk gradient between the highest and lowest quintile of VAI was 4.5 (95%CIs 3.0-6.9. VAI significantly improved predictive ability of the MetS. The relative IDI and cut-point free NRI for predictive ability added to MetS by VAI were 30.3% (95%CIs 18.8-41.8% and 30.7% (95%CIs 20.8-40.7%, respectively. WHtR, outperformed VAI with cut-point-free NRI of 24.6% (95%CIs 14.1-35.2%. Conclusions In conclusion, although VAI could be a prognostic tool for incident diabetes events, gathering information on its components (WC, BMI, TGs, and HDL-C is unlikely to improve the prediction ability beyond what could be achieved by the simply assessable and commonly available information on WHtR.

  18. The relative prognostic value of plasma HIV RNA levels and CD4 lymphocyte counts in advanced HIV infection

    DEFF Research Database (Denmark)

    Cozzi-Lepri, A; Katzenstein, T L; Ullum, H

    1998-01-01

    was associated with increased risk of death, but the association was smaller in patients with lower CD4 lymphocyte counts (test for interaction P HIV RNA and risk of death was not statistically significant (relative hazard per......OBJECTIVE: It has been suggested that the plasma HIV RNA level is a better predictor of AIDS and death than the CD4 lymphocyte count. We assessed whether the prognostic value of plasma virus levels was different according to the CD4 count. DESIGN: Prospective cohort study of HIV-infected patients...... followed for a median of 2.91 years (range, 0.02-4.54). SETTING: Department of Infectious Diseases at Rigshospitalet, Copenhagen, Denmark. PARTICIPANTS: A group of 255 HIV-infected individuals with an initial measurement of CD4 lymphocyte count and plasma HIV RNA. MAIN OUTCOME MEASURE: Survival time...

  19. Indian monsoon variability in relation to Regional Pressure Index

    Indian Academy of Sciences (India)

    In this paper Regional Pressure Index (RPI) over the Indian region (20°N-40°N and 70°E-85°E) has been constructed for 101 years (1899-1999) on a monthly scale. The relationship of these indices was carried out with the Indian Summer Monsoon Rainfall (June-September) (ISMR) over the various homogeneous regions, ...

  20. Economic Productive Characters of Buffaloes in Relation to Management Index

    Directory of Open Access Journals (Sweden)

    K.U. Bidwe

    2009-06-01

    Full Text Available On the basis of individual indices, the productive characters of buffaloes was formulated and it was noticed that the dairy farmers had fair management index (between 71 to 80 %. As regards quantity and quality of milk it was noticed that the milk yield was 5.27, 6.21 and 7.2 kg in group I, II and III respectively. The corresponding fat and SNF contents of milk were 6.17 and 8.75, 6.8 and 8.8 and 7.2 and 9.0 % respectively. It was also noticed that the level of management influenced the production in buffaloes. The production under satisfactory management status was 3 to 4, 4 to 5 and 5 to 7 kg under satisfactory, fair and good management index while it was 10 to 14 kg under very good management index. The milk produced by the buffaloes under all the three herd size groups was meeting out the fat content standard according to PFA rules prescribed for Maharashtra but the milk produced under herd size group I and II did not meet out the standards prescribed for SNF content. [Vet. World 2009; 2(3.000: 98-99

  1. CA 19-9 to peritoneal carcinomatosis index (PCI) ratio is prognostic in patients with epithelial appendiceal mucinous neoplasms and peritoneal dissemination undergoing cytoreduction surgery and intraperitoneal chemotherapy: A retrospective cohort study.

    Science.gov (United States)

    Kozman, Mathew A; Fisher, Oliver M; Rebolledo, Bree-Anne J; Valle, Sarah J; Alzahrani, Nayef; Liauw, Winston; Morris, David L

    2017-12-01

    Serum tumour levels have been shown to be prognostic in patients with epithelial appendiceal mucinous neoplasms with peritoneal dissemination (pseudomyxoma peritonei (PMP)). A singular index which incorporates both tumour activity (as depicted by serum tumour marker levels) and tumour volume (as depicted by peritoneal carcinomatosis index (PCI)), may give a more precise surrogate of tumour biological behaviour. The prognostic implication of this index has not yet been reported. A retrospective cohort study of all patients with PMP managed from 1996 to 2016 with cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) was performed by analysing the survival effect of the ratio of preoperative serum CEA, CA19.9 and CA125 to PCI. Three hundred and eighty-six patients were included. In patients with low-grade PMP, elevated CA19-9/PCI ratio resulted in poorer median overall survival times (104 months vs NR, 95%CI 83 - NR, log-rank p < 0.001) and was an independent predictor of reduced overall survival on multivariable analysis (adjusted HR 5.60, 95%CI 1.60-19.68, p = 0.007). In patients with high-grade PMP, no statistically significant difference in survival was recognised. CA19-9/PCI ratio is an independent prognostic factor for overall survival in patients with low-grade PMP undergoing CRS and IPC. By accounting for both tumour activity and tumour volume simultaneously, this novel index behaves as a surrogate of tumour biology and provides a useful adjunct for decisions regarding treatment allocation in this patient group. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  2. Tumor burden as the most important prognostic factor in early stage Hodgkin's disease. Relations to other prognostic factors and implications for choice of treatment

    DEFF Research Database (Denmark)

    Specht, L; Nordentoft, A M; Cold, Søren

    1988-01-01

    Two hundred ninety patients with Hodgkin's disease pathologic stage (PS) I or II were treated in the prospective randomized trial of the Danish National Hodgkin Study (see Appendix) with radiotherapy +/- adjuvant combination chemotherapy. The initial tumor burden of each patient was assessed......, and age were carried out. With regard to disease-free survival tumor burden was by far the most important prognostic factor for patients treated with adjuvant chemotherapy as well as for patients treated with radiotherapy alone. With regard to survival from Hodgkin's disease only tumor burden and age were...... independently significant. A combination of tumor burden, histologic subtype, and sex singled out patients with a high relapse rate both after radiotherapy only, and after radiotherapy plus chemotherapy. This combination also singled out patients destined to die from Hodgkin's disease more accurately than other...

  3. Creation of a Prognostic Index for Spine Metastasis to Stratify Survival in Patients Treated With Spinal Stereotactic Radiosurgery: Secondary Analysis of Mature Prospective Trials

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Chad [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hess, Kenneth [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Bishop, Andrew J.; Pan, Hubert Y.; Christensen, Eva N. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Yang, James N. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tannir, Nizar [Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Amini, Behrang [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tatsui, Claudio; Rhines, Laurence [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Brown, Paul [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ghia, Amol, E-mail: ajghia@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: There exists uncertainty in the prognosis of patients following spinal metastasis treatment. We sought to create a scoring system that stratifies patients based on overall survival. Methods and Materials: Patients enrolled in 2 prospective trials investigating stereotactic spine radiation surgery (SSRS) for spinal metastasis with ≥3-year follow-up were analyzed. A multivariate Cox regression model was used to create a survival model. Pretreatment variables included were race, sex, age, performance status, tumor histology, extent of vertebrae involvement, previous therapy at the SSRS site, disease burden, and timing of diagnosis and metastasis. Four survival groups were generated based on the model-derived survival score. Results: Median follow-up in the 206 patients included in this analysis was 70 months (range: 37-133 months). Seven variables were selected: female sex (hazard ratio [HR] = 0.7, P=.02), Karnofsky performance score (HR = 0.8 per 10-point increase above 60, P=.007), previous surgery at the SSRS site (HR = 0.7, P=.02), previous radiation at the SSRS site (HR = 1.8, P=.001), the SSRS site as the only site of metastatic disease (HR = 0.5, P=.01), number of organ systems involved outside of bone (HR = 1.4 per involved system, P<.001), and >5 year interval from initial diagnosis to detection of spine metastasis (HR = 0.5, P<.001). The median survival among all patients was 25.5 months and was significantly different among survival groups (in group 1 [excellent prognosis], median survival was not reached; group 2 reached 32.4 months; group 3 reached 22.2 months; and group 4 [poor prognosis] reached 9.1 months; P<.001). Pretreatment symptom burden was significantly higher in the patient group with poor survival than in the group with excellent survival (all metrics, P<.05). Conclusions: We developed the prognostic index for spinal metastases (PRISM) model, a new model that identified patient subgroups with poor and excellent prognoses.

  4. Relative sensitivity of Normalized Difference Vegetation Index (NDVI) and Microwave Polarization Difference Index (MPDI) for vegetation and desertification monitoring

    Science.gov (United States)

    Becker, Francois; Choudhury, Bhaskar J.

    1988-01-01

    A simple equation relating the Microwave Polarization Difference Index (MPDI) and the Normalized Difference Vegetation Index (NDVI) is proposed which represents well data obtained from Nimbus 7/SMMR at 37 GHz and NOAA/AVHRR Channels 1 and 2. It is found that there is a limit which is characteristic of a particular type of cover for which both indices are equally sensitive to the variation of vegetation, and below which MPDI is more efficient than NDVI. The results provide insight into the relationship between water content and chlorophyll absorption at pixel size scales.

  5. Relation of body mass index (BMI) to disease free (DFS) and distant disease free survivals (DDFS) among Turkish women with operable breast carcinoma.

    Science.gov (United States)

    Demirkan, Binnaz; Alacacioglu, Ahmet; Yilmaz, Ugur

    2007-04-01

    The correlation between body mass index (BMI) and patient and tumor characteristics related to prognosis has not been well explored and may help to elucidate the mechanisms involved in the carcinogenesis. Because of the equivocal, inconsistent and uncertain research results as well as racial and ethnic differences, we aimed to evaluate the prognostic significance of high BMI in Turkish women with operable breast carcinoma. Two hundred and sixty-six patients who had operable invasive breast carcinoma diagnosed from 2000 through 2004 in a single institution were evaluated for their demographic features, BMI, histopathological/immunohistochemical examinations and treatments. Quetelet BMI [weight (kg)/height (m)2] categories were selected according to the World Health Organization definition. Disease free survival (DSF) as well as distant disease free survival (DDSF) analyses were performed to identify independent prognostic factors. Post-menopausal patients were significantly in the higher quartile of BMI than pre-menopausal patients (P = 0.003). While post-menopausal obese patients had worse DSF and DDFS (P = 0.001), vascular invasion was the independent prognostic factor for both survival indices (P = 0.031). Post-menopausal obese Turkish women are at increased risk of developing breast tumors with aggressive phenotype and obesity is a strong predictor of poor DSF and DDFS. Preventive strategies to reduce not only the prevalence of obesity and breast cancer but also the mortality must be recognized as the cost-effective public-health policy for Turkey.

  6. Relation between exercise, depression and body mass index

    Directory of Open Access Journals (Sweden)

    José Vasconcelos-Raposo

    2009-03-01

    Full Text Available The purpose of this study is to determine the relationship between physical exercise, depression, and body mass index (BMI. The sample of the study consisted of 175 participants (43 male and 132 female with ages between the 18 and 27 years. The used instruments were: an adapted and validated Portuguese version of the Beck Depressive Inventory (BDI and an adaptation of the physical exercise scale developed by Prochaska, Sallis and Long (2001. The results suggested a negative correlation between the physical exercise and depression, with statistical significance. The group that does not reach the recommended level of physical exercise presents higher scores of depression in comparison with the group that reaches. This study corroborates previous studies that suggested positive effects of physical exercise on depression.

  7. Prognostic implications of parathyroid hormone-related protein in males and females with non--small-cell lung cancer.

    Science.gov (United States)

    Montgrain, Philippe R; Deftos, Leonard J; Arenberg, Douglas; Tipps, Ann; Quintana, Rick; Carskadon, Shannon; Hastings, Randolph H

    2011-05-01

    Non-small-cell lung carcinoma immunoreactivity for parathyroid hormone-related protein has been associated with increased survival in female patients but not in male patients. The current investigation attempted to substantiate this finding in 2 new patient groups. Patients were divided into groups with and without immunoreactivity for a carboxyl-terminal parathyroid hormone-related protein epitope assessed in deparaffinized sections by a blinded observer. One group included 85 female patients with stage I lung cancer, and the second group had 48 female and 66 male patients with stage I-IV lung cancer. Survival times were compared by the log-rank test between groups separated by tumor parathyroid hormone-related protein status. Parathyroid hormone-related protein was present in 70%-80% of the patients, independent of sex, stage, and smoking history. In the females with stage I lung cancer, parathyroid hormone-related protein increased median survival from 25 to 60 months (P < .05). In the second group, parathyroid hormone-related protein expression increased 48-month disease-free survival of female lung cancer patients from 44% to 63% (P < .05), but had no effect in male patients. Parathyroid hormone-related protein remained a significant, independent predictor when evaluated together with other covariates by Cox multivariate regression. This study verifies that parathyroid hormone-related protein is a sex-dependent survival factor for non-small-cell lung carcinoma, that it correlates with disease-free survival, and that the association with survival holds for women with early-stage disease as well as more advanced cancer. Thus, the protein could find use as a prognostic indicator and could be a target for therapy. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Prognostic values of pneumonia severity index, CURB-65 and expanded CURB-65 scores in community-acquired pneumonia in Zagazig University Hospitals

    Directory of Open Access Journals (Sweden)

    Samah M. Shehata

    2017-07-01

    Conclusions: Expanded CURB-65 score is simple, objective and more accurate scoring system for evaluation of CAP severity and can improve the efficiency of predicting the mortality in CAP patients, better than CURB-65 and PSI scores. Also, Expanded CUEB-65 may generate new therapeutic and prognostic modality in CAP especially in patients with liver cirrhosis.

  9. A Novel Inflammation- and Nutrition-Based Prognostic System for Patients with Laryngeal Squamous Cell Carcinoma: Combination of Red Blood Cell Distribution Width and Body Mass Index (COR-BMI)

    OpenAIRE

    Yan Fu; Yize Mao; Shiqi Chen; Ankui Yang; Quan Zhang

    2016-01-01

    Background Laryngeal squamous cell carcinoma (LSCC) is a head and neck cancer type. In this study, we introduced a novel inflammation- and nutrition-based prognostic system, referred to as COR-BMI (Combination of red blood cell distribution width and body mass index), for LSCC patients. Methods A total of 807 LSCC patients (784 male and 23 female, 22?87 y of age) who underwent surgery were enrolled in this retrospective cohort study. The patients were stratified by COR-BMI into three groups: ...

  10. Relative Dating and Classification of Minerals and Rocks Based on Statistical Calculations Related to Their Potential Energy Index

    OpenAIRE

    Labushev, Mikhail M.; Khokhlov, Alexander N.

    2012-01-01

    Index of proportionality of atomic weights of chemical elements is proposed for determining the relative age of minerals and rocks. Their chemical analysis results serve to be initial data for calculations. For rocks of different composition the index is considered to be classification value as well. Crystal lattice energy change in minerals and their associations can be measured by the index value change, thus contributing to the solution of important practical problems. There was determined...

  11. Development of a diet index for older adults and its relation to cardiovascular disease risk factors: the Elderly Dietary Index.

    Science.gov (United States)

    Kourlaba, Georgia; Polychronopoulos, Evangelos; Zampelas, Antonis; Lionis, Christos; Panagiotakos, Demosthenes B

    2009-06-01

    To develop an index that assesses the degree of adherence to nutritional recommendations for older adults (Elderly Dietary Index [EDI]) and investigate its association with risk factors related to cardiovascular disease (CVD). The EDI was constructed using 10 components (ie, questions about the consumption frequency of meat, fish, fruits, vegetables, grains, legumes, olive oil, and alcohol as well as the type of bread and dairy products) according to the Modified MyPyramid for Older Adults and select features of the traditional Mediterranean diet. Scores from 1 to 4 were assigned to all components of the index. The EDI total score had a range between 10 and 40. As a validation procedure, a sample of 668 elderly individuals without known CVD (the MEDIS Study) was used to evaluate the associations between the proposed index and various health outcomes. The overall mean EDI score was 29.2+/-3.5. This score implies that study participants were 73% (ie, 29.2/40) adherent to the nutritional recommendations that the EDI evaluates. Regarding the conventional CVD risk factors, it was found that a 1 unit increase in the EDI score is associated with almost 10% lower odds of being obese or hypertensive or having at least one of the investigated CVD risk factors (Phealth policymakers and other health care professionals to assess diet quality and health status (especially concerning the risk for developing CVD) in older adults.

  12. Telomerase in relation to clinicopathologic prognostic factors and survival in cervical cancer

    NARCIS (Netherlands)

    Wisman, GBA; Knol, AJ; Helder, MN; Krans, M; de Vries, EGE; Hollema, H; de Jong, S; van der Zee, AGJ

    2001-01-01

    We investigated, in cervical cancer, the relation between telomerase activity, telomerase RNA (hTR) and mRNA of the catalytic subunit of telomerase, hTERT, with "classic" clinicopathological factors as well as survival. Frozen specimens were obtained from 107 consecutive patients with cervical

  13. Elk Distributions Relative to Spring Normalized Difference Vegetation Index Values

    Directory of Open Access Journals (Sweden)

    Samuel T. Smallidge

    2010-01-01

    Full Text Available Rocky Mountain elk (Cervus elaphus that winter near San Antonio Mountain in northern New Mexico provide important recreational and economic benefits while creating management challenges related to temporospatial variation in their spring movements. Our objective was to examine spring distributions of elk in relation to vegetative emergence as it progresses across the landscape as measured by remote sensing. Spring distributions of elk were closely associated with greater photosynthetic activity of spring vegetation in 2 of 3 years as determined using NDVI values derived from AVHRR datasets. Observed elk locations were up to 271% greater than expected in the category representing the most photosynthetic activity. This association was not observed when analyses at a finer geographic scale were conducted. Managers facing challenges involving human-wildlife interactions and land-use issues should consider environmental conditions that may influence variation in elk association with greener portions of the landscape.

  14. Worldwide Scientific Production Indexed by Scopus on Labour Relations

    OpenAIRE

    Salmerón-Manzano, Esther (UNIR); Manzano-Agugliaro, Francisco

    2017-01-01

    This article examines the features of the worldwide contributions to the specialized literature in labour relations in the period 1970–2016. The source considered has been the Scopus Elsevier database, together with bibliometric analysis techniques. Different aspects of the publications are analysed, such as publication type, field, language, subcategory and journal type, as well as the keyword occurrence frequency. The results of this work show that the most popular keywords were Trade Union...

  15. Worldwide Scientific Production Indexed by Scopus on Labour Relations

    Directory of Open Access Journals (Sweden)

    Esther Salmerón-Manzano

    2017-10-01

    Full Text Available This article examines the features of the worldwide contributions to the specialized literature in labour relations in the period 1970–2016. The source considered has been the Scopus Elsevier database, together with bibliometric analysis techniques. Different aspects of the publications are analysed, such as publication type, field, language, subcategory and journal type, as well as the keyword occurrence frequency. The results of this work show that the most popular keywords were Trade Union, Employment, Labour Market and Industrial Relations. It is observed how the United States, being the most productive country, leads in almost all the keywords except in two, “Labour market” and “Working Conditions”, which are led by UK. If the keywords are studied only as geographical terms we can find the United States, Eurasia and India. The contributions are geographically and institutionally broken down. The most active categories are Social Sciences, Business, and Management and Accounting. The evolution of the most popular keywords indicates how in the last years “Trade Unions” “Industrial Relations” and “Personnel” have lost importance against “Labor Market” and “Employment”, showing new concerns in the labour relations field.

  16. Prognostic Ability of Practitioners of Traditional Arabic Medicine: Comparison with Western Methods through a Relative Patient Progress Scale

    Directory of Open Access Journals (Sweden)

    Bertrand Graz

    2010-01-01

    Full Text Available The ancient Greek medical theory based on balance or imbalance of humors disappeared in the western world, but does survive elsewhere. Is this survival related to a certain degree of health care efficiency? We explored this hypothesis through a study of classical Greco-Arab medicine in Mauritania. Modern general practitioners evaluated the safety and effectiveness of classical Arabic medicine in a Mauritanian traditional clinic, with a prognosis/follow-up method allowing the following comparisons: (i actual patient progress (clinical outcome compared with what the traditional ‘tabib’ had anticipated (= prognostic ability and (ii patient progress compared with what could be hoped for if the patient were treated by a modern physician in the same neighborhood. The practice appeared fairly safe and, on average, clinical outcome was similar to what could be expected with modern medicine. In some cases, patient progress was better than expected. The ability to correctly predict an individual's clinical outcome did not seem to be better along modern or Greco-Arab theories. Weekly joint meetings (modern and traditional practitioners were spontaneously organized with a modern health centre in the neighborhood. Practitioners of a different medical system can predict patient progress. For the patient, avoiding false expectations with health care and ensuring appropriate referral may be the most important. Prognosis and outcome studies such as the one presented here may help to develop institutions where patients find support in making their choices, not only among several treatment options, but also among several medical systems.

  17. Short-term mortality and prognostic factors related to status epilepticus

    Directory of Open Access Journals (Sweden)

    Fernando Gustavo Stelzer

    2015-08-01

    Full Text Available Objective Status epilepticus (SE is associated with significant morbidity and mortality, and there is some controversy concerning predictive indicators of outcome. Our main goal was to determine mortality and to identify factors associated with SE prognosis. Method This prospective study in a tertiary-care university hospital, included 105 patients with epileptic seizures lasting more than 30 minutes. Mortality was defined as death during hospital admission. Results The case-fatality rate was 36.2%, which was higher than in previous studies. In univariate analysis, mortality was associated with age, previous epilepsy, complex focal seizures; etiology, recurrence, and refractoriness of SE; clinical complications, and focal SE. In multivariate analysis, mortality was associated only with presence of clinical complications. Conclusions Mortality associated with SE was higher than reported in previous studies, and was not related to age, specific etiology, or SE duration. In multivariate analysis, mortality was independently related to occurrence of medical complications.

  18. Using a Relational Database to Index Infectious Disease Information

    Directory of Open Access Journals (Sweden)

    Jay A. Brown

    2010-05-01

    Full Text Available Mapping medical knowledge into a relational database became possible with the availability of personal computers and user-friendly database software in the early 1990s. To create a database of medical knowledge, the domain expert works like a mapmaker to first outline the domain and then add the details, starting with the most prominent features. The resulting "intelligent database" can support the decisions of healthcare professionals. The intelligent database described in this article contains profiles of 275 infectious diseases. Users can query the database for all diseases matching one or more specific criteria (symptom, endemic region of the world, or epidemiological factor. Epidemiological factors include sources (patients, water, soil, or animals, routes of entry, and insect vectors. Medical and public health professionals could use such a database as a decision-support software tool.

  19. Development of an environmental relative moldiness index for US homes

    Energy Technology Data Exchange (ETDEWEB)

    Vesper, Sephen J.; McKinstry, Craig A.; Haugland, Richard A.; Wymer, Larry; Bradham, Karen; Ashley, Peter; Cox, David J.; DeWalt, Gary; Friedman, Warren

    2007-08-01

    As part of the HUD American Healthy Survey, dust samples were collected by vacuuming 2 m2 in the bedroom plus 2 m2 in the living room of a nationally representative 1096 homes in the USA using the Mitest™ sampler. Five mg of sieved (300 µ pore, nylon mesh) dust was analyzed by mold specific quantitative PCR for the 36 EPA Mold Panel Species. On this basis, an “environmental relative moldiness index” (ERMI) was created with values ranging from about -10 to 20 (lowest to highest). In order to try to reduce the cost of this analysis, the number of test species was reduced by selecting only those species with a national average concentration of 30 cell equivalents (CE) per mg dust or greater. Only 19 of 36 species met this criterion. (In 40% of the homes, an additional 46 species were quantified from the same dust sample. All of these species had average concentrations less than 30 CE per mg dust.) These 19 species were then categorized into two groups based on their coefficient of variation (CV). If the CV was > 9, the mold was placed in Category 1 (10/19) and the other molds were placed in Category 2 (9/19). Using these Categories, the sum of the log-transformed concentrations of three Category 2 molds (C. herbarum, A. alternata and C. cladosporioides Type 1) was subtracted from the sum of the log-transformed concentrations of the ten Category 1 molds (Aspergillus niger, A. ochraceus, A. penicillioides, A. restrictus, A. sydowii, Chaetomium globosum, Eurotium amsteldoami, Paecilomyces variotii, Penicillium chrysogenum and Wallemia sebi). Assembling these values for the 1096 AHHS homes from lowest to highest produced the “American relative moldiness index” (ARMI). The correlation between the ERMI and ARMI values was 0.88. The ERMI or ARMI scales may be useful as a standard for mold exposure estimates in epidemiological studies.

  20. Event Related Potentials Index Rapid Recalibration to Audiovisual Temporal Asynchrony

    Science.gov (United States)

    Simon, David M.; Noel, Jean-Paul; Wallace, Mark T.

    2017-01-01

    Asynchronous arrival of multisensory information at the periphery is a ubiquitous property of signals in the natural environment due to differences in the propagation time of light and sound. Rapid adaptation to these asynchronies is crucial for the appropriate integration of these multisensory signals, which in turn is a fundamental neurobiological process in creating a coherent perceptual representation of our dynamic world. Indeed, multisensory temporal recalibration has been shown to occur at the single trial level, yet the mechanistic basis of this rapid adaptation is unknown. Here, we investigated the neural basis of rapid recalibration to audiovisual temporal asynchrony in human participants using a combination of psychophysics and electroencephalography (EEG). Consistent with previous reports, participant’s perception of audiovisual temporal synchrony on a given trial (t) was influenced by the temporal structure of stimuli on the previous trial (t−1). When examined physiologically, event related potentials (ERPs) were found to be modulated by the temporal structure of the previous trial, manifesting as late differences (>125 ms post second-stimulus onset) in central and parietal positivity on trials with large stimulus onset asynchronies (SOAs). These findings indicate that single trial adaptation to audiovisual temporal asynchrony is reflected in modulations of late evoked components that have previously been linked to stimulus evaluation and decision-making. PMID:28381993

  1. Clinical Features, Molecular Heterogeneity, and Prognostic Implications in YARS2-Related Mitochondrial Myopathy.

    Science.gov (United States)

    Sommerville, Ewen W; Ng, Yi Shiau; Alston, Charlotte L; Dallabona, Cristina; Gilberti, Micol; He, Langping; Knowles, Charlotte; Chin, Sophie L; Schaefer, Andrew M; Falkous, Gavin; Murdoch, David; Longman, Cheryl; de Visser, Marianne; Bindoff, Laurence A; Rawles, John M; Dean, John C S; Petty, Richard K; Farrugia, Maria E; Haack, Tobias B; Prokisch, Holger; McFarland, Robert; Turnbull, Douglass M; Donnini, Claudia; Taylor, Robert W; Gorman, Gráinne S

    2017-06-01

    YARS2 mutations have been associated with a clinical triad of myopathy, lactic acidosis, and sideroblastic anemia in predominantly Middle Eastern populations. However, the identification of new patients expands the clinical and molecular spectrum of mitochondrial disorders. To review the clinical, molecular, and genetic features of YARS2-related mitochondrial disease and to demonstrate a new Scottish founder variant. An observational case series study was conducted at a national diagnostic center for mitochondrial disease in Newcastle upon Tyne, England, and review of cases published in the literature. Six adults in a well-defined mitochondrial disease cohort and 11 additional cases described in the literature were identified with YARS2 variants between January 1, 2000, and January 31, 2015. The spectrum of clinical features and disease progression in unreported and reported patients with pathogenic YARS2 variants. Seventeen patients (median [interquartile range] age at onset, 1.5 [9.8] years) with YARS2-related mitochondrial myopathy were identified. Fifteen individuals (88%) exhibited an elevated blood lactate level accompanied by generalized myopathy; only 12 patients (71%) manifested with sideroblastic anemia. Hypertrophic cardiomyopathy (9 [53%]) and respiratory insufficiency (8 [47%]) were also prominent clinical features. Central nervous system involvement was rare. Muscle studies showed global cytochrome-c oxidase deficiency in all patients tested and severe, combined respiratory chain complex activity deficiencies. Microsatellite genotyping demonstrated a common founder effect shared between 3 Scottish patients with a p.Leu392Ser variant. Immunoblotting from fibroblasts and myoblasts of an affected Scottish patient showed normal YARS2 protein levels and mild respiratory chain complex defects. Yeast modeling of novel missense YARS2 variants closely correlated with the severity of clinical phenotypes. The p.Leu392Ser variant is likely a newly identified

  2. Refining prognostic stratification of human papillomavirus-related oropharyngeal squamous cell carcinoma: different prognosis between T1 and T2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Su Min; Lee, Sang Wook; Park, Sun Min [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); and others

    2017-09-15

    To validate the 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and investigate whether a modified classification better reflects the prognosis. Medical records of patients diagnosed with non-metastatic HPV-related OPSCC between 2010 and 2016 at a single institution were retrospectively reviewed. HPV status was determined by immunohistochemical analysis of p16 and/or HPV DNA polymerase chain reaction (PCR). We reclassified TNM stage T0-1 and N0-1 as group A, T2-3 or N2 as B, and T4 or N3 as C. Survival analysis according to 8th AJCC/UICC TNM staging and the modified classification was performed. Of 383 OPSCC patients, 211 were positive for HPV DNA PCR or p16. After exclusion, 184 patients were included in this analysis. Median age was 56 years (range, 31 to 81 years). Most primary tumors were in the palatine tonsil (148 tumors, 80%). The eighth AJCC/UICC TNM classification could not differentiate between stage I and II (p = 0.470) or II and III (p = 0.209). Applying modified grouping, the 3-year overall survival rate of group A was significantly higher than that of group B and C (98% vs. 91%, p = 0.039 and 98% vs. 78%, p < 0.001, respectively). Differentiation between group B and C was marginally significant (p = 0.053). The 8th AJCC/UICC TNM staging system did not clearly distinguish the prognosis of stage II from that of other stages. Including the T2N0-1 group in stage II may improve prognostic stratification.

  3. Relative Dating and Classification of Minerals and Rocks Based on Statistical Calculations Related to Their Potential Energy Index

    CERN Document Server

    Labushev, Mikhail M

    2012-01-01

    Index of proportionality of atomic weights of chemical elements is proposed for determining the relative age of minerals and rocks. Their chemical analysis results serve to be initial data for calculations. For rocks of different composition the index is considered to be classification value as well. Crystal lattice energy change in minerals and their associations can be measured by the index value change, thus contributing to the solution of important practical problems. There was determined the effect of more rapid increase of potential energy of limestone with relatively low lattice energy as compared with the others.

  4. Relation between visual function index and falls-related factors in patients with age-related cataract

    Directory of Open Access Journals (Sweden)

    Mei-Na Huang

    2016-01-01

    Full Text Available AIM:To investigate the relation between vision function index and falls-related factors in patients with age-related cataract.METHODS:Ninety-six patients with age-related cataract were interviewed using a seven-item visual function questionnaire(VF-7, then classified into poor, moderate, or good visual function group. The differences of the three groups on visual acuity, balance and mobility function, cognition, depressive symptoms, self-reported fear of falling were analyzed. RESULTS:The patients in poor visual function group had older age, tendency to depression, was more afraid of falling, compared with groups with higher score in VF-7, and they had worse visual acuity, performed worse on all balance and mobility tests. CONCLUSION:Poor visual function is related to worse visual acuity, weaker balance and mobility performance in patients with age-related cataract. The VF-7, as a simple and convenient self-reported method, can be used as a falling risk monitoring in patients with age-related cataract.

  5. Changes in absolute and relative importance in the prognostic value of left ventricular systolic function and congestive heart failure after acute myocardial infarction. TRACE Study Group. Trandolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Jørgensen, S

    1998-01-01

    ) by echocardiography, was assessed in 6,676 consecutive patients with an enzyme-confirmed AMI. So that changes in the prognostic value of WMI or CHF could be studied, separate analyses were performed at selected time periods. Average monthly mortality (deaths per 100 patients per month) was determined from life......Changes in the importance of left ventricular (LV) systolic dysfunction and congestive heart failure (CHF) with time after an acute myocardial infarction (AMI) after the introduction of thrombolytic therapy have not been studied. LV systolic function, measured as wall motion index (WMI...... dysfunction or CHF, monthly mortality was high during the first month (18.3 +/- 1.6% and 20.2 +/- 1.6%, respectively), decreased during the first year, and was stable thereafter (0.8 +/- 0.1% and 1.0 +/- 0.1%, respectively, average monthly mortality after year 3). The relative risk of LV dysfunction decreased...

  6. Prognostic Value of Ankle-Brachial Index in Patients Undergoing Percutaneous Coronary Intervention: In-Hospital and 1-Year Outcomes From the SHINANO Registry.

    Science.gov (United States)

    Hashizume, Naoto; Miura, Takashi; Miyashita, Yusuke; Motoki, Hirohiko; Ebisawa, Soichiro; Izawa, Atsushi; Koyama, Jun; Ikeda, Uichi; Kuwahara, Koichiro

    2017-11-01

    Concomitant coronary and peripheral artery disease is associated with higher periprocedural and long-term percutaneous coronary intervention (PCI) complication rates. We evaluated in-hospital and 1-year clinical outcomes of patients with low or borderline ankle-brachial indexes (ABIs) undergoing PCIs in the drug-eluting stent era. We divided 1370 SHINANO registry patients into 3 groups-low (ABI ≤ 0.9), borderline (0.9 < ABI ≤ 1.0), and normal (1.0 ≤ ABI < 1.4). During the 1-year follow-up, more PCI-related complications occurred in the low and borderline ABI groups than in the normal ABI group (7.7% vs 8.8% vs 4.0%, respectively). Low ABI patients were more likely to experience adverse clinical events (6.3% vs 3.6% vs 3.0%, respectively; log-rank P = .020 for low vs normal ABI), with a hazard ratio of 2.27 (95% confidence interval, 1.12-4.61; P = .023), compared with patients with normal ABIs. Patients with abnormal ABIs had a significantly higher incidence of PCI-related complications and a less favorable 1-year prognosis. Routine ABI measurement before PCI may help predict PCI-related complication incidence and 1-year prognosis.

  7. Re-operative abdominal predictive score: a prognostic model combining Acute Re-intervention Predictive Index and intra-abdominal pressure.

    Science.gov (United States)

    Soler-Morejón, Caridad de Dios; Lombardo-Vaillant, Tomás Ariel; Tamargo-Barbeito, Teddy Osmín; Wise, Robert; Malbrain, Manu L N G

    2017-11-22

    The decision to re-operate after abdominal surgery is still difficult, especially in the setting of intra-abdominal sepsis. Mathematical models provide a good aid to both diagnosis and decision-making. A prospective observational study was conducted with 300 patients consecutively admitted to the intensive care unit of an academic institution affiliated to Calixto García Medical Faculty following abdominal surgery from January 2008 to January 2010. The patients were randomly separated (2:1) into estimation and validation groups. Logistic regression analysis was used in the estimation group to develop three models for decision-making related to re-operation including related factors such as age, ARPI, IAP, type of surgery (elective or emergency), and the duration of surgery. The three models developed were validated on the other group. The acute re-operation predictive index-intra-abdominal pressure (ARPI-IAP) model was the best of the three models, with an excellent calibration, using the Hossmer-Lemeshow goodness-of-fit statistical test (C = 9.976, P = 0.267), as well as discrimination (AUC = 0.989; 95% CI: 0.976-1.000). The combination of IAP with ARPI in a mathematical model can add accuracy to the prediction of need for re-operation related to intra-abdominal infectious complications in patients following abdominal surgery. This may be useful in all medical settings, but especially those with limited resources.

  8. Lung volumes related to physical activity, physical fitness, aerobic capacity and body mass index in students

    Directory of Open Access Journals (Sweden)

    Mihailova A.

    2016-01-01

    Reduced lung volumes were associated with lower aerobic fitness, lower physical fitness and lower amount of weekly physical activity. Healthier body mass index was associated with higher aerobic fitness (relative VO2max in both female and male.

  9. Prognostic indicators of foot-related disability in patients with rheumatoid arthritis: results of a prospective three-year study.

    Science.gov (United States)

    Hooper, Lindsey; Bowen, Catherine J; Gates, Lucy; Culliford, David J; Ball, Carole; Edwards, Christopher J; Arden, Nigel K

    2012-08-01

    To determine the prevalence and natural history of foot-related disability in patients with rheumatoid arthritis (RA). A secondary aim was to identify explanatory variables, including forefoot bursae, that are either associated with or predictive of disabling foot complications in patients with RA. A longitudinal prospective cohort study recruited patients with RA from a rheumatology outpatient clinic. Data were collected at baseline (n = 149) and 1-year (n = 120) and 3-year followup (n = 60). Patient-reported disabling foot complications were evaluated using the subscales of the Foot Impairment Score (FIS): foot impairment/footwear restriction (FIS(IF)) and activity limitation/participation restriction (FIS(AP)). Explanatory variables investigated included ultrasound-detectable forefoot pathology and markers of disease activity. Disabling foot complications were highly prevalent on all occasions. Changes in foot impairment and activity limitation were significantly associated with fluctuations in disease activity (Disease Activity Score in 28 joints using the erythrocyte sedimentation rate [DAS28-ESR]: r = 0.455, P foot impairment (P = 0.009 and P = 0.012, respectively), explaining 16% of score variability in the final regression model. Disease duration, forefoot bursae, and erosion presence were identified as significant prognostic indicators of activity limitation (P = 0.002, P = 0.006, and P = 0.019, respectively), explaining 35% of score variability in the final regression model. Despite advances in disease management, patients report disability associated with foot problems. Forefoot bursae should be considered for targeted therapy. Copyright © 2012 by the American College of Rheumatology.

  10. Body Image and its Relation with Body Mass Index among Indian Adolescents.

    Science.gov (United States)

    Deshmukh, Vaishali R; Kulkarni, Aditi A

    2017-12-15

    To evaluate association of body mass index with perception and attitude towards bodyweight, shape and body image among adolescents. This cross-sectional study was done on 1811 adolescents. Attitude towards body image was assessed by using a self-administered Multidimensional Body-Self Relations Questionnaire. Perceived body shape was measured using the Stunkard scale. Adolescents showed significant difference (P<0.005) in perceptions and behaviors related to appearance, fitness, health, body areas and weight across various body mass index and socioeconomic categories. Girls articulated significantly higher (P<0.005) body dissatisfaction than boys. Attitudes and perceptions towards body image differ with sex, body mass index and socioeconomic class.

  11. Characterization of spatial variability of the relative chlorophyll index in wheat crop

    Directory of Open Access Journals (Sweden)

    Osmar Henrique de Castro Pias

    2014-09-01

    Full Text Available Site-specific nitrogen application, based on relative chlorophyll index from leaves, may provide many economic and environmental benefits, however, the knowledge on sampling methodologies is still incipient. Thus, this study aimed to evaluate the use of different sampling grids to characterize the spatial variability of relative chlorophyll index of leaves from wheat crop and elaborate thematic maps for site-specific nitrogen application. For determining the relative chlorophyll index, a CFL 1030 chlorophyll meter was used on a regular sampling grid of 10 m x 10 m with 472 sampling points. Based on the initial sampling grid, by using the point elimination method, the simulation was performed in the following sampling grids: 10 m x 20 m; 20 m x 20 m; 20 m x 30 m; 30 m x 30 m; 30 m x 40 m; and 40 m x 40 m. The increase of the sampling grid reduced the diagnostic accuracy of relative chlorophyll index in wheat leaves. As the sampling grid increased, the maps became more general and information on the spatial variability of the relative chlorophyll index were lost. Sampling grids smaller or equal to 20 m x 20 m were effective to detect the spatial variability of the relative chlorophyll index in wheat leaves and enable the elaboration of thematic maps for site-specific nitrogen application.

  12. Antioxidant-related gene polymorphisms associated with the cardio-ankle vascular index in young Russians.

    Science.gov (United States)

    Sorokin, Alexander V; Kotani, Kazuhiko; Bushueva, Olga Y; Polonikov, Alexey V

    2016-04-01

    The cardio-ankle vascular index is a measure of arterial stiffness, whereas oxidative stress underlies arterial pathology. This study aimed to investigate the association between the cardio-ankle vascular index and antioxidant-related gene polymorphisms in young Russians. A total of 89 patients (mean age, 21.6 years) were examined by the cardio-ankle vascular index and for 15 gene polymorphisms related to antioxidant enzymes including FMO3 (flavin-containing monooxygenase 3), GPX1 (glutathione peroxidase 1), and GPX4 (glutathione peroxidase 4). A higher cardio-ankle vascular index level was detected in carriers with the KK-genotype of FMO3 polymorphism rs2266782 than in those without (mean levels: 6.2 versus 5.6, respectively, pcardio-ankle vascular index level was seen in carriers with the CC-genotype of GPX4 polymorphism rs713041 than in those without (6.0 versus 5.5, respectively, pcardio-ankle vascular index levels and the other gene polymorphisms. Although carriers with the LL-genotype of GPX1 polymorphism rs1050450 showed a higher diastolic blood pressure level than those without, the polymorphism did not affect the cardio-ankle vascular index level. This study showed a significant association between rs2266782 and rs713041 polymorphisms and arterial stiffness, as measured by the cardio-ankle vascular index, in young Russians. The pathways utilised by antioxidant enzymes may be responsible for early arterial stiffening in the Russian population.

  13. Health-Related Quality of Life and Sociodemographic Characteristics as Prognostic Indicators of Long-term Survival in Disease-Free Cervical Cancer Survivors.

    Science.gov (United States)

    Kim, Mi-Kyung; Sim, Jin Ah; Yun, Young Ho; Bae, Duk-Soo; Nam, Joo Hyun; Park, Chong Taik; Cho, Chi-Heum; Lee, Jong-Min; Park, Sang Yoon

    2016-05-01

    Health-related quality-of-life (HRQOL) issues of cancer patients are considered an important clinical outcome. We aimed to investigate the prognostic value of HRQOL on long-term survival outcomes in disease-free cervical cancer survivors (CCSs). The study sample consisted of 860 disease-free CCSs from 6 Korean cancer hospitals recruited for HRQOL survey during 2005 (median time from diagnosis, 5.9 years). Health-related quality-of-life measures included the European Organization for Research and Treatment of Cancer QLQ-C30 and its Cervical Cancer Module (CX24). Survival data were retrieved from the Korean Statistical Office after 6 years from the survey. Health-related quality-of-life domains along with sociodemographic and clinicopathologic variables were analyzed as prognostic factors for survival from the date of survey. During the median follow-up period of 6.3 years after the survey, 30 (3.5%) patients died from all causes. Age, time since diagnosis, and physical activity were independent prognostic factors, which constituted the baseline model along with cancer stage. When HRQOL domains were tested separately against the baseline model, functional scales (physical, role, social, and emotional functioning), global health status, symptom scales (pain and appetite loss), and cervical cancer module items (body image, sexual inactivity, and sexual worry) were significantly associated with survival (P < 0.05). These findings suggest that, in addition to well-known prognostic factors, including age, time since diagnosis, and physical activity, HRQOL scores obtained from disease-free CCSs are associated with survival.

  14. Influence of low back pain and prognostic value of MRI in sciatica patients in relation to back pain

    NARCIS (Netherlands)

    A. el Barzouhi (Abdelilah); C.L.A.M. Vleggeert-Lankamp (Carmen); G.J.L.A. Nijeholt (Geert J. Lycklama A); B.F.W. van der Kallen (Bas); W.B. van den Hout (Wilbert); B.W. Koes (Bart); W.C. Peul (Wilco)

    2014-01-01

    textabstractBackground: Patients with sciatica frequently complain about associated back pain. It is not known whether there are prognostic relevant differences in Magnetic Resonance Imaging (MRI) findings between sciatica patients with and without disabling back pain. Methods: The study population

  15. Prognostic impact of hexokinase and glucose transporter expressions and clinicopathologic features related to F-18-FDG uptake in esophageal cancer

    NARCIS (Netherlands)

    Schreurs, Liesbeth M; Pultrum, Bareld B; Pavlov, Kirill; Pruim, Jan; Groen, Henk; Hollema, Harry; Plukker, John Theodorus

    39 Background: Elucidation of prognostic predictors based on biological viability may be useful for a better detection of patients with a high risk of relapse or death from esophageal cancer. METHODS: Maximum standardized uptake values (SUVmax) were measured in the preoperative 18F-FDG positron

  16. Prognostic factors related to clinical outcome following thrombectomy in ischemic stroke (RECOST Study). 50 patients prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Costalat, V., E-mail: vincentcost@hotmail.com [CHU Montpellier, Neuroradiology, Montpellier (France); Lobotesis, K., E-mail: kyriakos@lobotesis.co.uk [CHU Montpellier, Neuroradiology, Montpellier (France); Machi, P., E-mail: paolo.machi@gmail.com [CHU Montpellier, Neuroradiology, Montpellier (France); Mourand, I., E-mail: i-mourand@chu-montpellier.fr [CHU Montpellier, Neurology, Montpellier (France); Maldonado, I., E-mail: imaldonado@terra.com.br [CHU Montpellier, Neuroradiology, Montpellier (France); Heroum, C., E-mail: c-heroum@chu-montpellier.fr [CHU Montpellier, Neurology, Montpellier (France); Vendrell, J.F., E-mail: jf-vendrell@chu-montpellier.fr [CHU Montpellier, Neuroradiology, Montpellier (France); Milhaud, D., E-mail: d-milhaud@chu-montpellier.fr [CHU Montpellier, Neurology, Montpellier (France); Riquelme, C., E-mail: c-riquelme@chu-montpellier.fr [CHU Montpellier, Neuroradiology, Montpellier (France); Bonafé, A., E-mail: a-bonafe@chu-montpellier.fr [CHU Montpellier, Neuroradiology, Montpellier (France); Arquizan, C., E-mail: c-arquizan@chu-montpellier.fr [CHU Montpellier, Neurology, Montpellier (France)

    2012-12-15

    Background and aims: New thrombectomy devices allow successful and rapid recanalization in acute ischemic stroke. Nevertheless prognostics factors need to be systematically analyzed in the context of these new therapeutic strategies. The aim of this study was to analyze prognostic factors related to clinical outcome following Solitaire FR thrombectomy in ischemic stroke. Methods: Fifty consecutive ischemic stroke patients with large vessel occlusion were included. Three treatment strategies were applied; rescue therapy, combined therapy, and standalone thrombectomy. DWI ASPECT score < 5 was the main exclusion criterion after initial MRI (T2, T2*, TOF, FLAIR, DWI). Sexes, age, time to recanalization were prospectively collected. Clinical outcome was assessed post treatment, day one and discharge by means of a NIHSS. Three months mRS evaluation was performed by an independent neurologist. The probability of good outcome at 3 months was assessed by forward stepwise logistic regression using baseline NIHSS score, Glasgow score at entrance, hyperglycemia, dyslipidemia, blood–brain barrier disruption on post-operative CT, embolic and hemorrhagic post procedural complication, ischemic brain lesion extension on 24 h imaging, NIHSS at discharge, ASPECT score, and time to recanalization. All variables significantly associated with the outcome in the univariate analysis were entered in the model. The significance of adding or removing a variable from the logistic model was determined by the maximum likelihood ratio test. Odds-ratio (OR) and their 95% confidence intervals were calculated. Results: At 3 months 54% of patients had a mRS 0–2, 70% in MCA, 44% in ICA, and 43% in BA with an overall mortality rate of 12%. Baseline NIHSS score (p = 0.001), abnormal Glasgow score at entrance (p = 0.053) hyperglycemia (p = 0.023), dyslipidemia (p = 0.031), blood–brain barrier disruption (p = 0.022), embolic and hemorrhagic post procedural complication, ischemic brain lesion

  17. Population-based study of ovarian cancer in Côte d'Or: prognostic factors and trends in relative survival rates over the last 20 years

    Directory of Open Access Journals (Sweden)

    Altwegg Thierry

    2010-11-01

    Full Text Available Abstract Background The aim of this population-based study was to assess independent prognostic factors in ovarian cancer using relative survival (RS and to investigate changes in RS rates from 1982 to 2005. Methods Data on 748 patients with ovarian cancer were provided by the Côte d'Or gynaecologic cancer registry. The RS was estimated using a generalized linear model with a Poisson error structure. Relative survival and its 95% confidence interval (CI were described at the following specific time points 1, 3 and 5 years. The effect of prognostic factors on survival was assessed with multivariate analyses of RS. Results The median follow-up was 12 years. The RS rates at 1, 3 and 5 years were 81%, 55% and 44%, respectively. As compared with the period 1982-1989, an improvement in survival was found for the period 1998-2005: HR = 0.52[0.40-0.67]. Women who lived in urban areas had better RS: HR = 0.82[0.67-0.99]. Patients with epithelial types of ovarian cancer other than mucinous or endometrioid cancer had worse RS than those with serous histology. Age ≥ 70 years was associated with lower survival. Conclusions Period of diagnosis, stage at diagnosis, histology, place of residence and age were independent prognostic factors for survival in ovarian cancer. An improvement in the survival rate was observed after 1998 but a significant improvement was limited to advanced stage cancers.

  18. Intensity and Pattern of Enhancement on CESM: Prognostic Significance and its Relation to Expression of Podoplanin in Tumor Stroma - A Preliminary Report.

    Science.gov (United States)

    Luczynska, Elzbieta; Niemiec, Joanna; Heinze, Sylwia; Adamczyk, Agnieszka; Ambicka, Aleksandra; Marcyniuk, Paulina; Rudnicki, Wojciech; Mitus, Jerzy W; Dyczek, Sonia; Rys, Janusz; Sas-Korczynska, Beata

    2018-02-01

    It is possible that the degree of enhancement on contrast-enhanced spectral mammography (CESM), a new diagnostic method, might provide prognostic information for breast cancer patients. Therefore, in a group of 82 breast cancer patients, we analyzed the prognostic significance of degree and pattern of enhancement on CESM as well as its relation to: (a) breast cancer immunophenotype (based on ER/PR/HER2 status) (b) podoplanin expression in cancer stroma (lymphatic vessel density plus podoplanin-positivity of cancer-associated fibroblasts), and (c) other histological parameters. For each tumor the intensity of enhancement on CESM was qualitatively assessed as strong or weak/medium, while the pattern - as homogenous and heterogenous. Herein we report, for the first time, that strong and heterogenous enhancement on CESM was related to unfavorable disease-free survival of breast cancer patients (p=0.005). Moreover, the strong enhancement was more frequent in large and node-positive tumors (pT>1, pN>0) (p=0.002), as well as in carcinomas with podoplanin-sparse stroma (p=0.008). Intensity and pattern of enhancement on CESM might provide (together with the results of other diagnostic imaging methods) not only the confirmation of presence or absence of tumor, but also prognostic information. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  19. Hemodialysis-Induced Regional Left Ventricular Systolic Dysfunction: Prevalence, Patient and Dialysis Treatment-Related Factors, and Prognostic Significance

    Science.gov (United States)

    Assa, Solmaz; Hummel, Yoran M.; Voors, Adriaan A.; Kuipers, Johanna; Westerhuis, Ralf; de Jong, Paul E.

    2012-01-01

    Summary Background and objectives The hemodialysis procedure may acutely induce regional left ventricular systolic dysfunction. This study evaluated the prevalence, time course, and associated patient- and dialysis-related factors of this entity and its association with outcome. Design, setting, participants, & measurements Hemodialysis patients (105) on a three times per week dialysis schedule were studied between March of 2009 and March of 2010. Echocardiography was performed before dialysis, at 60 and 180 minutes intradialysis, and at 30 minutes postdialysis. Hemodialysis-induced regional left ventricular systolic dysfunction was defined as an increase in wall motion score in more than or equal to two segments. Results Hemodialysis-induced regional left ventricular systolic dysfunction occurred in 29 (27%) patients; 17 patients developed regional left ventricular systolic dysfunction 60 minutes after onset of dialysis. Patients with hemodialysis-induced left ventricular systolic dysfunction were more often male, had higher left ventricular mass index, and had worse predialysis left ventricular systolic function (left ventricular ejection fraction). The course of blood volume, BP, heart rate, electrolytes, and acid–base parameters during dialysis did not differ significantly between the two groups. Patients with hemodialysis-induced regional left ventricular systolic dysfunction had a significantly higher mortality after correction for age, sex, dialysis vintage, diabetes, cardiovascular history, ultrafiltration volume, left ventricular mass index, and predialysis wall motion score index. Conclusions Hemodialysis induces regional wall motion abnormalities in a significant proportion of patients, and these changes are independently associated with increased mortality. Hemodialysis-induced regional left ventricular systolic dysfunction occurs early during hemodialysis and is not related to changes in blood volume, electrolytes, and acid–base parameters. PMID

  20. A Generic Software Architecture For Prognostics

    Science.gov (United States)

    Teubert, Christopher; Daigle, Matthew J.; Sankararaman, Shankar; Goebel, Kai; Watkins, Jason

    2017-01-01

    Prognostics is a systems engineering discipline focused on predicting end-of-life of components and systems. As a relatively new and emerging technology, there are few fielded implementations of prognostics, due in part to practitioners perceiving a large hurdle in developing the models, algorithms, architecture, and integration pieces. As a result, no open software frameworks for applying prognostics currently exist. This paper introduces the Generic Software Architecture for Prognostics (GSAP), an open-source, cross-platform, object-oriented software framework and support library for creating prognostics applications. GSAP was designed to make prognostics more accessible and enable faster adoption and implementation by industry, by reducing the effort and investment required to develop, test, and deploy prognostics. This paper describes the requirements, design, and testing of GSAP. Additionally, a detailed case study involving battery prognostics demonstrates its use.

  1. A Novel Inflammation- and Nutrition-Based Prognostic System for Patients with Laryngeal Squamous Cell Carcinoma: Combination of Red Blood Cell Distribution Width and Body Mass Index (COR-BMI).

    Science.gov (United States)

    Fu, Yan; Mao, Yize; Chen, Shiqi; Yang, Ankui; Zhang, Quan

    Laryngeal squamous cell carcinoma (LSCC) is a head and neck cancer type. In this study, we introduced a novel inflammation- and nutrition-based prognostic system, referred to as COR-BMI (Combination of red blood cell distribution width and body mass index), for LSCC patients. A total of 807 LSCC patients (784 male and 23 female, 22-87 y of age) who underwent surgery were enrolled in this retrospective cohort study. The patients were stratified by COR-BMI into three groups: COR-BMI (0) (RDW ≤ 13.1 and BMI ≥ 25); COR-BMI (1) (RDW ≤ 13.1 and BMI 13.1 and 18.5 ≤ BMI 13.1 and BMI cancer-specific survival (CSS) rate among LSCC patients. The 5-y, 10-y, and 15-y CSS rates were 71.6%, 60.1%, and 55.4%, respectively. There were significant differences among the COR-BMI groups in age (nutrition-based prognostic system, which could predict long-term survival in LSCC patients who underwent surgery.

  2. Age-related normal ranges for the Haller index in children

    Energy Technology Data Exchange (ETDEWEB)

    Daunt, Stephen W.; Cohen, Justine H.; Miller, Stephen F. [Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8 (Canada)

    2004-04-01

    The Haller index is an accepted CT method for evaluating thoracic dimensions in patients with pectus excavatum. The purpose of this study is to establish age- and gender-related norms for the Haller index in childhood. We retrospectively reviewed 574 consecutive chest CT examinations (M=285, F=289) performed at our institution from August 2001 through March 2002. Seventeen patients with a history of chest-wall deformity, trauma, or syndrome were excluded, for a total sample size of 557 patients. The Haller index was calculated for each patient, using electronic calipers. The sample population was then separated by gender and placed into 2-year age groupings. Two-way analysis of variance and Tukey's multiple comparisons were performed to determine significance at a=0.05. The least-square mean Haller index values for each age group and gender were calculated with 95% confidence intervals. In both males and females, the 0- to 2-year age group showed a significantly smaller mean Haller index than older children. In addition, females had significantly greater Haller index values than males in the 0- to 6- and 12- to 18-year age groups. The Haller index, a quantitative measurement of chest-wall configuration, demonstrates significant age- and gender-related variability. This should be considered when evaluating the patient with suspected chest-wall deformity. (orig.)

  3. Expression of multi-drug resistance-related genes MDR3 and MRP as prognostic factors in clinical liver cancer patients.

    Science.gov (United States)

    Yu, Zheng; Peng, Sun; Hong-Ming, Pan; Kai-Feng, Wang

    2012-01-01

    To investigate the expression of multi-drug resistance-related genes, MDR3 and MRP, in clinical specimens of primary liver cancer and their potential as prognostic factors in liver cancer patients. A total of 26 patients with primary liver cancer were enrolled. The expression of MDR3 and MRP genes was measured by real-time PCR and the association between gene expression and the prognosis of patients was analyzed by the Kaplan-Meier method and COX regression model. This study showed that increases in MDR3 gene expression were identified in cholangiocellular carcinoma, cirrhosis and HBsAg-positive patients, while MRP expression increased in hepatocellular carcinoma, non-cirrhosis and HBsAg-negative patients. Moreover, conjugated bilirubin and total bile acid in the serum were significantly reduced in patients with high MRP expression compared to patients with low expression. The overall survival tended to be longer in patients with high MDR3 and MRP expression compared to the control group. MRP might be an independent prognostic factor in patients with liver cancer by COX regression analysis. MDR3 and MRP may play important roles in liver cancer patients as prognostic factors and their underlying mechanisms in liver cancer are worthy of further investigation.

  4. Prognostic, quantitative histopathologic variables in lobular carcinoma of the breast

    DEFF Research Database (Denmark)

    Ladekarl, M; Sørensen, Flemming Brandt

    1993-01-01

    of disease, vv(nuc), MI, and NI were of significant independent, prognostic value. On the basis of the multivariate analyses, a prognostic index with highly distinguishing capacity between prognostically poor and favorable cases was constructed. CONCLUSION: Quantitative histopathologic variables are of value...

  5. Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma [v2; ref status: indexed, http://f1000r.es/4k6

    Directory of Open Access Journals (Sweden)

    Tianhua Guo

    2014-10-01

    Full Text Available Thrombocytosis portends adverse prognostic significance in many types of cancers including ovarian and lung carcinoma. In this study, we determined the prevalence and prognostic significance of thrombocytosis (defined as platelet count in excess of 400 × 103/μl in patients with colorectal cancer. We performed a retrospective analysis of 310 consecutive patients diagnosed at our Institution between 2004 and 2013. The patients (48.7% male and 51.3% female had a mean age of 69.9 years (+/- 12.7 years at diagnosis. Thrombocytosis was found in a total of 25 patients, with a higher incidence in those with stage III and IV disease (14.4% of patients. Although the mean platelet count increased with the depth of tumor invasion (pT, its values remained within normal limits in the whole patient cohort. No patient with stage I cancer (n=57 had elevated platelet count at diagnosis. By contrast, five of the 78 patients (6.4% with stage II cancer showed thrombocytosis, and four of these patients showed early recurrence and/or metastatic disease, resulting in shortened survival (they died within one year after surgery. The incidence of thrombocytosis increased to 12.2% and 20.6%, respectively, in patients with stage III and IV disease. The overall survival rate of patients with thrombocytosis was lower than those without thrombocytosis in the stage II and III disease groups, but this difference disappeared in patients with stage IV cancer who did poorly regardless of their platelet count. We concluded that thrombocytosis at diagnosis indicates adverse clinical outcome in colorectal cancer patients with stage II or III disease. This observation is especially intriguing in stage II patients because the clinical management of these patients is controversial. If our data are confirmed in larger studies, stage II colon cancer patients with thrombocytosis may be considered for adjuvant chemotherapy.

  6. Prognostic evaluation of DNA index in HIV-HPV co-infected women cervical samples attending in reference centers for HIV-AIDS in Recife.

    Directory of Open Access Journals (Sweden)

    Albert Eduardo Silva Martins

    Full Text Available INTRODUCTION: Persistence of cervical infection caused by human papillomavirus (HPV types with high oncogenic risk may lead to cervical intraepithelial neoplasia (CIN. The aim of the present study was to evaluate whether, in HIV-positive women, the presence of aneuploidy in cervical cell samples is associated with presence and evolution of CIN. METHODS: The present study had two stages. In the first stage, comprising a cross-sectional study, the association between the presence of aneuploidy seen via flow cytometry and sociodemographic characteristics, habits and characteristics relating to HPV and HIV infection was analyzed. In the second stage, comprising a cohort study, it was investigated whether aneuploidy was predictive of CIN evolution. RESULTS: No association was observed between the presence of aneuploidy and HPV infection, or between its presence and alterations seen in oncotic cytological analysis. On the other hand, aneuploidy was associated with the presence of CIN (p = 0.030 in histological analysis and with nonuse of antiretroviral therapy (p = 0.001. Most of the HIV-positive women (234/272 presented normal CD4+ T lymphocyte counts (greater than 350 cells/mm3 and showed a greater aneuploidy regression rate (77.5% than a progression rate (23.9% over a follow-up of up to two years. CONCLUSION: Although there was an association between the presence of cervical tissue lesions and the DNA index, the latter was not predictive of progression of the cervical lesion. This suggests that progression of the cervical lesion to cancer in HIV-positive women may also be changed through improvement of the immunological state enabled by using antiretroviral therapy.

  7. Macrovesicular steatosis in living related liver donors: correlation of biopsy findings with CT liver attenuation index and body mass index.

    Science.gov (United States)

    Jehangir, Maham; Nazir, Rashed; Jang, Aisha; Rana, Atif; Rafique, Salman; Dar, Faisal Saud

    2016-09-01

    Hepatic steatosis threatens post-transplant graft survival; therefore, pre-operative quantification of steatosis is crucial. Gold standard for evaluation is donor liver biopsy but it is invasive. An alternative non-invasive method is a calculation of CT liver attenuation index. BMI can be an independent factor predicting grade of steatosis but it is necessary to re-define appropriate BMI cut-off points that are specific for Asians. To retrospectively analyze CT LAI and BMI for quantitative assessment of macrovesicular steatosis in living related liver donors, using histological analysis as gold standard. A radiologist blinded to histological grading calculated mean CT hepatic attenuation in 48 potential living related liver donors. CT-derived LAI correctly predicted steatosis in all except 1 patient. Parametric analysis for CT LAI and BMI showed overall weak positive correlation. No significant association was found between BMI and biopsy findings. Liver biopsy remains a gold standard for evaluation of steatosis. CT LAI of ≤0 correlates well with significant hepatic steatosis and biopsy may be avoided in such cases. Biopsy may be reserved for patients with CT LAI between 1 and 5. BMI alone is not a good predictor of hepatic steatosis in our study population. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Health-related quality of life is a prognostic factor for survival in older patients after colorectal cancer diagnosis: A population-based study.

    Science.gov (United States)

    Fournier, Evelyne; Jooste, Valérie; Woronoff, Anne-Sophie; Quipourt, Valérie; Bouvier, Anne-Marie; Mercier, Mariette

    2016-01-01

    Studies carried out in the context of clinical trials have shown a relationship between survival and health-related quality of life in colorectal cancer patients. We assessed the prognostic value of health-related quality of life at diagnosis and of its longitudinal evolution on survival in older colorectal cancer patients. All patients aged ≥65 years, diagnosed with new colorectal cancer between 2003 and 2005 and registered in the Digestive Cancer Registry of Burgundy were eligible. Patients were asked to complete the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at inclusion, three, six and twelve months after. Multivariate regression models were used to evaluate the prognostic value of health-related quality of life scores at diagnosis and their deterioration on relative survival. In multivariate analysis, a role functioning dimension lower than median was predictive of lower survival (hazard ratio=3.1, p=0.015). After three and six months of follow-up, patients with greater appetite loss were more likely to die, with hazard ratios of 4.7 (p=0.013) and 3.7 (p=0.002), respectively. Health-related quality of life assessments at diagnosis are independently associated with older colorectal cancer patients' survival. Its preservation should be a major management goal for older cancer patients. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  9. Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma.

    Science.gov (United States)

    Chang, Wei-Chin; Lin, Chun-Shu; Yang, Cheng-Yu; Lin, Chih-Kung; Chen, Yuan-Wu

    2017-10-17

    Lymph node metastasis in oral squamous cell carcinoma (OSCC) is a poor prognostic factor. The histopathologic stage (e.g., pN) is used to evaluate the severity of lymph node metastasis; however, the current staging system insufficiently predicts survival and recurrence. We investigated clinical outcomes and lymph node density (LND) in betel nut-chewing individuals. We retrospectively analyzed 389 betel nut-exposed patients with primary OSCC who underwent surgical resection in 2002-2015. The prognostic significance of LND was evaluated by overall survival (OS) and disease-free survival (DFS) using the Kaplan-Meier method. Kaplan-Meier analyses showed that the 5-year OS and DFS rates in all patients were 60.9 and 48.9%, respectively. Multivariate analysis showed that variables independently prognostic for OS were aged population (hazard ratio [HR] = 1.6, 95% confidence interval [95% CI] = 1.1-2.5; P = .025), and cell differentiation classification (HR = 2.4, 95% CI = 1.4-4.2; P = .002). In pathologic N-positive patients, a receiver operating characteristic (ROC) curve for OS was used and indicated the best cutoff of 0.05, and the multivariate analysis showed that LND was an independent predictor of OS (HR = 2.2, 95% CI = 1.3-3.7; P = .004). Lymph node density, at a cutoff of 0.05, was an independent predictor of OS and DFS. OS and DFS underwent multiple analyses, and LND remained significant. The pathologic N stage had no influence in the OS analysis. LND is a more reliable predictor of survival in betel nut-chewing patients for further post operation adjuvant treatment, such as reoperation or adjuvant radiotherapy.

  10. Hirsch Index Value and Variability Related to General Surgery in a UK Deanery.

    Science.gov (United States)

    Abdelrahman, Tarig; Brown, Josephine; Wheat, Jenny; Thomas, Charlotte; Lewis, Wyn

    2016-01-01

    The Hirsch Index (h-index) is often used to assess research impact, and on average a social science senior lecturer will have an h-index of 2.29, yet its validity within the context of UK General Surgery (GS) is unknown. The aim of this study was to calculate the h-indices of a cohort of GS consultants in a UK Deanery to assess its relative validity. Individual h-indices and total publication (TP) counts were obtained for GS consultants via the Scopus and Web of Science (WoS) Internet search engines. Assessment of construct validity and reliability of these 2 measures of the h-index was undertaken. All hospitals in a single UK National Health Service Deanery were included (14 general hospitals). All 136 GS consultants from the Deanery were included. Median h-index (Scopus) was 5 (0-52) and TP 15 (0-369), and strong correlation was found between h-index and TP (ρ = 0.932, p Scopus and WoS h-index also significant (intraclass correlation coefficient = 0.973 [95% CI: 0.962-0.981], p Scopus 12 vs 7 vs 4 [p 2.29 in 57.4% of consultants. No subspecialty differences were apparent in median h-indices (p = 0.792) and TP (p = 0.903). h-Index is a valid GS research productivity metric with over half of consultants performing at levels equivalent to social science Senior Lecturers. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. The prognostic value of the neoadjuvant response index in triple-negative breast cancer : validation and comparison with pathological complete response as outcome measure

    NARCIS (Netherlands)

    Jebbink, M.; van Werkhoven, E.; Mandjes, I. A. M.; Wesseling, J.; Lips, E. H.; Peeters, M. -J. T. D. F. Vrancken; Loo, C. E.; Sonke, G. S.; Linn, S. C.; Falo Zamora, C.; Rodenhuis, S.

    The Neoadjuvant response index (NRI) has been proposed as a simple measure of downstaging by neoadjuvant treatment in breast cancer. It was previously found to predict recurrence-free survival (RFS) in triple-negative (TN) breast cancer. It was at least as accurate as the standard binary system, the

  12. Work ability as prognostic risk marker of disability pension : Single-item work ability score versus multi-item work ability index

    NARCIS (Netherlands)

    Roelen, C.A.M.; Rhenen, van W.; Groothoff, J.W.; Klink, van der J.J.L.; Twisk, W.R.; Heymans, M.W.

    2014-01-01

    Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP.

  13. Serial changes and prognostic implications of a Doppler-derived index of combined left ventricular systolic and diastolic myocardial performance in acute myocardial infarction

    DEFF Research Database (Denmark)

    Poulsen, Steen H; Jensen, Svend E; Nielsen, Jens C

    2000-01-01

    relaxation time divided by ejection time was measured from mitral inflow and left ventricular outflow Doppler velocity profiles. The index was significantly higher in patients with AMI than in control subjects at days 1 and 360 (day 1, 0.58 +/- 0.09 vs 0.41 +/- 0.08, p

  14. 1960-69 Cumulative Index of Articles Related to Oceanography and Limnology Education in The Science Teacher.

    Science.gov (United States)

    Cohen, Maxwell

    Indexed are articles relating to oceanography and limnology published in "The Science Teacher" between 1960 and 1969. Articles are indexed under title, author, and topic. Topics include background information, course descriptions, and laboratory equipment and techniques. (EB)

  15. Aircraft Anomaly Prognostics Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Ridgetop Group will leverage its proven Electromechanical Actuator (EMA) prognostics methodology to develop an advanced model-based actuator prognostic reasoner...

  16. Oral Leukoplakia: Clinicopathological Correlation and Its Relevance to Regional Tobacco-related Habit Index.

    Science.gov (United States)

    Shetty, Prashanth; Hegde, Shweta; Vinod, K S; Kalra, Salona; Goyal, Prasoon; Patel, Mimansha

    2016-07-01

    A case control study was carried out to evaluate the synergistic effects of habits quantified by habit index and its effect and severity on the clinicopathological features of oral leukoplakia in a cohort of 100 patients visiting Triveni Dental College, Bilaspur, Chhattisgarh, India. One hundred patients indulging in tobacco-related habits (smoking and smokeless forms) were categorized into two groups: A case/experimental group consisting of 50 patients presenting with oral leukoplakia lesion and a control group consisting of 50 patients with no clinical signs of oral leukoplakia. Habit index was calculated in both groups. Case group was further subjected to incisional biopsy of the lesion followed by histopathological examination. All the variables in the study were statistically analyzed for the mean, standard deviation, i.e., value of central tendency, z-test, test of significance, and Pearson's correlation (r-test). For p habit index was significantly higher in the case group. Higher bidi habit index was evident in the severe stages of lesion ice, p habit index in the case group contributed significantly for severe stages of lesion and thereby indicates its probable progression toward malignancy. Nonhomogenous leukoplakia of the speckled subtype exhibited moderate and severe epithelial dysplasia. Hence, quantification of tobacco-related habits and the clinical appearance of the premalignant lesion predict the risk of subsequent malignant transformation of the disease.

  17. Lodgepole pine site index in relation to synoptic measures of climate, soil moisture and soil nutrients.

    Science.gov (United States)

    G. Geoff Wang; Shongming Huang; Robert A. Monserud; Ryan J. Klos

    2004-01-01

    Lodgepole pine site index was examined in relation to synoptic measures of topography, soil moisture, and soil nutrients in Alberta. Data came from 214 lodgepole pine-dominated stands sampled as a part of the provincial permanent sample plot program. Spatial location (elevation, latitude, and longitude) and natural subregions (NSRs) were topographic variables that...

  18. Dietary hyperglycemia, glycemic index and age-related metabolic retinal diseases

    Science.gov (United States)

    The glycemic index (GI) indicates how fast blood glucose is raised after consuming a carbohydrate-containing food. Human metabolic studies indicate that GI is related to patho-physiological responses after meals. Compared with a low-GI meal, a high-GI meal is characterized with hyperglycemia during ...

  19. Pregnancy-related pelvic pain is more frequent in women with increased body mass index

    DEFF Research Database (Denmark)

    Biering, K; Nohr, EA; Olsen, J

    2011-01-01

    were interviewed twice during pregnancy and twice after childbirth. The first pregnancy interview provided information on self-reported pre-pregnancy body mass index (BMI) and possible confounders, while data on pregnancy-related pelvic pain came from an interview sixmonths postpartum. Cases (n=2 271...

  20. Changes in relative consumer prices and the substitution bias of the Laspeyres price index: Ireland, 1985-2001

    OpenAIRE

    Somerville, R. A.

    2004-01-01

    This paper shows that Irish relative consumer prices have changed significantly, 1985- 2001, at the ten commodity-group level. A “true” cost-of-living index is derived from Madden’s (1993) parameter estimates for an Almost Ideal Demand System. Despite relative price changes, the substitution bias of a computed Laspeyres index is small, and the official Consumer Price Index tracks the computed index closely. Superlative indices are also constructed, but are not satisfactory cost-of-living indi...

  1. A Novel Inflammation- and Nutrition-Based Prognostic System for Patients with Laryngeal Squamous Cell Carcinoma: Combination of Red Blood Cell Distribution Width and Body Mass Index (COR-BMI.

    Directory of Open Access Journals (Sweden)

    Yan Fu

    Full Text Available Laryngeal squamous cell carcinoma (LSCC is a head and neck cancer type. In this study, we introduced a novel inflammation- and nutrition-based prognostic system, referred to as COR-BMI (Combination of red blood cell distribution width and body mass index, for LSCC patients.A total of 807 LSCC patients (784 male and 23 female, 22-87 y of age who underwent surgery were enrolled in this retrospective cohort study. The patients were stratified by COR-BMI into three groups: COR-BMI (0 (RDW ≤ 13.1 and BMI ≥ 25; COR-BMI (1 (RDW ≤ 13.1 and BMI 13.1 and 18.5 ≤ BMI 13.1 and BMI < 18.5. Cox regression models were used to investigate the association between COR-BMI and cancer-specific survival (CSS rate among LSCC patients.The 5-y, 10-y, and 15-y CSS rates were 71.6%, 60.1%, and 55.4%, respectively. There were significant differences among the COR-BMI groups in age (< 60 versus ≥ 60 y; P = 0.005 and T stage (T1, T2, T3, or T4; P = 0.013. Based on the results, COR-BMI (1 versus 0: HR = 1.76; 95% CI = 0.98-3.15; 2 versus 0: HR = 2.91; 95% CI = 1.53-5.54, P = 0.001 was a significant independent predictor of CSS.COR-BMI is a novel inflammation- and nutrition-based prognostic system, which could predict long-term survival in LSCC patients who underwent surgery.

  2. Standardized uptake value for (18)F-fluorodeoxyglucose is correlated with a high International Prognostic Index and the presence of extranodal involvement in patients with diffuse large B-cell lymphoma.

    Science.gov (United States)

    Akkas, B E; Vural, G U

    2014-01-01

    The aim of this study was to evaluate whether the maximum standardized uptake value (SUVmax) of (18)F-fluorodeoxyglucose (FDG) correlates with the International Prognostic Index (IPI) and the presence of extranodal involvement in patients with Diffuse Large B-Cell Lymphoma (DLBCL). 77 patients (age: 57.2±18.5, 40F, 37M) with DLBCL who underwent FDG PET/CT for initial staging were included. SUVmax of the predominant lesions were compared to Ann Arbor stage, IPI scores, the presence of extranodal involvement and the number extranodal sites. PET/CT detected nodal (n:25) and extranodal involvement (n:52) in all the patients. In 27 patients, extranodal disease could only be detected by PET. SUVmax of the predominant lesion in patients with extranodal disease was significantly higher than that of the patients who had only nodal disease (25±12 vs. 15.3±10 respectively, p=0.001). SUVmax significantly correlated with IPI scores; the average SUVmax was significantly correlated with the IPI: Mean SUVmax of the predominant lesion was 13.9±9.5 in patients with low risk (IPI=0-1), 14.2±8.8 in low-intermediate risk group (IPI=2) whereas 26.6±9.5 in high-intermediate risk group (IPI=3) and 25±13.6 in high risk group patients (IPI=4-5) (p=0.002). SUVmax was not correlated with clinical stage, the number of extranodal sites and serum LDH levels. FDG uptake correlates with IPI and the presence of extranodal involvement in DLBCL. PET is a powerful method to detect extranodal disease in DLBCL. The correlation of SUVmax with these prognostic factors may highlight the importance of pretreatment FDG uptake as a metabolic marker of poor prognosis for patients with DLBCL. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  3. Relation between ISE 30 index and ISE 30 index futures markets: Evidence from recursive and rolling cointegration

    Directory of Open Access Journals (Sweden)

    Aysegul Ates

    2016-03-01

    Full Text Available Turkey is one of the most dynamic emerging markets in the world and its futures market has developed significantly since the introduction of futures contracts by Turkish Derivatives Exchange in 2005. Istanbul Stock Index 30 (ISE 30 futures was one of the first contracts introduced and its trading increased rapidly over time. This study specifically focuses on the evolution and stability of cointegration relationship between the futures and spot prices of ISE 30 index during the sample period from February 4, 2005 through October 19, 2012. We test whether changing market conditions have an impact on the long-run relationship between spot index and index futures markets by employing recursive and rolling cointegration techniques. The findings reveal that the cointegration relationship weakens significantly during the global financial crisis and eurozone debt crisis periods but holds mostly over the estimation period.

  4. Variation of the Anthropometric Index for pectus excavatum relative to age, race, and sex

    Directory of Open Access Journals (Sweden)

    Eduardo Baldassari Rebeis

    2013-09-01

    Full Text Available OBJECTIVES: To determine possible variations in the Anthropometric Index for pectus excavatum relative to age, race, and sex in individuals free of thoracic wall deformities. METHODS: Between 2002 and 2012, 166 individuals with morphologically normal thoracic walls consented to have their chests and the perimeter of the lower third of the thorax measured according to the Anthropometric Index for pectus excavatum. The participant characteristics are presented (114 men and 52 women; 118 Caucasians and 48 people of African descent. RESULTS: Measurements of the Anthropometric Index for pectus excavatum were statistically significantly different between men and women (11-40 years old; however, no significant difference was found between Caucasians and people of African descent. For men, the index measurements were not significantly different across all of the age groups. For women, the index measurements were significantly lower for individuals aged 3 to 10 years old than for individuals aged 11 to 20 years old and 21 to 40 years old; however, no such difference was observed between women aged 11 to 20 years old and those aged 21 to 40 years old. CONCLUSION: In the sample, significant differences were observed between women aged 11 to 40 years old and the other age groups; however, there was no difference between Caucasian and people of African descent.

  5. The H-index as a quantitative indicator of the relative impact of human diseases.

    Science.gov (United States)

    McIntyre, K Marie; Hawkes, Iain; Waret-Szkuta, Agnès; Morand, Serge; Baylis, Matthew

    2011-01-01

    Assessment of the relative impact of diseases and pathogens is important for agencies and other organizations charged with providing disease surveillance, management and control. It also helps funders of disease-related research to identify the most important areas for investment. Decisions as to which pathogens or diseases to target are often made using complex risk assessment approaches; however, these usually involve evaluating a large number of hazards as it is rarely feasible to conduct an in-depth appraisal of each. Here we propose the use of the H-index (or Hirsch index) as an alternative rapid, repeatable and objective means of assessing pathogen impact. H-index scores for 1,414 human pathogens were obtained from the Institute for Scientific Information's Web of Science (WOS) in July/August 2010. Scores were compared for zoonotic/non-zoonotic, and emerging/non-emerging pathogens, and across taxonomic groups. H-indices for a subset of pathogens were compared with Disability Adjusted Life Year (DALY) estimates for the diseases they cause. H-indices ranged from 0 to 456, with a median of 11. Emerging pathogens had higher H-indices than non-emerging pathogens. Zoonotic pathogens tended to have higher H-indices than human-only pathogens, although the opposite was observed for viruses. There was a significant correlation between the DALY of a disease and the H-index of the pathogen(s) that cause it. Therefore, scientific interest, as measured by the H-index, appears to be a reflection of the true impact of pathogens. The H-index method can be utilized to set up an objective, repeatable and readily automated system for assessing pathogen or disease impact.

  6. The H-index as a quantitative indicator of the relative impact of human diseases.

    Directory of Open Access Journals (Sweden)

    K Marie McIntyre

    Full Text Available Assessment of the relative impact of diseases and pathogens is important for agencies and other organizations charged with providing disease surveillance, management and control. It also helps funders of disease-related research to identify the most important areas for investment. Decisions as to which pathogens or diseases to target are often made using complex risk assessment approaches; however, these usually involve evaluating a large number of hazards as it is rarely feasible to conduct an in-depth appraisal of each. Here we propose the use of the H-index (or Hirsch index as an alternative rapid, repeatable and objective means of assessing pathogen impact. H-index scores for 1,414 human pathogens were obtained from the Institute for Scientific Information's Web of Science (WOS in July/August 2010. Scores were compared for zoonotic/non-zoonotic, and emerging/non-emerging pathogens, and across taxonomic groups. H-indices for a subset of pathogens were compared with Disability Adjusted Life Year (DALY estimates for the diseases they cause. H-indices ranged from 0 to 456, with a median of 11. Emerging pathogens had higher H-indices than non-emerging pathogens. Zoonotic pathogens tended to have higher H-indices than human-only pathogens, although the opposite was observed for viruses. There was a significant correlation between the DALY of a disease and the H-index of the pathogen(s that cause it. Therefore, scientific interest, as measured by the H-index, appears to be a reflection of the true impact of pathogens. The H-index method can be utilized to set up an objective, repeatable and readily automated system for assessing pathogen or disease impact.

  7. Identification of prognostic biomarkers in hepatitis B virus-related hepatocellular carcinoma and stratification by integrative multi-omics analysis.

    Science.gov (United States)

    Miao, Ruoyu; Luo, Haitao; Zhou, Huandi; Li, Guangbing; Bu, Dechao; Yang, Xiaobo; Zhao, Xue; Zhang, Haohai; Liu, Song; Zhong, Ying; Zou, Zhen; Zhao, Yan; Yu, Kuntao; He, Lian; Sang, Xinting; Zhong, Shouxian; Huang, Jiefu; Wu, Yan; Miksad, Rebecca A; Robson, Simon C; Jiang, Chengyu; Zhao, Yi; Zhao, Haitao

    2014-10-01

    The differentiation of distinct multifocal hepatocellular carcinoma (HCC): multicentric disease vs. intrahepatic metastases, in which the management and prognosis varies substantively, remains problematic. We aim to stratify multifocal HCC and identify novel diagnostic and prognostic biomarkers by performing whole genome and transcriptome sequencing, as part of a multi-omics strategy. A complete collection of tumour and somatic specimens (intrahepatic HCC lesions, matched non-cancerous liver tissue and blood) were obtained from representative patients with multifocal HCC exhibiting two distinct postsurgical courses. Whole-genome and transcriptome sequencing with genotyping were performed for each tissue specimen to contrast genomic alterations, including hepatitis B virus integrations, somatic mutations, copy number variations, and structural variations. We then constructed a phylogenetic tree to visualise individual tumour evolution and performed functional enrichment analyses on select differentially expressed genes to elucidate biological processes involved in multifocal HCC development. Multi-omics data were integrated with detailed clinicopathological information to identify HCC biomarkers, which were further validated using a large cohort of HCC patients (n = 174). The multi-omics profiling and tumour biomarkers could successfully distinguish the two multifocal HCC types, while accurately predicting clonality and aggressiveness. The dual-specificity protein kinase TTK, which is a key mitotic checkpoint regulator with links to p53 signaling, was further shown to be a promising overall prognostic marker for HCC in the large patient cohort. Comprehensive multi-omics characterisation of multifocal tumour evolution may improve clinical decision-making, facilitate personalised medicine, and expedite identification of novel biomarkers and therapeutic targets in HCC. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All

  8. Microcystic, elongated, and fragmented pattern of invasion in relation to histopathologic and clinical prognostic factors in endometrioid endometrial adenocarcinoma

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    Naki, M. Murat; Oran, Gülbin; Tetikkurt, Seza Ümit; Sönmez, Cavide Fatma; Türkmen, İlknur; Köse, Faruk

    2017-01-01

    Objective: To investigate the association of microcystic, elongated, and fragmented (MELF) pattern of invasion with prognostic factors in endometrioid endometrial adenocarcinoma (EEA). Material and Methods: Stained tissue sections from 83 cases of EEA operated by the same gynecologic oncologist were reviewed to identify cases showing MELF-type invasion in this retrospective study. The association of MELF pattern with age, tumor grade, depth of myometrial invasion, and presence of lymphovascular space invasion (LVSI) was analyzed. Results: FIGO grade 2 and grade 1 tumors were evident in 53.0% and 38.6% of patients, respectively. Depth of myometrial invasion was <50% in 72.0% of patients, and LVSI was absent in 77.1%. MELF pattern was confirmed in 35 (42.2%) patients. Presence of MELF pattern was associated with significantly higher mean ± standard deviation age (62.9±6.9) years vs. 58.9±9.1 years, p=0.033), and found to be more likely in patients with high-grade tumor (FIGO grade III; 85.7% vs. 14.3%, p<0.001), deep (≥50%) myometrial invasion (78.3% vs. 21.7%, p<0.001), and presence of LVSI (94.7% vs. 5.3%, p<0.001) as compared with absence of MELF pattern. Conclusion: In conclusion, our findings revealed a high rate of MELF pattern among patients with EEA alongside the association of MELF pattern with poor prognostic factors such as high grade tumor, deep myometrial invasion, and LVSI. PMID:28890428

  9. Usefulness of Geriatric Nutritional Risk Index for Assessing Nutritional Status and Its Prognostic Impact in Patients Aged ≥65 Years With Acute Heart Failure.

    Science.gov (United States)

    Honda, Yasuyuki; Nagai, Toshiyuki; Iwakami, Naotsugu; Sugano, Yasuo; Honda, Satoshi; Okada, Atsushi; Asaumi, Yasuhide; Aiba, Takeshi; Noguchi, Teruo; Kusano, Kengo; Ogawa, Hisao; Yasuda, Satoshi; Anzai, Toshihisa

    2016-08-15

    Malnutrition is becoming one of the most important determinants of worse clinical outcomes in patients with acute heart failure (AHF). However, appropriate tools for evaluating the nutritional status in patients aged ≥65 years with AHF remain unclear. We examined 490 consecutive patients aged ≥65 years with AHF. They were divided into 2 groups according to Geriatric Nutritional Risk Index (GNRI; cut-off value = 92). During a median period of 189 days, the mortality rate was significantly higher in the lower GNRI group than the higher GNRI group (p nutritional indexes. Adding GNRI to an existing outcome prediction model for mortality in AHF significantly increased the C-statistic from 0.68 to 0.74 (p = 0.017). The net reclassification improvement afforded by GNRI was 60% overall, 27% for events, and 33% for nonevents (p nutritional parameters. Furthermore, the assessment of nutritional status using GNRI is very helpful for risk stratification. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Evaluation of Circulating Tumor Cells and Related Events as Prognostic Factors and Surrogate Biomarkers in Advanced NSCLC Patients Receiving First-Line Systemic Treatment

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    Muinelo-Romay, Laura; Vieito, Maria; Abalo, Alicia; Alonso Nocelo, Marta; Barón, Francisco; Anido, Urbano; Brozos, Elena; Vázquez, Francisca; Aguín, Santiago; Abal, Miguel; López López, Rafael, E-mail: rafael.lopez.lopez@sergas.es [Translational Medical Oncology, Health Research Institute of Santiago (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (SERGAS), Trav. Choupana s/n 15706 Santiago de Compostela (Spain)

    2014-01-21

    In the present study we investigated the prognostic value of Circulating Tumour Cells (CTC) and their utility for therapy monitoring in non-small cell lung cancer (NSCLC). A total of 43 patients newly diagnosed with NSCLC were prospectively enrolled. Blood samples were obtained before the 1st, 2nd and 5th cycles of chemotherapy and analyzed using CellSearch technology. Both CTC and CTC-related objects (not morphological standard or broken epithelial cells) were counted. At baseline 18 (41.9%) patients were positive for intact CTC count and 10 (23.2%) of them had ≥5 CTC, while CK positive events were found in 79.1% of patients. The group of patients with CTC ≥5 at baseline presented worse PFS and OS than those with <5 CTC (p = 0.034 and p = 0.008, respectively). Additionally, high levels of total CK positive events were associated with poor prognosis in the group of patients with <5 CTC. Regarding therapy monitoring, patients presenting increased levels of CTC during the treatment demonstrated lower OS and PFS rates. All these data supported the value of CTC as a prognostic biomarker and as a surrogate indicator of chemotherapy effectiveness in advanced NSCLC patients, with the additional value of analyzing other “objects” such as apoptotic CTC or CK fragments to guide the clinical management of these patients.

  11. Evaluation of Circulating Tumor Cells and Related Events as Prognostic Factors and Surrogate Biomarkers in Advanced NSCLC Patients Receiving First-Line Systemic Treatment

    Directory of Open Access Journals (Sweden)

    Laura Muinelo-Romay

    2014-01-01

    Full Text Available In the present study we investigated the prognostic value of Circulating Tumour Cells (CTC and their utility for therapy monitoring in non-small cell lung cancer (NSCLC. A total of 43 patients newly diagnosed with NSCLC were prospectively enrolled. Blood samples were obtained before the 1st, 2nd and 5th cycles of chemotherapy and analyzed using CellSearch technology. Both CTC and CTC-related objects (not morphological standard or broken epithelial cells were counted. At baseline 18 (41.9% patients were positive for intact CTC count and 10 (23.2% of them had ≥5 CTC, while CK positive events were found in 79.1% of patients. The group of patients with CTC ³5 at baseline presented worse PFS and OS than those with <5 CTC (p = 0.034 and p = 0.008, respectively. Additionally, high levels of total CK positive events were associated with poor prognosis in the group of patients with <5 CTC. Regarding therapy monitoring, patients presenting increased levels of CTC during the treatment demonstrated lower OS and PFS rates. All these data supported the value of CTC as a prognostic biomarker and as a surrogate indicator of chemotherapy effectiveness in advanced NSCLC patients, with the additional value of analyzing other “objects” such as apoptotic CTC or CK fragments to guide the clinical management of these patients.

  12. Prognostic value of M30/M65 for outcome of hepatitis B virus-related acute-on-chronic liver failure.

    Science.gov (United States)

    Zheng, Su-Jun; Liu, Shuang; Liu, Mei; McCrae, Malcolm A; Li, Jun-Feng; Han, Yuan-Ping; Xu, Chun-Hui; Ren, Feng; Chen, Yu; Duan, Zhong-Ping

    2014-03-07

    To determine the prognostic value of circulating indicators of cell death in acute-on-chronic liver failure (ACLF) patients with chronic hepatitis B virus (HBV) infection as the single etiology. Full length and caspase cleaved cytokeratin 18 (detected as M65 and M30 antigens) represent circulating indicators of necrosis and apoptosis. M65 and M30 were identified by enzyme-linked immunosorbent assay in 169 subjects including healthy controls (n = 33), patients with chronic hepatitis B (CHB, n = 55) and patients with ACLF (n = 81). According to the 3-mo survival period, ACLF patients were defined as having spontaneous recovery (n = 33) and non-spontaneous recovery which included deceased patients and those who required liver transplantation (n = 48). Both biomarker levels significantly increased gradually as liver disease progressed (for M65: P Liver Disease (MELD) and Child-Pugh scores at the 3-mo survival period, the AUC of the M30/M65 ratio was 0.66 with a sensitivity of 52.9% and the highest specificity of 92.6% (MELD:AUC = 0.71; sensitivity, 79.4%; specificity, 63.0%; Child-Pugh: AUC = 0.77; sensitivity, 61.8%; specificity, 88.9%). M65 and M30 are strongly associated with liver disease severity. The M30/M65 ratio may be a potential prognostic marker for spontaneous recovery in patients with HBV-related ACLF.

  13. Prognostic impact of nutritional risk assessment in patients with chronic schizophrenia.

    Science.gov (United States)

    Tsai, Ming-Tsun; Chang, Tien-Hao; Wu, Bo-Jian

    2017-04-22

    Protein-energy wasting is associated with poor outcome in various clinical settings. However, the prevalence of malnutrition and the prognostic impact of nutritional status are poorly understood in institutionalized patients with chronic schizophrenia. This study aimed to assess the predictive ability of the Geriatric Nutritional Risk Index and Onodera's Prognostic Nutritional Index for long-term outcomes in patients with chronic schizophrenia. All measurements, including nutritional scores, were performed at baseline after the enrollment of 542 (64.6% men, mean age 53.8±9.7years) patients with chronic schizophrenia. The median follow-up period was 408days. The endpoints were falls and infection-related hospitalizations. At study completion, 34 patients suffered falls and 40 patients were admitted to hospitals due to infection. Both indices showed significant association with infectious complications, whereas only the Onodera's Prognostic Nutritional Index was significantly associated with falls. The adjusted hazard ratios (95% confidence intervals) of low Onodera's Prognostic Nutritional Index were 2.38 (1.16-4.86) for falls and 1.99 (1.05-3.76) for infectious complications. The Onodera's Prognostic Nutritional Index is more appropriate than the Geriatric Nutritional Risk Index in identifying patients with chronic schizophrenia who are at risk for malnutrition and nutrition-related morbidity. Further studies are needed to explore whether early detection of patients with schizophrenia who are at risk for malnutrition could lead to the reduction of morbidity and mortality with the aid of appropriate interventions. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. RELATION OF BODY MASS INDEX (BMI TO STUDENTS’ ACHIEVEMENTS AND PERFORMANCE REGARDING THEIR MOTOR ABILITIES

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    Viktor Mitrevski

    2013-07-01

    Full Text Available The research has been conducted on 192 school boys, aged 15 (±3 months. All of them were regular attenders in the class of Physical Education and Sport at primary school. According to BMI (the coefficient of fat, there were determined three subsam¬ples of entities. The aim of the regressive analysis is to establish how the obtained index of fat is related to the students’ achievements and demonstration of their motor abilities.

  15. Hair toxic element content in adult men and women in relation to body mass index.

    Science.gov (United States)

    Skalnaya, Margarita G; Tinkov, Alexey A; Demidov, Vasily A; Serebryansky, Eugeny P; Nikonorov, Alexandr A; Skalny, Anatoly V

    2014-10-01

    The primary objective of the current study was to estimate the hair toxic metal content in adults in relation to body mass index. A total of 1,229 persons including 719 women and 510 men were examined. All subjects were divided into two age groups: 1 and 2 periods of adulthood. All men and women were also subdivided into groups in relation to their values of body mass index (BMI): underweight, normal weight, overweight and obese. Hair aluminium (Al), beryllium (Be), cadmium (Cd), mercury (Hg), lead (Pb) and tin (Sn) content was evaluated using mass spectrometry with inductively coupled plasma. It has been shown that increase in body weight is accompanied by elevated hair cadmium content in women. At the same time, no significant alteration of hair cadmium concentration was observed in males. Higher values of scalp hair mercury and lead content were observed in men and women with increased body mass index independently of their age. BMI-related elevation of hair tin content was registered only in men of the first period of adulthood. A significant correlation between hair metal content and the values of BMI was observed for mercury independently of the gender of the subjects, whereas BMI values correlated significantly with hair cadmium levels in women and lead and tin levels in men. It has been also estimated that hair cadmium, mercury and lead levels in men exceed the respective values in women.

  16. Relation of Dietary Glycemic Index and Glycemic Load to Coronary Artery Calcium in Asymptomatic Korean Adults.

    Science.gov (United States)

    Choi, Yuni; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Kim, Mi Kyung; Ahn, Younjhin; Lee, Jung Eun; Sung, Eunju; Kim, Boyoung; Ahn, Jiin; Kim, Chan-Won; Rampal, Sanjay; Zhao, Di; Zhang, Yiyi; Pastor-Barriuso, Roberto; Lima, Joao A C; Chung, Eun Chul; Shin, Hocheol; Guallar, Eliseo

    2015-08-15

    The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score >0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Comparison of clinical outcomes and prognostic utility of risk stratification tools in patients with therapy-related vs de novo myelodysplastic syndromes: a report on behalf of the MDS Clinical Research Consortium.

    Science.gov (United States)

    Zeidan, A M; Al Ali, N; Barnard, J; Padron, E; Lancet, J E; Sekeres, M A; Steensma, D P; DeZern, A; Roboz, G; Jabbour, E; Garcia-Manero, G; List, A; Komrokji, R

    2017-06-01

    While therapy-related (t)-myelodysplastic syndromes (MDS) have worse outcomes than de novo MDS (d-MDS), some t-MDS patients have an indolent course. Most MDS prognostic models excluded t-MDS patients during development. The performances of the International Prognostic Scoring System (IPSS), revised IPSS (IPSS-R), MD Anderson Global Prognostic System (MPSS), WHO Prognostic Scoring System (WPSS) and t-MDS Prognostic System (TPSS) were compared among patients with t-MDS. Akaike information criteria (AIC) assessed the relative goodness of fit of the models. We identified 370 t-MDS patients (19%) among 1950 MDS patients. Prior therapy included chemotherapy alone (48%), chemoradiation (31%), and radiation alone in 21%. Median survival for t-MDS patients was significantly shorter than for d-MDS (19 vs 46 months, PMDS (PMDS had a significantly higher hazard of death relative to d-MDS in every risk model, and had inferior survival compared to patients with d-MDS within all risk group categories. AIC Scores (lower is better) were 2316 (MPSS), 2343 (TPSS), 2343 (IPSS-R), 2361 (WPSS) and 2364 (IPSS). In conclusion, subsets of t-MDS patients with varying clinical outcomes can be identified using conventional risk stratification models. The MPSS, TPSS and IPSS-R provide the best predictive power.

  18. Prognostic role of left atrial strain and its combination index with transmitral E-wave velocity in patients with atrial fibrillation.

    Science.gov (United States)

    Hsu, Po-Chao; Lee, Wen-Hsien; Chu, Chun-Yuan; Lee, Hung-Hao; Lee, Chee-Siong; Yen, Hsueh-Wei; Lin, Tsung-Hsien; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung; Su, Ho-Ming

    2016-02-01

    Left atrial (LA) strain can reflect LA remodeling and is reduced in atrial fibrillation (AF) patients with prior stroke. This study sought to examine the ability of LA strain in predicting subsequent stroke event in AF and also evaluated whether E/LA strain could predict cardiovascular (CV) events in these patients. In 190 persistent AF patients, we performed comprehensive echocardiography with assessment of LA strain. There were 69 CV events including 19 CV death, 32 hospitalizations for heart failure, 3 myocardial infarctions, and 15 strokes during an average follow-up of 29 months. Multivariate analysis showed old age, chronic heart failure, increased left ventricular (LV) mass index, and increased E/LA strain were associated with CV events and decreased LA strain was associated with subsequent stroke event. The addition of E/LA strain and LA strain to a model containing CHA2DS2-VASc score and LV function significantly improved the values in predicting CV events and subsequent stroke event, respectively. In conclusion, E/LA strain and LA strain were respectively useful in predicting CV events and subsequent stroke event in AF. E/LA strain and LA strain could provide incremental values for CV outcome and subsequent stroke outcome prediction over conventional clinical and echocardiographic parameters in AF, respectively.

  19. Prognostic role of a new risk index for the prediction of 30-day cardiovascular mortality in patients with acute pulmonary embolism: the Age-Mean Arterial Pressure Index (AMAPI).

    Science.gov (United States)

    Zuin, Marco; Rigatelli, Gianluca; Picariello, Claudio; Carraro, Mauro; Zonzin, Pietro; Roncon, Loris

    2017-12-01

    Acute pulmonary embolism (PE) is the third cause of cardiovascular (CV) mortality. We evaluated a new risk index, named Age-Mean Arterial Pressure Index (AMAPI), to predict 30-day CV mortality in patients with acute PE. Data of 209 patients (44.0% male and 56.0% female, mean age 70.58 ± 14.14 years) with confirmed acute PE were retrospectively analysed. AMAPI was calculated as the ratio between age and mean arterial pressure (MAP), which was defined as [systolic blood pressure + (2 × diastolic blood pressure)]/3. To test AMAPI accuracy, a comparison with shock index (SI) and simplified pulmonary embolism severity index (sPESI) was performed. Patients were divided in two groups according their hemodynamic stability, or not, at admission. 30-day mortality rate, in all cases for CV events, was 10.5% (n = 22). Hemodynamically unstable patients had a higher AMAPI compare to those without hypotension at admission (1.28 ± 0.39 vs 0.78 ± 0.27, p < 0.0001). Receiving operative curve analyses (ROC) found the optimal cut-off for AMAPI in hemodynamically stable and unstable patients ≥0.9 and ≥0.92, respectively. In both groups, patients with an AMAPI over the cut-off were significantly older, hypotensive (both systolic and diastolic blood pressure), with a higher SI and lower MAP. In hemodynamically stable patients, 30-day CV mortality risk prediction was improved adding AMAPI ≥0.9 to both SI and sPESI (net reclassification improvement-NRI-of 14.2%, p = 0.0006 and 11.5%, p = 0.0002, respectively). In hemodynamically unstable patients NRI was 19.2%, p = 0.006. Mantel-Cox analysis revealed a statistical significant difference in the distribution of survival between hemodynamically stable patients with an AMAPI index ≥0.9 compared to those with an AMAPI <0.89 [log rank (Mantel-Cox) p < 0.0001] and in hemodynamically unstable patients with an AMAPI ≥0.92 [log rank (Mantel-Cox) p = 0.001]. AMAPI ≥0.90 and ≥0.92 predict 30-day CV mortality

  20. Body mass index is related to autonomic nervous system activity as measured by heart rate variability.

    Science.gov (United States)

    Molfino, A; Fiorentini, A; Tubani, L; Martuscelli, M; Rossi Fanelli, F; Laviano, A

    2009-10-01

    Autonomic nervous system activity is involved in body weight regulation. We assessed whether the body mass index (BMI) is related to the autonomic nervous system activity as assessed by heart rate variability (HRV). Twenty-five adult normotensive, euglycemic healthy males (M) and females (F) were studied (M/F=13/12). BMI was assessed in each individual. HRV was assessed and the domains of low frequencies (LF, index of the sympathetic modulation) and high frequencies (HF, index of the parasympathetic modulation) were measured. Data were statistically analyzed and are presented as mean+/-s.d. Mean BMI did not correlate with either HF or LF. It inversely related to HF (r=-0.50, P<0.01), whereas its relationship with LF was marginally significant (r=-0.39, P=0.05). The HF in individuals with BMI <20 kg/m(2) was significantly higher from those measured in the remaining subjects (P<0.05). The results support the role of parasympathetic activity in influencing BMI through likely modulation of body weight.

  1. ASSESSMENT OF BODY MASS INDEX AND HEALTH RELATED FITNESS AMONG SCHOOL CHILDREN

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    ANIL RAMACHANDRAN

    2009-12-01

    Full Text Available The present study on body mass index and health related physical fitness of school children was undertaken with the view of portraying the health related fitness profile of school children in Kannur district of Kerala. Data on body mass index and health related fitness according to ICHPER.SD Asia Youth Health Related Fitness test was collected from 1000 school children from different schools of Kannur district, Kerala. The study had sub samples of 250 boys and 250 girls from schools belonging to urban areas; and 250 boys and 250 girls belonging to rural areas. The data on BMI and health related fitness variables of the study were comparable to the data of Indian counterparts shown in previous studies. The analysis of data revealed that girls had significantly greater BMI as compared to boys. However, boys scored significantly better than girls on one milerun, sit ups and modified pull ups. Girls were significantly better than boys in case of flexibility performance in the sit and reach test. In case of sum of skinfolds, girls had significantly greater skinfold measurements as compared to boys. Rural sample of school children scored significantly better than urban school children inmodified pull ups. In case of sum of skinfolds, urban school children had greater skinfold measurements as compared to their rural counterparts. The study warrants the need for further investigations covering a wider segment of population and taking other vital parameters such as nutritional status, physical activity patterns, andsocio-economic conditions so as to obtain meaningful relationships.

  2. Prognostic Factors of Returning to Work after Sick Leave due to Work-Related Common Mental Disorders: A One- and Three-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Bo Netterstrøm

    2015-01-01

    Full Text Available The aim of this paper was to assess the prognostic factors of return to work (RTW after one and three years among people on sick leave due to occupational stress. Methods. The study population comprised 223 completers on sick leave, who participated in a stress treatment program. Self-reported psychosocial work environment, life events during the past year, severity of the condition, occupational position, employment sector, marital status, and medication were assessed at baseline. RTW was assessed with data from a national compensation database (DREAM. Results. Self-reported high demands, low decision authority, low reward, low support from leaders and colleagues, bullying, high global symptom index, length of sick leave at baseline, and stressful negative life events during the year before baseline were associated with no RTW after one year. Low work ability and full-time sick leave at inclusion were predictors after three years too. Being single was associated with no RTW after three years. The type of treatment, occupational position, gender, age, and degree of depression were not associated with RTW after one or three years. Conclusion. The impact of the psychosocial work environment as predictor for RTW disappeared over time and only the severity of the condition was a predictor for RTW in the long run.

  3. Interaction between body mass index and hormone-receptor status as a prognostic factor in lymph-node-positive breast cancer.

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    Il Yong Chung

    Full Text Available The aim of this study was to determine the relationship between the body mass index (BMI at a breast cancer diagnosis and various factors including the hormone-receptor, menopause, and lymph-node status, and identify if there is a specific patient subgroup for which the BMI has an effect on the breast cancer prognosis. We retrospectively analyzed the data of 8,742 patients with non-metastatic invasive breast cancer from the research database of Asan Medical Center. The overall survival (OS and breast-cancer-specific survival (BCSS outcomes were compared among BMI groups using the Kaplan-Meier method and Cox proportional-hazards regression models with an interaction term. There was a significant interaction between BMI and hormone-receptor status for the OS (P = 0.029, and BCSS (P = 0.013 in lymph-node-positive breast cancers. Obesity in hormone-receptor-positive breast cancer showed a poorer OS (adjusted hazard ratio [HR] = 1.51, 95% confidence interval [CI] = 0.92 to 2.48 and significantly poorer BCSS (HR = 1.80, 95% CI = 1.08 to 2.99. In contrast, a high BMI in hormone-receptor-negative breast cancer revealed a better OS (HR = 0.44, 95% CI = 0.16 to 1.19 and BCSS (HR = 0.53, 95% CI = 0.19 to 1.44. Being underweight (BMI < 18.50 kg/m2 with hormone-receptor-negative breast cancer was associated with a significantly worse OS (HR = 1.98, 95% CI = 1.00-3.95 and BCSS (HR = 2.24, 95% CI = 1.12-4.47. There was no significant interaction found between the BMI and hormone-receptor status in the lymph-node-negative setting, and BMI did not interact with the menopause status in any subgroup. In conclusion, BMI interacts with the hormone-receptor status in a lymph-node-positive setting, thereby playing a role in the prognosis of breast cancer.

  4. Influence of low back pain and prognostic value of MRI in sciatica patients in relation to back pain.

    Science.gov (United States)

    el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L A M; Lycklama à Nijeholt, Geert J; Van der Kallen, Bas F; van den Hout, Wilbert B; Koes, Bart W; Peul, Wilco C

    2014-01-01

    Patients with sciatica frequently complain about associated back pain. It is not known whether there are prognostic relevant differences in Magnetic Resonance Imaging (MRI) findings between sciatica patients with and without disabling back pain. The study population contained patients with sciatica who underwent a baseline MRI to assess eligibility for a randomized trial designed to compare the efficacy of early surgery with prolonged conservative care for sciatica. Two neuroradiologists and one neurosurgeon independently evaluated all MR images. The MRI readers were blinded to symptom status. The MRI findings were compared between sciatica patients with and without disabling back pain. The presence of disabling back pain at baseline was correlated with perceived recovery at one year. Of 379 included sciatica patients, 158 (42%) had disabling back pain. Of the patients with both sciatica and disabling back pain 68% did reveal a herniated disc with nerve root compression on MRI, compared to 88% of patients with predominantly sciatica (Psciatica at baseline was negatively associated with perceived recovery at one year (Odds ratio [OR] 0.32, 95% Confidence Interval 0.18-0.56, PSciatica patients with disabling back pain in absence of nerve root compression on MRI at baseline reported less perceived recovery at one year compared to those with predominantly sciatica and nerve root compression on MRI (50% vs 91%, PSciatica patients with disabling low back pain reported an unfavorable outcome at one-year follow-up compared to those with predominantly sciatica. If additionally a clear herniated disc with nerve root compression on MRI was absent, the results were even worse.

  5. Influence of low back pain and prognostic value of MRI in sciatica patients in relation to back pain.

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    Abdelilah el Barzouhi

    Full Text Available BACKGROUND: Patients with sciatica frequently complain about associated back pain. It is not known whether there are prognostic relevant differences in Magnetic Resonance Imaging (MRI findings between sciatica patients with and without disabling back pain. METHODS: The study population contained patients with sciatica who underwent a baseline MRI to assess eligibility for a randomized trial designed to compare the efficacy of early surgery with prolonged conservative care for sciatica. Two neuroradiologists and one neurosurgeon independently evaluated all MR images. The MRI readers were blinded to symptom status. The MRI findings were compared between sciatica patients with and without disabling back pain. The presence of disabling back pain at baseline was correlated with perceived recovery at one year. RESULTS: Of 379 included sciatica patients, 158 (42% had disabling back pain. Of the patients with both sciatica and disabling back pain 68% did reveal a herniated disc with nerve root compression on MRI, compared to 88% of patients with predominantly sciatica (P<0.001. The existence of disabling back pain in sciatica at baseline was negatively associated with perceived recovery at one year (Odds ratio [OR] 0.32, 95% Confidence Interval 0.18-0.56, P<0.001. Sciatica patients with disabling back pain in absence of nerve root compression on MRI at baseline reported less perceived recovery at one year compared to those with predominantly sciatica and nerve root compression on MRI (50% vs 91%, P<0.001. CONCLUSION: Sciatica patients with disabling low back pain reported an unfavorable outcome at one-year follow-up compared to those with predominantly sciatica. If additionally a clear herniated disc with nerve root compression on MRI was absent, the results were even worse.

  6. Analyzing socioeconomic related health inequality in mothers and children using the concentration index

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    Hossein Amirian

    2014-01-01

    Full Text Available Background: The effect of socioeconomic inequity on major public health indices such as maternal and child mortality rates in low- and middle-income countries are less understood and needs to be evaluated through the concentration index.Method: This cross-sectional study was conducted in 2012 in Hamadan City, the west of Iran, and 1400 households were enrolled through a stratified cluster random sampling method. The effect of inequity on health outcomes was investigated via a three-stage procedure including: (a definition of health outcomes; (b measuring socioeconomic status using an asset index; and (c measuring inequality of health outcome using concentration index (CI.Results: There was inequality for all outcomes of interest. The CI was negative for low birth weight, underweight, stunting, wasting, minor injuries, moderate injuries, consanguineous marriage, child with disability, short birth spacing, and adolescent pregnancy indicating the disproportionate concentration of the health outcomes among the poor. On the other hand, CI was positive for preterm birth, Nonexclusive breastfeeding, severe injuries, incomplete health care, cesarean section, and advanced maternal age indicating opposite conclusion.Conclusion: According to our results, there is a health inequality between the poor and the rich subgroups which may increase the risk of mothers and infant mortality and morbidity rates among the poor while the majority of the conditions related to the health outcomes are preventable.

  7. Contributions of psychology of thinking and cognition for the Farradane relational indexing

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Lourenço Santana

    2008-04-01

    Full Text Available Study the linking nature between psychology of thinking and cognition in context of Farradane relational indexing. Cognitive science as a new study area, originated at Century XX, has instigated the discovery over its link with the psychology of thinking. The term psychology was first time mentioned in the Modern Age, therefore, previous studies used terms as organization or methodical orientation of think. It were identified this mentions in Old Greece, when methodical orientation of think was a resource used for attainment more insurance results, as a form to reduce the search uncertainty. In the Modern Age, psychology was seen as a philosophy branch that had studied mind and behavior. In Century XIX, through persistent effort of some researchers, psychology came to consist as field deserving separate discipline. Through more than a hundred years of studies, the area has contributed very much for understanding structures, processes, functions, mental information processing and representations, amongst other topics. In Century XX, it had become the base for cognitive science foundation and posterior elaboration of Farradane universal relational indexing.

  8. Clinical impact of ki-67 labeling index in non-small cell lung cancer

    DEFF Research Database (Denmark)

    Jakobsen, Jan Nyrop; Sørensen, Jens Benn

    2013-01-01

    The ki-67 index is a marker of proliferation in malignant tumors. Studies from the period 2000 to 2012 on the prognostic and predictive value of ki-67 labeling index (LI) in non-small cell cancer (NSCLC) are reviewed. Twenty-eight studies reported on the prognostic value of ki-67 index with various...... of ki-67 to chemotherapy and none revealed significant influence. Ki-67 index seems to be of prognostic influence in NSCLC although largely variable cut-off levels have been used in the various studies and standardization of methodology is required. The relative importance of ki-67 compared to newer...... biomarkers has not been explored. It is likely that a signature of several biomarkers in combination may be necessary to more sufficiently stratify patients to various treatment options than is currently possible, especially when it comes to the question of the optimal use of classical chemotherapy...

  9. [Work-related Stress and the Allostatic Load Index - A Systematic Review].

    Science.gov (United States)

    Mauss, D; Li, J; Schmidt, B; Angerer, P; Jarczok, M N

    2017-12-01

    Work-related stress is a growing social challenge and has been associated with reduced employee health, well-being, and productivity. One tool to measure the stress-related wear and tear of the body is the Allostatic Load Index (ALI). This review summarizes recent evidence on the association between work-related stress and ALI in working adults. A systematic literature search following the PRISMA-Statement was conducted in 21 databases including Medline, PubPsych, MedPilot, and Cochrane Register. Publications addressing work related-stress and medical parameters using ALI were considered. Data on study population, analytic techniques, and results were tabulated. Methodological quality was evaluated using a standardized checklist. 9 articles were identified with a total of 3 532 employees from 5 countries reporting cross-sectional data from the years 2003-2013. Overall, 7 studies reported a positive and significant association between work-related stress and ALI, while 2 studies showed no or an insignificant association. Substantial heterogeneity was observed in methods applied and study quality. This systematic review provides evidence that work-related stress is associated with ALI in cross-sectional studies. This association needs to be demonstrated by future studies using longitudinal data on working populations. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Predicting Reading Growth with Event-Related Potentials: Thinking Differently about Indexing "Responsiveness"

    Science.gov (United States)

    Lemons, Christopher J; Key, Alexandra P F; Fuchs, Douglas; Yoder, Paul J; Fuchs, Lynn S; Compton, Donald L; Williams, Susan M; Bouton, Bobette

    2010-06-01

    The purpose of this study was to determine if event-related potential (ERP) data collected during three reading-related tasks (Letter Sound Matching, Nonword Rhyming, and Nonword Reading) could be used to predict short-term reading growth on a curriculum-based measure of word identification fluency over 19 weeks in a sample of 29 first-grade children. Results indicate that ERP responses to the Letter Sound Matching task were predictive of reading change and remained so after controlling for two previously validated behavioral predictors of reading, Rapid Letter Naming and Segmenting. ERP data for the other tasks were not correlated with reading change. The potential for cognitive neuroscience to enhance current methods of indexing responsiveness in a response-to-intervention (RTI) model is discussed.

  11. Genetic determinants of serum vitamin B12 and their relation to body mass index

    DEFF Research Database (Denmark)

    Allin, Kristine H; Friedrich, Nele; Pietzner, Maik

    2017-01-01

    Lower serum vitamin B12 levels have been related to adverse metabolic health profiles, including adiposity. We used a Mendelian randomization design to test whether this relation might be causal. We included two Danish population-based studies (ntotal = 9311). Linear regression was used to test...... for associations between (1) serum vitamin B12 levels and body mass index (BMI), (2) genetic variants and serum vitamin B12 levels, and (3) genetic variants and BMI. The effect of a genetically determined decrease in serum vitamin B12 on BMI was estimated by instrumental variable regression. Decreased serum...... vitamin B12 associated with increased BMI (P B12 associated variants associated strongly with serum vitamin B12 (P B12...

  12. Relative importance index (RII) in ranking of procrastination factors among university students

    Science.gov (United States)

    Aziz, Nazrina; Zain, Zakiyah; Mafuzi, Raja Muhammad Zahid Raja; Mustapa, Aini Mastura; Najib, Nur Hasibah Mohd; Lah, Nik Fatihah Nik

    2016-08-01

    Procrastination is the action of delaying or postponing something such as making a decision or starting or completing some tasks or activities. According to previous studies, students who have a strong tendency to procrastinate get low scores in their tests, resulting in poorer academic performance compared to those who do not procrastinate. This study aims to identify the procrastination factors in completing assignments among three groups of undergraduate students. The relative importance of procrastination factors was quantified by the relative importance index (RII) method prior to ranking. A multistage sampling technique was used in selecting the sample. The findings revealed that `too many works in one time' is one of the top three factors contributing to procrastination in all groups.

  13. Genetic determinants of serum vitamin B12 and their relation to body mass index

    DEFF Research Database (Denmark)

    Allin, Kristine Højgaard; Friedrich, Nele; Pietzner, Maik

    2017-01-01

    Lower serum vitamin B12 levels have been related to adverse metabolic health profiles, including adiposity. We used a Mendelian randomization design to test whether this relation might be causal. We included two Danish population-based studies (ntotal = 9311). Linear regression was used to test...... for associations between (1) serum vitamin B12 levels and body mass index (BMI), (2) genetic variants and serum vitamin B12 levels, and (3) genetic variants and BMI. The effect of a genetically determined decrease in serum vitamin B12 on BMI was estimated by instrumental variable regression. Decreased serum...... vitamin B12 associated with increased BMI (P vitamin B12 associated variants associated strongly with serum vitamin B12 (P vitamin B12...

  14. AGE-RELATED SPECIFICITIES OF ENDOMETRIAL PROLIFERATION/STEM CELL INDEX DISTRIBUTION.

    Science.gov (United States)

    Kikalishvili, N; Beriashvili, R; Muzashvili, T; Burkadze, G

    2017-09-01

    Endometrial stem cells take the special place among somatic stem cells of female reproductive system, since their essence and nature still remains unclear - cellular complexity of endometrium, its hormone-dependence and cycling remodeling makes the study of endometrial stem cells exclusively complicated. Consequently, the detection of endometrial stem cells and identification of their location in the complex cellular hierarchy still remains challenging. The aim of our study was to explore the age-related specificities of endometrial proliferative / stem cell index distribution under normal and hyperplasia conditions. The study represents a retrospective research. The coded and depersonalized material data from Acad. N. Kipshidze Central University Clinic was used in the study. 2 study groups - 1st study group "Norm" (12 cases) and 2nd study group "Endometrial Hyperplasia" condition (18 cases) were selected from routine histopathology tissue specimens of uterus. Hematoxilyn-eosin technology and immunohistochemistry with proliferation marker Ki67 and stem cell marker CD146 was performed. The proliferative/stem cell index was calculated by the ratio of Ki67-positive cell percentage value divided by CD146-positive cell percentage value. The study showed that in the 1st study group labeled as "norm", the proliferative/stem cell index ranges between 8 and 16.5. Its mean average value in the age distribution subgroups accounts for: 1.1) reproductive age - 10.6; 1.2) menopause - 4.5; 1.3) post-menopause - 1. In the 2nd study group labeled as "endometrial hyperplasia", the proliferative/stem cell index markedly increases and ranges within the interval 15-23. Its mean average value in the age distribution subgroups accounts for: 2.1) reproductive age - 18; 2.2) menopause - 18.2; 2.3) post-menopause - 18.5. It was found that proliferative/stem cell index in the 1st study group labeled as "Norm" progressively decreases with aging, while in the 2nd study group labeled as

  15. Genome-wide association studies and heritability estimates of body mass index related phenotypes in Bangladeshi adults.

    Directory of Open Access Journals (Sweden)

    Molly Scannell Bryan

    Full Text Available Many health outcomes are influenced by a person's body mass index, as well as by the trajectory of body mass index through a lifetime. Although previous research has established that body mass index related traits are influenced by genetics, the relationship between these traits and genetics has not been well characterized in people of South Asian ancestry. To begin to characterize this relationship, we analyzed the association between common genetic variation and five phenotypes related to body mass index in a population-based sample of 5,354 Bangladeshi adults. We discovered a significant association between SNV rs347313 (intron of NOS1AP and change in body mass index in women over two years. In a linear mixed-model, the G allele was associated with an increase of 0.25 kg/m2 in body mass index over two years (p-value of 2.3·10-8. We also estimated the heritability of these phenotypes from our genotype data. We found significant estimates of heritability for all of the body mass index-related phenotypes. Our study evaluated the genetic determinants of body mass index related phenotypes for the first time in South Asians. The results suggest that these phenotypes are heritable and some of this heritability is driven by variation that differs from those previously reported. We also provide evidence that the genetic etiology of body mass index related traits may differ by ancestry, sex, and environment, and consequently that these factors should be considered when assessing the genetic determinants of the risk of body mass index-related disease.

  16. A Quantitative Index to Support Recurrence Prevention Plans of Human-Related Events

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yochan; Park, Jinkyun; Jung, Wondea [KAERI, Daejeon (Korea, Republic of); Kim, Do Sam; Lee, Durk Hun [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-05-15

    In Korea, HuRAM+ (Human related event Root cause Analysis Method plus) was developed to scrutinize the causes of the human-related events. The information of the human-related events investigated by the HuRAM+ method has been also managed by a database management system, R-tracer. It is obvious that accumulating data of human error causes aims to support plans that reduce recurrences of similar events. However, in spite of the efforts for the development of the human error database, it was indicated that the database does not provide useful empirical basis for establishment of the recurrence prevention plans, because the framework to interpret the collected data and apply the insights from the data into the prevention plants has not been developed yet. In this paper, in order to support establishment of the recurrence prevention plans, a quantitative index, Human Error Repeat Interval (HERI), was proposed and its applications to human error prevention were introduced. In this paper, a quantitative index, the HERI was proposed and the statistics of HERIs were introduced. These estimations can be employed to evaluate effects of recurrence prevention plans to human errors. If a mean HERI score is low and the linear trend is not positive, it can be suspected that the recurrence prevention plans applied every human-related event has not been effectively propagated. For reducing repetitive error causes, the system design or operational culture can be reviewed. If there is a strong and negative trend, systematic investigation of the root causes behind these trends is required. Likewise, we expect that the HERI index will provide significant basis for establishing or adjusting prevention plans of human errors. The accurate estimation and application of HERI scores is expected to be done after accumulating more data. When a scatter plot of HERIs is fitted by two or more models, a statistical model selection method can be employed. Some criteria have been introduced by

  17. Concordance for prognostic models with competing risks

    DEFF Research Database (Denmark)

    Wolbers, Marcel; Blanche, Paul; Koller, Michael T

    2014-01-01

    The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate i...... of the working model. We further illustrate the methods by computing the concordance probability for a prognostic model of coronary heart disease (CHD) events in the presence of the competing risk of non-CHD death.......The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate...

  18. Neighbourhood Influences on Children’s Weight-related Behaviours and Body Mass Index

    Directory of Open Access Journals (Sweden)

    Gabrielle L. Jenkin

    2015-08-01

    Full Text Available Introduction: Neighbourhood contextual factors such as accessibility of food shops and green spaces are associated with adult bodyweight but not necessarily weight-related behaviours. Whether these associations are replicated amongst children is unknown.Aim: To understand which aspects of childrens' neighbourhoods are associated with unhealthy weight and weight-related behaviours.Methods: Individual-level data for children from the 2006/7 New Zealand Health Survey (of Body Mass Index (BMI, dietary indicators and socioeconomic variables were linked with geographic level data on neighbourhood deprivation, rural/urban status, percentage of community engaged in active travel, access to green space, food shops and sports/leisure facilities. Logistic regression models were fitted for measures of BMI and weight-related behaviours; sugar sweetened beverage (SSB consumption; fast-food consumption; and television viewing. Results:Increased Ccommunity engagement in active transport was, counterintuitively, the only neighbourhood contextual factor associated with unhealthy weight amongst children. After adjustment for socioeconomic and environmental variables, greater access to green space appeared to have a protective effect on SSB consumption and neighbourhood deprivation was associated with all three unhealthy weight-related behaviours (SSB and fast-food consumption and television viewing. Conclusions: Although further research is needed, evidence from the current study suggests that a repertoire of health promotion interventions and policies to change unhealthy weight- related behaviours in high deprivation neighbourhoods may be required to address childhood obesity.

  19. Tumor cell concentration and tumor burden in relation to histopathologic subtype and other prognostic factors in early stage Hodgkin's disease. The Danish National Hodgkin Study Group

    DEFF Research Database (Denmark)

    Specht, L; Lauritzen, A F; Nordentoft, A M

    1990-01-01

    concentration, yielding an estimate of the total tumor cell burden, was even better than the macroscopic tumor burden as a prognostic factor. In conclusion, a simple tumor cell concentration count seems to be the most useful form of histopathologic subtyping for prognostic purposes in early stage Hodgkin......Prognostic factors were examined by multivariate analysis after a recent follow-up of the 300 patients with Hodgkin's disease pathologic stage (PS) I or II treated with radiotherapy +/- adjuvant combination chemotherapy in the prospective randomized trial of the Danish National Hodgkin Study...

  20. Selection index based on the relative importance of traits and possibilities in breeding popcorn.

    Science.gov (United States)

    Vieira, R A; Rocha, R; Scapim, C A; Amaral Júnior, A T; Vivas, M

    2016-04-26

    One of the major difficulties faced by popcorn breeders is the negative correlation between popping expansion (PE) and grain yield (GY). It is necessary to overcome this difficulty to obtain promising genotypes. One helpful tool in this process is a selection index because it allows multiple features of interest to be selected. Thus, the present study proposes a new and comprehensive selection index applied in 169 half-sib families in UEM-Co1 and UEM-Co2 composites during two cycles of recurrent selection. An experiment was conducted in a 13 x 13 lattice square in the 2004/2005 and 2006/2007 crop years in Maringá, Paraná State, and PE and GY were evaluated. To calculate Fi statistics, the following relative importance (RI) assignments were used: 0.5 for both PE and GY, and 0.70 and 0.30 for PE and GY, respectively. Families were classified according to Fi values such that Fi = 0 indicated that genotypes met the average of those selected by direct selection, Fi 0 indicated that genotypes exceeded the average of those selected. Thus, desirable values of Fi were positive, indicating that the selected families were higher than those families that would be selected by direct selection for both traits. Therefore, we concluded that the novel Fi statistic was satisfactory for family selection because simultaneous and higher gains for both traits in both composites were obtained.

  1. Sonographic evaluation of plantar fasciitis and relation to body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Ozdemir, Huseyin [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey)]. E-mail: ozdemir@firat.edu.tr; Yilmaz, Erhan [Department Orthopedic Firat University, Faculty of Medicine, Elazig (Turkey); Murat, Ayse [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey); Karakurt, Lokman [Department Orthopedic Firat University, Faculty of Medicine, Elazig (Turkey); Poyraz, A. Kursad [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey); Ogur, Erkin [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey)

    2005-06-01

    Purpose: We have investigated the role of sonography in the diagnosis of plantar fasciitis. Materials and methods: This study evaluates 39 patients with plantar fasciitis and control group of 22 healthy volunteers. The plantar fascia thickness was measured 5 mm distal to the insertion of the calcaneus of plantar aponeurosis. Qualitative parameters such as decreased echogenity, biconvexity, perifascial fluid and calcification of plantar fascia were also noted. Results: Mean plantar fascia thickness was measured 2.9 mm in patients with unilateral heel pain, 2.2 mm for contralateral normal heel and 2.5 mm for control group. There was a statistically significant difference between heel with plantar fasciitis, contralateral normal heel and control groups (p = 0.009 and 0.0001, respectively). Mean body mass index was 28 kg/m{sup 2} in patients with heel pain and 25 kg/m{sup 2} in control group. Body mass index measurements were significantly different between plantar fasciitis and control groups. We found reduced plantar fascia echogenity in 16 cases (41%), calcaneal spur in 20 cases (51%), biconvex appearance in two cases (5.1%) and perifascial fluid in one case (2.5%). Conclusion: We conclude that in patients with plantar fasciitis, ultrasound may detect relatively small differences in plantar fascia thickness even in clinically unequivocal plantar fasciitis.

  2. Breakfast size is related to body mass index for men, but not women.

    Science.gov (United States)

    Kent, Lillian M; Worsley, Anthony

    2010-04-01

    The objective of this study was to examine the effect of self-reported breakfast size, daily eating, and other health habits on body mass index (BMI). We hypothesized that a consumption of a substantial breakfast compared with skipping or small breakfasts would be associated with lower BMI. Three independent, cross-sectional, screening surveys were conducted by Sydney Adventist Hospital in 1976, 1986, and 2005 in the surrounding community. The archived survey forms of 384 men and 338 women in 1976, 244 men and 229 women in 1986, and 270 men and 62 women in 2005 were randomly selected. Body mass index was determined from height and weight measured by hospital staff. The reported amount consumed at breakfast was one of several eating habits that predicted BMI for men but not women. It explained 5% to 6% of the variance in male BMI in all 3 years examined. As the reported breakfast amount increased, men's BMI decreased. Lifestyle confounders including vegetarianism and physical activity did not affect this relationship. However, the consumption of breakfast was significantly positively associated with consumption of cereals, bread, fruit, and spreads, while coffee consumption was significantly associated with smaller breakfasts or breakfast skipping. The consumption of relatively large breakfasts may influence BMI in men, and its promotion may help reduce the prevalence of obesity in Australia and elsewhere. Copyright 2010 Elsevier Inc. All rights reserved.

  3. Income-related inequality in mental health in Britain: the concentration index approach.

    Science.gov (United States)

    Mangalore, Roshni; Knapp, Martin; Jenkins, Rachel

    2007-07-01

    Reduction of health inequalities is a major policy goal in the UK. While there is general recognition of the disadvantaged position of people with mental health problems, the extent of inequality, particularly the association with socio-economic characteristics, has not been widely studied. We aimed to measure income-related inequality in the distribution of psychiatric disorders and to compare with inequality in other health domains. The concentration index (CI) approach was used to examine income-related inequality in mental health using data from the Psychiatric Morbidity Survey 2000 for Britain. There is marked inequality unfavourable to lower income groups with respect to mental health disorders. The extent of inequality increases with the severity of problems, with the greatest inequality observed for psychosis. Income-related inequality for psychiatric disorders is higher than for general health in the UK. Standardized CIs suggest that these inequalities are not due to the demographic composition of the income quintiles. Income-related inequalities exist in mental health in Britain. As much of the observed inequality is probably due to factors associated with income and not due to the demographic composition of the income quintiles, it may be that these inequalities are potentially 'avoidable'.

  4. Regional Deprivation Index and Socioeconomic Inequalities Related to Infant Deaths in Korea

    OpenAIRE

    Yun, Jae-Won; Kim, Young-Ju; Son, Mia

    2016-01-01

    Deprivation indices have been widely used to evaluate neighborhood socioeconomic status and therefore examine individuals within their regional context. Although some studies on the development of deprivation indices were conducted in Korea, additional research is needed to construct a more valid and reliable deprivation index. Therefore, a new deprivation index, named the K index, was constructed using principal component analysis. This index was compared with the Carstairs, Townsend and Cho...

  5. Cytokine responses in relation to age, gender, body mass index, Mycobacterium tuberculosis infection, and otitis media among inuit in greenland

    DEFF Research Database (Denmark)

    Nielsen, Nina Odgaard; Soborg, Bolette; Børresen, Malene

    2013-01-01

    To evaluate the cytokine response pattern in Inuit in Greenland in relation to age, gender, body mass index (BMI), Mycobacterium tuberculosis infection (MTI), and otitis media (OM) to assess whether Inuit may have signs of impaired immune responsiveness to infection....

  6. Fasting Ghrelin Levels Are Decreased in Obese Subjects and Are Significantly Related With Insulin Resistance and Body Mass Index

    Directory of Open Access Journals (Sweden)

    Dimitrios Papandreou

    2017-10-01

    CONCLUSION: Obese subjects have low fasting ghrelin levels that they are significantly related to insulin resistance and body mass index. More prospective studies are needed to establish the role of ghrelin in the pathogenesis of human obesity.

  7. Tumor cell concentration and tumor burden in relation to histopathologic subtype and other prognostic factors in early stage Hodgkin's disease. The Danish National Hodgkin Study Group

    DEFF Research Database (Denmark)

    Specht, L.; Lauritzen, A.F.; Nordentoft, A.M.

    1990-01-01

    . Initial biopsy material was classified according to the Rye histopathologic classification, the grading and subclassification proposed by the British National Lymphoma Investigation (BNLI), and tumor cell concentration in sections. Tumor cell concentration as a prognostic factor turned out to be better...... than the other classifications. However, if macroscopic tumor burden was taken into account both tumor cell concentration and the other histopathologic classification systems lost their prognostic significance. Significantly, however, a combination of macroscopic tumor burden and tumor cell...... concentration, yielding an estimate of the total tumor cell burden, was even better than the macroscopic tumor burden as a prognostic factor. In conclusion, a simple tumor cell concentration count seems to be the most useful form of histopathologic subtyping for prognostic purposes in early stage Hodgkin...

  8. Algunos factores pronósticos de interés en el melanoma maligno cutáneo Some interesting prognostic factors related to cutaneous malignant melanoma

    Directory of Open Access Journals (Sweden)

    AlejandroYuri Joan Figueroa

    2010-03-01

    3 and 5 years survival of more significant clinicopathological prognostic factors and in each stage, according to pathological staging system of tumor-nodule-metastasis (TNM in patients with cutaneous malignant melanoma (CMM. METHODS: A longitudinal, descriptive and retrospective study was conducted applying the Cox proportional risk form and the Kaplan-Meier method, aimed to search of different risk variables in patients with CMM. We studied 157 patients with CMM, seen during 8 years (1993 to 2001, diagnosed and treated in National Institute of Oncology and Radiobiology of La Habana. RESULTS: The more powerful prognostic variables related to localized disease (stage I and II were the Breslow density (P: 0,000, the mitosis rate (P: 0,004, and the Clark level (P: 0,04; among the variables related to the regional disease (stage III the number of lymphatic ganglia involved was the more weighthy (P:0,000 and the more important in Stage IV was the distant visceral metastasis (P:0,003. Survival was decreasing according to the advance of the pathological stage of disease. CONCLUSIONS: The more involved independent prognostic factors were the Breslow rate, the number of involved regional lymphatic nodules and the distant visceral metastasis, which is endorsed by a world consensus. However, variables as age, sex, lesion site, ulceration, host-tumor inflammatory response, histological subtype, satellitosis and transient metastasis, considered as independent prognostic indicators in big casuistries, had not statistical significance in present paper.

  9. Geographic distribution of Environmental Relative Moldiness Index molds in USA homes.

    Science.gov (United States)

    Vesper, Stephen; Wakefield, Jennie; Ashley, Peter; Cox, David; Dewalt, Gary; Friedman, Warren

    2011-01-01

    The objective of this study was to quantify and describe the distribution of the 36 molds that make up the Environmental Relative Moldiness Index (ERMI). As part of the 2006 American Healthy Homes Survey, settled dust samples were analyzed by mold-specific quantitative PCR (MSQPCR) for the 36 ERMI molds. Each species' geographical distribution pattern was examined individually, followed by partitioning analysis in order to identify spatially meaningful patterns. For mapping, the 36 mold populations were divided into disjoint clusters on the basis of their standardized concentrations, and First Principal Component (FPC) scores were computed. The partitioning analyses failed to uncover a valid partitioning that yielded compact, well-separated partitions with systematic spatial distributions, either on global or local criteria. Disjoint variable clustering resulted in seven mold clusters. The 36 molds and ERMI values themselves were found to be heterogeneously distributed across the United States of America (USA).

  10. The relation between energy intake and chewing index of diets fed to nursing ewes

    DEFF Research Database (Denmark)

    Nielsen, Mette Vestergaard; Nadeau, E.; Markussen, Bo

    2017-01-01

    The objective of this study was to determine whether a linear relation exists between the metabolizable energy intake (MEI) of nursing ewes in early lactation and the dietary chewing index (CI). This was investigated using five feeding trials with intake data from 108 nursing ewes in the first 4......–6 weeks after lambing, giving a total of 528 observations. The ewes were fed grass silage ad libitum separately, supplemented with concentrates or fed a total mixed ration (TMR) ad libitum. The ewes were of different breeds, ranging from 2 to 7 years old, had a mean body weight (BW) in the first week...... = ME0 − k × ME02 × CIcor, where MEI is the daily intake of metabolizable energy, ME0 is the theoretical maximum energy intake capacity of the animal in a situation with no physical constraints on intake, and k represents the decline in MEI with increasing CIcor. The model included random variation...

  11. Cerebral serotonin transporter binding is inversely related to body mass index

    DEFF Research Database (Denmark)

    Erritzoe, D; Frokjaer, V G; Haahr, M T

    2010-01-01

    ) in animal models is inversely related to food intake and body weight and some effective anti-obesity agents involve blockade of the serotonin transporter (SERT). We investigated in 60 healthy volunteers body mass index (BMI) and regional cerebral SERT binding as measured with [(11)C]DASB PET. In a linear...... regression model with adjustment for relevant covariates, we found that cortical and subcortical SERT binding was negatively correlated to BMI (-0.003 to -0.012 BP(ND) unit per kg/m(2)). Tobacco smoking and alcohol consumption did not affect cerebral SERT binding. Several effective anti-obesity drugs......Overweight and obesity is a health threat of increasing concern and understanding the neurobiology behind obesity is instrumental to the development of effective treatment regimes. Serotonergic neurotransmission is critically involved in eating behaviour; cerebral level of serotonin (5-HT...

  12. The adult body: how age, gender, and body mass index are related to body image.

    Science.gov (United States)

    Algars, Monica; Santtila, Pekka; Varjonen, Markus; Witting, Katarina; Johansson, Ada; Jern, Patrick; Sandnabba, N Kenneth

    2009-12-01

    OBJECTIVE. Body image and perceived attractiveness were examined, and the impact of age, gender, and body mass index (BMI) was analyzed and discussed from an evolutionary and a sociocultural perspective. METHOD. The population-based sample consisted of 11,468 Finnish men and women aged 18 to 49 years. RESULTS. Both age-related decrease and increase in body satisfaction was detected as well as interactions between age and gender. Some effects were nonlinear. Women were generally less satisfied with their bodies than men. BMI had a stronger influence on women's body image than men's. DISCUSSION. It was proposed that it is insufficient to merely study how age affects general body image because adults might become more satisfied with some aspects of their bodies as a function of age and less satisfied with other aspects. Body satisfaction might also fluctuate during different phases of the adult life, and the patterns possibly differ between men and women.

  13. Changes in Body Mass Index and Stoma Related Problems in the Elderly

    Science.gov (United States)

    Skeps, Raymond; McMullen, Carmit K.; Wendel, Christopher S.; Bulkley, Joanna; Grant, Marcia; Mohler, Jane; Hornbrook, Mark C.; Krouse, Robert S.; Herrinton, Lisa J.

    2012-01-01

    Objectives Weight gain can cause retraction of an intestinal stoma, possibly resulting in difficulty with wafer and pouch fit, daily care challenges, and discomfort. This cross-sectional study examined the association between body mass index (BMI) and ostomy-related problems among long-term (>5 years post-diagnosis) colorectal cancer (CRC) survivors. Materials and Methods CRC survivors from three Kaiser Permanente Regions completed a mailed survey. The response rate for those with an ostomy was 53% (283/529). Questions included stoma-related problems and time to conduct daily ostomy care. Poisson regression evaluated associations between report of problems and change in BMI. Our analysis sample included 235 survivors. Results Sample was 76% ≥65 years of age. Since their surgeries, BMI remained stable in 44% (ST), decreased in 20% (DE), and increased in 35% (IN) of survivors. Compared to ST, male IN (RR 2.15 [1.09–4.25]) and female DE (RR 5.06 [1.26–25.0]) were more likely to spend more than 30 minutes per day on stoma care. IN (vs. ST) were more likely to report interference with clothing (RR 1.51 [1.06–2.17]) and other stoma-related problems (RR 2.32 [1.30–4.14]). Survivors who were obese at time of survey were more likely to report interference with clothing (RR 1.88 [1.38–2.56]) and other stoma-related problems (RR 1.68 [1.07–2.65]). Conclusion A change in BMI is associated with ostomy-related problems among long-term CRC survivors. Equipment and care practices may need to be adapted for changes in abdominal shape. Health care providers should caution that a significant increase or decrease in BMI may cause ostomy-related problems. PMID:24071496

  14. The reliability of the Extra Load Index as a measure of relative load carriage economy.

    Science.gov (United States)

    Hudson, Sean; Cooke, Carlton; Lloyd, Ray

    2017-09-01

    The aim of this study was to measure the reliability of the extra load index (ELI) as a method for assessing relative load carriage economy. Seventeen volunteers (12 males, 5 females) performed walking trials at 3 km·h-1, 6 km·h-1 and a self-selected speed. Trial conditions were repeated 7 days later to assess test-retest reliability. Trials involved four 4-minute periods of walking, each separated by 5 min of rest. The initial stage was performed unloaded followed in a randomised order by a second unloaded period and walking with backpacks of 7 and 20 kg. Results show ELI values did not differ significantly between trials for any of the speeds (p = 0.46) with either of the additional loads (p = 0.297). The systematic bias, limits of agreement and coefficients of variation were small in all trial conditions. We conclude the ELI appears to be a reliable measure of relative load carriage economy. Practitioner Summary: This paper demonstrates that the ELI is a reliable measure of load carriage economy at a range of walking speeds with both a light and heavy load. The ELI, therefore, represents a useful tool for comparing the relative economy associated with different load carriage systems.

  15. The highly-cited Electrocardiogram-related articles in science citation index expanded: characteristics and hotspots.

    Science.gov (United States)

    Yang, Xianglin; Gu, Jiaojiao; Yan, Hong; Xu, Zhi; Ren, Bing; Yang, Yaming; Yang, Xiaodong; Chen, Qi; Tan, Shaohua

    2014-01-01

    We used bibliometric analysis methodology in the expanded Science Citation Index to identify highly-cited electrocardiogram (ECG)-related articles with total citations (TC2012) exceeding 100 from the publication year to 2012. Web of Science search tools were used to identify the highly-cited articles. The aspects analyzed for highly cited publications included effect of time on citation analysis, journals and Web of Science categories, number of authors per publication, originating institutions and countries, total citation and total citation per year life cycles of articles (C2012) and research hotspots. Results showed that a total of 467 electrocardiogram-related publications were regarded as the highly-cited publications. TC2012 ranged from 101 to 2879, with 215 as the average number of citations. No highly-cited publications have emerged yet during the first two years of the present 2010 Decade. All 11 countries and institutions originating highly-cited ECG-related publications were developed countries, USA in 9 of them. Four subject categories were identified as hotspots by total citations TC2012 and C2012: atrial fibrillation, long QT syndrome, angina and myocardial infarction, and risk factor analysis and health evaluation. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Cardiac mechanics and ventricular twist by three-dimensional strain analysis in relation to B-type natriuretic peptide as a clinical prognosticator for heart failure patients.

    Directory of Open Access Journals (Sweden)

    Sheng-Nan Chang

    Full Text Available BACKGROUND: Three dimensional (3D echocardiography-derived measurements of myocardial deformation and twist have recently advanced as novel clinical tools. However, with the exception of left ventricular ejection fraction and mass quantifications in hypertension and heart failure populations, the prognostic value of such imaging techniques remains largely unexplored. METHODS: We studied 200 subjects (mean age: 60.2±16 years, 54% female, female n = 107 with known hypertension (n = 51, diastolic heart failure (n = 61, or systolic heart failure (n = 30, recruited from heart failure outpatient clinics. Fifty-eight healthy volunteers were used as a control group. All participants underwent 3D-based myocardial deformation and twist analysis (Artida, Toshiba Medical Systems, Tokyo, Japan. We further investigated associations between these measures and brain natriuretic peptide levels and clinical outcomes. RESULTS: The global 3D strain measurements of the healthy, hypertension, diastolic heart failure, and systolic heart failure groups were 28.03%, 24.43%, 19.70%, and 11.95%, respectively (all p<0.001. Global twist measurements were estimated to be 9.49°, 9.77°, 8.32°, and 4.56°, respectively. We observed significant differences regarding 3D-derived longitudinal, radial, and global 3D strains between the different disease categories (p<0.05, even when age, gender, BMI and heart rate were matched. In addition, 3D-derived longitudinal, circumferential, and 3D strains were all highly correlated with brain natriuretic peptide levels (p<0.001. At a mean 567.7 days follow-up (25th-75th IQR: 197-909 days, poorer 3D-derived longitudinal, radial, and global 3D strain measurements remained independently associated with a higher risk of cardiovascular related death or hospitalization due to heart failure, after adjusting for age, gender, and left ventricular ejection fraction (all p<0.05. CONCLUSIONS: 3D-based strain analysis may be a

  17. HIV-associated lymphoma: histopathology and association with Epstein-Barr virus genome related to clinical, immunological and prognostic features

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Lundgren, Jens Dilling

    1991-01-01

    All 51 cases of HIV-related malignant lymphoma in Denmark diagnosed from 1983 to 1989 were reviewed. There were 12 Burkitt-type lymphomas, 30 immunoblast-rich lymphomas and 9 other lymphomas. Patients with immunoblast-rich lymphomas had significantly lower CD4 cell counts (median 60 vs. 188 x 10(...

  18. A complete parameterisation of the relative humidity and wavelength dependence of the refractive index of hygroscopic inorganic aerosol particles

    Science.gov (United States)

    Cotterell, Michael I.; Willoughby, Rose E.; Bzdek, Bryan R.; Orr-Ewing, Andrew J.; Reid, Jonathan P.

    2017-08-01

    Calculations of aerosol radiative forcing require knowledge of wavelength-dependent aerosol optical properties, such as single-scattering albedo. These aerosol optical properties can be calculated using Mie theory from knowledge of the key microphysical properties of particle size and refractive index, assuming that atmospheric particles are well-approximated to be spherical and homogeneous. We provide refractive index determinations for aqueous aerosol particles containing the key atmospherically relevant inorganic solutes of NaCl, NaNO3, (NH4)2SO4, NH4HSO4 and Na2SO4, reporting the refractive index variation with both wavelength (400-650 nm) and relative humidity (from 100 % to the efflorescence value of the salt). The accurate and precise retrieval of refractive index is performed using single-particle cavity ring-down spectroscopy. This approach involves probing a single aerosol particle confined in a Bessel laser beam optical trap through a combination of extinction measurements using cavity ring-down spectroscopy and elastic light-scattering measurements. Further, we assess the accuracy of these refractive index measurements, comparing our data with previously reported data sets from different measurement techniques but at a single wavelength. Finally, we provide a Cauchy dispersion model that parameterises refractive index measurements in terms of both wavelength and relative humidity. Our parameterisations should provide useful information to researchers requiring an accurate and comprehensive treatment of the wavelength and relative humidity dependence of refractive index for the inorganic component of atmospheric aerosol.

  19. Preliminary Survey on TRY Forest Traits and Growth Index Relations - New Challenges

    Science.gov (United States)

    Lyubenova, Mariyana; Kattge, Jens; van Bodegom, Peter; Chikalanov, Alexandre; Popova, Silvia; Zlateva, Plamena; Peteva, Simona

    2016-04-01

    Forest ecosystems provide critical ecosystem goods and services, including food, fodder, water, shelter, nutrient cycling, and cultural and recreational value. Forests also store carbon, provide habitat for a wide range of species and help alleviate land degradation and desertification. Thus they have a potentially significant role to play in climate change adaptation planning through maintaining ecosystem services and providing livelihood options. Therefore the study of forest traits is such an important issue not just for individual countries but for the planet as a whole. We need to know what functional relations between forest traits exactly can express TRY data base and haw it will be significant for the global modeling and IPBES. The study of the biodiversity characteristics at all levels and functional links between them is extremely important for the selection of key indicators for assessing biodiversity and ecosystem services for sustainable natural capital control. By comparing the available information in tree data bases: TRY, ITR (International Tree Ring) and SP-PAM the 42 tree species are selected for the traits analyses. The dependence between location characteristics (latitude, longitude, altitude, annual precipitation, annual temperature and soil type) and forest traits (specific leaf area, leaf weight ratio, wood density and growth index) is studied by by multiply regression analyses (RDA) using the statistical software package Canoco 4.5. The Pearson correlation coefficient (measure of linear correlation), Kendal rank correlation coefficient (non parametric measure of statistical dependence) and Spearman correlation coefficient (monotonic function relationship between two variables) are calculated for each pair of variables (indexes) and species. After analysis of above mentioned correlation coefficients the dimensional linear regression models, multidimensional linear and nonlinear regression models and multidimensional neural networks models are

  20. [SIMBO: a Screening Instrument for Identification of Work-Related Disabilities--analyses of construct and prognostic validity].

    Science.gov (United States)

    Streibelt, M; Gerwinn, H; Hansmeier, T; Thren, K; Müller-Fahrnow, W

    2007-10-01

    For a number of years, work-related interventions in medical rehabilitation (MBO) have been developed. Basically, these interventions concentrate on vocational problems of rehabilitees whose health disorders are strongly associated with contextual factors of the environment as well as personal factors. Previous studies showed a close relationship between the success of an intervention and identification of a specific demand. In fact there are several clinical concepts regarding specific demand. But there still is a lack of appropriate instruments for use in identification of occupational challenges. Therefore SIMBO (Screening Instrument for Identification of a Demand for Medical-Vocational Oriented Rehabilitation) has been developed recently. By using a scale for the intensity of work-related problems as well as a cut-off point, SIMBO is able to identify patients with and without a demand for work-related interventions. Analyses relative to construct validity and predictive validity were carried out on two different samples--a multi-clinic sample (patients with musculoskeletal disorders) and a sample from the German statutory pension insurance agency DRV Westfalen (successful applications for medical rehabilitation). In this context the cut-off level discussion is very important. By means of the multi-clinic sample--irrespective of cut-off definition--the SIMBO-decision and the clinical identification of MBO-demand were found to agree in 74-78% of the cases. This corresponds to a maximum adjusted correlation of r=0.59 (phi coefficient). Compared to the external ratings of vocational problems given by DRV staff in handling the applications, however, only little agreement is found (64%, r=0.25). In fact, SIMBO had in 77% (r=0.50) of the cases been able to correctly predict work-related problems to be expected. So the result obtained using this instrument is far better than prediction of these problems in the external ratings by DRV staff (54%, r=0,21). Also, return

  1. Prepregnancy and early adulthood body mass index and adult weight change in relation to fetal loss.

    Science.gov (United States)

    Gaskins, Audrey J; Rich-Edwards, Janet W; Colaci, Daniela S; Afeiche, Myriam C; Toth, Thomas L; Gillman, Matthew W; Missmer, Stacey A; Chavarro, Jorge E

    2014-10-01

    To examine prospectively the relationships of prepregnancy body mass index (BMI), BMI at age 18 years, and weight change since age 18 years with risk of fetal loss. Our prospective cohort study included 25,719 pregnancies reported by 17,027 women in the Nurses' Health Study II between 1990 and 2009. In 1989, height, current weight, and weight at age 18 years were self-reported. Current weight was updated every 2 years thereafter. Pregnancies were self-reported, with case pregnancies lost spontaneously and comparison pregnancies ending in ectopic pregnancy, induced abortion, or live birth. Incident fetal loss was reported in 4,494 (17.5%) pregnancies. Compared with those of normal BMI, the multivariate relative risks of fetal loss were 1.07 (95% CI [confidence interval] 1.00-1.15) for overweight women, 1.10 (95% CI 0.98-1.23) for class I obese women, and 1.27 (95% CI 1.11-1.45) for class II and class III obese women (P trend ≤ .001). Body mass index at age 18 years was not associated with fetal loss (P trend=.59). Compared with women who maintained a stable weight (± 4 kg) between age 18 years and before pregnancy, women who lost weight had a 20% (95% CI 9-29%) lower risk of fetal loss. This association was stronger among women who were overweight at age 18 years. Being overweight or obese before pregnancy was associated with higher risk of fetal loss. In women overweight or obese at age 18 years, losing 4 kg or more was associated with a lower risk of fetal loss. : II.

  2. Multidimensional Prognostic Index in Association with Future Mortality and Number of Hospital Days in a Population-Based Sample of Older Adults: Results of the EU Funded MPI_AGE Project.

    Science.gov (United States)

    Angleman, Sara B; Santoni, Giola; Pilotto, Alberto; Fratiglioni, Laura; Welmer, Anna-Karin

    2015-01-01

    The Multidimensional Prognostic Index (MPI) has been found to predict mortality in patients with a variety of clinical conditions. We aimed to assess the association of the MPI with future mortality and number of in-hospital days for the first time in a population-based cohort. The study population consisted of 2472 persons, aged 66-99 years, from the Swedish National Study on Aging and Care in Kungsholmen, Sweden, who underwent the baseline visit 2001-4, and were followed up >10 years for in-hospital days and >12 years for mortality. The MPI was a modified version of the original and aggregated seven domains (personal and instrumental activities of daily living, cognitive function, illness severity and comorbidity, number of medications, co-habitation status, and nutritional status). The MPI score was divided into risk groups: low, medium and high. Number of in-hospital days (within 1, 3 and 10 years) and mortality data were derived from official registries. All analyses were age-stratified (sexagenarians, septuagenarians, octogenarians, nonagenarians). During the follow-up 1331 persons (53.8%) died. Laplace regression models, suggested that median survival in medium risk groups varied by age from 2.2-3.6 years earlier than for those in the corresponding low risk groups (p = 0.002-p<0.001), and median survival in high risk groups varied by age from 3.8-9.0 years earlier than for corresponding low risk groups (p<0.001). For nonagenarians, the median age at death was 3.8 years earlier in the high risk group than for the low risk group (p<0.001). The mean number of in-hospital days increased significantly with higher MPI risk score within 1 and 3 years for people of each age group. For the first time, the effectiveness of MPI has been verified in a population-based cohort. Higher MPI risk scores associated with more days in hospital and with fewer years of survival, across a broad and stratified age range.

  3. Multidimensional Prognostic Index in Association with Future Mortality and Number of Hospital Days in a Population-Based Sample of Older Adults: Results of the EU Funded MPI_AGE Project.

    Directory of Open Access Journals (Sweden)

    Sara B Angleman

    Full Text Available The Multidimensional Prognostic Index (MPI has been found to predict mortality in patients with a variety of clinical conditions. We aimed to assess the association of the MPI with future mortality and number of in-hospital days for the first time in a population-based cohort.The study population consisted of 2472 persons, aged 66-99 years, from the Swedish National Study on Aging and Care in Kungsholmen, Sweden, who underwent the baseline visit 2001-4, and were followed up >10 years for in-hospital days and >12 years for mortality. The MPI was a modified version of the original and aggregated seven domains (personal and instrumental activities of daily living, cognitive function, illness severity and comorbidity, number of medications, co-habitation status, and nutritional status. The MPI score was divided into risk groups: low, medium and high. Number of in-hospital days (within 1, 3 and 10 years and mortality data were derived from official registries. All analyses were age-stratified (sexagenarians, septuagenarians, octogenarians, nonagenarians.During the follow-up 1331 persons (53.8% died. Laplace regression models, suggested that median survival in medium risk groups varied by age from 2.2-3.6 years earlier than for those in the corresponding low risk groups (p = 0.002-p<0.001, and median survival in high risk groups varied by age from 3.8-9.0 years earlier than for corresponding low risk groups (p<0.001. For nonagenarians, the median age at death was 3.8 years earlier in the high risk group than for the low risk group (p<0.001. The mean number of in-hospital days increased significantly with higher MPI risk score within 1 and 3 years for people of each age group.For the first time, the effectiveness of MPI has been verified in a population-based cohort. Higher MPI risk scores associated with more days in hospital and with fewer years of survival, across a broad and stratified age range.

  4. Stop-related subthalamic beta activity indexes global motor suppression in Parkinson’s Disease

    Science.gov (United States)

    Wessel, Jan R.; Ghahremani, Ayda; Udupa, Kaviraja; Saha, Utpal; Kalia, Suneil K.; Hodaie, Mojgan; Lozano, Andres M.; Aron, Adam R.; Chen, Robert

    2016-01-01

    Background Rapid action-stopping leads to global motor suppression. This is shown by studies using Transcranial Magnetic Stimulation to measure corticospinal excitability of task-unrelated effectors, e.g., from the hand during speech-stopping. We hypothesize this global suppression relates to the subthalamic nucleus of the basal ganglia. Several STN local field potential studies in Parkinson’s patients have shown increased ß-band power during successful stopping. Here, we aimed to test whether this STN ß-band activity indexes global motor suppression measured by transcranial magnetic stimulation. Methods We studied nine medicated PD patients (age: 47 – 67y, mean: 55.8; 3 female) who were implanted with STN-DBS electrodes. Participants performed a vocal stop-signal task (i.e., they had to occasionally stop a vocal response) while we simultaneously recorded local field potentials from right STN and delivered transcranial magnetic stimulation to primary motor cortex to measure corticospinal excitability from a task-unrelated hand muscle (first dorsal interosseous). Results Replicating prior results, STN ß-band power was increased (p power (median-split: p = .043), which was further evident in a negative correlation between single-trial STN ß-power and corticospinal excitability (mean r = -.176, p = .011). Conclusion These findings link stopping-related global motor suppression to STN ß-band activity through simultaneous recordings of STN and corticospinal excitability. The results support models of basal ganglia that propose the STN has broad motor suppressive effects. PMID:27474845

  5. The macrophage and its related cholesterol efflux as a HDL function index in atherosclerosis.

    Science.gov (United States)

    Yamamoto, Suguru; Narita, Ichiei; Kotani, Kazuhiko

    2016-06-01

    The macrophage and its related cholesterol efflux are considered to be a key player in atherosclerotic formation in relation to the function of high-density lipoprotein (HDL). The HDL function can be evaluated by the reaction between lipid-loaded macrophages and lipid-acceptors in the HDL fraction from the plasma, apolipoprotein B-depleted serum, and/or whole serum/plasma. Recent studies have reported that an impaired cholesterol efflux of HDL is observed in patients with cardiometabolic diseases, such as dyslipidemia, diabetes mellitus, and chronic kidney disease. A population-based cohort study has reported an inverse association between the cholesterol efflux capacity of HDL and the incidence of atherosclerotic disease, regardless of the serum HDL-cholesterol level. Moreover, in this paper, when we summarized several clinical interventional studies of statin treatment that examined cholesterol efflux, a potential increase in the efflux in patients treated with statins was implied. However, the effect was not fully defined in the current situation because of the small sample sizes, lack of a unified protocol for measuring the efflux, and short-term intervention periods without cardiovascular outcomes in available studies. Further investigation is necessary to determine the effect of drugs on cholesterol efflux. With additional advanced studies, cholesterol efflux is a promising laboratory index to understand the HDL function. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Should access to fertility-related services be conditional on body mass index?

    Science.gov (United States)

    Vahratian, Anjel; Smith, Yolanda R

    2009-07-01

    Guidelines for the clinical management of obese, reproductive age women with reduced fertility in the USA are limited. Clinical professional organizations have yet to publish practice guidelines on this topic. Thus, treatment decisions are made at the provider and/or clinic level and the variation in clinic policy regarding fertility treatment for obese women is not readily available. Globally, there is an ongoing discussion among reproductive endocrinologists that practice in countries with government-funded health care about whether treatment should be restricted to women under a certain body mass index. Our analysis of a representative US population identified that differences exist in the utilization of fertility-related services according to female body mass. Women with class II/III obesity were the group reporting the highest percentage seeking medical attention to become pregnant, but the lowest percentage receiving medical or surgical fertility-related services, although these differences were not statistically significant. As the prevalence of obesity among women of reproductive age increases both in the USA and abroad, it is critical to consider the medical, social and ethical issues involved in allocating resources for fertility treatment. Ongoing monitoring of trends in service utilization in light of the obesity epidemic and delayed childbearing will provide further insight into this clinical health policy issue.

  7. Aggregate Indices Method in Soil Quality Evaluation Using the Relative Soil Quality Index

    Directory of Open Access Journals (Sweden)

    Ho Ngoc Pham

    2015-01-01

    Full Text Available This paper presents a new approach to assess the soil quality by aggregate indices using the Relative Soil Quality Index (RSQI proposed by Ho Ngoc Pham. RSQI is integrated from the individual indices into a simple formula for overall assessment of the soil quality. RSQI is different from other approaches. Particularly, the individual indices and the weighting factors of Pham are calculated from the analytical laboratory data and the environmental standards, respectively, and not self-regulated as in methods of some other authors. In this paper, the authors applied the RSQI to assess the Soil Environmental Quality of rice intensive cultivation areas through a case study in Haiduong province in 2013. The RSQI is calculated for sampling points in 12 districts and simulated the Soil Environmental Quality on GIS map. The results show that the Soil Environmental Quality of rice intensive cultivation areas in Haiduong is predominantly divided into three levels: good, moderate, and poor. According to the report of General Statistics Office for Haiduong province, rice intensive cultivation areas in 2013 achieved a relatively high average rice yield of 5.90 tonnes per hectare; it means actual soil properties are in line with results of the research.

  8. Evaluation of serum DNA integrity as a screening and prognostic tool in patients with hepatitis C virus-related hepatocellular carcinoma.

    Science.gov (United States)

    El-Shazly, Sherien F; Eid, Manal A; El-Sourogy, Hesham A; Attia, Gehan F; Ezzat, Sherif A

    2010-01-01

    Hepatocellular carcinoma (HCC) is a common malignancy in Egypt due to the high frequency of hepatitis C virus (HCV) infection among the general population. Circulating free DNA is a potential molecular marker for the diagnosis and prognosis of malignant tumors. DNA released from apoptotic cells usually consists of short uniform fragments while DNA released from cancer cells is longer. The ratio of long DNA fragments to total DNA (DNA integrity) may be a potential marker for early detection of HCC and its progression in HCV patients. Sera from 25 patients with HCV-related HCC, 25 patients with chronic HCV infection, and 15 healthy volunteers were examined for Alu repeats by quantitative real-time PCR (qPCR) using 2 sets of primers of 115 and 247 base pairs. DNA integrity was calculated as the ratio of 247-bp to 115-bp Alu fragments. Compared with healthy volunteers and HCV patients, significantly higher DNA integrity was found in HCC patients. DNA integrity was associated with tumor size, TNM stage, vascular invasion, lymph node involvement, and distant metastasis. DNA integrity had a higher sensitivity and specificity in discriminating HCC from HCV patients than total DNA. Patients with high DNA integrity had a significantly shorter overall survival and high DNA integrity was shown to be an independent prognostic factor for survival in HCV-related HCC. DNA integrity is a promising molecular biomarker for detecting HCC in patients with chronic HCV infection; it reflects the progression and metastatic potential of the tumor, and high DNA integrity is associated with short overall survival in HCV-related HCC.

  9. No prognostic value added by vitamin D pathway SNPs to current prognostic system for melanoma survival.

    Science.gov (United States)

    Luo, Li; Orlow, Irene; Kanetsky, Peter A; Thomas, Nancy E; Fang, Shenying; Lee, Jeffrey E; Berwick, Marianne; Lee, Ji-Hyun

    2017-01-01

    The prognostic improvement attributed to genetic markers over current prognostic system has not been well studied for melanoma. The goal of this study is to evaluate the added prognostic value of Vitamin D Pathway (VitD) SNPs to currently known clinical and demographic factors such as age, sex, Breslow thickness, mitosis and ulceration (CDF). We utilized two large independent well-characterized melanoma studies: the Genes, Environment, and Melanoma (GEM) and MD Anderson studies, and performed variable selection of VitD pathway SNPs and CDF using Random Survival Forest (RSF) method in addition to Cox proportional hazards models. The Harrell's C-index was used to compare the performance of model predictability. The population-based GEM study enrolled 3,578 incident cases of cutaneous melanoma (CM), and the hospital-based MD Anderson study consisted of 1,804 CM patients. Including both VitD SNPs and CDF yielded C-index of 0.85, which provided slight but not significant improvement by CDF alone (C-index = 0.83) in the GEM study. Similar results were observed in the independent MD Anderson study (C-index = 0.84 and 0.83, respectively). The Cox model identified no significant associations after adjusting for multiplicity. Our results do not support clinically significant prognostic improvements attributable to VitD pathway SNPs over current prognostic system for melanoma survival.

  10. No prognostic value added by vitamin D pathway SNPs to current prognostic system for melanoma survival.

    Directory of Open Access Journals (Sweden)

    Li Luo

    Full Text Available The prognostic improvement attributed to genetic markers over current prognostic system has not been well studied for melanoma. The goal of this study is to evaluate the added prognostic value of Vitamin D Pathway (VitD SNPs to currently known clinical and demographic factors such as age, sex, Breslow thickness, mitosis and ulceration (CDF. We utilized two large independent well-characterized melanoma studies: the Genes, Environment, and Melanoma (GEM and MD Anderson studies, and performed variable selection of VitD pathway SNPs and CDF using Random Survival Forest (RSF method in addition to Cox proportional hazards models. The Harrell's C-index was used to compare the performance of model predictability. The population-based GEM study enrolled 3,578 incident cases of cutaneous melanoma (CM, and the hospital-based MD Anderson study consisted of 1,804 CM patients. Including both VitD SNPs and CDF yielded C-index of 0.85, which provided slight but not significant improvement by CDF alone (C-index = 0.83 in the GEM study. Similar results were observed in the independent MD Anderson study (C-index = 0.84 and 0.83, respectively. The Cox model identified no significant associations after adjusting for multiplicity. Our results do not support clinically significant prognostic improvements attributable to VitD pathway SNPs over current prognostic system for melanoma survival.

  11. Regional Deprivation Index and Socioeconomic Inequalities Related to Infant Deaths in Korea

    Science.gov (United States)

    2016-01-01

    Deprivation indices have been widely used to evaluate neighborhood socioeconomic status and therefore examine individuals within their regional context. Although some studies on the development of deprivation indices were conducted in Korea, additional research is needed to construct a more valid and reliable deprivation index. Therefore, a new deprivation index, named the K index, was constructed using principal component analysis. This index was compared with the Carstairs, Townsend and Choi indices. A possible association between infant death and deprivation was explored using the K index. The K index had a higher correlation with the infant mortality rate than did the other three indices. The regional deprivation quintiles were unequally distributed throughout the country. Despite the overall trend of gradually decreasing infant mortality rates, inequalities in infant deaths according to the deprivation quintiles persisted and widened. Despite its significance, the regional deprivation variable had a smaller effect on infant deaths than did individual variables. The K index functions as a deprivation index, and we may use this index to estimate the regional socioeconomic status in Korea. We found that inequalities in infant deaths according to the time trend persisted. To reduce the health inequalities among infants in Korea, regional deprivation should be considered. PMID:27051241

  12. Evaluating biomarkers for prognostic enrichment of clinical trials.

    Science.gov (United States)

    Kerr, Kathleen F; Roth, Jeremy; Zhu, Kehao; Thiessen-Philbrook, Heather; Meisner, Allison; Wilson, Francis Perry; Coca, Steven; Parikh, Chirag R

    2017-12-01

    A potential use of biomarkers is to assist in prognostic enrichment of clinical trials, where only patients at relatively higher risk for an outcome of interest are eligible for the trial. We investigated methods for evaluating biomarkers for prognostic enrichment. We identified five key considerations when considering a biomarker and a screening threshold for prognostic enrichment: (1) clinical trial sample size, (2) calendar time to enroll the trial, (3) total patient screening costs and the total per-patient trial costs, (4) generalizability of trial results, and (5) ethical evaluation of trial eligibility criteria. Items (1)-(3) are amenable to quantitative analysis. We developed the Biomarker Prognostic Enrichment Tool for evaluating biomarkers for prognostic enrichment at varying levels of screening stringency. We demonstrate that both modestly prognostic and strongly prognostic biomarkers can improve trial metrics using Biomarker Prognostic Enrichment Tool. Biomarker Prognostic Enrichment Tool is available as a webtool at http://prognosticenrichment.com and as a package for the R statistical computing platform. In some clinical settings, even biomarkers with modest prognostic performance can be useful for prognostic enrichment. In addition to the quantitative analysis provided by Biomarker Prognostic Enrichment Tool, investigators must consider the generalizability of trial results and evaluate the ethics of trial eligibility criteria.

  13. Prognostic Performance Metrics

    Data.gov (United States)

    National Aeronautics and Space Administration — This chapter presents several performance metrics for offline evaluation of prognostics algorithms. A brief overview of different methods employed for performance...

  14. Prognostics for Microgrid Components

    Science.gov (United States)

    Saxena, Abhinav

    2012-01-01

    Prognostics is the science of predicting future performance and potential failures based on targeted condition monitoring. Moving away from the traditional reliability centric view, prognostics aims at detecting and quantifying the time to impending failures. This advance warning provides the opportunity to take actions that can preserve uptime, reduce cost of damage, or extend the life of the component. The talk will focus on the concepts and basics of prognostics from the viewpoint of condition-based systems health management. Differences with other techniques used in systems health management and philosophies of prognostics used in other domains will be shown. Examples relevant to micro grid systems and subsystems will be used to illustrate various types of prediction scenarios and the resources it take to set up a desired prognostic system. Specifically, the implementation results for power storage and power semiconductor components will demonstrate specific solution approaches of prognostics. The role of constituent elements of prognostics, such as model, prediction algorithms, failure threshold, run-to-failure data, requirements and specifications, and post-prognostic reasoning will be explained. A discussion on performance evaluation and performance metrics will conclude the technical discussion followed by general comments on open research problems and challenges in prognostics.

  15. Relation between Voice Handicap Index (VHI) and disease severity in Iranian patients with Parkinson's disease.

    Science.gov (United States)

    Majdinasab, Fatemeh; Karkheiran, Siamak; Moradi, Negin; Shahidi, Gholam Ali; Salehi, Masoud

    2012-11-01

    One third of patients with Parkinson's disease (PD) have mentioned "dysphonia" as their most debilitating communication deficit. Patient-based measurements, such as Voice Handicap Index (VHI) add necessary supplementary information to clinical and physiological assessment. There are a few studies about relation between VHI and disease severity in PD, although none of them showed any significant correlation. The goal of this study was to find correlation between these variables in Iranian PD patients. This cross-sectional, analytical and non-interventional study was done on 23 PD patients who reported a voice disorder related to their disease. They were selected from attendants of movement disorders clinic of Hazrat Rasool Akram Hospital. The relationship between disease severity (according to Hoehn and Yahr/H&Y and Unified Parkinson's Disease Rating Scale-part3 /UPDRS-III) and VHI questionnaire (and its 3 domains) was investigated based on patients' sex, UPDRS-III score H&Y and VHI. Total VHI and its 3 domains had no relationship with disease severity (H&Y) in all patients and by sex separation. However, there was a positive correlation between VHI and disease severity (UPDRS-III) (r = 0.485). There was also a relation between physical and functional domains of VHI and UPDRS (rP=0.530, rF=0.479) while no relationship observed regarding sex differences. 9 out of 18 UPDRS-III items had strong relationship with VHI (total and 3subscales). Iranian PD patients feel handicap according to voice disorder caused by PD. Patient satisfaction of voice decreases with the disease severity and progression. A larger sample size is necessary to find relationship in genders. VHI is an important issue could be offered to be used in PD beside other assessments.

  16. Relation between Voice Handicap Index (VHI) and disease severity in Iranian patients with Parkinson's disease

    Science.gov (United States)

    Karkheiran, Siamak; Moradi, Negin; Shahidi, Gholam Ali; Salehi, Masoud

    2012-01-01

    Background One third of patients with Parkinson's disease (PD) have mentioned “dysphonia” as their most debilitating communication deficit. Patient-based measurements, such as Voice Handicap Index (VHI) add necessary supplementary information to clinical and physiological assessment. There are a few studies about relation between VHI and disease severity in PD, although none of them showed any significant correlation. The goal of this study was to find correlation between these variables in Iranian PD patients. Method This cross-sectional, analytical and non-interventional study was done on 23 PD patients who reported a voice disorder related to their disease. They were selected from attendants of movement disorders clinic of Hazrat Rasool Akram Hospital. The relationship between disease severity (according to Hoehn and Yahr/H&Y and Unified Parkinson's Disease Rating Scale-part3 /UPDRS-III) and VHI questionnaire (and its 3 domains) was investigated based on patients’ sex, UPDRS-III score H&Y and VHI. Results Total VHI and its 3 domains had no relationship with disease severity (H&Y) in all patients and by sex separation. However, there was a positive correlation between VHI and disease severity (UPDRS-III) (r = 0.485). There was also a relation between physical and functional domains of VHI and UPDRS (rP=0.530, rF=0.479) while no relationship observed regarding sex differences. 9 out of 18 UPDRS-III items had strong relationship with VHI (total and 3subscales). Conclusion Iranian PD patients feel handicap according to voice disorder caused by PD. Patient satisfaction of voice decreases with the disease severity and progression. A larger sample size is necessary to find relationship in genders. VHI is an important issue could be offered to be used in PD beside other assessments PMID:23482344

  17. HIV-associated lymphoma: histopathology and association with Epstein-Barr virus genome related to clinical, immunological and prognostic features

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Lundgren, Jens Dilling

    1991-01-01

    (6)/l, P less than 0.05), and more often a history of previous AIDS-defining illnesses (50% vs. 0%, P less than 0.005), compared with patients with Burkitt-type lymphomas. Epstein-Barr virus (EBV) DNA was demonstrated in 14 of 19 immunoblast-rich tumours, and in 2 of 7 Burkitt-type lymphomas (P = 0.......10). Compared with EBV DNA-negative tumours EBV DNA-positive tumours were associated with lower CD4 cell counts (median 39 vs. 188 x 10(6)/l, P = 0.01). It is concluded that two main types of HIV-related malignant lymphoma exist. One is associated with severe immunosuppression, is often of immunoblast......-rich morphology, and may be linked to EBV, whereas the other may occur in the absence of immunosuppression, is often of Burkitt-type morphology, and is probably not linked to EBV. In addition to these two main types, other non-Hodgkin lymphomas and Hodgkin's disease do occur....

  18. [Species distribution of pathogens and prognostic factors for catheter-related bloodstream infections in intensive care unit].

    Science.gov (United States)

    Li, Jun; Yu, Li; Yang, Junhui; Long, Ding; Zhang, Yuanchao; Bu, Xiaofen

    2015-03-10

    To explore the incidence and species distribution of catheter-related bloodstream infection (CRBSI) in intensive care unit (ICU) at our hospital and analyze the risk factors for CRBSI. Hospitalized patients microbiologically diagnosed as CRBSI were recruited from January 2012 to June 2013. And the clinical data were collected retrospectively and analyzed by software IBM SPSS 19.0. Among 67 patients diagnosed as nosocomial CRBSI, 24 cases (35.8%) died while 43 survived. And a total of 81 strains were detected, including 42 Gram-positive (G⁺) bacteria (51.9%), 36 Gram-negative (G⁻) bacteria (44.4%) and 3 fungi (3.7%).The predominant pathogenic G⁺ and G⁻ bacteria were Staphylococcus epidermidis and Acinetobacter baumannii respectively. With multiple Logistic regressions, age ≥ 65 years, higher acute physiology & chronic health evaluation II (APACHE II) score and polymicrobial CRBSI were independent predictors of worse outcomes. The recent prevalent pathogens of CRBSI in ICU are S.epidermidis and A.baumannii. Advanced age, disease severity and polymicrobial CRBSI are significant independent risk factor of mortality for CRBSI patients in ICU.

  19. Motor Proficiency and Body Mass Index of Preschool Children: In Relation to Socioeconomic Status

    Science.gov (United States)

    Mülazimoglu-Balli, Özgür

    2016-01-01

    The aim of the study was to investigate the correlation between motor proficiency and body mass index and to assess the socioeconomic status differences in motor proficiency and body mass index of preschool children. Sixty preschool children in the different socioeconomic status areas of central Denizli in Turkey participated in the study. The…

  20. A roughness-corrected index of relative bed stability for regional stream surveys

    Science.gov (United States)

    Kaufmann, Philip R.; Faustini, John M.; Larsen, David P.; Shirazi, Mostafa A.

    2008-07-01

    Quantitative regional assessments of streambed sedimentation and its likely causes are hampered because field investigations typically lack the requisite sample size, measurements, or precision for sound geomorphic and statistical interpretation. We adapted an index of relative bed stability (RBS) for data calculated from a national stream survey field protocol to enable general evaluation of bed stability and anthropogenic sedimentation in synoptic ecological surveys. RBS is the ratio of bed surface geometric mean particle diameter ( Dgm) divided by estimated critical diameter ( Dcbf) at bankfull flow, based on a modified Shield's criterion for incipient motion. Application of RBS to adequately depict bed stability in complex natural streams, however, has been limited because typical calculations of RBS do not explicitly account for reductions in bed shear stress that result from channel form roughness. We modified the index (RBS *) to incorporate the reduction in bed shear stress available for sediment transport that results from the hydraulic resistance of large wood and longitudinal irregularities in channel dimensions ("form roughness"). Based on dimensional analysis, we derived an adjustment to bankfull shear stress by multiplying the bankfull hydraulic radius ( Rbf) by the one-third power of the ratio of particle-derived resistance to total hydraulic resistance ( Cp/ Ct) 1/3, where both resistances are empirically based calculations. We computed Cp using a Keulegan equation relating resistance to relative submergence of bed particles. We then derived an empirical equation to predict reach-scale hydraulic resistance Ct from thalweg mean depth, thalweg mean residual depth, and large wood volume based on field dye transit studies, in which total hydraulic resistance Ct was measured over a wide range of natural stream channel complexity, including manipulation of large wood volumes. We tested our estimates of Ct and RBS * by applying them to data from a summer

  1. Acute Liver Failure/Injury Related to Drug Reaction With Eosinophilia and Systemic Symptoms: Outcomes and Prognostic Factors.

    Science.gov (United States)

    Ichai, Philippe; Laurent-Bellue, Astrid; Saliba, Faouzi; Moreau, David; Besch, Camille; Francoz, Claire; Valeyrie-Allanore, Laurence; Bretagne, Sylvie Roussin; Boudon, Marc; Antonini, Teresa Maria; Artru, Florent; Pittau, Gabriella; Roux, Olivier; Azoulay, Daniel; Levesque, Eric; Durand, François; Guettier, Catherine; Samuel, Didier

    2017-08-01

    Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare severe adverse drug-induced reaction with multiorgan involvement. The outcome and prediction of those patients who develop severe acute liver injury (sALI) or acute liver failure (ALF) remain little known. A multicenter retrospective study of patients admitted with a diagnosis of DRESS-related sALI or ALF. Histological review was performed on liver core biopsies from native livers. Sixteen patients (11 women, 5 men; mean age, 39±17.2 years) were classified as having definite (n=13) or probable (n=3) DRESS. At admission, 3 patients had hepatic encephalopathy; median levels of prothrombin time, INR, and total bilirubin were, respectively, 33% (Q1-Q3, 21-41), 2.74 (1.98-4.50), and 94 μmol/L (Q1-Q3, 39.5-243.5). Nine patients received corticosteroid therapy. Overall, 9 patients improved spontaneously and 7 worsened (liver transplantation [LT] (n=5), deceased (n=2)). Transplantation-free and post-LT survival was 56% and 60%, respectively. After LT, DRESS recurrence was observed in 3 of 5 patients. Systemic corticosteroid therapy was not significantly associated with a clinical improvement. In the multivariate analysis, factor V level less than 40% at day 0 and factor V levels of 40% or greater at admission but decreasing at day 2 were associated with worse outcome. Pathological findings (n=7) revealed atypical lymphoid infiltrates, Kupffer cell hyperplasia with erythrophagocytosis, and an inconstant presence of eosinophils. The spontaneous prognosis of patients with sALI/ALF due to DRESS is poor and was not improved by corticosteroid therapy. Histology is helpful to establish diagnosis. Dynamic variables regarding factor V values are predictive of a poor outcome.

  2. Relative resistance index (RRI) - a scoring system for antibiotic resistance in Pseudomonas aeruginosa.

    Science.gov (United States)

    Ewing, J; McCaughan, J; Moore, J; Fairley, D; Sutherland, B; Reid, A; Downey, D

    2017-10-01

    There is a need to measure antibiotic resistance of Pseudomonas aeruginosa (PA) in cystic fibrosis (CF), either qualitatively or quantitatively, to inform patient management. The aim of this study was to develop a simple method by which resistance can be quantified by calculating a relative resistance index (RRI), and to assess correlation of RRIs with clinical variables. In our model, RRIs were calculated based on resistance to aztreonam, ceftazidime, ciprofloxacin, colistin, meropenem, tazocin, temicillin and tobramycin. Eighty-five adults with CF and chronic PA colonisation were identified. For each, all PA cultures were allocated a score of 0 for susceptible, 0.5 for intermediate resistance or 1 for resistance for each antibiotic listed above, and the RRI calculated by dividing the sum of these by the number of antibiotics, giving a maximum score of 1. The mean RRIs for all cultures were correlated with key clinical variables monitored in CF patients (including age, FEV1, IV antibiotic days and BMI). RRIs for non-mucoid PA exhibited moderate positive correlation with total number of IV days (r = 0.405; p resistance.

  3. Prevalence of Helicobacter pylori infection and its relation with body mass index in a Chinese population.

    Science.gov (United States)

    Xu, Chengfu; Yan, Ming; Sun, Yan; Joo, Jungsoo; Wan, Xingyong; Yu, Chaohui; Wang, Qunyan; Shen, Chao; Chen, Peng; Li, Youming; Coleman, William G

    2014-12-01

    Helicobacter pylori infection is highly prevalent worldwide. The association between obesity and H. pylori infection is controversial in the literature. This study aims to investigate the prevalence of H. pylori infection and its relation with body mass index (BMI) in a Chinese population. A cross-sectional study was performed among adults who underwent health checkups at the First Affiliated Hospital, College of Medicine, Zhejiang University in 2013. The prevalence of H. pylori infection was examined by (13)C urea breath tests, and the association between prevalence of H. pylori infection and BMI was analyzed. Of the 8820 participants enrolled, 3859 (43.8%) were positive for H. pylori infection. H. pylori-positive participants had a more unfavorable metabolic profile than H. pylori-negative participants. Overweight/obese participants showed a higher prevalence of H. pylori infection than that of lean participants, and a positive linear correlation between BMI and prevalence of H. pylori infection was observed. Both unadjusted and adjusted analysis revealed that BMI was significantly associated with risk factors of H. pylori infection. Our results showed that BMI was significantly and positively associated with H. pylori infection, and a high BMI was associated with an increased risk of the infection. © 2014 John Wiley & Sons Ltd.

  4. Quantification of mold contamination in multi-level buildings using the Environmental Relative Moldiness Index.

    Science.gov (United States)

    Vesper, Stephen; Cox-Ganser, Jean M; Wymer, Larry; Park, Ju-Hyeong

    2017-10-20

    The goal of this study was to evaluate the possible use of the Environmental Relative Moldiness Index (ERMI) to quantify mold contamination in multi-level, office buildings. Settled-dust samples were collected in multi-level, office buildings and the ERMI value for each sample determined. In the first study, a comparison was made between two identical four-story buildings. There were health complaints in one building but none in the other building. In the second study, mold contamination was evaluated on levels 6 through 19 of an office building with a history of water problems and health complaints. In the first study, the average ERMI value in the building with health complaints was 5.33 which was significantly greater than the average ERMI value, 0.55, in the non-complaint building. In the second study, the average ERMI values ranged from a low of -0.58 on level 8 to a high of 5.66 on level 17, one of the top five ranked levels for medical symptoms or medication use. The mold populations of ten (six Group 1 and four Group 2) of the 36-ERMI molds were in significantly greater concentrations in the higher compared to lower ERMI environments. The ERMI metric may be useful in the quantification of water-damage and mold growth in multi-level buildings.

  5. Association between an Alzheimer's Disease-Related Index and APOE ε4 Gene Dose.

    Directory of Open Access Journals (Sweden)

    Frank Schraml

    Full Text Available We introduced a hypometabolic convergence index (HCI to characterize in a single measurement the extent to which a person's fluorodeoxyglucose positron emission tomogram (FDG PET corresponds to that in Alzheimer's disease (AD. Apolipoprotein E ε4 (APOE ε4 gene dose is associated with three levels of risk for late-onset AD. We explored the association between gene dose and HCI in cognitively normal ε4 homozygotes, heterozygotes, and non-carriers.An algorithm was used to characterize and compare AD-related HCIs in cognitively normal individuals, including 36 ε4 homozygotes, 46 heterozygotes, and 78 non-carriers.These three groups differed significantly in their HCIs (ANOVA, p = 0.004, and there was a significant association between HCIs and gene dose (linear trend, p = 0.001.The HCI is associated with three levels of genetic risk for late-onset AD. This supports the possibility of using a single FDG PET measurement to help in the preclinical detection and tracking of AD.

  6. Resistin levels are related to fat mass, but not to body mass index in children.

    Science.gov (United States)

    Ortega, Lorena; Riestra, Pía; Navarro, Pilar; Gavela-Pérez, Teresa; Soriano-Guillén, Leandro; Garcés, Carmen

    2013-11-01

    The relationship of resistin levels with obesity remains unclear. The aim of this study was to determine resistin levels in prepubertal children and adolescents and evaluate their association with anthropometric parameters and body composition. The study population included 420 randomly selected 6-8-year-old children and 712 children aged 12-16 years. Anthropometric data were measured and body mass index (BMI) and waist-to-hip and waist-to-height ratios were calculated. Body composition was assessed using an impedance body composition analyzer. Serum resistin levels were determined using a multiplexed bead immunoassay. Resistin levels were not significantly different between sexes. No significant differences in serum resistin concentrations were found between obese, overweight, and normal weight children at any age, and no significant correlations were observed between resistin concentrations and weight or BMI. However, resistin levels showed a significant positive correlation with fat mass in 12-16-year-old children, particularly in girls. In addition to describing serum resistin levels in prepubertal children and adolescents, our study suggests that resistin is related to body fat rather than to BMI in adolescents. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. The socioeconomic inequality in traffic-related disability among Chinese adults: the application of concentration index.

    Science.gov (United States)

    Chen, He; Du, Wei; Li, Ning; Chen, Gong; Zheng, Xiaoying

    2013-06-01

    Traffic crashes have become the fifth leading cause of burden of diseases and injuries in China. More importantly, it may further aggravate the degree of health inequality among Chinese population, which is still under-investigated. Based on a nationally representative data, we calculated the concentration index (CI) to measure the socioeconomic inequality in traffic-related disability (TRD), and decomposed CI into potential sources of the inequality. Results show that more than 1.5 million Chinese adults were disabled by traffic crashes and the adults with financial disadvantage bear disproportionately heavier burden of TRD. Besides, strategies of reducing income inequality and protecting the safety of poor road users, are of great importance. Residence appears to counteract the socioeconomic inequality in TRD, however, it does not necessarily come to an optimistic conclusion. In addition to the worrying income gap between rural and urban areas, other possible mechanisms, e.g. the low level of post-crash medical resources in rural area, need further studies. China is one of the developing countries undergoing fast motorization and our findings could provide other countries in similar context with some insights about how to maintain socioeconomic equality in road safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. The event-related brain potential as an index of attention allocation in complex displays

    Science.gov (United States)

    Wickens, C. D.; Heffley, E. F.; Kramer, A. F.; Donchin, E.

    1980-01-01

    The advantages of employing the event-related brain potential (ERP) in the assessment of allocation of attention in dynamic environments are discussed. Three experiments are presented in which the P300 component of the ERP is demonstrated to be a useful index of subjects' locus of attention. The first two experiments were concerned with the allocation of attention during discrete and continuous visual monitoring tasks. The results indicated that a P300 was elicited only by stimuli to which the subject had to attend in order to perform successfully the task. The third experiment was conducted to assess the sensitivity of P300 to the manner in which attention is allocated to different aspects of a display during the performance of a 3-dimensional target acquisition task. The amplitude of the P300 was found to reflect differences between two levels of workload, as well as the task relevance of the stimuli. The results of the experiments are discussed in terms of their utility in the evaluation of the design of man-machine systems as well as in the study of the allocation of attention in operational environments.

  9. Genetic uptake in BRCA-mutation families is related to emotional and behavioral communication characteristics of index patients.

    NARCIS (Netherlands)

    Landsbergen, K.M.; Verhaak, C.M.; Kraaimaat, F.W.; Hoogerbrugge-van der Linden, N.

    2005-01-01

    INTRODUCTION: Carriers of a hereditary mutation in BRCA are at high risk for breast and ovarian cancer. The first person from a family known to carry the mutation, the index person, has to share genetic information with relatives. This study is aimed at determining the number of relatives tested for

  10. Cfh genotype interacts with dietary glycemic index to modulate age-related macular degeneration-like features in mice

    Science.gov (United States)

    Age-related macular degeneration (AMD) is a leading cause of visual impairment worldwide. Genetics and diet contribute to the relative risk for developing AMD, but their interactions are poorly understood. Genetic variations in Complement Factor H (CFH), and dietary glycemic index (GI) are major ris...

  11. Heart rate response to exercise in heart failure patients: The prognostic role of metabolic-chronotropic relation and heart rate recovery.

    Science.gov (United States)

    Hajdusek, Pavel; Kotrc, Martin; Kautzner, Josef; Melenovsky, Vojtech; Benesova, Eva; Jarolim, Petr; Benes, Jan

    2017-02-01

    The dynamics of the sinus node response to exercise is linked to functional capacity and outcome in heart failure (HF). The goal of the work was to analyze determinants and impacts of cardio-acceleration, described by the concept of metabolic-chronotropic relation (MCR) and of cardio-deceleration, described by heart rate recovery (HRR). A cohort of 25 healthy controls and 78 patients with advanced systolic HF and optimized medical and/or device therapy (97% receiving beta-blockers, 54% ICD) underwent maximal cardiopulmonary exercise test and were prospectively followed. HF patients had impaired exercise performance compared with controls (pVO2 15±4 vs. 29±7ml.kg-1.min-1, pslope (0.54±0.24 vs. 0.90±0.15, pslope was inversely associated with beta-blocker dose (r=-0.24), NYHA class (r=-0.28) and HF duration (r=-0.25), whereas HRR with estimated glomerular filtration rate (eGFR, r=0.39), age (r=-0.28) and BMI (r=-0.31, all pslope (p=0.02) but not HRR (p=0.19). MCR slope (but not HRR) was a significant outcome predictor (p=0.02 for Cox unadjusted model) even after adjustment for LVEF, serum natrium, systolic blood pressure, eGFR and NT-proBNP (p=0.04). MCR slope is associated with different clinical variables than HRR. Compared to HRR, MCR slope provides significant prognostic information in HF patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Prognostic Role of Exhaled Breath Condensate pH and Fraction Exhaled Nitric Oxide in Systemic Sclerosis Related Interstitial Lung Disease.

    Science.gov (United States)

    Guillen-Del Castillo, Alfredo; Sánchez-Vidaurre, Sara; Simeón-Aznar, Carmen P; Cruz, María J; Fonollosa-Pla, Vicente; Muñoz, Xavier

    2017-03-01

    Interstitial lung disease (ILD) is one of the major causes of death in systemic sclerosis (SSc). This study investigated exhaled breath (EB) and exhaled breath condensate (EBC) biomarkers in patients with SSc and analyzed their role as a prognostic tool in SSc-related ILD. Fraction exhaled nitric oxide (FeNO) and exhaled carbon monoxide (eCO) measured in EB, together with pH, nitrite, nitrate and interleukin-6 levels measured in EBC were prospectively analyzed in 35 patients with SSc. Twelve patients had established ILD by chest high-resolution computed tomography (HRCT), and 23 patients showed no evidence of ILD. EB and EBC biomarkers were determined at inclusion, and pulmonary function tests were annually performed during 4 years of follow-up. No differences at baseline biomarkers levels were found between groups. In all patients studied, low EBC pH levels were associated with a decreased diffusing capacity for carbon monoxide (DLCO) during follow-up. Low FeNO levels were correlated with lower forced vital capacity (FVC) at baseline, 4years of follow-up and with a decrease in FVC and DLCO during monitoring. Among ILD patients, high eCO levels were correlated with lower baseline FVC. In the global cohort, a worse progression-free survival was identified in patients with EBC pH values lower than 7.88 and FeNO levels lower than 10.75ppb (Log Rank P=.03 and P<.01, respectively). EB and EBC could help to detect patients likely to present a deterioration on lung function during follow up. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. The validity of Geriatric Nutrition Risk Index: simple tool for prediction of nutritional-related complication of hospitalized elderly patients. Comparison with Mini Nutritional Assessment.

    Science.gov (United States)

    Abd-El-Gawad, Wafaa Mostafa; Abou-Hashem, Rania Mohammed; El Maraghy, Mohamed Omar; Amin, Ghada Essam

    2014-12-01

    The Geriatric Nutritional Risk Index (GNRI) is a promising tool initially proposed to predict nutrition-related complications in sub-acute care setting. So, the main aim of this study was to validate the use of GNRI in hospitalized elderly patients by testing its ability to predict patients' outcome through the comparison with Mini Nutritional Assessment (MNA). A prospective cohort study was conducted on 131 patients aged 60 and over admitted consecutively from October 2011 to September 2012 to the acute geriatrics medical ward in Ain Shams University hospitals, Cairo, Egypt. All patients were subjected to nutritional screening using GNRI and MNA and measurement of weight, body mass index (BMI), mid arm circumference (MAC), and calf circumference (CC), serum levels of total protein, albumin and prealbumin. Patients were followed for 6 months for the occurrence of major health complications as prolonged length of stay, infectious complications and mortality. Mean age was 69.32 ± 8.17 years. Lower GNRI scores were statically significantly associated with worse MNA scores, lower weight, BMI, MAC, CC and albumin (P value nutrition-related complication (from mild to moderate to severe). ORs (95%CI) for three month mortality were 1.63(0.0.27-10.00), 5.03(1.36-18.52), and 11.24(3.03-41.67), and OR (95%CI) for six month mortality were 1.64(0.403-6.62), 4.29 (1.45-12.66), and 5.71(1.87-17.54) respectively compared to patients with no risk and. By regression, both severe and moderate grade of GNRI were independent predictors of three and six month mortality (P value for three month: 0.002, 0.015; for six month: 0.002, 0.008 respectively) after adjustment of age, sex, and cancer rather than MNA. GNRI showed a higher prognostic value for describing and classification of nutritional status and nutritional-related complications in hospitalized elderly patients in addition to its simplicity. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and

  14. Development and Validation of the Work-Related Well-Being Index: Analysis of the Federal Employee Viewpoint Survey (FEVS).

    Science.gov (United States)

    Eaton, Jennifer L; Mohr, David C; Hodgson, Michael J; McPhaul, Kathleen M

    2017-10-11

    To describe development and validation of the Work-Related Well-Being (WRWB) Index. Principal Components Analysis was performed using Federal Employee Viewpoint Survey (FEVS) data (N = 392,752) to extract variables representing worker well-being constructs. Confirmatory factor analysis was performed to verify factor structure. To validate the WRWB index, we used multiple regression analysis to examine relationships with burnout associated outcomes. PCA identified three positive psychology constructs: "Work Positivity", "Co-worker Relationships", and "Work Mastery". An 11 item index explaining 63.5% of variance was achieved. The structural equation model provided a very good fit to the data. Higher WRWB scores were positively associated with all 3 employee experience measures examined in regression models. The new WRWB index shows promise as a valid and widely accessible instrument to assess worker well-being.

  15. GPU Accelerated Prognostics

    Science.gov (United States)

    Gorospe, George E., Jr.; Daigle, Matthew J.; Sankararaman, Shankar; Kulkarni, Chetan S.; Ng, Eley

    2017-01-01

    Prognostic methods enable operators and maintainers to predict the future performance for critical systems. However, these methods can be computationally expensive and may need to be performed each time new information about the system becomes available. In light of these computational requirements, we have investigated the application of graphics processing units (GPUs) as a computational platform for real-time prognostics. Recent advances in GPU technology have reduced cost and increased the computational capability of these highly parallel processing units, making them more attractive for the deployment of prognostic software. We present a survey of model-based prognostic algorithms with considerations for leveraging the parallel architecture of the GPU and a case study of GPU-accelerated battery prognostics with computational performance results.

  16. Factores pronósticos relacionados con el cáncer gástrico Prognostic factors related to gastric cancer

    Directory of Open Access Journals (Sweden)

    Zenén Rodríguez Fernández

    2011-09-01

    patients are diagnosed in III or IV stages and global 5-years survival is from 5 to 15 %. The objective of present review was to identify the prognostic factors related to gastric cancer in dependence of the patient, of the own tumor and of the treatment, which may to affecting the appearance of the tumor relapse after surgery and to help to take into account appropriate therapeutics. In the biological variables of patient there is not a significant association with the prognosis of gastric cancer, unlike the grade of wall invasion, the ganglion involvement and the tumor biological factors. Surgery is the only potentially curative treatment, but it is not enough for many patients despite the wide lymphadenectomies. Around the 80 % of patients operated on will show relapse with a fatal prognosis. Chemotherapy, radiotherapy and immunotherapy have not changed yet in a significant way, the natural history of this disease. The postoperative follow-up can not be systematized due to the low sensitivity of methods to detect the relapse pattern, as well as the lack of its effectiveness treatment. The characterization of the prognostic factors of gastric cancer allows to stratify the patients and to select different treatments trying to increase the survival.

  17. Relation between socioeconomic status and body mass index: evidence of an indirect path via television use.

    Science.gov (United States)

    Morgenstern, Matthis; Sargent, James D; Hanewinkel, Reiner

    2009-08-01

    To test the hypothesis that media use mediates the relation between socioeconomic status (SES) and body mass index (BMI). Analysis of 2 large cross-sectional surveys, 1 from Germany and 1 from the United States. Twenty-seven public schools in northern Germany; telephone interviews in the United States. A total of 4810 German children and adolescents aged 10 to 17 years (mean age, 12.8 years); 4473 US children and adolescents aged 12 to 16 years (mean age, 14.0 years) recruited using random-digit-dial methods. Main Exposures Media exposure was assessed via survey questions about the presence of a television in the bedroom, television screen time, computer and video game screen time, and movie viewing. The SES was derived from type of school (German sample) or parental reports of their own education and family income (US sample). The BMI was assessed by the use of self-reports in both samples, supplemented by parental reports (US sample) for height and weight. In both samples, SES was inversely associated with BMI, and media use was directly associated with BMI. The effect of SES on overweight was partially mediated by media exposure, which explained 35% of the SES-BMI association in the German sample and 16% in the US sample. In both groups, television in the bedroom and television screen time had statistically significant indirect paths, whereas video game use and movie viewing did not. Students from low-SES backgrounds are at higher risk for overweight in part because of higher levels of television viewing. The change of media use habits could modify this health disparity.

  18. Cell Index in the Diagnosis of External Ventricular Drain-Related Infections.

    Science.gov (United States)

    Lunardi, Luciano Werle; Zimmer, Eduardo R; Dos Santos, Samir C; Merzoni, Jóice; Portela, Luis V; Stefani, Marco Antonio

    2017-10-01

    The use of an external ventricular drain is required for the treatment of many diseases, such as traumatic brain injury and subarachnoid hemorrhage (SAH). Meningitis and ventriculitis are frequent complications arising from the use of external ventricular drain therapy. This study aimed to determine the sensitivity, specificity, and cutoff point for cell index (CI) in patients with traumatic brain injury, SAH, and hemorrhagic stroke. Our study population consisted of patients with different underlying diseases and few culture-positive cerebrospinal fluid samples. The diagnosis of infection was based on Centers of Disease Control and Prevention criteria. Overall CI analysis showed an area under the curve (AUC) of 0.982. The cutoff of 2.9 for overall CI provided a sensitivity of 95% and a specificity of 92.9%. In patients with SAH, the AUC was 1.0 for a CI of 2.8; furthermore, sensitivity and specificity were 100%. The relative variation of the CI was also assessed. This analysis revealed an AUC of 0.882, and a 4.33-fold increase was found be indicative of infection (P = 0.002), findings similar to those in the literature. In addition, a heatmap analysis demonstrated that the CI is unlikely to return to normal in patients with meningitis, even after treatment. Therefore, CI is valuable for the diagnosis of infection, but was inadequate for monitoring treatment. We hope to use the new cutoff point proposed by this study in our institution to improve patient clinical outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis.

    Science.gov (United States)

    Trimarchi, Hernán; Muryan, Alexis; Raña, María-Soledad; Paggi, Pedro; Lombi, Fernando; Forrester, Mariano; Pomeranz, Vanesa; Karl, Alejandra; Alonso, Mirta; Young, Pablo; Dicugno, Mariana

    2013-01-01

    Certain adipokines exert direct effects on proteinuria, a cardiovascular risk factor ignored in hemodialysis. We measured different adipokines according to body mass index (BMI) in relation to proteinuria. Patients numbered 57: group A (GA), BMIGB, BMI 25-30, n = 15; and GC, BMI > 30, n = 20. There were no statistical differences in age, sex, time on dialysis, cause of renal failure, diabetes, hypertension, C-reactive protein, or nutritional status. Measures were taken of 24-hour diuresis and proteinuria, ultrafltration, albumin, pro-brain natriuretic peptide (Pro-BNP), insulin, adiponectin, leptin, and ghrelin. Proteinuria was signifcantly higher in GC versus (vs) GA (1.5 g/day, range 0.30-14 vs 0.72 g/day, range 0.1-2.7; P Pro-BNP, adiponectin, and ghrelin were associated with lower degrees of proteinuria. Signifcant correlations were found between adiponectin and leptin (ρ = -0.54, P = 0.03), and adiponectin and Pro-BNP (ρ = 0.59, P = 0.02). Though not signifcant, there were more diabetics in GC (GA four, GB three, GC ten). As BMI increased in GB and GC, Pro-BNP, adiponectin, and ghrelin levels decreased signifcantly, while proteinuria, insulin, and homeostasis model assessment of insulin resistance increased. Leptin levels were signifcantly elevated in GC vs GA and GB. In GC, ghrelin correlated signifcantly with Pro-BNP (ρ = 0.51, P = 0.03), while leptin correlation with Pro-BNP was inverse and signifcant in GA (ρ = -0.74, P GB and GC. In patients with BMI Pro-BNP levels were associated with lower proteinuria and leptinemia. In obesity, hyperleptinemia and hyperinsulinemia associated with higher proteinuria; whether decreased adiponectin-ghrelin-ProBNP and/or elevated leptin-insulin levels aggravate proteinuria remains to be determined.

  20. Genetic determinants of serum vitamin B12 and their relation to body mass index.

    Science.gov (United States)

    Allin, Kristine H; Friedrich, Nele; Pietzner, Maik; Grarup, Niels; Thuesen, Betina H; Linneberg, Allan; Pisinger, Charlotta; Hansen, Torben; Pedersen, Oluf; Sandholt, Camilla H

    2017-02-01

    Lower serum vitamin B12 levels have been related to adverse metabolic health profiles, including adiposity. We used a Mendelian randomization design to test whether this relation might be causal. We included two Danish population-based studies (ntotal = 9311). Linear regression was used to test for associations between (1) serum vitamin B12 levels and body mass index (BMI), (2) genetic variants and serum vitamin B12 levels, and (3) genetic variants and BMI. The effect of a genetically determined decrease in serum vitamin B12 on BMI was estimated by instrumental variable regression. Decreased serum vitamin B12 associated with increased BMI (P B12 associated variants associated strongly with serum vitamin B12 (P B12 was associated with a 0.09 kg/m2 (95% CI 0.05; 0.13) increase in BMI (P = 3 × 10-5), whereas a genetically induced 20% decrease in serum vitamin B12 had no effect on BMI [-0.03 (95% CI -0.22; 0.16) kg/m2] (P = 0.74). Nevertheless, the strongest serum vitamin B12 variant, FUT2 rs602662, which was excluded from the B12 genetic risk score due to potential pleiotropic effects, showed a per allele effect of 0.15 kg/m2 (95% CI 0.01; 0.32) on BMI (P = 0.03). This association was accentuated including two German cohorts (ntotal = 5050), with a combined effect of 0.19 kg/m2 (95% CI 0.08; 0.30) (P = 4 × 10-4). We found no support for a causal role of decreased serum vitamin B12 levels in obesity. However, our study suggests that FUT2, through its regulation of the cross-talk between gut microbes and the human host, might explain a part of the observational association between serum vitamin B12 and BMI.

  1. Relation between Breast Cancer and High Glycemic Index or Glycemic Load: A Meta-analysis of Prospective Cohort Studies.

    Science.gov (United States)

    Mullie, Patrick; Koechlin, Alice; Boniol, Mathieu; Autier, Philippe; Boyle, Peter

    2016-01-01

    Breast cancer is the commonest form of cancer in women worldwide. It has been suggested that chronic hyperinsulinemia associated with insulin resistance plays a role in breast cancer etiology. To test the hyperinsulinemia hypothesis, a dietary pattern associated with a high glycemic index and glycemic load, both proxies for chronic hyperinsulinemia, should be associated with an increased risk of breast cancer. A meta-analysis restricted to prospective cohort studies was undertaken using a random effects model with tests for statistical significance, publication bias and heterogeneity. The metric for analysis was the risk of breast cancer in the highest relative to the lowest glycemic index and glycemic load dietary pattern. A dietary pattern with a high glycemic index was associated with a summary relative risk (SRR) of 1.05 (95% CI: 1.00, 1.11), and a high glycemic load with a SRR of 1.06 (95% CI: 1.00, 1.13). Adjustments for body mass index [BMI], physical activity and other lifestyle factors did not influence the SRR, nor did menopausal status and estrogen receptor status of the tumor. In conclusion, the current evidence supports a modest association between a dietary pattern with high glycemic index or glycemic load and the risk of breast cancer.

  2. Impact of reward and punishment motivation on behavior monitoring as indexed by the error-related negativity.

    Science.gov (United States)

    Potts, Geoffrey F

    2011-09-01

    The error-related negativity (ERN) is thought to index a neural behavior monitoring system with its source in anterior cingulate cortex (ACC). While ACC is involved in a wide variety of cognitive and emotional tasks, there is debate as to what aspects of ACC function are indexed by the ERN. In one model the ERN indexes purely cognitive function, responding to mismatch between intended and executed actions. Another model posits that the ERN is more emotionally driven, elicited when an action is inconsistent with motivational goals. If the ERN indexes mismatch between intended and executed actions, then it should be insensitive to motivational valence, e.g. reward or punishment; in contrast if the ERN indexes the evaluation of responses relative to goals, then it might respond differentially under differing motivational valence. This study used a flanker task motivated by potential reward and potential punishment on different trials and also examined the N2 and P3 to the imperative stimulus, the response Pe, and the FRN and P3 to the outcome feedback to assess the impact of motivation valence on other stages of information processing in this choice reaction time task. Participants were slower on punishment motivated trials and both the N2 and ERN were larger on punishment motivated trials, indicating that loss aversion has an impact on multiple stages of information processing including behavior monitoring. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. The Longitudinal Relation Between Accumulation of Adverse Life Events and Body Mass Index From Early Adolescence to Young Adulthood

    NARCIS (Netherlands)

    Elsenburg, L.; Smidt, N.; Liefbroer, A.C.

    2017-01-01

    Objective: Stressors, such as adverse life events, can cause weight changes through behavioral and biological mechanisms. Whether the accumulation of adverse life events is related to body mass index (BMI) across multiple time points from early adolescence to young adulthood has not been

  4. The Longitudinal Relation Between Accumulation of Adverse Life Events and Body Mass Index From Early Adolescence to Young Adulthood

    NARCIS (Netherlands)

    Elsenburg, Leonie K.; Smidt, Nynke; Liefbroer, Aart C.

    Objective: Stressors, such as adverse life events, can cause weight changes through behavioral and biological mechanisms. Whether the accumulation of adverse life events is related to body mass index (BMI) across multiple time points from early adolescence to young adulthood has not been

  5. DNA-Based Analyses of Molds in Singapore Public Buildings Results in a Proposed Singapore Environmental Relative Moldiness Index

    Science.gov (United States)

    Dust samples (n=75) were collected from shopping malls, hotels and libraries in Singapore and then analyzed using Mold Specific Quantitative Polymerase Chain Reaction(MSQPCR) for the 36 molds that make up the Environmental Relative Moldiness Index (ERMI). Most of these molds (23/...

  6. Correlation between environmental relative moldiness index (ERMI) values in French dwellings and other measures of fungal contamination

    Science.gov (United States)

    The Environmental Relative Moldiness Index (ERMI) is a DNA-based metric developed to describe the fungal contamination in US dwellings. Our goal was to determine if the ERMI values in dwellings in north western France were correlated with other measures of fungal contamination. D...

  7. Body mass index, poor diet quality and health related quality of life are associated with mortality in rural older adults

    Science.gov (United States)

    In an aging population, potentially modifiable factors impacting mortality such as diet quality, body mass index (BMI), and health-related quality of life (HRQOL) are of interest. Surviving members of the Geisinger Rural Aging Study (GRAS) (n = 5,993; aged =74 years) were contacted in the fall of 20...

  8. Differences between men and women in self-reported body mass index and its relation to drug use

    NARCIS (Netherlands)

    Vera-Villarroel, P.; Piqueras, J.A.; Kuhne, W.; Cuijpers, P.; van Straten, A.

    2014-01-01

    Background: Obesity is a public health problem of alarming proportions, including among the university population in Latin America. The purpose of this study was to determine the relation between the self-reported body mass index and the associated drug use and health-risk behaviors.Methods: We

  9. Vertebral Tortuosity Index in Patients with Non-Connective Tissue Disorder-Related Aneurysm Disease.

    Science.gov (United States)

    Virgilio, F; Maurel, B; Davis, M; Hamilton, G; Mastracci, T M

    2017-03-01

    The vertebral tortuosity index (VTI) predicts increased risk of acute aortic events in patients with known genetic aortopathies. This study describes the VTI in a cohort of patients with non-connective tissue disorder-related large aneurysms. Hospital imaging records from July 2012 to March 2016 were interrogated to identify patients with aneurysmal disease who had undergone computed tomographic angiography that included imaging of vertebral arteries. A control group of consecutive patients undergoing carotid and vertebral imaging was also assessed. VTI was calculated using the formula: [(centre-line distance) / (straight-line distance)-1] ×100 for all patients, and statistical analysis undertaken to determine whether measured VTI was statistically different in patients of younger age, with larger aneurysms, or an acute presentation. Comparison was made with patients who had no aneurysm disease. Sixty-five patients were identified with adequate imaging to assess the entire aorta, including vertebral arteries. The majority of patients were male (71%, 46/65) and mean age at the time of the CT scan was 71 years (SD 11.1 years). There were 11 patients under the age of 60 years in this cohort. The mean VTI was 33.17 (SD 20.43). There was no statistically significant difference between different territories of presentation (proximal vs. distal aneurysm, p=.94), age of patient (>60 years vs. 6 cm vs. <6 cm, p=.09). Acuity of presentation was not predicted by a higher VTI (p=.69). The VTI in patients with aneurysms was higher than in patients without aneurysm disease (VTI = 16.1, p<.005) CONCLUSIONS: An elevated VTI is consistently present in patients with degenerative aneurysms and has potential as a universally available predictive measurement. However, the increased VTI in the older cohort without connective tissue disease may not carry the same predictive value for acute presentations as has been demonstrated in younger patients with a known genetic basis for

  10. Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis

    Directory of Open Access Journals (Sweden)

    Trimarchi H

    2013-06-01

    Full Text Available Hernán Trimarchi,1 Alexis Muryan,2 María-Soledad Raña,1 Pedro Paggi,2 Fernando Lombi,1 Mariano Forrester,1 Vanesa Pomeranz,1 Alejandra Karl,1 Mirta Alonso,2 Pablo Young,3 Mariana Dicugno2 1Department of Nephrology, 2Department of Biochemistry, 3Department of Internal Medicine Services, Hospital Británico de Buenos Aires, Buenos Aires, Argentina Background: Certain adipokines exert direct effects on proteinuria, a cardiovascular risk factor ignored in hemodialysis. We measured different adipokines according to body mass index (BMI in relation to proteinuria. Methods: Patients numbered 57: group A (GA, BMI 30, n = 20. There were no statistical differences in age, sex, time on dialysis, cause of renal failure, diabetes, hypertension, C-reactive protein, or nutritional status. Measures were taken of 24-hour diuresis and proteinuria, ultrafiltration, albumin, pro-brain natriuretic peptide (Pro-BNP, insulin, adiponectin, leptin, and ghrelin. Results: Proteinuria was significantly higher in GC versus (vs GA (1.5 g/day, range 0.30–14 vs 0.72 g/day, range 0.1–2.7; P 0.05. In GA, elevated levels of Pro-BNP, adiponectin, and ghrelin were associated with lower degrees of proteinuria. Significant correlations were found between adiponectin and leptin (ρ = -0.54, P = 0.03, and adiponectin and Pro-BNP (ρ= 0.59, P = 0.02. Though not significant, there were more diabetics in GC (GA four, GB three, GC ten. As BMI increased in GB and GC, Pro-BNP, adiponectin, and ghrelin levels decreased significantly, while proteinuria, insulin, and homeostasis model assessment of insulin resistance increased. Leptin levels were significantly elevated in GC vs GA and GB. In GC, ghrelin correlated significantly with Pro-BNP (ρ= 0.51, P = 0.03, while leptin correlation with Pro-BNP was inverse and significant in GA (ρ = -0.74, P > 0.001 and inverse and nonsignificant in GB and GC. Conclusion: In patients with BMI < 25, higher adiponectin, ghrelin, and Pro-BNP levels

  11. Glycemic index and glycemic load in relation to glucose intolerance among Greenland's Inuit population

    DEFF Research Database (Denmark)

    van Aerde, Marieke A; Witte, Daniel Rinse; Jeppesen, Charlotte

    2012-01-01

    Intake of carbohydrates which elicit a large glycemic response is hypothesized to increase the risk of diabetes. However, studies assessing the relationship between glycemic index (GI) and glycemic load (GL) and diabetes are inconsistent. Only few studies have studied the relationship between GI ...

  12. Use of the generalized linear models in data related to dental caries index

    Directory of Open Access Journals (Sweden)

    Javali S

    2007-01-01

    Full Text Available The aim of this study is to encourage and initiate the application of generalized linear models (GLMs in the analysis of the covariates of decayed, missing, and filled teeth (DMFT index data, which is not necessarily normally distributed. GLMs can be performed assuming underlying many distributions; in fact Poisson distribution with log built-in link function and binomial distribution with Logit and Probit built-in link functions are considered. The Poisson model is used for modeling the DMFT index data and the Logit and Probit models are employed to model the dichotomous outcome of DMFT = 0 and DMFT ≠ 0 (caries free/caries present. The data comprised 7188 subjects aged 18-30 years from the study on the oral health status of Karnataka state conducted by SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India. The Poisson model and binomial models (Logit and Probit displayed dissimilarity in the outcome of results at 5% level of significance ( P < 0.05. The binomial models were a poor fit, whereas the Poisson model showed a good fit for the DMFT index data. Therefore, a suitable modeling approach for DMFT index data is to use a Poisson model for the DMFT response and a binomial model for the caries free and caries present (DMFT = 0 and DMFT ≠ 0. These GLMs allow separate estimation of those covariates which influence the magnitude of caries.

  13. Development and Validation of the Index of Race-Related Stress (IRRS).

    Science.gov (United States)

    Utsey, Shawn O.; Ponterotto, Joseph G.

    1996-01-01

    Describes the development and validation of a measure of the stress experienced by African Americans as a result of daily encounters with racism and discrimination. The scale has adequate indexes of internal consistency and fair-to-adequate estimates of test-retest stability. Several other factors also indicated the measure's reliability. (RJM)

  14. Dietary glycaemic index and glycaemic load in Danish children in relation to body fatness

    DEFF Research Database (Denmark)

    Nielsen, B. M.; Bjørnsbo, K. B.; Tetens, Inge

    2005-01-01

    The aim of this study was to describe dietary glycaemic index (GI) and glycaemic load (GL) values in the diets of Danish children, and to examine the associations between dietary GI, GL and body fatness. Data were collected during 1997-8 as part of the European Youth Heart Study. The study...

  15. Glycemic index and glycemic load in relation to glucose intolerance among Greenland's Inuit population

    NARCIS (Netherlands)

    Aerde, van M.A.; Witte, D.R.; Jeppesen, C.; Soedamah-Muthu, S.S.

    2012-01-01

    BACKGROUND: Intake of carbohydrates which elicit a large glycemic response is hypothesized to increase the risk of diabetes. However, studies assessing the relationship between glycemic index (GI) and glycemic load (GL) and diabetes are inconsistent. Only few studies have studied the relationship

  16. The association between three attitude-related indexes of oral hygiene and secondary implant failures: A retrospective longitudinal study.

    Science.gov (United States)

    Tecco, S; Grusovin, M G; Sciara, S; Bova, F; Pantaleo, G; Capparé, P

    2017-07-11

    This study evaluated the strength of the association between three widely used clinical indexes considered as distal behavioural indicators of attitude-related oral status (an index of oral hygiene, the plaque index [PI] and two periodontal indexes, that is the presence of bleeding on probing [BOP] and of pockets probing depth [PPD]) and secondary implant failure due to peri-implantitis in patients rehabilitated with cemented prosthesis. The study included patients who underwent implant-prosthetic rehabilitation and had joined the programme of maintenance of the same hospital. Implant failures, number of months between implant insertion and implant loading, and patients' surgical protocol were monitored and recorded. Further, PI, BOP and PPD-all attitude-related indicators of oral hygiene and periodontal inflammation-were recorded and related, in terms of odds ratios (ORs ) and corresponding risk factors, to secondary implant failures. A total of 1427 patients (2673 implants) were enrolled. The follow-up ranged from 1.5 to 9 years (mean 5.3 years±1.3). The cumulative survival rate was 98.01%. Thirty-two patients (36 implants, 1.36% of all implants) had implant failure. A statistically significant association between PI, BOP, PPD and secondary failures due to peri-implantitis was observed. Within the limitations of this study, all three attitude-related behavioural indicators-the plaque index (PI), bleeding on probing (BOP) and abnormal probing pocket depth (PPD)-proved to be significant risk indicators for secondary implant failure due to peri-implantitis, both from a clinical and from a socio-psychological attitude-related perspective. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Prognostics of Power MOSFET

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper demonstrates how to apply prognostics to power MOSFETs (metal oxide field effect transistor). The methodology uses thermal cycling to age devices and...

  18. Quality of Vision Index: a new method to appraise visual function changes in age-related macular degeneration.

    Science.gov (United States)

    Piermarocchi, Stefano; Varano, Monica; Parravano, Mariacristina; Oddone, Francesco; Sartore, Mauro; Ferrara, Roberto; Sera, Francesco; Virgili, Gianni

    2011-01-01

    To explore the correlation between psychophysical measures of visual function and vision-related quality of life (QOL) in exudative age-related macular degeneration (AMD) and to obtain a new quality of vision index expressed as corrected visual acuity (cVA) that is scaled like visual acuity (VA), but that incorporates the weighted contribution of VA, contrast sensitivity (CS), and reading ability. Visual acuity, CS, and reading ability were measured in 293 patients with AMD in this multicenter prospective study. Vision-related QOL was quantified by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). The validity of the questionnaire was assessed using Rasch analysis. The relationship between psychophysical tests and NEI-VFQ-25 scores was investigated. A cVA index was developed integrating Rasch-scaled NEI-VFQ-25 score with VA, CS, and reading ability as a tool to be used for evaluating vision-related QOL on the same scale as VA. A total of 27.5% of the variability of VFQ score was found to be explained by VA alone in patients with AMD. The proportion of Rasch-scaled QOL estimate variance explained by cVA was 33.2% as compared to 27.5% explained by VA and 24.5% by CS, which was a statistically significant improvement in both cases (p=0.015 and p<0.001, respectively). The correlation of reading ability with vision-related QOL was largely mediated by VA and CS and therefore it was not retained in the vision index. Visual acuity is poorly correlated with vision-related QOL in patients with AMD. Even though the new cVA index is a new method which better correlates with vision-related QOL, the major components of the individual perception of vision remain unexplained by common psychometric tests.

  19. Palliative medicine review: prognostication.

    Science.gov (United States)

    Glare, Paul A; Sinclair, Christian T

    2008-01-01

    Prognostication, along with diagnosis and treatment, is a traditional core clinical skill of the physician. Many patients and families receiving palliative care want information about life expectancy to help plan realistically for their futures. Although underappreciated, prognosis is, or at least should be, part of every clinical decision. Despite this crucial role, expertise in the art and science of prognostication diminished during the twentieth century, due largely to the ascendancy of accurate diagnostic tests and effective therapies. Consequently, "Doctor, how long do I have?" is a question most physicians find unprepared to answer effectively. As we focus on palliative care in the twenty-first century, prognostication will need to be restored as a core clinical proficiency. The discipline of palliative medicine can provide leadership in this direction. This paper begins by discussing a framework for understanding prognosis and how its different domains might be applied to all patients with life limiting illness, although the main focus of the paper is predicting survival in patients with cancer. Examples of prognostic tools are provided, although the subjective assessment of prognosis remains important in the terminally ill. Other issues addressed include: the importance of prognostication in terms of clinical decision-making, discharge planning, and care planning; the impact of prognosis on hospice referrals and patient/family satisfaction; and physicians' willingness to prognosticate.

  20. HOW PERFORMANCE OF JAKARTA ISLAMIC INDEX (JII STOCKS RELATIVE TO OTHER STOCKS?

    Directory of Open Access Journals (Sweden)

    Erna Listyaningsih

    2015-09-01

    Full Text Available This study was conducted to assess the performance of Jakarta Islamic Index (JII stocks and also investigate whether there was an ethical effect (JII selection restriction and compare it with non-Sharia stocks. The main model used in this study was the Capital Asset Pricing Model (CAPM single index model extended to the Fama and French three factors. This study employs elaborate matching data. The data used in this study was split into two periods: the 2005-2007 periods which consists of two groups: JII and non-JII and the 2008-2012 periods which consists of three groups: JII, Sharia and non-Sharia based on industry sector. This study found that basically there was no difference on performance between JII and non-JII stocks. Therefore, this result supports the previous studies in which there were no significant differences between Sharia and conventional investment.

  1. Weather-Related Flood and Landslide Damage: A Risk Index for Italian Regions

    Science.gov (United States)

    Messeri, Alessandro; Morabito, Marco; Messeri, Gianni; Brandani, Giada; Petralli, Martina; Natali, Francesca; Grifoni, Daniele; Crisci, Alfonso; Gensini, Gianfranco; Orlandini, Simone

    2015-01-01

    The frequency of natural hazards has been increasing in the last decades in Europe and specifically in Mediterranean regions due to climate change. For example heavy precipitation events can lead to disasters through the interaction with exposed and vulnerable people and natural systems. It is therefore necessary a prevention planning to preserve human health and to reduce economic losses. Prevention should mainly be carried out with more adequate land management, also supported by the development of an appropriate risk prediction tool based on weather forecasts. The main aim of this study is to investigate the relationship between weather types (WTs) and the frequency of floods and landslides that have caused damage to properties, personal injuries, or deaths in the Italian regions over recent decades. In particular, a specific risk index (WT-FLARI) for each WT was developed at national and regional scale. This study has identified a specific risk index associated with each weather type, calibrated for each Italian region and applicable to both annual and seasonal levels. The risk index represents the seasonal and annual vulnerability of each Italian region and indicates that additional preventive actions are necessary for some regions. The results of this study represent a good starting point towards the development of a tool to support policy-makers, local authorities and health agencies in planning actions, mainly in the medium to long term, aimed at the weather damage reduction that represents an important issue of the World Meteorological Organization mission. PMID:26714309

  2. Weather-Related Flood and Landslide Damage: A Risk Index for Italian Regions.

    Science.gov (United States)

    Messeri, Alessandro; Morabito, Marco; Messeri, Gianni; Brandani, Giada; Petralli, Martina; Natali, Francesca; Grifoni, Daniele; Crisci, Alfonso; Gensini, Gianfranco; Orlandini, Simone

    2015-01-01

    The frequency of natural hazards has been increasing in the last decades in Europe and specifically in Mediterranean regions due to climate change. For example heavy precipitation events can lead to disasters through the interaction with exposed and vulnerable people and natural systems. It is therefore necessary a prevention planning to preserve human health and to reduce economic losses. Prevention should mainly be carried out with more adequate land management, also supported by the development of an appropriate risk prediction tool based on weather forecasts. The main aim of this study is to investigate the relationship between weather types (WTs) and the frequency of floods and landslides that have caused damage to properties, personal injuries, or deaths in the Italian regions over recent decades. In particular, a specific risk index (WT-FLARI) for each WT was developed at national and regional scale. This study has identified a specific risk index associated with each weather type, calibrated for each Italian region and applicable to both annual and seasonal levels. The risk index represents the seasonal and annual vulnerability of each Italian region and indicates that additional preventive actions are necessary for some regions. The results of this study represent a good starting point towards the development of a tool to support policy-makers, local authorities and health agencies in planning actions, mainly in the medium to long term, aimed at the weather damage reduction that represents an important issue of the World Meteorological Organization mission.

  3. A Distributed Approach to System-Level Prognostics

    Science.gov (United States)

    Daigle, Matthew J.; Bregon, Anibal; Roychoudhury, Indranil

    2012-01-01

    Prognostics, which deals with predicting remaining useful life of components, subsystems, and systems, is a key technology for systems health management that leads to improved safety and reliability with reduced costs. The prognostics problem is often approached from a component-centric view. However, in most cases, it is not specifically component lifetimes that are important, but, rather, the lifetimes of the systems in which these components reside. The system-level prognostics problem can be quite difficult due to the increased scale and scope of the prognostics problem and the relative Jack of scalability and efficiency of typical prognostics approaches. In order to address these is ues, we develop a distributed solution to the system-level prognostics problem, based on the concept of structural model decomposition. The system model is decomposed into independent submodels. Independent local prognostics subproblems are then formed based on these local submodels, resul ting in a scalable, efficient, and flexible distributed approach to the system-level prognostics problem. We provide a formulation of the system-level prognostics problem and demonstrate the approach on a four-wheeled rover simulation testbed. The results show that the system-level prognostics problem can be accurately and efficiently solved in a distributed fashion.

  4. The relation between flexibility of human resources and performance indexes of selected hospitals of Tehran Medical Sciences University

    Directory of Open Access Journals (Sweden)

    Noushin Alibakhshi

    2016-12-01

    Full Text Available Today, flexibility has turned to one of important issues in management theories and policies and most current discussions about flexibility patterns focus on management policies, so that these patterns are one of important aspects of human resources strategic management. This study was performed with the aim of assessing the flexibility rate of human resources and performance indexes of Tehran Medical Sciences University hospitals and determining the possible relation between these variables. The present study is descriptive – analytical which was conducted in cross-sectional form in 2015. The statistical population was selected by stratifies random sampling method as 317 persons from nursing, administrative and financial personnel of 5 hospitals of Tehran Medical Sciences University. Data collecting toll was hospitals performance indexes form and Wright & Snell flexibility questionnaire of human resources. Data analysis was performed using SPSS 18 software and with the aid of descriptive statistical indexes and linear regression analysis. The results showed that personnel ( human resources had high flexibility = 4.16.\tthere was a significant relation between total flexibility and the index of bed circulation so that by one unit increase in bed circulation space, normally, the average of total flexibility decreased 0.64 units ( p-value<0.05. The results showed that human resources of Tehran Medical Sciences University hospitals have high flexibility, so authorities and policy makers are suggested to adopt policies of human resources management for creating flexibility in human resources and improving hospitals performance and amending hospitals status.

  5. Prognostic radiographic aspects of spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Saraste, H.; Brostroem, L.A.; Aparisi, T.

    1984-01-01

    A series of 202 patients (133 men, 69 women) with lumbar spondylolysis were examined radiographically on two occasions, first at the time of diagnosis and later at a follow-up, after an observation period of 20 years or more. The films from patients in groups without and with moderate and severe olisthesis were evaluated with respect to variables describing lumbosacral lordosis, wedging of the spondylolytic vertebra, lengths of the transverse processes and iliolumbar ligaments, disk height, progression of slipping, and influence on measured olisthesis of lumbar spine flexion and extension at the radiographic examination. The evaluation was made with special attention to possible signs which could be predictive for the prognosis of vertebral slipping. Progression of slipping did not differ between patients diagnosed as adults or adolescents. Reduction of disk height was correlated to the degree of slipping present at the initial examination and to the progression of olisthesis. Flexion and extension of the lumbar spine did not modify the degree of olisthesis. Data concerning the lengths of the transverse processes and the iliolumbar ligaments, and lumbar lordosis, cannot be used for prognostic purposes. The lumbar index reflecting the degree of wedge deformity of the spondylolytic vertebra was shown to be the only variable of prognostic value for the development of vertebral slipping.

  6. Relation between the prefrontal cortex and cerebro-cerebellar functions: evidence from the results of stabilometrical indexes.

    Science.gov (United States)

    Hatta, Takeshi; Masui, Tetsuo; Ito, Yasuhiro; Ito, Emi; Hasegawa, Yukiharu; Matsuyama, Yukihiro

    2004-01-01

    The relation between prefrontal cortex and cerebro-cerebellar functions of 50 normal healthy elderly people was examined. The function of the prefrontal cortex was measured by means of a letter fluency test and the Digit Cancellation Test (D-CAT, a test for the assessment of attention). Two indexes of postural tremor measured by the stabilometer were employed for the indication of cerebello-thalamo-cortical circuit functions. The results of groups consisting of participants showing higher or lower scores than the mean of the norm on the stabilometer index measurements were compared with their D-CAT and letter fluency test performances. The results showed that 2 indexes of cerebello-thalamo-cortical circuit functions related to the attention function while the relation to the language function was rather weak. The results of the behavioral measures demonstrated a mutual relation between prefrontal cortex and cerebello-thalamo-cortical circuit functions and strongly suggest the notion that the human brain functions as a system, which includes neocortex, subcortex, and cerebellum.

  7. Analysis of relative kinematic index with normalized standing time between subjects with and without recurrent low back pain.

    Science.gov (United States)

    Sung, Paul S; Danial, Pamela

    2017-02-01

    Although subjects with recurrent low back pain (LBP) demonstrate altered postural control, their postural steadiness during one leg standing is unknown. The purpose of this study was to investigate postural steadiness based on relative kinematic index of the lower limbs and trunk with normalized standing time in subjects with recurrent LBP during dominant and non-dominant leg standing. Sixty individuals participated in the study, including 29 subjects in the control group (18 male, 11 female) and 31 subjects with recurrent LBP (21 male, 10 female). The outcome measures included relative kinematic index of the body regions and normalized standing time during the one leg standing test. The relative kinematic index was the ratio between standstill time and successful standing time. The normalized standing time was defined as a ratio between the successful standing time and the requested standing time. The control group demonstrated significantly longer normalized standing time on the dominant (t = -2.57, p = 0.013) and non-dominant (t = -2.78, p = 0.007) legs than the LBP group. The relative kinematic index of the core spine model significantly decreased for the dominant (t = -3.01, p = 0.004) and non-dominant (t = -3.06, p = 0.003) legs in the LBP group. In addition, the kinematic index indicated pelvis and non-dominant shank during dominant leg standing (R 2 = 0.97) in the LBP group. In the control group, the pelvis was significantly correlated with the core spine model during standing on the dominant (R 2 = 0.95) and non-dominant (R 2 = 0.97) legs. The relative kinematic index of the pelvis was found to be most significant for longer standing durations in both groups. In the LBP group, the shank and foot were significantly higher in addition to the pelvis due to possible compensatory motion. The control group took advantage of pelvic control with the core spine to minimize lower limb movements. Clinicians need to consider the core spine for

  8. Relations between the Basel Index and the Level of Indebtedness of Brazilian Families

    Directory of Open Access Journals (Sweden)

    Sabrina Espinele da Silva

    2016-08-01

    Full Text Available The Basel Accord imposes a regulatory minimum capital requirement for banks to maintain their liquidity and are less susceptible to shocks from the interconnection of the financial system. Banks need to manage the dynamics of funding and applications in order to avoid excess or shortage of monetary resources, they are exposed to risks such as credit risk and liquidity risk. Credit risk is the risk that the counterparty in the transaction does not honor its obligation. Liquidity risk is the risk of the financial institution become unable to honor its obligations. The debt ratio of Brazilian families grew during the period analyzed, and a high level of debt increases the chances of default and expose financial institutions to credit risk and liquidity risk. The objective of this article is to analyze the relationship between the Basel index released by the banks and the high level of household debt in Brazil. The study used data available at the time series management system (SMS of the Central Bank of Brazil, which cover the period from January 2005 to December 2013, the following variables: Basel index, debt, inflation IPCA, Selic rate , Delinquency in SPC through an ARCH model (Autoregressive Conditional Heteroskedasticity. The results demonstrate that the Basel index, and the household debt levels have negative correlation, which makes the two vary in opposite directions. We can compare the model results for the Brazilian financial system with what was observed in the US market, as, for example, the perspective of authors who point to the beginning of the financial crisis of 2008, as a result of high indebtedness of American families in the business of mortgages.

  9. Childhood body mass index in relation to future risk of oesophageal adenocarcinoma

    DEFF Research Database (Denmark)

    Cook, M B; Freedman, N D; Gamborg, M

    2015-01-01

    BACKGROUND: Middle-aged obese adults are at substantially elevated risk of oesophageal adenocarcinoma. It is unclear whether this risk originates earlier in life. METHODS: We assessed associations between childhood body mass index (BMI) and height-measured annually between ages 7 and 13-with adult...... the mechanisms require further investigation, our findings provide additional evidence for the long-term health risks of childhood obesity....... oesophageal adenocarcinoma in a cohort from the Copenhagen School Health Records Register. Analyses included 255 053 children born during 1930-1971. Danish Cancer Registry linkage provided outcomes. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression...

  10. Inventory of Federal energy-related environment and safety research for FY 1978. Volume II. Project listings and indexes

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-12-01

    This volume contains summaries of FY-1978 government-sponsored environment and safety research related to energy. Project summaries were collected by Aerospace Corporation under contract with the Department of Energy, Office of Program Coordination, under the Assistant Secretary for Environment. Summaries are arranged by log number, which groups the projects by reporting agency. The log number is a unique number assigned to each project from a block of numbers set aside for each agency. Information about the projects is included in the summary listings. This includes the project title, principal investigators, research organization, project number, contract number, supporting organization, funding level if known, related energy sources with numbers indicating percentages of effort devoted to each, and R and D categories. A brief description of each project is given, and this is followed by subject index terms that were assigned for computer searching and for generating the printed subject index in Volume IV.

  11. Inventory of Federal energy-related environment and safety research for FY 1979. Volume II. Project listings and indexes

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-12-01

    This volume contains summaries of FY 1979 government-sponsored environment and safety research related to energy arranged by log number, which groups the projects by reporting agency. The log number is a unique number assigned to each project from a block of numbers set aside for each contributing agency. Information elements included in the summary listings are project title, principal investigators, research organization, project number, contract number, supporting organization, funding level, related energy sources with numbers indicating percentages of effort devoted to each, and R and D categories. A brief description of each project is given, and this is followed by subject index terms that were assigned for computer searching and for generating the printed subject index in the back of this volume.

  12. Pregestational body mass index is related to neonatal abdominal circumference at birth--a Danish population-based study

    DEFF Research Database (Denmark)

    Tanvig, M; Wehberg, S; Vinter, C A

    2013-01-01

    OBJECTIVES: To examine the impact of maternal pregestational body mass index (BMI) and smoking on neonatal abdominal circumference (AC) and weight at birth. To define reference curves for birth AC and weight in offspring of healthy, nonsmoking, normal weight women. DESIGN: Population-based study...... MEASURES: Birth AC and weight in relation to pregestational maternal BMI, maternal smoking and medical conditions (any). RESULTS: Birth AC and weight increased with increasing pregestational BMI, and decreased with smoking (P ...

  13. The potential role of pain-related SSEPs in the early prognostication of long-term functional outcome in post-anoxic coma.

    Science.gov (United States)

    Del Felice, Alessandra; Bargellesi, Stefano; Linassi, Federico; Scarpa, Bruno; Formaggio, Emanuela; Boldrini, Paolo; Masiero, Stefano; Zanatta, Paolo

    2017-05-12

    Cardiac arrest (CA) is a common cause of disability. Multimodal evaluation has improved prognosis but precocious biomarkers are not appropriate in determining long-term functional outcome. to identify early prognostication markers of long-term functional outcome in post-anoxic coma. retrospective assessment of outcomes. Individuals older than 18 years with post-anoxic coma hospitalized in intensive care units after cardiac arrest (CA) regardless of cause (cardiac or non-cardiac) and location of event (in or out-of-hospital). Clinical, biological and neurophysiological data were collected within 48 hours from CA. Clinical data included time of no and low flow, CA rhythm, pupillary reflex, Glasgow motor score at admission and hyperthermia. Biological marker was the highest creatinine level. Neurophysiological parameters included EEG pattern and reactivity, Somatosensory Evoked Potential (SSEP), and Middle-Latency (ML) SSEP evoked at low (10 mA) and high (50 mA) intensity stimulation. A LASSO multiple regression analysis was fitted to data to investigate the best predictors of LCF, DRS and CRS-R. In-sample prediction was obtained to verify the quality of fitting, and accuracy indices (i.e. total error rate) produced. presence of short and medium latency SSEPs with low and high stimulation intensity were identified as prognostic predictors of outcome for all the scales. Error rate was 4.5% for CRS and LCF, and 9.1% for DRS. Middle latency somatosensory evoked potentials associated with short latency somatosensory evoked potentials during the first 48 hours after a cardiac arrest are strong predictors of functional outcome at 12 months from the event. Replication on larger cohorts is needed to support their routine use as prognostic markers. These markers could inform more appropriate allocation of resources, provide a basis for realistic goal-setting, and help the family to adjust its' expectations.

  14. Ultrasonic reflection coefficient and surface roughness index of OA articular cartilage: relation to pathological assessment

    Directory of Open Access Journals (Sweden)

    Niu Hai-jun

    2012-03-01

    Full Text Available Abstract Background Early diagnosis of Osteoarthritis (OA is essential for preventing further cartilage destruction and decreasing severe complications. The aims of this study are to explore the relationship between OA pathological grades and quantitative acoustic parameters and to provide more objective criteria for ultrasonic microscopic evaluation of the OA cartilage. Methods Articular cartilage samples were prepared from rabbit knees and scanned using ultrasound biomicroscopy (UBM. Three quantitative parameters, including the roughness index of the cartilage surface (URI, the reflection coefficients from the cartilage surface (R and from the cartilage-bone interface (Rbone were extracted. The osteoarthritis grades of these cartilage samples were qualitatively assessed by histology according to the grading standards of International Osteoarthritis Institute (OARSI. The relationship between these quantitative parameters and the osteoarthritis grades was explored. Results The results showed that URI increased with the OA grade. URI of the normal cartilage samples was significantly lower than the one of the OA cartilage samples. There was no significant difference in URI between the grade 1 cartilage samples and the grade 2 cartilage samples. The reflection coefficient of the cartilage surface reduced significantly with the development of OA (p Conclusion High frequency ultrasound measurements can reflect the changes in the surface roughness index and the ultrasound reflection coefficients of the cartilage samples with different OA grades. This study may provide useful information for the quantitative ultrasonic diagnosis of early OA.

  15. High capacity embedding with indexed data recovery using adjunctive numerical relations in multimedia signal covers

    Science.gov (United States)

    Collins, James C.; Agaian, Sos S.

    2013-05-01

    We introduce a technique for covertly embedding data throughout an audio file using redundant number system decomposition across non-standard digital bit-lines. This bit-line implementation integrates an index recoverable embedded algorithm with an extended bit level representation that achieves a high capacity data channel within an audio multimedia file. It will be shown this new steganography method has minimal aural distortive affects while preserving both first and second order cover statistics, making it less susceptible to most steganalysis attacks. Our research approach involves reviewing the common numerical methods used in common binary-based algorithms. We then describe basic concepts and challenges when attempting to implement complex embedding algorithms that are based on redundant number systems. Finally, we introduce a novel class of numerical based multiple bit-line decomposition systems, which we define as Adjunctive Numerical Representations. The system is primarily described using basic PCM techniques in uncompressed audio files however extended applications for alternate multimedia is addressed. This new embedding system will not only provide the statistical stability required for effective steganography but will also give us an improvement in the embedding capacity in this class of multimedia carrier files. This novelty of our approach is demonstrated by an ability to embed high capacity covert data while simultaneously providing a means for rapid, indexed data recovery.

  16. A patient-centered methodology that improves the accuracy of prognostic predictions in cancer.

    Directory of Open Access Journals (Sweden)

    Mohammed Kashani-Sabet

    Full Text Available Individualized approaches to prognosis are crucial to effective management of cancer patients. We developed a methodology to assign individualized 5-year disease-specific death probabilities to 1,222 patients with melanoma and to 1,225 patients with breast cancer. For each cancer, three risk subgroups were identified by stratifying patients according to initial stage, and prediction probabilities were generated based on the factors most closely related to 5-year disease-specific death. Separate subgroup probabilities were merged to form a single composite index, and its predictive efficacy was assessed by several measures, including the area (AUC under its receiver operating characteristic (ROC curve. The patient-centered methodology achieved an AUC of 0.867 in the prediction of 5-year disease-specific death, compared with 0.787 using the AJCC staging classification alone. When applied to breast cancer patients, it achieved an AUC of 0.907, compared with 0.802 using the AJCC staging classification alone. A prognostic algorithm produced from a randomly selected training subsample of 800 melanoma patients preserved 92.5% of its prognostic efficacy (as measured by AUC when the same algorithm was applied to a validation subsample containing the remaining patients. Finally, the tailored prognostic approach enhanced the identification of high-risk candidates for adjuvant therapy in melanoma. These results describe a novel patient-centered prognostic methodology with improved predictive efficacy when compared with AJCC stage alone in two distinct malignancies drawn from two separate populations.

  17. Walkability Index

    Science.gov (United States)

    The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of the built environment that influence the likelihood of walking being used as a mode of travel. The Walkability Index is based on the EPA's previous data product, the Smart Location Database (SLD). Block group data from the SLD was the only input into the Walkability Index, and consisted of four variables from the SLD weighted in a formula to create the new Walkability Index. This dataset shares the SLD's block group boundary definitions from Census 2010. The methodology describing the process of creating the Walkability Index can be found in the documents located at ftp://newftp.epa.gov/EPADataCommons/OP/WalkabilityIndex.zip. You can also learn more about the Smart Location Database at https://edg.epa.gov/data/Public/OP/Smart_Location_DB_v02b.zip.

  18. Materializing Exposure: Developing an Indexical Method to Visualize Health Hazards Related to Fossil Fuel Extraction

    Directory of Open Access Journals (Sweden)

    Sara Wylie

    2017-09-01

    Full Text Available How can STS researchers collaborate with communities to design environmental monitoring devices that more effectively express their experiences and address gaps in regulation? This paper describes and shows the results of a novel method of visualizing environmental emissions of corrosive gases such as hydrogen sulfide (H2S exposure using photographic paper. H2S is a neurotoxic and flammable gas that smells like rotten eggs and is frequently associated with oil and natural gas extraction. Communities living with oil and gas development in Wyoming report odors of rotten eggs and describe symptoms of H2S exposure. H2S is recognized as an acute and chronic threat to human and environmental health and oil and gas companies are required to have plans in place to prevent and respond to accidental, high concentration releases of H2S. They are not, however, required to monitor, report or prevent routine daily emissions. Yet 15-25% of the oil and gas wells in the US are predicted to contain H2S, and some communities surrounded by multiple wells report chronic, routine exposure. Chronic exposure is difficult to represent with current tools for monitoring H2S because they are designed to measure acute workplace exposure. Informed by STS theories of black boxes and regimes of imperceptibility that focus on the need to revise not only regulations but also material tools of science, this paper describes the development of an indexical approach to visualizing this hazard. In indexical design, the reactive sensing element of a scientific instrument is brought to the foreground. The silver in the photopaper is an index as it tarnishes with H2S exposure. Discolored tests strips can be arranged together to form data-rich maps of the exposure landscape where this discoloration both represents how the gas spreads through a space and is a physical trace of the gas. Preliminary results in the form of data-rich maps show that regulating H2S emissions as primarily

  19. Examining the relation between rock mass cuttability index and rock drilling properties

    Science.gov (United States)

    Yetkin, Mustafa E.; Özfırat, M. Kemal; Yenice, Hayati; Şimşir, Ferhan; Kahraman, Bayram

    2016-12-01

    Drilling rate is a substantial index value in drilling and excavation operations at mining. It is not only a help in determining physical and mechanical features of rocks, but also delivers strong estimations about instantaneous cutting rates. By this way, work durations to be finished on time, proper machine/equipment selection and efficient excavation works can be achieved. In this study, physical and mechanical properties of surrounding rocks and ore zones are determined by investigations carried out on specimens taken from an underground ore mine. Later, relationships among rock mass classifications, drillability rates, cuttability, and abrasivity have been investigated using multi regression analysis. As a result, equations having high regression rates have been found out among instantaneous cutting rates and geomechanical properties of rocks. Moreover, excavation machine selection for the study area has been made at the best possible interval.

  20. Perceptible changes in Indian summer monsoon rainfall in relation to Indian Monsoon Index

    Science.gov (United States)

    Naidu, C. V.; Dharma Raju, A.; Vinay Kumar, P.; Satyanarayana, G. Ch.

    2017-10-01

    The changes in the summer monsoon rainfall over 30 meteorological subdivisions of India with respect to changes in circulation and the Indian Monsoon Index (IMI) have been studied for the period 1953-2012. The relationship between the IMIs in different months and whole season and the corresponding summer monsoon rainfall is studied and tested. The positive and negative extremes are evaluated basing on the normalized values of the deviations from the mean of the IMI. Composite rainfall distributions over India and the zonal wind distributions in the lower and upper troposphere of IMI's both positive and negative extremes are evaluated separately and discussed. In the recent three decades of global warming, the negative values of IMI in July and August lead to weakening of the monsoon system over India. It is observed that the rainfall variations in the Northeast India are different from the rest of India except Tamil Nadu in general.

  1. Cumulative Mass and NIOSH Variable Lifting Index Method for Risk Assessment: Possible Relations.

    Science.gov (United States)

    Stucchi, Giulia; Battevi, Natale; Pandolfi, Monica; Galinotti, Luca; Iodice, Simona; Favero, Chiara

    2017-09-01

    Objective The aim of this study was to explore whether the Variable Lifting Index (VLI) can be corrected for cumulative mass and thus test its efficacy in predicting the risk of low-back pain (LBP). Background A validation study of the VLI method was published in this journal reporting promising results. Although several studies highlighted a positive correlation between cumulative load and LBP, cumulative mass has never been considered in any of the studies investigating the relationship between manual material handling and LBP. Method Both VLI and cumulative mass were calculated for 2,374 exposed subjects using a systematic approach. Due to high variability of cumulative mass values, a stratification within VLI categories was employed. Dummy variables (1-4) were assigned to each class and used as a multiplier factor for the VLI, resulting in a new index (VLI_CMM). Data on LBP were collected by occupational physicians at the study sites. Logistic regression was used to estimate the risk of acute LBP within levels of risk exposure when compared with a control group formed by 1,028 unexposed subjects. Results Data showed greatly variable values of cumulative mass across all VLI classes. The potential effect of cumulative mass on damage emerged as not significant ( p value = .6526). Conclusion When comparing VLI_CMM with raw VLI, the former failed to prove itself as a better predictor of LBP risk. Application To recognize cumulative mass as a modifier, especially for lumbar degenerative spine diseases, authors of future studies should investigate potential association between the VLI and other damage variables.

  2. Determining the refractive index of human hemoglobin solutions by Kramers-Kronig relations with an improved absorption model.

    Science.gov (United States)

    Gienger, Jonas; Groß, Hermann; Neukammer, Jörg; Bär, Markus

    2016-11-01

    The real part of the refractive index of aqueous solutions of human hemoglobin is computed from their absorption spectra in the wavelength range 250-1100 nm using the Kramers-Kronig (KK) relations, and the corresponding uncertainty analysis is provided. The strong ultraviolet (UV) and infrared absorbance of the water outside this spectral range were taken into account in a previous study employing KK relations. We improve these results by including the concentration dependence of the water absorbance as well as by modeling the deep UV absorbance of hemoglobin's peptide backbone. The two free parameters of the model for the deep UV absorbance are fixed by a global fit.

  3. Health related quality of life and psychological problems in Egyptian children with simple obesity in relation to body mass index

    Directory of Open Access Journals (Sweden)

    Eman A. Abdel-Aziz

    2014-04-01

    Conclusions: Obese children and adolescents have lower health-related QOL that correlated negatively with BMI, also they are more susceptible to anxiety and depression symptoms than non obese children.

  4. Can transient elastography, Fib-4, Forns Index, and Lok Score predict esophageal varices in HCV-related cirrhotic patients?

    Science.gov (United States)

    Hassan, Eman M; Omran, Dalia A; El Beshlawey, Mohamad L; Abdo, Mahmoud; El Askary, Ahmad

    2014-02-01

    Gastroesophageal varices are present in approximately 50% of patients with liver cirrhosis. The aim of this study was to evaluate liver stiffness measurement (LSM), Fib-4, Forns Index and Lok Score as noninvasive predictors of esophageal varices (EV). This prospective study included 65 patients with HCV-related liver cirrhosis. All patients underwent routine laboratory tests, transient elastograhy (TE) and esophagogastroduodenoscopy. FIB-4, Forns Index and Lok Score were calculated. The diagnostic performances of these methods were assessed using sensitivity, specificity, positive predictive value, negative predictive value, accuracy and receiver operating characteristic curves. All predictors (LSM, FIB-4, Forns Index and Lok Score) demonstrated statistically significant correlation with the presence and the grade of EV. TE could diagnose EV at a cutoff value of 18.2kPa. Fib-4, Forns Index, and Lok Score could diagnose EV at cutoff values of 2.8, 6.61 and 0.63, respectively. For prediction of large varices (grade 2, 3), LSM showed the highest accuracy (80%) with a cutoff of 22.4kPa and AUROC of 0.801. Its sensitivity was 84%, specificity 72%, PPV 84% and NPV 72%. The diagnostic accuracies of FIB-4, Forns Index and Lok Score were 70%, 70% and76%, respectively, at cutoffs of 3.3, 6.9 and 0.7, respectively. For diagnosis of large esophageal varices, adding TE to each of the other diagnostic indices (serum fibrosis scores) increased their sensitivities with little decrease in their specificities. Moreover, this combination decreased the LR- in all tests. Noninvasive predictors can restrict endoscopic screening. This is very important as non invasiveness is now a major goal in hepatology. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  5. Walkability Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of...

  6. Prognostics of Power MOSFET

    Science.gov (United States)

    Celaya, Jose Ramon; Saxena, Abhinav; Vashchenko, Vladislay; Saha, Sankalita; Goebel, Kai Frank

    2011-01-01

    This paper demonstrates how to apply prognostics to power MOSFETs (metal oxide field effect transistor). The methodology uses thermal cycling to age devices and Gaussian process regression to perform prognostics. The approach is validated with experiments on 100V power MOSFETs. The failure mechanism for the stress conditions is determined to be die-attachment degradation. Change in ON-state resistance is used as a precursor of failure due to its dependence on junction temperature. The experimental data is augmented with a finite element analysis simulation that is based on a two-transistor model. The simulation assists in the interpretation of the degradation phenomena and SOA (safe operation area) change.

  7. Predicting Reading Growth with Event-Related Potentials: Thinking Differently about Indexing "Responsiveness"

    Science.gov (United States)

    Lemons, Christopher J.; Key, Alexandra P. F.; Fuchs, Douglas; Yoder, Paul J.; Fuchs, Lynn S.; Compton, Donald L.; Williams, Susan M.; Bouton, Bobette

    2010-01-01

    The purpose of this study was to determine if event-related potential (ERP) data collected during three reading-related tasks (Letter Sound Matching, Nonword Rhyming, and Nonword Reading) could be used to predict short-term reading growth on a curriculum-based measure of word identification fluency over 19 weeks in a sample of 29 first-grade…

  8. Factors related to pulse wave velocity and augmentation index in chronic hemodialysis patients.

    Science.gov (United States)

    Celik, Gülperi; Demirci, Meltem Sezis; Tumuklu, Murat; Ascı, Gulay; Sipahi, Savas; Toz, Huseyin; Bascı, Ali; Ok, Ercan

    2011-01-01

    Augmentation index (AIx) and pulse wave velocity (PWV) are early markers of atherosclerotic vascular changes and also have been shown to be predictive of cardiovascular disease and total mortality. The aim of our study was to evaluate the relationship between PWV and AIx-HR75, which is the corrected form of AIx according to a heart rate of 75 beats/min, echocardiographic parameters and biochemical parameters in chronic hemodialysis (HD) patients. AIx-HR75 and PWV were measured in 556 HD patients by applanation tonometry using the SphygmoCor device. The mean PWV and AIx-HR75 values of the study group were 10.2 ± 2.4 and 28.4 ± 10.2 m/s. A positive correlation was found between PWV and AIx-HR75 (r = 0.214, p = 0.000). AIx-HR75 correlated with age (r = 0.093, p = 0.028), body surface area (BSA) (r = -0.194, p = 0.000), mean arterial pressure (MAP) (r = 0.335, p = 0.000), pulse pressure (PP) (r = 0.212, p = 0.000), cardiothoracic index (r = 0.155, p = 0.016), and presence of left ventricular hypertrophy (r = 0.152, p = 0.001). PWV correlated with MAP (r = 0.208, p = 0.000), PP (r = 0.098, r = 0.021), left ventricular mass (r = 0.105, p = 0.023), and predialysis sodium level (r = -0.105, p = 0.023). In the multivariate analyses, PWV was associated with MAP (t = 3.78, p = 0.000), presence of diabetes (t = 3.20, p = 0.001), and predialysis sodium level (t = -2.06, p = 0.040), and AIx-HR75 was associated with age (t = 2.48, p = 0.014), female sex (t = 3.98, p = 0.000), BSA (t = -2.15, p = 0.033), and MAP (t = 7.02, p = 0.000). There is a strong association between MAP and arterial stiffness parameters in HD patients. We feel that efficient control of blood pressure could lead to reduced arterial stiffness in HD patients.

  9. Prognostic importance of complete atrioventricular block complicating acute myocardial infarction

    DEFF Research Database (Denmark)

    Aplin, Mark; Engstrøm, Thomas; Vejlstrup, Niels G

    2003-01-01

    Third-degree atrioventricular block after acute myocardial infarction is considered to have prognostic importance. However, its importance in conjunction with thrombolytic therapy and its relation to left ventricular function remains uncertain. This report also outlines an important distinction...... between atrioventricular block in the setting of anterior and inferior wall acute myocardial infarction, with profound clinical and prognostic implications....

  10. Prognostic Disclosures to Children: A Historical Perspective.

    Science.gov (United States)

    Sisk, Bryan A; Bluebond-Langner, Myra; Wiener, Lori; Mack, Jennifer; Wolfe, Joanne

    2016-09-01

    Prognostic disclosure to children has perpetually challenged clinicians and parents. In this article, we review the historical literature on prognostic disclosure to children in the United States using cancer as an illness model. Before 1948, there was virtually no literature focused on prognostic disclosure to children. As articles began to be published in the 1950s and 1960s, many clinicians and researchers initially recommended a "protective" approach to disclosure, where children were shielded from the harms of bad news. We identified 4 main arguments in the literature at this time supporting this "protective" approach. By the late 1960s, however, a growing number of clinicians and researchers were recommending a more "open" approach, where children were included in discussions of diagnosis, which at the time was often synonymous with a terminal prognosis. Four different arguments in the literature were used at this time supporting this "open" approach. Then, by the late 1980s, the recommended approach to prognostic disclosure in pediatrics shifted largely from "never tell" to "always tell." In recent years, however, there has been a growing appreciation for the complexity of prognostic disclosure in pediatrics. Current understanding of pediatric disclosure does not lead to simple "black-and-white" recommendations for disclosure practices. As with most difficult questions, we are left to balance competing factors on a case-by-case basis. We highlight 4 categories of current considerations related to prognostic disclosure in pediatrics, and we offer several approaches to prognostic disclosure for clinicians who care for these young patients and their families. Copyright © 2016 by the American Academy of Pediatrics.

  11. Sex Steroid Hormone Profiles are Related to Sleep Measures from Polysomnography and the Pittsburgh Sleep Quality Index

    Science.gov (United States)

    Sowers, Mary Fran; Zheng, Huiyong; Kravitz, Howard M.; Matthews, Karen; Bromberger, Joyce T.; Gold, Ellen B.; Owens, Jane; Consens, Flavia; Hall, Martica

    2008-01-01

    Study Objectives: To relate reproductive hormones (and the preceding 7-year rates of their change) to objectively and subjectively assessed sleep measures, independent of age, vasomotor symptom frequency, depressive symptoms, and body size. Design: A cross-sectional sleep substudy nested in the Study of Women's Health Across the Nation (SWAN), a longitudinal study of the menopausal transition. Setting: Community-based. Participants: 365 Caucasian, African American, and Chinese women. Measurements and Results: Sleep duration, continuity, and architecture were measured during two nights of in-home polysomnography (PSG) studies. Participants completed the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, sleep diaries for medication, vasomotor symptoms, lifestyle information and questionnaires for depressive symptoms. Blood collected annually in the years prior to sleep study was assayed for follicle stimulating hormone (FSH), estradiol (E2), and total testosterone (T). More rapid rate of FSH change was significantly associated with higher delta sleep percent, longer total sleep time (TST), but less favorable self-reported sleep quality (PSQI). Baseline E2 was modestly and negatively associated with sleep quality. Women in the lowest total testosterone quartile at baseline had more wake time after sleep onset (WASO) than women in the highest quartile. Lower E2/T ratio, an index reflecting the increasing androgenic environment with the menopause transition, was associated with less WASO. Conclusions: More rapid rate of FSH change was associated with longer sleep duration but poor sleep quality. Women with higher T or who were closer to the completion of the transition process (as indexed by a lower E2/T) had less sleep discontinuity (less WASO). Citation: Sowers MF; Zheng H; Kravitz HM; Matthews K; Bromberger JT; Gold EB; Owens J; Consens F; Hall M. Sex steroid hormone profiles are related to sleep measures From polysomnography and the pittsburgh sleep quality

  12. Relation between asthma and body mass index in 6-15 years old children.

    Directory of Open Access Journals (Sweden)

    Akefeh Ahmadiafshar

    2013-09-01

    Full Text Available Childhood asthma and obesity are significant public health problems. Most prospective studies suggest that obesity increases the risk of asthma. But, some authors did not found this association. In this study the association between asthma and body mass index (BMI was investigated. This case-control study was conducted on 200 asthmatic children aged 6-15 years and 200 children without asthma. The criteria for asthma diagnosis and its classification were on the basis of National Asthma Education and Prevention Program (NAEPP. BMI of patients and controls were also measured and BMI grater than 85% and 95% were defined as overweight and obese respectively. The data was analyzed by SPSS software. The BMI among the asthmatic children (17.9 kg/m2 was higher than the BMI among the non-asthmatics (16.5 kg/m2, P=0.0001. This relationship was significant in both males and females. 18% of asthmatic children were classified as overweight and 13.5% of them were obese versus 7.5% and 6% respectively in non asthmatics (P=0.0001. However, there was no significant relationship between severity, duration of asthma, kind of medication and BMI in children with asthma (P>0.05. Result of this study showed that there is an association between asthma symptoms and obesity in children. Therefore, any attempts for weight control in asthmatic children might be beneficial.

  13. Economist intelligence unit democracy index in relation to health services accessibility: a regression analysis.

    Science.gov (United States)

    Walker, Mary Ellen; Anonson, June; Szafron, Michael

    2015-01-01

    The relationship between political environment and health services accessibility (HSA) has not been the focus of any specific studies. The purpose of this study was to address this gap in the literature by examining the relationship between political environment and HSA. This relationship that HSA indicators (physicians, nurses and hospital beds per 10 000 people) has with political environment was analyzed with multiple least-squares regression using the components of democracy (electoral processes and pluralism, functioning of government, political participation, political culture, and civil liberties). The components of democracy were represented by the 2011 Economist Intelligence Unit Democracy Index (EIUDI) sub-scores. The EIUDI sub-scores and the HSA indicators were evaluated for significant relationships with multiple least-squares regression. While controlling for a country's geographic location and level of democracy, we found that two components of a nation's political environment: functioning of government and political participation, and their interaction had significant relationships with the three HSA indicators. These study findings are of significance to health professionals because they examine the political contexts in which citizens access health services, they come from research that is the first of its kind, and they help explain the effect political environment has on health. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Dietary glycemic index and load in relation to cardiovascular disease risk factors in Cuban American population.

    Science.gov (United States)

    Huffman, Fatma G; Zarini, Gustavo G; Cooper, Vanessa

    2010-11-01

    To examine whether dietary glycemic index (GI) or glycemic load (GL) had an effect on the cardiovascular disease (CVD) risk factors and whether the effects were dependent on the diabetes status in the Cuban American population. A case–control, single-time-point study. A total of 324 middle-aged Cuban American adults had completed data on fasting blood lipids, physical activity level and usual dietary intake using a validated food frequency questionnaire. Published GI values were assigned to food items and average dietary GI and GL were calculated per participant. Subjects without type 2 diabetes (T2D) were 3.3 times more likely to be in the recommended, highest high-density lipoprotein-cholesterol category if they were in the second dietary GL tertile as compared with those in the first dietary GL tertile (P = 0.042, 95% confidence interval = 1.94, 10.78). The results of the present study suggest that in this sample of Cuban Americans a high GI or GL diet do not adversely affects blood lipids, especially among subjects without T2D.

  15. Overall glycemic index and glycemic load of vegan diets in relation to plasma lipoproteins and triacylglycerols.

    Science.gov (United States)

    Waldmann, Annika; Ströhle, Alexander; Koschizke, Jochen W; Leitzmann, Claus; Hahn, Andreas

    2007-01-01

    To investigate the overall glycemic index (GI), glycemic load (GL), and intake of dietary fiber, and to examine the associations between these factors and plasma lipoproteins and triacylglycerols in adult vegans in the German Vegan Study (GVS). Cross-sectional study, Germany. Healthy men (n = 67) and women (n = 87), who fulfilled the study criteria (vegan diet for >or=1 year prior to study start; minimum age of 18 years; no pregnancy/childbirth during the last 12 months) and who participated in all study segments. The average dietary GL of the GVS population was 144, and the average GI was 51.4. The adjusted geometric mean total, HDL, and LDL cholesterol concentrations decreased across the increasing quartiles of GL, carbohydrate and dietary fiber intake. The associations between total cholesterol, HDL cholesterol, LDL cholesterol and GL density and GI were inconsistent. Also, associations between GI, GL, the intake of carbohydrates, and triacylglycerol concentration were not observed. Fiber-rich vegan diets are characterized by a low GI and a low to moderate GL. The data do not support the hypothesis that a carbohydrate-rich diet per se is associated with unfavorable effects on triaclyglycerols that would be predicted to increase the risk of coronary heart disease. Copyright (c) 2007 S. Karger AG, Basel.

  16. Glycemic index and glycemic load in relation to glucose intolerance among Greenland's Inuit population.

    Science.gov (United States)

    van Aerde, Marieke A; Witte, Daniel R; Jeppesen, Charlotte; Soedamah-Muthu, Sabita S; Bjerregaard, Peter; Jørgensen, Marit E

    2012-08-01

    Intake of carbohydrates which elicit a large glycemic response is hypothesized to increase the risk of diabetes. However, studies assessing the relationship between glycemic index (GI) and glycemic load (GL) and diabetes are inconsistent. Only few studies have studied the relationship between GI and GL and markers of glucose metabolism, mostly in western populations. To determine the relationship between GI and GL and indices of glucose metabolism and prevalence of diabetes in Greenland's Inuit population. The Inuit Health in Transition Study is a geographically representative cross-sectional study among aged ≥18years. Diet was assessed using a 67-item food frequency questionnaire. Logistic and linear regression was used to assess the association between GI and GL and diabetes, impaired fasting glucose, impaired glucose tolerance, HbA(1c), fasting plasma glucose, 2h plasma glucose, HOMA2-IR and HOMA2-%β. No association was found between GI and GL and diabetes. GL was significantly inversely associated with IFG (OR: 0.91 (0.84-0.98)). While GI was positively associated with FPG, GL was positively associated with both HOMA2-IR and HOMA2-%β and inversely associated with IFG. These findings do not support a link between dietary GI or GL and risk of type 2 diabetes among Greenland's Inuit population. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Polyhydramnios - frequency of congenital anomalies in relation to the value of the amniotic fluid index.

    Science.gov (United States)

    Kornacki, Jakub; Adamczyk, Magdalena; Wirstlein, Przemysław; Osiński, Maciej; Wender-Ożegowska, Ewa

    2017-01-01

    The aims of our study were to assess the correlation between the amniotic fluid index (AFI) value and the frequency and type of fetal anomalies. The material included 94 patients at the third trimester of pregnancy, 60 with mild polyhydramnios, 19 with moderate one, and 15 with severe one. Polyhydramnios was diagnosed if AFI was > 24 cm. All patients were divided into three groups based on the value of AFI: 1) mild polyhydramnios with AFI between 24.1 and 29.9 cm, 2) moderate polyhydramnios with AFI between 30-34.9 cm, and 3) severe polyhydramnios with AFI ≥ 35 cm. The incidence of fetal malformations correlated significantly with the degree of polyhydramnios and was the highest in patients with severe polyhydramnios (53.3%, p = 0.002). Congenital malformations of the gastrointestinal tract were the most frequent fetal anomalies in the whole group of patients (5.3%). Trisomy 18 was the most frequent aneuploidy found in women with polyhydramnios (2.1%). The incidence of fetal congenital anomalies significantly increases with the degree of polyhydramnios, being most frequent in severe one and rather rare in a mild one. Congenital malformations of the gastrointestinal tract were the most frequent anomalies in patients with polyhy-dramnios, especially in women with severe polyhydramnios.

  18. Children's school-related food and physical activity behaviors are associated with body mass index.

    Science.gov (United States)

    Vericker, Tracy C

    2014-02-01

    Childhood obesity is a critical public health issue, with prevalence rates reaching nearly one in five children. Schools may be a promising public policy intervention point. The foods schools sell and the physical activity environments they foster can influence dietary behaviors and overall physical activity. Using secondary data from a nationally representative sample of children from the kindergarten class of 1998-1999 and nonexperimental methods, this study examines the associations between the food and physical activity environments in school and body mass index (BMI) for low-income boys and girls in the 8th grade during 2007. Results reveal that participating in school sports is associated with a 0.55 lower BMI score for boys. For low-income girls, eating the school breakfast is associated with a 0.70 higher BMI score and eating the school lunch is associated with a 0.65 higher BMI score. Each hour spent on homework is associated with a 0.02 higher BMI score for low-income girls. These findings suggest that schools may influence adolescent BMI and that there is room for improvement in school food and physical activity environments to promote healthier weights for low-income boys and girls. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  19. Relation of Renal Function with Left Ventricular Systolic Function and NT-proBNP Level and Its Prognostic Implication in Heart Failure with Preserved versus Reduced Ejection Fraction: an analysis from the Korean Heart Failure (KorHF) Registry.

    Science.gov (United States)

    Park, Chan Soon; Park, Jin Joo; Oh, Il-Young; Yoon, Chang-Hwan; Choi, Dong-Ju; Park, Hyun-Ah; Kang, Seok-Min; Yoo, Byung-Su; Jeon, Eun-Seok; Kim, Jae-Joong; Cho, Myeong-Chan; Chae, Shung Chull; Ryu, Kyu-Hyung; Oh, Byung-Hee

    2017-09-01

    The relationship between ejection fraction (EF), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and renal function is unknown as stratified by heart failure (HF) type. We investigated their relation and the prognostic value of renal function in heart failure with preserved ejection fraction (HFpEF) vs. reduced ejection fraction (HFrEF). NT-proBNP, glomerular filtration rate (GFR), and EF were obtained in 1,932 acute heart failure (AHF) patients. HFrEF was defined as EFrenal dysfunction as GFRrenal dysfunction: 30≤GFRrenal dysfunction: GFRrenal dysfunction did not differ between HFpEF and HFrEF (49% vs. 52%, p=0.210). Patients with renal dysfunction had higher 12-month mortality in both HFpEF (7.9% vs. 15.2%, log-rank p=0.008) and HFrEF (8.6% vs. 16.8%, log-rank prenal dysfunction was an independent predictor of 12-month mortality (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.40-3.11). When stratified according to EF: the prognostic value of severe renal dysfunction was attenuated in HFpEF patients (HR, 1.46; 95% CI, 0.66-3.21) contrary to HFrEF patients (HR, 2.43; 95% CI, 1.52-3.89). In AHF patients, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF patients. However, the prognostic value of renal dysfunction was attenuated in HFpEF patients.

  20. Measuring Distributional Inequality: Relative Body Mass Index Distributions by Gender, Race/Ethnicity, and Education, United States (1999–2006

    Directory of Open Access Journals (Sweden)

    Brian C. Houle

    2010-01-01

    Full Text Available Few studies consider obesity inequalities as a distributional property. This study uses relative distribution methods to explore inequalities in body mass index (BMI; kg/m2. Data from 1999–2006 from the National Health and Nutrition Examination Survey were used to compare BMI distributions by gender, Black/White race, and education subgroups in the United States. For men, comparisons between Whites and Blacks show a polarized relative distribution, with more Black men at increased risk of over or underweight. Comparisons by education (overall and within race/ethnic groups effects also show a polarized relative distribution, with more cases of the least educated men at the upper and lower tails of the BMI distribution. For women, Blacks have a greater probability of high BMI values largely due to a right-shifted BMI distribution relative to White women. Women with less education also have a BMI distribution shifted to the right compared to the most educated women.

  1. Prognostic Impact of Visceral Fat Amount and Branched-Chain Amino Acids (BCAA) in Hepatocellular Carcinoma.

    Science.gov (United States)

    Higashi, Takaaki; Hayashi, Hiromitsu; Kaida, Takayoshi; Arima, Kota; Takeyama, Hideaki; Taki, Katsunobu; Izumi, Daisuke; Tokunaga, Ryuma; Kosumi, Keisuke; Nakagawa, Shigeki; Okabe, Hirohisa; Imai, Katsunobu; Nitta, Hidetoshi; Hashimoto, Daisuke; Chikamoto, Akira; Beppu, Toru; Baba, Hideo

    2015-12-01

    Dysregulation of lipid and amino acid metabolism in patients with liver diseases results in obesity-related carcinogenesis and decreased levels of branched-chain amino acids (BCAA), respectively. This study assessed the clinical and prognostic impact of visceral fat amount (VFA) and its association with amino acid metabolism in patients with hepatocellular carcinoma (HCC). In this study, 215 patients who underwent hepatic resection for HCC were divided into two groups based on VFA criteria for metabolic abnormalities in Japan. Computed tomography was used to measure VFA at the third lumbar vertebra in the inferior direction. Of the 215 patients, 132 had high and 83 had low VFA. High VFA was significantly associated with older age and higher body mass index (BMI), subcutaneous fat amount, and BCAA, but not with liver function, nutrient status, or tumoral factors. VFA was positively correlated with BMI (P BCAA levels (P BCAA, serum albumin, and prognostic nutritional index were not. High VFA was associated with a high BCAA level, with high VFA prognostic of improved overall survival in Japanese patients with HCC.

  2. Adherence to Alternative Healthy Eating Index in relation to depression and anxiety in Iranian adults.

    Science.gov (United States)

    Saneei, Parvane; Hajishafiee, Maryam; Keshteli, Ammar Hassanzadeh; Afshar, Hamid; Esmaillzadeh, Ahmad; Adibi, Peyman

    2016-07-01

    Earlier studies have shown a protective association between adherence to healthy eating guidelines and mental disorders in Western nations; however, data in this regard are limited from the understudied region of Middle East. We examined the association between adherence to healthy eating guidelines, as measured by Alternative Healthy Eating Index (AHEI)-2010, and prevalence of anxiety and depression in a large sample of Iranian adults. In this cross-sectional study, data on dietary intakes of 3363 adult participants were collected using a validated dish-based 106-item semi-quantitative FFQ. Adherence to healthy eating was quantified using AHEI-2010, as suggested by earlier publications. The Iranian validated version of Hospital Anxiety and Depression Scale was used to assess anxiety and depression in study participants. Data on other covariates were gathered using a pre-tested questionnaire. Overall, the prevalence of anxiety and depression was 15·2 % (males 10·8 % and females 18·3 %) and 30·0 % (males 22·9 % and females 35·1 %), respectively. After controlling for potential confounders, those in the top quartile of AHEI-2010 had a 49 % lower chance of anxiety (OR 0·51; 95 % CI 0·35, 0·72) and a 45 % lower odds of depression (OR 0·55; 95 % CI 0·42, 0·72), compared with those in the bottom quartile. Stratified analysis by sex revealed that women in the highest categories of AHEI-2010 had a 49 % lower odds of having anxiety and depression, after adjustment for confounders, but no significant association was found in men. In addition, among individuals who were 40 years old or younger, those with high adherence to AHEI-2010 were 58 and 51 % less likely to have anxiety and depression, compared with those with less adherence. Adherence to healthy eating was inversely associated with a lower chance of anxiety and depression in Iranian adults. Prospective studies are required to confirm these associations in Middle-Eastern populations.

  3. Factors related to patterns of body mass index in early infancy: 18 month longitudinal study.

    Science.gov (United States)

    Fujiwara, Tohru; Oguni, Tatsuya; Unishi, Gen; Tanabe, Takuya; Ohbayashi, Kazuhiko; Kaneko, Kazunari

    2014-06-01

    Children with early adiposity rebound (AR), measured using individual body mass index (BMI) growth curves, have an increased risk of metabolic disease as adults. The children with early AR, however, are not fully characterized. The aim of this study was to investigate the prevalence and characteristics of the infants who develop early AR. A total of 1248 full-term children and their mothers participated in the present study. Pre-pregnancy, prenatal, birth, 4 month and 18 month records were collected. Children were classified into two groups: a decrease (D) group, in which the 18 month BMI was lower than the 4 month BMI (n = 1097), in keeping with the standard BMI percentile curve, and an increase (I) group, in which the 18 month BMI was higher than the 4 month BMI (n = 151). Although children in both groups had similar body size at birth, those in the I group had a lower weight at 4 months and higher weight at 18 months than those in the D group (P < 0.001). Fewer mothers in the I group exclusively breast-fed their infants (P = 0.012). These characteristics of infants in the I group suggested a pattern of low fatness level followed by rapid increased fat gain. Approximately 10% (151/1248) of infants did not follow the standard BMI percentile curves between 4 months and 18 months of age. They were more likely not to be exclusively breast-fed. This finding further stresses the importance of breast-feeding in early infancy. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  4. Effects of body mass index-related disorders on cognition: preliminary results

    Directory of Open Access Journals (Sweden)

    Yesavage JA

    2014-05-01

    Full Text Available Jerome A Yesavage,1,2 Lisa M Kinoshita,1,2 Art Noda,2 Laura C Lazzeroni,2 Jennifer Kaci Fairchild,1,2 Joy Taylor,1,2 Doina Kulick,3 Leah Friedman,1,2 Jauhtai Cheng,1,2 Jamie M Zeitzer,1,2 Ruth O’Hara1,21Department of Veterans Affairs Health Care System, Palo Alto, CA, USA; 2Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; 3Department of Medicine, University of Nevada School of Medicine, Reno, NV, USABackground: Well-known risk factors for cognitive impairment are also associated with obesity. Research has highlighted genetic risk factors for obesity, yet the relationship of those risk factors with cognitive impairment is unknown. The objective of this study was to determine the associations between cognition, hypertension, diabetes, sleep-disordered breathing, and obesity. Genetic risk factors of obesity were also examined.Methods: The sample consisted of 369 nondemented individuals aged 50 years or older from four community cohorts. Primary outcome measures included auditory verbal memory, as measured by the Rey Auditory Verbal Learning Test, and executive functioning, as measured by the Color–Word Interference Test of the Delis–Kaplan Executive Function System battery. Apnea–hypopnea index indicators were determined during standard overnight polysomnography. Statistical analyses included Pearson correlations and linear regressions.Results: Poor executive function and auditory verbal memory were linked to cardiovascular risk factors, but not directly to obesity. Genetic factors appeared to have a small but measureable association to obesity.Conclusion: A direct linkage between obesity and poor executive function and auditory verbal memory is difficult to discern, possibly because nonobese individuals may show cognitive impairment due to insulin resistance and the “metabolic syndrome”.Keywords: sleep-disordered breathing, hypertension, diabetes, sleep apnea, BMI, obesity

  5. Prognostic factors in oligodendrogliomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1997-01-01

    An outcome analysis was performed on 96 patients with pure cerebral oligodendrogliomas operated in the 30-year period 1962 to 1991. The most important predictive prognostic factors were youth and no neurological deficit, demonstrated as a median survival for the group younger than 20 years of 17...

  6. Pain-related Somato Sensory Evoked Potentials: a potential new tool to improve the prognostic prediction of coma after cardiac arrest.

    Science.gov (United States)

    Zanatta, Paolo; Linassi, Federico; Mazzarolo, Anna Paola; Aricò, Maria; Bosco, Enrico; Bendini, Matteo; Sorbara, Carlo; Ori, Carlo; Carron, Michele; Scarpa, Bruno

    2015-11-17

    Early prediction of a good outcome in comatose patients after cardiac arrest still remains an unsolved problem. The main aim of the present study was to examine the accuracy of middle-latency SSEP triggered by a painful electrical stimulation on median nerves to predict a favorable outcome. No- and low-flow times, pupillary reflex, Glasgow motor score and biochemical data were evaluated at ICU admission. The following were considered within 72 h of cardiac arrest: highest creatinine value, hyperthermia occurrence, EEG, SSEP at low- (10 mA) and high-intensity (50 mA) stimulation, and blood pressure reactivity to 50 mA. Intensive care treatments were also considered. Data were compared to survival, consciousness recovery and 6-month CPC (Cerebral Performance Category). Pupillary reflex and EEG were statistically significant in predicting survival; the absence of blood pressure reactivity seems to predict brain death within 7 days of cardiac arrest. Middle- and short-latency SSEP were statistically significant in predicting consciousness recovery, and middle-latency SSEP was statistically significant in predicting 6-month CPC outcome. The prognostic capability of 50 mA middle-latency-SSEP was demonstrated to occur earlier than that of EEG reactivity. Neurophysiological evaluation constitutes the key to early information about the neurological prognostication of postanoxic coma. In particular, the presence of 50 mA middle-latency SSEP seems to be an early and reliable predictor of good neurological outcome, and its absence constitutes a marker of poor prognosis. Moreover, the absence 50 mA blood pressure reactivity seems to identify patients evolving towards the brain death.

  7. Glycemic variability in relation to oral disposition index in the subjects with different stages of glucose tolerance.

    Science.gov (United States)

    Chen, Tong; Xu, Feng; Su, Jian-Bin; Wang, Xue-Qin; Chen, Jin-Feng; Wu, Gang; Jin, Yan; Wang, Xiao-Hua

    2013-01-01

    Glucose variability could be an independent risk factor for diabetes complications in addition to average glucose. The deficiency in islet β cell secretion and insulin sensitivity, the two important pathophysiological mechanisms of diabetes, are responsible for glycemic disorders. The oral disposition index evaluated by product of insulin secretion and sensitivity is a useful marker of islet β cell function. The aim of the study is to investigate glycemic variability in relation to oral disposition index in the subjects across a range of glucose tolerance from the normal to overt type 2 diabetes. 75-g oral glucose tolerance test (OGTT) was performed in total 220 subjects: 47 with normal glucose regulation (NGR), 52 with impaired glucose metabolism (IGM, 8 with isolated impaired fasting glucose [IFG], 18 with isolated impaired glucose tolerance [IGT] and 26 with combined IFG and IGT), 61 screen-diagnosed diabetes by isolated 2-h glucose (DM2h) and 60 newly diagnosed diabetes by both fasting and 2-h glucose (DM). Insulin sensitivity index (Matsuda index, ISI), insulin secretion index (ΔI30/ΔG30), and integrated β cell function measured by the oral disposition index (ΔI30/ΔG30 multiplied by the ISI) were derived from OGTT. All subjects were monitored using the continuous glucose monitoring system for consecutive 72 hours. The multiple parameters of glycemic variability included the standard deviation of blood glucose (SD), mean of blood glucose (MBG), high blood glucose index (HBGI), continuous overlapping net glycemic action calculated every 1 h (CONGA1), mean of daily differences (MODD) and mean amplitude of glycemic excursions (MAGE). From the NGR to IGM to DM2h to DM group, the respective values of SD (mean ± SD) (0.9 ± 0.3, 1.5 ± 0.5, 1.9 ± 0.6 and 2.2 ± 0.6 mmol/), MBG (5.9 ± 0.5, 6.7 ± 0.7, 7.7 ± 1.0 and 8.7 ± 1.5 mmol/L), HGBI [median(Q1-Q3)][0.8(0.2-1.2), 2.0(1.2-3.7), 3.8(2.4-5.6) and 6

  8. On the origin of event-related potentials indexing covert attentional selection during visual search.

    Science.gov (United States)

    Cohen, Jeremiah Y; Heitz, Richard P; Schall, Jeffrey D; Woodman, Geoffrey F

    2009-10-01

    Despite nearly a century of electrophysiological studies recording extracranially from humans and intracranially from monkeys, the neural generators of nearly all human event-related potentials (ERPs) have not been definitively localized. We recorded an attention-related ERP component, known as the N2pc, simultaneously with intracranial spikes and local field potentials (LFPs) in macaques to test the hypothesis that an attentional-control structure, the frontal eye field (FEF), contributed to the generation of the macaque homologue of the N2pc (m-N2pc). While macaques performed a difficult visual search task, the search target was selected earliest by spikes from single FEF neurons, later by FEF LFPs, and latest by the m-N2pc. This neurochronometric comparison provides an empirical bridge connecting macaque and human experiments and a step toward localizing the neural generator of this important attention-related ERP component.

  9. Prognostic DNA Methylation Markers for Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Siri H. Strand

    2014-09-01

    Full Text Available Prostate cancer (PC is the most commonly diagnosed neoplasm and the third most common cause of cancer-related death amongst men in the Western world. PC is a clinically highly heterogeneous disease, and distinction between aggressive and indolent disease is a major challenge for the management of PC. Currently, no biomarkers or prognostic tools are able to accurately predict tumor progression at the time of diagnosis. Thus, improved biomarkers for PC prognosis are urgently needed. This review focuses on the prognostic potential of DNA methylation biomarkers for PC. Epigenetic changes are hallmarks of PC and associated with malignant initiation as well as tumor progression. Moreover, DNA methylation is the most frequently studied epigenetic alteration in PC, and the prognostic potential of DNA methylation markers for PC has been demonstrated in multiple studies. The most promising methylation marker candidates identified so far include PITX2, C1orf114 (CCDC181 and the GABRE~miR-452~miR-224 locus, in addition to the three-gene signature AOX1/C1orf114/HAPLN3. Several other biomarker candidates have also been investigated, but with less stringent clinical validation and/or conflicting evidence regarding their possible prognostic value available at this time. Here, we review the current evidence for the prognostic potential of DNA methylation markers in PC.

  10. Birth weight, childhood body mass index, and height in relation to mammographic density and breast cancer

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Baker, Jennifer Lyn; Bihrmann, Kristine

    2014-01-01

    High breast density, a strong predictor of breast cancer may be determined early in life. Childhood anthropometric factors have been related to breast cancer and breast density, but rarely simultaneously. We examined whether mammographic density (MD) mediates an association of birth weight...

  11. The relation between drinking pattern and body mass index and waist and hip circumference

    DEFF Research Database (Denmark)

    Tolstrup, J S; Heitmann, B. L.; Tjønneland, A M

    2005-01-01

    OBJECTIVES: To study the association between alcohol drinking pattern and obesity. DESIGN: Cross-sectional population study with assessment of quantity and frequency of alcohol intake, waist and hip circumference, height, weight, and lifestyle factors including diet. SUBJECTS: In all, 25 325 men...... indicate that frequent drinking of small amounts of alcohol is the optimal drinking pattern in this relation....

  12. Quality of Life, Disability, and Body Mass Index Are Related in Obese Patients

    Science.gov (United States)

    Sirtori, Anna; Brunani, Amelia; Liuzzi, Antonio; Pasqualinotto, Lucia; Villa, Valentina; Leonardi, Matilde; Raggi, Alberto

    2011-01-01

    The aim of this study is to analyze the relationship between health-related quality of life (QoL), disability, and degree of obesity. Adult obese patients (BMI greater than 30) were consecutively enrolled in this cross-sectional observational study. The WHO Disability Assessment Schedule (WHO-DAS II) and the short version of the impact of weight…

  13. Dissociation of Event-Related Potentials Indexing Arousal and Semantic Cohesion During Emotional Word Encoding

    Science.gov (United States)

    Dillon, Daniel G.; Cooper, Julie J.; Grent-'t-Jong, Tineke; Woldorff, Marty G.; LaBar, Kevin S.

    2006-01-01

    Event-related potential (ERP) studies have shown that emotional stimuli elicit greater amplitude late positive-polarity potentials (LPPs) than neutral stimuli. This effect has been attributed to arousal, but emotional stimuli are also more semantically coherent than uncategorized neutral stimuli. ERPs were recorded during encoding of positive,…

  14. Characteristics of eating habits and physical activity in relation to body mass index among adolescents.

    Science.gov (United States)

    Djordjevic-Nikic, Marina; Dopsaj, Milivoj

    2013-01-01

    To assess eating habits and the level of physical activity in adolescents and develop a predictive model for the body mass index (BMI) based on these variables. In this cross-sectional study, eating habits and the level of physical activity were assessed using a questionnaire validated in adolescents. Body mass and height collected during the last annual checkup were extracted from personal medical records. The sample included 330 boys and 377 girls (mean age 15.8 ± 0.2 years) who were first-year high school students in the city of Belgrade, Serbia. Responses to each of the 14 questions about eating habits and 6 questions about physical activity were scored from the least (0) to the most (3) desired behaviors. These ratings were then averaged to arrive to an aggregate score for each domain. The BMI was calculated according to the standard method. A series of regression analyses was performed to derive the best model for predicting BMI in boys and girls based on individual eating habits and physical activity items, first separately and then combined. In the sample, 24.5% of boys and 9.5% of girls were overweight or obese. Girls' eating habits were better than boys (mean aggregate score 2.3 ± 0.3 and 2.1 ± 0.3, respectively, p eating habits, and physical activity remained significant after controlling for their knowledge about healthy eating and education level of their parents. Eating habits were a better predictor of BMI than physical activity, particularly in boys (R (2) = 0.13 vs R (2) = 0.02) compared to girls (R (2) = 0.04 vs R (2) = 0.01). Combining eating habits and physical activity in the multivariate model of BMI resulted in a better predictive accuracy in boys (R (2) = 0.17) but not girls (R (2) = 0.04). Eating habits and physical activity differ between adolescent boys and girls and can predict BMI, particularly in boys. The results suggest the need to develop gender-specific programs for promoting healthy lifestyle among adolescents in our country.

  15. Relative nasopharyngeal patency index as possible objective indication for adenoidectomy in children with orthodontic problems.

    Science.gov (United States)

    Krasny, Marta; Wysocki, Jarosław; Zadurska, Małgorzata; Skarżyński, Piotr Henryk

    2011-02-01

    Although the harmful influence of nasopharyngeal obstruction on the facial skeleton has been demonstrated, clear criteria to qualify children with adenoid hypertrophy and malocclusion for adenoidectomy have not been established yet. Retrospective analysis of 148 patients qualified for orthodontic treatment (77 females and 71 males) at the age of 9-11 years (the average age was 10 years and 3 months). X-ray images performed with the use of a cephalostat were scanned and submitted for cephalometric assessment. The study investigated the correlation between standard cephalometric parameters and the value of relative nasopharyngeal flow defined as the ratio of the nasopharyngeal flow to the dimension of the entire nasopharynx. In statistics Bartlett's test, Tukey's test and Pearson's correlation coefficients were used. The value of relative nasopharyngeal lumen ranged from 0.0943 to 0.5532 with no significant differences between genders. The subjects were divided into decile groups for investigating the correlation with cephalometric parameters. The study demonstrated statistically significant negative correlations between relative nasopharyngeal flow and the following parameters: the angle between lines NA and NB (ANB), the angle between lines SN and ML (SN/ML), the posterior/anterior facial height ratio (Post.Fac.H./Ant.Fac.H.), the difference between the maxillary and mandibular length (difference maxillary/mandibular), the mandibular length (Co-Gn) and the lower anterior facial height (Sn-Me). The correlations generally referred to middle deciles: from the 40th to 80th decile. An apparent lack of significant correlations in patients located below the 40th decile, which corresponded to the value of relative nasopharyngeal flow up to 18%, may indicate, that this value constitutes a threshold and further decreasing it exceeds adaptive capabilities of the body. Relative nasopharyngeal flow below 38% should constitute an indication for adenoidectomy, due to the exceeded

  16. Accelerated Aging with Electrical Overstress and Prognostics for Power MOSFETs

    Science.gov (United States)

    Saha, Sankalita; Celaya, Jose Ramon; Vashchenko, Vladislav; Mahiuddin, Shompa; Goebel, Kai F.

    2011-01-01

    Power electronics play an increasingly important role in energy applications as part of their power converter circuits. Understanding the behavior of these devices, especially their failure modes as they age with nominal usage or sudden fault development is critical in ensuring efficiency. In this paper, a prognostics based health management of power MOSFETs undergoing accelerated aging through electrical overstress at the gate area is presented. Details of the accelerated aging methodology, modeling of the degradation process of the device and prognostics algorithm for prediction of the future state of health of the device are presented. Experiments with multiple devices demonstrate the performance of the model and the prognostics algorithm as well as the scope of application. Index Terms Power MOSFET, accelerated aging, prognostics

  17. Prognostic, quantitative histopathologic variables in lobular carcinoma of the breast

    DEFF Research Database (Denmark)

    Ladekarl, M; Sørensen, Flemming Brandt

    1993-01-01

    BACKGROUND: A retrospective investigation of 53 consecutively treated patients with operable lobular carcinoma of the breast, with a median follow-up of 6.6 years, was performed to examine the prognostic value of quantitative histopathologic parameters.METHODS: The measurements were performed...... of disease, vv(nuc), MI, and NI were of significant independent, prognostic value. On the basis of the multivariate analyses, a prognostic index with highly distinguishing capacity between prognostically poor and favorable cases was constructed.CONCLUSION: Quantitative histopathologic variables are of value...... for objective grading of malignancy in lobular carcinomas. The new parameter--estimates of the mean nuclear volume--is highly reproducible and suitable for routine use. However, larger and prospective studies are needed to establish the true value of the quantitative histopathologic variables in the clinical...

  18. Event-Related Potentials Index Subclinical Neurological Differences in HIV Patients During Rapid Decision-Making

    Science.gov (United States)

    1994-06-01

    W0C S. w C 1.44444444 4.44 0 7i tests were chosen instead of more traditional tests like the Weschler Adult Intelligence Test for three reasons: 1...battery of behavioral and electrophysiological assessments. The behavioral measures tested 10, computational skills, visual-spatial memory, and...affected. Another possible explanation for the inconsistencies in the HIV- related neuropsychological literature is that some tests allow the individual

  19. [Prognostic factors of early breast cancer].

    Science.gov (United States)

    Almagro, Elena; González, Cynthia S; Espinosa, Enrique

    2016-02-19

    Decision about the administration of adjuvant therapy for early breast cancer depends on the evaluation of prognostic factors. Lymph node status, tumor size and grade of differentiation are classical variables in this regard, and can be complemented by hormonal receptor status and HER2 expression. These factors can be combined into prognostic indexes to better estimate the risk of relapse or death. Other factors are less important. Gene profiles have emerged in recent years to identify low-risk patients who can forgo adjuvant chemotherapy. A number of profiles are available and can be used in selected cases. In the future, gene profiling will be used to select patients for treatment with new targeted therapies. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  20. Overlap relation between free-space Laguerre Gaussian modes and step-index fiber modes

    CSIR Research Space (South Africa)

    Bruning, R

    2015-09-01

    Full Text Available -equation. Considering a cylindrically symmetric fiber with core radius a, the solution is given by [4] LPlp(r, ϕ) = Nlp { Jl( νlpr a )/Jl(νlp) for rrelation between the LG and LP modes we need also a analytical expression for the normaliza- tion constant Nlp in Eq. (1). For that we use the normalization Research Article Journal of the Optical Society of America A 5 condition 1...

  1. Index of Laser Program publications and related reports, calendar year 1984

    Energy Technology Data Exchange (ETDEWEB)

    1985-05-01

    This document provides a listing of titles and authors of publications from the LLNL Laser program during calendar year 1984. It is presented as an aid for researchers in the field who may not otherwise have access to a full listing of laser-related work done at LLNL. The intent is to provide a brief and concise listing. Publications are classified by subject, but cross references are not supplied and those documents that logically fall in more than one category may not appear to be in the obvious location.

  2. Significance analysis of prognostic signatures.

    Directory of Open Access Journals (Sweden)

    Andrew H Beck

    Full Text Available A major goal in translational cancer research is to identify biological signatures driving cancer progression and metastasis. A common technique applied in genomics research is to cluster patients using gene expression data from a candidate prognostic gene set, and if the resulting clusters show statistically significant outcome stratification, to associate the gene set with prognosis, suggesting its biological and clinical importance. Recent work has questioned the validity of this approach by showing in several breast cancer data sets that "random" gene sets tend to cluster patients into prognostically variable subgroups. This work suggests that new rigorous statistical methods are needed to identify biologically informative prognostic gene sets. To address this problem, we developed Significance Analysis of Prognostic Signatures (SAPS which integrates standard prognostic tests with a new prognostic significance test based on stratifying patients into prognostic subtypes with random gene sets. SAPS ensures that a significant gene set is not only able to stratify patients into prognostically variable groups, but is also enriched for genes showing strong univariate associations with patient prognosis, and performs significantly better than random gene sets. We use SAPS to perform a large meta-analysis (the largest completed to date of prognostic pathways in breast and ovarian cancer and their molecular subtypes. Our analyses show that only a small subset of the gene sets found statistically significant using standard measures achieve significance by SAPS. We identify new prognostic signatures in breast and ovarian cancer and their corresponding molecular subtypes, and we show that prognostic signatures in ER negative breast cancer are more similar to prognostic signatures in ovarian cancer than to prognostic signatures in ER positive breast cancer. SAPS is a powerful new method for deriving robust prognostic biological signatures from clinically

  3. A Sport Fitness Index for Assessment of Sport-Related Injury Risk.

    Science.gov (United States)

    Wilkerson, Gary B; Colston, Marisa A; Baker, Carrie S

    2016-09-01

    To develop and validate a concise survey that will identify athletes who possess elevated injury risk. Cohort study. National Collegiate Athletic Association Division I athletic program. Cohorts of 188 and 146 college athletes who participated during successive academic years. The first cohort provided responses to 4 joint-specific outcome surveys that were related to subsequent time-loss injury occurrence. Receiver operating characteristic analysis identified survey items that provided best discrimination, which were combined with a negative life event stress item to create a new 10-item survey. The second cohort provided responses to the new survey, which were converted to a 0 to 100 score. Construct validity was assessed through documentation of time-loss injuries sustained during the preceding 12 months and predictive validity was assessed through prospective documentation of sport-related sprains and strains. Cronbach alpha was calculated to assess internal consistency. Each of the outcome survey items used to develop the new survey demonstrated much greater specificity than sensitivity. Both the retrospective and prospective receiver operating characteristic (ROC) analyses identified scores of 96 and 88 as cut-points that provided good discrimination between injured and noninjured cases. The area under the curve was 0.69 (P alpha was 0.89 (90% CI, 0.86-0.91). Self-reported effects of previous injury may be one method to efficiently identify athletes who possess elevated injury risk, and subsequently deliver preventive interventions, thereby providing an alternative method to time-intensive functional testing.

  4. Use of standardized precipitation evapotranspiration index to investigate drought relative to maize, in the Luvuvhu River catchment area, South Africa

    Science.gov (United States)

    Masupha, Teboho Elisa; Moeletsi, Mokhele Edmond

    2017-12-01

    Drought frequency and severity analysis during the growing period of maize was carried out by means of the Standardized Precipitation Evapotranspiration Index (SPEI) based on climatic data from seven weather stations (1975-2014). The index was aggregated at different time scales following three consecutive planting dates (October, November and December), relative to the average start of the rainy season in the area. Temporal analysis of droughts was conducted and trends were evaluated using the non-parametric Spearman's Rank Correlation test. The relative frequency distributions of the different drought categories were plotted for each growth stage of maize, with respect to the three planting dates. Results revealed an average drought occurrence of once every two seasons. The 1991/92 drought was identified as the most extreme drought during the analysis period; and generally there were no significant trends across the catchment, except for weak increasing SPEI at Levubu, Lwamondo and Thohoyandou with Spearman's ρ values of 0.4. This implies that the severity of drought decreased over time in these regions following the respective planting dates. The study further revealed that planting a 120-day maturing maize crop in December would pose a high risk of frequent severe-extreme droughts (SPEI -1.5 to ≤ -2) during the flowering to grain-filling stage at the high and moderate rainfall regions, while results at the low rainfall region indicated this risk following planting in October.

  5. Developmental Endophenotypes: Indexing Genetic Risk for Substance Abuse with the P300 Brain Event-Related Potential.

    Science.gov (United States)

    Iacono, William G; Malone, Stephen M

    2011-12-01

    Although substance use disorders are heritable, their complexity has made identifying genes underlying their development challenging. Endophenotypes, biologically informed quantitative measures that index genetic risk for a disorder, are being recognized for their potential to assist the search for disorder relevant genes. After outlining criteria for an endophenotype that includes developmental considerations, we review how the brain P300 response serves as an index of genetic risk for substance abuse and related externalizing disorders. The P300 response is highly heritable and associated broadly with characteristics of externalizing disorder, including childhood disruptive disorders, antisociality, and precocious expression of deviant behavior. This association appears to be mediated by shared genetic influences. Prospective studies confirm that reduced P300 amplitude present in youth prior to significant exposure to addictive substances is associated with the subsequent development of substance use disorders. Despite pronounced change in mean level over the course of development, P300 amplitude shows strong rank order stability with repeated assessment through young adulthood. In addition, P300 developmental trajectories based on multiple assessments show very high heritability and may be especially informative as measures of genetic risk. Collectively, these findings provide strong support that P300 amplitude and its change through development reflect genetic vulnerability to substance abuse and related externalizing psychopathology.

  6. Vibration Analysis and Time Series Prediction for Wind Turbine Gearbox Prognostics

    Directory of Open Access Journals (Sweden)

    Hossam A. Gabbar

    2013-01-01

    Full Text Available Premature failure of a gearbox in a wind turbine poses a high risk of increasing the operational and maintenance costs and decreasing the profit margins. Prognostics and health management (PHM techniques are widely used to access the current health condition of the gearbox and project it in future to predict premature failures. This paper proposes such techniques for predicting gearbox health condition index extracted from the vibration signals emanating from the gearbox. The progression of the monitoring index is predicted using two different prediction techniques, adaptive neuro-fuzzy inference system (ANFIS and nonlinear autoregressive model with exogenous inputs (NARX. The proposed prediction techniques are evaluated through sun-spot data-set and applied on vibration based health related monitoring index calculated through psychoacoustic phenomenon. A comparison is given for their prediction accuracy. The results are helpful in understanding the relationship of machine conditions, the corresponding indicating features, the level of damage/degradation, and their progression.

  7. Dimensions of socioeconomic position related to body mass index and obesity among Danish women and men

    DEFF Research Database (Denmark)

    Groth, Margit Velsing; Fagt, Sisse; Stockmarr, Anders

    2009-01-01

    were 2.9 (95% confidence interval (CI) 1.4–5.9) and 6.5 (95% CI 2.3–18.7) for those with basic school as compared with those with long higher education for men and women, respectively. Women outside the labour market had higher BMIs and a greater prevalence of obesity (OR 2.5 (95% CI 1.6–3.9)) after....... Associations between dimensions of socioeconomic position and weight status were examined by use of linear multiple regression analysis and logistic regression analysis. Results: BMI and prevalence of obesity were significantly associated with education for both men and women. Odds ratios (ORs) for obesity...... adjustment for educational level. Conclusions: Education was the dimension most consistently associated with BMI and obesity, indicating the importance of cultural capital for weight status. The gender-specific pattern showed a stronger social gradient for women, and indicated that a high relative body...

  8. Integrated Phenotypic/Genotypic Analysis of Papillary Renal Cell Carcinoma Subtypes: Identification of Prognostic Markers, Cancer-related Pathways, and Implications for Therapy.

    Science.gov (United States)

    Saleeb, Rola M; Plant, Pamela; Tawedrous, Eriny; Krizova, Adriana; Brimo, Fadi; Evans, Andrew J; Wala, Samantha Jane; Bartlett, John; Ding, Qiang; Boles, Dina; Rotando, Fabio; Farag, Mina; Yousef, George M

    2016-09-22

    Two histologic subtypes are recognized for papillary renal cell carcinoma (PRCC). Studies have shown that the subtypes differ in characteristic genetic alterations and clinical behavior. Clinically, the subtypes are managed similarly. To analyze the biological differences between the two PRCC histological subtypes, in order to further guide their clinical management. PRCC cohort consisting of 317 patients from the Cancer Genome Atlas database and our institution. Patients were stratified according to histologic criteria as type 1, type 2, or not otherwise specified (NOS). Gene and miRNA expression data for the cohort were examined via unsupervised and supervised clustering. Significant molecular signatures for each subtype were used to unravel the implicated molecular pathways via bioinformatics analysis. Survival was compared between the subtypes. Newly discovered biomarkers were used to further stratify survival of patients in the NOS category. Tumor genotyping revealed two distinct PRCC subtypes. The top molecular pathways enriched in PRCC1 were WNT, Hedgehog, and Notch signaling (p=0.001-0.01); highlighting an embryonic developmental theme to the pathogenesis of this subtype. PRCC2 showed enrichment in the mTOR, VEGF (p=7.49E-09) and HIF (p=7.63E-05) signaling pathways. Overall survival and disease-free survival significantly differed between the types. ABCC2 expression was identified as a significant prognostic biomarker for the NOS group in univariate (log rank p11.63) and multivariate analysis (p=0.003; HR >2.12). ABCC2 expression and its effect on survival should be further validated at the protein level. The classical PRCC types 1 and 2 have two distinct genotypes. We unraveled pathways that indicate that the two types could potentially respond differently to current therapies. We also identified biomarkers that stratify tumors within the PRCC NOS category into prognostic subgroups. Our findings highlight the need for molecular markers to accurately

  9. INDEXING AND INDEX FUNDS

    Directory of Open Access Journals (Sweden)

    HAKAN SARITAŞ

    2013-06-01

    Full Text Available Proponents of the efficient market hypothesis believe that active portfolio management is largely wasted effort and unlikely to justify the expenses incurred. Therefore, they advocate a passive investment strategy that makes no attempt to outsmart the market. One common strategy for passive management is indexing where a fund is designed to replicate the performance of a broad-based index of stocks and bonds. Traditionally, indexing was used by institutional investors, but today, the use of index funds proliferated among individual investors. Over the years, both international and domestic index funds have disproportionately outperformed the market more than the actively managed funds have.

  10. Indexing strategic retrieval of colour information with event-related potentials.

    Science.gov (United States)

    Wilding, E L; Fraser, C S; Herron, J E

    2005-09-01

    Event-related potentials (ERPs) were acquired during two experiments in order to determine boundary conditions for when recollection of colour information can be controlled strategically. In initial encoding phases, participants saw an equal number of words presented in red or green. In subsequent retrieval phases, all words were shown in white. Participants were asked to endorse old words that had been shown at encoding in one colour (targets), and to reject new test words as well as old words shown in the alternate colour (non-targets). Study and test lists were longer in Experiment 1, and as a result, the accuracy of memory judgments was superior in Experiment 2. The left-parietal ERP old/new effect--the electrophysiological signature of recollection--was reliable for targets in both experiments, and reliable for non-targets in Experiment 1 only. These findings are consistent with the view that participants were able to restrict recollection to targets in Experiment 2, while recollecting information about targets as well as non-targets in Experiment 1. The fact that this selective strategy was implemented in Experiment 2 despite the close correspondence between the kinds of information associated with targets and non-targets indicates that participants were able to exert considerable control over the conditions under which recollection of task-relevant information occurred.

  11. Relative and Combined Prognostic Importance of On-Treatment Mean and Visit-to-Visit Blood Pressure Variability in ONTARGET and TRANSCEND Patients.

    Science.gov (United States)

    Mancia, Giuseppe; Schumacher, Helmut; Böhm, Michael; Redon, Josep; Schmieder, Roland E; Verdecchia, Paolo; Sleight, Peter; Teo, Koon; Yusuf, Salim

    2017-11-01

    In 28 790 patients recruited for the ONTARGET (Ongoing Treatment Alone and in Combination With Ramipril Global End Point Trials) and TRANSCEND (Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease) trials, we investigated the prognostic value for cardiovascular events (primary outcome) of (1)on-treatment visit-to-visit systolic blood pressure (SBP) variability versus mean SBP and (2) the 2 measures together. SBP variability was measured by the coefficient of variation (CV) of mean SBP to which it was unrelated. Confounders such as variable time and number of visits from which to calculate SBP-CV were avoided by using the same number of visits at identical times in all patients. The covariate-adjusted risk of the primary outcome (Cox models) increased as SBP-CV or mean on-treatment quintile SBP increased, but only for mean on-treatment SBP, the relationship achieved statistical significance: global test for trend, P=0.12 versus PURL: http//www.clinicaltrial.gov. Unique identifier: NCT153.101. © 2017 American Heart Association, Inc.

  12. Treatment of pregnancy-related pelvic girdle and/or low back pain after delivery design of a randomized clinical trial within a comprehensive prognostic cohort study [ISRCTN08477490

    Directory of Open Access Journals (Sweden)

    Klabbers Aldegonda BA

    2004-12-01

    Full Text Available Abstract Background Pregnancy-related pelvic girdle and/or low back pain is a controversial syndrome because insight in etiology and prognosis is lacking. The controversy relates to factors eliciting pain and some prognostic factors such as the interpretation of pain at the symphysis. Recent research about treatment strategies also reflects those various opinions, in fact suggesting there is professional uncertainty about the optimal approach. Currently, physiotherapists often prescribe a pain-contingent treatment regime of relative rest and avoiding several day-to-day activities. Additionally, treatment more often includes an exercise program to guide rectification of the muscle imbalance and alignment of the pelvic girdle. Effectiveness of those interventions is not proven and the majority of the studies are methodologically flawed. Investigators draw particular attention to biomedical factors but there is growing evidence that important prognostic issues such as biopsychosocial factors appear to be even more important as point of action in a treatment program. Methods/design This pragmatic randomized controlled trial is designed to evaluate the effectiveness of a tailor-made treatment program with respect to biopsychosocial factors in primary care. The effect of the experimental intervention and usual care are evaluated as they are applied in primary health care. The trial is embedded in a cohort study that is designed as a longitudinal, prospective study, which studies prevalence, etiology, severity and prognosis during pregnancy until one year after delivery. The present paper focuses on choices regarding recruitment procedures, in-/exclusion criteria and the development of a well-timed intervention. Discussion This section briefly discusses the actions taken to minimize bias in the design, the proper time-window for the experimental intervention and the contrast between the experimental intervention and usual care.

  13. Dietary insulin index and insulin load in relation to biomarkers of glycemic control, plasma lipids, and inflammation markers.

    Science.gov (United States)

    Nimptsch, Katharina; Brand-Miller, Jennie C; Franz, Mary; Sampson, Laura; Willett, Walter C; Giovannucci, Edward

    2011-07-01

    Dietary glycemic index and load are widely used to estimate the effect of carbohydrate-containing foods on postprandial blood glucose concentrations and as surrogates for insulin response. The food insulin index (II) directly quantifies the postprandial insulin secretion of a food and takes into account foods with a low or no carbohydrate content. We investigated the average dietary II and insulin load (IL) in relation to biomarkers of glycemic control, plasma lipids, and inflammation markers. In a cross-sectional setting and with the use of data from the Nurses' Health Study and the Health Professionals Follow-Up Study, we measured plasma concentrations of C-peptide, glycated hemoglobin (Hb A(1c)), HDL cholesterol, LDL cholesterol, triglycerides, C-reactive protein (CRP), and interleukin-6 (IL-6) in fasting blood samples of 4002 healthy men and women. The dietary II and IL were assessed from food-frequency questionnaires by using directly analyzed or published food II data. After multivariate adjustment, participants in the highest quintile of II had 26% higher triglyceride concentrations than did participants in the lowest quintile of II (P for trend index (in kg/m(2)) ≥30] participants (difference between highest and lowest quintiles in the II: 72%; P for trend = 0.01). Dietary II was inversely associated with HDL cholesterol in obese participants (difference: -18%; P for trend = 0.03). Similar associations were seen for the IL. Dietary II and IL were not significantly associated with plasma C-peptide, Hb A(1c), LDL cholesterol, CRP, or IL-6. Dietary II and IL were not associated with fasting biomarkers of glycemic control but may be physiologically relevant to plasma lipids, especially in obese individuals.

  14. Dietary insulin index and insulin load in relation to biomarkers of glycemic control, plasma lipids, and inflammation markers123

    Science.gov (United States)

    Nimptsch, Katharina; Brand-Miller, Jennie C; Franz, Mary; Sampson, Laura; Willett, Walter C; Giovannucci, Edward

    2011-01-01

    Background: Dietary glycemic index and load are widely used to estimate the effect of carbohydrate-containing foods on postprandial blood glucose concentrations and as surrogates for insulin response. The food insulin index (II) directly quantifies the postprandial insulin secretion of a food and takes into account foods with a low or no carbohydrate content. Objective: We investigated the average dietary II and insulin load (IL) in relation to biomarkers of glycemic control, plasma lipids, and inflammation markers. Design: In a cross-sectional setting and with the use of data from the Nurses’ Health Study and the Health Professionals Follow-Up Study, we measured plasma concentrations of C-peptide, glycated hemoglobin (Hb A1c), HDL cholesterol, LDL cholesterol, triglycerides, C-reactive protein (CRP), and interleukin-6 (IL-6) in fasting blood samples of 4002 healthy men and women. The dietary II and IL were assessed from food-frequency questionnaires by using directly analyzed or published food II data. Results: After multivariate adjustment, participants in the highest quintile of II had 26% higher triglyceride concentrations than did participants in the lowest quintile of II (P for trend index (in kg/m2) ≥30] participants (difference between highest and lowest quintiles in the II: 72%; P for trend = 0.01). Dietary II was inversely associated with HDL cholesterol in obese participants (difference: −18%; P for trend = 0.03). Similar associations were seen for the IL. Dietary II and IL were not significantly associated with plasma C-peptide, Hb A1c, LDL cholesterol, CRP, or IL-6. Conclusion: Dietary II and IL were not associated with fasting biomarkers of glycemic control but may be physiologically relevant to plasma lipids, especially in obese individuals. PMID:21543531

  15. Changes of Chlorophyll Index (SPAD, Relative Water Content, Electrolyte Leakage and Seed Yield in Spring Safflower Genotypes under Irrigation Termination

    Directory of Open Access Journals (Sweden)

    B.E. Moosavifar

    2012-04-01

    Full Text Available In order to evaluate the effect of irrigation termination and genotype on chlorophyll index (SPAD, relative water content, electrolyte leakage and seed yield in spring safflower, an experiment was conducted, in a spilt plot arrangement based on randomized complete block design with four replications at Research Farm, Faculty of Agriculture, the University of Birjand, during 2008. Irrigation regimes (full irrigation (whole season irrigation, irrigation until grain filling, flowering and heading-bud and genotypes (Mahali Isfahan (a local variety, Isfahan28 and IL111 were arranged in main and subplots, respectively. Results showed chlorophyll content, relative water content, cell membrane stability and seed yield were influenced by irrigation termination. Provided that with terminating irrigation at an earlier stage, an increase in electrolyte leakage and reduction in relative water content and seed yield was observed in plants. There were negative relations between electrolyte leakage from plants leaf cells and seed yield. Plants which experienced irrigation termination in an earlier growth stage, suffered more damage to their cell membranes, leading to depression of their production potential. Based on the results, Mahali Isfahan and Isfahan28 can be introduced as drought resistant genotypes, because of their lower electrolyte leakage and higher relative water content. But, in general, Mahali Isfahan had the highest seed yield due to its nativeness and high adaptation to arid conditions southern of Khorasan, and therefore this genotype suggests for planting in the region.

  16. Descriptive study of relationship between cardio-ankle vascular index and biomarkers in vascular-related diseases.

    Science.gov (United States)

    Liu, Jinbo; Liu, Huan; Zhao, Hongwei; Shang, Guangyun; Zhou, Yingyan; Li, Lihong; Wang, Hongyu

    2017-01-01

    Cardio-ankle vascular index (CAVI) was supposed to be an independent predictor for vascular-related events. Biomarkers such as homocysteine (Hcy), N-terminal pro-brain natriuretic peptide (NT-proBNP), and urine albumin(microalbumin) (UAE) have involved the pathophysiological development of arteriosclerosis. The present study was to investigate relationship between CAVI and biomarkers in vascular-related diseases. A total of 656 subjects (M/F 272/384) from department of Vascular Medicine were enrolled into our study. They were divided into four groups according to the numbers of suffered diseases, healthy group (group 0: subjects without diseases of hypertension, diabetes mellitus (DM), coronary heart disease (CHD); n = 186), group 1 (with one of diseases of hypertension, CHD, DM; n = 237), group 2 (with two of diseases of hypertension, CHD, DM; n = 174), and group 3 (with all diseases of hypertension, CHD, DM; n = 59). CAVI was measured by VS-1000 apparatus. CAVI was increasing with increasing numbers of suffered vascular-related diseases. Similar results were found in the parameters of biomarkers such as Hcy, log NT-ProBNP, and log UAE. There were positive correlation between log NT-proBNP, Hcy, log UAE, and CAVI in the entire study group and nonhealthy group. Positive correlation between log UAE and CAVI were found in the entire study group after adjusting for age, body mass index (BMI), blood pressure, uric acid, and lipids. Multivariate analysis showed that log UAE was an independent associating factor of CAVI in all subjects. CAVI was significantly higher in subjects with hypertension, CHD, and DM. There was correlation between arterial stiffness and biomarkers such as NT-proBNP, Hcy, and UAE.

  17. Generation and validation of a prognostic score to predict outcome after re-irradiation of recurrent glioma

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E.; Welzel, Thomas; Debus, Juergen [Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)], E-mail: Stephanie.combs@med.uni-heidelberg.de; Edler, Lutz; Rausch, Renate [German Cancer Research Center (dkfz), Dept. of Biostatistics, Heidelberg (Germany); Wick, Wolfgang [Univ. Hospital of Heidelberg, Dept. of Neurooncology, Heidelberg (Germany)

    2013-01-15

    Re-irradiation using high-precision radiation techniques has been established within the clinical routine for patients with recurrent gliomas. In the present work, we developed a practical prognostic score to predict survival outcome after re-irradiation. Patients and methods. Fractionated stereotactic radiotherapy (FSRT) was applied in 233 patients. Primary histology included glioblastoma (n = 89; 38%), WHO Grade III gliomas (n = 52; 22%) and low-grade glioma (n = 92; 40%). FSRT was applied with a median dose of 36 Gy in 2 Gy single fractions. We evaluated survival after re-irradiation as well as progression-free survival after re-irradiation; prognostic factors analyzed included age, tumor volume at re-irradiation, histology, time between initial radiotherapy and re-irradiation, age and Karnofsky Performance Score. Results. Median survival after FSRT was 8 months for glioblastoma, 20 months for anaplastic gliomas, and 24 months for recurrent low-grade patients. The strongest prognostic factors significantly impacting survival after re-irradiation were histology (p <0.0001) and age (<50 vs. ={>=}50, p < 0.0001) at diagnosis and the time between initial radiotherapy and re-irradiation {<=}12 vs. >12 months (p < 0.0001). We generated a four-class prognostic score to distinguish patients with excellent (0 points), good (1 point), moderate (2 points) and poor (3-4 points) survival after re-irradiation. The difference in outcome was highly significant (p < 0.0001). Conclusion. We generated a practical prognostic score index based on three clinically relevant factors to predict the benefit of patients from re-irradiation. This score index can be helpful in patient counseling, and for the design of further clinical trials. However, individual treatment decisions may include other patient-related factors not directly influencing outcome.

  18. Explaining the variability of Photochemical Reflectance Index (PRI): deconvolution of variability related to Light Use Efficiency and Canopy attributes.

    Science.gov (United States)

    Merlier, Elodie; Hmimina, Gabriel; Dufrêne, Eric; Soudani, Kamel

    2014-05-01

    The Photochemical Reflectance Index (PRI) was designed as a proxy of the state of xanthophyll cycle which is used as a response of plants to excess of light (Gamon et al., 1990; 1992). Strong relationships between PRI and LUE were shown at leaf and canopy scales and over a wide range of species (Garbulsky et al., 2011). However, its use at canopy scale was shown to be significantly hampered by effects of confounding factors such as the PRI sensitivity to leaf pigment content (Gamon et al. 2001; Nakaji et al. 2006) and to canopy structure (Hilker et al. 2008). Several approaches aimed at correcting such effects and recent works focused on the deconvolution of LUE related and LUE unrelated PRI variability (Rahimzadeh-Bajgiran et al. 2012).In this study, the PRI variability at canopy scale is investigated over two years on three species (Fagus sylvatica, Quercus robur and Pinus sylvestris) growing under two water regimes. At daily scale, PRI variability is mainly explained by radiation conditions. As already reported at leaf scale in Hmimina et al. (2014), analysis of PRI responses to incoming photosynthetically active radiation over seasonal scale allowed to separate two sources of variability : a constitutive variability mainly related to canopy structure and leaf chlorophyll content and a facultative variability mainly related to LUE and soil moisture content. These results highlight the composite nature of PRI signal measured at canopy scale and the importance of disentangling its sources of variability in order to accurately assess ecosystem light use efficiency. Gamon JA, Field CB, Bilger W, Björkman O, Fredeen AL, Peñuelas J. 1990. Remote sensing of the xanthophyll cycle and chlorophyll fluorescence in sunflower leaves and canopies. Oecologia 85, 1-7. Gamon JA, Field CB, Fredeen A AL, Thayer S. 2001. Assessing photosynthetic downregulation in sunflower stands with an optically-based model. Photosynthesis Research 67, 113-125. Gamon JA, Peñuelas J, Field CB

  19. Dietary glycemic index, glycemic load and risk of age-related cataract extraction: a case-control study in Italy.

    Science.gov (United States)

    Turati, Federica; Filomeno, Maria; Galeone, Carlotta; Serraino, Diego; Bidoli, Ettore; La Vecchia, Carlo

    2015-04-01

    Although a role of glycemic index (GI) and glycemic load (GL) in age-related cataract development is plausible, a few studies, all conducted in USA or Australia, provided results on this issue. The aim of the present study was to provide new original data from a Mediterranean population. We analyzed data from an Italian case-control study including 761 cases with cataract extraction and 1,522 hospital controls, frequency-matched with cases by center, sex, and age. Multivariate odds ratios (ORs) for GI and GL intakes were obtained from logistic regression models after allowance for major confounding factors, including non carbohydrate energy intake, smoking, and diabetes. The ORs of cataract extraction for the highest versus the lowest tertile were 1.20 (95% confidence interval, CI 0.91-1.57) for GI and 1.57 (95% CI 1.16-2.13) for GL, with a statistically significant trend in risk for GL (p index. The present study supports a positive association between dietary GL and the risk of cataract extraction, independently from diabetes, and a lack of association for GI.

  20. Physical Activity, Sedentary Behaviors, and Nutritional Risk Profiles and Relations to Body Mass Index, Obesity, and Overweight in Eighth Grade.

    Science.gov (United States)

    Berlin, Kristoffer S; Kamody, Rebecca C; Thurston, Idia B; Banks, Gabrielle G; Rybak, Tiffany M; Ferry, Robert J

    2017-01-01

    The objective of this article was to determine (1) the existence of individually varying patterns of physical activity, sedentary behavior, and nutrition intake risk; and (2) how these risk-patterns relate to youth's demographics, Body mass index (BMI) and psychosocial functioning. Participants (N = 9,304) from the 2007 8th Grade Early Childhood Longitudinal Study Cohort completed the revised Self-Description Questionnaire II. Age, sex, height, and weight were used to calculate body mass index (BMI) z scores and percentiles. Three risk profiles emerged via Latent Profile Analyses: "Active + Healthy Diet" (AHD; 16.3% Obese); "Sedentary + Unbalanced Diet" (SUD; 21.3% Obese); and "Screen-Time + Recreational Food" (STRF; 25.0% Obese). Significant differences in BMIs, psychosocial factors, and demographic characteristics were found across the profiles. Differential patterns of physical activity, sedentary behavior, and nutritional choices were found to predict BMI and psychosocial functioning. These findings may be helpful to refine and develop modular-based prevention and weight control intervention programs.

  1. Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men

    DEFF Research Database (Denmark)

    Jensen, Tina Kold; Andersson, Anne-Maria; Jørgensen, Niels

    2004-01-01

    To examine the relationship between body mass index (BMI) and semen quality among young men from the general population.......To examine the relationship between body mass index (BMI) and semen quality among young men from the general population....

  2. Dietary inflammatory index in relation to sub-clinical atherosclerosis and atherosclerotic vascular disease mortality in older women.

    Science.gov (United States)

    Bondonno, Nicola P; Lewis, Joshua R; Blekkenhorst, Lauren C; Shivappa, Nitin; Woodman, Richard J; Bondonno, Catherine P; Ward, Natalie C; Hébert, James R; Thompson, Peter L; Prince, Richard L; Hodgson, Jonathan M

    2017-06-01

    Arterial wall thickening, stimulated by low-grade systemic inflammation, underlies many cardiovascular events. As diet is a significant moderator of systemic inflammation, the dietary inflammatory index (DIITM) has recently been devised to assess the overall inflammatory potential of an individual's diet. The primary objective of this study was to assess the association of the DII with common carotid artery-intima-media thickness (CCA-IMT) and carotid plaques. To substantiate the clinical importance of these findings we assessed the relationship of DII score with atherosclerotic vascular disease (ASVD)-related mortality, ischaemic cerebrovascular disease (CVA)-related mortality and ischaemic heart disease (IHD)-related mortality more. The study was conducted in Western Australian women aged over 70 years (n 1304). Dietary data derived from a validated FFQ (completed at baseline) were used to calculate a DII score for each individual. In multivariable-adjusted models, DII scores were associated with sub-clinical atherosclerosis: a 1 sd (2·13 units) higher DII score was associated with a 0·013-mm higher mean CCA-IMT (P=0·016) and a 0·016-mm higher maximum CCA-IMT (P=0·008), measured at 36 months. No relationship was seen between DII score and carotid plaque severity. There were 269 deaths during follow-up. High DII scores were positively associated with ASVD-related death (per sd, hazard ratio (HR): 1·36; 95 % CI 1·15, 1·60), CVA-related death (per sd, HR: 1·30; 95 % CI 1·00, 1·69) and IHD-related death (per sd, HR: 1·40; 95 % CI 1·13, 1·75). These results support the hypothesis that a pro-inflammatory diet increases systemic inflammation leading to development and progression of atherosclerosis and eventual ASVD-related death.

  3. Factores pronósticos relacionados con la supervivencia del cáncer de mama Prognostic factors related to breast cancer survival

    Directory of Open Access Journals (Sweden)

    Lourdes Flores-Luna

    2008-04-01

    Full Text Available OBJETIVO: Evaluar los factores pronósticos del cáncer de mama en mujeres mexicanas. MATERIAL Y MÉTODOS: Se incluyó a 432 mujeres con cáncer de mama admitidas de 1990 a 1999 en el Hospital General de México para evaluar la supervivencia mediante las técnicas de Kaplan-Meier y los métodos de riesgos proporcionales de Cox. RESULTADOS: La supervivencia global a cinco años fue de 58.9%. La menor supervivencia corresponde a los estadios clínicos IIIB (47.5%, IIIA (44.2% y IV(15%, la metástasis hematógena fue de 21.4% y el tumor positivo en bordes quirúrgicos de 12.5%. La invasión linfovascular (RR= 1.9; IC95% 1.3-2.8, el estadio clínico IV (RR= 14.8; IC95% 5.5-39.7 y el tumor en bordes quirúrgicos (RR= 2.4; IC95% 1.2-4.8 fueron los principales factores pronósticos. CONCLUSIONES: Estos resultados dan consistencia a los criterios de diagnóstico y tratamiento de las mujeres con cáncer de mama atendidas en México y toman en consideración las condiciones de la tumoración, como extensión de la malformación, etapa clínica y estado de los ganglios linfáticos antes de decidir la conducta terapéutica inicial.OBJECTIVE: To evaluate prognostic factors for breast cancer in Mexican women. MATERIAL AND METHODS: Four hundred and thirty two women with breast cancer, admitted from 1990 to 1999 to the General Hospital of Mexico, were included to evaluate their survival using the Kaplan-Meier technique and Cox proportional hazard method. RESULTS: Overall 5-year survival was 58.9%. The shortest survival rate corresponds to the clinical stage (IIIB, 47.5%; IIIA, 44.2%; and IV, 15%, the haematological metastasis (21.4% and surgical edges with positive tumor (12.5%. Lymph node-positive (RR, 1.9; IC95%, 1.3-2.8, clinical stage IV (RR, 14.8; IC95%, 5.5-39.7 and surgical edges with positive tumor (RR, 2.4; IC95%, 1.2-4.8 were the central prognostic factors. CONCLUSIONS: These results give consistency to diagnostic and therapeutic criteria for women

  4. Delaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome

    DEFF Research Database (Denmark)

    Filbay, Stephanie R; Roos, Ewa M; Frobell, Richard B

    2017-01-01

    , body mass index, preinjury activity level, education and smoking. RESULTS: For all participants (n=118), graft/contralateral ACL rupture, non-ACL surgery and worse baseline 36-item Short-Form Mental Component Scores were associated with worse outcomes. Treatment with exercise therapy alone......AIM: Identify injury-related, patient-reported and treatment-related prognostic factors for 5-year outcomes in acutely ACL-ruptured individuals managed with early reconstruction plus exercise therapy, exercise therapy plus delayed reconstruction or exercise therapy alone. METHODS: Exploratory...... was a prognostic factor for less knee symptoms compared with early reconstruction plus exercise therapy (regression coefficient 10.1, 95% CI 2.3 to 17.9). Baseline meniscus lesion was associated with worse sport/recreation function (-14.4, 95% CI -27.6 to -1.3) and osteochondral lesions were associated with worse...

  5. Transportation-related data bases extracted from the national index of energy and environmental data bases. Part II. Detailed data base descriptions

    Energy Technology Data Exchange (ETDEWEB)

    Birss, E.W.; Yeh, J.W.

    1976-11-15

    Lawrence Livermore Laboratory (LLL) extracted a set of 135 transportation-related data bases from a computerized national index of energy and environmental data bases. LLL had produced the national index for the Division of Biomedical and Environmental Research of the Energy Research and Development Administration (ERDA). The detailed transportation-related data base descriptions presented are part of a LLL ongoing research contract with the Information Division of the Transportation Systems Center of the U. S. Department of Transportation (DOT/TSC).

  6. Quantitative analysis of replication-related mutation and selection pressures in bacterial chromosomes and plasmids using generalised GC skew index

    Directory of Open Access Journals (Sweden)

    Suzuki Haruo

    2009-12-01

    Full Text Available Abstract Background Due to their bi-directional replication machinery starting from a single finite origin, bacterial genomes show characteristic nucleotide compositional bias between the two replichores, which can be visualised through GC skew or (C-G/(C+G. Although this polarisation is used for computational prediction of replication origins in many bacterial genomes, the degree of GC skew visibility varies widely among different species, necessitating a quantitative measurement of GC skew strength in order to provide confidence measures for GC skew-based predictions of replication origins. Results Here we discuss a quantitative index for the measurement of GC skew strength, named the generalised GC skew index (gGCSI, which is applicable to genomes of any length, including bacterial chromosomes and plasmids. We demonstrate that gGCSI is independent of the window size and can thus be used to compare genomes with different sizes, such as bacterial chromosomes and plasmids. It can suggest the existence of different replication mechanisms in archaea and of rolling-circle replication in plasmids. Correlation of gGCSI values between plasmids and their corresponding host chromosomes suggests that within the same strain, these replicons have reproduced using the same replication machinery and thus exhibit similar strengths of replication strand skew. Conclusions gGCSI can be applied to genomes of any length and thus allows comparative study of replication-related mutation and selection pressures in genomes of different lengths such as bacterial chromosomes and plasmids. Using gGCSI, we showed that replication-related mutation or selection pressure is similar for replicons with similar machinery.

  7. Prognostic indicators in alcoholic cirrhotic men

    DEFF Research Database (Denmark)

    Gluud, C; Henriksen, Jens Henrik Sahl; Nielsen, G

    1988-01-01

    The relationships between portal pressure, liver function and clinical variables on one hand and development of variceal hemorrhage and death on the other were investigated in 58 men with newly diagnosed alcoholic cirrhosis. Portal pressure was determined during hepatic vein catheterization...... information regarding development of variceal hemorrhage, even when easily obtained variables with known prognostic information were included [modified Child-Turcotte's criteria and incapacitation index (a weighted sum of days without normal health)]. During follow-up, 17 patients (29%) died. Applying Cox...... of prognosis in alcoholic cirrhotic men may be significantly improved by information about size of esophageal varices and level of portal pressure....

  8. Prognostic ability of 18F-FDG PET/CT in the assessment of colorectal liver metastases.

    Science.gov (United States)

    Muralidharan, Vijayaragavan; Kwok, Marco; Lee, Sze Ting; Lau, Lawrence; Scott, Andrew M; Christophi, Christopher

    2012-09-01

    Modern multidisciplinary therapy for colorectal liver metastases (CRLM) is associated with significant morbidity and must be adapted to the patient's relative risk. The tools currently available to risk-stratify patients are limited. This study assessed the prognostic utility of metabolic measurements derived from(18)F-FDG PET compared with previously proposed prognostic scoring systems. Preoperative (18)F-FDG PET/CT studies from a series of 30 patients who underwent liver resection for CRLM after neoadjuvant chemotherapy were evaluated. Quantitative (18)F-FDG PET analysis calculated the maximum and mean standardized uptake value, metabolic tumor volume (MTV), and tumor glycolytic volume (TGV) as measures of the metabolic activity of tumors. The predictive value of these parameters was compared with that of 4 prognostic scores developed by Fong, Iwatsuki, Nordlinger, and Rees. High MTV and TGV in patients before metastasectomy were significantly associated with poorer overall survival (MTV: P = 0.001; TGV: P = 0.004) and recurrence-free survival (MTV: P = 0.001, TGV; P = 0.002). Maximum and mean standardized uptake value did not show any significant predictive ability. Of the prognostic scores, prediction of outcome was most accurate using the Basingstoke index (area under the curve, 0.898). Assessment of metabolic tumor burden with volumetric (18)F-FDG PET parameters appears to be a valuable adjunct in determining the biology of CRLM before surgical resection and may enable better risk stratification of patients.

  9. Biological Computation Indexes of Brain Oscillations in Unattended Facial Expression Processing Based on Event-Related Synchronization/Desynchronization

    Directory of Open Access Journals (Sweden)

    Bo Yu

    2016-01-01

    Full Text Available Estimation of human emotions from Electroencephalogram (EEG signals plays a vital role in affective Brain Computer Interface (BCI. The present study investigated the different event-related synchronization (ERS and event-related desynchronization (ERD of typical brain oscillations in processing Facial Expressions under nonattentional condition. The results show that the lower-frequency bands are mainly used to update Facial Expressions and distinguish the deviant stimuli from the standard ones, whereas the higher-frequency bands are relevant to automatically processing different Facial Expressions. Accordingly, we set up the relations between each brain oscillation and processing unattended Facial Expressions by the measures of ERD and ERS. This research first reveals the contributions of each frequency band for comprehension of Facial Expressions in preattentive stage. It also evidences that participants have emotional experience under nonattentional condition. Therefore, the user’s emotional state under nonattentional condition can be recognized in real time by the ERD/ERS computation indexes of different frequency bands of brain oscillations, which can be used in affective BCI to provide the user with more natural and friendly ways.

  10. Deconvolution of pigment and physiologically related photochemical reflectance index variability at the canopy scale over an entire growing season.

    Science.gov (United States)

    Hmimina, G; Merlier, E; Dufrêne, E; Soudani, K

    2015-08-01

    The sensitivity of the photochemical reflectance index (PRI) to leaf pigmentation and its impacts on its potential as a proxy for light-use efficiency (LUE) have recently been shown to be problematic at the leaf scale. Most leaf-to-leaf and seasonal variability can be explained by such a confounding effect. This study relies on the analysis of PRI light curves that were generated at the canopy scale under natural conditions to derive a precise deconvolution of pigment-related and physiologically related variability in the PRI. These sources of variability were explained by measured or estimated physiologically relevant variables, such as soil water content, that can be used as indicators of water availability and canopy chlorophyll content. The PRI mainly reflected the variability in the pigment content of the canopy. However, the corrected PRI, which was obtained by subtracting the pigment-related seasonal variability from the PRI measurement, was highly correlated with the upscaled LUE measurements. Moreover, the sensitivity of the PRI to the leaf pigment content may mask the PRI versus LUE relationship or result in an artificial relationship that reflects the relationship of chlorophyll versus LUE, depending on the species phenology. © 2015 John Wiley & Sons Ltd.

  11. The Biochemical Prognostic Factors of Subclinical Hypothyroidism

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    Myung Won Lee

    2014-06-01

    Full Text Available BackgroundPatients with subclinical hypothyroidism (SHT are common in clinical practice. However, the clinical significance of SHT, including prognosis, has not been established. Further clarifying SHT will be critical in devising a management plan and treatment guidelines for SHT patients. Thus, the aim of this study was to investigate the prognostic factors of SHT.MethodsWe reviewed the medical records of Korean patients who visited the endocrinology outpatient clinic of Severance Hospital from January 2008 to September 2012. Newly-diagnosed patients with SHT were selected and reviewed retrospectively. We compared two groups: the SHT maintenance group and the spontaneous improvement group.ResultsThe SHT maintenance group and the spontaneous improvement group had initial thyroid-stimulating hormone (TSH levels that were significantly different (P=0.035. In subanalysis for subjects with TSH levels between 5 to 10 µIU/mL, the spontaneous improvement group showed significantly lower antithyroid peroxidase antibody (anti-TPO-Ab titer than the SHT maintenance group (P=0.039. Regarding lipid profiles, only triglyceride level, unlike total cholesterol and low density lipoprotein cholesterol, was related to TSH level, which is correlated with the severity of SHT. Diffuse thyroiditis on ultrasonography only contributed to the severity of SHT, not to the prognosis. High sensitivity C-reactive protein and urine iodine excretion, generally regarded as possible prognostic factors, did not show any significant relation with the prognosis and severity of SHT.ConclusionOnly initial TSH level was a definite prognostic factor of SHT. TPO-Ab titer was also a helpful prognostic factor for SHT in cases with mildly elevated TSH. Other than TSH and TPO-Ab, we were unable to validate biochemical prognostic factors in this retrospective study for Korean SHT patients.

  12. Prognostic factors in oligodendrogliomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1997-01-01

    .5 years and for the group older than 60 years of 13 months. The group without neurological deficits had a 5-years survival of 43 per cent while the group with deficits had a 5-years survival of 5 per cent. The 5-years survival for oligodendroglioma of grade II was 46 per cent and for grade III 10 per cent......An outcome analysis was performed on 96 patients with pure cerebral oligodendrogliomas operated in the 30-year period 1962 to 1991. The most important predictive prognostic factors were youth and no neurological deficit, demonstrated as a median survival for the group younger than 20 years of 17...

  13. Lifecycle Prognostics Architecture for Selected High-Cost Active Components

    Energy Technology Data Exchange (ETDEWEB)

    N. Lybeck; B. Pham; M. Tawfik; J. B. Coble; R. M. Meyer; P. Ramuhalli; L. J. Bond

    2011-08-01

    There are an extensive body of knowledge and some commercial products available for calculating prognostics, remaining useful life, and damage index parameters. The application of these technologies within the nuclear power community is still in its infancy. Online monitoring and condition-based maintenance is seeing increasing acceptance and deployment, and these activities provide the technological bases for expanding to add predictive/prognostics capabilities. In looking to deploy prognostics there are three key aspects of systems that are presented and discussed: (1) component/system/structure selection, (2) prognostic algorithms, and (3) prognostics architectures. Criteria are presented for component selection: feasibility, failure probability, consequences of failure, and benefits of the prognostics and health management (PHM) system. The basis and methods commonly used for prognostics algorithms are reviewed and summarized. Criteria for evaluating PHM architectures are presented: open, modular architecture; platform independence; graphical user interface for system development and/or results viewing; web enabled tools; scalability; and standards compatibility. Thirteen software products were identified and discussed in the context of being potentially useful for deployment in a PHM program applied to systems in a nuclear power plant (NPP). These products were evaluated by using information available from company websites, product brochures, fact sheets, scholarly publications, and direct communication with vendors. The thirteen products were classified into four groups of software: (1) research tools, (2) PHM system development tools, (3) deployable architectures, and (4) peripheral tools. Eight software tools fell into the deployable architectures category. Of those eight, only two employ all six modules of a full PHM system. Five systems did not offer prognostic estimates, and one system employed the full health monitoring suite but lacked operations and

  14. Prognostic significance of 5-fluorouracil metabolism-relating enzymes and enhanced chemosensitivity to 5-fluorouracil by 5-chloro 2,4-dihydroxy-pyridine in urothelial carcinoma

    Directory of Open Access Journals (Sweden)

    Ide Hiroki

    2012-09-01

    Full Text Available Abstract Background Recently, S-1, a novel 5-fluorouracil (5-FU-based agent containing the strong dihydropyrimidine dehydrogenase (DPD inhibitor, 5-chloro-2,4-dihydropyrimidine (CDHP has been clinically used to treat various non-urothelial carcinomas (UC. High levels of thymidylate synthase (TS, the target enzyme of 5-FU and DPD which degrades the majority of 5-FU, are associated with poor prognosis in some cancers. However, only a few reports have dealt with this in UC. The aim of this study was to investigate the clinical significance of TS and DPD in upper tract urothelial carcinoma (UTUC and evaluate the role of TS and DPD on the sensitivity of 5-FU in UC cell lines and the anti-tumor effect of S-1 in UC xenograft model. Methods Firstly, we evaluated the immunohistochemical expression of TS and DPD in 176 patients with UTUC to determine their prognostic significance. Secondly, the levels of TS and DPD in UC cell lines were measured by ELISA and real-time PCR. Furthermore, the association between their levels and the sensitivity to 5-FU was examined using the small interfering RNA (siRNA specific for TS and DPD. Thirdly, the anti-tumor effect of S-1 was evaluated in UC xenograft model. Results Immunohistochemical evaluation of TS and DPD in UTUC human samples revealed that TS expression was significantly associated with stage, grade, and lymphovascular invasion and DPD expression was significantly associated with grade. Multivariate analysis revealed that high TS expression was an independent predictor of disease-specific survival in them. In in vitro study using UC cell lines, high levels of TS and DPD were associated with low response to 5-FU and these associations were confirmed with siRNA specific for TS and DPD. In in vivo study using UC xenograft model, S-1 treatment dramatically inhibited tumor growth compared to controls, tegafur, or UFT in UC tumor with a high level of DPD. Conclusions TS plays an important role in the prognosis of

  15. Prognostic impact of absolute lymphocyte count/absolute monocyte count ratio and prognostic score in patients with nasal-type, extranodal natural killer/T-cell lymphoma.

    Science.gov (United States)

    Li, Na; Zhang, Li; Song, Hao-Lan; Zhang, Jing; Weng, Hua-Wei; Zou, Li-Qun

    2017-05-01

    Nasal-type, extranodal natural killer/T-cell lymphoma is a heterogeneous disorder with poor prognosis, requiring risk stratification in this population. The combined value of baseline absolute lymphocyte count and absolute monocyte count provided prognostic information in some malignancies. However, the evidence requires validation in extranodal natural killer/T-cell lymphoma. Aiming to investigate the prognostic significance of absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte count prognostic score for extranodal natural killer/T-cell lymphoma, a retrospective research was carried out. A total of 264 patients with newly diagnosed extranodal natural killer/T-cell lymphoma were analyzed in this study. The patients' absolute lymphocyte count and absolute monocyte count tested at initial diagnosis were collected. Receiver operating curve analysis showed that the optimal cut-off values for absolute lymphocyte count and absolute monocyte count were 1.0 × 10(9) and 0.5 × 10(9)L(-1), respectively, and for absolute lymphocyte count/absolute monocyte count ratio was 2.85. After a median follow-up of 27 months (range 1-87 months), the 3-year overall survival and progression-free survival was 75.4% and 67.6%, respectively. Patients with absolute lymphocyte count/absolute monocyte count ratio ≥ 2.85 had better 3-year overall survival and progression-free survival than those with absolute lymphocyte count/absolute monocyte count ratio lymphocyte count/absolute monocyte count prognostic score, significant difference has been noticed in 3-year overall survival and progression-free survival (p lymphocyte count/absolute monocyte count prognostic score was associated with poorer survival. The International Prognostic Index and Korean Prognostic Index were used for prognosis and showed no significant difference. When adding absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte

  16. Reproduction of a rat model of acute high-altitude sickness and evaluation of its related indexes

    Directory of Open Access Journals (Sweden)

    Chi WANG

    2015-10-01

    Full Text Available Objective To reproduce a rat model of acute mountain sickness by using a hypobaric chamber to simulate the plateau environment, and to study the related physiological parameters. Methods A total of 70 male Wistar rats were randomly divided into normal control (NC group, and 6 hypobaric hypoxia groups (10 each in which rats were housed in a hypobaric chamber and exposed to the enviroment simulating high altitude of 5000m and 6000m for 12h, 24h and 48h respectively. Memory Morris water maze test was conducted to evaluate the changes in working memory of rats in space. Histological changes in lung and brain tissue were observed. Blood from abdominal aorta was collected to analyze the parameters of blood gas. The histopathological changes in lung and cerebrum were observed, and their wet/dry ratios were calculated. Results Reduction in activity or even death was found in hypobaric hypoxia groups, and arterial PaO2 was significantly decreased in all rats of hypobaric hypoxia groups. Compared with NC group, rats exposed to a simulated altitude of 5000m for longer than 24h and 6000m for longer than 12h exhibited longer latency period in finding the hidden platform, shorter expedition time for target quadrant, and less frequency of platform crossing in the Morris water maze test (P<0.05. After exposure to simulated altitudes of both 5000m and 6000m for 48h, pathological changes were observed in lung and cerebrum, and wet/dry ratio of lung and brain was significantly increased compared with that of NC group. Conclusion Indexes of rat model of acute mountain sickness by using a hypobaric chamber show different changes at respective time points. Therefore the changes in multiple physiological indexes of mountain sickness can be assessed by using this animal model. DOI: 10.11855/j.issn.0577-7402.2015.09.06

  17. Association between dietary carbohydrate intake and dietary glycemic index and risk of age-related cataract: a meta-analysis.

    Science.gov (United States)

    Wu, Han; Zhang, Huina; Li, Peiwei; Gao, Tao; Lin, Jijian; Yang, Jun; Wu, Yihua; Ye, Juan

    2014-05-15

    To assess the association of dietary carbohydrate intake and dietary glycemic index (GI), and risk of age-related cataract (ARC), and quantitatively estimate their dose-response relationships. We searched Medline, the Cochrane Library, Excerpta Medica database (EMBASE), Institute for Scientific Information (ISI) Science Citation Index, ISI Web of Knowledge, and China National Knowledge Infrastructure (CNKI) databases before October 2013. Two authors independently extracted data and assessed study quality. The random-effect model was used to calculate the pooled odds ratios (ORs). Dose-response analyses, subgroup analyses based on ARC subtypes, heterogeneity, and publication bias assessment were also carried out. Seven studies were included in our meta-analysis. The pooled ORs of ARC for the highest versus the lowest category of carbohydrate intake and GI were 1.18 (95% confidence interval [CI]: 1.01-1.38) and 1.15 (95% CI: 1.00-1.32), respectively. Further subgroup analyses based on ARC subtypes suggested a marginally significant association between higher carbohydrate intake and cortical cataract risk (OR: 1.37, 95% CI: 0.99-1.90), and a statistically significant association between higher GI and nuclear cataract risk (OR: 1.23, 95% CI: 1.03-1.46). In addition, a significant dose-response relationship was observed between carbohydrate intake and the risk of cortical cataract. Our results indicate that higher dietary carbohydrate quantity and GI may be associated with the risk of cortical and nuclear cataract, respectively. The results should be interpreted cautiously and more studies are warranted to clarify this issue. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  18. Prognostic Significance of Melanoma Differentiation and Trans-Differentiation

    Energy Technology Data Exchange (ETDEWEB)

    Maddodi, Nityanand; Setaluri, Vijayasaradhi, E-mail: setaluri@wisc.edu [Department of Dermatology, University of Wisconsin School of Medicine and Public Health, 1300 University Avenue, B25, Madison WI 53706 (United States)

    2010-05-26

    Cutaneous malignant melanomas share a number of molecular attributes such as limitless replicative potential that define capabilities acquired by most malignancies. Accordingly, much effort has been focused on evaluating and validating protein markers related to these capabilities to function as melanoma prognostic markers. However, a few studies have also highlighted the prognostic value of markers that define melanocytic differentiation and the plasticity of melanoma cells to trans-differentiate along several other cellular pathways. Here, we provide a comprehensive review and evaluation of the prognostic significance of melanocyte-lineage markers such as MITF and melanogenic proteins, as well as markers of vascular epithelial and neuronal differentiation.

  19. Body mass index and short-term weight change in relation to treatment outcomes in women undergoing assisted reproduction.

    Science.gov (United States)

    Chavarro, Jorge E; Ehrlich, Shelley; Colaci, Daniela S; Wright, Diane L; Toth, Thomas L; Petrozza, John C; Hauser, Russ

    2012-07-01

    To assess the relation between body mass index (BMI) and short-term weight change with assisted reproductive technology (ART) outcomes. Prospective cohort study. Fertility center. A total of 170 women undergoing 233 ART cycles. Baseline BMI and short-term weight change were related to ART outcomes. Regression models accounting for repeated observations were used to adjust data for potential confounders. Peak E2 levels, oocyte yield, MII yield, fertilization rate, embryo quality, postive [beta]-hCH, clinical pregnancy and live birth rates. Overweight and obesity were associated with lower live birth rates. The adjusted live birth rate (95% confidence interval) was 42% (28%-58%) among women with a BMI between 20 and 22.4 kg/m(2) and 23% (14%-36%) among overweight or obese women. Short-term weight loss was associated with a higher proportion of metaphase II (MII) oocytes retrieved. The adjusted proportion of MII eggs was 91% (87%-94%) for women who lost 3 kg or more and 86% (81%-89%) for women whose weight remained stable. This association was stronger among women who were overweight or obese at baseline. Short-term weight loss was unrelated to positive β-hCG, clinical pregnancy, or live birth rates. Overweight and obesity were related to lower live birth rates in women undergoing ART. Short-term weight loss was related to higher MII yield, particularly among overweight and obese women, but unrelated to clinical outcomes. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. The grade-response relation between severity of peritonitis and serum cytokine concentrations explains Mannheim Peritonitis Index threshold.

    Science.gov (United States)

    Bracho-Riquelme, Rodolfo Leonel; Reyes-Romero, Miguel Arturo; Torres-Valenzuela, Alejandro; Flores-García, Ana Isabel

    2010-08-01

    To explore the gradient between the acute-phase response (APR) and peritonitis of differing severity. In 202 patients with peritonitis, we determined serum concentrations of interleukin (IL)-6, IL-10, IL-13, tumor necrosis factor (TNF)-alpha, and C-reactive protein (CRP). The severity of peritonitis was graded in accordance with the Mannheim Peritonitis Index (MPI). The grade-response relation between the severity of peritonitis and each analyte was explored. A statistically significant association was found between the medians of severity of peritonitis and IL-6 (p < 0.025), TNF-alpha (p < 0.01), CRP (p < 0.033), IL-10 (p < 0.0001), and IL-13 (p < 0.004). Both TNF-alpha and IL-10 had a direct, and IL-13 an indirect, relation to severity, whereas CRP and IL-6 tended toward linear behavior in equilibrium. A significant association persisted between individual MPI scores and IL-6 (p < 0.002), TNF-alpha (p < 0.002), CRP (p < 0.002), and IL-10 (p < 0.001), but not IL-13 (p = 0.646). Around the mean value of grade II peritonitis, the equilibrium between pro-inflammatory and anti-inflammatory cytokines is lost. This change coincides with the 26-point threshold for the MPI.

  1. Nutrient Cycling Index in Relation to Organic Matter and Soil Respiration of Rehabilitated Mine Sites in Kelian, East Kalimantan

    Directory of Open Access Journals (Sweden)

    Dwi Setyawan

    2011-09-01

    Full Text Available Degraded soils at mine sites are often associated with decreased soil fertility. However, soil nutrient status might be improved through biomass recovery primarily from re-vegetation. This paper relates nutrient cycling index (NCI derived from Landscape Function Analysis (LFA to soil respiration and soil organic matter as a measure of improving soil condition after rehabilitation. Fieldwork was conducted at Kelian Equatorial Mining, East Kalimantan in June 2001. Four sites were selected representing rehabilitation work in 1994 (7 year, 2000 (1 year and 2001 (3 month, and a reference site of undisturbed primary forest. The NCI value was calculated from scores of basal/canopy cover, litter (abundance, origin and degree of incorporation, cryptogam cover and surface roughness. Soil respiration was measured using the inverted-box method. In general, the NCI values increased with age of rehabilitation (12 to 56 % showing a significant increase compared with the values of reference site (80%. Soil respiration varied greatly and the values were equally high (200-800 mg CO2 m-2 hr2 across all sites. Tropical soils like those of Kelian might be inherently rich of soil organism as shown by high value of soil respiration. Nevertheless, the NCI values were not systematically related to soil respiration. We found that increased organic matter may be used as early sign of functioning soil resources in degraded land.

  2. Applicability of the Environmental Relative Moldiness Index for Quantification of Residential Mold Contamination in an Air Pollution Health Effects Study

    Directory of Open Access Journals (Sweden)

    Ali Kamal

    2014-01-01

    Full Text Available The Near-Road Exposures and Effects of Urban Air Pollutants Study (NEXUS investigated the impact of exposure to traffic-related air pollution on the respiratory health of asthmatic children in Detroit, Michigan. Since indoor mold exposure may also contribute to asthma, floor dust samples were collected in participants homes (n=112 to assess mold contamination using the Environmental Relative Moldiness Index (ERMI. The repeatability of the ERMI over time, as well as ERMI differences between rooms and dust collection methods, was evaluated for insights into the application of the ERMI metric. ERMI values for the standard settled floor dust samples had a mean ± standard deviation of 14.5±7.9, indicating high levels of mold contamination. ERMI values for samples collected from the same home 1 to 7 months apart (n=52 were consistent and without systematic bias. ERMI values for separate bedroom and living room samples were highly correlated (r=0.69, n=66. Vacuum bag dust ERMI values were lower than for floor dust but correlated (r=0.58, n=28. These results support the use of the ERMI to evaluate residential mold exposure as a confounder in air pollution health effects studies.

  3. Cumulative Intracranial Tumor Volume Augments the Prognostic Value of Diagnosis-Specific Graded Prognostic Assessment Model for Survival in Patients with Melanoma Cerebral Metastases

    DEFF Research Database (Denmark)

    Hirshman, Brian R; Wilson, Bayard R; Ali, Mir Amaan

    2017-01-01

    intracranial tumor volume (CITV) into the ds-GPA model for melanoma augmented its prognostic value. OBJECTIVE: To determine whether or not CITV augments the ds-GPA prognostic scale for melanoma. METHODS: We analyzed the survival pattern of 344 melanoma patients with BM treated with stereotactic radiosurgery...... (SRS) at separate institutions and validated our findings in an independent cohort of 201 patients. The prognostic value of ds-GPA for melanoma was quantitatively compared with and without the addition of CITV using the net reclassification index (NRI > 0) and integrated discrimination improvement (IDI...... validated these findings that CITV improves the prognostic utility of melanoma ds-GPA in an independent cohort of 201 melanoma cohort. CONCLUSION: The prognostic value of the ds-GPA scale for melanoma BM is enhanced by the incorporation of CITV....

  4. Prognostic factors in lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Starklint, Henrik; Halberg, Poul

    2006-01-01

    To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis.......To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis....

  5. Utility of the RENAL index -Radius; Exophytic/endophytic; Nearness to sinus; Anterior/posterior; Location relative to polar lines- in the management of renal masses.

    Science.gov (United States)

    Konstantinidis, C; Trilla, E; Lorente, D; Morote, J

    2016-12-01

    The growing incidence of renal masses and the wide range of available treatments require predictive tools that support the decision making process. The RENAL index -Radius; Exophytic/endophytic; Nearness to sinus; Anterior/posterior; Location relative to polar lines- helps standardise the anatomy of a renal mass by differentiating 3 groups of complexity. Since the introduction of the index, there have been a growing number of studies, some of which have been conflicting, that have evaluated the clinical utility of its implementation. To analyse the scientific evidence on the relationship between the RENAL index and the main strategies for managing renal masses. A search was conducted in the Medline database, which found 576 references on the RENAL index. In keeping with the PRISM Declaration, we selected 100 abstracts and ultimately reviewed 96 articles. The RENAL index has a high degree of interobserver correlation and has been validated as a predictive nomogram of histological results. In active surveillance, the index has been related to the tumour growth rate and probability of nephrectomy. In ablative therapy, the index has been associated with therapeutic efficacy, complications and tumour recurrence. In partial nephrectomy, the index has been related to the rate of complications, conversion to radical surgery, ischaemia time, function preservation and tumour recurrence, a finding also observed in radical nephrectomy. The RENAL index is an objective, reproducible and useful system as a predictive tool of highly relevant clinical parameters such as the rate of complications, ischaemia time, renal function and oncological results in the various currently accepted treatments for the management of renal masses. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Requirements Specifications for Prognostics: An Overview

    Data.gov (United States)

    National Aeronautics and Space Administration — With recent advancements in prognostics methodologies there has been a significant interest in maturing Prognostics and Health Management (PHM) to increase its...

  7. On Applying the Prognostic Performance Metrics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics performance evaluation has gained significant attention in the past few years. *As prognostics technology matures and more sophisticated methods for...

  8. Metrics for Offline Evaluation of Prognostic Performance

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostic performance evaluation has gained significant attention in the past few years.*Currently, prognostics concepts lack standard definitions and suffer from...

  9. Relative changes of MIB1 and PC10 labeling indexes in cell kinetics during radiotherapy for cervical squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Oka, Kuniyuki [Dept. of Pathology, Mito Saiseikai General Hospital, Ibaraki (Japan)]|[National Inst. of Radiological Sciences, Chiba (Japan). Unit of Clinical Examinations]|[National Inst. of Radiological Sciences, Chiba (Japan). Div. of Radiation Medicine; Nakano, Takashi [National Inst. of Radiological Sciences, Chiba (Japan). Unit of Clinical Oncology]|[National Inst. of Radiological Sciences, Chiba (Japan). Div. of Radiation Medicine; Hoshi, Tanji [Tokyo Metropolitan Univ. (Japan). Inst. for Urban Studies]|[National Inst. of Radiological Siences, Chiba (Japan). Research Center of Charged Particle Therapy

    1997-12-31

    To assess the changes in cell kinetics during radiotherapy (RT) in terms of the MIB1 and PC10 labeling indexes of cancer cells, a total of 230 biopsy specimens taken from 76 consecutive patients with cervical squamous cell carcinoma treated with RT was investigated. The MIB1 and PC10 indexes represent the growth fraction and proliferative activity, respectively. The MIB1 index ranged from 11 to 67% (mean value: 38%) before RT, from 21 to 86% (50%) at 5.4 Gy, from 15 to 85% (53%) at 9 Gy, and from 0 to 69% (26%) at 27 Gy. The PC10 index ranged from 4 to 46% (23%) before RT, from 5 to 62% (26%) at 5.4 Gy, from 6 to 63% (23%) at 9 Gy, and from 0 to 35% (11%) at 27 Gy. The correlational relationships between the increment of both indexes during RT ({Delta} index) and the index before RT were analyzed on an individual basis. The {Delta} index was calculated by the index at various doses during RT minus the index before RT. Negative linear relationships were observed between the {Delta} MIB1 index at 9 Gy or {Delta} MIB1 index at 27 Gy and the MIB1 before RT, and also between the {Delta} PC10 index at 9 Gy or {Delta} PC10 index at 27 Gy and the PC10 index before RT. The linear regression coefficient values showed more than 0.5 (0.511 to 0.682) with statistical significance. According to these results, it was suggested that the cervical cancers of lower proliferative activity showed greater increases in growth fraction and proliferative activity by irradiation than those of higher proliferative tumors. These findings suggest that reversal patterns of changes in cell kinetics including growth fraction and proliferative activity took place in the early period of RT for cervical squamous cell carcinomas. The study of changes in cell cycle kinetics in human tumors during RT may have potential impact on the further development of RT. (orig.).

  10. Relation between Voice Handicap Index (VHI and disease severity in Iranian patients with Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Fatemeh Majdinasab

    2012-11-01

    Full Text Available  Abstract Background: One third of patients with Parkinson’s disease (PD have mentioned “dysphonia” as their most debilitating communication deficit. Patient-based measurements, such as Voice Handicap Index (VHI add necessary supplementary information to clinical and physiological assessment. There are a few studies about relation between VHI and disease severity in PD, although none of them showed any significant correlation. The goal of this study was to find correlation between these variables in Iranian PD patients. Method: This cross-sectional, analytical and non-interventional study was done on 23 PD patients who reported a voice disorder related to their disease. They were selected from attendants of movement disorders clinic of Hazrat Rasool Akram Hospital. The relationship between disease severity (according to Hoehn and Yahr/H&Y and Unified Parkinson’s Disease Rating Scale-part3 /UPDRS-III and VHI questionnaire (and its 3 domains was investigated based on patients’ sex, UPDRS-III score H&Y and VHI. Results: Total VHI and its 3 domains had no relationship with disease severity (H&Y in all patients and by sex separation. However, there was a positive correlation between VHI and disease severity (UPDRS-III (r=0.485. There was also a relation between physical and functional domains of VHI and UPDRS (rP=0.530, rF=0.479 while no relationship observed regarding sex differences. 9 out of 18 UPDRS-III items had strong relationship with VHI (total and 3subscales. Conclusion: Iranian PD patients feel handicap according to voice disorder caused by PD. Patient satisfaction of voice decreases with the disease severity and progression. A larger sample size is necessary to find relationship in genders. VHI is an important issue could be offered to be used in PD beside other assessments. 

  11. Re-evaluation of pulmonary titanium dioxide nanoparticle distribution using the "relative deposition index": Evidence for clearance through microvasculature

    Directory of Open Access Journals (Sweden)

    Gehr Peter

    2007-08-01

    Full Text Available Abstract Background Translocation of nanoparticles (NP from the pulmonary airways into other pulmonary compartments or the systemic circulation is controversially discussed in the literature. In a previous study it was shown that titanium dioxide (TiO2 NP were "distributed in four lung compartments (air-filled spaces, epithelium/endothelium, connective tissue, capillary lumen in correlation with compartment size". It was concluded that particles can move freely between these tissue compartments. To analyze whether the distribution of TiO2 NP in the lungs is really random or shows a preferential targeting we applied a newly developed method for comparing NP distributions. Methods Rat lungs exposed to an aerosol containing TiO2 NP were prepared for light and electron microscopy at 1 h and at 24 h after exposure. Numbers of TiO2 NP associated with each compartment were counted using energy filtering transmission electron microscopy. Compartment size was estimated by unbiased stereology from systematically sampled light micrographs. Numbers of particles were related to compartment size using a relative deposition index and chi-squared analysis. Results Nanoparticle distribution within the four compartments was not random at 1 h or at 24 h after exposure. At 1 h the connective tissue was the preferential target of the particles. At 24 h the NP were preferentially located in the capillary lumen. Conclusion We conclude that TiO2 NP do not move freely between pulmonary tissue compartments, although they can pass from one compartment to another with relative ease. The residence time of NP in each tissue compartment of the respiratory system depends on the compartment and the time after exposure. It is suggested that a small fraction of TiO2 NP are rapidly transported from the airway lumen to the connective tissue and subsequently released into the systemic circulation.

  12. How wildfire risk is related to urban planning and Fire Weather Index in SE France (1990-2013).

    Science.gov (United States)

    Fox, D M; Carrega, P; Ren, Y; Caillouet, P; Bouillon, C; Robert, S

    2018-04-15

    Wildfires burn >450,000ha of forest every year in Euro-Mediterranean countries. Many fires originate in the Wildland Urban Interface (WUI) where housing density and weather conditions affect fire occurrence. Housing density is determined by long term land use policies while weather conditions evolve quickly. The first objective was to quantify the impacts of land use policy on WUI characteristics and fire risk in SE France during 1990-2012. The second objective was to quantify how Fire Weather Index (FWI) is related to fire occurrence. WUI was mapped from 1990, 1999, and 2012 building layers and crossed with a NDVI derived vegetation layer. In all, 12 WUI categories were derived: 4 building density classes and 3 vegetation layers. The I87 FWI was based on daily temperature, wind speed, relative humidity and soil water content. Despite a 30% increase in the number of new buildings, WUI area increased by only 5% as new housing filled in open space in existing WUI area. This trend can be linked to national level urban planning legislation and forest fire protection laws. Major driver variables determining housing location were aspect, slope, and distance to city centers. Fire frequency and burned area were nonlinearly related to FWI: 73% of the 99 fires occurred during weeks with FWI values ≥90 even though these accounted for only 44% of all weeks. Burned area was even more sensitive to FWI since 97% of total burned area occurred during weeks with mean FWI values ≥90. All days with burned areas >100ha had FWI values >150. The study demonstrated that WUI legislation can be an efficient tool to limit WUI fire risk. FWI results suggest the predicted increase in extreme summer heat events with global warming could increase burned area as firefighting resources are stretched beyond capacity. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Relation between Dental Caries and Body Mass Index-for-age among Schoolchildren of Jazan City, Kingdom of Saudi Arabia.

    Science.gov (United States)

    Quadri, Mir Fa; Hakami, Bassam M; Hezam, Asma Aa; Hakami, Raed Y; Saadi, Fadwa A; Ageeli, Layla M; Alsagoor, Wafqah H; Faqeeh, Mohammad A; Dhae, Mohammed A

    2017-04-01

    To analyze and report the type of relation present between dental caries and body mass index (BMI)-for-age among schoolchildren in Jazan region of Kingdom of Saudi Arabia. A cross-sectional study with multi-staged random sampling technique was designed to recruit the sample of schoolchildren. Caries was examined using the World Health Organization recommended "decayed and filled teeth"/"decayed missing and filled teeth (dft/DMFT)" method. The BMI-for-age was calculated using the value obtained from body weight and height (kg/m 2 ) of each child. The obtained results were plotted on age- and gender-specific percentile curves by the Centers for Disease Control and Prevention and categorized accordingly. Chi-squared test was conducted to analyze the relation between BMI-for-age and dental caries. Logistic regression was performed to judge the predictor variables. The p-value Dental caries, fast food, and snacks between meals were significant independent predictor variables for BMI (p Dental caries was a strong predictor, and the analysis showed that children with untreated caries had 81% (odds ratio = 0.19; confidence interval = 0.65, 0.58) higher chance of suffering from low BMI. To conclude, this is the first study attempted to see the relationship between BMI-for-age and dental caries among schoolchildren in Jazan city of Kingdom of Saudi Arabia. Negative relation between dental caries and BMI should warrant health promoters about dental caries as a reason for low BMI in a subset of children. High and alarming percentage of untreated dental caries demonstrates the oral health needs among the schoolgoing children in Jazan region. Public health dentists should develop and implement prevention programs so that the oral health issues among schoolchildren are addressed.

  14. Percentile distribution of blood pressure readings in relation to body mass index: a populationbased cross-sectional study ADOPOLNOR

    Directory of Open Access Journals (Sweden)

    Krzyżaniak Alicja

    2015-03-01

    Full Text Available Recent upward trends toward elevated blood pressure and increased weight expressed in terms of body mass index in children and adolescents call for regular monitoring of their physical growth and age-related changes in blood pressure. This requires adequate tools - reference values of a normal blood pressure range. The main objective of this study was to provide sex- and BMI-specific percentile reference values for systolic and diastolic blood pressure based on the adolescent Polish population, participants in the ADOPOLNOR study. A cross-sectional survey was carried out on a representative, randomly selected cohort of 4,941; 2,451 male and 2,490 female students aged 10-18 years, residents in Wielkopolska province and its capital, the city of Poznań. All examinations were performed in school nursery rooms during morning hours according to standard procedures. Body height and weight were measured and BMI was calculated. Blood pressure was measured twice on each occasion on the right arm using a fully calibrated TECH MED TM-Z mercury gauge sphygmomanometer with sets of exchangeable cuffs and a clinical stethoscope. The blood pressure classification was determined using the surveillance method. For each participant, the mean of measurements taken on each of the three occasions was calculated and served as his/her final blood pressure value. Using the LMS method, fitted percentile curves were created for BMI-related systolic and diastolic blood pressure. The findings revealed that age related blood pressure pattern was similar in boys and girls. It showed a steady increase of systolic and diastolic blood pressure with age. There was a positive correlation between the systolic and diastolic blood pressure indicating that when systolic blood pressure increased so diastolic did (r=0.61 at p<0.01. Boys were likely to have relatively higher mean values of systolic and diastolic blood pressure and steeper slope for BMI-related change in blood pressure

  15. Dietary insulin index and insulin load in relation to biomarkers of glycemic control, plasma lipids, and inflammation markers123

    OpenAIRE

    Nimptsch, Katharina; Jennie C. Brand-Miller; Franz, Mary; Sampson, Laura; Willett, Walter C.; Giovannucci, Edward

    2011-01-01

    Background: Dietary glycemic index and load are widely used to estimate the effect of carbohydrate-containing foods on postprandial blood glucose concentrations and as surrogates for insulin response. The food insulin index (II) directly quantifies the postprandial insulin secretion of a food and takes into account foods with a low or no carbohydrate content.

  16. The prognostic value of FET PET at radiotherapy planning in newly diagnosed glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Hoejklint Poulsen, Sidsel [The Finsen Center, Rigshospitalet, Department of Radiation Biology, Copenhagen (Denmark); Center of Diagnostic Investigation, Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen (Denmark); Urup, Thomas; Grunnet, Kirsten; Skovgaard Poulsen, Hans [The Finsen Center, Rigshospitalet, Department of Radiation Biology, Copenhagen (Denmark); The Finsen Center, Rigshospitalet, Department of Oncology, Copenhagen (Denmark); Jarle Christensen, Ib [University of Copenhagen, Hvidovre Hospital, Laboratory of Gastroenterology, Copenhagen (Denmark); Larsen, Vibeke Andree [Center of Diagnostic Investigation, Rigshospitalet, Department of Radiology, Copenhagen (Denmark); Lundemann Jensen, Michael; Munck af Rosenschoeld, Per [The Finsen Center, Rigshospitalet, Department of Oncology, Copenhagen (Denmark); The Finsen Center, Rigshospitalet, Section of Radiotherapy, Copenhagen (Denmark); Law, Ian [Center of Diagnostic Investigation, Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen (Denmark)

    2017-03-15

    Glioblastoma patients show a great variability in progression free survival (PFS) and overall survival (OS). To gain additional pretherapeutic information, we explored the potential of O-(2-{sup 18}F-fluoroethyl)-L-tyrosine (FET) PET as an independent prognostic biomarker. We retrospectively analyzed 146 consecutively treated, newly diagnosed glioblastoma patients. All patients were treated with temozolomide and radiation therapy (RT). CT/MR and FET PET scans were obtained postoperatively for RT planning. We used Cox proportional hazards models with OS and PFS as endpoints, to test the prognostic value of FET PET biological tumor volume (BTV). Median follow-up time was 14 months, and median OS and PFS were 16.5 and 6.5 months, respectively. In the multivariate analysis, increasing BTV (HR = 1.17, P < 0.001), poor performance status (HR = 2.35, P < 0.001), O(6)-methylguanine-DNA methyltransferase protein status (HR = 1.61, P = 0.024) and higher age (HR = 1.32, P = 0.013) were independent prognostic factors of poor OS. For poor PFS, only increasing BTV (HR = 1.18; P = 0.002) was prognostic. A prognostic index for OS was created based on the identified prognostic factors. Large BTV on FET PET is an independent prognostic factor of poor OS and PFS in glioblastoma patients. With the introduction of FET PET, we obtain a prognostic index that can help in glioblastoma treatment planning. (orig.)

  17. Evaluation of the relation between evapotranspiration and normalized difference vegetation index for downscaling the simplified surface energy balance model

    Science.gov (United States)

    Haynes, Jonathan V.; Senay, Gabriel B.

    2012-01-01

    The Simplified Surface Energy Balance (SSEB) model uses satellite imagery to estimate actual evapotranspiration (ETa) at 1-kilometer resolution. SSEB ETa is useful for estimating irrigation water use; however, resolution limitations restrict its use to regional scale applications. The U.S. Geological Survey investigated the downscaling potential of SSEB ETa from 1 kilometer to 250 meters by correlating ETa with the Normalized Difference Vegetation Index (NDVI) from the Moderate Resolution Imaging Spectroradiometer instrument (MODIS). Correlations were studied in three arid to semiarid irrigated landscapes of the Western United States (Escalante Valley near Enterprise, Utah; Palo Verde Valley near Blythe, California; and part of the Columbia Plateau near Quincy, Washington) during several periods from 2002 to 2008. Irrigation season ETa-NDVI correlations were lower than expected, ranging from R2 of 0.20 to 0.61 because of an eastward 2–3 kilometer shift in ETadata. The shift is due to a similar shift identified in the land-surface temperature (LST) data from the MODIS Terra satellite, which is used in the SSEB model. Further study is needed to delineate the Terra LST shift, its effect on SSEB ETa, and the relation between ETa and NDVI.

  18. Childhood body mass index in relation to subsequent risk of type 1 diabetes-A Danish cohort study

    DEFF Research Database (Denmark)

    Antvorskov, Julie C; Aunsholt, Lise; Buschard, Karsten

    2017-01-01

    The incidence of type 1 diabetes (T1D) is increasing, and obesity may be a contributing factor by increasing the risk and accelerating the onset. We investigated the relation between childhood body mass index z-scores (BMIz) and the later risk of T1D, including association with age at onset of T1D....... The study included 238 cases and 10 147 controls selected from the Copenhagen School Health Record Register (CSHRR). Cases of T1D were identified in the Danish Registry of Childhood and Adolescent Diabetes and 2 regional studies and linked to CSHRR. Using conditional logistic regression models......, the association of childhood prediagnostic BMIz at 7 and 13 years of age and changes between these ages with subsequent risk (odds ratio, OR) of T1D was estimated. A greater BMIz at 7 and 13 years of age was associated with increased risk of T1D with OR of 1.23 (confidence interval, CI 1.09-1.37; P = .0001) and 1...

  19. Racial Discipline Disproportionality in Montessori and Traditional Public Schools: A Comparative Study Using the Relative Rate Index

    Directory of Open Access Journals (Sweden)

    Katie E. Brown

    2015-11-01

    Full Text Available Research from the past 40 years indicates that African American students are subjected to exclusionary discipline, including suspension and expulsion, at rates two to three times higher than their White peers (Children’s Defense Fund, 1975; Skiba, Michael, Nardo, & Peterson, 2002. Although this phenomenon has been studied extensively in traditional public schools, rates of racially disproportionate discipline in public Montessori schools have not been examined. The purpose of this study is to examine racial discipline disproportionality in Montessori public elementary schools as compared to traditional elementary schools. The Relative Rate Index (RRI is used as a measure of racially disproportionate use of out-of-school suspensions (Tobin & Vincent, 2011. Suspension data from the Office of Civil Rights Data Collection was used to generate RRIs for Montessori and traditional elementary schools in a large urban district in the Southeast. While statistically significant levels of racial discipline disproportionality are found in both the Montessori and traditional schools, the effect is substantially less pronounced in Montessori settings. These findings suggest that Montessori schools are not immune to racially disproportionate discipline and should work to incorporate more culturally responsive classroom management techniques. Conversely, the lower levels of racially disproportionate discipline in the Montessori schools suggests that further study of discipline in Montessori environments may provide lessons for traditional schools to promote equitable discipline.

  20. Detection of venous needle dislodgement during haemodialysis using fractional order shape index ratio and fuzzy colour relation analysis.

    Science.gov (United States)

    Lin, Chia-Hung; Chen, Wei-Ling; Kan, Chung-Dann; Wu, Ming-Jui; Mai, Yi-Chen

    2015-12-01

    Venous needle dislodgement (VND) is a life-threatening complication during haemodialysis (HD) treatment. When VND occurs, it only takes a few minutes for blood loss in an adult patient. According to the ANNA (American Nephrology Nurses' Association) VND survey reports, VND is a concerning issue for the nephrology nurses/staff and patients. To ensure HD care and an effective treatment environment, this Letter proposes a combination of fractional order shape index ratio (SIR) and fuzzy colour relation analysis (CRA) to detect VND. If the venous needle drops out, clinical examinations show that both heart pulses and pressure wave variations have a low correlation at the venous anatomic site. Therefore, fractional order SIR is used to quantify the differences in transverse vibration pressures (TVPs) between the normal condition and meter reading. Linear regression shows that the fractional order SIR has a high correlation with the TVP variation. Fuzzy CRA is designed in a simple and visual message manner to identify the risk levels. A worst-case study demonstrated that the proposed model can be used for VND detection in clinical applications.

  1. Household fear of deportation in Mexican-origin families: Relation to body mass index percentiles and salivary uric acid.

    Science.gov (United States)

    Martínez, Airín D; Ruelas, Lillian; Granger, Douglas A

    2017-11-01

    Fear of deportation (FOD) is a prevalent concern among mixed-status families. Yet, our understanding of how FOD shapes human health and development is in its infancy. To begin to address this knowledge gap, we examined the relationship between household FOD, body mass index (BMI) percentiles and salivary uric acid (sUA), a biomarker related to oxidative stress/hypertension/metabolic syndrome, among 111 individuals living in Mexican-origin families. Participants were 65 children (2 months-17 years, 49% female) and 46 adults (20-58 years, 71% female) living in 30 Mexican-origin families with at least one immigrant parent in Phoenix, AZ. We recruited families using cluster probability sampling of 30 randomly selected census tracts with a high proportion of Hispanic/Latino immigrants. The head of household completed a survey containing demographic, FOD, and psychosocial measures. All family members provided saliva (later assayed for sUA) and anthropometric measures. Relationships between household FOD, BMI percentile, and sUA levels were estimated using multilevel models. Higher levels of household FOD were associated with lower BMI percentiles and lower sUA levels between families, after controlling for social support and socioeconomic proxies. Key features of the social ecology in which mixed-status families are embedded are associated with individual differences in biological processes linked to increased risk for chronic disease. © 2017 Wiley Periodicals, Inc.

  2. Spatiotemporal variations of potential evapotranspiration and aridity index in relation to influencing factors over Southwest China during 1960-2013

    Science.gov (United States)

    Zhao, Yifei; Zou, Xinqing; Cao, Liguo; Yao, Yulong; Fu, Guanghe

    2017-07-01

    This study investigated the spatial-temporal patterns and trends of potential evapotranspiration (ET0) and aridity index (AI) over Southwest China during 1960-2013 based on daily temperature, precipitation, wind speed, sunshine duration, total solar radiation, and relative humidity data from 108 meteorological stations. The Penman-Monteith model, Mann-Kendall (M-K) test, moving t test, and Morlet wavelet method were used. The results indicated that ET0 and AI across the region displayed decreasing trends, but the former was significant. After 2000, regionally average trends in ET0 and AI increased rapidly, indicating that droughts increased over Southwest China in recent years. Spatially, the changes of ET0 and AI were dissimilar and not clustered, either. Temporally, both ET0 and AI displayed obvious abrupt change points over different timescales and that of AI was during the winter monsoon period. Significant periodic variations with periods of 27, 13, and 5 years were found in ET0, but only of 13 and 5 years existed in AI. Correlation analysis revealed that the sunshine duration and wind speed were the dominant factors affecting ET0 and that AI showed strong negative correlation with precipitation. The findings of this study enhance the understanding of the relationship between climate change and drought in Southwest China, while the mechanism controlling the variation in drought requires further study.

  3. Relation between eating habits and a high body mass index among freshman students: a cross-sectional study.

    Science.gov (United States)

    Gunes, Fatma Esra; Bekiroglu, Nural; Imeryuz, Nese; Agirbasli, Mehmet

    2012-06-01

    This study aimed to examine the relation between eating habits and a high body mass index (BMI) in first-year freshman university students and included 2525 freshman university students 18 to 22 years old from a Turkish population. İn this study, 48% of the students were men. They were asked to complete a questionnaire on their dietary habits including the frequency of their consumption of individual food items, demographic data, and smoking habit. The effects of eating habits on increased BMI (≥25) were analyzed. Of 2259 subjects included in the analyses, 322 were overweight or obese and 1937 had normal and thin BMI (<25). Multivariate analyses identified male gender, recent weight change, and high number of meals as independent predictors of obesity/overweight. Frequent consumptions of beer, alcoholic drinks other than beer and wine (e.g., spirits including whisky, gin, raki, vodka), coffee, tea, coke, red meat, variety meat, and eggs were associated with a significantly higher risk of obesity/overweight, whereas frequent consumption of snacks was associated with a low risk. Findings of further studies, possibly taking into consideration the absolute quantities of consumption along with cultural and local issues, would guide the adoption of healthier feeding behaviors in this particular age group.

  4. Dietary fiber, whole grains, carbohydrate, glycemic index, and glycemic load in relation to risk of prostate cancer.

    Science.gov (United States)

    Wang, Rong-Jiang; Tang, Jian-Er; Chen, Yu; Gao, Jian-Guo

    2015-01-01

    The relationships between dietary fiber, whole grains, carbohydrate, glycemic index (GI), glycemic load (GL), and prostate cancer risk are unclear. We conducted a systematic review and meta-analysis to investigate these associations. Relevant studies were identified by a search of PubMed database and EMBASE database up to April 2015. A random effects model was used to calculate the summary relative risks (RRs) and their corresponding 95% confidence intervals (CIs). Twenty-seven epidemiological studies (18 case-control studies and nine cohort studies) were included in the final analysis. The pooled RRs of prostate cancer were 0.94 (95% CI 0.85-1.05, P=0.285), 1.13 (95% CI 0.98-1.30, P=0.095), 0.96 (95% CI 0.81-1.14, P=0.672), 1.06 (95% CI 0.96-1.18, P=0.254), and 1.04 (95% CI 0.91-1.18, P=0.590) for dietary fiber, whole grains, carbohydrate, GI, and GL, respectively. There was no evidence of significant publication bias based on the Begg's test and Egger's test. The findings of this meta-analysis indicate that, based on available information, dietary fiber, whole grains, carbohydrate, GI, and GL are not associated with the risk of prostate cancer.

  5. Facilitating the interpretation of pedobarography: the relative midfoot index as marker for pathologic gait in ankle osteoarthritic and contralateral feet.

    Science.gov (United States)

    Arno, Frigg; Roman, Frigg; Martin, Wiewiorski; Jennifer, Goldoni; Monika, Horisberger

    2016-01-01

    Pedobarography offers dynamic information about the foot, but the interpretation of its large data is challenging. In a prior study it was shown that attention can be restricted to pedobarographic midfoot load data. We aim to verify this observation in ankle osteoarthritic and contralateral feet. We assessed both feet of 120 patients with end-stage ankle osteoarthritis (OA) and 35 healthy volunteers with AOFAS-score and dynamic pedobarography in barefoot condition. We introduce a new parameter, the Relative Midfoot Index (RMI), representing the depth of the midfoot weighted by the maximal force (MF) in the hindfoot and forefoot. Main outcome measures were the RMI, MF and contact times in the hindfoot, midfoot and forefoot. Ankle OA, contralateral and healthy feet were compared with ANOVA. The RMI was significantly smaller in OA feet (0.65 ± 0.19) and contralateral feet (0.69 ± 0.15) than in healthy feet (0.84 ± 0.08, p feet. The RMI showed a correlation of 0.48 with the AOFAS score. Contralateral and OA feet were significantly different from healthy feet ( p feet of ankle OA patients differed significantly from healthy feet and are therefore not suitable as control group. Level of Evidence: 3 case control study.

  6. Glycation-altered proteolysis as a pathobiologic mechanism that links dietary glycemic index, aging, and age-related disease in non diabetics

    Science.gov (United States)

    Epidemiologic studies indicate that the risks for major age-related debilities including coronary heart disease, diabetes, and age-related macular degeneration (AMD) are diminished in people who consume lower glycemic index (GI) diets, but lack of a unifying physiobiochemical mechanism that explains...

  7. Identification of prognostic factors in canine mammary malignant tumours: a multivariable survival study

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    Santos Andreia A

    2013-01-01

    Full Text Available Abstract Background Although several histopathological and clinical features of canine mammary gland tumours have been widely studied from a prognostic standpoint, considerable variations in tumour individual biologic behaviour difficult the definition of accurate prognostic factors. It has been suggested that the malignant behaviour of tumours is the end result of several alterations in cellular physiology that culminate in tumour growth and spread. Accordingly, the aim of this study was to determine, using a multivariable model, the independent prognostic value of several immunohistochemically detected tumour-associated molecules, such as MMP-9 and uPA in stromal cells and Ki-67, TIMP-2 and VEGF in cancer cells. Results Eighty-five female dogs affected by spontaneous malignant mammary neoplasias were followed up for a 2-year post-operative period. In univariate analysis, tumour characteristics such as size, mode of growth, regional lymph node metastases, tumour cell MIB-1 LI and MMP-9 and uPA expressions in tumour-adjacent fibroblasts, were associated with both survival and disease-free intervals. Histological type and grade were related with overall survival while VEGF and TIMP-2 were not significantly associated with none of the outcome parameters. In multivariable analysis, only a MIB-1 labelling index higher than 40% and a stromal expression of MMP-9 higher than 50% retained significant relationships with poor overall and disease-free survival. Conclusions The results of this study indicate that MMP-9 and Ki-67 are independent prognostic markers of canine malignant mammary tumours. Furthermore, the high stromal expressions of uPA and MMP-9 in aggressive tumours suggest that these molecules are potential therapeutic targets in the post-operative treatment of canine mammary cancer.

  8. Prognostic factors for diffuse large B-cell lymphoma in the R(X)CHOP era

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    Vaidya, R.; Witzig, T. E.

    2014-01-01

    Background The introduction of rituximab (R) to conventional CHOP chemotherapy for newly diagnosed diffuse large B-cell lymphoma (DLBCL) led to an unequivocal improvement in survival, establishing RCHOP as the standard of care. Still, nearly 40% of DLBCL patients will eventually die of relapsed disease. Efforts to improve outcomes by addition of new biologic agents (X) to the RCHOP backbone are underway. In this era of R(X)CHOP, it is imperative to develop prognostic and predictive markers, not only to identify patients who will suffer a particularly aggressive course, but also to accurately select patients for clinical trials from which they will most benefit. Design The following review was undertaken to describe prognostic factors in DLBCL, with emphasis on markers that are accurate, relatively available, and clinically applicable in 2014. Results The International Prognostic Index retains its validity in the era of RCHOP, although with limited ability to predict those with DLBCL and led to the development of immunohistochemistry (IHC) algorithms that are in routine practice. Identification of a ‘double-hit’ (DH) lymphoma by fluorescent in situ hybridization with aberrations involving MYC and/or BCL2 and BCL6 genes has important implications due to its extremely dismal prognosis with RCHOP. Other markers such as the absolute lymphocyte count (ALC), serum immunoglobulin free light chains, vitamin D levels, serum cytokines/chemokines, and imaging with positron emission tomography (PET) have all shown promise as future predictive/prognostic tests. Conclusions The future for new treatment options in DLBCL is promising with current clinical trials testing novel targeted agents such as bortezomib, lenalidomide, and ibrutinib as the ‘X’ in R(X)CHOP. Predictive factors are required to select and randomize patients appropriately for these trials. We envision the day when ‘X’ will be chosen based on the biological characteristics of the tumor. PMID:24625454

  9. ¹⁸F-FDG PET/CT: a review of diagnostic and prognostic features in multiple myeloma and related disorders.

    Science.gov (United States)

    Dammacco, Franco; Rubini, Giuseppe; Ferrari, Cristina; Vacca, Angelo; Racanelli, Vito

    2015-02-01

    Conventional radiographic skeletal survey has been for many years the gold standard to detect the occurrence of osteolytic lesions in patients with multiple myeloma (MM). However, the introduction of more sensitive imaging procedures has resulted in an updated anatomic and functional Durie and Salmon "plus" staging system and has remarkably changed the diagnostic and prognostic approach to this tumor. It is now established that (18)fluorine-fluorodeoxyglucose ((18)F-FDG) positron-emission tomography (PET) combined with low-dose computed tomography (CT), shortly designated PET/CT, exhibits a higher screening and diagnostic sensitivity and specificity over the skeleton X-ray. In patients with monoclonal gammopathy of undetermined significance and in those with smoldering MM, PET/CT is consistently unable to detect focal and/or diffuse marrow abnormalities. Conversely, based on a systematic review of 18 studies comprising almost 800 MM patients, PET/CT was able to detect MM osteolytic lesions with a sensitivity of approximately 80-90% and a specificity of 80-100%. Importantly, a poor degree of concordance has also been emphasized between PET/CT and whole-body magnetic resonance imaging (WB-MRI) in that when both techniques were applied to the same patients, double-positive results were recorded in approximately 30% of the cases, but in the majority of them, a higher number of lesions were revealed with PET/CT than with MRI. Double-negative results, on the other hand, were found in about 22% of the patients. Because PET/CT is able to identify tumor foci throughout the body, it can be usefully applied to the study of solitary bone plasmacytoma and extra-medullary plasmacytoma: In both conditions, the detection of additional, previously overlooked sites of skeletal involvement would falsify the diagnosis of single-district disease, upstage the tumor, and therefore require a different therapeutic approach. In addition, although PET/CT is poorly sensitive to diffuse bone

  10. Obstetric Outcomes in Adolescents Related to Body Mass Index and Compared with Low-Risk Adult Women.

    Science.gov (United States)

    Ramö Isgren, Anna; Kjølhede, Preben; Blomberg, Marie

    2017-05-01

    To evaluate in adolescents the association between body mass index (BMI) and obstetric outcomes and to determine whether the outcomes in the BMI groups of adolescents differ from those of a low-risk population of adult women. This is a nationwide population-based register study. Obstetric outcomes of 31,386 singleton primiparous adolescents were evaluated in relation to BMI classes. Furthermore, the outcomes of the adolescents and 178,844 normal weight, nonsmoking, singleton primiparous women, 25-29 years old with no known comorbidity, defined as standard women, were compared. Multiple logistic regression models were used. Results are presented as crude odds ratios (ORs) or adjusted ORs and with a 95% confidence interval. Compared with normal weight adolescents, obese adolescents had a lower chance of a normal vaginal delivery (VD)-76% versus 85% [adjusted OR 0.61 (0.55-0.68)], a higher risk for acute cesarean section (CS)-8.9% versus 4.5% [adjusted OR 2.45 (2.08-2.88)], and stillbirth-0.7% versus 0.2% [adjusted OR 3.17 (1.74-5.77)]. Compared with standard women, overweight adolescents had a higher chance of a normal VD-82% versus 75% [crude OR 1.53 (1.44-1.64)] and a lower risk for acute CS-6.3% versus 7.1% [crude OR 0.85 (0.76-0.95)]. Obese adolescents had a lower risk for instrumental VD-8% versus 13% [crude OR 0.61 (0.53-0.71)] and obstetric anal sphincter injury-1% versus 3% [crude OR 0.38 (0.26-0.57)]. Several adverse obstetric outcomes were obesity related among adolescents. Overweight adolescents seemed to have better obstetric outcomes than standard women, something to consider when optimizing resources for women during pregnancy and delivery.

  11. Cfh genotype interacts with dietary glycemic index to modulate age-related macular degeneration-like features in mice.

    Science.gov (United States)

    Rowan, Sheldon; Weikel, Karen; Chang, Min-Lee; Nagel, Barbara A; Thinschmidt, Jeffrey S; Carey, Amanda; Grant, Maria B; Fliesler, Steven J; Smith, Donald; Taylor, Allen

    2014-01-23

    Age-related macular degeneration (AMD) is a leading cause of visual impairment worldwide. Genetics and diet contribute to the relative risk for developing AMD, but their interactions are poorly understood. Genetic variations in Complement Factor H (CFH), and dietary glycemic index (GI) are major risk factors for AMD. We explored the effects of GI on development of early AMD-like features and changes to central nervous system (CNS) inflammation in Cfh-null mice. Aged 11-week-old wild type (WT) C57Bl/6J or Cfh-null mice were group pair-fed high or low GI diets for 33 weeks. At 10 months of age, mice were evaluated for early AMD-like features in the neural retina and RPE by light and electron microscopy. Brains were analyzed for Iba1 macrophage/microglia immunostaining, an indicator of inflammation. The 10-month-old WT mice showed no retinal abnormalities on either diet. The Cfh-null mice, however, showed distinct early AMD-like features in the RPE when fed a low GI diet, including vacuolation, disruption of basal infoldings, and increased basal laminar deposits. The Cfh-null mice also showed thinning of the RPE, hypopigmentation, and increased numbers of Iba1-expressing macrophages in the brain, irrespective of diet. The presence of early AMD-like features by 10 months of age in Cfh-null mice fed a low GI diet is surprising, given the apparent protection from the development of such features in aged WT mice or humans consuming lower GI diets. Our findings highlight the need to consider gene-diet interactions when developing animal models and therapeutic approaches to treat AMD.

  12. Greater body mass index is related to greater self-identified cold tolerance and greater insensible body mass loss.

    Science.gov (United States)

    Jung, Dahee; Kim, Dami; Park, Joonhee; Lee, Joo Young

    2016-08-22

    Insensible body mass loss (IBL) from the human body continuously occurs, which is an important component in body heat exchange. The purpose of this study was to examine the relevance of IBL to anthropometric characteristics and self-identified thermal tolerance. A total of 289 healthy young Korean males were chosen and sorted into the following three groups: heat tolerable only (HTO, N = 79), cold tolerable only (CTO, N = 104), neither heat nor cold tolerable (NHC, N = 106). They weighed before and after a 30-min rest under lightly clothed condition at an air temperature of 23 ± 1 °C with a relative humidity 55 ± 5 %RH. (1) The IBL of 289 males had a mean of 90 ± 75 g h(-1) (48 ± 40 g h(-1) m(-2)); (2) No significant difference in IBL among the three groups were found; (3) Significant differences in body weight and body mass index (BMI) among three groups were found (P body surface area (P = 0.059); (4) CTO was approximately 4.1 kg heavier in body weight (P body surface area. For healthy young males within normal anthropometric ranges in Korea, IBL was positively related to BMI, and individuals with greater BMI showed greater self-identified cold tolerance, but no direct relationship was found between IBL and self-identified cold tolerance. This suggests that body physique (e.g., BMI) could be an explanatory factor between insensible body heat loss and subjective cognition on cold tolerance.

  13. Is improvement in the Healthy Food Intake Index (HFII) related to a lower risk for gestational diabetes?

    Science.gov (United States)

    Meinilä, Jelena; Valkama, Anita; Koivusalo, Saila B; Stach-Lempinen, Beata; Rönö, Kristiina; Lindström, Jaana; Kautiainen, Hannu; Eriksson, Johan G; Erkkola, Maijaliisa

    2017-04-01

    The aim was to analyse whether changes in the Healthy Food Intake Index (HFII) during pregnancy are related to gestational diab