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Sample records for selected high risk

  1. Metabolic risk factors in mice divergently selected for BMR fed high fat and high carb diets.

    Directory of Open Access Journals (Sweden)

    Julita Sadowska

    Full Text Available Factors affecting contribution of spontaneous physical activity (SPA; activity associated with everyday tasks to energy balance of humans are not well understood, as it is not clear whether low activity is related to dietary habits, precedes obesity or is a result of thereof. In particular, human studies on SPA and basal metabolic rates (BMR, accounting for >50% of human energy budget and their associations with diet composition, metabolic thrift and obesity are equivocal. To clarify these ambiguities we used a unique animal model-mice selected for divergent BMR rates (the H-BMR and L-BMR line type presenting a 50% between-line type difference in the primary selected trait. Males of each line type were divided into three groups and fed either a high fat, high carb or a control diet. They then spent 4 months in individual cages under conditions emulating human "sedentary lifestyle", with SPA followed every month and measurements of metabolic risk indicators (body fat mass %, blood lipid profile, fasting blood glucose levels and oxidative damage in the livers, kidneys and hearts taken at the end of study. Mice with genetically determined high BMR assimilated more energy and had higher SPA irrespective of type of diet. H-BMR individuals were characterized by lower dry body fat mass %, better lipid profile and lower fasting blood glucose levels, but higher oxidative damage in the livers and hearts. Genetically determined high BMR may be a protective factor against diet-induced obesity and most of the metabolic syndrome indicators. Elevated spontaneous activity is correlated with high BMR, and constitutes an important factor affecting individual capability to sustain energy balance even under energy dense diets.

  2. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    OpenAIRE

    Narges Pishva; Alie Mirzaee; Zohre Karamizade; Shahnaz Pourarian; Fariba Hemmati; Mostajab Razvi; Forough Saki

    2015-01-01

    Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases. Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for inv...

  3. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases. Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients. Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death. Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  4. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases.Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients.Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death.Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  5. A Small Molecule Inhibitor Selectively Induces Apoptosis in Cells Transformed by High Risk Human Papilloma Viruses.

    Directory of Open Access Journals (Sweden)

    Amy K Sheaffer

    Full Text Available A phenotypic high-throughput cell culture screen was performed to identify compounds that prevented proliferation of the human Papilloma virus type 16 (HPV-16 transformed cell line Ca Ski. A series of quinoxaline compounds exemplified by Compound 1 was identified. Testing against a panel of cell lines demonstrated that Compound 1 selectively inhibited replication of all HPV-16, HPV-18, and HPV-31 transformed cell lines tested with 50% Inhibitory Concentration (IC50 values of 2 to 8 μM relative to IC50 values of 28 to 73 μM in HPV-negative cell lines. Treatment with Compound 1 resulted in a cascade of multiple apoptotic events, including selective activation of effector caspases 3 and 7, fragmentation of cellular DNA, and PARP (poly(ADP-ribose polymerase cleavage in HPV-positive cells relative to HPV-negative cells. Unregulated proliferation of HPV transformed cells is dependent on the viral oncogenes, E6 and E7. Treatment with Compound 1 resulted in a decrease in HPV E7 protein in Ca Ski cells. However, the timing of this reduction relative to other effects of compound treatment suggests that this was a consequence, rather than a cause, of the apoptotic cascade. Likewise, compound treatment resulted in no obvious effects on the E6- and E7- mediated down regulation of p53 and Rb, or their downstream effectors, p21 or PCNA. Further investigation of apoptotic signals induced by Compound 1 revealed cleavage of Caspase-8 in HPV-positive cells as early as 2 hours post-treatment, suggesting the compound initiates apoptosis through the extrinsic, death receptor-mediated, pathway of cell death. These studies provide proof of concept that cells transformed by oncogenic Papillomaviruses can be selectively induced to undergo apoptosis by compound treatment.

  6. A Small Molecule Inhibitor Selectively Induces Apoptosis in Cells Transformed by High Risk Human Papilloma Viruses.

    Science.gov (United States)

    Sheaffer, Amy K; Lee, Min S; Qi, Huilin; Chaniewski, Susan; Zheng, Xiaofan; Farr, Glen A; Esposito, Kim; Harden, David; Lei, Ming; Schweizer, Liang; Friborg, Jacques; Agler, Michele; McPhee, Fiona; Gentles, Robert; Beno, Brett R; Chupak, Lou; Mason, Stephen

    2016-01-01

    A phenotypic high-throughput cell culture screen was performed to identify compounds that prevented proliferation of the human Papilloma virus type 16 (HPV-16) transformed cell line Ca Ski. A series of quinoxaline compounds exemplified by Compound 1 was identified. Testing against a panel of cell lines demonstrated that Compound 1 selectively inhibited replication of all HPV-16, HPV-18, and HPV-31 transformed cell lines tested with 50% Inhibitory Concentration (IC50) values of 2 to 8 μM relative to IC50 values of 28 to 73 μM in HPV-negative cell lines. Treatment with Compound 1 resulted in a cascade of multiple apoptotic events, including selective activation of effector caspases 3 and 7, fragmentation of cellular DNA, and PARP (poly(ADP-ribose) polymerase) cleavage in HPV-positive cells relative to HPV-negative cells. Unregulated proliferation of HPV transformed cells is dependent on the viral oncogenes, E6 and E7. Treatment with Compound 1 resulted in a decrease in HPV E7 protein in Ca Ski cells. However, the timing of this reduction relative to other effects of compound treatment suggests that this was a consequence, rather than a cause, of the apoptotic cascade. Likewise, compound treatment resulted in no obvious effects on the E6- and E7- mediated down regulation of p53 and Rb, or their downstream effectors, p21 or PCNA. Further investigation of apoptotic signals induced by Compound 1 revealed cleavage of Caspase-8 in HPV-positive cells as early as 2 hours post-treatment, suggesting the compound initiates apoptosis through the extrinsic, death receptor-mediated, pathway of cell death. These studies provide proof of concept that cells transformed by oncogenic Papillomaviruses can be selectively induced to undergo apoptosis by compound treatment.

  7. Relationship between number of sexual intercourse partners and selected health risk behaviors among public high school adolescents.

    Science.gov (United States)

    Valois, R F; Oeltmann, J E; Waller, J; Hussey, J R

    1999-11-01

    To examine the relationship between number of sexual partners and selected health risk behaviors in a statewide sample of public high school students. The Centers for Disease Control and Prevention Youth Risk Behavior Survey was used to secure usable sexual risk-taking, substance use, and violence/aggression data from 3805 respondents. Because simple polychotomous logistic regression analysis revealed a significant Race x Gender interaction, subsequent multivariate models were constructed separately for each race-gender group. Odds ratios and 95% confidence intervals was calculated from polychotomous logistic regression models for number of sexual intercourse partners and their potential risk behavior correlates. An increased number of sexual intercourse partners were correlated with a cluster of risk behaviors that place adolescents at risk for unintended pregnancy, human immunodeficiency virus/acquired immunodeficiency syndrome, and other sexually transmitted infections. For Black females, alcohol, tobacco, marijuana use, and dating violence behaviors were the strongest predictors of an increased number of sexual partners; white females had similar predictors with the addition of physical fighting. For white males, alcohol, tobacco, marijuana use, physical fighting, carrying weapons, and dating violence were the strongest predictors of an increased number of sexual intercourse partners. Black males had similar predictors with the addition of binge alcohol use. Prevention of adolescent sexual and other health risk behaviors calls for creative approaches in school and community settings and will require long-term intervention strategies focused on adolescent behavior changes and environmental modifications.

  8. Survival and Associated Risk Factors of Selective Caries Removal Treatments in Primary Teeth: A Retrospective Study in a High Caries Risk Population.

    Science.gov (United States)

    Melgar, Ximena C; Opdam, Niek J M; Britto Correa, Marcos; Franzon, Renata; Demarco, Flávio Fernando; Araujo, Fernando B; Casagrande, Luciano

    2017-01-01

    The aim of this retrospective study was to analyze the survival probability of selective caries removal (SCR) treatments in the primary teeth of children with high caries experience and factors potentially associated with treatment failure. The sample included SCR treatments conducted in anterior and posterior teeth without sedation or general anesthesia among children attending a university dental service. Kaplan-Meier survival analysis was used to estimate the longevity of restorations and multivariate Cox regression with shared frailty was used to assess risk factors. A total of 284 SCR treatments in 88 children (aged 5.2 ± 1.91 years) with high caries experience (mean dmft/DMFT = 11.1 ± 5.04) were analyzed. The 3-year survival reached 48.8%, with an annual failure rate of 21.2%. Restorative failures (n = 60) were found more frequently compared to pulp complications (n = 12). SCR performed in anterior primary teeth were more prone to failure (hazard ratio = 3.6, 95% CI: 1.94; 6.71). Patients with a higher amount of visible plaque experienced more failures in SCR treatments (hazard ratio 3.0, 95% CI:1.27; 7.07). In this retrospective study, SCR showed restricted survival when compared to other prospective clinical trials. Patient-related factors, especially the young age and high caries experience of the children, may represent a challenge for restoration survival. Regardless of the caries removal technique or restorative material, cariogenic biofilm has a negative effect on the survival of restorations, probably by acting directly on material deterioration and, particularly, on the development of new caries lesions of rapid progression. © 2017 S. Karger AG, Basel.

  9. Selective Methicillin-Resistant Staphylococcus Aureus (MRSA) screening of a high risk population does not adequately detect MRSA carriers within a country with low MRSA prevalence.

    Science.gov (United States)

    de Wouters, Solange; Daxhelet, Jérémy; Kaminski, Ludovic; Thienpont, Emmanuel; Cornu, Olivier; Yombi, Jean Cyr

    2015-12-01

    Methicillin-Resistant Staphylococcus Aureus (MRSA) has been widely recognized as a serious problem in hospital settings. The purpose of this study is to evaluate the predictive value of MRSA colonization factors in the detection of MRSA carriers in an orthopedic ward. A systematic MRSA detection strategy was set up to assess the predictive value of MRSA colonization factors among 554 patients undergoing elective knee arthroplasty. In total 116 patients were found positive for Staphylococcus Aureus; among those 110/116 patients were found positive for Methicillin-Sensitive Staphylococcus Aureus (MSSA) and 6/116 for MRSA. Only one patient out of six presented two risk factors according to MRSA risk factors. In this study, no correlation was found between the remaining conventional risk factors, according to Belgian guidelines, defined to target high-risk populations and to identify MRSA carriers. Established criteria for selective MRSA screening do not allow detecting MRSA carriers. The objective of detecting MRSA carriers is not correctly met by the actual applied criteria (Belgian consensus) for a selective screening policy. Future studies should aim at identifying the right risk factors, depending of the country's prevalence of MRSA, to improve the ability to predict the risk of MRSA carriage at hospital admission.

  10. Selecting Strategies to Reduce High-Risk Unsafe Work Behaviors Using the Safety Behavior Sampling Technique and Bayesian Network Analysis.

    Science.gov (United States)

    Ghasemi, Fakhradin; Kalatpour, Omid; Moghimbeigi, Abbas; Mohammadfam, Iraj

    2017-03-04

    High-risk unsafe behaviors (HRUBs) have been known as the main cause of occupational accidents. Considering the financial and societal costs of accidents and the limitations of available resources, there is an urgent need for managing unsafe behaviors at workplaces. The aim of the present study was to find strategies for decreasing the rate of HRUBs using an integrated approach of safety behavior sampling technique and Bayesian networks analysis. A cross-sectional study. The Bayesian network was constructed using a focus group approach. The required data was collected using the safety behavior sampling, and the parameters of the network were estimated using Expectation-Maximization algorithm. Using sensitivity analysis and belief updating, it was determined that which factors had the highest influences on unsafe behavior. Based on BN analyses, safety training was the most important factor influencing employees' behavior at the workplace. High quality safety training courses can reduce the rate of HRUBs about 10%. Moreover, the rate of HRUBs increased by decreasing the age of employees. The rate of HRUBs was higher in the afternoon and last days of a week. Among the investigated variables, training was the most important factor affecting safety behavior of employees. By holding high quality safety training courses, companies would be able to reduce the rate of HRUBs significantly.

  11. High Selectivity Oxygen Delignification

    Energy Technology Data Exchange (ETDEWEB)

    Lucian A. Lucia

    2005-11-15

    Project Objective: The objectives of this project are as follows: (1) Examine the physical and chemical characteristics of a partner mill pre- and post-oxygen delignified pulp and compare them to lab generated oxygen delignified pulps; (2) Apply the chemical selectivity enhancement system to the partner pre-oxygen delignified pulps under mill conditions (with and without any predetermined amounts of carryover) to determine how efficiently viscosity is preserved, how well selectivity is enhanced, if strength is improved, measure any yield differences and/or bleachability differences; and (3) Initiate a mill scale oxygen delignification run using the selectivity enhancement agent, collect the mill data, analyze it, and propose any future plans for implementation.

  12. High Selectivity Oxygen Delignification

    Energy Technology Data Exchange (ETDEWEB)

    Arthur J. Ragauskas

    2005-09-30

    The overall objective of this program was to develop improved extended oxygen delignification (EOD) technologies for current U.S. pulp mill operations. This was accomplished by: (1) Identifying pulping conditions that optimize O and OO performance; (2) Identifying structural features of lignin that enhance reactivity towards EOD of high kappa pulps; (3) Identifying factors minimizing carbohydrate degradation and improve pulp strength of EOD high kappa pulps; (4) Developing a simple, reproducible method of quantifying yield gains from EOD; and (5) Developing process conditions that significantly reduce the capital requirements of EOD while optimizing the yield benefits. Key research outcomes included, demonstrating the use of a mini-O sequence such as (E+O)Dkf:0.05(E+O) or Dkf:0.05(E+O)(E+O) without interstage washing could capture approximately 60% of the delignification efficiency of a conventional O-stage without the major capital requirements associated with an O-stage for conventional SW kraft pulps. The rate of formation and loss of fiber charge during an O-stage stage can be employed to maximize net fiber charge. Optimal fiber charge development and delignification are two independent parameters and do not parallel each other. It is possible to utilize an O-stage to enhance overall cellulosic fiber charge of low and high kappa SW kraft pulps which is beneficial for physical strength properties. The application of NIR and multi-variant analysis was developed into a rapid and simple method of determining the yield of pulp from an oxygen delignification stage that has real-world mill applications. A focus point of this program was the demonstration that Kraft pulping conditions and oxygen delignification of high and low-kappa SW and HW pulps are intimately related. Improved physical pulp properties and yield can be delivered by controlling the H-factor and active alkali charge. Low AA softwood kraft pulp with a kappa number 30 has an average improvement of 2% in

  13. Use of selective cyclooxygenase-2 inhibitors and nonselective nonsteroidal antiinflammatory drugs in high doses increases mortality and risk of reinfarction in patients with prior myocardial infarction

    DEFF Research Database (Denmark)

    Sørensen, Rikke; Abildstrøm, Steen Zabell; Torp-Pedersen, C.

    2008-01-01

    The selective cyclooxygenase-2 (COX-2) inhibitors and other nonselective nonsteroidal antiinflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk, but the risk in patients with established cardiovascular disease is unknown. In the present study, we analyzed the risk of...

  14. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention.

    Science.gov (United States)

    McIntosh, Jennifer; Feltovich, Helen; Berghella, Vincenzo; Manuck, Tracy

    2016-09-01

    Preterm birth remains a major cause of neonatal death and short and long-term disability in the US and across the world. The majority of preterm births are spontaneous and cervical length screening is one tool that can be utilized to identify women at increased risk who may be candidates for preventive interventions. The purpose of this document is to review the indications and rationale for CL screening to prevent preterm birth in various clinical scenarios. The Society for Maternal-Fetal Medicine recommends (1) routine transvaginal cervical length screening for women with singleton pregnancy and history of prior spontaneous preterm birth (grade 1A); (2) routine transvaginal cervical length screening not be performed for women with cervical cerclage, multiple gestation, preterm premature rupture of membranes, or placenta previa (grade 2B); (3) practitioners who decide to implement universal cervical length screening follow strict guidelines (grade 2B); (4) sonographers and/or practitioners receive specific training in the acquisition and interpretation of cervical imaging during pregnancy (grade 2B). Copyright © 2016 Elsevier Inc. All rights reserved.

  15. HIV transmission and pre-exposure prophylaxis in a high risk MSM population: A simulation study of location-based selection of sexual partners

    Science.gov (United States)

    Velter, Annie; Barin, Francis; Boelle, Pierre-Yves

    2017-01-01

    Objective In France, indications for pre-exposure prophylaxis (PrEP) for HIV prevention are based on individual-level risk factors for HIV infection. However, the risk of HIV infection may also depend on characteristics of sexual partnerships. Here we study how place-based selection of partners change transmission and the overall efficiency of PrEP. Methods We used the PREVAGAY survey of sexual behavior and HIV serostatus in men who have sex with men (MSM) in a Parisian district to look for associations between sexual network characteristics and HIV infection. We then simulated HIV transmission in a high-risk MSM population. We used information about venues visited to meet casual sexual partners (clubs, backrooms or saunas) to define sexual networks. We then simulated HIV transmission in these networks and assessed the impact of PrEP in this population. Results In the PREVAGAY study, we found that HIV serostatus changed with the type of venues visited, in addition to other individual risk factors. In simulations, we found similar differences in HIV incidence when the choice of venues visited was not random. The use of PrEP allowed reducing incidence, irrespective of the venues visited by PrEP users. However, with the same amount of PrEP, the number of infections adverted could almost double depending on network structure and venues visited by PrEP users. Conclusion This study shows that characteristics of the sexual network structure can strongly impact the effectiveness of PrEP interventions. These should be considered further to refine individual risk assessment and maximize the effect of individual-based prevention policies. PMID:29190784

  16. [Detecting high risk pregnancy].

    Science.gov (United States)

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  17. Comprehensive risk analysis for structure type selection.

    Science.gov (United States)

    2010-04-01

    Optimization of bridge selection and design traditionally has been sought in terms of the finished structure. This study presents a : more comprehensive risk-based analysis that includes user costs and accidents during the construction phase. Costs f...

  18. Group selection as behavioral adaptation to systematic risk.

    Science.gov (United States)

    Zhang, Ruixun; Brennan, Thomas J; Lo, Andrew W

    2014-01-01

    Despite many compelling applications in economics, sociobiology, and evolutionary psychology, group selection is still one of the most hotly contested ideas in evolutionary biology. Here we propose a simple evolutionary model of behavior and show that what appears to be group selection may, in fact, simply be the consequence of natural selection occurring in stochastic environments with reproductive risks that are correlated across individuals. Those individuals with highly correlated risks will appear to form "groups", even if their actions are, in fact, totally autonomous, mindless, and, prior to selection, uniformly randomly distributed in the population. This framework implies that a separate theory of group selection is not strictly necessary to explain observed phenomena such as altruism and cooperation. At the same time, it shows that the notion of group selection does captures a unique aspect of evolution-selection with correlated reproductive risk-that may be sufficiently widespread to warrant a separate term for the phenomenon.

  19. [Access to high-risk families through selected actors of the health care system. Results of an explorative questioning of early childhood intervention pilot projects].

    Science.gov (United States)

    Renner, I

    2010-10-01

    A requirement for preventive child protection is an early and systematic access to high-risk families. Actors of the health care system, in particular doctors in private practice and midwives, are highly accepted within the population and therefore offer perfect requirements to provide this access. For this reason the aim in the context of early childhood intervention is a close cooperation of the Child and Youth Services with doctors and midwives. To what extent can these service providers of the health care system fulfill these expectations? The National Centre on Early Prevention tried to find an answer to this question with the support of 10 pilot projects which were set up within the framework of the action program "Early Prevention and Intervention for Parents and Children and Social Warning Systems". The comprehensive project presentation of selected results, insights and experiences concerning cooperation between agents of the Child and Youth Services and doctors in private practice and midwives is based on explorative written questioning of the 10 projects. The study shows from the point of view of the pilot projects that the cooperation with freelance midwives is promising. In contrast, the cooperation with doctors in private practice does not yet meet the hopes and expectations. To achieve an improvement of this situation, conditions have to be supported which promote a stronger commitment of the medical profession to early childhood intervention.

  20. High risk pregnancy monitored antenatally at home

    NARCIS (Netherlands)

    Monincx, W. M.; Zondervan, H. A.; Birnie, E.; Ris, M.; Bossuyt, P. M.

    1997-01-01

    OBJECTIVE: Is domiciliary antenatal fetal surveillance for selected high risk pregnancies, a feasible alternative for hospital admission? DESIGN: A randomized controlled trial conducted at the Academical Medical Centre, Amsterdam, The Netherlands. SUBJECTS: Between September 1992 and June 1994, 76

  1. Penalized variable selection in competing risks regression.

    Science.gov (United States)

    Fu, Zhixuan; Parikh, Chirag R; Zhou, Bingqing

    2017-07-01

    Penalized variable selection methods have been extensively studied for standard time-to-event data. Such methods cannot be directly applied when subjects are at risk of multiple mutually exclusive events, known as competing risks. The proportional subdistribution hazard (PSH) model proposed by Fine and Gray (J Am Stat Assoc 94:496-509, 1999) has become a popular semi-parametric model for time-to-event data with competing risks. It allows for direct assessment of covariate effects on the cumulative incidence function. In this paper, we propose a general penalized variable selection strategy that simultaneously handles variable selection and parameter estimation in the PSH model. We rigorously establish the asymptotic properties of the proposed penalized estimators and modify the coordinate descent algorithm for implementation. Simulation studies are conducted to demonstrate the good performance of the proposed method. Data from deceased donor kidney transplants from the United Network of Organ Sharing illustrate the utility of the proposed method.

  2. [High dynamic risk cystoceles].

    Science.gov (United States)

    Salinas Casado, Jesús; Méndez Rubio, Santiago; Virseda Chamorro, Miguel; Pelaquim, Humberto; Silmi Moyano, Angel

    2010-06-01

    To assess the bladder compliance in a series of cystoceles referred for urodynamic study. Retrospective study of a series of patients with cystocele undergoing medical history, videurodynamic study, pelvic MRI and lower urinary tract, urological ultrasound and cystoscopy. We Excluded cases with neurogenic dysfunction and urinary infection. The terminology followed the criteria of the ICS, if not specified otherwise. The series includes 3333 cases of cystocele 616 of which are grade III cystocele. There were 3 cases with low bladder compliance; this is 0.0009% of total (1:1000) and 0.5% of grade III cystocele (1:200) All cases of cystocele whith low compliance were associated with feeling of a bulk in the vagina and functional symptoms of lower urinary tract(LUTS). No urinary incontinence was related to cough. These patients also showed urodynamic alterations in the voiding phase, type hypo / acontractile detrusor and postvoid residual. The patients were subjected to various techniques of abdominal and transvaginal cystocele repair (with preventive anti-incontinence surgery), getting a vagina bulk disappearance, improvement of symptoms of lower urinary tract function, normalization of bladder compliance and detrusor contractility, with elimination of the postvoid residual. Although they are not frequent, high-risk cystoceles should be discarded in high-grade cystocele that apart from low bladder accommodation, have a hipo/acontractile detrusor and postvoid residual. Surgical correction of cystocele not only reduces the bulk and LUTS, but normalizes urodynamic alterations.

  3. Perceptions of high risk sports.

    Science.gov (United States)

    Pedersen, D M

    1997-10-01

    High risk sports were rated as to risk, appeal, and likelihood of participation by 282 men and 162 women. Ascending order of perceived risk was skiing, scuba diving, bungee jumping, rock climbing, motorcycle racing, hang gliding, cliff jumping, and skydiving. Profile analysis showed stated likelihood of participation to be directly related to appeal and inversely related to perceived risk.

  4. A Cross-Sectional Study on Selected Correlates of High risk Sexual Behavior in Polish Migrants Resident in the United Kingdom.

    Science.gov (United States)

    Ganczak, Maria; Czubińska, Grażyna; Korzeń, Marcin; Szych, Zbigniew

    2017-04-14

    Objective : To assess the correlates of the high risk sexual behaviors of Polish migrants in the United Kingdom (UK) after 2004, and to compare such behaviors before/after immigration. Methods : In 2013, a cross-sectional study was conducted through the use of a Computer-assisted web interviewing surveying technique with the use of a self-administered questionnaire. Results : Among 408 respondents (56.9% women), with a median age of 32 years, significantly more admitted to having unprotected sexual contact with a casual partner while in the UK ( p self-esteem, were predictors of unprotected sex. A total of 19.6% of the respondents admitted to having been tested while in Poland, a lower ( p self-esteem, staying in the UK for less than two years. The results point to strengthening strategies which help reduce high risk sexual behavior among Polish migrants, and to introduce interventions to promote an awareness of HIV sero-status.

  5. Evaluation of selected food categories in a short FFQ covering questions regarding dairy and meat products among participants with moderate to high risk of cardiovascular disease

    OpenAIRE

    Østengen, Beate

    2016-01-01

    Master i samfunnsernæring Introduction: This study is a part of the nationwide VISA-project. Validation of FFQ is crucial to obtain valid information within nutritional epidemiology. The diet in Norway shows a high intake of dairy and meat products rich in fat. These fatty acids affect the cholesterol, which is one of the risk factors for developing cardiovascular disease (CVD). As CVD is still the leading cause of mortality, both dietary assessment and investigation of dietary...

  6. High-Risk Pregnancy

    Science.gov (United States)

    ... risk? » Related A-Z Topics Diabetes Pregnancy Loss Preeclampsia and Eclampsia NICHD News Spotlights Podcast: NICHD launches PregSource to learn more about pregnancy News Release: NIH Begins Large HIV Treatment Study in Pregnant Women Spotlight: Zika Research after ...

  7. Selected Abstracts of the 3rd Edition of Transport of High Risk Infants; Oxford (UK; August 31st-September 2nd, 2017

    Directory of Open Access Journals (Sweden)

    --- Various Authors

    2017-08-01

    Full Text Available Selected Abstracts of the 3rd Edition of Transport of High Risk Infants; Oxford (UK; August 31st-September 2nd, 2017ABS 1. MORTALITY RATE IN 23-30 WEEKS PRE­MATURE BORN IN LEVEL 2 HOSPITAL IN COMPARISON TO THOSE BORN IN TERTIARY-CARE HOSPITAL • J.P. Doray, J.L. DorayABS 2. THE QUEBEC AEROMEDICAL EXPERIENCE: EVACUATION OF NEONATES FROM AREAS IN EXTREME WEATHER CONDITIONS – IN­NOVATIONS IN SAFETY AND EFFICIENCY • É. Notebaert, J. Provencher, R. Bernier, S. Côté, S. KindABS 3. NASAL HIGH FLOW SUPPORT DURING NEONATAL RETRIEVAL IN VICTORIA, AUSTRALIA • V. Abraham, C. Roberts, B. Manley, L. Owen, M. Stewart, P. DavisABS 4. NEONATAL TRANSPORT TO AND FROM A REGIONAL LEVEL 2 CENTRE • C. Moore, M. Cassidy, M. Byrne, A. Bowden, J. Franta, I. Farombi, J. FitzsimonsABS 5. PASSIVE THERAPEUTIC HYPOTHERMIA DURING AMBULANCE AND HELICOPTER SECONDARY NEONATAL TRANSPORT IN NEONATES WITH HYPOXIC BRAIN INJURY: 10-YEARS RETROSPECTIVE SURVEY • M. Leben, M. Nolimal, I. Vidmar, S. GrosekABS 6. STABILIZATION OF CRITICALLY ILL NEW­BORNS: PREVENTION OF ACUTE KIDNEY INJURY • A. Babintseva, Y. Hodovanets, L. AgafonovaABS 7. TRANSPORT OF THE SURGICAL NEONATES • R. Pejaver, A. Poveidein, D. Winterbank-Scott, C. Keys, N. GuptaABS 8. AUDIT OF VENTILATED NEONATAL TRANS­FERS IN NORTHERN IRELAND FROM 1ST JANUARY 2017 UNTIL 1ST MAY 2017 • R. Moore, S. KnoxABS 9. “HUB AND SPOKE” ECMO IN NEONATES WITH MECONIUM ASPIRATION SYNDROME: A PRELIMINARY REPORT • N. Doglioni, D. Fichera, F. Zanella, M. Padalino, V. Vida, G. Stellin, P. Lago, D. TrevisanutoABS 10. INTRA-HOSPITAL TRANSPORTATION OF EX­TREMELY PRETERM INFANTS AND INCI­DENCE OF INTRAVENTRICULAR HAEMOR­RHAGES • N. Wadström, M. Breindahl, B. Hallberg, B. SkiöldABS 11. RISK OF POSTNATAL TRANSPORT AND OUT­COME OF LATE PRETERM INFANTS BORN AT NON-TERTIARY CENTRES: A RETRO­SPEC­TIVE COHORT STUDY • N. Doglioni, L. Salmaso, P. Facchin, D. TrevisanutoABS 12. COMPARING THREE METHODS OF THERA

  8. Selective serotonin reuptake inhibitors and risk for gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Batić-Mujanović Olivera

    2014-01-01

    Full Text Available The most of the known effects of selective serotonin reuptake inhibitors, beneficial or harmful, are associated with the inhibitory action of the serotonin reuptake transporter. This mechanism is present not only in neurons, but also in other cells such as platelets. Serotoninergic mechanism seems to have an important role in hemostasis, which has long been underestimated. Abnormal activation may lead to a prothrombotic state in patients treated with selective serotonin reuptake inhibitors. On one hand there may be an increased risk of bleeding, and on the other hand reduction in thrombotic risk may be possible. Serotonin is critical to maintain a platelet haemostatic function, such as platelet aggregation. Evidences from the studies support the hypothesis that antidepressants with a relevant blockade of action of serotonin reuptake mechanism may increase the risk of bleeding, which can occur anywhere in the body. Epidemiological evidences are, however, the most robust for upper gastrointestinal bleeding. It is estimated that this bleeding can occur in 1 in 100 to 1 in 1.000 patient-years of exposure to the high-affinity selective serotonin reuptake inhibitors, with very old patients at the highest risk. The increased risk may be of particular relevance when selective serotonin reuptake inhibitors are taken simultaneously with nonsteroidal anti-inflammatory drugs, low dose of aspirin or warfarin.

  9. Heavier drinking American college students may self-select into study abroad programs: An examination of sex and ethnic differences within a high-risk group.

    Science.gov (United States)

    Pedersen, Eric R; LaBrie, Joseph W; Hummer, Justin F; Larimer, Mary E; Lee, Christine M

    2010-09-01

    As with other heavier drinking groups, heavier drinking American college students may self-select into study abroad programs with specific intentions to use alcohol in the foreign environment. This cross-sectional study used a sample of 2144 students (mean age=20.00, SD=1.47) to explore differences in alcohol use and related negative consequences among (1) students intending to study abroad while in college, (2) students not intending to study abroad, and (3) students reporting prior study abroad participation. Results revealed that participants with no intention to study abroad drank less and experienced fewer alcohol-related consequences than participants intending to study abroad. In addition, students reporting prior completion of study abroad programs drank more and reported more hazardous alcohol use than those not intending to study abroad. Ethnic and sex differences existed; with White students, males, and females intending to study abroad and non-White students who previously completed study abroad programs demonstrating the most risk. These findings provide empirical support that study abroad students may be a heavier drinking subgroup necessitating intervention prior to beginning programs abroad. Copyright 2010 Elsevier Ltd. All rights reserved.

  10. An experimental investigation of risk sharing and adverse selection

    NARCIS (Netherlands)

    Tausch, F.; Potters, J.J.M.; Riedl, A.

    Does adverse selection hamper the effectiveness of voluntary risk sharing? How do differences in risk profiles affect adverse selection? We experimentally investigate individuals’ willingness to share risks with others. Across treatments we vary how risk profiles differ between individuals. We find

  11. The Return to College: Selection Bias and Dropout Risk

    OpenAIRE

    Hendricks, Lutz; Leukhina, Oksana

    2014-01-01

    We study two long-standing questions: (i) What part of the measured return to education is due to selection? (ii) The ex post return to schooling is higher than the return to most financial assets. How large are the contributions of various frictions to the "high" return to schooling? We focus in particular on the roles of college dropout risk, borrowing constraints, and learning about ability. We develop and calibrate a model of school choice. Key model features are: (i) ability heterogeneit...

  12. Uterine artery Doppler in high-risk pregnancies at 23-24 gestational weeks is of value in predicting adverse outcome of pregnancy and selecting cases for more intense surveillance.

    Science.gov (United States)

    Li, Na; Ghosh, Gisela; Gudmundsson, Saemundur

    2014-12-01

    To assess the role of the placental arterial Doppler examination at 23-24 gestational weeks for predicting adverse perinatal outcome in high-risk pregnancies. Retrospective register study. Skåne University Hospital in Malmö. Six hundred and forty-five women with high-risk pregnancies, without fetal malformations or chromosomal abnormalities. Placental (uterine and umbilical artery) Doppler ultrasound examination at 23-24 gestational weeks. Adverse perinatal outcomes including preeclampsia, small-for-gestational age newborns (smaller than 3rd percentile or smaller than the 10th percentile), preterm delivery (high-risk group but abnormal umbilical artery Doppler indices were only seen in 3.7%. Adverse perinatal outcome increased significantly with increasing placental vascular impedance (p pregnancies at risk of adverse outcome and in selecting cases for more intense surveillance. A surveillance plan is proposed based on Doppler screening at 23-24 weeks of gestation. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  13. The influence of selected factors on the attendance of the high-risk population in the early lung cancer detection program.

    Science.gov (United States)

    Zakrzewska, Agata; Szczepanowska, Magdalena; Książek, Janina; Biadacz, Iwona; Dziedzic, Robert; Jelitto-Górska, Małgorzata; Rzyman, Witold

    2014-01-01

    Lung cancer is the most common cause of cancer-related death worldwide, killing almost 22,000 people in Poland every year. Low-dose computed tomography (LDCT) is the most promising tool of secondary prophylaxis leading to early detection and thus successful treatment of this malignancy. Knowledge about socio-demographic factors that affect participation in lung cancer early detection programs is essential for the future design and implementation of such programs. Among the 8649 participants of the Pomeranian Lung Cancer Screening Program (PLCSP), 1619 individuals responded to a questionnaire that had been designed to assess socio-demographic data of participants at high risk of developing lung cancer. The survey was conducted on-site after reception of results by the program participants. Among the survey participants, 777 (48%) were current cigarette smokers. The majority of them represented low or medium level of wealth status. The respondents positively evaluated the promotional campaign during the PLCSP, although 43% of them indicated family and friends as a source of information about the program. As the most important action that stimulated the participation, 46% of the respondents indicated the awareness campaign involving a celebrity, and 45% of them indicated the presence of cancer in the family. The influence of healthcare employees on the participation in the screening program was minimal. More than half of the respondents (53%) declared a willingness to co-finance a similar prophylactic program in the future in an amount not exceeding 100 PLN. An effective promotional campaign in the media, the influence of family and a campaign involving a celebrity promoted attendance at the screening program. The influence of healthcare employees on the participation in the program was minimal. The majority of the screened population declared a willingness to actively participate in the costs of LDCT examination.

  14. An echocardiographic method for selecting high risk patients shortly after acute myocardial infarction, for inclusion in multi-centre studies (as used in the TRACE study). TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Carlsen, J

    1994-01-01

    The aim of our study was to examine if echocardiography can reproducibly be used in a multicentre study to select high risk patients with reduced left ventricular function early after an acute myocardial infarction (MI). In the TRAndolapril Cardiac Evaluation Study (TRACE) patients with reduced...... training course recorded a two-dimensional echocardiographic examination on videotape 2-6 days after MI. Within 24 h, wall motion index (WMI) was visually assessed by one of two cardiologists (examiners) with considerable experience in echocardiography. A WMI of

  15. High-risk neighborhoods and high-risk families: the human ecology of child maltreatment.

    Science.gov (United States)

    Garbarino, J; Sherman, D

    1980-03-01

    Based on multiple regression analysis to identify the socioeconomic, demographic, and attitudinal correlates of neighborhood differences in the rate of child abuse and neglect, a pair of neighborhoods matched for socioeconomic level was selected, one high risk, the other low risk. Interviews with expert informants ranging from elementary school principals to mailmen were used to develop neighborhood profiles. Samples of families were drawn from each neighborhood and interviews conducted to identify stresses and supports, with special emphasis on sources of help, social networks, evaluation of the neighborhood, and use of formal family support systems. The results lend support to the concept of neighborhood "risk." Families in the high-risk neighborhood, though socioeconomically similar to families in the low-risk neighborhood, report less positive evaluation of the neighborhood as a context for child and family development. Furthermore, they reveal a general pattern of "social impoverishment" in comparison with families in the low-risk neighborhood.

  16. Heavier drinking American college students may self-select into study abroad programs: An examination of sex and ethnic differences within a high-risk group

    OpenAIRE

    Pedersen, Eric R.; LaBrie, Joseph W.; Hummer, Justin F.; Larimer, Mary E.; Lee, Christine M.

    2010-01-01

    As with other heavier drinking groups, heavier drinking American college students may self-select into study abroad programs with specific intentions to use alcohol in the foreign environment. This cross-sectional study used a sample of 2144 students (mean age = 20.00, SD = 1.47) to explore differences in alcohol use and related negative consequences among (1) students intending to study abroad while in college, (2) students not intending to study abroad, and (3) students reporting prior stud...

  17. Uncertain Portfolio Selection with Background Risk and Liquidity Constraint

    Directory of Open Access Journals (Sweden)

    Jia Zhai

    2017-01-01

    Full Text Available This paper discusses an uncertain portfolio selection problem with consideration of background risk and asset liquidity. In addition, the transaction costs are also considered. The security returns, background asset return, and asset liquidity are estimated by experienced experts instead of historical data. Regarding them as uncertain variables, a mean-risk model with background risk, liquidity, and transaction costs is proposed for portfolio selection and the crisp forms of the model are provided when security returns obey different uncertainty distributions. Moreover, for better understanding of the impact of background risk and liquidity on portfolio selection, some important theorems are proved. Finally, numerical experiments are presented to illustrate the modeling idea.

  18. Risk Selection Threatens Quality Of Care For Certain Patients: Lessons From Europe's Health Insurance Exchanges.

    Science.gov (United States)

    van de Ven, Wynand P M M; van Kleef, Richard C; van Vliet, Rene C J A

    2015-10-01

    Experience in European health insurance exchanges indicates that even with the best risk-adjustment formulas, insurers have substantial incentives to engage in risk selection. The potentially most worrisome form of risk selection is skimping on the quality of care for underpriced high-cost patients--that is, patients for whom insurers are compensated at a rate lower than the predicted health care expenses of these patients. In this article we draw lessons for the United States from twenty years of experience with health insurance exchanges in Europe, where risk selection is a serious problem. Mistakes by European legislators and inadequate evaluation criteria for risk selection incentives are discussed, as well as strategies to reduce risk selection and the complex trade-off among selection (through quality skimping), efficiency, and affordability. Recommended improvements to the risk-adjustment process in the United States include considering the adoption of risk adjusters used in Europe, investing in the collection of data, using a permanent form of risk sharing, and replacing the current premium "band" restrictions with more flexible restrictions. Policy makers need to understand the complexities of regulating competitive health insurance markets and to prevent risk selection that threatens the provision of good-quality care for underpriced high-cost patients. Project HOPE—The People-to-People Health Foundation, Inc.

  19. Alcohol consumption and high risk sexual behaviour among female ...

    African Journals Online (AJOL)

    Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1 027 women selected from 'hot spots' in the suburbs of ...

  20. Risk Analysis and Security Countermeasure Selection

    CERN Document Server

    Norman, Thomas L

    2009-01-01

    Explains how to evaluate the appropriateness of security countermeasures, from a cost-effectiveness perspective. This title guides readers from basic principles to complex processes in a step-by-step fashion, evaluating DHS-approved risk assessment methods, including CARVER, API/NPRA, RAMCAP, and various Sandia methodologies

  1. Risk calculations in the manufacturing technology selection process

    DEFF Research Database (Denmark)

    Farooq, S.; O'Brien, C.

    2010-01-01

    in the shape of opportunities and threats in different decision-making environments. Practical implications - The research quantifies the risk associated with different available manufacturing technology alternatives. This quantification of risk crystallises the process of technology selection decision making...... and supports an industrial manager in achieving objective and comprehensive decisions regarding selection of a manufacturing technology. Originality/value - The paper explains the process of risk calculation in manufacturing technology selection by dividing the decision-making environment into manufacturing......Purpose - The purpose of this paper is to present result obtained from a developed technology selection framework and provide a detailed insight into the risk calculations and their implications in manufacturing technology selection process. Design/methodology/approach - The results illustrated...

  2. Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) County Prevalence Data (2010 and prior)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2002-2010. BRFSS SMART County Prevalence land line only data. The Selected Metropolitan Area Risk Trends (SMART) project uses the Behavioral Risk Factor Surveillance...

  3. Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) MMSA Prevalence Data (2010 and Prior)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2002-2010. BRFSS SMART MMSA Prevalence land line only data. The Selected Metropolitan Area Risk Trends (SMART) project uses the Behavioral Risk Factor Surveillance...

  4. An efficient sampling strategy for selection of biobank samples using risk scores.

    Science.gov (United States)

    Björk, Jonas; Malmqvist, Ebba; Rylander, Lars; Rignell-Hydbom, Anna

    2017-07-01

    The aim of this study was to suggest a new sample-selection strategy based on risk scores in case-control studies with biobank data. An ongoing Swedish case-control study on fetal exposure to endocrine disruptors and overweight in early childhood was used as the empirical example. Cases were defined as children with a body mass index (BMI) ⩾18 kg/m(2) ( n=545) at four years of age, and controls as children with a BMI of ⩽17 kg/m(2) ( n=4472 available). The risk of being overweight was modelled using logistic regression based on available covariates from the health examination and prior to selecting samples from the biobank. A risk score was estimated for each child and categorised as low (0-5%), medium (6-13%) or high (⩾14%) risk of being overweight. The final risk-score model, with smoking during pregnancy ( p=0.001), birth weight ( poperating characteristic curve of 67% ( n=3945 with complete data). The case group ( n=416) had the following risk-score profile: low (12%), medium (46%) and high risk (43%). Twice as many controls were selected from each risk group, with further matching on sex. Computer simulations showed that the proposed selection strategy with stratification on risk scores yielded consistent improvements in statistical precision. Using risk scores based on available survey or register data as a basis for sample selection may improve possibilities to study heterogeneity of exposure effects in biobank-based studies.

  5. RISK ANALYSIS IN CONSTRUCTION PROJECTS: A PRACTICAL SELECTION METHODOLOGY

    OpenAIRE

    Alberto De Marco; Muhammad Jamaluddin Thaheem

    2014-01-01

    Project Risk Management (PRM) is gaining attention from researchers and practitioners in the form of sophisticated tools and techniques to help construction managers perform risk management. However, the large variety of techniques has made selecting an appropriate solution a complex and risky task in itself. Accordingly, this study proposes a practical framework methodology to assist construction project managers and practitioners in choosing a suitable risk analysis technique based on selec...

  6. Selective development of a strong Th2 cytokine profile in high-risk children who develop atopy: risk factors and regulatory role of IFN-? IL-4 and IL-10

    NARCIS (Netherlands)

    Velden, van der V.H.J.; Laan, M.P.; Baert, M.R.M.; Waal-Malefyt, de R.; Neijens, H.J.; Savelkoul, H.F.J.

    2001-01-01

    Background The immunological processes in early life and their relation to allergic sensitization leading to a Th2 cytokine profile are still not well understood. Objective To analyse the environmental and genetic risk factors and immunological responses at birth in relation to the development of

  7. Hepatitis C Virus universal screening versus risk based selective screening during pregnancy.

    Science.gov (United States)

    Waruingi, W; Mhanna, M J; Kumar, D; Abughali, N

    2015-01-01

    We sought to compare the value of HCV universal screening versus risk-based selective screening in pregnant women. In a prospective observational study (Jan 2012 - March 2012), pregnant women, in a high risk inner city clinic, who were at "low risk" for HCV infection were tested for HCV antibodies (universal screening) and their medical records were compared to the medical records of pregnant women who were at "high risk" (risk based selective screening as assessed by their obstetricians' screening questionnaire). During the study period, 419 women delivered at our institution with 8.8% (37/419) at high risk for HCV. In 95% (183/193) of available and consenting low risk women, HCV antibody testing was done. The prevalence of HCV was 3.18% (7/220; 95% CI: 1.36-6.50) in all tested women versus 0.95% (4/419; 95% CI: 0.31-2.59) in risk-based selectively tested women. Overall the screening questionnaire had a sensitivity of 0.85 (0.42-0.99) and a specificity of 0.52 (0.45-0.58) in all women who had HCV antibody testing and questionnaire screening. Using a screening questionnaire to identify women at risk for HCV infection during pregnancy under-estimates the real prevalence of HCV. A universal screening should be considered in high risk cities.

  8. Selection of technical risk responses for efficient contingencies

    Energy Technology Data Exchange (ETDEWEB)

    Kujawski, Edouard

    2002-02-28

    The primary goal of good project risk management should be to successfully deliver projects for the lowest cost at an acceptable level of risk. This requires the systematic development and implementation of a set of Risk Response Actions (RRA) that achieves the lowest total project cost for a given probability of success while meeting technical performance and schedule. We refer to this set as the ''efficient RRA set''. This work presents a practical and mathematically sound approach for determining the efficient RRA set. It builds on some of Markowitz's portfolio selection principles and introduces several conceptual and modeling differences to properly treat project technical risks. The set of RRAs is treated as whole and not just individual risks. The efficient RRA set is determined based on ''Outcome Cost Vs Probability of Success''. The risks and RRAs are characterized using scenarios, decision trees, and cumulative probability distributions. The analysis provides information that enables decision-makers to select the efficient RRA set that explicitly takes their attitude toward project risk into account. Decision-makers should find it both useful and practical for sound decision-making under uncertainty/risk and efficiently optimizing project success. The computations are readily performed using commercially available Monte Carlo simulation tools. The approach is detailed using a realistic but simplified case of a project with two technical risks.

  9. Risk Selection, Risk Adjustment and Choice: Concepts and Lessons from the Americas

    Science.gov (United States)

    Ellis, Randall P.; Fernandez, Juan Gabriel

    2013-01-01

    Interest has grown worldwide in risk adjustment and risk sharing due to their potential to contain costs, improve fairness, and reduce selection problems in health care markets. Significant steps have been made in the empirical development of risk adjustment models, and in the theoretical foundations of risk adjustment and risk sharing. This literature has often modeled the effects of risk adjustment without highlighting the institutional setting, regulations, and diverse selection problems that risk adjustment is intended to fix. Perhaps because of this, the existing literature and their recommendations for optimal risk adjustment or optimal payment systems are sometimes confusing. In this paper, we present a unified way of thinking about the organizational structure of health care systems, which enables us to focus on two key dimensions of markets that have received less attention: what choices are available that may lead to selection problems, and what financial or regulatory tools other than risk adjustment are used to influence these choices. We specifically examine the health care systems, choices, and problems in four countries: the US, Canada, Chile, and Colombia, and examine the relationship between selection-related efficiency and fairness problems and the choices that are allowed in each country, and discuss recent regulatory reforms that affect choices and selection problems. In this sample, countries and insurance programs with more choices have more selection problems. PMID:24284351

  10. Procedure for selecting GCM datasets for climate risk assessment

    Directory of Open Access Journals (Sweden)

    Chia-Yu Lin Ching-Pin Tung

    2017-01-01

    Full Text Available General Circulation Models (GCMs are indispensable tools to project future climate. It is not realistic or necessary to use all GCM datasets when assessing climate risks and building adaptive capacity. Thus, a rational procedure for selecting GCM datasets is needed. It is also required to classify weather stations into climate zones and then suggest a suitable list of GCM datasets to avoid weather stations with similar climate patterns but using different GCM datasets. The purpose of this study is to establish a process for selecting GCM datasets for a region. The process consists of climate zonation, applicability ranking, and a model similarity check. Principal component analysis (PCA and cluster analysis are used to classify regional weather stations into climate zones. The weighted average ranking (WAR method and demerit point system (DPS are then used to rank the GCM performance using CMIP5 (Coupled Model Intercomparison Project Phase 5 datasets. The GCM family tree is then applied to screen out highly similar GCMs before generating a GCM suggestion list. Taiwan is chosen as the study area for this investigation. Taiwan receives monthly mean precipitation data from 25 weather stations. The weather stations were clustered into ten climate zones with different GCM datasets suggested for each zone. The top five GCM datasets suggested for Taiwan by the WAR method are HadGEM2-AO, CESM1-CAM5, CCSM4, MIROC5, and GISS-E2-R while those suggested by the DPS method are CSIRO-Mk3-6-0, HadGEM2-AO, CESM1-CAM5, MIROC5, and CCSM4. The GCM selection process presented in this study is applicable to other regions to assist users in finding GCM datasets suitable for their research.

  11. Managing risk selection incentives in health sector reforms.

    Science.gov (United States)

    Puig-Junoy, J

    1999-01-01

    The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

  12. An assessment of high risk sexual behaviour and HIV transmission ...

    African Journals Online (AJOL)

    Method: A total of 300 randomly selected migrant oil workers were assessed using structured questionnaires to evaluate key highrisk sexual behavioral parameters such as multiplicity of sexual partners, bisexuality (closet homosexuality), high grade sexual behaviour and lesbianism. Sampling period was two months with ...

  13. Early Detection of High Risk Pregnancy

    OpenAIRE

    Kurniawan, Arif; Sistiarani, Colti; Hariyadi, Bambang

    2017-01-01

    There are 30.939 pregnant women in Banyumas, with 6.206 cases referred due to high-risk pregnancies. Petahunan village in Pekuncen has the the highest incidence of high-risk pregnancies compared with other villages. The purpose of this study is to describe the implementation of early detection of high-risk pregnancies in Petahunan village, Pekuncen. This study used qualitative research methods with case study approach. Research instruments used in-depth interviews and focus group disscussion ...

  14. [Socioeconomic factors in high risk pregnancy].

    Science.gov (United States)

    Armas Domínguez, J; Shor Pinsker, V; Mac Gregor, C; Karchmer, S

    1977-05-01

    The study of high risk during pregnancy was undertaken to show the most viable ways for solving those problems affecting maternal-fetal morbidity and mortality. The authors are hopeful that in the future, the 2 branches of medicine, perinatology and obstetrics, will no longer differentiate between high risk for mother and fetus or neonate but will direct attention to what is high risk for 1 society in particular. These professionals will undertake an interdisciplinary approach of the problem to benefit society. (author's)

  15. Risk factor selection in rate making: EM adaptive LASSO for zero-inflated poisson regression models.

    Science.gov (United States)

    Tang, Yanlin; Xiang, Liya; Zhu, Zhongyi

    2014-06-01

    Risk factor selection is very important in the insurance industry, which helps precise rate making and studying the features of high-quality insureds. Zero-inflated data are common in insurance, such as the claim frequency data, and zero-inflation makes the selection of risk factors quite difficult. In this article, we propose a new risk factor selection approach, EM adaptive LASSO, for a zero-inflated Poisson regression model, which combines the EM algorithm and adaptive LASSO penalty. Under some regularity conditions, we show that, with probability approaching 1, important factors are selected and the redundant factors are excluded. We investigate the finite sample performance of the proposed method through a simulation study and the analysis of car insurance data from SAS Enterprise Miner database. © 2014 Society for Risk Analysis.

  16. Optimal Feature Selection in High-Dimensional Discriminant Analysis.

    Science.gov (United States)

    Kolar, Mladen; Liu, Han

    2015-02-01

    We consider the high-dimensional discriminant analysis problem. For this problem, different methods have been proposed and justified by establishing exact convergence rates for the classification risk, as well as the ℓ 2 convergence results to the discriminative rule. However, sharp theoretical analysis for the variable selection performance of these procedures have not been established, even though model interpretation is of fundamental importance in scientific data analysis. This paper bridges the gap by providing sharp sufficient conditions for consistent variable selection using the sparse discriminant analysis (Mai et al., 2012). Through careful analysis, we establish rates of convergence that are significantly faster than the best known results and admit an optimal scaling of the sample size n , dimensionality p , and sparsity level s in the high-dimensional setting. Sufficient conditions are complemented by the necessary information theoretic limits on the variable selection problem in the context of high-dimensional discriminant analysis. Exploiting a numerical equivalence result, our method also establish the optimal results for the ROAD estimator (Fan et al., 2012) and the sparse optimal scaling estimator (Clemmensen et al., 2011). Furthermore, we analyze an exhaustive search procedure, whose performance serves as a benchmark, and show that it is variable selection consistent under weaker conditions. Extensive simulations demonstrating the sharpness of the bounds are also provided.

  17. Selecting Universal Screening Measures to Identify Students at Risk Academically

    Science.gov (United States)

    Salinger, Rachel L.

    2016-01-01

    Universal screening measures can be used to identify students at risk academically due to learning disabilities or other difficulties. Research and legislation support the use of screening measures early in students' education to ensure they receive any supports necessary to bolster their academic achievement. When selecting a screening measure,…

  18. Risk management among mountain bikers in selected clubs in ...

    African Journals Online (AJOL)

    Mountain biking is the best pedal sport on road and off road trails. The element of adventure in this sport make many people like to join this challenging sports. This study examined the risk among mountain bikers in selected clubs in Malaysia. The main objective of this study is to reveal injuries among mountain bikers ...

  19. Security Risks Management in Selected Academic Libraries in Osun ...

    African Journals Online (AJOL)

    The survival of a library depends to a large extent on how secured its collections are. Security of collections constitutes a critical challenge facing academic libraries in Nigeria. It is against this background that this study investigated the security risks management in selected academic libraries in Osun State, Nigeria.

  20. Selection and Mode Effects in Risk Preference Elicitation Experiments

    NARCIS (Netherlands)

    von Gaudecker, H.M.; van Soest, A.H.O.; Wengstrom, E.

    2008-01-01

    We combine data from a risk preference elicitation experiment conducted on a representative sample via the Internet with laboratory data on student subjects for the same experiment in order to investigate effects of implementation mode and of subject pool selection. We find that the frequency of

  1. Selected risk factors for coronary heart disease in male scholars ...

    African Journals Online (AJOL)

    A num.ber of risk factors for coronary heart disease (CHD) in 7 groups of South African male scholars aged between 15 and 20 years were surveyed. Selection of the groups was based on socioeconomic status and comprised urban and rural blacks, Indians of higher and lower socio-economic status, coloureds of higher ...

  2. Low risk and high risk human papillomaviruses (HPVs) and cervical ...

    African Journals Online (AJOL)

    Low risk and high risk human papillomaviruses (HPVs) and cervical cancer in Zimbabwe: epidemiological evidence. M Chirara, G A Stanczuk, S A Tswana, L Nystrom, S Bergstrom, S R Moyo, M J Nzara. Abstract. No Abstract. Central African Journal of Medicine Vol. 47 (2) 2001: pp. 32-34.

  3. Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) County Prevalence Data (2011 to 2012)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011 to 2012. BRFSS SMART County Prevalence combined land line and cell phone data. The Selected Metropolitan Area Risk Trends (SMART) project uses the Behavioral...

  4. Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) MMSA Prevalence Data (2011 to Present)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011 to present. BRFSS SMART MMSA Prevalence combined land line and cell phone data. The Selected Metropolitan Area Risk Trends (SMART) project uses the Behavioral...

  5. Impact of Selection Bias on Estimation of Subsequent Event Risk.

    Science.gov (United States)

    Hu, Yi-Juan; Schmidt, Amand F; Dudbridge, Frank; Holmes, Michael V; Brophy, James M; Tragante, Vinicius; Li, Ziyi; Liao, Peizhou; Quyyumi, Arshed A; McCubrey, Raymond O; Horne, Benjamin D; Hingorani, Aroon D; Asselbergs, Folkert W; Patel, Riyaz S; Long, Qi

    2017-10-01

    Studies of recurrent or subsequent disease events may be susceptible to bias caused by selection of subjects who both experience and survive the primary indexing event. Currently, the magnitude of any selection bias, particularly for subsequent time-to-event analysis in genetic association studies, is unknown. We used empirically inspired simulation studies to explore the impact of selection bias on the marginal hazard ratio for risk of subsequent events among those with established coronary heart disease. The extent of selection bias was determined by the magnitudes of genetic and nongenetic effects on the indexing (first) coronary heart disease event. Unless the genetic hazard ratio was unrealistically large (>1.6 per allele) and assuming the sum of all nongenetic hazard ratios was bias was usually bias, the probability that a confidence interval included the true effect decreased (undercoverage) with increasing sample size because of increasing precision. Importantly, false-positive rates were not affected by selection bias. In most empirical settings, selection bias is expected to have a limited impact on genetic effect estimates of subsequent event risk. Nevertheless, because of undercoverage increasing with sample size, most confidence intervals will be over precise (not wide enough). When there is no effect modification by history of coronary heart disease, the false-positive rates of association tests will be close to nominal. © 2017 American Heart Association, Inc.

  6. Properties of Risk Measures of Generalized Entropy in Portfolio Selection

    Directory of Open Access Journals (Sweden)

    Rongxi Zhou

    2017-12-01

    Full Text Available This paper systematically investigates the properties of six kinds of entropy-based risk measures: Information Entropy and Cumulative Residual Entropy in the probability space, Fuzzy Entropy, Credibility Entropy and Sine Entropy in the fuzzy space, and Hybrid Entropy in the hybridized uncertainty of both fuzziness and randomness. We discover that none of the risk measures satisfy all six of the following properties, which various scholars have associated with effective risk measures: Monotonicity, Translation Invariance, Sub-additivity, Positive Homogeneity, Consistency and Convexity. Measures based on Fuzzy Entropy, Credibility Entropy, and Sine Entropy all exhibit the same properties: Sub-additivity, Positive Homogeneity, Consistency, and Convexity. These measures based on Information Entropy and Hybrid Entropy, meanwhile, only exhibit Sub-additivity and Consistency. Cumulative Residual Entropy satisfies just Sub-additivity, Positive Homogeneity, and Convexity. After identifying these properties, we develop seven portfolio models based on different risk measures and made empirical comparisons using samples from both the Shenzhen Stock Exchange of China and the New York Stock Exchange of America. The comparisons show that the Mean Fuzzy Entropy Model performs the best among the seven models with respect to both daily returns and relative cumulative returns. Overall, these results could provide an important reference for both constructing effective risk measures and rationally selecting the appropriate risk measure under different portfolio selection conditions.

  7. Risk scoring for selective screening of cervical cancer | Bukar ...

    African Journals Online (AJOL)

    Context: Cervical cancer is the leading cause of cancer related mortality in developing countries. The lack of routine cytological screening in developing countries is largely responsible for this high mortality. Objectives: To develop a risk score that would easily identify women at greater risk of having cervical intraepithelial ...

  8. High risk of permafrost thaw

    Science.gov (United States)

    E.A.G. Schuur; B.W. Abbott; W.B. Bowden; V. Brovkin; P. Camill; J.P. Canadell; F.S. Chapin; T.R. Christensen; J.P. Chanton; P. Ciais; P.M. Crill; B.T. Crosby; C.I. Czimczik; G. Grosse; D.J. Hayes; G. Hugelius; J.D. Jastrow; T. Kleinen; C.D. Koven; G. Krinner; P. Kuhry; D.M. Lawrence; S.M. Natali; C.L. Ping; A. Rinke; W.J. Riley; V.E. Romanovsky; A.B.K. Sannel; C. Schadel; K. Schaefer; Z.M. Subin; C. Tarnocai; M. Turetsky; K. M. Walter-Anthony; C.J. Wilson; S.A. Zimov

    2011-01-01

    Arctic temperatures are rising fast, and permafrost is thawing. Carbon released into the atmosphere from permafrost soils will accelerate climate change, but the magnitude of this effect remains highly uncertain. Our collective estimate is that carbon will be released more quickly than models suggest, and at levels that are cause for serious concern. We calculate that...

  9. Risk management practices of high school principals regarding ...

    African Journals Online (AJOL)

    This study was undertaken to identify what the key safety concerns at schools in PE are, and to establish what the risk management practices implemented by principals at high schools in selected provinces are. This paper follows the approach that school principals are staff with the highest authority and legal liability for the ...

  10. Highly Selective Hydroformylation of the Cinchona Alkaloids

    NARCIS (Netherlands)

    Lambers, Marielle; Beijer, Felix H.; Padron, José M.; Toth, Imre; Vries, Johannes G. de

    2002-01-01

    The four naturally occurring cinchona alkaloids were subjected to hydroformylation to create an extra functional group that allows immobilization. Cinchonidine, quinine, and quinidine, could be hydroformylated with virtually complete terminal selectivity, using a rhodium/tetraphosphite catalyst. The

  11. Efficient and Highly Aldehyde Selective Wacker Oxidation

    KAUST Repository

    Teo, Peili

    2012-07-06

    A method for efficient and aldehyde-selective Wacker oxidation of aryl-substituted olefins using PdCl 2(MeCN) 2, 1,4-benzoquinone, and t-BuOH in air is described. Up to a 96% yield of aldehyde can be obtained, and up to 99% selectivity can be achieved with styrene-related substrates. © 2012 American Chemical Society.

  12. Improving antenatal risk assessment in women exposed to high risks.

    Science.gov (United States)

    Perry, Natasha; Newman, Louise K; Hunter, Mick; Dunlop, Adrian

    2015-01-01

    Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview - Revised Short Version) and mother-infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the 'exposed to high risks' group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women 'exposed to high risks' were equally able to generate a model of their own and their infants' mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups. © The Author(s) 2013.

  13. The high-risk plaque initiative

    DEFF Research Database (Denmark)

    Falk, Erling; Sillesen, Henrik; Muntendam, Pieter

    2011-01-01

    The High-Risk Plaque (HRP) Initiative is a research and development effort to advance the understanding, recognition, and management of asymptomatic individuals at risk for a near-term atherothrombotic event such as myocardial infarction or stroke. Clinical studies using the newest technologies...

  14. Spatially-Correlated Risk in Nature Reserve Site Selection.

    Science.gov (United States)

    Albers, Heidi J; Busby, Gwenlyn M; Hamaide, Bertrand; Ando, Amy W; Polasky, Stephen

    2016-01-01

    Establishing nature reserves protects species from land cover conversion and the resulting loss of habitat. Even within a reserve, however, many factors such as fires and defoliating insects still threaten habitat and the survival of species. To address the risk to species survival after reserve establishment, reserve networks can be created that allow some redundancy of species coverage to maximize the expected number of species that survive in the presence of threats. In some regions, however, the threats to species within a reserve may be spatially correlated. As examples, fires, diseases, and pest infestations can spread from a starting point and threaten neighboring parcels' habitats, in addition to damage caused at the initial location. This paper develops a reserve site selection optimization framework that compares the optimal reserve networks in cases where risks do and do not reflect spatial correlation. By exploring the impact of spatially-correlated risk on reserve networks on a stylized landscape and on an Oregon landscape, this analysis demonstrates an appropriate and feasible method for incorporating such post-reserve establishment risks in the reserve site selection literature as an additional tool to be further developed for future conservation planning.

  15. Spatially-Correlated Risk in Nature Reserve Site Selection.

    Directory of Open Access Journals (Sweden)

    Heidi J Albers

    Full Text Available Establishing nature reserves protects species from land cover conversion and the resulting loss of habitat. Even within a reserve, however, many factors such as fires and defoliating insects still threaten habitat and the survival of species. To address the risk to species survival after reserve establishment, reserve networks can be created that allow some redundancy of species coverage to maximize the expected number of species that survive in the presence of threats. In some regions, however, the threats to species within a reserve may be spatially correlated. As examples, fires, diseases, and pest infestations can spread from a starting point and threaten neighboring parcels' habitats, in addition to damage caused at the initial location. This paper develops a reserve site selection optimization framework that compares the optimal reserve networks in cases where risks do and do not reflect spatial correlation. By exploring the impact of spatially-correlated risk on reserve networks on a stylized landscape and on an Oregon landscape, this analysis demonstrates an appropriate and feasible method for incorporating such post-reserve establishment risks in the reserve site selection literature as an additional tool to be further developed for future conservation planning.

  16. High risk of permafrost thaw

    Energy Technology Data Exchange (ETDEWEB)

    Schuur, E.A.G.; Abbott, B.; Koven, C.D,; Riley, W.J.; Subin, Z.M.; al, et

    2011-11-01

    In the Arctic, temperatures are rising fast, and permafrost is thawing. Carbon released to the atmosphere from permafrost soils could accelerate climate change, but the likely magnitude of this effect is still highly uncertain. A collective estimate made by a group of permafrost experts, including myself, is that carbon could be released more quickly than models currently suggest, and at levels that are cause for serious concern. While our models of carbon emission from permafrost thaw are lacking, experts intimately familiar with these landscapes and processes have accumulated knowledge about what they expect to happen, based on both quantitative data and qualitative understanding of these systems. We (the authors of this piece) attempted to quantify this expertise through a survey developed over several years, starting in 2009. Our survey asked experts what percentage of surface permafrost they thought was likely to thaw, how much carbon would be released, and how much of that would be methane, for three time periods and under four warming scenarios that are part of the new IPCC Fifth Assessment Report.

  17. Selected aspects of Mediterranean diet and cancer risk.

    Science.gov (United States)

    Pelucchi, Claudio; Bosetti, Cristina; Rossi, Marta; Negri, Eva; La Vecchia, Carlo

    2009-01-01

    European Mediterranean populations have a high life expectancy. Several aspects of their diet are considered favorable on health. We considered the role of various aspects of the Mediterranean diet on cancer risk in a series of Italian case-control studies including about 10,000 cases of cancer at 13 different sites and over 17,000 controls. For most epithelial cancers, the risk decreased with increasing vegetable consumption. Allium vegetables were also favorably related to cancer risk. Fruit intake was inversely associated with digestive tract and laryngeal cancers. For digestive tract cancers, the population attributable risks for low intake of vegetables and fruit ranged between 15% and 40%. Olive oil and unsaturated fats, which are typical aspects of the Mediterranean diet, were inversely related to the risk of several cancers, particularly of the upper aerodigestive tract. Whole grain food (and hence possibly fiber) intake was also related to reduced risk of various cancers. In contrast, refined grains and, consequently, glycemic load and index were associated to increased risks. Several micronutrients and food components (including folate, flavonoids, and carotenoids) showed inverse relations with cancer risk, but the main component(s) responsible for the favorable effect of a diet rich in vegetables and fruit remain undefined.

  18. Assessing risk to birds from industrial wind energy development via paired resource selection models.

    Science.gov (United States)

    Miller, Tricia A; Brooks, Robert P; Lanzone, Michael; Brandes, David; Cooper, Jeff; O'Malley, Kieran; Maisonneuve, Charles; Tremblay, Junior; Duerr, Adam; Katzner, Todd

    2014-06-01

    When wildlife habitat overlaps with industrial development animals may be harmed. Because wildlife and people select resources to maximize biological fitness and economic return, respectively, we estimated risk, the probability of eagles encountering and being affected by turbines, by overlaying models of resource selection for each entity. This conceptual framework can be applied across multiple spatial scales to understand and mitigate impacts of industry on wildlife. We estimated risk to Golden Eagles (Aquila chrysaetos) from wind energy development in 3 topographically distinct regions of the central Appalachian Mountains of Pennsylvania (United States) based on models of resource selection of wind facilities (n = 43) and of northbound migrating eagles (n = 30). Risk to eagles from wind energy was greatest in the Ridge and Valley region; all 24 eagles that passed through that region used the highest risk landscapes at least once during low altitude flight. In contrast, only half of the birds that entered the Allegheny Plateau region used highest risk landscapes and none did in the Allegheny Mountains. Likewise, in the Allegheny Mountains, the majority of wind turbines (56%) were situated in poor eagle habitat; thus, risk to eagles is lower there than in the Ridge and Valley, where only 1% of turbines are in poor eagle habitat. Risk within individual facilities was extremely variable; on average, facilities had 11% (SD 23; range = 0-100%) of turbines in highest risk landscapes and 26% (SD 30; range = 0-85%) of turbines in the lowest risk landscapes. Our results provide a mechanism for relocating high-risk turbines, and they show the feasibility of this novel and highly adaptable framework for managing risk of harm to wildlife from industrial development. © 2014 Society for Conservation Biology.

  19. Management of high-risk pregnancy.

    Science.gov (United States)

    Coco, L; Giannone, T T; Zarbo, G

    2014-08-01

    Today, 88% of pregnancies has a physiological course during which just basic care, while in 12% of cases there is a high-risk pregnancy that requires additional assistance and specific. The approach that should be used is that of supervision in all pregnant women considering their potential to have a normal pregnancy until there is no clear evidence to the contrary. Pregnancy is considered at risk if there are medical conditions that may affect maternal or fetal health or life of the mother, fetus or both. Among the risk factors for pregnancy there is first the woman's age, in fact the increase in high-risk pregnancies in the last 20 years is attributable to the increase in the average age of women who face pregnancy. In addition, the diet is very important during pregnancy and diabetes or autoimmune diseases often lead to the failure of a pregnancy. Risk factors for pregnancy, also, are the complications that occur during its course as hypertension during pregnancy, and infectious diseases. Fears and anxieties typical of a high-risk pregnancy prevent the couple to live happily in the months of gestation. Effective communication, control and early detection are important tools that doctors must be able to ensure that women in order to plan the best treatment strategies and to minimize the risks of maternal and / or fetal.

  20. Covariate selection for the semiparametric additive risk model

    DEFF Research Database (Denmark)

    Martinussen, Torben; Scheike, Thomas

    2009-01-01

    This paper considers covariate selection for the additive hazards model. This model is particularly simple to study theoretically and its practical implementation has several major advantages to the similar methodology for the proportional hazards model. One complication compared with the proport......This paper considers covariate selection for the additive hazards model. This model is particularly simple to study theoretically and its practical implementation has several major advantages to the similar methodology for the proportional hazards model. One complication compared...... of observations. We do this by studying the properties of the so-called Dantzig selector in the setting of the additive risk model. Specifically, we establish a bound on how close the solution is to a true sparse signal in the case where the number of covariates is large. In a simulation study, we also compare...

  1. Electroconvulsive therapy during high-risk pregnancy.

    Science.gov (United States)

    Walker, R; Swartz, C M

    1994-09-01

    Pregnancy increases the risk of injury associated with mental illness. The varieties of malnutrition, substance abuse, and aggression that may accompany mental illness can injure the unborn child in more severe ways than the patient herself. Dangers associated with illness-related behavior can outweight the risks of pharmacotherapy, but no psychotropic drug is approved for use during pregnancy. Failure to produce a prompt or lasting remission of psychiatric symptoms also is a significant possibility with medication. The morbidity from continued illness and the incompletely described adverse effects of psychotropic drugs increases the attractiveness of ECT for severely depressed pregnant patients, especially with associated high-risk conditions. This paper discusses physiologic changes occurring during pregnancy and ECT and reviews contemporary monitors of maternal and fetal well-being. Guidelines are suggested for ECT during regular and high-risk pregnancies. The authors conclude that using additional precautions with high-risk pregnant patients permits ECT to be given with relative safety; medical and obstetric risk factors need not prevent its use.

  2. Evaluation and Selection of International Supplier, Underscoring Risk Factors

    Directory of Open Access Journals (Sweden)

    seyed Mohammad Ali Khatami Firouzabadi

    2014-05-01

    Full Text Available This paper evaluates the decision making process for import complete manufactured pieces versus import of partial pieces to assemble in Iran, taking into account the risk factors for a manufacturing company. Since this sort of decision making confront with several risks, it is necessary to establish a process for finding the risks associated with this kind of problems in order to decrease the effects of these risks in the process. Since the problem is classified as a Multiple Criteria Decision Making (MCDM problem, Uncertain Analytical Hierarchy Process (UAHP was used to find the most attractive alternative. Because the alternatives were identified from the first point, a bottom-up procedure was used to organize the hierarchy. In initial stage, the attributes which distinct from the alternatives were obtained by literature review and experts' interviews. Then the attributes were grouped to upper level to establish the criteria. Three criteria were found from this stage. The criteria were product, partners, and environment which they encompassed 12 attributes. Forming the hierarchy and doing the uncertain pairwised comparisons, which considers a range of numbers instead of one single number for declaring the preference between two factors, a Linear Programming (LP model with two types of objective functions were formed for each individual alternative. Each single LP model can express the maximum and minimum value of each individual alternative. The research's results indicate the most appropriate alternative is to import the final product from India. The last preferred one was to import the parts of the final product from India. This study can be a suitable framework in supply chain management and purchasing decisions and risk evaluations because the major parts of manufacturing activities is always to decide about the selection of most preferred strategies for companies.

  3. Optical Transmitter Terminal for Selective RF High Frequency Bans Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of the proposal work is to investigate the highly innovative conceptual design of an optical communication selective frequency transmitter terminal...

  4. High risk process control system assessment methodology

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Venetia [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio), RJ (Brazil); Zamberlan, Maria Cristina [National Institute of Tehnology (INT), Rio de Janeiro, RJ (Brazil). Human Reliability and Ergonomics Research Group for the Oil, Gas and Energy Sector

    2009-07-01

    The evolution of ergonomics methodology has become necessary due to the dynamics imposed by the work environment, by the increase of the need of human cooperation and by the high interaction between various sections within a company. In the last 25 years, as of studies made in the high risk process control, we have developed a methodology to evaluate these situations that focus on the assessment of activities and human cooperation, the assessment of context, the assessment of the impact of work of other sectors in the final activity of the operator, as well as the modeling of existing risks. (author)

  5. Selection and characterisation of high ethanol tolerant ...

    African Journals Online (AJOL)

    STORAGESEVER

    2008-12-17

    Dec 17, 2008 ... 15% ethanol tolerance. High level ethanol tolerant Saccharomyces yeast, Orc 6, was investigated for its potential application in .... Growth in media of osmotic pressure range 0 - 25% (w/v) sorbitol ..... Saccharomyces cerevisiae through soya flour supplementation. Biotechnol. Lett. 10(3): 217-220. Bechem ...

  6. Treatment of high-risk smoldering myeloma.

    Science.gov (United States)

    Korde, Neha

    2016-12-01

    Multiple myeloma (MM) is a hematologic malignancy of the plasma cell that causes symptoms of bone pain, renal failure, and anemia. It is usually preceded by a precursor disease state, such as smoldering multiple myeloma (SMM) or monoclonal gammopathy of undetermined significance (MGUS), and traditional dogma dictates that treatment should be initiated on frank MM symptom development. Emerging evidence suggests that a defined group of "high-risk SMM" may benefit from early treatment, before organ damage and symptoms actually occur. The following article frames the evidence for treatment of high-risk SMM by defining risk categories, reviewing existing therapeutic trial data, and exploring the long-term biologic implications of early treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Not all risks are equal: the risk taking inventory for high-risk sports.

    Science.gov (United States)

    Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

    2013-10-01

    Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

  8. Multiple causes of high extinction risk in large mammal species.

    Science.gov (United States)

    Cardillo, Marcel; Mace, Georgina M; Jones, Kate E; Bielby, Jon; Bininda-Emonds, Olaf R P; Sechrest, Wes; Orme, C David L; Purvis, Andy

    2005-08-19

    Many large animal species have a high risk of extinction. This is usually thought to result simply from the way that species traits associated with vulnerability, such as low reproductive rates, scale with body size. In a broad-scale analysis of extinction risk in mammals, we find two additional patterns in the size selectivity of extinction risk. First, impacts of both intrinsic and environmental factors increase sharply above a threshold body mass around 3 kilograms. Second, whereas extinction risk in smaller species is driven by environmental factors, in larger species it is driven by a combination of environmental factors and intrinsic traits. Thus, the disadvantages of large size are greater than generally recognized, and future loss of large mammal biodiversity could be far more rapid than expected.

  9. Breast MRI in high risk patients

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie)

    2015-01-01

    markdownabstractAbstract In this thesis we address various indications of breast MRI, with the emphasis on the value of MRI in screening of women with high genetic risk for breast cancer, and especially in BRCA1 mutation carriers. We showed that in the era of up-to-date MRI expertise and

  10. Trends in emerging and high risk activities

    Science.gov (United States)

    Robert C. White; Richard Schreyer; Kent Downing

    1980-01-01

    Newly emerging and high risk activities have increased markedly in the last generation, yet little is known about trends in participation. Factors such as technological innovation and creative experimentation with traditional activities appear to play a major role in the development of new activities. Christy's criteria for mass demand in recreation are used to...

  11. Evaluation of a matrix-assisted laser desorption ionization-time of flight mass spectrometry assisted, selective broth method to screen for vancomycin-resistant enterococci in patients at high risk.

    Science.gov (United States)

    Huang, Tsi-Shu; Lee, Susan Shin-Jung; Lee, Chia-Chien; Chen, Chiu-Yen; Chen, Fang-Chen; Chen, Bao-Chen; Sy, Cheng Len; Wu, Kuan-Sheng

    2017-01-01

    Bile esculin azide with vancomycin (BEAV) medium is a sensitive, but slightly less specific method for vancomycin-resistant enterococci (VRE) screening. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a rapid method for identification of clinical pathogens. This study aimed to assess the performance of a novel combination screening test for VRE, using BEAV broth combined with MALDI-TOF MS. Clinical specimens were collected from patients at risk of VRE carriage, and tested by the novel combination method, using selective BEAV broth culture method followed by MALDI-TOF MS identification (SBEAVM). The reference method used for comparison was the ChromID VRE agar method. A total of 135 specimens were collected from 78 patients, and 63 specimens tested positive for VRE positive using the ChromID VRE method (positive rate 46.7%). The sensitivity, specificity, positive predictive value, and negative predictive value of SBEAVM method after an incubation period of 28 hours were 93.7%, 90.3%, 89.4%, and 94.2%, respectively. The SBEAVM method when compared to the ChromID VRE method had a shorter turnaround time (29 vs. 48-72 hours) and lower laboratory cost ($2.11 vs. $3.23 per test). This study demonstrates that SBEAVM is a rapid, inexpensive, and accurate method for use in VRE screening.

  12. Prevalent cardiovascular disease, risk factors and selection out of shift work.

    Science.gov (United States)

    Kivimäki, Mika; Virtanen, Marianna; Elovainio, Marko; Väänänen, Ari; Keltikangas-Järvinen, Liisa; Vahtera, Jussi

    2006-06-01

    This study examines whether health-related selection out of shift work is likely to bias the association between shift work and cardiovascular disease (CVD). Survey data on doctor-diagnosed CVD (myocardial infarction, angina, or hypertension) and risk factors (high blood pressure, high cholesterol concentration, obesity, and diabetes) were collected in 2000-2002 for a cohort of 7037 female nurses (5038 shift workers, 1999 day workers) in 21 Finnish hospitals. The follow-up in 2004 determined those who had left their workplace or changed from shift work to day work. Among the shift workers, the age-adjusted odds for leaving the organization was 1.83 (95% CI 1.01-3.32) times higher for those with prevalent diabetes and 2.21 (95% CI 1.12-4.39) times higher for those with three to four risk factors than for their counterparts with no diabetes or risk factors. The associations between CVD risk factors and leaving the organization were similar for the day workers. The prevalent CVD and risk factors did not predict a change to day work among the shift workers who remained in the organization during the entire follow-up period. Employees with several risk factors are more likely to leave an organization regardless of the type of work schedule. Health-related selection out of shift work is an unlikely source of major bias in research on shift work and CVD.

  13. Selected Tools for Risk Analysis in Logistics Processes

    Science.gov (United States)

    Kulińska, Ewa

    2012-03-01

    As each organization aims at managing effective logistics processes, risk factors can and should be controlled through proper system of risk management. Implementation of complex approach to risk management allows for the following: - evaluation of significant risk groups associated with logistics processes implementation, - composition of integrated strategies of risk management, - composition of tools for risk analysis in logistics processes.

  14. Selection of Highly Expressed Gene Variants in Escherichia coli Using Translationally Coupled Antibiotic Selection Markers

    DEFF Research Database (Denmark)

    Rennig, Maja; Daley, Daniel O.; Nørholm, Morten H. H.

    2018-01-01

    Strategies to select highly expressed variants of a protein coding sequence are usually based on trial-and-error approaches, which are time-consuming and expensive. We address this problem using translationally coupled antibiotic resistance markers. The system requires that the target gene can...... be fused at the 3'-end with a translational coupling element and an antibiotic resistance gene. Highly expressed target genes can then be selected using a fast and simple whole cell survival assay in the presence of high antibiotic concentrations. Herein we show that the system can be used to select highly...

  15. Does widowhood increase mortality risk?: testing for selection effects by comparing causes of spousal death.

    Science.gov (United States)

    Boyle, Paul J; Feng, Zhiqiang; Raab, Gillian M

    2011-01-01

    We consider whether widowhood increases mortality risk. Although commonly observed, this "widowhood effect" could be due to selection effects, as married couples share various characteristics related to the risk of death. We therefore consider the widowhood effect by various causes of spousal death; some causes of death are correlated with shared characteristics in couples, while others are not. Using data from the Scottish Longitudinal Study, we compare outcomes for men and women by the causes of death of their spouse, controlling for a range of individual- and household-level characteristics. The widowhood effect in these data is greater than has been found in other recent studies, with adjusted hazard ratios of 1.40 (95% confidence interval = 1.33-1.47) for men and 1.36 (1.30-1.44) for women. The risk is highest shortly after widowhood, but remains raised for at least 10 years. There was little evidence that these hazard ratios differed by any classification of the cause of death of the spouse, but interactions were found for those with pre-existing illness or other risk factors. The hazard ratios for widowhood were lower for persons with preexisting risks. Our analysis of the widowhood effect uses 3 methods of classifying the causes of spousal death in an attempt to control for potential selection effects. Our results are highly consistent and suggest that this is a causal effect, rather than a result of selection.

  16. Staying Out of Trouble: Community Resources and Problem Behavior among High-Risk Adolescents.

    Science.gov (United States)

    Kowaleski-Jones, Lori

    2000-01-01

    Using merged data on adolescents (N=860), research looks at how community resources affect adolescent risk-taking attitudes and problem behavior. Determined that among high-risk adolescents, selected community resources have significant associations with adolescent outcomes. Residential stability decreases both adolescent risk-taking attitudes and…

  17. Major Risk Factors for Heart Disease: High Blood Cholesterol

    Science.gov (United States)

    ... Major Risk Factors for Heart Disease High Blood Cholesterol High blood cholesterol is another major risk factor for heart disease ... can do something about. The higher your blood cholesterol level, the greater your risk for developing heart ...

  18. Risk assessment - hospital view in selecting medical technology.

    Science.gov (United States)

    David, Yadin; Jahnke, Ernest; Blair, Curtis

    2004-01-01

    Appropriate deployment of technological innovation contributes to improvement in the quality of healthcare delivered, the containment of cost, and access to the healthcare system. Hospitals have been allocating a significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for new medical equipment and are asked to manage existing inventory for which they are not well prepared. To objectively direct their investment, hospitals are developing medical technology management programs that need pertinent information and planning methodology for integrating new equipment into existing operations as well as for mitigating patient safety issues and costs of ownership. Clinical engineers identify technological solutions based on the matching of new medical equipment with hospital's objectives. They review their institution's overall technological position, determine strengths and weaknesses, develop equipment-selection criteria, supervise installations, train users and monitor post procurement performance to assure meeting of goals. This program, together with consistent assessment methodology and evaluation analysis, will objectively guide the capital assets decision-making process. At Texas Children's Hospital we integrated engineering simulation, bench testing and clinical studies with financial information to assure the validity of risk avoidance practice and the promotion of medical equipment and supplies selection based on quantitative measurement process and product comparison practice. The clinical engineer's skills and expertise are needed to facilitate the adoption of an objective methodology for implementing the program, thus improving the match between the hospital's needs and budget projections, equipment performance and cost of ownership. The result of systematic planning and execution is a program that assures the safety and appropriateness of inventory level at the lowest life-cycle costs at the

  19. Selected anthropometric variables and aerobic fitness as predictors of cardiovascular disease risk in children

    Directory of Open Access Journals (Sweden)

    R Gonçalves

    2015-09-01

    Full Text Available The aim of this study was to assess the suitability of body mass index, waist circumference, waist-to-height ratio and aerobic fitness as predictors of cardiovascular risk factor clustering in children. A cross-sectional study was conducted with 290 school boys and girls from 6 to 10 years old, randomly selected. Blood was collected after a 12-hour fasting period. Blood pressure, waist circumference (WC, height and weight were evaluated according to international standards. Aerobic fitness (AF was assessed by the 20-metre shuttle-run test. Clustering was considered when three of these factors were present: high systolic or diastolic blood pressure, high low-density lipoprotein (LDL cholesterol, high triglycerides, high plasma glucose, high insulin concentrations and low high-density lipoprotein (HDL cholesterol. A ROC curve identified the cut-off points of body mass index (BMI, WC, waist-to-height ratio (WHtR and AF as predictors of risk factor clustering. BMI, WC and WHR resulted in significant areas under the ROC curves, which was not observed for AF. The anthropometric variables were good predictors of cardiovascular risk factor clustering in both sexes, whereas aerobic fitness should not be used to identify cardiovascular risk factor clustering in these children.

  20. CBFS: high performance feature selection algorithm based on feature clearness.

    Directory of Open Access Journals (Sweden)

    Minseok Seo

    Full Text Available BACKGROUND: The goal of feature selection is to select useful features and simultaneously exclude garbage features from a given dataset for classification purposes. This is expected to bring reduction of processing time and improvement of classification accuracy. METHODOLOGY: In this study, we devised a new feature selection algorithm (CBFS based on clearness of features. Feature clearness expresses separability among classes in a feature. Highly clear features contribute towards obtaining high classification accuracy. CScore is a measure to score clearness of each feature and is based on clustered samples to centroid of classes in a feature. We also suggest combining CBFS and other algorithms to improve classification accuracy. CONCLUSIONS/SIGNIFICANCE: From the experiment we confirm that CBFS is more excellent than up-to-date feature selection algorithms including FeaLect. CBFS can be applied to microarray gene selection, text categorization, and image classification.

  1. Can Risk Adjustment prevent Risk Selection in a Competitive Long-Term Care Insurance Market?

    NARCIS (Netherlands)

    P.L.H. Bakx (Pieter); F.T. Schut (Erik); E.K.A. van Doorslaer (Eddy)

    2013-01-01

    textabstractWhen public long-term care (LTC) insurance is provided by insurers, they typically lack incentives for purchasing cost-effective LTC. Providing insurers with appropriate incentives for efficiency without jeopardizing access for high-risk individuals requires, among other things, an

  2. A Novel Multiobjective Programming Model for Coping with Supplier Selection Disruption Risks under Mixed Uncertainties

    Directory of Open Access Journals (Sweden)

    Ying Li

    2016-01-01

    Full Text Available Supply chain has become more and more vulnerable to disruption since it is suffering widespread risk issues from inside or outside. Higher uncertainties in the supplier selection problem have gone beyond the traditional cost minimization concern. These uncertainties are related to an ever increasing product variety, more demanding customers, and a highly interconnected distribution network. This paper focuses on the supplier selection problem with disruption risks and mixed uncertainties. A novel multiobjective optimization model with mixed uncertain coefficients is developed, which maximizes the total profits and minimizes the percentage of items delivered late, percentage of items rejected, and total loss cost due to supplier dysfunction. Meanwhile, we also consider the customer demand to be a random fuzzy variable and the unit purchase cost to be a fuzzy variable. By examining a numerical example, we found that the confidence level and demand of customers have impact on the quantities purchased by customers from suppliers although the distribution of suppliers will not change. The cost, quality, and service also influence the selection of suppliers. The superevents have little influence on the distribution of supplier selection; however, when unique event occurs, the distribution of supplier selection will change.

  3. Solving portfolio selection problems with minimum transaction lots based on conditional-value-at-risk

    Science.gov (United States)

    Setiawan, E. P.; Rosadi, D.

    2017-01-01

    Portfolio selection problems conventionally means ‘minimizing the risk, given the certain level of returns’ from some financial assets. This problem is frequently solved with quadratic or linear programming methods, depending on the risk measure that used in the objective function. However, the solutions obtained by these method are in real numbers, which may give some problem in real application because each asset usually has its minimum transaction lots. In the classical approach considering minimum transaction lots were developed based on linear Mean Absolute Deviation (MAD), variance (like Markowitz’s model), and semi-variance as risk measure. In this paper we investigated the portfolio selection methods with minimum transaction lots with conditional value at risk (CVaR) as risk measure. The mean-CVaR methodology only involves the part of the tail of the distribution that contributed to high losses. This approach looks better when we work with non-symmetric return probability distribution. Solution of this method can be found with Genetic Algorithm (GA) methods. We provide real examples using stocks from Indonesia stocks market.

  4. Defining high risk in endovascular aneurysm repair.

    Science.gov (United States)

    Mastracci, Tara M; Greenberg, Roy K; Hernandez, Adrian V; Morales, Catherine

    2010-05-01

    Long-term survival benefit contrasted with rupture risk should determine which patients are suitable for abdominal aortic aneurysm (AAA) intervention. Our aim was to develop a model capable of predicting long-term survival based on preoperative characteristics. A prospective cohort study using Cox regression modeling. We aimed to associate preoperative characteristics with long-term mortality, and create a predictive nomogram, which was then externally validated on an independent cohort (697 patients) who underwent endovascular abdominal aortic aneurysm (AAA) repair. We pooled the results of 412 patients undergoing endovascular repair of infrarenal and juxtarenal aneurysm who were high risk (average Glasgow aneurysm scores of 72.8 [SD 10.4]). Despite anatomic differences, there were no statistically significant differences in perioperative or long-term outcomes between infrarenal and juxtarenal aneurysms (log rank test, P = .5). Data from this group (64% infrarenal aneurysms and 36% juxtarenal aneurysms) were randomly and evenly split into a model development and test group. Independent predictors of mortality included in the model are age, aneurysm diameter, history of peripheral artery disease, chronic obstructive pulmonary disease (COPD), or congestive heart failure, requirement for supplemental home oxygen, and use of salicylates. Internal validation reveals good calibration and discriminative ability (c-statistic 0.68 [95% confidence interval 0.65-0.71]). External validation confirms good calibration. In the context of acceptable perioperative results, long-term mortality risk can be predicted in endovascular AAA repair and must be balanced against risk of rupture to determine which patients should be offered treatment. Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  5. Ozone Health Risk Assessment for Selected Urban Areas

    Science.gov (United States)

    The health risk assessment described in this report estimated various health effects associated with O3 exposures as well as the reduced risks for one O3 season associated with just meeting the current O3 NAAQS.

  6. Super-surface selective nanomembranes providing simultaneous high permeation flux and high selectivity

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Michael Z.; Simpson, John T.; Aytug, Tolga; Paranthaman, Mariappan Parans; Sturgeon, Matthew R.

    2016-04-12

    Superhydrophobic membrane structures having a beneficial combination of throughput and a selectivity. The membrane structure can include a porous support substrate; and a membrane layer adherently disposed on and in contact with the porous support substrate. The membrane layer can include a nanoporous material having a superhydrophobic surface. The superhydrophobic surface can include a textured surface, and a modifying material disposed on the textured surface. Methods of making and using the membrane structures.

  7. Highly Enhanced Risk Management Emergency Satellite

    DEFF Research Database (Denmark)

    Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

    HERMES (Highly Enhanced Risk Management Emergency Satellite) is potential European satellite mission for global flood management, being implemented by Technical University Munich and European Space Agency. With its main instrument - a reliable and precise Synthetic Aperture Radar (SAR) antenna...... - and its orbit characteristics (covering the whole earth surface in 3 days, low altitude), HERMES will provide stand-alone-data for: flood disaster monitoring, flood forecasting and flood prevention. Data obtained by HERMES can be used for commercial soil type maps (e.g. for optimized land use). As only...... highly effective and orbit proven hardware is used, HERMES is designed to be reliable, precise and of low cost. The project can be extended for use on other space bodies (planets) for rapid observation of the planetary surface....

  8. Mechanical Circulatory Support for High-Risk Pulmonary Embolism.

    Science.gov (United States)

    Elder, Mahir; Blank, Nimrod; Shemesh, Adi; Pahuja, Mohit; Kaki, Amir; Mohamad, Tamam; Schreiber, Theodore; Giri, Jay

    2018-01-01

    Temporary mechanical circulatory support (MCS) devices have a role in treating high-risk patients with pulmonary embolism with cardiogenic shock. Mechanical circulatory device selection should be made based on center experience and device-specific features. All current devices are effective in decreasing right arterial pressure and providing circulatory support of 4 to 5 L/min. The pulmonary artery pulsatility index may prove to be an unreliable method to assess right ventricular function. Careful clinical evaluation on an individual patient basis should determine the need for MCS. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Assessment of Short Term Cardiovascular Risk Among 40 Years and Above Population in a Selected Community of Kathmandu, Nepal.

    Science.gov (United States)

    Dhungana, R R; Khanal, M K; Pandey, A R; Thapa, P; Devkota, S; Mumu, S J; Shayami, A; Ali, L

    2015-01-01

    Cardiovascular disease (CVD) risk assessment is effective for identifying whether people are at low or high risk of CVD events. It is also useful for determining the intensity of intervention. People with low risk of CVD can take more benefit by lifestyle modifications, whereas people at high risk need pharmacological intervention in addition. But, there is dearth of related study in Nepal. Therefore, this study aimed to assess short term CVD risk prediction in selected community of Kathmandu, Nepal. We conducted a cross-sectional study in Sitapaila Village Development Committee, Kathmandu, Nepal between November 2014 and April 2015. We, first selected the household randomly to enroll 347 participants with 18 to 70 years of age, and later assessed the short term CVD risk prediction among ≥ 40 years age group using WHO/ISH chart. The mean age of respondents was 52 years. The majority of participants were female (58.4%), homemakers (45.2%), from Newar ethnic group (31.9%), and without formal education (42.8%). Smoking was present in 21.7% of respondents, diabetes in 19.9 %, and hypertension in 53.6%. The ≥10% CVD risk was seen in 14.6% (95% CI: 9.2, 20) of the respondents. It was significantly associated with age (ppopulation is in high risk of developing CVDs in near future. Lifestyle modifications and pharmaceutical interventions to manage the risk factors among study population are highly recommended.

  10. Multislice computed tomography in an asymptomatic high-risk population.

    Science.gov (United States)

    Romeo, Francesco; Leo, Roberto; Clementi, Fabrizio; Razzini, Cinzia; Borzi, Mauro; Martuscelli, Eugenio; Pizzuto, Francesco; Chiricolo, Gaetano; Mehta, Jawahar L

    2007-02-01

    Approximately 50% of all acute coronary syndromes occur in previously asymptomatic patients. This study evaluated the value of multislice computed tomography for early detection of significant coronary artery disease (CAD) in high-risk asymptomatic subjects. One hundred sixty-eight asymptomatic subjects with >or=1 major risk factor (hypertension, diabetes, hypercholesterolemia, family history, or smoking) and an inconclusive or unfeasible noninvasive stress test result (stress electrocardiography, echocardiography, or nuclear scintigraphy) were evaluated in an outpatient setting. After clinical examination and laboratory risk analysis, all patients underwent multislice computed tomographic (MSCT) coronary angiography within 1 week. In all subjects, conventional coronary angiography was also carried out. Multislice computed tomography displayed single-vessel CAD in 16% of patients, 2-vessel CAD in 7%, and 3-vessel CAD in 4%. Selective coronary angiography confirmed the results of multislice computed tomography in 99% of all patients. Sensitivity and specificity of MSCT coronary angiography were 100% and 98%, respectively, with a positive predictive value of 95% and a negative predictive value of 100%. In conclusion, MSCT coronary angiography is an excellent noninvasive technique for early identification of significant CAD in high-risk asymptomatic patients with inconclusive or unfeasible noninvasive stress test results.

  11. [Antiphospholipid antibodies in high-risk pregnancy].

    Science.gov (United States)

    Nestorowicz, B; Ostanek, L; Ronin-Walknowska, E; Fiedorowicz-Fabrycy, I; Skoczowska, M; Czajkowska, E; Fischer, K

    2000-06-01

    Recently the connection of antiphospholipid antibodies (aPLs) presence with pregnancy loss and complications in pregnancy has been observed APLs related obstetric complications include: miscarriages after 10 weeks, IUGR, intrauterine foetal death, preeclampsia and severe preeclampsia. Our objective was to determine the aPLs prevalence in patients with recurrent pregnancy loss and/or complicated pregnancy. We examined 154 pregnant women aged 19-42 (average of 29.1) with recurrent pregnancy loss, current pregnancy complicated by preeclampsia and severe preeclampsia and/or IUGR, thrombotic episodes, thrombocytopenia or autoimmune disease. In all the patients anticardiolipin antibodies (aCL) were determined at least twice using ELISA and their coagulation system was tested including lupus anticoagulant (LA) test. In justified cases immunological examinations detecting connective tissue systemic diseases were conducted. Increased aCL titre was detected in 54 (34.4%) women. Statistically significant risk of increased aCL titre was observed in patients with autoimmunological diseases (RR = 4.3). Increased, but Statistically insignificant, risk of high aCL titre was observed in patients with venous thrombosis (RR = 2.45) as well as in patients with thrombocytopenia (RR = 2.45). LA prevailed significantly more often in patients with venous thrombosis episodes (RR = 6.33) and with autoimmunological diseases (RR = 17.4). Preterm deliveries were significantly more frequent in pregnant women with increased aCL titre and/or LA. Moreover, in this group foetal death and preterm stillbirth more often occurred. The above mentioned risks increased when aCL and LA coexisted. No relation between increased aPLs and miscarriage frequency was observed. 1) Increased aPLs titre prevail in multiparas with bad obstetrical anamnesis and with pathological course in present pregnancy, 2) increased aPLs titre prevail in patients with autoimmunological diseases, 3) increased aPLs titre are

  12. The Comparison of Selected Risk Management Methods for Project Management

    OpenAIRE

    Obrová, Vladěna; Smolíková, Lenka

    2013-01-01

    Part 7: Environmental Management/-Accounting and -Statistics; International audience; Project management is a set of validated and described procedures that comprehensively solve the implementation and management of defined activities that relate to a specific project. In the Czech Republic, the issue of risk management in projects often neglected and began to be more used to the ESF projects where is the risk management required. There are used most often for risk analysis 3 methods - sensit...

  13. Prenatal screening with evaluated high risk scores.

    Science.gov (United States)

    Papiernik, E; Grangé, G

    1999-01-01

    This paper reviews data that support the effectiveness of the French approach of using risk scoring for evaluating the risk of preterm delivery. This approach, which was developed in 1969 and spread to obstetricians and midwives throughout France in the early 1970s, includes systematic information about the recognition of uterine contractions, advice about reduction of physical exercise, and the prescription of work-leave for women with heavy or physically demanding work loads. The effectiveness of this prevention strategy is assessed using three different data sets: an evaluation of a preterm prevention program in the Alsace Region of France, five successive French national sample surveys which collected data on pregnant women, and a study of the effectiveness of a prevention program for twins in the district of Haut de Seine near Paris. The authors show that the rate of preterm birth in France declined substantially, but that the decline was concentrated among singleton spontaneous births. Since the 1970s induced preterm births have increased, and, interventions have not reduced the high rates of preterm birth among twins.

  14. High-risk obstetrics, medicolegal problems.

    Science.gov (United States)

    Herczeg, J

    1997-02-01

    The perinatal period is one of the most dangerous time of life. The responsibilities of the obstetricians are multifold. It is very difficult to draw a line between good and substandard care, therefore in perinatology and especially in high-risk obstetrical cases there are no absolute rules of management. The lay public is convinced through media channels, that modern reproductive research eliminated all the risks and hazards associated with childbirths, therefore only 100% healthy babies are accepted. Pregnancy is regarded as a 'success story' and if the baby is born with neurological defects (cerebral palsy) the parents and their advisors feel, that someone responsible for the defect should be found in the chain of management. This attitude starts a legal battle focusing on the events of labor and delivery. But in most cases it is very difficult to determine if a peripartal neonatal encephalopathy originated from the time period of labor and delivery, or started weeks earlier during pregnancy as an unnoticed event. Perinatal morbidity indicators are best based on neonatal clinical signs, which are predictive of later morbidity of the child. Neonatal seizures within 48 h of delivery of the baby could be a good index of later morbidity.

  15. Price and Structure Risks Consideration when Selecting a Marketing Strategy for an Agricultural Enterprise

    Directory of Open Access Journals (Sweden)

    Shiyan Dmytro V.

    2013-11-01

    Full Text Available The goal of the article lies in development and approval of the indicator of complex assessment of the level of price and structure risks of agricultural enterprises with the further goal of selecting a marketing strategy. It was established in the result of the study that agricultural enterprises with a high price and structure risk ratio have high indicators of economic efficiency compared to the groups with a low value of this indicator. At the same time, major enterprises (mostly agro-holdings at a certain stage, which corresponds with the set critical size of the area or livestock, have a possibility to diversify production and, consequently, reduce the price and structure risk ratio. Further studies would deal with establishing groups of agricultural enterprises on the basis of differences in economic efficiency by selected criteria (profitability of realisation of products, profit per 1 hectare and crop capacity and livestock productivity, that result not from the territorial and geographical location, but from specific features of formation of the market of agrarian products of Ukraine.

  16. Suicide risk assessment in high-risk adolescents.

    Science.gov (United States)

    Gray, Barbara P; Dihigo, Sharolyn K

    2015-09-13

    A significant number of adolescents experience depression and other mental health disorders that may put them at risk for suicide. Mental health assessment is an important component of primary healthcare. Depression and suicide risk screening can assist healthcare providers in preventing suicides.

  17. High body mass index and cancer risk

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjærg-Hansen, Anne; Smith, George Davey

    2016-01-01

    alleles was associated with a 3 % higher BMI (P cancer. In instrumental variable analysis for a 10 kg/m(2) higher genetically determined BMI the odds ratio for any non-skin cancer was 1.16 (0.64-2.09), with a corresponding observational estimate of 0.94 (0.88-1.01). Using......High body mass index (BMI) has been associated with increased risk of some cancer. Whether these reflect causal associations is unknown. We examined this issue. Using a Mendelian randomisation approach, we studied 108,812 individuals from the general population. During a median of 4.7 years...... of follow-up (range 0-37), 8002 developed non-skin cancer, 3347 non-melanoma skin cancer, 1396 lung cancer, 637 other smoking related cancers, 1203 colon cancer, 159 kidney cancer, 1402 breast cancer, 1062 prostate cancer, and 2804 other cancers. Participants were genotyped for five genetic variants...

  18. Safety culture in high-risk industries.

    Science.gov (United States)

    Martyka, Joanna; Lebecki, Kazimierz

    2014-01-01

    This paper addresses the question of whether adopting safety culture improves hazard prevention in enterprises characterized by high primary risk. To answer this question, sample underground coal mines were examined to investigate the basic elements of the safety culture of employees. This paper presents the results of a diagnosis of the basic elements of the safety culture of supervisors (midlevel managers) and blue-collar workers in 3 underground coal mines. The study used 2 techniques: a Likert-type scale and a questionnaire. The results indicate the need to introduce changes in the safety culture of underground coal mine employees. This study also presents the conditions for improvement. Special attention was paid to (a) the conditions for improving safety culture and (b) a programme for modifying risky behaviours.

  19. Risk selection in a regulated health insurance market: a review of the concept, possibilities and effects.

    Science.gov (United States)

    van Kleef, Richard C; van de Ven, Wynand P M M; van Vliet, René C J A

    2013-12-01

    The Dutch basic health insurance is based on the principles of regulated competition. This implies that insurers and providers compete on price and quality while the regulator sets certain rules to achieve public objectives such as solidarity. Two regulatory aspects of this scheme are that insurers are not allowed to risk rate their premiums and are compensated for predictable variation in individual medical expenses (i.e., risk equalization). Research, however, indicates that the current risk equalization is imperfect, which confronts insurers and consumers with incentives for risk selection. The goal of this paper is to review the concept, possibilities and potential effects of risk selection in the Dutch basic health insurance. We conclude that the possibilities for risk selection are numerous and a potential threat to solidarity, efficiency and quality of care. Regulators should be aware that measurement of risk selection is a methodological and data-demanding challenge.

  20. Selected medical conditions and risk of pancreatic cancer.

    Science.gov (United States)

    Olson, Sara H

    2012-01-01

    We review the current evidence for associations of several medical conditions with risk of pancreatic cancer, including allergies, pancreatitis, gall bladder disease, cholecystectomy, ulcers, gastrectomy, appendectomy, and tonsillectomy. There are consistent findings of reduced risk associated with presence of self-reported allergies, particularly hay fever but not asthma; data on other allergies are limited and inconclusive. Several studies provide evidence that patients with pancreatic cancer are more likely than comparison groups to report pancreatitis. Those studies that investigated the time between onset of pancreatitis and diagnosis of pancreatic cancer found that risk estimates declined with longer periods of time; however, increased risks were noted for long-term pancreatitis, indicating that this condition is both a risk factor and a sign of early disease. Increased risk was reported in association with cholelithiasis, but the few studies that considered time before diagnosis of cancer did not find increased risk for cholelithiasis diagnosed in the more distant past. There is weak evidence that cholecystectomy 2 or more years before cancer diagnosis is related to risk, but this is based on only a few studies. There is no consistent association between ulcers and risk, while gastrectomy may increase risk. Overall, study of these conditions, particularly those that are rare, presents methodologic challenges. Time between diagnoses is likely to be important but is not considered in most studies. Lack of adequate control in several studies for risk factors such as smoking and heavy alcohol use also makes it difficult to draw firm conclusions about these results. Copyright © 2011 Wiley Periodicals, Inc.

  1. An ecologically-based method for selecting ecological indicators for assessing risks to biological diversity from genetically-engineered plants

    DEFF Research Database (Denmark)

    Andow, D. A.; Lövei, Gabor L; Arpaia, Salvatore

    2013-01-01

    into ecological functional groups and selecting those that deliver the identified environmental values. (3) All of the species or ecosystem processes related to the selected functional groups are identified and (4) multi-criteria decision analysis (MCDA) is used to rank the indicator endpoint entities, which may...... be species or ecological processes. MCDA focuses on those species and processes that are critical for the identified ecological functions and are likely to be highly exposed to the GE organism. The highest ranked indicator entities are selected for the next step. (5) Relevant risk hypotheses are identified....... Knowledge about the specific transgene and its possible environmental effects in other countries can be used to assist development of risk hypotheses. (6) The risk hypotheses are ranked using MCDA with criteria related to the severity of the potential risk. The model emphasizes transparent, expert...

  2. Risk-based audit selection of dairy farms

    NARCIS (Netherlands)

    Asseldonk, van M.A.P.M.; Velthuis, A.G.J.

    2014-01-01

    Dairy farms are audited in the Netherlands on numerous process standards. Each farm is audited once every 2 years. Increasing demands for cost-effectiveness in farm audits can be met by introducing risk-based principles. This implies targeting subpopulations with a higher risk of poor process

  3. Height, selected genetic markers and prostate cancer risk

    DEFF Research Database (Denmark)

    Lophatananon, Artitaya; Stewart-Brown, Sarah; Kote-Jarai, Zsofia

    2017-01-01

    BACKGROUND: Evidence on height and prostate cancer risk is mixed, however, recent studies with large data sets support a possible role for its association with the risk of aggressive prostate cancer. METHODS: We analysed data from the PRACTICAL consortium consisting of 6207 prostate cancer cases ...

  4. Habitat selection and risk of predation: re-colonization by lynx had limited impact on habitat selection by roe deer.

    Science.gov (United States)

    Samelius, Gustaf; Andrén, Henrik; Kjellander, Petter; Liberg, Olof

    2013-01-01

    Risk of predation is an evolutionary force that affects behaviors of virtually all animals. In this study, we examined how habitat selection by roe deer was affected by risk of predation by Eurasian lynx - the main predator of roe deer in Scandinavia. Specifically, we compared how habitat selection by roe deer varied (1) before and after lynx re-established in the study area and (2) in relation to habitat-specific risk of predation by lynx. All analyses were conducted at the spatial and temporal scales of home ranges and seasons. We did not find any evidence that roe deer avoided habitats in which the risk of predation by lynx was greatest and information-theoretic model selection showed that re-colonization by lynx had limited impact on habitat selection by roe deer despite lynx predation causing 65% of known mortalities after lynx re-colonized the area. Instead we found that habitat selection decreased when habitat availability increased for 2 of 5 habitat types (a pattern referred to as functional response in habitat selection). Limited impact of re-colonization by lynx on habitat selection by roe deer in this study differs from elk in North America altering both daily and seasonal patterns in habitat selection at the spatial scales of habitat patches and home ranges when wolves were reintroduced to Yellowstone National Park. Our study thus provides further evidence of the complexity by which animals respond to risk of predation and suggest that it may vary between ecosystems and predator-prey constellations.

  5. Habitat selection and risk of predation: re-colonization by lynx had limited impact on habitat selection by roe deer.

    Directory of Open Access Journals (Sweden)

    Gustaf Samelius

    Full Text Available Risk of predation is an evolutionary force that affects behaviors of virtually all animals. In this study, we examined how habitat selection by roe deer was affected by risk of predation by Eurasian lynx - the main predator of roe deer in Scandinavia. Specifically, we compared how habitat selection by roe deer varied (1 before and after lynx re-established in the study area and (2 in relation to habitat-specific risk of predation by lynx. All analyses were conducted at the spatial and temporal scales of home ranges and seasons. We did not find any evidence that roe deer avoided habitats in which the risk of predation by lynx was greatest and information-theoretic model selection showed that re-colonization by lynx had limited impact on habitat selection by roe deer despite lynx predation causing 65% of known mortalities after lynx re-colonized the area. Instead we found that habitat selection decreased when habitat availability increased for 2 of 5 habitat types (a pattern referred to as functional response in habitat selection. Limited impact of re-colonization by lynx on habitat selection by roe deer in this study differs from elk in North America altering both daily and seasonal patterns in habitat selection at the spatial scales of habitat patches and home ranges when wolves were reintroduced to Yellowstone National Park. Our study thus provides further evidence of the complexity by which animals respond to risk of predation and suggest that it may vary between ecosystems and predator-prey constellations.

  6. Prescription of the High Risk Narcotics and Trading or Illicit Purchasing of High Risk Narcotics

    Directory of Open Access Journals (Sweden)

    Nicoleta-Elena Buzatu

    2012-05-01

    Full Text Available The present essay will analyze the offence of prescribing high risk narcotics and trading or illicit purchasing of high risk narcotics, as it was regulated - together with other offences - by Law no 143 of July 26, 2000 on preventing and fighting against the traffic and illicit consumption of narcotics. The same law defines the meaning of such a phrase “substances which are under national control” by mentioning the fact that they are the narcotics and their precursors listed in Annexes I-IV of the law. The analysis of the offence of prescribing the high risk narcotics and trading or illicit purchasing of high risk narcotics is following the already known structure mentioned in the doctrine and which consists of: object and subjects of the offence, its constituent content: the objective side with its material element, the immediate consequence and causality connections; the subjective side of the offence, as well as forms and modalities of these offences, and the applicable sanctions, of course.

  7. Contraception: Efficacy, Risks, Continuation Rates, and Use in High-Risk Women.

    Science.gov (United States)

    Batur, Pelin; Bowersox, Natalie; McNamara, Megan

    2016-08-01

    The clinical update serves as a brief review of recently published, high-impact, and potentially practice-changing journal articles summarized for our readers. Topics include menopause, sexual dysfunction, breast health, contraception, osteoporosis, and cardiovascular disease. In this clinical update, we selected recent publications relevant to the use of contraceptive methods. We highlight articles on continuation rates of long-acting reversible contraception versus nonlong-acting methods, updated risks of intrauterine devices, use of estrogen-containing contraceptives during anticoagulation for venous thromboembolic events, and the efficacy of oral and emergency contraception in women with elevated body mass index.

  8. Built Environment, Selected Risk Factors and Major Cardiovascular Disease Outcomes: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Pasmore Malambo

    Full Text Available Built environment attributes have been linked to cardiovascular disease (CVD risk. Therefore, identifying built environment attributes that are associated with CVD risk is relevant for facilitating effective public health interventions.To conduct a systematic review of literature to examine the influence of built environmental attributes on CVD risks.Multiple database searches including Science direct, CINAHL, Masterfile Premier, EBSCO and manual scan of reference lists were conducted.Studies published in English between 2005 and April 2015 were included if they assessed one or more of the neighborhood environmental attributes in relation with any major CVD outcomes and selected risk factors among adults.Author(s, country/city, sex, age, sample size, study design, tool used to measure neighborhood environment, exposure and outcome assessments and associations were extracted from eligible studies.Eighteen studies met the inclusion criteria. Most studies used both cross-sectional design and Geographic Information System (GIS to assess the neighborhood environmental attributes. Neighborhood environmental attributes were significantly associated with CVD risk and CVD outcomes in the expected direction. Residential density, safety from traffic, recreation facilities, street connectivity and high walkable environment were associated with physical activity. High walkable environment, fast food restaurants, supermarket/grocery stores were associated with blood pressure, body mass index, diabetes mellitus and metabolic syndrome. High density traffic, road proximity and fast food restaurants were associated with CVDs outcomes.This study confirms the relationship between neighborhood environment attributes and CVDs and risk factors. Prevention programs should account for neighborhood environmental attributes in the communities where people live.

  9. Built Environment, Selected Risk Factors and Major Cardiovascular Disease Outcomes: A Systematic Review

    Science.gov (United States)

    Malambo, Pasmore; Kengne, Andre P.; De Villiers, Anniza; Lambert, Estelle V.; Puoane, Thandi

    2016-01-01

    Introduction Built environment attributes have been linked to cardiovascular disease (CVD) risk. Therefore, identifying built environment attributes that are associated with CVD risk is relevant for facilitating effective public health interventions. Objective To conduct a systematic review of literature to examine the influence of built environmental attributes on CVD risks. Data Source Multiple database searches including Science direct, CINAHL, Masterfile Premier, EBSCO and manual scan of reference lists were conducted. Inclusion Criteria Studies published in English between 2005 and April 2015 were included if they assessed one or more of the neighborhood environmental attributes in relation with any major CVD outcomes and selected risk factors among adults. Data Extraction Author(s), country/city, sex, age, sample size, study design, tool used to measure neighborhood environment, exposure and outcome assessments and associations were extracted from eligible studies. Results Eighteen studies met the inclusion criteria. Most studies used both cross-sectional design and Geographic Information System (GIS) to assess the neighborhood environmental attributes. Neighborhood environmental attributes were significantly associated with CVD risk and CVD outcomes in the expected direction. Residential density, safety from traffic, recreation facilities, street connectivity and high walkable environment were associated with physical activity. High walkable environment, fast food restaurants, supermarket/grocery stores were associated with blood pressure, body mass index, diabetes mellitus and metabolic syndrome. High density traffic, road proximity and fast food restaurants were associated with CVDs outcomes. Conclusion This study confirms the relationship between neighborhood environment attributes and CVDs and risk factors. Prevention programs should account for neighborhood environmental attributes in the communities where people live. PMID:27880835

  10. A risk-based decision support framework for selection of appropriate safety measure system for underground coal mines.

    Science.gov (United States)

    Samantra, Chitrasen; Datta, Saurav; Mahapatra, Siba Sankar

    2017-03-01

    In the context of underground coal mining industry, the increased economic issues regarding implementation of additional safety measure systems, along with growing public awareness to ensure high level of workers safety, have put great pressure on the managers towards finding the best solution to ensure safe as well as economically viable alternative selection. Risk-based decision support system plays an important role in finding such solutions amongst candidate alternatives with respect to multiple decision criteria. Therefore, in this paper, a unified risk-based decision-making methodology has been proposed for selecting an appropriate safety measure system in relation to an underground coal mining industry with respect to multiple risk criteria such as financial risk, operating risk, and maintenance risk. The proposed methodology uses interval-valued fuzzy set theory for modelling vagueness and subjectivity in the estimates of fuzzy risk ratings for making appropriate decision. The methodology is based on the aggregative fuzzy risk analysis and multi-criteria decision making. The selection decisions are made within the context of understanding the total integrated risk that is likely to incur while adapting the particular safety system alternative. Effectiveness of the proposed methodology has been validated through a real-time case study. The result in the context of final priority ranking is seemed fairly consistent.

  11. Challenging Propofol Sedation in Gastrointestinal Endoscopy: High Risk Patients and High Risk Procedures

    Directory of Open Access Journals (Sweden)

    Eduardo Redondo-Cerezo

    2012-12-01

    Full Text Available Sedation is increasingly becoming a must for most endoscopic procedures. Non-anesthesiologist administration of propofol is the standard of practice in many European countries. Nevertheless, despite anesthesiology societies concerns about sedation guided by endoscopist, practitioners find some limits to propofol administration, related to high risk patients or high risk and complex procedures, which can be long lasting and technically challenging. The main patient related risk factors for sedation are elderly patients, obesity, ASA≥3 patients, individuals with craniofacial abnormalities or with pharyngolaringeal tumors, patients with an acute gastrointestinal bleeding, under pain medications, sedatives, antidepressants, or who consume significant amounts of alcohol or drugs. Procedure related risk factors have more to do with the duration and complexity of the procedure than with other factors, in which considering a general anesthesia allows the endoscopist to concentrate on a difficult task. Published papers addressing the most challenging sedation groups in endoscopy are exploring and even trespassing previously assumed frontiers, and new scenarios are opening to the endoscopist, increasing his/her autonomy, reducing costs and giving patients levels of comfort previously unknown. In this review we analyse each risk group determining the ones in which a sedation protocol could be widely applied, and other in which the published evidence does not guarantee a safe endoscopist guided propofol sedation.

  12. Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) MMSA Age-adjusted Prevalence Data (2011 to Present)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011 to present. BRFSS SMART MMSA age-adjusted prevalence combined land line and cell phone data. The Selected Metropolitan Area Risk Trends (SMART) project uses the...

  13. Inhalation risk assessment of exposure to the selected volatile organic compounds (VOCs) emitted from the facilities of a steel plant.

    Science.gov (United States)

    Chiang, Hung L; Lin, Wen H; Lai, Jim S; Wang, Wei C

    2010-09-01

    Concentrations of volatile organic compounds (VOCs) were investigated in the workplace air of four processes: sintering, cokemaking, hot forming, and cold forming in an integrated iron and steel plant. In addition, the cancer risk was measured for workers in these 4 processes. Seven VOCs (chloroform, carbon tetrachloride, 1,1,2-trichloroethane, trichloroethylene, tetrachloroethylene, benzene, and ethylbenzene) were selected for cancer risk measurement. Trichloroethylene concentrations are high in the 4 processes, and carbon tetrachloride and tetrachloroethylene concentrations are high in both the cold and hot forming processes. The sequence of the total cancer risk of the 7 species was as follows: cokemaking > sintering > cold forming congruent with hot forming. About 66-93% of the cancer risk of the four processes was caused by trichloroethylene. The cancer risks (3.7 x 10(-3)-30 x 10(-3)) of the average VOC concentrations suggest that improvement of workplace air quality and protection of workers are necessary to reduce cancer risks.

  14. Modeling HIV Risk in Highly Vulnerable Youth

    Science.gov (United States)

    Huba, G. J.; Panter, A. T.; Melchior, Lisa A.; Trevithick, Lee; Woods, Elizabeth R.; Wright, Eric; Feudo, Rudy; Tierney, Steven; Schneir, Arlene; Tenner, Adam; Remafedi, Gary; Greenberg, Brian; Sturdevant, Marsha; Goodman, Elizabeth; Hodgins, Antigone; Wallace, Michael; Brady, Russell E.; Singer, Barney; Marconi, Katherine

    2003-01-01

    This article examines the structure of several HIV risk behaviors in an ethnically and geographically diverse sample of 8,251 clients from 10 innovative demonstration projects intended for adolescents living with, or at risk for, HIV. Exploratory and confirmatory factor analyses identified 2 risk factors for men (sexual intercourse with men and a…

  15. Modeling HIV risk in highly vulnerable youth

    NARCIS (Netherlands)

    Huba, GJ; Panter, AT; Melchior, LA; Trevithick, L; Woods, ER; Wright, E; Feudo, R; Tierney, S; Schneir, A; Tenner, A; Remafedi, G; Greenberg, B; Sturdevant, M; Goodman, E; Hodgins, A; Wallace, M; Brady, RE; Singer, B; Marconi, K

    2003-01-01

    This article examines the structure of several HIV risk behaviors in an ethnically and geographically diverse sample of 8,251 clients from 10 innovative demonstration projects intended for adolescents living with, or at risk for, HIV. Exploratory and confirmatory factor analyses identified 2 risk

  16. Continuous Time Portfolio Selection under Conditional Capital at Risk

    Directory of Open Access Journals (Sweden)

    Gordana Dmitrasinovic-Vidovic

    2010-01-01

    Full Text Available Portfolio optimization with respect to different risk measures is of interest to both practitioners and academics. For there to be a well-defined optimal portfolio, it is important that the risk measure be coherent and quasiconvex with respect to the proportion invested in risky assets. In this paper we investigate one such measure—conditional capital at risk—and find the optimal strategies under this measure, in the Black-Scholes continuous time setting, with time dependent coefficients.

  17. Microhabitat selection by marine mesoconsumers in a thermally heterogeneous habitat: behavioral thermoregulation or avoiding predation risk?

    Directory of Open Access Journals (Sweden)

    Jeremy J Vaudo

    Full Text Available Habitat selection decisions by consumers has the potential to shape ecosystems. Understanding the factors that influence habitat selection is therefore critical to understanding ecosystem function. This is especially true of mesoconsumers because they provide the link between upper and lower tropic levels. We examined the factors influencing microhabitat selection of marine mesoconsumers - juvenile giant shovelnose rays (Glaucostegus typus, reticulate whiprays (Himantura uarnak, and pink whiprays (H. fai - in a coastal ecosystem with intact predator and prey populations and marked spatial and temporal thermal heterogeneity. Using a combination of belt transects and data on water temperature, tidal height, prey abundance, predator abundance and ray behavior, we found that giant shovelnose rays and reticulate whiprays were most often found resting in nearshore microhabitats, especially at low tidal heights during the warm season. Microhabitat selection did not match predictions derived from distributions of prey. Although at a course scale, ray distributions appeared to match predictions of behavioral thermoregulation theory, fine-scale examination revealed a mismatch. The selection of the shallow nearshore microhabitat at low tidal heights during periods of high predator abundance (warm season suggests that this microhabitat may serve as a refuge, although it may come with metabolic costs due to higher temperatures. The results of this study highlight the importance of predators in the habitat selection decisions of mesoconsumers and that within thermal gradients, factors, such as predation risk, must be considered in addition to behavioral thermoregulation to explain habitat selection decisions. Furthermore, increasing water temperatures predicted by climate change may result in complex trade-offs that might have important implications for ecosystem dynamics.

  18. Design and Analysis of a High Speed Carry Select Adder

    OpenAIRE

    Simarpreet Singh Chawla; Swapnil Aggarwal; Anshika; Nidhi Goel

    2015-01-01

    An optimal high-speed and low-power VLSI architecture requires an efficient arithmetic processing unit that is optimized for speed and power consumption. Adders are one of the widely used in digital integrated circuit and system design. High speed adder is the necessary component in a data path, e.g. Microprocessors and a Digital signal processor. The present paper proposes a novel high-speed adder by combining the advantages of Carry Look Ahead Adder (CLAA) and Carry Select Adder (CSA), devi...

  19. Design and Analysis of a High Speed Carry Select Adder

    OpenAIRE

    Simarpreet Singh Chawla; Swapnil Aggarwal; Anshika; Nidhi Goel

    2015-01-01

    An optimal high-speed and low-power VLSI architecture requires an efficient arithmetic processing unit that is optimized for speed and power consumption. Adders are one of the widely used in digital integrated circuit and system design.High speed adder is the necessary component in a data path, e.g. Microprocessors and a Digital signal processor. The present paper proposes a novel high-speed adder by combining the advantages of Carry Look Ahead Adder (CLAA) and Carry Select Adder (CSA), devis...

  20. Overview of selected infectious disease risks for the corporate traveler.

    Science.gov (United States)

    Hudson, T Warner; Fortuna, Joseph

    2008-08-01

    International business travel to under-developed and developing countries has increased considerably over the past two decades. Most of these destinations are endemic to a variety of infectious diseases, many of which are associated with considerable morbidity, mortality, or both and the nonimmune, unprepared corporate traveler is at risk. Comprehensive pretravel consultation is essential to prevent travel-related illness. This review addresses some of the infectious diseases that can be acquired during international travel, including regions of endemicity, assessment of risk, and available means of prevention. In addition, we discuss data concerning current practices and attitudes of travelers, along with some of the issues surrounding the counseling of corporate travelers.

  1. Prevalence and Risk Factors of High Risk Human Papillomavirus ...

    African Journals Online (AJOL)

    Cervical cancer is the most common female cancer in northern Nigeria, yet the pattern of infection with human papillomavirus, the principal aetiologic agent is unknown. This was a preliminary study conducted in two referral hospitals in order to establish base-line data on the prevalence and risk factors for the infection in ...

  2. A Primer on High-Throughput Computing for Genomic Selection

    Directory of Open Access Journals (Sweden)

    Xiao-Lin eWu

    2011-02-01

    Full Text Available High-throughput computing (HTC uses computer clusters to solve advanced computational problems, with the goal of accomplishing high throughput over relatively long periods of time. In genomic selection, for example, a set of markers covering the entire genome is used to train a model based on known data, and the resulting model is used to predict the genetic merit of selection candidates. Sophisticated models are very computationally demanding and, with several traits to be evaluated sequentially, computing time is long and output is low. In this paper, we present scenarios and basic principles of how HTC can be used in genomic selection, implemented using various techniques from simple batch processing to pipelining in distributed computer clusters. Various scripting languages, such as shell scripting, Perl and R, are also very useful to devise pipelines. By pipelining, we can reduce total computing time and consequently increase throughput. In comparison to the traditional data processing pipeline residing on the central processors, performing general purpose computation on a graphics processing unit (GPU provide a new-generation approach to massive parallel computing in genomic selection. While the concept of HTC may still be new to many researchers in animal breeding, plant breeding, and genetics, HTC infrastructures have already been built in many institutions, such as the University of Wisconsin – Madison, which can be leveraged for genomic selection, in terms of central processing unit (CPU capacity, network connectivity, storage availability, and middleware connectivity. Exploring existing HTC infrastructures as well as general purpose computing environments will further expand our capability to meet increasing computing demands posed by unprecedented genomic data that we have today. We anticipate that HTC will impact genomic selection via better statistical models, faster solutions, and more competitive products (e.g., from design of

  3. Selected Aspects Of The Risk In The Supply Chain In Context Of The Supplier Quality Management

    Science.gov (United States)

    Koblen, Ivan; Lestyánszka Škůrková, Katarína

    2015-06-01

    The introductory part of the paper underlines the importance of "Risk-based thinking" in the Quality Management System (QMS) and risk in the supply chain, as a principle part of the QMS. After introducing the key terms, the authors focused on the principle part of the article - explanation of the external and internal supply chain risks and the main factors concerning the supply risks, demand risks and environmental risks (as cardinal types of external supply chain risks) as well as the manufacturing and process risks, network/planning and control risks (as most important types of internal supply chain risks). The authors inform on the selected supply chain risk management tools, especially on those which are linked to the appropriate utilization of quality management tools.

  4. Selected Aspects Of The Risk In The Supply Chain In Context Of The Supplier Quality Management

    Directory of Open Access Journals (Sweden)

    Koblen Ivan

    2015-06-01

    Full Text Available The introductory part of the paper underlines the importance of "Risk-based thinking" in the Quality Management System (QMS and risk in the supply chain, as a principle part of the QMS. After introducing the key terms, the authors focused on the principle part of the article - explanation of the external and internal supply chain risks and the main factors concerning the supply risks, demand risks and environmental risks (as cardinal types of external supply chain risks as well as the manufacturing and process risks, network/planning and control risks (as most important types of internal supply chain risks. The authors inform on the selected supply chain risk management tools, especially on those which are linked to the appropriate utilization of quality management tools.

  5. Economic growth and longevity risk with adverse selection

    NARCIS (Netherlands)

    Heijdra, Ben J.; Reijnders, Laurie S. M.

    We study the implications of adverse selection in annuity markets in a general-equilibrium model of the closed economy. Agents differ in their health type and invest their assets in the annuity market. Without informational asymmetries each agent would obtain an actuarially fair insurance. If the

  6. Optimal portfolio selection for cashflows with bounded capital at risk

    NARCIS (Netherlands)

    Vyncke, D.; Goovaerts, M.J.; Dhaene, J.L.M.; Vanduffel, S.

    2005-01-01

    We consider a continuous-time Markowitz type portfolio problem that consists of minimizing the discounted cost of a given cash-fl ow under the constraint of a restricted Capital at Risk. In a Black-Scholes setting, upper and lower bounds are obtained by means of simple analytical expressions that

  7. Evaluating Mediterranean Soil Contamination Risks in Selected Hydrological Scenarios.

    NARCIS (Netherlands)

    Rosa, de la D.; Crompvoets, J.

    1997-01-01

    This paper reports an attempt of predicting the contamination risk of soils and water as they respond to hydrological changes in the agricultural lands of Sevilla province, Spain. Based on land evaluation methodologies, a semi-empirical model (named Pantanal, as module of the integrated package

  8. Risk Attitudes, Sample Selection and Attrition in a Longitudinal Field Experiment

    DEFF Research Database (Denmark)

    Harrison, Glenn W.; Lau, Morten Igel

    with respect to risk attitudes. Our design builds in explicit randomization on the incentives for participation. We show that there are significant sample selection effects on inferences about the extent of risk aversion, but that the effects of subsequent sample attrition are minimal. Ignoring sample...... temporal stability. We evaluate the hypothesis that risk preferences are stable over time using a remarkable data set combining administrative information from the Danish registry with longitudinal experimental data we designed to allow better identification of joint selection and attrition effects...... selection leads to inferences that subjects in the population are more risk averse than they actually are. Correcting for sample selection and attrition affects utility curvature, but does not affect inferences about probability weighting. Properly accounting for sample selection and attrition effects leads...

  9. Spatial ecology of refuge selection by an herbivore under risk of predation

    Science.gov (United States)

    Wilson, Tammy L.; Rayburn, Andrew P.; Edwards, Thomas C.

    2012-01-01

    Prey species use structures such as burrows to minimize predation risk. The spatial arrangement of these resources can have important implications for individual and population fitness. For example, there is evidence that clustered resources can benefit individuals by reducing predation risk and increasing foraging opportunity concurrently, which leads to higher population density. However, the scale of clustering that is important in these processes has been ignored during theoretical and empirical development of resource models. Ecological understanding of refuge exploitation by prey can be improved by spatial analysis of refuge use and availability that incorporates the effect of scale. We measured the spatial distribution of pygmy rabbit (Brachylagus idahoensis) refugia (burrows) through censuses in four 6-ha sites. Point pattern analyses were used to evaluate burrow selection by comparing the spatial distribution of used and available burrows. The presence of food resources and additional overstory cover resources was further examined using logistic regression. Burrows were spatially clustered at scales up to approximately 25 m, and then regularly spaced at distances beyond ~40 m. Pygmy rabbit exploitation of burrows did not match availability. Burrows used by pygmy rabbits were likely to be located in areas with high overall burrow density (resource clusters) and high overstory cover, which together minimized predation risk. However, in some cases we observed an interaction between either overstory cover (safety) or understory cover (forage) and burrow density. The interactions show that pygmy rabbits will use burrows in areas with low relative burrow density (high relative predation risk) if understory food resources are high. This points to a potential trade-off whereby rabbits must sacrifice some safety afforded by additional nearby burrows to obtain ample forage resources. Observed patterns of clustered burrows and non-random burrow use improve

  10. The relation of risk-taking propensity, professional preferences and the approach to the selection of future profession

    Directory of Open Access Journals (Sweden)

    Rosić-Marković Olga

    2014-01-01

    Full Text Available Research has shown that risk-taking individuals choose professions that involve a high level of uncertainty, change or flexibility. The aim of this research was to study the relation between risk-taking propensity and professional preferences, as well as between different indicators of the approach to the selection of future profession and risk-taking propensity. The study was conducted on the sample of 583 students attending the final grade of secondary school. For the assessment of risk-taking propensity we used a modified version of the Evaluation of Risk scale (EVAR, while professional interests were investigated by the Test of Professional Orientation (TPO. In addition, we analysed certain indicators of the approach to the selection of profession that were interesting in the context of career counselling, namely: duration of the selection of profession, the number of professional preferences and readiness to make a professional choice. The results have shown that risk-taking propensity is significantly correlated with professional preferences where risk is an important job feature (such as professions in the field of security as well as with the professions where risk is an important part of success (such as sports. It has also been shown that risk-taking individuals assess themselves as more ready to make decisions on their own professional choice. Based on the obtained results, it can be concluded that risk-taking propensity is an important characteristic that should be taken into account when studying professional preferences and the approach to the selection of future profession in adolescents.

  11. Protecting military personnel from high risk dietary supplements.

    Science.gov (United States)

    Deuster, Patricia A; Lieberman, Harris R

    2016-01-01

    It is legal tomarketmost naturally occurring substances as dietary supplements in the USA without manufacturers demonstrating they are safe or effective, and an endless variety of ingredients, from esoteric botanicals to unapproved pharmaceuticals, can be found in dietary supplements. Use of certain supplements can pose a risk, but since a robust reporting systemdoes not exist in the USA it is difficult to know which are problematic and the number of adverse events (AE) resulting from their use. Certain populations, includingmilitary personnel, aremore likely to use dietary supplements than the general population. Approximately 70% of military personnel take dietary supplements while about 50% of civilians do. Service members prefer supplements purported to enhance physical performance such as supposedly natural stimulants, protein and amino acids, and combination products. Since some of thesemay be problematic, Servicemembers are probably at higher risk of injury than the general population. Ten percent of military populations appear to be taking potentially risky supplements, and the US Department of Defense (DoD) has taken variousmeasures to protect uniformed personnel including education, policy changes, and restricting sales. Actions taken include launching Operation Supplement Safety (OPSS), introducing a High Risk Supplement list, educating health care professionals on reporting AE thatmight be associated with dietary supplements, recommending policy for reporting AE, and developing an online AE reporting system. OPSS is a DoD-wide effort to educate service members, leaders, health care providers, military families, and retirees on how to safely select supplements

  12. Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru.

    Directory of Open Access Journals (Sweden)

    Hayoung Park

    Full Text Available Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru.Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02.Of 2,709 participants, 191 (7.05% were RPR-reactive (median 1:8, range 1:1-1:1024 with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR 3.84; P <0.001 and IR 8.15; P <0.001 and being MSM/TW (IR 6.48; P <0.001 were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001, not being in a stable partnership (IR 1.56, P = 0.035, higher number of sex partners (IR 3.01; P <0.001, unprotected sex in the past 3 months (IR 0.56; P = 0.003, HIV infection at baseline (IR 3.98; P <0.001 and incident HIV infection during the study period (IR 6.26; P = 0.003 were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR 6.18; P <0.001, men reporting having sex with a man (aIR 4.63; P <0.001, and incident HIV infection (aIR 4.48; P = 0.008 were significantly associated.We report a high rate of syphilis

  13. Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru

    Science.gov (United States)

    Konda, Kelika A.; Roberts, Chelsea P.; Maguiña, Jorge L.; Leon, Segundo R.; Clark, Jesse L.; Coates, Thomas J.; Caceres, Carlos F.; Klausner, Jeffrey D.

    2016-01-01

    Background Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. Methods Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02). Results Of 2,709 participants, 191 (7.05%) were RPR-reactive (median 1:8, range 1:1–1:1024) with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR) 3.84; P <0.001 and IR 8.15; P <0.001) and being MSM/TW (IR 6.48; P <0.001) were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001), not being in a stable partnership (IR 1.56, P = 0.035), higher number of sex partners (IR 3.01; P <0.001), unprotected sex in the past 3 months (IR 0.56; P = 0.003), HIV infection at baseline (IR 3.98; P <0.001) and incident HIV infection during the study period (IR 6.26; P = 0.003) were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR) 6.18; P <0.001), men reporting having sex with a man (aIR 4.63; P <0.001), and incident HIV infection (aIR 4.48; P = 0.008) were significantly associated

  14. Economic growth and longevity risk with adverse selection

    OpenAIRE

    Heijdra, Ben J.; Laurie S. M. Reijnders

    2009-01-01

    We study a closed economy featuring heterogeneous agents and exhibiting endogenous economic growth due to interfirm external effects. Individual agents differ in terms of their mortality profile. At birth, nature assigns a health status to each agent. Health type is private information and annuity firms can only observe an agent’s age. In the presence of longevity risk, agents want to annuitize their wealth conform the classic result by Yaari (1965). In the first-best case with perfect annuit...

  15. Communicating about risk: strategies for situations where public concern is high but the risk is low

    OpenAIRE

    Claire Hooker; Adam Capon; Julie Leask

    2017-01-01

    In this article, we summarise research that identifies best practice for communicating about hazards where the risk is low but public concern is high. We apply Peter Sandman’s ‘risk = hazard + outrage’ formulation to these risks, and review factors associated with the amplification of risk signals. We discuss the structures that determine the success of risk communication strategies, such as the capacity for early communication to ‘capture’ the dominant representation of risk issues, the impo...

  16. High density transcriptional mapping of chromosome 21 by hybridization selection

    Energy Technology Data Exchange (ETDEWEB)

    Tassone, F.; Wade, H.; Gardiner, K. [Eleanor Roosevelt Institute, Denver, CO (United States)] [and others

    1994-09-01

    A transcriptional map of human chromosome 21 is important for the study of Down syndrome, development processes and genome organization. To construct a high density transcriptional map, the technique of cDNA hybrid selection is being applied to a minimal tiling path of YAC clones that span 21q. The cDNA used for selection represents a complex pool of sequences obtained from a variety of fetal and adult tissues and cell lines. Approximately 70-80 YAC clones are sufficient to span 21q; each is individually processed through the selection procedure to obtain a YAC-specific {open_quotes}selected cDNA library{close_quotes}. Survey analysis of each library includes determination of levels of ribosomal contamination, verification of enrichment of control genes, identification of a preliminary number of novel unique sequences, and verification that novel sequences map to the correct YAC and chromosomal regions. This analysis has been completed for 19 YACs that together comprise approximately 10 Mb of non-overlapping DNA, 25% of the long arm. Ribosomal cDNA contamination is low (<10%) and all known genes of appropriate tissue specificity of expression have been recovered, as well as new genes from each YAC. Libraries of expression have been recovered, as well as new genes from each YAC. Libraries from 8 of these YACs are now being subjected to exhaustive analysis to identify all novel genes contained within them and to obtain complete cDNAs and expression analysis for each. Not all regions of the chromosome, however, are equally amenable to these analyses. Selected cDNA libraries from the centromeric YACs are yielding apparently novel genes, but confirmation of map position is problematic. Also of interest is a region of several megabases within the Giemsa dark band, 21q21. Selected cDNA libraries from these YACs so far have yielded no novel genes and support the idea of a genuinely very gene-poor region.

  17. High-dimensional model estimation and model selection

    CERN Document Server

    CERN. Geneva

    2015-01-01

    I will review concepts and algorithms from high-dimensional statistics for linear model estimation and model selection. I will particularly focus on the so-called p>>n setting where the number of variables p is much larger than the number of samples n. I will focus mostly on regularized statistical estimators that produce sparse models. Important examples include the LASSO and its matrix extension, the Graphical LASSO, and more recent non-convex methods such as the TREX. I will show the applicability of these estimators in a diverse range of scientific applications, such as sparse interaction graph recovery and high-dimensional classification and regression problems in genomics.

  18. [Anesthesiological management of the high-risk surgical patient].

    Science.gov (United States)

    Bertoldi, G; Avalle, M

    1980-03-01

    Evaluation of the anaesthesiological risk in surgical patients is described and an account is given of results obtained with an association of ketamin and NLA II in 57 high-risk patients subjected to general surgical management.

  19. Advanced Risk Analysis for High-Performing Organizations

    National Research Council Canada - National Science Library

    Alberts, Christopher; Dorofee, Audrey

    2006-01-01

    ...) are not readily identified using traditional risk analysis techniques. High-performing organizations have the basic skills needed to identify and manage these new types of risk, but lack sufficient techniques...

  20. Selected non-somatic risk factors for pregnancy loss in patients with abnormal early pregnancy

    Directory of Open Access Journals (Sweden)

    Maciej Paszkowski

    2015-12-01

    Full Text Available [b]Introduction and objective. [/b]Spontaneous abortion constitutes one of the most frequent complication of human pregnancy. Despite intensive research efforts undertaken to date, the etiopathogenesis of early pregnancy loss has not been fully elucidated. The objective of this study was to analyze the role of selected non-somatic risk factors for early pregnancy loss in patients with various clinical manifestations of spontaneous abortion. [b]Materials and methods[/b]. The study included 242 women hospitalized between 2001 and 2004 in the 3rd Chair and Department of Gynecology, Medical University of Lublin, Poland (Teaching Hospital No.4 with various clinical categories of spontaneous abortion. Each patient completed a questionnaire assessing her exposure to the examined factors. In patients with threatened abortion dismissed from the hospital with viable gestation, the course of pregnancy was followed-up using questionnaire data and medical records. [b]Results.[/b] In the studied population of women with abnormal early pregnancy course, a significant impact on the risk of miscarriage was observed in case of such factors as: exposure to stress at home and limited number of hours of nightly sleep. Factors such as occupational hazards, diet, stress, heavy housework and use of cigarettes or alcohol did not exert a significant effect on the risk of miscarriage in the studied population. [b]Conclusions.[/b] The results of this study confirm the complexity of the early pregnancy loss etiopatogenesis. Further research need to be conducted in order to identify the non-somatic causative agents of various clinical forms of miscarriage. It may help do select women in reproductive age at high risk of early pregnancy loss and show the ways in which effective preventive measures can be introduced in such population.

  1. Selected non-somatic risk factors for pregnancy loss in patients with abnormal early pregnancy.

    Science.gov (United States)

    Paszkowski, Maciej; Czuczwar, Piotr; Woźniak, Sławomir; Paszkowska, Monika; Szkodziak, Piotr; Patyra, Krzysztof; Paszkowski, Tomasz

    2016-01-01

    Spontaneous abortion constitutes one of the most frequent complication of human pregnancy. Despite intensive research efforts undertaken to date, the etiopathogenesis of early pregnancy loss has not been fully elucidated. The objective of this study was to analyze the role of selected non-somatic risk factors for early pregnancy loss in patients with various clinical manifestations of spontaneous abortion. The study included 242 women hospitalized between 2001 and 2004 in the 3rd Chair and Department of Gynecology, Medical University of Lublin, Poland (Teaching Hospital No.4) with various clinical categories of spontaneous abortion. Each patient completed a questionnaire assessing her exposure to the examined factors. In patients with threatened abortion dismissed from the hospital with viable gestation, the course of pregnancy was followed-up using questionnaire data and medical records. In the studied population of women with abnormal early pregnancy course, a significant impact on the risk of miscarriage was observed in case of such factors as: exposure to stress at home and limited number of hours of nightly sleep. Factors such as occupational hazards, diet, stress, heavy housework and use of cigarettes or alcohol did not exert a significant effect on the risk of miscarriage in the studied population. The results of this study confirm the complexity of the early pregnancy loss etiopatogenesis. Further research need to be conducted in order to identify the non-somatic causative agents of various clinical forms of miscarriage. It may help do select women in reproductive age at high risk of early pregnancy loss and show the ways in which effective preventive measures can be introduced in such population.

  2. Correlates of High-Risk and Low-Risk Alcohol Use among College Students in Kerala, India.

    Science.gov (United States)

    Jaisoorya, T S; Gowda, Guru S; Nair, B Sivasankaran; Menon, Priya G; Rani, Anjana; Radhakrishnan, K S; Revamma, M; Jeevan, C R; Kishore, Anupam; Thennarasu, K; Benegal, Vivek

    2017-09-26

    This study describes the prevalence and correlates of alcohol use among college students in Ernakulam, Kerala State, India. A total of 5784 students from 58 colleges selected by stratified random sampling completed a questionnaire incorporating standardized instruments. The prevalence of lifetime alcohol use was 21.4% with a male predominance. Among users, low-risk, hazardous, and dependent use were 80.2%, 18.3% and 0.9% respectively. Initiation was mostly with friends (45.3%). Both low-risk and high-risk alcohol users (hazardous and dependent users), in comparison to abstainers, had higher odds of being older, non-Muslim, having a part-time job, using other substances, and exposure to sexual abuse. Students who reported low-risk use also had an urban background, more severe psychological distress and suicidal thoughts, while high-risk users had attention deficit hyperactivity disorder (ADHD) symptoms. Students who reported high-risk use compared to low-risk users had higher odds of having a part-time job, tobacco use, and ADHD symptoms. Alcohol use among college students is common, with both low- and high-risk drinking associated with significant morbidity. This study highlights the need to promote public health policies to target and prevent all patterns of alcohol use among young people.

  3. A Primer on High-Throughput Computing for Genomic Selection

    Science.gov (United States)

    Wu, Xiao-Lin; Beissinger, Timothy M.; Bauck, Stewart; Woodward, Brent; Rosa, Guilherme J. M.; Weigel, Kent A.; Gatti, Natalia de Leon; Gianola, Daniel

    2011-01-01

    High-throughput computing (HTC) uses computer clusters to solve advanced computational problems, with the goal of accomplishing high-throughput over relatively long periods of time. In genomic selection, for example, a set of markers covering the entire genome is used to train a model based on known data, and the resulting model is used to predict the genetic merit of selection candidates. Sophisticated models are very computationally demanding and, with several traits to be evaluated sequentially, computing time is long, and output is low. In this paper, we present scenarios and basic principles of how HTC can be used in genomic selection, implemented using various techniques from simple batch processing to pipelining in distributed computer clusters. Various scripting languages, such as shell scripting, Perl, and R, are also very useful to devise pipelines. By pipelining, we can reduce total computing time and consequently increase throughput. In comparison to the traditional data processing pipeline residing on the central processors, performing general-purpose computation on a graphics processing unit provide a new-generation approach to massive parallel computing in genomic selection. While the concept of HTC may still be new to many researchers in animal breeding, plant breeding, and genetics, HTC infrastructures have already been built in many institutions, such as the University of Wisconsin–Madison, which can be leveraged for genomic selection, in terms of central processing unit capacity, network connectivity, storage availability, and middleware connectivity. Exploring existing HTC infrastructures as well as general-purpose computing environments will further expand our capability to meet increasing computing demands posed by unprecedented genomic data that we have today. We anticipate that HTC will impact genomic selection via better statistical models, faster solutions, and more competitive products (e.g., from design of marker panels to realized

  4. Systemic immunomodulatory strategies in high-risk corneal transplantation

    Directory of Open Access Journals (Sweden)

    Tulio B Abud

    2017-01-01

    Full Text Available The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation.

  5. Peptide-Directed Highly Selective Targeting of Pulmonary Arterial Hypertension

    Science.gov (United States)

    Urakami, Takeo; Järvinen, Tero A.H.; Toba, Michie; Sawada, Junko; Ambalavanan, Namasivayam; Mann, David; McMurtry, Ivan; Oka, Masahiko; Ruoslahti, Erkki; Komatsu, Masanobu

    2011-01-01

    Pulmonary arterial hypertension (PAH) is a disorder of the pulmonary vasculature associated with elevated pulmonary vascular resistance. Despite recent advances in the treatment of PAH, with eight approved clinical therapies and additional therapies undergoing clinical trials, PAH remains a serious life-threatening condition. The lack of pulmonary vascular selectivity and associated systemic adverse effects of these therapies remain the main obstacles to successful treatment. Peptide-mediated drug delivery that specifically targets the vasculature of PAH lungs may offer a solution to the lack of drug selectivity. Herein, we show highly selective targeting of rat PAH lesions by a novel cyclic peptide, CARSKNKDC (CAR). Intravenous administration of CAR peptide resulted in intense accumulation of the peptide in monocrotaline-induced and SU5416/hypoxia-induced hypertensive lungs but not in healthy lungs or other organs of PAH rats. CAR homed to all layers of remodeled pulmonary arteries, ie, endothelium, neointima, medial smooth muscle, and adventitia, in the hypertensive lungs. CAR also homed to capillary vessels and accumulated in the interstitial space of the PAH lungs, manifesting its extravasation activity. These results demonstrated the remarkable ability of CAR to selectively target PAH lung vasculature and effectively penetrate and spread throughout the diseased lung tissue. These results suggest the clinical utility of CAR in the targeted delivery of therapeutic compounds and imaging probes to PAH lungs. PMID:21549345

  6. Parental prey selection affects risk-taking behaviour and spatial learning in avian offspring.

    Science.gov (United States)

    Arnold, Kathryn E; Ramsay, Scot L; Donaldson, Christine; Adam, Aileen

    2007-10-22

    Early nutrition shapes life history. Parents should, therefore, provide a diet that will optimize the nutrient intake of their offspring. In a number of passerines, there is an often observed, but unexplained, peak in spider provisioning during chick development. We show that the proportion of spiders in the diet of nestling blue tits, Cyanistes caeruleus, varies significantly with the age of chicks but is unrelated to the timing of breeding or spider availability. Moreover, this parental prey selection supplies nestlings with high levels of taurine particularly at younger ages. This amino acid is known to be both vital and limiting for mammalian development and consequently found in high concentrations in placenta and milk. Based on the known roles of taurine in mammalian brain development and function, we then asked whether by supplying taurine-rich spiders, avian parents influence the stress responsiveness and cognitive function of their offspring. To test this, we provided wild blue tit nestlings with either a taurine supplement or control treatment once daily from the ages of 2-14 days. Then pairs of size- and sex-matched siblings were brought into captivity for behavioural testing. We found that juveniles that had received additional taurine as neonates took significantly greater risks when investigating novel objects than controls. Taurine birds were also more successful at a spatial learning task than controls. Additionally, those individuals that succeeded at a spatial learning task had shown intermediate levels of risk taking. Non-learners were generally very risk-averse controls. Early diet therefore has downstream impacts on behavioural characteristics that could affect fitness via foraging and competitive performance. Fine-scale prey selection is a mechanism by which parents can manipulate the behavioural phenotype of offspring.

  7. Prolonged Isotretinoin in Ultra High-Risk Neuroblastoma.

    Science.gov (United States)

    Cash, Thomas; Alazraki, Adina; Qayed, Muna; Katzenstein, Howard M

    2017-01-01

    Patients with high-risk neuroblastoma remain a therapeutic challenge with significant numbers of patients failing to respond sufficiently to initial therapy. These patients with poor response to induction are considered as ultra high-risk and are in need of novel treatment strategies. Isotretinoin is part of the standard of care treatment for patients with high-risk disease who undergo high-dose chemotherapy with autologous stem cell rescue although some have questioned the optimal administration schedule. Prolonged use of isotretinoin was well tolerated and may have contributed to long-term survival in a group of patients with ultra high-risk neuroblastoma.

  8. Lung cancer risk prediction method based on feature selection and artificial neural network.

    Science.gov (United States)

    Xie, Nan-Nan; Hu, Liang; Li, Tai-Hui

    2014-01-01

    A method to predict the risk of lung cancer is proposed, based on two feature selection algorithms: Fisher and ReliefF, and BP Neural Networks. An appropriate quantity of risk factors was chosen for lung cancer risk prediction. The process featured two steps, firstly choosing the risk factors by combining two feature selection algorithms, then providing the predictive value by neural network. Based on the method framework, an algorithm LCRP (lung cancer risk prediction) is presented, to reduce the amount of risk factors collected in practical applications. The proposed method is suitable for health monitoring and self-testing. Experiments showed it can actually provide satisfactory accuracy under low dimensions of risk factors.

  9. ON SELECTION OF CIRCUIT-BREAKERS SWITCHING ELECTRICAL INSTALLATIONS OF HIGH AND EXTRA-HIGH VOLTAGE

    Directory of Open Access Journals (Sweden)

    T. M. Lazimov

    2005-01-01

    Full Text Available The paper proposes some additional conditions for high-voltage circuit-breaker selection keeping in mind coordination of the switched over-voltages and voltages induced in secondary circuits with their permissible values.

  10. Transport of water vapor and inert gas mixtures through highly selective and highly permeable polymer membranes

    NARCIS (Netherlands)

    Metz, S.J.; van de Ven, W.J.C.; Potreck, Jens; Mulder, M.H.V.; Wessling, Matthias

    2005-01-01

    This paper studies in detail the measurement of the permeation properties of highly permeable and highly selective polymers for water vapor/nitrogen gas mixtures. The analysis of the mass transport of a highly permeable polymer is complicated by the presence of stagnant boundary layers at feed and

  11. How can the regulator show evidence of (no) risk selection in health insurance markets? Conceptual framework and empirical evidence.

    Science.gov (United States)

    van de Ven, Wynand P M M; van Vliet, René C J A; van Kleef, Richard C

    2017-03-01

    If consumers have a choice of health plan, risk selection is often a serious problem (e.g., as in Germany, Israel, the Netherlands, the United States of America, and Switzerland). Risk selection may threaten the quality of care for chronically ill people, and may reduce the affordability and efficiency of healthcare. Therefore, an important question is: how can the regulator show evidence of (no) risk selection? Although this seems easy, showing such evidence is not straightforward. The novelty of this paper is two-fold. First, we provide a conceptual framework for showing evidence of risk selection in competitive health insurance markets. It is not easy to disentangle risk selection and the insurers' efficiency. We suggest two methods to measure risk selection that are not biased by the insurers' efficiency. Because these measures underestimate the true risk selection, we also provide a list of signals of selection that can be measured and that, in particular in combination, can show evidence of risk selection. It is impossible to show the absence of risk selection. Second, we empirically measure risk selection among the switchers, taking into account the insurers' efficiency. Based on 2-year administrative data on healthcare expenses and risk characteristics of nearly all individuals with basic health insurance in the Netherlands (N > 16 million) we find significant risk selection for most health insurers. This is the first publication of hard empirical evidence of risk selection in the Dutch health insurance market.

  12. Risk factors and effect of selective removal on retroviral infections prevalence in Belgian stray cats.

    Science.gov (United States)

    Garigliany, M; Jolly, S; Dive, M; Bayrou, C; Berthemin, S; Robin, P; Godenir, R; Petry, J; Dahout, S; Cassart, D; Thiry, E; Desmecht, D; Saegerman, C

    2016-01-09

    The aim of this study was to evaluate the effect of several risk/protective factors and predictors on the prevalence of feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) infections in 302 stray cats captured during a trap-neuter-release programme in a mixed urban-rural area from Belgium, from 2010 to 2012. The impact of selective removal of FIV-positive cats on the apparent prevalence in the remaining population over this three-year period was also assessed. The seroprevalences over three years were 18.8 per cent for FIV and 0.7 per cent for FeLV. For FIV, the seroprevalence decreased significantly from the first year of the programme (2010; 30.5 per cent) to the last (2012; 13.1 per cent). Sex (male) and age (adult and old cats) were risk factors, while the year of sampling (years 2011 and 2012) was a protective factor. Age, sex and location were the most relevant predictors of FIV status. The data presented in this study revealed a very high FIV seroprevalence in Belgian stray cats, while FeLV was almost absent. The selective removal of positive cats had a drastic effect on the FIV seroprevalence in the remaining cat population. British Veterinary Association.

  13. Material Selection and Characterization for High Gradient RF Applications

    CERN Document Server

    Arnau-Izquierdo, G; Heikkinen, S; Ramsvik, T; Sgobba, Stefano; Taborelli, M; Wuensch, W

    2007-01-01

    The selection of candidate materials for the accelerating cavities of the Compact Linear Collider (CLIC) is carried out in parallel with high power RF testing. The maximum DC breakdown field of copper, copper alloys, refractory metals, aluminium and titanium have been measured with a dedicated setup. Higher maximum fields are obtained for refractory metals and for titanium, which exhibits, however, important damages after conditioning. Fatigue behaviour of copper alloys has been studied for surface and bulk by pulsed laser irradiation and ultrasonic excitation, respectively. The selected copper alloys show consistently higher fatigue resistance than copper in both experiments. In order to obtain the best local properties in the device a possible solution is a bi-metallic assembly. Junctions of molybdenum and copper-zirconium UNS C15000 alloy, achieved by HIP (Hot Isostatic Pressing) diffusion bonding or explosion bonding were evaluated for their mechanical strength. The reliability of the results obtained wit...

  14. In utero exposure to selective serotonin reuptake inhibitors and risk for autism spectrum disorder

    DEFF Research Database (Denmark)

    Gidaya, Nicole B; Lee, Brian K; Burstyn, Igor

    2014-01-01

    We investigated whether there is an association between increased risk for autism spectrum disorders (ASD) and selective serotonin reuptake inhibitors (SSRIs) used during pregnancy. This study used Denmark's health and population registers to obtain information regarding prescription drugs, ASD...

  15. Cardiovascular risk factors and primary selection into shift work

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Garde, Anne Helene; Tüchsen, Finn

    2008-01-01

    OBJECTIVES: This study examined differences between future shift workers and future day workers as regards cardiovascular risk factors before they began different work schedules and the differences that remained after control for sociodemographic factors and general self-efficacy. METHODS......: Altogether 2870 newly educated social and health care workers filled out a questionnaire a few weeks before finishing their formal training and again 1 year after graduation. They answered questions on diabetes, hypertension, lifestyle habits, sociodemographic factors, and general self-efficacy. RESULTS......, fixed night work, and two- or three- shift work including night work. After adjustment for sociodemographic factors and general self-efficacy, smoking was prospectively associated with fixed evening work [OR 1.56, 95% confidence interval (95% CI) 1.21-2.02] and fixed night work (OR 1.64, 95% CI 1...

  16. Heterogeneity of Psychosis Risk Within Individuals at Clinical High Risk: A Meta-analytical Stratification

    NARCIS (Netherlands)

    Fusar-Poli, Paolo; Cappucciati, Marco; Borgwardt, Stefan; Woods, Scott W.; Addington, Jean; Nelson, Barnaby; Nieman, Dorien H.; Stahl, Daniel R.; Rutigliano, Grazia; Riecher-Rössler, Anita; Simon, Andor E.; Mizuno, Masafumi; Lee, Tae Young; Kwon, Jun Soo; Lam, May M. L.; Perez, Jesus; Keri, Szabolcs; Amminger, Paul; Metzler, Sibylle; Kawohl, Wolfram; Rössler, Wulf; Lee, Jimmy; Labad, Javier; Ziermans, Tim; An, Suk Kyoon; Liu, Chen-Chung; Woodberry, Kristen A.; Braham, Amel; Corcoran, Cheryl; McGorry, Patrick; Yung, Alison R.; McGuire, Philip K.

    2016-01-01

    Individuals can be classified as being at clinical high risk (CHR) for psychosis if they meet at least one of the ultra-high-risk (UHR) inclusion criteria (brief limited intermittent psychotic symptoms [BLIPS] and/or attenuated psychotic symptoms [APS] and/or genetic risk and deterioration syndrome

  17. Strong signature of natural selection within an FHIT intron implicated in prostate cancer risk.

    Directory of Open Access Journals (Sweden)

    Yan Ding

    Full Text Available Previously, a candidate gene linkage approach on brother pairs affected with prostate cancer identified a locus of prostate cancer susceptibility at D3S1234 within the fragile histidine triad gene (FHIT, a tumor suppressor that induces apoptosis. Subsequent association tests on 16 SNPs spanning approximately 381 kb surrounding D3S1234 in Americans of European descent revealed significant evidence of association for a single SNP within intron 5 of FHIT. In the current study, re-sequencing and genotyping within a 28.5 kb region surrounding this SNP further delineated the association with prostate cancer risk to a 15 kb region. Multiple SNPs in sequences under evolutionary constraint within intron 5 of FHIT defined several related haplotypes with an increased risk of prostate cancer in European-Americans. Strong associations were detected for a risk haplotype defined by SNPs 138543, 142413, and 152494 in all cases (Pearson's chi(2 = 12.34, df 1, P = 0.00045 and for the homozygous risk haplotype defined by SNPs 144716, 142413, and 148444 in cases that shared 2 alleles identical by descent with their affected brothers (Pearson's chi(2 = 11.50, df 1, P = 0.00070. In addition to highly conserved sequences encompassing SNPs 148444 and 152413, population studies revealed strong signatures of natural selection for a 1 kb window covering the SNP 144716 in two human populations, the European American (pi = 0.0072, Tajima's D = 3.31, 14 SNPs and the Japanese (pi = 0.0049, Fay & Wu's H = 8.05, 14 SNPs, as well as in chimpanzees (Fay & Wu's H = 8.62, 12 SNPs. These results strongly support the involvement of the FHIT intronic region in an increased risk of prostate cancer.

  18. Bleeding risk under selective serotonin reuptake inhibitor (SSRI) antidepressants: A meta-analysis of observational studies.

    Science.gov (United States)

    Laporte, Silvy; Chapelle, Céline; Caillet, Pascal; Beyens, Marie-Noëlle; Bellet, Florelle; Delavenne, Xavier; Mismetti, Patrick; Bertoletti, Laurent

    2017-04-01

    Selective serotonin reuptake inhibitors (SSRIs) have been reported to be potentially associated with an increased risk of bleeding. A meta-analysis of observational studies was conducted to quantify this risk. Case-control and cohort studies investigating bleeding risk under SSRI therapy were retrieved by searching the Medline, Pascal, Google Scholar and Scopus databases. Case-control studies were included if they reported bleeding incidents with and without the use of SSRIs and cohort studies were included if they reported the rate of bleeds among SSRI users and non-users. The main outcome was severe bleeding, whatever the site. Only data concerning SSRI belonging to the ATC class N06AB were used. For both case-control and cohort studies, we recorded the adjusted effect estimates and their 95% confidence intervals (CI). Pooled adjusted odds ratio (OR) estimates were computed for case-control and cohort studies using an inverse-variance model. Meta-analysis of the adjusted ORs of 42 observational studies showed a significant association between SSRI use and the risk of bleeding [OR 1.41 (95% CI 1.27-1.57), random effect model, prisk of 41% of bleeding [OR 1.41 (95% CI 1.25-1.60)], as well as for the 11 cohort studies including 187,956 patients [OR 1.36 (95% CI 1.12-1.64)]. Subgroup analyses showed that the association remained constant whatever the characteristics of studies. This meta-analysis shows an increased risk of bleeding of at least 36% (from 12% to 64%) based on the high-level of observational studies with SSRIs use. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. High Selectivity Wideband Bandpass Filter Using Stub Loaded Resonator

    Science.gov (United States)

    Ma, Xing-Bing; Jiang, Ting

    2017-07-01

    This article presents a high selectivity wideband bandpass filter (BPF) adopting stub loaded resonator. Hereinto, aim passband is determined by BPF without stub embedded, which is only composed of four half-wavelength open-loop resonators. Based on typical tapped-line coupling, two same stubs are located at physical middle points of two resonators connected with I/O feed lines, respectively. Due to embedded point at middle of loaded resonator, the stub with two open-end branches has no influence on original half-wavelength resonant frequency, and aim passband keeps unchanged. Because of different even-mode resonant frequencies between loaded and unloaded resonators, no new passband is constructed. With the help of embedded stubs, original transmission zero (TZ) near low-edge of aim passband is shifted towards passband, and a new TZ is introduced near high-edge. High selectivity and good passband characteristics are obtained optimizing sizes of stubs, I/O tapped position and top open-end length of loaded resonator.

  20. Guidelines for Microplate Selection in High Content Imaging.

    Science.gov (United States)

    Trask, Oscar J

    2018-01-01

    Since the inception of commercialized automated high content screening (HCS) imaging devices in the mid to late 1990s, the adoption of media vessels typically used to house and contain biological specimens for interrogation has transitioned from microscope slides and petri dishes into multi-well microtiter plates called microplates. The early 96- and 384-well microplates commonly used in other high-throughput screening (HTS) technology applications were often not designed for optical imaging. Since then, modifications and the use of next-generation materials with improved optical clarity have enhanced the quality of captured images, reduced autofocusing failures, and empowered the use of higher power magnification objectives to resolve fine detailed measurements at the subcellular pixel level. The plethora of microplates and their applications requires practitioners of high content imaging (HCI) to be especially diligent in the selection and adoption of the best plates for running longitudinal studies or larger screening campaigns. While the highest priority in experimental design is the selection of the biological model, the choice of microplate can alter the biological response and ultimately may change the experimental outcome. This chapter will provide readers with background, troubleshooting guidelines, and considerations for choosing an appropriate microplate.

  1. Selected determinants may account for dropout risks among medical students

    DEFF Research Database (Denmark)

    Mørcke, Anne Mette; O'Neill, Lotte; Kjeldsen, Inge Trads

    2012-01-01

    INTRODUCTION: The dropout level from the Danish medical schools is high, but we have only little insight into this problem. The purpose of this study was to qualify the ongoing discussions concerning dropout. MATERIAL AND METHODS: In this retrospective cohort study, relevant variables were....... CONCLUSION: The dropout rate has been decreasing during the past decade. Young people considering studying medicine could be advised to choose natural science subjects in high school, and a number of research questions concerning preparedness for medical school are worth pursuing. Leave or very low grades...... during their first year. The type of admission exam was a strong predictor of dropout in the pre-admission model, whereas previous higher education protected against dropout. Obtaining leave was a very strong predictor of dropout in the post-admission model, whereas high grades protected against dropout...

  2. Risk of selected gastrointestinal and hepatic toxicities in cancer patients treated with nintedanib: a meta-analysis.

    Science.gov (United States)

    Abdel-Rahman, Omar; Bahie Eldin, Nermean; ElHalawani, Hesham

    2016-09-01

    A meta-analysis of the risk of selected gastrointestinal and hepatic toxicities associated with nintedanib has been conducted. Randomized Phase II/III trials of cancer patients on nintedanib; describing events of diarrhea, vomiting, elevated ALT and elevated AST constituted the eligible studies. The odds ratio for high-grade diarrhea was 3.76 (95% CI: 1.42-9.96; p = 0.008); high-grade vomiting: 1.38 (95% CI: 0.76-2.51; p = 0.28); high-grade elevated ALT: 4.36 (95% CI: 2.14-8.85; p Nintedanib-based regimens are associated with a higher risk of high-grade diarrhea, elevated ALT and elevated AST. Moreover, there is a proportional relationship between nintedanib dose and the risk of elevated transaminases.

  3. Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

    Science.gov (United States)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

    This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

  4. Standardizing care for high-risk patients in spine surgery: the Northwestern high-risk spine protocol.

    Science.gov (United States)

    Halpin, Ryan J; Sugrue, Patrick A; Gould, Robert W; Kallas, Peter G; Schafer, Michael F; Ondra, Stephen L; Koski, Tyler R

    2010-12-01

    Review article of current literature on the preoperative evaluation and postoperative management of patients undergoing high-risk spine operations and a presentation of a multidisciplinary protocol for patients undergoing high-risk spine operation. To provide evidence-based outline of modifiable risk factors and give an example of a multidisciplinary protocol with the goal of improving outcomes. Protocol-based care has been shown to improve outcomes in many areas of medicine. A protocol to evaluate patients undergoing high-risk procedures may ultimately improve patient outcomes. The English language literature to date was reviewed on modifiable risk factors for spine surgery. A multidisciplinary team including hospitalists, critical care physicians, anesthesiologists, and spine surgeons from neurosurgery and orthopedics established an institutional protocol to provide comprehensive care in the pre-, peri-, and postoperative periods for patients undergoing high-risk spine operations. An example of a comprehensive pre-, peri-, and postoperative high-risk spine protocol is provided, with focus on the preoperative assessment of patients undergoing high-risk spine operations and modifiable risk factors. Standardizing preoperative risk assessment may lead to better outcomes after major spine operations. A high-risk spine protocol may help patients by having dedicated physicians in multiple specialties focusing on all aspects of a patients care in the pre-, intra-, and postoperative phases.

  5. Assessing risk to birds from industrial wind energy development via paired resource selection nodels

    Science.gov (United States)

    Tricia A. Miller; Robert P. Brooks; Michael Lanzone; David Brandes; Jeff Cooper; Kieran O' malley; Charles Maisonneuve; Junior Tremblay; Adam Duerr; Todd. Katzner

    2014-01-01

    When wildlife habitat overlaps with industrial development animals may be harmed. Because wildlife and people select resources to maximize biological fitness and economic return, respectively, we estimated risk, the probability of eagles encountering and being affected by turbines, by overlaying models of resource selection for each entity. This conceptual framework...

  6. Mean-Coherent Risk and Mean-Variance Approaches in Portfolio Selection : An Empirical Comparison

    NARCIS (Netherlands)

    Polbennikov, S.Y.; Melenberg, B.

    2005-01-01

    We empirically analyze the implementation of coherent risk measures in portfolio selection.First, we compare optimal portfolios obtained through mean-coherent risk optimization with corresponding mean-variance portfolios.We find that, even for a typical portfolio of equities, the outcomes can be

  7. Risk prediction models for selection of lung cancer screening candidates: A retrospective validation study

    NARCIS (Netherlands)

    K. ten Haaf (Kevin); J. Jeon (Jihyoun); M.C. Tammemagi (Martin); S.S. Han (Summer); C.Y. Kong (Chung Yin); S.K. Plevritis (Sylvia); E. Feuer (Eric); H.J. de Koning (Harry); E.W. Steyerberg (Ewout W.); R. Meza (Rafael)

    2017-01-01

    textabstractBackground: Selection of candidates for lung cancer screening based on individual risk has been proposed as an alternative to criteria based on age and cumulative smoking exposure (pack-years). Nine previously established risk models were assessed for their ability to identify those most

  8. High-Risk and Low-Risk Human Papillomavirus and the Absolute Risk of Cervical Intraepithelial Neoplasia or Cancer

    DEFF Research Database (Denmark)

    Thomsen, Louise T; Frederiksen, Kirsten; Munk, Christian

    2014-01-01

    OBJECTIVE: To determine the absolute risk of cervical intraepithelial neoplasia (CIN) grade 3 or cervical cancer (CIN 3 or worse) after detection of low-risk human papillomavirus (HPV) and after a negative high-risk HPV test. METHODS: In this prospective cohort study, consecutive liquid-based cer......OBJECTIVE: To determine the absolute risk of cervical intraepithelial neoplasia (CIN) grade 3 or cervical cancer (CIN 3 or worse) after detection of low-risk human papillomavirus (HPV) and after a negative high-risk HPV test. METHODS: In this prospective cohort study, consecutive liquid...

  9. Cardiovascular risk factors and primary selection into shift work.

    Science.gov (United States)

    Nabe-Nielsen, Kirsten; Garde, Anne Helene; Tüchsen, Finn; Hogh, Annie; Diderichsen, Finn

    2008-06-01

    This study examined differences between future shift workers and future day workers as regards cardiovascular risk factors before they began different work schedules and the differences that remained after control for sociodemographic factors and general self-efficacy. Altogether 2870 newly educated social and health care workers filled out a questionnaire a few weeks before finishing their formal training and again 1 year after graduation. They answered questions on diabetes, hypertension, lifestyle habits, sociodemographic factors, and general self-efficacy. In the unadjusted analyses, baseline obesity was associated with fixed evening work at follow-up. Minimal or light-to-moderate leisure-time physical activity was associated with a decrease in the odds ratio (OR) for two or three shifts including night work. Smoking status was associated with fixed evening work, fixed night work, and two- or three- shift work including night work. After adjustment for sociodemographic factors and general self-efficacy, smoking was prospectively associated with fixed evening work [OR 1.56, 95% confidence interval (95% CI) 1.21-2.02] and fixed night work (OR 1.64, 95% CI 1.04-2.56). Being an ex-smoker was associated with two- or three-shift work including night work (OR 1.85, 95% CI 1.28-2.68). The association between two- and three-shift work and smoking was only of borderline significance (OR 1.37, 95% CI 1.00-1.87). Compared with future day workers, fixed evening or fixed night workers already smoked more before they began shift work. Being an ex-smoker was significantly associated with two- or three-shift work including night work. These results indicate that smoking status should not solely be treated as a mediator between some variants of shiftwork schedules and cardiovascular diseases but should also be considered a confounder.

  10. Frequency selective surfaces based high performance microstrip antenna

    CERN Document Server

    Narayan, Shiv; Jha, Rakesh Mohan

    2016-01-01

    This book focuses on performance enhancement of printed antennas using frequency selective surfaces (FSS) technology. The growing demand of stealth technology in strategic areas requires high-performance low-RCS (radar cross section) antennas. Such requirements may be accomplished by incorporating FSS into the antenna structure either in its ground plane or as the superstrate, due to the filter characteristics of FSS structure. In view of this, a novel approach based on FSS technology is presented in this book to enhance the performance of printed antennas including out-of-band structural RCS reduction. In this endeavor, the EM design of microstrip patch antennas (MPA) loaded with FSS-based (i) high impedance surface (HIS) ground plane, and (ii) the superstrates are discussed in detail. The EM analysis of proposed FSS-based antenna structures have been carried out using transmission line analogy, in combination with the reciprocity theorem. Further, various types of novel FSS structures are considered in desi...

  11. Plans, Patterns, and Move Categories Guiding a Highly Selective Search

    Science.gov (United States)

    Trippen, Gerhard

    In this paper we present our ideas for an Arimaa-playing program (also called a bot) that uses plans and pattern matching to guide a highly selective search. We restrict move generation to moves in certain move categories to reduce the number of moves considered by the bot significantly. Arimaa is a modern board game that can be played with a standard Chess set. However, the rules of the game are not at all like those of Chess. Furthermore, Arimaa was designed to be as simple and intuitive as possible for humans, yet challenging for computers. While all established Arimaa bots use alpha-beta search with a variety of pruning techniques and other heuristics ending in an extensive positional leaf node evaluation, our new bot, Rat, starts with a positional evaluation of the current position. Based on features found in the current position - supported by pattern matching using a directed position graph - our bot Rat decides which of a given set of plans to follow. The plan then dictates what types of moves can be chosen. This is another major difference from bots that generate "all" possible moves for a particular position. Rat is only allowed to generate moves that belong to certain categories. Leaf nodes are evaluated only by a straightforward material evaluation to help avoid moves that lose material. This highly selective search looks, on average, at only 5 moves out of 5,000 to over 40,000 possible moves in a middle game position.

  12. Selection of High Temperature Organic Materials for Future Stirling Convertors

    Science.gov (United States)

    Shin, Euy-Sik Eugene

    2017-01-01

    In the future higher temperature Stirling convertors for improved efficiency and performance, various high temperature organic materials have been demanded as essential components for their unique properties and functions such as bonding, potting, sealing, thread locking, insulation, and lubrication. The higher temperature capabilities would also allow current state-of-the-art (SOA) convertors to be used in additional missions, particularly those that require a Venus flyby for a gravity assist. Stirling convertor radioisotope generators have been developed for potential future space applications including Lunar/Mars surface power or a variety of spacecraft and vehicles, especially with a long mission cycle, sometimes up to 17 years, such as deep space exploration. Thus, performance, durability, and reliability of the organics should be critically evaluated in terms of comprehensive structure-process-service environment relations based on the potential mission specifications. The initial efforts in screening the high temperature candidates focused on the most susceptible organics, such as adhesive, potting compound, o-ring, shrink tubing, and thread locker materials in conjunction with commercially available materials. More systematic and practical test methodologies that were developed and optimized based on the extensive organic evaluations and validations performed for various Stirling convertor types were employed to determine thermal stability, outgassing, and material compatibility of the selected organic candidates against their functional requirements. Processing and fabrication conditions and procedures were also optimized. This paper presents results of the three-step candidate evaluation processes, their application limitations, and the final selection recommendations.

  13. Special features of high-risk pregnancies as factors in development of mental distress: a review

    Directory of Open Access Journals (Sweden)

    Paula Borba Rodrigues

    Full Text Available Abstract Introduction: Approximately 22% of all pregnant women are classified as having high-risk pregnancies, which may involve feelings of vulnerability because of having a high-risk pregnancy, resulting in greater exposure to stressful feelings. Objective: To review aspects of high-risk pregnancy that can have a negative impact on the these women's mental health status. Method: Original articles were identified by conducting searches of the PubMed/MEDLINE, LILACS and SciELO databases, followed by a manual search of references to select articles and additional bibliographic material. Articles from the last 22 years were included in the review (1992-2014. Results: Fifteen articles were found that specifically studied high-risk pregnancies and mental health outcomes. Women with high-risk pregnancies exhibited a significantly higher level of stress and reported negative emotions as they dealt with stress and had worse emotional status than women with normal pregnancies. Researchers found that hospitalized pregnant women had higher levels of anxiety than non-hospitalized women. Studies of women going through normal and high-risk pregnancies show that women with normal pregnancies had good self-perceived quality of life. Conclusion: Special features of high-risk pregnancies could be factors in development of mental distress, in addition to psychological and social factors. Therefore, only a biopsychosocial research study would be able to identify the factors that can affect the quality of mental health during high-risk pregnancy.

  14. Enzyme assays: high-throughput screening, genetic selection, and fingerprinting

    National Research Council Canada - National Science Library

    Reymond, Jean-Louis

    2006-01-01

    ... (Testing Many Substrates Toward Hydrolase) Comparison with Other Methods 26 Estimating and Measuring Selectivity 27 Estimating Selectivity without a Reference Compound 28 Quantitative Measure of Se...

  15. Sociodemographic differences in selected eating practices among alternative high school students.

    Science.gov (United States)

    Arcan, Chrisa; Kubik, Martha Y; Fulkerson, Jayne A; Story, Mary

    2009-05-01

    Students attending alternative high schools are an at-risk group of youth for poor health behaviors and obesity. However, little is known about their dietary practices. To examine associations between sex, race/ethnicity, and socioeconomic status and selected dietary practices, including consumption of sugar-sweetened beverages, high-fat foods, and fruits and vegetables and fast-food restaurant use, among students attending alternative high schools. Population-based, cross-sectional study. A convenience sample of adolescents (n=145; 52% men; 63% aged sociodemographic differences in fruit/vegetable consumption. Higher socioeconomic status was associated with a higher consumption of regular soda (P=0.027). Racial/ethnic and sex differences in the consumption of regular soda, high-fat foods, and fast-food restaurant use among alternative high school students underscores the importance of implementing health promotion programs in alternative high schools.

  16. High Blood Pressure, Afib and Your Risk of Stroke

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, AFib and Your Risk of Stroke Updated:Aug ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  17. Elite High Schools Breed Higher Risk of Addiction

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166144.html Elite High Schools Breed Higher Risk of Addiction: Study ... from drug addiction, new research suggests. Teens at elite U.S. high schools seem to face a higher ...

  18. Risk Attitudes, Sample Selection and Attrition in a Longitudinal Field Experiment

    DEFF Research Database (Denmark)

    Harrison, Glenn W.; Lau, Morten; Yoo, Hong Il

    incentives can affect sample response rates and help one identify the effects of selection. Correcting for endogenous sample selection and panel attrition changes inferences about risk preferences in an economically and statistically significant manner. We draw mixed conclusions on temporal stability of risk......Longitudinal experiments allow one to evaluate the temporal stability of latent preferences, but raise concerns about sample selection and attrition that may confound inferences about temporal stability. We evaluate the hypothesis of temporal stability in risk preferences using a remarkable data...... set that combines socio-demographic information from the Danish Civil Registry with information on risk attitudes from a longitudinal field experiment. Our experimental design builds in explicit randomization on the incentives for participation. The results show that the use of different participation...

  19. Sexual risk behaviours of high school female learners in Mbonge ...

    African Journals Online (AJOL)

    Introduction: since female learners in high schools in Cameroon fall within the age group hardest hit by HIV/AIDS, it is assumed that these learners might be exposed to sexual risk behaviours. However, little has been explored on the sexual risk behaviours of high school female learners in Cameroon. This study aimed at ...

  20. Correlation between high-risk pregnancy and developmental delay ...

    African Journals Online (AJOL)

    Background: The future development of children is considered more than ever now due to the advances in medical knowledge and thus the increase in survival rates of high-risk infants. This study investigated the correlation between high-risk pregnancy and developmental delay in children aged 4- 60 months. Methods: ...

  1. High Risk Behavior among Adolescent Mothers: The Problem in Context.

    Science.gov (United States)

    Kissman, Kris

    1998-01-01

    Discusses the particular consequences of high-risk behavior for adolescent women, including unintended pregnancies, sexually transmitted diseases, school dropout and poverty, developmental disabilities, and poor school performance. Considers the role of male partners in teenage women's high risk behavior. Describes prevention efforts such as…

  2. Elevated level of serum triglyceride among high risk stress bank ...

    African Journals Online (AJOL)

    The objective of this study was to estimate lipid profile among high risk stress bank employees' correlated with heart disorders in Riyadh, Saudi Arabia. A total of 129 patients with high risk stress employees were involved in this study, which were divided into 69 males and 60 females between the age of 25 to 55 years.

  3. Prevalence and risk factors of obesity and high blood pressure ...

    African Journals Online (AJOL)

    Risk factors for these diseases have been well studied in high income countries but less studied in developing countries. Objective: The study was to document the prevalence and risk factors of Obesity and high blood pressure among healthy adults in a military settlement in Ibagwa, Southern Nigeria. The study also sought ...

  4. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  5. Early Molecular Stratification of High-risk Primary Biliary Cholangitis.

    Science.gov (United States)

    Hardie, Claire; Green, Kile; Jopson, Laura; Millar, Ben; Innes, Barbara; Pagan, Sarah; Tiniakos, Dina; Dyson, Jessica; Haniffa, Muzlifah; Bigley, Venetia; Jones, David E; Brain, John; Walker, Lucy J

    2016-12-01

    High-risk primary biliary cholangitis (PBC), defined by inadequate response at one year to Ursodeoxycholic acid (UDCA), is associated with disease progression and liver transplantation. Stratifying high-risk patients early would facilitate improved approaches to care. Using long-term follow-up data to define risk at presentation, 6 high-risk PBC patients and 8 low-risk patients were identified from biopsy, transplant and biochemical archival records. Formalin-fixed paraffin-embedded (FFPE) liver biopsies taken at presentation were graded (Scheuer and Nakanuma scoring) and gene expression analysed using the NanoString® nCounter PanCancer Immunity 770-gene panel. Principle component analysis (PCA) demonstrated discrete gene expression clustering between controls and high- and low-risk PBC. High-risk PBC was characterised by up-regulation of genes linked to T-cell activation and apoptosis, INF-γ signalling and leukocyte migration and down-regulation of those linked to the complement pathway. CDKN1a, up-regulated in high-risk PBC, correlated with significantly increased expression of its gene product, the senescence marker p21 WAF1/Cip , by biliary epithelial cells. Our findings suggest high- and low-risk PBC are biologically different from disease outset and senescence an early feature in high-risk disease. Identification of a high-risk 'signal' early from standard FFPE tissue sections has clear clinical utility allowing for patient stratification and second-line therapeutic intervention. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  6. High Center Volume Does Not Mitigate Risk Associated with Using High Donor Risk Organs in Liver Transplantation.

    Science.gov (United States)

    Beal, Eliza W; Black, Sylvester M; Mumtaz, Khalid; Hayes, Don; El-Hinnawi, Ashraf; Washburn, Kenneth; Tumin, Dmitry

    2017-09-01

    High-risk donor allografts increase access to liver transplant, but potentially reduce patient and graft survival. It is unclear whether the risk associated with using marginal donor livers is mitigated by increasing center experience. The United Network for Organ Sharing registry was queried for adult first-time liver transplant recipients between 2/2002 and 12/2015. High donor risk was defined as donor risk index >1.9, and 1-year patient and graft survival were compared according to donor risk index in small and large centers. Multivariable Cox regression estimated the hazard ratio (HR) associated with using high-risk donor organs, according to a continuous measure of annual center volume. The analysis included 51,770 patients. In 67 small and 67 large centers, high donor risk index predicted increased mortality (p = 0.001). In multivariable analysis, high-donor risk index allografts predicted greater mortality hazard at centers performing 20 liver transplants per year (HR 1.35; 95% CI 1.22, 1.49; p transplant. Specific strategies to mitigate the risk of liver transplant involving high-risk donors are needed, in addition to accumulation of center expertise.

  7. Risk-Informed Decision Making: Application to Technology Development Alternative Selection

    Science.gov (United States)

    Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

    2010-01-01

    NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making (RIDM) and Continuous Risk Management (CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains (e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA's new technology development programs are initiated.

  8. Heading for the hills: risk avoidance drives den site selection in African wild dogs.

    Directory of Open Access Journals (Sweden)

    Craig R Jackson

    Full Text Available Compared to their main competitors, African wild dogs (Lycaon pictus have inferior competitive abilities and interspecific competition is a serious fitness-limiting factor. Lions (Panthera leo are the dominant large carnivore in African savannah ecosystems and wild dogs avoid them both spatially and temporally. Wild dog young are particularly vulnerable and suffer high rates of mortality from lions. Since lions do not utilize all parts of the landscape with an equal intensity, spatial variation in lion densities can be exploited by wild dogs both during their general ranging behaviour, but more specifically when they are confined to a den with vulnerable young. Since patches of rugged terrain are associated with lower lion densities, we hypothesized that these comparatively safe habitats should be selected by wild dogs for denning. We investigated the relationship between the distribution of 100 wild dog den sites and the occurrence of rugged terrain in four wild dog populations located in Tanzania, Zimbabwe and South Africa. A terrain ruggedness index was derived from a 90 m digital elevation model and used to map terrain ruggedness at each site. We compared characteristics of actual and potential (random den sites to determine how wild dogs select den sites. The distributions of wild dog dens were strongly associated with rugged terrain and wild dogs actively selected terrain that was more rugged than that available on average. The likelihood of encountering lions is reduced in these habitats, minimizing the risk to both adults and pups. Our findings have important implications for the conservation management of the species, especially when assessing habitat suitability for potential reintroductions. The simple technique used to assess terrain ruggedness may be useful to investigate habitat suitability, and even predict highly suitable denning areas, across large landscapes.

  9. Heading for the hills: risk avoidance drives den site selection in African wild dogs.

    Science.gov (United States)

    Jackson, Craig R; Power, R John; Groom, Rosemary J; Masenga, Emmanuel H; Mjingo, Ernest E; Fyumagwa, Robert D; Røskaft, Eivin; Davies-Mostert, Harriet

    2014-01-01

    Compared to their main competitors, African wild dogs (Lycaon pictus) have inferior competitive abilities and interspecific competition is a serious fitness-limiting factor. Lions (Panthera leo) are the dominant large carnivore in African savannah ecosystems and wild dogs avoid them both spatially and temporally. Wild dog young are particularly vulnerable and suffer high rates of mortality from lions. Since lions do not utilize all parts of the landscape with an equal intensity, spatial variation in lion densities can be exploited by wild dogs both during their general ranging behaviour, but more specifically when they are confined to a den with vulnerable young. Since patches of rugged terrain are associated with lower lion densities, we hypothesized that these comparatively safe habitats should be selected by wild dogs for denning. We investigated the relationship between the distribution of 100 wild dog den sites and the occurrence of rugged terrain in four wild dog populations located in Tanzania, Zimbabwe and South Africa. A terrain ruggedness index was derived from a 90 m digital elevation model and used to map terrain ruggedness at each site. We compared characteristics of actual and potential (random) den sites to determine how wild dogs select den sites. The distributions of wild dog dens were strongly associated with rugged terrain and wild dogs actively selected terrain that was more rugged than that available on average. The likelihood of encountering lions is reduced in these habitats, minimizing the risk to both adults and pups. Our findings have important implications for the conservation management of the species, especially when assessing habitat suitability for potential reintroductions. The simple technique used to assess terrain ruggedness may be useful to investigate habitat suitability, and even predict highly suitable denning areas, across large landscapes.

  10. Prognosis of Carotid Endarterectomy in High Risk Patients

    Directory of Open Access Journals (Sweden)

    MH Modaghegh

    2016-04-01

    Full Text Available Introduction: Carotid Endarterectomy (CE can be mentioned as a valuable theraputic method for primary and secondary prevention of stroke, provided it can be performed in vascular surgery centers with a low surgical risk. Thus, the present study aimed to assess prognosis of CE in high risk patients of an Iranian vascular surgery center. Methods: This prospective observational study consisted of 50 high risk CE patients during 2011-14 in Mashhad University of Medical Sciences. All the high risk CE were performed by a vascular surgeon and a surgical carotid shunt was placed in each CE. Neurologic evaluation was performed before CE and serial neurologic axamination was done after CE by a neurologist. Surgical complications including stroke, death and lower cranial nerve palsy were recorded for 30 days after operation. Results: The study results revealed that 80% of high risk CE patients had symptomatic carotid stenosis on the operation side and 80% had carotid stenosis contralateral to the operation side. Thirteen high risk CE were performed simultaneously with coronary artery by pass graft and 24 patients were demonstrated to have diabetes. Post surgical death and stroke in the high risk CE patients were reported 2% and 4%, respectively. Lower cranial nerve palsy appeared in 2% of patients. Conclusion: The 6% post operative stroke and death rate in the high risk CE patients are comparable to best vascular surgery centers in Europe and North America.

  11. Carbohydrate intake and cardiometabolic risk factors in high BMI African American children

    OpenAIRE

    Roberts Lindsay S; Sharma Sushma; Lustig Robert H; Fleming Sharon E

    2010-01-01

    Abstract The aim of this study was to evaluate the relationship between intakes of subgroups of energy-providing carbohydrate, and markers of cardiometabolic risk factors in high BMI African American (AA) children. A cross sectional analysis was performed on data from a sample of 9-11 year old children (n = 95) with BMI greater than the 85th percentile. Fasting hematological and biochemical values for selected markers of cardiometabolic risk factors were related to intakes of carbohydrates an...

  12. Novel antimicrobial peptides with high anticancer activity and selectivity.

    Science.gov (United States)

    Chu, Hung-Lun; Yip, Bak-Sau; Chen, Kuan-Hao; Yu, Hui-Yuan; Chih, Ya-Han; Cheng, Hsi-Tsung; Chou, Yu-Ting; Cheng, Jya-Wei

    2015-01-01

    We describe a strategy to boost anticancer activity and reduce normal cell toxicity of short antimicrobial peptides by adding positive charge amino acids and non-nature bulky amino acid β-naphthylalanine residues to their termini. Among the designed peptides, K4R2-Nal2-S1 displayed better salt resistance and less toxicity to hRBCs and human fibroblast than Nal2-S1 and K6-Nal2-S1. Fluorescence microscopic studies indicated that the FITC-labeled K4R2-Nal2-S1 preferentially binds cancer cells and causes apoptotic cell death. Moreover, a significant inhibition in human lung tumor growth was observed in the xenograft mice treated with K4R2-Nal2-S1. Our strategy provides new opportunities in the development of highly effective and selective antimicrobial and anticancer peptide-based therapeutics.

  13. Novel antimicrobial peptides with high anticancer activity and selectivity.

    Directory of Open Access Journals (Sweden)

    Hung-Lun Chu

    Full Text Available We describe a strategy to boost anticancer activity and reduce normal cell toxicity of short antimicrobial peptides by adding positive charge amino acids and non-nature bulky amino acid β-naphthylalanine residues to their termini. Among the designed peptides, K4R2-Nal2-S1 displayed better salt resistance and less toxicity to hRBCs and human fibroblast than Nal2-S1 and K6-Nal2-S1. Fluorescence microscopic studies indicated that the FITC-labeled K4R2-Nal2-S1 preferentially binds cancer cells and causes apoptotic cell death. Moreover, a significant inhibition in human lung tumor growth was observed in the xenograft mice treated with K4R2-Nal2-S1. Our strategy provides new opportunities in the development of highly effective and selective antimicrobial and anticancer peptide-based therapeutics.

  14. A benefit/risk approach towards selecting appropriate pharmaceutical dosage forms - an application for paediatric dosage form selection.

    Science.gov (United States)

    Sam, Tom; Ernest, Terry B; Walsh, Jennifer; Williams, Julie L

    2012-10-05

    The design and selection of new pharmaceutical dosage forms involves the careful consideration and balancing of a quality target product profile against technical challenges and development feasibility. Paediatric dosage forms present particular complexity due to the diverse patient population, patient compliance challenges and safety considerations of this vulnerable population. This paper presents a structured framework for assessing the comparative benefits and risks of different pharmaceutical design options against pre-determined criteria relating to (1) efficacy, (2) safety and (3) patient access. This benefit/risk framework has then been applied to three hypothetical, but realistic, scenarios for paediatric dosage forms in order to explore its utility in guiding dosage form design and formulation selection. The approach allows a rigorous, systematic and qualitative assessment of the merits and disadvantages of each dosage form option and helps identify mitigating strategies to modify risk. The application of a weighting and scoring system to the criteria depending on the specific case could further refine the analysis and aid decision-making. In this paper, one case study is scored for illustrative purposes. However, it is acknowledged that in real development scenarios, the generation of actual data considering the very specific situation for the patient/product/developer would come into play to drive decisions on the most appropriate dosage form strategy. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. High Framingham risk score decreases quality of life in adults

    Directory of Open Access Journals (Sweden)

    Christian Yosaputra

    2010-04-01

    Full Text Available Cardiovascular disease (CVD risk factors, such as diabetes, hypertension, hypercholesterolemia, smoking, and obesity tend to occur together in the general population. Increasing prevalence of multiple CVD risk factors has been related to increased risk of death from coronary heart disease and stroke. Studies have suggested that people with several risk factors of CVD may have impaired health-related quality of life. The objective of this study was to assess the association of CVD risk factors with quality of life (QOL among adults aged 40 to 65 years. A cross-sectional study was conducted involving 220 subjects 40 - 65 years of age at a health center. The CVD risk factors were assessed using the Framingham risk score that is the standard instrument for assessment of the risk of a first cardiac event. The risk factors assessed were age, smoking, blood pressure, total cholesterol and high density lipoprotein cholesterol concentrations. QOL was assessed by means of the WHOQOL-BREF instrument that had been prevalidated. The results of the study showed that 28.2% of subjects were smokers, 56.4% had stage 1 hypertension, 42.8% high total cholesterol and 13.6% low HDL cholesterol. The high risk group amounted to 45.5% and 42.3% constitued an intermediate risk group. High CVD risk scores were significantly associated with a low QOL for all domains (physical, psychological, social and environment (p=0.000. Preventing or reducing the multiple CVD risk factors to improve QOL is necessary among adults.

  16. Human health risk assessment: selected Internet and world wide web resources.

    Science.gov (United States)

    Patterson, Jacqueline; Hakkinen, P J Bert; Wullenweber, Andrea E

    2002-04-25

    The world wide web (WWW) has become a valuable source of 24 hour-a-day access to information needed by human health risk assessors. Various web sites and other Internet resources provide information needed for human hazard identification, dose-response evaluation, exposure assessment, risk characterization, and risk management. Information on risk communication is also available. Substantial collections of information on multiple aspects of risk assessment are found in sites sponsored by RiskWorld, the (US) EPA's National Center for Environmental Assessment (NCEA), the (US) National Library of Medicine's TOXNET, the (US) Agency for Toxic Substances and Disease Registry (ATSDR), and the International Programme on Chemical Safety (IPCS). Also valuable are various web sites providing information on the physical and chemical properties of chemicals, the environmental fate and transport of chemicals, government regulations, and guidance and training for performing risk assessments. Several professional societies and other organizations have web sites addressing risk assessment issues and information, and there are Internet mailing lists for online help and for sharing information and perspectives. We classify selected web sites according to user needs and provide the reader with a collection of selected sites that can serve as entry points to risk assessment-related web resources.

  17. Percutaneous nephrolithotripsy under assisted local anaesthesia for high risk patients: Is it effective?

    Directory of Open Access Journals (Sweden)

    T.KH. Fathelbab

    2013-12-01

    Conclusion: Our results demonstrated that PNL under local anesthesia with narcotics and sedatives seems to be a satisfying solution for the treatment of a selected group of patients with renal pelvic stones and who have high anesthetic risk. However, additional studies with different groups of patients are required to validate our results.

  18. Who seeks Teratology Information Service's advice? Assessing the risk of selection bias in observational cohort studies on drug risks in pregnancy.

    Science.gov (United States)

    Beck, Evelin; Lechner, Anna; Schaefer, Christof

    2017-01-01

    All women of reproductive age should have access to Teratology Information Services (TIS). Observational cohort studies based on TIS data are one of the most important sources for risk characterization of drugs during pregnancy. A selection in TIS populations towards higher socioeconomic level would compromise the TIS' goal of health prevention and the quality of research. The aim of this study is to investigate in which respect Berlin TIS enquirers are different from the general female population of reproductive age in Germany. 5,239 women aged between 20 and 39 were compared with the general female population of reproductive age in Germany. Medium- and high-level educated women tend to be overrepresented among TIS enquirers. TIS should strive towards reaching subpopulations with poor access to health care. TIS-based observational studies require appropriate comparison cohorts from the same data pool with similar procedures of ascertainment to reduce the risk of selection bias. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. 'High-risk' pregnancy after perinatal loss: understanding the label.

    Science.gov (United States)

    Simmons, Heather A; Goldberg, Lisa S

    2011-08-01

    to explore women's experience of living with a 'high-risk' pregnancy following a perinatal loss. a feminist phenomenological methodology provided the framework for the research study. the experience of 'high-risk' pregnancy following perinatal loss of seven women receiving care at a tertiary health centre in Atlantic Canada was explored by way of conversational interviews and reflective journaling. four themes emerged through thematic analysis and researcher interpretation: (1) understanding the meaning in the label of 'high-risk' pregnancy, (2) relational engagement with the unborn infant, (3) insight and acceptance of the influence of previous loss, and (4) essentiality of information. Taken together, these four themes represent the storied text embedded in the research study. The focus of attention in this article is based solely on the first theme, understanding the meaning in the label of 'high-risk' pregnancy, in so far as this fosters an ability to attend to the interpretive text in the methodological manner appropriate to phenomenological inquiry. although previous research indicates that the label of 'high-risk' in pregnancy is often associated with increased anxiety and fear, findings from this study suggest that a 'high-risk' pregnancy following perinatal loss results in women embracing the 'high-risk' label. By recognising the possibility that women experiencing 'high-risk' pregnancy following perinatal loss may perceive the label of 'high-risk' pregnancy in a positive way, nurses, midwives and other health-care providers may begin to alter their practices when caring for these women in current health-care environments. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Highly oxidized peroxisomes are selectively degraded via autophagy in Arabidopsis.

    Science.gov (United States)

    Shibata, Michitaro; Oikawa, Kazusato; Yoshimoto, Kohki; Kondo, Maki; Mano, Shoji; Yamada, Kenji; Hayashi, Makoto; Sakamoto, Wataru; Ohsumi, Yoshinori; Nishimura, Mikio

    2013-12-01

    The positioning of peroxisomes in a cell is a regulated process that is closely associated with their functions. Using this feature of the peroxisomal positioning as a criterion, we identified three Arabidopsis thaliana mutants (peroxisome unusual positioning1 [peup1], peup2, and peup4) that contain aggregated peroxisomes. We found that the PEUP1, PEUP2, and PEUP4 were identical to Autophagy-related2 (ATG2), ATG18a, and ATG7, respectively, which are involved in the autophagic system. The number of peroxisomes was increased and the peroxisomal proteins were highly accumulated in the peup1 mutant, suggesting that peroxisome degradation by autophagy (pexophagy) is deficient in the peup1 mutant. These aggregated peroxisomes contained high levels of inactive catalase and were more oxidative than those of the wild type, indicating that peroxisome aggregates comprise damaged peroxisomes. In addition, peroxisome aggregation was induced in wild-type plants by exogenous application of hydrogen peroxide. The cat2 mutant also contained peroxisome aggregates. These findings demonstrate that hydrogen peroxide as a result of catalase inactivation is the inducer of peroxisome aggregation. Furthermore, an autophagosome marker, ATG8, frequently colocalized with peroxisome aggregates, indicating that peroxisomes damaged by hydrogen peroxide are selectively degraded by autophagy in the wild type. Our data provide evidence that autophagy is crucial for quality control mechanisms for peroxisomes in Arabidopsis.

  1. High throughput selection of effective serodiagnostics for Trypanosoma cruzi infection.

    Directory of Open Access Journals (Sweden)

    Gretchen Cooley

    2008-10-01

    Full Text Available Diagnosis of Trypanosoma cruzi infection by direct pathogen detection is complicated by the low parasite burden in subjects persistently infected with this agent of human Chagas disease. Determination of infection status by serological analysis has also been faulty, largely due to the lack of well-characterized parasite reagents for the detection of anti-parasite antibodies.In this study, we screened more than 400 recombinant proteins of T. cruzi, including randomly selected and those known to be highly expressed in the parasite stages present in mammalian hosts, for the ability to detect anti-parasite antibodies in the sera of subjects with confirmed or suspected T. cruzi infection.A set of 16 protein groups were identified and incorporated into a multiplex bead array format which detected 100% of >100 confirmed positive sera and also documented consistent, strong and broad responses in samples undetected or discordant using conventional serologic tests. Each serum had a distinct but highly stable reaction pattern. This diagnostic panel was also useful for monitoring drug treatment efficacy in chronic Chagas disease.These results substantially extend the variety and quality of diagnostic targets for Chagas disease and offer a useful tool for determining treatment success or failure.

  2. ANDROS: A code for Assessment of Nuclide Doses and Risks with Option Selection

    Energy Technology Data Exchange (ETDEWEB)

    Begovich, C.L.; Sjoreen, A.L.; Ohr, S.Y.; Chester, R.O.

    1986-11-01

    ANDROS (Assessment of Nuclide Doses and Risks with Option Selection) is a computer code written to compute doses and health effects from atmospheric releases of radionuclides. ANDROS has been designed as an integral part of the CRRIS (Computerized Radiological Risk Investigation System). ANDROS reads air concentrations and environmental concentrations of radionuclides to produce tables of specified doses and health effects to selected organs via selected pathways (e.g., ingestion or air immersion). The calculation may be done for an individual at a specific location or for the population of the whole assessment grid. The user may request tables of specific effects for every assessment grid location. Along with the radionuclide concentrations, the code requires radionuclide decay data, dose and risk factors, and location-specific data, all of which are available within the CRRIS. This document is a user manual for ANDROS and presents the methodology used in this code.

  3. Price and Structure Risks Consideration when Selecting a Marketing Strategy for an Agricultural Enterprise

    National Research Council Canada - National Science Library

    Shiyan Dmytro V; Strapchuk Svitlana I

    2013-01-01

    ... a marketing strategy. It was established in the result of the study that agricultural enterprises with a high price and structure risk ratio have high indicators of economic efficiency compared to the groups with a low...

  4. Risk adjustment and the trade-off between efficiency and risk selection: an application of the theory of fair compensation.

    Science.gov (United States)

    Schokkaert, E; Dhaene, G; Van de Voorde, C

    1998-08-01

    We exploit the similarity between the problem of risk adjustment with prospective reimbursement schemes in the health care sector and the problem of fair compensation analysed in the social choice literature. The starting point is the distinction between two sets of variables in the explanation of medical expenditures: those for which the insurers (or the providers) can be held responsible, and those for which they have to be compensated. Using this partitioning the objectives of cost-efficiency and no risk selection can be expressed in terms of two simple axioms. If the medical expenditure function is additively separable in the two sets of variables, there exists a natural division rule which is analogous to the standard linear risk adjustment schemes. We show how this rule should be applied if the total level of actual medical expenditures is different from the budget to be divided over the insurers (or providers) and how information from the disturbances in the regression equation can be used in an optimal way. We discuss the analogy with mixed reimbursement systems. If the medical expenditure function is not additively separable in the two sets of variables, the conflict between efficiency and risk selection is unavoidable, even if one has perfect information about that function. The theoretical results are illustrated with empirical results derived from the Belgian setting where the move towards prospective reimbursement of the mutualities has necessitated the introduction of a risk adjustment formula.

  5. Radical prostatectomy in clinically localized high-risk prostate cancer

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Berg, Kasper Drimer; Christensen, Ib Jarle

    2013-01-01

    Abstract Objective. The optimal therapeutic strategy for high-risk localized prostate cancer (PCa) is controversial. Supported by randomized trials, the combination of external beam radiation therapy (EBRT) and endocrine therapy (ET) is advocated by many, while radical prostatectomy (RP......) is regarded as primary therapy by others. This study examined the outcome for high-risk localized PCa patients treated with RP. Material and methods. Of 1300 patients who underwent RP, 231 were identified as high-risk. Patients were followed for biochemical recurrence (BCR) (defined as prostate...

  6. Patterns of population differentiation and natural selection on the celiac disease background risk network.

    Directory of Open Access Journals (Sweden)

    Aaron Sams

    Full Text Available Celiac disease is a common small intestinal inflammatory condition induced by wheat gluten and related proteins from rye and barley. Left untreated, the clinical presentation of CD can include failure to thrive, malnutrition, and distension in juveniles. The disease can additionally lead to vitamin deficiencies, anemia, and osteoporosis. Therefore, CD potentially negatively affected fitness in past populations utilizing wheat, barley, and rye. Previous analyses of CD risk variants have uncovered evidence for positive selection on some of these loci. These studies also suggest the possibility that risk for common autoimmune conditions such as CD may be the result of positive selection on immune related loci in the genome to fight infection. Under this evolutionary scenario, disease phenotypes may be a trade-off from positive selection on immunity. If this hypothesis is generally true, we can expect to find a signal of natural selection when we survey across the network of loci known to influence CD risk. This study examines the non-HLA autosomal network of gene loci associated with CD risk in Europe. We reject the null hypothesis of neutrality on this network of CD risk loci. Additionally, we can localize evidence of selection in time and space by adding information from the genome of the Tyrolean Iceman. While we can show significant differentiation between continental regions across the CD network, the pattern of evidence is not consistent with primarily recent (Holocene selection across this network in Europe. Further localization of ancient selection on this network may illuminate the ecological pressures acting on the immune system during this critically interesting phase of our evolution.

  7. A social work study high-risk behavior among teenagers

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Iravani

    2012-01-01

    Full Text Available Teenagers are believed the people who are supposed to build the world's future. High-risk behaviors such as addiction to drugs, smoking cigarettes, sex, etc. could significantly hurts teenagers and there must be some supporting programs to reduce these issues as much as possible. This paper performs an empirical investigation to study the different factors influencing high- risk behavior among teenagers who live in a city of Esfahan, Iran. The proposed study designs a questionnaire and distribute between two groups of female and male teenagers. The results indicate that while there is a meaningful relationship between high-risk behaviors and average high school marks among male students there is no meaningful relationship between high-risk behaviors and high school grades among female students. The results also indicate that there is a meaningful difference between gender and high-risk behavior. The season of birth for female and male students is another important factor for having high-risk behaviors. While the order of birth plays an important role among male students, the order of birth is not an important factor among female teenagers. Finally, the results indicate that teenagers' parental financial affordability plays a vital role on both female and male teenagers.

  8. Chances of Adverse Neonatal Outcome in High-Risk and Low-Risk Obstetrical Patients

    Directory of Open Access Journals (Sweden)

    Y. Krilova

    2008-01-01

    Full Text Available Objective To analyze and compare occurrence of adverse immediate neonatal outcomes in high and low-risk obstetrical population. Methods Retrospective cohort study of 2370 pregnant women. The odds of adverse outcomes (i.e. low Apgar score (1–4 points and intermediate Apgar score (5–8 points at 1 and 5 minutes of life, birth to a small-for-gestational-age neonate (below 90th percentile of birth weight, and requirement for advanced level II-III nursery care as well as odds of primary cesarean delivery–-were analyzed using logistic regression analysis. Results All of the studied outcomes were seen more often among the high-risk patients. When the outcomes were analyzed within a given group some interesting observations were made. The highest odds of abnormal Apgar scores (when compared to the low risk population were seen in patients with preeclampsia–-6.06 (95% CI 3.28; 11.22 and twin pregnancies–-odds ratio of 6.63 (95% CI 2.24; 19.67. Among Small-for-Gestational-Age newborns the most frequently identified maternal condition was preeclampsia (21.57%, out of all fetal conditions twin gestation (26.67% was number one identified scenario. The highest proportion of patients requiring advanced level nursery care (level II and III was observed in those with twin gestation, pregnancies complicated by hypertension with and without diabetes. The highest odds of having primary cesarean delivery in laboring patients (when compared to the low risk population were seen in the patients with IUGR fetus–-odds ratio of 26.78 [95% CI 7.65; 93.75], followed by macrosomia–-odds ratio 5.74 [95% CI 2.14; 15.41], preeclampsia–-odds ratio 5.52 [95% CI 3.14; 9.69]. For additional findings and more information on select conditions, please, refer to the full-text article. Conclusion The studied outcomes are useful markers of fetal/neonatal status and can be used to compare perinatal outcomes between different medical conditions, different locales and to

  9. Epidemiological modifiers of non-alcoholic fatty liver disease: Focus on high-risk groups.

    Science.gov (United States)

    Lonardo, Amedeo; Bellentani, Stefano; Argo, Curtis K; Ballestri, Stefano; Byrne, Christopher D; Caldwell, Stephen H; Cortez-Pinto, Helena; Grieco, Antonio; Machado, Mariana V; Miele, Luca; Targher, Giovanni

    2015-12-01

    An improved understanding of non-alcoholic fatty liver disease epidemiology would lead to identification of individuals at high risk of developing chronic liver disease and extra-hepatic complications, thus contributing to more effective case finding of non-alcoholic fatty liver disease among selected groups. We aimed to illustrate the epidemiology of non-alcoholic fatty liver disease in high-risk groups, which were identified based on existing literature. To this end, PubMed was searched to retrieve original articles published until May 2015 using relevant and pertinent keywords "nonalcoholic fatty liver disease" and "diabetes", "obesity", "hyperlipidaemia", "familial heterozygous hypobetalipoproteinaemia", "hypertension", "metabolic syndrome", "ethnicity", "family history" or "genetic polymorphisms". We found that age, sex and ethnicity are major physiological modifiers of the risk of non-alcoholic fatty liver disease, along with belonging to "non-alcoholic fatty liver disease families" and carrying risk alleles for selected genetic polymorphisms. Metabolic syndrome, diabetes, obesity, mixed hyperlipidaemia and hypocholesterolaemia due to familial hypobetalipoproteinaemia are the major metabolic modifiers of non-alcoholic fatty liver disease risk. Compared with these metabolic conditions, however, arterial hypertension appears to carry a relatively more modest risk of non-alcoholic fatty liver disease. A better understanding of the epidemiology of non-alcoholic fatty liver disease may result in a more liberal policy of case finding among high-risk groups. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  10. Brief communication "Fast-track earthquake risk assessment for selected urban areas in Turkey"

    Directory of Open Access Journals (Sweden)

    D. Kepekci

    2011-02-01

    Full Text Available This study is presented as a contribution to earthquake disaster mitigation studies for selected cities in Turkey. The risk evaluations must be based on earthquake hazard analysis and city information. To estimate the ground motion level, data for earthquakes with a magnitude greater than 4.5 and an epicenter location within a 100-km radius of each city were used for the period from 1900 to 2006, as recorded at the Kandilli Observatory and Earthquake Research Institute. Probabilistic seismic hazard analysis for each city was carried out using Poisson probabilistic approaches. Ground motion level was estimated as the probability of a given degree of acceleration with a 10% exceedence rate during a 50-year time period for each city. The risk level of each city was evaluated using the number of houses, the per-capita income of city residents, population, and ground motion levels. The maximum risk level obtained for the cities was taken as a reference value for relative risk assessment, and other risk values were estimated relative to the maximum risk level. When the selected cities were classified according to their relative risk levels, the five most risky cities were found to be, in descending order of risk, Istanbul, Izmir, Ankara, Bursa, and Kocaeli.

  11. A policy of routine umbilical cord blood gas analysis decreased missing samples from high-risk births.

    Science.gov (United States)

    Ahlberg, M; Elvander, C; Johansson, S; Cnattingius, S; Stephansson, O

    2017-01-01

    This study compared obstetric units practicing routine or selective umbilical cord blood gas analysis, with respect to the risk of missing samples in high-risk deliveries and in infants with birth asphyxia. This was a Swedish population-based cohort study that used register data for 155 235 deliveries of live singleton infants between 2008 and 2014. Risk ratios and 95% confidence intervals were calculated to estimate the association between routine and selective umbilical cord blood gas sampling strategies and the risk of missing samples. Selective sampling increased the risk ratios when routine sampling was used as the reference, with a value of 1.0, and these were significant in high-risk deliveries and birth asphyxia. The risk ratios for selective sampling were large-for-gestational age (9.07), preterm delivery at up to 36 weeks of gestation (8.24), small-for-gestational age (7.94), two or more foetal scalp blood samples (5.96), an Apgar score of less than seven at one minute (2.36), emergency Caesarean section (1.67) and instrumental vaginal delivery (1.24). Compared with routine sampling, selective umbilical cord blood gas sampling significantly increased the risks of missing samples in high-risk deliveries and in infants with birth asphyxia. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  12. Awareness and prevalence of metabolic syndrome among high-risk ...

    African Journals Online (AJOL)

    MetS) in high-risk individuals attending 30 internal medicine clinics in Amman, Jordan, and also to evaluate the various factors associated with increased risk of MetS among them. Methods: This retrospective cross-sectional study was carried out ...

  13. Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Vinayak Muralidhar

    2016-02-01

    Full Text Available Purpose : Recent retrospective data suggest that brachytherapy (BT boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA 20 ng/ml. Material and methods: We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results : EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258, and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270. Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022. Conclusions : Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease.

  14. Physical activity barriers and motivators among high-risk employees.

    Science.gov (United States)

    Paguntalan, John C; Gregoski, Mathew

    2016-11-22

    Worksite wellness programs offer an ideal setting to target high-risk sedentary workers to improve health status. Lack of physical activity is associated with increased risk for coronary heart disease and mortality. Despite the risks, the number of sedentary workers is increasing. This study examined the perceived barriers and motivators for physical activity among employees at high-risk for coronary heart disease. A purposive sample of 24 high-risk workers participating in a wellness program in rural South Carolina were enrolled in the study. Qualitative data was obtained through semi-structured face-to-face interviews. Grounded theory was used to analyze qualitative data, and identify overarching themes. Physical limitations due to pain and weakness, lack of motivation, and lack of time emerged as the main barriers to physical activity. Family relationships were reported as the strongest motivator along with social support and potential health benefits. Findings highlight the unique experience of high-risk workers with physical activity. The findingsunderscore the need to design and implement effective interventions specifically designed to meet the needs of high-risk employees.

  15. DASH - Youth Risk Behavior Surveillance System (YRBSS): High School

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1991-2015. High School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

  16. Suicide Risk Especially High for U.S. Farmers

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166800.html Suicide Risk Especially High for U.S. Farmers Other occupations ... Two decades after the U.S. farm crisis, the suicide rate among American farmers remains much higher than ...

  17. Sensation seeking in males involved in recreational high risk sports

    National Research Council Canada - National Science Library

    Guszkowska, M; Bołdak, A

    2010-01-01

    ...) of Zuckerman was applied.Results show, that high risk sports males are featured by stronger need of sensations in comparison to control group and this concerned all but one aspect of sensation seeking variable...

  18. High prevalence of cardiovascular risk factors in Durban South ...

    African Journals Online (AJOL)

    High prevalence of cardiovascular risk factors in Durban South African Indians: The Phoenix Lifestyle Project. ... All participants had demographic, anthropometric and biochemical measurements using the modified World Health Organization (WHO) STEPwise survey methods. Hypertension, obesity, lipid abnormalities and ...

  19. Psychological characteristics in high-risk MSM in China

    National Research Council Canada - National Science Library

    Chen, Guanzhi; Li, Yang; Zhang, Beichuan; Yu, Zengzhao; Li, Xiufang; Wang, Lixin; Yu, Ziming

    2012-01-01

    .... To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk...

  20. Treating Patients with High-Risk Smoldering Myeloma

    Science.gov (United States)

    In this phase III clinical trial, patients with smoldering myeloma classified as high risk for progression will be randomly assigned to undergo standard observation or six 4-week courses of treatment with the drug lenalidomide.

  1. High alcohol consumption causes high IgE levels but not high risk of allergic disease

    DEFF Research Database (Denmark)

    Lomholt, Frederikke K; Nielsen, Sune F; Nordestgaard, Børge G

    2016-01-01

    .2-2.5) for 1 allergic disease, 3.9 (95% CI, 3.5-4.4) for 2 allergic diseases, and 7.5 (95% CI, 6.2-9.0) for 3 allergic diseases. High alcohol consumption was associated with high IgE levels but not with high risk of allergic disease. The odds ratio for high versus low IgE levels per 1 alcoholic drink per week......BACKGROUND: High alcohol consumption is associated with high IgE levels in observational studies; however, whether high alcohol consumption leads to high IgE levels and allergic disease is unclear. OBJECTIVE: We tested the hypothesis that high alcohol consumption is associated with high IgE levels...... for the alcohol-metabolizing enzymes alcohol dehydrogenase 1B (ADH-1B; rs1229984) and alcohol dehydrogenase 1c (ADH-1C; rs698). Observationally, we investigated associations between IgE levels and allergic disease (allergic asthma, rhinitis, and eczema) and between alcohol consumption and IgE levels and allergic...

  2. Vaginal micronized progesterone and risk of preterm delivery in high-risk twin pregnancies

    DEFF Research Database (Denmark)

    Klein, K; Rode, L; Nicolaides, K H

    2011-01-01

    OBJECTIVES: Progesterone treatment reduces the risk of preterm delivery in high-risk singleton pregnancies. Our aim was to evaluate the preventive effect of vaginal progesterone in high-risk twins. METHODS: This was a subanalysis of a Danish-Austrian, double-blind, placebo-controlled, randomized...... trial (PREDICT study), in which women with twin pregnancies were randomized to daily treatment with progesterone or placebo pessaries from 20-24 weeks until 34 weeks' gestation. This subpopulation consisted of high-risk pregnancies, defined by the finding of cervical length ≤ 10th centile at 20-24 weeks...... (10.6%) of the 677 women participating in the PREDICT study, the pregnancy was considered to be high-risk, including 47 with cervical length ≤ 10th centile, 28 with a history of preterm delivery or late miscarriage and three fulfilling both criteria. Baseline characteristics for progesterone...

  3. High-Risk Human Papillomavirus Targets Crossroads in Immune Signaling

    OpenAIRE

    Bart Tummers; van der Burg, Sjoerd H

    2015-01-01

    Persistent infections with a high-risk type human papillomavirus (hrHPV) can progress to cancer. High-risk HPVs infect keratinocytes (KCs) and successfully suppress host immunity for up to two years despite the fact that KCs are well equipped to detect and initiate immune responses to invading pathogens. Viral persistence is achieved by active interference with KCs innate and adaptive immune mechanisms. To this end hrHPV utilizes proteins encoded by its viral genome, as well as exploits cellu...

  4. Factoring attitudes towards armed conflict risk into selection of protected areas for conservation

    DEFF Research Database (Denmark)

    Hammill, E.; Tulloch, A.I.T.; Possingham, H.P.

    2016-01-01

    The high incidence of armed conflicts in biodiverse regions poses significant challenges in achieving international conservation targets. Because attitudes towards risk vary, we assessed different strategies for protected area planning that reflected alternative attitudes towards the risk of armed...... conflicts would not only increase the return on investment (an effect that is enhanced when high-risk areas are excluded) but also increase upfront conservation costs. Our results also demonstrate that fine-scale estimations of conflict risk could enhance the cost-effectiveness of investments. We conclude...

  5. Outcomes of parental investment in high-risk children.

    Science.gov (United States)

    Bugental, Daphne Blunt; Corpuz, Randy; Samec, Rachel

    2013-09-01

    This study assesses the combined effects of children's early medical risk (e.g., preterm status) and parental investment levels (time spent in provision of care to target children as opposed to other family members) on children's response to novel, potentially distressing stimuli. While engaged in play activities, children were exposed to stimuli that were either neutral (a speaker on television with a calm voice) or threatening (a speaker with an angry voice). A significant interaction between children's risk status and parental investment was found only for threatening stimuli. High-risk children with high-investing parents showed high visual engagement with potentially threatening responses, whereas high-risk children with low-investing parents were more likely to show visual avoidance. No comparable effects were found for low-risk children. Findings were interpreted as showing that high-risk children with a history of high parental investment are more likely to attend to potentially threatening events, an adaptive response in the presence of reliable support. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. A Study on Site Selecting for National Project including High Level Radioactive Waste Disposal

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kilyoo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    Many national projects are stopped since sites for the projects are not determined. The sites selections are hold by NIMBY for unpleasant facilities or by PYMFY for preferable facilities among local governments. The followings are the typical ones; NIMBY projects: high level radioactive waste disposal, THAAD, Nuclear power plant(NPP), etc. PIMFY projects: South-east new airport, KTX station, Research center for NPP decommission, etc. The site selection for high level radioactive waste disposal is more difficult problem, and thus government did not decide and postpone to a dead end street. Since it seems that there is no solution for site selection for high level radioactive waste disposal due to NIMBY among local governments, a solution method is proposed in this paper. To decide a high level radioactive waste disposal, the first step is to invite a bid by suggesting a package deal including PIMFY projects such as Research Center for NPP decommission. Maybe potential host local governments are asked to submit sealed bids indicating the minimum compensation sum that they would accept the high level radioactive waste disposal site. If there are more than one local government put in a bid, then decide an adequate site by considering both the accumulated PESS point and technical evaluation results. By considering how fairly preferable national projects and unpleasant national projects are distributed among local government, sites selection for NIMBY or PIMFY facilities is suggested. For NIMBY national projects, risk, cost benefit analysis is useful and required since it generates cost value to be used in the PESS. For many cases, the suggested method may be not adequate. However, similar one should be prepared, and be basis to decide sites for NIMBY or PIMFY national projects.

  7. High-risk smoldering myeloma: Perspective on watchful monitoring.

    Science.gov (United States)

    Leng, Siyang; Lentzsch, Suzanne

    2016-12-01

    In a 2008 paper, Dispenzieri and colleagues at the Mayo Clinic proposed a risk stratification system for patients with smoldering multiple myeloma (SMM) based on the presence of three risk factors: serum M-protein ≥3 g/dL, bone marrow plasma cell percentage ≥10%, and a free light chain (FLC) ratio (κ to λ) of either ≤0.125 or ≥8. The patient in this vignette has all three risk factors, classifying him as high-risk, with an associated median time to progression (TTP) of 1.9 years. This is significantly worse than a patient with intermediate-risk (median TTP 5.1 years) or low-risk (10 years) disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Relationship of child abuse with personality features and high risk behaviors in adolescents

    Directory of Open Access Journals (Sweden)

    Mehdi Ghezelseflo

    2015-05-01

    Full Text Available Background: Children are one of the most vulnerable groups of the society and are constantly threatened by different people in their family or society. The aim of this study was investigating the correlation of child abuse with personality features and high risk behavior in high school students of Islamshahr, Iran. Methods: This study cross-sectional analytical was conducted on the high school girls and boys of Islamshahr in spring 2014.528 students were selected by cluster random sampling among 4 high schools (two female and two male high schools. Childhood trauma questionnaire, NEO-Five Factor Inventory and Youth Risk-Taking Scale were used for data collection. Data were analyzed by independence t-test, Pearson's correlation coefficient and multiple linear regression. Results: The results of independence t-test indicated significant differences between girls and boys in terms of child abuse and high risk experience (t=-2.16,p=0.03 and t=-5.03, P=0.001, respectively. Also, the results demonstrated a significant relationship between child abuse and personality characteristics, high risk behavior and all its subscales (P<0.05. The findings of multiple linear regressionindicated that child abuse could explain 14% total risk-taking, 25% neurotic personality feature , 14% extroversion, 10% agreeableness, 1% flexibility and 13% conscientiousness (P<0.05. Conclusion: According to the research findings, appropriate behavior with children is of great importance. Therefore, child abuse would form inappropriate personality features and increase risk behaviors among children.

  9. Health risk assessment of exposure to selected volatile organic compounds emitted from an integrated iron and steel plant.

    Science.gov (United States)

    Chang, E-E; Wei-Chi, Wang; Li-Xuan, Zeng; Hung-Lung, Chiang

    2010-12-01

    Workplace air samples from sintering, cokemaking, and hot and cold forming processes in the integrated iron and steel industry were analyzed to determine their volatile organic compound (VOC) concentration. Sixteen VOC species including three paraffins (cyclohexane, n-hexane, methylcyclohexane), five chlorinated VOC species (trichloroethylene, 1,1,1-trichloroethane, tetrachloroethylene, chlorobenzene, 1,4-dichlorobenzene), and eight aromatics (benzene, ethylbenzene, styrene, toluene, m,p-xylene, o-xylene, 1,2,4-trimethylbenzene, 1,3,5-trimethylbenzene) were selected to measure their noncancer risk for workers. Concentrations of toluene, xylene, 1,2,4-trimethylbenzene, 1,3,5-trimethylbenzene, dichlorobenzene, and trichloroethylene were high in all four processes. Carbon tetrachloride and tetrachloroethylene concentrations were high in the hot and cold forming processes. The noncancer risk followed the increasing order: cokemaking > sintering > hot forming > cold forming. 1,2,4-trimethylbenzene and 1,3,5-trimethylbenzene contributed 44% to 65% and 13% to 20% of noncancer risk, respectively, for the four processes. Benzene accounted for a high portion of the noncancer risk in cokemaking. The hazard index (HI: 17-108) of the average VOC concentrations suggests that health risks can be reduced by improving workplace air quality and protecting workers.

  10. Highly selective enrichment of phosphorylated peptides using titanium dioxide

    DEFF Research Database (Denmark)

    Thingholm, Tine; Jørgensen, Thomas J D; Jensen, Ole N

    2006-01-01

    a protocol for selective phosphopeptide enrichment using titanium dioxide (TiO2) chromatography. The selectivity toward phosphopeptides is obtained by loading the sample in a 2,5-dihydroxybenzoic acid (DHB) or phthalic acid solution containing acetonitrile and trifluoroacetic acid (TFA) onto a TiO2 micro...

  11. Assessment of behavioural risk factors for HIV/AIDS in selected ...

    African Journals Online (AJOL)

    A stratified cross-sectional survey was conducted on 2 278 people residing in and around Addis Ababa and Nazareth cities to assess the behavioural risk factors in HIV/AIDS in selected target groups from August 2000 to December 2000. The target groups, consisting of students, urban residents, farmers, and commercial ...

  12. Selection of critical factors for identifying emerging food safety risks in dynamic food production chains

    NARCIS (Netherlands)

    Asselt, van E.D.; Meuwissen, M.P.M.; Asseldonk, van M.A.P.M.; Teeuw, J.; Fels-Klerx, van der H.J.

    2010-01-01

    A pro-active emerging risk identification system starts with the selection of critical factors related to the occurrence of emerging hazards. This paper describes a method to derive the most important factors in dynamic production chains starting from a gross list of critical factors. The method

  13. Helicobacter pylori and risk of upper gastrointestinal bleeding among users of selective serotonin reuptake inhibitors

    DEFF Research Database (Denmark)

    Dall, Michael; Schaffalitzky de Muckadell, Ove B; Møller Hansen, Jane

    2011-01-01

    A number of studies have reported a possible association between use of selective serotonin reuptake inhibitors (SSRIs) and serious upper gastrointestinal bleeding (UGB). We conducted this case-control study to assess if Helicobacter pylori (H. pylori) potentiates the risk of serious UGB in SSRI ...

  14. Nest site selection in a hot desert : Trade-off between microclimate and predation risk?

    NARCIS (Netherlands)

    Tieleman, B. Irene; van Noordwijk, Hendrika J.; Williams, Joseph B.

    Nest placement affects the risk of predation on both eggs and incubating parents and determines the microclimate for incubation, two functions that may be in conflict, especially in hot deserts. We studied the roles of microclimate and nest predation on nest site selection by Hoopoe Larks (Alaemon

  15. In Utero Exposure to Selective Serotonin Reuptake Inhibitors and Risk for Autism Spectrum Disorder

    Science.gov (United States)

    Gidaya, Nicole B.; Lee, Brian K.; Burstyn, Igor; Yudell, Michael; Mortensen, Erik L.; Newschaffer, Craig J.

    2014-01-01

    We investigated whether there is an association between increased risk for autism spectrum disorders (ASD) and selective serotonin reuptake inhibitors (SSRIs) used during pregnancy. This study used Denmark's health and population registers to obtain information regarding prescription drugs, ASD diagnosis, and health and socioeconomic status. There…

  16. Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of specific congenital anomalies

    DEFF Research Database (Denmark)

    Wemakor, Anthony; Casson, Karen; Garne, Ester

    2015-01-01

    Evidence of an association between early pregnancy exposure to selective serotonin reuptake inhibitors (SSRI) and congenital heart defects (CHD) has contributed to recommendations to weigh benefits and risks carefully. The objective of this study was to determine the specificity of association be...

  17. A profile analysis of some selected health risk indicators in South ...

    African Journals Online (AJOL)

    The objective of this study was to compile a profile of some selected health risk indicators (hypertension, hypercholesterolemia, obesity, smoking and physical inactivity) of South African women, aged 30-65 years ( x = 41.6 ± 12.8 years) which can be influenced by lifestyle. The respondents comprised 3 818 women who ...

  18. Selected risk factors for coronary heart disease in m.ale scholars ...

    African Journals Online (AJOL)

    Selected risk factors for coronary heart disease in m.ale scholars from. the major South African population groups. H. c. SEFfEL, M. s. ASVAT, B. I. JOFFE, F. J. RAAL, v. R. PANZ, w. J. H. VERMAAK, M. E. LOOCK, M. c. RAJPUT, M. A. K. OMAR,. M. s. JEENAH, K. STEYN, P. J. BECKER for the Seven Schools' Study Group.

  19. Evaluation of selected risk elements removal processes from wastewater in constructed wetlands.

    OpenAIRE

    MRÁZKOVÁ, Ivana

    2008-01-01

    The purpose of this bachelor work is to provide a literature survey aimed at the processes responsible for removal of selected risk elements (arsenate, lead, nickel, Merkury, kadmium and manganese) during the wastewater treatment in constructed wetlands. Also, constructed wetlands are compared with conventional treatment plants.

  20. Predicting reattendance at a high-risk breast cancer clinic.

    Science.gov (United States)

    Ormseth, Sarah R; Wellisch, David K; Aréchiga, Adam E; Draper, Taylor L

    2015-10-01

    The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic. Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES-D score ≥ 16), current level of anxiety (State-Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer). A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted "U" relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels. Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.

  1. Joint effect of modifying selected risk factors on attributable burden of Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Fatemeh Khosravi Shadmani

    2013-01-01

    Full Text Available Background: There are few published studies that consider the joint effect of multiple risk factors on avoidable burden of cardiovascular diseases (CVDs. This study aimed to estimate the joint effect of avoidable burden of multiple risk factors to CVDs. Methods : Estimates of avoidable burden to CVDs were made using potential impact fraction (PIF. In order to calculate PIF, data on the Prevalence of the risk factors include diabetes, hypertension, central obesity, and hypercholesterolemia were obtained from 3 rd national Surveillance of Risk Factors of Non-Communicable Diseases-2007 in Iran and data on corresponding measures of effect were derived from a cohort study with multivariate adjusted hazard ratios. Then, joint effect of risk factors was calculated. Results : About 37% (95% uncertainty interval: 21.7-50.2 of attributable disability adjusted life years (DALYs to CVDs in adult males and 59.4% (95% uncertainty interval: 30-76 in adult females due to selected risk factors are avoidable in theoretical minimum risk levels. After changing the current prevalence of these risk factors to the plausible minimum risk levels, 17.8% (95% uncertainty interval: 10.1-25.1 of CVDs′ attributable DALYs among adult males and 34% (95% uncertainty interval: 20-46.7 in adult females can be avoided. Conclusions : To better priority setting as well as reporting the magnitude of avoidable DALYs rather than the percentage of avoidable burden, PIF should be applied to updated and revised burden of CVDs.

  2. Communicating about risk: strategies for situations where public concern is high but the risk is low.

    Science.gov (United States)

    Hooker, Claire; Capon, Adam; Leask, Julie

    2017-01-15

    In this article, we summarise research that identifies best practice for communicating about hazards where the risk is low but public concern is high. We apply Peter Sandman's 'risk = hazard + outrage' formulation to these risks, and review factors associated with the amplification of risk signals. We discuss the structures that determine the success of risk communication strategies, such as the capacity for early communication to 'capture' the dominant representation of risk issues, the importance of communicating uncertainty, and the usefulness of engaging with communities. We argue that, when facing trade-offs in probable outcomes from communication, it is always best to choose strategies that maintain or build trust, even at the cost of initial overreactions. We discuss these features of successful risk communication in relation to a range of specific examples, particularly opposition to community water fluoridation, Ebola, and routine childhood immunisation.

  3. Communicating about risk: strategies for situations where public concern is high but the risk is low

    Directory of Open Access Journals (Sweden)

    Claire Hooker

    2017-02-01

    Full Text Available In this article, we summarise research that identifies best practice for communicating about hazards where the risk is low but public concern is high. We apply Peter Sandman’s ‘risk = hazard + outrage’ formulation to these risks, and review factors associated with the amplification of risk signals. We discuss the structures that determine the success of risk communication strategies, such as the capacity for early communication to ‘capture’ the dominant representation of risk issues, the importance of communicating uncertainty, and the usefulness of engaging with communities. We argue that, when facing trade-offs in probable outcomes from communication, it is always best to choose strategies that maintain or build trust, even at the cost of initial overreactions. We discuss these features of successful risk communication in relation to a range of specific examples, particularly opposition to community water fluoridation, Ebola, and routine childhood immunisation.

  4. Genomic analysis of high-risk smoldering multiple myeloma.

    Science.gov (United States)

    López-Corral, Lucía; Mateos, María Victoria; Corchete, Luis A; Sarasquete, María Eugenia; de la Rubia, Javier; de Arriba, Felipe; Lahuerta, Juan-José; García-Sanz, Ramón; San Miguel, Jesús F; Gutiérrez, Norma C

    2012-09-01

    Smoldering myeloma is an asymptomatic plasma cell dyscrasia with a heterogeneous propensity to progress to active myeloma. In order to investigate the biology of smoldering myeloma patients with high risk of progression, we analyzed the genomic characteristics by FISH, SNP-arrays and gene expression profile of a group of patients with high-risk smoldering myeloma included in a multicenter randomized trial. Chromosomal abnormalities detected by FISH and SNP-arrays at diagnosis were not associated to risk of progression to symptomatic myeloma. However, the overexpression of four SNORD genes (SNORD25, SNORD27, SNORD30 and SNORD31) was correlated with shorter time to progression (Psmoldering patients who progressed to symptomatic myeloma were sequentially analyzed, newly acquired lesions together with an increase in the proportion of plasma cells carrying a given abnormality were observed. These findings suggest that gene expression profiling is a valuable technique to identify smoldering myeloma patients with high risk of progression. (Clinical Trials NCT00443235).

  5. Factoring attitudes towards armed conflict risk into selection of protected areas for conservation.

    Science.gov (United States)

    Hammill, E; Tulloch, A I T; Possingham, H P; Strange, N; Wilson, K A

    2016-03-30

    The high incidence of armed conflicts in biodiverse regions poses significant challenges in achieving international conservation targets. Because attitudes towards risk vary, we assessed different strategies for protected area planning that reflected alternative attitudes towards the risk of armed conflicts. We find that ignoring conflict risk will deliver the lowest return on investment. Opting to completely avoid conflict-prone areas offers limited improvements and could lead to species receiving no protection. Accounting for conflict by protecting additional areas to offset the impacts of armed conflicts would not only increase the return on investment (an effect that is enhanced when high-risk areas are excluded) but also increase upfront conservation costs. Our results also demonstrate that fine-scale estimations of conflict risk could enhance the cost-effectiveness of investments. We conclude that achieving biodiversity targets in volatile regions will require greater initial investment and benefit from fine-resolution estimates of conflict risk.

  6. High alcohol consumption causes high IgE levels but not high risk of allergic disease.

    Science.gov (United States)

    Lomholt, Frederikke K; Nielsen, Sune F; Nordestgaard, Børge G

    2016-11-01

    High alcohol consumption is associated with high IgE levels in observational studies; however, whether high alcohol consumption leads to high IgE levels and allergic disease is unclear. We tested the hypothesis that high alcohol consumption is associated with high IgE levels and allergic disease both observationally and genetically using a Mendelian randomization design free of reverse causation and largely free of confounding. Among 111,408 subjects aged 20 to 100 years from the general population, 50,019 had plasma IgE measurements, and 102,270 were genotyped for the alcohol-metabolizing enzymes alcohol dehydrogenase 1B (ADH-1B; rs1229984) and alcohol dehydrogenase 1c (ADH-1C; rs698). Observationally, we investigated associations between IgE levels and allergic disease (allergic asthma, rhinitis, and eczema) and between alcohol consumption and IgE levels and allergic disease. Genetically, we explored potential causal relationships between alcohol consumption and IgE levels and allergic disease. The multivariable adjusted odds ratio for IgE levels greater than versus less than 150 kU/L and compared with subjects without allergic disease was 2.3 (95% CI, 2.2-2.5) for 1 allergic disease, 3.9 (95% CI, 3.5-4.4) for 2 allergic diseases, and 7.5 (95% CI, 6.2-9.0) for 3 allergic diseases. High alcohol consumption was associated with high IgE levels but not with high risk of allergic disease. The odds ratio for high versus low IgE levels per 1 alcoholic drink per week higher consumption was 1.12 (95% CI, 1.02-1.23) genetically and 1.01 (95% CI, 1.01-1.02) observationally; for allergic disease, the corresponding odds ratios were 0.96 (95% CI, 0.92-1.00) genetically and 1.00 (95% CI, 1.00-1.00) observationally. High alcohol consumption is associated observationally and genetically with high IgE levels but not with high risk of allergic disease. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Comprehensive brain MRI segmentation in high risk preterm newborns.

    Directory of Open Access Journals (Sweden)

    Xintian Yu

    2010-11-01

    Full Text Available Most extremely preterm newborns exhibit cerebral atrophy/growth disturbances and white matter signal abnormalities on MRI at term-equivalent age. MRI brain volumes could serve as biomarkers for evaluating the effects of neonatal intensive care and predicting neurodevelopmental outcomes. This requires detailed, accurate, and reliable brain MRI segmentation methods. We describe our efforts to develop such methods in high risk newborns using a combination of manual and automated segmentation tools. After intensive efforts to accurately define structural boundaries, two trained raters independently performed manual segmentation of nine subcortical structures using axial T2-weighted MRI scans from 20 randomly selected extremely preterm infants. All scans were re-segmented by both raters to assess reliability. High intra-rater reliability was achieved, as assessed by repeatability and intra-class correlation coefficients (ICC range: 0.97 to 0.99 for all manually segmented regions. Inter-rater reliability was slightly lower (ICC range: 0.93 to 0.99. A semi-automated segmentation approach was developed that combined the parametric strengths of the Hidden Markov Random Field Expectation Maximization algorithm with non-parametric Parzen window classifier resulting in accurate white matter, gray matter, and CSF segmentation. Final manual correction of misclassification errors improved accuracy (similarity index range: 0.87 to 0.89 and facilitated objective quantification of white matter signal abnormalities. The semi-automated and manual methods were seamlessly integrated to generate full brain segmentation within two hours. This comprehensive approach can facilitate the evaluation of large cohorts to rigorously evaluate the utility of regional brain volumes as biomarkers of neonatal care and surrogate endpoints for neurodevelopmental outcomes.

  8. Highly sensitive and selective colorimetric sensing of antibiotics in milk.

    Science.gov (United States)

    Zhang, Xiaofang; Zhang, Yang; Zhao, Hong; He, Yujian; Li, Xiangjun; Yuan, Zhuobin

    2013-05-17

    Antibiotics residues in foods are very harmful to human beings. Determination of antibiotics residues relies largely on the availability of adequate analytical techniques. Currently, there is an urgent need for on site and real time detection of antibiotics in food. In this work, a novel one step synthesis of gold nanoparticles (AuNPs) was proposed using pyrocatechol violet (PCV) as a reducer agent. Highly sensitive and selective colorimetric detection of four antibiotics kanamycin mono sulfate (KA), neomycin sulfate (NE), streptomycin sulfate (ST) and bleomycin sulfate (BL) was realized during the formation of AuNPs. PCV has -OH groups and these antibiotics have -OH, -NH2, -NH- groups, so there may be some special hydrogen-bonding interactions between PCV and these antibiotics. Therefore, the presence of KA, NE, ST and BL would influence the synthesis of AuNPs, then the color and state of AuNPs would change, which could be observed with the naked eye or a UV-vis spectrophotometer. Results showed that A670 was linear with the logarithm of KA concentration in the range from 1.0×10(-8) to 5.0×10(-7)M and 5.0×10(-7) to 5.5×10(-5)M. The detection limit of KA was 1.0×10(-9)M (S/N=3). The coexisting substances including 1.0×10(-5)M phenylalanine, alanine, glycerol, glucose, Mg(2+), Ca(2+), Na(+), K(+), CO3(2-), SO4(2-), NO3(-), Cl(-) and Br(-) did not affect the determination of 1.0×10(-7)M antibiotics. In particular, the proposed method could be applied successfully to the detection of antibiotics in the pretreated liquid milk products. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. The risk ogf high-risk jobs : psychological health consequences in forensic physicians and ambulance workers

    NARCIS (Netherlands)

    Ploeg, E. van der

    2003-01-01

    The risk of high-risk jobs: Psychological health consequences in forensic doctors and ambulance workers This thesis has shown that forensic physicians and ambulance personnel frequently suffer from psychological complaints as a result of dramatic events and sources of chronic work stress. A

  10. Risk factors for congenital anomalies in high risk pregnant women: A ...

    African Journals Online (AJOL)

    Tella Sunitha

    2016-05-14

    May 14, 2016 ... Abstract Background: High Risk Pregnancy (HRP) is a condition where mother or developing fetus or both are at increased risk of complications during or after pregnancy and birth. There are no studies so far which have characterized congenital anomalies (CAs) in HRP women with dif- ferent previous ...

  11. Risk factors for congenital anomalies in high risk pregnant women: A ...

    African Journals Online (AJOL)

    Tella Sunitha

    2016-05-14

    May 14, 2016 ... Rubella;. CMV and HSV. Abstract Background: High Risk Pregnancy (HRP) is a condition where mother or developing fetus or both are at increased risk of complications during or after pregnancy and birth. There are no studies so far which have characterized congenital anomalies (CAs) in HRP women ...

  12. On risk, leverage and banks: do highly leveraged banks take on excessive risk?

    NARCIS (Netherlands)

    Koudstaal, M.; van Wijnbergen, S.

    2012-01-01

    This paper deals with the relation between excessive risk taking and capital structure in banks. Examining a quarterly dataset of U.S. banks between 1993 and 2010, we find that equity is valued higher when more risky portfolios are chosen when leverage is high, and that more risk taking has a

  13. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia

    NARCIS (Netherlands)

    Wong, Tsz Y.; Groen, Henk; Faas, Marijke M.; van Pampus, Maria G.

    2013-01-01

    Objectives: To evaluate clinical risk factors for the development of gestational hypertensive disorders in a group of pregnant women at high risk for developing preeclampsia. Secondly we evaluated the incidence and recurrence rate of preeclampsia and pregnancy-induced hypertension. Study design: A

  14. Who Takes Risks in High-Risk Sports? A Typological Personality Approach

    Science.gov (United States)

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-01-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing, mountaineering, rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and…

  15. Risk behaviors for the health of adolescents from High School

    Directory of Open Access Journals (Sweden)

    José Henrique Ramos

    2009-09-01

    Full Text Available Objective: To investigate the risk behaviors (smoking addiction, alcoholism, drug use and sexual risk behavior of adolescents from High School. Methods: It was an analytical and cross-sectional study. The sample consisted of 720 scholars (252 boys and 468 girls from the age group of 16 to 17 years-old, from three public schools in Florianopolis/SC. The data was collected through two types of self administrated questionnaires; one for the parents and another one for the students, from March to December, 2005. The studied variables were legal and illegal drug use and sexual risk behavior. The descriptive statistics and the chi- squared test were used to carry out the data analysis Results: The beginning of risk behaviors occurred between 14 and 15 years old, for both genders. It was observed that 26 (3.6% scholars drank alcohol regularly; 38 (5.3% smoked daily; 66 (9.2 % were drug users or had used drugs several times and 14 (2% were drug dependents. Concerning to sexual risk behavior, 318 (44.5% scholars had sexual risk behavior and from those, 97 (13.6% did not always use condom. From the studied sample, 545 (76.5% scholars did not present any risk behavior. Among risk behaviors, sexual risk prevailed (42.5%. Conclusion: The number of adolescents with risk behavior was not high. Nevertheless, there is a small proportion of adolescents that smoke, drink and do drugs and have sexual risk behavior. This points out to the need of a bigger supervision and guidance for these students.

  16. Job stressors and other risk factors related to the risk of hypertension among selected employees in Jakarta

    Directory of Open Access Journals (Sweden)

    Feni Krisnawati

    2006-09-01

    Full Text Available Almost everyone, including employees, may develop hypertension. Several risk factors, including stresses in the work environment, are related to hypertension. The aim of this study is to identify these work-related risk factors in hypertension. A nested case-control study was conducted among office employees in Jakarta during May 2004. Employees with stage 1 or stage 2 hypertension (based on the United States of America Joint National Committee on high blood pressure 2003, or those taking antihypertensive drugs were designated as cases. As controls were employees with no history of hypertension. One case was randomly matched by gender with two controls. All risk factors for cases and controls were counted as of the reference date of diagnosis for cases. There were 70 cases and 140 controls aged 25 to 65 years. Hypertension was found to be related to the qualitative and quantitative increase in the workload, career development, age, obesity, current and past smoking habits, and a family history of hypertension. However, it was noted that role of ambiguity, role of conflict, and personal responsibility did not increase the risk of hypertension. Compared to those with low qualitative job stressor, those who had moderate or high qualitative job stressor had a seven-fold risk to be hypertensive [adjusted odds ratio (ORa = 7.47; 95% confidence interval (CI = 1.40-39.76]. In addition, relative to those who had low quantitative job stressor, those with moderate or high stressors were four times at risk to be hypertensive (ORa = 4.10; 95% CI = 1.06-15.90. In conclusion moderate or high qualitative and quantitative job stressors as well as career development increased risk hypertension. Therefore these stressors need to be prevented. (Med J Indones 2006; 15:177-84 Keywords: hypertension, qualitative job stressor, quantitative job stressor, career development

  17. Early Parental Adaptation, Prenatal Distress, and High-Risk Pregnancy.

    Science.gov (United States)

    Dollberg, Daphna G; Rozenfeld, Tamir; Kupfermincz, Michael

    2016-09-01

    To examine the examined the effects of high risk pregnancy and prenatal distress on parental postnatal adaptation. A sample of 111 expecting parents, consisting of 32 high risk pregnancy (HRP) mothers and 21 spouses and 36 matched low risk pregnancy (LRP) mothers and 22 spouses completed reports of depression symptoms (BDI) and pregnancy related concerns prenatally. At three months postpartum, parent-infant direct observations and reports of parenting alliance (PAI), stress (PSI-SF), satisfaction and efficacy (PSOC) were gathered. Data was analyzed with GLM multivariate analyses and the actor-partner interdependence model. Parents' prenatal BDI predicted postnatal parental stress. BDI and concerns predicted postnatal satisfaction, but only for mothers. Mother's concerns predicted low maternal and high paternal parenting alliance. Partner effect was found so that high concerns predicted high reports of parenting alliance by spouse. Mean-group differences were found between HRP and LRP during parent-infant observations, so that HRP parents displayed lower sensitivity and reciprocity. Prenatal distress, and to some degree high risk pregnancy, are risk factors that may interfere with the early formation of parent-infant relationship. Clinical implications of these findings are presented. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. The risk of hydrogen explosion in a submarine p. IV The implementation of high risk projects

    Directory of Open Access Journals (Sweden)

    Kłos Ryszard

    2017-06-01

    Full Text Available This series of articles on high risk projects looks at the example of the modernisation of hydrogen incinerators on a submarine. The article describes problems connected with the management of such a project.

  19. Cumulative Experiences of Violence among High-Risk Urban Youth

    Science.gov (United States)

    Taylor, Catherine A.; Boris, Neil W.; Heller, Sherryl Scott; Clum, Gretchen A.; Rice, Janet C.; Zeanah, Charles H.

    2008-01-01

    This study examines type-specific and cumulative experiences of violence among a vulnerable population of youth. Sixty high-risk, shelter-dwelling, urban youth were interviewed regarding their history of childhood maltreatment, exposure to community violence (ECV), and experience with intimate partner violence (IPV). Results show a high prevalence…

  20. Simultaneous purifying selection on the ancestral MC1R allele and positive selection on the melanoma-risk allele V60L in south Europeans.

    Science.gov (United States)

    Martínez-Cadenas, Conrado; López, Saioa; Ribas, Gloria; Flores, Carlos; García, Oscar; Sevilla, Arrate; Smith-Zubiaga, Isabel; Ibarrola-Villaba, Maider; Pino-Yanes, Maria del Mar; Gardeazabal, Jesús; Boyano, Dolores; García de Galdeano, Alicia; Izagirre, Neskuts; de la Rúa, Concepción; Alonso, Santos

    2013-12-01

    In humans, the geographical apportionment of the coding diversity of the pigmentary locus melanocortin-1 receptor (MC1R) is, unusually, higher in Eurasians than in Africans. This atypical observation has been interpreted as the result of purifying selection due to functional constraint on MC1R in high UV-B radiation environments. By analyzing 3,142 human MC1R alleles from different regions of Spain in the context of additional haplotypic information from the 1000 Genomes (1000G) Project data, we show that purifying selection is also strong in southern Europe, but not so in northern Europe. Furthermore, we show that purifying and positive selection act simultaneously on MC1R. Thus, at least in Spain, regions at opposite ends of the incident UV-B radiation distribution show significantly different frequencies for the melanoma-risk allele V60L (a mutation also associated to red hair and fair skin and even blonde hair), with higher frequency of V60L at those regions of lower incident UV-B radiation. Besides, using the 1000G south European data, we show that the V60L haplogroup is also characterized by an extended haplotype homozygosity (EHH) pattern indicative of positive selection. We, thus, provide evidence for an adaptive value of human skin depigmentation in Europe and illustrate how an adaptive process can simultaneously help to maintain a disease-risk allele. In addition, our data support the hypothesis proposed by Jablonski and Chaplin (Human skin pigmentation as an adaptation to UVB radiation. Proc Natl Acad Sci U S A. 2010;107:8962-8968), which posits that habitation of middle latitudes involved the evolution of partially depigmented phenotypes that are still capable of suitable tanning.

  1. High risk drinking and college students' self-perceptions.

    Science.gov (United States)

    Araujo, Gabriel C; Wong, Eugene H

    2005-12-01

    The present study examined the relationship between high risk drinking and college students' self-perceptions. High risk drinking was defined as the consumption of four or more drinks in a row for women and five or more drinks in a row for men during a single sitting (within the last year). Historical trends regarding college-age drinking indicate that 44% of college students fit the criteria for high risk drinking at least once over the past year. A survey was administered to 210 college students (52 men and 158 women) between 18 and 22 years of age (M = 20.9, SD = 1.3) to assess their use of alcohol and their self-perceptions. Students' self-perceptions were measured with four subscales from the Neemann-Harter Self-perception Profile for College Students. Students either volunteered to participate in this study outside of class or were solicited during class. It was predicted that students' self-perceptions would differ significantly depending upon their alcohol consumption, i.e., 17.1% were Abstainers, 25.2% were Nonproblem Drinkers, and 57.6% were High Risk Drinkers. Analysis gave significant difference on Global Self-worth between students who abstained and those who were High Risk Drinkers. However, students' perceptions of Scholastic Competence, Intellectual Ability, and Social Acceptance did not differ significantly for the alcohol consumption groups. In addition to high risk drinking, a number of other variables were associated with self-perceptions, such as high school alcohol use, low high school GPA, and students' reported academic involvement. These relations are discussed.

  2. Psychological characteristics in high-risk MSM in China.

    Science.gov (United States)

    Chen, Guanzhi; Li, Yang; Zhang, Beichuan; Yu, Zengzhao; Li, Xiufang; Wang, Lixin; Yu, Ziming

    2012-01-20

    Men who have sex with men (MSM) have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Of the 714 MSM analyzed, 59 (8.26%) had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P discrimination (P > 0.05). A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China.

  3. Telomerase activation by genomic rearrangements in high-risk neuroblastoma.

    Science.gov (United States)

    Peifer, Martin; Hertwig, Falk; Roels, Frederik; Dreidax, Daniel; Gartlgruber, Moritz; Menon, Roopika; Krämer, Andrea; Roncaioli, Justin L; Sand, Frederik; Heuckmann, Johannes M; Ikram, Fakhera; Schmidt, Rene; Ackermann, Sandra; Engesser, Anne; Kahlert, Yvonne; Vogel, Wenzel; Altmüller, Janine; Nürnberg, Peter; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Mariappan, Aruljothi; Heynck, Stefanie; Mariotti, Erika; Henrich, Kai-Oliver; Gloeckner, Christian; Bosco, Graziella; Leuschner, Ivo; Schweiger, Michal R; Savelyeva, Larissa; Watkins, Simon C; Shao, Chunxuan; Bell, Emma; Höfer, Thomas; Achter, Viktor; Lang, Ulrich; Theissen, Jessica; Volland, Ruth; Saadati, Maral; Eggert, Angelika; de Wilde, Bram; Berthold, Frank; Peng, Zhiyu; Zhao, Chen; Shi, Leming; Ortmann, Monika; Büttner, Reinhard; Perner, Sven; Hero, Barbara; Schramm, Alexander; Schulte, Johannes H; Herrmann, Carl; O'Sullivan, Roderick J; Westermann, Frank; Thomas, Roman K; Fischer, Matthias

    2015-10-29

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system. Roughly half of these tumours regress spontaneously or are cured by limited therapy. By contrast, high-risk neuroblastomas have an unfavourable clinical course despite intensive multimodal treatment, and their molecular basis has remained largely elusive. Here we have performed whole-genome sequencing of 56 neuroblastomas (high-risk, n = 39; low-risk, n = 17) and discovered recurrent genomic rearrangements affecting a chromosomal region at 5p15.33 proximal of the telomerase reverse transcriptase gene (TERT). These rearrangements occurred only in high-risk neuroblastomas (12/39, 31%) in a mutually exclusive fashion with MYCN amplifications and ATRX mutations, which are known genetic events in this tumour type. In an extended case series (n = 217), TERT rearrangements defined a subgroup of high-risk tumours with particularly poor outcome. Despite a large structural diversity of these rearrangements, they all induced massive transcriptional upregulation of TERT. In the remaining high-risk tumours, TERT expression was also elevated in MYCN-amplified tumours, whereas alternative lengthening of telomeres was present in neuroblastomas without TERT or MYCN alterations, suggesting that telomere lengthening represents a central mechanism defining this subtype. The 5p15.33 rearrangements juxtapose the TERT coding sequence to strong enhancer elements, resulting in massive chromatin remodelling and DNA methylation of the affected region. Supporting a functional role of TERT, neuroblastoma cell lines bearing rearrangements or amplified MYCN exhibited both upregulated TERT expression and enzymatic telomerase activity. In summary, our findings show that remodelling of the genomic context abrogates transcriptional silencing of TERT in high-risk neuroblastoma and places telomerase activation in the centre of transformation in a large fraction of these tumours.

  4. Psychological characteristics in high-risk MSM in China

    Directory of Open Access Journals (Sweden)

    Chen Guanzhi

    2012-01-01

    Full Text Available Abstract Background Men who have sex with men (MSM have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26% had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P P > 0.05. A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China.

  5. Effectiveness of a selective alcohol prevention program targeting personality risk factors: Results of interaction analyses.

    Science.gov (United States)

    Lammers, Jeroen; Goossens, Ferry; Conrod, Patricia; Engels, Rutger; Wiers, Reinout W; Kleinjan, Marloes

    2017-08-01

    To explore whether specific groups of adolescents (i.e., scoring high on personality risk traits, having a lower education level, or being male) benefit more from the Preventure intervention with regard to curbing their drinking behaviour. A clustered randomized controlled trial, with participants randomly assigned to a 2-session coping skills intervention or a control no-intervention condition. Fifteen secondary schools throughout The Netherlands; 7 schools in the intervention and 8 schools in the control condition. 699 adolescents aged 13-15; 343 allocated to the intervention and 356 to the control condition; with drinking experience and elevated scores in either negative thinking, anxiety sensitivity, impulsivity or sensation seeking. Differential effectiveness of the Preventure program was examined for the personality traits group, education level and gender on past-month binge drinking (main outcome), binge frequency, alcohol use, alcohol frequency and problem drinking, at 12months post-intervention. Preventure is a selective school-based alcohol prevention programme targeting personality risk factors. The comparator was a no-intervention control. Intervention effects were moderated by the personality traits group and by education level. More specifically, significant intervention effects were found on reducing alcohol use within the anxiety sensitivity group (OR=2.14, CI=1.40, 3.29) and reducing binge drinking (OR=1.76, CI=1.38, 2.24) and binge drinking frequency (β=0.24, p=0.04) within the sensation seeking group at 12months post-intervention. Also, lower educated young adolescents reduced binge drinking (OR=1.47, CI=1.14, 1.88), binge drinking frequency (β=0.25, p=0.04), alcohol use (OR=1.32, CI=1.06, 1.65) and alcohol use frequency (β=0.47, p=0.01), but not those in the higher education group. Post hoc latent-growth analyses revealed significant effects on the development of binge drinking (β=-0.19, p=0.02) and binge drinking frequency (β=-0.10, p=0

  6. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Tilburt Jon C

    2011-05-01

    Full Text Available Abstract Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92% used an observational design and focused on women (70% with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although

  7. HIFU therapy for patients with high risk prostate cancer

    Science.gov (United States)

    Solovov, V. A.; Vozdvizhenskiy, M. O.; Matysh, Y. S.

    2017-03-01

    Objectives. Patients with high-risk prostate cancer undergoing radical prostatectomy, external beam radiation therapy (EBRT) combined with androgen deprivation therapy (ADT) or ADT alone. The widely accepted definition of high-risk prostate was first proposed by D'Amico based on a pretreatment Gleason score of ≥8, clinical stage T3, PSA level ≥20 ng/mL. There is no trial that compares traditional methods of treatment of such patients with HIFU therapy. Here we explored the effectiveness of the HIFU in multimodal treatment for patients with high risk prostate cancer. Materials & Methods. 701 patients with high risk prostate cancer were treated in our center between September 2007 and December 2013. Gleason score were 8-10, stage T3N0M0, age 69 (58-86) years, mean PSA before treatment 43.3 (22.1-92.9) ng/ml, mean prostate volume - 59.3 (38-123) cc. 248 patients were treated by HIFU. We compare this group of patients with patients who undertook EBRT: number 196, and ADT: number 257. Mean follow-up time 58 months (6-72). Results. The 5-year overall survival rates in patients after HIFU were 73.8 %, after EBRT - 63.0 % and after ADT - 18.1%. Conclusions. Our experience showed that HIFU therapy in combined treatment were successful for high risk prostate cancer.

  8. Detection of high risk campylobacteriosis clusters at three geographic levels

    Directory of Open Access Journals (Sweden)

    Jennifer Weisent

    2011-11-01

    Full Text Available Campylobacteriosis is a leading cause of bacterial gastroenteritis in the United States and many other developed countries. Understanding the spatial distribution of this disease and identifying high-risk areas is vital to focus resources for prevention and control measures. In addition, determining the appropriate scale for geographical analysis of surveillance data is an area of concern to epidemiologists and public health officials. The purpose of this study was to (i compare standardized risk estimates for campylobacteriosis in Tennessee over three distinct geographical scales (census tract, zip code and county subdivision, and (ii identify and investigate high-risk spatial clustering of campylobacteriosis at the three geographical scales to determine if clustering is scale dependent. Significant high risk clusters (P <0.05 were detected at all three spatial scales. There were overlaps in regions of high-risk and clusters at all three geographic levels. At the census tract level, spatial analysis identified smaller clusters of finer resolution and detected more clusters than the other two levels. However, data aggregation at zip code or county subdivision yielded similar findings. The importance of this line of research is to create a framework whereby economically efficient disease control strategies become more attainable through improved geographical precision and risk detection. Accurate identification of disease clusters for campylobacteriosis can enable public health personnel to focus scarce resources towards prevention and control programmes on the most at-risk populations. Consistent results at multiple spatial levels highlight the robustness of the geospatial techniques utilized in this study. Furthermore, analyses at the zip code and county subdivision levels can be useful when address level information (finer resolution data are not available. These procedures may also be used to help identify regionally specific risk factors for

  9. Personality and sensation seeking in high-risk sports

    OpenAIRE

    Polona Klinar; Stojan Burnik; Tanja Kajtna

    2017-01-01

    Background: Personality represents a relatively consistent and unique sum of psychological, cognitive and physical characteristics of an individual. Sensation seeking is defined as an action, characterized by the search for different, new, complex and intensive emotions and experiences and preparedness to take physical, social, legal and financial risks in order to achieve these experiences.Objective: We were looking for differences in personality and sensation seeking between high-risk sport...

  10. Correlates of hopelessness in the high suicide risk police occupation

    OpenAIRE

    Violanti, John M.; Andrew, Michael E.; Mnatsakanova, Anna; Hartley, Tara A.; Fekedulegn, Desta; Burchfiel, Cecil M.

    2015-01-01

    Police officers are chronically exposed to work stress. We examined specific stressors that may be associated with hopelessness, a possible risk factor for suicide in this high suicide risk population. The study included 378 officers (276 men and 102 women) with complete data. Analysis of variance was used to estimate mean levels of hopelessness scores as associated with stress, adjusted for age, gender, and race/ ethnicity. Posttraumatic symptoms were tested as a modifier of the association ...

  11. EFFICACY OF FIXED COMBINATION OF VALSARTAN, AMLODIPINE AND HYDROCHLOROTHIAZIDE IN COMPLEX THERAPY OF THE PATIENT OF VERY HIGH CARDIOVASCULAR RISK

    Directory of Open Access Journals (Sweden)

    I. M. Sokolov

    2012-01-01

    Full Text Available The high prevalence of arterial hypertension in association with high and very high cardiovascular risk requires widespread use of combined therapy. Current approaches to selection of combination components of antihypertensive drugs are based the efficacy of these drugs proven in multicenter randomized clinical trials. The triple combination of calcium antagonist, angiotensin II receptor blocker and thiazide diuretic is regarded as the best option for combined therapy in patients with arterial hypertension and ischemic heart disease to reduce cardiovascular risk.

  12. A novel risk classification paradigm for patients with impaired glucose tolerance and high cardiovascular risk.

    Science.gov (United States)

    Bethel, M Angelyn; Chacra, Antonio R; Deedwania, Prakash; Fulcher, Gregory R; Holman, Rury R; Jenssen, Trond; Kahn, Steven E; Levitt, Naomi S; McMurray, John J V; Califf, Robert M; Raptis, Sotirios A; Thomas, Laine; Sun, Jie-Lena; Haffner, Steven M

    2013-07-15

    We used baseline data from the NAVIGATOR trial to (1) identify risk factors for diabetes progression in those with impaired glucose tolerance and high cardiovascular risk, (2) create models predicting 5-year incident diabetes, and (3) provide risk classification tools to guide clinical interventions. Multivariate Cox proportional hazards models estimated 5-year incident diabetes risk and simplified models examined the relative importance of measures of glycemia in assessing diabetes risk. The C-statistic was used to compare models; reclassification analyses compare the models' ability to identify risk groups defined by potential therapies (routine or intensive lifestyle advice or pharmacologic therapy). Diabetes developed in 3,254 (35%) participants over 5 years median follow-up. The full prediction model included fasting and 2-hour glucose and hemoglobin A1c (HbA1c) values but demonstrated only moderate discrimination for diabetes (C = 0.70). Simplified models with only fasting glucose (C = 0.67) or oral glucose tolerance test values (C = 0.68) had higher C statistics than models with HbA1c alone (C = 0.63). The models were unlikely to inappropriately reclassify participants to risk groups that might receive pharmacologic therapy. Our results confirm that in a population with dysglycemia and high cardiovascular risk, traditional risk factors are appropriate predictors and glucose values are better predictors than HbA1c, but discrimination is moderate at best, illustrating the challenges of predicting diabetes in a high-risk population. In conclusion, our novel risk classification paradigm based on potential treatment could be used to guide clinical practice based on cost and availability of screening tests. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Use of selective serotonin reuptake inhibitors antidepressants and bleeding risk in breast cosmetic surgery.

    Science.gov (United States)

    Basile, Filipe Volpe; Basile, Antonio Roberto; Basile, Vinicius Volpe

    2013-06-01

    Selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressant prescribed currently. Data regarding SSRI use among plastic surgery patients may differ between different populations, but the incidence could be as high as 10 %. It is known that SSRIs decrease platelet serotonin storage and platelet function, and their association with postsurgical bleeding in mastectomy patients and orthopedic surgery patients is well established. An increased risk of postsurgical bleeding among plastic surgery patients may have important clinical implications, but this has not been evaluated to date. The authors therefore conducted a hospital-based study with prospectively collected data to examine the association between the use of SSRIs and postsurgical bleeding. To the authors' knowledge, this is the first study to evaluate the effects of SSRIs on bleeding risk in the breast cosmetic surgery population. All patients who underwent breast cosmetic plastic surgery procedures (breast augmentation, breast reduction, or mastopexy) at our institution between January of 2001 and December of 2011 were reviewed. The patients were divided into two groups by SSRI use history: a no-use group and an active-use group. The primary end point for a bleeding event was the need for intervention. Patients were further subcategorized by type of breast surgery performed, body mass index, and age. Descriptive statistics tabulated the frequency of a bleeding event within the groups. Logistic regression was applied to evaluate the risk of a bleeding event according to the use of SSRIs. The odds ratios (ORs) with their 95 % confidence intervals (CIs) associating SSRI use with postoperative bleeding were computed. During the study period, 2,285 patients had breast cosmetic surgery, and 33 of these patients (1.44 %) experienced a bleeding event (hematoma requiring surgical draining). Of the 196 patients (8.58 %) in the active-use group, 9 (4.59 %) experienced a bleeding event. Of the 2

  14. Paediatric obesity appears to lower the risk of diabetes if selection bias is ignored.

    Science.gov (United States)

    Stovitz, Steven D; Banack, Hailey R; Kaufman, Jay S

    2018-01-26

    Frustrated with the onslaught of articles reporting fascination with results that appear paradoxical but are merely due to selection bias, we studied the apparent effect of obesity on diabetes risk in youth who had a test for diabetes. We hypothesised that obese subjects would have lower rates of diabetes than non-obese subjects due to selection bias, and consequently, obesity would appear to lower the risk of diabetes. Retrospective cohort study of children (4-9 years), pre-teens (10-12 years) and teenagers (13-19 years). Participation was restricted to those who had a test of haemoglobin A1C along with measured height and weight. Body mass index percentile via the Centers for Disease Control and Prevention age and sex standards was calculated and categorised. The main outcome was A1C%, subsequently categorised at the level for diagnosis of diabetes mellitus (≥6.5%). The sample consisted of 134 (2%) underweight, 1718 (30%) healthy weight, 660 (12%) overweight and 3190 (56%) obese individuals. 16% (n=936) had an A1C≥6.5%. Overall, healthy weight children had 8.2 times the risk of A1C≥6.5% (95% CI 5.3 to 12.7) compared with those in the obese category. The relative risk was 13 in pre-teens (95% CI 8.5 to 20.0) and 3.9 in teenagers (95% CI 3.3 to 4.7). Healthy weight was associated with a 4-13 times higher relative risk of diabetes mellitus compared with being obese. While apparently shocking, the study's fatal flaw (selection bias) explains the 'paradoxical' finding. Ignoring selection bias can delay advances in medical science. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. High throughput in vivo protease inhibitor selection platform

    DEFF Research Database (Denmark)

    2017-01-01

    The invention relates to a recombinant microbial cell comprising a selection platform for screening for a protease inhibitor, wherein the platform comprises transgenes encoding a protease having selective peptide bond cleavage activity at a recognition site amino acid sequence; and transgenes...... encoding polypeptides conferring resistance to microbial growth inhibitors; wherein the polypeptides comprise the recognition site amino acid sequence cleavable by the protease. Protease inhibitors are detected by their ability to inhibit protease specific cleavage and inactivation of the polypeptides...... platform for screening for a protease inhibitor....

  16. High-Risk Stress Fractures: Diagnosis and Management.

    Science.gov (United States)

    McInnis, Kelly C; Ramey, Lindsay N

    2016-03-01

    Stress fractures are common overuse injuries in athletes. They occur during periods of increased training without adequate rest, disrupting normal bone reparative mechanisms. There are a host of intrinsic and extrinsic factors, including biochemical and biomechanical, that put athletes at risk. In most stress fractures, the diagnosis is primarily clinical, with imaging indicated at times, and management focused on symptom-free relative rest with advancement of activity as tolerated. Overall, stress fractures in athletes have an excellent prognosis for return to sport, with little risk of complication. There is a subset of injuries that have a greater risk of fracture progression, delayed healing, and nonunion and are generally more challenging to treat with nonoperative care. Specific locations of high-risk stress fracture include the femoral neck (tension side), patella, anterior tibia, medial malleolus, talus, tarsal navicular, proximal fifth metatarsal, and great toe sesamoids. These sites share a characteristic region of high tensile load and low blood flow. High-risk stress fractures require a more aggressive approach to evaluation, with imaging often necessary, to confirm early and accurate diagnosis and initiate immediate treatment. Treatment consists of nonweight-bearing immobilization, often with a prolonged period away from sport, and a more methodic and careful reintroduction to athletic activity. These stress fractures may require surgical intervention. A high index of suspicion is essential to avoid delayed diagnosis and optimize outcomes in this subset of stress fractures. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  17. Selection and Mode Effects in Risk Preference Elicitation Experiments

    DEFF Research Database (Denmark)

    von Gaudecker, Hans-Martin; van Soest, Arthur; Wengström, Erik Roland

    2008-01-01

    We combine data from a risk preference elicitation experiment conducted on a representative sample via the Internet with laboratory data on students for the same experiment to investigate effects of implementation mode and of subject pool selection. We find that the frequency of errors in the lab...... experiment is drastically below that of the representative sample in the Internet experiment, and average risk aversion is also lower. Considering the student-like subsample of the Internet subjects and comparing a traditional lab design with an Internet-like design in the lab gives two ways to decompose...

  18. Assessment of Primitive Reflexes in High-risk Newborns.

    Science.gov (United States)

    Sohn, Min; Ahn, Youngmee; Lee, Sangmi

    2011-12-01

    Assessment of primitive reflexes is one of the earliest, simplest, and most frequently used assessment tools among health care providers for newborns and young infants. However, very few data exist for high-risk infants in this topic. Among the various primitive reflexes, this study was undertaken particularly to describe the sucking, Babinski and Moro reflexes in high-risk newborns and to explore their relationships with clinical variables. This study is a cross-sectional descriptive study. Sixty seven high-risk newborns including full-term infants required intensive care as well as premature infants were recruited in a neonatal intensive care unit using convenient sampling method. The sucking, Babinski and Moro reflexes were assessed and classified by normal, abnormal and absence. To explore their relationships with clinical variables, birth-related variables, brain sonogram results, and behavioral state (the Anderson Behavioral State Scale, ABSS) and mental status (the Infant Coma Scale, ICS) were assessed. The sucking reflex presented a normal response most frequently (63.5%), followed by Babinski reflex (58.7%) and Moro reflex (42.9%). Newborns who presented normal sucking and Babinski reflex responses were more likely to have older gestational age, heavier birth and current weight, higher Apgar scores, shorter length of hospitalization, better respiratory conditions, and better mental status assessed by ICS, but not with Moro reflex. High risk newborns presented more frequent abnormal and absence responses of primitive reflex and the proportions of the responses varied by reflex. Further researches are necessary in exploring diverse aspects of primitive reflexes and revealing their clinical implication in the high-risk newborns that are unique and different to normal healthy newborns. Primitive reflex; High risk infants; Korean; Moro reflex; Sucking reflex; Babinski reflex; The Anderson Behavioral State Scale; Infant Coma Scale.

  19. Family Structure Changes during High School and College Selectivity

    Science.gov (United States)

    An, Brian P.; Sorensen, Kia N.

    2017-01-01

    Research has shown that family structure changes negatively influence educational attainment, but they overlook qualitative distinctions in college choice, such as college selectivity. Yet, college choice research has largely focused on static measures of family structure, failing to account for year-to-year family structure changes that occur…

  20. Quantifying the risk of respiratory infection in healthcare workers performing high-risk procedures.

    Science.gov (United States)

    Macintyre, C R; Seale, H; Yang, P; Zhang, Y; Shi, W; Almatroudi, A; Moa, A; Wang, X; Li, X; Pang, X; Wang, Q

    2014-09-01

    This study determined the risk of respiratory infection associated with high-risk procedures (HRPs) performed by healthcare workers (HCWs) in high-risk settings. We prospectively studied 481 hospital HCWs in China, documented risk factors for infection, including performing HRPs, measured new infections, and analysed whether HRPs predicted infection. Infection outcomes were clinical respiratory infection (CRI), laboratory-confirmed viral or bacterial infection, and an influenza infection. About 12% (56/481) of the study participants performed at least one HRP, the most common being airway suctioning (7·7%, 37/481). HCWs who performed a HRP were at significantly higher risk of developing CRI and laboratory-confirmed infection [adjusted relative risk 2·9, 95% confidence interval (CI) 1·42-5·87 and 2·9, 95% CI 1·37-6·22, respectively]. Performing a HRP resulted in a threefold increase in the risk of respiratory infections. This is the first time the risk has been prospectively quantified in HCWs, providing data to inform occupational health and safety policies.

  1. Maternal and foetal outcome of 206 high risk pregnancy cases in border guard hospital, dhaka.

    Science.gov (United States)

    Shapla, N R; Islam, M A; Shahida, S M; Parveen, Z; Lipe, Y S

    2015-04-01

    This observational study was carried out to identify the various types of high risk pregnancy and to determine the maternal and foetal outcome. The study was carried out on 206 pregnant high risk women in the Gynecology and Obstetrics department of Border Guard Hospital, Dhaka from January 2012 to December 2012. During mentioned period among 598 pregnant women 206 high risk pregnancy cases were randomly selected. Pregnant women (gestational age from 34 weeks upto 40 weeks) having medical condition and pregnancy related high risk factors were included and uncomplicated pregnancy, pregnancy before 37 weeks, post dated pregnancy were excluded from this study. Data was collected from semi structured history sheet and data analysis done by percentage. High risk pregnant women were grouped into three. Group A and Group B includes pregnant women having medical condition before and during pregnancy respectively. Group C consists of pregnant women had pregnancy related high risk issues. Among 206 high risk pregnancy cases majority 47.57% women had medical condition during pregnancy, 31.55% patient had medical condition before pregnancy. Among them majority 30.58% of the patient suffered from pregnancy induced hypertension, 15.04% patients suffered from gestational Diabetes Mellitus and premature rupture of membranes were 12.13%. In this study majority 43.68% of high risk pregnant patients were in age group of 30-35 years, 19.90% pregnant women were in age group of >35 years and 19.40% were in age group of upto 20 years. Among study groups maximum 65.04% of the patients were multiparous. Among 206 study population 60.19% high risk pregnant women were at term at the time of delivery and 39.8% women delivered their babies preterm. Caesarean section was done in 69.41% of high risk pregnant women. After delivery majority 77.66% women had no complication, only 10.19%, 8.25%, 2.91% and 0.97% high risk pregnant women suffered from fever, UTI, abdominal wound infection and post

  2. Input variable selection for interpolating high-resolution climate ...

    African Journals Online (AJOL)

    Accurate climate surfaces are vital for applications relating to groundwater recharge modelling, evapotranspiration estimation, sediment yield, stream flow prediction and flood risk mapping. Interpolated climate surface accuracy is determined by the interpolation algorithm employed, the resolution of the generated surfaces, ...

  3. Humanized birth in high risk pregnancy: barriers and facilitating factors.

    Science.gov (United States)

    Behruzi, Roxana; Hatem, Marie; Goulet, Lise; Fraser, William; Leduc, Nicole; Misago, Chizuru

    2010-02-01

    The medical model of childbearing assumes that a pregnancy always has the potential to turn into a risky procedure. In order to advocate humanized birth in high risk pregnancy, an important step involves the enlightenment of the professional's preconceptions on humanized birth in such a situation. The goal of this paper is to identify the professionals' perception of the potential obstacles and facilitating factors for the implementation of humanized care in high risk pregnancies. Twenty-one midwives, obstetricians, and health administrator professionals from the clinical and academic fields were interviewed in nine different sites in Japan from June through August 2008. The interviews were audio taped, and transcribed with the participants' consent. Data was subsequently analyzed using content analysis qualitative methods. Professionals concurred with the concept that humanized birth is a changing and promising process, and can often bring normality to the midst of a high obstetric risk situation. No practice guidelines can be theoretically defined for humanized birth in a high risk pregnancy, as there is no conflict between humanized birth and medical intervention in such a situation. Barriers encountered in providing humanized birth in a high risk pregnancy include factors such as: the pressure of being responsible for the safety of the mother and the fetus, lack of the women's active involvement in the decision making process and the heavy burden of responsibility on the physician's shoulders, potential legal issues, and finally, the lack of midwifery authority in providing care at high risk pregnancy. The factors that facilitate humanized birth in a high risk include: the sharing of decision making and other various responsibilities between the physicians and the women; being caring; stress management, and the fact that the evolution of a better relationship and communication between the health professional and the patient will lead to a stress

  4. Selection of common bean lines with high grain yield and high grain calcium and iron concentrations

    Directory of Open Access Journals (Sweden)

    Nerinéia Dalfollo Ribeiro

    2014-02-01

    Full Text Available Genetic improvement of common bean nutritional quality has advantages in marketing and can contribute to society as a food source. The objective of this study was to evaluate the genetic variability for grain yield, calcium and iron concentrations in grains of inbred common bean lines obtained by different breeding methods. For this, 136 F7 inbred lines were obtained using the Pedigree method and 136 F7 inbred lines were obtained using the Single-Seed Descent (SSD method. The lines showed genetic variability for grain yield, and concentrations of calcium and iron independently of the method of advancing segregating populations. The Pedigree method allows obtaining a greater number of lines with high grain yield. Selection using the SSD method allows the identification of a larger number of lines with high concentrations of calcium and iron in grains. Weak negative correlations were found between grain yield and calcium concentration (r = -0.0994 and grain yield and iron concentration (r = -0.3926. Several lines show genetic superiority for grain yield and concentrations of calcium and iron in grains and their selection can result in new common bean cultivars with high nutritional quality.

  5. Risk-Controlled Multiobjective Portfolio Selection Problem Using a Principle of Compromise

    Directory of Open Access Journals (Sweden)

    Takashi Hasuike

    2014-01-01

    Full Text Available This paper proposes a multiobjective portfolio selection problem with most probable random distribution derived from current market data and other random distributions of boom and recession under the risk-controlled parameters determined by an investor. The current market data and information include not only historical data but also interpretations of economists’ oral and linguistic information, and hence, the boom and recession are often caused by these nonnumeric data. Therefore, investors need to consider several situations from most probable condition to boom and recession and to avoid the risk less than the target return in each situation. Furthermore, it is generally difficult to set random distributions of these cases exactly. Therefore, a robust-based approach for portfolio selection problems using the only mean values and variances of securities is proposed as a multiobjective programming problem. In addition, an exact algorithm is developed to obtain an explicit optimal portfolio using a principle of compromise.

  6. Risk by use of hearing protectors--expert programme supports SMEs in appropriate selection and use.

    Science.gov (United States)

    Liedtke, M

    2005-01-01

    Comprehensive protection by use of PPE against the hazards at work requires more than proper selection based on the protection level needed: The PPE user directive (Council Directive 89/656/EEC, Official Journal of the European Communities L 393, 30/12/1989 p.0018 - 0028) requires an assessment of personal protective equipment itself, which has to consider the risks which may be introduced by use of PPE or use of combinations of PPE. As an example risks which may be introduced by use of hearing protectors are described. Assistance in the assessment required by PPE user directive (Council Directive 89/656/EEC, Official Journal of the European Communities L 393, 30/12/1989 p. 0018 - 0028) and in selection and use of hearing protectors with regard to this assessment is presented.

  7. Physical activity and sedentary behavior patterns are associated with selected adolescent health risk behaviors.

    Science.gov (United States)

    Nelson, Melissa C; Gordon-Larsen, Penny

    2006-04-01

    Little is known about how physical activity (PA), sedentary behavior, and various adolescent health risk behaviors are associated. The objective of this study was to examine relationships between PA and sedentary behavior patterns and an array of risk behaviors, including leading causes of adolescent morbidity/mortality. Nationally representative self-reported data were collected (National Longitudinal Study of Adolescent Health; wave I: 1994-1995; II: 1996; N = 11957). Previously developed and validated cluster analyses identified 7 homogeneous groups of adolescents sharing PA and sedentary behaviors. Poisson regression predicted the relative risk of health risk behaviors, other weekly activities, and self-esteem across the 7 PA/sedentary behavior clusters controlling for demographics and socioeconomic status. Main outcome measures were adolescent risk behaviors (eg, truancy, cigarette smoking, sexual intercourse, delinquency), other weekly activities (eg, work, academic performance, sleep), self-esteem. Relative to high television (TV) and video viewers, adolescents in clusters characterized by skating and video gaming, high overall sports and sports participation with parents, using neighborhood recreation center, strict parental control of TV, reporting few activities overall, and being active in school were less likely to participate in a range of risky behaviors, ranging from an adjusted risk ratio (ARR) of 0.42 (outcome: illegal drug use, cluster: strict parental control of TV) to 0.88 (outcome: violence, cluster: sports with parents). Active teens were less likely to have low self-esteem (eg, adolescents engaging in sports with parents, ARR: 0.73) and more likely to have higher grades (eg, active in school, ARR: 1.20). Participation in a range of PA-related behaviors, particularly those characterized by high parental sports/exercise involvement, was associated with favorable adolescent risk profiles. Adolescents with high TV/video viewership were less

  8. Personality and sensation seeking in high-risk sports

    Directory of Open Access Journals (Sweden)

    Polona Klinar

    2017-03-01

    Full Text Available Background: Personality represents a relatively consistent and unique sum of psychological, cognitive and physical characteristics of an individual. Sensation seeking is defined as an action, characterized by the search for different, new, complex and intensive emotions and experiences and preparedness to take physical, social, legal and financial risks in order to achieve these experiences.Objective: We were looking for differences in personality and sensation seeking between high-risk sports athletes and recreational athletes and the correlation between one's purpose to participate in high-risk sports and actual participation.Method: The data was acquired using three different questionnaires: Sensation Seeking Scale (forms SSS - V and SSS - VI and the Big Five Questionnaire. The sample consisted of 76 high-risk sports athletes and 51 recreational athletes. Data was analyzed using the SPSS statistical program.Results: The results were unexpected because we noticed differences between the two groups in which recreational athletes received higher results, especially in openness. Mostly results from such research show the converse - athletes of high-risk sports are more open. We did not find any difference between the two groups in sensation seeking. We found some correlations between personality traits and factors of Sensation Seeking Scale (SSS - V and SSS - VI. Openness and the Thrill and adventure seeking factor correlated in both versions of SSS.Conclusions: We conclude that high-risk sports athletes differ from recreational athletes, especially in openness. Also, we can confirm that both used versions of SSS are equally effective for analyzing sensation seeking.

  9. Widespread signatures of positive selection in common risk alleles associated to autism spectrum disorder.

    Directory of Open Access Journals (Sweden)

    Renato Polimanti

    2017-02-01

    Full Text Available The human brain is the outcome of innumerable evolutionary processes; the systems genetics of psychiatric disorders could bear their signatures. On this basis, we analyzed five psychiatric disorders, attention deficit hyperactivity disorder, autism spectrum disorder (ASD, bipolar disorder, major depressive disorder, and schizophrenia (SCZ, using GWAS summary statistics from the Psychiatric Genomics Consortium. Machine learning-derived scores were used to investigate two natural-selection scenarios: complete selection (loci where a selected allele reached fixation and incomplete selection (loci where a selected allele has not yet reached fixation. ASD GWAS results positively correlated with incomplete-selection (p = 3.53*10-4. Variants with ASD GWAS p<0.1 were shown to have a 19%-increased probability to be in the top-5% for incomplete-selection score (OR = 1.19, 95%CI = 1.11-1.8, p = 9.56*10-7. Investigating the effect directions of minor alleles, we observed an enrichment for positive associations in SNPs with ASD GWAS p<0.1 and top-5% incomplete-selection score (permutation p<10-4. Considering the set of these ASD-positive-associated variants, we observed gene-expression enrichments for brain and pituitary tissues (p = 2.3*10-5 and p = 3*10-5, respectively and 53 gene ontology (GO enrichments, such as nervous system development (GO:0007399, p = 7.57*10-12, synapse organization (GO:0050808, p = 8.29*10-7, and axon guidance (GO:0007411, p = 1.81*10-7. Previous genetic studies demonstrated that ASD positively correlates with childhood intelligence, college completion, and years of schooling. Accordingly, we hypothesize that certain ASD risk alleles were under positive selection during human evolution due to their involvement in neurogenesis and cognitive ability.

  10. Selected Risk Behaviour at the Secondary Schools in the Region of Domažlice

    OpenAIRE

    Černá, Pavlína

    2011-01-01

    The topic of this bachelor thesis is ?Selected Risky Behaviour at the Secondary Schools in the Region of Domažlice?. Risky behaviour is a phenomenon threatening societies across all cultures. Its negative consequences can be intensified even more if it occurs at the adolescent age. Healthy development of adolescents is at risk under its influence. It affects the biological, psychological and social features not only at the time when the adolescent behaves risky but also in future when the ind...

  11. Identification of high risk metropolitan intersection sites in Perth, Australia.

    Science.gov (United States)

    Hobday, Michelle; Chow, Kyle; Meuleners, Lynn; Argus, Fritha

    2017-09-01

    As convergence points for road users approaching from multiple directions, intersections have more opportunities for conflicts, thus higher crash risk than other parts of the road network. Given the limited resources available for road safety, it is important to identify high risk intersections so that they can be prioritised for infrastructure improvement. This study used a three-stage approach to identify intersections in Perth, Western Australia: using Road Trauma Risk Analysis, then Comparative Safety Performance Analysis and finally ranking the intersections by the KSI (Killed and Serious Injury) metric. These methodologies were developed by Main Roads Western Australia. Crash data from 2011 to 2015 were used in the analyses. The results identify the top high risk intersections for each intersection type (by speed environment and control type). Recommendations are made for extensions to this process to improve identification of high risk intersections, and the use of a taxonomy to identify candidate treatments. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  12. Feature selection for high-dimensional integrated data

    KAUST Repository

    Zheng, Charles

    2012-04-26

    Motivated by the problem of identifying correlations between genes or features of two related biological systems, we propose a model of feature selection in which only a subset of the predictors Xt are dependent on the multidimensional variate Y, and the remainder of the predictors constitute a “noise set” Xu independent of Y. Using Monte Carlo simulations, we investigated the relative performance of two methods: thresholding and singular-value decomposition, in combination with stochastic optimization to determine “empirical bounds” on the small-sample accuracy of an asymptotic approximation. We demonstrate utility of the thresholding and SVD feature selection methods to with respect to a recent infant intestinal gene expression and metagenomics dataset.

  13. Emotional Intelligence and Identity Style as Risk Factors for High-Risk Behavior in Prisoners: The Mediating Role of Resiliency and Social Adjustment

    Directory of Open Access Journals (Sweden)

    Maktabi

    2016-02-01

    Full Text Available Background A motivation for the intense scientific interest in high-risk behaviors is to do with firmly held belief that behaviors such as substance abuse and delinquency have ubiquitous, catastrophic outcomes. Objectives The current study aimed to examine a model of risk factors for high-risk behaviors in prisoners. It was hypothesized that emotional intelligence and identity style have an indirect effect on high-risk behaviors via the mediating role of social adjustment and resiliency. Materials and Methods The sample consisted of 293 prisoners that were selected via simple random sampling and participated in this research by completing Schutte’s emotional intelligence scale, Berzonsky identity style inventory, social adjustment scale, Conner-Davidson’s resilience scale, and high risk behavior scale; all these instruments are reliable and have been validated. Structural equation modeling (SEM through SPSS 20 and AMOS 20 were used for data analysis. Results The results suggested that the model had good fit (root mean square of approximation = 0.07, comparative fit index = 0.95, normed fit index = 0.91, goodness of fit index =0.93 with the data. Accordingly, the indirect effect of resiliency on high-risk behavior via social adjustment and resiliency, and the indirect effect of identity style on high-risk behavior via emotional intelligence and resiliency were approved. Conclusions Our findings suggest the importance of high-risk behaviors in terms of etiological pathways, maintenance process and treatment interventions.

  14. Recording of risk-factors and lifestyle counselling in patients at high risk for cardiovascular diseases in European primary care.

    NARCIS (Netherlands)

    Ludt, S.; Petek, D.; Laux, G.; Lieshout, J. van; Campbell, S.M.; Kunzi, B.; Glehr, M.; Wensing, M.J.

    2012-01-01

    BACKGROUND: Detection and registration of high risk for cardiovascular diseases (CVD) by assessing individual's absolute cardiovascular risk is recommended in clinical guidelines. Effective interventions to reduce cardiovascular risk are available, but not optimally implemented. The aim of this

  15. Design of a high activity and selectivity alcohol catalyst

    Energy Technology Data Exchange (ETDEWEB)

    Foley, H.C.; Mills, G.A.

    1992-11-30

    Efforts to synthesize bimetallic cluster-derived Rh-Mo catalysts for CO and CO[sub 2] hydrogenation to preferentially produce oxygenates. The rhodium-molybdenum cluster, (PPh[sub 3])[sub 2]RhMO(CO)([mu]-CO)[sub 2]Cp, was employed as a precursor to alumina- and silica-supported catalysts which were in CO hydrogenation. When compared to catalysts made from the distinct organometallic complexes, RhH(CO)(PPh[sub 3])[sub 3] and [MO(CO)[sub 3]Cp][sub 2], the catalysts derived from a binuclear precursor show higher activities for CO hydrogenation and superior selectivities towards oxygenates, namely, methanol, dimethyl ether and ethanol. Their product distributions depend on the support. Fourier transform infrared spectroscopy studies indicate that CO chemisorbs on cluster-derived catalysts as gem-dicarbonyls while it is chemisorbed only in the linear-carbonyl configuration on catalysts made from separate rhodium and molybdenum complexes. The particular oxygenate selectivity of the cluster-derived catalysts may be correlated to the strong electronic interaction between Rh and Mo. Carbon dioxide hydrogenation has also been carried out on the catalysts mentioned above. Again, the cluster-derived catalysts show higher oxygenate selectivities. Finally, the catalysts were studied with regard to both CO and CO[sub 2] hydrogenation kinetics, apparent activation energies inferred.

  16. Regional Prefrontal Cortex Gray Matter Volumes in Youth at Familial Risk for Schizophrenia from the Harvard Adolescent High Risk Study

    Science.gov (United States)

    Rosso, Isabelle M.; Makris, Nikos; Thermenos, Heidi W.; Hodge, Steven M.; Brown, Ariel; Kennedy, David; Caviness, Verne S.; Faraone, Stephen V.; Tsuang, Ming T.; Seidman, Larry J.

    2010-01-01

    Background Regional prefrontal cortex gray matter reductions have been identified in schizophrenia, likely reflecting a combination of genetic vulnerability and disease effects. Few morphometric studies to date have examined regional prefrontal abnormalities in non-psychotic biological relatives who have not passed through the age range of peak risk for onset of psychosis. We conducted a region-of-interest morphometric study of prefrontal subregions in adolescent and young adult relatives of schizophrenia patients. Methods Twenty-seven familial high-risk (FHR) first-degree relatives of schizophrenia patients and forty-eight control subjects without a family history of psychosis (ages 13–28) underwent high-resolution magnetic resonance imaging at 1.5 Tesla. The prefrontal cortex was parcellated into polar, dorsolateral, ventrolateral, ventromedial and orbital subregions. The Chapman scales measured subpsychotic symptoms. General linear models examined associations of prefrontal subregion volumes with familial risk and subpsychotic symptoms. Results FHR subjects had significantly reduced bilateral ventromedial prefrontal and frontal pole gray matter volumes compared with controls. Ventromedial volume was significantly negatively correlated with magical ideation and anhedonia scores in FHR subjects. Conclusions Selective, regional prefrontal gray matter reductions may differentially mark genetic vulnerability and early symptom processes among non-psychotic young adults at familial risk for schizophrenia. PMID:20705433

  17. Evolutionary ecology of human papillomavirus: trade-offs, coexistence, and origins of high-risk and low-risk types.

    Science.gov (United States)

    Orlando, Paul A; Gatenby, Robert A; Giuliano, Anna R; Brown, Joel S

    2012-01-15

    We address the ecological and evolutionary dynamics of human papillomavirus (HPV) that lead to the dichotomy between high-risk (HR) and low-risk (LR) types. We hypothesize that HPV faces an evolutionary tradeoff between persistence and per-contact transmission probability. High virion production enhances transmissibility but also provokes an immune response leading to clearance and limited persistence. Alternatively, low virion production increases persistence at the cost of diminished transmission probability per sexual contact. We propose that LR HPV types use the former strategy and that HR types use the latter. Sexual behaviors in a host population determine the success of each strategy. We develop an evolutionary model of HPV epidemiology, which includes host sexual behavior, and we find evolutionarily stable strategies of HPV. A slow turnover of sexual partners favors HR HPV, whereas high frequency of partner turnover selects for LR. When both sexual behaviors exist as subcultures in a population, disruptive selection can result in the coevolution and ecological coexistence of both HR and LR HPV types. Our results indicate that the elimination of HR HPV through vaccines may alter the evolutionary trajectory of the remaining types and promote evolution of new HR HPV types.

  18. Selection of a tool to decision making for site selection for high level waste

    Directory of Open Access Journals (Sweden)

    Guiller Madeira Jonni

    2016-01-01

    Full Text Available The aim of this paper is to create a panel comparing some of the key decision-making support tools used in situations with the characteristics of the problem of selecting suitable areas for constructing a final deep geologic repository. The tools addressed in this work are also well known and with easy implementation. The decision-making process in matters of this kind is, in general, complex due to its multicriteria nature and the conflicting opinions of various stakeholders. Thus, a comprehensive study was performed with the literature in this subject, specifically in documents of the International Atomic Energy Agency (IAEA, regarding the importance of the criteria involved in the decision-making process. Therefore, we highlighted six judgment attributes for selecting a decision support tool, suitable for the problem. For this study, we have selected the following multicriteria tools: AHP, Delphi, Brainstorm, Nominal Group Technique and AHP-Delphi. Finally, the AHP-Delphi method has demonstrated to be more appropriate for managing the inherent multiple attributes to the problem proposed.

  19. The Effect of Premarital Sex on Sexually Transmitted Infections (STIs) and High Risk Behaviors in Women

    OpenAIRE

    Ghebremichael, Musie S; Finkelman, Matthew D.

    2013-01-01

    This research aimed to study the effect of premarital sex on sexually transmitted infections (STIs) and high risk behaviors among women in sub-Saharan Africa. It included 1393 women randomly selected from the Moshi urban district of northern Tanzania. Participants’ demographic and socio-demographic characteristics, alcohol use, condom use, number of partners, symptoms of STIs and age at first sex and marriage were obtained. Moreover, blood and urine samples were tested for HIV-1, HSV-2, syphi...

  20. Risk prediction models for selection of lung cancer screening candidates: A retrospective validation study.

    Directory of Open Access Journals (Sweden)

    Kevin Ten Haaf

    2017-04-01

    Full Text Available Selection of candidates for lung cancer screening based on individual risk has been proposed as an alternative to criteria based on age and cumulative smoking exposure (pack-years. Nine previously established risk models were assessed for their ability to identify those most likely to develop or die from lung cancer. All models considered age and various aspects of smoking exposure (smoking status, smoking duration, cigarettes per day, pack-years smoked, time since smoking cessation as risk predictors. In addition, some models considered factors such as gender, race, ethnicity, education, body mass index, chronic obstructive pulmonary disease, emphysema, personal history of cancer, personal history of pneumonia, and family history of lung cancer.Retrospective analyses were performed on 53,452 National Lung Screening Trial (NLST participants (1,925 lung cancer cases and 884 lung cancer deaths and 80,672 Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO ever-smoking participants (1,463 lung cancer cases and 915 lung cancer deaths. Six-year lung cancer incidence and mortality risk predictions were assessed for (1 calibration (graphically by comparing the agreement between the predicted and the observed risks, (2 discrimination (area under the receiver operating characteristic curve [AUC] between individuals with and without lung cancer (death, and (3 clinical usefulness (net benefit in decision curve analysis by identifying risk thresholds at which applying risk-based eligibility would improve lung cancer screening efficacy. To further assess performance, risk model sensitivities and specificities in the PLCO were compared to those based on the NLST eligibility criteria. Calibration was satisfactory, but discrimination ranged widely (AUCs from 0.61 to 0.81. The models outperformed the NLST eligibility criteria over a substantial range of risk thresholds in decision curve analysis, with a higher sensitivity for all models and a

  1. Low Cost High Performance Nanostructured Spectrally Selective Coating

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Sungho [Univ. of California, San Diego, CA (United States)

    2017-04-05

    Sunlight absorbing coating is a key enabling technology to achieve high-temperature high-efficiency concentrating solar power operation. A high-performance solar absorbing material must simultaneously meet all the following three stringent requirements: high thermal efficiency (usually measured by figure of merit), high-temperature durability, and oxidation resistance. The objective of this research is to employ a highly scalable process to fabricate and coat black oxide nanoparticles onto solar absorber surface to achieve ultra-high thermal efficiency. Black oxide nanoparticles have been synthesized using a facile process and coated onto absorber metal surface. The material composition, size distribution and morphology of the nanoparticle are guided by numeric modeling. Optical and thermal properties have been both modeled and measured. High temperature durability has been achieved by using nanocomposites and high temperature annealing. Mechanical durability on thermal cycling have also been investigated and optimized. This technology is promising for commercial applications in next-generation high-temperature concentration solar power (CSP) plants.

  2. Biological effects of static magnetic fields: a selective review with emphasis on risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Easterly, C. E.

    1982-04-01

    Rather than focusing on literature per se, the current study determines the status of magnetic field information that is applicable to risk assessment. Hence, an attempt is made to identify both the literature that is useful to the goal of risk assessment and a framework within which risk assessment methodologies can be derived. From this selected review, it is concluded that three areas exist for which adequate information can be found to begin modelling: disease induction, reproduction and development, and cardiovascular response. The first two are supported by a combination of positive and negative findings and the last by a calculational technique which utilizes the physically well-known principle of flow retardation for a conducting fluid moving through a magnetic field.

  3. High wall shear stress and high-risk plaque: an emerging concept.

    Science.gov (United States)

    Eshtehardi, Parham; Brown, Adam J; Bhargava, Ankit; Costopoulos, Charis; Hung, Olivia Y; Corban, Michel T; Hosseini, Hossein; Gogas, Bill D; Giddens, Don P; Samady, Habib

    2017-07-01

    In recent years, there has been a significant effort to identify high-risk plaques in vivo prior to acute events. While number of imaging modalities have been developed to identify morphologic characteristics of high-risk plaques, prospective natural-history observational studies suggest that vulnerability is not solely dependent on plaque morphology and likely involves additional contributing mechanisms. High wall shear stress (WSS) has recently been proposed as one possible causative factor, promoting the development of high-risk plaques. High WSS has been shown to induce specific changes in endothelial cell behavior, exacerbating inflammation and stimulating progression of the atherosclerotic lipid core. In line with experimental and autopsy studies, several human studies have shown associations between high WSS and known morphological features of high-risk plaques. However, despite increasing evidence, there is still no longitudinal data linking high WSS to clinical events. As the interplay between atherosclerotic plaque, artery, and WSS is highly dynamic, large natural history studies of atherosclerosis that include WSS measurements are now warranted. This review will summarize the available clinical evidence on high WSS as a possible etiological mechanism underlying high-risk plaque development.

  4. Characterization of patients at high risk of melanoma in Austria.

    Science.gov (United States)

    Müller, C; Wendt, J; Rauscher, S; Burgstaller-Muehlbacher, S; Sunder-Plassmann, R; Scheurecker, C; Richtig, E; Fae, I; Fischer, G; Pehamberger, H; Okamoto, I

    2016-06-01

    Risk of melanoma is determined by genetic and exogenous factors. Only a few studies have included both characteristics in a comprehensive multivariable analysis. To find determinants of patients at high risk of melanoma in Austria, including phenotype, genotype and lifestyle characteristics in comprehensive analyses. In total, 1668 patients with melanoma from the M3 case-control study were studied. Overall, 567 participants were sequenced for CDKN2A, 232 for CDK4, 123 for MITF encoding the variant E318K and 964 for MC1R. Patients with melanoma with a positive family history (n = 190, 11·6%), multiple primary melanomas (n = 261, 15·7%) and younger age (risk. All other patients with melanoma were defined as the reference group. We found significant differences between those two groups and between the high-risk subgroups (positive family history, multiple primary melanomas and younger age). Pigmentation phenotype was associated with the high-risk group in general (childhood freckling, odds ratio 1·46, P = 0·007; blond/reddish hair colour, odds ratio 1·43, P = 0·011). Patients with a positive family history and patients with early-onset disease were similar regarding both their phenotypic characteristics and external factors. Established high-risk mutations in CDKN2A were found in cases with a positive family history (n = 12) or multiple melanomas (n = 2). Moreover, we found three patients carrying the MITF p.E318K variant, two with a CDK4 variant and seven with nonsynonymous MC1R variants with undescribed biological significance, of which four were predicted as damaging. Austrian patients could represent a reservoir for novel genetic variants. Further investigation of populations in Central and Eastern Europe might reveal more novel and disease-relevant variants. © 2016 British Association of Dermatologists.

  5. Relationship Between Parent Child– Rearing Practices and High Risk Behavior on Basis of Cloninger's Scale

    Directory of Open Access Journals (Sweden)

    E Zarei

    2010-09-01

    Full Text Available Introduction: Family is the initial nurture environment of a child that affects future behavior. The types of rewards and punishments in the initial stages of life affect future behavior. The aim of this study was to study the relationship between parent child– rearing practices and high risk behavior on basis of Cloninger's scale in Bandarabbas city. Methods: The study was a descriptive correlation study. In this study permissiveness, democratic and authority parent child– rearing practices were measured with Bamerind parent child– rearing practices inventory and Cloninger's high risk behavior scale. The population under study included adolescents aged 11-18 years and their parents. A total of 150 subjects were selected randomly. Results: The results of analysis showed that there was a significant correlation between parent child– rearing practices and subscale avoid of pathology in high risk behavior ( P value =0.035. The relation between parent child– rearing practices and authority- logical and subscale innovation in high risk behavior was also significant (P=0.022. The relation between subscale authority- logical parent child– rearing practices and subscale social reward in high risk behavior with P value of 0.037 was significant. Conclusion: There is a significant relationship between parent child– rearing practices and helpful, harmful or destructive behavior and therefore parent's role is very important. Parent's knowledge and family trainings for rearing health are very important.

  6. Risk factors for the occurrence and spread of Highly Pathogenic ...

    African Journals Online (AJOL)

    Outbreaks of Highly Pathogenic Avian Influenza (HPAI) subtype H5N1 occurred previously for three consecutive years, 2006, 2007 and 2008 in Kano State, Nigeria, causing heavy economic losses to farmers and the government. It was against this background that risk factors for the occurrence and spread of HPAI H5N1 ...

  7. Health risk behaviours of high school learners and their perceptions ...

    African Journals Online (AJOL)

    Learners reported a high prevalence of health risk behaviours: 65% for alcohol use, 57% for sexual activity, 39% for tobacco use and 15% for drug use. 2. The predominant pattern of substance use ..... are predominantly from the lower and middle socio-economic groups. Learners generally do not know the family income.

  8. an assessment of high risk sexual behaviour and hiv transmission ...

    African Journals Online (AJOL)

    We did not also encounter any lesbian sexual orientation in this study. The distribution of. HRSB amongst the migrant oil wOrkers showed that the commonest variety was bisexuality (closet homosexuality) with 10(43.5%) followed by high-risk sexual behaviour 7(30.4%), while the least common was multiplicity of sexual ...

  9. High risk bladder cancer : current management and survival

    NARCIS (Netherlands)

    Leliveld-Kors, Anna; Bastiaannet, Esther; Doornweerd, Benjamin H J; Schaapveld, Michael; de Jong, Igle J

    2011-01-01

    Purpose: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC) in the Comprehensive Cancer Center North-Netherlands (CCCN) and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. Materials and

  10. Cyberbullying and Its Risk Factors among Chinese High School Students

    Science.gov (United States)

    Zhou, Zongkui; Tang, Hanying; Tian, Yuan; Wei, Hua; Zhang, Fengjuan; Morrison, Chelsey M.

    2013-01-01

    Cyberbullying has become a common occurrence among adolescents worldwide; however, it has yet to receive adequate scholarly attention in China, especially in the mainland. The present study investigated the epidemiological characteristics and risk factors of cyberbullying, utilizing a sample of 1,438 high school students from central China.…

  11. Sensation seeking in males involved in recreational high risk sports

    Directory of Open Access Journals (Sweden)

    M Guszkowska

    2010-09-01

    Full Text Available The study examined sensation seeking intensity level in males involved in recreational high risk sports and investigated whether its level depends on type of sport practised. Additionally, in case of parachutists, sport experience of study participants were scrutinised with regard to its possible impact on the level of sensation seeking.The research involved 217 males aged 17 to 45, practising recreational high risk sports, namely: parachuting (n=98; wakeboarding (n=30; snowboarding (n=30; scuba diving (n=22; alpinism (n=20; paragliding (n=17. The control group included 54 men not involved in sports. Polish version of Sensation Seeking Scale (SSS-IV of Zuckerman was applied.Results show, that high risk sports males are featured by stronger need of sensations in comparison to control group and this concerned all but one aspect of sensation seeking variable. The only exception was the need of intellectual stimulation. Except from the thrill and adventure seeking dimension, type of sport may also be an important determinant of sensation seeking. Men practising snowboard and wakeboard presented stronger need for sensations, especially in the dimension of experience seeking, disinhibition and boredom susceptibility. Sport experience (number of jumps in parachuting did not differentiate the level of sensation seeking among investigated parachutists. Population of sport high risk male takers was not homogeneous, and therefore in future research one should analyse specific sports (or events in a certain sport separately.

  12. Chorangioma of Placenta with High Risk Pregnancy: A Case Series

    African Journals Online (AJOL)

    Chorangioma of Placenta with High Risk Pregnancy: A Case Series. Uma S Andola, Shabnam Karangadan1, Sainath K Andola1, Rajashekhar Jewargikar1. Department of Obstetrics and Gynecology, 1Resident, Professor and Head of Department, Professor, Department of Pathology, Mahadevappa. Rampure Medical ...

  13. Monitoring paneer for Listeria monocytogenes - A high risk food ...

    African Journals Online (AJOL)

    A multiplex polymerase chain reaction (PCR) assay was developed and applied to spiked and natural paneer samples to detect Listeria monocytogenes, a high risk food pathogen. The sensitivity of the assay on L. monocytogenes spiked paneer samples was 104 cells prior to enrichment, was improved to 103 cells after 4 h ...

  14. anaesthetic challenges in a high risk parturient with myasthenia ...

    African Journals Online (AJOL)

    10 October 2013. ANAESTHETIC CHALLENGES IN A HIGH RISK PARTURIENT WITH MYASTHENIA GRAVIS UNDERGOING ... to highlight some of the challenges, the management and the lessons learnt during the management of this patient. .... be more appropriate if there is bulbar involvement, or severe respiratory ...

  15. High Risk Drinking among Non-Affiliated College Students

    Science.gov (United States)

    Smith, Margaret; Finneran, John; Droppa, Marj

    2014-01-01

    This study investigated the high risk drinking practices of unaffiliated college students who are not involved in formal athletics, fraternities, or sororities. Using a qualitative research design, the investigators interviewed students at a northeast public college in fall 2010 to learn about unaffiliated students' drinking experiences and their…

  16. Hypertensive patients and diabetes : A high-risk population

    NARCIS (Netherlands)

    Bilo, HJG; Gans, ROB

    1998-01-01

    Rising worldwide rates of diabetes mellitus heighten the need to maintain adequate metabolic control in diabetic patients and to control for other cardiovascular risk factors, such as lipid profile disturbances, high blood pressure, and smoking habits. This is especially the case in diabetic

  17. Risk management practices of high school sport coaches and ...

    African Journals Online (AJOL)

    The purpose of this study was to identify the key safety dimensions of school sport, and to assess the risk management practices implemented by coaches and administrators at high schools. The aim was also to highlight the chief problems associated with safety in sport and to develop strategies to protect learners.

  18. Drug response prediction in high-risk multiple myeloma

    DEFF Research Database (Denmark)

    Vangsted, A J; Helm-Petersen, S; Cowland, J B

    2018-01-01

    A Drug Response Prediction (DRP) score was developed based on gene expression profiling (GEP) from cell lines and tumor samples. Twenty percent of high-risk patients by GEP70 treated in Total Therapy 2 and 3A have a progression-free survival (PFS) of more than 10years. We used available GEP data ...

  19. Detection of Patients at High Risk of Medication Errors

    DEFF Research Database (Denmark)

    Sædder, Eva Aggerholm; Lisby, Marianne; Nielsen, Lars Peter

    2016-01-01

    Medication errors (MEs) are preventable and can result in patient harm and increased expenses in the healthcare system in terms of hospitalization, prolonged hospitalizations and even death. We aimed to develop a screening tool to detect acutely admitted patients at low or high risk of MEs...

  20. Identifying patients at high risk for obstructive sleep apnoea ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalized patients at risk for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to determine the factors associated with high ...

  1. Disease Risk Assessments Involving Companion Animals: an Overview for 15 Selected Pathogens Taking a European Perspective.

    Science.gov (United States)

    Rijks, J M; Cito, F; Cunningham, A A; Rantsios, A T; Giovannini, A

    2016-07-01

    Prioritization of companion animal transmissible diseases was performed by the Companion Animals multisectoriaL interprofessionaL Interdisciplinary Strategic Think tank On zoonoses (CALLISTO) project. The project considered diseases occurring in domesticated species commonly kept as pets, such as dogs and cats, but also included diseases occurring in captive wild animals and production animal species. The prioritization process led to the selection of 15 diseases of prime public health relevance, agricultural economic importance, or both. An analysis was made of the current knowledge on the risk of occurrence and transmission of these diseases among companion animals, and from companion animals to man (zoonoses) or to livestock. The literature was scanned for risk assessments for these diseases. Studies were classified as import risk assessments (IRAs) or risk factor analyses (RFAs) in endemic areas. For those pathogens that are absent from Europe, only IRAs were considered; for pathogens present throughout Europe, only RFAs were considered. IRAs were identified for seven of the eight diseases totally or partially absent from Europe. IRAs for classical rabies and alveolar echinococcosis found an increased risk for introduction of the pathogen into officially disease-free areas as a consequence of abandoning national rules and adopting the harmonized EU rules for pet travel. IRAs for leishmaniosis focused on risk associated with the presence of persistently infected dogs in new geographical areas, taking into consideration the risk of disease establishment should a competent vector arise. IRAs for Crimean-Congo haemorrhagic fever and West Nile fever indicated that the likelihood of introduction via companion animals was low. IRAs for bluetongue paid no attention to the risk of introduction via companion animals, which was also the case for IRAs for foot-and-mouth disease, the only disease considered to be absent from Europe. RFAs dealing with the risk factors for

  2. The National Cross-Site Evaluation of High-Risk Youth Programs: Understanding Risk, Protection, and Substance Use among High-Risk Youth. Monograph Series.

    Science.gov (United States)

    Springer, J. Fred; Sambrano, Soledad; Sale, Elizabeth; Kasim, Rafa; Hermann, Jack

    This document summarizes findings from the Center for Substance Abuse Prevention's National Cross-Site Evaluation of High-Risk Youth Programs, which identified characteristics associated with strong substance abuse prevention outcomes in 48 prevention programs. Major findings include: as youth age, levels of risk and protection shift considerably,…

  3. Antiplatelet therapy in populations at high risk of atherothrombosis.

    Science.gov (United States)

    Faxon, David P; Nesto, Richard W

    2006-05-01

    Atherothrombosis is the most common cause of an acute ischemic event. Antiplatelet agents form the cornerstone of atherothrombosis prevention. The purpose of this article is to review the use of antiplatelet agents in patients that are at particularly high risk of atherothrombotic events. To undertake this review, we searched the literature to identify key studies on the use of antiplatelet agents in this group of patients. Antiplatelet agents, such as aspirin and clopidogrel, play a fundamental role in the treatment and management of secondary thrombotic events. The routine use of aspirin is recommended, as it has been shown to reduce the risk of thrombotic events by approximately 25%. Additional benefit has been demonstrated with clopidogrel, both as a monotherapy and in combination with aspirin. In the CAPRIE trial, 19,185 patients with atherosclerotic vascular disease were randomized to receive clopidogrel (75 mg/day) or aspirin (325 mg/day) for a mean duration of follow-up of 1.91 years. Clopidogrel provided an additional 8.7% relative risk reduction in the primary composite endpoint of ischemic stroke, myocardial infraction or vascular death compared with aspirin. In the CURE trial, the addition of clopidogrel to background aspirin was associated with a 20% relative risk reduction in a composite of death from cardiovascular causes, nonfatal myocardial infarction or stroke compared with aspirin alone. In patients undergoing PCI as part of the PCI-CURE substudy, clopidogrel was associated with a 30% relative reduction in the incidence of cardiovascular events in the first 30 days after intervention compared with aspirin. The benefits of antiplatelet therapy continue to be investigated. Whether dual antiplatelet therapy is superior to aspirin monotherapy for high-risk primary prevention is unknown. The ongoing CHARISMA trial aims to determine the relative efficacies of aspirin monotherapy and aspirin/clopidogrel combination therapy in a broad range of high-risk

  4. Lifecycle Prognostics Architecture for Selected High-Cost Active Components

    Energy Technology Data Exchange (ETDEWEB)

    N. Lybeck; B. Pham; M. Tawfik; J. B. Coble; R. M. Meyer; P. Ramuhalli; L. J. Bond

    2011-08-01

    There are an extensive body of knowledge and some commercial products available for calculating prognostics, remaining useful life, and damage index parameters. The application of these technologies within the nuclear power community is still in its infancy. Online monitoring and condition-based maintenance is seeing increasing acceptance and deployment, and these activities provide the technological bases for expanding to add predictive/prognostics capabilities. In looking to deploy prognostics there are three key aspects of systems that are presented and discussed: (1) component/system/structure selection, (2) prognostic algorithms, and (3) prognostics architectures. Criteria are presented for component selection: feasibility, failure probability, consequences of failure, and benefits of the prognostics and health management (PHM) system. The basis and methods commonly used for prognostics algorithms are reviewed and summarized. Criteria for evaluating PHM architectures are presented: open, modular architecture; platform independence; graphical user interface for system development and/or results viewing; web enabled tools; scalability; and standards compatibility. Thirteen software products were identified and discussed in the context of being potentially useful for deployment in a PHM program applied to systems in a nuclear power plant (NPP). These products were evaluated by using information available from company websites, product brochures, fact sheets, scholarly publications, and direct communication with vendors. The thirteen products were classified into four groups of software: (1) research tools, (2) PHM system development tools, (3) deployable architectures, and (4) peripheral tools. Eight software tools fell into the deployable architectures category. Of those eight, only two employ all six modules of a full PHM system. Five systems did not offer prognostic estimates, and one system employed the full health monitoring suite but lacked operations and

  5. Selection of local extremophile lactic acid bacteria with high capacity ...

    African Journals Online (AJOL)

    This study is related to the isolation and identification of strains of local thermophilic lactic acid bacteria belonging to the species, Streptococcus thermophilus and Lactobacillus bulgaricus. These bacteria can exist under extreme conditions of the digestive tract (acidity and high concentration of bile salts) and have a high ...

  6. An Integrated Model for Supplier Selection for a High-Tech Manufacturer

    Science.gov (United States)

    Lee, Amy H. I.; Kang, He-Yau; Lin, Chun-Yu

    2011-11-01

    Global competitiveness has become the biggest concern of manufacturing companies, especially in high-tech industries. Improving competitive edges in an environment with rapidly changing technological innovations and dynamic customer needs is essential for a firm to survive and to acquire a decent profit. Thus, the introduction of successful new products is a source of new sales and profits and is a necessity in the intense competitive international market. After a product is developed, a firm needs the cooperation of upstream suppliers to provide satisfactory components and parts for manufacturing final products. Therefore, the selection of suitable suppliers has also become a very important decision. In this study, an analytical approach is proposed to select the most appropriate critical-part suppliers in order to maintain a high reliability of the supply chain. A fuzzy analytic network process (FANP) model, which incorporates the benefits, opportunities, costs and risks (BOCR) concept, is constructed to evaluate various aspects of suppliers. The proposed model is adopted in a TFT-LCD manufacturer in Taiwan in evaluating the expected performance of suppliers with respect to each important factor, and an overall ranking of the suppliers can be generated as a result.

  7. Female infertility in India: Causes, treatment and impairment of fertility in selected districts with high prevalence

    Directory of Open Access Journals (Sweden)

    Shraboni Patra

    2017-01-01

    Full Text Available Although the ‘universal access to sexual and reproductive health care’ has received priority in the SDG‐3, the rural women experiencing infertility problem in India are unable to access and afford quality reproductive health care. The study investigates the present infertility situation, with a focus on risk factors, treatment seeking for infertility, and impact of infertility on fertility in India and its districts with high infertility prevalence. The DLHS‐3 data is used. Top fifteen districts with high infertility prevalence are selected for analysis. Simple bivariate and multivariate techniques are applied. In India, the prevalence of ever‐experienced primary, secondary, and current infertility is 6.6%, 2.1% and 4.6% respectively, whereas, in the selected districts, the estimates for the same indicators are 15%, 3.1%, and 5% respectively. A higher prevalence of reported symptoms of RTIs/STIs and menstrual problems is observed among women who ever had infertility. Treatment seeking for infertility is low in Korba and Koryia. The MCEB is less among women who ever had experienced infertility. The prevalence of ever‐experienced infertility and current infertility is considerably higher among women from socio‐economically disadvantaged sections. Awareness of RTIs, STIs, and menstrual problems, and preventive care can reduce infertility among rural women.

  8. 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

  9. Scapular muscle activity from selected strengthening exercises performed at low and high intensity

    DEFF Research Database (Denmark)

    Andersen, Christoffer H; Zebis, Mette K; Saervoll, Charlotte

    2012-01-01

    practical implications for exercise prescription for optimal shoulder function. For example, both workers with neck pain and athletes at risk of shoulder impingement (e.g. overhead sports) should perform push-up plus and press-up to specifically strengthen the serratus anterior and lower trapezius.......A balanced level of muscle strength between the different parts of the scapular muscles is important to optimize performance and prevent injuries in athletes. Emerging evidence suggests that many athletes lack balanced strength in the scapular muscles. Evidence based recommendations are important...... for proper exercise prescription. This study determines scapular muscle activity during strengthening exercises for scapular muscles performed at low and high intensities (Borg-CR10 level 3 and 8). Surface electromyography (EMG) from selected scapular muscles was recorded during seven strengthening exercises...

  10. The integrated method to select drilling muds for abnormally high pressure formations

    Science.gov (United States)

    Khorev, V. S.; Dmitriev, A. Yu; Boyko, I. A.; Kayumova, N. S.; Rakhimov, T. R.

    2016-03-01

    The article describes the method for choosing a drilling mud for drilling abnormally high pressure formations. A carefully selected drilling mud formulation would not only enhance an array of interrelated fluid properties, but also minimize the impact on the pay zones when the drill bit first penetrates the pay. To ensure a better assessment of drilling mud impact on the pay zone, it is reasonable to carry out the study focused on the analysis of technological parameters, involving filtration, acid and drilling mud tests, as well as formation damage analysis. This would enable evaluating the degree of mudding off, reservoirs acid fracturing effect and the risks of pipe sticking at significant depth. The article presents the results of the above-described study with regard to the currently used drilling mud and new experimental formulations developed at National Research Tomsk Polytechnic University (Drilling Mud and Cement Slurry Laboratory).

  11. Noria: A Highly Xe-Selective Nanoporous Organic Solid

    Energy Technology Data Exchange (ETDEWEB)

    Patil, Rahul S. [Department of Chemistry, University of Missouri, Columbia Missouri 65211 United States; Fundamental and Computational Science Directorate, Pacific Northwest National Laboratory, Richland Washington 99352 United States; Banerjee, Debasis [Fundamental and Computational Science Directorate, Pacific Northwest National Laboratory, Richland Washington 99352 United States; Simon, Cory M. [Department of Chemical & Biomolecular Engineering, University of California, Berkeley, Berkeley California 94720 United States; Atwood, Jerry L. [Department of Chemistry, University of Missouri, Columbia Missouri 65211 United States; Thallapally, Praveen K. [Fundamental and Computational Science Directorate, Pacific Northwest National Laboratory, Richland Washington 99352 United States

    2016-07-05

    The successful mass-implementation of nuclear energy requires reprocessing of used nuclear fuel (UNF) to mitigate harmful radioactive waste. Volatile radionuclides such as Xe and Kr evolve into off-gas streams of UNF reprocessing facilities in parts per million concentrations; their capture and successive safe handing is essential from a regulatory point of view. As radioactive Xe has a short half-life, this captured Xe could be sold in the chemical market. Energy-intensive, expensive, and hazardous cryogenic distillation is the current benchmark process to capture and separate radioactive Xe and Kr from air. Thus, a cost-effective, alternative technology for the separation of Xe and Kr and their capture from air is of significant importance. Thus far, nanoporous materials, such as aluminosilicate zeolites, metal organic frameworks (MOFs) and porous organic molecules have shown promise for an adsorption-based separation process at room temperature. Herein, we report the selective Xe uptake in a crystalline porous organic oligomeric molecule, noria, and its structural analogue, PgC-noria, under ambient conditions. The selectivity of noria towards Xe arises from its tailored pore size and small cavities, which allows a directed non-bonding interaction of Xe atoms with a large number of carbon atoms of the noria molecular wheel in a confined space.

  12. Aromatic amino acids in high selectivity bismuth(III) recognition.

    Science.gov (United States)

    Ghatak, Sumanta Kumar; Dey, Debarati; Sen, Souvik; Sen, Kamalika

    2013-04-21

    The three aromatic amino acids, tyrosine, tryptophan and phenylalanine, play different physiological roles in life processes. Metal ions capable of binding these amino acids may aid in the reduction of effective concentration of these amino acids in any physiological system. Here we have studied the efficacy of some heavy metals for their complexation with these three amino acids. Bismuth has been found to bind selectively with these aromatic amino acids and this was confirmed using spectrofluorimetric, spectrophotometric and cyclic voltammetric studies. The series of heavy metals has been chosen because each of these metals remains associated with the others at very low concentration levels and Bi(III) is the least toxic amongst the other elements. So, selective recognition for Bi(III) would also mean no response for the other heavy elements if contaminants are present even at low concentration levels. The affinity towards these amino acids has been found to be in the order tryptophan < phenylalanine < tyrosine. The association constants of these amino acids have been calculated using Benesi-Hildebrand equations and the corresponding free energy change has also been calculated. The values of the association constants obtained from BH equations using absorbance values corroborate with the Stern-Volmer constants obtained from fluorimetric studies. The evidence for complexation is also supported by the results of cyclic voltammetry.

  13. 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

  14. Beyond sensation seeking: affect regulation as a framework for predicting risk-taking behaviors in high-risk sport.

    Science.gov (United States)

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-10-01

    Sensation seeking has been widely studied when investigating individual differences in the propensity for taking risks. However, risk taking can serve many different goals beyond the simple management of physiological arousal. The present study is an investigation of affect self-regulation as a predictor of risk-taking behaviors in high-risk sport. Risk-taking behaviors, negative affectivity, escape self-awareness strategy, and sensation seeking data were obtained from 265 high-risk sportsmen. Moderated hierarchical regression analysis revealed significant main and interaction effects of negative affectivity and escape self-awareness strategy in predicting risk-taking behaviors: high-risk sportsmen's negative affectivity leads them to adopt risk-taking behaviors only if they also use escape self-awareness strategy. Furthermore, the affective model remained significant when controlling for sensation seeking. The present study contributes to an in-depth understanding of risk taking in high-risk sport.

  15. Wandering spleen: 'presentation in adolescent with high thrombotic risk'.

    Science.gov (United States)

    Tchidjou, Hyppolite K; Castelluzzo, Maria A; Messia, Virginia; Luciani, Matteo; Monti, Lidia; Grimaldi, Chiara; Bernardi, Stefania; D'Argenio, Patrizia

    2014-07-01

    The term 'wandering spleen' refers to an abnormal hypermobility of the spleen, which may be congenital or acquired. The absence or abnormal laxity of splenic ligaments combined with an abnormally long and mobile vascular pedicle predispose to complications such as torsion of the splenic pedicle, infarction and splenic vein thrombosis. The clinical presentation of such disease is highly variable. In this case, we describe an asymptomatic case of wandering spleen in high thrombotic risk patients with cavernoma of splenic vein and infarction of the spleen. Physical examination was normal except the enlarged and no tender consistency spleen palpable at left iliac fossa. Ultrasonography revealed enlarged spleniform mass below its normal position suggesting vascular impairment and subsequently has been confirmed by colour Doppler ultrasound and computed tomography. The family history was positive for ischemic thrombotic vascular diseases and the screening for thrombotic risk has revealed hyperhomocysteinemia, thrombophilic homozygous gene mutations for factor V (H1299R) and MTHFR (C677T). For high thrombotic risk, prophylaxis postsplenectomy was suggested according to the international recommendations with subcutaneous low molecular weight heparin, associated with a preventive treatment with acetyl salicylic acid and folic acid along with B-vitamin. This case report may be helpful for clinicians involved in the care of splenectomized patients, because it has shown the importance of an appropriate pre and postoperative antithrombotic management to reduce as soon as possible the risk of thrombotic events in such patients after splenectomy.

  16. Case Management Reduces Drinking During Pregnancy among High Risk Women.

    Science.gov (United States)

    May, Philip A; Marais, Anna-Susan; Gossage, J Phillip; Barnard, Ronel; Joubert, Belinda; Cloete, Marise; Hendricks, Natalie; Roux, Sumien; Blom, Annalien; Steenekamp, Jeanetta; Alexander, Theresa; Andreas, Romena; Human, Suzanne; Snell, Cudore; Seedat, Soraya; Parry, Charles C; Kalberg, Wendy O; Buckley, David; Blankenship, Jason

    2013-05-01

    Estimate the efficacy of Case Management (CM) for women at high risk for bearing a child with Fetal Alcohol Spectrum Disorders (FASD). Women were recruited from antenatal clinics and engaged in 18 months of CM. A South African community with a subculture of heavy, regular, weekend, recreational drinking and high documented rates of FASD. Forty-one women who were high risk for bearing a child with FASD. Statistical analysis of trends in drinking and other risk factors. At intake 87.8% were pregnant, most had previous alcohol-exposed pregnancies, most/all of their friends drink alcohol (67.5%), and 50.0% had stressful lives. CM was particularly valuable for pregnant women, as statistically significant reductions in alcohol risk were obtained for them in multiple variables: total drinks on weekends after six months of CM (p = .026) and estimated peak blood alcohol concentration (BAC) at six (p managers reduced maternal drinking at critical times, and therefore, alcohol exposure levels to the fetus.

  17. Analyzing actual risk in malaria-deferred donors through selective serologic testing.

    Science.gov (United States)

    Nguyen, Megan L; Goff, Tami; Gibble, Joan; Steele, Whitney R; Leiby, David A

    2013-08-01

    Approximately 150,000 US blood donors are deferred annually for travel to malaria-endemic areas. However, the majority do not travel to the high-risk areas of Africa associated with transfusion-transmitted malaria (TTM) but visit low-risk areas such as Mexico. This study tests for Plasmodium infection among malaria-deferred donors, particularly those visiting Mexico. Blood donors deferred for malaria risk (travel, residence, or previous infection) provided blood samples and completed a questionnaire. Plasma was tested for Plasmodium antibodies by enzyme immunoassay (EIA); repeat-reactive (RR) samples were considered positive and tested by real-time polymerase chain reaction (PCR). Accepted donors provided background testing data. During 2005 to 2011, a total of 5610 malaria-deferred donors were tested by EIA, including 5412 travel deferrals. Overall, 88 (1.6%) were EIA RR; none were PCR positive. Forty-nine (55.7%) RR donors previously had malaria irrespective of deferral category, including 34 deferred for travel. Among 1121 travelers to Mexico, 90% visited Quintana Roo (no or very low risk), but just 2.2% visited Oaxaca/Chiapas (moderate or high risk). Only two Mexican travelers tested RR; both previously had malaria not acquired in Mexico. Travel to Mexico represents a large percentage of US donors deferred for malaria risk; however, these donors primarily visit no- or very-low-risk areas. No malaria cases acquired in Mexico were identified thereby supporting previous risk estimates. Consideration should be given to allowing blood donations from U.S. donors who travel to Quintana Roo and other low-risk areas in Mexico. A more effective approach to preventing TTM would be to defer all donors with a history of malaria, even if remote. © 2012 American Association of Blood Banks.

  18. Gender, family income, and the risk of mental emotional disorders in selected population

    Directory of Open Access Journals (Sweden)

    Sri Idaiani

    2016-01-01

    National Instituteof Health Research and Development in 2011. There were 1914 subjects out of a total of 2361 subjects.Sample was choosen purposively. The age ranged from 25-65 years. MED was assessed using SelfReporting Questionnaire (SRQ which consisted of 20 questions, and answered the questions themselvesor assisted by an interviewer. MED was indicated if there was at least 6 “yeses”. Statistical analysis wasby Cox regression with constant time using STATA 10.0 version.Results: The proportion of MED was 27.9%. Low rather than high family income subjects had 26% morerisk to be MED [adjusted relative risk (RRa = 1.26; 95% confidence interval (CI = 1.08 – 1.47]. In termsof gender, females had 43% more risk to be MED (RRa = 1.43; 95% CI = 1.22 - 1.68.Conclusion: Low rather than high family income subject had more risk to be MED. (Health ScienceJournal of Indonesia 2015;6:23-28.Keywords: Family income, mental emotional disorders

  19. Selection, resistance risk assessment, and reversion toward susceptibility of pyriproxyfen in Musca domestica L.

    Science.gov (United States)

    Shah, Rizwan Mustafa; Abbas, Naeem; Shad, Sarfraz Ali; Sial, Ashfaq Ahmad

    2015-02-01

    Pyriproxyfen, a juvenile hormone mimic, is an effective larvicide against many pests of veterinary and public health importance. Pyriproxyfen is a biorational insecticide having many environmentally friendly attributes that make it compatible with integrated pest management programs. This experiment was performed for the assessment of resistance evolution and reversion toward susceptibility of Musca domestica to pyriproxyfen. Repeated selection at successive generations resulted in 5.09- and 130-fold increase in lethal concentration 50 (LC50) compared to field and susceptible strain, respectively. A significant decline after 22 generations without selection suggesting resistance to pyriproxyfen was unstable in M. domestica. Realized heritability (h (2)) of resistance to pyriproxyfen was 0.035 in pyriproxyfen-selected strain of M. domestica. The projected rate of resistance development indicated that, if slope = 1.28 and h (2) = 0.035, then 46-21 generations are required for 10-fold increase in LC50 at 50-90 % selection intensity. These findings suggest that a risk for resistance development to pyriproxyfen occurred in M. domestica under continuous selection pressure. Pyriproxyfen susceptibility reversed when its application is ceased for a specified duration.

  20. Bayesian Variable Selection in High-dimensional Applications

    NARCIS (Netherlands)

    V. Rockova (Veronika)

    2013-01-01

    markdownabstract__Abstract__ Advances in research technologies over the past few decades have encouraged the proliferation of massive datasets, revolutionizing statistical perspectives on high-dimensionality. Highthroughput technologies have become pervasive in diverse scientific disciplines

  1. Engineering Data on Selected High Speed Passenger Trucks

    Science.gov (United States)

    1978-07-01

    The purpose of this project is to compile a list of high speed truck engineering parameters for characterization in dynamic performance modeling activities. Data tabulations are supplied for trucks from France, Germany, Italy, England, Japan, U.S.S.R...

  2. System Architecture of Explorer Class Spaceborne Telescopes: A look at Optimization of Cost, Testability, Risk and Operational Duty Cycle from the Perspective of Primary Mirror Material Selection

    Science.gov (United States)

    Hull, Anthony B.; Westerhoff, Thomas

    2015-01-01

    Management of cost and risk have become the key enabling elements for compelling science to be done within Explorer or M-Class Missions. We trace how optimal primary mirror selection may be co-optimized with orbit selection. And then trace the cost and risk implications of selecting a low diffusivity low thermal expansion material for low and medium earth orbits, vs. high diffusivity high thermal expansion materials for the same orbits. We will discuss that ZERODUR®, a material that has been in space for over 30 years, is now available as highly lightweighted open-back mirrors, and the attributes of these mirrors in spaceborne optical telescope assemblies. Lightweight ZERODUR® solutions are practical from mirrors 4m in diameter. An example of a 1.2m lightweight ZERODUR® mirror will be discussed.

  3. Estimation Risk Modeling in Optimal Portfolio Selection: An Empirical Study from Emerging Markets

    Directory of Open Access Journals (Sweden)

    Sarayut Nathaphan

    2010-01-01

    Full Text Available Efficient portfolio is a portfolio that yields maximum expected return given a level of risk or has a minimum level of risk given a level of expected return. However, the optimal portfolios do not seem to be as efficient as intended. Especially during financial crisis period, optimal portfolio is not an optimal investment as it does not yield maximum return given a specific level of risk, and vice versa. One possible explanation for an unimpressive performance of the seemingly efficient portfolio is incorrectness in parameter estimates called “estimation risk in parameter estimates”. Six different estimating strategies are employed to explore ex-post-portfolio performance when estimation risk is incorporated. These strategies are traditional Mean-Variance (EV, Adjusted Beta (AB approach, Resampled Efficient Frontier (REF, Capital Asset Pricing Model (CAPM, Single Index Model (SIM, and Single Index Model incorporating shrinkage Bayesian factor namely, Bayesian Single Index Model (BSIM. Among the six alternative strategies, shrinkage estimators incorporating the single index model outperform other traditional portfolio selection strategies. Allowing for asset mispricing and applying Bayesian shrinkage adjusted factor to each asset's alpha, a single factor namely, excess market return is adequate in alleviating estimation uncertainty.

  4. Youth risk behavior surveillance. National Alternative High School Youth Risk Behavior Survey, United States, 1998.

    Science.gov (United States)

    Grunbaum, J A; Kann, L; Kinchen, S A; Ross, J G; Gowda, V R; Collins, J L; Kolbe, L J

    2000-01-01

    Alternative high schools serve approximately 280,000 students nationwide who are at high risk for failing or dropping out of regular high school or who have been expelled from regular high school because of illegal activity or behavioral problems. Such settings provide important opportunities for delivering health promotion education and services to these youth and young adults. However, before this survey, the prevalence of health-risk behaviors among students attending alternative high schools nationwide was unknown. The Youth Risk Behavior Surveillance System (YRBSS) monitors the following six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The national Alternative High School Youth Risk Behavior Survey (ALT-YRBS) is one component of the YRBSS; it was conducted in 1998 to measure priority health-risk behaviors among students at alternative high schools. The 1998 ALT-YRBS used a three-stage cluster sample design to produce a nationally representative sample of students in grades 9-12 in the United States who attend alternative high schools. The school response rate was 81.0%, and the student response rate was 81.9%, resulting in an overall response rate of 66.3%. This report summarizes results from the 1998 ALT-YRBS. The reporting period is February-May 1998. In the United States, 73.6% of all deaths among youth and young adults aged 10-24 years results from only four causes--motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1998 ALT-YRBS demonstrate that many students at alternative high schools engage in behaviors that increase their likelihood of death from these four causes

  5. Youth Risk Behavior Surveillance--National Alternative High School Youth Risk Behavior Survey, United States, 1998.

    Science.gov (United States)

    Grunbaum, J A; Kann, L; Kinchen, S A; Ross, J G; Gowda, V R; Collins, J L; Kolbe, L J

    1999-10-29

    Alternative high schools serve approximately 280,000 students nationwide who are at high risk for failing or dropping out of regular high school or who have been expelled from regular high school because of illegal activity or behavioral problems. Such settings provide important opportunities for delivering health promotion education and services to these youth and young adults. However, before this survey, the prevalence of health-risk behaviors among students attending alternative high schools nationwide was unknown. February-May 1998. The Youth Risk Behavior Surveillance System (YRBSS) monitors the following six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The national Alternative High School Youth Risk Behavior Survey (ALT-YRBS) is one component of the YRBSS; it was conducted in 1998 to measure priority health-risk behaviors among students at alternative high schools. The 1998 ALT-YRBS used a three-stage cluster sample design to produce a nationally representative sample of students in grades 9-12 in the United States who attend alternative high schools. The school response rate was 81.0%, and the student response rate was 81.9%, resulting in an overall response rate of 66.3%. This report summarizes results from the 1998 ALT-YRBS. In the United States, 73.6% of all deaths among youth and young adults aged 10-24 years results from only four causes--motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1998 ALT-YRBS demonstrate that many students at alternative high schools engage in behaviors that increase their likelihood of death from these four causes. During the 30 days

  6. ASPHYXIA AND DEVELOPMENTAL OUTCOME IN HIGH RISK INFANTS

    Directory of Open Access Journals (Sweden)

    Valentina DUKOVSKA

    2010-04-01

    Full Text Available Asphyxia is a risk factor that is very often related to neuro-developmental issues in high risk infants and equally affects preterm and term infants, however its outcome on the developed brain differs from the outcome on the preterm brain.In preterm infants, asphyxia usually exerts a hemorrhagic or ischaemic event and periventricular leukomalacia.In term infants, asphyxia leads to cerebral edema and atrophy of the brain, which may later lead to hypoxic ischaemic encephalopathy (HIE.The number of term infants with HIE who have survived is lower than those of preterm infants, while the percentage of term infants with HIE who have neuro-developmental issues is higher. Preemies face more problems in their motor development as a result of the brain damage, while term infants suffer from encephalopathy and their cognitive abilities are more affected.We have conducted a study about the effects that asphyxia has on the developmental outcomes in high risk infants. In our study, we did a longitudinal developmental follow-up of 30 high risk infants and an evaluation of their developmental outcome using the Griffiths Mental Development Scales, from the 4th month of life until the end of the 36th month. First, we found that high risk infants had a much lower developmental outcome than the control group during the trial. Finally, we found that asphyxia makes a difference in the developmental outcome of preterm infants without asphyxia who have a very low birth weight, the preterm infants with asphyxia, and the term infants with HIE-II.

  7. Regeneration of the vagus nerve after highly selective vagotomy, an autoradiographic study in the ferret stomach .

    OpenAIRE

    Al Muhtaseb, M. H. [محمد هاشم المحتسب; Abu-Khalaf, M.

    1995-01-01

    This study investigates the regeneration of the vagal nerve fibres after highly selective vagotomy in the ferret stomach by using the autoradiographic technique. Autoradiographic examination of the body of the stomach in the acute experimental animals has failed to show any labelled nerve fibres after highly selective vagotomy while the pylorus has shown many labelled nerve fibres . These observations indicate that the highly selective vagotomy has been performed properly and adequately. ...

  8. Validation of the High-Risk Pregnancy Stress Scale in a sample of hospitalized Greek high-risk pregnant women.

    Science.gov (United States)

    Gourounti, Kleanthi; Karpathiotaki, Natassa; Karapanou, Vassiliki; Antzaklis, Panos; Daskalakis, Georgios

    2016-01-01

    The aim of the authors in this study was to determine the psychometric properties of the Greek adaptation of the High-Risk Pregnancy Stress Scale (HRPSS) in a sample of high-risk hospitalized pregnant women. The sample consisted of 133 high-risk pregnant women with gestational age from 9 to 37 weeks. Data were collected between February and June of 2014. HRPSS was "forward-backward" translated from English to Greek. Principal axis factoring with promax rotation was used to test the factor structure of the HRPSS. Measures of state anxiety (STAI) and depressive symptoms (EPDS) were used to assess the convergent validity of the HRPSS. Exploratory factor analysis suggested three factors: concerns of pregnancy, movement restriction, and isolation and restriction of external activities. Construct validity was confirmed by computing correlations between the HRPSS and constructions of anxiety and depressive symptoms. Internal consistency reliability was satisfactory (α = 0.813). The original factor structure of the HRPSS was only partly replicated. The results of the exploratory factor analysis suggested that a three-factor solution instead of a two-factor solution would be the most adequate. The HRPSS is an appropriate measure for assessing the levels of concerns regarding pregnancy outcome, movement restriction, isolation, and external activity restrictions in Greek high-risk pregnant women.

  9. Improving risk equalization for individuals with persistently high costs: Experiences from the Netherlands.

    Science.gov (United States)

    Eijkenaar, Frank; van Vliet, René C J A

    2017-11-01

    Risk-equalization (RE) models in competitive health insurance markets have become increasingly sophisticated. However, these models still have important imperfections. A specific problem in the Netherlands is that insurers are insufficiently compensated for individuals who can persistently be found in the right-end tail of the cost distribution. The goal of this study is to explore and evaluate options for improving compensation for persistently high-cost individuals in the Dutch basic health insurance. Prescription drugs claims (2012) and administrative data on costs and risk-characteristics (2010-2013) for the entire Dutch population are used to identify high-cost individuals and evaluate improvement options. These options - including new risk-classes and a form of risk-sharing - are evaluated in terms of insurers' incentives for risk-selection and efficiency. Three significantly undercompensated high-cost groups are identified: users of specific expensive drugs for rare diseases, hemophilia-patients, and individuals whose costs are in the top-0.50% in 3 prior years. The improvement options effectively remove the undercompensations for these groups and lead to a considerable improvement in individual-level model fit. However, the options differ in terms of their (potential) effects on insurers' efficiency incentives. Although this study provides useful insights in the possibilities for improving RE-models for persistently high-cost individuals, improving compensation remains challenging and dependent on the ongoing debate regarding coverage and reimbursement of expensive drugs. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. The issue of studying the effect of interventions in renal replacement therapy -- to what extent may we be deceived by selection and competing risk?

    NARCIS (Netherlands)

    Jager, Kitty J.; Stel, Vianda S.; Zoccali, Carmine; Wanner, Christoph; Dekker, Friedo W.

    2010-01-01

    Patients with chronic kidney disease (CKD) who live up to renal replacement therapy (RRT) are a selected group of patients with a high mortality risk. The aim of this paper is to contribute a potential epidemiological explanation as to why therapeutic interventions - targeting specific causes of

  11. A Novel Ion - selective Polymeric Membrane Sensor for Determining Thallium(I) With High Selectivity

    Science.gov (United States)

    Kassim, Anuar; Rezayi, Majid; Ahmadzadeh, Saeid; Rounaghi, Gholamhossein; Mohajeri, Masoomeh; Azah Yusof, Noor; Tee, Tan Wee; Yook Heng, Lee; Halim Abdullah, Abd

    2011-02-01

    Thallium is a toxic metal that introduced into the environment mainly as a waste from the production of zinc, cadmium, and lead and by combustion of coal. Thallium causes gastrointestinal irritation and nerve damage when people are exposed to it for relatively short period of time. For long term, thallium has the potential to cause the following effects: change in blood chemistry, damage to liver, kidney, intestinal and testicular tissue, and hair loss. In this work a membrane was prepared by use of 4'-nitrobenzo -18-crown-6 (4'NB18C6) as an ion carrier, polyvinylchloride (PVC) as a matrix, and diocthylphetalate (DOP) as a plasticizer for making an ion selective electrode for measurement of Tl+ cation in solutions. The amount of 4'-nitrobenzo-18C6 and polyvinylchloride were optimized in the preparation of the membrane. The response of the electrode was Nernstian within the concentration range 1.0 × 10-8 to 1.0 × 10-1M. This sensor displays a drift in Nernstian response for this cation with increasing the amount of ionophore and decreasing the amount of polyvinylchloride.The results of potentiometric measurements showed that, this electrode also responses to Cu2+ Ni2+ and Pb2+ cations, but the electrode has a wider dynamic range and a lower detection limit to Tl+ cation. The effects of various parameters such as pH, different cations interferences, effect of the amount of ionophore and polyvinylchloride and time on response of the coated ion selective electrode were investigated. Finally the constructed electrode was used in complexometric and precipitation titrations of Tl+ cation with EDTA and KBr, respectively. The response of the fabricated electrode at concentration range from 1.0 × 10-8 to 1.0 × 10-1M is linear with a Nernstian slope of 57.27 mV.

  12. Antenatal Care Utilisation and Content between Low-Risk and High-Risk Pregnant Women

    Science.gov (United States)

    Yeoh, Ping Ling; Hornetz, Klaus; Dahlui, Maznah

    2016-01-01

    Background The purpose of antenatal care is to monitor and improve the wellbeing of the mother and foetus. The World Health Organization recommends risk-oriented strategy that includes: (i) routine care to all women, (ii) additional care for women with moderately severe diseases and complications, (iii) specialised obstetrical and neonatal care for women with severe diseases and complications. Antenatal care is concerned with adequate care in order to be effective. Measurement for adequacy of antenatal care often applies indexes that assess initiation of care and number of visits. In addition, adequacy of care content should also be assessed. Results of studies in developed settings demonstrate that women without risk factors use antenatal services more frequently than recommended. Such over-utilisation is problematic for low-resourced settings. Moreover, studies show that a substantial proportion of high-risk women had utilisation or content of care below the recommended standard. Yet studies in developing countries have seldom included a comparison between low-risk and high-risk women. The purpose of the study was therefore to assess adequacy of care and pregnancy outcomes for the different risk groups. Methods A retrospective study using a multistage sampling technique, at public-funded primary health care clinics was conducted. Antenatal utilisation level was assessed using a modified Adequacy of Prenatal Care Utilisation index that measures the timing for initiation of care and observed-to-expected visits ratio. Adequacy of antenatal care content assessed compliance to routine care based on the local guidelines. Results Intensive or “adequate-plus” antenatal care utilisation as defined by the modified index was noted in over half of the low-risk women. On the other hand, there were 26% of the high-risk women without the expected intensive utilisation. Primary- or non-educated high-risk women were less likely to have a higher antenatal care utilisation

  13. Combination of high ankle-brachial index and hard coronary heart disease Framingham Risk Score in predicting the risk of ischemic stroke in general population.

    Science.gov (United States)

    Zhang, Yinyin; Chen, Jie; Zhang, Kun; Wang, Tong; Kong, Minyi; Chen, Renhua; Liu, Yu; Chen, Jianping; Wang, Zhiyu; Wang, Jingfeng; Huang, Hui

    2014-01-01

    Our previous study showed that the patients with more metabolic risk factors had higher risk of high ankle-brachial index (ABI), but the relationship between high ABI and the risk of severe cardiovascular and cerebrovascular diseases is still under debate. This study aims to evaluate this association in the general population. 1486 subjects of South China were recruited in the study. 61 subjects were defined as high ABI group (ABI≥1.3) and 65 subjects were randomly selected as normal ABI group (0.9smoking were proved to be the independent factors and effective predictors for high ABI (P<0.05). In conclusion, high ABI combined with high HCHD FRS should be a potential predictor of ischemic stroke in the general population of South China.

  14. Who takes risks in high-risk sport?: the role of alexithymia.

    Science.gov (United States)

    Barlow, Matthew; Woodman, Tim; Chapman, Caradog; Milton, Matthew; Stone, Daniel; Dodds, Tom; Allen, Ben

    2015-02-01

    People who have difficulty identifying and describing their emotions are more likely to seek out the experience of emotions in the high-risk domain. This is because the high-risk domain provides the experience of more easily identifiable emotions (e.g., fear). However, the continued search for intense emotion may lead such individuals to take further risks within this domain, which, in turn, would lead to a greater likelihood of experiencing accidents. Across three studies, we provide the first evidence in support of this view. In Study 1 (n = 762), alexithymia was associated with greater risk taking and a greater propensity to experience accidents and close calls. In Study 2 (n = 332) and Study 3 (n = 356), additional bootstrapped mediation models confirmed these relationships. The predictive role of alexithymia remained significant when controlling for sensation seeking (Study 1) and anhedonia (Study 2 and Study 3). We discuss the practical implications of the present model as they pertain to minimizing accidents and close calls in the high-risk domain.

  15. [Co-payment on prescription drugs in the Spanish public health system: Certainty, risk and selection of risks].

    Science.gov (United States)

    Simó Miñana, Juan

    2015-12-01

    The model of co-payment on prescription drugs in the Spanish National Health System (NHS) changed on 1 July 2012. For more than three decades that it was not modified. This article provides a brief historical reminder of the evolution of this model of co-payment. The basic characteristics of this model are compared with the model of copayment on prescription drugs of the Administrative Mutualism (Civil Servants). The document provides detailed information on the percentage of effective copayment, fundraising effects, the economic participation of the patient, among others, in both models. Finally, listed pending improvements not addressed by 2012 changes such as the concentration of the co-payment in the active patient population and risk selection promoted by the differences in the financial contribution between the two models of co-payment (NHS and Mutualist). Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  16. Chronic kidney disease and bleeding risk in patients at high cardiovascular risk: a cohort study.

    Science.gov (United States)

    Ocak, G; Rookmaaker, M B; Algra, A; de Borst, G J; Doevendans, P A; Kappelle, L J; Verhaar, M C; Visseren, F L

    2018-01-01

    Essentials The association between chronic kidney disease and bleeding is unknown. We followed 10 347 subjects at high cardiovascular risk for bleeding events. Chronic kidney disease was associated with a 1.5-fold increased bleeding risk. Especially albuminuria rather than decreased kidney function was associated with bleeding events. Background There are indications that patients with chronic kidney disease have an increased bleeding risk. Objectives To investigate the association between chronic kidney disease and bleeding in patients at high cardiovascular risk. Methods We included 10 347 subjects referred to the University Medical Center Utrecht (the Netherlands) from September 1996 to February 2015 for an outpatient visit with classic risk factors for arterial disease or with symptomatic arterial disease (Second Manifestation of Arterial disease [SMART] cohort). Patients were staged according to the KDIGO guidelines, on the basis of estimated glomerular filtration rate (eGFR) and albuminuria, and were followed for the occurrence of major hemorrhagic events until March 2015. Hazard ratios (HRs) with 95% confidence intervals (CIs) for bleeding were calculated with Cox proportional hazards analyses. Results The incidence rate for bleeding in subjects with chronic kidney disease was 8.0 per 1000 person-years and that for subjects without chronic kidney disease was 3.5 per 1000 person-years. Patients with chronic kidney disease (n = 2443) had a 1.5-fold (95% CI 1.2-1.9) increased risk of bleeding as compared with subjects without chronic kidney disease (n = 7904) after adjustment. Subjects with an eGFR of Chronic kidney disease is a risk factor for bleeding in patients with classic risk factors for arterial disease or with symptomatic arterial disease, especially in the presence of albuminuria. © 2017 University Medical Center Utrecht. Journal of Thrombosis and Haemostasis © 2017 International Society on Thrombosis and Haemostasis.

  17. [Analysis of selected risk factors for cardiovascular diseases in patients scheduled for Coronary Artery Bypass Graft].

    Science.gov (United States)

    Szylińska, Aleksandra; Mikońajczyk, Anna; Pytńak, Mateusz; Mosiejczuk, Hanna; Listewnik, Mariusz; Ptak, Magdalena; Rotter, Iwona

    2015-01-01

    Cardiovascular diseases are classified as diseases of civilization, and constitute a major social problem because they are the main cause of death. For this reason, according to the WHO, more than 17.3 million people die every year in developed countries. In the European Union the number of deaths is over 2 million, and represents 42% of total mortality. The aim of the study was analysis of selected risk factors for cardiovascular disease in patients scheduled for surgical revascularization, and an outline of their social profile. The study was conducted among patients scheduled for surgery in Cardiac Surgery Department SPSK no. 2 in Szczecin. Ninety patients were studied. The research was carried out using proprietary diagnostic surveys and data obtained from medical records. The selected modifiable risk factors for diseases of the cardiovascular system were evaluated. In the study group 15 patients (17%) were current smokers. Most patients (38, 42%) had not smoked for more than 2 years. 33 patients (37%) suffered from diabetes. More than half (47, 52%) of the respondents did not follow a balanced diet. Most of the patients were obese (37, 41%), including 18 diabetics and 19 non-diabetics. 58 patients (64%) suffered from hypertension. Diabetes, obesity, and smoking were confirmed as risk factors for coronary heart disease. The educational activity of family doctors should be mainly focused on the prevention of diabetes, stopping smoking, and lifestyle changes in order to prevent diseases of the cardiovascular system, especially among the elderly.

  18. Primary selection into shift work and change of cardiovascular risk profile.

    Science.gov (United States)

    Yong, Mei; Germann, Christina; Lang, Stefan; Oberlinner, Christoph

    2015-05-01

    A potential "healthy shift worker effect" may bias the studied effect of shift work on health. The observed differences among shift and day workers in health behavior and health outcomes can be caused by: (i) primary selection, (ii) the influence from the shift work-related environment, and (iii) the impact of shift work. We aimed to study these potential sources. A cohort of 4754 male trainees who had finished their professional training and started their career in production in a chemical company between 1995 and 2012 was identified. Among them, 1348 (28%) were involved in rotating shift work and 3406 (72%) in day work. Information on health behavior and risk factors for cardiovascular diseases was retrieved from the medical examinations. This information was then compared (i) at the beginning of training, (ii) at the end of training, and (iii) 3 years after the employment, in relation to the working time. At the beginning of the training, the prevalence of smokers was higher among future shift workers (26% versus 21%), from 1995 to 2012. During the training and the first three years of employment, a marginal decline of systolic blood pressure and an elevation of triglyceride were related with shift work. No difference was found with respect to other risk factors for cardiovascular diseases. Our findings do not support a primary selection in favor of shift workers. An impact of shift work on the risk profile of cardiovascular diseases was not indicated in the observation period.

  19. Gang masculinity and high-risk sexual behaviours.

    Science.gov (United States)

    Dickson-Gomez, Julia; Quinn, Katherine; Broaddus, Michelle; Pacella, Maria

    2017-02-01

    High-risk sexual behaviours include practices such as relationship violence and substance use, which often cluster together among young people in high-risk settings. Youth gang members often show high rates of such behaviours, substance use and relationship violence. This paper draws on data from in-depth interviews with male and female gang members from six different gangs to explore the role of powerful socialising peer groups that set gender, sexual and relationship roles and expectations for their male and female members. High-risk sexual behaviours among gang members included sex with multiple partners and group sex. Gang norms included the belief that male members were sexually insatiable with multiple sexual partners and that female gang members should be sexually available to male members. Alcohol and drugs were seen to have a large influence on sexual desire and the inability to use condoms. Much sexual behaviour with gangs, such as group sex, was viewed with ambivalence and seen as somewhat coercive. Finally, gendered sexual expectations (boys as sexually insatiable and girls as sexually available) made forming long-term romantic relationships problematic for gang members. The influence of gang norms such as these must be addressed in future programmes and interventions with gang members.

  20. Environmental risk factors associated with bovine tuberculosis among cattle in high-risk areas.

    Science.gov (United States)

    Winkler, B; Mathews, F

    2015-11-01

    Our research shows that environmental features are important predictors of bovine tuberculosis (bTB) in British cattle herds in high-prevalence regions. Data from 503 case and 808 control farms included in the randomized badger culling trial (RBCT) were analysed. bTB risk increased in larger herds and on farms with greater areas of maize, deciduous woodland and marsh, whereas a higher percentage of boundaries composed of hedgerows decreased the risk. The model was tested on another case-control study outside RBCT areas, and here it had a much smaller predictive power. This suggests that different infection dynamics operate outside high-risk areas, although it is possible that unknown confounding factors may also have played a role. © 2015 The Author(s).

  1. Input variable selection for interpolating high-resolution climate ...

    African Journals Online (AJOL)

    2010-10-20

    Oct 20, 2010 ... Accurate climate surfaces are vital for applications relating to groundwater recharge modelling, evapotranspiration estima- ... with distance to oceans and elevation to generate 8 sets of high-resolution (i.e. 3 arc second) climate surfaces of the Western .... ANUSPLIN, developed by the Australian National.

  2. Marker-assisted selection of high molecular weight glutenin alleles ...

    Indian Academy of Sciences (India)

    Bread-making quality in hexaploid wheats is a complex trait. It has been shown that the amount and composition of protein can influence dough rheological properties. The high-molecular-weight (HMW) glutenins are encoded by a complex locus, Glu-1, on the long arm of group-1 homoeologus chromosome of the A, B and ...

  3. Green chemistry: highly selective biocatalytic hydrolysis of nitrile compounds

    CSIR Research Space (South Africa)

    Brady, D

    2006-09-01

    Full Text Available The application of highly substrate-specific catalysts, such as biocatalysts, can reduce the number of synthetic steps required to generate organic compounds. A wide range of bacteria and yeast cultures were enriched on nitriles as the sole source...

  4. Machine learning for event selection in high energy physics

    NARCIS (Netherlands)

    Whiteson, S.; Whiteson, D.

    2009-01-01

    The field of high energy physics aims to discover the underlying structure of matter by searching for and studying exotic particles, such as the top quark and Higgs boson, produced in collisions at modern accelerators. Since such accelerators are extraordinarily expensive, extracting maximal

  5. Selected Practices and Characteristics of Highly Effective Elementary Schools

    Science.gov (United States)

    Lauritson, George Allen

    2012-01-01

    The federal government, through NCLB legislation, has provided target proficiency goals schools will be accountable to meet. Missouri public elementary schools use these target goals to determine their success. The focus of this study was to examine the highly effective public elementary schools in Missouri that met or exceeded the 2011 Adequate…

  6. Venous Thromboembolism Risk and Adequacy of Prophylaxis in High Risk Pregnancy in the Arabian Gulf.

    Science.gov (United States)

    Alsayegh, Faisal; Al-Jassar, Waleed; Wani, Salima; Tahlak, Muna; Albahar, Awatef; Al Kharusi, Lamya; Al-Tamimi, Halima; El-Taher, Faten; Mahmood, Naeema; Al-Zakwani, Ibrahim

    2016-01-01

    To estimate the prevalence of venous thromboembolism (VTE) risk factors in pregnancy and the proportion of pregnancies at risk of VTE that received the recommended prophylaxis according to the American College of Chest Physicians (ACCP) 2012 published guidelines in antenatal clinics in the Arabian Gulf. The evaluation of venous thromboembolism (EVE)-Risk project was a non-interventional, cross-sectional, multi-centre, multi-national study of all eligible pregnant women (≥17 years) screened during antenatal clinics from 7 centres in the Arabian Gulf countries (United Arab Emirates, Kuwait, Bahrain, Qatar and Oman). Pregnant women were recruited during a 3-month period between September and December 2012. Of 4,131 screened pregnant women, 32% (n=1,337) had ≥1 risk factors for VTE. Common VTE risk factors included obesity (76%), multiparity (33%), recurrent miscarriages (9.1%), varicose veins (6.9%), thrombophilia (2.6%), immobilization (2.0%), sickle cell disease (2.8%) and previous VTE (1.6%). Only 8.3% (n=111) of the high risk patients were on the recommended VTE prophylaxis. Enoxaparin was used in 80% (n=89) of the cases followed by tinzaparin (4%; n=4). Antiplatelet agents were prescribed in 11% (n=149) of pregnant women. Of those on anticoagulants (n=111), 59% (n=66) were also co-prescribed antiplatelet agents. Side effects (mainly local bruising at the injection site) were reported in 12% (n=13) of the cases. A large proportion of pregnant women in the Arabian Gulf countries have ≥1 VTE risk factor with even a smaller fraction on prophylaxis. VTE risk assessment must be adopted to identify those at risk who would need VTE prophylaxis.

  7. High-density nanopore array for selective biomolecule transport.

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Kamlesh D.

    2011-11-01

    Development of sophisticated tools capable of manipulating molecules at their own length scale enables new methods for chemical synthesis and detection. Although nanoscale devices have been developed to perform individual tasks, little work has been done on developing a truly scalable platform: a system that combines multiple components for sequential processing, as well as simultaneously processing and identifying the millions of potential species that may be present in a biological sample. The development of a scalable micro-nanofluidic device is limited in part by the ability to combine different materials (polymers, metals, semiconductors) onto a single chip, and the challenges with locally controlling the chemical, electrical, and mechanical properties within a micro or nanochannel. We have developed a unique construct known as a molecular gate: a multilayered polymer based device that combines microscale fluid channels with nanofluidic interconnects. Molecular gates have been demonstrated to selectively transport molecules between channels based on size or charge. In order to fully utilize these structures, we need to develop methods to actively control transport and identify species inside a nanopore. While previous work has been limited to creating electrical connections off-channel or metallizing the entire nanopore wall, we now have the ability to create multiple, separate conductive connections at the interior surface of a nanopore. These interior electrodes will be used for direct sensing of biological molecules, probing the electrical potential and charge distribution at the surface, and to actively turn on and off electrically driven transport of molecules through nanopores.

  8. Atopic dermatitis in a high-risk cohort: natural history, associated allergic outcomes, and risk factors.

    Science.gov (United States)

    Carlsten, Chris; Dimich-Ward, Helen; Ferguson, Alexander; Watson, Wade; Rousseau, Roxanne; Dybuncio, Anne; Becker, Allan; Chan-Yeung, Moira

    2013-01-01

    Atopic dermatitis (AD) is commonly associated with asthma and other atopic disorders in childhood. To evaluate the natural history of AD and its association with other allergic outcomes in a high-risk cohort through the age of 7 years. A total of 373 high-risk infants, who had undergone a randomized controlled trial with intervention measures for primary prevention of asthma applied during the first year of life, were assessed for asthma, AD, and allergic sensitization at 1, 2, and 7 years. The multifaceted intervention program did not reduce AD despite reducing the prevalence of asthma significantly. Sixty-two children (16.6%) had AD during the first 2 years (early-onset AD); of these, 26 continue to have AD at the age of 7 years (persistent), whereas 36 no longer had the disease (nonpersistent) at the age of 7 years. Twenty-three children (6.2%) developed AD only after the age of 2 years (late-onset AD). Early-onset AD, persistent or nonpersistent, was associated with increased risk of allergic sensitization to food allergens within the first 2 years of life and asthma diagnosis at year 7. However, only persistent AD was associated with an increased risk of other atopic diseases and allergic sensitization to food and aeroallergens at year 7. Late-onset AD was not associated with atopic diseases or allergic sensitization at year 7 with the exception of Alternaria alternans. In this cohort of infants at high risk of asthma, early-onset persistent AD, which was highly associated with atopic sensitization, increased the risk of atopic diseases in later childhood and thus appears to be part of the atopic march. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  9. Competing Risks Data Analysis with High-dimensional Covariates: An Application in Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Leili Tapak

    2015-06-01

    Full Text Available Analysis of microarray data is associated with the methodological problems of high dimension and small sample size. Various methods have been used for variable selection in high-dimension and small sample size cases with a single survival endpoint. However, little effort has been directed toward addressing competing risks where there is more than one failure risks. This study compared three typical variable selection techniques including Lasso, elastic net, and likelihood-based boosting for high-dimensional time-to-event data with competing risks. The performance of these methods was evaluated via a simulation study by analyzing a real dataset related to bladder cancer patients using time-dependent receiver operator characteristic (ROC curve and bootstrap .632+ prediction error curves. The elastic net penalization method was shown to outperform Lasso and boosting. Based on the elastic net, 33 genes out of 1381 genes related to bladder cancer were selected. By fitting to the Fine and Gray model, eight genes were highly significant (P < 0.001. Among them, expression of RTN4, SON, IGF1R, SNRPE, PTGR1, PLEK, and ETFDH was associated with a decrease in survival time, whereas SMARCAD1 expression was associated with an increase in survival time. This study indicates that the elastic net has a higher capacity than the Lasso and boosting for the prediction of survival time in bladder cancer patients. Moreover, genes selected by all methods improved the predictive power of the model based on only clinical variables, indicating the value of information contained in the microarray features.

  10. Plaque At RISK (PARISK): prospective multicenter study to improve diagnosis of high-risk carotid plaques

    NARCIS (Netherlands)

    Truijman, M.T.; Kooi, M.E.; Dijk, A.; de Rotte, A.A.J.; van der Kolk, A.G.; Liem, M.; Schreuder, F.H.; Boersma, M.; Mess, W.H.; van Oostenbrugge, R.J.; Koudstaal, P.J.; Kappelle, L.J.; Nederkoorn, P.J.; Nederveen, A.J.; Hendrikse, J.; van der Steen, A.F.; Daemen, M.J.; van der Lugt, A.

    2014-01-01

    BACKGROUND: Patients with symptomatic carotid artery stenosis are at high risk for recurrent stroke. To date, the decision to perform carotid endarterectomy in patients with a recent cerebrovascular event is mainly based on degree of stenosis of the ipsilateral carotid artery. However, additional

  11. Risk factors for congenital anomalies in high risk pregnant women: A large study from South India

    Directory of Open Access Journals (Sweden)

    Tella Sunitha

    2017-01-01

    Conclusion: High prevalence of CAs was found in HRP women compared to general population. Low parental age contributed toward CAs in primi gravida women while consanguinity was found to be a predisposing factor for CAs in HRP with previous BOH. Toxoplasmosis conferred risk for CAs in HRP women with previous normal pregnancies.

  12. Prevalence, Risk Factors, and Clinical Findings of Candidiasis and Trichomoniasis in Women Supported by Selected Health Centers of Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Sehhatie-Shafaie Fahimeh

    2014-10-01

    Full Text Available Objective: Vulvovaginitis candidiasis and trichomoniasis constitute at least 50% of infectious vaginitis cases. The aim of this study was to determine the prevalence, risk factors, and clinical findings of candidiasis and trichomoniasis in women supported by selected health centers of Tabriz, Iran. Materials and Methods: This was a cross-sectional study, in which 1000 women who had the study criteria were selected by random sampling. In addition, 12 health centers of Tabriz were selected for this study. A questionnaire was used to obtain their personal and reproductive information, checklist for clinical observations, and culture methods (sabouraud dextrose agar and diamond for diagnose vaginal infections. Results: The prevalence of candidiasis and trichomoniasis were 25.2 and 9.2%, respectively. Findings showed that candidiasis infection, history of diseases, vaginal pH, number of coitus, number of delivery, and number of vaginal delivery, breast feeding status, method of last delivery, and contraceptive methods are risk factors for candidacies. Moreover, age at marriage, personal health, sexual hygiene, and vaginal pH are risk factors for trichomoniasis. A statistically significant relationship was observed between candidiasis and clinical findings, such as pruritus, pruritus during coitus, burning sensation with coitus, dysuria in woman and her husband, dyspareunia, low abdominal pain, urinal symptoms, vaginal status, amount of discharge, consistency appearance, and color of discharges. Furthermore, a significant relationship was observed between trichomoniasis and dysuria, and appearance and color of vaginal discharge. Conclusion: Due to the high prevalence of candidiasis, trichomoniasis infections, and infected women as asymptomatic carriers, it seems necessary to pay more attention to these infections and make efforts for their prevention.

  13. Survey on basic knowledge about exposure and potential environmental and health risks for selected nanomaterials

    DEFF Research Database (Denmark)

    Mikkelsen, Sonja Hagen; Hansen, Erik; Christensen, Trine Boe

    Based on a literature review this report provides a general description as well as an environmental and health profile of 7 nanomaterials. The examined nanomaterials are selected because of expected high use or specific environmental and health properties. Fullerenes, iron, silver, nanoclay...... other nanomaterials were identified, there are areas where there may be reason for attention and thus need for more knowledge....

  14. An objective method for High Dynamic Range source content selection

    DEFF Research Database (Denmark)

    Narwaria, Manish; Mantel, Claire; Da Silva, Matthieu Perreira

    2014-01-01

    With the aim of improving the immersive experience of the end user, High Dynamic Range (HDR) imaging has been gaining popularity. Therefore, proper validation and performance benchmarking of HDR processing algorithms is a key step towards standardization and commercial deployment. A crucial compo...... visible errors on contrast reduction. This information is subsequently analyzed via fuzzy clustering to enable a probabilistic interpretation. To evaluate the proposed approach, we performed an experimental study on a large set of publicly available HDR images....

  15. [Testing the probability of a model to predict suicide risk in high school and university students].

    Science.gov (United States)

    Sahin, Nesrin Hisli; Batigün, Ayşegül Durak

    2009-01-01

    The aim of this study was to investigate the validity of a model proposed by Batigün and Sahin regarding suicide probability. The sample was composed of 2343 students aged 15-25 years that were attending various high schools and universities. According to the proposed model, 2 risk groups were formed from this sample, according to their scores on the investigation variables (those that simultaneously received high scores 1 standard deviation above the mean on the Problem Solving Inventory, Multidimensional Anger Scale, and Impulsivity Scale). Two other risk groups were formed according to the criteria variable scores (suicide probability scores 1 standard deviation above and below the mean). A series of analyses were conducted to investigate the similarity between the model risk groups and criteria risk groups. The results reveal that the model had a 43.3% success rate for predicting those with high suicide probability, while the false negative rate was 0%. Discriminant analysis showed that the model correctly discriminated 90.2% of those with low suicide probability and 87.3% of those with high suicide probability. The results support the validity of the proposed model for selecting individuals with high suicide probability. In addition, the model can be used to offer these individuals certain preventive measures, such as problem solving, communication skills, and anger management training.

  16. Papillary thyroid microcarcinoma: the significance of high risk features.

    Science.gov (United States)

    Bradley, Nori L; Wiseman, Sam M

    2017-02-16

    Papillary carcinomas that measure 1.0cm or less are diagnosed as papillary thyroid microcarcinomas (PTMs). The clinical significance and recommendations for management of these PTMs is still evolving. The objective of the study was to compare the characteristics of small (PTM. We performed a retrospective analysis of these cases using Fisher's Exact Test. The statistical significance was set at p PTM and high risk features was observed only for extra-thyroidal cancer extension (ETE). Six of 57 large PTM (11%) but none of the 75 small PTM had ETE (p PTM (5/9 cases) and large PTM (4/9 cases). A distant metastases was diagnosed in association with a small PTM. For PTM, neither small cancer size, nor the absence of high-risk features, excluded the possibility of synchronous lymph node metastases.

  17. The Violence Risk Scale: Predictive Validity and Linking Changes in Risk with Violent Recidivism in a Sample of High-Risk Offenders with Psychopathic Traits

    Science.gov (United States)

    Lewis, Kathy; Olver, Mark E.; Wong, Stephen C. P.

    2013-01-01

    The Violence Risk Scale (VRS) uses ratings of static and dynamic risk predictors to assess violence risk, identify targets for treatment, and assess changes in risk following treatment. The VRS was rated pre- and posttreatment on a sample of 150 males, mostly high-risk violent offenders many with psychopathic personality traits. These individuals…

  18. Effectiveness of a selective alcohol prevention program targeting personality risk factors : Results of interaction analyses

    NARCIS (Netherlands)

    Lammers, J.; Goossens, F.; Conrod, P.; Engels, R.; Wiers, R.W.; Kleinjan, M.

    AIM: To explore whether specific groups of adolescents (i.e., scoring high on personality risk traits, having a lower education level, or being male) benefit more from the Preventure intervention with regard to curbing their drinking behaviour. DESIGN: A clustered randomized controlled trial, with

  19. Effectiveness of a selective alcohol prevention program targeting personality risk factors: Results of interaction analyses

    NARCIS (Netherlands)

    Lammers, J.; Goossens, F.; Conrod, P.; Engels, R.C.M.E.; Wiers, R.W.H.J.; Kleinjan, M.

    2017-01-01

    Aim: To explore whether specific groups of adolescents (i.e., scoring high on personality risk traits, having a lower education level, or being male) benefit more from the Preventure intervention with regard to curbing their drinking behaviour. Design: A clustered randomized controlled trial, with

  20. Risk Factors for Inadequate Defibrillation Safety Margins Vary With the Underlying Cardiac Disease: Implications for Selective Testing Strategies.

    Science.gov (United States)

    Bonnes, Judith L; Westra, Sjoerd W; Bouwels, Leon H R; DE Boer, Menko Jan; Brouwer, Marc A; Smeets, Joep L R M

    2016-05-01

    In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial substrate between ischemic and nonischemic heart disease (IHD/non-IHD) and the accompanying differences in clinical characteristics, we studied inadequate DSMs and their predictors in relation to the underlying etiology. Cohort of routine defibrillation tests (n = 785) after first implantable cardioverter defibrillator (ICD)-implantations at the Radboud UMC (2005-2014). A defibrillation threshold >25 J was regarded as an inadequate DSM. In total, 4.3% of patients had an inadequate DSM; in IHD 2.5% versus 7.3% in non-IHD (P = 0.002). We identified a group of non-IHD patients at high risk (13-42% inadequate DSM); the remainder of the cohort (>70%) had a risk of only 2% (C-statistic entire cohort 0.74; C-statistic non-IHD 0.82). This was based upon two identified interaction terms: (1) non-IHD and age (aOR 0.94 [95% CI 0.91-0.97]); (2) non-IHD and the indexed left ventricular (LV) internal diastolic diameter (aOR 3.50 [95% CI 2.10-5.82]). The present study on risk stratification for an inadequate DSM not only confirms the importance of making a distinction between IHD and non-IHD, but also shows that risk factors in an entire cohort (LV dilatation, age) may only apply to a subgroup (non-IHD). Appreciation of this concept could favorably affect current risk stratification. If confirmed, our approach may be used to optimize individualized testing decisions in an upcoming era of non-routine testing. © 2016 Wiley Periodicals, Inc.

  1. Reference satellite selection method for GNSS high-precision relative positioning

    OpenAIRE

    Xiao Gao; Wujiao Dai; Zhiyong Song; Changsheng Cai

    2017-01-01

    Selecting the optimal reference satellite is an important component of high-precision relative positioning because the reference satellite directly influences the strength of the normal equation. The reference satellite selection methods based on elevation and positional dilution of precision (PDOP) value were compared. Results show that all the above methods cannot select the optimal reference satellite. We introduce condition number of the design matrix in the reference satellite selection ...

  2. High risk bladder cancer: current management and survival

    Directory of Open Access Journals (Sweden)

    Anna M. Leliveld

    2011-04-01

    Full Text Available PURPOSE: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC in the Comprehensive Cancer Center North-Netherlands (CCCN and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. MATERIALS AND METHODS: Retrospective analysis of 412 patients with newly diagnosed high risk NMIBC. Clinical, demographic and follow-up data were obtained from the CCCN Cancer Registry and a detailed medical record review. Uni and multivariate analysis was performed to identify factors related to choice of treatment and 5 year recurrence and progression free survival. RESULTS: 74/412 (18% patients with high risk NMIBC underwent a transurethral resection (TUR as single treatment. Adjuvant treatment after TUR was performed in 90.7% of the patients treated in teaching hospitals versus 71.8 % in non-teaching hospitals (p 80 years OR 0.1 p = 0.001 and treatment in non-teaching hospitals (OR 0.25; p < 0.001 were associated with less adjuvant treatment after TUR. Tumor recurrence occurred in 191/392 (49% and progression in 84 /392 (21.4% patients. The mean 5-years progression free survival was 71.6% (95% CI 65.5-76.8. CONCLUSION: In this pattern of care study in high risk NMIBC, 18% of the patients were treated with TUR as single treatment. Age and treatment in non-teaching hospitals were associated with less adjuvant treatment after TUR. None of the variables sex, age, comorbidity, hospital type, stage and year of treatment was associated with 5 year recurrence or progression rates.

  3. Cryosurgical ablation of the prostate: high risk patient outcomes.

    Science.gov (United States)

    Prepelica, Kristofer L; Okeke, Zephaniah; Murphy, Alana; Katz, Aaron E

    2005-04-15

    The authors report their experience with cryosurgical ablation of the prostate in men with high-risk features for prostate carcinoma who were unwilling to undergo radical surgery or radiation therapy. Between January 1998 and April 2002, 65 men underwent primary cryosurgery for prostate carcinoma with high-risk features. All patients had biopsy-proven prostate carcinoma without evidence for metastatic disease on magnetic resonance images, computed tomography scans, or radionuclide images of bones. High-risk parameters were defined as either a prostate-specific antigen (PSA) level >/= 10 ng/mL, or a Gleason sum score >/= 8, or both. Patients who had undergone prior surgery, radiation therapy, or cryoablation for prostate carcinoma were excluded from the study. Patients were monitored with physical examination and PSA screening every 3 months and with radiologic imaging when indicated. The median patient age was 72 years (range, 41-86 years), and t he median follow-up was 35 months (range, 4-77 months). There were 2 patients (3.1%) with rectal pain and incontinence. Durable PSA biochemical disease-free survival was noted in 83.3% of patients according to the American Society for Therapeutic Radiology and Oncology (ASTRO) criteria. A 6-year Kaplan-Meier analysis revealed an 81.7% ASTRO survival probability as well as PSA nadir < 4.0 ng/mL and PSA nadir < 1.0 ng/mL projections of 50% and 35%, respectively. One of 8 postcryosurgery biopsies (12.5%) were positive. No patient had progressed at last follow-up, and the overall survival rate was 100%. Cryoablation was a feasible treatment option in patients with organ-confined prostate carcinoma who had high-risk features. Longer follow-up will be necessary to determine the effectiveness of this approach. (c) 2005 American Cancer Society.

  4. Comprehensive brain MRI segmentation in high risk preterm newborns.

    OpenAIRE

    Xintian Yu; Yanjie Zhang; Robert E Lasky; Sushmita Datta; Nehal A Parikh; Ponnada A Narayana

    2010-01-01

    Most extremely preterm newborns exhibit cerebral atrophy/growth disturbances and white matter signal abnormalities on MRI at term-equivalent age. MRI brain volumes could serve as biomarkers for evaluating the effects of neonatal intensive care and predicting neurodevelopmental outcomes. This requires detailed, accurate, and reliable brain MRI segmentation methods. We describe our efforts to develop such methods in high risk newborns using a combination of manual and automated segmentation too...

  5. Rosuvastatin: Role in Cardiovascular High-risk Patient

    Directory of Open Access Journals (Sweden)

    John E Feliciano-Alfonso

    2013-01-01

    Full Text Available Statins are the lipid-lowering drug family of first choice in situations of hypercholesterolemia or mixed dyslipidemia with predominant increase in cholesterol. The evidence shows conclusively that each one of the commercially available statins have proven benefits on outcomes of cardiovascular morbidity and mortality. However, rosuvastatin has certain pharmacokinetic efficacy and cost-effectiveness characteristics that make it an attractive molecule to be the statin of choice in patients at high cardiovascular risk.

  6. Risk factors for progressive neuromuscular scoliosis requiring posterior spinal fusion after selective dorsal rhizotomy.

    Science.gov (United States)

    Ravindra, Vijay M; Christensen, Michael T; Onwuzulike, Kaine; Smith, John T; Halvorson, Kyle; Brockmeyer, Douglas L; Walker, Marion L; Bollo, Robert J

    2017-11-01

    OBJECTIVE Selective dorsal rhizotomy (SDR) via limited laminectomy is an effective treatment of lower-extremity spasticity in the pediatric population. Children with spasticity are also at risk for neuromuscular scoliosis; however, specific risk factors for progressive spinal deformity requiring posterior spinal fusion (PSF) after SDR are unknown. The authors' goal was to identify potential risk factors. METHODS The authors performed a retrospective cohort study of patients who underwent SDR via limited laminectomy between 2003 and 2014 and who had at least 1 year of follow-up. They analyzed demographic, clinical, and radiographic variables to elucidate risk factors for progressive neuromuscular scoliosis. The primary outcome was need for PSF. RESULTS One hundred thirty-four patients underwent SDR and had at least 12 months of follow-up (mean 65 months); 48 patients (36%) had detailed pre- and postoperative radiographic data available. The mean age at surgery was 10 years (SD 5.1 years). Eighty-four patients (63%) were ambulatory before SDR, 109 (82%) underwent a single-level laminectomy, and a mean of 53% of the dorsal rootlets from L-1 to S-1 were sectioned. Fifteen patients (11.2%) subsequently required PSF for progressive deformity. Nonambulatory status (p 30° (p = 0.003) were significantly associated with PSF on univariate analysis, but no statistically significant correlation was found with any clinical or radiographic variable and PSF after SDR on multivariate regression analysis. CONCLUSIONS Patients with preoperative nonambulatory status and Cobb angle > 30° may be at risk for progressive spinal deformity requiring PSF after SDR. These are well-known risk factors for progressive deformity in children with spasticity in general. Although our analysis suggests SDR via limited laminectomy may not significantly accelerate the development of neuromuscular scoliosis, further case-control studies are critical to elucidate the impact of SDR on spinal deformity.

  7. Selective Serotonin Reuptake Inhibitors and Cataract Risk: A Case-Control Analysis.

    Science.gov (United States)

    Becker, Claudia; Jick, Susan S; Meier, Christoph R

    2017-11-01

    Use of selective serotonin reuptake inhibitors (SSRIs) has been associated with an increased cataract risk. We aimed to assess cataract risk after exposure to SSRI or to other antidepressant drugs in a large electronic primary care database. Case-control study. The study population was derived from the UK-based Clinical Practice Research Datalink (CPRD). We included patients with first-time cataract aged ≥40 years between 1995 and 2015 and an equal number of cataract-free controls matched on age, sex, general practice, date of cataract recording (i.e., index date), and years of history in the CPRD before the index date. We conducted conditional logistic regression analyses adjusted for body mass index, smoking, hypertension, diabetes, and systemic steroid use. Exposure of interest was the number of SSRI prescriptions and prescriptions for other antidepressant drugs. We further explored mutually exclusive use of single SSRI substances. In sensitivity analyses, we shifted the index date backwards by 2 years, and we restricted our analyses to cases and controls without a prior glaucoma diagnosis. Relative risk estimates as odds ratios (ORs) with 95% confidence intervals (CIs). We identified 206 931 cataract cases and the same number of matched controls. Current long-term use of SSRI (≥20 prescriptions) was not associated with an increased cataract risk (adjusted OR, 0.99; 95% CI, 0.94-1.03). However, in a subset of patients aged 40 to 64 years, we found a slightly increased risk of cataract for long-term SSRI users (adjusted OR, 1.24; 95% CI, 1.15-1.34) compared with nonusers. In these data, use of SSRI was not associated with an increased risk of cataract. The slightly increased OR for individuals younger than 65 years of age in association with long-term SSRI use needs to be investigated in further studies. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  8. Role of robot-assisted radical prostatectomy in the management of high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Akshay Sood

    2014-01-01

    Full Text Available We aimed to evaluate the role of robot-assisted radical prostatectomy (RARP in the management of high-risk prostate cancer (PCa, with a focus on oncological, functional and perioperative outcomes. Further, we also aimed to briefly describe our novel modification to conventional RARP that allows immediate organ retrieval and examination for intra-operative surgical margin assessment. A literature search of PubMed was performed for articles on the management of high-risk PCa. Papers written in English and concerning clinical outcomes following RARP for locally advanced and high-risk PCa were selected. Outcomes data from our own center were also included. A total of 10 contemporary series were evaluated. Biopsy Gleason score ≥ 8 was the most common cause for classification of patients into the high-risk PCa group. Biochemical failure rate, in the few series that looked at long-term follow-up, varied from 9% to 26% at 1 year. The positive surgical margin rate varied from 12% to 53.3%. Urinary continence rates varied from 78% to 92% at 1 year. The overall complication rates varied from 2.4% to 30%, with anastomotic leak and lymphocele being the most common complications. Long-term data on oncological control following RARP in high-risk patients is lacking. Short-term oncological outcomes and functional outcomes are equivalent to open radical prostatectomy (RP. Safety outcomes are better in patients undergoing RARP when compared with open RP. Improved tools for predicting the presence of organ-confined disease (OCD are available. High-risk patients with OCD would be ideal candidates for RARP and would benefit most from surgery alone.

  9. Cardiac risk index as a simple geometric indicator to select patients for the heart-sparing radiotherapy of left-sided breast cancer.

    Science.gov (United States)

    Sung, KiHoon; Choi, Young Eun; Lee, Kyu Chan

    2017-06-01

    This is a dosimetric study to identify a simple geometric indicator to discriminate patients who meet the selection criterion for heart-sparing radiotherapy (RT). The authors proposed a cardiac risk index (CRI), directly measurable from the CT images at the time of scanning. Treatment plans were regenerated using the CT data of 312 consecutive patients with left-sided breast cancer. Dosimetric analysis was performed to estimate the risk of cardiac mortality using cardiac dosimetric parameters, such as the relative heart volumes receiving ≥25 Gy (heart V25 ). For each CT data set, in-field heart depth (HD) and in-field heart width (HW) were measured to generate the geometric parameters, including maximum HW (HWmax ) and maximum HD (HDmax ). Seven geometric parameters were evaluated as candidates for CRI. Receiver operating characteristic (ROC) curve analyses were used to examine the overall discriminatory power of the geometric parameters to select high-risk patients (heart V25  ≥ 10%). Seventy-one high-risk (22.8%) and 241 low-risk patients (77.2%) were identified by dosimetric analysis. The geometric and dosimetric parameters were significantly higher in the high-risk group. Heart V25 showed the strong positive correlations with all geometric parameters examined (r > 0.8, p Cardiac risk index proposed as a simple geometric indicator to select high-risk patients provides useful guidance for clinicians considering optimal implementation of heart-sparing RT. © 2016 The Royal Australian and New Zealand College of Radiologists.

  10. High Dietary Fat Selectively Increases Catalase Expression within Cardiac Mitochondria*

    Science.gov (United States)

    Rindler, Paul M.; Plafker, Scott M.; Szweda, Luke I.; Kinter, Michael

    2013-01-01

    Obesity is a predictor of diabetes and cardiovascular disease. One consequence of obesity is dyslipidemia characterized by high blood triglycerides. It has been proposed that oxidative stress, driven by utilization of lipids for energy, contributes to these diseases. The effects of oxidative stress are mitigated by an endogenous antioxidant enzyme network, but little is known about its response to high fat utilization. Our experiments used a multiplexed quantitative proteomics method to measure antioxidant enzyme expression in heart tissue in a mouse model of diet-induced obesity. This experiment showed a rapid and specific up-regulation of catalase protein, with subsequent assays showing increases in activity and mRNA. Catalase, traditionally considered a peroxisomal protein, was found to be present in cardiac mitochondria and significantly increased in content and activity during high fat feeding. These data, coupled with the fact that fatty acid oxidation enhances mitochondrial H2O2 production, suggest that a localized catalase increase is needed to consume excessive mitochondrial H2O2 produced by increased fat metabolism. To determine whether the catalase-specific response is a common feature of physiological conditions that increase blood triglycerides and fatty acid oxidation, we measured changes in antioxidant expression in fasted versus fed mice. Indeed, a similar specific catalase increase was observed in mice fasted for 24 h. Our findings suggest a fundamental metabolic process in which catalase expression is regulated to prevent damage while preserving an H2O2-mediated sensing of diet composition that appropriately adjusts insulin sensitivity in the short term as needed to prioritize lipid metabolism for complete utilization. PMID:23204527

  11. Postoperative chemoradiotherapy in high risk locally advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sang Hyuk; Chie, Eui Kyu; Kim, Kyu Bo; Lee, Hyuk Joon; Yang, Han Kwang; Han, Sae Won; Oh, Do Youn; Im, Seok Ah; Bang, Yung Jue; Ha, Sung W. [Seoul National University College of Medicine, Seoul(Korea, Republic of)

    2012-12-15

    To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Loco-regional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

  12. TOB-G: Tobacco Cessation Guidelines for High risk Populations

    Directory of Open Access Journals (Sweden)

    Panagiotis Behrakis

    2016-03-01

    Full Text Available The TOB-G project is funded under the EU 3rd Health Programme which is the main instrument that the Commission uses to implement the EU Health Strategy. The project started in June 2014 and will be completed in September 2017. The project consortium consists of 5 partners from 4 European countries (Belgium, Greece, Ireland and Romania. The TOB-G project aims to develop and implement an innovative and cost effective approach to prevent chronic diseases related to tobacco dependence by focusing on creating specialized tobacco cessation guidelines for populations of high risk including adolescents, pregnant women, adults with COPD, Cardiovascular disease and diabetes. The specialized guidelines for high risks groups will be developed according to ENSP’s evidence based and good practices in tobacco cessation. The smoking cessation guidelines contain strategies and recommendations designed to assist clinicians/ doctors in delivering and supporting effective treatments for tobacco use and dependence and will also be available within the context of an e-learning platform for European clinicians. Overall, the TOB-G project will enhance the overall European capacity in the treatment of tobacco dependence, through offering smoking cessation tools, appropriately assessed and fitted to the specific needs of high risk groups.

  13. Development of Financial Support Program for High Risk Pregnant Women.

    Science.gov (United States)

    Jeong, Ihnsook; Kim, Jiyun; Im, Sook Bin

    2016-06-01

    The purpose of this study was to develop a financial support program for high-risk pregnant women based on opinions obtained using a questionnaire survey. The program development involved two steps: (1) developing a questionnaire through reviewing previous financial support programs for maternal care and then validating it via professional consultation; and (2) drafting a financial support program. Sixty professionals, 26 high-risk pregnant women, and 100 program implementers completed the questionnaire between August 2014 and October 2014. Based on the obtained professional consultation and survey investigation, the framework of the financial support program was constructed. The suggested recipients were mothers with early labor pains, mothers who have been hospitalized for > 3 weeks, and mothers who used uterine stimulant Pitocin during hospitalization. All hospitalization, medication, and examination costs needed to be supported considering the income level of the recipient. A basic policy for financially supporting high-risk pregnant women has been developed. The efficacy and feasibility of the policy needs to be carefully examined in future studies.

  14. Correlation between the state of periodontal tissues and selected risk factors for periodontitis and myocardial infarction.

    Science.gov (United States)

    Górska, Renata; Dembowska, Elżbieta; Konopka, Tomasz P; Wysokińska-Miszczuk, Joanna; Pietruska, Małgorzata; Ganowicz, Ewa

    2017-01-01

    The current level of knowledge indicates a relationship between periodontitis and diabetes and/or cardiovascular diseases (CVD). Periodontitis can be not only a risk factor for these diseases, but also a condition modifying other primary risk factors associated with the occurrence of cardiovascular complications (lipid disorders, arterial hypertension, etc.) or diabetes. The aim of the study was an analysis of the correlation between the state of periodontal tissues and selected risk factors for myocardial infarction (MI) in patients after recent myocardial infarction. The study included 417 patients (92 women, 325 men) hospitalized due to recent MI. The inclusion criteria were MI history and age below 70 years. The state of periodontal tissues (plaque index, bleeding on probing, pocket depth and clinical attachment loss, CPI index) and selected risk factors for periodontitis and CVD were recorded. An analysis of the results showed no statistically significant correlation between the depth, the number, percentage of periodontal pockets and the average clinical attachment level on one hand and BMI on the other hand. Whereas a statistically significant correlation was observed between tobacco smoking and the degree of severity of periodontal diseases measured by the average pocket depth, the number and percentage of pockets above 4 mm and the average clinical attachment loss, as well as between hypertension and the state of oral hygiene and between diabetes and the number of preserved teeth and the number of pockets above 4 mm. The degree of severity of periodontal disease can impact hypertension and diabetes, which could potentially influence the occurrence and course of CVD.

  15. A case-control investigation of adenomyosis: impact of control group selection on risk factor strength.

    Science.gov (United States)

    Trabert, Britton; Weiss, Noel S; Rudra, Carole B; Scholes, Delia; Holt, Victoria L

    2011-01-01

    Using a medical record abstraction-based case-control study with two control groups, we evaluated adenomyosis risk factors and investigated differences related to comparison group selection. Medical records of all female 18- to 49-year-old Group Health (GH) enrollees with ICD-9 code 617.0 were abstracted using a standard data collection form. Cases were enrollees diagnosed with adenomyosis (n = 174) between April 1996 and September 2001. For comparison, medical records of two control groups were selected from the GH population: An age-matched sample of female enrollees (population-based controls; n = 149) and all female 18- to 49-year-old enrollees undergoing a hysterectomy (hysterectomy controls; n = 106) during the same time without adenomyosis. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression, adjusted for identified covariates. Compared with normal and underweight women, overweight and obese women had increased adenomyosis risk using hysterectomy controls (OR, 2.2, 95% CI, 1.0-4.5; obese: OR, 2.2; 95% CI, 1.1-4.3) and population controls (overweight: OR, 2.1; 95% CI, 1.2-4.0; obese: OR, 3.8; 95% CI, 2.0-7.0). Using population controls, women with at least one live birth were more likely to have adenomyosis than nulliparous women (OR, 3.4; 95% CI, 1.9-6.2). Although some risk factors persisted in analyses using either control group, divergent results in relation to other risk factors for adenomyosis suggest that results of investigations of this disease may be affected by the choice of the comparison population. Published by Elsevier Inc.

  16. Selected topics in high temperature chemistry defect chemistry of solids

    CERN Document Server

    Johannesen, Ø

    2013-01-01

    The properties of materials at high temperature play a vital role in their processing and practical use. The real properties of materials at elevated temperatures are very often governed by defects in their structure. Lattice defects may consist of point defects like vacancies, interstitial atoms or substituted atoms. These classes are discussed in general and specifically for oxides, nitrides, carbides and sulfides. Defect aggregates, shear structures and adaptive structures are also described. Special attention is paid to hydrogen defects which seem to play an important role in several mater

  17. Gene-environment correlation in the development of adolescent substance abuse: selection effects of child personality and mediation via contextual risk factors.

    Science.gov (United States)

    Hicks, Brian M; Johnson, Wendy; Durbin, C Emily; Blonigen, Daniel M; Iacono, William G; McGue, Matt

    2013-02-01

    We used a longitudinal twin design to examine selection effects of personality traits at age 11 on high-risk environmental contexts at age 14 and the extent to which these contexts mediated risk for substance abuse at age 17. Socialization at age 11 (willingness to follow rules and endorse conventional values) predicted exposure to contextual risk at age 14. Contextual risk partially mediated the effect of socialization on substance abuse, though socialization also had a direct effect. In contrast, boldness at age 11 (social engagement and assurance, thrill seeking, and stress resilience) also predicted substance abuse directly but was unrelated to contextual risk. There was substantial overlap in the genetic and shared environmental influences on socialization and contextual risk, and genetic risk in socialization contributed to substance abuse indirectly via increased exposure to contextual risk. This suggests that active gene-environment correlations related to individual differences in socialization contributed to an early, high-risk developmental trajectory for adolescent substance abuse. In contrast, boldness appeared to index an independent and direct genetic risk factor for adolescent substance abuse.

  18. Learning rate and temperament in a high predation risk environment

    Science.gov (United States)

    DePasquale, C.; Wagner, Tyler; Archard, G.A.; Ferguson, B.; Braithwaite, V.A.

    2014-01-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration—collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  19. Learning rate and temperament in a high predation risk environment.

    Science.gov (United States)

    DePasquale, C; Wagner, T; Archard, G A; Ferguson, B; Braithwaite, V A

    2014-11-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration-collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  20. Food-drug interactions: Careful drug selection and patient counseling can reduce the risk in older patients.

    Science.gov (United States)

    Leibovitch, Eric R; Deamer, Robert L; Sanderson, Leslie A

    2004-03-01

    Older patients are at high risk for food-drug Interactions. These patients are commonly on multiple medications for chronic medical conditions. Age-related physiologic changes affecting drug absorption, distribution, metabolism and excretion, as well as drug action occur in these patients, and this variability in drug action may be further potentiated by interactions with foods. The most prominent interactions involve drug absorption from the GI tract; however alterations in drug metabolism are also highly significant. Food-drug interactions have been reported amongst a wide range of therapeutic drug classes, including, but not limited to, cardiovascular, psychoactive, anti-infective, endocrinologic, gastrointestinal, and respiratory agents. Health care providers can prevent significant drug therapy-related morbidity by carefully selecting drugs for geriatric patients and thoroughly counseling these patients about drug interactions with the foods they eat.

  1. The Dark Side of the Moon: Meta-analytical Impact of Recruitment Strategies on Risk Enrichment in the Clinical High Risk State for Psychosis.

    Science.gov (United States)

    Fusar-Poli, Paolo; Schultze-Lutter, Frauke; Cappucciati, Marco; Rutigliano, Grazia; Bonoldi, Ilaria; Stahl, Daniel; Borgwardt, Stephan; Riecher-Rössler, Anita; Addington, Jean; Perkins, Diana O; Woods, Scott W; McGlashan, Thomas; Lee, Jimmy; Klosterkötter, Joachim; Yung, Alison R; McGuire, Philip

    2016-05-01

    The individual risk of developing psychosis after being tested for clinical high-risk (CHR) criteria (posttest risk of psychosis) depends on the underlying risk of the disease of the population from which the person is selected (pretest risk of psychosis), and thus on recruitment strategies. Yet, the impact of recruitment strategies on pretest risk of psychosis is unknown. Meta-analysis of the pretest risk of psychosis in help-seeking patients selected to undergo CHR assessment: total transitions to psychosis over the pool of patients assessed for potential risk and deemed at risk (CHR+) or not at risk (CHR-). Recruitment strategies (number of outreach activities per study, main target of outreach campaign, and proportion of self-referrals) were the moderators examined in meta-regressions. 11 independent studies met the inclusion criteria, for a total of 2519 (CHR+: n = 1359; CHR-: n = 1160) help-seeking patients undergoing CHR assessment (mean follow-up: 38 months). The overall meta-analytical pretest risk for psychosis in help-seeking patients was 15%, with high heterogeneity (95% CI: 9%-24%, I (2) = 96, P < .001). Recruitment strategies were heterogeneous and opportunistic. Heterogeneity was largely explained by intensive (n = 11, β = -.166, Q = 9.441, P = .002) outreach campaigns primarily targeting the general public (n = 11, β = -1.15, Q = 21.35, P < .001) along with higher proportions of self-referrals (n = 10, β = -.029, Q = 4.262, P = .039), which diluted pretest risk for psychosis in patients undergoing CHR assessment. There is meta-analytical evidence for overall risk enrichment (pretest risk for psychosis at 38 monhts = 15%) in help-seeking samples selected for CHR assessment as compared to the general population (pretest risk of psychosis at 38 monhts=0.1%). Intensive outreach campaigns predominantly targeting the general population and a higher proportion of self-referrals diluted the pretest risk for psychosis. © The Author 2015. Published by

  2. Common Risk Alleles for Inflammatory Diseases Are Targets of Recent Positive Selection

    Science.gov (United States)

    Raj, Towfique; Kuchroo, Manik; Replogle, Joseph M.; Raychaudhuri, Soumya; Stranger, Barbara E.; De Jager, Philip L.

    2013-01-01

    Genome-wide association studies (GWASs) have identified hundreds of loci harboring genetic variation influencing inflammatory-disease susceptibility in humans. It has been hypothesized that present day inflammatory diseases may have arisen, in part, due to pleiotropic effects of host resistance to pathogens over the course of human history, with significant selective pressures acting to increase host resistance to pathogens. The extent to which genetic factors underlying inflammatory-disease susceptibility has been influenced by selective processes can now be quantified more comprehensively than previously possible. To understand the evolutionary forces that have shaped inflammatory-disease susceptibility and to elucidate functional pathways affected by selection, we performed a systems-based analysis to integrate (1) published GWASs for inflammatory diseases, (2) a genome-wide scan for signatures of positive selection in a population of European ancestry, (3) functional genomics data comprised of protein-protein interaction networks, and (4) a genome-wide expression quantitative trait locus (eQTL) mapping study in peripheral blood mononuclear cells (PBMCs). We demonstrate that loci for inflammatory-disease susceptibility are enriched for genomic signatures of recent positive natural selection, with selected loci forming a highly interconnected protein-protein interaction network. Further, we identify 21 loci for inflammatory-disease susceptibility that display signatures of recent positive selection, of which 13 also show evidence of cis-regulatory effects on genes within the associated locus. Thus, our integrated analyses highlight a set of susceptibility loci that might subserve a shared molecular function and has experienced selective pressure over the course of human history; today, these loci play a key role in influencing susceptibility to multiple different inflammatory diseases, in part through alterations of gene expression in immune cells. PMID:23522783

  3. High-dose chemotherapy with hematopoietic stem-cell rescue for high-risk breast cancer

    NARCIS (Netherlands)

    Rodenhuis, S; Bontenbal, M; Beex, LVAM; Wagstaff, J; Richel, DJ; Nooij, MA; Voest, EE; Hupperets, P; van Tinteren, H; Peterse, HL; TenVergert, EM; de Vries, EGE

    2003-01-01

    BACKGROUND: The use of high-dose adjuvant chemotherapy for high-risk primary breast cancer is controversial. We studied its efficacy in patients with 4 to 9 or 10 or more tumor-positive axillary lymph nodes. METHODS: Patients younger than 56 years of age who had undergone surgery for breast cancer

  4. NKS NordRisk. Atlas of long-range atmospheric dispersion and deposition of radionuclides from selected risk sites in the Northern Hemisphere

    Energy Technology Data Exchange (ETDEWEB)

    Havskov Soerensen, J.; Baklanov, A.; Mahura, A. (Danish Meteorological Institute, Copenhagen (Denmark)); Lauritzen, Bent; Mikkelsen, Torben (Technical Univ. of Denmark, Risoe National Lab. for Sustainable Energy, Roskilde (Denmark))

    2008-07-15

    Within the NKS NordRisk project, 'Nuclear risk from atmospheric dispersion in Northern Europe', the NKS NordRisk Atlas has been developed. The atlas describes risks from hypothetical long-range atmospheric dispersion and deposition of radionuclides from selected nuclear risk sites in the Northern Hemisphere. A number of case studies of long-term long-range atmospheric transport and deposition of radionuclides has been developed, based on two years of meteorological data. Radionuclide concentrations in air and radionuclide depositions have been evaluated and examples of long-term averages of the dispersion and deposition and of the variability around these mean values are provided. (au)

  5. When selection ratios are high: predicting the expatriation willingness of prospective domestic entry-level job applicants

    NARCIS (Netherlands)

    Mol, S.T.; Born, M.P.; Willemsen, M.E.; van der Molen, H.T.; Derous, E.

    2009-01-01

    High expatriate selection ratios thwart the ability of multinational organizations to select expatriates. Reducing the selection ratio may be accomplished by selecting those applicants for entry level domestic positions who have expatriate aspirations. Regression analyses conducted on data from a

  6. Dynamo Enhancement and Mode Selection Triggered by High Magnetic Permeability

    Science.gov (United States)

    Kreuzahler, S.; Ponty, Y.; Plihon, N.; Homann, H.; Grauer, R.

    2017-12-01

    We present results from consistent dynamo simulations, where the electrically conducting and incompressible flow inside a cylinder vessel is forced by moving impellers numerically implemented by a penalization method. The numerical scheme models jumps of magnetic permeability for the solid impellers, resembling various configurations tested experimentally in the von Kármán sodium experiment. The most striking experimental observations are reproduced in our set of simulations. In particular, we report on the existence of a time-averaged axisymmetric dynamo mode, self-consistently generated when the magnetic permeability of the impellers exceeds a threshold. We describe a possible scenario involving both the turbulent flow in the vicinity of the impellers and the high magnetic permeability of the impellers.

  7. [Employees in high-reliability organizations: systematic selection of personnel as a final criterion].

    Science.gov (United States)

    Oubaid, V; Anheuser, P

    2014-05-01

    Employees represent an important safety factor in high-reliability organizations. The combination of clear organizational structures, a nonpunitive safety culture, and psychological personnel selection guarantee a high level of safety. The cockpit personnel selection process of a major German airline is presented in order to demonstrate a possible transferability into medicine and urology.

  8. High familial risk for mood disorder is associated with low dorsolateral prefrontal cortex serotonin transporter binding

    DEFF Research Database (Denmark)

    Frokjaer, Vibe G; Vinberg, Maj; Erritzoe, David

    2009-01-01

    Mood disorders are elicited through a combination of genetic and environmental stress factors, and treatment with selective serotonin reuptake inhibitors ameliorates depressive symptoms. Changes in the serotonin transporter (SERT) binding may therefore occur in depressive patients and in subjects...... at risk for developing depression. The aim of this study was to explore whether abnormalities in SERT might be present in healthy individuals with familial predisposition to mood disorder. Nine individuals at high familial risk (mean age 32.2+/-4.2 years) and 11 individuals at low risk (mean age 32.......4+/-5.0 years) for developing mood disorder were included. The subjects were healthy twins with or without a co-twin history of mood disorder identified by linking information from the Danish Twin Register and the Danish Psychiatric Central Register. Regional in vivo brain serotonin transporter binding...

  9. Efficacy of smartphone applications in high-risk pigmented lesions.

    Science.gov (United States)

    Ngoo, Alexander; Finnane, Anna; McMeniman, Erin; Tan, Jean-Marie; Janda, Monika; Soyer, H Peter

    2017-02-27

    Melanoma apps are smartphone applications that assess risk of pigmented lesions using a smartphone camera and underlying algorithm. We aimed to assess the capability of melanoma smartphone applications (apps) in making clinical decisions about risk, compared with lesion assessment by specialist trained dermatologists. A prospective study of 3 melanoma apps was conducted between 2015 and 2016, recruiting 30 patients with 57 pigmented lesions. Risk categories assigned by the apps were compared with the clinical decisions of two consultant dermatologists classifying lesions as 'suspicious' or 'benign'. Of the 42 lesions deemed clinically suspicious to a dermatologist, from 9 to 26 were classified as suspicious by the apps; of the 15 clinically benign lesions 3 to 15 were correctly classified as benign by the apps. The apps' sensitivity and specificity ranged from 21 to 72% and 27 to 100.0%, respectively, when compared with the specialists' decisions. Two apps were unable to analyse 14 and 18% of lesions submitted, respectively. Interrater agreement between dermatologists and apps was poor (κ = -0.01 SE = 0.16; P = 0.97) to slight (κ = 0.16 SE = 0.09; P = 0.12). None of the melanoma apps tested had high enough agreement with the dermatologist's clinical opinion to be considered to provide additional benefit to patients in assessing their skin for high-risk pigmented lesions. The low sensitivity in detecting lesions that are suspicious to a trained specialist may mean false reassurance is being given to patients. Development of highly sensitive and specific melanoma apps remains a work in progress. © 2017 The Australasian College of Dermatologists.

  10. Preterm birth risk at high altitude in Peru.

    Science.gov (United States)

    Levine, Lisa D; Gonzales, Gustavo F; Tapia, Vilma L; Gasco, Manuel; Sammel, Mary D; Srinivas, Sindhu K; Ludmir, Jack

    2015-02-01

    High altitude has been implicated in a variety of adverse pregnancy outcomes including preeclampsia and stillbirth. Smaller studies show conflicting data on the association between high altitude and preterm birth (PTB). The objective of this study was to assess the association between altitude and PTB. A retrospective cohort study was performed using data from the Perinatal Information System, which includes deliveries from 43 hospitals in Peru from 2000 through 2010. Altitude was classified into the following categories: low (0-1999 m), moderate (2000-2900 m), and high (3000-4340 m). The primary outcome was PTB (delivery <37 weeks). Secondary outcomes were cesarean delivery and small for gestational age (SGA). Deliveries less than 23 weeks are not included in the database. χ(2) analyses were performed to compare categorical variables, and a logistic regression was used to calculate the odds ratios and control for confounders. Clustering by hospital was accounted for using generalized estimating equations. A total of 550,166 women were included (68% low, 15% moderate, 17% high altitude). The overall PTB rate was 5.9%, with no difference in the PTB rate among the 3 altitudes (5.6%, 6.2%, 6.8%, P = .13). There was a significant difference in cesarean rates (28.0%, 26.6%, 20.6%, P < .001) with a 34% decreased risk at high vs low altitude adjusted for confounders (adjusted odds ratio, 0.66; 95% confidence interval, 0.51-0.85). There was a difference in SGA (3.3%, 3.6%, 5.0%, P = .02) with a 51% increased risk at high vs low altitude adjusted for confounders (adjusted odds ratio, 1.49; 95% confidence interval, 1.14-1.93). High altitude is not associated with PTB. At high altitude, the cesarean rate was reduced and the SGA rate was increased. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW.

    Science.gov (United States)

    Mirzaei, Mojtaba; Ahmadi, Khodabakhsh; Saadat, Seyed-Hassan; Ramezani, Mohammad Arash

    2016-02-01

    Sexual behavior is a complex activity affecting all aspects of human's life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures. we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of "risky sexual behavior assessment", "sexual risk assessment", "high risk sexual behavior", "sexual risk taking". By reviewing references of the articles, some complementary studies were added. Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin. Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended.

  12. High performance selectively oxidized VCSELs and arrays for parallel high-speed optical interconnects

    Science.gov (United States)

    Mederer, Felix; Grabherr, Martin; Eberhard, Franz; Ecker, Irene; Jäger, Roland; Joos, Jürgen; Jung, Chistian; Kicherer, Max; King, Roger; Schnitzer, Peter; Unold, Heiko; Wiedenmann, Dieter; Ebeling, Karl Joachim

    We introduce a new layout for high-bandwidth single-mode selectively oxidized vertical-cavity surface-emitting laser (VCSEL) arrays operating at 980 nm or 850 nm emission wavelength for substrate or epitaxial side emission. Coplanar feeding lines and polyimide passivation are used to reduce electrical parasitics in top-emitting GaAs and bottom-emitting InGaAs VCSELs. In order to enhance fundamental single-mode emission for larger devices of reduced series resistance a surface relief transverse mode filter is employed. Fabricated VCSELs are applied in various interconnect schemes. In detail, we demonstrate 2.5 Gb/s pseudo-random data transmission with GaAs VCSELs at an emission wavelength of λ=835 nm over 120 μm core diameter step index plastic-optical fiber (POF) of 2.5 m length. InGaAs quantum-well based VCSELs at 935 nm emission wavelength are investigated for use in perfluorinated graded-index plastic-optical fiber (GI-POF) links. We obtain a 7 Gb/s pseudo random bit sequence (PRBS) non-return-to-zero (NRZ) data transmission over 80 m long 155 μm diameter GI-POF. We investigate data transmission over standard 1300 nm, 9 μm core diameter single-mode fiber using selectively oxidized single-mode GaAs or InGaAs VCSELs. We achieve biased 3 Gb/s and bias-free 1 Gb/s pseudo-random data transmission over 4.3 km at 830 nm emission wavelength where a simple fiber mode filter is used to suppress intermodal dispersion caused by the second order fiber mode. For the first time, we demonstrate 12.5 Gb/s data rate transmission of PRBS signals over 100 m graded-index multimode fiber or 1 km single-mode fiber using high performance single-mode GaAs VCSELs of 12.3 GHz modulation bandwidth emitting at λ=850 nm. Longer wave-length InGaAs VCSELs with emission at λ=1130 nm are used to transmit 2.5 Gb/s signals over 10 km of 9 μm standard fiber. For all data transmission experiments bit-error rates (BER) remain better than 10-11 for transmission of PRBS signals for back

  13. Psychosocial differences in high risk versus low risk acute low-back pain patients.

    Science.gov (United States)

    Pulliam, C B; Gatchel, R J; Gardea, M A

    2001-03-01

    The current study built upon previous research that predicted with 90.7% accuracy which patients presenting with acute low-back pain go on to develop chronic disability problems. Fifty-seven patients were classified as high risk (HR) or low risk (LR) according to a predictive algorithm, and were evaluated with a variety of psychosocial measures. Overall, HR patients had more Axis I pathology than LR patients, and used poorer coping styles. Logistic regression analyses identified variables that differentiated, with 80% accuracy, between the HR and LR patients. The results highlight the importance of identifying patients who are at risk for developing chronic pain following acute injury so that prophylactic intervention can be offered before chronic pain disability status becomes entrenched.

  14. Flood Risk Assessment on Selected Critical Infrastructure in Kota Marudu Town, Sabah, Malaysia

    Directory of Open Access Journals (Sweden)

    Ayog Janice Lynn

    2017-01-01

    Full Text Available This study investigates the risk of flood on selected critical infrastructure in a flood-prone catchment in Sabah, Malaysia. Kota Marudu, located in the Bandau floodplain, one of the Sabah’s northern water catchments, was selected as the study site due to its frequent flood occurrence and large floodplain coverage. Two of its largest rivers, namely Sungai Bongon and Sungai Bandau, tends to flood during rainy season and cause temporary displacements of thousands of people living in the floodplain. A total of 362 respondents participated in the questionnaire survey in order to gather information on historical flood occurrence. Three flood depth groups were determined, which are 1 less than 0.3 meter, 2 0.3 – 0.6 meter and 3 more than 0.6 meter, while three categories of critical infrastructure were defined, namely transportation system, communication system and buildings. It is found that the transportation system encounters the most severe impact as flood inundation increases, where 92% of the respondents believe that the transportation access should be abandoned when flood depth is more than 0.6m. The findings of this study will be used for detailed risk assessment, specifically on the vulnerability of the critical infrastructures to flood in this floodplain.

  15. Evaluation of Selected Atherosclerosis Risk Factors in Women with Subclinical Hypothyroidism Treated with L-Thyroxine.

    Science.gov (United States)

    Adamarczuk-Janczyszyn, Maria; Zdrojowy-Wełna, Aleksandra; Rogala, Natalia; Zatońska, Katarzyna; Bednarek-Tupikowska, Grażyna

    2016-01-01

    Subclinical hypothyroidism (SCH) is a common endocrine disorder, probably increasing cardiovascular (CV) risk. However, the relation between SCH and atherosclerosis risk factors remains unclear. The aim of the study was to evaluate selected atherosclerosis risk factors in women with SCH in comparison to a group of healthy women and women with overt hypothyroidism, as well as to investigate the influence of L-thyroxine replacement on those risk factors. The study group consisted of 187 obese women aged between 50 and 70 years: 100 women with SCH, 45 women with overt hypothyroidism and 42 women with TSH level in reference ranges. Anthropometric parameters were evaluated. Laboratory tests included thyroid hormones concentrations, lipid profile with apolipoproteins, CRP, homocysteine. Atherosclerotic indexes were calculated: LDL C/HDL C ratio, apoA1/apoB ratio and Castelli risk index. Women with hypothyroidism were given L-thyroxine treatment and after 6 months in euthyroidism the evaluation was repeated. Total cholesterol, LDL-cholesterol and triglycerides concentrations as well as LDL-C/HDL-C ratio and Castelli index were higher in SCH than in controls and decreased after L-thyroxin substitution. All of the calculated atherosclerosis indexes showed significant positive correlations with TSH concentration in SCH group. Also in this group the systolic and diastolic blood pressure decreased significantly after treatment. Dyslipidemia in obese SCH women is not severe, but if untreated for many years, it may lead to atherosclerosis. Substitution therapy improves the lipid profile, changing the relations between protective and proatherogenic fractions of serum lipids, and optimises blood pressure.

  16. Risk Factors for Inadequate Defibrillation Safety Margins Vary With the Underlying Cardiac Disease: Implications for Selective Testing Strategies

    NARCIS (Netherlands)

    Bonnes, J.L.; Westra, S.W.; Bouwels, L.H.; Boer, M.J. de; Brouwer, M.A.; Smeets, J.L.R.M.

    2016-01-01

    INTRODUCTION: In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial

  17. [Home care for the high-risk newborn infant].

    Science.gov (United States)

    Puddu, M

    2010-06-01

    With increased survival of extremely low birth weigh (ELBW) and very ill infants, a lot of them are discharged with unresolved medical issues that complicate their subsequent care. Infants born preterm with low birth weight who require neonatal intensive care experience a much higher rate of hospital readmission and death during the first year after birth compared with healthy term infants. Despite initial hospital care which is one of the most expensive of all kind of hospitalization, home care services are sometimes still sparse though the high risk of this group for failure to thrive, respiratory problems, developmental delays, parenting problems. In addition, societal and economic forces have come to bear on the timing and process of discharge and home care. Moreover it takes time for the family of a high-risk infant to prepare to care for their infant in a home setting and to obtain the necessary support services and mobilize community resources. Careful preparation for discharge, good follow-up and medical home after discharge may reduce these risks.

  18. Thermal Expansion Studies of Selected High Temperature Thermoelectric Materials

    Science.gov (United States)

    Ravi, Vilupanur; Firdosy, Samad; Caillat, Thierry; Brandon, Erik; Van Der Walde, Keith; Maricic, Lina; Sayir, Ali

    2008-01-01

    Radioisotope thermoelectric generators (RTGs) generate electrical power by converting the heat released from the nuclear decay of radioactive isotopes (typically plutonium-238) into electricity using a thermoelectric converter. RTGs have been successfully used to power a number of space missions and have demonstrated their reliability over an extended period of time (tens of years) and are compact, rugged, radiation resistant, scalable, and produce no noise, vibration or torque during operation. System conversion efficiency for state-of-practice RTGs is about 6% and specific power less than or equal to 5.1 W/kg. Higher specific power would result in more on-board power for the same RTG mass, or less RTG mass for the same on-board power. The Jet Propulsion Laboratory has been leading, under the advanced thermoelectric converter (ATEC) project, the development of new high-temperature thermoelectric materials and components for integration into advanced, more efficient RTGs. Thermoelectric materials investigated to date include skutterudites, the Yb14MnSb11 compound, and SiGe alloys. The development of long-lived thermoelectric couples based on some of these materials has been initiated and is assisted by a thermo-mechanical stress analysis to ensure that all stresses under both fabrication and operation conditions will be within yield limits for those materials. Several physical parameters are needed as input to this analysis. Among those parameters, the coefficient of thermal expansion (CTE) is critically important. Thermal expansion coefficient measurements of several thermoelectric materials under consideration for ATEC are described in this paper. The stress response at the interfaces in material stacks subjected to changes in temperature is discussed, drawing on work from the literature and project-specific tools developed here. The degree of CTE mismatch and the associated effect on the formation of stress is highlighted.

  19. Bias and Efficiency Tradeoffs in the Selection of Storm Suites Used to Estimate Flood Risk

    Directory of Open Access Journals (Sweden)

    Jordan R. Fischbach

    2016-02-01

    Full Text Available Modern joint probability methods for estimating storm surge or flood statistics are based on statistical aggregation of many hydrodynamic simulations that can be computationally expensive. Flood risk assessments that consider changing future conditions due to sea level rise or other drivers often require each storm to be run under a range of uncertain scenarios. Evaluating different flood risk mitigation measures, such as levees and floodwalls, in these future scenarios can further increase the computational cost. This study uses the Coastal Louisiana Risk Assessment model (CLARA to examine tradeoffs between the accuracy of estimated flood depth exceedances and the number and type of storms used to produce the estimates. Inclusion of lower-intensity, higher-frequency storms significantly reduces bias relative to storm suites with a similar number of storms but only containing high-intensity, lower-frequency storms, even when estimating exceedances at very low-frequency return periods.

  20. Correlates of hopelessness in the high suicide risk police occupation.

    Science.gov (United States)

    Violanti, John M; Andrew, Michael E; Mnatsakanova, Anna; Hartley, Tara A; Fekedulegn, Desta; Burchfiel, Cecil M

    Police officers are chronically exposed to work stress. We examined specific stressors that may be associated with hopelessness, a possible risk factor for suicide in this high suicide risk population. The study included 378 officers (276 men and 102 women) with complete data. Analysis of variance was used to estimate mean levels of hopelessness scores as associated with stress, adjusted for age, gender, and race/ ethnicity. Posttraumatic symptoms were tested as a modifier of the association between stress and hopelessness. Increasing stress of administrative practices and lack of support were significantly associated with increasing hopelessness among officers (p hopelessness range: 1.64-2.65; and p hopelessness range 1.60-2.80, respectively). Posttraumatic stress disorder (PTSD) symptoms significantly modified the association between lack of organizational support and hopelessness (p hopelessness is associated with specific stressors in police work, and this is modified by posttraumatic symptomatology.

  1. Despotism and risk of infanticide influence grizzly bear den-site selection.

    Directory of Open Access Journals (Sweden)

    Nathan S Libal

    Full Text Available Given documented social dominance and intraspecific predation in bear populations, the ideal despotic distribution model and sex hypothesis of sexual segregation predict adult female grizzly bears (Ursus arctos will avoid areas occupied by adult males to reduce risk of infanticide. Under ideal despotic distribution, juveniles should similarly avoid adult males to reduce predation risk. Den-site selection and use is an important component of grizzly bear ecology and may be influenced by multiple factors, including risk from conspecifics. To test the role of predation risk and the sex hypothesis of sexual segregation, we compared adult female (n = 142, adult male (n = 36, and juvenile (n = 35 den locations in Denali National Park and Preserve, Alaska, USA. We measured elevation, aspect, slope, and dominant land cover for each den site, and used maximum entropy modeling to determine which variables best predicted den sites. We identified the global model as the best-fitting model for adult female (area under curve (AUC = 0.926 and elevation as the best predictive variable for adult male (AUC = 0.880 den sites. The model containing land cover and elevation best-predicted juvenile (AUC = 0.841 den sites. Adult females spatially segregated from adult males, with dens characterized by higher elevations (mean= 1,412 m, SE = 52 and steeper slopes (mean = 21.9°, SE = 1.1 than adult male (elevation: mean = 1,209 m, SE = 76; slope: mean = 15.6°, SE = 1.9 den sites. Juveniles used a broad range of landscape attributes but did not avoid adult male denning areas. Observed spatial segregation by adult females supports the sex hypothesis of sexual segregation and we suggest is a mechanism to reduce risk of infanticide. Den site selection of adult males is likely related to distribution of food resources during spring.

  2. Despotism and risk of infanticide influence grizzly bear den-site selection.

    Science.gov (United States)

    Libal, Nathan S; Belant, Jerrold L; Leopold, Bruce D; Wang, Guiming; Owen, Patricia A

    2011-01-01

    Given documented social dominance and intraspecific predation in bear populations, the ideal despotic distribution model and sex hypothesis of sexual segregation predict adult female grizzly bears (Ursus arctos) will avoid areas occupied by adult males to reduce risk of infanticide. Under ideal despotic distribution, juveniles should similarly avoid adult males to reduce predation risk. Den-site selection and use is an important component of grizzly bear ecology and may be influenced by multiple factors, including risk from conspecifics. To test the role of predation risk and the sex hypothesis of sexual segregation, we compared adult female (n = 142), adult male (n = 36), and juvenile (n = 35) den locations in Denali National Park and Preserve, Alaska, USA. We measured elevation, aspect, slope, and dominant land cover for each den site, and used maximum entropy modeling to determine which variables best predicted den sites. We identified the global model as the best-fitting model for adult female (area under curve (AUC) = 0.926) and elevation as the best predictive variable for adult male (AUC = 0.880) den sites. The model containing land cover and elevation best-predicted juvenile (AUC = 0.841) den sites. Adult females spatially segregated from adult males, with dens characterized by higher elevations (mean= 1,412 m, SE = 52) and steeper slopes (mean = 21.9°, SE = 1.1) than adult male (elevation: mean = 1,209 m, SE = 76; slope: mean = 15.6°, SE = 1.9) den sites. Juveniles used a broad range of landscape attributes but did not avoid adult male denning areas. Observed spatial segregation by adult females supports the sex hypothesis of sexual segregation and we suggest is a mechanism to reduce risk of infanticide. Den site selection of adult males is likely related to distribution of food resources during spring.

  3. Entropy measure of credit risk in highly correlated markets

    Science.gov (United States)

    Gottschalk, Sylvia

    2017-07-01

    We compare the single and multi-factor structural models of corporate default by calculating the Jeffreys-Kullback-Leibler divergence between their predicted default probabilities when asset correlations are either high or low. Single-factor structural models assume that the stochastic process driving the value of a firm is independent of that of other companies. A multi-factor structural model, on the contrary, is built on the assumption that a single firm's value follows a stochastic process correlated with that of other companies. Our main results show that the divergence between the two models increases in highly correlated, volatile, and large markets, but that it is closer to zero in small markets, when asset correlations are low and firms are highly leveraged. These findings suggest that during periods of financial instability, when asset volatility and correlations increase, one of the models misreports actual default risk.

  4. Combining Co-Benefits and Stakeholders Perceptions into Green Infrastructure Selection for Flood Risk Reduction

    Directory of Open Access Journals (Sweden)

    Alida Alves

    2018-02-01

    Full Text Available An important increase in flood risk levels is expected in future decades in many areas around the globe. In addition, the traditional approaches for flood management offer options with low sustainability. As a response, the use of non-traditional drainage measures, also called green infrastructures, has been increasingly suggested in the last years. One important reason for their increasing popularity has been the co-benefits that they offer to the environment. The development of an efficient planning for sustainable urban drainage systems is a complex process that needs the involvement of multiple stakeholders. Moreover, the measures to be adopted should be evaluated considering their potential to achieve multiple benefits related to human well-being, rather than just to flood risk management. In this work, we propose a framework for the selection of green infrastructures on the basis of a co-benefits analysis. The aim is to include the achievement of co-benefits and human well-being into decision-making for flood management, considering the stakeholders’ perceptions to define the most important benefits to be enhanced. The application of the framework presented here to a case study in Ayutthaya, Thailand, shows the importance of including different stakeholder’s opinions. In addition, it shows that decision makers should consider locally defined co-benefits as well as flood risk reduction when defining which green infrastructures to apply.

  5. Risk-based decision-making framework for the selection of sediment dredging option.

    Science.gov (United States)

    Manap, Norpadzlihatun; Voulvoulis, Nikolaos

    2014-10-15

    The aim of this study was to develop a risk-based decision-making framework for the selection of sediment dredging option. Descriptions using case studies of the newly integrated, holistic and staged framework were followed. The first stage utilized the historical dredging monitoring data and the contamination level in media data into Ecological Risk Assessment phases, which have been altered for benefits in cost, time and simplicity. How Multi-Criteria Decision Analysis (MCDA) can be used to analyze and prioritize dredging areas based on environmental, socio-economic and managerial criteria was described for the next stage. The results from MCDA will be integrated into Ecological Risk Assessment to characterize the degree of contamination in the prioritized areas. The last stage was later described using these findings and analyzed using MCDA, in order to identify the best sediment dredging option, accounting for the economic, environmental and technical aspects of dredging, which is beneficial for dredging and sediment management industries. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Foraging patch selection in winter: a balance between predation risk and thermoregulation benefit.

    Science.gov (United States)

    Villén-Pérez, Sara; Carrascal, Luis M; Seoane, Javier

    2013-01-01

    In winter, foraging activity is intended to optimize food search while minimizing both thermoregulation costs and predation risk. Here we quantify the relative importance of thermoregulation and predation in foraging patch selection of woodland birds wintering in a Mediterranean montane forest. Specifically, we account for thermoregulation benefits related to temperature, and predation risk associated with both illumination of the feeding patch and distance to the nearest refuge provided by vegetation. We measured the amount of time that 38 marked individual birds belonging to five small passerine species spent foraging at artificial feeders. Feeders were located in forest patches that vary in distance to protective cover and exposure to sun radiation; temperature and illumination were registered locally by data loggers. Our results support the influence of both thermoregulation benefits and predation costs on feeding patch choice. The influence of distance to refuge (negative relationship) was nearly three times higher than that of temperature (positive relationship) in determining total foraging time spent at a patch. Light intensity had a negligible and no significant effect. This pattern was generalizable among species and individuals within species, and highlights the preponderance of latent predation risk over thermoregulation benefits on foraging decisions of birds wintering in temperate Mediterranean forests.

  7. 2017 Taiwan lipid guidelines for high risk patients

    Directory of Open Access Journals (Sweden)

    Yi-Heng Li

    2017-04-01

    Full Text Available In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C and non-high density lipoprotein cholesterol (non-HDL-C are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD, including coronary artery disease (CAD, ischemic stroke and peripheral arterial disease (PAD. Because the risk of ASCVD is high in patients with diabetes mellitus (DM, chronic kidney disease (CKD and familial hypercholesterolemia (FH, lipid control is also necessary in these patients. Lifestyle modification is the first step to control lipid. Weight reduction, regular physical exercise and limitation of alcohol intake all reduce triglyceride (TG levels. Lipid-lowering drugs include HMG-CoA reductase inhibitors (statins, cholesterol absorption inhibitors (ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9 inhibitors, nicotinic acids (niacin, fibric acids derivatives (fibrates, and long-chain omega-3 fatty acids. Statin is usually the first line therapy. Combination therapy with statin and other lipid-lowering agents may be considered in some clinical settings. For patients with acute coronary syndrome (ACS and stable CAD, LDL-C 40 in men and >50 mg/dL in women in DM. LDL-C increased CV risk in patients with CKD. In adults with glomerular filtration rate (GFR < 60 mL/min/1.73m2 without chronic dialysis (CKD stage 3–5, statin therapy should be initiated if LDL-C ≥ 100 mg/dL. Ezetimibe can be added to statin to consolidate the CV protection in CKD patients. Mutations in LDL receptor, apolipoprotein B and PCSK9 genes are the common causes of FH. Diagnosis of FH usually depends on family history, clinical history of premature CAD, physical findings of xanthoma or corneal arcus and high levels of LDL-C. In addition to conventional lipid

  8. High-sensitivity Troponin T Assay in Asymptomatic High Cardiovascular Risk Patients. The TUSARC Registry.

    Science.gov (United States)

    Álvarez, Isabel; Hernández, Luis; García, Héctor; Villamandos, Vicente; López, María Gracia; Palazuelos Molinero, Jorge; Martín Raymondi, Diego

    2017-04-01

    High-sensitivity troponin T assays (Hs-TnT) have been carried out in selected populations in clinical trials and in registries of the general population with low cardiovascular risk (CVR). The aim of this study was to determine the proportion of individuals with detectable Hs-TnT and the proportion of individuals with elevated Hs-TnT in a Spanish population of asymptomatic individuals with very high CVR, as well as the parameters associated with Hs-TnT elevation. The study included 690 patients. Hs-TnT detection and Hs-TnT elevation (≥99th percentile value), as well the association of elevated Hs-TnT and clinical, analytical, and treatment data were analyzed. Hs-TnT was analyzed in 646 patients and was detected in 645. Elevated TnT was detected in 212 patients (32.9%). On multivariate analysis, elevated TnT was independently associated with male sex (OR, 2.81; 95%CI, 1.67-4.73; P < .001), older age (OR, 1.06; 95%CI, 1.04-1.09; P < .001), a higher body mass index (OR, 1.07; 95%CI, 1.02-1.12; P < .002), insulin therapy (OR, 1.99; 95%CI, 1.15-3.46; P = .01), history of heart failure (OR, 3.92; 95%CI, 1.24-12.39; P = .02), and estimated glomerular filtration rate calculated by CKD-EPI (OR, 0.96; 95%CI, 0.95-0.97; P < .001). In a Spanish population of asymptomatic individuals at very high CVR, Hs-TnT was associated with older age, male sex, higher body mass index, insulin therapy, history of heart failure, and lower glomerular filtration rate. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  9. Operational Collision Risk Management - Evaluating and Mitigating High-Risk Conjunction Events

    Science.gov (United States)

    Duncan, M.; Wysack, J.

    2011-09-01

    Operational collision threat characterization is now an essential component of space mission operations. Most spacecraft operators have some semblance of a process to evaluate and mitigate high-risk conjunction events. As the size of the space object catalog increases, satellite operators will be faced with more conjunction events to evaluate. Thus more sophisticated collision threat characterization and collision avoidance strategies must be implemented. This paper presents an overview of SpaceNav’s Collision Risk Management software. The software suite enables mission stakeholders to qualify high interest conjunction events. The tools produce various figures and graphs, which aid in analyzing event data. Optimal avoidance maneuver solutions are generated for a user defined set of goals and constraints.

  10. Old age, high risk medication, polypharmacy: a trilogy of risks in older patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Wang Y

    2016-06-01

    Full Text Available Background: The safety of pharmacotherapy in atrial fibrillation (AF is compounded by a trilogy of risks old age, high-risk medications (e.g., antithrombotics, antiarrhythmics, polypharmacy due to multiple patient comorbidities. However, to date, scarce study has investigated the use of polypharmacy (including potentially inappropriate medication (PIM in AF patients, and how this may contribute to their overall risk of medication misadventure. Objectives: To review the extent of polypharmacy and PIM use in older patients (65 years or older with AF. Methods: Information was extracted from a database characterising a cohort of older AF patients treated in general practice in New South Wales, Australia. Patient characteristics, number and types of drugs, the degree of PIM use were recorded. The predictors for the use of polypharmacy in older AF patients were identified. Results: Overall, 367 patients (mean age 77.8 years were reviewed, among which 94.8% used 5 medications or more and over half used 10 medications or more. Cardiovascular agents were most commonly used (98.9%, followed by antithrombotics (90.7%. Among agents deemed PIMs, digoxin (30.2% was the most frequently used, followed by benzodiazepines (19.6%, and sotalol (9.8%. AF patients using polypharmacy were more likely to have low bleeding risk (OR=10.97, representing those patients in whom high-risk antithrombotics are mostly indicated. Patients with major-polypharmacy (5-9 medications are more likely to have obstructive pulmonary diseases (OR=2.32, upper gastrointestinal diseases (OR=2.02 and poor physical function (OR=1.04, but less likely to have cognitive impairment (OR=0.27. Conclusion: Polypharmacy affects oldest AF patients, comprising medications that are indicated for AF, yet regarded as PIMs. Patients with lower risk of bleeding, obstructive pulmonary diseases, upper gastrointestinal diseases and poor physical function are also at higher risk of using higher number of

  11. Cross-Sectional Association between Length of Incarceration and Selected Risk Factors for Non-Communicable Chronic Diseases in Two Male Prisons of Mexico City.

    Directory of Open Access Journals (Sweden)

    Omar Silverman-Retana

    Full Text Available Mexico City prisons are characterized by overcrowded facilities and poor living conditions for housed prisoners. Chronic disease profile is characterized by low prevalence of self reported hypertension (2.5% and diabetes (1.8% compared to general population; 9.5% of male inmates were obese. There is limited evidence regarding on the exposure to prison environment over prisoner's health status; particularly, on cardiovascular disease risk factors. The objective of this study is to assess the relationship between length of incarceration and selected risk factors for non-communicable chronic diseases (NCDs.We performed a cross-sectional analysis using data from two large male prisons in Mexico City (n = 14,086. Using quantile regression models we assessed the relationship between length of incarceration and selected risk factors for NCDs; stratified analysis by age at admission to prison was performed. We found a significant negative trend in BMI and WC across incarceration length quintiles. BP had a significant positive trend with a percentage change increase around 5% mmHg. The greatest increase in systolic blood pressure was observed in the older age at admission group.This analysis provides insight into the relationship between length of incarceration and four selected risk factors for NCDs; screening for high blood pressure should be guarantee in order to identify at risk individuals and linked to the prison's health facility. It is important to assess prison environment features to approach potential risk for developing NCDs in this context.

  12. Cross-Sectional Association between Length of Incarceration and Selected Risk Factors for Non-Communicable Chronic Diseases in Two Male Prisons of Mexico City.

    Science.gov (United States)

    Silverman-Retana, Omar; Lopez-Ridaura, Ruy; Servan-Mori, Edson; Bautista-Arredondo, Sergio; Bertozzi, Stefano M

    2015-01-01

    Mexico City prisons are characterized by overcrowded facilities and poor living conditions for housed prisoners. Chronic disease profile is characterized by low prevalence of self reported hypertension (2.5%) and diabetes (1.8%) compared to general population; 9.5% of male inmates were obese. There is limited evidence regarding on the exposure to prison environment over prisoner's health status; particularly, on cardiovascular disease risk factors. The objective of this study is to assess the relationship between length of incarceration and selected risk factors for non-communicable chronic diseases (NCDs). We performed a cross-sectional analysis using data from two large male prisons in Mexico City (n = 14,086). Using quantile regression models we assessed the relationship between length of incarceration and selected risk factors for NCDs; stratified analysis by age at admission to prison was performed. We found a significant negative trend in BMI and WC across incarceration length quintiles. BP had a significant positive trend with a percentage change increase around 5% mmHg. The greatest increase in systolic blood pressure was observed in the older age at admission group. This analysis provides insight into the relationship between length of incarceration and four selected risk factors for NCDs; screening for high blood pressure should be guarantee in order to identify at risk individuals and linked to the prison's health facility. It is important to assess prison environment features to approach potential risk for developing NCDs in this context.

  13. The PANDORA study: peripheral arterial disease in patients with non-high cardiovascular risk.

    Science.gov (United States)

    Cimminiello, Claudio; Kownator, Serge; Wautrecht, Jean-Claude; Carvounis, Christos P; Kranendonk, Stefanus Eliza; Kindler, Beat; Mangrella, Mario; Borghi, Claudio

    2011-12-01

    Few studies are available with sufficient sample size to accurately describe the prevalence of low ankle-brachial index (ABI) in patients at 'non-high' cardiovascular (CV) risk. The aim of this study was to evaluate the prevalence of asymptomatic peripheral arterial disease (PAD), as determined by using ABI, in this patient population. A non-interventional, cross-sectional, pan-European study was conducted in patients with ≥1 CV risk factor in addition to age, evaluating the prevalence of asymptomatic PAD (ABI ≤ 0.90). Secondary objectives included assessing the prevalence and treatment of CV risk factors. Patients were consecutively recruited during scheduled visits to the physician's office, or were randomly selected by the physician from a list of eligible patients. Patients with diabetes were excluded as this condition was deemed to be a secondary prevention risk. 10,287 patients were enrolled (9,816 evaluable: mean age 64.3 years; 53.5% male). Prevalence of asymptomatic PAD was 17.8% (99% CI 16.84-18.83). Factors significantly associated with asymptomatic PAD included hypertension, age, alcohol intake, family history of coronary heart disease, low levels of high-density lipoprotein-cholesterol, and smoking (p < 0.0001). Patients treated with statins were significantly less likely to have asymptomatic PAD than those who were not (odds ratio 0.62; 95% CI 0.50-0.76; p < 0.0001). Asymptomatic PAD was highly prevalent in patients with non-high CV risk, the majority of whom would not typically be candidates for ABI assessment. These patients should be carefully screened, and ABI measured, so that therapeutic interventions known to diminish their increased CV risk may be offered.

  14. High-Dose Citalopram and Escitalopram and the Risk of Out-of-Hospital Death.

    Science.gov (United States)

    Ray, Wayne A; Chung, Cecilia P; Murray, Katherine T; Hall, Kathi; Stein, C Michael

    2017-02-01

    Studies demonstrating that higher doses of citalopram (> 40 mg) and escitalopram (> 20 mg) prolong the corrected QT interval prompted regulatory agency warnings, which are controversial, given the absence of confirmatory clinical outcome studies. We compared the risk of potential arrhythmia-related deaths for high doses of these selective serotonin reuptake inhibitors (SSRIs) to that for equivalent doses of fluoxetine, paroxetine, and sertraline. The Tennessee Medicaid retrospective cohort study included 54,220 persons 30-74 years of age without cancer or other life-threatening illness who were prescribed high-dose SSRIs from 1998 through 2011. The mean age was 47 years, and 76% were female. Demographic characteristics and comorbidity for individual SSRIs were comparable. Because arrhythmia-related deaths are typically sudden and occur outside the hospital, we analyzed out-of-hospital sudden unexpected death as well as sudden cardiac deaths, a more specific indicator of proarrhythmic effects. The adjusted risk of sudden unexpected death for citalopram did not differ significantly from that for the other SSRIs. The respective hazard ratios (HRs) for citalopram versus escitalopram, fluoxetine, paroxetine, and sertraline were 0.84 (95% CI, 0.40-1.75), 1.24 (95% CI, 0.75-2.05), 0.75 (95% CI, 0.45-1.24), and 1.53 (95% CI, 0.91-2.55). There were no significant differences for sudden cardiac death or all study deaths, nor were there significant differences among high-risk patients (≥ 60 years of age, upper quartile baseline cardiovascular risk). Escitalopram users had no significantly increased risk for any study end point. We found no evidence that risk of sudden unexpected death, sudden cardiac death, or total mortality for high-dose citalopram and escitalopram differed significantly from that for comparable doses of fluoxetine, paroxetine, and sertraline.

  15. Fetal and umbilical Doppler ultrasound in high-risk pregnancies.

    Science.gov (United States)

    Alfirevic, Zarko; Stampalija, Tamara; Dowswell, Therese

    2017-06-13

    Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible that false positive Doppler ultrasound findings could lead to adverse outcomes from unnecessary interventions, including preterm delivery. The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes. We updated the search of Cochrane Pregnancy and Childbirth's Trials Register on 31 March 2017 and checked reference lists of retrieved studies. Randomised and quasi-randomised controlled trials of Doppler ultrasound for the investigation of umbilical and fetal vessels waveforms in high-risk pregnancies compared with no Doppler ultrasound. Cluster-randomised trials were eligible for inclusion but none were identified. Two review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Data entry was checked. We assessed the quality of evidence using the GRADE approach. Nineteen trials involving 10,667 women were included. Risk of bias in trials was difficult to assess accurately due to incomplete reporting. None of the evidence relating to our main outcomes was graded as high quality. The quality of evidence was downgraded due to missing information on trial methods, imprecision in risk estimates and heterogeneity. Eighteen of these studies compared the use of Doppler ultrasound of the umbilical artery of the unborn baby with no Doppler or with cardiotocography (CTG). One more recent trial compared Doppler examination of other fetal blood vessels (ductus venosus) with computerised CTG.The use of Doppler ultrasound of the umbilical artery in high-risk pregnancy was associated with fewer perinatal deaths (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.52 to 0.98, 16 studies, 10,225 babies, 1.2% versus 1.7 %, number needed to treat (NNT) = 203; 95% CI 103 to 4352

  16. [Residual risk: The roles of triglycerides and high density lipoproteins].

    Science.gov (United States)

    Grammer, Tanja; Kleber, Marcus; Silbernagel, Günther; Scharnagl, Hubert; März, Winfried

    2016-06-01

    In clinical trials, the reduction of LDL-cholesterol (LDL-C) with statins reduces the incidence rate of cardiovascular events by approximately one third. This means, that a sizeable "residual risk" remains. Besides high lipoprotein (a), disorders in the metabolism of triglyceride-rich lipoproteins and high density liproteins have been implicated as effectors of the residual risk. Both lipoprotein parameters correlate inversely with each other. Therefore, the etiological contributions of triglycerides and / or of HDL for developing cardiovascular disease can hardly be estimated from either observational studies or from intervention studies. The largely disappointing results of intervention studies with inhibitors of the cholesteryl ester transfer protein and in particular the available set of genetically-epidemiological studies suggest that in the last decade, the importance of HDL cholesterol has been overvalued, while the importance of triglycerides has been underestimated. High triglycerides not always atherogenic, but only if they are associated with the accumulation relatively cholesterol-enriched, incompletely catabolized remnants of chylomicrons and very low density lipoproteins (familial type III hyperlipidemia, metabolic syndrome, diabetes mellitus). The normalization of the concentration of triglycerides and remnants by inhibiting the expression of apolipoprotein C3 is hence a new, promising therapeutic target. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Quantitative breast MRI radiomics for cancer risk assessment and the monitoring of high-risk populations

    Science.gov (United States)

    Mendel, Kayla R.; Li, Hui; Giger, Maryellen L.

    2016-03-01

    Breast density is routinely assessed qualitatively in screening mammography. However, it is challenging to quantitatively determine a 3D density from a 2D image such as a mammogram. Furthermore, dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is used more frequently in the screening of high-risk populations. The purpose of our study is to segment parenchyma and to quantitatively determine volumetric breast density on pre-contrast axial DCE-MRI images (i.e., non-contrast) using a semi-automated quantitative approach. In this study, we retroactively examined 3D DCE-MRI images taken for breast cancer screening of a high-risk population. We analyzed 66 cases with ages between 28 and 76 (mean 48.8, standard deviation 10.8). DCE-MRIs were obtained on a Philips 3.0 T scanner. Our semi-automated DCE-MRI algorithm includes: (a) segmentation of breast tissue from non-breast tissue using fuzzy cmeans clustering (b) separation of dense and fatty tissues using Otsu's method, and (c) calculation of volumetric density as the ratio of dense voxels to total breast voxels. We examined the relationship between pre-contrast DCE-MRI density and clinical BI-RADS density obtained from radiology reports, and obtained a statistically significant correlation [Spearman ρ-value of 0.66 (p < 0.0001)]. Our method within precision medicine may be useful for monitoring high-risk populations.

  18. Estimating young Australian adults' risk of hearing damage from selected leisure activities.

    Science.gov (United States)

    Beach, Elizabeth; Williams, Warwick; Gilliver, Megan

    2013-01-01

    Several previous studies have attempted to estimate the risk of noise-induced hearing loss from loud leisure noise. Some of these studies may have overestimated the risk because they used noise estimates taken from the higher end of reported levels. The aim of the present study was to provide a realistic estimate of the number of young Australian adults who may be at risk of hearing damage and eventual hearing loss from leisure-noise exposure. Average noise levels at five high-noise leisure activities, (1) nightclubs; (2) pubs, bars, and registered clubs; (3) fitness classes; (4) live sporting events; (5) concerts and live music venues, were calculated using 108 measurements taken from a large database of leisure noise measurements. In addition, an online survey was administered to a convenience sample of 1000 young adults aged 18 to 35 years, who reported the time spent at these leisure activities and the frequency with which they undertook the activities. They also answered questions about tinnitus and their perceived risk of hearing damage. Although the survey data cannot be considered representative of the population of young Australian adults, it was weighted to this population in respect of age, gender, education, and location. The survey data and the average noise levels were used to estimate each individual's annual noise exposure, and in turn, estimate those at risk of hearing damage from leisure-noise exposure. For the majority of participants (n = 868), the accumulated leisure noise level was within the acceptable workplace limit. However, 132 participants or 14.1% (population weighted) were exposed to an annual noise dose greater than the acceptable workplace noise limit. By far, the main source of high-risk leisure noise was from nightclubs. Those with more leisure-noise exposure experienced more tinnitus and perceived themselves to be more at risk than those with lower noise exposures. It is recommended that nightclub operators reduce noise levels

  19. Heterogeneous natural selection on oxidative phosphorylation genes among fishes with extreme high and low aerobic performance.

    Science.gov (United States)

    Zhang, Feifei; Broughton, Richard E

    2015-08-26

    Oxidative phosphorylation (OXPHOS) is the primary source of ATP in eukaryotes and serves as a mechanistic link between variation in genotypes and energetic phenotypes. While several physiological and anatomical factors may lead to increased aerobic capacity, variation in OXPHOS proteins may influence OXPHOS efficiency and facilitate adaptation in organisms with varied energy demands. Although there is evidence that natural selection acts on OXPHOS genes, the focus has been on detection of directional (positive) selection on specific phylogenetic branches where traits that increase energetic demands appear to have evolved. We examined patterns of selection in a broader evolutionary context, i.e., on multiple lineages of fishes with extreme high and low aerobic performance. We found that patterns of natural selection on mitochondrial OXPHOS genes are complex among fishes with different swimming performance. Positive selection is not consistently associated with high performance taxa and appears to be strongest on lineages containing low performance taxa. In contrast, within high performance lineages, purifying (negative) selection appears to predominate. We provide evidence that selection on OXPHOS varies in both form and intensity within and among lineages through evolutionary time. These results provide evidence for fluctuating selection on OXPHOS associated with divergence in aerobic performance. However, in contrast to previous studies, positive selection was strongest on low performance taxa suggesting that adaptation of OXPHOS involves many factors beyond enhancing ATP production in high performance taxa. The broader pattern indicates a complex interplay between organismal adaptations, ATP demand, and OXPHOS function.

  20. Teamwork in high-risk environments analogous to space

    Science.gov (United States)

    Kanki, Barbara G.

    1990-01-01

    Mountaineering expeditions combine a number of factors which make them potentially good analogs to the planetary exploration facet of long-duration space missions. A study of mountain climbing teams was conducted in order to evaluate the usefulness of the environment as a space analog and to specifically identify the factors and issues surrounding teamwork and 'successful' team performance in two mountaineering environments. This paper focuses on social/organizational factors, including team size and structure, leadership styles and authority structure which were found in the sample of 22 climb teams (122 individuals). The second major issue discussed is the construction of a valid performance measure in this high-risk environment.

  1. High-Risk Cardiac Disease in Pregnancy: Part I.

    Science.gov (United States)

    Elkayam, Uri; Goland, Sorel; Pieper, Petronella G; Silverside, Candice K

    2016-07-26

    The incidence of pregnancy in women with cardiovascular disease is rising, primarily due to the increased number of women with congenital heart disease reaching childbearing age and the changing demographics associated with advancing maternal age. Although most cardiac conditions are well tolerated during pregnancy and women can deliver safely with favorable outcomes, there are some cardiac conditions that have significant maternal and fetal morbidity and mortality. The purpose of this paper is to review the available published reports and provide recommendations on the management of women with high-risk cardiovascular conditions during pregnancy. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. Against the tide: climate change and high-risk cities

    Energy Technology Data Exchange (ETDEWEB)

    Dodman, David

    2008-11-15

    In the world's poorest and most vulnerable nations, most cities and towns face a distinct dual pressure: rapidly growing population and high vulnerability to the impacts of climate change. Drought, storms, flooding and sea level rise are likely to hit hardest here. These in turn put water supplies, infrastructure, health and livelihoods at risk in the very cities already struggling to provide or safeguard such key needs. An effective response demands capable local and national government and support from strong international networks in building capacity to cope. Most of the Least Developed Countries lack both.

  3. Epidural Anesthesia in a Patient with High Cardiac Risk

    Directory of Open Access Journals (Sweden)

    Tuğba Doğu

    2014-03-01

    Full Text Available Cardiac morbidity is the most common cause postoperative of mortality furthermore anesthesia technics are associated with cardiac morbidity and mortality. A 48-year-old male, 90 kg, ASA physical status IV patient underwent femoropopliteal bypass under epidural anesthesia. Comorbidities included atrial fibrillation, dilated cardiomyopathy and 20%  left ventricular ejection fraction. Epidural anesthesia was established with bupivacaine and fentanyl at L3-L4 intervertebral space. Hemodynamic stability and pain relief were established during and after the surgery. We consider that epidural anesthesia is preferable as an alternative regarding the risks of spinal anesthesia and general anesthesia for high cardiac risky patients.

  4. Recommendations of activity restriction in high-risk pregnancy scenarios

    DEFF Research Database (Denmark)

    Bendix, Jane; Hegaard, Hanne Kristine; Bergholt, Thomas

    2015-01-01

    and the Danish Association of Midwives were asked to complete a tested, structured questionnaire. Results: We sent 1815 invitations; the overall response rate was 54%. A majority of clinicians recommended some form of activity restriction in the nine scenarios. The midwives recommended strict or moderate...... obstetricians and midwives prescribe activity restriction in most high-risk pregnancies. The degree of activity restriction and the presumed effect vary between clinicians. This may reflect different attitudes and lack of guidelines based on clinical studies of a possible benefit of activity restriction....

  5. Vaginal micronized progesterone and risk of preterm delivery in high-risk twin pregnancies: secondary analysis of a placebo-controlled randomized trial and meta-analysis

    DEFF Research Database (Denmark)

    Klein, K; Rode, L; Nicolaides, K H

    2011-01-01

    Progesterone treatment reduces the risk of preterm delivery in high-risk singleton pregnancies. Our aim was to evaluate the preventive effect of vaginal progesterone in high-risk twins.......Progesterone treatment reduces the risk of preterm delivery in high-risk singleton pregnancies. Our aim was to evaluate the preventive effect of vaginal progesterone in high-risk twins....

  6. Application of Fuzzy Delphi in the Selection of COPD Risk Factors among Steel Industry Workers.

    Science.gov (United States)

    Dapari, Rahmat; Ismail, Halim; Ismail, Rosnah; Ismail, Noor Hassim

    2017-01-01

    The Delphi method has been widely applied in many study areas to systematically gather experts' input on particular topic. Recently, it has become increasingly well known in health related research. This paper applied the Fuzzy Delphi method to enhance the validation of a questionnaire pertaining chronic obstructive pulmonary disease (COPD) risk factors among metal industry workers. A detailed, predefined list of possible risk factors for COPD among metal industry workers was created through a comprehensive and exhaustive review of literature from 1995 to 2015. The COPD questionnaire were distributed among people identified as occupational, environmental, and hygiene experts. Linguistic variable using Likert scale was used by the expert to indicate their expert judgment of each item. Subsequently, the linguistic variable was converted into a triangular fuzzy number. The average score of the fuzzy number will be used to determine whether the item will be removed or retained. Ten experts were involved in evaluating 26 items. The experts were in agreement with most of the items, with an average fuzzy number range between 0.429 and 0.800. Two items were removed and three items were added, leaving a total 26 items selected for the COPD risk factors questionnaire. The experts were in disagreement with each other for items F10 and F11 where most of the experts claimed that the question is too subjective and based on self-perception only. The fuzzy Delphi method enhanced the accuracy of the questionnaire pertaining to COPD risk factors, and decreased the length of the established tools.

  7. At-risk high school seniors: Science remediation for Georgia's High School Graduation Test

    Science.gov (United States)

    Carroll, Carolyn M.

    State departments of education have created a system of accountability for the academic achievement of students under the mandate of the No Child Left Behind Act of 2001. The Georgia Department of Education established the Georgia High School Graduation Test (GHSGT) as their method of evaluating the academic achievement of high school students. The GHSGT consist of five sections and students must pass all five sections before students they are eligible to receive a diploma. The purpose of the study was to examine the effects of teacher-lead and computer based remediation for a group of high school seniors who have been unsuccessful in passing the science portion of the GHSGT. The objectives of this study include (a) Identify the most effective method of remediation for at-risk students on the science section of the GHSGT, and (b) evaluate the methods of remediation for at-risk students on the science section of GHSGT available to high school students. The participants of this study were at-risk seniors enrolled in one high school during the 2007-2008 school year. The findings of this research study indicated that at-risk students who participated in both types of remediation, teacher-led and computer-based, scored significantly higher than the computer-based remediation group alone. There was no significant relationship between the test scores and the number of times the students were tested.

  8. High-risk behaviors in teenage male athletes.

    Science.gov (United States)

    Forman, E S; Dekker, A H; Javors, J R; Davison, D T

    1995-01-01

    This project studied high-risk activities in adolescent male athletes (ages 13-19) compared with a control group of adolescent male and female nonathletes. All athletes surveyed participated in one or more interscholastic sports. The prevalence of drug use by athletes compared to nonathletes was determined. Of the 19 drugs observed in this study, all were shown to have a lower prevalence of use among athletes in their senior year of high school, compared to the comparison group. Among the more commonly abused substances by the athlete population, beer, wine and whiskey, cigarettes, and marijuana were shown to have a lower use rate, by 25.5, 39.9, 57.5, and 57.7%, respectively. The prevalence of drug use by adolescent male athletes compared to adolescent nonathletes was also studied. Of the 19 individual drugs surveyed, all demonstrated a lower prevalence of use among athletes in their senior year of high school compared to the national data. The second high-risk activity measured was sexual activity. Of the athletes, 45.5% stated that they had never had sexual intercourse, compared to 50.0% of the nonathletes. Of the sexually active athletes, 81.9% had their first intercourse at between 13 and 15 years of age, whereas only 67.8% of the nonathlete control group had done so. This difference diminished significantly at age 16 and above. The results of this study suggest that participation in athletics by male athletes may lead to a significant decrease in drug and alcohol use and abuse but, also may increase early sexual contact. These trends were seen throughout all 4 years of high school in the athletes studied.

  9. Carotid stenosis: what is the high-risk population?

    Directory of Open Access Journals (Sweden)

    Jong Hun Park

    Full Text Available OBJECTIVE: Prevention is the best treatment for cerebrovascular disease, which is why early diagnosis and the immediate treatment of carotid stenosis contribute significantly to reducing the incidence of stroke. Given its silent nature, 80% of stroke cases occur in asymptomatic individuals, emphasizing the importance of screening individuals with carotid stenosis and identifying high-risk groups for the disease. The aim of this study was to determine the prevalence and the most frequent risk factors for carotid stenosis. METHODS: A transversal study was conducted in the form of a stroke prevention campaign held on three nonconsecutive Saturdays. During the sessions, carotid stenosis diagnostic procedures were performed for 500 individuals aged 60 years or older who had systemic arterial hypertension and/or diabetes mellitus and/or coronary heart disease and/or a family history of stroke. RESULTS: The prevalence of carotid stenosis in the population studied was 7.4%, and the most frequent risk factors identified were mean age of 70 years, carotid bruit, peripheral obstructive arterial disease, coronary insufficiency and smoking. Independent predictive factors of carotid stenosis include the presence of carotid bruit or peripheral obstructive heart disease and/or coronary insufficiency. CONCLUSIONS: The population with peripheral obstructive heart disease and carotid bruit should undergo routine screening for carotid stenosis.

  10. [Relevance of diabetes in high cardiovascular risk hypertensive patients].

    Science.gov (United States)

    Segura, Julián; de la Sierra, Alejandro; Fernández, Sandra; Ruilope, Luis M

    2013-10-05

    The aim of this cross-sectional study was to compare the prevalence of target organ damage (TOD) and established cardiovascular disease (CVD) in a cohort of nondiabetic hypertensive patients with 3 or more cardiovascular risk factors (CVRF) against a group of hypertensives with type 2 diabetes. We included 4,725 hypertensive patients, 62% male, mean age 64 (SD 12) years, with type 2 diabetes mellitus, independently of the number of associated CVRF (N=2,608), or non-diabetics, in which case we required the presence of 3 CVRF (N=2,117). The prevalence of established CVD (clinical interview) and TOD (left ventricular hypertrophy by electrocardiogram, microalbuminuria and estimated glomerular filtration rate) were estimated. Hypertensive patients with type 2 diabetes had an older age and more marked obesity. Furthermore, these patients showed a higher prevalence of micro- and macroalbuminuria, renal failure, left ventricular hypertrophy, atherosclerotic plaques in carotid arteries and CVD compared with nondiabetic hypertensive patients with 3 or more CVRF. Multivariate analysis showed that the risk of TOD or established CVD were associated independently with the presence of diabetes. Hypertensive patients with type 2 diabetes have a higher prevalence of LOD and CVD compared to nondiabetic hypertensive patients with 3 or more CVRF. Although both situations are included in the high cardiovascular risk stratum, it would be expected an increased incidence of cardiovascular complications in hypertensive diabetic patients. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  11. Lipid profiles reflecting high and low risk for coronary heart disease: contribution of apolipoprotein E polymorphism and lifestyle.

    NARCIS (Netherlands)

    Boer, J.M.A.; Feskens, E.J.M.; Schouten, E.G.; Havekes, L.M.; Seidell, J.C.; Kromhout, D.

    1998-01-01

    To elucidate the role of modifiable factors and the apolipoprotein E polymorphism in explaining lipid profiles reflecting low, average and high risk for coronary heart disease, we selected subjects from a large population-based study. Subjects with low total cholesterol (TC) (<15th percentile)

  12. Lipid profiles reflecting high and low risk for coronary heart disease : Contribution of apolipoprotein E polymorphism and lifestyle

    NARCIS (Netherlands)

    Boer, J.M.A.; Feskens, E.J.M.; Schouten, E.G.; Havekes, L.M.; Seidell, J.C.; Kromhout, D.

    1998-01-01

    To elucidate the role of modifiable factors and the apolipoprotein E polymorphism in explaining lipid profiles reflecting low, average and high risk for coronary heart disease, we selected subjects from a large population-based study. Subjects with low total cholesterol (TC) (< 15th percentile) and

  13. Lipid profiles reflecting high and low risk for coronary heart disease : contribution of apolipoprotein E polymorphism and lifestyle

    NARCIS (Netherlands)

    Feskens, E.J.; Schouten, E G; Havekes, L.M.; Seidell, J C; Kromhout, D.

    To elucidate the role of modifiable factors and the apolipoprotein E polymorphism in explaining lipid profiles reflecting low, average and high risk for coronary heart disease, we selected subjects from a large population-based study. Subjects with low total cholesterol (TC) (< 15th percentile) and

  14. The Effect of Parenting Stress on Child Behavior Problems in High-Risk Children with Prenatal Drug Exposure

    Science.gov (United States)

    Bagner, Daniel M.; Sheinkopf, Stephen J.; Miller-Loncar, Cynthia; LaGasse, Linda L.; Lester, Barry M.; Liu, Jing; Bauer, Charles R.; Shankaran, Seetha; Bada, Henrietta; Das, Abhik

    2009-01-01

    Objective: To examine the relationship between early parenting stress and later child behavior in a high-risk sample and measure the effect of drug exposure on the relationship between parenting stress and child behavior. Methods: A subset of child-caregiver dyads (n = 607) were selected from the Maternal Lifestyle Study (MLS), which is a large…

  15. Haptoglobin phenotype is not a predictor of recurrence free survival in high-risk primary breast cancer patients

    NARCIS (Netherlands)

    M.C.W. Gast; H. van Tinteren (Harm); M. Bontenbal (Marijke); R.Q.G.C.M. van Hoesel (René); M.A. Nooij; S. Rodenhuis (Sjoerd); P.N. Span (Paul); V.C.G. Tjan-Heijnen (Vivianne); E. de Vries (Esther); N. Harris (Nathan); J.W.R. Twisk (Jos); J.H.M. Schellens (Jan); J.H. Beijnen (Jos)

    2008-01-01

    textabstractBackground: Better breast cancer prognostication may improve selection of patients for adjuvant therapy. We conducted a retrospective follow-up study in which we investigated sera of high-risk primary breast cancer patients, to search for proteins predictive of recurrence free survival.

  16. Haptoglobin phenotype is not a predictor of recurrence free survival in high-risk primary breast cancer patients

    NARCIS (Netherlands)

    Gast, Marie-Christine W.; van Tinteren, Harm; Bontenbal, Marijke; van Hoesel, Rene Q. G. C. M.; Nooij, Marianne A.; Rodenhuis, Sjoerd; Span, Paul N.; Tjan-Heijnen, Vivianne C. G.; de Vries, Elisabeth G. E.; Harris, Nathan; Twisk, Jos W. R.; Schellens, Jan H. M.; Beijnen, Jos H.

    2008-01-01

    Background: Better breast cancer prognostication may improve selection of patients for adjuvant therapy. We conducted a retrospective follow-up study in which we investigated sera of high-risk primary breast cancer patients, to search for proteins predictive of recurrence free survival. Methods: Two

  17. Haptoglobin phenotype is not a predictor of recurrence free survival in high-risk primary breast cancer patients.

    NARCIS (Netherlands)

    Gast, M.C.; Tinteren, H van; Bontenbal, M.; Hoesel, R.Q. van; Nooij, M.A.; Rodenhuis, S.; Span, P.N.; Tjan-Heijnen, V.C.; Vries, E.G.F. de; Harris, N.; Twisk, J.W.; Schellens, J.H.M.; Beijnen, J.H.

    2008-01-01

    BACKGROUND: Better breast cancer prognostication may improve selection of patients for adjuvant therapy. We conducted a retrospective follow-up study in which we investigated sera of high-risk primary breast cancer patients, to search for proteins predictive of recurrence free survival. METHODS: Two

  18. Pharmacological management of dyslipidemia in high and very high cardiovascular risk patients

    Directory of Open Access Journals (Sweden)

    V. Pascual Fuster

    Full Text Available Dyslipaemia is one of the main risk factors in the development of cardiovascular diseases. Currently, there are different alternatives available (amongst which statins occupy a pre-eminent place, to optimise the treatment of patients at high or very high cardiovascular risk. Despite this, the percentage of patients that achieve good lipid control is low. The causes of the mismatch with proposed objectives include lack of patient adherence and therapeutic inertia. This review uses available evidence and the latest clinical guides as a basis to assess the pharmacological treatment of dyslipaemia in patients with a background of arteriosclerotic vascular disease, diabetes, chronic kidney disease, cardiovascular risk at ≥5% calculated by SCORE and familial hypercholesterolaemia. The treatment of hypertriglyceridemia is also reviewed along with the special consideration that poly-pharmacy deserves in patients treated with statins, making mention of the treatment of dyslipaemia with HIV infection. The global assessment of cardiovascular risk is of high priority to adapt treatment to the specific objectives of the c-LDL for each risk category.

  19. Pilot study risk assessment for selected problems at the Nevada Test Site (NTS)

    Energy Technology Data Exchange (ETDEWEB)

    Daniels, J.I. [ed.; Anspaugh, L.R.; Bogen, K.T.; Daniels, J.I.; Layton, D.W.; Straume, T. [Lawrence Livermore National Lab., CA (United States); Andricevic, R.; Jacobson, R.L. [Nevada Univ., Las Vegas, NV (United States). Water Resources Center; Meinhold, A.F.; Holtzman, S.; Morris, S.C.; Hamilton, L.D. [Brookhaven National Lab., Upton, NY (United States)

    1993-06-01

    The Nevada Test Site (NTS) is located in southwestern Nevada, about 105 km (65 mi) northwest of the city of Las Vegas. A series of tests was conducted in the late 1950s and early 1960s at or near the NTS to study issues involving plutonium-bearing devices. These tests resulted in the dispersal of about 5 TBq of {sup 239,24O}Pu on the surficial soils at the test locations. Additionally, underground tests of nuclear weapons devices have been conducted at the NTS since late 1962; ground water beneath the NTS has been contaminated with radionuclides produced by these tests. These two important problems have been selected for assessment. Regarding the plutonium contamination, because the residual {sup 239}Pu decays slowly (half-life of 24,110 y), these sites could represent a long-term hazard if they are not remediated and if institutional controls are lost. To investigate the magnitude of the potential health risks for this no-remediation case, three basic exposure scenarios were defined that could bring individuals in contact with {sup 239,24O}Pu at the sites: (1) a resident living in a subdivision, (2) a resident farmer, and (3) a worker at a commercial facility -- all located at a test site. The predicted cancer risks for the resident farmer were more than a factor of three times higher than the suburban resident at the median risk level, and about a factor of ten greater than the reference worker at a commercial facility. At 100 y from the present, the 5, 50, and 95th percentile risks for the resident farmer at the most contaminated site were 4 x 10{sup {minus}6}, 6 x 10{sup {minus}5}, and 5 x 10{sup {minus}4}, respectively. For the assessment of Pu in surface soil, the principal sources of uncertainty in the estimated risks were population mobility, the relationship between indoor and outdoor contaminant levels, and the dose and risk factors for bone, liver, and lung.

  20. Pilot study risk assessment for selected problems at the Nevada Test Site (NTS)

    Energy Technology Data Exchange (ETDEWEB)

    Daniels, J.I. (ed.)

    1993-06-01

    The Nevada Test Site (NTS) is located in southwestern Nevada, about 105 km (65 mi) northwest of the city of Las Vegas. A series of tests was conducted in the late 1950s and early 1960s at or near the NTS to study issues involving plutonium-bearing devices. These tests resulted in the dispersal of about 5 TBq of [sup 239,24O]Pu on the surficial soils at the test locations. Additionally, underground tests of nuclear weapons devices have been conducted at the NTS since late 1962; ground water beneath the NTS has been contaminated with radionuclides produced by these tests. These two important problems have been selected for assessment. Regarding the plutonium contamination, because the residual [sup 239]Pu decays slowly (half-life of 24,110 y), these sites could represent a long-term hazard if they are not remediated and if institutional controls are lost. To investigate the magnitude of the potential health risks for this no-remediation case, three basic exposure scenarios were defined that could bring individuals in contact with [sup 239,24O]Pu at the sites: (1) a resident living in a subdivision, (2) a resident farmer, and (3) a worker at a commercial facility -- all located at a test site. The predicted cancer risks for the resident farmer were more than a factor of three times higher than the suburban resident at the median risk level, and about a factor of ten greater than the reference worker at a commercial facility. At 100 y from the present, the 5, 50, and 95th percentile risks for the resident farmer at the most contaminated site were 4 x 10[sup [minus]6], 6 x 10[sup [minus]5], and 5 x 10[sup [minus]4], respectively. For the assessment of Pu in surface soil, the principal sources of uncertainty in the estimated risks were population mobility, the relationship between indoor and outdoor contaminant levels, and the dose and risk factors for bone, liver, and lung.

  1. Maternal Style Selectively Shapes Amygdalar Development and Social Behavior in Rats Genetically Prone to High Anxiety.

    Science.gov (United States)

    Cohen, Joshua L; Glover, Matthew E; Pugh, Phyllis C; Fant, Andrew D; Simmons, Rebecca K; Akil, Huda; Kerman, Ilan A; Clinton, Sarah M

    2015-01-01

    The early-life environment critically influences neurodevelopment and later psychological health. To elucidate neural and environmental elements that shape emotional behavior, we developed a rat model of individual differences in temperament and environmental reactivity. We selectively bred rats for high versus low behavioral response to novelty and found that high-reactive (bred high-responder, bHR) rats displayed greater risk-taking, impulsivity and aggression relative to low-reactive (bred low-responder, bLR) rats, which showed high levels of anxiety/depression-like behavior and certain stress vulnerability. The bHR/bLR traits are heritable, but prior work revealed bHR/bLR maternal style differences, with bLR dams showing more maternal attention than bHRs. The present study implemented a cross-fostering paradigm to examine the contribution of maternal behavior to the brain development and emotional behavior of bLR offspring. bLR offspring were reared by biological bLR mothers or fostered to a bLR or bHR mother and then evaluated to determine the effects on the following: (1) developmental gene expression in the hippocampus and amygdala and (2) adult anxiety/depression-like behavior. Genome-wide expression profiling showed that cross-fostering bLR rats to bHR mothers shifted developmental gene expression in the amygdala (but not hippocampus), reduced adult anxiety and enhanced social interaction. Our findings illustrate how an early-life manipulation such as cross-fostering changes the brain's developmental trajectory and ultimately impacts adult behavior. Moreover, while earlier studies highlighted hippocampal differences contributing to the bHR/bLR phenotypes, our results point to a role of the amygdala as well. Future work will pursue genetic and cellular mechanisms within the amygdala that contribute to bHR/bLR behavior either at baseline or following environmental manipulations. © 2015 S. Karger AG, Basel.

  2. Reducing sexual risk behavior among high-risk couples in Northern India.

    Science.gov (United States)

    Jones, Deborah; Bagga, Rashmi; Nehra, Ritu; Deepika; Sethi, Sunil; Walia, Kamini; Kumar, Mahendra; Villar-Loubet, Olga; Lopez, Maria; Weiss, Stephen M

    2013-09-01

    With a population of 1.1 billion, India is considered to be a country in which effective prevention interventions could contain the development of a human immunodeficiency virus (HIV) epidemic. Heterosexual transmission accounts for 85 % of the extant HIV infections. This study sought to assess the feasibility of conducting a group, culturally tailored behavioral intervention and its impact on sexual barrier use, self-efficacy, knowledge, conflict resolution, and coping among high-risk heterosexual couples in Northern India. This pilot study was conducted at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India from February 2008 to January 2009. Thirty sexually active high-risk couples were drawn from a convenience sample of PGIMER patients attending infectious disease and family planning clinics. Couples participated in 1 month of three weekly gender-concordant behavioral intervention groups and were individually administered assessments preintervention and post-intervention. The intervention was tailored to the Northern Indian context and addressed sexual barrier use, human immunodeficiency virus (HIV)/sexually transmitted infection transmission, and cognitive behavioral skill building focusing on sexual negotiation and communication. The participants had a mean age of 32 years (men) and 29 years (women), and the majority had at least 10 years of education. At baseline, the majority reported inconsistent condom use (coping tactics. The results highlight the potential to successfully utilize a group intervention to discuss sensitive issues such as sexual risk behavior among both men and women. Strategies to improve condom use and communication without increasing intimate partner violence in high-risk couples may be an important adjunct to preventing the development of a generalized epidemic in India.

  3. High-risk food consumption and food safety practices in a Canadian community.

    Science.gov (United States)

    Nesbitt, Andrea; Majowicz, Shannon; Finley, Rita; Marshall, Barbara; Pollari, Frank; Sargeant, Jan; Ribble, Carl; Wilson, Jeff; Sittler, Nancy

    2009-12-01

    Understanding consumers' high-risk food consumption patterns and food handling in the home is critical in reducing foodborne illness. This study was conducted to determine the prevalence of unsafe food practices of individuals in a Canadian-based population, specifically, high-risk food consumption and home food safety practices. During November 2005 to March 2006, a sample of 2,332 randomly selected residents of the Waterloo Region (Ontario, Canada) participated in a telephone survey of food consumption and food safety. Questions covered consumption of high-risk foods, hand washing practices, safe food handling knowledge, source of food safety education, meat thawing and cooking practices, cross-contamination after raw food preparation, and refrigeration temperatures. Certain high-risk food behaviors were common among respondents and were associated with demographic characteristics. In general, unsafe practices increased with increasing total annual household income level. Males were more likely to report engaging in risky practices than were females. Specific high-risk behaviors of public health concern were reported by elderly individuals (e.g., consuming undercooked eggs), children (e.g., consuming chicken nuggets), and rural residents (e.g., drinking unpasteurized milk). Respondents appeared to know proper food safety practices, but did not put them into practice. Thus, educational programs emphasizing specific practices to improve food safety should be directed to targeted audiences, and they should stress the importance of consumer behavior in the safety of foods prepared at home. Further investigation of consumer perceptions is needed to design such programs to effectively increase the implementation of safe food practices by consumers.

  4. High dislocation cumulative risk in THA versus hemiarthroplasty for fractures.

    Science.gov (United States)

    Poignard, Alexandre; Bouhou, Mohamed; Pidet, Olivier; Flouzat-Lachaniette, Charles-Henri; Hernigou, Philippe

    2011-11-01

    Although not all elderly patients with femoral neck fractures are candidates for THA, active, mentally competent, independent patients achieve the most durable functional scores with THA compared with hemiarthroplasty. However, a relatively high frequency of early or late dislocation could reduce the potential benefits with THA. We asked whether the incidence of first-time, recurrent dislocation, and revision differed in patients with hip fractures having THA or hemiarthroplasty. We retrospectively reviewed 380 patients with hip fractures (380 hips) who underwent THAs between 1995 and 1999, and compared them with 412 patients with hip fractures (412 hips) who underwent hemiarthroplasties between 1990 and 1994. The mean followup was 8 years (range, 1-20 years). THA had a higher early risk of first-time dislocation and a higher late risk: 19 (4.5%) of the 412 hips treated with hemiarthroplasty had at least one dislocation whereas 30 (8.1%) of the 380 hips treated with THA had at least one dislocation. The cumulative number of dislocations at the most recent followup (first time and recurrent dislocations) was 58 (13%) for the 380 THAs and 22 (5%) for the 412 hemiarthroplasties. At the 10-year followup, eight THAs (2%) had revision (six recurrent dislocations, two loosenings), and 42 hemiarthroplasties (10%) had revision (40 acetabular protrusions, one recurrent dislocation). The risk of revision for recurrent dislocation increases with THA, but it remains lower than the risk of revision for wear of cartilage and acetabular protrusion in hemiarthroplasty. Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

  5. Risk factors associated with developmental abnormalities among high-risk children attended at a multidisciplinary clinic.

    Science.gov (United States)

    Resegue, Rosa; Puccini, Rosana Fiorini; Silva, Edina Mariko Koga da

    2008-01-02

    Knowledge of risk factors associated with child development disorders is essential for delivering high-quality childcare. The objective here was to evaluate the relationships between risk factors and occurrences of developmental abnormalities among children attended at a reference clinic for children at risk of developmental abnormalities. Retrospective study at a multidisciplinary reference center, Embu, São Paulo. All cases followed up for more than three months between 1995 and 2003 were reviewed. The risk factors assessed were low birth weight, gestational age, length of stay in neonatal ward, perinatal asphyxia, mothers age 5 days, prematurity and mothers age 18 years and older. Low birth weight, history of perinatal asphyxia and mothers age continued to be significant in multivariate analysis. Special attention must be paid to the development of low birth weight infants and/or infants with histories of neonatal complications. Low birth weight is easily assessed and should be considered to be an important marker when defining guidelines for following up child development.

  6. Risk factors associated with developmental abnormalities among high-risk children attended at a multidisciplinary clinic

    Directory of Open Access Journals (Sweden)

    Rosa Resegue

    Full Text Available CONTEXT AND OBJECTIVE: Knowledge of risk factors associated with child development disorders is essential for delivering high-quality childcare. The objective here was to evaluate the relationships between risk factors and occurrences of developmental abnormalities among children attended at a reference clinic for children at risk of developmental abnormalities. DESIGN AND SETTING: Retrospective study at a multidisciplinary reference center, Embu, São Paulo. METHODS: All cases followed up for more than three months between 1995 and 2003 were reviewed. The risk factors assessed were low birth weight, gestational age, length of stay in neonatal ward, perinatal asphyxia, mother’s age 5 days, prematurity and mother’s age 18 years and older. Low birth weight, history of perinatal asphyxia and mother’s age continued to be significant in multivariate analysis. CONCLUSIONS: Special attention must be paid to the development of low birth weight infants and/or infants with histories of neonatal complications. Low birth weight is easily assessed and should be considered to be an important marker when defining guidelines for following up child development.

  7. Bayesian Variable Selection in High Dimensional Survival Time Cancer Genomic Datasets using Nonlocal Priors

    OpenAIRE

    Nikooienejad, Amir; Wang, Wenyi; Johnson, Valen E.

    2017-01-01

    Variable selection in high dimensional cancer genomic studies has become very popular in the past decade, due to the interest in discovering significant genes pertinent to a specific cancer type. Censored survival data is the main data structure in such studies and performing variable selection for such data type requires certain methodology. With recent developments in computational power, Bayesian methods have become more attractive in the context of variable selection. In this article we i...

  8. Characterizing and reaching high-risk drinkers using audience segmentation.

    Science.gov (United States)

    Moss, Howard B; Kirby, Susan D; Donodeo, Fred

    2009-08-01

    Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment, including where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions, and research efforts. We described the results of a segmentation analysis of those individuals who self-reported to consume 5 or more drinks per drinking episode at least twice in the last 30 days. The study used the proprietary PRIZM (Claritas, Inc., San Diego, CA) audience segmentation database merged with the Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top 10 of the 66 PRIZM audience segments for this risky drinking pattern are described. For five of these segments we provided additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers resided. The top 10 audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge-drinking behavior is referred to as the "Cyber Millenials." This cluster is characterized as "the nation's tech

  9. Physical performance following acute high-risk abdominal surgery

    DEFF Research Database (Denmark)

    Jønsson, Line Rokkedal; Ingelsrud, Lina Holm; Tengberg, Line Toft

    2018-01-01

    BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical...... with regards to physical performance, using the Cumulated Ambulation Score (CAS; 0-6 points) to assess basic mobility and the activePAL monitor to assess the 24-hour physical activity level. We recorded barriers to independent mobilization. RESULTS: Fifty patients undergoing AHA surgery (mean age 61.4 ± 17...... for a median of 23.4 hours daily during the first week after AHA surgery, and the main barriers to independent mobilization were fatigue and abdominal pain. CONCLUSION: Patients who receive AHA surgery have very limited physical performance in the first postoperative week. Barriers to independent mobilization...

  10. Female youth who sexually coerce: prevalence, risk, and protective factors in two national high school surveys.

    Science.gov (United States)

    Kjellgren, Cecilia; Priebe, Gisela; Svedin, Carl Göran; Mossige, Svein; Långström, Niklas

    2011-12-01

    Sexual coercion is recognized as a serious societal problem. Correlates and risk factors of sexually abusive behavior in females are not well known. Etiological theory and empirical study of female perpetrators of sexual coercion are usually based on small or highly selected samples. Specifically, population-based data are needed to elucidate risk/protective factors. Main outcome measures include a self-report questionnaire containing 65 items tapping socio-demographic and health conditions, social relations, sexual victimization, conduct problems and a set of normative and deviant sexual cognitions, attitudes, and behaviors. We used a 2003-2004 survey of sexual attitudes and experiences among high school students in Norway and Sweden to identify risk factors and correlates to sexually coercive behavior (response rate 80%); 4,363 females participated (Mean = 18.1 years). Thirty-seven women (0.8%) reported sexual coercion (ever talked someone into, used pressure, or forced somebody to have sex). Sexually coercive compared with non-coercive women were similar on socio-demographic variables, but reported less parental care and more parental overprotection, aggression, depressive symptoms, and substance misuse. Also, sexually coercive females reported more sexual lust, sex partners, penetrative sexual victimization, rape myths, use of violent porn, and friends more likely to use porn. When using the Swedish subsample to differentiate risk factors specific for sexual coercion from those for antisocial behavior in general, we found less cannabis use, but more sexual preoccupation, pro-rape attitudes, and friends using violent porn in sexually coercive compared with non-sex conduct problem females. Sexually coercive behavior in high school women was associated with general risk/needs factors for antisocial behavior, but also with specific sexuality-related risk factors. This differential effect has previously been overlooked, agrees with similar findings in men, and

  11. Cyclooxygenase-2 (COX-2) expression in high-risk premalignant oral lesions.

    Science.gov (United States)

    Sudbø, Jon; Ristimäki, Ari; Sondresen, Jan Erik; Kildal, Wanja; Boysen, Morten; Koppang, Hanna S; Reith, Albrecht; Risberg, Björn; Nesland, Jahn M; Bryne, Magne

    2003-07-01

    Emerging data indicate a link between genetic instability and up-regulation of cyclooxygenase-2 (COX-2). To see if individuals at high risk of oral cancer are candidates for treatment with selective COX-2 inhibitors (coxibs), levels of COX-2 expression in healthy, premalignant and cancerous oral mucosa were compared with the occurrence of DNA ploidy status as a genetic risk marker of oral cancer. COX-2 gene product was evaluated immunohistochemically in 30 healthy persons, in 22 patients with dysplastic lesions without previous or concomitant carcinomas, and in 29 patients with oral carcinomas. The immunohistochemical findings were verified by western blotting. COX-2 expression was correlated to DNA content as a genetic risk marker of oral cancer. COX-2 was up-regulated from healthy to premalignant to cancerous oral mucosa. Thus, COX-2 expression was found in 1 case of healthy oral mucosa (3%). All specimens from healthy mucosa had a normal DNA content. In patients with premalignancies. In 29 patients with oral carcinomas, cyclooxygenase-2 expression was observed in 26 (88%), and aneuploidy was observed in 25 cases (94%, P=0.04). Notably, of 22 patients with dysplastic lesions, COX-2 was exclusively expressed in a subgroup of nine patients (41%) identified to be at high risk of cancer by the aberrant DNA content of their lesions. Seven of these patients were followed for 5 years or more. An oral carcinoma developed in six of them (85%; P=0.02). These findings emphasize the need to determine whether coxibs can reduce the risk of oral cancer in patients with high-risk precancerous lesions.

  12. Patient selection for TAVI 2015 - TAVI in low-risk patients: fact or fiction?

    Science.gov (United States)

    Haussig, Stephan; Linke, Axel

    2015-09-01

    For decades, surgical aortic valve replacement (SAVR) has been the standard treatment for severe aortic stenosis (AS). With the clinical introduction of the concept of transcatheter aortic valve implantation (TAVI), a rapid development took place and, based on the results of landmark randomised controlled trials, within a few years TAVI became first-line therapy for inoperable patients with severe AS and an alternative to SAVR in operable high-risk patients. Indeed, data from a recent randomised controlled trial suggest that TAVI is superior to SAVR in higher-risk patients with AS. New TAVI devices have been developed to address current limitations, to optimise results further and to minimise complications. First results using these second-generation valves are promising. However, no data from randomised controlled trials assessing TAVI in younger, low-risk patients are yet available. While we await the results of trials addressing these issues (e.g., SURTAVI [NCT01586910] and PARTNER II [NCT01314313]), recent data from TAVI registries suggest that treatment of low-risk patients is already fact and no longer fiction.

  13. Neurophysiology for Detection of High Risk for Psychosis

    Directory of Open Access Journals (Sweden)

    Lara N. Pantlin

    2016-01-01

    Full Text Available Schizophrenia is a complex and often disabling disorder that is characterized by a wide range of social, emotional, and cognitive deficits. Increasing research suggests that the greatest social and cognitive therapeutic impact comes from early identification. The present study applied a well-established neurophysiological paradigm in the schizophrenia literature, mismatch negativity (MMN, to college students identified as high risk (HR for psychosis to investigate MMN as a potential biomarker for the onset of psychosis. The hypothesis was that HR would exhibit attenuated MMN amplitudes compared to controls, as has been established in individuals with chronic schizophrenia. Participants (N=121 were separated into Group 1 (controls (n1=72 and Group 2 (HR (n2=49 based on the established cutoff score of the 16-item Prodromal Questionnaire. Participants then completed a time based MMN paradigm during which brain activity was recorded with EEG. For all electrode locations, controls demonstrated significantly more negative amplitudes than HR (Cz: F(1,119=8.09, p=.005; Fz: F(1,119=5.74, p=.018; Pz: F(1,119=5.88, p=.017. Results suggested that MMN may assist in identifying those who appear high-functioning but may be at risk for later development of psychosis or cognitive and psychological difficulties associated with psychosis.

  14. Uncertainty Instability Risk Analysis of High Concrete Arch Dam Abutments

    Directory of Open Access Journals (Sweden)

    Xin Cao

    2017-01-01

    Full Text Available The uncertainties associated with concrete arch dams rise with the increased height of dams. Given the uncertainties associated with influencing factors, the stability of high arch dam abutments as a fuzzy random event was studied. In addition, given the randomness and fuzziness of calculation parameters as well as the failure criterion, hazard point and hazard surface uncertainty instability risk ratio models were proposed for high arch dam abutments on the basis of credibility theory. The uncertainty instability failure criterion was derived through the analysis of the progressive instability failure process on the basis of Shannon’s entropy theory. The uncertainties associated with influencing factors were quantized by probability or possibility distribution assignments. Gaussian random theory was used to generate random realizations for influence factors with spatial variability. The uncertainty stability analysis method was proposed by combining the finite element analysis and the limit equilibrium method. The instability risk ratio was calculated using the Monte Carlo simulation method and fuzzy random postprocessing. Results corroborate that the modeling approach is sound and that the calculation method is feasible.

  15. High-Risk Human Papillomavirus Targets Crossroads in Immune Signaling

    Science.gov (United States)

    Tummers, Bart; Van Der Burg, Sjoerd H.

    2015-01-01

    Persistent infections with a high-risk type human papillomavirus (hrHPV) can progress to cancer. High-risk HPVs infect keratinocytes (KCs) and successfully suppress host immunity for up to two years despite the fact that KCs are well equipped to detect and initiate immune responses to invading pathogens. Viral persistence is achieved by active interference with KCs innate and adaptive immune mechanisms. To this end hrHPV utilizes proteins encoded by its viral genome, as well as exploits cellular proteins to interfere with signaling of innate and adaptive immune pathways. This results in impairment of interferon and pro-inflammatory cytokine production and subsequent immune cell attraction, as well as resistance to incoming signals from the immune system. Furthermore, hrHPV avoids the killing of infected cells by interfering with antigen presentation to antigen-specific cytotoxic T lymphocytes. Thus, hrHPV has evolved multiple mechanisms to avoid detection and clearance by both the innate and adaptive immune system, the molecular mechanisms of which will be dealt with in detail in this review. PMID:26008697

  16. [High oncogenic risk human papillomavirus and urinary bladder cancer].

    Science.gov (United States)

    Loran, O B; Sinyakova, L A; Gundorova, L V; Kosov, V A; Kosova, I V; Pogodina, I E; Kolbasov, D N

    2017-07-01

    To determine the role of human papillomavirus (HPV) of high oncogenic risk in the development of urinary bladder cancer. 100 patients (72 men and 28 women) aged 38 to 90 years (mean age 65+/-10 years) diagnosed with bladder cancer were examined and underwent treatment. Clinical assessment was complemented by enzyme-linked immunosorbent assays for the presence of antiviral antibodies to herpes simplex virus (HSV) type 1 and type 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), urethra scraping for detecting high oncogenic risk HPV. Tumor tissue was sampled for PCR virus detection. Semi-quantitative analysis was used to evaluate the components of lymphocyte-plasmocyte and leukocyte infiltrates and cytopathic changes in tumor tissue. There were positive correlations between cytopathic cell changes (koylocytosis and intranuclear inclusions, as manifestations of HPV) and the level of antiviral antibodies, the presence of viruses in the tumor, as well as with the components of the lymphoid-plasmocyte infiltrate. Negative correlations were found between the presence of papillomatosis and the above changes. Human papillomavirus is believed to be a trigger for the initiation of a tumor in young patients with a latent infection (CMV and EBV, HSV, HPV). Cytopathic changes (kylocytosis and intranuclear inclusions) were associated with the activity and morphological features of herpes-viral infections. Their degree varied depending on the stage of the process, but not on the anaplasia degree. Papillomatosis is associated with a more favorable course of the tumor process.

  17. High-Risk Human Papillomavirus Targets Crossroads in Immune Signaling

    Directory of Open Access Journals (Sweden)

    Bart Tummers

    2015-05-01

    Full Text Available Persistent infections with a high-risk type human papillomavirus (hrHPV can progress to cancer. High-risk HPVs infect keratinocytes (KCs and successfully suppress host immunity for up to two years despite the fact that KCs are well equipped to detect and initiate immune responses to invading pathogens. Viral persistence is achieved by active interference with KCs innate and adaptive immune mechanisms. To this end hrHPV utilizes proteins encoded by its viral genome, as well as exploits cellular proteins to interfere with signaling of innate and adaptive immune pathways. This results in impairment of interferon and pro-inflammatory cytokine production and subsequent immune cell attraction, as well as resistance to incoming signals from the immune system. Furthermore, hrHPV avoids the killing of infected cells by interfering with antigen presentation to antigen-specific cytotoxic T lymphocytes. Thus, hrHPV has evolved multiple mechanisms to avoid detection and clearance by both the innate and adaptive immune system, the molecular mechanisms of which will be dealt with in detail in this review.

  18. High-risk human papillomavirus targets crossroads in immune signaling.

    Science.gov (United States)

    Tummers, Bart; Burg, Sjoerd H Van Der

    2015-05-21

    Persistent infections with a high-risk type human papillomavirus (hrHPV) can progress to cancer. High-risk HPVs infect keratinocytes (KCs) and successfully suppress host immunity for up to two years despite the fact that KCs are well equipped to detect and initiate immune responses to invading pathogens. Viral persistence is achieved by active interference with KCs innate and adaptive immune mechanisms. To this end hrHPV utilizes proteins encoded by its viral genome, as well as exploits cellular proteins to interfere with signaling of innate and adaptive immune pathways. This results in impairment of interferon and pro-inflammatory cytokine production and subsequent immune cell attraction, as well as resistance to incoming signals from the immune system. Furthermore, hrHPV avoids the killing of infected cells by interfering with antigen presentation to antigen-specific cytotoxic T lymphocytes. Thus, hrHPV has evolved multiple mechanisms to avoid detection and clearance by both the innate and adaptive immune system, the molecular mechanisms of which will be dealt with in detail in this review.

  19. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma.

    Science.gov (United States)

    Mateos, María-Victoria; Hernández, Miguel-Teodoro; Giraldo, Pilar; de la Rubia, Javier; de Arriba, Felipe; López Corral, Lucía; Rosiñol, Laura; Paiva, Bruno; Palomera, Luis; Bargay, Joan; Oriol, Albert; Prosper, Felipe; López, Javier; Olavarría, Eduardo; Quintana, Nuria; García, José-Luis; Bladé, Joan; Lahuerta, Juan-José; San Miguel, Jesús-F

    2013-08-01

    For patients with smoldering multiple myeloma, the standard of care is observation until symptoms develop. However, this approach does not identify high-risk patients who may benefit from early intervention. In this randomized, open-label, phase 3 trial, we randomly assigned 119 patients with high-risk smoldering myeloma to treatment or observation. Patients in the treatment group received an induction regimen (lenalidomide at a dose of 25 mg per day on days 1 to 21, plus dexamethasone at a dose of 20 mg per day on days 1 to 4 and days 12 to 15, at 4-week intervals for nine cycles), followed by a maintenance regimen (lenalidomide at a dose of 10 mg per day on days 1 to 21 of each 28-day cycle for 2 years). The primary end point was time to progression to symptomatic disease. Secondary end points were response rate, overall survival, and safety. After a median follow-up of 40 months, the median time to progression was significantly longer in the treatment group than in the observation group (median not reached vs. 21 months; hazard ratio for progression, 0.18; 95% confidence interval [CI], 0.09 to 0.32; Psmoldering myeloma delays progression to active disease and increases overall survival. (Funded by Celgene; ClinicalTrials.gov number, NCT00480363.).

  20. Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births.

    Science.gov (United States)

    Wax, Joseph R; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2010-02-01

    We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home). Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility. A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight labors and low 5-minute Apgar scores. Copyright 2010 Mosby, Inc. All rights reserved.