Some computer simulations based on the linear relative risk model

International Nuclear Information System (INIS)

Gilbert, E.S.

1991-10-01

This report presents the results of computer simulations designed to evaluate and compare the performance of the likelihood ratio statistic and the score statistic for making inferences about the linear relative risk mode. The work was motivated by data on workers exposed to low doses of radiation, and the report includes illustration of several procedures for obtaining confidence limits for the excess relative risk coefficient based on data from three studies of nuclear workers. The computer simulations indicate that with small sample sizes and highly skewed dose distributions, asymptotic approximations to the score statistic or to the likelihood ratio statistic may not be adequate. For testing the null hypothesis that the excess relative risk is equal to zero, the asymptotic approximation to the likelihood ratio statistic was adequate, but use of the asymptotic approximation to the score statistic rejected the null hypothesis too often. Frequently the likelihood was maximized at the lower constraint, and when this occurred, the asymptotic approximations for the likelihood ratio and score statistics did not perform well in obtaining upper confidence limits. The score statistic and likelihood ratio statistics were found to perform comparably in terms of power and width of the confidence limits. It is recommended that with modest sample sizes, confidence limits be obtained using computer simulations based on the score statistic. Although nuclear worker studies are emphasized in this report, its results are relevant for any study investigating linear dose-response functions with highly skewed exposure distributions. 22 refs., 14 tabs

Economic inequality increases risk taking.

Science.gov (United States)

Payne, B Keith; Brown-Iannuzzi, Jazmin L; Hannay, Jason W

2017-05-02

Rising income inequality is a global trend. Increased income inequality has been associated with higher rates of crime, greater consumer debt, and poorer health outcomes. The mechanisms linking inequality to poor outcomes among individuals are poorly understood. This research tested a behavioral account linking inequality to individual decision making. In three experiments ( n = 811), we found that higher inequality in the outcomes of an economic game led participants to take greater risks to try to achieve higher outcomes. This effect of unequal distributions on risk taking was driven by upward social comparisons. Next, we estimated economic risk taking in daily life using large-scale data from internet searches. Risk taking was higher in states with greater income inequality, an effect driven by inequality at the upper end of the income distribution. Results suggest that inequality may promote poor outcomes, in part, by increasing risky behavior.

An SDP Approach for Multiperiod Mixed 0–1 Linear Programming Models with Stochastic Dominance Constraints for Risk Management

DEFF Research Database (Denmark)

Escudero, Laureano F.; Monge, Juan Francisco; Morales, Dolores Romero

2015-01-01

In this paper we consider multiperiod mixed 0–1 linear programming models under uncertainty. We propose a risk averse strategy using stochastic dominance constraints (SDC) induced by mixed-integer linear recourse as the risk measure. The SDC strategy extends the existing literature to the multist...

Non-linear models for the relation between cardiovascular risk factors and intake of wine, beer and spirits.

Science.gov (United States)

Ambler, Gareth; Royston, Patrick; Head, Jenny

2003-02-15

It is generally accepted that moderate consumption of alcohol is associated with a reduced risk of coronary heart disease (CHD). It is not clear however whether this benefit is derived through the consumption of a specific beverage type, for example, wine. In this paper the associations between known CHD risk factors and different beverage types are investigated using a novel approach with non-linear modelling. Two types of model are proposed which are designed to detect differential effects of beverage type. These may be viewed as extensions of Box and Tidwell's power-linear model. The risk factors high density lipoprotein cholesterol, fibrinogen and systolic blood pressure are considered using data from a large longitudinal study of British civil servants (Whitehall II). The results for males suggest that gram for gram of alcohol, the effect of wine differs from that of beer and spirits, particularly for systolic blood pressure. In particular increasing wine consumption is associated with slightly more favourable levels of all three risk factors studied. For females there is evidence of a differential relationship only for systolic blood pressure. These findings are tentative but suggest that further research is required to clarify the similarities and differences between the results for males and females and to establish whether either of the models is the more appropriate. However, having clarified these issues, the apparent benefit of consuming wine instead of other alcoholic beverages may be relatively small. Copyright 2003 John Wiley & Sons, Ltd.

Increasing resilience through participative flood risk map design

Science.gov (United States)

Fuchs, Sven; Spira, Yvonne; Stickler, Therese

2013-04-01

In recent years, an increasing number of flood hazards has shown to the European Commission and the Member States of the European Union the importance of flood risk management strategies in order to reduce losses and to protect the environment and the citizens. Exposure to floods as well as flood vulnerability might increase across Europe due to the ongoing economic development in many EU countries. Thus even without taking climate change into account an increase of flood disasters in Europe might be foreseeable. These circumstances have produced a reaction in the European Commission, and a Directive on the Assessment and Management of Flood Risks was issued as one of the three components of the European Action Programme on Flood Risk Management. Floods have the potential to jeopardise economic development, above all due to an increase of human activities in floodplains and the reduction of natural water retention by land use activities. As a result, an increase in the likelihood and adverse impacts of flood events is expected. Therefore, concentrated action is needed at the European level to avoid severe impacts on human life and property. In order to have an effective tool available for gathering information, as well as a valuable basis for priority setting and further technical, financial and political decisions regarding flood risk mitigation and management, it is necessary to provide for the establishment of flood risk maps which show the potential adverse consequences associated with different flood scenarios. So far, hazard and risk maps are compiled in terms of a top-down linear approach: planning authorities take the responsibility to create and implement these maps on different national and local scales, and the general public will only be informed about the outcomes (EU Floods Directive, Article 10). For the flood risk management plans, however, an "active involvement of interested parties" is required, which means at least some kind of multilateral

Partially linear mixed-effects joint models for skewed and missing longitudinal competing risks outcomes.

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Lu, Tao; Lu, Minggen; Wang, Min; Zhang, Jun; Dong, Guang-Hui; Xu, Yong

2017-12-18

Longitudinal competing risks data frequently arise in clinical studies. Skewness and missingness are commonly observed for these data in practice. However, most joint models do not account for these data features. In this article, we propose partially linear mixed-effects joint models to analyze skew longitudinal competing risks data with missingness. In particular, to account for skewness, we replace the commonly assumed symmetric distributions by asymmetric distribution for model errors. To deal with missingness, we employ an informative missing data model. The joint models that couple the partially linear mixed-effects model for the longitudinal process, the cause-specific proportional hazard model for competing risks process and missing data process are developed. To estimate the parameters in the joint models, we propose a fully Bayesian approach based on the joint likelihood. To illustrate the proposed model and method, we implement them to an AIDS clinical study. Some interesting findings are reported. We also conduct simulation studies to validate the proposed method.

Analyzing systemic risk using non-linear marginal expected shortfall and its minimum spanning tree

Science.gov (United States)

Song, Jae Wook; Ko, Bonggyun; Chang, Woojin

2018-02-01

The aim of this paper is to propose a new theoretical framework for analyzing the systemic risk using the marginal expected shortfall (MES) and its correlation-based minimum spanning tree (MST). At first, we develop two parametric models of MES with their closed-form solutions based on the Capital Asset Pricing Model. Our models are derived from the non-symmetric quadratic form, which allows them to consolidate the non-linear relationship between the stock and market returns. Secondly, we discover the evidences related to the utility of our models and the possible association in between the non-linear relationship and the emergence of severe systemic risk by considering the US financial system as a benchmark. In this context, the evolution of MES also can be regarded as a reasonable proxy of systemic risk. Lastly, we analyze the structural properties of the systemic risk using the MST based on the computed series of MES. The topology of MST conveys the presence of sectoral clustering and strong co-movements of systemic risk leaded by few hubs during the crisis. Specifically, we discover that the Depositories are the majority sector leading the connections during the Non-Crisis period, whereas the Broker-Dealers are majority during the Crisis period.

Increasing Linear Dynamic Range of a CMOS Image Sensor

Science.gov (United States)

Pain, Bedabrata

2007-01-01

A generic design and a corresponding operating sequence have been developed for increasing the linear-response dynamic range of a complementary metal oxide/semiconductor (CMOS) image sensor. The design provides for linear calibrated dual-gain pixels that operate at high gain at a low signal level and at low gain at a signal level above a preset threshold. Unlike most prior designs for increasing dynamic range of an image sensor, this design does not entail any increase in noise (including fixed-pattern noise), decrease in responsivity or linearity, or degradation of photometric calibration. The figure is a simplified schematic diagram showing the circuit of one pixel and pertinent parts of its column readout circuitry. The conventional part of the pixel circuit includes a photodiode having a small capacitance, CD. The unconventional part includes an additional larger capacitance, CL, that can be connected to the photodiode via a transfer gate controlled in part by a latch. In the high-gain mode, the signal labeled TSR in the figure is held low through the latch, which also helps to adapt the gain on a pixel-by-pixel basis. Light must be coupled to the pixel through a microlens or by back illumination in order to obtain a high effective fill factor; this is necessary to ensure high quantum efficiency, a loss of which would minimize the efficacy of the dynamic- range-enhancement scheme. Once the level of illumination of the pixel exceeds the threshold, TSR is turned on, causing the transfer gate to conduct, thereby adding CL to the pixel capacitance. The added capacitance reduces the conversion gain, and increases the pixel electron-handling capacity, thereby providing an extension of the dynamic range. By use of an array of comparators also at the bottom of the column, photocharge voltages on sampling capacitors in each column are compared with a reference voltage to determine whether it is necessary to switch from the high-gain to the low-gain mode. Depending upon

A Western Dietary Pattern Increases Prostate Cancer Risk: A Systematic Review and Meta-Analysis.

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Fabiani, Roberto; Minelli, Liliana; Bertarelli, Gaia; Bacci, Silvia

2016-10-12

Dietary patterns were recently applied to examine the relationship between eating habits and prostate cancer (PC) risk. While the associations between PC risk with the glycemic index and Mediterranean score have been reviewed, no meta-analysis is currently available on dietary patterns defined by "a posteriori" methods. A literature search was carried out (PubMed, Web of Science) to identify studies reporting the relationship between dietary patterns and PC risk. Relevant dietary patterns were selected and the risks estimated were calculated by a random-effect model. Multivariable-adjusted odds ratios (ORs), for a first-percentile increase in dietary pattern score, were combined by a dose-response meta-analysis. Twelve observational studies were included in the meta-analysis which identified a "Healthy pattern" and a "Western pattern". The Healthy pattern was not related to PC risk (OR = 0.96; 95% confidence interval (CI): 0.88-1.04) while the Western pattern significantly increased it (OR = 1.34; 95% CI: 1.08-1.65). In addition, the "Carbohydrate pattern", which was analyzed in four articles, was positively associated with a higher PC risk (OR = 1.64; 95% CI: 1.35-2.00). A significant linear trend between the Western ( p = 0.011) pattern, the Carbohydrate ( p = 0.005) pattern, and the increment of PC risk was observed. The small number of studies included in the meta-analysis suggests that further investigation is necessary to support these findings.

Ten Years Experience In Geo-Databases For Linear Facilities Risk Assessment (Lfra)

Science.gov (United States)

Oboni, F.

2003-04-01

Keywords: geo-environmental, database, ISO14000, management, decision-making, risk, pipelines, roads, railroads, loss control, SAR, hazard identification ABSTRACT: During the past decades, characterized by the development of the Risk Management (RM) culture, a variety of different RM models have been proposed by governmental agencies in various parts of the world. The most structured models appear to have originated in the field of environmental RM. These models are briefly reviewed in the first section of the paper focusing the attention on the difference between Hazard Management and Risk Management and the need to use databases in order to allow retrieval of specific information and effective updating. The core of the paper reviews a number of different RM approaches, based on extensions of geo-databases, specifically developed for linear facilities (LF) in transportation corridors since the early 90s in Switzerland, Italy, Canada, the US and South America. The applications are compared in terms of methodology, capabilities and resources necessary to their implementation. The paper then focuses the attention on the level of detail that applications and related data have to attain. Common pitfalls related to decision making based on hazards rather than on risks are discussed. The paper focuses the last sections on the description of the next generation of linear facility RA application, including examples of results and discussion of future methodological research. It is shown that geo-databases should be linked to loss control and accident reports in order to maximize their benefits. The links between RA and ISO 14000 (environmental management code) are explicitly considered.

Cross-sectional area of the murine aorta linearly increases with increasing core body temperature.

Science.gov (United States)

Crouch, A Colleen; Manders, Adam B; Cao, Amos A; Scheven, Ulrich M; Greve, Joan M

2017-11-06

The cardiovascular (CV) system plays a vital role in thermoregulation. To date, the response of core vasculature to increasing core temperature has not been adequately studied in vivo. Our objective was to non-invasively quantify the arterial response in murine models due to increases in body temperature, with a focus on core vessels of the torso and investigate whether responses were dependent on sex or age. Male and female, adult and aged mice were anaesthetised and underwent magnetic resonance imaging (MRI). Data were acquired from the circle of Willis (CoW), heart, infrarenal aorta and peripheral arteries at core temperatures of 35, 36, 37 and 38 °C (±0.2 °C). Vessels in the CoW did not change. Ejection fraction decreased and cardiac output (CO) increased with increasing temperature in adult female mice. Cross-sectional area of the aorta increased significantly and linearly with temperature for all groups, but at a diminished rate for aged animals (p temperature are biologically important because they may affect conductive and convective heat transfer. Leveraging non-invasive methodology to quantify sex and age dependent vascular responses due to increasing core temperature could be combined with bioheat modelling in order to improve understanding of thermoregulation.

RISKAP: a computer code for analysis of increased risk to arbitrary populations

International Nuclear Information System (INIS)

Leggett, R.W.

1986-06-01

The computer code RISKAP is used to estimate risk to a population exposed to radioactivity. Risk is measured in terms of the expected number of premature deaths resulting from radiogenic cancers, the number of years of life lost as a result of these deaths, and the average number of years of life lost per premature death. Radiation doses are used to compute an annual, age-specific risk of premature cancer death, based on a dose-response function selected by the user. Calculations of premature radiation deaths, deaths from all causes, and the new age distribution of the population are performed for one-year intervals. RISKAP has been designed to accommodate latency and plateau periods that vary with age at exposure and risk functions that vary with age at exposure as well as time after exposure. RISKAP allows the use of a linear, quadratic, or linear-quadratic dose-response function, although the code is structured so that the user may include an exponential factor or substitute any preferred dose-response function

A High Performance Silicon-on-Insulator LDMOSTT Using Linearly Increasing Thickness Techniques

International Nuclear Information System (INIS)

Yu-Feng, Guo; Zhi-Gong, Wang; Gene, Sheu; Jian-Bing, Cheng

2010-01-01

We present a new technique to achieve uniform lateral electric field and maximum breakdown voltage in lateral double-diffused metal-oxide-semiconductor transistors fabricated on silicon-on-insulator substrates. A linearly increasing drift-region thickness from the source to the drain is employed to improve the electric field distribution in the devices. Compared to the lateral linear doping technique and the reduced surface field technique, two-dimensional numerical simulations show that the new device exhibits reduced specific on-resistance, maximum off- and on-state breakdown voltages, superior quasi-saturation characteristics and improved safe operating area. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

Sweetened beverage consumption and increased risk of metabolic syndrome in Mexican adults.

Science.gov (United States)

Denova-Gutiérrez, Edgar; Talavera, Juan O; Huitrón-Bravo, Gerardo; Méndez-Hernández, Pablo; Salmerón, Jorge

2010-06-01

To examine the relationship between sweetened beverage consumption and components of the metabolic syndrome in a Mexican population. We performed a cross-sectional analysis of data from selected adults participating in the baseline assessment of the Health Workers Cohort Study. Information on participants' sociodemographic characteristics, dietary patterns and physical activity were collected via self-administered questionnaires. Sweetened beverage consumption was evaluated through a validated semi-quantitative FFQ. Anthropometric and clinical measures were assessed with standardized procedures. The definition of metabolic syndrome was determined using criteria from the National Cholesterol Education Program Adult Treatment Panel III. The associations of interest were evaluated by means of linear and logistic regression models. The Mexican states of Morelos and Mexico. A total of 5240 individuals aged 20 to 70 years (mean 39.4 (sd 11.5) years) were evaluated. Overweight/obesity prevalence was 56.6 %. The prevalence of metabolic syndrome in this sample was 26.6 %. We found that for each additional daily sweetened beverage serving consumed, participants experienced an average increase of 0.49 mmol/l in TAG and a decrease in HDL cholesterol of 0.31 mmol/l. Subjects consuming more than two servings of sweetened beverages daily were at 2.0 times greater risk of metabolic syndrome than those who did not consume sweetened beverages. We also observed that higher sweetened beverage consumption increased the risk of all components of the metabolic syndrome. Our data support the hypothesis that sweetened beverage consumption increases the risk of metabolic syndrome in Mexican adults, possibly by providing excess energy and large amounts of rapidly absorbable sugars.

INFORMATION SECURITY RISKS OPTIMIZATION IN CLOUDY SERVICES ON THE BASIS OF LINEAR PROGRAMMING

Directory of Open Access Journals (Sweden)

I. A. Zikratov

2013-01-01

Full Text Available The paper discusses theoretical aspects of secure cloud services creation for information processing of various confidentiality degrees. A new approach to the reasoning of information security composition in distributed computing structures is suggested, presenting the problem of risk assessment as an extreme problem of decisionmaking. Linear programming method application is proved to minimize the risk of information security for given performance security in compliance with the economic balance for the maintenance of security facilities and cost of services. An example is given to illustrate the obtained theoretical results.

The increased risk of predation enhances cooperation

Science.gov (United States)

Krams, Indrikis; Bērziņš, Arnis; Krama, Tatjana; Wheatcroft, David; Igaune, Kristīne; Rantala, Markus J.

2010-01-01

Theory predicts that animals in adverse conditions can decrease individual risks and increase long-term benefits by cooperating with neighbours. However, some empirical studies suggest that animals often focus on short-term benefits, which can reduce the likelihood that they will cooperate with others. In this experimental study, we tested between these two alternatives by evaluating whether increased predation risk (as a correlate of environmental adversity) enhances or diminishes the occurrence of cooperation in mobbing, a common anti-predator behaviour, among breeding pied flycatchers Ficedula hypoleuca. We tested whether birds would join their mobbing neighbours more often and harass a stuffed predator placed near their neighbours' nests more intensely in areas with a higher perceived risk of predation. Our results show that birds attended mobs initiated by their neighbours more often, approached the stuffed predator significantly more closely, and mobbed it at a higher intensity in areas where the perceived risk of predation was experimentally increased. In such high-risk areas, birds also were more often involved in between-pair cooperation. This study demonstrates the positive impact of predation risk on cooperation in breeding songbirds, which might help in explaining the emergence and evolution of cooperation. PMID:19846454

Modified ocean circulation, albedo instability and ice-flow instability. Risks of non-linear climate change

Energy Technology Data Exchange (ETDEWEB)

Ham, J. van; Beer, R.J. van; Builtjes, P.J.H.; Roemer, M.G.M. [TNO Inst. of Environmental Sciences, Delft (Netherlands); Koennen, G.P. [KNMI, Royal Netherlands Meteorological Inst., de Bilt (Netherlands); Oerlemans, J. [Utrecht Univ. (Netherlands). Inst. for Meteorological and Atmospheric Research

1995-12-31

In this presentation part of an investigation is described into risks for climate change which are presently not adequately covered in General Circulation Models. In the concept of climate change as a result of the enhanced greenhouse effect it is generally assumed that the radiative forcings from increased concentrations of greenhouse gases (GHG) will result in a proportional or quasilinear global warming. Though correlations of this kind are known from palaeoclimate research, the variability of the climate seems to prevent the direct proof of a causal relation between recent greenhouse gas concentrations and temperature observations. In order to resolve the issue the use of General Circulation Models (GCMs), though still inadequate at present, is indispensable. Around the world some 10 leading GCMs exist which have been the subject of evaluation and intercomparison in a number of studies. Their results are regularly assessed in the IPCC process. A discussion on their performance in simulating present or past climates and the causes of their weak points shows that the depiction of clouds is a major weakness of GCMs. A second element which is virtually absent in GCMs are the feedbacks from natural biogeochemical cycles. These cycles are influenced by man in a number of ways. GCMs have a limited performance in simulating regional effects on climate. Moreover, albedo instability, in part due to its interaction with cloudiness, is only roughly represented. Apparently, not all relevant processes have been included in the GCMs. That situation constitutes a risk, since it cannot be ruled out that a missing process could cause or trigger a non-linear climate change. In the study non-linear climate change is connected with those processes which could provide feedbacks with a risk for non-monotonous or discontinuous behaviour of the climate system, or which are unpredictable or could cause rapid transitions

Modified ocean circulation, albedo instability and ice-flow instability. Risks of non-linear climate change

Energy Technology Data Exchange (ETDEWEB)

Ham, J van; Beer, R.J. van; Builtjes, P J.H.; Roemer, M G.M. [TNO Inst. of Environmental Sciences, Delft (Netherlands); Koennen, G P [KNMI, Royal Netherlands Meteorological Inst., de Bilt (Netherlands); Oerlemans, J [Utrecht Univ. (Netherlands). Inst. for Meteorological and Atmospheric Research

1996-12-31

In this presentation part of an investigation is described into risks for climate change which are presently not adequately covered in General Circulation Models. In the concept of climate change as a result of the enhanced greenhouse effect it is generally assumed that the radiative forcings from increased concentrations of greenhouse gases (GHG) will result in a proportional or quasilinear global warming. Though correlations of this kind are known from palaeoclimate research, the variability of the climate seems to prevent the direct proof of a causal relation between recent greenhouse gas concentrations and temperature observations. In order to resolve the issue the use of General Circulation Models (GCMs), though still inadequate at present, is indispensable. Around the world some 10 leading GCMs exist which have been the subject of evaluation and intercomparison in a number of studies. Their results are regularly assessed in the IPCC process. A discussion on their performance in simulating present or past climates and the causes of their weak points shows that the depiction of clouds is a major weakness of GCMs. A second element which is virtually absent in GCMs are the feedbacks from natural biogeochemical cycles. These cycles are influenced by man in a number of ways. GCMs have a limited performance in simulating regional effects on climate. Moreover, albedo instability, in part due to its interaction with cloudiness, is only roughly represented. Apparently, not all relevant processes have been included in the GCMs. That situation constitutes a risk, since it cannot be ruled out that a missing process could cause or trigger a non-linear climate change. In the study non-linear climate change is connected with those processes which could provide feedbacks with a risk for non-monotonous or discontinuous behaviour of the climate system, or which are unpredictable or could cause rapid transitions

High Birth Weight Increases the Risk for Bone Tumor: A Systematic Review and Meta-Analysis

Directory of Open Access Journals (Sweden)

Songfeng Chen

2015-09-01

Full Text Available There have been several epidemiologic studies on the relationship between high birth weight and the risk for bone tumor in the past decades. However, due to the rarity of bone tumors, the sample size of individual studies was generally too small for reliable conclusions. Therefore, we have performed a meta-analysis to pool all published data on electronic databases with the purpose to clarify the potential relationship. According to the inclusion and exclusion criteria, 18 independent studies with more than 2796 cases were included. As a result, high birth weight was found to increase the risk for bone tumor with an Odds Ratio (OR of 1.13, with the 95% confidence interval (95% CI ranging from 1.01 to 1.27. The OR of bone tumor for an increase of 500 gram of birth weight was 1.01 (95% CI 1.00–1.02; p = 0.048 for linear trend. Interestingly, individuals with high birth weight had a greater risk for osteosarcoma (OR = 1.22, 95% CI 1.06–1.40, p = 0.006 than those with normal birth weight. In addition, in the subgroup analysis by geographical region, elevated risk was detected among Europeans (OR = 1.14, 95% CI 1.00–1.29, p = 0.049. The present meta-analysis supported a positive association between high birth weight and bone tumor risk.

Impact of Crack on Stability of Slope with Linearly Increasing Undrained Strength

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Bing Li

2018-01-01

Full Text Available This paper presents a procedure for assessment of the impact of tension crack on stability of slope in clays with linearly increasing undrained strength. The procedure is based on the limit equilibrium method with variational extremization. The distribution of the normal stress over slip surface is mathematically obtained for slopes in clays with the linearly increasing undrained strength and then used to determine the tension crack for clays with zero tensile strength. The seismic effect is also included using the pseudostatic approach. Closed-form solutions to the minimum safety factor and the maximum crack depth can be derived and given in the form of chart for convenient use. The results demonstrate a significant effect of the tension crack on the stability of steep slopes, especially for strong seismic conditions. In this situation, neglecting the impact of tension crack in traditional ϕ=0 analyses may overestimate the slope safety. The most adverse location of the tension crack can be also determined and presented in the charts, which may be useful in designing reinforcements and remedial measures for slope stabilization.

New Inference Procedures for Semiparametric Varying-Coefficient Partially Linear Cox Models

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Yunbei Ma

2014-01-01

Full Text Available In biomedical research, one major objective is to identify risk factors and study their risk impacts, as this identification can help clinicians to both properly make a decision and increase efficiency of treatments and resource allocation. A two-step penalized-based procedure is proposed to select linear regression coefficients for linear components and to identify significant nonparametric varying-coefficient functions for semiparametric varying-coefficient partially linear Cox models. It is shown that the penalized-based resulting estimators of the linear regression coefficients are asymptotically normal and have oracle properties, and the resulting estimators of the varying-coefficient functions have optimal convergence rates. A simulation study and an empirical example are presented for illustration.

Nine-year risk of depression diagnosis increases with increasing self-reported concussions in retired professional football players.

Science.gov (United States)

Kerr, Zachary Y; Marshall, Stephen W; Harding, Herndon P; Guskiewicz, Kevin M

2012-10-01

Concussions may accelerate the progression to long-term mental health outcomes such as depression in athletes. To prospectively determine the effects of recurrent concussions on the clinical diagnosis of depression in a group of retired football players. Cohort study; Level of evidence, 2. Members of the National Football League Retired Players Association responded to a baseline General Health Survey (GHS) in 2001. They also completed a follow-up survey in 2010. Both surveys asked about demographic information, number of concussions sustained during their professional football career, physical/mental health, and prevalence of diagnosed medical conditions. A physical component summary (Short Form 36 Measurement Model for Functional Assessment of Health and Well-Being [SF-36 PCS]) was calculated from responses for physical health. The main exposure, the history of concussions during the professional playing career (self-report recalled in 2010), was stratified into 5 categories: 0 (referent), 1 to 2, 3 to 4, 5 to 9, and 10+ concussions. The main outcome was a clinical diagnosis of depression between the baseline and follow-up GHS. Classic tabular methods computed crude risk ratios. Binomial regression with a Poisson residual and robust variance estimation to stabilize the fitting algorithm estimated adjusted risk ratios. χ(2) analyses identified associations and trends between concussion history and the 9-year risk of a depression diagnosis. Of the 1044 respondents with complete data from the baseline and follow-up GHS, 106 (10.2%) reported being clinically diagnosed as depressed between the baseline and follow-up GHS. Approximately 65% of all respondents self-reported sustaining at least 1 concussion during their professional careers. The 9-year risk of a depression diagnosis increased with an increasing number of self-reported concussions, ranging from 3.0% in the "no concussions" group to 26.8% in the "10+" group (linear trend: P football and 2001 SF-36 PCS

Rare disaster information can increase risk-taking

Science.gov (United States)

Newell, Ben R.; Rakow, Tim; Yechiam, Eldad; Sambur, Michael

2016-02-01

The recent increase in the frequency and impact of natural disasters highlights the need to provide the public with accurate information concerning disaster prevalence. Most approaches to this problem assume that providing summaries of the nature and scale of disasters will lead people to reduce their exposure to risk. Here we present experimental evidence that such ex post `news reports’ of disaster occurrences can increase the tolerance for risk-taking (which implies that rare events are underweighted). This result is robust across several hundred rounds of choices in a simulated microworld, persists even when the long-run expected value of risky choices is substantially lower than safe choices, and is contingent on providing risk information about disasters that have been (personally) experienced and those that have been avoided (`forgone’ outcomes). The results suggest that augmenting personal experience with information summaries of the number of adverse events (for example, storms, floods) in different regions may, paradoxically, increase the appeal of a disaster-prone region. This finding implies a need to communicate long-term trends in severe climatic events, thereby reinforcing the accumulation of events, and the increase in their associated risks, across time.

Use of an operating microscope during spine surgery is associated with minor increases in operating room times and no increased risk of infection.

Science.gov (United States)

Basques, Bryce A; Golinvaux, Nicholas S; Bohl, Daniel D; Yacob, Alem; Toy, Jason O; Varthi, Arya G; Grauer, Jonathan N

2014-10-15

Retrospective database review. To evaluate whether microscope use during spine procedures is associated with increased operating room times or increased risk of infection. Operating microscopes are commonly used in spine procedures. It is debated whether the use of an operating microscope increases operating room time or confers increased risk of infection. The American College of Surgeons National Surgical Quality Improvement Program database, which includes data from more than 370 participating hospitals, was used to identify patients undergoing elective spinal procedures with and without the use of an operating microscope for the years 2011 and 2012. Bivariate and multivariate linear regressions were used to test the association between microscope use and operating room times. Bivariate and multivariate logistic regressions were similarly conducted to test the association between microscope use and infection occurrence within 30 days of surgery. A total of 23,670 elective spine procedures were identified, of which 2226 (9.4%) used an operating microscope. The average patient age was 55.1±14.4 years. The average operative time (incision to closure) was 125.7±82.0 minutes.Microscope use was associated with minor increases in preoperative room time (+2.9 min, P=0.013), operative time (+13.2 min, Pmicroscope and nonmicroscope groups for occurrence of any infection, superficial surgical site infection, deep surgical site infection, organ space infection, or sepsis/septic shock, regardless of surgery type. We did not find operating room times or infection risk to be significant deterrents for use of an operating microscope during spine surgery. 3.

Multiple Sclerosis Increases Fracture Risk: A Meta-Analysis

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Guixian Dong

2015-01-01

Full Text Available Purpose. The association between multiple sclerosis (MS and fracture risk has been reported, but results of previous studies remain controversial and ambiguous. To assess the association between MS and fracture risk, a meta-analysis was performed. Method. Based on comprehensive searches of the PubMed, Embase, and Web of Science, we identified outcome data from all articles estimating the association between MS and fracture risk. The pooled risk ratios (RRs with 95% confidence intervals (CIs were calculated. Results. A significant association between MS and fracture risk was found. This result remained statistically significant when the adjusted RRs were combined. Subgroup analysis stratified by the site of fracture suggested significant associations between MS and tibia fracture risk, femur fracture risk, hip fracture risk, pelvis fracture risk, vertebrae fracture risk, and humerus fracture risk. In the subgroup analysis by gender, female MS patients had increased fracture risk. When stratified by history of drug use, use of antidepressants, hypnotics/anxiolytics, anticonvulsants, and glucocorticoids increased the risk of fracture risk in MS patients. Conclusions. This meta-analysis demonstrated that MS was significantly associated with fracture risk.

Increased health risk in subjects with high self-reported seasonality.

Directory of Open Access Journals (Sweden)

Nicolas M Øyane

Full Text Available BACKGROUND: Seasonal variations in mood and behaviour, termed seasonality, are commonly reported in the general population. As a part of a large cross-sectional health survey in Hordaland, Norway, we investigated the relationship between seasonality, objective health measurements and health behaviours. METHODOLOGY/PRINCIPAL FINDINGS: A total of 11,545 subjects between 40-44 years old participated, completing the Global Seasonality Score, measuring seasonality. Waist/hip circumference, BMI and blood pressure were measured, and blood samples were analyzed for total cholesterol, HDL cholesterol, triglycerides and glucose. Subjects also completed a questionnaire on miscellaneous health behaviours (exercise, smoking, alcohol consumption. Hierarchical linear regression analyses were used to investigate associations between seasonality and objective health measurements, while binary logistic regression was used for analysing associations between seasonality and health behaviours. Analyses were adjusted for sociodemographic factors, month of questionnaire completion and sleep duration. Seasonality was positively associated with high waist-hip-ratio, BMI, triglyceride levels, and in men high total cholesterol. Seasonality was negatively associated with HDL cholesterol. In women seasonality was negatively associated with prevalence of exercise and positively associated with daily cigarette smoking. CONCLUSIONS/SIGNIFICANCE: High seasonality was associated with objective health risk factors and in women also with health behaviours associated with an increased risk for cardiovascular disease.

Low dose diagnostic radiation does not increase cancer risk in cancer prone mice

Energy Technology Data Exchange (ETDEWEB)

Boreham, D., E-mail: dboreham@nosm.ca [Northern Ontario School of Medicine, ON (Canada); Phan, N., E-mail: nghiphan13@yahoo.com [Univ. of Ottawa, Ottawa, ON (Canada); Lemon, J., E-mail: lemonja@mcmaster.ca [McMaster Univ., Hamilton, ON (Canada)

2014-07-01

The increased exposure of patients to low dose diagnostic ionizing radiation has created concern that these procedures will result in greater risk of carcinogenesis. However, there is substantial evidence that shows in many cases that low dose exposure has the opposite effect. We have investigated whether CT scans can modify mechanisms associated with carcinogenesis in cancer-prone mice. Cancer was induced in Trp53+/- mice with an acute high dose whole-body 4 Gy γ-radiation exposure. Four weeks following the cancer-inducing dose, weekly whole-body CT scans (10 mGy/scan, 75 kVp X-rays) were given for ten consecutive weeks adding an additional radiation burden of 0.1 Gy. Short-term biological responses and subsequent lifetime cancer risk were investigated. Five days following the last CT scan, there were no detectable differences in the spontaneous levels of DNA damage in blood cells (reticulocytes). In fact, CT scanned mice had significantly lower constitutive levels of oxidative DNA damage and cell death (apoptosis), compared to non-CT scanned mice. This shows that multiple low dose radiation exposures modified the radio response and indicates protective processes were induced in mice. In mice treated with the multiple CT scans following the high cancer-inducing 4 Gy dose, tumour latency was increased, significantly prolonging lifespan. We conclude that repeated CT scans can reduce the cancer risk of a prior high-dose radiation exposure, and delay the progression of specific types of radiation-induced cancers in Trp53+/-mice. This research shows for the first time that low dose exposure long after cancer initiation events alter risk and reduce cancer morbidity. Cancer induction following low doses does not follow a linear non-threshold model of risk and this model should not be used to extrapolate risk to humans following low dose exposure to ionizing radiation. (author)

Is use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level

DEFF Research Database (Denmark)

Thorell, Kristine; Ranstad, Karin; Midlöv, Patrik

2014-01-01

BACKGROUND: Risk factors for hip fracture are well studied because of the negative impact on patients and the community, with mortality in the first year being almost 30% in the elderly. Age, gender and fall risk-increasing drugs, identified by the National Board of Health and Welfare in Sweden......, are well known risk factors for hip fracture, but how multimorbidity level affects the risk of hip fracture during use of fall risk-increasing drugs is to our knowledge not as well studied. This study explored the relationship between use of fall risk-increasing drugs in combination with multimorbidity...... level and risk of hip fracture in an elderly population. METHODS: Data were from Östergötland County, Sweden, and comprised the total population in the county aged 75 years and older during 2006. The odds ratio (OR) for hip fracture during use of fall risk-increasing drugs was calculated by multivariate...

Relationship Between Maternal Obesity And Increased Risk Of ...

African Journals Online (AJOL)

Introduction: The incidence of obesity has risen over the past several decades and in spite of advancement in modern medicine, it remains a risk factor for maternal morbidity and mortality. Objective: To determine the association between obesity (increased body mass index) and increased risk of preeclampsia. The possible ...

Adolescent Metabolic Syndrome Risk Is Increased with Higher Infancy Weight Gain and Decreased with Longer Breast Feeding

Directory of Open Access Journals (Sweden)

Kim Khuc

2012-01-01

Full Text Available Background. Prevalence of the metabolic syndrome is increasing in pediatric age groups worldwide. Meeting the criteria for the metabolic syndrome puts children at risk for later cardiovascular and metabolic disease. Methods. Using linear regression, we examined the association between infant weight gain from birth to 3 months and risk for the metabolic syndrome among 16- to 17-year-old Chilean adolescents (n=357, accounting for the extent of breastfeeding in infancy and known covariates including gender, birth weight, and socioeconomic status. Results. Participants were approximately half male (51%, born at 40 weeks of gestation weighing 3.5 kg, and 48% were exclusively breastfed for ≥90 days. Factors independently associated with increased risk of metabolic syndrome in adolescence were faster weight gain in the first 3 months of life (B=0.16, P<0.05 and male gender (B=0.24, P<0.05. Breastfeeding as the sole source of milk for ≥90 days was associated with significantly decreased risk of metabolic syndrome (B=−0.16. Conclusion. This study adds to current knowledge about early infant growth and breastfeeding and their long-term health effects.

Communicating Zika Risk: Using Metaphor to Increase Perceived Risk Susceptibility.

Science.gov (United States)

Lu, Hang; Schuldt, Jonathon P

2018-02-27

Effectively communicating the risks associated with emerging zoonotic diseases remains an important challenge. Drawing on research into the psychological effects of metaphoric framing, we explore the conditions under which exposure to the "nation as a body" metaphor influences perceived risk susceptibility, behavioral intentions, and policy support in the context of Zika virus. In a between-subjects experiment, 354 U.S. adults were randomly assigned to one of four experimental conditions as part of a 2 (severity message: high vs. low) × 2 (U.S. framing: metaphoric vs. literal) design. Results revealed an interaction effect such that metaphoric (vs. literal) framing increased perceived risk susceptibility in the high-severity condition only. Further analyses revealed that perceived risk susceptibility and negative affect mediated the path between the two-way interaction and policy support and behavioral intentions regarding Zika prevention. Overall, these findings complement prior work on the influence of metaphoric framing on risk perceptions, while offering practical insights for risk communicators seeking to communicate about Zika and other zoonotic diseases. © 2018 Society for Risk Analysis.

The linear hypothesis and radiation carcinogenesis

International Nuclear Information System (INIS)

Roberts, P.B.

1981-10-01

An assumption central to most estimations of the carcinogenic potential of low levels of ionising radiation is that the risk always increases in direct proportion to the dose received. This assumption (the linear hypothesis) has been both strongly defended and attacked on several counts. It appears unlikely that conclusive, direct evidence on the validity of the hypothesis will be forthcoming. We review the major indirect arguments used in the debate. All of them are subject to objections that can seriously weaken their case. In the present situation, retention of the linear hypothesis as the basis of extrapolations from high to low dose levels can lead to excessive fears, over-regulation and unnecessarily expensive protection measures. To offset these possibilities, support is given to suggestions urging a cut-off dose, probably some fraction of natural background, below which risks can be deemed acceptable

Pet ownership increases human risk of encountering ticks.

Science.gov (United States)

Jones, E H; Hinckley, A F; Hook, S A; Meek, J I; Backenson, B; Kugeler, K J; Feldman, K A

2018-02-01

We examined whether pet ownership increased the risk for tick encounters and tickborne disease among residents of three Lyme disease-endemic states as a nested cohort within a randomized controlled trial. Information about pet ownership, use of tick control for pets, property characteristics, tick encounters and human tickborne disease were captured through surveys, and associations were assessed using univariate and multivariable analyses. Pet-owning households had 1.83 times the risk (95% CI = 1.53, 2.20) of finding ticks crawling on and 1.49 times the risk (95% CI = 1.20, 1.84) of finding ticks attached to household members compared to households without pets. This large evaluation of pet ownership, human tick encounters and tickborne diseases shows that pet owners, whether of cats or dogs, are at increased risk of encountering ticks and suggests that pet owners are at an increased risk of developing tickborne disease. Pet owners should be made aware of this risk and be reminded to conduct daily tick checks of all household members, including the pets, and to consult their veterinarian regarding effective tick control products. © 2017 Blackwell Verlag GmbH.

Higher consumption of sugar-sweetened soft drinks increases the risk of hyperuricemia in Korean population: The Korean Multi-Rural Communities Cohort Study.

Science.gov (United States)

Bae, Jisuk; Chun, Byung-Yeol; Park, Pil Sook; Choi, Bo Youl; Kim, Mi Kyung; Shin, Min-Ho; Lee, Young-Hoon; Shin, Dong Hoon; Kim, Seong-Kyu

2014-04-01

The clinical implication of sugar-sweetened soft drinks on the risk of hyperuricemia has increased, especially in Western population studies. The aim of this study is to clarify the association between sugar-sweetened soft drinks and fruit drinks made from oranges and apples and the risk of hyperuricemia in the Korean Multi-Rural Communities Cohort. A total of 9400 subjects were enrolled in the Korean Multi-Rural Communities Cohort Study, and a cross-sectional analysis was performed. Five quintiles (Q1-Q5) according to consumption of soft drinks and other fruit/fruit juices were classified and then categorized into three groups (Q1-Q3, Q4, and Q5) to assess the risk of hyperuricemia. Information on dietary intake was collected by well-trained interviewers using validated food frequency questionnaires. Higher consumption of sugar-sweetened soft drinks (Q5) increased the risk of hyperuricemia in males (adjusted OR = 1.35, 95% CI: 1.07-1.71) with a linear trend (p for trend = 0.01) and in females (adjusted OR = 1.40, 95% CI: 1.03-1.90) with no linear trend (p for trend = 0.09), compared to lower consumption (Q1-Q3). However, there were no significant differences of serum uric acid level according to the three categories of soft drink consumption, Q1-Q3, Q3, and Q5, in males (p = 0.21) or in females (p = 0.16), whereas all subjects showed statistical significance of serum uric acid level within the categories (p Korean population, showing a differential linear trend for hyperuricemia according to gender. © 2013 Published by Elsevier Inc.

Increase of nonlinear signal distortions due to linear mode coupling in space division multiplexed systems

DEFF Research Database (Denmark)

Kutluyarov, Ruslan V.; Bagmanov, Valeriy Kh; Antonov, Vyacheslav V.

2017-01-01

This paper is focused on the analysis of linear and nonlinear mode coupling in space division multiplexed (SDM) optical communications over step-index fiber in few-mode regime. Linear mode coupling is caused by the fiber imperfections, while the nonlinear coupling is caused by the Kerr......-nonlinearities. Therefore, we use the system of generalized coupled nonlinear Schrödinger equations (GCNLSE) to describe the signal propagation. We analytically show that the presence of linear mode coupling may cause increasing of the nonlinear signal distortions. For the detailed study we solve GCNLSE numerically...... for the standard step index fiber at the wavelength of 850 nm in the basis of spatial modes with helical phase front (vortex modes) and for a special kind of few-mode fiber with enlarged core, providing propagation of five spatial modes at 1550 nm. Simulation results confirm that the linear mode coupling may lead...

Increased colon cancer risk after severe Salmonella infection.

Directory of Open Access Journals (Sweden)

Lapo Mughini-Gras

Full Text Available Colon cancer constitutes one of the most frequent malignancies. Previous studies showed that Salmonella manipulates host cell signaling pathways and that Salmonella Typhimurium infection facilitates colon cancer development in genetically predisposed mice. This epidemiological study examined whether severe Salmonella infection, usually acquired from contaminated food, is associated with increased colon cancer risk in humans.We performed a nationwide registry-based study to assess colon cancer risk after diagnosed Salmonella infection. National infectious disease surveillance records (1999-2015 for Dutch residents aged ≥20 years when diagnosed with salmonellosis (n = 14,264 were linked to the Netherlands Cancer Registry. Salmonella-infected patients were laboratory-confirmed under medical consultation after 1-2 weeks of illness. These datasets also contained information on Salmonella serovar and type of infection. Colon cancer risk (overall and per colon subsite among patients with a diagnosed Salmonella infection was compared with expected colon cancer risk in the general population. Data from the nationwide registry of histo- and cytopathology (PALGA and Statistics Netherlands (CBS allowed assessing potential effects of age, gender, latency, socioeconomic status, genetic predisposition, inflammatory bowel disease (IBD, and tumor features. We found that compared to the general population, colon cancer risk was significantly increased (standardized incidence ratio [SIR] 1.54; 95%CI 1.09-2.10 among patients with Salmonella infection diagnosed <60 years of age. Such increased risk concerned specifically the ascending/transverse colon (SIR 2.12; 95%CI 1.38-3.09 after S. Enteritidis infection (SIR 2.97; 95%CI 1.73-4.76. Salmonellosis occurred more frequently among colon cancer patients with pre-infectious IBD, a known risk factor for colon cancer. Colon tumors of patients with a history of Salmonella infection were mostly of low grade

Increased cancer risk in patients with periodontitis.

Science.gov (United States)

Dizdar, Omer; Hayran, Mutlu; Guven, Deniz Can; Yılmaz, Tolga Birtan; Taheri, Sahand; Akman, Abdullah C; Bilgin, Emre; Hüseyin, Beril; Berker, Ezel

2017-12-01

Previous studies have noted a possible association between periodontal diseases and the risk of various cancers. We assessed cancer risk in a cohort of patients with moderate to severe periodontitis. Patients diagnosed with moderate to severe periodontitis by a periodontist between 2001 and 2010 were identified from the hospital registry. Patients younger than 35 years of age or with a prior cancer diagnosis were excluded. The age- and gender-standardized incidence rates (SIR) were calculated by dividing the number of observed cases by the number of expected cases from Turkish National Cancer Registry 2013 data. A total of 280 patients were included (median age 49.6, 54% female). Median follow-up was 12 years. Twenty-five new cancer cases were observed. Patients with periodontitis had 77% increased risk of cancer (SIR 1.77, 95% CI 1.17-2.58, p = .004). Women with periodontitis had significantly higher risk of breast cancer (SIR 2.40, 95% CI 0.88-5.33) and men with periodontitis had significantly higher risk of prostate cancer (SIR 3.75, 95% CI 0.95-10.21) and hematological cancers (SIR 6.97, 95% CI 1.77-18.98). Although showing a causal association necessitates further investigation, our results support the idea that periodontitis might be associated with increased cancer risk, particularly with hematological, breast and prostate cancers.

Debunking vaccination myths: strong risk negations can increase perceived vaccination risks.

Science.gov (United States)

Betsch, Cornelia; Sachse, Katharina

2013-02-01

Information about risks is often contradictory, especially in the health domain. A vast amount of bizarre information on vaccine-adverse events (VAE) can be found on the Internet; most are posted by antivaccination activists. Several actors in the health sector struggle against these statements by negating claimed risks with scientific explanations. The goal of the present work is to find optimal ways of negating risk to decrease risk perceptions. In two online experiments, we varied the extremity of risk negations and their source. Perception of the probability of VAE, their expected severity (both variables serve as indicators of perceived risk), and vaccination intentions. Paradoxically, messages strongly indicating that there is "no risk" led to a higher perceived vaccination risk than weak negations. This finding extends previous work on the negativity bias, which has shown that information stating the presence of risk decreases risk perceptions, while information negating the existence of risk increases such perceptions. Several moderators were also tested; however, the effect occurred independently of the number of negations, recipient involvement, and attitude. Solely the credibility of the information source interacted with the extremity of risk negation: For credible sources (governmental institutions), strong and weak risk negations lead to similar perceived risk, while for less credible sources (pharmaceutical industries) weak negations lead to less perceived risk than strong negations. Optimal risk negation may profit from moderate rather than extreme formulations as a source's trustworthiness can vary.

Railway Crossing Risk Area Detection Using Linear Regression and Terrain Drop Compensation Techniques

Science.gov (United States)

Chen, Wen-Yuan; Wang, Mei; Fu, Zhou-Xing

2014-01-01

Most railway accidents happen at railway crossings. Therefore, how to detect humans or objects present in the risk area of a railway crossing and thus prevent accidents are important tasks. In this paper, three strategies are used to detect the risk area of a railway crossing: (1) we use a terrain drop compensation (TDC) technique to solve the problem of the concavity of railway crossings; (2) we use a linear regression technique to predict the position and length of an object from image processing; (3) we have developed a novel strategy called calculating local maximum Y-coordinate object points (CLMYOP) to obtain the ground points of the object. In addition, image preprocessing is also applied to filter out the noise and successfully improve the object detection. From the experimental results, it is demonstrated that our scheme is an effective and corrective method for the detection of railway crossing risk areas. PMID:24936948

Railway Crossing Risk Area Detection Using Linear Regression and Terrain Drop Compensation Techniques

Directory of Open Access Journals (Sweden)

Wen-Yuan Chen

2014-06-01

Full Text Available Most railway accidents happen at railway crossings. Therefore, how to detect humans or objects present in the risk area of a railway crossing and thus prevent accidents are important tasks. In this paper, three strategies are used to detect the risk area of a railway crossing: (1 we use a terrain drop compensation (TDC technique to solve the problem of the concavity of railway crossings; (2 we use a linear regression technique to predict the position and length of an object from image processing; (3 we have developed a novel strategy called calculating local maximum Y-coordinate object points (CLMYOP to obtain the ground points of the object. In addition, image preprocessing is also applied to filter out the noise and successfully improve the object detection. From the experimental results, it is demonstrated that our scheme is an effective and corrective method for the detection of railway crossing risk areas.

Increased risk of sudden cardiac arrest in obstructive pulmonary disease

DEFF Research Database (Denmark)

Warnier, Miriam Jacoba; Blom, Marieke Tabo; Bardai, Abdennasser

2013-01-01

BACKGROUND: We aimed to determine whether (1) patients with obstructive pulmonary disease (OPD) have an increased risk of sudden cardiac arrest (SCA) due to ventricular tachycardia or fibrillation (VT/VF), and (2) the SCA risk is mediated by cardiovascular risk-profile and/or respiratory drug use...... with electrocardiographic documentation of VT/VF were included. Conditional logistic regression analysis was used to assess the association between SCA and OPD. Pre-specified subgroup analyses were performed regarding age, sex, cardiovascular risk-profile, disease severity, and current use of respiratory drugs. RESULTS...... is associated with an increased observed risk of SCA. The most increased risk was observed in patients with a high cardiovascular risk-profile, and in those who received SABA and, possibly, those who received AC at the time of SCA....

Perception of neighborhood crime and drugs increases cardiometabolic risk in Chilean adolescents

Science.gov (United States)

Martinez, Suzanna M; Blanco, Estela; Delva, Jorge; Burrows, Raquel; Reyes, Marcela; Lozoff, Betsy; Gahagan, Sheila

2013-01-01

Purpose Studies report an association between neighborhood risk and both obesity and cardiometabolic risk factors (CMR) among adolescents. Here we describe the effect of perceived neighborhood risk on adiposity and CMR among Chilean adolescents. Methods Participants were 523 low- to middle-income Chilean adolescents. We assessed neighborhood risk in early adolescence, adiposity in childhood and in early and later adolescence, and blood pressure and fasting glucose in later adolescence. Neighborhood risk profiles were estimated using latent profile analysis (LPA) and based on reported perceptions of crime and drug sales/use. Using linear and logistic regression, we examined the effect of neighborhood risk on adiposity and CMR. Results Mean age in early and later adolescence was 14 and 17 years, respectively. Participants were 52% male, with a mean BMI z-score of 0.67, and 8% met criteria for the metabolic syndrome. LPA identified two neighborhood profiles: 61% low risk and 39% high risk. In later adolescence, being in the high risk profile predicted a higher BMI z-score, waist-to-height ratio, and fat mass index (p-values Chilean neighborhoods with high crime and drugs, targeted public health interventions and policies for youth could be beneficial. PMID:24411818

Increased Baseline C-Reactive Protein Concentrations Are Associated with Increased Risk of Infections

DEFF Research Database (Denmark)

Zacho, Jeppe; Benfield, Thomas; Tybjærg-Hansen, Anne

2016-01-01

BACKGROUND: The acute-phase reactant C-reactive protein (CRP) increases rapidly during an infection. We tested the hypothesis that chronic low-level increases in CRP are associated with an increased risk of infectious disease. METHODS: We studied 9660 individuals from a prospective general...... population cohort, including 3592 in whom infectious disease developed, and another 60 896 individuals from a cross-sectional general population study, of whom 13 332 developed infectious disease; 55% were women, and the mean age was 57 years. Hospital diagnoses of infections in 1977-2010 were based....... RESULTS: Individuals with CRP >3 mg/L had 1.2 and 1.7 times increased risk of infectious disease, in the prospective general population cohort and the cross-sectional general population study, respectively, compared with individuals with CRP

Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study

NARCIS (Netherlands)

van der Velde, Nathalie; Stricker, Bruno H. Ch; Pols, Huib A. P.; van der Cammen, Tischa J. M.

2007-01-01

AIMS: Falling in older persons is a frequent and serious clinical problem. Several drugs have been associated with increased fall risk. The objective of this study was to identify differences in the incidence of falls after withdrawal (discontinuation or dose reduction) of fall-risk-increasing drugs

Increased stomach cancer risk following radiotherapy for testicular cancer

DEFF Research Database (Denmark)

Hauptmann, M; Fossa, S D; Stovall, M

2015-01-01

BACKGROUND: Abdominal radiotherapy for testicular cancer (TC) increases risk for second stomach cancer, although data on the radiation dose-response relationship are sparse. METHODS: In a cohort of 22,269 5-year TC survivors diagnosed during 1959-1987, doses to stomach subsites were estimated...... for 92 patients who developed stomach cancer and 180 matched controls. Chemotherapy details were recorded. Odds ratios (ORs) were estimated using logistic regression. RESULTS: Cumulative incidence of second primary stomach cancer was 1.45% at 30 years after TC diagnosis. The TC survivors who received...... radiotherapy (87 (95%) cases, 151 (84%) controls) had a 5.9-fold (95% confidence interval (CI) 1.7-20.7) increased risk of stomach cancer. Risk increased with increasing stomach dose (P-trend

Number of addictive substances used related to increased risk of unnatural death: A combined medico-legal and case-record study

Directory of Open Access Journals (Sweden)

Lindgren Anna

2009-08-01

Full Text Available Abstract Background Substance use disorders have repeatedly been found to lead to premature death, i.e. drug-related death by disease, fatal intoxications, or trauma (accidents, suicide, undetermined suicide, and homicide. The present study examined the relationship between multi-drug substance use and natural and unnatural death. Methods All consecutive, autopsied patients who had been in contact with the Addiction Centre in Malmö University Hospital from 1993 to 1997 inclusive were investigated. Drug abuse was investigated blindly in the case records and related to the cause of death in 387 subjects. Results Every substance apart from alcohol used previously in life added to the risk of unnatural death in a linear way. There were independent increased risks of fatal heroin overdoses or undetermined suicide. Death by suicide and violent death were unrelated to additional abuse. Conclusion The number of drugs used was related to an increased risk of unnatural death by undetermined suicide (mainly fatal intoxications and heroin overdose.

Cryptorchidism and increased risk of neurodevelopmental disorders.

Science.gov (United States)

Chen, Jianping; Sørensen, Henrik Toft; Miao, Maohua; Liang, Hong; Ehrenstein, Vera; Wang, Ziliang; Yuan, Wei; Li, Jiong

2018-01-01

Male congenital malformations as cryptorchidism may contribute to the development of neurodevelopmental disorders directly or via shared familial genetic and/or environmental factors, but the evidence is sparse. Using population-based health registries, we conducted a cohort study of all liveborn singleton boys in Denmark during 1979-2008. Boys with a diagnosis of cryptorchidism were categorized into the exposed cohort and the other boys into the unexposed comparison cohort. The outcomes were diagnoses of any neurodevelopmental disorders and their subtypes. We used Cox proportional hazards regression to compute hazard ratios (HRs), taking into consideration several potential confounders. Among 884,083 male infants, 27,505 received a diagnosis of cryptorchidism during follow-up. Boys with cryptorchidism were more likely to be diagnosed with intellectual disability (HR = 1.77; 95%confidence interval [CI]:1.59,1.97), autism spectrum disorders (ASD) (HR = 1.24; 95% CI:1.13,1.35), attention-deficit hyperactivity disorder (ADHD) (HR = 1.17; 95% CI: 1.08,1.26), anxiety (HR = 1.09; 95% CI: 1.01,1.17), and other behavioral/emotional disorders (HR = 1.16; 95% CI: 1.08,1.26) compared to boys without cryptorchidism. The observed risks of intellectual disability, ASD, and ADHD were increased further in boys with bilateral cryptorchidism. Except for anxiety, cryptorchid boys had higher risks of neurodevelopmental disorders than their non-cryptorchid full brothers. The observed increased risks were similar among boys who underwent orchiopexy, as well as among those with shorter waiting times for this surgery. Cryptorchidism may be associated with increased risks of intellectual disability, ASD, ADHD, and other behavioral/emotional disorders. Cryptorchidism and neurodevelopmental disorders may have shared genetic or in-utero/early postnatal risk factors, which need to be further investigated. Copyright © 2017. Published by Elsevier Ltd.

Significant increase of Echinococcus multilocularis prevalencein foxes, but no increased predicted risk for humans

NARCIS (Netherlands)

Maas, M.; Dam-Deisz, W.D.C.; Roon, van A.M.; Takumi, K.; Giessen, van der J.W.B.

2014-01-01

The emergence of the zoonotic tapeworm Echinococcus multilocularis, causative agent ofalveolar echinococcosis (AE), poses a public health risk. A previously designed risk mapmodel predicted a spread of E. multilocularis and increasing numbers of alveolar echinococ-cosis patients in the province of

Increased risk of hyperthyroidism among patients hospitalized with bipolar disorder

DEFF Research Database (Denmark)

Thomsen, Anders F; Kessing, Lars V

2005-01-01

OBJECTIVES: Hyperthyroidism has been associated with affective disorder in many cross-sectional studies, but longitudinal studies in this connection are scarce. We assessed whether hospitalization with depressive disorder or bipolar disorder was a risk factor for development of hyperthyroidism....... METHODS: We conducted a historical cohort study using the Danish register data. The observational period was 1977--99. Three study cohorts were identified: all patients with a first hospital admission with resulting index discharge diagnoses of depression, bipolar disorder, or osteoarthritis. The risks...... with depressive disorder did not have an increased risk of hyperthyroidism, whereas patients with bipolar disorder had an increased of risk on the margin of statistical significance, when compared to patients with osteoarthritis. Patients with bipolar disorder had a significantly increased risk of hyperthyroidism...

Increased colon cancer risk after severe Salmonella infection

Science.gov (United States)

Mooij, Sofie; Neefjes-Borst, E. Andra; van Pelt, Wilfrid; Neefjes, Jacques

2018-01-01

Background Colon cancer constitutes one of the most frequent malignancies. Previous studies showed that Salmonella manipulates host cell signaling pathways and that Salmonella Typhimurium infection facilitates colon cancer development in genetically predisposed mice. This epidemiological study examined whether severe Salmonella infection, usually acquired from contaminated food, is associated with increased colon cancer risk in humans. Methods and findings We performed a nationwide registry-based study to assess colon cancer risk after diagnosed Salmonella infection. National infectious disease surveillance records (1999–2015) for Dutch residents aged ≥20 years when diagnosed with salmonellosis (n = 14,264) were linked to the Netherlands Cancer Registry. Salmonella-infected patients were laboratory-confirmed under medical consultation after 1–2 weeks of illness. These datasets also contained information on Salmonella serovar and type of infection. Colon cancer risk (overall and per colon subsite) among patients with a diagnosed Salmonella infection was compared with expected colon cancer risk in the general population. Data from the nationwide registry of histo- and cytopathology (PALGA) and Statistics Netherlands (CBS) allowed assessing potential effects of age, gender, latency, socioeconomic status, genetic predisposition, inflammatory bowel disease (IBD), and tumor features. We found that compared to the general population, colon cancer risk was significantly increased (standardized incidence ratio [SIR] 1.54; 95%CI 1.09–2.10) among patients with Salmonella infection diagnosed transverse colon (SIR 2.12; 95%CI 1.38–3.09) after S. Enteritidis infection (SIR 2.97; 95%CI 1.73–4.76). Salmonellosis occurred more frequently among colon cancer patients with pre-infectious IBD, a known risk factor for colon cancer. Colon tumors of patients with a history of Salmonella infection were mostly of low grade. Conclusions Patients diagnosed with severe

Linearity and Nonlinearity in HIV/STI Transmission: Implications for the Evaluation of Sexual Risk Reduction Interventions

Science.gov (United States)

Pinkerton, Steven D.; Chesson, Harrell W.; Crosby, Richard A.; Layde, Peter M.

2011-01-01

A mathematical model of HIV/sexually transmitted infections (STI) transmission was used to examine how linearity or nonlinearity in the relationship between the number of unprotected sex acts (or the number of sex partners) and the risk of acquiring HIV or a highly infectious STI (such as gonorrhea or chlamydia) affects the utility of sexual…

LINEAR2007, Linear-Linear Interpolation of ENDF Format Cross-Sections

International Nuclear Information System (INIS)

2007-01-01

1 - Description of program or function: LINEAR converts evaluated cross sections in the ENDF/B format into a tabular form that is subject to linear-linear interpolation in energy and cross section. The code also thins tables of cross sections already in that form. Codes used subsequently need thus to consider only linear-linear data. IAEA1311/15: This version include the updates up to January 30, 2007. Changes in ENDF/B-VII Format and procedures, as well as the evaluations themselves, make it impossible for versions of the ENDF/B pre-processing codes earlier than PREPRO 2007 (2007 Version) to accurately process current ENDF/B-VII evaluations. The present code can handle all existing ENDF/B-VI evaluations through release 8, which will be the last release of ENDF/B-VI. Modifications from previous versions: - Linear VERS. 2007-1 (JAN. 2007): checked against all ENDF/B-VII; increased page size from 60,000 to 600,000 points 2 - Method of solution: Each section of data is considered separately. Each section of File 3, 23, and 27 data consists of a table of cross section versus energy with any of five interpolation laws. LINEAR will replace each section with a new table of energy versus cross section data in which the interpolation law is always linear in energy and cross section. The histogram (constant cross section between two energies) interpolation law is converted to linear-linear by substituting two points for each initial point. The linear-linear is not altered. For the log-linear, linear-log and log- log laws, the cross section data are converted to linear by an interval halving algorithm. Each interval is divided in half until the value at the middle of the interval can be approximated by linear-linear interpolation to within a given accuracy. The LINEAR program uses a multipoint fractional error thinning algorithm to minimize the size of each cross section table

Alcoholic Cirrhosis Increases Risk for Autoimmune Diseases

DEFF Research Database (Denmark)

Grønbæk, Lisbet; Vilstrup, Hendrik; Deleuran, Bent

2015-01-01

IRR, 1.56; 95% CI, 1.26-1.92), celiac disease (aIRR, 5.12; 95% CI, 2.58-10.16), pernicious anemia (aIRR, 2.35; 95% CI, 1.50-3.68), and psoriasis (aIRR, 4.06; 95% CI, 3.32-4.97). There was no increase in the incidence rate for rheumatoid arthritis (aIRR, 0.89; 95% CI, 0.69-1.15); the incidence rate......BACKGROUND & AIMS: Alcoholic cirrhosis is associated with hyperactivation and dysregulation of the immune system. In addition to its ability to increase risk for infections, it also may increase the risk for autoimmune diseases. We studied the incidence of autoimmune diseases among patients...... (controls) of the same sex and age. The incidence rates of various autoimmune diseases were compared between patients with cirrhosis and controls and adjusted for the number of hospitalizations in the previous year (a marker for the frequency of clinical examination). RESULTS: Of the 24,679 patients...

A risk explicit interval linear programming model for uncertainty-based environmental economic optimization in the Lake Fuxian watershed, China.

Science.gov (United States)

Zhang, Xiaoling; Huang, Kai; Zou, Rui; Liu, Yong; Yu, Yajuan

2013-01-01

The conflict of water environment protection and economic development has brought severe water pollution and restricted the sustainable development in the watershed. A risk explicit interval linear programming (REILP) method was used to solve integrated watershed environmental-economic optimization problem. Interval linear programming (ILP) and REILP models for uncertainty-based environmental economic optimization at the watershed scale were developed for the management of Lake Fuxian watershed, China. Scenario analysis was introduced into model solution process to ensure the practicality and operability of optimization schemes. Decision makers' preferences for risk levels can be expressed through inputting different discrete aspiration level values into the REILP model in three periods under two scenarios. Through balancing the optimal system returns and corresponding system risks, decision makers can develop an efficient industrial restructuring scheme based directly on the window of "low risk and high return efficiency" in the trade-off curve. The representative schemes at the turning points of two scenarios were interpreted and compared to identify a preferable planning alternative, which has the relatively low risks and nearly maximum benefits. This study provides new insights and proposes a tool, which was REILP, for decision makers to develop an effectively environmental economic optimization scheme in integrated watershed management.

A Risk Explicit Interval Linear Programming Model for Uncertainty-Based Environmental Economic Optimization in the Lake Fuxian Watershed, China

Directory of Open Access Journals (Sweden)

Xiaoling Zhang

2013-01-01

Full Text Available The conflict of water environment protection and economic development has brought severe water pollution and restricted the sustainable development in the watershed. A risk explicit interval linear programming (REILP method was used to solve integrated watershed environmental-economic optimization problem. Interval linear programming (ILP and REILP models for uncertainty-based environmental economic optimization at the watershed scale were developed for the management of Lake Fuxian watershed, China. Scenario analysis was introduced into model solution process to ensure the practicality and operability of optimization schemes. Decision makers’ preferences for risk levels can be expressed through inputting different discrete aspiration level values into the REILP model in three periods under two scenarios. Through balancing the optimal system returns and corresponding system risks, decision makers can develop an efficient industrial restructuring scheme based directly on the window of “low risk and high return efficiency” in the trade-off curve. The representative schemes at the turning points of two scenarios were interpreted and compared to identify a preferable planning alternative, which has the relatively low risks and nearly maximum benefits. This study provides new insights and proposes a tool, which was REILP, for decision makers to develop an effectively environmental economic optimization scheme in integrated watershed management.

Increased linear bone growth by GH in the absence of SOCS2 is independent of IGF-1.

Science.gov (United States)

Dobie, Ross; Ahmed, Syed F; Staines, Katherine A; Pass, Chloe; Jasim, Seema; MacRae, Vicky E; Farquharson, Colin

2015-11-01

Growth hormone (GH) signaling is essential for postnatal linear bone growth, but the relative importance of GHs actions on the liver and/or growth plate cartilage remains unclear. The importance of liver derived insulin like-growth factor-1 (IGF-1) for endochondral growth has recently been challenged. Here, we investigate linear growth in Suppressor of Cytokine Signaling-2 (SOCS2) knockout mice, which have enhanced growth despite normal systemic GH/IGF-1 levels. Wild-type embryonic ex vivo metatarsals failed to exhibit increased linear growth in response to GH, but displayed increased Socs2 transcript levels (P growth over a 12 day period. Despite this increase, IGF-1 transcript and protein levels were not increased in response to GH. In accordance with these data, IGF-1 levels were unchanged in GH-challenged postnatal Socs2(-/-) conditioned medium despite metatarsals showing enhanced linear growth. Growth-plate Igf1 mRNA levels were not elevated in juvenile Socs2(-/-) mice. GH did however elevate IGF-binding protein 3 levels in conditioned medium from GH challenged metatarsals and this was more apparent in Socs2(-/-) metatarsals. GH did not enhance the growth of Socs2(-/-) metatarsals when the IGF receptor was inhibited, suggesting that IGF receptor mediated mechanisms are required. IGF-2 may be responsible as IGF-2 promoted metatarsal growth and Igf2 expression was elevated in Socs2(-/-) (but not WT) metatarsals in response to GH. These studies emphasise the critical importance of SOCS2 in regulating GHs ability to promote bone growth. Also, GH appears to act directly on the metatarsals of Socs2(-/-) mice, promoting growth via a mechanism that is independent of IGF-1. © 2014 The Authors. Journal of Cellular Physiology Published by Wiley Periodicals, Inc.

Hypospadias and increased risk for neurodevelopmental disorders.

Science.gov (United States)

Butwicka, Agnieszka; Lichtenstein, Paul; Landén, Mikael; Nordenvall, Anna S; Nordenström, Anna; Nordenskjöld, Agneta; Frisén, Louise

2015-02-01

Hypospadias (aberrant opening of the urethra on the underside of the penis) occurs in 1 per 300 newborn boys. It has been previously unknown whether this common malformation is associated with increased psychiatric morbidity later in life. Studies of individuals with hypospadias also provide an opportunity to examine whether difference in androgen signaling is related to neurodevelopmental disorders. To elucidate the mechanisms behind a possible association, we also studied psychiatric outcomes among brothers of the hypospadias patients. Registry study within a national cohort of all 9,262 males with hypospadias and their 4,936 healthy brothers born in Sweden between 1973 and 2009. Patients with hypospadias and their brothers were matched with controls by year of birth and county. The following outcomes were evaluated (1) any psychiatric (2) psychotic, (3) mood, (4) anxiety, (5) eating, and (6) personality disorders, (7) substance misuse, (8) attention-deficit hyperactivity disorder (ADHD), (9) autism spectrum disorders (ASD), (10) intellectual disability, and (11) other behavioral/emotional disorders with onset in childhood. Patients with hypospadias were more likely to be diagnosed with intellectual disability (OR 3.2; 95% CI 2.8-3.8), ASD (1.4; 1.2-1.7), ADHD (1.5; 1.3-1.9), and behavioral/emotional disorders (1.4; 1.2-1.6) compared with the controls. Brothers of patients with hypospadias had an increased risk of ASD (1.6; 1.3-2.1) and other behavioral/emotional disorders with onset in childhood (1.2; 0.9-1.5) in comparison to siblings of healthy individuals. A slightly higher, although not statistically significant, risk was found for intellectual disability (1.3; 1.0-1.9). No relation between other psychiatric diagnosis and hypospadias was found. This is the first study to identify an increased risk for neurodevelopmental disorders in patients with hypospadias, as well as an increased risk for ASD in their brothers, suggesting a common familial (genetic and

Photoneutrons from medical linear accelerators--radiobiological measurements and risk estimates

International Nuclear Information System (INIS)

Hall, Eric J.; Martin, Stewart G.; Amols, Howard; Hei, Tom K.

1995-01-01

Purpose: To assess the oncogenic potential of the photoneutrons produced by high energy medical linear accelerators. Methods and Materials: An established line of cells of rodent origin (C 3 H 10T1/2) was used to assess the oncogenic potential of the radiation dose received in the breast of an anthropomorphic 'randoman' phanton, while the cervix received a dose of 70 Gy. Experiments were performed at 6 MV, below the threshold for the production of photoneutrons, and at 20 MV where the dose includes about 0.01 Gy of photoneutrons as well as scattered x-rays. Results: A significantly higher transformation incidence was observed for the 20-MV machine, consistent with the measured neutron dose of about 0.01 Gy and a quality factor of 20. Conclusion: An estimate can be made of the additional deaths from second malignancies that might result from the photoneutrons generated by higher energy linear accelerators (Linacs), which must be offset against the possible improvements in survival that might result from the higher tumor doses made possible by the increased percentage depth doses

Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies.

Science.gov (United States)

Shiri, Rahman; Euro, Ulla; Heliövaara, Markku; Hirvensalo, Mirja; Husgafvel-Pursiainen, Kirsti; Karppinen, Jaro; Lahti, Jouni; Rahkonen, Ossi; Raitakari, Olli T; Solovieva, Svetlana; Yang, Xiaolin; Viikari-Juntura, Eira; Lallukka, Tea

2017-12-01

The purpose of this study is to assess the effects of lifestyle risk factors on the risk of hospitalization for sciatica and to determine whether overweight or obesity modifies the effect of leisure-time physical activity on hospitalization for sciatica. We included 4 Finnish prospective cohort studies (Health 2000 Survey, Mobile Clinic Survey, Helsinki Health Study, and Young Finns Study) consisting of 34,589 participants and 1259 hospitalizations for sciatica during 12 to 30 years of follow-up. Sciatica was based on hospital discharge register data. We conducted a random-effects individual participant data meta-analysis. After adjustment for confounding factors, current smoking at baseline increased the risk of subsequent hospitalization for sciatica by 33% (95% confidence interval [CI], 13%-56%), whereas past smokers were no longer at increased risk. Obesity defined by body mass index increased the risk of hospitalization for sciatica by 36% (95% CI 7%-74%), and abdominal obesity defined by waist circumference increased the risk by 41% (95% CI 3%-93%). Walking or cycling to work reduced the risk of hospitalization for sciatica by 33% (95% CI 4%-53%), and the effect was independent of body weight and other leisure activities, while other types of leisure activities did not have a statistically significant effect. Smoking and obesity increase the risk of hospitalization for sciatica, whereas walking or cycling to work protects against hospitalization for sciatica. Walking and cycling can be recommended for the prevention of sciatica in the general population. Copyright © 2017 Elsevier Inc. All rights reserved.

Climate change and sugarcane expansion increase Hantavirus infection risk.

Science.gov (United States)

Prist, Paula Ribeiro; Uriarte, María; Fernandes, Katia; Metzger, Jean Paul

2017-07-01

Hantavirus Cardiopulmonary Syndrome (HCPS) is a disease caused by Hantavirus, which is highly virulent for humans. High temperatures and conversion of native vegetation to agriculture, particularly sugarcane cultivation can alter abundance of rodent generalist species that serve as the principal reservoir host for HCPS, but our understanding of the compound effects of land use and climate on HCPS incidence remains limited, particularly in tropical regions. Here we rely on a Bayesian model to fill this research gap and to predict the effects of sugarcane expansion and expected changes in temperature on Hantavirus infection risk in the state of São Paulo, Brazil. The sugarcane expansion scenario was based on historical data between 2000 and 2010 combined with an agro-environment zoning guideline for the sugar and ethanol industry. Future evolution of temperature anomalies was derived using 32 general circulation models from scenarios RCP4.5 and RCP8.5 (Representative greenhouse gases Concentration Pathways adopted by IPCC). Currently, the state of São Paulo has an average Hantavirus risk of 1.3%, with 6% of the 645 municipalities of the state being classified as high risk (HCPS risk ≥ 5%). Our results indicate that sugarcane expansion alone will increase average HCPS risk to 1.5%, placing 20% more people at HCPS risk. Temperature anomalies alone increase HCPS risk even more (1.6% for RCP4.5 and 1.7%, for RCP8.5), and place 31% and 34% more people at risk. Combined sugarcane and temperature increases led to the same predictions as scenarios that only included temperature. Our results demonstrate that climate change effects are likely to be more severe than those from sugarcane expansion. Forecasting disease is critical for the timely and efficient planning of operational control programs that can address the expected effects of sugarcane expansion and climate change on HCPS infection risk. The predicted spatial location of HCPS infection risks obtained here can be

Climate change and sugarcane expansion increase Hantavirus infection risk.

Directory of Open Access Journals (Sweden)

Paula Ribeiro Prist

2017-07-01

Full Text Available Hantavirus Cardiopulmonary Syndrome (HCPS is a disease caused by Hantavirus, which is highly virulent for humans. High temperatures and conversion of native vegetation to agriculture, particularly sugarcane cultivation can alter abundance of rodent generalist species that serve as the principal reservoir host for HCPS, but our understanding of the compound effects of land use and climate on HCPS incidence remains limited, particularly in tropical regions. Here we rely on a Bayesian model to fill this research gap and to predict the effects of sugarcane expansion and expected changes in temperature on Hantavirus infection risk in the state of São Paulo, Brazil. The sugarcane expansion scenario was based on historical data between 2000 and 2010 combined with an agro-environment zoning guideline for the sugar and ethanol industry. Future evolution of temperature anomalies was derived using 32 general circulation models from scenarios RCP4.5 and RCP8.5 (Representative greenhouse gases Concentration Pathways adopted by IPCC. Currently, the state of São Paulo has an average Hantavirus risk of 1.3%, with 6% of the 645 municipalities of the state being classified as high risk (HCPS risk ≥ 5%. Our results indicate that sugarcane expansion alone will increase average HCPS risk to 1.5%, placing 20% more people at HCPS risk. Temperature anomalies alone increase HCPS risk even more (1.6% for RCP4.5 and 1.7%, for RCP8.5, and place 31% and 34% more people at risk. Combined sugarcane and temperature increases led to the same predictions as scenarios that only included temperature. Our results demonstrate that climate change effects are likely to be more severe than those from sugarcane expansion. Forecasting disease is critical for the timely and efficient planning of operational control programs that can address the expected effects of sugarcane expansion and climate change on HCPS infection risk. The predicted spatial location of HCPS infection risks

An empirical study for ranking risk factors using linear assignment: A case study of road construction

Directory of Open Access Journals (Sweden)

Amin Foroughi

2012-04-01

Full Text Available Road construction projects are considered as the most important governmental issues since there are normally heavy investments required in such projects. There is also shortage of financial resources in governmental budget, which makes the asset allocation more challenging. One primary step in reducing the cost is to determine different risks associated with execution of such project activities. In this study, we present some important risk factors associated with road construction in two levels for a real-world case study of rail-road industry located between two cities of Esfahan and Deligan. The first group of risk factors includes the probability and the effects for various attributes including cost, time, quality and performance. The second group of risk factors includes socio-economical factors as well as political and managerial aspects. The study finds 21 main risk factors as well as 193 sub risk factors. The factors are ranked using groups decision-making method called linear assignment. The preliminary results indicate that the road construction projects could finish faster with better outcome should we carefully consider risk factors and attempt to reduce their impacts.

Increased Suicide Risk in Patients with Hidradenitis Suppurativa

DEFF Research Database (Denmark)

Thorlacius, Linnea; Cohen, Arnon D; Gislason, Gunnar H

2018-01-01

Patients with skin disorders are considered at a higher risk of depression and anxiety than the background population. Patients with hidradenitis suppurativa (HS) may be particularly affected. We explored the association between HS and depression, anxiety, and completed suicides in the Danish...... nonsignificant association with depression (odds ratio [95% confidence interval] = 1.13; 0.87-1.47]; P = 0.36 and hospitalization due to depression (1.32 [0.94-1.85]; P = 0.1083). To the best of our knowledge, no previous studies have reported on the increased risk of completed suicide among HS patients...... national registries, expanding to include data on suicidal behavior, using both a cross-sectional and a cohort study design. Both designs included 7,732 patients with HS and a background population of 4,354,137. The cohort study revealed that HS patients had an increased risk of completed suicide after...

Assessing Risk in Costing High-energy Accelerators: from Existing Projects to the Future Linear Collider

CERN Document Server

Lebrun, Philippe

2010-01-01

High-energy accelerators are large projects funded by public money, developed over the years and constructed via major industrial contracts both in advanced technology and in more conventional domains such as civil engineering and infrastructure, for which they often constitute one-of markets. Assessing their cost, as well as the risk and uncertainty associated with this assessment is therefore an essential part of project preparation and a justified requirement by the funding agencies. Stemming from the experience with large circular colliders at CERN, LEP and LHC, as well as with the Main Injector, the Tevatron Collider Experiments and Accelerator Upgrades, and the NOvA Experiment at Fermilab, we discuss sources of cost variance and derive cost risk assessment methods applicable to the future linear collider, through its two technical approaches for ILC and CLIC. We also address disparities in cost risk assessment imposed by regional differences in regulations, procedures and practices.

Accurate Evaluation of Expected Shortfall for Linear Portfolios with Elliptically Distributed Risk Factors

Directory of Open Access Journals (Sweden)

Dobrislav Dobrev∗

2017-02-01

Full Text Available We provide an accurate closed-form expression for the expected shortfall of linear portfolios with elliptically distributed risk factors. Our results aim to correct inaccuracies that originate in Kamdem (2005 and are present also in at least thirty other papers referencing it, including the recent survey by Nadarajah et al. (2014 on estimation methods for expected shortfall. In particular, we show that the correction we provide in the popular multivariate Student t setting eliminates understatement of expected shortfall by a factor varying from at least four to more than 100 across different tail quantiles and degrees of freedom. As such, the resulting economic impact in financial risk management applications could be significant. We further correct such errors encountered also in closely related results in Kamdem (2007 and 2009 for mixtures of elliptical distributions. More generally, our findings point to the extra scrutiny required when deploying new methods for expected shortfall estimation in practice.

Recursive and non-linear logistic regression: moving on from the original EuroSCORE and EuroSCORE II methodologies.

Science.gov (United States)

Poullis, Michael

2014-11-01

EuroSCORE II, despite improving on the original EuroSCORE system, has not solved all the calibration and predictability issues. Recursive, non-linear and mixed recursive and non-linear regression analysis were assessed with regard to sensitivity, specificity and predictability of the original EuroSCORE and EuroSCORE II systems. The original logistic EuroSCORE, EuroSCORE II and recursive, non-linear and mixed recursive and non-linear regression analyses of these risk models were assessed via receiver operator characteristic curves (ROC) and Hosmer-Lemeshow statistic analysis with regard to the accuracy of predicting in-hospital mortality. Analysis was performed for isolated coronary artery bypass grafts (CABGs) (n = 2913), aortic valve replacement (AVR) (n = 814), mitral valve surgery (n = 340), combined AVR and CABG (n = 517), aortic (n = 350), miscellaneous cases (n = 642), and combinations of the above cases (n = 5576). The original EuroSCORE had an ROC below 0.7 for isolated AVR and combined AVR and CABG. None of the methods described increased the ROC above 0.7. The EuroSCORE II risk model had an ROC below 0.7 for isolated AVR only. Recursive regression, non-linear regression, and mixed recursive and non-linear regression all increased the ROC above 0.7 for isolated AVR. The original EuroSCORE had a Hosmer-Lemeshow statistic that was above 0.05 for all patients and the subgroups analysed. All of the techniques markedly increased the Hosmer-Lemeshow statistic. The EuroSCORE II risk model had a Hosmer-Lemeshow statistic that was significant for all patients (P linear regression failed to improve on the original Hosmer-Lemeshow statistic. The mixed recursive and non-linear regression using the EuroSCORE II risk model was the only model that produced an ROC of 0.7 or above for all patients and procedures and had a Hosmer-Lemeshow statistic that was highly non-significant. The original EuroSCORE and the EuroSCORE II risk models do not have adequate ROC and Hosmer

Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude

OpenAIRE

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

2016-01-01

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

Radiation safety assessment of treatment teletherapy linear accelerators using the method of the risk matrix

International Nuclear Information System (INIS)

Dumenigo Gonzalez, Cruz; Vilaragut Llanes, Juan J.; Morales Lopez, Jorge L.

2009-01-01

Accidents in the world of radiation, demonstrating the need for deepen security assessments. This study evaluates the safety of the treatment of teletherapy linear accelerator (LINAC) at a hospital in Cuba, based on applying the method Risk Matrix. This method has been used for many years in conventional industry, is simple, easy to apply and is based on the equation General risk R = f * P * C (where: f frequency of occurrence of the initiating event, P probability of failure of all barriers and magnitude of the consequences C expected). We have evaluated 140 accident sequences that were identified during the analysis of the treatment process. It was identified that 5 sequences are associated with the level of risk is very low, 96 low-risk, high risk and 39 with no very high risk. All accident sequences associated with high risk (considered unacceptable), have an impact on patients, and no concerns workers and public, which reaffirms that major security problems are related to radiation protection of patients. 34 sequences accidental high risk are associated with human errors and failures only 5 to equipment (LINAC, TPS, TAC, etc.). demonstrating the importance of human error. It shows that 35 of the 39 high-risk accident sequences leading to serious or very serious consequences for patients, which would mean the death of one or more patients, making specific recommendations to reduce risk in these cases. The findings of this work and regulators allow users to refine their programs quality assurance and inspection and suggest the hospital management, prioritize material resources according to criteria of irrigation management. (author)

Recognising and managing increased HIV transmission risk in newborns

Directory of Open Access Journals (Sweden)

Max Kroon

2015-05-01

Full Text Available Prevention of mother-to-child transmission (PMTCT programmes have improved maternalhealth outcomes and reduced the incidence of paediatric HIV, resulting in improved childhealth and survival. Nevertheless, high-risk vertical exposures remain common and areresponsible for a high proportion of transmissions. In the absence of antiretrovirals (ARVs,an 8- to 12-hour labour has approximately the same 15% risk of transmission as 18 monthsof mixed feeding. The intensity of transmission risk is highest during labour and delivery;however, the brevity of this intra-partum period lends itself to post-exposure interventions toreduce such risk. There is good evidence that infant post-exposure prophylaxis (PEP reducesintra-partum transmission even in the absence of maternal prophylaxis. Recent reports suggestthat infant combination ARV prophylaxis (cARP is more efficient at reducing intra-partumtransmission than a single agent in situations of minimal pre-labour prophylaxis. Guidelinesfrom the developed world have incorporated infant cARP for increased-risk scenarios. Incontrast, recent guidelines for low-resource settings have rightfully focused on reducingpostnatal transmission to preserve the benefits of breastfeeding, but have largely ignored thepotential of augmented infant PEP for reducing intra-partum transmissions. Minimal prelabourprophylaxis, poor adherence in the month prior to delivery, elevated maternal viralload at delivery, spontaneous preterm labour with prolonged rupture of membranes andchorioamnionitis are simple clinical criteria that identify increased intra-partum transmissionrisk. In these increased-risk scenarios, transmission frequency may be halved by combiningnevirapine and zidovudine as a form of boosted infant PEP. This strategy may be important toreduce intra-partum transmissions when PMTCT is suboptimal.

Polygenic risk score is associated with increased disease risk in 52 Finnish breast cancer families

OpenAIRE

Muranen, Taru A.; Mavaddat, Nasim; Khan, Sofia; Fagerholm, Rainer; Pelttari, Liisa; Lee, Andrew; Aittom?ki, Kristiina; Blomqvist, Carl; Easton, Douglas F.; Nevanlinna, Heli

2016-01-01

The risk of developing breast cancer is increased in women with family history of breast cancer and particularly in families with multiple cases of breast or ovarian cancer. Nevertheless, many women with a positive family history never develop the disease. Polygenic risk scores (PRSs) based on the risk effects of multiple common genetic variants have been proposed for individual risk assessment on a population level. We investigate the applicability of the PRS for risk prediction within breas...

Traumatic Stress Interacts With Bipolar Disorder Genetic Risk to Increase Risk for Suicide Attempts.

Science.gov (United States)

Wilcox, Holly C; Fullerton, Janice M; Glowinski, Anne L; Benke, Kelly; Kamali, Masoud; Hulvershorn, Leslie A; Stapp, Emma K; Edenberg, Howard J; Roberts, Gloria M P; Ghaziuddin, Neera; Fisher, Carrie; Brucksch, Christine; Frankland, Andrew; Toma, Claudio; Shaw, Alex D; Kastelic, Elizabeth; Miller, Leslie; McInnis, Melvin G; Mitchell, Philip B; Nurnberger, John I

2017-12-01

Bipolar disorder (BD) is one of the most heritable psychiatric conditions and is associated with high suicide risk. To explore the reasons for this link, this study examined the interaction between traumatic stress and BD polygenic risk score in relation to suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) in adolescent and young adult offspring and relatives of persons with BD (BD-relatives) compared with adolescent and young adult offspring of individuals without psychiatric disorders (controls). Data were collected from 4 sites in the United States and 1 site in Australia from 2006 through 2012. Generalized estimating equation models were used to compare rates of ideation, attempts, and NSSI between BD-relatives (n = 307) and controls (n = 166) and to determine the contribution of demographic factors, traumatic stress exposure, lifetime mood or substance (alcohol/drug) use disorders, and BD polygenic risk score. After adjusting for demographic characteristics and mood and substance use disorders, BD-relatives were at increased risk for suicidal ideation and attempts but not for NSSI. Independent of BD-relative versus control status, demographic factors, or mood and substance use disorders, exposure to trauma within the past year (including bullying, sexual abuse, and domestic violence) was associated with suicide attempts (p = .014), and BD polygenic risk score was marginally associated with attempts (p = .061). Importantly, the interaction between BD polygenic risk score and traumatic event exposures was significantly associated with attempts, independent of demographics, relative versus control status, and mood and substance use disorders (p = .041). BD-relatives are at increased risk for suicide attempts and ideation, especially if they are exposed to trauma and have evidence of increased genetic vulnerability. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Increased suicidal risk among smoking schizophrenia patients.

Science.gov (United States)

Iancu, Iulian; Sapir, Anna Piccone; Shaked, Ginette; Poreh, Amir; Dannon, Pinhas Nadim; Chelben, Joseph; Kotler, Moshe

2006-01-01

Schizophrenia patients display a high suicidal risk, although this risk is difficult to predict. One of the variables associated with increased suicide risk is smoking. In the present study, we assessed the suicidal risk in schizophrenia patients, smokers and nonsmokers. We also evaluated the impact of various variables such as psychotic symptoms, impulsivity, and extra-pyramidal side effects on suicidal risk. Sixty-one schizophrenia patients responded to a battery of measures, including the suicidal risk scale (SRS), the positive and negative syndrome scale (PANSS), the impulsivity control scale, and the Simpson Angus Scale for extrapyramidal side effects. The effect of smoking on the various measures, especially suicidal risk, was examined. Schizophrenia patients who smoke obtained higher PANSS scores (both total score and positive and negative subscales), but did not differ on the Simpson Angus scale of extrapyramidal side effects. They also exhibited higher suicide risk as reflected by higher scores on the SRS, and a trend for higher impulsivity as measured by the impulsivity control scale. Women that smoked had higher SRS scores as compared with female nonsmokers, and also higher than in males, smokers and nonsmokers. Smoking and a history of suicide attempt predicted in our regression analysis a higher SRS score. When conducting separate analyses for the male and female patients, the significant contributors were the PANSS total score among the males and the number of pack-years among the female patients. Despite hints toward the role of smoking in suicidal behavior in Schizophrenia, especially among female patients, more studies are needed to elucidate the association between smoking and suicidality in schizophrenia patients.

Long working hours may increase risk of coronary heart disease.

Science.gov (United States)

Kang, Mo-Yeol; Cho, Soo-Hun; Yoo, Min-Sang; Kim, Taeshik; Hong, Yun-Chul

2014-11-01

To evaluate the association between long working hours and risk of coronary heart disease (CHD) estimated by Framingham risk score (FRS) in Korean adults. This study evaluated adult participants in Korean National Health and Nutrition Examination Survey IV (2007-2009). After inclusion and exclusion criteria were applied, the final sample size for this study model was 8,350. Subjects were asked about working hours and health status. Participants also completed physical examinations and biochemical measurement necessary for estimation of FRS. Multiple logistic regression was conducted to investigate the association between working hours and 10-year risk for CHD estimated by FRS. Compared to those who work 31-40 hr, significantly higher 10-year risk was estimated among subjects working longer hours. As working hours increased, odds ratio (OR) for upper 10 percent of estimated 10-year risk for CHD was increased up to 1.94. Long working hours are significantly related to risk of coronary heart disease. © 2014 Wiley Periodicals, Inc.

Endocan is a predictor of increased cardiovascular risk in women with polycystic ovary syndrome.

Science.gov (United States)

Bicer, Merve; Guler, Aslı; Unal Kocabas, Gokcen; Imamoglu, Cetin; Baloglu, Ali; Bilgir, Oktay; Yuksel, Arif; Bozkaya, Giray; Calan, Mehmet

2017-05-01

Endocan is a proteoglycan secreted mainly from endothelial cells. It has been implicated that there is a link between endocan and endothelial dysfunction. Polycystic ovary syndrome (PCOS) is a reproductive and metabolic disease associated with increased risk of cardiovascular events. The aims of this study were to ascertain whether circulating endocan levels are altered in women with PCOS, and whether there is an association between endocan and carotid intima media thickness (cIMT). This cross-sectional study included 80 women with PCOS and 80 age- and BMI-matched controls without PCOS. Circulating endocan levels were measured using ELISA. Metabolic, hormonal parameters and cIMT were determined. 2-h oral glucose tolerance test (2-h OGTT) was performed on all women. Circulating endocan levels were significantly elevated in women with PCOS compared with controls (5.99 ± 2.37 vs. 3.66 ± 1.79 ng/ml, P insulin resistance (HOMA-IR), free androgen index (FAI), high-sensitivity C-reactive protein (hs-CRP), and cIMT in both PCOS and control groups. Endocan levels did not correlate with fasting blood glucose, 2-h OGTT, A1 C and lipid parameters. Multiple linear regression analysis revealed that endocan is an independent predictor for cIMT (β = 0.128, 95% CI = 0.118-0.138, P = 0.011). Circulating endocan levels are significantly higher in women with PCOS and endocan is independently associated with cIMT. Elevated endocan levels can be a predictor of increased cardiovascular risk in PCOS subjects.

Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement is Not Associated With Increased Early or Late Readmission Risk.

Science.gov (United States)

Sud, Maneesh; Qui, Feng; Austin, Peter C; Ko, Dennis T; Wood, David; Czarnecki, Andrew; Patel, Vaidehi; Lee, Douglas S; Wijeysundera, Harindra C

2017-04-24

Elderly patients undergoing transcatheter aortic valve replacement (TAVR) are at risk of hospital readmission postprocedure. It is not known whether the index hospital length of stay and, specifically, early discharge post-TAVR is associated with an increased risk of readmission. We hypothesized a nonlinear relationship whereby both short and long lengths of stay were associated with increased readmission risk. We performed a retrospective multicenter cohort analysis of patients undergoing elective transfemoral TAVR and surviving to discharge between January 2007 and March 2014. The exposure variable was hospital length of stay measured from the procedure date to the date of discharge and modeled as a continuous variable in a multivariable cause-specific Cox regression. Main outcome measures were 30-day and 1-year all-cause readmissions. The study population consisted of 709 patients with a median length of stay of 6 days (interquartile range, 4-8). At 30-days and 1-year, 13.5% and 44.0% of patients were readmitted, respectively. Although post-TAVR length of stay was not associated with 30-day all-cause readmissions ( P =0.925), there existed a significant association with 1-year readmission ( P =0.010) after adjustment for baseline clinical variables. The association between post-TAVR length of stay and 1-year readmission was linear ( P =0.549 for nonlinearity) with no evidence supporting an increased readmission risk for shorter length of stays. Among elderly survivors of elective transfemoral TAVR, a short postprocedural length of stay was not associated with an increased risk readmission within 30 days or 1 year. However, the risk of 1-year readmission increased with longer post-TAVR lengths of stay. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Increased risk of stroke in contact dermatitis patients

Science.gov (United States)

Chang, Wei-Lun; Hsu, Min-Hsien; Lin, Cheng-Li; Chan, Po-Chi; Chang, Ko-Shih; Lee, Ching-Hsiao; Hsu, Chung-Yi; Tsai, Min-Tein; Yeh, Chung-Hsin; Sung, Fung-Chang

2017-01-01

Abstract Dermatologic diseases are not traditional risk factors of stroke, but recent studies show atopic dermatitis, psoriasis, and bullous skin disease may increase the risk of stroke and other cardiovascular diseases. No previous studies have focused on the association between contact dermatitis and stroke. We established a cohort comprised of 48,169 contact dermatitis patients newly diagnosed in 2000–2003 and 96,338 randomly selected subjects without the disorder, frequency matched by sex, age, and diagnosis year, as the comparison cohort. None of them had a history of stroke. Stroke incidence was assessed by the end of 2011 for both cohorts. The incidence stroke was 1.1-fold higher in the contact dermatitis cohort than in the comparison cohort (5.93 vs 5.37 per 1000 person-years, P contact dermatitis cohort increased with age, from 1.14 (95% CI, 1.03–1.27) for 65 to 74 years; to 1.27 (95% CI, 1.15–1.42) for 75 years and older. The aHR of stroke were 1.16 (95% CI, 1.07–1.27) and 1.09 (95% CI, 1.00–1.18) for men and women, respectively. This study suggests that patients with contact dermatitis were at a modestly increased risk of stroke, significant for ischemic stroke but not for hemorrhagic stroke. Comorbidity, particularly hypertension, increased the hazard of stroke further. PMID:28272195

Has risk associated with smoking increased?

DEFF Research Database (Denmark)

Prescott, E; Osler, M; Andersen, P K

1997-01-01

BACKGROUND: Two recent much cited publications have raised the concern that risk associated with cigarette smoking has so far been underestimated. In this study we wish to determine whether excess all-cause mortality associated with smoking has increased during the last 20-30 years in a study...... population representative of the general Danish population and whether any such changes relate to changes in smoking behaviour. METHODS: Pooled data from three prospective population studies conducted in Copenhagen with detailed information on smoking habits. A total of 31,194 subjects, 17,669 males and 13......,525 females, initially examined between 1964 and 1992 with examinations repeated at intervals from 1-10 years, were followed until 1995 for all-cause mortality. Relative mortality risk in smokers versus never-smokers was calculated within periods of five calendar years and compared throughout the study period...

Western dietary pattern increases risk of cardiovascular disease in Iranian adults: a prospective population-based study.

Science.gov (United States)

Mirmiran, Parvin; Bahadoran, Zahra; Vakili, Azita Zadeh; Azizi, Fereidoun

2017-03-01

Limited data are available regarding the association of major dietary patterns and risk of cardiovascular disease (CVD) in Middle Eastern countries. We aimed to evaluate the association of major dietary patterns, using factor analysis, with the risk of CVD. Participants without CVD (n = 2284) were recruited from the Tehran Lipid and Glucose Study and were followed for a mean of 4.7 years. Dietary intake of participants was assessed at baseline (2006-2008); biochemical variables were evaluated at baseline and follow-up examination. Multivariate Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate risk of CVD across tertiles of dietary pattern scores. Linear regression models were used to indicate association of dietary pattern scores with changes of CVD risk factors over the study period. Two major dietary patterns, Western and traditional, were identified. During a mean 4.7 ± 1.4 years of follow-up, 57 participants experienced CVD-related events. In the fully adjusted model, we observed an increased risk of CVD-related events in the highest compared to the lowest tertile category of Western dietary pattern score (HR = 2.07, 95% CI = 1.03-4.18, P for trend = 0.01). Traditional dietary pattern was not associated with incidence of CVD or CVD risk factors. A significant association was observed between the Western dietary pattern and changes in serum insulin (β = 5.88, 95% CI = 0.34-11.4). Our findings confirm that the Western dietary pattern, characterized by higher loads of processed meats, salty snacks, sweets, and soft drinks, is a dietary risk factor for CVD in the Iranian population.

Increased risk of pneumonia among ventilated patients with traumatic brain injury: every day counts!

Science.gov (United States)

Hui, Xuan; Haider, Adil H; Hashmi, Zain G; Rushing, Amy P; Dhiman, Nitasha; Scott, Valerie K; Selvarajah, Shalini; Haut, Elliott R; Efron, David T; Schneider, Eric B

2013-09-01

Patients with traumatic brain injury (TBI) frequently require mechanical ventilation (MV). The objective of this study was to examine the association between time spent on MV and the development of pneumonia among patients with TBI. Patients older than 18 y with head abbreviated injury scale (AIS) scores coded 1-6 requiring MV in the National Trauma Data Bank 2007-2010 data set were included. The study was limited to hospitals reporting pneumonia cases. AIS scores were calculated using ICDMAP-90 software. Patients with injuries in any other region with AIS score >3, significant burns, or a hospital length of stay >30 d were excluded. A generalized linear model was used to determine the approximate relative risk of developing all-cause pneumonia (aspiration pneumonia, ventilator-associated pneumonia [VAP], and infectious pneumonia identified by the International Classification of Disease, Ninth Revision, diagnosis code) for each day of MV, controlling for age, gender, Glasgow coma scale motor score, comorbidity (Charlson comorbidity index) score, insurance status, and injury type and severity. Among the 24,525 patients with TBI who required MV included in this study, 1593 (6.5%) developed all-cause pneumonia. After controlling for demographic and injury factors, each additional day on the ventilator was associated with a 7% increase in the risk of pneumonia (risk ratio 1.07, 95% confidence interval 1.07-1.08). Patients who have sustained TBIs and require MV are at higher risk for VAP than individuals extubated earlier; therefore, shortening MV exposure will likely reduce the risk of VAP. As patients with TBI frequently require MV because of neurologic impairment, it is key to develop aggressive strategies to expedite ventilator independence. Copyright © 2013 Elsevier Inc. All rights reserved.

Subfertility increases risk of testicular cancer: evidence from population-based semen samples.

Science.gov (United States)

Hanson, Heidi A; Anderson, Ross E; Aston, Kenneth I; Carrell, Douglas T; Smith, Ken R; Hotaling, James M

2016-02-01

To further understand the association between semen quality and cancer risk by means of well defined semen parameters. Retrospective cohort study. Not applicable. A total of 20,433 men who underwent semen analysis (SA) and a sample of 20,433 fertile control subjects matched by age and birth year. None. Risk of all cancers as well as site-specific results for prostate cancer, testicular cancer, and melanoma. Compared with fertile men, men with SA had an increased risk of testicular cancer (hazard rate [HR] 3.3). When the characterization of infertility was refined using individual semen parameters, we found that oligozoospermic men had an increased risk of cancer compared with fertile control subjects. This association was particularly strong for testicular cancer, with increased risk in men with oligozoospermia based on concentration (HR 11.9) and on sperm count (HR 10.3). Men in the in the lowest quartile of motility (HR 4.1), viability (HR 6.6), morphology (HR 4.2), or total motile count (HR 6.9) had higher risk of testicular cancer compared with fertile men. Men with sperm concentration and count in the 90th percentiles of the distribution (≥178 and ≥579 × 10(6)/mL, respectively), as well as total motile count, had an increased risk of melanoma (HRs 2.1, 2.7, and 2.0, respectively). We found no differences in cancer risk between azoospermic and fertile men. Men with SA had an increased risk of testicular cancer which varied by semen quality. Unlike earlier work, we did not find an association between azoospermia and increased cancer risk. Published by Elsevier Inc.

Endometriosis increases the risk of obstetrical and neonatal complications.

Science.gov (United States)

Berlac, Janne Foss; Hartwell, Dorthe; Skovlund, Charlotte Wessel; Langhoff-Roos, Jens; Lidegaard, Øjvind

2017-06-01

The objective of this study was to assess obstetrical complications and neonatal outcomes in women with endometriosis as compared with women without endometriosis. National cohort including all delivering women and their newborns in Denmark 1997-2014. Data were extracted from the Danish Health Register and the Medical Birth Register. Logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI). Sub-analyses were made for primiparous women with a singleton pregnancy and for women with endometriosis who underwent gynecological surgery before pregnancy. In 19 331 deliveries, women with endometriosis had a higher risk of severe preeclampsia (OR 1.7, 95% CI 1.5-2.0), hemorrhage in pregnancy (OR 2.3, 95% CI 2.0-2.5), placental abruption (OR 2.0, 95% CI 1.7-2.3), placenta previa (OR 3.9, 95% CI 3.5-4.3), premature rupture of membranes (OR 1.7, 95% CI 1.5-1.8), and retained placenta (OR 3.1, 95% CI 1.4-6.6). The neonates had increased risks of preterm birth before 28 weeks (OR 3.1, 95% CI 2.7-3.6), being small for gestational age (OR 1.5, 95% CI 1.4-1.6), being diagnosed with congenital malformations (OR 1.3, 95% CI 1.3-1.4), and neonatal death (OR 1.8, 95% CI 1.4-2.1). Results were similar in primiparous women with a singleton pregnancy. Gynecological surgery for endometriosis before pregnancy carried a further increased risk. Women with endometriosis had a significantly higher risk of several complications, such as preeclampsia and placental complications in pregnancy and at delivery. The newborns had increased risk of being delivered preterm, having congenital malformations, and having a higher neonatal death rate. Pregnant women with endometriosis require increased antenatal surveillance. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Fuel poverty increases risk of mould contamination, regardless of adult risk perception & ventilation in social housing properties.

Science.gov (United States)

Sharpe, Richard A; Thornton, Christopher R; Nikolaou, Vasilis; Osborne, Nicholas J

2015-06-01

Fuel poverty affects 2.4 million UK homes leading to poor hygrothermal conditions and risk of mould and house dust mite contaminations, which in turn increases risk of asthma exacerbation. For the first time we assess how fuel poverty, occupants' risk perception and use of mechanical ventilation mediate the risk of mould contamination in social housing. Postal questionnaires were sent to 3867 social housing properties to collect adult risk perception, and demographic and environmental information on occupants. Participant details were linked to data pertaining to the individual properties. Multiple logistic regression was used to calculate odds ratios and confidence intervals while allowing for clustering of individuals coming from the same housing estate. We used Structured Equation Modelling and Goodness of Fit analysis in mediation analyses to examine the role of fuel poverty, risk perception, use of ventilation and energy efficiency. Eighteen percent of our target social housing populations (671 households) were included into our study. High risk perception (score of 8-10) was associated with reduced risk of mould contamination in the bedrooms of children (OR 0.5 95% CI; 0.3-0.9) and adults (OR 0.4 95% CI; 0.3-0.7). High risk perception of living with inadequate heating and ventilation reduced the risk of mould contamination (OR 0.5 95% CI; 0.3-0.8 and OR 0.5 95% CI; 0.3-0.7, respectively). Participants living with inadequate heating and not heating due to the cost of fuel had an increased risk of mould contamination (OR 3.4 95% CI; 2.0-5.8 and OR 2.2 95% CI; 1.5-3.2, respectively). Increased risk perception and use of extractor fans did not mediate the association between fuel poverty behaviours and increased risk of mould contamination. Fuel poverty behaviours increased the risk of mould contamination, which corresponds with existing literature. For the first time we used mediation analysis to assess how this association maybe modified by occupant behaviours

Increased risk of stomach and esophageal malignancies in people with AIDS.

Science.gov (United States)

Persson, E Christina; Shiels, Meredith S; Dawsey, Sanford M; Bhatia, Kishor; Anderson, Lesley A; Engels, Eric A

2012-10-01

People infected with human immunodeficiency virus (HIV) have an increased risk of some malignancies, but little is known about the effects of infection on risk of cancers of the upper gastrointestinal tract. We evaluated the risks of different histologic and anatomic subtypes of carcinomas and non-Hodgkin lymphomas (NHLs) of the stomach and esophagus in people with acquired immunodeficiency syndrome (AIDS). We analyzed data from the HIV/AIDS Cancer Match Study, which links data collected from 1980 to 2007 for 16 US population-based HIV and AIDS and cancer registries. We compared risks of stomach and esophageal malignancies in people with AIDS (N = 596,955) with those of the general population using standardized incidence ratios (SIRs). We assessed calendar trends using Poisson regression. People with AIDS had increased risks of carcinomas of the esophagus (SIR, 1.69; 95% confidence interval [CI], 1.37-2.07; n = 95) and stomach (SIR, 1.44; 95% CI, 1.17-1.76; n = 96). Risk was increased for esophageal adenocarcinoma (SIR, 1.91; 95% CI, 1.31-2.70) and squamous cell carcinoma (SIR, 1.47; 95% CI, 1.10-1.92). People with AIDS had greater risks of carcinomas of the gastric cardia (SIR, 1.36; 95% CI, 0.83-2.11) and noncardia (SIR, 1.53; 95% CI, 1.12-2.05) than the general population. Although most stomach and esophageal NHLs that developed in people with AIDS were diffuse large B-cell lymphomas, these individuals also had an increased risk of stomach mucosa-associated lymphoid tissue lymphoma (SIR, 5.99; 95% CI, 3.19-10.2; n = 13). The incidence of carcinomas remained fairly constant over time, but rates of NHL decreased from 1980 to 2007 (P(trend) AIDS are at increased risk for developing esophageal and stomach carcinomas and NHLs. Although the incidence of NHL decreased from 1980 to 2007 as treatments for HIV infection improved, HIV-infected individuals face continued risks of esophageal and stomach carcinomas. Copyright © 2012 AGA Institute. Published by Elsevier Inc

Near-linear cost increase to reduce climate-change risk

NARCIS (Netherlands)

Schaeffer, M.; Kram, T.; Meinshausen, M.; Vuuren, van D.P.; Hare, W.L.

2008-01-01

One approach in climate-change policy is to set normative long-term targets first and then infer the implied emissions pathways. An important example of a normative target is to limit the global-mean temperature change to a certain maximum. In general, reported cost estimates for limiting global

Fractures and the increased risk of suicide.

Science.gov (United States)

Chang, C-F; Lai, E C-C; Yeh, M-K

2018-06-01

Aims A high rate of suicide has been reported in patients who sustain fractures, but the association remains uncertain in the context of other factors. The aim of this study was to examine the association between fractures and the risk of suicide in this contextual setting. Patients and Methods We performed a case-control study of patients aged 40 years or older who died by suicide between 2000 and 2011. We included patients' demographics, physical and mental health problems, and socioeconomic factors. We performed conditional logistic regression to evaluate the associations between fractures and the risk of suicide. Results We included a total of 34 794 patients who died by suicide and 139 176 control patients. We found that fractures as a homogenous group (adjusted odds ratios (aOR), 1.48; 95% confidence interval (CI) 1.43 to 1.53), and specifically pelvic (aOR 2.04; 95% CI 1.68 to 2.47) and spinal fractures (aOR 1.53; 95% CI 1.43 to 1.64), were associated with a higher risk of suicide. In addition, we found that patients who had a lower income, had never married, had lower levels of educational attainment, or had coexistent physical and mental conditions such as anxiety, mood disorders, and psychosis-related disorders had a higher risk of suicide. Conclusion Fractures, specifically those of the hip and spine, were associated with an increased risk of suicide. The findings suggest that greater clinical attention should be given to this risk in patients with fractures, especially for those with additional risk factors. Cite this article: Bone Joint J 2018;100-B:780-6.

Increasing tsunami risk awareness via mobile application

Science.gov (United States)

Leelawat, N.; Suppasri, A.; Latcharote, P.; Imamura, F.; Abe, Y.; Sugiyasu, K.

2017-02-01

In the information and communication technology era, smartphones have become a necessity. With the capacity and availability of smart technologies, a number of benefits are possible. As a result, designing a mobile application to increase tsunami awareness has been proposed, and a prototype has been designed and developed. The application uses data from the 2011 Great East Japan Tsunami. Based on the current location determined by a GPS function matched with the nearest point extracted from the detailed mesh data of that earlier disaster, the application generates the inundation depth at the user’s location. Thus, not only local people but also tourists visiting the affected areas can understand the risks involved. Application testing has been conducted in an evacuation experiment involving both Japanese and foreign students. The proposed application can be used as a supplementary information tool in tsunami evacuation drills. It also supports the idea of smart tourism: when people realize their risks, they possess risk awareness and hence can reduce their risks. This application can also be considered a contribution to disaster knowledge and technology, as well as to the lessons learned from the practical outcome.

Sleep duration and risk of all-cause mortality: A flexible, non-linear, meta-regression of 40 prospective cohort studies.

Science.gov (United States)

Liu, Tong-Zu; Xu, Chang; Rota, Matteo; Cai, Hui; Zhang, Chao; Shi, Ming-Jun; Yuan, Rui-Xia; Weng, Hong; Meng, Xiang-Yu; Kwong, Joey S W; Sun, Xin

2017-04-01

Approximately 27-37% of the general population experience prolonged sleep duration and 12-16% report shortened sleep duration. However, prolonged or shortened sleep duration may be associated with serious health problems. A comprehensive, flexible, non-linear meta-regression with restricted cubic spline (RCS) was used to investigate the dose-response relationship between sleep duration and all-cause mortality in adults. Medline (Ovid), Embase, EBSCOhost-PsycINFO, and EBSCOhost-CINAHL Plus databases, reference lists of relevant review articles, and included studies were searched up to Nov. 29, 2015. Prospective cohort studies investigating the association between sleep duration and all-cause mortality in adults with at least three categories of sleep duration were eligible for inclusion. We eventually included in our study 40 cohort studies enrolling 2,200,425 participants with 271,507 deaths. A J-shaped association between sleep duration and all-cause mortality was present: compared with 7 h of sleep (reference for 24-h sleep duration), both shortened and prolonged sleep durations were associated with increased risk of all-cause mortality (4 h: relative risk [RR] = 1.05; 95% confidence interval [CI] = 1.02-1.07; 5 h: RR = 1.06; 95% CI = 1.03-1.09; 6 h: RR = 1.04; 95% CI = 1.03-1.06; 8 h: RR = 1.03; 95% CI = 1.02-1.05; 9 h: RR = 1.13; 95% CI = 1.10-1.16; 10 h: RR = 1.25; 95% CI = 1.22-1.28; 11 h: RR = 1.38; 95% CI = 1.33-1.44; n = 29; P < 0.01 for non-linear test). With regard to the night-sleep duration, prolonged night-sleep duration was associated with increased all-cause mortality (8 h: RR = 1.01; 95% CI = 0.99-1.02; 9 h: RR = 1.08; 95% CI = 1.05-1.11; 10 h: RR = 1.24; 95% CI = 1.21-1.28; n = 13; P < 0.01 for non-linear test). Subgroup analysis showed females with short sleep duration a day (<7 h) were at high risk of all-cause mortality (4 h: RR = 1.07; 95% CI = 1.02-1.13; 5 h: RR = 1.08; 95

Genetic variants in CETP increase risk of intracerebral hemorrhage

NARCIS (Netherlands)

Anderson, C.D.; Falcone, G.J.; Phuah, C.L.; Radmanesh, F.; Brouwers, H.B.; Battey, T.W.; Biffi, A.; Peloso, G.M.; Liu, D.J.; Ayres, A.M.; Goldstein, J.N.; Viswanathan, A.; Greenberg, S.M.; Selim, M.; Meschia, J.F.; Brown, D.L.; Worrall, B.B.; Silliman, S.L.; Tirschwell, D.L.; Flaherty, M.L.; Kraft, P.; Jagiella, J.M.; Schmidt, H.; Hansen, B.M.; Jimenez-Conde, J.; Giralt-Steinhauer, E.; Elosua, R.; Cuadrado-Godia, E.; Soriano, C.; Nieuwenhuizen, K.M. van; Klijn, C.J.M.; Rannikmae, K.; Samarasekera, N.; Salman, R.A.; Sudlow, C.L.; Deary, I.J.; Morotti, A.; Pezzini, A.; Pera, J.; Urbanik, A.; Pichler, A.; Enzinger, C.; Norrving, B.; Montaner, J.; Fernandez-Cadenas, I.; Delgado, P.; Roquer, J.; Lindgren, A.; Slowik, A.; Schmidt, R.; Kidwell, C.S.; Kittner, S.J.; Waddy, S.P.; Langefeld, C.D.; Abecasis, G.; Willer, C.J.; Kathiresan, S.; Woo, D.; Rosand, J.

2016-01-01

OBJECTIVE: In observational epidemiologic studies, higher plasma high-density lipoprotein cholesterol (HDL-C) has been associated with increased risk of intracerebral hemorrhage (ICH). DNA sequence variants that decrease cholesteryl ester transfer protein (CETP) gene activity increase plasma HDL-C;

Genetic variants in CETP increase risk of intracerebral hemorrhage

NARCIS (Netherlands)

Anderson, Christopher D.; Falcone, Guido J.; Phuah, Chia Ling; Radmanesh, Farid; Brouwers, H. Bart; Battey, Thomas W K; Biffi, Alessandro; Peloso, Gina M.; Liu, Dajiang J.; Ayres, Alison M.; Goldstein, Joshua N.; Viswanathan, Anand; Greenberg, Steven M.; Selim, Magdy; Meschia, James F.; Brown, Devin L.; Worrall, Bradford B.; Silliman, Scott L.; Tirschwell, David L.; Flaherty, Matthew L.; Kraft, Peter; Jagiella, Jeremiasz M.; Schmidt, Helena; Hansen, Björn M.; Jimenez-Conde, Jordi; Giralt-Steinhauer, Eva; Elosua, Roberto; Cuadrado-Godia, Elisa; Soriano, Carolina; van Nieuwenhuizen, Koen M.; Klijn, Catharina J M; Rannikmae, Kristiina; Samarasekera, Neshika; Salman, Rustam Al Shahi; Sudlow, Catherine L.; Deary, Ian J.; Morotti, Andrea; Pezzini, Alessandro; Pera, Joanna; Urbanik, Andrzej; Pichler, Alexander; Enzinger, Christian; Norrving, Bo; Montaner, Joan; Fernandez-Cadenas, Israel; Delgado, Pilar; Roquer, Jaume; Lindgren, Arne; Slowik, Agnieszka; Schmidt, Reinhold; Kidwell, Chelsea S.; Kittner, Steven J.; Waddy, Salina P.; Langefeld, Carl D.; Abecasis, Goncalo; Willer, Cristen J.; Kathiresan, Sekar; Woo, Daniel; Rosand, Jonathan

2016-01-01

Objective: In observational epidemiologic studies, higher plasma high-density lipoprotein cholesterol (HDL-C) has been associated with increased risk of intracerebral hemorrhage (ICH). DNA sequence variants that decrease cholesteryl ester transfer protein (CETP) gene activity increase plasma HDL-C;

Cigarette graphic warning labels increase both risk perceptions and smoking myth endorsement.

Science.gov (United States)

Evans, Abigail T; Peters, Ellen; Shoben, Abigail B; Meilleur, Louise R; Klein, Elizabeth G; Tompkins, Mary Kate; Tusler, Martin

2018-02-01

Cigarette graphic warning labels elicit negative emotion, which increases risk perceptions through multiple processes. We examined whether this emotion simultaneously affects motivated cognitions like smoking myth endorsement (e.g. 'exercise can undo the negative effects of smoking') and perceptions of cigarette danger versus other products. 736 adult and 469 teen smokers/vulnerable smokers viewed one of three warning label types (text-only, low emotion graphic or high emotion graphic) four times over two weeks. Emotional reactions to the warnings were reported during the first and fourth exposures. Participants reported how often they considered the warnings, smoking myth endorsement, risk perceptions and perceptions of cigarette danger relative to smokeless tobacco and electronic cigarettes. In structural equation models, emotional reactions influenced risk perceptions and smoking myth endorsement through two processes. Emotion acted as information about risk, directly increasing smoking risk perceptions and decreasing smoking myth endorsement. Emotion also acted as a spotlight, motivating consideration of the warning information. Warning consideration increased risk perceptions, but also increased smoking myth endorsement. Emotional reactions to warnings decreased perceptions of cigarette danger relative to other products. Emotional reactions to cigarette warnings increase smoking risk perceptions, but also smoking myth endorsement and misperceptions that cigarettes are less dangerous than potentially harm-reducing tobacco products.

Smoking increases the risk of early meniscus repair failure.

Science.gov (United States)

Blackwell, Ryan; Schmitt, Laura C; Flanigan, David C; Magnussen, Robert A

2016-05-01

The goal of this study is to determine whether patients who smoke cigarettes at the time of surgery are at significantly increased risk of early meniscus repair failure relative to non-smokers. Retrospective chart review identified 64 current smokers within a series of 444 consecutive patients who underwent meniscus repair during a 7 years period. Fifty-two of these 64 smokers were available for follow-up and were matched by age, sex, and ACL status with non-smokers from the same cohort. Records of these 104 patients with a total of 120 meniscus repairs were reviewed to identify meniscus repair failure (defined as repeat surgery on the index meniscus) during the median 13-month (range: 3-79 months) follow-up period. The smoking and non-smoking groups were similar in age, sex, ACL status, BMI, meniscus repair technique, and meniscus involved. Meniscus repair failure occurred in 19 of the 112 menisci in 104 patients, for an overall failure risk of 17 %. Of the 19 failures, 14 occurred in 79 repaired medial menisci (18 % failure risk) and 5 occurred in 33 repaired lateral menisci (15 % failure risk). Meniscus repair failure occurred in significantly more smokers (15 failures in 56 menisci in 52 patients -27 % failure risk) than non-smokers (4 failures in 56 menisci in 52 patients -7 % failure risk) (p = 0.0076). Smoking is associated with significantly increased risk of early meniscus repair failure as defined by the incidence of repeat surgery on the index meniscus. III.

Portfolio optimization using fuzzy linear programming

Science.gov (United States)

Pandit, Purnima K.

2013-09-01

Portfolio Optimization (PO) is a problem in Finance, in which investor tries to maximize return and minimize risk by carefully choosing different assets. Expected return and risk are the most important parameters with regard to optimal portfolios. In the simple form PO can be modeled as quadratic programming problem which can be put into equivalent linear form. PO problems with the fuzzy parameters can be solved as multi-objective fuzzy linear programming problem. In this paper we give the solution to such problems with an illustrative example.

Views of Low-Income Women of Color at Increased Risk for Breast Cancer.

Science.gov (United States)

E Anderson, Emily; Tejada, Silvia; B Warnecke, Richard; Hoskins, Kent

2018-01-01

Individual risk assessment (IRA) for breast cancer may increase adherence to risk-appropriate screening and prevention measures. However, knowledge gaps exist regarding how best to communicate IRA results and support women at increased risk in future health care decisions, in part because patients conceptualize and make meaning of risk differently from the medical community. Better understanding the views of low-income women of color identified as being at increased risk for breast cancer can inform efforts to conduct IRA in an ethical and respectful manner. We conducted in-depth interviews with 13 low-income African American and Latina women who receive care at a federally qualified health center (FQHC) and had recently learned of their increased risk for breast cancer. These interviews explored their experience of the IRA process, their interpretation of what being at increased risk means, and their reactions to provider recommendations. Eight key themes were identified. We conclude with recommendations for the implementation of IRA for breast cancer in underserved primary care settings.

Integrating linear optimization with structural modeling to increase HIV neutralization breadth.

Directory of Open Access Journals (Sweden)

Alexander M Sevy

2018-02-01

Full Text Available Computational protein design has been successful in modeling fixed backbone proteins in a single conformation. However, when modeling large ensembles of flexible proteins, current methods in protein design have been insufficient. Large barriers in the energy landscape are difficult to traverse while redesigning a protein sequence, and as a result current design methods only sample a fraction of available sequence space. We propose a new computational approach that combines traditional structure-based modeling using the Rosetta software suite with machine learning and integer linear programming to overcome limitations in the Rosetta sampling methods. We demonstrate the effectiveness of this method, which we call BROAD, by benchmarking the performance on increasing predicted breadth of anti-HIV antibodies. We use this novel method to increase predicted breadth of naturally-occurring antibody VRC23 against a panel of 180 divergent HIV viral strains and achieve 100% predicted binding against the panel. In addition, we compare the performance of this method to state-of-the-art multistate design in Rosetta and show that we can outperform the existing method significantly. We further demonstrate that sequences recovered by this method recover known binding motifs of broadly neutralizing anti-HIV antibodies. Finally, our approach is general and can be extended easily to other protein systems. Although our modeled antibodies were not tested in vitro, we predict that these variants would have greatly increased breadth compared to the wild-type antibody.

Integrating linear optimization with structural modeling to increase HIV neutralization breadth.

Science.gov (United States)

Sevy, Alexander M; Panda, Swetasudha; Crowe, James E; Meiler, Jens; Vorobeychik, Yevgeniy

2018-02-01

Computational protein design has been successful in modeling fixed backbone proteins in a single conformation. However, when modeling large ensembles of flexible proteins, current methods in protein design have been insufficient. Large barriers in the energy landscape are difficult to traverse while redesigning a protein sequence, and as a result current design methods only sample a fraction of available sequence space. We propose a new computational approach that combines traditional structure-based modeling using the Rosetta software suite with machine learning and integer linear programming to overcome limitations in the Rosetta sampling methods. We demonstrate the effectiveness of this method, which we call BROAD, by benchmarking the performance on increasing predicted breadth of anti-HIV antibodies. We use this novel method to increase predicted breadth of naturally-occurring antibody VRC23 against a panel of 180 divergent HIV viral strains and achieve 100% predicted binding against the panel. In addition, we compare the performance of this method to state-of-the-art multistate design in Rosetta and show that we can outperform the existing method significantly. We further demonstrate that sequences recovered by this method recover known binding motifs of broadly neutralizing anti-HIV antibodies. Finally, our approach is general and can be extended easily to other protein systems. Although our modeled antibodies were not tested in vitro, we predict that these variants would have greatly increased breadth compared to the wild-type antibody.

On capital allocation for stochastic arrangement increasing actuarial risks

Directory of Open Access Journals (Sweden)

Pan Xiaoqing

2017-01-01

Full Text Available This paper studies the increasing convex ordering of the optimal discounted capital allocations for stochastic arrangement increasing risks with stochastic arrangement decreasing occurrence times. The application to optimal allocation of policy limits is presented as an illustration as well.

Identification and management of patients at increased risk of osteoporotic fracture

DEFF Research Database (Denmark)

Kanis, J A; Cooper, C; Rizzoli, R

2017-01-01

where the risk of a subsequent fracture following a first fracture is high. Consequently, there is a significant treatment gap between those who would benefit from treatment and those who receive it, which urgently needs to be addressed so that the burden of disease can be reduced. Conclusions......Summary: Osteoporosis represents a significant and increasing healthcare burden in Europe, but most patients at increased risk of fracture do not receive medication, resulting in a large treatment gap. Identification of patients who are at particularly high risk will help clinicians target...... appropriate treatment more precisely and cost-effectively, and should be the focus of future research. Introduction: The purpose of the study was to review data on the identification and treatment of patients with osteoporosis at increased risk of fracture. Methods: A working group convened by the European...

Increased risk of oesophageal adenocarcinoma among upstream petroleum workers

Science.gov (United States)

Kirkeleit, Jorunn; Riise, Trond; Bjørge, Tone; Moen, Bente E; Bråtveit, Magne; Christiani, David C

2013-01-01

Objectives To investigate cancer risk, particularly oesophageal cancer, among male upstream petroleum workers offshore potentially exposed to various carcinogenic agents. Methods Using the Norwegian Registry of Employers and Employees, 24 765 male offshore workers registered from 1981 to 2003 was compared with 283 002 male referents from the general working population matched by age and community of residence. The historical cohort was linked to the Cancer Registry of Norway and the Norwegian Cause of Death Registry. Results Male offshore workers had excess risk of oesophageal cancer (RR 2.6, 95% CI 1.4 to 4.8) compared with the reference population. Only the adenocarcinoma type had a significantly increased risk (RR 2.7, 95% CI 1.0 to 7.0), mainly because of an increased risk among upstream operators (RR 4.3, 95% CI 1.3 to 14.5). Upstream operators did not have significant excess of respiratory system or colon cancer or mortality from any other lifestyle-related diseases investigated. Conclusion We found a fourfold excess risk of oesophageal adenocarcinoma among male workers assumed to have had the most extensive contact with crude oil. Due to the small number of cases, and a lack of detailed data on occupational exposure and lifestyle factors associated with oesophageal adenocarcinoma, the results must be interpreted with caution. Nevertheless, given the low risk of lifestyle-related cancers and causes of death in this working group, the results add to the observations in other low-powered studies on oesophageal cancer, further suggesting that factors related to the petroleum stream or carcinogenic agents used in the production process might be associated with risk of oesophageal adenocarcinoma. PMID:19858535

Increased risk of migraine in patients with psoriasis

DEFF Research Database (Denmark)

Egeberg, A.; Mallbris, L.; Gislason, G. H.

2015-01-01

Background: Psoriasis and migraine are common conditions with potential overlap of pathophysiological mechanisms. Both these diseases have been associated with increased cardiovascular risk but little is known about their interplay. Objective: We sought to investigate the link between psoriasis...... and adjusted incidence rate ratios were estimated by Poisson regression models. Results: The study comprised a total of 5,379,859 individuals, including 53,006 and 6831 patients with mild and severe psoriasis, respectively, and 6243 patients with psoriatic arthritis. Fully adjusted incidence rate ratios...... for migraine were 1.37 (95% confidence interval 1.30-1.45), 1.55 (95% confidence interval 1.29-1.86), and 1.92 (95% confidence interval 1.65-2.22) for mild psoriasis, severe psoriasis, and psoriatic arthritis, respectively. Stratification for sex revealed increased risk of migraine in both male and female...

Micronutrient-fortified rice can increase hookworm infection risk

DEFF Research Database (Denmark)

de Gier, Brechje; Campos Ponce, Maiza; Perignon, Marlene

2016-01-01

or inflammation after iron supplementation. OBJECTIVE: To study effects of micronutrient-fortified rice on hookworm infection in Cambodian schoolchildren. METHODS: A double-blinded, cluster-randomized trial was conducted in 16 Cambodian primary schools partaking in the World Food Program school meal program....... Three types of multi-micronutrient fortified rice were tested against placebo rice within the school meal program: UltraRice_original, UltraRice_improved and NutriRice. Four schools were randomly assigned to each study group (placebo n = 492, UltraRice_original n = 479, UltraRice_improved n = 500, NutriRice.......6%, but differed considerably among schools (range 0%- 48.1%).Micronutrient-fortified rice significantly increased risk of new hookworm infection. This effect was modified by baseline hookworm prevalence at the school; hookworm infection risk was increased by all three types of fortified rice in schools where...

Financing increasing flood risk: evidence from millions of buildings

Science.gov (United States)

Jongman, B.; Koks, E. E.; Husby, T. G.; Ward, P. J.

2014-01-01

The effectiveness of disaster risk management and financing mechanisms depends on the accurate assessment of current and future hazard exposure. The increasing availability of detailed data offers policy makers and the insurance sector new opportunities to understand trends in risk, and to make informed decisions on the ways to deal with these trends. In this paper we show how comprehensive property level information can be used for the assessment of exposure to flooding on a national scale, and how this information can contribute to discussions on possible risk financing practices. The case-study used is the Netherlands, which is one of the countries most exposed to flooding globally, and which is currently undergoing a debate on strategies for the compensation of potential losses. Our results show that flood exposure has increased rapidly between 1960 and 2012, and that the growth of the building stock and its economic value in flood prone areas has been higher than in not flood prone areas. We also find that property values in flood prone areas are lower than those in not flood prone areas. We argue that the increase in the share of economic value located in potential flood prone areas can have a negative effect on the feasibility of private insurance schemes in the Netherlands. The methodologies and results presented in this study are relevant for many regions around the world where the effects of rising flood exposure create a challenge for risk financing.

Risk of cancer formation by radiotherapy

International Nuclear Information System (INIS)

Fuji, Hiroshi

2011-01-01

Described are the difference between exposures to radiation for medical purpose and to environmental radiation at low dose, estimation of carcinogenic risk by medical radiation, and notice for referring the risk at clinical practice. ICRP employs linear non-threshold (LNT) model for risk of cancer formation even at <200 mSv for safety, with a recognition that it is scientifically obscure. The model essentially stands on data of A-bomb survivors (the Gold Standard), where the relationship between 5-10% excess relative risk (ERR) of cancer formation and dose 0.05-2.5 Sv is linear. Analyses of the secondary carcinogenesis after radiotherapy have begun to be reported since around 2005: e.g., the secondary thyroid cancer risk in pediatric patients treated with radiotherapy has a peak at 20 Gy, suggesting the actual risk depends both on the linearity of carcinogenic increase and on the exponential probability of cell death increase. On this concept, the risk of cancer formation is not always linear to dose. At the practical radiotherapy, its secondary carcinogenic risk should be estimated not only on the dose but also on other factors such as the individual organ, patient's age and attainable age/time after the treatment. In treated teen-ager patients, ERRs of mortality/Gy are 2.28 for cancers of the skin of non-malignant melanoma, 1.32 of bladder and 1.21 of thyroid and in patients of fifties, 1.15 of bladder and lung. The EER tends to become lower as the treated age is older. Pediatric cancer patients to be treated with radiotherapy should be informed about the secondary cancer that the low dose risk given by ICRP is not always appropriate, a certain cancer risk has a peak dose, and ERR of cancer mortality is not a cancer risk of an organ. Many factors like anticancers and immuno-modifiers, modify the outcome of radiotherapy and should be carefully speculated for evaluating the outcome. (T.T.)

Increased Risk of Gallstone Disease Following Colectomy for Ulcerative Colitis

DEFF Research Database (Denmark)

Mark-Christensen, Anders; Brandsborg, Søren; Laurberg, Søren

2017-01-01

Objectives:Biochemical studies suggest that patients who have had a colectomy or restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) are at an increased risk of developing gallstone disease, but epidemiological studies are lacking. We evaluated the risk of gallstone disease follo...

Daytime napping and increased risk of incident respiratory diseases: symptom, marker, or risk factor?

Science.gov (United States)

Leng, Yue; Wainwright, Nick W J; Cappuccio, Francesco P; Surtees, Paul G; Hayat, Shabina; Luben, Robert; Brayne, Carol; Khaw, Kay-Tee

2016-07-01

We have identified a strong association between daytime napping and increased mortality risk from respiratory diseases, but little is known about the relationship between daytime napping and respiratory morbidity. Data were drawn from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort. Participants reported napping habits during 1998-2000 and were followed up for respiratory disease hospital admissions until March 2009. Cox proportional hazards regression was used to examine the association between daytime napping and respiratory disease incidence risk. The study sample included 10,978 men and women with a mean age of 61.9 years, and a total of 946 incident respiratory disease cases were recorded. After adjustment for age, sex, social class, education, marital status, employment status, nightshift work, body mass index, physical activity, smoking, alcohol intake, self-reported general health, hypnotic drug use, habitual sleep duration, and preexisting health conditions, daytime napping was associated with an increase in the overall respiratory disease incidence risk (hazard ratio (HR) = 1.32, 95% confidence interval (CI) 1.15, 1.52 for napping respiratory diseases, especially for the risk of chronic lower respiratory diseases (HR = 1.52, 95% CI: 1.18, 1.96 for napping respiratory disease incidence risk. Further studies are required to confirm these findings and help understand potential mechanisms. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

Non-linear education gradient across the nutrition transition: mothers’ overweight and the population education transition

Science.gov (United States)

Salinas, Daniel; Baker, David P

2015-01-01

Objective Previous studies found that developed and developing countries present opposite education-overweight gradients but have not considered the dynamics at different levels of national development. A U-inverted curve is hypothesized to best describe the education-overweight association. It is also hypothesized that as the nutrition transition unfolds within nations the shape of education-overweight curve change. Design Multi-level logistic regression estimates the moderating effect of the nutrition transition at the population level on education-overweight gradient. At the individual level, a non-linear estimate of the education association assesses the optimal functional form of the association across the nutrition transition. Setting Twenty-two administrations of the Demographic and Health Survey, collected at different time points across the nutrition transition in nine Latin American/Caribbean countries. Subjects Mothers of reproductive age (15–49) in each administration (n 143,258). Results In the pooled sample, a non-linear education gradient on mothers‘ overweight is found; each additional year of schooling increases the probability of being overweight up to the end of primary schooling, after which each additional year of schooling decreases the probability of overweight. Also, as access to diets of high animal fats and sweeteners increases over time, the curve‘s critical point moves to lower education levels, the detrimental positive effect of education diminishes, and both occur as the overall risk of overweight increases with greater access to harmful diets. Conclusions Both hypotheses are supported. As the nutrition transition progresses, the education-overweight curve steadily shifts to a negative linear association with higher average risk of overweight; and education, at increasingly lower levels, acts as a “social vaccine” against increasing risk of overweight. These empirical patterns fit the general “population education

Optimal social insurance with linear income taxation

DEFF Research Database (Denmark)

Bovenberg, Lans; Sørensen, Peter Birch

2009-01-01

We study optimal social insurance aimed at insuring disability risk in the presence of linear income taxation. Optimal disability insurance benefits rise with previous earnings. Optimal insurance is incomplete even though disability risks are exogenous and verifiable so that moral hazard in disab...... in disability insurance is absent. Imperfect insurance is optimal because it encourages workers to insure themselves against disability by working and saving more, thereby alleviating the distortionary impact of the redistributive income tax on labor supply and savings.......We study optimal social insurance aimed at insuring disability risk in the presence of linear income taxation. Optimal disability insurance benefits rise with previous earnings. Optimal insurance is incomplete even though disability risks are exogenous and verifiable so that moral hazard...

Psycho Educational Group Intervention for Women at Increased Risk for Breast Cancer

National Research Council Canada - National Science Library

Kash, Kathryn

1998-01-01

... in women at increased risk for breast cancer; (2) examine the impact of a psychoeducational intervention on the endpoint variables of quality of life and adherence to screening in women at increased risk for breast cancer; and (3...

The Racing-Game Effect : Why Do Video Racing Games Increase Risk-Taking Inclinations?

NARCIS (Netherlands)

Fischer, Peter; Greitemeyer, Tobias; Morton, Thomas; Kastenmueller, Andreas; Postmes, Tom; Frey, Dieter; Kubitzki, Joerg; Odenwaelder, Joerg; Kastenmüller, A.; Odenwälder, J.

2009-01-01

The present studies investigated why video racing games increase players' risk-taking inclinations. Four studies reveal that playing video racing games increases risk taking in a subsequent simulated road traffic situation, as well as risk-promoting cognitions and emotions, blood pressure, sensation

Psycho Educational Group Intervention for Women at Increased Risk for Breast Cancer

National Research Council Canada - National Science Library

Kash, Kathryn

1997-01-01

... skills in women at increased risk for breast cancer; (2) to examine the impact of a psychoeducational intervention on the endpoint variables of quality of life and adherence to screening in women at increased risk for breast cancer; and (3...

Mechanism and preclinical prevention of increased breast cancer risk caused by pregnancy.

Science.gov (United States)

Haricharan, Svasti; Dong, Jie; Hein, Sarah; Reddy, Jay P; Du, Zhijun; Toneff, Michael; Holloway, Kimberly; Hilsenbeck, Susan G; Huang, Shixia; Atkinson, Rachel; Woodward, Wendy; Jindal, Sonali; Borges, Virginia F; Gutierrez, Carolina; Zhang, Hong; Schedin, Pepper J; Osborne, C Kent; Tweardy, David J; Li, Yi

2013-12-31

While a first pregnancy before age 22 lowers breast cancer risk, a pregnancy after age 35 significantly increases life-long breast cancer risk. Pregnancy causes several changes to the normal breast that raise barriers to transformation, but how pregnancy can also increase cancer risk remains unclear. We show in mice that pregnancy has different effects on the few early lesions that have already developed in the otherwise normal breast-it causes apoptosis evasion and accelerated progression to cancer. The apoptosis evasion is due to the normally tightly controlled STAT5 signaling going astray-these precancerous cells activate STAT5 in response to pregnancy/lactation hormones and maintain STAT5 activation even during involution, thus preventing the apoptosis normally initiated by oncoprotein and involution. Short-term anti-STAT5 treatment of lactation-completed mice bearing early lesions eliminates the increased risk after a pregnancy. This chemoprevention strategy has important implications for preventing increased human breast cancer risk caused by pregnancy. DOI: http://dx.doi.org/10.7554/eLife.00996.001.

Obesity increases risk of ischemic stroke in young adults.

Science.gov (United States)

Mitchell, Andrew B; Cole, John W; McArdle, Patrick F; Cheng, Yu-Ching; Ryan, Kathleen A; Sparks, Mary J; Mitchell, Braxton D; Kittner, Steven J

2015-06-01

Body mass index has been associated with ischemic stroke in older populations, but its association with stroke in younger populations is not known. In light of the current obesity epidemic in the United States, the potential impact of obesity on stroke risk in young adults deserves attention. A population-based case-control study design with 1201 cases and 1154 controls was used to investigate the relationship of obesity and young onset ischemic stroke. Stroke cases were between the ages of 15 and 49 years. Logistic regression analysis was used to evaluate the association between body mass index and ischemic stroke with and without adjustment for comorbid conditions associated with stroke. In analyses adjusted for age, sex, and ethnicity, obesity (body mass index >30 kg/m(2)) was associated with an increased stroke risk (odds ratio, 1.57; 95% confidence interval, 1.28-1.94) although this increased risk was highly attenuated and not statistically significant after adjustment for smoking, hypertension, and diabetes mellitus. These results indicate that obesity is a risk factor for young onset ischemic stroke and suggest that this association may be partially mediated through hypertension, diabetes mellitus, or other variables associated with these conditions. © 2015 American Heart Association, Inc.

Betel nut chewing associated with increased risk of arterial stiffness.

Science.gov (United States)

Wei, Yu-Ting; Chou, Yu-Tsung; Yang, Yi-Ching; Chou, Chieh-Ying; Lu, Feng-Hwa; Chang, Chih-Jen; Wu, Jin-Shang

2017-11-01

Betel nut chewing is associated with certain cardiovascular outcomes. Subclinical atherosclerosis may be one link between betel nut chewing and cardiovascular risk. Few studies have examined the association between chewing betel nut and arterial stiffness. The aim of this study was thus to determine the relationship between betel nut chewing and arterial stiffness in a Taiwanese population. We enrolled 7540 eligible subjects in National Cheng Kung University Hospital from October 2006 to August 2009. The exclusion criteria included history of cerebrovascular events, coronary artery disease, and taking lipid-lowering drugs, antihypertensives, and hypoglycemic agents. Increased arterial stiffness was defined as brachial-ankle pulse wave velocity (baPWV) ≥1400cm/s. According to their habit of betel nut use, the subjects were categorized into non-, ex-, and current chewers. The prevalence of increased arterial stiffness was 32.7, 43.3, and 43.2% in non-, ex- and current chewers, respectively (p=0.011). Multiple logistic regression analysis revealed that ex-chewers (odds ratio [OR] 1.69, 95% confidence interval (CI)=1.08-2.65) and current chewers (OR 2.29, 95% CI=1.05-4.99) had elevated risks of increased arterial stiffness after adjustment for co-variables. Both ex- and current betel nut chewing were associated with a higher risk of increased arterial stiffness. Stopping betel nut chewing may thus potentially be beneficial to reduce cardiovascular risk, based on the principals of preventive medicine. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk based maintenance to increase safety and decrease costs

International Nuclear Information System (INIS)

Phillips, J.H.

2000-01-01

Risk-Based techniques have been developed for commercial nuclear power plants for the last eight years by a team working through the ASME Center for Research and Technology Development (CRTD). System boundaries and success criteria is defined using the Probabilistic Risk Analysis or Probabilistic Safety Analysis developed to meet the Individual Plant Evaluation. Final ranking of components is by a plant expert panel similar to the one developed for the Maintenance Rule. Components are identified as being high risk-significant or low risk-significant. Maintenance and resources are focused on those components that have the highest risk-significance. The techniques have been developed and applied at a number of plants. Results from the first risk-based inspection pilot plant indicates safety due to pipe failure can be doubled while the inspection reduced to about 80% when compared with current inspection programs. Pilot studies on risk-based testing indicate that about 60% of pumps and 25 to 30% of valves in plants are high safety-significant The reduction in inspection and testing reduces the person-rem exposure and resulting in further increases in safety. These techniques have been documented in publications by the ASME CRTD which are referenced. (author)

Extreme Geohazards: Reducing the Disaster Risk and Increasing Resilience

Science.gov (United States)

Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Marsh, Stuart; Campus, Paola

2013-04-01

Extreme geohazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Exposure of human assets to geohazards has increased dramatically in recent decades, and the sensitivity of the built environment and the embedded socio-economic fabric have changed. We are putting the urban environment, including megacities, in harm's way. Paradoxically, innovation during recent decades, in particular, urban innovation, has increased the disaster risk and coupled this risk to the sustainability crisis. Only more innovation can reduce disaster risk and lead us out of the sustainability crisis. Extreme geohazards (volcanic eruptions, earthquakes, tsunamis) that occurred regularly throughout the last few millennia mostly did not cause major disasters because population density was low and the built environment was not sprawling into hazardous areas to the same extent as today. Similar extreme events today would cause unparalleled damage on a global scale and could worsen the sustainability crisis. Simulation of these extreme hazards under present conditions can help to assess the disaster risk. The Geohazards Community of Practice of the Group on Earth Observations (GEO) with support from the European Science Foundation is preparing a white paper assessing the contemporary disaster risks associated with extreme geohazards and developing a vision for science and society to engage in deliberations addressing this risk (see http://www.geohazcop.org/projects/extgeowp). Risk awareness and monitoring is highly uneven across the world, and this creates two kinds of problems. Firstly, potential hazards are much more closely monitored in wealthy countries than in the developing world. But the largest hazards are global in nature, and it is critical to get as much forewarning as possible to develop an effective response. The disasters and near-misses of the past show that adherence to scientific

Breast cancer patients with dense breasts do not have increased death risk

Science.gov (United States)

High mammographic breast density, which is a marker of increased risk of developing breast cancer, does not seem to increase the risk of death among breast cancer patients, according to a study led by Gretchen L. Gierach, Ph.D., NCI. Image shows physician

Increased Correlation in Bear markets: A Downside Risk Perspective

OpenAIRE

Campbell, Rachel; Koedijk, Kees; Kofman, Paul

2002-01-01

A number of studies have provided evidence of increased correlation in global financial market returns during bear markets. Others, however, have shown that some of this evidence may have been biased. We derive an alternative estimator for implied correlation based on portfolio downside risk measures that does not suffer from this bias. These unbiased quantile correlation estimates are directly applicable to portfolio optimization and to risk management techniques in general. This simple and ...

Increasing risk of prosthetic joint infection after total hip arthroplasty

DEFF Research Database (Denmark)

Dale, Håvard; Fenstad, Anne M; Hallan, Geir

2012-01-01

Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods The...... explain this increase. We believe that there has been an actual increase in the incidence of prosthetic joint infections after THA.......Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods...... The study was based on the Nordic Arthroplasty Register Association (NARA) dataset. 432,168 primary THAs from 1995 to 2009 were included (Denmark: 83,853, Finland 78,106, Norway 88,455, and Sweden 181,754). Adjusted survival analyses were performed using Cox regression models with revision due to infection...

From risk-seeking to risk-averse: The development of economic risk preference from early childhood to adulthood.

Directory of Open Access Journals (Sweden)

David J. Paulsen

2012-09-01

Full Text Available Adolescence is often described as a period of heightened risk-taking. Adolescents are notorious for impulsivity, emotional volatility, and risky behaviors such as drinking under the influence of alcohol. By contrast, we found that risk-taking declines linearly from childhood to adulthood when individuals make choices over monetary gambles. Further, with age we found increases in the sensitivity to economic risk, defined as the degree to which a preference for assured monetary gains over a risky payoff depends upon the variability in the risky payoff. These findings indicate that decisions about economic risk may follow a different developmental trajectory than other kinds of risk taking, and that changes in sensitivity to risk may be a major factor in the development of mature risk aversion.

Increased sexually transmitted infection incidence in a low risk population: identifying the risk factors.

LENUS (Irish Health Repository)

Shiely, Frances

2010-04-01

Between 1994 and 2006, the incidence of sexually transmitted infections (STIs) in Ireland has increased by over 300%. Recent literature would suggest that this figure is an underestimation of the true scale of infection. Our objective was to determine the risk factors associated with STI diagnosis in a population with a rapidly increasing STI incidence.

Tourette syndrome increases risk of bone fractures: a population-based cohort study.

Science.gov (United States)

Lu, Yuan-Yuan; Wang, Ming-Yu; Wei, I-Hua; Lin, Che-Chen; Huang, Chih-Chia

2017-05-01

This study assesses the risk of fractures among children with Tourette syndrome (TS), and identifies the effects of comorbidities and antipsychotics. We randomly sampled the claims data of 1 million enrollees in the National Health Insurance program of Taiwan, and identified 1258 children with TS diagnosed between 2000 and 2010. Additionally, 12,580 children without TS who were frequency matched for sex, age, residential area, parental occupation, and index year were identified for comparison. The children's cases were followed until December 31, 2010, or censored to ascertain incident fractures cases and associations with comorbidities of attention-deficit/hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD) and treatments with antipsychotics, antidepressants, or clonidine. The TS cohort had a 1.27-fold higher incidence of fractures than did the comparison cohort (190.37 vs. 149.94 per 10,000 person-years), with an adjusted hazard ratio (HR) of 1.28 [95% confidence interval (CI) 1.06-1.55] based on multivariable Cox regression analysis. This increased risk of fractures was apparent for fractures of the skull, neck, and spine. Comorbid ADHD and OCD did not result in an additional risk of fractures. The children without both ADHD and OCD were also at a higher risk of fractures, indicating that TS alone increases the risk of fractures. The children taking antipsychotics had a reduced risk of fractures, and the adjusted HR decreased to 1.17 (95% CI 0.90-1.52). Children with TS have an increased risk of fractures. ADHD and OCD do not increase the risk further.

Profiling of barrier capacitance and spreading resistance using a transient linearly increasing voltage technique.

Science.gov (United States)

Gaubas, E; Ceponis, T; Kusakovskij, J

2011-08-01

A technique for the combined measurement of barrier capacitance and spreading resistance profiles using a linearly increasing voltage pulse is presented. The technique is based on the measurement and analysis of current transients, due to the barrier and diffusion capacitance, and the spreading resistance, between a needle probe and sample. To control the impact of deep traps in the barrier capacitance, a steady state bias illumination with infrared light was employed. Measurements of the spreading resistance and barrier capacitance profiles using a stepwise positioned probe on cross sectioned silicon pin diodes and pnp structures are presented.

Increased risk for ovarian cancer and borderline ovarian tumours in subfertile women with endometriosis

NARCIS (Netherlands)

Buis, C. C. M.; van Leeuwen, F. E.; Mooij, T. M.; Burger, C. W.; Lambalk, Cornelis B.; Kortman, Marian; Laven, Joop S. E.; Jansen, Cees A. M.; Helmerhorst, Frans M.; Cohlen, Ben J.; Willemsen, Wim N. P.; Smeenk, Jesper M. J.; Simons, Arnold H. M.; van der Veen, Fulco; Evers, Johannes L. H.; van Dop, Peter A.; Macklon, Nicholas S.

2013-01-01

Is ovarian or extra-ovarian endometriosis associated with an increased risk of ovarian cancer and borderline ovarian tumours (BOT)? We found a 3- to 8-fold increased risk of ovarian tumours associated with endometriosis: the magnitude of the risk increase depended on the definition of endometriosis.

Increased risk of cardiovascular disease (CVD) with age in HIV-positive men

DEFF Research Database (Denmark)

Petoumenos, K; Reiss, P; Ryom, L

2014-01-01

equations. METHODS: We analysed three endpoints: myocardial infarction (MI), coronary heart disease (CHD: MI or invasive coronary procedure) and CVD (CHD or stroke). We fitted a number of parametric age effects, adjusting for known risk factors and antiretroviral therapy (ART) use. The best-fitting age...... rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40-45 years to 6.53, 11.91 and 15.89 in those aged 60-65 years, respectively. The best-fitting models included inverse age for MI and age + age(2) for CHD and CVD. In D:A:D there was a slowly accelerating increased risk of CHD...... and CVD per year older, which appeared to be only modest yet was consistently raised compared with the risk in the general population. The relative risk of MI with age was not different between D:A:D and the general population. CONCLUSIONS: We found only limited evidence of accelerating increased risk...

Increased risk of antidepressant use in childhood cancer survivors

DEFF Research Database (Denmark)

Lund, Lasse Wegener; Winther, J.F.; Cederkvist, L

2015-01-01

to the National Prescription Drug Database, which worldwide is the oldest nationwide registry of prescription medication. Hazard ratios (HRs) for antidepressant use were estimated in a Cox proportional hazards model stratified on sex, with population comparisons as referents. RESULTS: Overall, childhood cancer......AIM: Childhood cancer survivors are at risk of both somatic and mental late effects, but large population-based studies of depression are lacking. METHODS: Risk of antidepressant use was evaluated in a population-based cohort of 5452 Danish children treated for cancer in 1975-2009 by linkage....... Increased HRs of 30-50% were seen for survivors of cancers of all main groups (haematological malignancies, central nervous system (CNS) and solid tumors); the highest risk was among children treated with haematopoietic stem cell transplantation (HR, 1.9; 95% CI, 1.2-3.1). Our data suggested that the risk...

Problems and fall risk determinants of quality of life in older adults with increased risk of falling.

Science.gov (United States)

Lin, Sang-I; Chang, Ku-Chou; Lee, Hsuei-Chen; Yang, Yi-Ching; Tsauo, Jau-Yih

2015-05-01

Determine quality of life and its association with fall risk factors in older adults with increased risk of falling. A total of 597 community-dwelling Taiwanese older adults who were screened to have increased risk of falling participated in the present study. The fall risk factors included sociodemographics, physical and psychological function, Timed Up and Go, past fall/medical histories, fear of falling and medications. The Euro QOL EQ-5D was used to measure health-related quality of life. Pain/discomfort was the EQ-5D dimension most frequently reported to be impaired (35%), regardless of the level of fall risk or age groups, followed by mobility (25%). Hierarchical regression analysis showed that Geriatric Depression Scale, Mini-Mental State Examination, physiological function, up-and-go, fear of falling and psychotropic medication were independent predictors for total EQ-5D, explaining 68.37% of the variance. Logistic regression analysis showed that for the five EQ-5D dimensions, Geriatric Depression Scale and Up and Go time were the most common determinants. Pain/discomfort was the leading impairment, and greater Geriatric Depression Scale and longer up-and-go time were the main contributing factors in declines in quality of life in older adults with increased risk of falling. These factors are often modifiable, and their management might be considered a priority in falls prevention. © 2014 Japan Geriatrics Society.

Endogenous and exogenous testosterone and prostate cancer: decreased-, increased- or null-risk?

Science.gov (United States)

Lopez, David S; Advani, Shailesh; Tsilidis, Konstantinos K; Wang, Run; Canfield, Steven

2017-06-01

For more than 70 years, the contention that high levels of testosterone or that the use of testosterone therapy (TTh) increases the development and progression of prostate cancer (PCa) has been widely accepted and practiced. Yet, the increasing and emerging evidence on testosterone research seems to challenge that contention. To review literature on the associations of endogenous and exogenous testosterone with decreased-, increased-, or null-risk of PCa, and to further evaluate only those studies that reported magnitude of associations from multivariable modeling as it minimizes confounding effects. We conducted a literature search to identify studies that investigated the association of endogenous total testosterone [continuous (per 1 unit increment and 5 nmol/L increment) and categorical (high vs. low)] and use of TTh with PCa events [1990-2016]. Emphasis was given to studies/analyses that reported magnitude of associations [odds ratio (OR), relative risk (RR) and hazard ratios (HRs)] from multivariable analyses to determine risk of PCa and their statistical significance. Most identified studies/analyses included observational and randomized placebo-controlled trials. This review was organized in three parts: (I) association of endogenous total testosterone (per 1 unit increment and 5 nmol/L increment) with PCa; (II) relationship of endogenous total testosterone (categorical high vs. low) with PCa; and (III) association of use of TTh with PCa in meta-analyses of randomized placebo-controlled trials. The first part included 31 observational studies [20 prospective (per 5 nmol/L increment) and 11 prospective and retrospective cohort studies (per 1 unit increment)]. None of the 20 prospective studies found a significant association between total testosterone (5 nmol/L increment) and increased- or decreased-risk of PCa. Two out of the 11 studies/analyses showed a significant decreased-risk of PCa for total testosterone per 1 unit increment, but also two other

Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

DEFF Research Database (Denmark)

Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

2015-01-01

.72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and....../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study......INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (

Does vital exhaustion increase the risk of type 2 diabetes?

DEFF Research Database (Denmark)

Volden, Sasia; Wimmelmann, Cathrine Lawaetz; Flensborg-Madsen, Trine

2017-01-01

Hospital Discharge Register to detect registrations with type 2 diabetes until 2014. Results: A high degree of VE was associated with an increased risk of developing type 2 diabetes in both substudies. In the first substudy, the OR for developing type 2 diabetes was 2.56 (95% CI, 1.53; 4,29, P ...Background: There is evidence that both stress and depression have a causal relationship with type 2 diabetes suggesting that vital exhaustion (VE) too could be a risk factor. The association between VE and type 2 diabeteshas, however, not been investigated prospectively. Aim: To prospectively...... investigate whether VE is associated with an increased risk of type 2 diabetes in a Danish population. Methods: A prospective cohort study based on the Copenhagen City Heart Study (1991–1993). The degree of VE was measured among 9075 participants without type 1 or 2 diabetes at baseline. To detect type 2...

Does employee resistance during a robbery increase the risk of customer injury?

Science.gov (United States)

Yau, Rebecca K; Casteel, Carri; Nocera, Maryalice; Bishop, Stephanie F; Peek-Asa, Corinne

2015-04-01

Retail business robberies can lead to employee and customer injury. Previous work demonstrates that employee resistance increases employee injury risk; limited research has investigated customer injuries. This study examines associations between employee resistance against perpetrators and the risk of customer injury. Retail and service robbery reports were obtained from a metropolitan police department. Generalized estimating equations estimated risk ratios and 95% confidence intervals (CIs). Customers were injured in 75 out of 697 robberies. Employees resisted the perpetrator in 32 out of 697 robberies. Customers had higher injury risk when employees resisted the perpetrator, compared with robberies where employees did not resist (adjusted risk ratio [95% CI], 2.6 [1.5 to 4.5]). Employee resistance against a perpetrator during a robbery increased customer injury risk. Businesses can train employees to not resist during a robbery, providing benefits for both customers and the business itself.

Reducing risks and increasing safety in everyday life: the role of the public

International Nuclear Information System (INIS)

Enander, A.

1998-01-01

Full text of publication follows: in social science risk research more attention has been paid to examining how people in general perceive risks than to how they perceive possible measures to reduce risks and to increase their own safety. The latter area is, however, becoming increasingly important to understand, particularly in the light of current emphasis on individual responsibility in risk prevention and emergency preparedness. For example, in Sweden a major effort to increase safety awareness among the general public and to increase knowledge and skills in a number of safety-related areas is at present being planned. This effort is being undertaken as a cooperative effort between different authorities and institutions and is coordinated by the Swedish Rescue Services Agency. The intentions behind this and similar programmes raise a number of questions concerning how people view risks and safety measures in their own immediate environment. Knowledge of the factors affecting willingness to take precautions is important in the design of communication and information. The factors which are of significance may be risk-related and concern perceptions of personal risk, but may also be related to attitudes an beliefs concerning different precautionary measures, to perception of social norms and conventions as well as to personal experiences and values. This paper presents some data concerning views and actions among lay groups in relation to reducing risks and increasing safety. Factors affecting these views are discussed in the light of previous research and of empirical data from some recent studies. (author)

Oxidative stress is increased in sarcopenia and associated with cardiovascular disease risk in sarcopenic obesity.

Science.gov (United States)

Bellanti, Francesco; Romano, Antonino D; Lo Buglio, Aurelio; Castriotta, Valeria; Guglielmi, Giuseppe; Greco, Antonio; Serviddio, Gaetano; Vendemiale, Gianluigi

2018-03-01

To define whether circulating markers of oxidative stress correlate with sarcopenia in terms of glutathione balance and oxidative protein damage, and whether these biomarkers are associated with risk of cardiovascular disease (CVD). Population-based cross-sectional study. 115 out of 347 elderly subjects were classified as non-sarcopenic non-obese (NS-NO), sarcopenic non-obese (S-NO), non-sarcopenic obese (NS-O), and sarcopenic obese (S-O). Sarcopenia was defined as a relative skeletal muscle mass index (RASM) 27 for men or >38 for women. The CVD risk was estimated by the carotid intima-media thickness (IMT) and the Framingham score. Blood reduced glutathione (GSH), oxidized glutathione (GSSG), plasma malondialdehyde-(MDA) and 4-hydroxy-2,3-nonenal-(HNE) protein adducts were analyzed. Significantly greater blood GSSG/GSH ratio and plasma MDA/HNE protein adducts were observed in sarcopenic than in non-sarcopenic patients. A logistic regression model showed a close relationship between serum HNE and MDA adducts and sarcopenia (OR=1.133, 95% CI 1.057-1.215, and OR=1.592, 95% CI 1.015-1.991, respectively). Linear and logistic regression analysis evidenced strong associations between the IMT or the Framingham CVD risk category and blood GSSG/GSH or serum HNE protein adducts in the S-O group. Circulating markers of oxidative stress are increased in sarcopenia and related to CVD risk in sarcopenic obesity, suggesting that redox balance analysis would be a useful part of a multidimensional evaluation in aging. Further research is encouraged to support interventional strategies to correct redox imbalance, which might contribute to the prevention or at least limitation of sarcopenia and its co-morbidities. Copyright © 2017 Elsevier B.V. All rights reserved.

Female gonadal shielding with automatic exposure control increases radiation risks

Energy Technology Data Exchange (ETDEWEB)

Kaplan, Summer L.; Zhu, Xiaowei [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); Magill, Dennise; Felice, Marc A. [University of Pennsylvania, Environmental Health and Radiation Safety, Philadelphia, PA (United States); Xiao, Rui [University of Pennsylvania, Department of Biostatistics and Epidemiology, Philadelphia, PA (United States); Ali, Sayed [Temple University Hospital, Department of Radiology, Philadelphia, PA (United States)

2018-02-15

Gonadal shielding remains common, but current estimates of gonadal radiation risk are lower than estimated risks to colon and stomach. A female gonadal shield may attenuate active automatic exposure control (AEC) sensors, resulting in increased dose to colon and stomach as well as to ovaries outside the shielded area. We assess changes in dose-area product (DAP) and absorbed organ dose when female gonadal shielding is used with AEC for pelvis radiography. We imaged adult and 5-year-old equivalent dosimetry phantoms using pelvis radiograph technique with AEC in the presence and absence of a female gonadal shield. We recorded DAP and mAs and measured organ absorbed dose at six internal sites using film dosimetry. Female gonadal shielding with AEC increased DAP 63% for the 5-year-old phantom and 147% for the adult phantom. Absorbed organ dose at unshielded locations of colon, stomach and ovaries increased 21-51% in the 5-year-old phantom and 17-100% in the adult phantom. Absorbed organ dose sampled under the shield decreased 67% in the 5-year-old phantom and 16% in the adult phantom. Female gonadal shielding combined with AEC during pelvic radiography increases absorbed dose to organs with greater radiation sensitivity and to unshielded ovaries. Difficulty in proper use of gonadal shields has been well described, and use of female gonadal shielding may be inadvisable given the risks of increasing radiation. (orig.)

Female gonadal shielding with automatic exposure control increases radiation risks

International Nuclear Information System (INIS)

Kaplan, Summer L.; Zhu, Xiaowei; Magill, Dennise; Felice, Marc A.; Xiao, Rui; Ali, Sayed

2018-01-01

Gonadal shielding remains common, but current estimates of gonadal radiation risk are lower than estimated risks to colon and stomach. A female gonadal shield may attenuate active automatic exposure control (AEC) sensors, resulting in increased dose to colon and stomach as well as to ovaries outside the shielded area. We assess changes in dose-area product (DAP) and absorbed organ dose when female gonadal shielding is used with AEC for pelvis radiography. We imaged adult and 5-year-old equivalent dosimetry phantoms using pelvis radiograph technique with AEC in the presence and absence of a female gonadal shield. We recorded DAP and mAs and measured organ absorbed dose at six internal sites using film dosimetry. Female gonadal shielding with AEC increased DAP 63% for the 5-year-old phantom and 147% for the adult phantom. Absorbed organ dose at unshielded locations of colon, stomach and ovaries increased 21-51% in the 5-year-old phantom and 17-100% in the adult phantom. Absorbed organ dose sampled under the shield decreased 67% in the 5-year-old phantom and 16% in the adult phantom. Female gonadal shielding combined with AEC during pelvic radiography increases absorbed dose to organs with greater radiation sensitivity and to unshielded ovaries. Difficulty in proper use of gonadal shields has been well described, and use of female gonadal shielding may be inadvisable given the risks of increasing radiation. (orig.)

Female gonadal shielding with automatic exposure control increases radiation risks.

Science.gov (United States)

Kaplan, Summer L; Magill, Dennise; Felice, Marc A; Xiao, Rui; Ali, Sayed; Zhu, Xiaowei

2018-02-01

Gonadal shielding remains common, but current estimates of gonadal radiation risk are lower than estimated risks to colon and stomach. A female gonadal shield may attenuate active automatic exposure control (AEC) sensors, resulting in increased dose to colon and stomach as well as to ovaries outside the shielded area. We assess changes in dose-area product (DAP) and absorbed organ dose when female gonadal shielding is used with AEC for pelvis radiography. We imaged adult and 5-year-old equivalent dosimetry phantoms using pelvis radiograph technique with AEC in the presence and absence of a female gonadal shield. We recorded DAP and mAs and measured organ absorbed dose at six internal sites using film dosimetry. Female gonadal shielding with AEC increased DAP 63% for the 5-year-old phantom and 147% for the adult phantom. Absorbed organ dose at unshielded locations of colon, stomach and ovaries increased 21-51% in the 5-year-old phantom and 17-100% in the adult phantom. Absorbed organ dose sampled under the shield decreased 67% in the 5-year-old phantom and 16% in the adult phantom. Female gonadal shielding combined with AEC during pelvic radiography increases absorbed dose to organs with greater radiation sensitivity and to unshielded ovaries. Difficulty in proper use of gonadal shields has been well described, and use of female gonadal shielding may be inadvisable given the risks of increasing radiation.

Metoprolol Increases Uric Acid and Risk of Gout in African Americans With Chronic Kidney Disease Attributed to Hypertension.

Science.gov (United States)

Juraschek, Stephen P; Appel, Lawrence J; Miller, Edgar R

2017-09-01

There is little evidence guiding selection of nondiuretic, antihypertensive agents with a goal of lowering uric acid (SUA) and minimizing gout risk. In the African American Study of Kidney Disease and Hypertension (AASK) trial, African Americans with chronic kidney disease were randomly assigned to metoprolol (a beta-blocker), ramipril (an angiotensin-converting enzyme inhibitors [ACEi]), or amlodipine (a dihydropyridine calcium-channel blocker). SUA was measured at baseline and 12 months. Gout-related hospitalizations were based on ICD9 codes. Gout-related medication use (GRMs) was based on active prescriptions of allopurinol, colchicine, or probenecid during the baseline visit of the AASK cohort phase. We examined the effect of drug assignment on 12-month SUA (linear regression), gout-related hospitalization (Cox regression), and GRM (logistic regression). Of the 630 participants, 40% were female with a mean age of 55 years (SD, 10), mean SUA of 8.2 mg/dl (2.0), and mean serum creatinine of 1.8 mg/dl (0.6). After 12 months, metoprolol increased SUA by 0.3 mg/dl, while ramipril or amlodipine had no effect on SUA. Compared to ramipril, metoprolol significantly increased 12-month SUA (0.40; 0.10, 0.70 mg/dl; P = 0.009), nonsignificantly increased risk of gout-related hospitalization (hazard ratio: 3.87; 0.82, 18.26; P = 0.09), and significantly increased the odds of GRM (odds ratio: 1.62; 1.03, 2.54; P = 0.04). While metoprolol was associated with a higher 12-month SUA compared with amlodipine (0.57; 0.18, 0.95; P = 0.004), there was no difference in gout-related hospitalizations or GRM. Metoprolol increased SUA and GRM in African American adults. Health professionals treating patients with kidney disease at risk for gout should avoid metoprolol and possibly consider an ACEi. Trial Number NCT00582777. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Increasing flood exposure in the Netherlands: implications for risk financing

NARCIS (Netherlands)

Jongman, B.; Koks, E.E.; Husby, T.G.; Ward, P.J.

2014-01-01

The effectiveness of disaster risk management and financing mechanisms depends on an accurate assessment of current and future hazard exposure. The increasing availability of detailed data offers policy makers and the insurance sector new opportunities to understand trends in risk, and to make

Hearing loss is associated with increased CHD risk and unfavorable CHD-related biomarkers in the Dongfeng-Tongji cohort.

Science.gov (United States)

Fang, Qin; Wang, Zhichao; Zhan, Yue; Li, Dan; Zhang, Kun; Zhou, Tao; Yang, Handong; Zhang, Ce; Li, Xiulou; Min, Xinwen; Chen, Weihong; Guo, Huan; He, Mei-An; Kong, Weijia; Wu, Tangchun; Zhang, Xiaomin

2018-04-01

The association between hearing loss and coronary heart disease (CHD) is inconsistent. We aimed to investigate the association of hearing loss with prevalent CHD and CHD-related biomarkers among a middle aged and elderly Chinese population. We included 14,755 Chinese aged 64.6 years from the Dongfeng-Tongji Cohort in 2013. Hearing loss was classified into normal, mild, moderate or greater levels by the pure tone average (PTA) at low frequency and high frequency, respectively. Logistic regression models were used to estimate the odds ratios (ORs) of CHD risk in relation to hearing loss. Linear regression models were used to evaluate the effect of hearing loss on CHD-related biomarkers. The adjusted ORs for prevalent CHD increased gradually with the increasing hearing loss levels. Compared with normal hearing, individuals having mild- and moderate or greater-hearing loss had a higher CHD risk of 19% and 20% at low frequency, and 33% and 41% at high frequency, respectively (all p for trend occupational noise and with hyperglycemia, hypertension or dyslipidemia at low frequency, and those with hyperglycemia at high frequency. Meanwhile, moderate or greater hearing loss combined with overweight, hyperglycemia, hypertension or dyslipidemia had joint effects on CHD. In addition, the majority of CHD-related biomarkers worsened with increasing hearing loss levels. There may be a dose-response relationship between hearing loss and CHD prevalence, and the association could partially be explained by intermediate CHD-related biomarkers. Copyright © 2018 Elsevier B.V. All rights reserved.

Low serum magnesium levels are associated with increased risk of fractures: a long-term prospective cohort study.

Science.gov (United States)

Kunutsor, Setor Kwadzo; Whitehouse, Michael Richard; Blom, Ashley William; Laukkanen, Jari Antero

2017-07-01

Magnesium, which is an essential trace element that plays a key role in several cellular processes, is a major component of bone; however, its relationship with risk of major bone fractures is uncertain. We aimed to investigate the association of baseline serum magnesium concentrations with risk of incident fractures. We analyzed data on 2245 men aged 42-61 years in the Kuopio Ischemic Heart Disease prospective cohort study, with the assessment of serum magnesium measurements and dietary intakes made at baseline. Hazard ratios [95% confidence intervals (CI)] for incident total (femoral, humeral, and forearm) and femoral fractures were assessed. During a median follow-up of 25.6 years, 123 total fractures were recorded. Serum magnesium was non-linearly associated with risk of total fractures. In age-adjusted Cox regression analysis, the hazard ratio (HR) (95% CIs) for total fractures in a comparison of the bottom quartile versus top quartile of magnesium concentrations was 2.10 (1.30-3.41), which persisted on adjustment for several established risk factors 1.99 (1.23-3.24). The association remained consistent on further adjustment for renal function, socioeconomic status, total energy intake, and several trace elements 1.80 (1.10-2.94). The corresponding adjusted HRs for femoral fractures were 2.56 (1.38-4.76), 2.43 (1.30-4.53) and 2.13 (1.13-3.99) respectively. There was no evidence of an association of dietary magnesium intake with risk of any fractures. In middle-aged Caucasian men, low serum magnesium is strongly and independently associated with an increased risk of fractures. Further research is needed to assess the potential relevance of serum magnesium in the prevention of fractures.

Coronary fluorine-18-sodium fluoride uptake is increased in healthy adults with an unfavorable cardiovascular risk profile: results from the CAMONA study.

Science.gov (United States)

Blomberg, Björn A; Thomassen, Anders; de Jong, Pim A; Lam, Marnix G E; Diederichsen, Axel C P; Olsen, Michael H; Mickley, Hans; Mali, Willem P T M; Alavi, Abass; Høilund-Carlsen, Poul F

2017-11-01

Coronary artery fluorine-18-sodium fluoride (F-NaF) uptake reflects coronary artery calcification metabolism and is considered to be an early prognostic marker of coronary heart disease. This study evaluated the relationship between coronary artery F-NaF uptake and cardiovascular risk in healthy adults at low cardiovascular risk. Study participants underwent blood pressure measurements, blood analyses, and coronary artery F-NaF PET/CT imaging. In addition, the 10-year risk for the development of cardiovascular disease, on the basis of the Framingham Risk Score, was estimated. Multivariable linear regression evaluated the dependence of coronary artery F-NaF uptake on cardiovascular risk factors. We recruited 89 (47 men, 42 women) healthy adults aged 21-75 years. Female sex (0.34 kBq/ml; P=0.009), age (0.16 kBq/ml per SD; P=0.002), and BMI (0.42 kBq/ml per SD; Prisk factors present (Prisk for the development of cardiovascular disease was on average 2.4 times higher in adults with coronary artery F-NaF uptake in the highest quartile compared with those in the lowest quartile of the distribution (8.0 vs. 3.3%, Prisk and that an unfavorable cardiovascular risk profile is associated with a marked increase in coronary artery F-NaF uptake.

HIV infection is associated with an increased risk for lung cancer, independent of smoking.

Science.gov (United States)

Kirk, Gregory D; Merlo, Christian; O' Driscoll, Peter; Mehta, Shruti H; Galai, Noya; Vlahov, David; Samet, Jonathan; Engels, Eric A

2007-07-01

Human immunodeficiency virus (HIV)-infected persons have an elevated risk for lung cancer, but whether the increase reflects solely their heavy tobacco use remains an open question. The Acquired Immunodeficiency Syndrome (AIDS) Link to the Intravenous Experience Study has prospectively observed a cohort of injection drug users in Baltimore, Maryland, since 1988, using biannual collection of clinical, laboratory, and behavioral data. Lung cancer deaths were identified through linkage with the National Death Index. Cox proportional hazards regression was used to examine the effect of HIV infection on lung cancer risk, controlling for smoking status, drug use, and clinical variables. Among 2086 AIDS Link to the Intravenous Experience Study participants observed for 19,835 person-years, 27 lung cancer deaths were identified; 14 of the deaths were among HIV-infected persons. All but 1 (96%) of the patients with lung cancer were smokers, smoking a mean of 1.2 packs per day. Lung cancer mortality increased during the highly active antiretroviral therapy era, compared with the pre-highly active antiretroviral therapy period (mortality rate ratio, 4.7; 95% confidence interval, 1.7-16). After adjusting for age, sex, smoking status, and calendar period, HIV infection was associated with increased lung cancer risk (hazard ratio, 3.6; 95% confidence interval, 1.6-7.9). Preexisting lung disease, particularly noninfectious diseases and asthma, displayed trends for increased lung cancer risk. Illicit drug use was not associated with increased lung cancer risk. Among HIV-infected persons, smoking remained the major risk factor; CD4 cell count and HIV load were not strongly associated with increased lung cancer risk, and trends for increased risk with use of highly active antiretroviral therapy were not significant. HIV infection is associated with significantly increased risk for developing lung cancer, independent of smoking status.

The risk of low doses of ionising radiation and the linear no threshold relationship debate

International Nuclear Information System (INIS)

Tubiana, M.; Masse, R.; Vathaire, F. de; Averbeck, D.; Aurengo, A.

2007-01-01

The ICRP and the B.E.I.R. VII reports recommend a linear no threshold (L.N.T.) relationship for the estimation of cancer excess risk induced by ionising radiations (IR), but the 2005 report of Medicine and Science French Academies concludes that it leads to overestimate of risk for low and very low doses. The bases of L.N.T. are challenged by recent biological and animal experimental studies which show that the defence against IR involves the cell microenvironment and the immunologic system. The defence mechanisms against low doses are different and comparatively more effective than for high doses. Cell death is predominant against low doses. DNA repairing is activated against high doses, in order to preserve tissue functions. These mechanisms provide for multicellular organisms an effective and low cost defence system. The differences between low and high doses defence mechanisms are obvious for alpha emitters which show several greys threshold effects. These differences result in an impairment of epidemiological studies which, for statistical power purpose, amalgamate high and low doses exposure data, since it would imply that cancer IR induction and defence mechanisms are similar in both cases. Low IR dose risk estimates should rely on specific epidemiological studies restricted to low dose exposures and taking precisely into account potential confounding factors. The preliminary synthesis of cohort studies for which low dose data (< 100 mSv) were available show no significant risk excess, neither for solid cancer nor for leukemias. (authors)

Increasing Risk Awareness: The Coastal Community Resilience Index

Science.gov (United States)

Thompson, Jody A.; Sempier, Tracie; Swann, LaDon

2012-01-01

As the number of people moving to the Gulf Coast increases, so does the risk of exposure to floods, hurricanes, and other storm-related events. In an effort to assist communities in preparing for future storm events, the Coastal Community Resilience Index was created. The end result is for communities to take actions to address the weaknesses they…

Increasing flood exposure in the Netherlands: implications for risk financing

Science.gov (United States)

Jongman, B.; Koks, E. E.; Husby, T. G.; Ward, P. J.

2014-05-01

The effectiveness of disaster risk management and financing mechanisms depends on an accurate assessment of current and future hazard exposure. The increasing availability of detailed data offers policy makers and the insurance sector new opportunities to understand trends in risk, and to make informed decisions on ways to deal with these trends. In this paper we show how comprehensive property level information can be used for the assessment of exposure to flooding on a national scale, and how this information provides valuable input to discussions on possible risk financing practices. The case study used is the Netherlands, which is one of the countries most exposed to flooding globally, and which is currently undergoing a debate on strategies for the compensation of potential losses. Our results show that flood exposure has increased rapidly between 1960 and 2012, and that the growth of the building stock and its economic value in flood-prone areas has been higher than in non-flood-prone areas. We also find that property values in flood-prone areas are lower than those in non-flood-prone areas. We argue that the increase in the share of economic value located in potential flood-prone areas can have a negative effect on the feasibility of private insurance schemes in the Netherlands. The methodologies and results presented in this study are relevant for many regions around the world where the effects of rising flood exposure create a challenge for risk financing.

The increased risk of joint venture promotes social cooperation.

Directory of Open Access Journals (Sweden)

Te Wu

Full Text Available The joint venture of many members is common both in animal world and human society. In these public enterprizes, highly cooperative groups are more likely to while low cooperative groups are still possible but not probable to succeed. Existent literature mostly focuses on the traditional public goods game, in which cooperators create public wealth unconditionally and benefit all group members unbiasedly. We here institute a model addressing this public goods dilemma with incorporating the public resource foraging failure risk. Risk-averse individuals tend to lead a autarkic life, while risk-preferential ones tend to participate in the risky public goods game. For participants, group's success relies on its cooperativeness, with increasing contribution leading to increasing success likelihood. We introduce a function with one tunable parameter to describe the risk removal pattern and study in detail three representative classes. Analytical results show that the widely replicated population dynamics of cyclical dominance of loner, cooperator and defector disappear, while most of the time loners act as savors while eventually they also disappear. Depending on the way that group's success relies on its cooperativeness, either cooperators pervade the entire population or they coexist with defectors. Even in the later case, cooperators still hold salient superiority in number as some defectors also survive by parasitizing. The harder the joint venture succeeds, the higher level of cooperation once cooperators can win the evolutionary race. Our work may enrich the literature concerning the risky public goods games.

The increased risk of joint venture promotes social cooperation.

Science.gov (United States)

Wu, Te; Fu, Feng; Zhang, Yanling; Wang, Long

2013-01-01

The joint venture of many members is common both in animal world and human society. In these public enterprizes, highly cooperative groups are more likely to while low cooperative groups are still possible but not probable to succeed. Existent literature mostly focuses on the traditional public goods game, in which cooperators create public wealth unconditionally and benefit all group members unbiasedly. We here institute a model addressing this public goods dilemma with incorporating the public resource foraging failure risk. Risk-averse individuals tend to lead a autarkic life, while risk-preferential ones tend to participate in the risky public goods game. For participants, group's success relies on its cooperativeness, with increasing contribution leading to increasing success likelihood. We introduce a function with one tunable parameter to describe the risk removal pattern and study in detail three representative classes. Analytical results show that the widely replicated population dynamics of cyclical dominance of loner, cooperator and defector disappear, while most of the time loners act as savors while eventually they also disappear. Depending on the way that group's success relies on its cooperativeness, either cooperators pervade the entire population or they coexist with defectors. Even in the later case, cooperators still hold salient superiority in number as some defectors also survive by parasitizing. The harder the joint venture succeeds, the higher level of cooperation once cooperators can win the evolutionary race. Our work may enrich the literature concerning the risky public goods games.

Unmetabolized Folic Acid, Tetrahydrofolate, and Colorectal Adenoma Risk.

Science.gov (United States)

Rees, Judy R; Morris, Carolyn B; Peacock, Janet L; Ueland, Per M; Barry, Elizabeth L; McKeown-Eyssen, Gail E; Figueiredo, Jane C; Snover, Dale C; Baron, John A

2017-08-01

In a randomized trial of folic acid supplementation for the prevention of colorectal adenomas, we previously found indications of increased risk during later treatment and follow-up. This could have been due to the unmetabolized folic acid (UFA) or natural reduced and methylated folates (mF) to which it is metabolized. In post hoc analyses, we measured mF (the sum of 5-methyl-tetrahydrofolate and 4-alfa-hydroxy-5-methyl-THF) and UFA concentrations in the serum of 924 participants. Using binomial regression models with a log link, we assessed the associations between plasma mF or UFA and adenoma occurrence. We found no association between plasma mF or UFA and overall adenoma risk. However, during later follow-up, the prespecified, composite endpoint of high-risk findings (advanced or multiple adenomas) was positively associated with plasma mF ( P linear trend = 0.009), with a 58% increased risk for participants in the upper versus lowest quartile. An irregular association was seen with plasma UFA, with suggestions of an inverse trend ( P linear trend =0.049). A modest, significant inverse association was also seen between mF and risk of serrated lesions, with a 39% lower risk for upper versus lower quartile participants ( P linear trend = 0.03). In conclusion, during the later follow-up period in which folic acid supplementation was previously seen to increase the risk of advanced and multiple adenomas, higher serum mF was associated with a higher risk of multiple and/or advanced adenomas, but no clear indication that UFA played a direct role. There were indications that higher mF was associated with reduced risk of serrated polyps. Cancer Prev Res; 10(8); 451-8. ©2017 AACR . ©2017 American Association for Cancer Research.

Stochastic arrangement increasing risks in financial engineering andactuarial science – a review

Directory of Open Access Journals (Sweden)

Chen Li

2018-03-01

Full Text Available We review recent research results on stochastic arrangement increasing risks in financialand actuarial risk management, including allocation of deductibles and coverage limits concerned withmultiple dependent risks in an insurance policy, the independence model and the threshold models fora portfolio of defaults risks with dependence, and the optimal capital allocation for a financial institutewith multiple line of business.

Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

DEFF Research Database (Denmark)

Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

2015-01-01

INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (METHODS: In a cohort study, 1,202 deliveries among....../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study.......72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and...

The Ability of American Football Helmets to Manage Linear Acceleration With Repeated High-Energy Impacts.

Science.gov (United States)

Cournoyer, Janie; Post, Andrew; Rousseau, Philippe; Hoshizaki, Blaine

2016-03-01

Football players can receive up to 1400 head impacts per season, averaging 6.3 impacts per practice and 14.3 impacts per game. A decrease in the capacity of a helmet to manage linear acceleration with multiple impacts could increase the risk of traumatic brain injury. To investigate the ability of football helmets to manage linear acceleration with multiple high-energy impacts. Descriptive laboratory study. Laboratory. We collected linear-acceleration data for 100 impacts at 6 locations on 4 helmets of different models currently used in football. Impacts 11 to 20 were compared with impacts 91 to 100 for each of the 6 locations. Linear acceleration was greater after multiple impacts (91-100) than after the first few impacts (11-20) for the front, front-boss, rear, and top locations. However, these differences are not clinically relevant as they do not affect the risk for head injury. American football helmet performance deteriorated with multiple impacts, but this is unlikely to be a factor in head-injury causation during a game or over a season.

Endogenous and exogenous testosterone and prostate cancer: decreased-, increased- or null-risk?

Science.gov (United States)

Advani, Shailesh; Tsilidis, Konstantinos K.; Wang, Run; Canfield, Steven

2017-01-01

For more than 70 years, the contention that high levels of testosterone or that the use of testosterone therapy (TTh) increases the development and progression of prostate cancer (PCa) has been widely accepted and practiced. Yet, the increasing and emerging evidence on testosterone research seems to challenge that contention. To review literature on the associations of endogenous and exogenous testosterone with decreased-, increased-, or null-risk of PCa, and to further evaluate only those studies that reported magnitude of associations from multivariable modeling as it minimizes confounding effects. We conducted a literature search to identify studies that investigated the association of endogenous total testosterone [continuous (per 1 unit increment and 5 nmol/L increment) and categorical (high vs. low)] and use of TTh with PCa events [1990–2016]. Emphasis was given to studies/analyses that reported magnitude of associations [odds ratio (OR), relative risk (RR) and hazard ratios (HRs)] from multivariable analyses to determine risk of PCa and their statistical significance. Most identified studies/analyses included observational and randomized placebo-controlled trials. This review was organized in three parts: (I) association of endogenous total testosterone (per 1 unit increment and 5 nmol/L increment) with PCa; (II) relationship of endogenous total testosterone (categorical high vs. low) with PCa; and (III) association of use of TTh with PCa in meta-analyses of randomized placebo-controlled trials. The first part included 31 observational studies [20 prospective (per 5 nmol/L increment) and 11 prospective and retrospective cohort studies (per 1 unit increment)]. None of the 20 prospective studies found a significant association between total testosterone (5 nmol/L increment) and increased- or decreased-risk of PCa. Two out of the 11 studies/analyses showed a significant decreased-risk of PCa for total testosterone per 1 unit increment, but also two other

Increased risk of hepatocellular carcinoma in patients with chronic hepatitis C

DEFF Research Database (Denmark)

Hallager, Sofie; Weis, Nina

2014-01-01

Chronic hepatitis C (CHC) frequently leads to cirrhosis with an increased risk of hepatocellular carcinomas (HCC). CHC therapy is currently changing for the better whereas prognosis for HCC remains dismal if not detected early and thus regular screening in cirrhotic CHC patients for HCC...... is recommended. CHC is known to be underdiagnosed in Denmark where it is up to the involved physician to screen for risk factors for CHC and increase the patient's chance of a cure for CHC with therapy....

Increased peripheral vascular disease risk progressively constrains perfusion adaptability in the skeletal muscle microcirculation

Science.gov (United States)

Butcher, Joshua T.; Frisbee, Stephanie J.; Olfert, I. Mark; Chantler, Paul D.; Tabone, Lawrence E.; d'Audiffret, Alexandre C.; Shrader, Carl D.; Goodwill, Adam G.; Stapleton, Phoebe A.; Brooks, Steven D.; Brock, Robert W.; Lombard, Julian H.

2015-01-01

To determine the impact of progressive elevations in peripheral vascular disease (PVD) risk on microvascular function, we utilized eight rat models spanning “healthy” to “high PVD risk” and used a multiscale approach to interrogate microvascular function and outcomes: healthy: Sprague-Dawley rats (SDR) and lean Zucker rats (LZR); mild risk: SDR on high-salt diet (HSD) and SDR on high-fructose diet (HFD); moderate risk: reduced renal mass-hypertensive rats (RRM) and spontaneously hypertensive rats (SHR); high risk: obese Zucker rats (OZR) and Dahl salt-sensitive rats (DSS). Vascular reactivity and biochemical analyses demonstrated that even mild elevations in PVD risk severely attenuated nitric oxide (NO) bioavailability and caused progressive shifts in arachidonic acid metabolism, increasing thromboxane A2 levels. With the introduction of hypertension, arteriolar myogenic activation and adrenergic constriction were increased. However, while functional hyperemia and fatigue resistance of in situ skeletal muscle were not impacted with mild or moderate PVD risk, blood oxygen handling suggested an increasingly heterogeneous perfusion within resting and contracting skeletal muscle. Analysis of in situ networks demonstrated an increasingly stable and heterogeneous distribution of perfusion at arteriolar bifurcations with elevated PVD risk, a phenomenon that was manifested first in the distal microcirculation and evolved proximally with increasing risk. The increased perfusion distribution heterogeneity and loss of flexibility throughout the microvascular network, the result of the combined effects on NO bioavailability, arachidonic acid metabolism, myogenic activation, and adrenergic constriction, may represent the most accurate predictor of the skeletal muscle microvasculopathy and poor health outcomes associated with chronic elevations in PVD risk. PMID:26702145

Linear dose response curves in fungi and tradescantia

International Nuclear Information System (INIS)

Unrau, P.

1999-07-01

heterozygosity (LOH) events occur because Clone 02 repairs both DSB and LCD by recombination. Clone 02 has a linear dose response for high LET radiation. Starting from the same initial yieId frequency, wild-types have a sublinear response. The sublinear response reflects a smoothly decreasing probability that 'pinks' are generated as a function of increasing high LET dose for wild-type but not Clone 02. This smoothly decreasing response would be expected for LOH in 'wild-type' humans. It reflects an increasing proportion of DNA damage being repaired by non-recombinational pathways and/or an increasing probability of cell death with increasing dose. Clone 02 at low doses and low dose rates of low LET radiation has a linear dose response, reflecting a 1/16 probability of a lesion leading to LOH, relative to high LET lesions. This differential is held to reflect: microdosimetric differences in energy deposition and, therefore, DNA damage by low and high LET radiations; the effects of lesion clustering after high LET on the probability of generating the end wild-types. While no observations have been made at very low doses and dose rates in wild-types, there is no reason to suppose that the low LET linear non-threshold dose response of Clone 02 is abnormal. The importance of the LOH somatic genetic end-point is that it reflects cancer risk in humans. The linear non-threshold low dose low LET response curves reflects either the probability that recombinational Holliday junctions are occasionally cleaved in a rare orientation to generate LOH, or the probability that low LET lesions include a small proportion of clustered events similar to high LET ionization or both. Calculations of the Poisson probability that two or more low LET lesions will be induced in the same target suggest that dose rate effects depend upon the coincidence of DNA lesions in the same target, and that the probability of LOH depends upon lesion and repair factors. But the slope of LOH in Clone 02 and all other

Linear dose response curves in fungi and tradescantia

Energy Technology Data Exchange (ETDEWEB)

Unrau, P. [Atomic Energy of Canada Ltd., Chalk River, Ontario (Canada)

1999-07-15

;pink' loss of heterozygosity (LOH) events occur because Clone 02 repairs both DSB and LCD by recombination. Clone 02 has a linear dose response for high LET radiation. Starting from the same initial yieId frequency, wild-types have a sublinear response. The sublinear response reflects a smoothly decreasing probability that 'pinks' are generated as a function of increasing high LET dose for wild-type but not Clone 02. This smoothly decreasing response would be expected for LOH in 'wild-type' humans. It reflects an increasing proportion of DNA damage being repaired by non-recombinational pathways and/or an increasing probability of cell death with increasing dose. Clone 02 at low doses and low dose rates of low LET radiation has a linear dose response, reflecting a 1/16 probability of a lesion leading to LOH, relative to high LET lesions. This differential is held to reflect: microdosimetric differences in energy deposition and, therefore, DNA damage by low and high LET radiations; the effects of lesion clustering after high LET on the probability of generating the end wild-types. While no observations have been made at very low doses and dose rates in wild-types, there is no reason to suppose that the low LET linear non-threshold dose response of Clone 02 is abnormal. The importance of the LOH somatic genetic end-point is that it reflects cancer risk in humans. The linear non-threshold low dose low LET response curves reflects either the probability that recombinational Holliday junctions are occasionally cleaved in a rare orientation to generate LOH, or the probability that low LET lesions include a small proportion of clustered events similar to high LET ionization or both. Calculations of the Poisson probability that two or more low LET lesions will be induced in the same target suggest that dose rate effects depend upon the coincidence of DNA lesions in the same target, and that the probability of LOH depends upon lesion and repair factors. But the

Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude.

Science.gov (United States)

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

2016-06-01

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

Is there an increased risk of second primaries following prostate irradiation?

International Nuclear Information System (INIS)

Movsas, Benjamin; Hanlon, Alexandra L.; Pinover, Wayne; Hanks, Gerald E.

1998-01-01

Purpose: To assess the risk of developing a second primary cancer following prostate irradiation compared to the underlying risk in patients with prostate cancer. Methods and Materials: The baseline rate of secondary cancers following prostate cancer was obtained from a study of 18,135 patients from the Connecticut Tumor Registry, of whom only 12.5% received radiotherapy. These patients, with a mean age of 72 and a mean follow-up of 3.9 years, were compared to a cohort of 543 patients (median age 70) with similar follow-up (median 3.9 years), all of whom were treated with definitive radiotherapy at Fox Chase Cancer Center. The possible association between various covariates (age, dose, palpation stage, field size, Gleason score, pretreatment PSA) and the development of a secondary cancer was assessed. Results: 1,053 of 18,135 patients (5.8%) in the Connecticut Tumor Registry developed a second primary cancer compared with 31 of 543 (5.7%) patients treated with prostate radiation (p = 0.99). Although this risk increases gradually over time, it is not significantly different, at any time period, between the two groups of patients. Of the 31 secondary primaries in the irradiated group, 82% had a history of tobacco and/or alcohol use. Only melanomas were significantly increased compared to the expected rate in an age-matched population (p <0.001). Five of the 31 secondary cancers occurred within the radiation field (four bladder, one colon), four within 3 years and only one occurred 9 years after radiotherapy. No association was found between age (<70 vs. ≥70 and as a continuous variable), dose (<74 vs. ≥74 Gy), palpation stage (< T2C vs. ≥T2C), field size (prostate vs. pelvic), radiation technique (conventional vs. conformal), Gleason score (2-6 vs. 7-10), or pretreatment PSA (<15 vs. ≥15 and as a continuous variable) and the risk of developing a second primary. Although a lower radiation dose (as a continuous variable) correlated with an increased risk of

Mössbauer spectra linearity improvement by sine velocity waveform followed by linearization process

Science.gov (United States)

Kohout, Pavel; Frank, Tomas; Pechousek, Jiri; Kouril, Lukas

2018-05-01

This note reports the development of a new method for linearizing the Mössbauer spectra recorded with a sine drive velocity signal. Mössbauer spectra linearity is a critical parameter to determine Mössbauer spectrometer accuracy. Measuring spectra with a sine velocity axis and consecutive linearization increases the linearity of spectra in a wider frequency range of a drive signal, as generally harmonic movement is natural for velocity transducers. The obtained data demonstrate that linearized sine spectra have lower nonlinearity and line width parameters in comparison with those measured using a traditional triangle velocity signal.

Increased Bleeding Risk With Concurrent Use of Selective Serotonin Reuptake inhibitors and Coumarins

NARCIS (Netherlands)

Schalekamp, Tom; Klungel, Olaf H; Souverein, Patrick C; de Boer, Anthonius

2008-01-01

BACKGROUND: Treatment with vitamin K antagonists (coumarins) is associated with an increased risk of bleeding. Because use of selective serotonin reuptake inhibitors (SSRIs) is also associated with an increased risk of bleeding, we assessed the odds ratio (OR) of abnormal bleeding associated with

Association of Increased Prenatal Estrogen With Risk Factors for Schizophrenia

OpenAIRE

Brown, James S.

2010-01-01

The author previously described a theoretical cause of schizophrenia based on the effects of estrogenic endocrine disruption. In the current review, the author describes how increased estrogen during pregnancy increases susceptibility to certain viral infections associated with increased risk for schizophrenia. The review further discusses how prenatal estrogen exposure could explain associations of schizophrenia with autoimmune diseases, urban environments, and stress. Based on the associati...

Homocysteine increases the risk associated with hyperlipidaemia.

LENUS (Irish Health Repository)

Daly, Caroline

2009-04-01

The European Concerted Action Project \\'Homocysteine and Vascular Disease\\' showed that an elevated homocysteine is associated with a substantially increased risk of cardiovascular disease, and particularly when combined with other factors such as smoking, hypertension and hypercholesterolaemia. The purpose of this study was to examine the potential interactions between homocysteine and individual lipid subfractions. In addition, it was hypothesized that HDL cholesterol may protect against hyperhomocysteinaemia because HDL cholesterol is associated with the enzyme paroxonase, which reduces oxidization of homocysteine to the harmful metabolite, homocysteine thiolactonase.

Linear response of mutans streptococci to increasing frequency of xylitol chewing gum use: a randomized controlled trial [ISRCTN43479664

Directory of Open Access Journals (Sweden)

Yamaguchi David K

2006-03-01

Full Text Available Abstract Background Xylitol is a naturally occurring sugar substitute that has been shown to reduce the level of mutans streptococci in plaque and saliva and to reduce tooth decay. It has been suggested that the degree of reduction is dependent on both the amount and the frequency of xylitol consumption. For xylitol to be successfully and cost-effectively used in public health prevention strategies dosing and frequency guidelines should be established. This study determined the reduction in mutans streptococci levels in plaque and unstimulated saliva to increasing frequency of xylitol gum use at a fixed total daily dose of 10.32 g over five weeks. Methods Participants (n = 132 were randomized to either active groups (10.32 g xylitol/day or a placebo control (9.828 g sorbitol and 0.7 g maltitol/day. All groups chewed 12 pieces of gum per day. The control group chewed 4 times/day and active groups chewed xylitol gum at a frequency of 2 times/day, 3 times/day, or 4 times/day. The 12 gum pieces were evenly divided into the frequency assigned to each group. Plaque and unstimulated saliva samples were taken at baseline and five-weeks and were cultured on modified Mitis Salivarius agar for mutans streptococci enumeration. Results There were no significant differences in mutans streptococci level among the groups at baseline. At five-weeks, mutans streptococci levels in plaque and unstimulated saliva showed a linear reduction with increasing frequency of xylitol chewing gum use at the constant daily dose. Although the difference observed for the group that chewed xylitol 2 times/day was consistent with the linear model, the difference was not significant. Conclusion There was a linear reduction in mutans streptococci levels in plaque and saliva with increasing frequency of xylitol gum use at a constant daily dose. Reduction at a consumption frequency of 2 times per day was small and consistent with the linear-response line but was not statistically

Bidi smokers at increased risk of oral cancer.

Science.gov (United States)

Warnakulasuriya, Saman

2005-01-01

Source articles were searched for using Medline, the Cochrane Library and within the references lists of identified articles. Articles were selected that included data enabling construction of 2 x 2 tables to estimate odds ratios (OR) and 95% confidence intervals (CI). For each study, two-way contingency tables were constructed, based on exposure frequency distributions, for cases and controls. Unadjusted OR and 95% CI were recalculated based on the reported data using standard procedures. Separate contingency tables were made for bidi smoking, cigarette smoking and both types of smoking if the data were available in the same article. The overall OR combined across all studies, and its 95% CI, was calculated using a random-effects model for bidi and cigarette smoking. Tests for publication bias and heterogeneity were conducted. Confounding factors, for example, betel quid chewing or alcohol use, were not included in the meta-regression model. An increased risk of oral cancer was found for bidi smokers compared with people who had never smoked (OR, 3.1; 95% CI, 2.0-5.0) whereas no significant pattern of risk was found for cigarette smokers (OR, 1.1; 95% CI, 0.7-1.8). There was substantial heterogeneity in the pooled OR estimate. The results clearly indicate that bidi smokers are at increased risk of oral cancer. It is important that this information be incorporated into smoking prevention and cessation efforts, particularly in the urban poor and rural mass in south Asian countries where bidi smoking is widespread.

Splenectomy increases the subsequent risk of systemic lupus erythematosus.

Science.gov (United States)

Hsu, Chao-Yu; Chen, Hsuan-Ju; Hsu, Chung Y; Kao, Chia-Hung

2016-02-01

Splenectomy may be necessary to treat systemic lupus erythematosus (SLE) patients with thrombocytopenia; however, whether performing a splenectomy on patients without SLE increases the subsequent risk of SLE remains unknown. Therefore, this study was conducted to determine the association between splenectomy and SLE. We conducted a cohort study by using data from the Taiwan National Health Institute Research Database to identify 10,298 patients with received a splenectomy between 2000 and 2006 and 41,192 participants without received a splenectomy who were selected by frequency matched based on sex, age, and the index year. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of developing SLE associated with splenectomy compared with patients who did not receive a splenectomy. During the study period, the overall incidence density rate of SLE was higher in the splenectomy cohort than in the non-splenectomy cohort (adjusted HR 10.55; 95 % CI 50.55-20.05). The incidence density rates of SLE in women and men who received a splenectomy were higher than those of patients who did not receive a splenectomy. Non-traumatic splenectomy increases the subsequent risk of SLE. The risk of SLE should be considered before performing a splenectomy, particularly in women and younger patients.

Early menarche is associated with increased risk of asthma

DEFF Research Database (Denmark)

Lieberoth, Sofie; Gade, Elisabeth; Kyvik, Kirsten Ohm

2015-01-01

in girls with early menarche compared to girls without early menarche (7.4 vs. 4.5%), OR = 1.71 (1.31-2.22), p increased by 8% (1-15%), p = 0...... in discordant monozygotic and dizygotic twins. CONCLUSION: Early menarche is associated with increased risk of asthma among Danish female twins independently of BMI, age, physical activity, educational level and smoking. Results indicate a complex relationship possibly mediated through innate and non...

Templates for Linear Algebra Problems

NARCIS (Netherlands)

Bai, Z.; Day, D.; Demmel, J.; Dongarra, J.; Gu, M.; Ruhe, A.; Vorst, H.A. van der

1995-01-01

The increasing availability of advanced-architecture computers is having a very signicant eect on all spheres of scientic computation, including algorithm research and software development in numerical linear algebra. Linear algebra {in particular, the solution of linear systems of equations and

Is white-coat hypertension a harbinger of increased risk?

Science.gov (United States)

Kollias, Anastasios; Ntineri, Angeliki; Stergiou, George S

2014-09-01

White-coat hypertension is defined by elevated office and normal out-of-office blood pressure (home or ambulatory) in untreated subjects. This condition is common in clinical practice and requires appropriate work-up for detection and management. Many studies have examined the relationship between white-coat hypertension and cardiovascular risk but with marked heterogeneity in the definitions and methodology applied. Thus, the results have been inconsistent leading to confusion in scientific research and clinical practice. Some but not all the relevant studies suggested that white-coat hypertension is associated with subclinical target-organ damage, yet the cross-sectional design of these studies and the fact that these indices are only surrogate end points do not allow firm conclusions to be drawn. In recent years, longitudinal studies have examined the prognostic significance of white-coat hypertension in terms of cardiovascular morbidity and mortality. Most of them indicate that white-coat hypertensive compared with normotensive subjects present a moderate-in most cases not significant-increase in risk. Meta-analyses of raw data from large databases, such as the International Database on Ambulatory blood pressure and Cardiovascular Outcomes (IDACO) and the International Database on HOme blood pressure in relation to Cardiovascular Outcomes (IDHOCO) allowed separate powered analyses in untreated subjects and provided a clearer picture regarding the modest risk associated with white-coat hypertension, especially in the long term. White-coat hypertension is regarded as an intermediate phenotype between normotension and hypertension associated with increased risk of developing sustained hypertension, and therefore requires regular follow-up using nonpharmacological measures.

Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

DEFF Research Database (Denmark)

Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

2015-01-01

.72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and......INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (... pregnant women referred to two Danish clinics of occupational medicine (Copenhagen and Aarhus) from 1984 to 2010 were compared with the referred women's 1,077 non-referred pregnancy outcomes and with the pregnancy outcomes of 345,467 gainfully employed women from the same geographical areas and time period...

What can be offered to couples at (possibly) increased genetic risk?

OpenAIRE

Read, Andrew P.; Donnai, Dian

2012-01-01

We review the reasons why a couple might seek specialist genetic counselling about a possible reproductive risk and the options available to them. Most commonly, the couple will be concerned about the risk of recurrence of a medical condition that has already occurred in the family. Sometimes, the increased risk may come from their ethnicity or because of a consanguineous marriage, rather than because any problem has occurred previously. The geneticist must identify the exact nature of any pr...

Increasing stress on disaster-risk finance due to large floods

Science.gov (United States)

Jongman, Brenden; Hochrainer-Stigler, Stefan; Feyen, Luc; Aerts, Jeroen C. J. H.; Mechler, Reinhard; Botzen, W. J. Wouter; Bouwer, Laurens M.; Pflug, Georg; Rojas, Rodrigo; Ward, Philip J.

2014-04-01

Recent major flood disasters have shown that single extreme events can affect multiple countries simultaneously, which puts high pressure on trans-national risk reduction and risk transfer mechanisms. So far, little is known about such flood hazard interdependencies across regions and the corresponding joint risks at regional to continental scales. Reliable information on correlated loss probabilities is crucial for developing robust insurance schemes and public adaptation funds, and for enhancing our understanding of climate change impacts. Here we show that extreme discharges are strongly correlated across European river basins. We present probabilistic trends in continental flood risk, and demonstrate that observed extreme flood losses could more than double in frequency by 2050 under future climate change and socio-economic development. We suggest that risk management for these increasing losses is largely feasible, and we demonstrate that risk can be shared by expanding risk transfer financing, reduced by investing in flood protection, or absorbed by enhanced solidarity between countries. We conclude that these measures have vastly different efficiency, equity and acceptability implications, which need to be taken into account in broader consultation, for which our analysis provides a basis.

The Increase in Animal Mortality Risk following Exposure to Sparsely Ionizing Radiation Is Not Linear Quadratic with Dose

OpenAIRE

Haley, Benjamin M.; Paunesku, Tatjana; Grdina, David J.; Woloschak, Gayle E.

2015-01-01

Introduction The US government regulates allowable radiation exposures relying, in large part, on the seventh report from the committee to estimate the Biological Effect of Ionizing Radiation (BEIR VII), which estimated that most contemporary exposures- protracted or low-dose, carry 1.5 fold less risk of carcinogenesis and mortality per Gy than acute exposures of atomic bomb survivors. This correction is known as the dose and dose rate effectiveness factor for the life span study of atomic bo...

Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies.

Science.gov (United States)

Schwingshackl, Lukas; Hoffmann, Georg; Lampousi, Anna-Maria; Knüppel, Sven; Iqbal, Khalid; Schwedhelm, Carolina; Bechthold, Angela; Schlesinger, Sabrina; Boeing, Heiner

2017-05-01

The aim of this systematic review and meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups and risk of type 2 diabetes (T2D). We conducted a systematic search in PubMed, Embase, Medline (Ovid), Cochrane Central, and Google Scholar for prospective studies investigating the association between whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSB) on risk of T2D. Summary relative risks were estimated using a random effects model by contrasting categories, and for linear and non-linear dose-response relationships. Six out of the 12 food-groups showed a significant relation with risk of T2D, three of them a decrease of risk with increasing consumption (whole grains, fruits, and dairy), and three an increase of risk with increasing consumption (red meat, processed meat, and SSB) in the linear dose-response meta-analysis. There was evidence of a non-linear relationship between fruits, vegetables, processed meat, whole grains, and SSB and T2D risk. Optimal consumption of risk-decreasing foods resulted in a 42% reduction, and consumption of risk-increasing foods was associated with a threefold T2D risk, compared to non-consumption. The meta-evidence was graded "low" for legumes and nuts; "moderate" for refined grains, vegetables, fruit, eggs, dairy, and fish; and "high" for processed meat, red meat, whole grains, and SSB. Among the investigated food groups, selecting specific optimal intakes can lead to a considerable change in risk of T2D.

Increased risk of flooding on the coast of Alicante (Region of Valencia, Spain

Directory of Open Access Journals (Sweden)

J. Olcina Cantos

2010-11-01

Full Text Available In the past two decades, episodes of flooding on the coast of Alicante (Spain have led to substantial losses in human life in economic terms. With increased exposure to these phenomena comes also increased vulnerability. Given the various effects of flooding in areas of similar exposure, differences in vulnerability across regions at risk need to be analysed also in terms of the socioeconomic factors of the groups of society that may be affected, and of their perception of risk. This paper studies the increased risk of flooding in three locations on the Alicante coast as a result of urban occupation of areas subject to this hazard. The consequences of the most recent episodes in this area are analysed and a risk assessment, using survey-based research in the affected areas, is performed.

Risk factor management in a contemporary Australian population at increased cardiovascular disease risk.

Science.gov (United States)

Campbell, D J; Coller, J M; Gong, F F; McGrady, M; Prior, D L; Boffa, U; Shiel, L; Liew, D; Wolfe, R; Owen, A J; Krum, H; Reid, C M

2017-11-14

Effective management of cardiovascular and chronic kidney disease risk factors offers longer, healthier lives and savings in health care. We examined risk factor management in participants of the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years. Exclusion criteria were known heart failure or cardiac abnormality on echocardiography or other imaging. Medical history, clinical examination, full blood examination and biochemistry (without lipids and HbA1c) were performed for 3847 participants on enrolment, and blood pressure, lipids and HbA1c were measured 1-2 years after enrolment for 3202 participants. Despite 99% of 3294 participants with hypertension receiving antihypertensive medication, half had blood pressures >140/90 mmHg. Approximately 77% of participants were overweight or obese, with one third obese. Additionally, 74% of participants at high cardiovascular disease risk had low density lipoprotein cholesterol levels ≥2 mmol/l, one third of diabetic participants had HbA1c >7%, 22% had estimated glomerular filtration rate management of modifiable risk factors. This article is protected by copyright. All rights reserved.

Omega-3 polyunsaturated fatty acid blood biomarkers increase linearly in men and women after tightly controlled intakes of 0.25, 0.5, and 1 g/d of EPA + DHA.

Science.gov (United States)

Patterson, Ashley C; Chalil, Alan; Aristizabal Henao, Juan J; Streit, Isaac T; Stark, Ken D

2015-12-01

Blood levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been related to coronary heart disease risk. Understanding the response of EPA + DHA in blood to dietary intake of EPA + DHA would facilitate the use of blood measures as markers of adherence and enable the development of dietary recommendations. The objective of this study is examine the blood response to intakes of EPA + DHA ≤1 g/d with an intervention designed for dietary adherence. It was hypothesized this relationship would be linear and that intakes of EPA + DHA DHA intake of men and women (n = 20) was determined by food frequency questionnaire and adherence was monitored by weekly fingertip blood sampling for fatty acid determinations. Participants consumed nutraceuticals to achieve intakes of 0.25 g/d and 0.5 g/d EPA + DHA for successive four-week periods. A subgroup (n = 5) had intakes of 1.0 g/d EPA + DHA for an additional 4 weeks. Fatty acid composition of whole blood, erythrocytes, and plasma phospholipids were determined at each time point. Blood levels of EPA and DHA increased linearly in these pools. A comprehensive review of the literature was used to verify the blood-intake relationship. Blood levels of long chain omega-3 polyunsaturated fatty acids reached blood levels associated with the highest levels of primary cardiac arrest reduction and sudden cardiac death risk only with intakes of 1.0 g/d of EPA + DHA. The blood biomarker response to intakes of EPA + DHA ≤1 g/d is linear in a small but highly adherent study sample and this information can assist in determining adherence in clinical studies and help identify dietary intake targets from associations between blood and disease. Copyright © 2015 Elsevier Inc. All rights reserved.

Increased colon cancer risk after severe Salmonella infection

OpenAIRE

Mughini-Gras, Lapo; Schaapveld, Michael; Kramers, Jolanda; Mooij, Sofie; Neefjes-Borst, E. Andra; van Pelt, Wilfrid; Neefjes, Jacques

2018-01-01

Background Colon cancer constitutes one of the most frequent malignancies. Previous studies showed that Salmonella manipulates host cell signaling pathways and that Salmonella Typhimurium infection facilitates colon cancer development in genetically predisposed mice. This epidemiological study examined whether severe Salmonella infection, usually acquired from contaminated food, is associated with increased colon cancer risk in humans. Methods and findings We performed a nationwide registry-b...

How Non-Gaussian Shocks Affect Risk Premia in Non-Linear DSGE Models

DEFF Research Database (Denmark)

Andreasen, Martin Møller

This paper studies how non-Gaussian shocks affect risk premia in DSGE models approximated to second and third order. Based on an extension of the results in Schmitt-Grohé & Uribe (2004) to third order, we derive propositions for how rare disasters, stochastic volatility, and GARCH affect any risk...... premia in a wide class of DSGE models. To quantify these effects, we then set up a standard New Keynesian DSGE model where total factor productivity includes rare disasters, stochastic volatility, and GARCH. We …find that rare disasters increase the mean level of the 10-year nominal term premium, whereas...

The Racing-Game Effect: Why Do Video Racing Games Increase Risk-Taking Inclinations?

OpenAIRE

Fischer, Peter; Greitemeyer, Tobias; Morton, Thomas; Kastenmüller, Andreas; Postmes, Tom; Frey, Dieter; Kubitzki, Jörg; Odenwälder, Jörg

2009-01-01

The present studies investigated why video racing games increase players’ risk-taking inclinations. Four studies reveal that playing video racing games increases risk taking in a subsequent simulated road traffic situation, as well as risk-promoting cognitions and emotions, blood pressure,sensation seeking, and attitudes toward reckless driving. Study 1 ruled out the role of experimental demand in creating such effects. Studies 2 and 3 showed that the effect of playing video racing games on r...

LINEAR ACCELERATOR

Science.gov (United States)

Christofilos, N.C.; Polk, I.J.

1959-02-17

Improvements in linear particle accelerators are described. A drift tube system for a linear ion accelerator reduces gap capacity between adjacent drift tube ends. This is accomplished by reducing the ratio of the diameter of the drift tube to the diameter of the resonant cavity. Concentration of magnetic field intensity at the longitudinal midpoint of the external sunface of each drift tube is reduced by increasing the external drift tube diameter at the longitudinal center region.

At-Risk Variant in TCF7L2 for Type II Diabetes Increases Risk of Schizophrenia

DEFF Research Database (Denmark)

Hansen, Thomas; Ingason, Andrés; Djurovic, Srdjan

2011-01-01

BACKGROUND: Schizophrenia is associated with increased risk of type II diabetes and metabolic disorders. However, it is unclear whether this comorbidity reflects shared genetic risk factors, at-risk lifestyle, or side effects of antipsychotic medication. METHODS: Eleven known risk variants of type...... (SGENE+) using Mantel-Haenszel test. RESULTS: One type II diabetes at-risk allele located in TCF7L2, rs7903146 [T], was associated with schizophrenia in the discovery sample (p = .0052) and in the replication with an odds ratio of 1.07 (95% confidence interval 1.01-1.14, p = .033). CONCLUSION...... II diabetes were genotyped in patients with schizophrenia in a sample of 410 Danish patients, each matched with two healthy control subjects on sex, birth year, and month. Replication was carried out in a large multinational European sample of 4089 patients with schizophrenia and 17,597 controls...

Increase in speed of Wilkinson-type ADC and improvement of differential non-linearity

Energy Technology Data Exchange (ETDEWEB)

Kinbara, S [Japan Atomic Energy Research Inst., Tokai, Ibaraki. Tokai Research Establishment

1977-06-01

It is shown that the differential non-linearity of a Wilkinson-type analog-to-digital converter (ADC) is dominated by the unbalance of even-numbered periods caused by the action of interference resulting from operation of a channel scaler. To improve this situation, new methods were tested which allow such action of interference to be dispersed. Measurements show that a differential non-linearity value of +- 0.043% is attainable for a clock rate of 300 MHz.

Adverse life events increase risk for postpartum psychiatric episodes: A population-based epidemiologic study.

Science.gov (United States)

Meltzer-Brody, S; Larsen, J T; Petersen, L; Guintivano, J; Florio, A Di; Miller, W C; Sullivan, P F; Munk-Olsen, T

2018-02-01

Trauma histories may increase risk of perinatal psychiatric episodes. We designed an epidemiological population-based cohort study to explore if adverse childhood experiences (ACE) in girls increases risk of later postpartum psychiatric episodes. Using Danish registers, we identified women born in Denmark between January 1980 and December 1998 (129,439 childbirths). Exposure variables were ACE between ages 0 and 15 including: (1) family disruption, (2) parental somatic illness, (3) parental labor market exclusion, (4) parental criminality, (5) parental death, (6) placement in out-of-home care, (7) parental psychopathology excluding substance use, and (8) parental substance use disorder. Primary outcome was first occurrence of in- or outpatient contact 0-6 months postpartum at a psychiatric treatment facility with any psychiatric diagnoses, ICD-10, F00-F99 (N = 651). We conducted survival analyses using Cox proportional hazard regressions of postpartum psychiatric episodes. Approximately 52% of the sample experienced ACE, significantly increasing risk of any postpartum psychiatric diagnosis. Highest risks were observed among women who experienced out-of-home placement, hazard ratio (HR) 2.57 (95% CI: 1.90-3.48). Women experiencing two adverse life events had higher risks of postpartum psychiatric diagnosis HR: 1.88 (95% CI: 1.51-2.36), compared to those with one ACE, HR: 1.24 (95% CI: 1.03-49) and no ACE, HR: 1.00 (reference group). ACE primarily due to parental psychopathology and disability contributes to increased risk of postpartum psychiatric episodes; and greater numbers of ACE increases risk for postpartum psychiatric illness with an observed dose-response effect. Future work should explore genetic and environmental factors that increase risk and/or confer resilience. © 2017 Wiley Periodicals, Inc.

Increased bleeding risk during percutaneous coronary interventions by arterial hypertension.

Science.gov (United States)

Ndrepepa, Gjin; Groha, Philipp; Lahmann, Anna L; Lohaus, Raphaela; Cassese, Salvatore; Schulz-Schüpke, Stefanie; Kufner, Sebastian; Mayer, Katharina; Bernlochner, Isabell; Byrne, Robert A; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan

2016-08-01

We aimed to assess the association between arterial hypertension and bleeding in patients undergoing percutaneous coronary intervention (PCI). The impact of arterial hypertension on bleeding risk of patients with coronary artery disease undergoing PCI is unknown. This study included 14,180 patients who underwent PCI. Bleeding was defined using the Bleeding Academic Research Consortium (BARC) criteria. Arterial hypertension was defined as treatment with antihypertensive drugs or a systolic blood pressure >140 mm Hg and/or diastolic blood pressure value >90 mm Hg documented on at least 2 occasions. The primary outcome was bleeding rate within 30 days of PCI. Overall, 11,066 patients (78.0%) had arterial hypertension. Bleeding events occurred in 1,232 patients with arterial hypertension and 278 patients without arterial hypertension (11.1% vs 8.9%; odds ratio [OR] = 1.28, 95% confidence interval [CI] 1.11-1.46, P arterial hypertension and 175 patients without arterial hypertension (6.6% vs 5.6%: OR = 1.19 [1.01-1.41], P = 0.049). Non-access-site bleeding occurred in 502 patients with and 103 patients without arterial hypertension (4.5% vs 3.3%; OR = 1.39 [1.12-1.72], P = 0.003). After adjustment, arterial hypertension was significantly associated with any bleeding (adjusted OR = 1.41 [1.19-1.67], P arterial hypertension increased the risk of non-access-site bleeding (P = 0.002), whereas systolic blood pressure at the time of PCI increased the risk of access site bleeding (P = 0.018). Arterial hypertension is associated with increased risk of bleeding during PCI procedures. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Atopic dermatitis is associated with an increased risk for rheumatoid arthritis and inflammatory bowel disease, and a decreased risk for type 1 diabetes

DEFF Research Database (Denmark)

Schmitt, Jochen; Schwarz, Kristin; Baurecht, Hansjörg

2016-01-01

rheumatoid arthritis (RA) and inflammatory bowel disease (IBD; Crohn disease [CD], ulcerative colitis [UC]) and is inversely related to type 1 diabetes (T1D) and to investigate established RA, IBD, and T1D susceptibility loci in AD. METHODS: This cohort study used data from German National Health Insurance......BACKGROUND: Atopic dermatitis (AD) is characterized by epidermal barrier failure and immune-mediated inflammation. Evidence on AD as a potential risk factor for inflammatory comorbidities is scarce. OBJECTIVES: We sought to test the hypothesis that prevalent AD is a risk factor for incident...... beneficiaries aged 40 years or younger (n = 655,815) from 2005 through 2011. Prevalent AD in the period 2005 to 2006 was defined as primary exposure, and incident RA, IBD, and T1D in the period 2007 to 2011 were defined as primary outcomes. Risk ratios were calculated with generalized linear models. Established...

Linear endoscopic ultrasound for clinically suspected bile duct stones

Directory of Open Access Journals (Sweden)

Lien-Fu Lin

2012-06-01

Conclusion: Linear EUS is sensitive for the detection of CBDS. It detected 56% of CBDS in a high-risk group and 14.2% in an intermediate-risk group and therefore is a useful assessment tool in patients with high or intermediate risk of CBDS.

Topiramate increases the risk of valproic acid-induced encephalopathy.

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Noh, Young; Kim, Dong Wook; Chu, Kon; Lee, Soon-Tae; Jung, Keun-Hwa; Moon, Hye-Jin; Lee, Sang Kun

2013-01-01

Metabolic encephalopathy is a rare but serious complication of valproic acid (VPA) therapy that usually presents with impaired consciousness or increased seizure frequency. Although it has been suggested that topiramate (TPM) increases the risk of VPA-induced encephalopathy, the additional risk in patients receiving TPM therapy has not been evaluated. We reviewed all adult patients who took VPA between January 2005 and February 2009 at the Seoul National University Hospital and identified patients with VPA-induced encephalopathy based on clinical and electroencephalography (EEG) data. Information on sex, age, serum ammonia level, serum VPA level, liver function test, and EEG was collected from patient registry and medical data. We enrolled 8,372 patients who received VPA therapy and 1,236 patients who received VPA/TPM combination therapy. We identified 11 patients with VPA-induced encephalopathy (0.13%), 7 of whom received a combination therapy of VPA and TPM. The odds ratio of VPA-induced encephalopathy with TPM over that without TPM was 10.16. There were no significant differences in sex distribution, number of antiepileptic agents, ammonia level, VPA serum level, underlying diseases, dosage of VPA, duration of VPA treatment, treatment of encephalopathy, and outcomes between the two groups. Our study showed that the prevalence of VPA-induced encephalopathy is approximately 0.1% among patients treated with VPA and that the risk of this condition, although still low, can increase by approximately 10 times in the presence of TPM therapy. Based on these results, we suggest that TPM should be carefully used in patients receiving VPA treatment. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

Acromegaly is associated with increased cancer risk: a survey in Italy.

Science.gov (United States)

Terzolo, Massimo; Reimondo, Giuseppe; Berchialla, Paola; Ferrante, Emanuele; Malchiodi, Elena; De Marinis, Laura; Pivonello, Rosario; Grottoli, Silvia; Losa, Marco; Cannavo, Salvatore; Ferone, Diego; Montini, Marcella; Bondanelli, Marta; De Menis, Ernesto; Martini, Chiara; Puxeddu, Efisio; Velardo, Antonino; Peri, Alessandro; Faustini-Fustini, Marco; Tita, Patrizia; Pigliaru, Francesca; Peraga, Giulia; Borretta, Giorgio; Scaroni, Carla; Bazzoni, Nicoletta; Bianchi, Antonio; Berton, Alessandro; Serban, Andreea Liliana; Baldelli, Roberto; Fatti, Letizia Maria; Colao, Annamaria; Arosio, Maura

2017-09-01

It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 ± 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18-1.68, P  acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk. © 2017 Society for Endocrinology.

Behavioural adjustment in response to increased predation risk: a study in three duck species.

Directory of Open Access Journals (Sweden)

Cédric Zimmer

Full Text Available Predation directly triggers behavioural decisions designed to increase immediate survival. However, these behavioural modifications can have long term costs. There is therefore a trade-off between antipredator behaviours and other activities. This trade-off is generally considered between vigilance and only one other behaviour, thus neglecting potential compensations. In this study, we considered the effect of an increase in predation risk on the diurnal time-budget of three captive duck species during the wintering period. We artificially increased predation risk by disturbing two groups of 14 mallard and teals at different frequencies, and one group of 14 tufted ducks with a radio-controlled stressor. We recorded foraging, vigilance, preening and sleeping durations the week before, during and after disturbance sessions. Disturbed groups were compared to an undisturbed control group. We showed that in all three species, the increase in predation risk resulted in a decrease in foraging and preening and led to an increase in sleeping. It is worth noting that contrary to common observations, vigilance did not increase. However, ducks are known to be vigilant while sleeping. This complex behavioural adjustment therefore seems to be optimal as it may allow ducks to reduce their predation risk. Our results highlight the fact that it is necessary to encompass the whole individual time-budget when studying behavioural modifications under predation risk. Finally, we propose that studies of behavioural time-budget changes under predation risk should be included in the more general framework of the starvation-predation risk trade-off.

Increasing stress on disaster risk finance due to large floods

Science.gov (United States)

Jongman, Brenden; Hochrainer-Stigler, Stefan; Feyen, Luc; Aerts, Jeroen; Mechler, Reinhard; Botzen, Wouter; Bouwer, Laurens; Pflug, Georg; Rojas, Rodrigo; Ward, Philip

2014-05-01

Recent major flood disasters have shown that single extreme events can affect multiple countries simultaneously, which puts high pressure on trans-national risk reduction and risk transfer mechanisms. To date, little is known about such flood hazard interdependencies across regions, and the corresponding joint risks at regional to continental scales. Reliable information on correlated loss probabilities is crucial for developing robust insurance schemes and public adaptation funds, and for enhancing our understanding of climate change impacts. Here we show that extreme discharges are strongly correlated across European river basins and that these correlations can, or should, be used in national to continental scale risk assessment. We present probabilistic trends in continental flood risk, and demonstrate that currently observed extreme flood losses could more than double in frequency by 2050 under future climate change and socioeconomic development. The results demonstrate that accounting for tail dependencies leads to higher estimates of extreme losses than estimates based on the traditional assumption of independence between basins. We suggest that risk management for these increasing losses is largely feasible, and we demonstrate that risk can be shared by expanding risk transfer financing, reduced by investing in flood protection, or absorbed by enhanced solidarity between countries. We conclude that these measures have vastly different efficiency, equity and acceptability implications, which need to be taken into account in broader consultation, for which our analysis provides a basis.

Analysis of blood pressure signal in patients with different ventricular ejection fraction using linear and non-linear methods.

Science.gov (United States)

Arcentales, Andres; Rivera, Patricio; Caminal, Pere; Voss, Andreas; Bayes-Genis, Antonio; Giraldo, Beatriz F

2016-08-01

Changes in the left ventricle function produce alternans in the hemodynamic and electric behavior of the cardiovascular system. A total of 49 cardiomyopathy patients have been studied based on the blood pressure signal (BP), and were classified according to the left ventricular ejection fraction (LVEF) in low risk (LR: LVEF>35%, 17 patients) and high risk (HR: LVEF≤35, 32 patients) groups. We propose to characterize these patients using a linear and a nonlinear methods, based on the spectral estimation and the recurrence plot, respectively. From BP signal, we extracted each systolic time interval (STI), upward systolic slope (BPsl), and the difference between systolic and diastolic BP, defined as pulse pressure (PP). After, the best subset of parameters were obtained through the sequential feature selection (SFS) method. According to the results, the best classification was obtained using a combination of linear and nonlinear features from STI and PP parameters. For STI, the best combination was obtained considering the frequency peak and the diagonal structures of RP, with an area under the curve (AUC) of 79%. The same results were obtained when comparing PP values. Consequently, the use of combined linear and nonlinear parameters could improve the risk stratification of cardiomyopathy patients.

Using dynamic walking models to identify factors that contribute to increased risk of falling in older adults.

Science.gov (United States)

Roos, Paulien E; Dingwell, Jonathan B

2013-10-01

Falls are common in older adults. The most common cause of falls is tripping while walking. Simulation studies demonstrated that older adults may be restricted by lower limb strength and movement speed to regain balance after a trip. This review examines how modeling approaches can be used to determine how different measures predict actual fall risk and what some of the causal mechanisms of fall risk are. Although increased gait variability predicts increased fall risk experimentally, it is not clear which variability measures could best be used, or what magnitude of change corresponded with increased fall risk. With a simulation study we showed that the increase in fall risk with a certain increase in gait variability was greatly influenced by the initial level of variability. Gait variability can therefore not easily be used to predict fall risk. We therefore explored other measures that may be related to fall risk and investigated the relationship between stability measures such as Floquet multipliers and local divergence exponents and actual fall risk in a dynamic walking model. We demonstrated that short-term local divergence exponents were a good early predictor for fall risk. Neuronal noise increases with age. It has however not been fully understood if increased neuronal noise would cause an increased fall risk. With our dynamic walking model we showed that increased neuronal noise caused increased fall risk. Although people who are at increased risk of falling reduce their walking speed it had been questioned whether this slower speed would actually cause a reduced fall risk. With our model we demonstrated that a reduced walking speed caused a reduction in fall risk. This may be due to the decreased kinematic variability as a result of the reduced signal-dependent noise of the smaller muscle forces that are required for slower. These insights may be used in the development of fall prevention programs in order to better identify those at increased risk of

Using Dynamic Walking Models to Identify Factors that Contribute to Increased Risk of Falling in Older Adults

Science.gov (United States)

Roos, Paulien E.; Dingwell, Jonathan B.

2013-01-01

Falls are common in older adults. The most common cause of falls is tripping while walking. Simulation studies demonstrated that older adults may be restricted by lower limb strength and movement speed to regain balance after a trip. This review examines how modeling approaches can be used to determine how different measures predict actual fall risk and what some of the causal mechanisms of fall risk are. Although increased gait variability predicts increased fall risk experimentally, it is not clear which variability measures could best be used, or what magnitude of change corresponded with increased fall risk. With a simulation study we showed that the increase in fall risk with a certain increase in gait variability was greatly influenced by the initial level of variability. Gait variability can therefore not easily be used to predict fall risk. We therefore explored other measures that may be related to fall risk and investigated the relationship between stability measures such as Floquet multipliers and local divergence exponents and actual fall risk in a dynamic walking model. We demonstrated that short-term local divergence exponents were a good early predictor for fall risk. Neuronal noise increases with age. It has however not been fully understood if increased neuronal noise would cause an increased fall risk. With our dynamic walking model we showed that increased neuronal noise caused increased fall risk. Although people who are at increased risk of falling reduce their walking speed it had been questioned whether this slower speed would actually cause a reduced fall risk. With our model we demonstrated that a reduced walking speed caused a reduction in fall risk. This may be due to the decreased kinematic variability as a result of the reduced signal-dependent noise of the smaller muscle forces that are required for slower. These insights may be used in the development of fall prevention programs in order to better identify those at increased risk of

An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity

Science.gov (United States)

Simopoulos, Artemis P.

2016-01-01

In the past three decades, total fat and saturated fat intake as a percentage of total calories has continuously decreased in Western diets, while the intake of omega-6 fatty acid increased and the omega-3 fatty acid decreased, resulting in a large increase in the omega-6/omega-3 ratio from 1:1 during evolution to 20:1 today or even higher. This change in the composition of fatty acids parallels a significant increase in the prevalence of overweight and obesity. Experimental studies have suggested that omega-6 and omega-3 fatty acids elicit divergent effects on body fat gain through mechanisms of adipogenesis, browning of adipose tissue, lipid homeostasis, brain-gut-adipose tissue axis, and most importantly systemic inflammation. Prospective studies clearly show an increase in the risk of obesity as the level of omega-6 fatty acids and the omega-6/omega-3 ratio increase in red blood cell (RBC) membrane phospholipids, whereas high omega-3 RBC membrane phospholipids decrease the risk of obesity. Recent studies in humans show that in addition to absolute amounts of omega-6 and omega-3 fatty acid intake, the omega-6/omega-3 ratio plays an important role in increasing the development of obesity via both AA eicosanoid metabolites and hyperactivity of the cannabinoid system, which can be reversed with increased intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). A balanced omega-6/omega-3 ratio is important for health and in the prevention and management of obesity. PMID:26950145

An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity

Directory of Open Access Journals (Sweden)

Artemis P. Simopoulos

2016-03-01

Full Text Available In the past three decades, total fat and saturated fat intake as a percentage of total calories has continuously decreased in Western diets, while the intake of omega-6 fatty acid increased and the omega-3 fatty acid decreased, resulting in a large increase in the omega-6/omega-3 ratio from 1:1 during evolution to 20:1 today or even higher. This change in the composition of fatty acids parallels a significant increase in the prevalence of overweight and obesity. Experimental studies have suggested that omega-6 and omega-3 fatty acids elicit divergent effects on body fat gain through mechanisms of adipogenesis, browning of adipose tissue, lipid homeostasis, brain-gut-adipose tissue axis, and most importantly systemic inflammation. Prospective studies clearly show an increase in the risk of obesity as the level of omega-6 fatty acids and the omega-6/omega-3 ratio increase in red blood cell (RBC membrane phospholipids, whereas high omega-3 RBC membrane phospholipids decrease the risk of obesity. Recent studies in humans show that in addition to absolute amounts of omega-6 and omega-3 fatty acid intake, the omega-6/omega-3 ratio plays an important role in increasing the development of obesity via both AA eicosanoid metabolites and hyperactivity of the cannabinoid system, which can be reversed with increased intake of eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA. A balanced omega-6/omega-3 ratio is important for health and in the prevention and management of obesity.

Radiation protection in large linear accelerators; Seguranca radiologica de aceleradores lineares de grande porte

Energy Technology Data Exchange (ETDEWEB)

Oliva, Jose de Jesus Rivero, E-mail: rivero@con.ufrj.br [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Departamento de Engenharia Nuclear; Sousa, Fernando Nuno Carneiro de, E-mail: fernandonunosousa@gmail.com [Aceletron Irradiacao lndustrial, Rio de Janeiro, RJ (Brazil)

2013-07-01

The electron linear accelerators can be used in industrial applications that require powerful sources of ionizing radiation. They have the important characteristic of not representing a radiation hazard when the accelerators remain electrically disconnected. With the plant in operation, a high reliability defense in depth reduces the risk of radiological accidents to extremely small levels. It is practically impossible that a person could enter into the radiation bunker with the accelerators connected. Aceletron Irradiacao Industrial, located in Rio de Janeiro, offers services of irradiation by means of two powerful electron linear accelerators, with 15 kW power and 10 MeV electron energy. Despite the high level of existing radiation safety, a simplified risk study is underway to identify possible sequences of radiological accidents. The study is based on the combined application of the event and fault trees techniques. Preliminary results confirm that there is a very small risk of entering into the irradiation bunker with the accelerators in operation, but the risk of an operator entering into the bunker during a process interruption and remaining there without notice after the accelerators were restarted may be considerably larger. Based on these results the Company is considering alternatives to reduce the likelihood of human error of this type that could lead to a radiological accident. The paper describes the defense in depth of the irradiation process in Aceletron Irradiacao Industrial, as well as the models and preliminary results of the ongoing risk analysis, including the additional safety measures which are being evaluated. (author)

Arthritis increases the risk for fractures--results from the Women's Health Initiative.

Science.gov (United States)

Wright, Nicole C; Lisse, Jeffrey R; Walitt, Brian T; Eaton, Charles B; Chen, Zhao

2011-08-01

To examine the relationship between arthritis and fracture. Women were classified into 3 self-reported groups at baseline: no arthritis (n = 83,295), osteoarthritis (OA; n = 63,402), and rheumatoid arthritis (RA; n = 960). Incident fractures were self-reported throughout followup. Age-adjusted fracture rates by arthritis category were generated, and the Cox proportional hazards model was used to test the association between arthritis and fracture. After an average of 7.80 years, 24,137 total fractures were reported including 2559 self-reported clinical spinal fractures and 1698 adjudicated hip fractures. For each fracture type, age-adjusted fracture rates were highest in the RA group and lowest in the nonarthritic group. After adjustment for several covariates, report of arthritis was associated with increased risk for spine, hip, and any clinical fractures. Compared to the nonarthritis group, the risk of sustaining any clinical fracture in the OA group was HR 1.09 (95% CI 1.05, 1.13; p < 0.001) and HR 1.49 (95% CI 1.26, 1.75; p < 0.001) in the RA group. The risk of sustaining a hip fracture was not statistically increased in the OA group (HR 1.11; 95% CI 0.98, 1.25; p = 0.122) compared to the nonarthritis group; however, the risk of hip fracture increased significantly (HR 3.03; 95% CI 2.03, 4.51; p < 0.001) in the RA group compared to the nonarthritis group. The increase in fracture risk confirms the importance of fracture prevention in patients with RA and OA.

SSRIs increase risk of blood transfusion in patients admitted for hip surgery.

Directory of Open Access Journals (Sweden)

Hermien Janneke Schutte

Full Text Available BACKGROUND: Recent studies have shown that an increased bleeding tendency can be caused by Selective Serotonin Reuptake Inhibitors (SSRI use. We aimed to investigate the occurrence and risk of blood transfusion in SSRI users compared to non-SSRI users in a cohort of patients admitted for hip-surgery. METHODS: We conducted a retrospective cohort study of patients who underwent planned or emergency hip surgery from 1996 to 2011 in the Academic Medical Center in Amsterdam. Primary outcome measure was risk of blood transfusion. Secondary outcome measures were pre- and postoperative hemoglobin level. Multivariate logistic regression was used to adjust for potential confounders. RESULTS: One-hundred and fourteen SSRI users were compared to 1773 non-SSRI users. Risk of blood transfusion during admission was increased for SSRI users in multivariate analyses (OR 1.7 [95% CI 1.1-2.5]. Also, pre-operative hemoglobin levels were lower in SSRI users (7.8 ± 1.0 mmol/L compared to non-SSRI users (8.0 ± 1.0 mmol/L (p  =  0.042, as were postoperative hemoglobin levels (6.2 ± 1.0 mmol/L vs. 6.4 ± 1.0 mmol/L respectively (p  =  0.017. CONCLUSIONS: SSRI users undergoing hip surgery have an increased risk for blood transfusion during admission, potentially explained by a lower hemoglobin level before surgery. SSRI use should be considered as a potential risk indicator for increased blood loss in patients admitted for hip surgery. These results need to be confirmed in a prospective study.

Increased mortality risk in women with depression and diabetes mellitus

Science.gov (United States)

Pan, An; Lucas, Michel; Sun, Qi; van Dam, Rob M.; Franco, Oscar H.; Willett, Walter C.; Manson, JoAnn E.; Rexrode, Kathryn M.; Ascherio, Alberto; Hu, Frank B.

2011-01-01

Context Both depression and diabetes have been associated with an increased risk of all-cause and cardiovascular diseases (CVD) mortality. However, data evaluating the joint effects of these two conditions on mortality are sparse. Objectives To evaluate the individual and joint effects of depression and diabetes on all-cause and CVD mortality in a prospective cohort study. Design, Settings and Participants A total of 78282 female participants in the Nurses' Health Study aged 54-79 years at baseline in 2000 were followed until 2006. Depression was defined as having self-reported diagnosed depression, treatment with antidepressant medications, or a score indicating severe depressive symptomatology, i.e., a five-item Mental Health Index score ≤52. Self-reported type 2 diabetes was confirmed using a supplementary questionnaire. Main outcome measures All-cause and CVD-specific mortality. Results During 6 years of follow-up (433066 person-years), 4654 deaths were documented, including 979 deaths from CVD. Compared to participants without either condition, the age-adjusted relative risks (95% confidence interval, CI) for all-cause mortality were 1.76 (1.64-1.89) for women with depression only, 1.71 (1.54-1.89) for individuals with diabetes only, and 3.11 (2.70-3.58) for those with both conditions. The corresponding age-adjusted relative risks of CVD mortality were 1.81 (1.54-2.13), 2.67 (2.20-3.23), and 5.38 (4.19-6.91), respectively. These associations were attenuated after multivariate adjustment for other demographic variables, body mass index, smoking status, alcohol intake, physical activity, and major comorbidities (including hypertension, hypercholesterolemia, heart diseases, stroke and cancer) but remained significant, with the highest relative risks for all-cause and CVD mortality found in those with both conditions (2.07 [95% CI, 1.79-2.40] and 2.72 [95% CI, 2.09-3.54], respectively). Furthermore, the combination of depression with a long duration of diabetes

Worsening Cognitive Impairment and Neurodegenerative Pathology Progressively Increase Risk for Delirium

Science.gov (United States)

Davis, Daniel H.J.; Skelly, Donal T.; Murray, Carol; Hennessy, Edel; Bowen, Jordan; Norton, Samuel; Brayne, Carol; Rahkonen, Terhi; Sulkava, Raimo; Sanderson, David J.; Rawlins, J. Nicholas; Bannerman, David M.; MacLullich, Alasdair M.J.; Cunningham, Colm

2015-01-01

Background Delirium is a profound neuropsychiatric disturbance precipitated by acute illness. Although dementia is the major risk factor this has typically been considered a binary quantity (i.e., cognitively impaired versus cognitively normal) with respect to delirium risk. We used humans and mice to address the hypothesis that the severity of underlying neurodegenerative changes and/or cognitive impairment progressively alters delirium risk. Methods Humans in a population-based longitudinal study, Vantaa 85+, were followed for incident delirium. Odds for reporting delirium at follow-up (outcome) were modeled using random-effects logistic regression, where prior cognitive impairment measured by Mini-Mental State Exam (MMSE) (exposure) was considered. To address whether underlying neurodegenerative pathology increased susceptibility to acute cognitive change, mice at three stages of neurodegenerative disease progression (ME7 model of neurodegeneration: controls, 12 weeks, and 16 weeks) were assessed for acute cognitive dysfunction upon systemic inflammation induced by bacterial lipopolysaccharide (LPS; 100 μg/kg). Synaptic and axonal correlates of susceptibility to acute dysfunction were assessed using immunohistochemistry. Results In the Vantaa cohort, 465 persons (88.4 ± 2.8 years) completed MMSE at baseline. For every MMSE point lost, risk of incident delirium increased by 5% (p = 0.02). LPS precipitated severe and fluctuating cognitive deficits in 16-week ME7 mice but lower incidence or no deficits in 12-week ME7 and controls, respectively. This was associated with progressive thalamic synaptic loss and axonal pathology. Conclusion A human population-based cohort with graded severity of existing cognitive impairment and a mouse model with progressing neurodegeneration both indicate that the risk of delirium increases with greater severity of pre-existing cognitive impairment and neuropathology. PMID:25239680

Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients.

Science.gov (United States)

van der Velde, Nathalie; Meerding, Willen Jan; Looman, Caspar W; Pols, Huibert A P; van der Cammen, Tischa J M

2008-01-01

Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. Within a common geriatric outpatient population, patients with a history of falls were assessed for falls risk (n = 139). Fall-risk-increasing drugs were withdrawn when appropriate (n = 75). All participants had a 2-month follow-up for fall incidents. The number of prevented falls was calculated using a loglinear regression model. The savings on health expenditures as a result of prevented injuries (estimated from a literature review) and reduced consumption of pharmaceuticals were compared with the intervention costs. After adjustment for confounders, drug withdrawal resulted in a falls risk reduction of 0.89 (95% CI 0.33, 0.98) per patient compared with the non-withdrawal group. Net cost savings were euro1691 (95% CI 662, 2181) per patient in the cohort. This resulted in a cost saving of euro491 (95% CI 465, 497) per prevented fall. Withdrawal of fall-risk-increasing drugs generates significant cost savings. Extrapolation of these findings to a national scale results in an estimated reduction of euro60 million in healthcare expenditures, that is, 15% of fall-related health costs.

Radiation dose dependent risk of liver cancer mortality in the German uranium miners cohort 1946–2003

International Nuclear Information System (INIS)

Dufey, F; Walsh, L; Sogl, M; Tschense, A; Schnelzer, M; Kreuzer, M

2013-01-01

An increased risk of mortality from primary liver cancers among uranium miners has been observed in various studies. An analysis of the data from a German uranium miner cohort (the ‘Wismut cohort’) was used to assess the relationship with ionising radiation. To that end the absorbed organ dose due to high and low linear energy transfer radiation was calculated for 58 987 miners with complete information on radiation exposure from a detailed job–exposure matrix. 159 deaths from liver cancer were observed in the follow-up period from 1946 to 2003. Relative risk models with either linear or categorical dependence on high and low linear energy transfer radiation liver doses were fitted by Poisson regression, stratified on age and calendar year. The linear trend of excess relative risk in a model with both low and high linear transfer radiation is −0.8 (95% confidence interval (CI): −3.7, 2.1) Gy −1 and 48.3 (95% CI: −32.0, 128.6) Gy −1 for low and high linear energy transfer radiation, respectively, and thus not statistically significant for either dose. The increase of excess relative risk with equivalent liver dose is 0.57 (95% CI: −0.69, 1.82) Sv −1 . Adjustment for arsenic only had a negligible effect on the radiation risk. In conclusion, there is only weak evidence for an increase of liver cancer mortality with increasing radiation dose in the German uranium miners cohort considered. However, both a lack of statistical power and potential misclassification of primary liver cancer are issues. (paper)

Increased risk of precocious puberty in internationally adopted children in Denmark

DEFF Research Database (Denmark)

Teilmann, G.; Pedersen, Carsten Bøcker; Skakkebæk, N.E.

2006-01-01

settings from birth to adoption, whereas most other countries are reported to take care of the children in orphanages before adoption. It can only be speculated whether a relation between preadoption living conditions and later risk of precocious puberty exists. Genetic factors play a key role...... identified through the unique Danish Civil Registration System and subsequently categorized as being Danish (N = 1,062,333), adopted (N = 10,997), immigrating with their family (N = 72,181), or being descendants of immigrants (N = 128,152). The incidence rate ratio of precocious puberty was estimated by log......-linear Poisson regression. All rate ratios were adjusted for age and its interaction with gender and calendar year. P values were based on likelihood ratio tests, and 95% confidence intervals were calculated by Wald's test. RESULTS: In the study period, 655 children developed precocious puberty during 5...

Does Schizophrenia in Offspring Increase the Risk of Developing Alzheimer's Dementia

Directory of Open Access Journals (Sweden)

Christopher Rohde

2016-08-01

Full Text Available Background/Aims: Prior studies have consistently found a higher risk of dementia in individuals with schizophrenia, but whether this is due to a common etiology between the disorders remains obscure. We wanted to elucidate this association by investigating whether schizophrenia in offspring increases the risk of Alzheimer's dementia. Methods: All individuals born between 1930 and 1953 were identified through national registers and followed from their 50th birthday until the date of Alzheimer's dementia, death or end of the study. Regressions were performed to evaluate the association between offspring with schizophrenia and Alzheimer's dementia. Results: Individuals with offspring with schizophrenia did not have an increased risk of Alzheimer's dementia [incidence rate ratio (IRR, 0.97; 95% CI, 0.88-1.07] compared to individuals with offspring without psychiatric contact. This finding remained stable when evaluating early-onset (IRR, 1.10; 95% CI, 0.91-1.31 and late-onset Alzheimer's dementia (IRR, 0.92; 95% CI, 0.88-1.07. Similar findings were made for vascular and unspecified dementia. Conclusion: The finding of no familial coaggregation between schizophrenia and Alzheimer's dementia may suggest that no common etiology between the disorders exists. This may indicate that the excess risk of dementia in individuals with schizophrenia is a by-product of the higher rates of somatic comorbidity and adverse health risk factors among these individuals.

Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study.

Science.gov (United States)

Zhang, Ming; Wang, Bingyuan; Liu, Yu; Sun, Xizhuo; Luo, Xinping; Wang, Chongjian; Li, Linlin; Zhang, Lu; Ren, Yongcheng; Zhao, Yang; Zhou, Junmei; Han, Chengyi; Zhao, Jingzhi; Hu, Dongsheng

2017-03-01

Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China. We included data from 5706 people with normal body mass index (BMI) (18.5-23.9 kg/m 2 ) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure-response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2]. Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20-5.11], 3.77 [1.83-7.79], and 5.30 [2.21-12.71], P trend  index). Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22-6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index. Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.

Linear Growth and Fat and Lean Tissue Gain during Childhood: Associations with Cardiometabolic and Cognitive Outcomes in Adolescent Indian Children.

Science.gov (United States)

Krishnaveni, Ghattu V; Veena, Sargoor R; Srinivasan, Krishnamachari; Osmond, Clive; Fall, Caroline H D

2015-01-01

We aimed to determine how linear growth and fat and lean tissue gain during discrete age periods from birth to adolescence are related to adolescent cardiometabolic risk factors and cognitive ability. Adolescents born to mothers with normal glucose tolerance during pregnancy from an Indian birth cohort (N = 486, age 13.5 years) had detailed anthropometry and measurements of body fat (fat%), fasting plasma glucose, insulin and lipid concentrations, blood pressure and cognitive function. Insulin resistance (HOMA-IR) was calculated. These outcomes were examined in relation to birth measurements and statistically independent measures (conditional SD scores) representing linear growth, and fat and lean tissue gain during birth-1, 1-2, 2-5, 5-9.5 and 9.5-13.5 years in 414 of the children with measurements at all these ages. Birth length and linear growth at all ages were positively associated with current height. Fat gain, particularly during 5-9.5 years was positively associated with fat% at 13.5 years (0.44 SD per SD [99.9% confidence interval: 0.29,0.58]). Greater fat gain during mid-late childhood was associated with higher systolic blood pressure (5-9.5 years: 0.23 SD per SD [0.07,0.40]) and HOMA-IR (5-9.5 years: 0.24 [0.08,0.40], 9.5-13.5 years: 0.22 [0.06,0.38]). Greater infant growth (up to age 2 years) in linear, fat or lean components was unrelated to cardiometabolic risk factors or cognitive function. This study suggests that factors that increase linear, fat and lean growth in infancy have no adverse cardiometabolic effects in this population. Factors that increase fat gain in mid-late childhood may increase cardiometabolic risk, without any benefit to cognitive abilities.

Linear Growth and Fat and Lean Tissue Gain during Childhood: Associations with Cardiometabolic and Cognitive Outcomes in Adolescent Indian Children.

Directory of Open Access Journals (Sweden)

Ghattu V Krishnaveni

Full Text Available We aimed to determine how linear growth and fat and lean tissue gain during discrete age periods from birth to adolescence are related to adolescent cardiometabolic risk factors and cognitive ability.Adolescents born to mothers with normal glucose tolerance during pregnancy from an Indian birth cohort (N = 486, age 13.5 years had detailed anthropometry and measurements of body fat (fat%, fasting plasma glucose, insulin and lipid concentrations, blood pressure and cognitive function. Insulin resistance (HOMA-IR was calculated. These outcomes were examined in relation to birth measurements and statistically independent measures (conditional SD scores representing linear growth, and fat and lean tissue gain during birth-1, 1-2, 2-5, 5-9.5 and 9.5-13.5 years in 414 of the children with measurements at all these ages.Birth length and linear growth at all ages were positively associated with current height. Fat gain, particularly during 5-9.5 years was positively associated with fat% at 13.5 years (0.44 SD per SD [99.9% confidence interval: 0.29,0.58]. Greater fat gain during mid-late childhood was associated with higher systolic blood pressure (5-9.5 years: 0.23 SD per SD [0.07,0.40] and HOMA-IR (5-9.5 years: 0.24 [0.08,0.40], 9.5-13.5 years: 0.22 [0.06,0.38]. Greater infant growth (up to age 2 years in linear, fat or lean components was unrelated to cardiometabolic risk factors or cognitive function.This study suggests that factors that increase linear, fat and lean growth in infancy have no adverse cardiometabolic effects in this population. Factors that increase fat gain in mid-late childhood may increase cardiometabolic risk, without any benefit to cognitive abilities.

Perioperative complications increase the risk of venous thromboembolism following bariatric surgery.

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Helm, Melissa C; Simon, Kathleen; Higgins, Rana; Kindel, Tammy L; Gould, Jon C

2017-12-01

Morbidly obese patients are at increased risk of venous thromboembolism (VTE) following surgery. This study explores the impact of a perioperative complication on the risk of VTE after bariatric surgery. Patients who underwent bariatric surgery were identified from the American College of Surgeons National Surgical Quality Improvement Program dataset (2012-2014). The 17 most common perioperative complications were analyzed by multivariate regression analysis to determine the effect of complications on the risk of VTE. The postoperative incidence of VTE was 0.5% (n = 59,424 bariatric surgeries). The average time to diagnosis of VTE was 11.6 days. 80% of VTE events occurred after discharge. A major complication occurred prior to VTE in 22.6% of patients. The more complications experienced by an individual patient, the more likely they were to experience VTE. Unadjusted thirty-day mortality increased 13.89-fold following VTE (p bariatric surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Anticipating divine protection? Reminders of god can increase nonmoral risk taking.

Science.gov (United States)

Kupor, Daniella M; Laurin, Kristin; Levav, Jonathan

2015-04-01

Religiosity and participation in religious activities have been linked with decreased risky behavior. In the current research, we hypothesized that exposure to the concept of God can actually increase people's willingness to engage in certain types of risks. Across seven studies, reminders of God increased risk taking in nonmoral domains. This effect was mediated by the perceived danger of a risky option and emerged more strongly among individuals who perceive God as a reliable source of safety and protection than among those who do not. Moreover, in an eighth study, when participants were first reminded of God and then took a risk that produced negative consequences (i.e., when divine protection failed to materialize), participants reported feeling more negatively toward God than did participants in the same situation who were not first reminded of God. This research contributes to an understanding of the divergent effects that distinct components of religion can exert on behavior. © The Author(s) 2015.

Portfolio optimization by using linear programing models based on genetic algorithm

Science.gov (United States)

Sukono; Hidayat, Y.; Lesmana, E.; Putra, A. S.; Napitupulu, H.; Supian, S.

2018-01-01

In this paper, we discussed the investment portfolio optimization using linear programming model based on genetic algorithms. It is assumed that the portfolio risk is measured by absolute standard deviation, and each investor has a risk tolerance on the investment portfolio. To complete the investment portfolio optimization problem, the issue is arranged into a linear programming model. Furthermore, determination of the optimum solution for linear programming is done by using a genetic algorithm. As a numerical illustration, we analyze some of the stocks traded on the capital market in Indonesia. Based on the analysis, it is shown that the portfolio optimization performed by genetic algorithm approach produces more optimal efficient portfolio, compared to the portfolio optimization performed by a linear programming algorithm approach. Therefore, genetic algorithms can be considered as an alternative on determining the investment portfolio optimization, particularly using linear programming models.

Allergic asthma is associated with increased risk of infections requiring antibiotics

DEFF Research Database (Denmark)

Woehlk, Christian; von Bülow, Anna; Kriegbaum, Margit

2018-01-01

: To investigate allergy as a risk factor for respiratory infections requiring antibiotics based on register data from a nationwide population of patients with asthma. METHODS: A register-based prospective follow-up study was performed using the Danish prescription database. In the inclusion period from 2010......BACKGROUND: Viral infection and allergy have been identified as major risk factors for exacerbation in asthma, especially in the presence of both. However, whether patients with allergic asthma are more susceptible to respiratory infections requiring antibiotics remains unknown. OBJECTIVE...... asthma was associated with an increased risk of filling at least 2 antibiotic prescriptions per year compared with nonallergic asthma (odds ratio 1.28, 95% confidence interval 1.24-1.33, P effect of immunotherapy against the risk...

Better consenting for thyroidectomy: who has an increased risk of postoperative hypocalcaemia?

Science.gov (United States)

Harris, Andrew S; Prades, Eduardo; Tkachuk, Olena; Zeitoun, Hisham

2016-12-01

Hypocalcaemia is the most common complication following thyroidectomy. This study aimed to establish the factors associated with increased risk of hypocalcaemia on day 1 following thyroidectomy. All patients who underwent thyroidectomy under a single consultant during a 5-year period were included. A multivariate analysis was undertaken to ascertain which variables had the most effect on the risk of hypocalcaemia. A prognosis table was constructed to allow risk to be predicted for individual patients based on these factors. Included in the analysis were 210 procedures and 194 patients. Eighty-two percent of patients had no calcium derangement postoperatively. Fourteen point nine percent were categorised as early hypocalcaemia, 1 % had protracted hypocalcaemia and 2.1 % had permanent hypocalcaemia. For hemi-thyroidectomies 2.8 % had postoperative hypocalcaemia and 0.9 % had permanent hypocalcaemia. The multivariate analysis revealed total thyroidectomy (risk ratio 26.5, p < 0.0001), diabetes (risk ratio 4.8, p = 0.07) and thyrotoxicosis (risk ratio 3.1, p = 0.04) as statistically significant variables for early postoperative hypocalcaemia. Gender as an isolated factor did not reach significance but was included in the model. The p value for the model was p < 1 × 10 -12 . Total thyroidectomy increases risk of early hypocalcaemia when compared to hemithyroidectomy. Gender, diabetes and thyrotoxicosis were also been found to influence the risk. All of these factors are available pre-operatively and can therefore be used to predict a more specific risk for individual patients. It is hoped that this can lead to better informed consent, prevention and better resource allocation.

Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others.

Science.gov (United States)

Seppala, Lotta J; van de Glind, Esther M M; Daams, Joost G; Ploegmakers, Kimberley J; de Vries, Max; Wermelink, Anne M A T; van der Velde, Nathalie

2018-04-01

The use of psychotropic medication and cardiovascular medication has been associated with an increased risk of falling. However, other frequently prescribed medication classes are still under debate as potential risk factors for falls in the older population. The aim of this systematic review and meta-analysis is to evaluate the associations between fall risk and nonpsychotropic and noncardiovascular medications. A systematic review and meta-analysis. A search was conducted in Medline, PsycINFO, and Embase. Key search concepts were "falls," "aged," "medication," and "causality." Studies were included that investigated nonpsychotropic and noncardiovascular medications as risk factors for falls in participants ≥60 years or participants with a mean age ≥70 years. A meta-analysis was performed using the generic inverse variance method, pooling unadjusted and adjusted odds ratio (OR) estimates separately. In a qualitative synthesis, 281 studies were included. The results of meta-analysis using adjusted data were as follows (a pooled OR [95% confidence interval]): analgesics, 1.42 (0.91-2.23); nonsteroidal anti-inflammatory drugs (NSAIDs), 1.09 (0.96-1.23); opioids, 1.60 (1.35-1.91); anti-Parkinson drugs, 1.54 (0.99-2.39); antiepileptics, 1.55 (1.25-1.92); and polypharmacy, 1.75 (1.27-2.41). Most of the meta-analyses resulted in substantial heterogeneity that did not disappear after stratification for population and setting in most cases. In a descriptive synthesis, consistent associations with falls were observed for long-term proton pump inhibitor use and opioid initiation. Laxatives showed inconsistent associations with falls (7/20 studies showing a positive association). Opioid and antiepileptic use and polypharmacy were significantly associated with increased risk of falling in the meta-analyses. Long-term use of proton pump inhibitors and opioid initiation might increase the fall risk. Future research is necessary because the causal role of some medication

Proximity to vacant buildings is associated with increased fire risk in Baltimore, Maryland, homes.

Science.gov (United States)

Schachterle, Stephen E; Bishai, David; Shields, Wendy; Stepnitz, Rebecca; Gielen, Andrea C

2012-04-01

Fires and burns are a leading cause of unintentional injury death in the USA. Although it has been anecdotally reported that vacant dwellings are at a higher risk for fire, the association between vacancy and fire risk at the individual household level has not been empirically measured. In this cross-sectional study, geocoded residential vacant properties (VP) and fire events are analysed in Baltimore City at the census tract level and the individual household level. On average, a 10% increase in the proportion of vacancies in a census tract was associated with a 9.9% increase in fires (95% CI: 5% to 15%). Random-effects Poisson models, controlling for housing and neighbourhood conditions, found contagion effects. The risk of fire in an occupied dwelling increased by 8% (95% CI: 1% to 10%) for every vacant structure within 10 m, and the risk of fire decreased by half (95% CI: 45% to 62%) for every km between an occupied dwelling and vacant building. Close proximity to VP was associated with trash fires within dwellings (p=0.039) and structure fires (p=0.012). We believe that this is the first study to demonstrate increased risk posed by nearby VP at the household level, confirming earlier ecological analyses of the role of VP as strong correlates of home fires. Measurement of this risk can motivate property owners, policy makers and insurers to invest in risk reduction measures that include building maintenance and trash removal.

Low Adiponectin Levels and Increased Risk of Type 2 Diabetes in Patients With Myocardial Infarction

DEFF Research Database (Denmark)

Lindberg, Søren; Jensen, Jan S; Pedersen, Sune H

2014-01-01

OBJECTIVE: Patients with acute myocardial infarction (MI) have increased risk of developing type 2 diabetes mellitus (T2DM). Adiponectin is an insulin-sensitizing hormone produced in adipose tissue, directly suppressing hepatic gluconeogenesis, stimulating fatty acid oxidation and glucose uptake...... 5.3-6.1]) 6% (n = 38) developed T2DM. Risk of T2DM was analyzed using a competing risk analysis. RESULTS: Low adiponectin levels were associated with increased risk of T2DM (P age, sex, hypertension, hypercholesterolemia, current smoking.......001). Importantly, plasma adiponectin added to the predictive value of blood glucose, with the combination of high blood glucose and low plasma adiponectin, vastly increasing the risk of developing T2DM (HR 9.6 [3.7-25.3]; P

Rationality on the rise: Why relative risk aversion increases with stake size

OpenAIRE

Fehr-Duda, Helga; Bruhin, Adrian; Epper, Thomas F.; Schubert, Renate

2008-01-01

How does risk tolerance vary with stake size? This important question cannot be adequately answered if framing effects, nonlinear probability weighting, and heterogeneity of preference types are neglected. We show that, contrary to gains, no coherent change in relative risk aversion is observed for losses. The increase in relative risk aversion over gains cannot be captured by the curvature of the utility function. It is driven predominantly by a change in probability weighting of a majority ...

Patients with chronic pancreatitis are at increased risk for osteoporosis.

LENUS (Irish Health Repository)

Duggan, SN

2012-10-01

Patients with chronic pancreatitis may be at an increased risk of low bone density because of malabsorption of vitamin D and calcium, poor diet, pain, alcoholism, and smoking. We investigated the rates of osteoporosis in patients with chronic pancreatitis compared to matched controls.

Radiotherapy and risk of implantable cardioverter-defibrillator malfunctions: experimental data from direct exposure at increasing doses.

Science.gov (United States)

Zecchin, Massimo; Artico, Jessica; Morea, Gaetano; Severgnini, Mara; Bianco, Elisabetta; De Luca, Antonio; Fantasia, Anna Zorzin; Salvatore, Luca; Milan, Vittorino; Lucarelli, Matteo; Dissegna, Roberta; Cannatà, Antonio; Sinagra, Gianfranco

2018-04-01

During radiotherapy, in patients with implantable cardioverter-defibrillators (ICDs) malfunctions are considered more likely if doses more than 2 Gy reach the ICD site; however, most malfunctions occur with high-energy (>10 MV) radiations, and the risk is less defined using 6-MV linear accelerators. The purpose of the study is to experimentally evaluate the occurrence of malfunctions in ICDs radiated with a 6-MV linear accelerator at increasing photon doses. Thirty-two ICDs from all manufacturers (31 explanted and one demo) were evaluated; all devices with a sufficient battery charge underwent multiple radiations with a 6-MV photon beam reaching a cumulative dose at ICD site of 0.5, 1, 2, 3, 5 and 10 Gy and interrogated after every session. All antitachycardia therapies were left enabled; two ICDs were connected to a rhythm simulator (one simulating a complete atrioventricular block without ventricular activity) and visually monitored by external ECG and the ICD programmer during radiation. Thirteen ICDs were excluded before radiation because of battery depletion; after radiation up to the cumulative dose at the cardiac implantable electronic device site of 10 Gy, in the remaining 19 devices, programmation and battery charge remained unchanged and no switch to safety mode was observed; oversensing, pacing inhibition or inappropriate antitachycardia therapy were neither recorded nor visually observed during radiation. With a low-energy accelerator, neither malfunctions nor electromagnetic interferences were detected radiating the ICDs at doses usually reaching the ICD pocket during radiotherapy sessions. In this context, magnet application to avoid oversensing and inappropriate therapy seems, therefore, useless.

Linearization Method and Linear Complexity

Science.gov (United States)

Tanaka, Hidema

We focus on the relationship between the linearization method and linear complexity and show that the linearization method is another effective technique for calculating linear complexity. We analyze its effectiveness by comparing with the logic circuit method. We compare the relevant conditions and necessary computational cost with those of the Berlekamp-Massey algorithm and the Games-Chan algorithm. The significant property of a linearization method is that it needs no output sequence from a pseudo-random number generator (PRNG) because it calculates linear complexity using the algebraic expression of its algorithm. When a PRNG has n [bit] stages (registers or internal states), the necessary computational cost is smaller than O(2n). On the other hand, the Berlekamp-Massey algorithm needs O(N2) where N(≅2n) denotes period. Since existing methods calculate using the output sequence, an initial value of PRNG influences a resultant value of linear complexity. Therefore, a linear complexity is generally given as an estimate value. On the other hand, a linearization method calculates from an algorithm of PRNG, it can determine the lower bound of linear complexity.

MINIMASI RESIKO DALAM SISTEM PENGELOLAAN LIMBAH MEDIS DI KOTA BANDUNG, INDONESIA DENGAN PENDEKATAN LINEAR PROGRAMMING (Risk Minimization for Medical Waste Management System in Bandung City, Indonesia: A Linear Programming Approach

Directory of Open Access Journals (Sweden)

Mochammad Chaerul

2013-07-01

Full Text Available ABSTRAK Berbagai macam pelayanan perawatan kesehatan yang disediakan oleh rumah sakit akan berpotensi menghasilkan limbah medis. Walaupun sebagian besar limbah rumah sakit dapat dikelompokkan sebagai limbah yang tidak berbahaya yang memiliki sifat yang sama dengan sampah rumah tangga dan dapat dibuang ke tempat penimbunan sampah, sebagian kecil dari limbah medis harus dikelola dengan tepat untuk meminimasi resiko terhadap kesehatan masyarakat. Model pengelolaan limbah medis yang dikembangkan ditujukan untuk meminimasi resiko terhadap fasilitas umum dan komersial seperti fasilitas ibadah, bank, perkantoran, restoran, hotel, stasiun pengisian bahan bakar, fasilitas pendidikan, mall dan pusat perbelanjaan, taman dan pusat olahraga/kebugaran, akibat pengangkutan limbah medis dan abu hasil pengolahannya. Tingkat resiko dari setiap fasilitas di atas ditentukan menggunakan metode Analytical Hierarchy Process (AHP. Permasalahan diselesaikan dengan mengaplikasikan linear programming menggunakan software optimimasi LINGO®. Output model berupa optimasi alokasi limbah medis dari setiap rumah sakit ke fasilitas pengolahan dan alokasi abu dari fasilitas pengolahan ke tempat penimbunan akhir. Hasil model memperlihatkan bahwa rute terpendek tidak menghasilkan total resiko terkecil karena dipengaruhi oleh jumlah dan tingkat resiko dari setiap fasilitas yang dilalui oleh kemdaraan pengangkut limbah medis dan abu. Perbedaan fasilitas yang berada di sekitar pengolahan limbah medis juga akan menghasilkan total resiko yang berbeda. ABSTRACT A broad range of healthcare services provided by hospital may generate medical waste. Although a large percentage of hospital waste is classified as general waste, which has similar nature as that of municipal solid waste and, therefore, could be disposed in municipal landfill, a small portion of medical waste has to be managed in a proper manner to minimize risk to public health. A medical waste management model is proposed in

Climate change will increase the naturalization risk from garden plants in Europe.

Science.gov (United States)

Dullinger, Iwona; Wessely, Johannes; Bossdorf, Oliver; Dawson, Wayne; Essl, Franz; Gattringer, Andreas; Klonner, Günther; Kreft, Holger; Kuttner, Michael; Moser, Dietmar; Pergl, Jan; Pyšek, Petr; Thuiller, Wilfried; van Kleunen, Mark; Weigelt, Patrick; Winter, Marten; Dullinger, Stefan; Beaumont, Linda

2017-01-01

Plant invasions often follow initial introduction with a considerable delay. The current non-native flora of a region may hence contain species that are not yet naturalized but may become so in the future, especially if climate change lifts limitations on species spread. In Europe, non-native garden plants represent a huge pool of potential future invaders. Here, we evaluate the naturalization risk from this species pool and how it may change under a warmer climate. Europe. We selected all species naturalized anywhere in the world but not yet in Europe from the set of non-native European garden plants. For this subset of 783 species, we used species distribution models to assess their potential European ranges under different scenarios of climate change. Moreover, we defined geographical hotspots of naturalization risk from those species by combining projections of climatic suitability with maps of the area available for ornamental plant cultivation. Under current climate, 165 species would already find suitable conditions in > 5% of Europe. Although climate change substantially increases the potential range of many species, there are also some that are predicted to lose climatically suitable area under a changing climate, particularly species native to boreal and Mediterranean biomes. Overall, hotspots of naturalization risk defined by climatic suitability alone, or by a combination of climatic suitability and appropriate land cover, are projected to increase by up to 102% or 64%, respectively. Our results suggest that the risk of naturalization of European garden plants will increase with warming climate, and thus it is very likely that the risk of negative impacts from invasion by these plants will also grow. It is therefore crucial to increase awareness of the possibility of biological invasions among horticulturalists, particularly in the face of a warming climate.

Ante partum depression and husband’s mental problem increased risk maternity blues

Directory of Open Access Journals (Sweden)

R. I. Ismail

2006-06-01

Full Text Available Maternity blues disorder (MB is common, and it is usually undiagnosed. This study to identify several risk factors related to MB. Subjects were pregnant women who had antenatal and delivery at the Persahabatan Hospital (RSP Jakarta from 1 November 1999 to 15 August 2001. Consecutive sampling and was followed-up until two-week postpartum. Those who ever had psychiatric disorders (schizophrenia or other psychotic disorders were excluded. MB and ante partum depression (APD detected by using Edinburgh Postnatal Depression Scale (EPDS. Husband’s mental status based on Symptom Check List-90 (SCL-90 respectively. Among 580 subjects, 25% suffering from MB. Compared with those who did not have APD, those who experienced it had more than three-fold increased risk to be MB [adjusted hazard ratio (aHR = 3.57; 95% confidence interval (CI = 2.54;5.03]. Those who had not healthy baby on the first 5 days afterbirth than who had healthy baby had twice increased risk to be MB (aHR = 2.21; 95% CI = 1.34 ; 3.66. Who had husband with problem in mental health had 1.9 increased risk to be MB (aHR = 1.91; 95% CI = 1.36 ; 2.68. Stress during pregnancy had 1.6 increased risk to be MB (aHR = 1.59; 95% CI = 1.14 ; 2.25. To control MB, special attention should be paid to women who had APD history, who had unhealthy baby on 5 first days afterbirth, who had husbands’ mental health problems, and who had stress during pregnancy. (Med J Indones 2006; 15:74-80Keywords: ante partum, maternity blues, depression, mental problem

Stress-induced alterations in estradiol sensitivity increase risk for obesity in women.

Science.gov (United States)

Michopoulos, Vasiliki

2016-11-01

The prevalence of obesity in the United States continues to rise, increasing individual vulnerability to an array of adverse health outcomes. One factor that has been implicated causally in the increased accumulation of fat and excess food intake is the activity of the limbic-hypothalamic-pituitary-adrenal (LHPA) axis in the face of relentless stressor exposure. However, translational and clinical research continues to understudy the effects sex and gonadal hormones and LHPA axis dysfunction in the etiology of obesity even though women continue to be at greater risk than men for stress-induced disorders, including depression, emotional feeding and obesity. The current review will emphasize the need for sex-specific evaluation of the relationship between stress exposure and LHPA axis activity on individual risk for obesity by summarizing data generated by animal models currently being leveraged to determine the etiology of stress-induced alterations in feeding behavior and metabolism. There exists a clear lack of translational models that have been used to study female-specific risk. One translational model of psychosocial stress exposure that has proven fruitful in elucidating potential mechanisms by which females are at increased risk for stress-induced adverse health outcomes is that of social subordination in socially housed female macaque monkeys. Data from subordinate female monkeys suggest that increased risk for emotional eating and the development of obesity in females may be due to LHPA axis-induced changes in the behavioral and physiological sensitivity of estradiol. The lack in understanding of the mechanisms underlying these alterations necessitate the need to account for the effects of sex and gonadal hormones in the rationale, design, implementation, analysis and interpretation of results in our studies of stress axis function in obesity. Doing so may lead to the identification of novel therapeutic targets with which to combat stress-induced obesity

Risk estimates for the health effects of alpha radiation

International Nuclear Information System (INIS)

Thomas, D.C.; McNeill, K.G.

1981-09-01

This report provides risk estimates for various health effects of alpha radiation. Human and animal data have been used to characterize the shapes of dose-response relations and the effects of various modifying factors, but quantitative risk estimates are based solely on human data: for lung cancer, on miners in the Colorado plateau, Czechoslovakia, Sweden, Ontario and Newfoundland; for bone and head cancers, on radium dial painters and radium-injected patients. Slopes of dose-response relations for lung cancer show a tendency to decrease with increasing dose. Linear extrapolation is unlikely to underestimate the excess risk at low doses by more than a factor of l.5. Under the linear cell-killing model, our best estimate

Diffusion-weighted MRI for detecting prostate tumour in men at increased genetic risk

International Nuclear Information System (INIS)

Souza, Nandita M. de; Morgan, Veronica A.; Bancroft, Elizabeth; Sohaib, S. Aslam; Giles, Sharon L.; Kote-Jarai, Zsofia; Castro, Elena; Hazell, Steven; Jafar, Maysam; Eeles, Rosalind

2014-01-01

•Endorectal T2W + DW-MRI is potentially useful for prostate cancer screening.•MRI is specific for detecting prostate cancer in men with increased genetic risk.•Detection of prostate cancer in men at genetically low risk with MRI is limited. Endorectal T2W + DW-MRI is potentially useful for prostate cancer screening. MRI is specific for detecting prostate cancer in men with increased genetic risk. Detection of prostate cancer in men at genetically low risk with MRI is limited. Diffusion-weighted (DW)-MRI is invaluable in detecting prostate cancer. We determined its sensitivity and specificity and established interobserver agreement for detecting tumour in men with a family history of prostate cancer stratified by genetic risk. 51 men with a family history of prostate cancer underwent T2-W + DW-endorectal MRI at 3.0 T. Presence of tumour was noted at right and left apex, mid and basal prostate sextants by 2 independent observers, 1 experienced and the other inexperienced in endorectal MRI. Sensitivity and specificity against a 10-core sampling technique (lateral and medial cores at each level considered together) in men with >2× population risk based on 71 SNP analysis versus those with lower genetic risk scores was established. Interobserver agreement was determined at a subject level. Biopsies indicated cancer in 28 sextants in 13/51 men; 32 of 51 men had twice the population risk (>0.25) based on 71 SNP profiling. Sensitivity/specificity per-subject for patients was 90.0%/86.4% (high-risk) vs. 66.7%/100% (low-risk, observer 1) and 60.0%/86.3% (high-risk) vs. 33.3%/93.8% (low-risk, observer 2) with moderate overall inter-observer agreement (kappa = 0.42). Regional sensitivities/specificities for high-risk vs. low-risk for observer 1 apex 72.2%/100% [33.3%/100%], mid 100%/93.1% [100%/97.3%], base 16.7%/98.3% [0%/100%] and for observer 2 apex 36.4%/98.1% [0%/100%], mid 28.6%/96.5% [100%/100%], base 20%/100% [0%/97.3%] were poorer as they failed to detect

Prenatal Maternal Smoking and Increased Risk for Tourette Syndrome and Chronic Tic Disorders.

Science.gov (United States)

Browne, Heidi A; Modabbernia, Amirhossein; Buxbaum, Joseph D; Hansen, Stefan N; Schendel, Diana E; Parner, Erik T; Reichenberg, Abraham; Grice, Dorothy E

2016-09-01

We assessed the role of prenatal maternal smoking in risk for Tourette syndrome and chronic tic disorder (TS/CT) and pediatric-onset obsessive-compulsive disorder (OCD). In an analysis of 73,073 singleton pregnancies from the Danish National Birth Cohort, we calculated incidence rates (IR) per 1,000 person-year for TS/CT and OCD. We then determined crude and adjusted hazard ratios and 95% CIs associated with prenatal maternal smoking, considering smoking as a dichotomous (yes/no) variable or a stratified variable (no smoking, light smoking, and heavy smoking [≥10 cigarettes/day]). Additional analyses examined the effect of maternal smoking on risk for TS/CT with other comorbid psychiatric conditions. In final adjusted analyses, heavy smoking was associated with a 66% increased risk for TS/CT (adjusted hazard ratio = 1.66, 95% CI = 1.17-2.35). In addition, heavy smoking was associated with a 2-fold increased risk for TS/CT with comorbid attention-deficit/hyperactivity disorder (ADHD), and both light and heavy smoking were associated with a more than 2-fold increased risk for TS/CT with any non-ADHD psychiatric comorbidity. Our parallel analyses of pediatric-onset OCD were likely underpowered but showed similar relationships. Prenatal maternal smoking was associated with increased risk for TS/CT as well as TS/CT with comorbid psychiatric conditions, even after adjustment for several important variables, including maternal psychiatric history, socioeconomic status, and partner smoking. Our findings point to a pathway linking prenatal tobacco exposure and altered brain development to TS/CT. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Recursive Algorithm For Linear Regression

Science.gov (United States)

Varanasi, S. V.

1988-01-01

Order of model determined easily. Linear-regression algorithhm includes recursive equations for coefficients of model of increased order. Algorithm eliminates duplicative calculations, facilitates search for minimum order of linear-regression model fitting set of data satisfactory.

On the increased risk of developing late-onset epilepsy for patients with major affective disorder

DEFF Research Database (Denmark)

Nilsson, Flemming Mørkeberg; Kessing, Lars Vedel; Bolwig, Tom Gert

2003-01-01

for the control groups. However, the increased risk seemed to be due to the effect of comorbid alcohol or drug abuse and not to the effect of the affective illness itself. LIMITATIONS: The results only apply to hospitalised patients. Diagnoses are not validated for research purposes. CONCLUSION: Patients...... with a diagnosis of affective disorder have an increased risk of developing epilepsy in later life. In patients with affective disorder, comorbid alcoholism/drug abuse seriously increased the risk of a subsequent diagnosis of epilepsy....

Increased risk of breast cancer in women with false-positive test

DEFF Research Database (Denmark)

von Euler-Chelpin, My; Kuchiki, Megumi; Vejborg, Ilse

2014-01-01

of misclassification, i.e. women who were actually false-negatives instead of false-positives. METHOD: We used data from the Copenhagen Mammography Screening Programme, Denmark. The study population was the 295 women, out of 4743 recalled women from a total of 58,003 participants, with a false-positive test during...... the women with misclassified tests had been excluded, there was an excess risk of breast cancer of 27% (RR=1.27, 95% confidence interval (CI), 1.11-1.46) among the women with a false-positive test compared to women with only negative tests. Women with a false-positive test determined at assessment had...... an excess risk of 27%, while false-positives determined at surgery had an excess risk of 30%. CONCLUSIONS: The results indicate that the increased risk is not explained only by misclassification. The excess risk remains for false-positives determined at assessment as well as at surgery, which favours some...

Are recreational SCUBA divers with asthma at increased risk?

Science.gov (United States)

Ustrup, Amalie S; Ulrik, Charlotte S

2017-10-01

Asthma has traditionally been regarded as a contraindication to self-contained underwater breathing apparatus (SCUBA) diving, although large numbers of patients with asthma dive. The aim of the review is to provide an update on current knowledge on potential disease-related hazards in SCUBA divers with asthma. Systematic literature review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Seven studies met the criteria for inclusion in the review (comprising a total of 560 subjects). Five studies reported an increased risk for developing diving-related injuries in divers with asthma, based on case reports (n = 1), case history combined with objective assessment (n = 1), and dives and/or simulated dives (n = 3). The remaining studies (n = 2) were based on self-reported diving habits in divers suffering from asthma, obtained from anonymous questionnaires in diving magazines, reported no diving-related injuries among respondents. Due to limited evidence it is difficult to draw valid conclusions, but there are indications that recreational divers with asthma may be at increased risk for diving-related injuries compared to non-asthmatic divers. However, it is of at most importance to obtain further evidence from large-scale, well-designed studies.

Elevated Lipoprotein(a) Levels, LPA Risk Genotypes, and Increased Risk of Heart Failure in the General Population

DEFF Research Database (Denmark)

Kamstrup, Pia R; Nordestgaard, Børge G

2016-01-01

OBJECTIVES: This study sough to test whether elevated lipoprotein(a) levels and corresponding LPA risk genotypes (low number of kringle IV type 2 repeats, rs3798220 and rs10455872, minor allele carriers) are associated with an increased risk of heart failure (HF). BACKGROUND: Elevated lipoprotein...

Non-linear increase of respiratory diseases and their costs under severe air pollution.

Science.gov (United States)

Shen, Ying; Wu, Yiyun; Chen, Guangdi; Van Grinsven, Hans J M; Wang, Xiaofeng; Gu, Baojing; Lou, Xiaoming

2017-05-01

China is experiencing severe and persistent air pollution, with concentrations of fine particulate matters (PM 2.5 ) reaching unprecedentedly high levels in many cities. Quantifying the detrimental effects on health and their costs derived from high PM 2.5 levels is crucial because of the unsolved challenges to mitigate air pollution in the following decades. Using the daily monitoring data on PM 2.5 concentrations and clinic visits, we found a non-linear increase of respiratory diseases, but not for other diseases (e.g., digestive diseases) under severe air pollution. We found an increase of respiratory diseases by 1% for each 10 μg m -3 increase in PM 2.5 when the annual average daily PM 2.5 concentration was less than 50 μg m -3 ; while this ratio was doubled (around 2%) with the daily PM 2.5 concentration larger than 50 μg m -3 . Under severe air pollution (PM 2.5 concentration >150 μg m -3 ), the respiratory diseases increased by over 50% compared to that in clean days. Children are more sensitive to the severe air pollution. The increase of clinic visits, especially for adults, was observed mainly in bigger (>500 beds) hospitals. Re-allocating medical resources (e.g., doctors) from big hospitals to community hospitals can benefit the respiratory patients due to air pollution. The total medical cost of clinic visits of respiratory diseases derived from PM 2.5 pollution was estimated at 17.2-57.0 billion Yuan in 2014 in China, accounting for 0.5-1.6% of national total health expenditure. Because these medical costs only represent a small part of total health cost derived from air pollution, the reduction of associated health costs would be an important co-benefit of implementation of air pollution preventive strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Family history of esophageal cancer increases the risk of esophageal squamous cell carcinoma

Science.gov (United States)

Chen, Tiantian; Cheng, Hongwei; Chen, Xingdong; Yuan, Ziyu; Yang, Xiaorong; Zhuang, Maoqiang; Lu, Ming; Jin, Li; Ye, Weimin

2015-01-01

A population-based case-control was performed to explore familial aggregation of esophageal squamous cell carcinoma (ESCC). Family history of cancer was assessed by a structured questionnaire, and from which 2 cohorts of relatives of cases and controls were reconstructed. Unconditional logistic regression and Cox proportional hazards regression were applied for case-control design and reconstructed cohort design, respectively. We observed a close to doubled risk of ESCC associated with a positive family history of esophageal cancer among first degree relatives (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.42–2.41), after adjusting age, sex, family size and other confounders. The excess risks of ESCC increased with the increasing of first-degree relatives affected by esophageal cancer (p < 0.001). In particular, those individuals whose both parents with esophageal cancer had an 8-fold excess risk of ESCC (95% CI: 1.74–36.32). The reconstructed cohort analysis showed that the cumulative risk of esophageal cancer to age 75 was 12.2% in the first-degree relatives of cases and 7.0% in those of controls (hazard ratio = 1.91, 95% CI: 1.54–2.37). Our results suggest family history of esophageal cancer significantly increases the risk for ESCC. Future studies are needed to understand how the shared genetic susceptibility and/or environmental exposures contribute to the observed excess risk. PMID:26526791

Increasing risk of psychiatric morbidity after childhood onset type 1 diabetes

DEFF Research Database (Denmark)

Dybdal, Daniel; Tolstrup, Janne S; Sildorf, Stine M

2018-01-01

AIMS/HYPOTHESIS: The aim of this study was to investigate psychiatric morbidity following childhood onset of type 1 diabetes. METHODS: In a matched, population-based cohort study based on Danish national registers, we identified children and adolescents who had been diagnosed as an in- or outpati......AIMS/HYPOTHESIS: The aim of this study was to investigate psychiatric morbidity following childhood onset of type 1 diabetes. METHODS: In a matched, population-based cohort study based on Danish national registers, we identified children and adolescents who had been diagnosed as an in...... of psychiatric disorders as well as the effects of age at onset and duration of type 1 diabetes on the risk of subsequently developing psychiatric morbidities. RESULTS: An increased risk of being diagnosed with mood disorders and anxiety, dissociative, eating, stress-related and somatoform disorders was observed....... CONCLUSIONS/INTERPRETATION: In the years following type 1 diabetes onset, an increased risk of eating disorders, anxiety and mood disorders, substance misuse, and personality disorders was found. These findings highlight a clinical need to monitor the mental health of children and adolescents in the years...

Infradiaphragmatic irradiation and high procarbazine doses increase colorectal cancer risk in Hodgkin lymphoma survivors

NARCIS (Netherlands)

Eggermond, A.M. van; Schaapveld, M.; Janus, C.P.; Boer, J.P. de; Krol, A.D.; Zijlstra, J.M.; Maazen, R.W.M. van der; Kremer, L.C.; Leerdam, M.E. van; Louwman, M.W.; Visser, O; Bruin, M.L. De; Aleman, B.M.; Leeuwen, F.E. van

2017-01-01

BACKGROUND: Hodgkin lymphoma (HL) survivors are at increased risk of second malignancies, but few studies have assessed colorectal cancer (CRC) risk after HL treatment. We assessed long-term, subsite-specific CRC risk associated with specific radiation fields and chemotherapy regimens. METHODS: In a

No increased risk of developing depression in diabetes compared to other chronic illness

DEFF Research Database (Denmark)

Kessing, Lars Vedel; Nilsson, Flemming Mørkeberg; Siersma, Volkert

2003-01-01

of patients. There was no difference in the risk for Type 1 and Type 2 diabetes. It is concluded that older patients with diabetes do not seem to have an increased risk of developing severe depression compared with patients with other chronic illness.......Several studies have found that the prevalence of depression in patients with diabetes is higher than in the general population but it is unclear whether patients with diabetes have an increased risk of developing depression compared with patients with other chronic illnesses. In a nationwide case...... register study, all patients who had a discharge diagnosis of diabetes or of osteoarthritis at first admission in a period from 1977 to 1997 were identified. The probability of being readmitted and discharged with a diagnosis of depression was estimated with competing risks models in survival analysis...

Enduring increased risk of developing depression and mania in patients with dementia

DEFF Research Database (Denmark)

Nilsson, Flemming Mørkeberg; Kessing, Lars Vedel; Sørensen, Tine Møller

2002-01-01

OBJECTIVE: To investigate the time relation between dementia and major affective disorders (major depression and mania). METHODS: Register linkage study of the Danish Hospital Register and the Danish Psychiatric Central Research Register, to establish study cohorts of patients with dementia...... and control groups (osteoarthritis or diabetes) on first discharge from hospital. Follow up of cohorts was for up to 21 years. Hazard of death was allowed for by the use of competing risks models. RESULTS: Patients with dementia had an increased risk of being admitted to hospital for major depression or mania...... during the course of the illness. The incidence remained elevated throughout the rest of the patient's life. CONCLUSIONS: Patients with dementia have an increased risk of developing depression or mania. Proper treatment of affective disorders in patients with dementia is important in reducing suffering...

Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis.

Science.gov (United States)

Murray, Robin M; Quigley, Harriet; Quattrone, Diego; Englund, Amir; Di Forti, Marta

2016-10-01

Epidemiological evidence demonstrates that cannabis use is associated with an increased risk of psychotic outcomes, and confirms a dose-response relationship between the level of use and the risk of later psychosis. High-potency cannabis and synthetic cannabinoids carry the greatest risk. Experimental administration of tetrahydrocannabinol, the active ingredient of cannabis, induces transient psychosis in normal subjects, but this effect can be ameliorated by co-administration of cannabidiol. This latter is a constituent of traditional hashish, but is largely absent from modern high-potency forms of cannabis. Argument continues over the extent to which genetic predisposition is correlated to, or interacts with, cannabis use, and what proportion of psychosis could be prevented by minimizing heavy use. As yet, there is not convincing evidence that cannabis use increases risk of other psychiatric disorders, but there are no such doubts concerning its detrimental effect on cognitive function. All of the negative aspects are magnified if use starts in early adolescence. Irrespective of whether use of cannabis is decriminalized or legalized, the evidence that it is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids. © 2016 World Psychiatric Association.

Traditional marijuana, high‐potency cannabis and synthetic cannabinoids: increasing risk for psychosis

Science.gov (United States)

Murray, Robin M.; Quigley, Harriet; Quattrone, Diego; Englund, Amir; Di Forti, Marta

2016-01-01

Epidemiological evidence demonstrates that cannabis use is associated with an increased risk of psychotic outcomes, and confirms a dose‐response relationship between the level of use and the risk of later psychosis. High‐potency cannabis and synthetic cannabinoids carry the greatest risk. Experimental administration of tetrahydrocannabinol, the active ingredient of cannabis, induces transient psychosis in normal subjects, but this effect can be ameliorated by co‐administration of cannabidiol. This latter is a constituent of traditional hashish, but is largely absent from modern high‐potency forms of cannabis. Argument continues over the extent to which genetic predisposition is correlated to, or interacts with, cannabis use, and what proportion of psychosis could be prevented by minimizing heavy use. As yet, there is not convincing evidence that cannabis use increases risk of other psychiatric disorders, but there are no such doubts concerning its detrimental effect on cognitive function. All of the negative aspects are magnified if use starts in early adolescence. Irrespective of whether use of cannabis is decriminalized or legalized, the evidence that it is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high‐potency cannabis and synthetic cannabinoids. PMID:27717258

Increased risk for diabetes mellitus in patients with carbon monoxide poisoning

Science.gov (United States)

Huang, Chien-Cheng; Ho, Chung-Han; Chen, Yi-Chen; Lin, Hung-Jung; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Guo, How-Ran

2017-01-01

Carbon monoxide poisoning (COP) causes hypoxic injury and inflammatory and immunological reactions in the brain and local organs including the pancreas. Therefore, it is plausible that COP may increase the risk for developing diabetes mellitus (DM), but studies on this possible association are limited. We conducted a nationwide study in Taiwan to fill the data gap. We used the Nationwide Poisoning Database and the Longitudinal Health Insurance Database 2000 to identify all COP patients diagnosed between 1999 and 2012 (the study cohort) and then construct a comparison cohort of patients without COP through matching at 1:3 by the index date and age. The risk for DM between the two cohorts was compared by following up until 2013. We also investigated the independent predictors for DM in all the patients. During the study period, 22,308 COP patients were identified, and 66,924 non-COP patients were included in the comparison cohort accordingly. Patients with COP had an increased risk for DM with an adjusted hazard ratio (AHR) of 1.92 (95% confidence interval [CI]: 1.79–2.06) after adjusting for age, sex, comorbidities, and monthly income, especially in the subgroups of age increased risk for DM was highest in the first month after COP (AHR= 3.38; 95% CI: 2.29–4.99) and lasted even after 4 years (AHR= 1.82; 95% CI: 1.62–2.04). We found that COP, older age, male sex, hypertension, hyperlipidemia, hyperuricemia, and low monthly income were independent predictors for DM. Intervention studies are needed to validate the results and delineate the detailed mechanisms. PMID:28969020

Commentary: Air-conditioning as a risk for increased use of healthservices

Energy Technology Data Exchange (ETDEWEB)

Mendell, Mark J.

2004-06-01

In this issue of the journal, Preziosi et al. [2004] report the first study to assess differences in the utilization of health care related to the presence of air-conditioning in office workplaces. Although the study was simple and cross-sectional, the data variables from questionnaires, and the findings subject to a variety of questions, the findings are striking enough to deserve clarification. The study used a large random national sample of French women assembled for another purpose (to study antioxidant nutrients and prevention of cancer and cardiovascular disease). Participants reported health services and health events in monthly questionnaires over 1 year, and in one questionnaire in the middle of that period also reported whether air-conditioning was in use at their workplace. Fifteen percent of participants reported air-conditioning at work. Analyses adjusting for age and smoking status of participants found increases in most outcomes assessed: use of specific kinds of physicians, sickness absence, and hospital stays. While the increases in odds ratios (OR) and 95% confidence intervals (CI) were statistically significant for only otorhinolaryngology [OR (95% CI) = 2.33 (1.35-4.04)] and sickness absence [1.70 (1.13-2.58)], other increases were notable--dermatology [1.6 (0.98-2.65)]; hospital stay [1.51 (0.92-2.45)], and pneumonology [2.10 (0.65-6.82)]. The least elevated outcomes were for general practice medicine [0.99 (0.65-1.48)] and global medical visits [1.18 (0.67-2.07)]. [Preziosi et al., 2004 ,(Table 2)] Odds ratios for relatively common health outcomes often lie farther from the null than the risk ratios most useful for quantifying the increase in risk. Risk ratios, or prevalence ratios (PRs, the equivalent measure of effect for cross-sectional data), have seldom been used because of the convenience and availability of logistic regression models that estimate odds ratios. With baseline prevalences ranging up to 85.7% in the data from Preziosi et

Infradiaphragmatic irradiation and high procarbazine doses increase colorectal cancer risk in Hodgkin lymphoma survivors

NARCIS (Netherlands)

van Eggermond, Anna M.; Schaapveld, Michael; Janus, Cécile Pm; de Boer, Jan Paul; Krol, Augustinus Dg; Zijlstra, Josée M.; van der Maazen, Richard Wm; Kremer, Leontien C.; van Leerdam, Monique E.; Louwman, Marieke Wj; Visser, Otto; de Bruin, Marie L.; Aleman, Berthe Mp; van Leeuwen, Flora E.

2017-01-01

Hodgkin lymphoma (HL) survivors are at increased risk of second malignancies, but few studies have assessed colorectal cancer (CRC) risk after HL treatment. We assessed long-term, subsite-specific CRC risk associated with specific radiation fields and chemotherapy regimens. In a Dutch cohort of 3121

Infradiaphragmatic irradiation and high procarbazine doses increase colorectal cancer risk in Hodgkin lymphoma survivors

DEFF Research Database (Denmark)

van Eggermond, Anna M; Schaapveld, Michael; Janus, Cécile Pm

2017-01-01

incidence ratios (SIR) was 2.4-fold increased (95% confidence interval (95%CI) 1.8-3.2), leading to 5.7 excess cases per 10 000 patient-years. Risk was still increased 30 years after HL treatment (SIR: 2.8; 95%CI: 1.6-4.6). The highest (SIR: 6.5, 95%CI: 3.3-11.3) was seen for transverse colon cancer (15......BACKGROUND: Hodgkin lymphoma (HL) survivors are at increased risk of second malignancies, but few studies have assessed colorectal cancer (CRC) risk after HL treatment. We assessed long-term, subsite-specific CRC risk associated with specific radiation fields and chemotherapy regimens. METHODS...... a hazard ratio of 6.8 (95%CI: 3.0-15.6) compared with patients receiving neither treatment, which is significantly higher than an additive joint effect (Padditivity=0.004). CONCLUSIONS: Colorectal cancer surveillance should be considered for HL survivors who received Infradiaphragmatic radiotherapy...

Model linear absolute and relative risk estimates for cancer induced by ionizing radiation in Mexican cohort of occupationally exposed

International Nuclear Information System (INIS)

Alvarez, R.J.T.; Trovar, M.V.M; González, J.F.

2015-01-01

From the rate of natural mortality m s cancer (t) for every 100 thousand habitants, modeled by a fourth-degree polynomial function of the age data of the Mexican population (2008), and assuming: a) a relationship 1: 5 of cancer induced radiation respect to presented spontaneously, b) a size of initial cohort No = 100 k SOPs, c) a speed of H E = (2 ± 1) mSv / received by the SOPs from 18 to 65 years, d) a latency of 8 years for cancer induction after irradiation, e) a time tracking cohort to 75 years, f) and taking the coefficients absolute and relative risk BEIRs induction of cancer models II and VII (excluding leukemia); It determined: BEIR II for a total of 125 and 400 deaths from cancer for absolute and relative linear models respectively. For BEIR VII has a number of fatal cases of 345 and 927 deaths respectively for absolute and relative linear model cancer. [es

Type 2 Diabetes Mellitus and Increased Risk for Malaria Infection

Centers for Disease Control (CDC) Podcasts

This podcast describes research done in Ghana examining a correlation between type 2 diabetes and a possible increased risk for malaria infection in adults. Dr. Manoj Menon, a medical officer in the Division of Parasitic Diseases and Malaria in the Center for Global Health, discusses questions the study raises.

Does Childhood Disability Increase Risk for Child Abuse and Neglect?

Science.gov (United States)

Leeb, Rebecca T.; Bitsko, Rebecca H.; Merrick, Melissa T.; Armour, Brian S.

2012-01-01

In this article we review the empirical evidence for the presumptions that children with disabilities are at increased risk for child maltreatment, and parents with disabilities are more likely to perpetrate child abuse and neglect. Challenges to the epidemiological examination of the prevalence of child maltreatment and disabilities are…

Organ utilization from increased infectious risk donors: An observational study.

Science.gov (United States)

L'Huillier, Arnaud G; Humar, Atul; Payne, Clare; Kumar, Deepali

2017-12-01

Donors with an increased risk of transmitting human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV) (increased risk donors [IRDs]) are a potential source of organs for transplant. Organs from IRDs can be utilized with appropriate recipient consent and post-transplant follow-up. We reviewed the characteristics and utilization of IRDs in our Organ Procurement Organization (OPO) over a 2-year period. Donor information from April 1, 2013 to March 31, 2015 was obtained through the OPO database. Only consented donors were included. Donors were categorized as IRDs according to Health Canada/Canadian Standards Association (CSA) criteria. A total of 494 potential donors were identified, of which 92 (18.6%) were IRDs. Of these, at least one organ was transplanted from 76 (82.6%). Risk factors for IRDs included injection drug user (IDU) (12%), men having sex with men (MSM) (7%), commercial sex worker (CSW) (4%), and incarceration (24%). Fifty-nine percent (253/429) of IRD organs were utilized. The most frequently used organ was kidney, followed by liver. Median number of organs recovered per IRD was 3 (interquartile range: 2-5). Nucleic acid testing (NAT) was performed in 18.5% (17/92) of IRDs. Reasons for NAT were IDU (n = 2), MSM (n = 2), CSW (n = 2), and previous incarceration (n = 7). Organ utilization from donors that had NAT was similar to donors who did not (94% vs 80%, P = .29). Follow-up NAT was done in multiple factors contribute to the perception of infectious risk from such organs. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An improved risk-explicit interval linear programming model for pollution load allocation for watershed management.

Science.gov (United States)

Xia, Bisheng; Qian, Xin; Yao, Hong

2017-11-01

Although the risk-explicit interval linear programming (REILP) model has solved the problem of having interval solutions, it has an equity problem, which can lead to unbalanced allocation between different decision variables. Therefore, an improved REILP model is proposed. This model adds an equity objective function and three constraint conditions to overcome this equity problem. In this case, pollution reduction is in proportion to pollutant load, which supports balanced development between different regional economies. The model is used to solve the problem of pollution load allocation in a small transboundary watershed. Compared with the REILP original model result, our model achieves equity between the upstream and downstream pollutant loads; it also overcomes the problem of greatest pollution reduction, where sources are nearest to the control section. The model provides a better solution to the problem of pollution load allocation than previous versions.

Increased nuchal translucency thickness and the risk of neurodevelopmental disorders

DEFF Research Database (Denmark)

Hellmuth, Signe G; Pedersen, L H; Miltoft, Caroline B

2016-01-01

spectrum disorders (ASD), cerebral palsy, epilepsy and febrile seizures was obtained from national patient registries. RESULTS: There was no excess risk of neurodevelopmental disorders among euploid children with first-trimester NT 95(th) -99(th) percentile. For children with NT > 99(th) percentile...... in the risk of cerebral palsy (OR, 1.91 (95% CI, 0.61-5.95), 0.47%), epilepsy (OR, 1.51 (95% CI, 0.63-3.66), 0.78%) or febrile seizures (OR, 0.72 (95% CI, 0.44-1.16), 2.65%). CONCLUSIONS: In a large unselected cohort of euploid children, there was no increased risk of neurodevelopmental disorders among those......OBJECTIVE: To investigate the association between fetal nuchal translucency (NT) thickness and neurodevelopmental disorders in euploid children. METHODS: This study included 222 505 euploid children who had undergone routine first-trimester screening during fetal life. Children were divided...

Red meat consumption and risk of cardiovascular diseases-is increased iron load a possible link?

Science.gov (United States)

Quintana Pacheco, Daniel A; Sookthai, Disorn; Wittenbecher, Clemens; Graf, Mirja E; Schübel, Ruth; Johnson, Theron; Katzke, Verena; Jakszyn, Paula; Kaaks, Rudolf; Kühn, Tilman

2018-01-01

High iron load and red meat consumption could increase the risk of cardiovascular diseases (CVDs). As red meat is the main source of heme iron, which is in turn a major determinant of increased iron load, adverse cardiometabolic effects of meat consumption could be mediated by increased iron load. The object of the study was to assess whether associations between red meat consumption and CVD risk are mediated by iron load in a population-based human study. We evaluated relations between red meat consumption, iron load (plasma ferritin), and risk of CVD in the prospective EPIC-Heidelberg Study using a case-cohort sample including a random subcohort (n = 2738) and incident cases of myocardial infarction (MI, n = 555), stroke (n = 513), and CVD mortality (n = 381). Following a 4-step mediation analysis, associations between red meat consumption and iron load, red meat consumption and CVD risk, and iron load and CVD risk were assessed by multivariable regression models before finally testing to which degree associations between red meat consumption and CVD risk were attenuated by adjustment for iron status. Red meat consumption was significantly positively associated with ferritin concentrations and MI risk [HR per 50 g daily intake: 1.18 (95% CI: 1.05, 1.33)], but no significant associations with stroke risk and CVD mortality were observed. While direct associations between ferritin concentrations and MI risk as well as CVD mortality were significant in age- and sex-adjusted Cox regression models, these associations were substantially attenuated and no longer significant after multivariable adjustment for classical CVD risk factors. Strikingly, ferritin concentrations were positively associated with a majority of classical CVD risk factors (age, male sex, alcohol intake, obesity, inflammation, and lower education). Increased ferritin concentrations may be a marker of an overall unfavorable risk factor profile rather than a mediator of greater CVD risk due to meat

The racing-game effect: why do video racing games increase risk-taking inclinations?

Science.gov (United States)

Fischer, Peter; Greitemeyer, Tobias; Morton, Thomas; Kastenmüller, Andreas; Postmes, Tom; Frey, Dieter; Kubitzki, Jörg; Odenwälder, Jörg

2009-10-01

The present studies investigated why video racing games increase players' risk-taking inclinations. Four studies reveal that playing video racing games increases risk taking in a subsequent simulated road traffic situation, as well as risk-promoting cognitions and emotions, blood pressure, sensation seeking, and attitudes toward reckless driving. Study 1 ruled out the role of experimental demand in creating such effects. Studies 2 and 3 showed that the effect of playing video racing games on risk taking was partially mediated by changes in self-perceptions as a reckless driver. These effects were evident only when the individual played racing games that reward traffic violations rather than racing games that do not reward traffic violations (Study 3) and when the individual was an active player of such games rather than a passive observer (Study 4). In sum, the results underline the potential negative impact of racing games on traffic safety.

Elderly individuals with increased risk of falls show postural balance impairment

OpenAIRE

Oliveira, Márcio Rogério de; Inokuti, Thiago Tadashi; Bispo, Nuno Noronha da Costa; Oliveira, Deise Aparecida de Almeida Pires; Oliveira, Rodrigo Franco de; Silva Jr., Rubens Alexandre da

2015-01-01

Introduction Falls are a serious public health problem. Objective The aim of this study was to evaluate whether elderly individuals with increased risk of falls have a postural balance deficit, evaluated using a force platform during a one-leg stance. Materials and methods The sample consisted of 94 physically independent elderly individuals from the EELO project. The instruments used were the Downton scale, in order to assess the risk as well as the history of falls, and the force platf...

Does topical isotretinoin exposure during pregnancy increase the risk of congenital malformations?

Directory of Open Access Journals (Sweden)

İsmail Yılmaz

2015-06-01

Full Text Available A 34-year-old patient learned that she was 7 weeks pregnant while she was using topical isotretinoin + erythromycin gel for acne treatment and referred to Izmir Katip Celebi University Teratology Information Service for information regarding the risk of teratogenicity. Systemic use of isotretinoin is well-known for its teratogenic effects and case reports suggesting possible teratogenic effects regarding topical exposure to retinoids in pregnancy exist in the literature. However, findings reported in four prospective controlled studies do not suggest an increased congenital malformation risk in case of inadvertent exposure during pregnancy. This manuscript aims to give a summary and evaluation of available data for counseling pregnant patients regarding the possible teratogenic risk of inadvertent topical isotretinoin exposure during pregnancy. It also aims to emphasize the importance of increasing communication between pregnant patients, clinicians and teratology information services for the benefit of mother and unborn.

Caesarean section greatly increases risk of scar endometriosis.

Science.gov (United States)

Nominato, Nilo Sérgio; Prates, Luis Felipe Victor Spyer; Lauar, Isabela; Morais, Jaqueline; Maia, Laura; Geber, Selmo

2010-09-01

To estimate the incidence of scar endometriosis after different surgical procedures. A retrospective study of 72 patients diagnosed with scar endometriosis between 1978 and 2003 was performed. Patient age, site of endometriosis, previous operations, time-gap between last surgery and onset of symptoms, nodule characteristics, and recurrence were evaluated. Age ranged from 16 to 48 years. Location varied according to the previous surgery: 46 caesarean section, one hysterectomy, one in abdominal surgery, 19 episiotomy, one was a relapse and two pelvic floor procedures, two women with no previous surgery. The incidence of scar endometriosis after caesarean section was significantly higher than after episiotomy (0.2 and 0.06%, respectively: p<0.00001) with a relative risk of 3.3. Pain was the most frequent symptom. The mean time between surgery and onset of symptoms was 3.7 years. Our findings confirm that scar endometriosis is a rare condition and indicate, probably for the first time, that caesarean section greatly increases the risk of developing scar endometriosis. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Caregiver perceptions of children's linear growth in Bangladesh: a qualitative analysis.

Science.gov (United States)

Hossain, Muttaquina; Ickes, Scott; Rice, Lauren; Ritter, Gaelen; Naila, Nurun Nahar; Zia, Tasnia; Nahar, Baitun; Mahfuz, Mustafa; Denno, Donna M; Ahmed, Tahmeed; Walson, Judd

2018-03-26

To understand caregivers' perceptions of children's linear growth and to identify the cultural meanings and perceptions of risk associated with poor height attainment. Three investigators from Bangladesh conducted twelve focus group discussions. The study was conducted in rural and slum settings in Bangladesh. Participants included mothers and alternative caregivers (n 81) who were recruited by household screening. No eligible, recruited subjects refused participation. Caregivers reported limited experience with growth monitoring services from the health system. Caregivers mainly use visual cues and developmental milestones to understand if children are growing properly, and recognize that children normally experience both weight gain and linear growth with age. Mothers expressed concern over children's malnutrition and short stature, but did not discuss children's failure to attain a 'growth potential' or distinguish inherited short stature from stunting. Caregivers interpret the consequences of poor height attainment as primarily social and economic and cite few health risks. Linear growth interpretation is determined more by community norms than by guidance from nutrition programming or the health system. Interventions to prevent or reduce linear growth failure may be perceived to have limited value where appropriate linear growth in children is determined by comparison to peers and siblings. Such perceptions may be significant barriers to programmes addressing stunting prevention in settings where many children are stunted. Efforts to raise awareness about the risks of linear growth faltering may need to consider delivering messages to caregivers that emphasize the social and economic consequences of stunting.

What can be offered to couples at (possibly) increased genetic risk?

Science.gov (United States)

Read, Andrew P; Donnai, Dian

2012-07-01

We review the reasons why a couple might seek specialist genetic counselling about a possible reproductive risk and the options available to them. Most commonly, the couple will be concerned about the risk of recurrence of a medical condition that has already occurred in the family. Sometimes, the increased risk may come from their ethnicity or because of a consanguineous marriage, rather than because any problem has occurred previously. The geneticist must identify the exact nature of any problem and determine the risks in the light of the mode of inheritance, any investigations undertaken and any other relevant information. The geneticist will then review the options open to the couple, and help them arrive at their own decision in a non-directive way. Some couples may opt to do nothing and let nature take its course but others may request prenatal or pre-implantation diagnosis, or they may avoid the conception of an at-risk child by using donor gametes, adoption or even decide not to have children.

Ulcerative Colitis and Crohn’s Disease Are Associated with Decreased Serum Selenium Concentrations and Increased Cardiovascular Risk

Directory of Open Access Journals (Sweden)

Teresa Castro Aguilar-Tablada

2016-12-01

Full Text Available The incidence of inflammatory bowel disease (IBD and associated oxidative stress is increasing. The antioxidant mineral selenium (Se was measured in serum samples from 106 IBD patients (53 with ulcerative colitis (UC and 53 with Crohn’s disease (CD and from 30 healthy controls. Serum Se concentrations were significantly lower in UC and CD patients than in healthy controls (p < 0.001 and significantly lower in CD patients than in UC patients (p = 0.006. Se concentrations in patients were significantly influenced by sex, body mass index (BMI, the inflammatory biomarker α-1-antitrypsin, surgery, medical treatment, the severity, extent, and form of the disease and the length of time since onset (p < 0.05. Se concentrations in IBD patients were positively and linearly correlated with nutritional (protein, albumin, prealbumin, cholinesterase and total cholesterol and iron status-related (hemoglobin, Fe and hematocrit parameters (p < 0.05. A greater impairment of serum Se and cardiovascular status was observed in CD than in UC patients. An adequate nutritional Se status is important in IBD patients to minimize the cardiovascular risk associated with increased inflammation biomarkers, especially in undernourished CD patients, and is also related to an improved nutritional and body iron status.

Risk perception after genetic counseling in patients with increased risk of cancer

Directory of Open Access Journals (Sweden)

Rantala Johanna

2009-08-01

Full Text Available Abstract Background Counselees are more aware of genetics and seek information, reassurance, screening and genetic testing. Risk counseling is a key component of genetic counseling process helping patients to achieve a realistic view for their own personal risk and therefore adapt to the medical, psychological and familial implications of disease and to encourage the patient to make informed choices 12. The aim of this study was to conceptualize risk perception and anxiety about cancer in individuals attending to genetic counseling. Methods The questionnaire study measured risk perception and anxiety about cancer at three time points: before and one week after initial genetic counseling and one year after completed genetic investigations. Eligibility criteria were designed to include only index patients without a previous genetic consultation in the family. A total of 215 individuals were included. Data was collected during three years period. Results Before genetic counseling all of the unaffected participants subjectively estimated their risk as higher than their objective risk. Participants with a similar risk as the population overestimated their risk most. All risk groups estimated the risk for children's/siblings to be lower than their own. The benefits of preventive surveillance program were well understood among unaffected participants. The difference in subjective risk perception before and directly after genetic counseling was statistically significantly lower in all risk groups. Difference in risk perception for children as well as for population was also statistically significant. Experienced anxiety about developing cancer in the unaffected subjects was lower after genetic counseling compared to baseline in all groups. Anxiety about cancer had clear correlation to perceived risk of cancer before and one year after genetic investigations. The affected participants overestimated their children's risk as well as risk for anyone in

Increased wind risk from sting-jet windstorms with climate change

Science.gov (United States)

Martínez-Alvarado, Oscar; Gray, Suzanne L.; Hart, Neil C. G.; Clark, Peter A.; Hodges, Kevin; Roberts, Malcolm J.

2018-04-01

Extra-tropical cyclones dominate autumn and winter weather over western Europe. The strongest cyclones, often termed windstorms, have a large socio-economic impact on landfall due to strong surface winds and coastal storm surges. Climate model integrations have predicted a future increase in the frequency of, and potential damage from, European windstorms and yet these integrations cannot properly represent localised jets, such as sting jets, that may significantly enhance damage. Here we present the first prediction of how the climatology of sting-jet-containing cyclones will change in a future warmer climate, considering the North Atlantic and Europe. A proven sting-jet precursor diagnostic is applied to 13 year present-day and future (~2100) climate integrations from the Met Office Unified Model in its Global Atmosphere 3.0 configuration. The present-day climate results are consistent with previously-published results from a reanalysis dataset (with around 32% of cyclones exhibiting the sing-jet precursor), lending credibility to the analysis of the future-climate integration. The proportion of cyclones exhibiting the sting-jet precursor in the future-climate integration increases to 45%. Furthermore, while the proportion of explosively-deepening storms increases only slightly in the future climate, the proportion of those storms with the sting-jet precursor increases by 60%. The European resolved-wind risk associated with explosively-deepening storms containing a sting-jet precursor increases substantially in the future climate; in reality this wind risk is likely to be further enhanced by the release of localised moist instability, unresolved by typical climate models.

Increased Risk of Hemorrhagic and Ischemic Strokes in Patients With Splenic Injury and Splenectomy

Science.gov (United States)

Lin, Jiun-Nong; Lin, Cheng-Li; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Yang, Chih-Hui; Kao, Chia-Hung

2015-01-01

Abstract The spleen is a crucial organ in humans. Little is known about the association between stroke and splenic injury or splenectomy. The aim of this study was to determine the risk of stroke in patients with splenic injury and splenectomy. A nationwide cohort study was conducted by analyzing the National Health Insurance Research Database in Taiwan. For comparison, control patients were selected and matched with splenic injury patients in a ratio of 4:1 according to age, sex, and the year of hospitalization. We analyzed the risks of stroke using a Cox proportional-hazards regression analysis. A total of 11,273 splenic injury patients, including 5294 splenectomized and 5979 nonsplenectomized patients, and 45,092 control patients were included in this study. The incidence rates of stroke were 8.05, 6.53, and 4.25 per 1000 person-years in splenic injury patients with splenectomy, those without splenectomy, and the control cohort, respectively. Compared with the control cohort, splenic injury patients with splenectomy exhibited a 2.05-fold increased risk of stroke (95% confidence interval [CI] 1.8–2.34), whereas those without splenectomy exhibited a 1.74-fold increased risk (95% CI 1.51–2). Splenectomy entailed an additional 1.21-fold increased risk of stroke compared with nonsplenectomy in patients with splenic injury. This study revealed that splenic injury and splenectomy were significantly associated with an increased risk of hemorrhagic and ischemic strokes. The results of this study may alert physicians and patients to the complications of splenic injury and splenectomy. PMID:26334909

Increasing awareness in African American BSN students of the health risks of obesity.

Science.gov (United States)

Williamson, Wanda; Kautz, Donald D

2013-01-01

This paper reports on the perceived effectiveness of a program to increase awareness of the health risks of obesity among African-American students. Thirty (n = 30) senior level Bachelor of Science in Nursing students attending a Historically Black College and University (HBCU) took a knowledge test, then participated in an hour-long educational session on obesity. Following the session, the students completed a 10-item post-test to evaluate the effectiveness of the program in increasing awareness of obesity as a risk for heart disease and diabetes. The findings suggested a need to further educate African-American students on the consequences of obesity as well as recommendations to advance the science of personal and family risk awareness in nursing students.

Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

DEFF Research Database (Denmark)

Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

2015-01-01

pregnant women referred to two Danish clinics of occupational medicine (Copenhagen and Aarhus) from 1984 to 2010 were compared with the referred women's 1,077 non-referred pregnancy outcomes and with the pregnancy outcomes of 345,467 gainfully employed women from the same geographical areas and time period.......72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and....../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study...

Non-exposure parenting increases risk of bullying behavior in junior high school students

Directory of Open Access Journals (Sweden)

Surilena Hasan

2016-05-01

Non-exposure parenting was the most relevant risk factor of bullying behavior. Low self-esteem increases the risk of bullying behavior. These findings suggest the need of timely bullying prevention and intervention programs that should have a special focus on families of primary high school students.

Does red noise increase or decrease extinction risk? Single extreme events versus series of unfavorable conditions.

Science.gov (United States)

Schwager, Monika; Johst, Karin; Jeltsch, Florian

2006-06-01

Recent theoretical studies have shown contrasting effects of temporal correlation of environmental fluctuations (red noise) on the risk of population extinction. It is still debated whether and under which conditions red noise increases or decreases extinction risk compared with uncorrelated (white) noise. Here, we explain the opposing effects by introducing two features of red noise time series. On the one hand, positive autocorrelation increases the probability of series of poor environmental conditions, implying increasing extinction risk. On the other hand, for a given time period, the probability of at least one extremely bad year ("catastrophe") is reduced compared with white noise, implying decreasing extinction risk. Which of these two features determines extinction risk depends on the strength of environmental fluctuations and the sensitivity of population dynamics to these fluctuations. If extreme (catastrophic) events can occur (strong noise) or sensitivity is high (overcompensatory density dependence), then temporal correlation decreases extinction risk; otherwise, it increases it. Thus, our results provide a simple explanation for the contrasting previous findings and are a crucial step toward a general understanding of the effect of noise color on extinction risk.

Increased fracture rate in women with breast cancer: a review of the hidden risk

Directory of Open Access Journals (Sweden)

Body Jean-Jacques

2011-08-01

Full Text Available Abstract Background Women with breast cancer, particularly individuals diagnosed at a relatively early age, have an increased incidence of fractures. Fractures can have serious clinical consequences including the need for major surgery, increased morbidity and mortality, increased cost of disease management, and reduced quality of life for patients. The primary cause of the increased fracture risk appears to be an accelerated decrease in bone mineral density (BMD resulting from the loss of estrogenic signaling that occurs with most treatments for breast cancer, including aromatase inhibitors. However, factors other than BMD levels alone may influence treatment decisions to reduce fracture risk in this setting. Our purpose is to review current evidence for BMD loss and fracture risk during treatment for breast cancer and discuss pharmacologic means to reduce this risk. Results Fracture risk during treatment for breast cancer may be influenced by the rate of BMD loss and the consequent rapid alterations in bone microarchitecture, in addition to the established fracture risk factors in postmenopausal osteoporosis. The rapid decrease in BMD during adjuvant chemoendocrine therapy for breast cancer may necessitate more aggressive pharmacotherapy than is indicated for healthy postmenopausal women who develop osteoporosis. Over the last few years, clinical trials have established the effectiveness of bisphosphonates and other antiresorptive agents to preserve BMD during adjuvant therapy for early breast cancer. In addition, some bisphosphonates (eg, zoledronic acid may also delay disease recurrence in women with hormone-responsive tumors, thereby providing an adjuvant benefit in addition to preserving BMD and potentially preventing fractures. Conclusions It is likely that a combined fracture risk assessment (eg, as in the WHO FRAX algorithm will more accurately identify both women with postmenopausal osteoporosis and women with breast cancer who require

Radiation protection in large linear accelerators

International Nuclear Information System (INIS)

Oliva, Jose de Jesus Rivero

2013-01-01

The electron linear accelerators can be used in industrial applications that require powerful sources of ionizing radiation. They have the important characteristic of not representing a radiation hazard when the accelerators remain electrically disconnected. With the plant in operation, a high reliability defense in depth reduces the risk of radiological accidents to extremely small levels. It is practically impossible that a person could enter into the radiation bunker with the accelerators connected. Aceletron Irradiacao Industrial, located in Rio de Janeiro, offers services of irradiation by means of two powerful electron linear accelerators, with 15 kW power and 10 MeV electron energy. Despite the high level of existing radiation safety, a simplified risk study is underway to identify possible sequences of radiological accidents. The study is based on the combined application of the event and fault trees techniques. Preliminary results confirm that there is a very small risk of entering into the irradiation bunker with the accelerators in operation, but the risk of an operator entering into the bunker during a process interruption and remaining there without notice after the accelerators were restarted may be considerably larger. Based on these results the Company is considering alternatives to reduce the likelihood of human error of this type that could lead to a radiological accident. The paper describes the defense in depth of the irradiation process in Aceletron Irradiacao Industrial, as well as the models and preliminary results of the ongoing risk analysis, including the additional safety measures which are being evaluated. (author)

is there an increased risk of post-operative surgical site infection

African Journals Online (AJOL)

2012-09-06

Sep 6, 2012 ... requiring implant orthopaedic surgery are at an increased risk for post-operative surgical ... further studies should determine the effect of reduced CD4 counts, viral load .... Language not Enlish, French, Ducth or German (n=2).

Cannabis use and childhood trauma interact additively to increase the risk of psychotic symptoms in adolescence.

LENUS (Irish Health Repository)

Harley, M

2010-10-01

Adolescent cannabis use has been shown in many studies to increase the risk of later psychosis. Childhood trauma is associated with both substance misuse and risk for psychosis. In this study our aim was to investigate whether there is a significant interaction between cannabis use and childhood trauma in increasing the risk for experiencing psychotic symptoms during adolescence.

Different risk-increasing drugs in recurrent versus single fallers: are recurrent fallers a distinct population?

NARCIS (Netherlands)

Askari, Marjan; Eslami, Saied; Scheffer, Alice C.; Medlock, Stephanie; de Rooij, Sophia E.; van der Velde, Nathalie; Abu-Hanna, Ameen

2013-01-01

Polypharmacy, and specifically the use of multiple fall-risk-increasing drugs (FRID), have been associated with increased risk of falling in older age. However, it is not yet clear whether the known set of FRIDs can be extrapolated to recurrent fallers, since they form a distinct group of more

Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia.

Science.gov (United States)

Gathirua-Mwangi, Wambui G; Monahan, Patrick; Song, Yiqing; Zollinger, Terrell W; Champion, Victoria L; Stump, Timothy E; Imperiale, Thomas F

2017-11-01

Waist circumference (WC) is a stronger predictor of colon cancer (CRC) risk than body mass index (BMI). However, how well change in either WC or BMI predicts risk of advanced colorectal neoplasia (AN) is unclear. To determine the relationship between change in BMI and WC from early adulthood to later age and the risk of AN and which change measure is a stronger predictor. In 4500 adults, ages 50-80, with no previous neoplasia and undergoing screening colonoscopy, BMI and WC at age 21 and at time of screening were reported. Changes in BMI and WC were defined using universal risk cutoffs. Known CRC risk factors were controlled in the logistic models. Overall, model statistics showed WC change (omnibus test χ 2  = 10.15, 2 DF, p value = 0.006) was a statistically stronger predictor of AN than BMI change (omnibus test χ 2  = 5.66, 5 DF, p value = 0.34). Independent of BMI change, participants who increased WC (OR 1.44; 95% CI 1.05-1.96) or maintained a high-risk WC (OR 2.50; 95% CI 1.38-4.53) at age 21 and at screening had an increased risk of AN compared to those with a low-risk WC. Study participants who were obese at age 21 and at screening had an increased risk of AN (OR 1.87; 95% CI 1.08-3.23) compared to those who maintained a healthy BMI. Maintaining an overweight BMI or increasing BMI was not associated with AN. Maintaining an unhealthy BMI and WC throughout adult life may increase risk of AN. WC change may be a better predictor of AN than BMI change.

Classification of acute stress using linear and non-linear heart rate variability analysis derived from sternal ECG

DEFF Research Database (Denmark)

Tanev, George; Saadi, Dorthe Bodholt; Hoppe, Karsten

2014-01-01

Chronic stress detection is an important factor in predicting and reducing the risk of cardiovascular disease. This work is a pilot study with a focus on developing a method for detecting short-term psychophysiological changes through heart rate variability (HRV) features. The purpose of this pilot...... study is to establish and to gain insight on a set of features that could be used to detect psychophysiological changes that occur during chronic stress. This study elicited four different types of arousal by images, sounds, mental tasks and rest, and classified them using linear and non-linear HRV...

How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research.

Science.gov (United States)

Fielden, Hannah G; Brown, Stephen L; Saini, Pooja; Beesley, Helen; Salmon, Peter

2017-09-01

Risk-reducing procedures can be offered to people at increased cancer risk, but many procedures can have iatrogenic effects. People therefore need to weigh risks associated with both cancer and the risk-reduction procedure in their decisions. By reviewing relevant literature on breast cancer (BC) risk reduction, we aimed to understand how women at relatively high risk of BC perceive their risk and how their risk perceptions influence their decisions about risk reduction. Synthesis of 15 qualitative studies obtained from systematic searches of SCOPUS, Web of Knowledge, PsychINFO, and Medline electronic databases (inception-June 2015). Women did not think about risk probabilistically. Instead, they allocated themselves to broad risk categories, typically influenced by their own or familial experiences of BC. In deciding about risk-reduction procedures, some women reported weighing the risks and benefits, but papers did not describe how they did so. For many women, however, an overriding wish to reduce intense worry about BC led them to choose aggressive risk-reducing procedures without such deliberation. Reasoning that categorisation is a fundamental aspect of risk perception, we argue that patients can be encouraged to develop more nuanced and accurate categorisations of their own risk through their interactions with clinicians. Empirically-based ethical reflection is required to determine whether and when it is appropriate to provide risk-reduction procedures to alleviate worry. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Social and economic factors of the natural risk increasing: estimation of the Russian regions

Directory of Open Access Journals (Sweden)

E. Petrova

2004-01-01

Full Text Available This study is an attempt to assess quantitatively social and economic factors that determine vulnerability of Russian regions to natural risk, to trace the space differences of the considered factors, and to group the regions by their similarity. In order to indicate the regional differences in social and economic development, equipment condition, dangerous substances accumulation, and social trouble four the most suitable parameters were estimated, including the per capita production of Gross Regional Product (GRP, capital consumption, volume of total toxic waste, and crime rate. Increase of the first parameter causes vulnerability reducing, the increase of the last three causes its increasing. Using multidimensional cluster analysis five types of regions were found for Russia according to similarity of the considered parameters. These types are characterized with higher value of a single (rarely two chosen parameter, which seems to be sufficient enough to affect natural risks increasing in these regions in near future. Only few regions belonging to the fifth type proved to have rather high value of GRP and relatively low values of the other parameters. The negative correlation was found between a number of natural disasters (ND and the per capita GRP in case when some parameters reached anomalously high value. The distinctions between regions by prevailing different parameters, which result in natural risk increasing, help risk management to find directions where to focus on.

Acceptance and adherence to chemoprevention among women at increased risk of breast cancer.

Science.gov (United States)

Roetzheim, Richard G; Lee, Ji-Hyun; Fulp, William; Matos Gomez, Elizabeth; Clayton, Elissa; Tollin, Sharon; Khakpour, Nazanin; Laronga, Christine; Lee, Marie Catherine; Kiluk, John V

2015-02-01

Chemoprevention is an option for women who are at increased risk of breast cancer (five year risk ≥1.7%). It is uncertain, however, how often women accept and complete five years of therapy and whether clinical or demographic factors predict completion. Medical records were abstracted for 219 women whose five year risk of breast cancer was ≥1.7% and who were offered chemoprevention while attending a high risk breast clinic at the Moffitt Cancer Center. We examined the likelihood of accepting chemoprevention and completing five years of therapy, and potential clinical and demographic predictors of these outcomes, using multivariable logistic regression and survival analysis models. There were 118/219 women (54.4%) who accepted a recommendation for chemoprevention and began therapy. The likelihood of accepting chemoprevention was associated with lifetime breast cancer risk and was higher for women with specific high risk conditions (lobular carcinoma in situ and atypical ductal hyperplasia). Women with osteoporosis and those that consumed alcohol were also more likely to accept medication. There were 58/118 (49.2%) women who stopped medication at least temporarily after starting therapy. Based on survival curves, an estimated 60% of women who begin chemoprevention will complete five years of therapy. A substantial percentage of women at increased risk of breast cancer will decline chemoprevention and among those that accept therapy, approximately 40% will not be able to complete five years of therapy because of side effects. Copyright © 2014 Elsevier Ltd. All rights reserved.

People with Increased Risk of Eye Damage from UV Light

Science.gov (United States)

... With Increased Risk of Eye Damage from UV Light Leer en Español: Algunas Personas Están en Mayor Riesgo de Sufrir Daño Ocular por los Rayos UV Written By: Shirley Dang Apr. 30, 2014 Everyone of any age and any degree of skin pigmentation is susceptible to UV damage. Children are ...

Study Finds Small Increase in Cancer Risk after Childhood CT Scans

Science.gov (United States)

A study published in the June 6, 2012, issue of The Lancet shows that radiation exposure from computed tomography (CT) scans in childhood results in very small but increased risks of leukemia and brain tumors in the first decade after exposure.

Assessment of Credit Risk Approaches in Relation with Competitiveness Increase of the Banking Sector

Directory of Open Access Journals (Sweden)

Cipovová Eva

2012-06-01

Full Text Available The article is focused on a presentation and analysis of selected methods of credit risk management in relation with competitiveness increase of the banking sector. The article is defined credit risk approaches under the Basel III gradually. Aim of this contribution constitutes various methods of credit risk management and effects of their usage on regulatory capital amount in respect of corporate exposures. Optimal equity amount in relation to the risk portfolio presents an essential prerequisite of performance and competitiveness growth of commercial banks. Gradually capital requirements using Standardized Approach and Internal Based Approach in a case of used and unused techniques of credit risk reduce has been quantified. We presume that sophisticated approach means significant saving for bank’s equity which increases competitiveness of banking sector also. Within the article, quantification of capital savings in case of Standardized (with and without assigned external ratings and Foundation Internal Based Approach at the selected credit portfolio has been effected.

linear-quadratic-linear model

Directory of Open Access Journals (Sweden)

Tanwiwat Jaikuna

2017-02-01

Full Text Available Purpose: To develop an in-house software program that is able to calculate and generate the biological dose distribution and biological dose volume histogram by physical dose conversion using the linear-quadratic-linear (LQL model. Material and methods : The Isobio software was developed using MATLAB version 2014b to calculate and generate the biological dose distribution and biological dose volume histograms. The physical dose from each voxel in treatment planning was extracted through Computational Environment for Radiotherapy Research (CERR, and the accuracy was verified by the differentiation between the dose volume histogram from CERR and the treatment planning system. An equivalent dose in 2 Gy fraction (EQD2 was calculated using biological effective dose (BED based on the LQL model. The software calculation and the manual calculation were compared for EQD2 verification with pair t-test statistical analysis using IBM SPSS Statistics version 22 (64-bit. Results: Two and three-dimensional biological dose distribution and biological dose volume histogram were displayed correctly by the Isobio software. Different physical doses were found between CERR and treatment planning system (TPS in Oncentra, with 3.33% in high-risk clinical target volume (HR-CTV determined by D90%, 0.56% in the bladder, 1.74% in the rectum when determined by D2cc, and less than 1% in Pinnacle. The difference in the EQD2 between the software calculation and the manual calculation was not significantly different with 0.00% at p-values 0.820, 0.095, and 0.593 for external beam radiation therapy (EBRT and 0.240, 0.320, and 0.849 for brachytherapy (BT in HR-CTV, bladder, and rectum, respectively. Conclusions : The Isobio software is a feasible tool to generate the biological dose distribution and biological dose volume histogram for treatment plan evaluation in both EBRT and BT.

Non-linear osmosis

Science.gov (United States)

Diamond, Jared M.

1966-01-01

1. The relation between osmotic gradient and rate of osmotic water flow has been measured in rabbit gall-bladder by a gravimetric procedure and by a rapid method based on streaming potentials. Streaming potentials were directly proportional to gravimetrically measured water fluxes. 2. As in many other tissues, water flow was found to vary with gradient in a markedly non-linear fashion. There was no consistent relation between the water permeability and either the direction or the rate of water flow. 3. Water flow in response to a given gradient decreased at higher osmolarities. The resistance to water flow increased linearly with osmolarity over the range 186-825 m-osM. 4. The resistance to water flow was the same when the gall-bladder separated any two bathing solutions with the same average osmolarity, regardless of the magnitude of the gradient. In other words, the rate of water flow is given by the expression (Om — Os)/[Ro′ + ½k′ (Om + Os)], where Ro′ and k′ are constants and Om and Os are the bathing solution osmolarities. 5. Of the theories advanced to explain non-linear osmosis in other tissues, flow-induced membrane deformations, unstirred layers, asymmetrical series-membrane effects, and non-osmotic effects of solutes could not explain the results. However, experimental measurements of water permeability as a function of osmolarity permitted quantitative reconstruction of the observed water flow—osmotic gradient curves. Hence non-linear osmosis in rabbit gall-bladder is due to a decrease in water permeability with increasing osmolarity. 6. The results suggest that aqueous channels in the cell membrane behave as osmometers, shrinking in concentrated solutions of impermeant molecules and thereby increasing membrane resistance to water flow. A mathematical formulation of such a membrane structure is offered. PMID:5945254

Increasing fall risk awareness using wearables: A fall risk awareness protocol.

Science.gov (United States)

Danielsen, Asbjørn; Olofsen, Hans; Bremdal, Bernt Arild

2016-10-01

Each year about a third of elderly aged 65 or older experience a fall. Many of these falls may have been avoided if fall risk assessment and prevention tools where available in a daily living situation. We identify what kind of information is relevant for doing fall risk assessment and prevention using wearable sensors in a daily living environment by investigating current research, distinguishing between prospective and context-aware fall risk assessment and prevention. Based on our findings, we propose a fall risk awareness protocol as a fall prevention tool integrating both wearables and ambient sensing technology into a single platform. Copyright © 2016. Published by Elsevier Inc.

Treatment Resistant Epilepsy in Autism Spectrum Disorder: Increased Risk for Females.

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Blackmon, Karen; Bluvstein, Judith; MacAllister, William S; Avallone, Jennifer; Misajon, Jade; Hedlund, Julie; Goldberg, Rina; Bojko, Aviva; Mitra, Nirmala; Giridharan, Radha; Sultan, Richard; Keller, Seth; Devinsky, Orrin

2016-02-01

The male:female ratio in autism spectrum disorder (ASD) averages greater than 4:1 while the male:female ratio of ASD with epilepsy averages less than 3:1. This indicates an elevated risk of epilepsy in females with ASD; yet, it is unknown whether phenotypic features of epilepsy and ASD differ between males and females with this comorbidity. The goal of this study is to investigate sex differences in phenotypic features of epilepsy and ASD in a prospective sample of 130 children and young adults with an initial ASD diagnosis and subsequent epilepsy diagnosis. All participants were characterized by standardized diagnostic inventories, parent/caregiver completed questionnaires, and medical/academic record review. Diagnostic classifications of epilepsy, ASD, and intellectual disability were performed by board certified neurologists and a pediatric neuropsychologist. Results demonstrated a lower male:female ratio (1.8:1) in individuals with ASD and treatment-resistant epilepsy relative to those with ASD and treatment-responsive epilepsy (4.9:1), indicating a higher risk of treatment-resistant epilepsy in females. Mild neuroimaging abnormalities were more common in females than males and this was associated with increased risk of treatment-resistance. In contrast, ASD symptom severity was lower in females compared with males. Findings distinguish females with ASD and epilepsy as a distinct subgroup at higher risk for a more severe epilepsy phenotype in the context of a less severe ASD phenotype. Increased risk of anti-epileptic treatment resistance in females with ASD and epilepsy suggests that comprehensive genetic, imaging, and neurologic screening and enhanced treatment monitoring may be indicated for this subgroup. Autism Res 2016, 9: 311-320. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Increased Risk of Tics in Children Infected with Enterovirus: A Nationwide Population-Based Study.

Science.gov (United States)

Lin, Jiun-Nong; Lin, Cheng-Li; Yen, Hung-Rong; Yang, Chi-Hui; Lai, Chung-Hsu; Lin, Hsi-Hsun; Kao, Chia-Hung

2017-05-01

Both tics and enterovirus (EV) infections are common in children. The association between EV infections and tics has been seldom evaluated. The aim of this study was to evaluate the risk of diagnosed tics after EV infections in children. A nationwide retrospective cohort study was conducted to determine the risk of tics after EV infections by analyzing data from the National Health Insurance Research Database in Taiwan. Children aged tics, death, loss to follow-up, withdrawal from the insurance system, or December 31, 2008. A total of 282,321 EV-infected and 282,317 non-EV-infected children were included in this study. The mean age was 2.39 years in both cohorts. The overall incidences of tics were 9.12 and 6.21 per 10,000 person-years in the EV-infected and non-EV-infected cohorts, respectively. Children with EV infection were significantly associated with an increased risk of tics compared with those without EV infection (adjusted hazard ratio, 1.38; 95% confidence interval, 1.27-1.5). Multivariable analyses showed that boys, children living in urbanized areas, children whose parents had white-collar jobs, and children with allergic rhinitis or bronchial asthma exhibited a significantly increased risk of tics. This study revealed an increased risk of tics after EV infection in children.

Linear Algebra and Smarandache Linear Algebra

OpenAIRE

Vasantha, Kandasamy

2003-01-01

The present book, on Smarandache linear algebra, not only studies the Smarandache analogues of linear algebra and its applications, it also aims to bridge the need for new research topics pertaining to linear algebra, purely in the algebraic sense. We have introduced Smarandache semilinear algebra, Smarandache bilinear algebra and Smarandache anti-linear algebra and their fuzzy equivalents. Moreover, in this book, we have brought out the study of linear algebra and vector spaces over finite p...

Linear ubiquitination in immunity.

Science.gov (United States)

Shimizu, Yutaka; Taraborrelli, Lucia; Walczak, Henning

2015-07-01

Linear ubiquitination is a post-translational protein modification recently discovered to be crucial for innate and adaptive immune signaling. The function of linear ubiquitin chains is regulated at multiple levels: generation, recognition, and removal. These chains are generated by the linear ubiquitin chain assembly complex (LUBAC), the only known ubiquitin E3 capable of forming the linear ubiquitin linkage de novo. LUBAC is not only relevant for activation of nuclear factor-κB (NF-κB) and mitogen-activated protein kinases (MAPKs) in various signaling pathways, but importantly, it also regulates cell death downstream of immune receptors capable of inducing this response. Recognition of the linear ubiquitin linkage is specifically mediated by certain ubiquitin receptors, which is crucial for translation into the intended signaling outputs. LUBAC deficiency results in attenuated gene activation and increased cell death, causing pathologic conditions in both, mice, and humans. Removal of ubiquitin chains is mediated by deubiquitinases (DUBs). Two of them, OTULIN and CYLD, are constitutively associated with LUBAC. Here, we review the current knowledge on linear ubiquitination in immune signaling pathways and the biochemical mechanisms as to how linear polyubiquitin exerts its functions distinctly from those of other ubiquitin linkage types. © 2015 The Authors. Immunological Reviews Published by John Wiley & Sons Ltd.

Resent advance in electron linear accelerators

International Nuclear Information System (INIS)

Takeda, Seishi; Tsumori, Kunihiko; Takamuku, Setsuo; Okada, Toichi; Hayashi, Koichiro; Kawanishi, Masaharu

1986-01-01

In recently constructed electron linear accelerators, there has been remarkable advance both in acceleration of a high-current single bunch electron beam for radiation research and in generation of high accelerating gradient for high energy accelerators. The ISIR single bunch electron linear accelerator has been modified an injector to increase a high-current single bunch charge up to 67 nC, which is ten times greater than the single bunch charge expected in early stage of construction. The linear collider projects require a high accelerating gradient of the order of 100 MeV/m in the linear accelerators. High-current and high-gradient linear accelerators make it possible to obtain high-energy electron beam with small-scale linear accelerators. The advance in linear accelerators stimulates the applications of linear accelerators not only to fundamental research of science but also to industrial uses. (author)

Changing the paradigm of organ utilization from PHS increased-risk donors: an opportunity whose time has come?

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Sibulesky, Lena; Javed, Imran; Reyes, Jorge D; Limaye, Ajit P

2015-09-01

Approximately 8-11% of all organ donors are classified by Public Health Service (PHS) as increased-risk. The proportion of PHS increased-risk donors is on the rise. At the University of Washington Medical Center, in 2014, the proportion of transplants from PHS increased-risk donors was 28% of liver transplants and 23% of kidney transplants. Nationally, transplant providers have been reluctant to use organs from PHS increased-risk donors because of concern for transmission of HIV, HCV, or HBV. There is also patient apprehension when these organs are being offered, and thus the discard rate of these otherwise good quality organs is high. Because of the organ shortage, preventing underutilization of such organs is essential. We provide data and considerations that should be used to guide the use of organs from PHS increased-risk donors. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

"Towards a Future Linear Collider" and "The Linear Collider Studies at CERN"

CERN Document Server

CERN. Geneva

2010-01-01

During the week 18-22 October, more than 400 physicists will meet at CERN and in the CICG (International Conference Centre Geneva) to review the global progress towards a future linear collider. The 2010 International Workshop on Linear Colliders will study the physics, detectors and accelerator complex of a linear collider covering both the CLIC and ILC options. Among the topics presented and discussed will be the progress towards the CLIC Conceptual Design Report in 2011, the ILC Technical Design Report in 2012, physics and detector studies linked to these reports, and an increasing numbers of common working group activities. The seminar will give an overview of these topics and also CERN’s linear collider studies, focusing on current activities and initial plans for the period 2011-16. n.b: The Council Chamber is also reserved for this colloquium with a live transmission from the Main Auditorium.

THE INTERSECTION OF INDEPENDENT LIES: INCREASING REALISM IN ECOLOGICAL RISK ASSESSMENT

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In 1966, Levins presented a philosophical discussion on making inference about populations using clusters of models. In this article we provide an overview of model inference in ecological risk assessment, discuss the benefits and trade-offs of increasing model realism, show the...

Increased Relative Risk of Tick-Borne Encephalitis in Warmer Weather

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Milan Daniel

2018-03-01

Full Text Available Tick-borne encephalitis (TBE is a serious acute neuroinfection of humans caused by a tick-borne flavivirus. The disease is typically seasonal, linked to the host-seeking activity of Ixodes ricinus (predominantly nymphs, the principal European tick vector species. To address the need for accurate risk predictions of contracting TBE, data on 4,044 TBE cases reported in the Czech Republic during 2001–2006 were compared with questing activity of I. ricinus nymphs monitored weekly at a defined location for the same 6-year period. A time shift of 21 days between infected tick bite and recorded disease onset provided the optimal model for comparing the number of cases of TBE with numbers of questing nymphs. Mean annual distribution of TBE cases and tick counts showed a similar bimodal distribution. Significantly, the ratio of TBE cases to questing nymphs was highest in the summer-autumn period even though the number of questing nymphs peaked in the spring-summer period. However, this pattern changed during a period of extreme meteorological events of flooding and abnormally high temperatures, indicating that changes in climate affect the incidence of TBE. Previous studies failed to link human behavior with changes in incidence of TBE but showed extrinsic temperature impacts arbovirus replication. Hence, we hypothesize the apparent discrepancy between peak nymphal tick activity and greatest risk of contracting TBE is due to the effect of temperature on virus replication in the tick vector. Relative proportions of questing nymphs and the numbers of weeks in which they were found were greater in summer-autumn compared with spring-summer at near-ground temperatures >5°C and at standard day and weekly average temperatures of >15°C. Thus, during the summer-autumn period, the virus dose in infected tick bites is likely greater owing to increased virus replication at higher microclimatic temperatures, consequently increasing the relative risk of

Cortisol and testosterone increase financial risk taking and may destabilize markets

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Cueva, Carlos; Roberts, R. Edward; Spencer, Tom; Rani, Nisha; Tempest, Michelle; Tobler, Philippe N.; Herbert, Joe; Rustichini, Aldo

2015-01-01

It is widely known that financial markets can become dangerously unstable, yet it is unclear why. Recent research has highlighted the possibility that endogenous hormones, in particular testosterone and cortisol, may critically influence traders’ financial decision making. Here we show that cortisol, a hormone that modulates the response to physical or psychological stress, predicts instability in financial markets. Specifically, we recorded salivary levels of cortisol and testosterone in people participating in an experimental asset market (N = 142) and found that individual and aggregate levels of endogenous cortisol predict subsequent risk-taking and price instability. We then administered either cortisol (single oral dose of 100 mg hydrocortisone, N = 34) or testosterone (three doses of 10 g transdermal 1% testosterone gel over 48 hours, N = 41) to young males before they played an asset trading game. We found that both cortisol and testosterone shifted investment towards riskier assets. Cortisol appears to affect risk preferences directly, whereas testosterone operates by inducing increased optimism about future price changes. Our results suggest that changes in both cortisol and testosterone could play a destabilizing role in financial markets through increased risk taking behaviour, acting via different behavioural pathways. PMID:26135946

Failure to Redose Antibiotic Prophylaxis in Long Surgery Increases Risk of Surgical Site Infection.

Science.gov (United States)

Kasatpibal, Nongyao; Whitney, Joanne D; Dellinger, E Patchen; Nair, Bala G; Pike, Kenneth C

Antibiotic prophylaxis is a key component of the prevention of surgical site infection (SSI). Failure to manage antibiotic prophylaxis effectively may increase the risk of SSI. This study aimed to examine the effects of antibiotic prophylaxis on SSI risk. A retrospective cohort study was conducted among patients having general surgery between May 2012 and June 2015 at the University of Washington Medical Center. Peri-operative data extracted from hospital databases included patient and operation characteristics, intra-operative medication and fluid administration, and survival outcome. The effects of antibiotic prophylaxis and potential factors on SSI risk were estimated using multiple logistic regression and were expressed as risk ratios (RRs). A total of 4,078 patients were eligible for analysis. Of these, 180 had an SSI. Mortality rates within and after 30 days were 0.8% and 0.3%, respectively. Improper antibiotic redosing increased the risk of SSI (RR 4.61; 95% confidence interval [CI] 1.33-15.91). Other risk factors were in-patient status (RR 4.05; 95% CI 1.69-9.66), smoking (RR 1.63; 95% CI 1.03-2.55), emergency surgery (RR 1.97; 95% CI 1.26-3.08), colectomy (RR 3.31; 95% CI 1.19-9.23), pancreatectomy (RR 4.52; 95% CI 1.53-13.39), proctectomy (RR 5.02; 95% CI 1.72-14.67), small bowel surgery (RR 6.16; 95% CI 2.13-17.79), intra-operative blood transfusion >500 mL (RR 2.76; 95% CI 1.45-5.26), and multiple procedures (RR 1.40; 95% CI 1.01-1.95). These data demonstrate that failure to redose prophylactic antibiotic during long operations increases the risk of SSI. Strengthening a collaborative surgical quality improvement program may help to eradicate this risk.

Measures of Adiposity Are Associated with Increased Risk of Peptic Ulcer

Science.gov (United States)

Boylan, Matthew R.; Khalili, Hamed; Huang, Edward S.; Chan, Andrew T.

2014-01-01

Background & Aims Obesity is associated with systemic inflammation, alterations in the intestinal microbiome, and decreased epithelial integrity. The association between obesity and peptic ulcer has not been thoroughly investigated. Methods We conducted a prospective cohort study of 47,120 men enrolled in the Health Professionals Follow-up Study (mean age of 54 years at baseline). Biennially, we updated information on body mass index (BMI), physical activity, smoking, and use of non-steroidal anti-inflammatory drugs (NSAID) or aspirin. Self-reported waist and hip measurements were validated among a subsample of participants. Self-reported cases of gastric and duodenal ulcers were confirmed by medical record review. Helicobacter pylori status was determined from endoscopic biopsies, serum antibody measurements, and/or stool antigen assays documented in the medical record. We used Cox proportional hazards modeling to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results We documented 272 gastric and 320 duodenal ulcers over 24 years of follow up. The multivariate-adjusted HR for gastric ulcer was 1.83 (95% CI, 1.20–2.78; Ptrendulcer was not associated with BMI (Ptrend=.24) or WHR (Ptrend=.68). In secondary analyses, increased BMI and WHR were each associated with increased risk of H pylori-negative, but not H pylori-positive, ulcers. The effect of BMI on ulcer risk did not change with use of aspirin or NSAID, alcohol consumption, physical activity, or smoking. Conclusions In a large prospective cohort of male health professionals, central and total obesity were associated with increased risk of peptic ulcer—particularly gastric and H pylori-negative ulcers. PMID:24681076

Host density increases parasite recruitment but decreases host risk in a snail-trematode system.

Science.gov (United States)

Buck, J C; Hechinger, R F; Wood, A C; Stewart, T E; Kuris, A M; Lafferty, K D

2017-08-01

Most species aggregate in local patches. High host density in patches increases contact rate between hosts and parasites, increasing parasite transmission success. At the same time, for environmentally transmitted parasites, high host density can decrease infection risk to individual hosts, because infective stages are divided among all hosts in a patch, leading to safety in numbers. We tested these predictions using the California horn snail, Cerithideopsis californica (=Cerithidea californica), which is the first intermediate host for at least 19 digenean trematode species in California estuaries. Snails become infected by ingesting trematode eggs or through penetration by free-swimming miracidia that hatch from trematode eggs deposited with final-host (bird or mammal) feces. This complex life cycle decouples infective-stage production from transmission, raising the possibility of an inverse relationship between host density and infection risk at local scales. In a field survey, higher snail density was associated with increased trematode (infected snail) density, but decreased trematode prevalence, consistent with either safety in numbers, parasitic castration, or both. To determine the extent to which safety in numbers drove the negative snail-density-trematode-prevalence association, we manipulated uninfected snail density in 83 cages at eight sites within Carpinteria Salt Marsh (California, USA). At each site, we quantified snail density and used data on final-host (bird and raccoon) distributions to control for between-site variation in infective-stage supply. After three months, overall trematode infections per cage increased with snail biomass density. For egg-transmitted trematodes, per-snail infection risk decreased with snail biomass density in the cage and surrounding area, whereas per-snail infection risk did not decrease for miracidium-transmitted trematodes. Furthermore, both trematode recruitment and infection risk increased with infective

Sarcoma risk after radiation exposure

Directory of Open Access Journals (Sweden)

Berrington de Gonzalez Amy

2012-10-01

Full Text Available Abstract Sarcomas were one of the first solid cancers to be linked to ionizing radiation exposure. We reviewed the current evidence on this relationship, focusing particularly on the studies that had individual estimates of radiation doses. There is clear evidence of an increased risk of both bone and soft tissue sarcomas after high-dose fractionated radiation exposure (10 + Gy in childhood, and the risk increases approximately linearly in dose, at least up to 40 Gy. There are few studies available of sarcoma after radiotherapy in adulthood for cancer, but data from cancer registries and studies of treatment for benign conditions confirm that the risk of sarcoma is also increased in this age-group after fractionated high-dose exposure. New findings from the long-term follow-up of the Japanese atomic bomb survivors suggest, for the first time, that sarcomas can be induced by acute lower-doses of radiation (

Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis.

Science.gov (United States)

Kappus, Natalie; Weinstock-Guttman, Bianca; Hagemeier, Jesper; Kennedy, Cheryl; Melia, Rebecca; Carl, Ellen; Ramasamy, Deepa P; Cherneva, Mariya; Durfee, Jacqueline; Bergsland, Niels; Dwyer, Michael G; Kolb, Channa; Hojnacki, David; Ramanathan, Murali; Zivadinov, Robert

2016-02-01

Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS). To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes. In a prospective study, 326 patients with relapsing-remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status. Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p = 0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥ 2 CV risks (p = 0.003), while the frequency of ≥ 3 CV risks was 18.8% in the MS group and 8.6% in the HCs group (p = 0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes (p < 0.05), while overweight/obesity was associated with increased T1-LV (p < 0.39) and smoking with decreased whole brain volume (p = 0.049). Increased lateral ventricle volume was associated with heart disease (p = 0.029) in CIS. Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Increasing potential risk for American visceral leishmaniasis in Amapá, Brazil

Directory of Open Access Journals (Sweden)

Thiago Vasconcelos dos Santos

Full Text Available Abstract: INTRODUCTION: The present note discusses some evidence on the increasing potential risk for American visceral leishmaniasis (AVL transmission in the Northern Brazilian State of Amapá, the Guianan-Amazon biome. METHODS Early and present data about AVL were collected, including our recent entomological findings. RESULTS: The spread of the sand fly vector Lutzomyia longipalpis, and a sylvatic reservoir host, the crab-eating fox Cerdocyon thous in that region represents important findings related to the epidemiology of AVL in the Guianan-Amazon biome. CONCLUSIONS: These observations suggest that Brazilian authorities need to develop surveillance strategies in these risk areas.

Stormwater Volume Control to Prevent Increases in Lake Flooding and Dam Failure Risk

Science.gov (United States)

Potter, K. W.

2017-12-01

Urban expansion is not often considered a major factor contributing to dam failure. But if urbanization occurs without mitigation of the hydrologic impacts, the risk of dam failure will increase. Of particular concern are increases in the volume of storm runoff resulting from increases in the extent of impervious surfaces. Storm runoff volumes are not regulated for much the U.S, and where they are, the required control is commonly less than 100%. Unmitigated increases in runoff volume due to urbanization can pose a risk to dams. A recent technical advisory committee of Dane County has recommended that the county require 100% control of stormwater volumes for new developments. The primary motivation was to prevent increases in the water levels in the Yahara Lakes, slowly draining lakes that are highly sensitive to runoff volume. The recommendations included the use of "volume trading" to achieve efficient compliance. Such recommendations should be considered for other slowly draining lakes, including those created by artificial structures.

Insulin use increases risk of asthma but metformin use reduces the risk in patients with diabetes in a Taiwanese population cohort.

Science.gov (United States)

Chen, Chiung-Zuei; Hsu, Chih-Hui; Li, Chung-Yi; Hsiue, Tzuen-Ren

2017-12-01

Recent reports have suggested that insulin promotes airway smooth muscle contraction and enhances airway hyperresponsiveness, which are cardinal features of asthma. In contrast, metformin can reduce both airway inflammatory and remodeling properties. However, these results are all from in vitro and animal studies. This study investigated whether diabetes and various antidiabetic agents associate with the risk of asthma. We used a retrospective population-based cohort study using Taiwan's National Health Insurance claim database from 2000 to 2010 and a Cox proportional hazards regression model to compare the incidence of asthma between patients with diabetes (n = 19,428) and a matched non-diabetic group (n = 38,856). We also used a case-control study nested from the above cohort including 1,982 incident cases of asthma and 1,982 age- and sex-matched controls. A time density sampling technique was used to assess the effects of various antidiabetic agents on the risk of asthma. The incidence of asthma was significantly higher in the diabetic cohort than that in the non-diabetic cohort after adjustment for age, sex, and obesity, with a hazard ratio of 1.30 (95% confidence interval [CI]: 1.24-1.38). Insulin was found to increase the risk of asthma among diabetic patients (odds ratio [OR] 2.23; 95% CI: 1.52-3.58). In contrast, the use of metformin correlated with a decreased risk of asthma (OR 0.75; 95% CI: 0.60-0.95). Individuals with diabetes are at an increased risk of asthma. Insulin may further increase the risk of asthma, but the risk could possibly be reduced by using metformin.

Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: I. Cardiovascular Drugs.

Science.gov (United States)

de Vries, Max; Seppala, Lotta J; Daams, Joost G; van de Glind, Esther M M; Masud, Tahir; van der Velde, Nathalie

2018-04-01

Use of certain medications is recognized as a major and modifiable risk factor for falls. Although the literature on psychotropic drugs is compelling, the literature on cardiovascular drugs as potential fall-risk-increasing drugs is conflicting. The aim of this systematic review and meta-analysis is to provide a comprehensive overview of the associations between cardiovascular medications and fall risk in older adults. Design: A systematic review and meta-analysis. Medline, Embase, and PsycINFO. Key search concepts were "fall," "aged," "causality," and "medication." Studies that investigated cardiovascular medications as risk factors for falls in participants ≥60 years old or participants with a mean age of 70 or older were included. A meta-analysis was performed using the generic inverse variance method, pooling unadjusted and adjusted odds ratios (ORs) separately. In total, 131 studies were included in the qualitative synthesis. Meta-analysis using adjusted ORs showed significant results (pooled OR [95% confidence interval]) for loop diuretics, OR 1.36 (1.17, 1.57), and beta-blocking agents, OR 0.88 (0.80, 0.97). Meta-analysis using unadjusted ORs showed significant results for digitalis, OR 1.60 (1.08, 2.36); digoxin, OR 2.06 (1.56, 2.74); and statins, OR 0.80 (0.65, 0.98). Most of the meta-analyses resulted in substantial heterogeneity that mostly did not disappear after stratification for population and setting. In a descriptive synthesis, consistent associations were not observed. Loop diuretics were significantly associated with increased fall risk, whereas beta-blockers were significantly associated with decreased fall risk. Digitalis and digoxin may increase the risk of falling, and statins may reduce it. For the majority of cardiovascular medication groups, outcomes were inconsistent. Furthermore, recent studies indicate that specific drug properties, such as selectivity of beta-blockers, may affect fall risk, and drug-disease interaction also may play

Subcontractors and increased risk for work-related diseases and absenteeism.

Science.gov (United States)

Min, Kyoung B; Park, Shin G; Song, Jae S; Yi, Kwan H; Jang, Tae W; Min, Jin Y

2013-11-01

Despite increasing reliance on subcontracting in many economic sectors, there is little information available on occupational health and safety issues among subcontractor employees. The purpose of this study was to investigate the effect of subcontracting on self-reported health problems and absences due to occupational accidents and sickness using a nationally representative sample from South Korea. The data used were sampled from the second wave of the Korean Working Conditions Survey [2010]. Information on 3,282 parent firm employees and 728 subcontractor employees was obtained. For the logistic regression model, the outcomes were work-related health problems and absenteeism. The independent variables were personal and occupational characteristics, job aspects, and working hazards. Subcontractor employees were significantly more likely to experience health problems than the employee at parent firms. In particular, subcontractors' risk of injuries and anxiety/depression increased twofold (odd ratios, OR=2.01, 95% confidence interval, CIs, 1.24-3.26) and threefold (OR=2.95, 95% CIs 1.52-5.73), respectively, after controlling for potential variables. In addition, subcontractor employees were three times more likely than employees at parent firms to miss work due to illness (OR=3.56; 95% CIs 2.02-6.26). Working conditions, especially those related to job aspects and workplace exposures, attenuated these risks. Subcontracting workers were found to have a higher risk of work-related diseases and a higher absenteeism rate than parent firm workers. Our study highlights the need to protect and improve the occupational health and safety of subcontractor employees. Copyright © 2013 Wiley Periodicals, Inc.

Elimination of indigenous linear plasmids in Streptomyces hygroscopicus var. jinggangensis and Streptomyces sp. FR008 to increase validamycin A and candicidin productivities.

Science.gov (United States)

Lu, Chenyang; Wu, Hang; Su, Xiurong; Bai, Linquan

2017-05-01

Giant linear plasmids, which replicate independently of the chromosomes, widely exist in actinobacteria. Previous studies mostly focused on the replication and evolution of the linear plasmids or the secondary metabolite gene clusters and the resistance gene clusters therein. However, the relationships of the linear plasmids to the productivities of secondary metabolites have not been studied. In this work, we developed a method to eliminate the indigenous linear plasmid pSHJG1 in Streptomyces hygroscopicus var. jinggangensis, and validamycin A titer increased by 12.5% (from 19.16 ± 1.93 to 21.56 ± 2.25 g/L) in the high-yielding strain TL01 and 43.7% (from 4.67 ± 0.05 to 6.71 ± 0.21 g/L) in the wild-type strain 5008, whereas the cellular growth of the plasmid-cured mutant was reduced. Subsequently, the plasmid-cured mutant was complemented with three structure genes involved in cellular growth in pSHJG1 under the control of a strong PvalA promoter. Among them, the complementation of genes pSHJG1.069 and pSHJG1.072, encoding a putative hydrolase and putative P-loop ATPase, respectively, resulted in the restoration of cellular growth and validamycin A titer. Furthermore, the elimination of indigenous linear plasmid pHZ228 in the candicidin producer Streptomyces sp. FR008 also led to enhanced candicidin production and reduced cellular growth. Because of the wide distribution of indigenous linear plasmids in actinobacteria, the engineering strategy described here could be implemented in a variety of strains for the overproduction of various natural products.

Medication use and kidney cancer risk: A population-based study.

Science.gov (United States)

Nayan, Madhur; Juurlink, David N; Austin, Peter C; Macdonald, Erin M; Finelli, Antonio; Kulkarni, Girish S; Hamilton, Robert J

2017-09-01

Exposure to commonly prescribed medications may be associated with cancer risk. However, there is limited data in kidney cancer. Furthermore, methods of classifying cumulative medication exposure in previous studies may be prone to bias. We conducted a population-based case-control study of 10,377 incident kidney cancer cases aged ≥66 years matched with 35,939 controls on age, sex, history of hypertension, comorbidity score, and geographic location. Cumulative exposure to commonly prescribed medications hypothesised to modulate cancer risk was obtained using prescription claims data. We modelled exposure in four different fashions: (1) as continuous exposures using (a) fractional polynomials (which allow for a non-linear relationship between an exposure and outcome) or (b) assuming linear relationships; and 2) as dichotomous exposures denoting (a) ≥3 years versus kidney cancer. The directions of association were relatively consistent across analyses; however, the magnitudes were sensitive to the method of analysis. When utilising fractional polynomials, increasing cumulative exposure to acetylsalicylic acid, selective serotonin reuptake inhibitors, and proton-pump inhibitors was associated with significantly reduced risk of kidney cancer, while increasing exposure to antihypertensive drugs was associated with significantly increased risk. Our study provides impetus to further explore the effect of commonly prescribed medications on carcinogenesis to identify modifiable pharmacological interventions to reduce the risk of kidney cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

Security Risk Assessment in Software Development Projects

OpenAIRE

Svendsen, Heidi

2017-01-01

Software security is increasing in importance, linearly with vulnerabilities caused by software flaws. It is not possible to spend all the project s resources on software security. To spend the resources given to security in an effective way, one should know what is most important to protect. By performing a risk analysis the project know which vulnerabilities they face. A risk analysis will prioritise the vulnerabilities, and when the vulnerabilities are prioritised the project know where th...

Increased risk taking in relation to chronic stress in young adults

Directory of Open Access Journals (Sweden)

Smarandita eCeccato

2016-01-01

Full Text Available Chronic stress is a public health problem that affects a significant part of the population. While the physiological damage it causes is under ongoing scrutiny, its behavioral effects have been overlooked. This is one of the first studies to examine the relation between chronic stress and decision-making, using a standard lottery paradigm. We measured learning-independent risk taking in the gain domain through binary choices between financially incentivized lotteries. We then measured self-reported chronic stress with the Trier Inventory for the Assessment of Chronic Stress (TICS. We additionally collected hair samples in a subsample of volunteers, in order to quantify chronic cortisol exposure. We discovered a significant, positive correlation between self-reported chronic stress and risk taking that is stronger for women than for men. This confirms part of the findings in acute stress research that show a connection between higher stress and increased risk taking. However, unlike the biologically-based results from acute stress research, we did not identify a significant relation between hair cortisol and behavior. In line with previous literature, we found a clear gender difference in risk taking and self-reports: women generally take less risk and report slightly higher stress levels than men. We conclude that perceived chronic stress can impact behavior in risky situations.

Virtual driving and risk taking: do racing games increase risk-taking cognitions, affect, and behaviors?

Science.gov (United States)

Fischer, Peter; Kubitzki, Jörg; Guter, Stephanie; Frey, Dieter

2007-03-01

Research has consistently shown that aggressive video console and PC games elicit aggressive cognitions, affect, and behaviors. Despite the increasing popularity of racing (driving) games, nothing is known about the psychological impact of this genre. This study investigated whether playing racing games affects cognitions, affect, and behaviors that can promote risk taking in actual road traffic situations. In Study 1, the authors found that the frequency of playing racing games was positively associated with competitive driving, obtrusive driving, and car accidents; a negative association with cautious driving was observed. To determine cause and effect, in Study 2, the authors manipulated whether participants played 1 of 3 racing games or 1 of 3 neutral games. Participants who played a racing game subsequently reported a higher accessibility of cognitions and affect positively associated with risk taking than did participants who played a neutral game. Finally, on a more behavioral level, in Study 3, the authors found that men who played a racing game subsequently took higher risks in computer-simulated critical road traffic situations than did men who played a neutral game. Theoretical and practical implications are discussed. ((c) 2007 APA, all rights reserved).

Increased risk of intraoperative and early postoperative periprosthetic femoral fracture with uncemented stems

DEFF Research Database (Denmark)

Lindberg-Larsen, Martin; Jørgensen, Christoffer C.; Solgaard, Søren

2017-01-01

Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing facto...

Possible risk factors for increased suicide following bariatric surgery.

Science.gov (United States)

Mitchell, James E; Crosby, Ross; de Zwaan, Martina; Engel, Scott; Roerig, James; Steffen, Kristine; Gordon, Kathryn H; Karr, Trisha; Lavender, Jason; Wonderlich, Steve

2013-04-01

There is a growing research literature suggesting that there may be elevated risk of suicide following bariatric surgery. Most of the data reported thus far has been cross-sectional and observational, and very little is known about the possible specific causal variables involved. The purpose of this report is to review this literature and to review possible risk factors for increased suicidal risk following bariatric surgery, to delineate future research directions. First a variety of medical, biological, and genetic factors, including the persistence or recurrence of medical comorbidities after bariatric surgery, the disinhibition and impulsivity secondary to changes in the absorption of alcohol, hypoglycemia, as well as pharmacokinetic changes that may affect the absorption of various medications including antidepressant medications are reviewed. Also reviewed are possible mediating factors involving changes in various peptidergic systems such as GLP-1 and Ghrelin. A number of psychosocial issues that might be involved are discussed, including lack of improvement in quality of life after surgery, continued or recurrent physical mobility restrictions, persistence or recurrence of sexual dysfunction and relationship problems, low self-esteem, and a history of child maltreatment. Inadequate weight loss or weight regain are also discussed. A number of possible contributing factors have been identified. Possible theoretical models involved and directions for research are suggested. Copyright © 2012 The Obesity Society.

Peculiarities of territorial governing in the area of increased risk

International Nuclear Information System (INIS)

Marchinskas, A.

1998-01-01

The area of Ignalina NPP can be evaluated from the standpoint of governing as the area of increased risk territory (zone), so the local administration should acquire a specific status. The results of expert examination show insufficient efficiency of the administration's activity, it's orientation to quantitative results. An objective fund is necessary for the supporting the local administration and population of this area. (author)

Reduction of Linear Programming to Linear Approximation

OpenAIRE

Vaserstein, Leonid N.

2006-01-01

It is well known that every Chebyshev linear approximation problem can be reduced to a linear program. In this paper we show that conversely every linear program can be reduced to a Chebyshev linear approximation problem.

Increased Flooding Risk - Accelerating Threat and Stakeholder Response

Science.gov (United States)

Atkinson, L. P.; Ezer, T.; De Young, R.; McShane, M. K.; McFarlane, B.

2012-12-01

projects, and "…subsidence …. is not well-documented". Studies sponsored by the City of Norfolk for example suggest massive tidal barriers. Flood insurance - Flood insurance is available only from the National Flood Insurance Program (NFIP), not from private insurers. NFIP has a current deficit of about 18B, which is estimated to increase by about 2B annually. The rates are subsidized and do not reflect the true risk of coastal flooding and do not incorporate the likelihood of future sea-level rise. In effect, the subsidy promotes increased building on the coast, leading to increased deficits in the tax-payer financed program. Risk-based flood insurance pricing would lead to less coastal development, therefore decreasing the tax base of the community. Stakeholder needs - Planning for increased flooding due to sea level rise extends 50 to 100 years given the lifetime of infrastructure. Planners need guidance and error estimates. To make adequate predictions for users we must understand the various components of sea level rise including subsidence, global sea level rise and regional and local dynamic sea level rise. Predictions of regional sea level rise will be presented in the context of existing infrastructure such as NASA research facilities and the city of Norfolk, Virginia.

Linear versus non-linear: a perspective from health physics and radiobiology

International Nuclear Information System (INIS)

Gentner, N.E.; Osborne, R.V.

1998-01-01

There is a vigorous debate about whether or not there may be a 'threshold' for radiation-induced adverse health effects. A linear-no threshold (LNT) model allows radiation protection practitioners to manage putative risk consistently, because different types of exposure, exposures at different times, and exposures to different organs may be summed. If we are to argue to regulators and the public that low doses are less dangerous than we presently assume, it is incumbent on us to prove this. The question is, therefore, whether any consonant body of evidence exists that the risk of low doses has been over-estimated. From the perspectives of both health physics and radiobiology, we conclude that the evidence for linearity at high doses (and arguably of fairly small total doses if delivered at high dose rate) is strong. For low doses (or in fact, even for fairly high doses) delivered at low dose rate, the evidence is much less compelling. Since statistical limitations at low doses are almost always going to prevent a definitive answer, one way or the other, from human data, we need a way out of this epistemological dilemma of 'LNT or not LNT, that is the question'. To our minds, the path forward is to exploit (1) radiobiological studies which address directly the question of what the dose and dose rate effectiveness factor is in actual human bodies exposed to low-level radiation, in concert with (2) epidemiological studies of human populations exposed to fairly high doses (to obtain statistical power) but where exposure was protracted over some years. (author)

Smoking, environmental tobacco smoke and occupational irritants increase the risk of chronic rhinitis.

Science.gov (United States)

Hisinger-Mölkänen, Hanna; Piirilä, Päivi; Haahtela, Tari; Sovijärvi, Anssi; Pallasaho, Paula

2018-01-01

Allergic and non-allergic rhinitis cause a lot of symptoms in everyday life. To decrease the burden more information of the preventable risk factors is needed. We assessed prevalence and risk factors for chronic nasal symptoms, exploring the effects of smoking, environmental tobacco smoke, exposure to occupational irritants, and their combinations. In 2016, a postal survey was conducted among a random population sample of 8000 adults in Helsinki, Finland with a 50.5% response rate. Smoking was associated with a significant increase in occurrence of chronic rhinitis (longstanding nasal congestion or runny nose), but not with self-reported or physician diagnosed allergic rhinitis. The highest prevalence estimates of nasal symptoms, 55.1% for chronic rhinitis, 49.1% for nasal congestion, and 40.7% for runny nose, were found among smokers with occupational exposure to gases, fumes or dusts.Besides active smoking, also exposure to environmental tobacco smoke combined with occupational exposure increased the risk of nasal symptoms. Smoking, environmental tobacco smoke, and occupational irritants are significant risk factors for nasal symptoms with an additive pattern. The findings suggest that these factors should be systematically inquired in patients with nasal symptoms for appropriate preventive measures. (192 words).

Analytical Modeling for Underground Risk Assessment in Smart Cities

Directory of Open Access Journals (Sweden)

Israr Ullah

2018-06-01

Full Text Available In the developed world, underground facilities are increasing day-by-day, as it is considered as an improved utilization of available space in smart cities. Typical facilities include underground railway lines, electricity lines, parking lots, water supply systems, sewerage network, etc. Besides its utility, these facilities also pose serious threats to citizens and property. To preempt accidental loss of precious human lives and properties, a real time monitoring system is highly desirable for conducting risk assessment on continuous basis and timely report any abnormality before its too late. In this paper, we present an analytical formulation to model system behavior for risk analysis and assessment based on various risk contributing factors. Based on proposed analytical model, we have evaluated three approximation techniques for computing final risk index: (a simple linear approximation based on multiple linear regression analysis; (b hierarchical fuzzy logic based technique in which related risk factors are combined in a tree like structure; and (c hybrid approximation approach which is a combination of (a and (b. Experimental results shows that simple linear approximation fails to accurately estimate final risk index as compared to hierarchical fuzzy logic based system which shows that the latter provides an efficient method for monitoring and forecasting critical issues in the underground facilities and may assist in maintenance efficiency as well. Estimation results based on hybrid approach fails to accurately estimate final risk index. However, hybrid scheme reveals some interesting and detailed information by performing automatic clustering based on location risk index.

Modifiable risk factors for increased arterial stiffness in outpatient nephrology.

Directory of Open Access Journals (Sweden)

Usama Elewa

Full Text Available Arterial stiffness, as measured by pulse wave velocity (PWV, is an independent predictor of cardiovascular events and mortality. Arterial stiffness increases with age. However, modifiable risk factors such as smoking, BP and salt intake also impact on PWV. The finding of modifiable risk factors may lead to the identification of treatable factors, and, thus, is of interest to practicing nephrologist. We have now studied the prevalence and correlates of arterial stiffness, assessed by PWV, in 191 patients from nephrology outpatient clinics in order to identify modifiable risk factors for arterial stiffness that may in the future guide therapeutic decision-making. PWV was above normal levels for age in 85/191 (44.5% patients. Multivariate analysis showed that advanced age, systolic BP, diabetes mellitus, serum uric acid and calcium polystyrene sulfonate therapy or calcium-containing medication were independent predictors of PWV. A new parameter, Delta above upper limit of normal PWV (Delta PWV was defined to decrease the weight of age on PWV values. Delta PWV was calculated as (measured PWV - (upper limit of the age-adjusted PWV values for the general population. Mean±SD Delta PWV was 0.76±1.60 m/sec. In multivariate analysis, systolic blood pressure, active smoking and calcium polystyrene sulfonate therapy remained independent predictors of higher delta PWV, while age, urinary potassium and beta blocker therapy were independent predictors of lower delta PWV. In conclusion, arterial stiffness was frequent in nephrology outpatients. Systolic blood pressure, smoking, serum uric acid, calcium-containing medications, potassium metabolism and non-use of beta blockers are modifiable factors associated with increased arterial stiffness in Nephrology outpatients.

Association between Carotid Intima Media Thickness and Heart Rate Variability in Adults at Increased Cardiovascular Risk

Directory of Open Access Journals (Sweden)

Ovidiu C. Baltatu

2017-04-01

Full Text Available Background: Atherosclerotic carotid intima-media thickness (IMT may be associated with alterations in the sensitivity of carotid baroreceptors. The aim of this study was to investigate the association between carotid IMT and the autonomic modulation of heart rate variability (HRV.Methods: A total of 101 subjects were enrolled in this prospective observational study. The carotid IMT was determined by duplex ultrasonography. The cardiac autonomic function was determined through HRV measures during the Deep Breathing Test. Linear regression models, adjusted for demographics, comorbidities, body mass index, waist-hip-ratio, and left ventricular ejection fraction were used to evaluate the association between HRV parameters and carotid IMT.Results: Participants had a mean age of 60.4 ± 13.4 years and an estimated 10-year atherosclerotic cardiovascular disease (ASCVD risk score (using the Pooled Cohort Equations of 16.4 ± 17. The mean carotid media thickness was highest (0.90 ± 0.19 mm in the first quartile of the standard deviation of all RR intervals (SDNN (19.7 ± 5.1 ms and progressively declined in each subsequent quartile to 0.82 ± 0.21 mm, 0.81 ± 0.16 mm, and 0.68 ± 0.19 in quartiles 2 (36.5 ± 5.9 ms, 3 (57.7 ± 6.2 ms and 4 (100.9 ± 22.2 ms, respectively. In multivariable adjusted models, there was a statistical significant association between SDNN and carotid IMT (OR −0.002; 95%CI −0.003 to −0.001, p = 0.005. The same significant association was found between carotid IMT and other measures of HRV, including coefficient of variation of RR intervals (CV and dispersion of points along the line of identity (SD2.Conclusions: In a cohort of individuals at increased cardiovascular risk, carotid IMT as a marker of subclinical atherosclerosis was associated with alterations of HRV indicating an impaired cardiac autonomic control, independently of other cardiovascular risk factors.

Mechanisms of increased risk of tumorigenesis in Atm and Brca1 double heterozygosity

Directory of Open Access Journals (Sweden)

Wang Jufang

2011-08-01

Full Text Available Abstract Background Both epidemiological and experimental studies suggest that heterozygosity for a single gene is linked with tumorigenesis and heterozygosity for two genes increases the risk of tumor incidence. Our previous work has demonstrated that Atm/Brca1 double heterozygosity leads to higher cell transformation rate than single heterozygosity. However, the underlying mechanisms have not been fully understood yet. In the present study, a series of pathways were investigated to clarify the possible mechanisms of increased risk of tumorigenesis in Atm and Brca1 heterozygosity. Methods Wild type cells, Atm or Brca1 single heterozygous cells, and Atm/Brca1 double heterozygous cells were used to investigate DNA damage and repair, cell cycle, micronuclei, and cell transformation after photon irradiation. Results Remarkable high transformation frequency was confirmed in Atm/Brca1 double heterozygous cells compared to wild type cells. It was observed that delayed DNA damage recognition, disturbed cell cycle checkpoint, incomplete DNA repair, and increased genomic instability were involved in the biological networks. Haploinsufficiency of either ATM or BRCA1 negatively impacts these pathways. Conclusions The quantity of critical proteins such as ATM and BRCA1 plays an important role in determination of the fate of cells exposed to ionizing radiation and double heterozygosity increases the risk of tumorigenesis. These findings also benefit understanding of the individual susceptibility to tumor initiation.

Mechanisms of increased risk of tumorigenesis in Atm and Brca1 double heterozygosity

International Nuclear Information System (INIS)

Wang, Jufang; Su, Fengtao; Smilenov, Lubomir B; Zhou, Libin; Hu, Wentao; Ding, Nan; Zhou, Guangming

2011-01-01

Both epidemiological and experimental studies suggest that heterozygosity for a single gene is linked with tumorigenesis and heterozygosity for two genes increases the risk of tumor incidence. Our previous work has demonstrated that Atm/Brca1 double heterozygosity leads to higher cell transformation rate than single heterozygosity. However, the underlying mechanisms have not been fully understood yet. In the present study, a series of pathways were investigated to clarify the possible mechanisms of increased risk of tumorigenesis in Atm and Brca1 heterozygosity. Wild type cells, Atm or Brca1 single heterozygous cells, and Atm/Brca1 double heterozygous cells were used to investigate DNA damage and repair, cell cycle, micronuclei, and cell transformation after photon irradiation. Remarkable high transformation frequency was confirmed in Atm/Brca1 double heterozygous cells compared to wild type cells. It was observed that delayed DNA damage recognition, disturbed cell cycle checkpoint, incomplete DNA repair, and increased genomic instability were involved in the biological networks. Haploinsufficiency of either ATM or BRCA1 negatively impacts these pathways. The quantity of critical proteins such as ATM and BRCA1 plays an important role in determination of the fate of cells exposed to ionizing radiation and double heterozygosity increases the risk of tumorigenesis. These findings also benefit understanding of the individual susceptibility to tumor initiation

Energy drink consumption and increased risk for alcohol dependence.

Science.gov (United States)

Arria, Amelia M; Caldeira, Kimberly M; Kasperski, Sarah J; Vincent, Kathryn B; Griffiths, Roland R; O'Grady, Kevin E

2011-02-01

Energy drinks are highly caffeinated beverages that are increasingly consumed by young adults. Prior research has established associations between energy drink use and heavier drinking and alcohol-related problems among college students. This study investigated the extent to which energy drink use might pose additional risk for alcohol dependence over and above that from known risk factors. Data were collected via personal interview from 1,097 fourth-year college students sampled from 1 large public university as part of an ongoing longitudinal study. Alcohol dependence was assessed according to DSM-IV criteria. After adjustment for the sampling design, 51.3%(wt) of students were classified as "low-frequency" energy drink users (1 to 51 days in the past year) and 10.1%(wt) as "high-frequency" users (≥52 days). Typical caffeine consumption varied widely depending on the brand consumed. Compared to the low-frequency group, high-frequency users drank alcohol more frequently (141.6 vs. 103.1 days) and in higher quantities (6.15 vs. 4.64 drinks/typical drinking day). High-frequency users were at significantly greater risk for alcohol dependence relative to both nonusers (AOR = 2.40, 95% CI = 1.27 to 4.56, p = 0.007) and low-frequency users (AOR = 1.86, 95% CI = 1.10, 3.14, p = 0.020), even after holding constant demographics, typical alcohol consumption, fraternity/sorority involvement, depressive symptoms, parental history of alcohol/drug problems, and childhood conduct problems. Low-frequency energy drink users did not differ from nonusers on their risk for alcohol dependence. Weekly or daily energy drink consumption is strongly associated with alcohol dependence. Further research is warranted to understand the possible mechanisms underlying this association. College students who frequently consume energy drinks represent an important target population for alcohol prevention. Copyright © 2010 by the Research Society on Alcoholism.

How suboptimal are linear sharing rules?

DEFF Research Database (Denmark)

Jensen, Bjarne Astrup; Nielsen, Jørgen Aase

2016-01-01

that significant losses can arise when investors are diverse in their risk attitude. We also show that an investor with a low degree of risk aversion, like the logarithmic or the square root investor, often applied in portfolio choice models, can either inflict or be subject to severe losses when being forced...... two sources of suboptimal investment decisions as seen from each of the two investors individually. One is the suboptimal choice of portfolio, the other is the forced linear sharing rule. We measure the combined consequence for each investor by their respective loss in wealth equivalent. We show...

Robust Linear Models for Cis-eQTL Analysis.

Science.gov (United States)

Rantalainen, Mattias; Lindgren, Cecilia M; Holmes, Christopher C

2015-01-01

Expression Quantitative Trait Loci (eQTL) analysis enables characterisation of functional genetic variation influencing expression levels of individual genes. In outbread populations, including humans, eQTLs are commonly analysed using the conventional linear model, adjusting for relevant covariates, assuming an allelic dosage model and a Gaussian error term. However, gene expression data generally have noise that induces heavy-tailed errors relative to the Gaussian distribution and often include atypical observations, or outliers. Such departures from modelling assumptions can lead to an increased rate of type II errors (false negatives), and to some extent also type I errors (false positives). Careful model checking can reduce the risk of type-I errors but often not type II errors, since it is generally too time-consuming to carefully check all models with a non-significant effect in large-scale and genome-wide studies. Here we propose the application of a robust linear model for eQTL analysis to reduce adverse effects of deviations from the assumption of Gaussian residuals. We present results from a simulation study as well as results from the analysis of real eQTL data sets. Our findings suggest that in many situations robust models have the potential to provide more reliable eQTL results compared to conventional linear models, particularly in respect to reducing type II errors due to non-Gaussian noise. Post-genomic data, such as that generated in genome-wide eQTL studies, are often noisy and frequently contain atypical observations. Robust statistical models have the potential to provide more reliable results and increased statistical power under non-Gaussian conditions. The results presented here suggest that robust models should be considered routinely alongside other commonly used methodologies for eQTL analysis.

Elderly individuals with increased risk of falls show postural balance impairment

Directory of Open Access Journals (Sweden)

Márcio Rogério de Oliveira

Full Text Available Introduction Falls are a serious public health problem. Objective The aim of this study was to evaluate whether elderly individuals with increased risk of falls have a postural balance deficit, evaluated using a force platform during a one-leg stance. Materials and methods The sample consisted of 94 physically independent elderly individuals from the EELO project. The instruments used were the Downton scale, in order to assess the risk as well as the history of falls, and the force platform to measure postural balance through parameters from the center of pressure (COP. Results Elderly individuals were split into two groups according to the score observed with the Downton scale: G1 — low fall risk (score ≤ 2 — and G2 — high fall risk (score > 2. No differences were observed between the groups concerning gender (P > 0.05, Chi Square test. On the other hand, individuals from G2 showed postural instability when compared to individuals from G1, and individuals from G2 showed higher values in all COP parameters analysed (Mann-Whitney test, P < 0.05. Conclusion It can be concluded that the Downton scale has sensitivity for identifying individuals with balance impairment as well as a risk of falls. Therefore, it may be suggested that this scale may be useful in primary health care for detecting falls in the elderly.

Risk evaluations of aging phenomena: The linear aging reliability model and its extensions

International Nuclear Information System (INIS)

Vesely, W.E.; Wolford, A.J.

1988-01-01

A model for component failure rates due to aging mechanisms is developed from basic phenomenological considerations. In the treatment, the occurrences of deterioration are modeled as following a Poisson process. The severity of damage is allowed to have any distribution, however the damage is assumed to accumulate independently. Finally, the failure rate is modeled as being proportional to the accumulated damage. Using this treatment, the linear aging failure rate model is obtained. The applicability of the linear aging model to various mechanisms is discussed. Extensions of the model to cover nonlinear and dependent aging phenomena are also described. The implementability of the linear aging model is demonstrated by applying it to the aging data collected in the U.S. NRC Nuclear Plant Aging Research (NPAR) Program. (orig./HP)

A class of non-linear exposure-response models suitable for health impact assessment applicable to large cohort studies of ambient air pollution.

Science.gov (United States)

Nasari, Masoud M; Szyszkowicz, Mieczysław; Chen, Hong; Crouse, Daniel; Turner, Michelle C; Jerrett, Michael; Pope, C Arden; Hubbell, Bryan; Fann, Neal; Cohen, Aaron; Gapstur, Susan M; Diver, W Ryan; Stieb, David; Forouzanfar, Mohammad H; Kim, Sun-Young; Olives, Casey; Krewski, Daniel; Burnett, Richard T

2016-01-01

The effectiveness of regulatory actions designed to improve air quality is often assessed by predicting changes in public health resulting from their implementation. Risk of premature mortality from long-term exposure to ambient air pollution is the single most important contributor to such assessments and is estimated from observational studies generally assuming a log-linear, no-threshold association between ambient concentrations and death. There has been only limited assessment of this assumption in part because of a lack of methods to estimate the shape of the exposure-response function in very large study populations. In this paper, we propose a new class of variable coefficient risk functions capable of capturing a variety of potentially non-linear associations which are suitable for health impact assessment. We construct the class by defining transformations of concentration as the product of either a linear or log-linear function of concentration multiplied by a logistic weighting function. These risk functions can be estimated using hazard regression survival models with currently available computer software and can accommodate large population-based cohorts which are increasingly being used for this purpose. We illustrate our modeling approach with two large cohort studies of long-term concentrations of ambient air pollution and mortality: the American Cancer Society Cancer Prevention Study II (CPS II) cohort and the Canadian Census Health and Environment Cohort (CanCHEC). We then estimate the number of deaths attributable to changes in fine particulate matter concentrations over the 2000 to 2010 time period in both Canada and the USA using both linear and non-linear hazard function models.

Algorithms for non-linear M-estimation

DEFF Research Database (Denmark)

Madsen, Kaj; Edlund, O; Ekblom, H

1997-01-01

In non-linear regression, the least squares method is most often used. Since this estimator is highly sensitive to outliers in the data, alternatives have became increasingly popular during the last decades. We present algorithms for non-linear M-estimation. A trust region approach is used, where...

A Multiphase Non-Linear Mixed Effects Model: An Application to Spirometry after Lung Transplantation

Science.gov (United States)

Rajeswaran, Jeevanantham; Blackstone, Eugene H.

2014-01-01

In medical sciences, we often encounter longitudinal temporal relationships that are non-linear in nature. The influence of risk factors may also change across longitudinal follow-up. A system of multiphase non-linear mixed effects model is presented to model temporal patterns of longitudinal continuous measurements, with temporal decomposition to identify the phases and risk factors within each phase. Application of this model is illustrated using spirometry data after lung transplantation using readily available statistical software. This application illustrates the usefulness of our flexible model when dealing with complex non-linear patterns and time varying coefficients. PMID:24919830

Increased Cardiovascular Risk in Patients with Adrenal Insufficiency: A Short Review

Directory of Open Access Journals (Sweden)

Amir-Hossein Rahvar

2017-01-01

Full Text Available Cardiovascular disease (CVD is the most common cause of death in the world. Recent studies have shown an association between adrenal insufficiency (AI and increased cardiovascular risk (CVR. Patients with AI receive glucocorticoid (GC replacement therapy which can lead to varying levels of blood cortisol. It was shown that these imbalances in blood cortisol may lead to a higher prevalence of coronary heart disease, major adverse coronary events, and increased mortality. GC substitution is essential in the treatment of AI without which the disease has been shown to be fatal. The most frequently used GC formula for replacement therapy is hydrocortisone (HC. There is no uniform opinion on hydrocortisone replacement therapy. Alternative GC such as prednisolone is also in use. Overreplacement of GC may lead to adverse effects including obesity, high blood pressure, and hyperglycaemia. Outcome may vary between primary and secondary AI mainly due to differences in the renin-angiotensin-aldosterone system (RAAS. Furthermore, decreased blood levels of cortisol may lead to a compensatory secretion of inflammatory mediators such as Interleukin-1 (IL-1, Interleukin-6 (IL-6, and/or tumor-necrosis factor (TNF. Physicians and patients should be properly educated about the increased risk of CVD in patients with AI.

Quantitative microbial risk assessment (QMRA) shows increased public health risk associated with exposure to river water under conditions of riverbed sediment resuspension

CSIR Research Space (South Africa)

Abia

2016-10-01

Full Text Available of The Total Environment, 556-557, pp 1143-1151 Quantitative microbial risk assessment (QMRA) shows increased public health risk associated with exposure to river water under conditions of riverbed sediment resuspension Akebe Luther King Abia a...

Increased relative risk of myelodysplastic syndrome in atomic bomb survivors

International Nuclear Information System (INIS)

Oda, Kenji; Kimura, Akiro; Matsuo, Tatsuki; Tomonaga, Masao; Kodama, Kazunori; Mabuchi, Kiyohiko

1998-01-01

It was investigated what blood disorders except leukemia increased the relative risk with dose dependency in atomic bomb survivors. Subjects were 217 patients of atomic bomb survivors in Hiroshima and Nagasaki, who had blood disorders except leukemia and died between 1950 and 1990. Their medical records were analyzed and their diagnoses were reevaluated. Sixteen cases were diagnosed as the aplastic anemia and 12 as the myelodysplastic syndrome (MDS). In the aplastic anemia, there was no correlation between the exposure dose and the mortality. In MDS, the excess relative risk (ERR)/bone marrow exposure dose of 1 Sv was very high (13.0). These results supports the hypothesis that MDS would be broken out by the clonal abnormality of the hematopoietic stem cell and radiation exposure could cause the appearance of the abnormal stem cell clone. (K.H.)

Increased relative risk of myelodysplastic syndrome in atomic bomb survivors

Energy Technology Data Exchange (ETDEWEB)

Oda, Kenji [Hiroshima City Hospital (Japan); Kimura, Akiro; Matsuo, Tatsuki; Tomonaga, Masao; Kodama, Kazunori; Mabuchi, Kiyohiko

1998-12-01

It was investigated what blood disorders except leukemia increased the relative risk with dose dependency in atomic bomb survivors. Subjects were 217 patients of atomic bomb survivors in Hiroshima and Nagasaki, who had blood disorders except leukemia and died between 1950 and 1990. Their medical records were analyzed and their diagnoses were reevaluated. Sixteen cases were diagnosed as the aplastic anemia and 12 as the myelodysplastic syndrome (MDS). In the aplastic anemia, there was no correlation between the exposure dose and the mortality. In MDS, the excess relative risk (ERR)/bone marrow exposure dose of 1 Sv was very high (13.0). These results supports the hypothesis that MDS would be broken out by the clonal abnormality of the hematopoietic stem cell and radiation exposure could cause the appearance of the abnormal stem cell clone. (K.H.)

Sleep disorders increase the risk of burning mouth syndrome: a retrospective population-based cohort study.

Science.gov (United States)

Lee, Chun-Feng; Lin, Kuan-Yu; Lin, Ming-Chia; Lin, Cheng-Li; Chang, Shih-Ni; Kao, Chia-Hung

2014-11-01

Sleep disorders (SD), including apnea and nonapnea, and burning mouth syndrome (BMS) have been mutually associated with systemic diseases. Based on our research, the association between BMS and SD has not been elucidated. We determined whether SD patients have an increased risk of BMS. We used information from health insurance claims obtained from the Taiwanese National Health Insurance (NHI) program. We identified patients newly diagnosed with sleep apnea syndrome between 1998 and 2001 as the apnea SD cohort, and newly diagnosed patients with nonapnea SD as the nonapnea SD cohort. The non-SD cohort was 1:2 frequency matched the case group according to sex, age, and index year. We analyzed the risks of BMS by using Cox proportional hazards regression models. Compared with the non-SD cohort, both of the apnea SD (adjusted HR = 2.56, 95% CI = 1.30-5.05) and nonapnea SD (adjusted HR = 2.89, 95% CI = 2.51-3.34) were associated with a significantly higher risk of BMS. The hazard ratio (HR) increased with increased age in the apnea SD cohort and in the nonapnea SD cohort compared with patients younger than 40 years of age. Female apnea SD patients (IRR = 4.63, 95% CI = 3.82-5.61) had a higher risk of developing BMS than did male patients (IRR = 1.76, 95% CI = 1.39-2.24). Based on our research, SD might increase the risk of BMS. Copyright © 2014 Elsevier B.V. All rights reserved.

Ultra-Low-Dropout Linear Regulator

Science.gov (United States)

Thornton, Trevor; Lepkowski, William; Wilk, Seth

2011-01-01

A radiation-tolerant, ultra-low-dropout linear regulator can operate between -150 and 150 C. Prototype components were demonstrated to be performing well after a total ionizing dose of 1 Mrad (Si). Unlike existing components, the linear regulator developed during this activity is unconditionally stable over all operating regimes without the need for an external compensation capacitor. The absence of an external capacitor reduces overall system mass/volume, increases reliability, and lowers cost. Linear regulators generate a precisely controlled voltage for electronic circuits regardless of fluctuations in the load current that the circuit draws from the regulator.

Type 2 Diabetes Mellitus and Increased Risk for Malaria Infection

Centers for Disease Control (CDC) Podcasts

2010-09-23

This podcast describes research done in Ghana examining a correlation between type 2 diabetes and a possible increased risk for malaria infection in adults. Dr. Manoj Menon, a medical officer in the Division of Parasitic Diseases and Malaria in the Center for Global Health, discusses questions the study raises.  Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases; Center for Global Health.   Date Released: 9/23/2010.

Comparison of linear and zero-inflated negative binomial regression models for appraisal of risk factors associated with dental caries.

Science.gov (United States)

Batra, Manu; Shah, Aasim Farooq; Rajput, Prashant; Shah, Ishrat Aasim

2016-01-01

Dental caries among children has been described as a pandemic disease with a multifactorial nature. Various sociodemographic factors and oral hygiene practices are commonly tested for their influence on dental caries. In recent years, a recent statistical model that allows for covariate adjustment has been developed and is commonly referred zero-inflated negative binomial (ZINB) models. To compare the fit of the two models, the conventional linear regression (LR) model and ZINB model to assess the risk factors associated with dental caries. A cross-sectional survey was conducted on 1138 12-year-old school children in Moradabad Town, Uttar Pradesh during months of February-August 2014. Selected participants were interviewed using a questionnaire. Dental caries was assessed by recording decayed, missing, or filled teeth (DMFT) index. To assess the risk factor associated with dental caries in children, two approaches have been applied - LR model and ZINB model. The prevalence of caries-free subjects was 24.1%, and mean DMFT was 3.4 ± 1.8. In LR model, all the variables were statistically significant. Whereas in ZINB model, negative binomial part showed place of residence, father's education level, tooth brushing frequency, and dental visit statistically significant implying that the degree of being caries-free (DMFT = 0) increases for group of children who are living in urban, whose father is university pass out, who brushes twice a day and if have ever visited a dentist. The current study report that the LR model is a poorly fitted model and may lead to spurious conclusions whereas ZINB model has shown better goodness of fit (Akaike information criterion values - LR: 3.94; ZINB: 2.39) and can be preferred if high variance and number of an excess of zeroes are present.

Ionizing radiation risks to satellite power systems (SPS) workers

International Nuclear Information System (INIS)

1980-11-01

The radiation risks to the health of workers who will construct and maintain solar power satellites in the space environment were examined. For ionizing radiation, the major concern will be late or delayed health effects, particularly the increased risk of radiation-induced cancer. The estimated lifetime risk for cancer is 0.8 to 5.0 excess deaths per 10,000 workers per rad of exposure. Thus, for example, in 10,000 workers who completed ten missions with an exposure of 40 rem per mission, 320 to 2000 additional deaths in excess of the 1640 deaths from normally occurring cancer, would be expected. These estimates would indicate a 20 to 120% increase in cancer deaths in the worker-population. The wide range in these estimates stems from the choice of the risk-projection model and the dose-response relationsip. The choice between a linear and a linear-quadratic dose-response model may alter the risk estimate by a factor of about two. The method of analysis (e.g., relative vs absolute risk model) can alter the risk estimate by an additional factor of three. Choosing different age and sex distributions can further change the estimate by another factor of up to three. The potential genetic consequences could be of significance, but at the present time, sufficient information on the age and sex distribution of the worker population is lacking for precise estimation of risk. The potential teratogenic consequences resulting from radiation are considered significant. Radiation exposure of a pregnant worker could result in developmental abnormalities

Ionizing radiation risks to satellite power systems (SPS) workers

Energy Technology Data Exchange (ETDEWEB)

Lyman, J.T.; Ainsworth, E.J.; Alpen, E.L.; Bond, V.; Curtis, S.B.; Fry, R.J.M.; Jackson, K.L.; Nachtwey, S.; Sondhaus, C.; Tobias, C.A.; Fabrikant, J.I.

1980-11-01

The radiation risks to the health of workers who will construct and maintain solar power satellites in the space environment were examined. For ionizing radiation, the major concern will be late or delayed health effects, particularly the increased risk of radiation-induced cancer. The estimated lifetime risk for cancer is 0.8 to 5.0 excess deaths per 10,000 workers per rad of exposure. Thus, for example, in 10,000 workers who completed ten missions with an exposure of 40 rem per mission, 320 to 2000 additional deaths in excess of the 1640 deaths from normally occurring cancer, would be expected. These estimates would indicate a 20 to 120% increase in cancer deaths in the worker-population. The wide range in these estimates stems from the choice of the risk-projection model and the dose-response relationsip. The choice between a linear and a linear-quadratic dose-response model may alter the risk estimate by a factor of about two. The method of analysis (e.g., relative vs absolute risk model) can alter the risk estimate by an additional factor of three. Choosing different age and sex distributions can further change the estimate by another factor of up to three. The potential genetic consequences could be of significance, but at the present time, sufficient information on the age and sex distribution of the worker population is lacking for precise estimation of risk. The potential teratogenic consequences resulting from radiation are considered significant. Radiation exposure of a pregnant worker could result in developmental abnormalities.

Cannabis increased the risk of primary spontaneous pneumothorax in tobacco smokers

DEFF Research Database (Denmark)

Hedevang Olesen, Winnie; Katballe, Niels; Sindby, Jesper Eske

2017-01-01

OBJECTIVES: Previous smaller case series suggested that cannabis smoking may cause spontaneous pneumothorax, but this finding remains controversial. We investigated the possible association between smoking tobacco and cannabis and the risk of having a primary spontaneous pneumothorax in a large...... tobacco and cannabis were obtained from questionnaires presented on admittance. We compared our findings with those of a population-based control group matched by age, sex and geographical area. Calculated odds ratios were compared using the Fisher’s exact test for small frequencies and the χ2 test.......61–14.14, P cannabis and tobacco in men increased the risk of spontaneous pneumothorax significantly (odds ratio = 8.74, 95% confidence interval: 4.30–19.51, P 

When Combined with Chemotherapy, Bevacizumab Is Associated with Increased Risk of Death

Science.gov (United States)

Cancer patients who receive the targeted therapy bevacizumab (Avastin) in combination with chemotherapy are at increased risk of serious side effects that may lead to death, according to a meta-analysis of 16 clinical trials that was published February 2,

Delay in blood sampling for routine newborn screening is associated with increased risk of schizophrenia.

Science.gov (United States)

Nordentoft, Merete; Larsen, Janne Tidselbak; Pedersen, Carsten Bøcker; Sørensen, Holger Jelling; Hollegaard, Mads Villiam; Hougaard, David Michael; Mortensen, Preben Bo; Petersen, Liselotte

2015-03-01

The Danish Neonatal Screening Biobank, containing dried blood spot samples from all newborn in Denmark, is a unique source of data that can be utilized for analyses of genetic and environmental exposures related to schizophrenia and other mental disorders. In previous analyses, we have found that early and late blood sampling, compared to sampling at day 5, was associated with increased risk of schizophrenia. As delay in sampling of blood for neonatal screening cannot in itself influence the risk of schizophrenia, it must be seen as a proxy for unknown underlying causes responsible for this association. Therefore, we investigated whether the increased risk can be explained by other risk factors for schizophrenia. A case-control design was applied. A total of 846 cases with schizophrenia were selected from the Danish Psychiatric Case Register. One control was selected for each case, matched on sex and exact date of birth. Both early and late blood sampling was associated with increased risk for schizophrenia. Compared to blood sampling at day 5, sampling at days 0 to 4 after birth was associated with an incidence rate ratio (IRR) of 1.46 (95% CI 1.15-1.87) for development of schizophrenia, and sampling at days 6 to 9 and at days 10 to 53 was associated with an IRR of 1.5 (95% CI 1.13-1.98) and 3.00 (95% CI 1.59-5.67), respectively. After adjusting the estimates for place of birth, both parents' psychiatric illness, maternal and paternal age, parents' country of origin, child admission, and parental education and income, the estimates were slightly different. Thus, blood collection at 0-4days was associated with an IRR of 1.27 (95% CI 0.94-1.71), 6-9days 1.31 (95% CI 0.94-1.84) and 10+days 3.52 (95% CI 1.50 to 8.24). After adjusting risk estimates for well-known risk factors, delay in sampling of blood for neonatal screening was associated with unexplained increased risk of schizophrenia. Thus, a key finding is that age at test is a proxy for unobserved risk factors

Thyroid cancer risk is not increased in diabetic patients.

Directory of Open Access Journals (Sweden)

Chin-Hsiao Tseng

-inflammatory drugs might be associated with a significantly lower risk. CONCLUSIONS: There is a lack of an overall association between diabetes and thyroid cancer, but patients with diabetes duration <5 years have a significantly lower risk. Sulfonylurea may increase the risk of thyroid cancer.

Increased risk of atrial fibrillation among elderly Norwegian men with a history of long-term endurance sport practice

OpenAIRE

Myrstad, M; L?chen, M-L; Graff-Iversen, S; Gulsvik, A K; Thelle, D S; Stigum, H; Ranhoff, A H

2013-01-01

Background Atrial fibrillation (AF) is the most common clinically relevant cardiac arrhythmia. AF is associated with reduced functional capacity and other symptoms, drug use, poor subjective health, increased risk of ischemic stroke and increased mortality. Physical activity (PA) reduces the risk of cardiovascular diseases and has multiple beneficial health effects, but male endurance athletes seem to have an increased risk of AF. Few studies, however, have investigated the association betwee...

Are certain fractures at increased risk for compartment syndrome after civilian ballistic injury?

Science.gov (United States)

Meskey, Thomas; Hardcastle, John; O'Toole, Robert V

2011-11-01

Compartment syndrome after ballistic fracture is uncommon but potentially devastating. Few data are available to help guide clinicians regarding risk factors for developing compartment syndrome after ballistic fractures. Our primary hypothesis was that ballistic fractures of certain bones would be at higher risk for development of compartment syndrome. A retrospective review at a Level I trauma center from 2001 through 2007 yielded 650 patients with 938 fractures resulting from gunshots. We reviewed all operative notes, clinic notes, discharge summaries, and data from our prospective trauma database. Cases in which the attending orthopedic surgeon diagnosed compartment syndrome and performed fasciotomy were considered cases with compartment syndrome. We excluded all prophylactic fasciotomies. Univariate analyses were conducted to identify risk factors associated with development of compartment syndrome. Twenty-six (2.8%) of the 938 fractures were associated with compartment syndrome. Only fibular (11.6%) and tibial (11.4%) fractures had incidence significantly higher than baseline for all ballistic fractures (p Ballistic fractures of the fibula and tibia are at increased risk for development of compartment syndrome over other ballistic fractures. We recommend increased vigilance when treating these injuries, particularly if the fracture is in the proximal aspect of the bone or is associated with vascular injury.

Schooling increases risk exposure for fish navigating past artificial barriers.

Directory of Open Access Journals (Sweden)

Bertrand H Lemasson

Full Text Available Artificial barriers have become ubiquitous features in freshwater ecosystems and they can significantly impact a region's biodiversity. Assessing the risk faced by fish forced to navigate their way around artificial barriers is largely based on assays of individual swimming behavior. However, social interactions can significantly influence fish movement patterns and alter their risk exposure. Using an experimental flume, we assessed the effects of social interactions on the amount of time required for juvenile palmetto bass (Morone chrysops × M. saxatilis to navigate downstream past an artificial barrier. Fish were released either individually or in groups into the flume using flow conditions that approached the limit of their expected swimming stamina. We compared fish swimming behaviors under solitary and schooling conditions and measured risk as the time individuals spent exposed to the barrier. Solitary fish generally turned with the current and moved quickly downstream past the barrier, while fish in groups swam against the current and displayed a 23-fold increase in exposure time. Solitary individuals also showed greater signs of skittish behavior than those released in groups, which was reflected by larger changes in their accelerations and turning profiles. While groups displayed fission-fusion dynamics, inter-individual positions were highly structured and remained steady over time. These spatial patterns align with theoretical positions necessary to reduce swimming exertion through either wake capturing or velocity sheltering, but diverge from any potential gains from channeling effects between adjacent neighbors. We conclude that isolated performance trials and projections based on individual behaviors can lead to erroneous predictions of risk exposure along engineered structures. Our results also suggest that risk perception and behavior may be more important than a fish's swimming stamina in artificially modified systems.

Schooling increases risk exposure for fish navigating past artificial barriers.

Science.gov (United States)

Lemasson, Bertrand H; Haefner, James W; Bowen, Mark D

2014-01-01

Artificial barriers have become ubiquitous features in freshwater ecosystems and they can significantly impact a region's biodiversity. Assessing the risk faced by fish forced to navigate their way around artificial barriers is largely based on assays of individual swimming behavior. However, social interactions can significantly influence fish movement patterns and alter their risk exposure. Using an experimental flume, we assessed the effects of social interactions on the amount of time required for juvenile palmetto bass (Morone chrysops × M. saxatilis) to navigate downstream past an artificial barrier. Fish were released either individually or in groups into the flume using flow conditions that approached the limit of their expected swimming stamina. We compared fish swimming behaviors under solitary and schooling conditions and measured risk as the time individuals spent exposed to the barrier. Solitary fish generally turned with the current and moved quickly downstream past the barrier, while fish in groups swam against the current and displayed a 23-fold increase in exposure time. Solitary individuals also showed greater signs of skittish behavior than those released in groups, which was reflected by larger changes in their accelerations and turning profiles. While groups displayed fission-fusion dynamics, inter-individual positions were highly structured and remained steady over time. These spatial patterns align with theoretical positions necessary to reduce swimming exertion through either wake capturing or velocity sheltering, but diverge from any potential gains from channeling effects between adjacent neighbors. We conclude that isolated performance trials and projections based on individual behaviors can lead to erroneous predictions of risk exposure along engineered structures. Our results also suggest that risk perception and behavior may be more important than a fish's swimming stamina in artificially modified systems.

Increased Wildfire Risk Driven by Climate and Development Interactions in the Bolivian Chiquitania, Southern Amazonia.

Science.gov (United States)

Devisscher, Tahia; Anderson, Liana O; Aragão, Luiz E O C; Galván, Luis; Malhi, Yadvinder

2016-01-01

Wildfires are becoming increasingly dominant in tropical landscapes due to reinforcing feedbacks between land cover change and more severe dry conditions. This study focused on the Bolivian Chiquitania, a region located at the southern edge of Amazonia. The extensive, unique and well-conserved tropical dry forest in this region is susceptible to wildfires due to a marked seasonality. We used a novel approach to assess fire risk at the regional level driven by different development trajectories interacting with changing climatic conditions. Possible future risk scenarios were simulated using maximum entropy modelling with presence-only data, combining land cover, anthropogenic and climatic variables. We found that important determinants of fire risk in the region are distance to roads, recent deforestation and density of human settlements. Severely dry conditions alone increased the area of high fire risk by 69%, affecting all categories of land use and land cover. Interactions between extreme dry conditions and rapid frontier expansion further increased fire risk, resulting in potential biomass loss of 2.44±0.8 Tg in high risk area, about 1.8 times higher than the estimates for the 2010 drought. These interactions showed particularly high fire risk in land used for 'extensive cattle ranching', 'agro-silvopastoral use' and 'intensive cattle ranching and agriculture'. These findings have serious implications for subsistence activities and the economy in the Chiquitania, which greatly depend on the forestry, agriculture and livestock sectors. Results are particularly concerning if considering the current development policies promoting frontier expansion. Departmental protected areas inhibited wildfires when strategically established in areas of high risk, even under drought conditions. However, further research is needed to assess their effectiveness accounting for more specific contextual factors. This novel and simple modelling approach can inform fire and land

Persistence of type-specific human papillomavirus infection and increased long-term risk of cervical cancer.

Science.gov (United States)

Chen, Hui-Chi; Schiffman, Mark; Lin, Ching-Yu; Pan, Mei-Hung; You, San-Lin; Chuang, Li-Chung; Hsieh, Chang-Yao; Liaw, Kai-Li; Hsing, Ann W; Chen, Chien-Jen

2011-09-21

Human papillomavirus (HPV) persistence is the pivotal event in cervical carcinogenesis. We followed a large-scale community-based cohort for 16 years to investigate the role of genotype-specific HPV persistence in predicting cervical cancer including invasive and in situ carcinoma. At the baseline examination in 1991-1992, 11,923 participants (aged 30-65 years) consented to HPV testing and cytology; 6923 participants were reexamined in 1993-1995. For HPV testing, we used a polymerase chain reaction-based assay that detected 39 HPV types. Women who developed cervical cancer were identified from cancer and death registries. Cumulative risks for developing cervical cancer among infected and persistently infected women were calculated by the Kaplan-Meier method. Of 10,123 women who were initially cytologically normal, 68 developed cervical cancer. The 16-year cumulative risks of subsequent cervical cancer for women with HPV16, HPV58 (without HPV16), or other carcinogenic HPV types (without HPV16 or HPV58) were 13.5%, 10.3%, and 4.0%, respectively, compared with 0.26% for HPV-negative women. Women with type-specific persistence of any carcinogenic HPV had greatly increased risk compared with women who were HPV-negative at both visits (hazard ratio = 75.4, 95% confidence interval = 31.8 to 178.9). The cumulative cervical cancer risks following persistent carcinogenic HPV infections increased with age: The risks were 5.5%, 14.4%, and 18.1% for women aged 30-44 years, 45-54 years, and 55 years and older, respectively. However, newly acquired infections were associated with a low risk of cervical cancer regardless of age. HPV negativity was associated with a very low long-term risk of cervical cancer. Persistent detection of HPV among cytologically normal women greatly increased risk. Thus, it is useful to perform repeated HPV testing following an initial positive test.

Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease?

Directory of Open Access Journals (Sweden)

David E. Laaksonen

2012-07-01

Full Text Available Consumption of sugar has been relatively high in the Nordic countries; the impact of sugar intake on metabolic risk factors and related diseases has been debated. The objectives were to assess the effect of sugar intake (sugar-sweetened beverages, sucrose and fructose on association with type 2 diabetes, cardiovascular disease and related metabolic risk factors (impaired glucose tolerance, insulin sensitivity, dyslipidemia, blood pressure, uric acid, inflammation markers, and on all-cause mortality, through a systematic review of prospective cohort studies and randomised controlled intervention studies published between January 2000 and search dates. The methods adopted were as follows: the first search was run in PubMed in October 2010. A second search with uric acid as risk marker was run in April 2011. The total search strategy was rerun in April 2011 in SveMed+. An update was run in PubMed in January 2012. Two authors independently selected studies for inclusion from the 2,743 abstracts according to predefined eligibility criteria. The outcome was that out of the 17 studies extracted, 15 were prospective cohort studies and two were randomised controlled crossover trials. All of the studies included only adults. With respect to incident type 2 diabetes (nine studies, four of six prospective cohort studies found a significant positive association for sugar-sweetened beverage intake. In general, larger cohort studies with longer follow-up more often reported positive associations, and BMI seemed to mediate part of the increased risk. For other metabolic or cardiovascular risk factors or outcomes, too few studies have been published to draw conclusions. In conclusion, data from prospective cohort studies published in the years 2000–2011 suggest that sugar-sweetened beverages probably increase the risk of type 2 diabetes. For related metabolic risk factors, cardiovascular disease or all-cause mortality and other types of sugars, too few studies

Delay in blood sampling for routine newborn screening is associated with increased risk of schizophrenia

DEFF Research Database (Denmark)

Nordentoft, Merete; Tidselbak Larsen, Janne; Pedersen, Carsten Bøcker

2015-01-01

for this association. Therefore, we investigated whether the increased risk can be explained by other risk factors for schizophrenia. METHODS: A case-control design was applied. A total of 846 cases with schizophrenia were selected from the Danish Psychiatric Case Register. One control was selected for each case......BACKGROUND: The Danish Neonatal Screening Biobank, containing dried blood spot samples from all newborn in Denmark, is a unique source of data that can be utilized for analyses of genetic and environmental exposures related to schizophrenia and other mental disorders. In previous analyses, we have...... found that early and late blood sampling, compared to sampling at day 5, was associated with increased risk of schizophrenia. As delay in sampling of blood for neonatal screening cannot in itself influence the risk of schizophrenia, it must be seen as a proxy for unknown underlying causes responsible...

Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review.

Science.gov (United States)

Cheng, Hang; Chen, Brian Po-Han; Soleas, Ireena M; Ferko, Nicole C; Cameron, Chris G; Hinoul, Piet

The incidence of surgical site infection (SSI) across surgical procedures, specialties, and conditions is reported to vary from 0.1% to 50%. Operative duration is often cited as an independent and potentially modifiable risk factor for SSI. The objective of this systematic review was to provide an in-depth understanding of the relation between operating time and SSI. This review included 81 prospective and retrospective studies. Along with study design, likelihood of SSI, mean operative times, time thresholds, effect measures, confidence intervals, and p values were extracted. Three meta-analyses were conducted, whereby odds ratios were pooled by hourly operative time thresholds, increments of increasing operative time, and surgical specialty. Pooled analyses demonstrated that the association between extended operative time and SSI typically remained statistically significant, with close to twice the likelihood of SSI observed across various time thresholds. The likelihood of SSI increased with increasing time increments; for example, a 13%, 17%, and 37% increased likelihood for every 15 min, 30 min, and 60 min of surgery, respectively. On average, across various procedures, the mean operative time was approximately 30 min longer in patients with SSIs compared with those patients without. Prolonged operative time can increase the risk of SSI. Given the importance of SSIs on patient outcomes and health care economics, hospitals should focus efforts to reduce operative time.

New Metrics for Evaluating Technical Benefits and Risks of DGs Increasing Penetration

DEFF Research Database (Denmark)

Akbari, Mohammad Amin; Aghaei, Jamshid; Barani, Mostafa

2017-01-01

and risks should be qualified and quantified. This paper introduces several probabilistic indices to evaluate the potential operational effects of increasing penetration of renewable DG units such as wind power and photovoltaic on rural distribution network with the aid of evaluating technical benefits...... and risks trade-offs. A probabilistic generation-load model is suggested to calculate these indices which combine a large number of possible operating conditions of renewable DG units with their probabilities. Temporal and annual indices of voltage profile and line flow related attributes such as Interest...... Voltage Rise (IVR), Risky Voltage Rise (RVR), Risky Voltage Down (RVD), Line Loss Reduction (LLR), Line Loss Increment (LLI) and Line overload flow (LOF) are introduced using probability and expected values of their occurrence. Also, to measure the overall interests and risks of installing DG, composite...

Risk of cancer in an occupationally exposed cohort with increased level of chromosomal aberrations.

Science.gov (United States)

Smerhovsky, Z; Landa, K; Rössner, P; Brabec, M; Zudova, Z; Hola, N; Pokorna, Z; Mareckova, J; Hurychova, D

2001-01-01

We used cytogenetic analysis to carry out a cohort study in which the major objective was to test the association between frequency of chromosomal aberrations and subsequent risk of cancer. In spite of the extensive use of the cytogenetic analysis of human peripheral blood lymphocytes in biomonitoring of exposure to various mutagens and carcinogens on an ecologic level, the long-term effects of an increased frequency of chromosomal aberrations in individuals are still uncertain. Few epidemiologic studies have addressed this issue, and a moderate risk of cancer in individuals with an elevated frequency of chromosomal aberrations has been observed. In the present study, we analyzed data on 8,962 cytogenetic tests and 3,973 subjects. We found a significant and strong association between the frequency of chromosomal aberrations and cancer incidence in a group of miners exposed to radon, where a 1% increase in frequency of chromosomal aberrations was followed by a 64% increase in risk of cancer (p < 0.000). In contrast, the collected data are inadequate for a critical evaluation of the association with exposure to other chemicals. PMID:11171523

Maternal dyslipidemia during pregnancy may increase the risk of preterm birth: A meta-analysis

Directory of Open Access Journals (Sweden)

Shuying Jiang

2017-02-01

Full Text Available Epidemiological studies have reported an inconsistent relationship between maternal lipid levels and preterm birth (PTB. We performed this meta-analysis to evaluate the association between maternal dyslipidemia and PTB. Overall, three nested case-control studies and eight cohort studies were eligible. Effect estimates [odds ratio(OR/relative risk] were pooled using a fixed-effects or a random-effects model. Subgroup and metaregression analyses were conducted to evaluate the sources of heterogeneity. Eleven studies involving 13,025 pregnant women were included. Compared with pregnant women with normal lipid levels, the women with elevated levels of lipids had an increased risk of PTB, and the pooled OR was 1.68 [95% confidence interval (CI: 1.25–2.26]; meanwhile, women with lower levels of lipids also had a trend of an increased risk of PTB (OR=1.52, 95% CI=0.60–3.82. The pooled ORs for elevated levels of total cholesterol, triglycerides, low density lipoprotein-cholesterol, and lower levels of high density lipoprotein-cholesterol were 1.71 (95% CI: 1.05–2.79, 1.55 (95% CI: 1.13–2.12, 1.19 (95% CI: 0.95–1.48, and 1.33 (95% CI: 1.14–1.56, respectively. The present meta-analysis found that maternal dyslipidemia during pregnancy, either the elevated total cholesterol or triglycerides, was associated with an increased risk of PTB. These findings indicate that a normal level of maternal lipid during pregnancy may reduce the risk of PTB.

A multi-region assessment of population rates of cardiac catheterization and yield of high-risk coronary artery disease

Directory of Open Access Journals (Sweden)

Clement Fiona M

2011-11-01

Full Text Available Abstract Background There is variation in cardiac catheterization utilization across jurisdictions. Previous work from Alberta, Canada, showed no evidence of a plateau in the yield of high-risk disease at cardiac catheterization rates as high as 600 per 100,000 population suggesting that the optimal rate is higher. This work aims 1 To determine if a previously demonstrated linear relationship between the yield of high-risk coronary disease and cardiac catheterization rates persists with contemporary data and 2 to explore whether the linear relationship exists in other jurisdictions. Methods Detailed clinical information on all patients undergoing cardiac catheterization in 3 Canadian provinces was available through the Alberta Provincial Project for Outcomes Assessment in Coronary Heart (APPROACH disease and partner initiatives in British Columbia and Nova Scotia. Population rates of catheterization and high-risk coronary disease detection for each health region in these three provinces, and age-adjusted rates produced using direct standardization. A mixed effects regression analysis was performed to assess the relationship between catheterization rate and high-risk coronary disease detection. Results In the contemporary Alberta data, we found a linear relationship between the population catheterization rate and the high-risk yield. Although the yield was slightly less in time period 2 (2002-2006 than in time period 1(1995-2001, there was no statistical evidence of a plateau. The linear relationship between catheterization rate and high-risk yield was similarly demonstrated in British Columbia and Nova Scotia and appears to extend, without a plateau in yield, to rates over 800 procedures per 100,000 population. Conclusions Our study demonstrates a consistent finding, over time and across jurisdictions, of linearly increasing detection of high-risk CAD as population rates of cardiac catheterization increase. This internationally-relevant finding

Is there still a role for additional linear ablation in addition to pulmonary vein isolation in patients with paroxysmal atrial fibrillation? An Updated Meta-analysis of randomized controlled trials.

Science.gov (United States)

Hu, Xiaoliang; Jiang, Jingzhou; Ma, Yuedong; Tang, Anli

2016-04-15

The benefits and risks of additional left atrium (LA) linear ablation in patients with paroxysmal atrial fibrillation (AF) remain unclear. Randomized controlled trials were identified in the PubMed, Web of Science, Embase and Cochrane databases, and the relevant papers were examined. Pooled relative risks (RR) and 95% confidence interval (95% CI) were estimated using random effects models. The primary endpoint was the maintenance of sinus rhythm after a single ablation. Nine randomized controlled trials involving 1138 patients were included in this analysis. Additional LA linear ablation did not improve the maintenance of the sinus rhythm following a single procedure (RR, 1.03; 95% CI, 0.93-1.13; P=0.60). A subgroup analysis demonstrated that all methods of additional linear ablation failed to improve the outcome. Additional linear ablation significantly increased the mean procedural time (166.53±67.7 vs. 139.57±62.44min, Plinear ablation did not exhibit any benefits in terms of sinus rhythm maintenance for paroxysmal AF patients following a single procedure. Additional linear ablation significantly increased the mean procedural, fluoroscopy and RF application times. This additional ablation was not associated with a statistically significant increase in complication rates. This finding must be confirmed by further large, high-quality clinical trials. Copyright © 2016. Published by Elsevier Ireland Ltd.

Risk adjusted receding horizon control of constrained linear parameter varying systems

NARCIS (Netherlands)

Sznaier, M.; Lagoa, C.; Stoorvogel, Antonie Arij; Li, X.

2005-01-01

In the past few years, control of Linear Parameter Varying Systems (LPV) has been the object of considerable attention, as a way of formalizing the intuitively appealing idea of gain scheduling control for nonlinear systems. However, currently available LPV techniques are both computationally

Charge transport and recombination in bulk heterojunction solar cells studied by the photoinduced charge extraction in linearly increasing voltage technique

OpenAIRE

Mozer, AJ; Sariciftci, NS; Osterbacka, R; Westerling, M; Juska, G; LUTSEN, Laurence; VANDERZANDE, Dirk

2005-01-01

Charge carrier mobility and recombination in a bulk heterojunction solar cell based on the mixture of poly[2-methoxy-5-(3,7-dimethyloctyloxy)-phenylene vinylene] (MDMO-PPV) and 1-(3-methoxycarbonyl)propyl-1-phenyl-(6,6)-C-61 (PCBM) has been studied using the novel technique of photoinduced charge carrier extraction in a linearly increasing voltage (Photo-CELIV). In this technique, charge carriers are photogenerated by a short laser flash, and extracted under a reverse bias voltage ramp after ...

Prior inpatient admission increases the risk of post-operative infection in hepatobiliary and pancreatic surgery.

Science.gov (United States)

Dong, Zachary M; Chidi, Alexis P; Goswami, Julie; Han, Katrina; Simmons, Richard L; Rosengart, Matthew R; Tsung, Allan

2015-12-01

Hepatobiliary and pancreatic (HPB) operations have a high incidence of post-operative nosocomial infections. The aim of the present study was to determine whether hospitalization up to 1 year before HPB surgery is associated with an increased risk of post-operative infection, surgical-site infection (SSI) and infection resistant to surgical chemoprophylaxis. A retrospective cohort study of patients undergoing HPB surgeries between January 2008 and June 2013 was conducted. A multivariable logistic regression model was used for controlling for potential confounders to determine the association between pre-operative admission and post-operative infection. Of the 1384 patients who met eligibility criteria, 127 (9.18%) experienced a post-operative infection. Pre-operative hospitalization was independently associated with an increased risk of a post-operative infection [adjusted odds ratio (aOR): 1.61, 95% confidence interval [CI]: 1.06-2.46] and SSI (aOR: 1.79, 95% CI: 1.07-2.97). Pre-operative hospitalization was also associated with an increased risk of post-operative infections resistant to standard pre-operative antibiotics (OR: 2.64, 95% CI: 1.06-6.59) and an increased risk of resistant SSIs (OR: 3.99, 95% CI: 1.25-12.73). Pre-operative hospitalization is associated with an increased incidence of post-operative infections, often with organisms that are resistant to surgical chemoprophylaxis. Patients hospitalized up to 1 year before HPB surgery may benefit from extended spectrum chemoprophylaxis. © 2015 International Hepato-Pancreato-Biliary Association.

Application of a General Risk Management Model to Portfolio Optimization Problems with Elliptical Distributed Returns for Risk Neutral and Risk Averse Decision Makers

NARCIS (Netherlands)

B. Kaynar; S.I. Birbil (Ilker); J.B.G. Frenk (Hans)

2007-01-01

textabstractIn this paper portfolio problems with linear loss functions and multivariate elliptical distributed returns are studied. We consider two risk measures, Value-at-Risk and Conditional-Value-at-Risk, and two types of decision makers, risk neutral and risk averse. For Value-at-Risk, we show

Society of Thoracic Surgeons Risk Score Predicts Hospital Charges and Resource Utilization After Aortic Valve Replacement

Science.gov (United States)

Arnaoutakis, George J.; George, Timothy J.; Alejo, Diane E.; Merlo, Christian A.; Baumgartner, William A.; Cameron, Duke E.; Shah, Ashish S.

2011-01-01

Context The impact of Society of Thoracic Surgeons (STS) predicted mortality risk score on resource utilization after aortic valve replacement (AVR) has not been previously studied. Objective We hypothesize that increasing STS risk scores in patients having AVR are associated with greater hospital charges. Design, Setting, and Patients Clinical and financial data for patients undergoing AVR at a tertiary care, university hospital over a ten-year period (1/2000–12/2009) were retrospectively reviewed. The current STS formula (v2.61) for in-hospital mortality was used for all patients. After stratification into risk quartiles (Q), index admission hospital charges were compared across risk strata with Rank-Sum tests. Linear regression and Spearman’s coefficient assessed correlation and goodness of fit. Multivariable analysis assessed relative contributions of individual variables on overall charges. Main Outcome Measures Inflation-adjusted index hospitalization total charges Results 553 patients had AVR during the study period. Average predicted mortality was 2.9% (±3.4) and actual mortality was 3.4% for AVR. Median charges were greater in the upper Q of AVR patients [Q1–3,$39,949 (IQR32,708–51,323) vs Q4,$62,301 (IQR45,952–97,103), p=<0.01]. On univariate linear regression, there was a positive correlation between STS risk score and log-transformed charges (coefficient: 0.06, 95%CI 0.05–0.07, p<0.01). Spearman’s correlation R-value was 0.51. This positive correlation persisted in risk-adjusted multivariable linear regression. Each 1% increase in STS risk score was associated with an added $3,000 in hospital charges. Conclusions This study showed increasing STS risk score predicts greater charges after AVR. As competing therapies such as percutaneous valve replacement emerge to treat high risk patients, these results serve as a benchmark to compare resource utilization. PMID:21497834

Increased Risks of Upper Tract Urothelial Carcinoma in Male and Female Chinese Herbalists

Directory of Open Access Journals (Sweden)

Hsiao-Yu Yang

2011-03-01

Conclusion: The significant risk of urothelial carcinoma noted in male herbalists increases our suspicion that this is an occupational disease that renders regular health assessment of herbalists an urgent necessity.

Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis.

Science.gov (United States)

Haider, Batool A; Olofin, Ibironke; Wang, Molin; Spiegelman, Donna; Ezzati, Majid; Fawzi, Wafaie W

2013-06-21

To summarise evidence on the associations of maternal anaemia and prenatal iron use with maternal haematological and adverse pregnancy outcomes; and to evaluate potential exposure-response relations of dose of iron, duration of use, and haemoglobin concentration in prenatal period with pregnancy outcomes. Systematic review and meta-analysis Searches of PubMed and Embase for studies published up to May 2012 and references of review articles. Randomised trials of prenatal iron use and prospective cohort studies of prenatal anaemia; cross sectional and case-control studies were excluded. 48 randomised trials (17 793 women) and 44 cohort studies (1 851 682 women) were included. Iron use increased maternal mean haemoglobin concentration by 4.59 (95% confidence interval 3.72 to 5.46) g/L compared with controls and significantly reduced the risk of anaemia (relative risk 0.50, 0.42 to 0.59), iron deficiency (0.59, 0.46 to 0.79), iron deficiency anaemia (0.40, 0.26 to 0.60), and low birth weight (0.81, 0.71 to 0.93). The effect of iron on preterm birth was not significant (relative risk 0.84, 0.68 to 1.03). Analysis of cohort studies showed a significantly higher risk of low birth weight (adjusted odds ratio 1.29, 1.09 to 1.53) and preterm birth (1.21, 1.13 to 1.30) with anaemia in the first or second trimester. Exposure-response analysis indicated that for every 10 mg increase in iron dose/day, up to 66 mg/day, the relative risk of maternal anaemia was 0.88 (0.84 to 0.92) (P for linear trendtrend=0.005) and risk of low birth weight decreased by 3% (relative risk 0.97, 0.95 to 0.98) for every 10 mg increase in dose/day (P for linear trendtrend=0.002); however, mean haemoglobin was not associated with the risk of low birth weight and preterm birth. No evidence of a significant effect on duration of gestation, small for gestational age births, and birth length was noted. Daily prenatal use of iron substantially improved birth weight in a linear dose-response fashion

Linearly Adjustable International Portfolios

International Nuclear Information System (INIS)

Fonseca, R. J.; Kuhn, D.; Rustem, B.

2010-01-01

We present an approach to multi-stage international portfolio optimization based on the imposition of a linear structure on the recourse decisions. Multiperiod decision problems are traditionally formulated as stochastic programs. Scenario tree based solutions however can become intractable as the number of stages increases. By restricting the space of decision policies to linear rules, we obtain a conservative tractable approximation to the original problem. Local asset prices and foreign exchange rates are modelled separately, which allows for a direct measure of their impact on the final portfolio value.

Linearly Adjustable International Portfolios

Science.gov (United States)

Fonseca, R. J.; Kuhn, D.; Rustem, B.

2010-09-01

We present an approach to multi-stage international portfolio optimization based on the imposition of a linear structure on the recourse decisions. Multiperiod decision problems are traditionally formulated as stochastic programs. Scenario tree based solutions however can become intractable as the number of stages increases. By restricting the space of decision policies to linear rules, we obtain a conservative tractable approximation to the original problem. Local asset prices and foreign exchange rates are modelled separately, which allows for a direct measure of their impact on the final portfolio value.

Cumulative risk effects for the development of behaviour difficulties in children and adolescents with special educational needs and disabilities.

Science.gov (United States)

Oldfield, Jeremy; Humphrey, Neil; Hebron, Judith

2015-01-01

Research has identified multiple risk factors for the development of behaviour difficulties. What have been less explored are the cumulative effects of exposure to multiple risks on behavioural outcomes, with no study specifically investigating these effects within a population of young people with special educational needs and disabilities (SEND). Furthermore, it is unclear whether a threshold or linear risk model better fits the data for this population. The sample included 2660 children and 1628 adolescents with SEND. Risk factors associated with increases in behaviour difficulties over an 18-month period were summed to create a cumulative risk score, with this explanatory variable being added into a multi-level model. A quadratic term was then added to test the threshold model. There was evidence of a cumulative risk effect, suggesting that exposure to higher numbers of risk factors, regardless of their exact nature, resulted in increased behaviour difficulties. The relationship between risk and behaviour difficulties was non-linear, with exposure to increasing risk having a disproportionate and detrimental impact on behaviour difficulties in child and adolescent models. Interventions aimed at reducing behaviour difficulties need to consider the impact of multiple risk variables. Tailoring interventions towards those exposed to large numbers of risks would be advantageous. Copyright © 2015 Elsevier Ltd. All rights reserved.

Risk management strategy to increase the safety of workers in the nanomaterials industry

Energy Technology Data Exchange (ETDEWEB)

Ling, Min-Pei, E-mail: lingmp@mail.cmu.edu.tw [Department of Health Risk Management, China Medical University, Taichung 40402, Taiwan, ROC (China); Lin, Wei-Chao; Liu, Chia-Chyuan [Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan, ROC (China); Huang, Yi-Shiao; Chueh, Miao-Ju [Industrial Safety and Health Association of the ROC, Taipei 11670, Taiwan, ROC (China); Shih, Tung-Sheng [Institute of Occupational Safety and Health, Council of Labor Affairs, Taipei 22143, Taiwan, ROC (China)

2012-08-30

Highlights: Black-Right-Pointing-Pointer On-site assessment of nanomaterials using physiochemical and cytotoxic analysis can help identify risks for each nanomaterials manufacturing plant. Black-Right-Pointing-Pointer The risk of the nanomaterials manufacturing plants can be divided into three levels based on exposure routes (tier 1), aspect identification (tier 2), and toxicological screening (tier 3). Black-Right-Pointing-Pointer According to the different risk levels, the precautionary risk management (PRM) such as technology control, engineering control, and personal protective equipment were applied. Black-Right-Pointing-Pointer The PRM strategy can be effectively reduced workers risks for nanomaterial industries. - Abstract: In recent years, many engineered nanomaterials (NMs) have been produced, but increasing research has revealed that these may have toxicities far greater than conventional materials and cause significant adverse health effects. At present, there is insufficient data to determine the permissible concentrations of NMs in the workplace. There is also a lack of toxicity data and environmental monitoring results relating to complete health risk assessment. In view of this, we believe that workers in the NMs industry should be provided with simple and practical risk management strategy to ensure occupational health and safety. In this study, we developed a risk management strategy based on the precautionary risk management (PRM). The risk of the engineered NMs manufacturing plants can be divided into three levels based on aspect identification, solubility tests, dermal absorption, and cytotoxic analyses. The risk management strategies include aspects relating to technology control, engineering control, personal protective equipment, and monitoring of the working environment for each level. Here we report the first case in which a simple and practical risk management strategy applying in specific engineered NMs manufacturing plants. We are

Risk management strategy to increase the safety of workers in the nanomaterials industry

International Nuclear Information System (INIS)

Ling, Min-Pei; Lin, Wei-Chao; Liu, Chia-Chyuan; Huang, Yi-Shiao; Chueh, Miao-Ju; Shih, Tung-Sheng

2012-01-01

Highlights: ► On-site assessment of nanomaterials using physiochemical and cytotoxic analysis can help identify risks for each nanomaterials manufacturing plant. ► The risk of the nanomaterials manufacturing plants can be divided into three levels based on exposure routes (tier 1), aspect identification (tier 2), and toxicological screening (tier 3). ► According to the different risk levels, the precautionary risk management (PRM) such as technology control, engineering control, and personal protective equipment were applied. ► The PRM strategy can be effectively reduced workers risks for nanomaterial industries. - Abstract: In recent years, many engineered nanomaterials (NMs) have been produced, but increasing research has revealed that these may have toxicities far greater than conventional materials and cause significant adverse health effects. At present, there is insufficient data to determine the permissible concentrations of NMs in the workplace. There is also a lack of toxicity data and environmental monitoring results relating to complete health risk assessment. In view of this, we believe that workers in the NMs industry should be provided with simple and practical risk management strategy to ensure occupational health and safety. In this study, we developed a risk management strategy based on the precautionary risk management (PRM). The risk of the engineered NMs manufacturing plants can be divided into three levels based on aspect identification, solubility tests, dermal absorption, and cytotoxic analyses. The risk management strategies include aspects relating to technology control, engineering control, personal protective equipment, and monitoring of the working environment for each level. Here we report the first case in which a simple and practical risk management strategy applying in specific engineered NMs manufacturing plants. We are confident that our risk management strategy can be effectively reduced engineered NM industries risks for

Increased relative risk of subsequent affective disorders in patients with a hospital diagnosis of obesity

DEFF Research Database (Denmark)

Thomsen, A F; Kvist, T K; Andersen, P K

2006-01-01

OBJECTIVE: To investigate the risk of clinical affective disorders of patients who were hospitalized because of obesity in the study period 1 January 1977 to 31 December 1999. METHOD: Using data from Danish hospital registers, three study cohorts were identified by their diagnoses at discharge from...... discharged with an index diagnosis was identified. In total, 1081 events occurred in the observation period. An index diagnosis of obesity was associated with an increased risk of affective-disorders hospitalization when compared with patients with osteoarthritis (Rate ratio: 1.35 (95% CI: 1.......09-1.67)) and tended to be associated with an increased risk when compared to patients with non-toxic goiter (Rate ratio: 1.23 (95% CI: 0.99-1.53)). Patients with obesity diagnoses who did not have additional hospital diagnoses of substance- or alcohol abuse had a risk of affective disorders that was 1.55 (95% CI: 1...

Weak circadian rhythm increases neutropenia risk among breast cancer patients undergoing adjuvant chemotherapy.

Science.gov (United States)

Li, Wentao; Kwok, Carol Chi-Hei; Chan, Dominic Chun-Wan; Wang, Feng; Tse, Lap Ah

2018-04-01

Severe neutropenia is a common dose-limiting side effect of adjuvant breast cancer chemotherapy. We aimed to test the hypothesis that weak circadian rhythm is associated with an increased risk of neutropenia using a cohort study. We consecutively recruited 193 breast cancer patients who received adjuvant chemotherapy (5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel; doxorubicin and cyclophosphamide; docetaxel and cyclophosphamide). Participants wore a wrist actigraph continuously for 168 h at the beginning of chemotherapy. Values of percent rhythm and double amplitude below medians represented weak circadian rhythm. Mesor measured the mean activity level and acrophase symboled the peak time of the rhythm. We used Cox proportional hazard regression model to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of grade 4 neutropenia and febrile neutropenia in relation to actigraphy-derived parameters. Low levels of percent rhythm (HR:2.59, 95% CI 1.50-4.72), double amplitude (HR:2.70, 95% CI 1.51-4.85), and mesor (HR: 2.48, 95% CI 1.44-4.29) were positively associated with the risk of grade 4 neutropenia during chemotherapy. Low levels of percent rhythm (HR: 2.41, 95% CI 1.02-5.69) and double amplitude (HR:2.49, 95% CI 1.05-5.90) were also associated with increased risks of febrile neutropenia. The HRs for acrophase were not statistically significant. This study provides the first epidemiological evidence that increased risks of grade 4 neutropenia and febrile neutropenia are associated with weak circadian rhythm among adjuvant breast cancer patients. The results suggest that circadian rhythm might be one potential target for the prevention of chemotherapy-induced neutropenia among cancer patients.

TGFβ1 genetic variants are associated with an increased risk of acute brucellosis.

Science.gov (United States)

Sepanjnia, Adel; Eskandari-Nasab, Ebrahim; Moghadampour, Mehdi; Tahmasebi, Arezoo; Dahmardeh, Fatemeh

2015-07-01

Cytokines play a critical role in the regulation of the immune response against brucellosis infection, and mediate production of many pro- and anti-inflammatory signals. Transforming growth factor-beta 1 (TGFβ1), a powerful suppressive cytokine, inhibits macrophage activation and modulates T-cell function, and plays crucial roles in regulation of microbial replication and host responses to brucella. The association of three polymorphisms in the TGFβ1 gene (-509 C/T [rs1800469], + 868 C/T [rs1800470], and + 913 G/C [rs1800471]) in promoter, codons 10 and 25, respectively, with brucellosis infection was evaluated. This case-control study was performed on a total of 281 Iranian subjects including 153 patients with active brucellosis and 128 age- and sex-matched healthy individuals as controls. Genotyping for the TGFβ1 -509 C/T and + 868 C/T variants was performed using tetra amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR). Also, the + 913 G/C polymorphism was genotyped using an allele-specific PCR. The results demonstrated that the TGFβ1 + 868 C/T mutant homozygote genotype (TT vs CC), was a risk factor for developing brucellosis in the co-dominant and recessive models (odds ratio (OR) = 2.60, p = 0.023; OR = 2.602, p = 0.014, respectively). Additionally, the diplotype analyses revealed that TGFβ1 codon 10 and 25 diplotype, TT/GG, was associated with an increased risk of brucellosis (OR = 2.49, p = 0.038). Other TGFβ1 variants did not increase the risk of brucellosis infection. Our findings propose that TGFβ1 + 868 TT genotype and TT/GG diplotype may confer increased risk of brucellosis in the examined population.

Incidence of nonarteritic anterior ischemic optic neuropathy: increased risk among diabetic patients

Science.gov (United States)

Lee, Michael S; Grossman, Daniel; Arnold, Anthony C.; Sloan, Frank A

2011-01-01

Objective Previous studies have identified a higher prevalence of diabetes mellitus (DM) among patient cohorts with non-arteritic anterior ischemic optic neuropathy (NAION). We sought to determine the development of incident NAION among a group of newly diagnosed patients with DM and to estimate the incidence of NAION among the elderly. Design Medicare 5% database study. Participants 25,515 patients with DM and an equal number of age- and gender-matched non-diabetics. Methods Query of Medicare 5% claims files identified patients with new diagnosis of DM in 1994. A randomly selected control group was created using one-to-one propensity score matching. Patients with a diagnosis of giant cell arteritis, pre-existing DM, and age 95 years were excluded. Patients with DM and controls were followed for the development of NAION over the following 4,745 days. Main Outcome Measures Incidence of anterior ischemic optic neuropathy (AION) among patients with and without DM. Results Each group was 85% White, 11% Black, and 4% other race, aged 76.4 years, and 40% male with a mean followup time of 7.6 years. In the diabetes group, 188 individuals developed AION (0.7%) compared to 131 individuals (0.5%; p<0.01) in the control group. In unadjusted Cox regression analysis, having diabetes mellitus was associated with a 43% increased risk (Hazard ratio [HR]: 1.431; 95% confidence interval [CI]: 1.145,1.789) of developing AION. After adjusting for other covariates, the risk of developing AION among individuals with DM was reduced to 40% (HR: 1.397; 95% CI: 1.115,1.750). Male gender increased an individual's risk of developing AION by 32% (HR: 1.319; 95% CI: 1.052,1.654). No other covariate was statistically significantly associated with developing AION. The annual incidence of NAION was 82 per 100,000. Conclusions DM significantly increased the risk of the diagnosis NAION. The incidence of NAION among patients older than 67 years may be higher than previously reported. PMID:21439645

Smoking increases the risk of diabetic foot amputation: A meta-analysis.

Science.gov (United States)

Liu, Min; Zhang, Wei; Yan, Zhaoli; Yuan, Xiangzhen

2018-02-01

Accumulating evidence suggests that smoking is associated with diabetic foot amputation. However, the currently available results are inconsistent and controversial. Therefore, the present study performed a meta-analysis to systematically review the association between smoking and diabetic foot amputation and to investigate the risk factors of diabetic foot amputation. Public databases, including PubMed and Embase, were searched prior to 29th February 2016. The heterogeneity was assessed using the Cochran's Q statistic and the I 2 statistic, and odds ratio (OR) and 95% confidence interval (CI) were calculated and pooled appropriately. Sensitivity analysis was performed to evaluate the stability of the results. In addition, Egger's test was applied to assess any potential publication bias. Based on the research, a total of eight studies, including five cohort studies and three case control studies were included. The data indicated that smoking significantly increased the risk of diabetic foot amputation (OR=1.65; 95% CI, 1.09-2.50; Pdiabetic foot amputation. Smoking cessation appears to reduce the risk of diabetic foot amputation.

Increased Risk of New-Onset Hypertension After Shock Wave Lithotripsy in Urolithiasis: A Nationwide Cohort Study.

Science.gov (United States)

Huang, Shi-Wei; Tsai, Chung-You; Wang, Jui; Pu, Yeong-Shiau; Chen, Pei-Chun; Huang, Chao-Yuan; Chien, Kuo-Liong

2017-10-01

Although shock wave lithotripsy is minimally invasive, earlier studies argued that it may increase patients' subsequent risk of hypertension and diabetes mellitus. This study evaluated the association between shock wave lithotripsy and new-onset hypertension or diabetes mellitus. The Taiwanese National Health Insurance Research Database was used to identify 20 219 patients aged 18 to 65 years who underwent the first stone surgical treatment (shock wave lithotripsy or ureterorenoscopic lithotripsy) between January 1999 and December 2011. A Cox proportional model was applied to evaluate associations. Time-varying Cox models were applied to evaluate the association between the number of shock wave lithotripsy sessions and the incidence of hypertension or diabetes mellitus. After a median follow-up of 74.9 and 82.6 months, 2028 and 688 patients developed hypertension in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups, respectively. Patients who underwent shock wave lithotripsy had a higher probability of developing hypertension than patients who underwent ureterorenoscopic lithotripsy, with a hazard ratio of 1.20 (95% confidence interval, 1.10-1.31) after adjusting for covariates. The risk increased as the number of shock wave lithotripsy sessions increased. However, the diabetes mellitus risk was similar in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups. Furthermore, the hazard ratio did not increase as the number of shock wave lithotripsy sessions increased. Shock wave lithotripsy consistently increased the incidence of hypertension on long-term follow-up. Therefore, alternatives to urolithiasis treatment (eg, endoscopic surgery or medical expulsion therapy) could avoid the hypertension risk. Furthermore, avoiding multiple sessions of shock wave lithotripsy could also evade the hypertension risk. © 2017 American Heart Association, Inc.

Risk evaluations of aging phenomena: the linear aging reliability model and its extensions

International Nuclear Information System (INIS)

Vesely, W.E.

1987-01-01

A model for component failure rates due to aging mechanisms has been developed from basic phenomenological considerations. In the treatment, the occurrences of deterioration are modeled as following a Poisson process. The severity of damage is allowed to have any distribution, however the damage is assumed to accumulate independently. Finally, the failure rate is modeled as being proportional to the accumulated damage. Using this treatment, the linear aging failure rate model is obtained. The applicability of the linear aging model to various mechanisms is discussed. The model can be extended to cover nonlinear and dependent aging phenomena. The implementability of the linear aging model is demonstrated by applying it to the aging data collected in NRC's Nuclear Plant Aging Research (NPAR) Program. The applications show that aging as observed in collected data have significant effects on the component failure probability and component reliability when aging is not effectively detected and controlled by testing and maintenance

Risk evaluations of aging phenomena: The linear aging reliability model and its extensions

International Nuclear Information System (INIS)

Vesely, W.E.

1986-01-01

A model for component failure rates due to aging mechanisms has been developed from basic phenomenological considerations. In the treatment, the occurrences of deterioration are modeled as following a Poisson process. The severity of damage is allowed to have any distribution, however the damage is assumed to accumulate independently. Finally, the failure rate is modeled as being proportional to the accumulated damage. Using this treatment, the linear aging failure rate model is obtained. The applicability of the linear aging model to various mechanisms is discussed. The model can be extended to cover nonlinear and dependent aging phenomena. The implementability of the linear aging model is demonstrated by applying it of the aging data collected in NRC's Nuclear Plant Aging Research (NPAR) Program. The applications show that aging as observed in collected data have significant effects on the component failure probability and component reliability when aging is not effectively detected and controlled by testing and maintenance

Linear versus non-linear supersymmetry, in general

Energy Technology Data Exchange (ETDEWEB)

Ferrara, Sergio [Theoretical Physics Department, CERN,CH-1211 Geneva 23 (Switzerland); INFN - Laboratori Nazionali di Frascati,Via Enrico Fermi 40, I-00044 Frascati (Italy); Department of Physics and Astronomy, UniversityC.L.A.,Los Angeles, CA 90095-1547 (United States); Kallosh, Renata [SITP and Department of Physics, Stanford University,Stanford, California 94305 (United States); Proeyen, Antoine Van [Institute for Theoretical Physics, Katholieke Universiteit Leuven,Celestijnenlaan 200D, B-3001 Leuven (Belgium); Wrase, Timm [Institute for Theoretical Physics, Technische Universität Wien,Wiedner Hauptstr. 8-10, A-1040 Vienna (Austria)

2016-04-12

We study superconformal and supergravity models with constrained superfields. The underlying version of such models with all unconstrained superfields and linearly realized supersymmetry is presented here, in addition to the physical multiplets there are Lagrange multiplier (LM) superfields. Once the equations of motion for the LM superfields are solved, some of the physical superfields become constrained. The linear supersymmetry of the original models becomes non-linearly realized, its exact form can be deduced from the original linear supersymmetry. Known examples of constrained superfields are shown to require the following LM’s: chiral superfields, linear superfields, general complex superfields, some of them are multiplets with a spin.

Linear versus non-linear supersymmetry, in general

International Nuclear Information System (INIS)

Ferrara, Sergio; Kallosh, Renata; Proeyen, Antoine Van; Wrase, Timm

2016-01-01

We study superconformal and supergravity models with constrained superfields. The underlying version of such models with all unconstrained superfields and linearly realized supersymmetry is presented here, in addition to the physical multiplets there are Lagrange multiplier (LM) superfields. Once the equations of motion for the LM superfields are solved, some of the physical superfields become constrained. The linear supersymmetry of the original models becomes non-linearly realized, its exact form can be deduced from the original linear supersymmetry. Known examples of constrained superfields are shown to require the following LM’s: chiral superfields, linear superfields, general complex superfields, some of them are multiplets with a spin.

No Increased Risk of Cancer after Coal Tar Treatment in Patients with Psoriasis or Eczema

NARCIS (Netherlands)

Roelofzen, Judith H. J.; Aben, Katja K. H.; Oldenhof, Ursula T. H.; Coenraads, Pieter-Jan; Alkemade, Hans A.; van de Kerkhof, Peter C. M.; van der Valk, Pieter G. M.; Kiemeney, Lambertus A. L. M.

Coal tar is an effective treatment for psoriasis and eczema, but it contains several carcinogenic compounds. Occupational and animal studies have shown an increased risk of cancer after exposure to coal tar. Many dermatologists have abandoned this treatment for safety reasons, although the risk of

Can stress in farm animals increase food safety risk?

Science.gov (United States)

Rostagno, Marcos H

2009-09-01

All farm animals will experience some level of stress during their lives. Stress reduces the fitness of an animal, which can be expressed through failure to achieve production performance standards, or through disease and death. Stress in farm animals can also have detrimental effects on the quality of food products. However, although a common assumption of a potential effect of stress on food safety exists, little is actually known about how this interaction may occur. The aim of this review was to examine the current knowledge of the potential impact of stress in farm animals on food safety risk. Colonization of farm animals by enteric pathogens such as Escherichia coli O157:H7, Salmonella, and Campylobacter, and their subsequent dissemination into the human food chain are a major public health and economic concern for the food industries. This review shows that there is increasing evidence to demonstrate that stress can have a significant deleterious effect on food safety through a variety of potential mechanisms. However, as the impact of stress is difficult to precisely determine, it is imperative that the issue receives more research attention in the interests of optimizing animal welfare and minimizing losses in product yield and quality, as well as to food safety risks to consumers. While there is some evidence linking stress with pathogen carriage and shedding in farm animals, the mechanisms underlying this effect have not been fully elucidated. Understanding when pathogen loads on the farm are the highest or when animals are most susceptible to infection will help identifying times when intervention strategies for pathogen control may be most effective, and consequently, increase the safety of food of animal origin.

Linear and non-linear autoregressive models for short-term wind speed forecasting

International Nuclear Information System (INIS)

Lydia, M.; Suresh Kumar, S.; Immanuel Selvakumar, A.; Edwin Prem Kumar, G.

2016-01-01

Highlights: • Models for wind speed prediction at 10-min intervals up to 1 h built on time-series wind speed data. • Four different multivariate models for wind speed built based on exogenous variables. • Non-linear models built using three data mining algorithms outperform the linear models. • Autoregressive models based on wind direction perform better than other models. - Abstract: Wind speed forecasting aids in estimating the energy produced from wind farms. The soaring energy demands of the world and minimal availability of conventional energy sources have significantly increased the role of non-conventional sources of energy like solar, wind, etc. Development of models for wind speed forecasting with higher reliability and greater accuracy is the need of the hour. In this paper, models for predicting wind speed at 10-min intervals up to 1 h have been built based on linear and non-linear autoregressive moving average models with and without external variables. The autoregressive moving average models based on wind direction and annual trends have been built using data obtained from Sotavento Galicia Plc. and autoregressive moving average models based on wind direction, wind shear and temperature have been built on data obtained from Centre for Wind Energy Technology, Chennai, India. While the parameters of the linear models are obtained using the Gauss–Newton algorithm, the non-linear autoregressive models are developed using three different data mining algorithms. The accuracy of the models has been measured using three performance metrics namely, the Mean Absolute Error, Root Mean Squared Error and Mean Absolute Percentage Error.

Increased risk of colorectal cancer in type 2 diabetes is independent of diet quality.

Directory of Open Access Journals (Sweden)

Soghra Jarvandi

Full Text Available Poor diet increases the risk of both colorectal cancer and type 2 diabetes. We investigated the role of diet in the association between diabetes and colorectal cancer.We analyzed data from 484,020 individuals, aged 50-71 years who participated in the prospective National Institutes of Health-AARP Diet and Health Study and were cancer free at baseline (1995-1996. History of diabetes was self-reported. Diet quality was measured with the Healthy Eating Index-2005 (HEI-2005, using a self-administered food-frequency questionnaire. Cox regression models were constructed to estimate the hazard ratios (HR and 95% confidence intervals (CI of first primary incident colorectal cancer, overall and by anatomical location.During an average follow-up of 9.2 years, we identified 7,598 new cases of colorectal cancer. After controlling for non-dietary confounders, diabetes was associated with increased risk of colorectal cancer (HR 1.27, 95% CI: 1.18, 1.36. Further adjustment for diet quality did not attenuate this association. Diabetes was associated with a HR of 1.23 (95% CI: 1.07, 1.40 in individuals with good diet (quartile 4 of HEI-2005 and 1.58 (95% CI: 1.34, 1.86 in those with poor diet (quartile 1 of HEI-2005, compared to those with no diabetes and good diet. Moreover, diabetes was associated with a stronger risk of proximal than distal colon cancer (HR: 1.33 vs. HR: 1.20, while poor diet was associated with a weaker risk of proximal colon cancer (HR: 1.18 vs. HR: 1.46.Diabetes and poor diet, independently and additively are associated with the increased risk of colorectal cancer.

A genetic risk score of 45 coronary artery disease risk variants associates with increased risk of myocardial infarction in 6041 Danish individuals

DEFF Research Database (Denmark)

Krarup, N T; Borglykke, A; Allin, K H

2015-01-01

with age as time scale was adjusted for sex, BMI, type 2 diabetes mellitus and smoking status. Analyses were also stratified either by sex or median age (below or above 45 years of age). We estimated GRS contribution to MI prediction by assessing net reclassification index (NRI) and integrated...... discrimination improvement (IDI) added to the European SCORE for 10-year MI risk prediction. RESULTS: The GRS associated significantly with risk of incident MI (allele-dependent hazard ratio (95%CI): 1.06 (1.02-1.11), p = 0.01) but not with CAD (p = 0.39). Stratification revealed association of GRS with MI...... in men (1.06 (1.01-1.12), p = 0.02) and in individuals above the median of 45.11 years of age (1.06 (1.00-1.12), p = 0.03). There was no interaction between GRS and gender (p = 0.90) or age (p = 0.83). The GRS improved neither NRI nor IDI. CONCLUSION: The GRS of 45 GWAS identified risk variants increase...

Epidemiologic Evidence That Excess Body Weight Increases Risk of Cervical Cancer by Decreased Detection of Precancer.

Science.gov (United States)

Clarke, Megan A; Fetterman, Barbara; Cheung, Li C; Wentzensen, Nicolas; Gage, Julia C; Katki, Hormuzd A; Befano, Brian; Demarco, Maria; Schussler, John; Kinney, Walter K; Raine-Bennett, Tina R; Lorey, Thomas S; Poitras, Nancy E; Castle, Philip E; Schiffman, Mark

2018-04-20

Purpose Obesity has been inconsistently linked to increased cervical cancer incidence and mortality; however, the effect of obesity on cervical screening has not been explored. We investigated the hypothesis that increased body mass might decrease detection of cervical precancer and increase risk of cervical cancer even in women undergoing state-of-the-art screening. Methods We conducted a retrospective cohort study of 944,227 women age 30 to 64 years who underwent cytology and human papillomavirus DNA testing (ie, cotesting) at Kaiser Permanente Northern California (January 2003 to December 2015). Body mass index was categorized as normal/underweight (< 25 kg/m 2 ), overweight (25 to < 30 kg/m 2 ), or obese (≥ 30 kg/m 2 ). We estimated 5-year cumulative risks of cervical precancer and cancer by category of body mass index using logistic Weibull survival models. Results We observed lower risk of cervical precancer (n = 4,489) and higher risk of cervical cancer (n = 490) with increasing body mass index. Specifically, obese women had the lowest 5-year risk of precancer (0.51%; 95% CI, 0.48% to 0.54% v 0.73%; 95% CI, 0.70% to 0.76% in normal/underweight women; P trend < .001). In contrast, obese women had the highest 5-year risk of cancer (0.083%; 95% CI, 0.072% to 0.096% v 0.056%; 95% CI, 0.048% to 0.066% in normal/underweight women; P trend < .001). Results were consistent in subgroups defined by age (30 to 49 v 50 to 64 years), human papillomavirus status (positive v negative), and histologic subtype (glandular v squamous). Approximately 20% of cervical cancers could be attributed to overweight or obesity in the women in our study who underwent routine cervical screening. Conclusion In this large, screened population, overweight and obese women had an increased risk of cervical cancer, likely because of underdiagnosis of cervical precancer. Improvements in equipment and/or technique to assure adequate sampling and visualization of women with elevated body mass

Increased risk of venous thromboembolism associated with polymyositis and dermatomyositis: a meta-analysis

Directory of Open Access Journals (Sweden)

Li Y

2018-01-01

Full Text Available Yanqing Li,1 Peihong Wang,2 Lei Li,3 Fei Wang,4 Yuxiu Liu5 1Department of Pharmacy Intravenous Admixture Services, Affiliated Hospital of Weifang Medical University, Weifang, 2Department of Interventional Oncology, Weifang Tumor Hospital, Weifang, 3Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, 4Department of Neurosurgery, Affiliated Hospital of Weifang Medical University, Weifang, 5School of Nursing, Weifang Medical University, Weifang, People’s Republic of China Objective: Polymyositis and dermatomyositis (PM/DM have been implicated in the development of venous thromboembolism (VTE. Previous studies investigating the association between PM/DM and VTE risk had yielded inconsistent findings. The aim of this study was to precisely estimate this association by meta-analysis of all available publications.Methods: Two investigators independently performed a comprehensive literature search in databases of PubMed, Embase, and the Cochrane Library for eligible studies. The strength for the association was weighed by pooled odds ratios (ORs with 95% confidence intervals (95% CIs. Stratified analysis and sensitivity analysis were performed for further analysis.Results: Six studies including 9,045 patients with PM/DM were analyzed. The pooled OR suggested that inflammatory myositis was associated with increased risk of VTE (OR =4.31, 95% CI: 2.55–7.29, P<0.001. Besides, significantly elevated risk of VTE was related with PM and DM, respectively (for PM: OR =6.87, 95% CI: 4.12–11.46, P<0.001; for DM: OR =11.59, 95% CI: 6.54–20.55, P<0.001. In addition, inflammatory myositis could increase the risk of DVT (OR =4.85, 95% CI: 1.38–17.12, P<0.05 and PE (OR =4.74, 95% CI: 2.18–10.30, P<0.05. Sensitivity analysis did not materially alter the pooled results.Conclusion: Our study shows strong evidence that patients with inflammatory myositis have an increased risk of VTE. Keywords: polymyositis