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Sample records for significant prospective prediction

  1. Features and prospects of juridical predicting of entrepreneurial activity

    Directory of Open Access Journals (Sweden)

    Natalya V. Rubtsova

    2017-03-01

    Full Text Available Objective to identify characteristics and prospects of predicting the business activity. Methods historical sociological logical systematicstructural formallegal comparativelegal legal modeling method. Results in article suggests the legal definition of prediction of business activity as a scientific and practical study aimed at the determination of the future state and prospects of development of business activity consisting of the evaluation of legal regulation and analysis of the prospectsof further socioeconomic development which aims to select the optimal solution for the further development of entrepreneurship through legal regulators. The work proves the necessity of achieving a balanced legal regulation of social relations by changing the legislation in the field of business agreements investment and innovation. Scientific novelty the article for the first time formulates the concept characteristics and features of legal prediction of business activity substantiates the impact of predicting on the development of legal regulation of social relations. Practical significance the main provisions and conclusions of the article can be used in research and teaching while considering the issues of predicting both the socioeconomic processes in general and business activity in particular.

  2. The predictive validity of prospect theory versus expected utility in health utility measurement.

    Science.gov (United States)

    Abellan-Perpiñan, Jose Maria; Bleichrodt, Han; Pinto-Prades, Jose Luis

    2009-12-01

    Most health care evaluations today still assume expected utility even though the descriptive deficiencies of expected utility are well known. Prospect theory is the dominant descriptive alternative for expected utility. This paper tests whether prospect theory leads to better health evaluations than expected utility. The approach is purely descriptive: we explore how simple measurements together with prospect theory and expected utility predict choices and rankings between more complex stimuli. For decisions involving risk prospect theory is significantly more consistent with rankings and choices than expected utility. This conclusion no longer holds when we use prospect theory utilities and expected utilities to predict intertemporal decisions. The latter finding cautions against the common assumption in health economics that health state utilities are transferable across decision contexts. Our results suggest that the standard gamble and algorithms based on, should not be used to value health.

  3. Variables that predict academic procrastination behavior in prospective primary school teachers

    Directory of Open Access Journals (Sweden)

    Asuman Seda SARACALOĞLU

    2016-04-01

    Full Text Available This study aimed to examine the variables predicting academic procrastination behavior of prospective primary school teachers and is conducted using the correlational survey model. The study group is composed of 294 undergraduate students studying primary school teaching programs in faculties of education at Adnan Menderes, Pamukkale, and Muğla Sıtkı Koçman Universities in Turkey. The data collection instruments used were the Procrastination Assessment Scale Students (PASS, Academic Self-Efficacy Scale (ASES, and Academic Motivation Scale (AMS. While analyzing the gathered data, descriptive analysis techniques were utilized. Moreover, while analyzing the data, power of variables namely reasons of academic procrastination, academic motivation, and academic efficacy to predict prospective primary school teachers’ academic procrastination tendencies were tested. For that purpose, stepwise regression analysis was employed. It was found that nearly half of the prospective primary school teachers displayed no academic procrastination behavior. Participants’ reasons for procrastination were fear of failure, laziness, taking risks, and rebellion against control. An average level significant correlation was found between participants’ academic procrastination and other variables. As a result, it was identified that prospective primary school teachers had less academic procrastination than reported in literature and laziness, fear of failure, academic motivation predicted academic procrastination.

  4. Preoperative Metabolic Syndrome Is Predictive of Significant Gastric Cancer Mortality after Gastrectomy: The Fujian Prospective Investigation of Cancer (FIESTA Study

    Directory of Open Access Journals (Sweden)

    Dan Hu

    2017-02-01

    Full Text Available Metabolic syndrome (MetS has been shown to be associated with an increased risk of gastric cancer. However, the impact of MetS on gastric cancer mortality remains largely unknown. Here, we prospectively examined the prediction of preoperative MetS for gastric cancer mortality by analyzing a subset of data from the ongoing Fujian prospective investigation of cancer (FIESTA study. This study was conducted among 3012 patients with gastric cancer who received radical gastrectomy between 2000 and 2010. The latest follow-up was completed in 2015. Blood/tissue specimens, demographic and clinicopathologic characteristics were collected at baseline. During 15-year follow-up, 1331 of 3012 patients died of gastric cancer. The median survival time (MST of patients with MetS was 31.3 months, which was significantly shorter than that of MetS-free patients (157.1 months. The coexistence of MetS before surgery was associated with a 2.3-fold increased risk for gastric cancer mortality (P < 0.001. The multivariate-adjusted hazard ratios (HRs were increased with invasion depth T1/T2 (HR = 2.78, P < 0.001, regional lymph node metastasis N0 (HR = 2.65, P < 0.001, positive distant metastasis (HR = 2.53, P < 0.001, TNM stage I/II (HR = 3.00, P < 0.001, intestinal type (HR = 2.96, P < 0.001, negative tumor embolus (HR = 2.34, P < 0.001, and tumor size ≤4.5 cm (HR = 2.49, P < 0.001. Further survival tree analysis confirmed the top splitting role of TNM stage, followed by MetS or hyperglycemia with remarkable discrimination ability. In this large cohort study, preoperative MetS, especially hyperglycemia, was predictive of significant gastric cancer mortality in patients with radical gastrectomy, especially for early stage of gastric cancer.

  5. Investigation of a breathing surrogate prediction algorithm for prospective pulmonary gating

    International Nuclear Information System (INIS)

    White, Benjamin M.; Low, Daniel A.; Zhao Tianyu; Wuenschel, Sara; Lu, Wei; Lamb, James M.; Mutic, Sasa; Bradley, Jeffrey D.; El Naqa, Issam

    2011-01-01

    Purpose: A major challenge of four dimensional computed tomography (4DCT) in treatment planning and delivery has been the lack of respiration amplitude and phase reproducibility during image acquisition. The implementation of a prospective gating algorithm would ensure that images would be acquired only during user-specified breathing phases. This study describes the development and testing of an autoregressive moving average (ARMA) model for human respiratory phase prediction under quiet respiration conditions. Methods: A total of 47 4DCT patient datasets and synchronized respiration records was utilized in this study. Three datasets were used in model development and were removed from further evaluation of the ARMA model. The remaining 44 patient datasets were evaluated with the ARMA model for prediction time steps from 50 to 1000 ms in increments of 50 and 100 ms. Thirty-five of these datasets were further used to provide a comparison between the proposed ARMA model and a commercial algorithm with a prediction time step of 240 ms. Results: The optimal number of parameters for the ARMA model was based on three datasets reserved for model development. Prediction error was found to increase as the prediction time step increased. The minimum prediction time step required for prospective gating was selected to be half of the gantry rotation period. The maximum prediction time step with a conservative 95% confidence criterion was found to be 0.3 s. The ARMA model predicted peak inhalation and peak exhalation phases significantly better than the commercial algorithm. Furthermore, the commercial algorithm had numerous instances of missed breath cycles and falsely predicted breath cycles, while the proposed model did not have these errors. Conclusions: An ARMA model has been successfully applied to predict human respiratory phase occurrence. For a typical CT scanner gantry rotation period of 0.4 s (0.2 s prediction time step), the absolute error was relatively small, 0

  6. Random forest predictive modeling of mineral prospectivity with small number of prospects and data with missing values in Abra (Philippines)

    Science.gov (United States)

    Carranza, Emmanuel John M.; Laborte, Alice G.

    2015-01-01

    Machine learning methods that have been used in data-driven predictive modeling of mineral prospectivity (e.g., artificial neural networks) invariably require large number of training prospect/locations and are unable to handle missing values in certain evidential data. The Random Forests (RF) algorithm, which is a machine learning method, has recently been applied to data-driven predictive mapping of mineral prospectivity, and so it is instructive to further study its efficacy in this particular field. This case study, carried out using data from Abra (Philippines), examines (a) if RF modeling can be used for data-driven modeling of mineral prospectivity in areas with a few (i.e., individual layers of evidential data. Furthermore, RF modeling can handle missing values in evidential data through an RF-based imputation technique whereas in WofE modeling values are simply represented by zero weights. Therefore, the RF algorithm is potentially more useful than existing methods that are currently used for data-driven predictive mapping of mineral prospectivity. In particular, it is not a purely black-box method like artificial neural networks in the context of data-driven predictive modeling of mineral prospectivity. However, further testing of the method in other areas with a few mineral occurrences is needed to fully investigate its usefulness in data-driven predictive modeling of mineral prospectivity.

  7. Theory of mind and switching predict prospective memory performance in adolescents.

    Science.gov (United States)

    Altgassen, Mareike; Vetter, Nora C; Phillips, Louise H; Akgün, Canan; Kliegel, Matthias

    2014-11-01

    Research indicates ongoing development of prospective memory as well as theory of mind and executive functions across late childhood and adolescence. However, so far the interplay of these processes has not been investigated. Therefore, the purpose of the current study was to investigate whether theory of mind and executive control processes (specifically updating, switching, and inhibition) predict prospective memory development across adolescence. In total, 42 adolescents and 41 young adults participated in this study. Young adults outperformed adolescents on tasks of prospective memory, theory of mind, and executive functions. Switching and theory of mind predicted prospective memory performance in adolescents. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Early adolescent symptoms of social phobia prospectively predict alcohol use.

    Science.gov (United States)

    Dahne, Jennifer; Banducci, Anne N; Kurdziel, Gretchen; MacPherson, Laura

    2014-11-01

    The current study examined whether social phobia (SP) symptoms in early adolescence prospectively predicted alcohol use through middle adolescence in a community sample of youth. Data from an ongoing longitudinal study (N = 277) of mechanisms of HIV-related risk behaviors in youth were used to assess the extent to which SP symptoms in early adolescence (mean [SD] age = 11.00 years [0.81]) would predict alcohol use across five annual assessment waves. Adolescents completed measures of SP symptoms, depressive symptoms, and alcohol use at each wave. Higher SP symptoms at baseline predicted higher average odds of alcohol consumption during subsequent waves but did not significantly predict an increase in the odds of alcohol use as a function of time. Within a lagged model, SP symptoms measured at a prior assessment point (1 year earlier) predicted greater odds of drinking alcohol at the following assessment point. Importantly, alcohol use did not significantly predict SP symptoms over time. These results suggest that early SP symptoms are an important risk factor for increased odds of subsequent alcohol use. The present findings highlight that elevated SP symptoms place adolescents at risk for early alcohol use. Early interventions targeting SP symptoms may be crucial for the prevention of problematic alcohol use in early to mid-adolescence. Implications for prevention and treatment approaches are discussed.

  9. Rumination prospectively predicts executive functioning impairments in adolescents.

    Science.gov (United States)

    Connolly, Samantha L; Wagner, Clara A; Shapero, Benjamin G; Pendergast, Laura L; Abramson, Lyn Y; Alloy, Lauren B

    2014-03-01

    The current study tested the resource allocation hypothesis, examining whether baseline rumination or depressive symptom levels prospectively predicted deficits in executive functioning in an adolescent sample. The alternative to this hypothesis was also evaluated by testing whether lower initial levels of executive functioning predicted increases in rumination or depressive symptoms at follow-up. A community sample of 200 adolescents (ages 12-13) completed measures of depressive symptoms, rumination, and executive functioning at baseline and at a follow-up session approximately 15 months later. Adolescents with higher levels of baseline rumination displayed decreases in selective attention and attentional switching at follow-up. Rumination did not predict changes in working memory or sustained and divided attention. Depressive symptoms were not found to predict significant changes in executive functioning scores at follow-up. Baseline executive functioning was not associated with change in rumination or depression over time. Findings partially support the resource allocation hypothesis that engaging in ruminative thoughts consumes cognitive resources that would otherwise be allocated towards difficult tests of executive functioning. Support was not found for the alternative hypothesis that lower levels of initial executive functioning would predict increased rumination or depressive symptoms at follow-up. Our study is the first to find support for the resource allocation hypothesis using a longitudinal design and an adolescent sample. Findings highlight the potentially detrimental effects of rumination on executive functioning during early adolescence. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Seasonal Drought Prediction: Advances, Challenges, and Future Prospects

    Science.gov (United States)

    Hao, Zengchao; Singh, Vijay P.; Xia, Youlong

    2018-03-01

    Drought prediction is of critical importance to early warning for drought managements. This review provides a synthesis of drought prediction based on statistical, dynamical, and hybrid methods. Statistical drought prediction is achieved by modeling the relationship between drought indices of interest and a suite of potential predictors, including large-scale climate indices, local climate variables, and land initial conditions. Dynamical meteorological drought prediction relies on seasonal climate forecast from general circulation models (GCMs), which can be employed to drive hydrological models for agricultural and hydrological drought prediction with the predictability determined by both climate forcings and initial conditions. Challenges still exist in drought prediction at long lead time and under a changing environment resulting from natural and anthropogenic factors. Future research prospects to improve drought prediction include, but are not limited to, high-quality data assimilation, improved model development with key processes related to drought occurrence, optimal ensemble forecast to select or weight ensembles, and hybrid drought prediction to merge statistical and dynamical forecasts.

  11. Does predictability matter? Effects of cue predictability on neurocognitive mechanisms underlying prospective memory

    OpenAIRE

    Cona, Giorgia; Arcara, Giorgio; Tarantino, Vincenza; Bisiacchi, Patrizia S.

    2015-01-01

    Prospective memory (PM) represents the ability to successfully realize intentions when the appropriate moment or cue occurs. In this study, we used event-related potentials (ERPs) to explore the impact of cue predictability on the cognitive and neural mechanisms supporting PM. Participants performed an ongoing task and, simultaneously, had to remember to execute a pre-specified action when they encountered the PM cues. The occurrence of the PM cues was predictable (being signaled by a warning...

  12. Prospective assessment of dosimetric/physiologic-based models for predicting radiation pneumonitis

    International Nuclear Information System (INIS)

    Kocak, Zafer; Borst, Gerben R.; Zeng Jing; Zhou Sumin; Hollis, Donna R.; Zhang Junan; Evans, Elizabeth S.; Folz, Rodney J.; Wong, Terrence; Kahn, Daniel; Belderbos, Jose S.A.; Lebesque, Joos V.; Marks, Lawrence B.

    2007-01-01

    Purpose: Clinical and 3D dosimetric parameters are associated with symptomatic radiation pneumonitis rates in retrospective studies. Such parameters include: mean lung dose (MLD), radiation (RT) dose to perfused lung (via SPECT), and pre-RT lung function. Based on prior publications, we defined pre-RT criteria hypothesized to be predictive for later development of pneumonitis. We herein prospectively test the predictive abilities of these dosimetric/functional parameters on 2 cohorts of patients from Duke and Netherlands Cancer Institute (NKI). Methods and Materials: For the Duke cohort, 55 eligible patients treated between 1999 and 2005 on a prospective IRB-approved study to monitor RT-induced lung injury were analyzed. A similar group of patients treated at the NKI between 1996 and 2002 were identified. Patients believed to be at high and low risk for pneumonitis were defined based on: (1) MLD; (2) OpRP (sum of predicted perfusion reduction based on regional dose-response curve); and (3) pre-RT DLCO. All doses reflected tissue density heterogeneity. The rates of grade ≥2 pneumonitis in the 'presumed' high and low risk groups were compared using Fisher's exact test. Results: In the Duke group, pneumonitis rates in patients prospectively deemed to be at 'high' vs. 'low' risk are 7 of 20 and 9 of 35, respectively; p = 0.33 one-tailed Fisher's. Similarly, comparable rates for the NKI group are 4 of 21 and 6 of 44, respectively, p = 0.41 one-tailed Fisher's. Conclusion: The prospective model appears unable to accurately segregate patients into high vs. low risk groups. However, considered retrospectively, these data are consistent with prior studies suggesting that dosimetric (e.g., MLD) and functional (e.g., PFTs or SPECT) parameters are predictive for RT-induced pneumonitis. Additional work is needed to better identify, and prospectively assess, predictors of RT-induced lung injury

  13. Examining the specific dimensions of distress tolerance that prospectively predict perceived stress.

    Science.gov (United States)

    Bardeen, Joseph R; Fergus, Thomas A; Orcutt, Holly K

    2017-04-01

    We examined five dimensions of distress tolerance (i.e. uncertainty, ambiguity, frustration, negative emotion, physical discomfort) as prospective predictors of perceived stress. Undergraduate students (N = 135) completed self-report questionnaires over the course of two assessment sessions (T1 and T2). Results of a linear regression in which the five dimensions of distress tolerance and covariates (i.e. T1 perceived stress, duration between T1 and T2) served as predictor variables and T2 perceived stress served as the outcome variable showed that intolerance of uncertainty was the only dimension of distress tolerance to predict T2 perceived stress. To better understand this prospective association, we conducted a post hoc analysis simultaneously regressing two subdimensions of intolerance of uncertainty on T2 perceived stress. The subdimension representing beliefs that "uncertainty has negative behavioral and self-referent implications" significantly predicted T2 perceived stress, while the subdimension indicating that "uncertainty is unfair and spoils everything" did not. Results support a growing body of research suggesting intolerance of uncertainty as a risk factor for a wide variety of maladaptive psychological outcomes. Clinical implications will be discussed.

  14. Hopefulness predicts resilience after hereditary colorectal cancer genetic testing: a prospective outcome trajectories study

    OpenAIRE

    Chu Annie TW; Bonanno George A; Ho Judy WC; Ho Samuel MY; Chan Emily MS

    2010-01-01

    Abstract Background - Genetic testing for hereditary colorectal cancer (HCRC) had significant psychological consequences for test recipients. This prospective longitudinal study investigated the factors that predict psychological resilience in adults undergoing genetic testing for HCRC. Methods - A longitudinal study was carried out from April 2003 to August 2006 on Hong Kong Chinese HCRC family members who were recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer R...

  15. Prospective versus predictive control in timing of hitting a falling ball.

    Science.gov (United States)

    Katsumata, Hiromu; Russell, Daniel M

    2012-02-01

    Debate exists as to whether humans use prospective or predictive control to intercept an object falling under gravity (Baurès et al. in Vis Res 47:2982-2991, 2007; Zago et al. in Vis Res 48:1532-1538, 2008). Prospective control involves using continuous information to regulate action. τ, the ratio of the size of the gap to the rate of gap closure, has been proposed as the information used in guiding interceptive actions prospectively (Lee in Ecol Psychol 10:221-250, 1998). This form of control is expected to generate movement modulation, where variability decreases over the course of an action based upon more accurate timing information. In contrast, predictive control assumes that a pre-programmed movement is triggered at an appropriate criterion timing variable. For a falling object it is commonly argued that an internal model of gravitational acceleration is used to predict the motion of the object and determine movement initiation. This form of control predicts fixed duration movements initiated at consistent time-to-contact (TTC), either across conditions (constant criterion operational timing) or within conditions (variable criterion operational timing). The current study sought to test predictive and prospective control hypotheses by disrupting continuous visual information of a falling ball and examining consistency in movement initiation and duration, and evidence for movement modulation. Participants (n = 12) batted a ball dropped from three different heights (1, 1.3 and 1.5 m), under both full-vision and partial occlusion conditions. In the occlusion condition, only the initial ball drop and the final 200 ms of ball flight to the interception point could be observed. The initiation of the swing did not occur at a consistent TTC, τ, or any other timing variable across drop heights, in contrast with previous research. However, movement onset was not impacted by occluding the ball flight for 280-380 ms. This finding indicates that humans did not

  16. Forecasting Significant Societal Events Using The Embers Streaming Predictive Analytics System.

    Science.gov (United States)

    Doyle, Andy; Katz, Graham; Summers, Kristen; Ackermann, Chris; Zavorin, Ilya; Lim, Zunsik; Muthiah, Sathappan; Butler, Patrick; Self, Nathan; Zhao, Liang; Lu, Chang-Tien; Khandpur, Rupinder Paul; Fayed, Youssef; Ramakrishnan, Naren

    2014-12-01

    Developed under the Intelligence Advanced Research Project Activity Open Source Indicators program, Early Model Based Event Recognition using Surrogates (EMBERS) is a large-scale big data analytics system for forecasting significant societal events, such as civil unrest events on the basis of continuous, automated analysis of large volumes of publicly available data. It has been operational since November 2012 and delivers approximately 50 predictions each day for countries of Latin America. EMBERS is built on a streaming, scalable, loosely coupled, shared-nothing architecture using ZeroMQ as its messaging backbone and JSON as its wire data format. It is deployed on Amazon Web Services using an entirely automated deployment process. We describe the architecture of the system, some of the design tradeoffs encountered during development, and specifics of the machine learning models underlying EMBERS. We also present a detailed prospective evaluation of EMBERS in forecasting significant societal events in the past 2 years.

  17. Performance predictions affect attentional processes of event-based prospective memory.

    Science.gov (United States)

    Rummel, Jan; Kuhlmann, Beatrice G; Touron, Dayna R

    2013-09-01

    To investigate whether making performance predictions affects prospective memory (PM) processing, we asked one group of participants to predict their performance in a PM task embedded in an ongoing task and compared their performance with a control group that made no predictions. A third group gave not only PM predictions but also ongoing-task predictions. Exclusive PM predictions resulted in slower ongoing-task responding both in a nonfocal (Experiment 1) and in a focal (Experiment 2) PM task. Only in the nonfocal task was the additional slowing accompanied by improved PM performance. Even in the nonfocal task, however, was the correlation between ongoing-task speed and PM performance reduced after predictions, suggesting that the slowing was not completely functional for PM. Prediction-induced changes could be avoided by asking participants to additionally predict their performance in the ongoing task. In sum, the present findings substantiate a role of metamemory for attention-allocation strategies of PM. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Mobile Phone-Based Mood Ratings Prospectively Predict Psychotherapy Attendance.

    Science.gov (United States)

    Bruehlman-Senecal, Emma; Aguilera, Adrian; Schueller, Stephen M

    2017-09-01

    Psychotherapy nonattendance is a costly and pervasive problem. While prior research has identified stable patient-level predictors of attendance, far less is known about dynamic (i.e., time-varying) factors. Identifying dynamic predictors can clarify how clinical states relate to psychotherapy attendance and inform effective "just-in-time" interventions to promote attendance. The present study examines whether daily mood, as measured by responses to automated mobile phone-based text messages, prospectively predicts attendance in group cognitive-behavioral therapy (CBT) for depression. Fifty-six Spanish-speaking Latino patients with elevated depressive symptoms (46 women, mean age=50.92years, SD=10.90years), enrolled in a manualized program of group CBT, received daily automated mood-monitoring text messages. Patients' daily mood ratings, message response rate, and delay in responding were recorded. Patients' self-reported mood the day prior to a scheduled psychotherapy session significantly predicted attendance, even after controlling for patients' prior attendance history and age (OR=1.33, 95% CI [1.04, 1.70], p=.02). Positive mood corresponded to a greater likelihood of attendance. Our results demonstrate the clinical utility of automated mood-monitoring text messages in predicting attendance. These results underscore the value of text messaging, and other mobile technologies, as adjuncts to psychotherapy. Future work should explore the use of such monitoring to guide interventions to increase attendance, and ultimately the efficacy of psychotherapy. Copyright © 2017. Published by Elsevier Ltd.

  19. Sasang constitutional types for the risk prediction of metabolic syndrome: a 14-year longitudinal prospective cohort study.

    Science.gov (United States)

    Lee, Sunghee; Lee, Seung Ku; Kim, Jong Yeol; Cho, Namhan; Shin, Chol

    2017-09-02

    To examine whether the use of Sasang constitutional (SC) types, such as Tae-yang (TY), Tae-eum (TE), So-yang (SY), and So-eum (SE) types, increases the accuracy of risk prediction for metabolic syndrome. From 2001 to 2014, 3529 individuals aged 40 to 69 years participated in a longitudinal prospective cohort. The Cox proportional hazard model was utilized to predict the risk of developing metabolic syndrome. During the 14 year follow-up, 1591 incident events of metabolic syndrome were observed. Individuals with TE type had higher body mass indexes and waist circumferences than individuals with SY and SE types. The risk of developing metabolic syndrome was the highest among individuals with the TE type, followed by the SY type and the SE type. When the prediction risk models for incident metabolic syndrome were compared, the area under the curve for the model using SC types was significantly increased to 0.8173. Significant predictors for incident metabolic syndrome were different according to the SC types. For individuals with the TE type, the significant predictors were age, sex, body mass index (BMI), education, smoking, drinking, fasting glucose level, high-density lipoprotein (HDL) cholesterol level, systolic and diastolic blood pressure, and triglyceride level. For Individuals with the SE type, the predictors were sex, smoking, fasting glucose, HDL cholesterol level, systolic and diastolic blood pressure, and triglyceride level, while the predictors in individuals with the SY type were age, sex, BMI, smoking, drinking, total cholesterol level, fasting glucose level, HDL cholesterol level, systolic and diastolic blood pressure, and triglyceride level. In this prospective cohort study among 3529 individuals, we observed that utilizing the SC types significantly increased the accuracy of the risk prediction for the development of metabolic syndrome.

  20. Stressful Life Events Predict Eating Disorder Relapse Following Remission: Six-Year Prospective Outcomes

    Science.gov (United States)

    Grilo, Carlos M.; Pagano, Maria E.; Stout, Robert L.; Markowitz, John C.; Ansell, Emily B.; Pinto, Anthony; Zanarini, Mary C.; Yen, Shirley; Skodol, Andrew E.

    2012-01-01

    Objective To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not-otherwise-specified (EDNOS) and test for the effects of stressful life events (SLE) on relapse after remission from these eating disorders. Method 117 female patients with BN (N = 35) or EDNOS (N = 82) were prospectively followed for 72 months using structured interviews performed at baseline, 6- and 12-months, and then yearly thereafter. ED were assessed with the structured clinical interview for DSM-IV, and monitored over time with the longitudinal interval follow-up evaluation. Personality disorders were assessed with the diagnostic interview for DSM-IV-personality-disorders, and monitored over time with the follow-along-version. The occurrence and specific timing of SLE were assessed with the life events assessment interview. Cox proportional-hazard-regression-analyses tested associations between time-varying levels of SLE and ED relapse, controlling for comorbid psychiatric disorders, ED duration, and time-varying personality-disorder status. Results ED relapse probability was 43%; BN and EDNOS did not differ in time to relapse. Negative SLE significantly predicted ED relapse; elevated work and social stressors were significant predictors. Psychiatric comorbidity, ED duration, and time-varying personality-disorder status were not significant predictors. Discussion Higher work and social stress represent significant warning signs for triggering relapse for women with remitted BN and EDNOS. PMID:21448971

  1. Elevated left mid-frontal cortical activity prospectively predicts conversion to bipolar I disorder

    Science.gov (United States)

    Nusslock, Robin; Harmon-Jones, Eddie; Alloy, Lauren B.; Urosevic, Snezana; Goldstein, Kim; Abramson, Lyn Y.

    2013-01-01

    Bipolar disorder is characterized by a hypersensitivity to reward-relevant cues and a propensity to experience an excessive increase in approach-related affect, which may be reflected in hypo/manic symptoms. The present study examined the relationship between relative left-frontal electroencephalographic (EEG) activity, a proposed neurophysiological index of approach-system sensitivity and approach/reward-related affect, and bipolar course and state-related variables. Fifty-eight individuals with cyclothymia or bipolar II disorder and 59 healthy control participants with no affective psychopathology completed resting EEG recordings. Alpha power was obtained and asymmetry indices computed for homologous electrodes. Bipolar spectrum participants were classified as being in a major/minor depressive episode, a hypomanic episode, or a euthymic/remitted state at EEG recording. Participants were then followed prospectively for an average 4.7 year follow-up period with diagnostic interview assessments every four-months. Sixteen bipolar spectrum participants converted to bipolar I disorder during follow-up. Consistent with hypotheses, elevated relative left-frontal EEG activity at baseline 1) prospectively predicted a greater likelihood of converting from cyclothymia or bipolar II disorder to bipolar I disorder over the 4.7 year follow-up period, 2) was associated with an earlier age-of-onset of first bipolar spectrum episode, and 3) was significantly elevated in bipolar spectrum individuals in a hypomanic episode at EEG recording. This is the first study to identify a neurophysiological marker that prospectively predicts conversion to bipolar I disorder. The fact that unipolar depression is characterized by decreased relative left-frontal EEG activity suggests that unipolar depression and vulnerability to hypo/mania may be characterized by different profiles of frontal EEG asymmetry. PMID:22775582

  2. Premorbid teacher-rated social functioning predicts adult schizophrenia-spectrum disorder: A high-risk prospective investigation

    DEFF Research Database (Denmark)

    Tsuji, Thomas; Kline, Emily; Sorensen, Holger J.

    2013-01-01

    Social functioning deficits are a core component of schizophrenia spectrum disorders, and may emerge years prior to the onset of diagnosable illness. The current study prospectively examines the relation between teacher-rated childhood social dysfunction and later mental illness among participants...... who were at genetic high-risk for schizophrenia and controls (n=244). The teacher-rated social functioning scale significantly predicted psychiatric outcomes (schizophrenia-spectrum vs. other psychiatric disorder vs. no mental illness). Poor premorbid social functioning appears to constitute a marker...

  3. Shame and guilt as shared vulnerability factors: Shame, but not guilt, prospectively predicts both social anxiety and bulimic symptoms.

    Science.gov (United States)

    Levinson, Cheri A; Byrne, Meghan; Rodebaugh, Thomas L

    2016-08-01

    Social anxiety disorder (SAD) and bulimia nervosa (BN) are highly comorbid. However, little is known about the shared vulnerability factors that prospectively predict both SA and BN symptoms. Two potential factors that have not yet been tested are shame and guilt. In the current study we tested if shame and guilt were shared vulnerability factors for SA and BN symptoms. Women (N=300) completed measures of SA symptoms, BN symptoms, state shame and guilt, and trait negative affect at two time points, two months apart. Utilizing structural equation modeling we tested a cross-sectional and prospective model of SA and BN vulnerability. We found that shame prospectively predicted both SA and BN symptoms. We did not find that guilt prospectively predicted SA or BN symptoms. However, higher levels of both BN and SA symptoms predicted increased guilt over time. We found support for shame as a shared prospective vulnerability factor between BN and SA symptoms. Interventions that focus on decreasing shame could potentially alleviate symptoms of BN and SA in one protocol. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Predicting ongoing pregnancy chances after IVF and ICSI: A national prospective study

    OpenAIRE

    Lintsen, Bea; Eijkemans, René; Hunault, C.C.; Bouwmans-Frijters, Clazien; Hakkaart-van Roijen, Leona; Habbema, Dik; Braat, Didi

    2007-01-01

    textabstractBackground: The Dutch IVF guideline suggests triage of patients for IVF based on diagnostic category, duration of infertility and female age. There is no evidence for the effectiveness of these criteria. We evaluated the predictive value of patient characteristics that are used in the Dutch IVF guideline and developed a model that predicts the IVF ongoing pregnancy chance within 12 months. Methods: In a national prospective cohort study, pregnancy chances after IVF and ICSI treatm...

  5. Significant interarm blood pressure difference predicts cardiovascular risk in hypertensive patients

    Science.gov (United States)

    Kim, Su-A; Kim, Jang Young; Park, Jeong Bae

    2016-01-01

    Abstract There has been a rising interest in interarm blood pressure difference (IAD), due to its relationship with peripheral arterial disease and its possible relationship with cardiovascular disease. This study aimed to characterize hypertensive patients with a significant IAD in relation to cardiovascular risk. A total of 3699 patients (mean age, 61 ± 11 years) were prospectively enrolled in the study. Blood pressure (BP) was measured simultaneously in both arms 3 times using an automated cuff-oscillometric device. IAD was defined as the absolute difference in averaged BPs between the left and right arm, and an IAD ≥ 10 mm Hg was considered to be significant. The Framingham risk score was used to calculate the 10-year cardiovascular risk. The mean systolic IAD (sIAD) was 4.3 ± 4.1 mm Hg, and 285 (7.7%) patients showed significant sIAD. Patients with significant sIAD showed larger body mass index (P < 0.001), greater systolic BP (P = 0.050), more coronary artery disease (relative risk = 1.356, P = 0.034), and more cerebrovascular disease (relative risk = 1.521, P = 0.072). The mean 10-year cardiovascular risk was 9.3 ± 7.7%. By multiple regression, sIAD was significantly but weakly correlated with the 10-year cardiovascular risk (β = 0.135, P = 0.008). Patients with significant sIAD showed a higher prevalence of coronary artery disease, as well as an increase in 10-year cardiovascular risk. Therefore, accurate measurements of sIAD may serve as a simple and cost-effective tool for predicting cardiovascular risk in clinical settings. PMID:27310982

  6. Interaction of CD38 Variant and Chronic Interpersonal Stress Prospectively Predicts Social Anxiety and Depression Symptoms Over Six Years

    Science.gov (United States)

    Tabak, Benjamin A.; Vrshek-Schallhorn, Suzanne; Zinbarg, Richard E.; Prenoveau, Jason M.; Mineka, Susan; Redei, Eva E.; Adam, Emma K.; Craske, Michelle G.

    2015-01-01

    Variation in the CD38 gene, which regulates secretion of the neuropeptide oxytocin, has been associated with several social phenotypes. Specifically, rs3796863 A allele carriers have demonstrated increased social sensitivity. In 400 older adolescents, we used trait-state-occasion modeling to investigate how rs3796863 genotype, baseline ratings of chronic interpersonal stress, and their gene-environment (GxE) interaction predicted trait social anxiety and depression symptoms over six years. We found significant GxE effects for CD38 A-carrier genotypes and chronic interpersonal stress at baseline predicting greater social anxiety and depression symptoms. A significant GxE effect of smaller magnitude was also found for C/C genotype and chronic interpersonal stress predicting greater depression; however, this effect was small compared to the main effect of chronic interpersonal stress. Thus, in the context of chronic interpersonal stress, heightened social sensitivity associated with the rs3796863 A allele may prospectively predict risk for social anxiety and (to a lesser extent) depression. PMID:26958455

  7. Novel use of the Wii Balance Board to prospectively predict falls in community-dwelling older adults.

    Science.gov (United States)

    Kwok, Boon-Chong; Clark, Ross A; Pua, Yong-Hao

    2015-06-01

    The Wii Balance Board has received increasing attention as a balance measurement tool; however its ability to prospectively predict falls is unknown. This exploratory study investigated the use of the Wii Balance Board and other clinical-based measures for prospectively predicting falls among community-dwelling older adults. Seventy-three community-dwelling men and women, aged 60-85years were followed-up over a year for falls. Standing balance was indexed by sway velocities measured using the Wii Balance Board interfaced with a laptop. Clinical-based measures included Short Physical Performance Battery, gait speed and Timed-Up-and-Go test. Multivariable regression analyses were used to assess the ability of the Wii Balance Board measure to complement the TUG test in fall screening. Individually, the study found Wii Balance Board anteroposterior (odds ratio 1.98, 95% CI 1.16 to 3.40, P=0.01) and mediolateral (odds ratio 2.80, 95% CI 1.10 to 7.13, p=0.03) sway velocity measures predictive of prospective falls. However, when each velocity measure was adjusted with body mass index and Timed-Up-and-Go, only anteroposterior sway velocity was predictive of prospective falls (odds ratio 2.21, 95% CI 1.18 to 4.14). A faster anteroposterior velocity was associated with increased odds of falling. Area-under-the-curves for Wii Balance Board sway velocities were 0.67 and 0.71 for anteroposterior and mediolateral respectively. The Wii Balance Board-derived anteroposterior sway velocity measure could complement existing clinical-based measures in predicting future falls among community-dwelling older adults. Australian New Zealand Clinical Trials Registry number: ACTRN12610001099011. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Stress sensitivity interacts with depression history to predict depressive symptoms among youth: prospective changes following first depression onset.

    Science.gov (United States)

    Technow, Jessica R; Hazel, Nicholas A; Abela, John R Z; Hankin, Benjamin L

    2015-04-01

    Predictors of depressive symptoms may differ before and after the first onset of major depression due to stress sensitization. Dependent stressors, or those to which characteristics of individuals contribute, have been shown to predict depressive symptoms in youth. The current study sought to clarify how stressors' roles may differ before and after the first depressive episode. Adolescents (N = 382, aged 11 to 15 at baseline) were assessed at baseline and every 3 months over the course of 2 years with measures of stressors and depressive symptoms. Semi-structured interviews were conducted every 6 months to assess for clinically significant depressive episodes. Hierarchical linear modeling showed a significant interaction between history of depression and idiographic fluctuations in dependent stressors to predict prospective elevations of symptoms, such that dependent stressors were more predictive of depressive symptoms after onset of disorder. Independent stressors predicted symptoms, but the strength of the association did not vary by depression history. These results suggest a synthesis of dependent stress and stress sensitization processes that might maintain inter-episode depressive symptoms among youth with a history of clinical depression.

  9. Stress sensitivity interacts with depression history to predict depressive symptoms among youth: Prospective changes following first depression onset

    Science.gov (United States)

    Technow, Jessica R.; Hazel, Nicholas A.; Abela, John R. Z.; Hankin, Benjamin L.

    2015-01-01

    Predictors of depressive symptoms may differ before and after the first onset of major depression due to stress sensitization. Dependent stressors, or those to which characteristics of individuals contribute, have been shown to predict depressive symptoms in youth. The current study sought to clarify how stressors’ roles may differ before and after the first depressive episode. Adolescents (N = 382, aged 11 to 15 at baseline) were assessed at baseline and every three months over the course of two years with measures of stressors and depressive symptoms. Semi-structured interviews were conducted every 6 months to assess for clinically significant depressive episodes. Hierarchical linear modeling showed a significant interaction between history of depression and idiographic fluctuations in dependent stressors to predict prospective elevations of symptoms, such that dependent stressors were more predictive of depressive symptoms after onset of disorder. Independent stressors predicted symptoms, but the strength of the association did not vary by depression history. These results suggest a synthesis of stress sensitization and generation processes that might maintain inter-episode depressive symptoms among youth with a history of clinical depression. PMID:25123081

  10. Utility of the theories of reasoned action and planned behavior for predicting physician behavior: a prospective analysis.

    Science.gov (United States)

    Millstein, S G

    1996-09-01

    The utility of the theory of reasoned action (TRA) and the theory of planned behavior (TPB) for prospectively predicting physicians' delivery of preventive services was compared. Primary care physicians (N = 765) completed 2 mail surveys at periods 6 months apart. The addition of perceived behavioral control to the TRA model significantly increased the variance accounted for in behavioral intention and subsequent behavior (p behavioral control had direct effects on behavior and interacted with social norms and behavioral intentions. Applications of models such as the TRA or TPB have focused primarily on predicting the behavioral intentions and behaviors of patients. Results suggest that these models have relevance for studying the behavior of health care providers as well.

  11. Does predictability matter? Effects of cue predictability on neurocognitive mechanisms underlying prospective memory.

    Science.gov (United States)

    Cona, Giorgia; Arcara, Giorgio; Tarantino, Vincenza; Bisiacchi, Patrizia S

    2015-01-01

    Prospective memory (PM) represents the ability to successfully realize intentions when the appropriate moment or cue occurs. In this study, we used event-related potentials (ERPs) to explore the impact of cue predictability on the cognitive and neural mechanisms supporting PM. Participants performed an ongoing task and, simultaneously, had to remember to execute a pre-specified action when they encountered the PM cues. The occurrence of the PM cues was predictable (being signaled by a warning cue) for some participants and was completely unpredictable for others. In the predictable cue condition, the behavioral and ERP correlates of strategic monitoring were observed mainly in the ongoing trials wherein the PM cue was expected. In the unpredictable cue condition they were instead shown throughout the whole PM block. This pattern of results suggests that, in the predictable cue condition, participants engaged monitoring only when subjected to a context wherein the PM cue was expected, and disengaged monitoring when the PM cue was not expected. Conversely, participants in the unpredictable cue condition distributed their resources for strategic monitoring in more continuous manner. The findings of this study support the most recent views-the "Dynamic Multiprocess Framework" and the "Attention to Delayed Intention" (AtoDI) model-confirming that strategic monitoring is a flexible mechanism that is recruited mainly when a PM cue is expected and that may interact with bottom-up spontaneous processes.

  12. Significance of prior percutaneous revascularisation in patients with acute coronary syndromes: insights from the prospective PROSPECT registry.

    Science.gov (United States)

    Iñiguez, Andrés; Brener, Sorin J; Jiménez, Victor A; Maehara, Akiko; Mintz, Gary S; Xu, Ke; Weisz, Giora; Lansky, Alexandra J; De Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W

    2016-04-20

    Prior percutaneous coronary intervention (PCI) is increasingly encountered in acute coronary syndrome (ACS) patients, with uncertain significance. We sought to evaluate the impact of prior PCI in ACS patients. Patients with ACS enrolled in the prospective PROSPECT registry underwent three-vessel intravascular ultrasound and virtual histology evaluation after successful PCI of the culprit lesion(s). We identified patients with prior PCI (>6 months before index ACS) and compared their outcomes to those without prior PCI. Time-to-event for major adverse cardiac events (MACE) was estimated up to three years, and the independent association between prior PCI and MACE was evaluated in a multivariable model. Among 696 patients enrolled, 77 (11.1%) had prior PCI. They were older and more likely to have prior myocardial infarction, chronic kidney disease, and congestive heart failure. At three years, patients with prior PCI had significantly higher rates of cardiac death, rehospitalisation for worsening angina, and MACE (adjusted HR=1.73 [95% CI: 1.09, 2.75], p=0.02), independent of other comorbidities and intravascular ultrasound findings. Prior PCI was noted in over 10% of patients with ACS and was associated with higher mortality and morbidity, independent of other comorbidities. Prior PCI should be considered a high-risk feature when evaluating ACS patients.

  13. Artificial neural networks to predict presence of significant pathology in patients presenting to routine colorectal clinics.

    Science.gov (United States)

    Maslekar, S; Gardiner, A B; Monson, J R T; Duthie, G S

    2010-12-01

    Artificial neural networks (ANNs) are computer programs used to identify complex relations within data. Routine predictions of presence of colorectal pathology based on population statistics have little meaning for individual patient. This results in large number of unnecessary lower gastrointestinal endoscopies (LGEs - colonoscopies and flexible sigmoidoscopies). We aimed to develop a neural network algorithm that can accurately predict presence of significant pathology in patients attending routine outpatient clinics for gastrointestinal symptoms. Ethics approval was obtained and the study was monitored according to International Committee on Harmonisation - Good Clinical Practice (ICH-GCP) standards. Three-hundred patients undergoing LGE prospectively completed a specifically developed questionnaire, which included 40 variables based on clinical symptoms, signs, past- and family history. Complete data sets of 100 patients were used to train the ANN; the remaining data was used for internal validation. The primary output used was positive finding on LGE, including polyps, cancer, diverticular disease or colitis. For external validation, the ANN was applied to data from 50 patients in primary care and also compared with the predictions of four clinicians. Clear correlation between actual data value and ANN predictions were found (r = 0.931; P = 0.0001). The predictive accuracy of ANN was 95% in training group and 90% (95% CI 84-96) in the internal validation set and this was significantly higher than the clinical accuracy (75%). ANN also showed high accuracy in the external validation group (89%). Artificial neural networks offer the possibility of personal prediction of outcome for individual patients presenting in clinics with colorectal symptoms, making it possible to make more appropriate requests for lower gastrointestinal endoscopy. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

  14. Does predictability matter? Effects of cue predictability on neurocognitive mechanisms underlying Prospective Memory

    Directory of Open Access Journals (Sweden)

    Giorgia eCona

    2015-04-01

    Full Text Available Prospective memory (PM represents the ability to successfully realize intentions when the appropriate moment or cue occurs. In this study, we used event-related potentials (ERPs to explore the impact of cue predictability on the cognitive and neural mechanisms supporting PM. Participants performed an ongoing task and, simultaneously, had to remember to execute a pre-specified action when they encountered the PM cues. The occurrence of the PM cues was predictable (being signalled by a warning cue for some participants and was completely unpredictable for others. In the predictable cue condition, the behavioural and ERP correlates of strategic monitoring were observed mainly in the ongoing trials wherein the PM cue was expected. In the unpredictable cue condition they were instead shown throughout the whole PM block. This pattern of results suggests that, in the predictable cue condition, participants engaged monitoring only when subjected to a context wherein the PM cue was expected, and disengaged monitoring when the PM cue was not expected. Conversely, participants in the unpredictable cue condition distributed their resources for strategic monitoring in more continuous manner. The findings of this study support the most recent views – the ‘Dynamic Multiprocess Framework’ and the ‘Attention to Delayed Intention’ (AtoDI model – confirming that strategic monitoring is a flexible mechanism that is recruited mainly when a PM cue is expected and that may interact with bottom-up spontaneous processes.

  15. Source-Specific Oppositional Defiant Disorder among Inner-City Children: Prospective Prediction and Moderation

    Science.gov (United States)

    Drabick, Deborah A. G.; Bubier, Jennifer; Chen, Diane; Price, Julia; Lanza, H. Isabella

    2011-01-01

    We examined prospective prediction from parent- and teacher-reported oppositional defiant disorder (ODD) symptoms to parent-reported ODD, conduct disorder (CD), major depressive disorder (MDD), and generalized anxiety disorder symptoms and whether child executive functioning abilities moderated these relations among an urban, low-income sample of…

  16. Controlling factors of uranium mineralization and prospect prediction in Qimantage area

    International Nuclear Information System (INIS)

    Yao Chunling; Zhu Pengfei; Cai Yuqi; Zhang Wenming; Zhao Yong'an; Song Jiye; Zhang Xiaojin

    2011-01-01

    Based on the analysis of regional geology in Qimantage area, the condition for uranium mineralization is summarized in regional geology setting, volcanic, granite and faults. This study shows that this area has favorable prospect for uranium mineralization. The metallogenic model is built up according to the controlling factors over uranium mineralization. Under this model, six potential areas are predicted in MRAS software with mineralization factors of synthetically geological information method. (authors)

  17. Bilirubin nomogram for prediction of significant hyperbilirubinemia in north Indian neonates.

    Science.gov (United States)

    Pathak, Umesh; Chawla, Deepak; Kaur, Saranjit; Jain, Suksham

    2013-04-01

    (i) To construct hour-specific serum total bilirubin (STB) nomogram in neonates born at =35 weeks of gestation; (ii)To evaluate efficacy of pre-discharge bilirubin measurement in predicting hyperbilirubinemia needing treatment. Diagnostic test performance in a prospective cohort study. Teaching hospital in Northern India. Healthy neonates with gestation =35 weeks or birth weight =2000 g. Serum total bilirubin was measured in all enrolled neonates at 24 ± 6, 72-96 and 96-144 h of postnatal age and when indicated clinically. Neonates were followed up during hospital stay and after discharge till completion of 7th postnatal day. Key outcome was significant hyperbilirubinemia (SHB) defined as need of phototherapy based on modified American Academy of Pediatrics (AAP) guidelines. In neonates born at 38 or more weeks of gestation middle line and in neonates born at 37 or less completed weeks of gestation, lower line of phototherapy thresholds were used to initiate phototherapy. For construction of nomogram, STB values were clubbed in six-hour epochs (age ± 3 hours) for postnatal age up to 48 h and twelve-hour epochs (age ± 6 hours) for age beyond 48 h. Predictive ability of the nomogram was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio, by plotting receiver-operating characteristics (ROC) curve and calculating c-statistic. 997 neonates (birth weight: 2627 ± 536 g, gestation: 37.8 ± 1.5 weeks) were enrolled, of which 931 completed followup. Among enrolled neonates 344 (34.5%) were low birth weight. Rate of exclusive breastfeeding during hospital stay was more than 80%. Bilirubin nomogram was constructed using 40th, 75th and 95th percentile values of hour-specific bilirubin. Pre-discharge STB of =95th percentile was assigned to be in high-risk zone, between 75th and 94th centile in upper-intermediate risk zone, between 40th and 74th centile in lower-intermediate risk zone and below 40th

  18. Predictive Power of Prospective Physical Education Teachers' Attitudes towards Educational Technologies for Their Technological Pedagogical Content Knowledge

    Science.gov (United States)

    Varol, Yaprak Kalemoglu

    2015-01-01

    The aim of the research is to determine the predictive power of prospective physical education teachers' attitudes towards educational technologies for their technological pedagogical content knowledge. In this study, a relational research model was used on a study group that consisted of 529 (M[subscript age]=21.49, SD=1.44) prospective physical…

  19. Prospective validation of immunological infiltrate for prediction of response to neoadjuvant chemotherapy in HER2-negative breast cancer--a substudy of the neoadjuvant GeparQuinto trial.

    Science.gov (United States)

    Issa-Nummer, Yasmin; Darb-Esfahani, Silvia; Loibl, Sibylle; Kunz, Georg; Nekljudova, Valentina; Schrader, Iris; Sinn, Bruno Valentin; Ulmer, Hans-Ullrich; Kronenwett, Ralf; Just, Marianne; Kühn, Thorsten; Diebold, Kurt; Untch, Michael; Holms, Frank; Blohmer, Jens-Uwe; Habeck, Jörg-Olaf; Dietel, Manfred; Overkamp, Friedrich; Krabisch, Petra; von Minckwitz, Gunter; Denkert, Carsten

    2013-01-01

    We have recently described an increased lymphocytic infiltration rate in breast carcinoma tissue is a significant response predictor for anthracycline/taxane-based neoadjuvant chemotherapy (NACT). The aim of this study was to prospectively validate the tumor-associated lymphocyte infiltrate as predictive marker for response to anthracycline/taxane-based NACT. The immunological infiltrate was prospectively evaluated in a total of 313 core biopsies from HER2 negative patients of the multicenter PREDICT study, a substudy of the neoadjuvant GeparQuinto study. Intratumoral lymphocytes (iTuLy), stromal lymphocytes (strLy) as well as lymphocyte-predominant breast cancer (LPBC) were evaluated by histopathological assessment. Pathological complete response (pCR) rates were analyzed and compared between the defined subgroups using the exact test of Fisher. Patients with lymphocyte-predominant breast cancer (LPBC) had a significantly increased pCR rate of 36.6%, compared to non-LPBC patients (14.3%, pimmunological infiltrate in breast tumor tissue is predictive for response to anthracycline/taxane-based NACT. Patients with LPBC and increased stromal lymphocyte infiltration have significantly increased pCR rates. The lymphocytic infiltrate is a promising additional parameter for histopathological evaluation of breast cancer core biopsies.

  20. Clinical and angiographic predictors of haemodynamically significant angiographic lesions: development and validation of a risk score to predict positive fractional flow reserve.

    Science.gov (United States)

    Sareen, Nishtha; Baber, Usman; Kezbor, Safwan; Sayseng, Sonny; Aquino, Melissa; Mehran, Roxana; Sweeny, Joseph; Barman, Nitin; Kini, Annapoorna; Sharma, Samin K

    2017-04-07

    Coronary revascularisation based upon physiological evaluation of lesions improves clinical outcomes. Angiographic or visual stenosis assessment alone is insufficient in predicting haemodynamic stenosis severity by fractional flow reserve (FFR) and therefore cannot be used to guide revascularisation, particularly in the lesion subset system formulated. Of 1,023 consecutive lesions (883 patients), 314 (31%) were haemodynamically significant. Characteristics associated with FFR ≤0.8 include male gender, higher SYNTAX score, lesions ≥20 mm, stenosis >50%, bifurcation, calcification, absence of tortuosity and smaller reference diameter. A user-friendly integer score was developed with the five variables demonstrating the strongest association. On prospective validation (in 279 distinct lesions), the increasing value of the score correlated well with increasing haemodynamic significance (C-statistic 0.85). We identified several clinical and angiographic characteristics and formulated a scoring system to guide the approach to intermediate lesions. This may translate into cost savings. Larger studies with prospective validation are required to confirm our results.

  1. Predicting complication risk in spine surgery: a prospective analysis of a novel risk assessment tool.

    Science.gov (United States)

    Veeravagu, Anand; Li, Amy; Swinney, Christian; Tian, Lu; Moraff, Adrienne; Azad, Tej D; Cheng, Ivan; Alamin, Todd; Hu, Serena S; Anderson, Robert L; Shuer, Lawrence; Desai, Atman; Park, Jon; Olshen, Richard A; Ratliff, John K

    2017-07-01

    OBJECTIVE The ability to assess the risk of adverse events based on known patient factors and comorbidities would provide more effective preoperative risk stratification. Present risk assessment in spine surgery is limited. An adverse event prediction tool was developed to predict the risk of complications after spine surgery and tested on a prospective patient cohort. METHODS The spinal Risk Assessment Tool (RAT), a novel instrument for the assessment of risk for patients undergoing spine surgery that was developed based on an administrative claims database, was prospectively applied to 246 patients undergoing 257 spinal procedures over a 3-month period. Prospectively collected data were used to compare the RAT to the Charlson Comorbidity Index (CCI) and the American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator. Study end point was occurrence and type of complication after spine surgery. RESULTS The authors identified 69 patients (73 procedures) who experienced a complication over the prospective study period. Cardiac complications were most common (10.2%). Receiver operating characteristic (ROC) curves were calculated to compare complication outcomes using the different assessment tools. Area under the curve (AUC) analysis showed comparable predictive accuracy between the RAT and the ACS NSQIP calculator (0.670 [95% CI 0.60-0.74] in RAT, 0.669 [95% CI 0.60-0.74] in NSQIP). The CCI was not accurate in predicting complication occurrence (0.55 [95% CI 0.48-0.62]). The RAT produced mean probabilities of 34.6% for patients who had a complication and 24% for patients who did not (p = 0.0003). The generated predicted values were stratified into low, medium, and high rates. For the RAT, the predicted complication rate was 10.1% in the low-risk group (observed rate 12.8%), 21.9% in the medium-risk group (observed 31.8%), and 49.7% in the high-risk group (observed 41.2%). The ACS NSQIP calculator consistently

  2. Continuous electroencephalography predicts delayed cerebral ischemia after subarachnoid hemorrhage: A prospective study of diagnostic accuracy.

    Science.gov (United States)

    Rosenthal, Eric S; Biswal, Siddharth; Zafar, Sahar F; O'Connor, Kathryn L; Bechek, Sophia; Shenoy, Apeksha V; Boyle, Emily J; Shafi, Mouhsin M; Gilmore, Emily J; Foreman, Brandon P; Gaspard, Nicolas; Leslie-Mazwi, Thabele M; Rosand, Jonathan; Hoch, Daniel B; Ayata, Cenk; Cash, Sydney S; Cole, Andrew J; Patel, Aman B; Westover, M Brandon

    2018-04-16

    Delayed cerebral ischemia (DCI) is a common, disabling complication of subarachnoid hemorrhage (SAH). Preventing DCI is a key focus of neurocritical care, but interventions carry risk and cannot be applied indiscriminately. Although retrospective studies have identified continuous electroencephalographic (cEEG) measures associated with DCI, no study has characterized the accuracy of cEEG with sufficient rigor to justify using it to triage patients to interventions or clinical trials. We therefore prospectively assessed the accuracy of cEEG for predicting DCI, following the Standards for Reporting Diagnostic Accuracy Studies. We prospectively performed cEEG in nontraumatic, high-grade SAH patients at a single institution. The index test consisted of clinical neurophysiologists prospectively reporting prespecified EEG alarms: (1) decreasing relative alpha variability, (2) decreasing alpha-delta ratio, (3) worsening focal slowing, or (4) late appearing epileptiform abnormalities. The diagnostic reference standard was DCI determined by blinded, adjudicated review. Primary outcome measures were sensitivity and specificity of cEEG for subsequent DCI, determined by multistate survival analysis, adjusted for baseline risk. One hundred three of 227 consecutive patients were eligible and underwent cEEG monitoring (7.7-day mean duration). EEG alarms occurred in 96.2% of patients with and 19.6% without subsequent DCI (1.9-day median latency, interquartile range = 0.9-4.1). Among alarm subtypes, late onset epileptiform abnormalities had the highest predictive value. Prespecified EEG findings predicted DCI among patients with low (91% sensitivity, 83% specificity) and high (95% sensitivity, 77% specificity) baseline risk. cEEG accurately predicts DCI following SAH and may help target therapies to patients at highest risk of secondary brain injury. Ann Neurol 2018. © 2018 American Neurological Association.

  3. Preoperative predictive model for acute kidney injury after elective cardiac surgery: a prospective multicentre cohort study.

    Science.gov (United States)

    Callejas, Raquel; Panadero, Alfredo; Vives, Marc; Duque, Paula; Echarri, Gemma; Monedero, Pablo

    2018-05-11

    Predictive models of CS-AKI include emergency surgery and patients with haemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the case of poor performance. A prospective, multicentre, observational study was designed. Data were collected from 942 patients undergoing cardiac surgery, after excluding emergency surgery and patients with an intraaortic balloon pump. The main outcome measure was CS-AKI defined by the composite of requiring dialysis or doubling baseline creatinine values. Both models showed poor discrimination in elective surgery (Thakar's model, AUROC = 0.57, 95% CI = 0.50-0.64 and Demirjian's model, AUROC= 0.64, 95% CI = 0.58-0.71). We generated a new model whose significant independent predictors were: anaemia, age, hypertension, obesity, congestive heart failure, previous cardiac surgery and type of surgery. It classifies patients with scores 0-3 as low risk ( 8 as high risk (>30%) of developing CS-AKI with a statistically significant correlation (p <0.001). Our model reflects acceptable discriminatory ability (AUC = 0.72, 95% CI = 0.66-0.78) which is significantly better than Thakar and Demirjian's models (p<0.01). We developed a new simple predictive model of CS-AKI in elective surgery based on available preoperative information. Our new model is easy to calculate and can be an effective tool for communicating risk to patients and guiding decision-making in the perioperative period. The study requires external validation.

  4. A prospective study on personality and the cortisol awakening response to predict posttraumatic stress symptoms in response to military deployment

    NARCIS (Netherlands)

    van Zuiden, Mirjam; Kavelaars, Annemieke; Rademaker, Arthur R.; Vermetten, Eric; Heijnen, Cobi J.; Geuze, Elbert

    2011-01-01

    Few prospective studies on pre-trauma predictors for subsequent development of posttraumatic stress disorder (PTSD) have been conducted. In this study we prospectively investigated whether pre-deployment personality and the cortisol awakening response (CAR) predicted development of PTSD symptoms in

  5. Fluid responsiveness predicted by transcutaneous partial pressure of oxygen in patients with circulatory failure: a prospective study.

    Science.gov (United States)

    Xu, Jingyuan; Peng, Xiao; Pan, Chun; Cai, Shixia; Zhang, Xiwen; Xue, Ming; Yang, Yi; Qiu, Haibo

    2017-12-01

    Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO 2 ) in the critically ill patients. This was a single-center prospective study conducted in the intensive care unit of a tertiary care teaching hospital. Shock patients who presented with at least one clinical sign of inadequate tissue perfusion, defined as systolic blood pressure 40 mmHg in previously hypertensive patients or the need for vasopressive drugs; urine output 4 mmol/l, for less than 24 h in the absence of a contraindication for fluids were eligible to participate in the study. PtcO 2 was continuously recorded before and during a passive leg raising (PLR) test, and then before and after a 250 ml rapid saline infusion in 10 min. Fluid responsiveness is defined as a change in the stroke volume ≥10% after 250 ml of volume infusion. Thirty-four patients were included, and 14 responded to volume expansion. In the responders, the mean arterial pressure, central venous pressure, cardiac output, stroke volume and PtcO 2 increased significantly, while the heart rate decreased significantly by both PLR and volume expansion. Changes in the stroke volume induced either by PLR or volume expansion were significantly greater in responders than in non-responders. The correlation between the changes in PtcO 2 and stroke volume induced by volume expansion was significant. Volume expansion induced an increase in the PtcO 2 of 14% and PLR induced an increase in PtcO 2 of 13% predicted fluid responsiveness. This study suggested the changes in PtcO 2 induced by volume expansion and a PLR test predicted fluid responsiveness in critically ill patients. Trial registration NCT02083757.

  6. Prediction of Prospective Mathematics Teachers' Academic Success in Entering Graduate Education by Using Back-Propagation Neural Network

    Science.gov (United States)

    Bahadir, Elif

    2016-01-01

    The purpose of this study is to examine a neural network based approach to predict achievement in graduate education for Elementary Mathematics prospective teachers. With the help of this study, it can be possible to make an effective prediction regarding the students' achievement in graduate education with Artificial Neural Networks (ANN). Two…

  7. Prediction of immediate postoperative pain using the analgesia/nociception index: a prospective observational study.

    Science.gov (United States)

    Boselli, E; Bouvet, L; Bégou, G; Dabouz, R; Davidson, J; Deloste, J-Y; Rahali, N; Zadam, A; Allaouchiche, B

    2014-04-01

    The analgesia/nociception index (ANI) is derived from heart rate variability, ranging from 0 (maximal nociception) to 100 (maximal analgesia), to reflect the analgesia/nociception balance during general anaesthesia. This should be correlated with immediate postoperative pain in the post-anaesthesia care unit (PACU). The aim of this study was to evaluate the performance of ANI measured at arousal from general anaesthesia to predict immediate postoperative pain on arrival in PACU. Two hundred patients undergoing ear, nose, and throat or lower limb orthopaedic surgery with general anaesthesia using an inhalational agent and remifentanil were included in this prospective observational study. The ANI was measured immediately before tracheal extubation and pain intensity was assessed within 10 min of arrival in PACU using a 0-10 numerical rating scale (NRS). The relationship between ANI and NRS was assessed using linear regression. A receiver-operating characteristic (ROC) curve was used to evaluate the performance of ANI to predict NRS>3. A negative linear relationship was observed between ANI immediately before extubation and NRS on arrival in PACU. Using a threshold of 3 were both 86% with 92% negative predictive value, corresponding to an area under the ROC curve of 0.89. The measurement of ANI immediately before extubation after inhalation-remifentanil anaesthesia was significantly associated with pain intensity on arrival in PACU. The performance of ANI for the prediction of immediate postoperative pain is good and may assist physicians in optimizing acute pain management. ClinicalTrials.gov NCT01796249.

  8. The contribution of a 9p21.3 variant, a KIF6 variant, and C-reactive protein to predicting risk of myocardial infarction in a prospective study

    Directory of Open Access Journals (Sweden)

    Tracy Russell P

    2011-03-01

    Full Text Available Abstract Background Genetic risk factors might improve prediction of coronary events. Several variants at chromosome 9p21.3 have been widely reported to be associated with coronary heart disease (CHD in prospective and case-control studies. A variant of KIF6 (719Arg has also been reported to be associated with increased risk of CHD in large prospective studies, but not in case-control studies. We asked whether the addition of genetic information (the 9p21.3 or KIF6 variants or a well-established non-genetic risk factor (C-reactive protein [CRP] can improve risk prediction by the Framingham Risk Score (FRS in the Cardiovascular Health Study (CHS--a prospective observational study of risk factors for cardiovascular disease among > 5,000 participants aged 65 or older. Methods Improvement of risk prediction was assessed by change in the area under the receiver-operator characteristic curve (AUC and by net reclassification improvement (NRI. Results Among white participants the FRS was improved by addition of KIF6 719Arg carrier status among men as assessed by the AUC (from 0.581 to 0.596, P = 0.03 but not by NRI (NRI = 0.027, P = 0.32. Adding both CRP and 719Arg carrier status to the FRS improved risk prediction by the AUC (0.608, P = 0.02 and NRI (0.093, P = 0.008 in men, but not women (P ≥ 0.24. Conclusions While none of these risk markers individually or in combination improved risk prediction among women, a combination of KIF6 719Arg carrier status and CRP levels modestly improved risk prediction among white men; although this improvement is not significant after multiple-testing correction. These observations should be investigated in other prospective studies.

  9. Risk prediction of emergency department revisit 30 days post discharge: a prospective study.

    Directory of Open Access Journals (Sweden)

    Shiying Hao

    Full Text Available Among patients who are discharged from the Emergency Department (ED, about 3% return within 30 days. Revisits can be related to the nature of the disease, medical errors, and/or inadequate diagnoses and treatment during their initial ED visit. Identification of high-risk patient population can help device new strategies for improved ED care with reduced ED utilization.A decision tree based model with discriminant Electronic Medical Record (EMR features was developed and validated, estimating patient ED 30 day revisit risk. A retrospective cohort of 293,461 ED encounters from HealthInfoNet (HIN, Maine's Health Information Exchange (HIE, between January 1, 2012 and December 31, 2012, was assembled with the associated patients' demographic information and one-year clinical histories before the discharge date as the inputs. To validate, a prospective cohort of 193,886 encounters between January 1, 2013 and June 30, 2013 was constructed. The c-statistics for the retrospective and prospective predictions were 0.710 and 0.704 respectively. Clinical resource utilization, including ED use, was analyzed as a function of the ED risk score. Cluster analysis of high-risk patients identified discrete sub-populations with distinctive demographic, clinical and resource utilization patterns.Our ED 30-day revisit model was prospectively validated on the Maine State HIN secure statewide data system. Future integration of our ED predictive analytics into the ED care work flow may lead to increased opportunities for targeted care intervention to reduce ED resource burden and overall healthcare expense, and improve outcomes.

  10. Sleep disturbances predict prospective declines in resident physicians’ psychological well-being

    Directory of Open Access Journals (Sweden)

    Alice A. Min

    2015-07-01

    Full Text Available Background: Medical residency can be a time of increased psychological stress and sleep disturbance. We examine the prospective associations between self-reported sleep quality and resident wellness across a single training year. Methods: Sixty-nine (N=69 resident physicians completed the Brief Resident Wellness Profile (M=17.66, standard deviation [SD]=3.45, range: 0–17 and the Pittsburgh Sleep Quality Index (M=6.22, SD=2.86, range: 12–25 at multiple occasions in a single training year. We examined the 1-month lagged effect of sleep disturbances on residents’ self-reported wellness. Results: Accounting for residents’ overall level of sleep disturbance across the entire study period, both the concurrent (within-person within-occasion effect of sleep disturbance (B=−0.20, standard error [SE]=0.06, p=0.003, 95% confidence interval [CI]: −0.33, −0.07 and the lagged within-person effect of resident sleep disturbance (B=−0.15, SE=0.07, p=0.037, 95% CI: −0.29, −0.009 were significant predictors of decreased resident wellness. Increases in sleep disturbances are a leading indicator of resident wellness, predicting decreased well-being 1 month later. Conclusions: Sleep quality exerts a significant effect on self-reported resident wellness. Periodic evaluation of sleep quality may alert program leadership and the residents themselves to impending decreases in psychological well-being.

  11. Ultrasound cervical length in predicting preterm birth: Prospective study

    Directory of Open Access Journals (Sweden)

    Achour Radhouane

    2017-08-01

    Full Text Available Background Preterm birth is a leading cause of perinatal morbidity and mortality and represents a major public health problem. It is associated with a 15–20 per cent mortality rate and remains responsible for 75 per cent of perinatal deaths in foetuses without anomalies. Aims The aim of this study was to evaluate the importance of cervical length measured in the first trimester (11–14 Weeks of amenorrhea “WA” and the second trimester (20–24 Weeks of amenorrhea” WA” in an asymptomatic population of singleton pregnancies to assess the risk of spontaneous preterm birth compared to the digital assessment. Methods We conducted a prospective, longitudinal study involving 117 asymptomatic women with singleton pregnancies between January and December 2015. Results In our study, the clinical examination had a low positive predictive value and a low sensibility for screening women at risk of preterm delivery. Cervical length less than 35mm between 12–14WA and 30mm between 22–24WA predicts the occurrence of preterm birth with a high sensitivity (Se, and specificity (Sp. Conclusion We conclude that ultrasound screening of preterm delivery is now highly recommended.

  12. The predictive value of preoperative perfusion/ventilation scintigraphy, spirometry and x-ray of the lungs on postoperative pulmonary complications. A prospective study

    International Nuclear Information System (INIS)

    Fogh, J.; Wille-Joergensen, P.; Brynjolf, I.; Thorup, J.; Joergensen, T.; Bording, L.; Kjaergaard, J.

    1987-01-01

    Prospectively, 125 patients were examined with 99m Tc-perfusion scintigraphy, 89m Kr- or 127 Xe-ventilation scintigraphy and chest radiogram prior to major surgery. Postoperative therapy-demanding pulmonary complications occurred in 18% of the patients. A statistical association could be demonstrated between all the preoperative tests except ventilation scintigraphy and the frequency of complications. However, the predictive values of each of the tests, or even the combined results, were not significantly different from the frequency of complications among all the patients. It is concluded that the predictive values of perfusion-and ventilation scintigraphy, spirometry and radiogram of the chest are too low to be of any practical use. (author)

  13. Can the cerebroplacental ratio (CPR) predict intrapartum fetal compromise? : a prospective observational study

    OpenAIRE

    Page, Ann-Sophie; Page, Geert; Dehaene, Isabelle; Roets, Ellen; Roelens, Kristien

    2017-01-01

    Objective: To investigate the potential clinical use of serial fetal CPR measurements during the last month of pregnancy for the prediction of adverse perinatal outcome in unselected low-risk pregnancies. Methods: A multicenter prospective observational cohort study in 315 consecutively recruited low-risk pregnancies. All eligible pregnancies underwent serial sonographic evaluation of fetal weight and Doppler indices at two week intervals, from 36 weeks gestation until delivery. Data were ...

  14. Predicting Early Fatherhood and Whether Young Fathers Live with Their Children: Prospective Findings and Policy Recommendations. Discussion Paper.

    Science.gov (United States)

    Jaffee, Sara R.; Caspi, Avshalom; Moffitt, Terrie E.; Taylor, Alan; Dickson, Nigel

    This prospective, birth cohort study addressed three questions: Which individual and family-of-origin characteristics predict the age at which young men make the transition to fatherhood? Do these characteristics predict how long young men live with their children? Are individual differences in the amount of time fathers spend living with their…

  15. Predicting surgical site infection after spine surgery: a validated model using a prospective surgical registry.

    Science.gov (United States)

    Lee, Michael J; Cizik, Amy M; Hamilton, Deven; Chapman, Jens R

    2014-09-01

    The impact of surgical site infection (SSI) is substantial. Although previous study has determined relative risk and odds ratio (OR) values to quantify risk factors, these values may be difficult to translate to the patient during counseling of surgical options. Ideally, a model that predicts absolute risk of SSI, rather than relative risk or OR values, would greatly enhance the discussion of safety of spine surgery. To date, there is no risk stratification model that specifically predicts the risk of medical complication. The purpose of this study was to create and validate a predictive model for the risk of SSI after spine surgery. This study performs a multivariate analysis of SSI after spine surgery using a large prospective surgical registry. Using the results of this analysis, this study will then create and validate a predictive model for SSI after spine surgery. The patient sample is from a high-quality surgical registry from our two institutions with prospectively collected, detailed demographic, comorbidity, and complication data. An SSI that required return to the operating room for surgical debridement. Using a prospectively collected surgical registry of more than 1,532 patients with extensive demographic, comorbidity, surgical, and complication details recorded for 2 years after the surgery, we identified several risk factors for SSI after multivariate analysis. Using the beta coefficients from those regression analyses, we created a model to predict the occurrence of SSI after spine surgery. We split our data into two subsets for internal and cross-validation of our model. We created a predictive model based on our beta coefficients from our multivariate analysis. The final predictive model for SSI had a receiver-operator curve characteristic of 0.72, considered to be a fair measure. The final model has been uploaded for use on SpineSage.com. We present a validated model for predicting SSI after spine surgery. The value in this model is that it gives

  16. Low self-esteem prospectively predicts depression in adolescence and young adulthood.

    Science.gov (United States)

    Orth, Ulrich; Robins, Richard W; Roberts, Brent W

    2008-09-01

    Low self-esteem and depression are strongly correlated in cross-sectional studies, yet little is known about their prospective effects on each other. The vulnerability model hypothesizes that low self-esteem serves as a risk factor for depression, whereas the scar model hypothesizes that low self-esteem is an outcome, not a cause, of depression. To test these models, the authors used 2 large longitudinal data sets, each with 4 repeated assessments between the ages of 15 and 21 years and 18 and 21 years, respectively. Cross-lagged regression analyses indicated that low self-esteem predicted subsequent levels of depression, but depression did not predict subsequent levels of self-esteem. These findings held for both men and women and after controlling for content overlap between the self-esteem and depression scales. Thus, the results supported the vulnerability model, but not the scar model, of self-esteem and depression.

  17. Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve: A single-center prospective study.

    Science.gov (United States)

    Tanaka, Haruki; Takahashi, Teruyuki; Ohashi, Norihiko; Tanaka, Koichi; Okada, Takenori; Kihara, Yasuki

    2017-12-01

    The aim of this study was to clarify the predictive value of fractional flow reserve (FFR) determined by myocardial perfusion imaging (MPI) using thallium (Tl)-201 IQ-SPECT without and with computed tomography-based attenuation correction (CT-AC) for patients with stable coronary artery disease (CAD).We assessed 212 angiographically identified diseased vessels using adenosine-stress Tl-201 MPI-IQ-SPECT/CT in 84 consecutive, prospectively identified patients with stable CAD. We compared the FFR in 136 of the 212 diseased vessels using visual semiquantitative interpretations of corresponding territories on MPI-IQ-SPECT images without and with CT-AC.FFR inversely correlated most accurately with regional summed difference scores (rSDS) in images without and with CT-AC (r = -0.584 and r = -0.568, respectively, both P system can predict FFR at an optimal cut-off of reserved.

  18. Hopefulness predicts resilience after hereditary colorectal cancer genetic testing: a prospective outcome trajectories study.

    Science.gov (United States)

    Ho, Samuel M Y; Ho, Judy W C; Bonanno, George A; Chu, Annie T W; Chan, Emily M S

    2010-06-11

    Genetic testing for hereditary colorectal cancer (HCRC) had significant psychological consequences for test recipients. This prospective longitudinal study investigated the factors that predict psychological resilience in adults undergoing genetic testing for HCRC. A longitudinal study was carried out from April 2003 to August 2006 on Hong Kong Chinese HCRC family members who were recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer Registry to determine psychological outcomes after genetic testing. Self-completed questionnaires were administered immediately before (pre-disclosure baseline) and 2 weeks, 4 months and 1 year after result disclosure. Using validated psychological inventories, the cognitive style of hope was measured at baseline, and the psychological distress of depression and anxiety was measured at all time points. Of the 76 participating subjects, 71 individuals (43 men and 28 women; mean age 38.9 +/- 9.2 years) from nine FAP and 24 HNPCC families completed the study, including 39 mutated gene carriers. Four patterns of outcome trajectories were created using established norms for the specified outcome measures of depression and anxiety. These included chronic dysfunction (13% and 8.7%), recovery (0% and 4.3%), delayed dysfunction (13% and 15.9%) and resilience (76.8% and 66.7%). Two logistic regression analyses were conducted using hope at baseline to predict resilience, with depression and anxiety employed as outcome indicators. Because of the small number of participants, the chronic dysfunction and delayed dysfunction groups were combined into a non-resilient group for comparison with the resilient group in all subsequent analysis. Because of low frequencies, participants exhibiting a recovery trajectory (n = 3 for anxiety and n = 0 for depression) were excluded from further analysis. Both regression equations were significant. Baseline hope was a significant predictor of a resilience outcome trajectory for depression

  19. Narcissism and Callous-Unemotional Traits Prospectively Predict Child Conduct Problems.

    Science.gov (United States)

    Jezior, Kristen L; McKenzie, Meghan E; Lee, Steve S

    2016-01-01

    Although narcissism and callous-unemotional (CU) traits are separable facets of psychopathy, their independent prediction of conduct problems (CP) among young children is not well known. In addition, above-average IQ was central to the original conceptualization of psychopathy, yet IQ is typically inversely associated with youth CP. We examined narcissism and CU traits as independent and prospective predictors of oppositional defiant disorder (ODD), conduct disorder (CD), and youth self-reported antisocial behavior, as well as their moderation by IQ. At baseline, parents and teachers separately rated narcissism and CU traits in 188 6-to-10-year-old children (47.9% non-White; 69.1% male; M = 7.34 years, SD = 1.09) with (n = 99) and without (n = 89) attention-deficit/hyperactivity disorder (ADHD). Approximately 2 years later, parents and teachers separately rated youth ODD and CD symptoms, and youth self-reported antisocial behavior. With control of baseline ADHD and ODD/CD symptoms, narcissism and CU traits independently and positively predicted ODD and CD symptoms at follow-up. IQ did not moderate any CP predictions from baseline narcissism or CU traits. These preliminary findings suggest that individual differences in narcissism and CU traits, even relatively early in development, are uniquely associated with emergent CP. Findings are considered within a developmental framework and the multiple pathways underlying the heterogeneity of CP are discussed.

  20. Predicting Dyslexia in a Transparent Orthography from Grade 1 Literacy Skills: A Prospective Cohort Study

    Science.gov (United States)

    Bigozzi, Lucia; Tarchi, Christian; Pinto, Giuliana; Accorti Gamannossi, Beatrice

    2016-01-01

    We conducted this prospective cohort study to explore the predictability of dyslexia from 1st-grade literacy skills in Italian students. We followed 407 Italian students in primary school from the 1st through the 3rd grades. Students were diagnosed with dyslexia in the 3rd grade. We retrospectively tested participants' 1st-grade performance in…

  1. Personality traits prospectively predict verbal fluency in a lifespan sample.

    Science.gov (United States)

    Sutin, Angelina R; Terracciano, Antonio; Kitner-Triolo, Melissa H; Uda, Manuela; Schlessinger, David; Zonderman, Alan B

    2011-12-01

    In a community-dwelling sample (N = 4,790; age range 14-94), we examined whether personality traits prospectively predicted performance on a verbal fluency task. Open, extraverted, and emotionally stable participants had better verbal fluency. At the facet level, dispositionally happy and self-disciplined participants retrieved more words; those prone to anxiety and depression and those who were deliberative retrieved fewer words. Education moderated the association between conscientiousness and fluency such that participants with lower education performed better on the fluency task if they were also conscientious. Age was not a moderator at the domain level, indicating that the personality-fluency associations were consistent across the life span. A disposition toward emotional vulnerability and being less open, less happy, and undisciplined may be detrimental to cognitive performance.

  2. The common sense model of self-regulation and psychological adjustment to predictive genetic testing: a prospective study

    NARCIS (Netherlands)

    van Oostrom, Iris; Meijers-Heijboer, Hanne; Duivenvoorden, Hugo J.; Bröcker-Vriends, Annette H. J. T.; van Asperen, Christi J.; Sijmons, Rolf H.; Seynaeve, Caroline; van Gool, Arthur R.; Klijn, Jan G. M.; Tibben, Aad

    2007-01-01

    This prospective study explored the contribution of illness representations and coping to cancer-related distress in unaffected individuals undergoing predictive genetic testing for an identified mutation in BRCA1/2 (BReast CAncer) or an HNPCC (Hereditary Nonpolyposis Colorectal Cancer)-related

  3. The common sense model of self-regulation and psychological adjustment to predictive genetic testing: a prospective study.

    NARCIS (Netherlands)

    Oostrom, I.I.H. van; Meijers-Heijboer, H.; Duivenvoorden, H.J.; Brocker-Vriends, A.H.; Asperen, C.J. van; Sijmons, R.H.; Seynaeve, C.; Gool, A.R. van; Klijn, J.G.M.; Tibben, A.

    2007-01-01

    This prospective study explored the contribution of illness representations and coping to cancer-related distress in unaffected individuals undergoing predictive genetic testing for an identified mutation in BRCA1/2 (BReast CAncer) or an HNPCC (Hereditary Nonpolyposis Colorectal Cancer)-related

  4. The common sense model of self-regulation and psychological adjustment to predictive genetic testing : a prospective study

    NARCIS (Netherlands)

    van Oostrom, Iris; Meijers-Heijboer, Hanne; Duivenvoorden, Hugo J.; Broecker-Vriends, Annette H. J. T.; van Asperen, Christi J.; Sijmons, Rolf H.; Seynaeve, Caroline; Van Gool, Arthur R.; Klijn, Jan G. M.; Tibben, Aad

    2007-01-01

    This prospective study explored the contribution of illness representations and coping to cancer-related distress in unaffected individuals undergoing predictive genetic testing for an identified mutation in BRCA1/2 (BReast CAncer) or an HNPCC (Hereditary Nonpolyposis Colorectal Cancer)-related

  5. Sarcopenia predicts 1-year mortality in elderly patients undergoing curative gastrectomy for gastric cancer: a prospective study.

    Science.gov (United States)

    Huang, Dong-Dong; Chen, Xiao-Xi; Chen, Xi-Yi; Wang, Su-Lin; Shen, Xian; Chen, Xiao-Lei; Yu, Zhen; Zhuang, Cheng-Le

    2016-11-01

    One-year mortality is vital for elderly oncologic patients undergoing surgery. Recent studies have demonstrated that sarcopenia can predict outcomes after major abdominal surgeries, but the association of sarcopenia and 1-year mortality has never been investigated in a prospective study. We conducted a prospective study of elderly patients (≥65 years) who underwent curative gastrectomy for gastric cancer from July 2014 to July 2015. Sarcopenia was determined by the measurements of muscle mass, handgrip strength, and gait speed. Univariate and multivariate analyses were used to identify the risk factors associated with 1-year mortality. A total of 173 patients were included, in which 52 (30.1 %) patients were identified as having sarcopenia. Twenty-four (13.9 %) patients died within 1 year of surgery. Multivariate analysis showed that sarcopenia was an independent risk factor for 1-year mortality. Area under the receiver operating characteristic curve demonstrated an increased predictive power for 1-year mortality with the inclusion of sarcopenia, from 0.835 to 0.868. Solely low muscle mass was not predictive of 1-year mortality in the multivariate analysis. Sarcopenia is predictive of 1-year mortality in elderly patients undergoing gastric cancer surgery. The measurement of muscle function is important for sarcopenia as a preoperative assessment tool.

  6. Prostate cancer volume adds significantly to prostate-specific antigen in the prediction of early biochemical failure after external beam radiation therapy

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Propert, Kathleen J.

    1996-01-01

    Purpose: A new clinical pretreatment quantity that closely approximates the true prostate cancer volume is defined. Methods and Materials: The cancer-specific prostate-specific antigen (PSA), PSA density, prostate cancer volume (V Ca ), and the volume fraction of the gland involved with carcinoma (V Ca fx) were calculated for 227 prostate cancer patients managed definitively with external beam radiation therapy. 1. PSA density PSA/ultrasound prostate gland volume 2. Cancer-specific PSA = PSA - [PSA from benign epithelial tissue] 3. V Ca = Cancer-specific PSA/[PSA in serum per cm 3 of cancer] 4. V Ca fx = V Ca /ultrasound prostate gland volume A Cox multiple regression analysis was used to test whether any of these-clinical pretreatment parameters added significantly to PSA in predicting early postradiation PSA failure. Results: The prostate cancer volume (p = 0.039) and the volume fraction of the gland involved by carcinoma (p = 0.035) significantly added to the PSA in predicting postradiation PSA failure. Conversely, the PSA density and the cancer-specific PSA did not add significantly (p > 0.05) to PSA in predicting postradiation PSA failure. The 20-month actuarial PSA failure-free rates for patients with calculated tumor volumes of ≤0.5 cm 3 , 0.5-4.0 cm 3 , and >4.0 cm 3 were 92, 80, and 47%, respectively (p = 0.00004). Conclusion: The volume of prostate cancer (V Ca ) and the resulting volume fraction of cancer both added significantly to PSA in their ability to predict for early postradiation PSA failure. These new parameters may be used to select patients in prospective randomized trials that examine the efficacy of combining radiation and androgen ablative therapy in patients with clinically localized disease, who are at high risk for early postradiation PSA failure

  7. Significant interarm blood pressure difference predicts cardiovascular risk in hypertensive patients: CoCoNet study.

    Science.gov (United States)

    Kim, Su-A; Kim, Jang Young; Park, Jeong Bae

    2016-06-01

    There has been a rising interest in interarm blood pressure difference (IAD), due to its relationship with peripheral arterial disease and its possible relationship with cardiovascular disease. This study aimed to characterize hypertensive patients with a significant IAD in relation to cardiovascular risk. A total of 3699 patients (mean age, 61 ± 11 years) were prospectively enrolled in the study. Blood pressure (BP) was measured simultaneously in both arms 3 times using an automated cuff-oscillometric device. IAD was defined as the absolute difference in averaged BPs between the left and right arm, and an IAD ≥ 10 mm Hg was considered to be significant. The Framingham risk score was used to calculate the 10-year cardiovascular risk. The mean systolic IAD (sIAD) was 4.3 ± 4.1 mm Hg, and 285 (7.7%) patients showed significant sIAD. Patients with significant sIAD showed larger body mass index (P < 0.001), greater systolic BP (P = 0.050), more coronary artery disease (relative risk = 1.356, P = 0.034), and more cerebrovascular disease (relative risk = 1.521, P = 0.072). The mean 10-year cardiovascular risk was 9.3 ± 7.7%. By multiple regression, sIAD was significantly but weakly correlated with the 10-year cardiovascular risk (β = 0.135, P = 0.008). Patients with significant sIAD showed a higher prevalence of coronary artery disease, as well as an increase in 10-year cardiovascular risk. Therefore, accurate measurements of sIAD may serve as a simple and cost-effective tool for predicting cardiovascular risk in clinical settings.

  8. Body Dissatisfaction Prospectively Predicts Depressive Mood and Low Self-Esteem in Adolescent Girls and Boys

    Science.gov (United States)

    Paxton, Susan J.; Neumark-Sztainer, Dianne; Hannan, Peter J.; Eisenberg, Marla E.

    2006-01-01

    This research examined whether body dissatisfaction prospectively predicted depressive mood and low self-esteem in adolescent girls and boys 5 years later. Participants were early-adolescent girls (n = 440, Time 1 M age = 12.7 years) and boys (n = 366, Time 1 M age = 12.8 years) and midadolescent girls (n = 946, Time 1 M age = 15.8 years) and boys…

  9. Anatomic features of the neck as predictive markers of difficult direct laryngoscopy in men and women: A prospective study.

    Science.gov (United States)

    Liaskou, Chara; Chara, Liaskou; Vouzounerakis, Eleftherios; Eleftherios, Vouzounerakis; Moirasgenti, Maria; Maria, Moirasgenti; Trikoupi, Anastasia; Anastasia, Trikoupi; Staikou, Chryssoula; Chryssoula, Staikou

    2014-03-01

    Difficult airway assessment is based on various anatomic parameters of upper airway, much of it being concentrated on oral cavity and the pharyngeal structures. The diagnostic value of tests based on neck anatomy in predicting difficult laryngoscopy was assessed in this prospective, open cohort study. We studied 341 adult patients scheduled to receive general anaesthesia. Thyromental distance (TMD), sternomental distance (STMD), ratio of height to thyromental distance (RHTMD) and neck circumference (NC) were measured pre-operatively. The laryngoscopic view was classified according to the Cormack-Lehane Grade (1-4). Difficult laryngoscopy was defined as Cormack-Lehane Grade 3 or 4. The optimal cut-off points for each variable were identified by using receiver operating characteristic analysis. Sensitivity, specificity and positive predictive value and negative predictive value (NPV) were calculated for each test. Multivariate analysis with logistic regression, including all variables, was used to create a predictive model. Comparisons between genders were also performed. Laryngoscopy was difficult in 12.6% of the patients. The cut-off values were: TMD ≤7 cm, STMD ≤15 cm, RHTMD >18.4 and NC >37.5 cm. The RHTMD had the highest sensitivity (88.4%) and NPV (95.2%), while TMD had the highest specificity (83.9%). The area under curve (AUC) for the TMD, STMD, RHTMD and NC was 0.63, 0.64, 0.62 and 0.54, respectively. The predictive model exhibited a higher and statistically significant diagnostic accuracy (AUC: 0.68, P < 0.001). Gender-specific cut-off points improved the predictive accuracy of NC in women (AUC: 0.65). The TMD, STMD, RHTMD and NC were found to be poor single predictors of difficult laryngoscopy, while a model including all four variables had a significant predictive accuracy. Among the studied tests, gender-specific cut-off points should be used for NC.

  10. What Factors are Predictive of Patient-reported Outcomes? A Prospective Study of 337 Shoulder Arthroplasties.

    Science.gov (United States)

    Matsen, Frederick A; Russ, Stacy M; Vu, Phuong T; Hsu, Jason E; Lucas, Robert M; Comstock, Bryan A

    2016-11-01

    Although shoulder arthroplasties generally are effective in improving patients' comfort and function, the results are variable for reasons that are not well understood. We posed two questions: (1) What factors are associated with better 2-year outcomes after shoulder arthroplasty? (2) What are the sensitivities, specificities, and positive and negative predictive values of a multivariate predictive model for better outcome? Three hundred thirty-nine patients having a shoulder arthroplasty (hemiarthroplasty, arthroplasty for cuff tear arthropathy, ream and run arthroplasty, total shoulder or reverse total shoulder arthroplasty) between August 24, 2010 and December 31, 2012 consented to participate in this prospective study. Two patients were excluded because they were missing baseline variables. Forty-three patients were missing 2-year data. Univariate and multivariate analyses determined the relationship of baseline patient, shoulder, and surgical characteristics to a "better" outcome, defined as an improvement of at least 30% of the maximal possible improvement in the Simple Shoulder Test. The results were used to develop a predictive model, the accuracy of which was tested using a 10-fold cross-validation. After controlling for potentially relevant confounding variables, the multivariate analysis showed that the factors significantly associated with better outcomes were American Society of Anesthesiologists Class I (odds ratio [OR], 1.94; 95% CI, 1.03-3.65; p = 0.041), shoulder problem not related to work (OR, 5.36; 95% CI, 2.15-13.37; p factors listed above. The area under the receiver operating characteristic curve generated from the cross-validated enhanced predictive model was 0.79 (generally values of 0.7 to 0.8 are considered fair and values of 0.8 to 0.9 are considered good). The false-positive fraction and the true-positive fraction depended on the cutoff probability selected (ie, the selected probability above which the prediction would be classified as

  11. Predicting Hemorrhagic Transformation of Acute Ischemic Stroke: Prospective Validation of the HeRS Score.

    Science.gov (United States)

    Marsh, Elisabeth B; Llinas, Rafael H; Schneider, Andrea L C; Hillis, Argye E; Lawrence, Erin; Dziedzic, Peter; Gottesman, Rebecca F

    2016-01-01

    Hemorrhagic transformation (HT) increases the morbidity and mortality of ischemic stroke. Anticoagulation is often indicated in patients with atrial fibrillation, low ejection fraction, or mechanical valves who are hospitalized with acute stroke, but increases the risk of HT. Risk quantification would be useful. Prior studies have investigated risk of systemic hemorrhage in anticoagulated patients, but none looked specifically at HT. In our previously published work, age, infarct volume, and estimated glomerular filtration rate (eGFR) significantly predicted HT. We created the hemorrhage risk stratification (HeRS) score based on regression coefficients in multivariable modeling and now determine its validity in a prospectively followed inpatient cohort.A total of 241 consecutive patients presenting to 2 academic stroke centers with acute ischemic stroke and an indication for anticoagulation over a 2.75-year period were included. Neuroimaging was evaluated for infarct volume and HT. Hemorrhages were classified as symptomatic versus asymptomatic, and by severity. HeRS scores were calculated for each patient and compared to actual hemorrhage status using receiver operating curve analysis.Area under the curve (AUC) comparing predicted odds of hemorrhage (HeRS score) to actual hemorrhage status was 0.701. Serum glucose (P hemorrhages were more likely to be symptomatic and more severe.The HeRS score is a valid predictor of HT in patients with ischemic stroke and indication for anticoagulation.

  12. Predicting early onset of intoxication versus drinking—A population-based prospective study of Norwegian adolescents

    Directory of Open Access Journals (Sweden)

    Frøydis Enstad

    2017-12-01

    Full Text Available Aims: Recent research suggests that early onset of intoxication (EOI may be of greater importance for a wide range of subsequent adverse outcomes than early drinking experiences without intoxication. However, research on antecedents of EOI is scarce. The present study identifies predictors of EOI and whether they differ from those of early onset of drinking (EOD. Methods: Data was drawn from the prospective Tracking Opportunities and Problems (TOPP study of Norwegian families (n=382, which followed up mothers and their children with six data collections from childhood (age 1.5 to adolescence (age 14.5. Self-reports from the adolescents (parenting practices, adolescent's conduct problems and friends' deviant behaviour and their mothers (adolescent temperament, socio-economic factors and household alcohol problems were used to identify predictors of EOI and EOD. Findings: A variety of temperamental, socio-economic, and family factors predicted EOI, whereas EOD was predicted of substantially fewer variables. Particularly, when controlling for relevant covariates, low levels of shyness, own conduct problems and having friends with deviant behaviour prospectively predicted EOI, but not EOD. Conclusions: Future research and prevention efforts should take into consideration that EOI and EOD without getting drunk appear to be predicted by different risk factors in childhood and adolescence. Keywords: Adolescents, Alcohol, Intoxication, Drinking, Onset, Predictors

  13. Predictive accuracy of Edinburgh Postnatal Depression Scale assessment during pregnancy for the risk of developing postpartum depressive symptoms : a prospective cohort study

    NARCIS (Netherlands)

    Meijer, J. L.; Beijers, C.; van Pampus, M. G.; Verbeek, T.; Stolk, R. P.; Milgrom, J.; Bockting, C. L. H.; Burger, H.

    2014-01-01

    ObjectiveTo investigate whether the 10-item Edinburgh Postnatal Depression Scale (EPDS) administered antenatally is accurate in predicting postpartum depressive symptoms, and whether a two-item EPDS has similar predictive accuracy. DesignProspective cohort study. SettingObstetric care in the

  14. Individual differences in episodic memory abilities predict successful prospective memory output monitoring.

    Science.gov (United States)

    Hunter Ball, B; Pitães, Margarida; Brewer, Gene A

    2018-02-07

    Output monitoring refers to memory for one's previously completed actions. In the context of prospective memory (PM) (e.g., remembering to take medication), failures of output monitoring can result in repetitions and omissions of planned actions (e.g., over- or under-medication). To be successful in output monitoring paradigms, participants must flexibly control attention to detect PM cues as well as engage controlled retrieval of previous actions whenever a particular cue is encountered. The current study examined individual differences in output monitoring abilities in a group of younger adults differing in attention control (AC) and episodic memory (EM) abilities. The results showed that AC ability uniquely predicted successful cue detection on the first presentation, whereas EM ability uniquely predicted successful output monitoring on the second presentation. The current study highlights the importance of examining external correlates of PM abilities and contributes to the growing body of research on individual differences in PM.

  15. Prospective comparison among transient elastography, supersonic shear imaging, and ARFI imaging for predicting fibrosis in nonalcoholic fatty liver disease.

    Directory of Open Access Journals (Sweden)

    Myoung Seok Lee

    Full Text Available The diagnostic performance of supersonic shear imaging (SSI in comparison with those of transient elastography (TE and acoustic radiation force impulse imaging (ARFI for staging fibrosis in nonalcoholic fatty liver disease (NAFLD patients has not been fully assessed, especially in Asian populations with relatively lean NAFLD compared to white populations. Thus, we focused on comparing the diagnostic performances of TE, ARFI, and SSI for staging fibrosis in a head-to-head manner, and identifying the clinical, anthropometric, biochemical, and histological features which might affect liver stiffness measurement (LSM in our prospective biopsy-proven NAFLD cohort. In this study, ninety-four patients with biopsy-proven NAFLD were included prospectively. Liver stiffness was measured using TE, SSI, and ARFI within 1 month of liver biopsy. The diagnostic performance for staging fibrosis was assessed using receiver operating characteristic (ROC analysis. Anthropometric data were evaluated as covariates influencing LSM by regression analyses. Liver stiffness correlated with fibrosis stage (p < 0.05; the area under the ROC curve of TE (kPa, SSI (kPa, and ARFI (m/s were as follows: 0.757, 0.759, and 0.657 for significant fibrosis and 0.870, 0.809, and 0.873 for advanced fibrosis. Anthropometric traits were significant confounders affecting SSI, while serum liver injury markers significantly confounded TE and ARFI. In conclusion, the LSM methods had similar diagnostic performance for staging fibrosis in patients with NAFLD. Pre-LSM anthropometric evaluation may help predict the reliability of SSI.

  16. Hopefulness predicts resilience after hereditary colorectal cancer genetic testing: a prospective outcome trajectories study

    Directory of Open Access Journals (Sweden)

    Chu Annie TW

    2010-06-01

    Full Text Available Abstract Background - Genetic testing for hereditary colorectal cancer (HCRC had significant psychological consequences for test recipients. This prospective longitudinal study investigated the factors that predict psychological resilience in adults undergoing genetic testing for HCRC. Methods - A longitudinal study was carried out from April 2003 to August 2006 on Hong Kong Chinese HCRC family members who were recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer Registry to determine psychological outcomes after genetic testing. Self-completed questionnaires were administered immediately before (pre-disclosure baseline and 2 weeks, 4 months and 1 year after result disclosure. Using validated psychological inventories, the cognitive style of hope was measured at baseline, and the psychological distress of depression and anxiety was measured at all time points. Results - Of the 76 participating subjects, 71 individuals (43 men and 28 women; mean age 38.9 ± 9.2 years from nine FAP and 24 HNPCC families completed the study, including 39 mutated gene carriers. Four patterns of outcome trajectories were created using established norms for the specified outcome measures of depression and anxiety. These included chronic dysfunction (13% and 8.7%, recovery (0% and 4.3%, delayed dysfunction (13% and 15.9% and resilience (76.8% and 66.7%. Two logistic regression analyses were conducted using hope at baseline to predict resilience, with depression and anxiety employed as outcome indicators. Because of the small number of participants, the chronic dysfunction and delayed dysfunction groups were combined into a non-resilient group for comparison with the resilient group in all subsequent analysis. Because of low frequencies, participants exhibiting a recovery trajectory (n = 3 for anxiety and n = 0 for depression were excluded from further analysis. Both regression equations were significant. Baseline hope was a significant

  17. Non-invasive prediction of hemodynamically significant coronary artery stenoses by contrast density difference in coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hell, Michaela M., E-mail: michaela.hell@uk-erlangen.de [Department of Cardiology, University of Erlangen (Germany); Dey, Damini [Department of Biomedical Sciences, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Taper Building, Room A238, 8700 Beverly Boulevard, Los Angeles, CA 90048 (United States); Marwan, Mohamed; Achenbach, Stephan; Schmid, Jasmin; Schuhbaeck, Annika [Department of Cardiology, University of Erlangen (Germany)

    2015-08-15

    Highlights: • Overestimation of coronary lesions by coronary computed tomography angiography and subsequent unnecessary invasive coronary angiography and revascularization is a concern. • Differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve, were assessed. • At a threshold of ≥24%, contrast density difference predicted hemodynamically significant lesions with a specificity of 75%, sensitivity of 33%, PPV of 35% and NPV of 73%. • The determination of contrast density difference required less time than transluminal attenuation gradient measurement. - Abstract: Objectives: Coronary computed tomography angiography (CTA) allows the detection of obstructive coronary artery disease. However, its ability to predict the hemodynamic significance of stenoses is limited. We assessed differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve (FFR). Methods: Lesion characteristics of 59 consecutive patients (72 lesions) in whom invasive FFR was performed in at least one coronary artery with moderate to high-grade stenoses in coronary CTA were evaluated by two experienced readers. Coronary CTA data sets were acquired on a second-generation dual-source CT scanner using retrospectively ECG-gated spiral acquisition or prospectively ECG-triggered axial acquisition mode. Plaque volume and composition (non-calcified, calcified), remodeling index as well as contrast density difference (defined as the percentage decline in luminal CT attenuation/cross-sectional area over the lesion) were assessed using a semi-automatic software tool (Autoplaq). Additionally, the transluminal attenuation gradient (defined as the linear regression coefficient between intraluminal CT attenuation and length from the ostium) was determined

  18. Factors predictive for incidence and remission of internet addiction in young adolescents: a prospective study.

    Science.gov (United States)

    Ko, Chih-Hung; Yen, Ju-Yu; Yen, Cheng-Fang; Lin, Huang-Chi; Yang, Ming-Jen

    2007-08-01

    The aim of the study is to determine the incidence and remission rates for Internet addiction and the associated predictive factors in young adolescents over a 1-year follow-up. This was a prospective, population-based investigation. Five hundred seventeen students (267 male and 250 female) were recruited from three junior high schools in southern Taiwan. The factors examined included gender, personality, mental health, self-esteem, family function, life satisfaction, and Internet activities. The result revealed that the 1-year incidence and remission rates for Internet addiction were 7.5% and 49.5% respectively. High exploratory excitability, low reward dependence, low self-esteem, low family function, and online game playing predicted the emergency of the Internet addiction. Further, low hostility and low interpersonal sensitivity predicted remission of Internet addiction. The factors predictive incidence and remission of Internet addiction identified in this study could be provided for prevention and promoting remission of Internet addiction in adolescents.

  19. Predicting medical complications after spine surgery: a validated model using a prospective surgical registry.

    Science.gov (United States)

    Lee, Michael J; Cizik, Amy M; Hamilton, Deven; Chapman, Jens R

    2014-02-01

    The possibility and likelihood of a postoperative medical complication after spine surgery undoubtedly play a major role in the decision making of the surgeon and patient alike. Although prior study has determined relative risk and odds ratio values to quantify risk factors, these values may be difficult to translate to the patient during counseling of surgical options. Ideally, a model that predicts absolute risk of medical complication, rather than relative risk or odds ratio values, would greatly enhance the discussion of safety of spine surgery. To date, there is no risk stratification model that specifically predicts the risk of medical complication. The purpose of this study was to create and validate a predictive model for the risk of medical complication during and after spine surgery. Statistical analysis using a prospective surgical spine registry that recorded extensive demographic, surgical, and complication data. Outcomes examined are medical complications that were specifically defined a priori. This analysis is a continuation of statistical analysis of our previously published report. Using a prospectively collected surgical registry of more than 1,476 patients with extensive demographic, comorbidity, surgical, and complication detail recorded for 2 years after surgery, we previously identified several risk factor for medical complications. Using the beta coefficients from those log binomial regression analyses, we created a model to predict the occurrence of medical complication after spine surgery. We split our data into two subsets for internal and cross-validation of our model. We created two predictive models: one predicting the occurrence of any medical complication and the other predicting the occurrence of a major medical complication. The final predictive model for any medical complications had a receiver operator curve characteristic of 0.76, considered to be a fair measure. The final predictive model for any major medical complications had

  20. Prediction of methotrexate intolerance in juvenile idiopathic arthritis: a prospective, observational cohort study.

    Science.gov (United States)

    van Dijkhuizen, Evert Hendrik Pieter; Bulatović Ćalasan, Maja; Pluijm, Saskia M F; de Rotte, Maurits C F J; Vastert, Sebastiaan J; Kamphuis, Sylvia; de Jonge, Robert; Wulffraat, Nico M

    2015-01-01

    Methotrexate (MTX) is an effective and safe drug in the treatment of juvenile idiopathic arthritis (JIA). Despite its safety, MTX-related gastrointestinal adverse effects before and after MTX administration, termed MTX intolerance, occur frequently, leading to non-compliance and potentially premature MTX termination. The aim of this study was to construct a risk model to predict MTX intolerance. In a prospective JIA cohort, clinical variables and single nucleotide polymorphisms were determined at MTX start. The Methotrexate Intolerance Severity Score was employed to measure MTX intolerance in the first year of treatment. MTX intolerance was most prevalent at 6 or 12 months after MTX start, which was defined as the outcome for the prediction model. The model was developed in 152 patients using multivariable logistic regression analysis and subsequently internally validated using bootstrapping. The prediction model included the following predictors: JIA category, antinuclear antibody, parent/patient assessment of pain, Juvenile Arthritis Disease Activity Score-27, thrombocytes, alanine aminotransferase and creatinine. The model classified 77.5% of patients correctly, and 66.7% of patients after internal validation by bootstrapping. The lowest predicted risk of MTX intolerance was 18.9% and the highest predicted risk was 85.9%. The prediction model was transformed into a risk score (range 0-17). At a cut-off of ≥6, sensitivity was 82.0%, specificity 56.1%, positive predictive value was 58.7% and negative predictive value 80.4%. This clinical prediction model showed moderate predictive power to detect MTX intolerance. To develop into a clinically usable tool, it should be validated in an independent cohort and updated with new predictors. Such an easy-to-use tool could then assist clinicians in identifying patients at risk to develop MTX intolerance, and in turn to monitor them closely and intervene timely in order to prevent the development of MTX intolerance

  1. Testing earthquake prediction algorithms: Statistically significant advance prediction of the largest earthquakes in the Circum-Pacific, 1992-1997

    Science.gov (United States)

    Kossobokov, V.G.; Romashkova, L.L.; Keilis-Borok, V. I.; Healy, J.H.

    1999-01-01

    Algorithms M8 and MSc (i.e., the Mendocino Scenario) were used in a real-time intermediate-term research prediction of the strongest earthquakes in the Circum-Pacific seismic belt. Predictions are made by M8 first. Then, the areas of alarm are reduced by MSc at the cost that some earthquakes are missed in the second approximation of prediction. In 1992-1997, five earthquakes of magnitude 8 and above occurred in the test area: all of them were predicted by M8 and MSc identified correctly the locations of four of them. The space-time volume of the alarms is 36% and 18%, correspondingly, when estimated with a normalized product measure of empirical distribution of epicenters and uniform time. The statistical significance of the achieved results is beyond 99% both for M8 and MSc. For magnitude 7.5 + , 10 out of 19 earthquakes were predicted by M8 in 40% and five were predicted by M8-MSc in 13% of the total volume considered. This implies a significance level of 81% for M8 and 92% for M8-MSc. The lower significance levels might result from a global change in seismic regime in 1993-1996, when the rate of the largest events has doubled and all of them become exclusively normal or reversed faults. The predictions are fully reproducible; the algorithms M8 and MSc in complete formal definitions were published before we started our experiment [Keilis-Borok, V.I., Kossobokov, V.G., 1990. Premonitory activation of seismic flow: Algorithm M8, Phys. Earth and Planet. Inter. 61, 73-83; Kossobokov, V.G., Keilis-Borok, V.I., Smith, S.W., 1990. Localization of intermediate-term earthquake prediction, J. Geophys. Res., 95, 19763-19772; Healy, J.H., Kossobokov, V.G., Dewey, J.W., 1992. A test to evaluate the earthquake prediction algorithm, M8. U.S. Geol. Surv. OFR 92-401]. M8 is available from the IASPEI Software Library [Healy, J.H., Keilis-Borok, V.I., Lee, W.H.K. (Eds.), 1997. Algorithms for Earthquake Statistics and Prediction, Vol. 6. IASPEI Software Library]. ?? 1999 Elsevier

  2. A nuclear-free zone for the Southwest Pacific: prospects and significance

    International Nuclear Information System (INIS)

    Fry, G.

    1983-01-01

    The Australian Government is currently seeking to promote the concept of a nuclear-free zone for the Southwest Pacific. This paper explores three fundamental questions concerning the Australian proposal. Firstly, what would be the boundaries of such a zone and what does 'nuclear-free' mean in this context Secondly, what are the prospects for agreement on the establishment of a zone. Could regional states and nuclear powers agree to what is being proposed. And finally, what would be the significance, in arms control terms, were such an agreement to be signed. Would it, in fact, achieve anything. In an approach to these questions, the author surveys the strategic situation in the region, the level and pattern of nuclear involvement, past experience with zone proposals, and the current positions of various regional states and nuclear weapons powers on this question. He concludes that the necessary basis for agreement does exist and that modest arms control objectives could be served by the establishment of such a zone

  3. A prospective evaluation of patient-reported quality-of-life after (chemo)radiation for oropharyngeal cancer: Which patients are at risk of significant quality-of-life deterioration?

    International Nuclear Information System (INIS)

    Al-Mamgani, Abrahim; Rooij, Peter van; Tans, Lisa; Verduijn, Gerda M.; Sewnaik, Aniel; Jong, Rob J. Baatenburg de

    2013-01-01

    Background and purpose: To prospectively investigate the impact of different patients’ characteristics on quality-of-life (QoL) after (chemo)radiation for oropharyngeal cancer (OPC). Materials and methods: Between 2008 and 2011, 207 patients were treated with 46-Gy of (chemo)-IMRT followed by a boost by means of IMRT, brachytherapy (BT), or Cyberknife (CK). QoL-assessment was performed using the EORTC QLQ-C30, and QLQ-H and N35-questionnaires at baseline, end of treatment, 2, 4, 6 weeks and 3, 6, 12, and 18 months after treatment. The correlation between patients’ characteristics (AJCC-stage, tumor subsite, chemotherapy, neck dissection, unilateral neck irradiation, and boost technique), and changes in QoL over time were investigated. Results: At 18 months, improvements were seen in QLQ-C30 emotional functioning, insomnia, and pain and QLQ-H and N35 pain and speech. The scores on QLQ-H and N35 swallowing returned to baseline level while the scores on dry mouth, sticky saliva, opening mouth, and teeth were significantly deteriorated compared to baseline. Boost techniques and unilateral neck irradiation were significantly predictive for dry mouth, swallowing and opening mouth while chemotherapy was correlated with changes on swallowing and opening mouth scales. Conclusions: The most significant deterioration was seen in patient-related xerostomia. Boost technique, unilateral neck irradiation and chemotherapy were significantly predictive for QoL-changes over time

  4. Functional Performances on Admission Predict In-Hospital Falls, Injurious Falls, and Fractures in Older Patients: A Prospective Study.

    Science.gov (United States)

    Hars, Mélany; Audet, Marie-Claude; Herrmann, François; De Chassey, Jean; Rizzoli, René; Reny, Jean-Luc; Gold, Gabriel; Ferrari, Serge; Trombetti, Andrea

    2018-05-01

    Falls are common among older inpatients and remain a great challenge for hospitals. Despite the relevance of physical impairments to falls, the prognostic value of performance-based functional measures for in-hospital falls and injurious falls remains unknown. This study aimed to determine the predictive ability and accuracy of various functional tests administered at or close to admission in a geriatric hospital to identify in-hospital fallers and injurious fallers. In this prospective study, conducted in a geriatric hospital in Geneva, Switzerland, 807 inpatients (mean age 85.0 years) were subjected to a battery of functional tests administered by physiotherapists within 3 days (interquartile range 1 to 6) of admission, including Short Physical Performance Battery (SPPB), simplified Tinetti, and Timed Up and Go tests. Patients were prospectively followed up for falls and injurious falls until discharge using mandatory standardized incident report forms and electronic patients' records. During a median length of hospital stay of 23 days (interquartile range 14 to 36), 329 falls occurred in 189 (23.4%) patients, including 161 injurious falls of which 24 were serious. In-hospital fallers displayed significantly poorer functional performances at admission on all tests compared with non-fallers (p performances on all functional tests predicted in-hospital falls and injurious falls (p poor functional performances, as assessed by SPPB, are independent predictors of in-hospital falls, injurious falls, and fractures in patients admitted to a geriatric hospital. These findings should help to design preventive strategies for in-hospital falls and support the adoption of objective performance-based functional measures into routine hospital practice. © 2018 American Society for Bone and Mineral Research. © 2018 American Society for Bone and Mineral Research.

  5. Rib fractures predict incident limb fractures: results from the European prospective osteoporosis study.

    Science.gov (United States)

    Ismail, A A; Silman, A J; Reeve, J; Kaptoge, S; O'Neill, T W

    2006-01-01

    Population studies suggest that rib fractures are associated with a reduction in bone mass. While much is known about the predictive risk of hip, spine and distal forearm fracture on the risk of future fracture, little is known about the impact of rib fracture. The aim of this study was to determine whether a recalled history of rib fracture was associated with an increased risk of future limb fracture. Men and women aged 50 years and over were recruited from population registers in 31 European centres for participation in a screening survey of osteoporosis (European Prospective Osteoporosis Study). Subjects were invited to complete an interviewer-administered questionnaire that included questions about previous fractures including rib fracture, the age of their first fracture and also the level of trauma. Lateral spine radiographs were performed and the presence of vertebral deformity was determined morphometrically. Following the baseline survey, subjects were followed prospectively by annual postal questionnaire to determine the occurrence of clinical fractures. The subjects included 6,344 men, with a mean age of 64.2 years, and 6,788 women, with a mean age of 63.6 years, who were followed for a median of 3 years (range 0.4-5.9 years), of whom 135 men (2.3%) and 101 women (1.6%) reported a previous low trauma rib fracture. In total, 138 men and 391 women sustained a limb fracture during follow-up. In women, after age adjustment, those with a recalled history of low trauma rib fracture had an increased risk of sustaining 'any' limb fracture [relative hazard (RH)=2.3; 95% CI 1.3, 4.0]. When stratified by fracture type the predictive risk was more marked for hip (RH=7.7; 95% CI 2.3, 25.9) and humerus fracture (RH=4.5; 95% CI 1.4, 14.6) than other sites (RH=1.6; 95% CI 0.6, 4.3). Additional adjustment for prevalent vertebral deformity and previous (non-rib) low trauma fractures at other sites slightly reduced the strength of the association between rib fracture and

  6. Symptom clusters predict mortality among dialysis patients in Norway: a prospective observational cohort study.

    Science.gov (United States)

    Amro, Amin; Waldum, Bård; von der Lippe, Nanna; Brekke, Fredrik Barth; Dammen, Toril; Miaskowski, Christine; Os, Ingrid

    2015-01-01

    Patients with end-stage renal disease on dialysis have reduced survival rates compared with the general population. Symptoms are frequent in dialysis patients, and a symptom cluster is defined as two or more related co-occurring symptoms. The aim of this study was to explore the associations between symptom clusters and mortality in dialysis patients. In a prospective observational cohort study of dialysis patients (n = 301), Kidney Disease and Quality of Life Short Form and Beck Depression Inventory questionnaires were administered. To generate symptom clusters, principal component analysis with varimax rotation was used on 11 kidney-specific self-reported physical symptoms. A Beck Depression Inventory score of 16 or greater was defined as clinically significant depressive symptoms. Physical and mental component summary scores were generated from Short Form-36. Multivariate Cox regression analysis was used for the survival analysis, Kaplan-Meier curves and log-rank statistics were applied to compare survival rates between the groups. Three different symptom clusters were identified; one included loading of several uremic symptoms. In multivariate analyses and after adjustment for health-related quality of life and depressive symptoms, the worst perceived quartile of the "uremic" symptom cluster independently predicted all-cause mortality (hazard ratio 2.47, 95% CI 1.44-4.22, P = 0.001) compared with the other quartiles during a follow-up period that ranged from four to 52 months. The two other symptom clusters ("neuromuscular" and "skin") or the individual symptoms did not predict mortality. Clustering of uremic symptoms predicted mortality. Assessing co-occurring symptoms rather than single symptoms may help to identify dialysis patients at high risk for mortality. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Exploring the significance of human mobility patterns in social link prediction

    KAUST Repository

    Alharbi, Basma Mohammed

    2014-01-01

    Link prediction is a fundamental task in social networks. Recently, emphasis has been placed on forecasting new social ties using user mobility patterns, e.g., investigating physical and semantic co-locations for new proximity measure. This paper explores the effect of in-depth mobility patterns. Specifically, we study individuals\\' movement behavior, and quantify mobility on the basis of trip frequency, travel purpose and transportation mode. Our hybrid link prediction model is composed of two modules. The first module extracts mobility patterns, including travel purpose and mode, from raw trajectory data. The second module employs the extracted patterns for link prediction. We evaluate our method on two real data sets, GeoLife [15] and Reality Mining [5]. Experimental results show that our hybrid model significantly improves the accuracy of social link prediction, when comparing to primary topology-based solutions. Copyright 2014 ACM.

  8. Prospects and Potential Uses of Genomic Prediction of Key Performance Traits in Tetraploid Potato

    Directory of Open Access Journals (Sweden)

    Benjamin Stich

    2018-03-01

    Full Text Available Genomic prediction is a routine tool in breeding programs of most major animal and plant species. However, its usefulness for potato breeding has not yet been evaluated in detail. The objectives of this study were to (i examine the prospects of genomic prediction of key performance traits in a diversity panel of tetraploid potato modeling additive, dominance, and epistatic effects, (ii investigate the effects of size and make up of training set, number of test environments and molecular markers on prediction accuracy, and (iii assess the effect of including markers from candidate genes on the prediction accuracy. With genomic best linear unbiased prediction (GBLUP, BayesA, BayesCπ, and Bayesian LASSO, four different prediction methods were used for genomic prediction of relative area under disease progress curve after a Phytophthora infestans infection, plant maturity, maturity corrected resistance, tuber starch content, tuber starch yield (TSY, and tuber yield (TY of 184 tetraploid potato clones or subsets thereof genotyped with the SolCAP 8.3k SNP array. The cross-validated prediction accuracies with GBLUP and the three Bayesian approaches for the six evaluated traits ranged from about 0.5 to about 0.8. For traits with a high expected genetic complexity, such as TSY and TY, we observed an 8% higher prediction accuracy using a model with additive and dominance effects compared with a model with additive effects only. Our results suggest that for oligogenic traits in general and when diagnostic markers are available in particular, the use of Bayesian methods for genomic prediction is highly recommended and that the diagnostic markers should be modeled as fixed effects. The evaluation of the relative performance of genomic prediction vs. phenotypic selection indicated that the former is superior, assuming cycle lengths and selection intensities that are possible to realize in commercial potato breeding programs.

  9. Circulating histones for predicting prognosis after cardiac surgery: a prospective study.

    Science.gov (United States)

    Gao, Hongxiang; Zhang, Naipu; Lu, Fangfang; Yu, Xindi; Zhu, Limin; Mo, Xi; Wang, Wei

    2016-11-01

    The objective of this study was to assess the perioperative changes in circulating histones and their relationships with other biomarkers and clinical outcomes after cardiac surgery with cardiopulmonary bypass (CPB) in patients. Forty-eight patients with congenital cardiac diseases undergoing corrective procedure with CPB were prospectively enrolled in this study. Circulating histones, N-terminal pro-brain natriuretic peptide (NT-proBNP), procalcitonin (PCT) and C-reactive protein (CRP) were measured preoperatively (T0) and at 0 (T1), 24 (T2), 48 (T3) and 72 (T4) h postoperatively. The relationships between biomarkers and clinical outcomes were analysed. Circulating histones, NT-proBNP, PCT and CRP increased significantly postoperatively, with histones reaching the peak value earliest at T1. Circulating histone levels were higher in patients with adverse events. Receiver operating characteristic curve analysis showed that peak histone levels had a better predictive value for adverse events postoperatively. Peak histone levels correlated with the peak level of NT-proBNP (r = 0.563, P histones reached peak levels faster than NT-proBNP, PCT and CRP. Furthermore, peak histone levels correlated with biomarkers and postoperative clinical outcomes. Circulating histones may be used as a prognostic indicator for patients after cardiac surgery with CPB. ClinicalTrials.gov (ID: NCT02325765). © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  10. The Predictive Value of Integrated Pulmonary Index after Off-Pump Coronary Artery Bypass Grafting: A Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Evgenia V. Fot

    2017-08-01

    Full Text Available BackgroundThe early warning scores may increase the safety of perioperative period. The objective of this study was to assess the diagnostic and predictive role of Integrated Pulmonary Index (IPI after off-pump coronary artery bypass grafting (OPCAB.Materials and MethodsForty adult patients undergoing elective OPCAB were enrolled into a single-center prospective observational study. We assessed respiratory function using IPI that includes oxygen saturation, end-tidal CO2, respiratory rate, and pulse rate. In addition, we evaluated blood gas analyses and hemodynamics, including ECG, invasive arterial pressure, and cardiac index. The measurements were performed after transfer to the intensive care unit, after spontaneous breathing trial and at 2, 6, 12, and 18 h after extubation.Results and DiscussionThe value of IPI registered during respiratory support correlated weakly with cardiac index (rho = 0.4; p = 0.04 and ScvO2 (rho = 0.4, p = 0.02. After extubation, IPI values decreased significantly, achieving a minimum by 18 h. The IPI value ≤9 at 6 h after extubation was a predictor of complicated early postoperative period (AUC = 0.71; p = 0.04 observed in 13 patients.ConclusionIn off-pump coronary surgery, the IPI decreases significantly after tracheal extubation and may predict postoperative complications.

  11. Emphysema predicts hospitalisation and incident airflow obstruction among older smokers: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    David A McAllister

    Full Text Available Emphysema on CT is common in older smokers. We hypothesised that emphysema on CT predicts acute episodes of care for chronic lower respiratory disease among older smokers.Participants in a lung cancer screening study age ≥ 60 years were recruited into a prospective cohort study in 2001-02. Two radiologists independently visually assessed the severity of emphysema as absent, mild, moderate or severe. Percent emphysema was defined as the proportion of voxels ≤ -910 Hounsfield Units. Participants completed a median of 5 visits over a median of 6 years of follow-up. The primary outcome was hospitalization, emergency room or urgent office visit for chronic lower respiratory disease. Spirometry was performed following ATS/ERS guidelines. Airflow obstruction was defined as FEV1/FVC ratio <0.70 and FEV1<80% predicted.Of 521 participants, 4% had moderate or severe emphysema, which was associated with acute episodes of care (rate ratio 1.89; 95% CI: 1.01-3.52 adjusting for age, sex and race/ethnicity, as was percent emphysema, with similar associations for hospitalisation. Emphysema on visual assessment also predicted incident airflow obstruction (HR 5.14; 95% CI 2.19-21.1.Visually assessed emphysema and percent emphysema on CT predicted acute episodes of care for chronic lower respiratory disease, with the former predicting incident airflow obstruction among older smokers.

  12. Unhappiness and dissatisfaction in doctors cannot be predicted by selectors from medical school application forms: A prospective, longitudinal study

    Directory of Open Access Journals (Sweden)

    Ferguson E

    2005-12-01

    Full Text Available Abstract Background Personal statements and referees' reports are widely used on medical school application forms, particularly in the UK, to assess the suitability of candidates for a career in medicine. However there are few studies which assess the validity of such information for predicting unhappiness or dissatisfaction with a career in medicine. Here we combine data from a long-term prospective study of medical student selection and training, with an experimental approach in which a large number of assessors used a paired comparison technique to predict outcome. Methods Data from a large-scale prospective study of students applying to UK medical schools in 1990 were used to identify 40 pairs of doctors, matched by sex, for whom personal statements and referees' reports were available, and who in a 2002/3 follow-up study, one pair member was very satisfied and the other very dissatisfied with medicine as a career. In 2005, 96 assessors, who were experienced medical school selectors, doctors, medical students or psychology students, used information from the doctors' original applications to judge which member of each pair of doctors was the happier, more satisfied doctor. Results None of the groups of assessors were significantly different from chance expectations in using applicants' personal statements and the referees' reports to predict actual future satisfaction or dissatisfaction, the distribution being similar to binomial expectations. However judgements of pairs of application forms from pairs of doctors showed a non-binomial distribution, indicating consensus among assessors as to which doctor would be the happy doctor (although the consensus was wrong in half the cases. Assessors taking longer to do the task concurred more. Consensus judgements seem mainly to be based on referees' predictions of academic achievement (even though academic achievement is not actually a valid predictor of happiness or satisfaction. Conclusion

  13. Clinical Significance of the Prognostic Nutritional Index for Predicting Short- and Long-Term Surgical Outcomes After Gastrectomy: A Retrospective Analysis of 7781 Gastric Cancer Patients.

    Science.gov (United States)

    Lee, Jee Youn; Kim, Hyoung-Il; Kim, You-Na; Hong, Jung Hwa; Alshomimi, Saeed; An, Ji Yeong; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon; Kim, Choong-Bai

    2016-05-01

    To evaluate the predictive and prognostic significance of the prognostic nutritional index (PNI) in a large cohort of gastric cancer patients who underwent gastrectomy.Assessing a patient's immune and nutritional status, PNI has been reported as a predictive marker for surgical outcomes in various types of cancer.We retrospectively reviewed data from a prospectively maintained database of 7781 gastric cancer patients who underwent gastrectomy from January 2001 to December 2010 at a single center. From this data, we analyzed clinicopathologic characteristics, PNI, and short- and long-term surgical outcomes for each patient. We used the PNI value for the 10th percentile (46.70) of the study cohort as a cut-off for dividing patients into low and high PNI groups.Regarding short-term outcomes, multivariate analysis showed a low PNI (odds ratio [OR] = 1.505, 95% CI = 1.212-1.869, P cancer recurrence.

  14. Validation of the RRE-90 Scale to Predict Stroke Risk after Transient Symptoms with Infarction: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Bo Song

    Full Text Available The risk of stroke after a transient ischemic attack (TIA for patients with a positive diffusion-weighted image (DWI, i.e., transient symptoms with infarction (TSI, is much higher than for those with a negative DWI. The aim of this study was to validate the predictive value of a web-based recurrence risk estimator (RRE; http://www.nmr.mgh.harvard.edu/RRE/ of TSI.Data from the prospective hospital-based TIA database of the First Affiliated Hospital of Zhengzhou University were analyzed. The RRE and ABCD2 scores were calculated within 7 days of symptom onset. The predictive outcome was ischemic stroke occurrence at 90 days. The receiver-operating characteristics curves were plotted, and the predictive value of the two models was assessed by computing the C statistics.A total of 221 eligible patients were prospectively enrolled, of whom 46 (20.81% experienced a stroke within 90 days. The 90-day stroke risk in high-risk TSI patients (RRE ≥4 was 3.406-fold greater than in those at low risk (P <0.001. The C statistic of RRE (0.681; 95% confidence interval [CI], 0.592-0.771 was statistically higher than that of ABCD2 score (0.546; 95% CI, 0.454-0.638; Z = 2.115; P = 0.0344 at 90 days.The RRE score had a higher predictive value than the ABCD2 score for assessing the 90-day risk of stroke after TSI.

  15. Early detection of clinically significant prostate cancer at diagnosis: a prospective study using a novel panel of TMPRSS2:ETS fusion gene markers

    International Nuclear Information System (INIS)

    Chan, Sam W.; Nguyen, Phuong-Nam; Violette, Philippe; Brimo, Fadi; Taguchi, Yosh; Aprikian, Armen; Chen, Junjian Z.

    2013-01-01

    We explore noninvasive clinical applications of multiple disease-specific fusion markers recently discovered in prostate cancer to predict the risk of cancer occurrence and aggressiveness at diagnosis. A total of 92 men who were prostate-specific antigen (PSA) screened and scheduled for diagnostic biopsy were enrolled for this study. Prospectively collected urine was blind coded for laboratory tests. RNA from urine sediments was analyzed using a panel of 6 TMPRSS2:ETS fusion markers with a sensitive quantitative PCR platform. The pathology reported 39 biopsy-positive cases from 92 patients (42.4%). In urine test, 10 unique combinations of fusion types were detected in 32 of 92 (34.8%) prebiopsy samples. A novel combination of fusion markers, termed Fx (III, IV, ETS), was identified with a sensitivity of 51.3% and an odds ratio of 10.1 in detecting cancer on biopsy. Incorporating a categorical variable of Fx (III, IV, ETS) with urine PCA3 and serum PSA, a regression model was developed to predict biopsy outcomes with an overall accuracy of 77%. Moreover, the overexpression of Fx (III, IV, or ETS) was shown to be an independent predictor to the high-grade cancer, with a predictive accuracy of 80% when coupled with PSA density. The individualized risk scores further stratified a high-risk group that is composed of 92% high-grade cancers and a low-risk group that harbors mainly clinically insignificant cancers. In conclusion, we have identified a novel combination of fusion types very specific to the clinically significant prostate cancer and developed effective regression models to predict biopsy outcomes and aggressive cancers at diagnosis

  16. The Real World Significance of Performance Prediction

    Science.gov (United States)

    Pardos, Zachary A.; Wang, Qing Yang; Trivedi, Shubhendu

    2012-01-01

    In recent years, the educational data mining and user modeling communities have been aggressively introducing models for predicting student performance on external measures such as standardized tests as well as within-tutor performance. While these models have brought statistically reliable improvement to performance prediction, the real world…

  17. Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve

    Science.gov (United States)

    Tanaka, Haruki; Takahashi, Teruyuki; Ohashi, Norihiko; Tanaka, Koichi; Okada, Takenori; Kihara, Yasuki

    2017-01-01

    Abstract The aim of this study was to clarify the predictive value of fractional flow reserve (FFR) determined by myocardial perfusion imaging (MPI) using thallium (Tl)-201 IQ-SPECT without and with computed tomography-based attenuation correction (CT-AC) for patients with stable coronary artery disease (CAD). We assessed 212 angiographically identified diseased vessels using adenosine-stress Tl-201 MPI-IQ-SPECT/CT in 84 consecutive, prospectively identified patients with stable CAD. We compared the FFR in 136 of the 212 diseased vessels using visual semiquantitative interpretations of corresponding territories on MPI-IQ-SPECT images without and with CT-AC. FFR inversely correlated most accurately with regional summed difference scores (rSDS) in images without and with CT-AC (r = −0.584 and r = −0.568, respectively, both P system can predict FFR at an optimal cut-off of <0.80, and we propose a novel application of CT-AC to MPI-IQ-SPECT for predicting clinically significant and insignificant FFR even in nonobese patients. PMID:29390486

  18. The predictive ability of the STarT Back Tool was limited in people with chronic low back pain: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Michelle Kendell

    2018-04-01

    Full Text Available Questions: In people with chronic non-specific low back pain (LBP, what is the predictive and discriminative validity of the STarT Back Tool (SBT for pain intensity, self-reported LBP-related disability, and global self-perceived change at 1-year follow-up? What is the profile of the SBT risk subgroups with respect to demographic variables, pain intensity, self-reported LBP-related disability, and psychological measures? Design: Prospective cohort study. Participants: A total of 290 adults with dominant axial LBP of ≥ 3 months’ duration recruited from the general community, and private physiotherapy, psychology, and pain-management clinics in Western Australia. Outcome measures: The 1-year follow-up measures were pain intensity, LBP-related disability, and global self-perceived change. Results: Outcomes were collected on 264 participants. The SBT categorised 82 participants (28% as low risk, 116 (40% as medium risk, and 92 (32% as high risk. The risk subgroups differed significantly (p < 0.05 on baseline pain, disability, and psychological scores. The SBT’s predictive ability was strongest for disability: RR was 2.30 (95% CI 1.28 to 4.10 in the medium-risk group and 2.86 (95% CI 1.60 to 5.11 in the high-risk group. The SBT’s predictive ability was weaker for pain: RR was 1.25 (95% CI 1.04 to 1.51 in the medium-risk group and 1.26 (95% CI 1.03 to 1.52 in the high-risk group. For the SBT total score, the AUC was 0.71 (95% CI 0.64 to 0.77 for disability and 0.63 (95% CI 0.55 to 0.71 for pain. Conclusion: This was the first large study to investigate the SBT in a population exclusively with chronic LBP. The SBT provided an acceptable indication of 1-year disability, had poor predictive and discriminative ability for future pain, and was unable to predict or discriminate global perceived change. In this cohort with chronic non-specific LBP, the SBT’s predictive and discriminative abilities were restricted to disability at 1

  19. A Multi-Center Prospective Study to Validate an Algorithm Using Urine and Plasma Biomarkers for Predicting Gleason ≥3+4 Prostate Cancer on Biopsy

    DEFF Research Database (Denmark)

    Albitar, Maher; Ma, Wanlong; Lund, Lars

    2017-01-01

    a prospective multicenter study recruiting patients from community-based practices. Patients and Methods: Urine and plasma samples from 2528 men were tested prospectively. Results were correlated with biopsy findings, if a biopsy was performed as deemed necessary by the practicing urologist. Of the 2528......Background: Unnecessary biopsies and overdiagnosis of prostate cancer (PCa) remain a serious healthcare problem. We have previously shown that urine- and plasma-based prostate-specific biomarkers when combined can predict high grade prostate cancer (PCa). To further validate this test, we performed...... of high grade prostate cancer with negative predictive value (NPV) of 90% to 97% for Gleason ≥3+4 and between 98% to 99% for Gleason ≥4+3....

  20. The characteristics of original geochemical halo in fault zone and its prospecting significance in Xiangyangping uranium deposit

    International Nuclear Information System (INIS)

    Ouyang Pingning; Huang Manxiang; Liu Xinyang; Chen Yue; Xiao Jianjun

    2012-01-01

    Xiangyangping uranium deposit is a hydrothermal filling deposit controlled by faults. The axial zonation of original element along the fault is sequence of Ni-Rb-Bi-Sn-Cu-W-Hg→As-U-Sb-Mo→Sr-Zn which shows the characteristics of superimposed halos and multiphase mineralization. The distribution characteristics of original halos along structure suggests that uranium mineralization may possess multi-enrichment zones along axial and strata tend. These characteristics are of prospecting significance. (authors)

  1. Appraisal in a Team Context: Perceptions of Cohesion Predict Competition Importance and Prospects for Coping.

    Science.gov (United States)

    Wolf, Svenja A; Eys, Mark A; Sadler, Pamela; Kleinert, Jens

    2015-10-01

    Athletes' precompetitive appraisal is important because it determines emotions, which may impact performance. When part of a team, athletes make their appraisal within a social context, and in this study we examined whether perceived team cohesion, as a characteristic of this context, related to appraisal. We asked 386 male and female intercollegiate team-sport athletes to respond to measures of cohesion and precompetitive appraisal before an in-season game. For males and females, across all teams, (a) an appraisal of increased competition importance was predicted by perceptions of higher task cohesion (individual level), better previous team performance, and a weaker opponent (team level) and (b) an appraisal of more positive prospects for coping with competitive demands was predicted by higher individual attractions to the group (individual level). Consequently, athletes who perceive their team as more cohesive likely appraise the pending competition as a challenge, which would benefit both emotions and performance.

  2. A prospective echocardiographic evaluation of pulmonary hypertension in chronic hemodialysis patients in the United States: prevalence and clinical significance

    Directory of Open Access Journals (Sweden)

    Kumudha Ramasubbu

    2010-09-01

    Full Text Available Kumudha Ramasubbu1, Anita Deswal1, Cheryl Herdejurgen2, David Aguilar1, Adaani E Frost21Section of Cardiology, Michael E DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas, USA; 2Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USABackground: Pulmonary hypertension (PH, a disease which carries substantial morbidity and mortality, has been reported to occur in 25%–45% of dialysis patients. No prospective evaluation of the prevalence or clinical significance of PH in chronic dialysis patients in the United States (US has been undertaken.Methods: Echocardiograms were performed prospectively in chronic hemodialysis patients prior to dialysis at a single dialysis center. PH was defined as a tricuspid regurgitant jet ≥2.5 m/s and “more severe PH” as ≥3.0 m/s. Clinical outcomes recovered were all-cause hospitalizations and death at 12 months.Results: In a cohort of 90 patients, 42 patients (47% met the definition of PH. Of those, 18 patients (20% met the definition of more severe PH. At 12 months, mortality was significantly higher in patients with PH (26% compared with patients without PH (6%. All-cause hospitalizations were similar in patients with PH and without PH. Echocardiographic findings suggesting impaired left ventricular function and elevated pulmonary capillary wedge pressure were significantly associated with PH.Conclusion: This prospective cross-sectional study of a single dialysis unit suggests that PH may be present in nearly half of US dialysis patients and when present is associated with increased mortality. Echocardiographic findings demonstrate an association between elevated filling pressures, elevated pulmonary artery pressures, and higher mortality, suggesting that the PH may be secondary to diastolic dysfunction and compounded by volume overload.Keywords: renal failure, pulmonary hypertension, diastolic dysfunction

  3. Predicting survival time in noncurative patients with advanced cancer: a prospective study in China.

    Science.gov (United States)

    Cui, Jing; Zhou, Lingjun; Wee, B; Shen, Fengping; Ma, Xiuqiang; Zhao, Jijun

    2014-05-01

    Accurate prediction of prognosis for cancer patients is important for good clinical decision making in therapeutic and care strategies. The application of prognostic tools and indicators could improve prediction accuracy. This study aimed to develop a new prognostic scale to predict survival time of advanced cancer patients in China. We prospectively collected items that we anticipated might influence survival time of advanced cancer patients. Participants were recruited from 12 hospitals in Shanghai, China. We collected data including demographic information, clinical symptoms and signs, and biochemical test results. Log-rank tests, Cox regression, and linear regression were performed to develop a prognostic scale. Three hundred twenty patients with advanced cancer were recruited. Fourteen prognostic factors were included in the prognostic scale: Karnofsky Performance Scale (KPS) score, pain, ascites, hydrothorax, edema, delirium, cachexia, white blood cell (WBC) count, hemoglobin, sodium, total bilirubin, direct bilirubin, aspartate aminotransferase (AST), and alkaline phosphatase (ALP) values. The score was calculated by summing the partial scores, ranging from 0 to 30. When using the cutoff points of 7-day, 30-day, 90-day, and 180-day survival time, the scores were calculated as 12, 10, 8, and 6, respectively. We propose a new prognostic scale including KPS, pain, ascites, hydrothorax, edema, delirium, cachexia, WBC count, hemoglobin, sodium, total bilirubin, direct bilirubin, AST, and ALP values, which may help guide physicians in predicting the likely survival time of cancer patients more accurately. More studies are needed to validate this scale in the future.

  4. Prospective validation of a predictive model that identifies homeless people at risk of re-presentation to the emergency department.

    Science.gov (United States)

    Moore, Gaye; Hepworth, Graham; Weiland, Tracey; Manias, Elizabeth; Gerdtz, Marie Frances; Kelaher, Margaret; Dunt, David

    2012-02-01

    To prospectively evaluate the accuracy of a predictive model to identify homeless people at risk of representation to an emergency department. A prospective cohort analysis utilised one month of data from a Principal Referral Hospital in Melbourne, Australia. All visits involving people classified as homeless were included, excluding those who died. Homelessness was defined as living on the streets, in crisis accommodation, in boarding houses or residing in unstable housing. Rates of re-presentation, defined as the total number of visits to the same emergency department within 28 days of discharge from hospital, were measured. Performance of the risk screening tool was assessed by calculating sensitivity, specificity, positive and negative predictive values and likelihood ratios. Over the study period (April 1, 2009 to April 30, 2009), 3298 presentations from 2888 individuals were recorded. The homeless population accounted for 10% (n=327) of all visits and 7% (n=211) of all patients. A total of 90 (43%) homeless people re-presented to the emergency department. The predictive model included nine variables and achieved 98% (CI, 0.92-0.99) sensitivity and 66% (CI, 0.57-0.74) specificity. The positive predictive value was 68% and the negative predictive value was 98%. The positive likelihood ratio 2.9 (CI, 2.2-3.7) and the negative likelihood ratio was 0.03 (CI, 0.01-0.13). The high emergency department re-presentation rate for people who were homeless identifies unresolved psychosocial health needs. The emergency department remains a vital access point for homeless people, particularly after hours. The risk screening tool is key to identify medical and social aspects of a homeless patient's presentation to assist early identification and referral. Copyright © 2012 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Predictive factors of occupational noise-induced hearing loss in Spanish workers: A prospective study.

    Science.gov (United States)

    Pelegrin, Armando Carballo; Canuet, Leonides; Rodríguez, Ángeles Arias; Morales, Maria Pilar Arévalo

    2015-01-01

    The purpose of our study was to identify the main factors associated with objective noise-induced hearing loss (NIHL), as indicated by abnormal audiometric testing, in Spanish workers exposed to occupational noise in the construction industry. We carried out a prospective study in Tenerife, Spain, using 150 employees exposed to occupational noise and 150 age-matched controls who were not working in noisy environments. The variables analyzed included sociodemographic data, noise-related factors, types of hearing protection, self-report hearing loss, and auditory-related symptoms (e.g., tinnitus, vertigo). Workers with pathological audiograms had significantly longer noise-exposure duration (16.2 ± 11.4 years) relative to those with normal audiograms (10.2 ± 7.0 years; t = 3.99, P hearing protection measures had audiometric abnormalities (94.1%). Additionally, workers using at least one of the protection devices (earplugs or earmuffs) had significantly more audiometric abnormalities than those using both protection measures simultaneously (Chi square = 16.07; P hearing protection measures [odds ratio (OR) = 12.30, confidence interval (CI) = 4.36-13.81, P hearing protection measures, in particular earplugs and earmuffs, associates with a lower rate of audiometric abnormalities in subjects with high occupational noise exposure. The use of hearing protection measures at work and noise-exposure duration are best predictive factors of NIHL. Auditory-related symptoms and self-report hearing loss do not represent good indicators of objective NIHL. Routine monitoring of noise levels and hearing status are of great importance as part of effective hearing conservation programs.

  6. Do race, neglect, and childhood poverty predict physical health in adulthood? A multilevel prospective analysis.

    Science.gov (United States)

    Nikulina, Valentina; Widom, Cathy Spatz

    2014-03-01

    Childhood neglect and poverty often co-occur and both have been linked to poor physical health outcomes. In addition, Blacks have higher rates of childhood poverty and tend to have worse health than Whites. This paper examines the unique and interacting effects of childhood neglect, race, and family and neighborhood poverty on adult physical health outcomes. This prospective cohort design study uses a sample (N=675) of court-substantiated cases of childhood neglect and matched controls followed into adulthood (M(age)=41). Health indicators (C-Reactive Protein [CRP], hypertension, and pulmonary functioning) were assessed through blood collection and measurements by a registered nurse. Data were analyzed using hierarchical linear models to control for clustering of participants in childhood neighborhoods. Main effects showed that growing up Black predicted CRP and hypertension elevations, despite controlling for neglect and childhood family and neighborhood poverty and their interactions. Multivariate results showed that race and childhood adversities interacted to predict adult health outcomes. Childhood family poverty predicted increased risk for hypertension for Blacks, not Whites. In contrast, among Whites, childhood neglect predicted elevated CRP. Childhood neighborhood poverty interacted with childhood family poverty to predict pulmonary functioning in adulthood. Gender differences in health indicators were also observed. The effects of childhood neglect, childhood poverty, and growing up Black in the United States are manifest in physical health outcomes assessed 30 years later. Implications are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Beyond the Effects of Comprehensive Sexuality Education: The Significant Prospective Effects of Youth Assets on Contraceptive Behaviors.

    Science.gov (United States)

    Green, Jennifer; Oman, Roy F; Vesely, Sara K; Cheney, Marshall; Carroll, Leslie

    2017-12-01

    The purpose of the study was to prospectively determine if youth assets were significantly associated with contraception use after accounting for the effects of youths' exposure to comprehensive sexuality education programming. Prospective associations between youth asset scores, comprehensive sexuality education topics received, type of contraceptive used, and consistent contraceptive use were analyzed using multinomial and binomial logistic regression in a sample of 757 sexually active youth. Higher youth asset scores were associated with condom use (adjusted odds ratio [AOR] = 1.51, 95% CI = 1.01-2.28), hormonal birth control use (AOR = 2.71, 95% CI = 1.69-4.35), dual method use (AOR = 2.35, 95% CI = 1.44-3.82), and consistent contraceptive use (AOR = 1.97, 95% CI = 1.38-2.82). After controlling for youths' experience with comprehensive sexuality education, higher youth asset scores remained a significant predictor of hormonal birth control use (AOR = 2.09, 95% CI = 1.28-3.42), dual method use (AOR = 2.58, 95% CI = 1.61-4.15), and consistent contraceptive use (AOR = 1.95, 95% CI = 1.36-2.80). Youth serving organizations that are interested in preventing teen pregnancy should consider widespread implementation of evidence-based youth development programs that focus on building and strengthening specific youth assets. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. The predictive ability of the STarT Back Tool was limited in people with chronic low back pain: a prospective cohort study.

    Science.gov (United States)

    Kendell, Michelle; Beales, Darren; O'Sullivan, Peter; Rabey, Martin; Hill, Jonathan; Smith, Anne

    2018-04-01

    In people with chronic non-specific low back pain (LBP), what is the predictive and discriminative validity of the STarT Back Tool (SBT) for pain intensity, self-reported LBP-related disability, and global self-perceived change at 1-year follow-up? What is the profile of the SBT risk subgroups with respect to demographic variables, pain intensity, self-reported LBP-related disability, and psychological measures? Prospective cohort study. A total of 290 adults with dominant axial LBP of≥3months' duration recruited from the general community, and private physiotherapy, psychology, and pain-management clinics in Western Australia. The 1-year follow-up measures were pain intensity, LBP-related disability, and global self-perceived change. Outcomes were collected on 264 participants. The SBT categorised 82 participants (28%) as low risk, 116 (40%) as medium risk, and 92 (32%) as high risk. The risk subgroups differed significantly (ppredictive ability was strongest for disability: RR was 2.30 (95% CI 1.28 to 4.10) in the medium-risk group and 2.86 (95% CI 1.60 to 5.11) in the high-risk group. The SBT's predictive ability was weaker for pain: RR was 1.25 (95% CI 1.04 to 1.51) in the medium-risk group and 1.26 (95% CI 1.03 to 1.52) in the high-risk group. For the SBT total score, the AUC was 0.71 (95% CI 0.64 to 0.77) for disability and 0.63 (95% CI 0.55 to 0.71) for pain. This was the first large study to investigate the SBT in a population exclusively with chronic LBP. The SBT provided an acceptable indication of 1-year disability, had poor predictive and discriminative ability for future pain, and was unable to predict or discriminate global perceived change. In this cohort with chronic non-specific LBP, the SBT's predictive and discriminative abilities were restricted to disability at 1year. [Kendell M, Beales D, O'Sullivan P, Rabey M, Hill J, Smith A (2018) The predictive ability of the STarT Back Tool was limited in people with chronic low back pain: a prospective

  9. Prognostic significance of CA 125 and TPS levels after 3 chemotherapy courses in ovarian cancer patients

    NARCIS (Netherlands)

    van Dalen, A; Favier, J; Burges, A; Hasholzner, U; de Bruijn, HWA; Dobler-Girdziunaite, D; Dombi, VH; Fink, D; Giai, M; McGing, P; Harlozinska, A; Kainz, C; Markowska, J; Molina, R; Sturgeon, C; Bowman, A; Einarsson, R

    2000-01-01

    Objective. To evaluate the prognostic significance of and predictive value for survival of CA 125 and TPS levels after three chemotherapy courses in ovarian cancer patients. Methods. We analyzed in a prospective multicenter study the 1- and 2-year overall survival (OS) in ovarian carcinoma patients.

  10. Past, present and prospect of an Artificial Intelligence (AI) based model for sediment transport prediction

    Science.gov (United States)

    Afan, Haitham Abdulmohsin; El-shafie, Ahmed; Mohtar, Wan Hanna Melini Wan; Yaseen, Zaher Mundher

    2016-10-01

    An accurate model for sediment prediction is a priority for all hydrological researchers. Many conventional methods have shown an inability to achieve an accurate prediction of suspended sediment. These methods are unable to understand the behaviour of sediment transport in rivers due to the complexity, noise, non-stationarity, and dynamism of the sediment pattern. In the past two decades, Artificial Intelligence (AI) and computational approaches have become a remarkable tool for developing an accurate model. These approaches are considered a powerful tool for solving any non-linear model, as they can deal easily with a large number of data and sophisticated models. This paper is a review of all AI approaches that have been applied in sediment modelling. The current research focuses on the development of AI application in sediment transport. In addition, the review identifies major challenges and opportunities for prospective research. Throughout the literature, complementary models superior to classical modelling.

  11. Maternal anxiety disorders predict excessive infant crying: a prospective longitudinal study.

    Science.gov (United States)

    Petzoldt, Johanna; Wittchen, Hans-Ulrich; Wittich, Julia; Einsle, Franziska; Höfler, Michael; Martini, Julia

    2014-09-01

    To prospectively examine relations between maternal DSM-IV-TR anxiety and depressive disorders and excessive infant crying. Based on the prospective longitudinal Maternal Anxiety in Relation to Infant Development Study, n=306 expectant mothers were enrolled during early pregnancy and repeatedly interviewed until 16 months post partum. Lifetime and prospective information on maternal anxiety and depressive disorders was assessed via standardised diagnostic interviews (Composite International Diagnostic Interview for Women). Excessive crying (crying for ≥3 h per day on ≥3 days per week for ≥3 weeks) was assessed via Baby-DIPS. During the first 16 months after delivery, n=286 mother-infant dyads were available and included in the analyses. Excessive crying was reported by n=29 mothers (10.1%). Infants of mothers with anxiety disorders prior to pregnancy were at higher risk for excessive crying than infants of mothers without any anxiety disorder prior to pregnancy (OR=2.54, 95% CI 1.11 to 5.78, p=0.027). Risk was even increased when considering additionally incident anxiety disorders until delivery (OR=3.02, 95% CI 1.25 to 7.32, p=0.014) and until 16 months post partum (OR=2.87, 95% CI 1.13 to 7.28, p=0.027). Associations remained stable when adjusting for sociodemographic and perinatal covariates. Maternal depressive disorders prior to pregnancy were not significantly associated with excessive crying in this sample. Maternal lifetime and incident anxiety disorders revealed to be a robust predictor for excessive crying. Thus, early identification and monitoring of women with anxiety disorders is important to identify mother-infant dyads at risk for excessive crying. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Original and cumulative prospect theory: a discussion of empirical differences

    NARCIS (Netherlands)

    Wakker, P.P.; Fennema, H.

    1997-01-01

    This note discusses differences between prospect theory and cumulative prospect theory. It shows that cumulative prospect theory is not merely a formal correction of some theoretical problems in prospect theory, but it also gives different predictions. Experiments are described that favor cumulative

  13. Dynamic contrast-enhanced MR imaging in predicting progression of enhancing lesions persisting after standard treatment in glioblastoma patients: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Roh-Eul; Choi, Hye Jeong; You, Sung-Hye; Kang, Koung Mi; Yun, Tae Jin; Kim, Ji-Hoon; Sohn, Chul-Ho [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Choi, Seung Hong [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University, Center for Nanoparticle Research, Institute for Basic Science, and School of Chemical and Biological Engineering, Seoul (Korea, Republic of); Seoul National University, School of Chemical and Biological Engineering, Seoul (Korea, Republic of); Kim, Tae Min [Seoul National University College of Medicine, Department of Internal Medicine, Cancer Research Institute, Seoul (Korea, Republic of); Park, Chul-Kee [Seoul National University College of Medicine, Department of Neurosurgery, Biomedical Research Institute, Seoul (Korea, Republic of); Park, Sung-Hye; Won, Jae-Kyung [Seoul National University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Kim, Il Han [Seoul National University College of Medicine, Department of Radiation Oncology, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Soon Tae [Seoul National University College of Medicine, Department of Neurology, Seoul (Korea, Republic of)

    2017-08-15

    To prospectively explore the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the progression of enhancing lesions persisting after standard treatment in patients with surgically resected glioblastoma (GBM). Forty-seven GBM patients, who underwent near-total tumorectomy followed by concurrent chemoradiation therapy (CCRT) with temozolomide (TMZ) between May 2014 and February 2016, were enrolled. Twenty-four patients were finally analyzed for measurable enhancing lesions persisting after standard treatment. DCE-MRI parameters were calculated at enhancing lesions. Mann-Whitney U tests and multivariable stepwise logistic regression were used to compare parameters between progression (n = 16) and non-progression (n = 8) groups. Mean K{sup trans} and v{sub e} were significantly lower in progression than in non-progression (P = 0.037 and P = 0.037, respectively). The 5th percentile of the cumulative K{sup trans} histogram was also significantly lower in the progression than in non-progression group (P = 0.017). Mean v{sub e} was the only independent predictor of progression (P = 0.007), with a sensitivity of 100%, specificity of 63%, and an overall accuracy of 88% at a cut-off value of 0.873. DCE-MRI may help predict the progression of enhancing lesions persisting after the completion of standard treatment in patients with surgically resected GBM, with mean v{sub e} serving as an independent predictor of progression. (orig.)

  14. Dynamic contrast-enhanced MR imaging in predicting progression of enhancing lesions persisting after standard treatment in glioblastoma patients: a prospective study

    International Nuclear Information System (INIS)

    Yoo, Roh-Eul; Choi, Hye Jeong; You, Sung-Hye; Kang, Koung Mi; Yun, Tae Jin; Kim, Ji-Hoon; Sohn, Chul-Ho; Choi, Seung Hong; Kim, Tae Min; Park, Chul-Kee; Park, Sung-Hye; Won, Jae-Kyung; Kim, Il Han; Lee, Soon Tae

    2017-01-01

    To prospectively explore the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the progression of enhancing lesions persisting after standard treatment in patients with surgically resected glioblastoma (GBM). Forty-seven GBM patients, who underwent near-total tumorectomy followed by concurrent chemoradiation therapy (CCRT) with temozolomide (TMZ) between May 2014 and February 2016, were enrolled. Twenty-four patients were finally analyzed for measurable enhancing lesions persisting after standard treatment. DCE-MRI parameters were calculated at enhancing lesions. Mann-Whitney U tests and multivariable stepwise logistic regression were used to compare parameters between progression (n = 16) and non-progression (n = 8) groups. Mean K trans and v e were significantly lower in progression than in non-progression (P = 0.037 and P = 0.037, respectively). The 5th percentile of the cumulative K trans histogram was also significantly lower in the progression than in non-progression group (P = 0.017). Mean v e was the only independent predictor of progression (P = 0.007), with a sensitivity of 100%, specificity of 63%, and an overall accuracy of 88% at a cut-off value of 0.873. DCE-MRI may help predict the progression of enhancing lesions persisting after the completion of standard treatment in patients with surgically resected GBM, with mean v e serving as an independent predictor of progression. (orig.)

  15. The Data of Levy and Levy (2002) ÜProspect Theory: Much Ado About Nothing?Ý Actually Support Prospect Theory

    OpenAIRE

    Peter P. Wakker

    2003-01-01

    Levy and Levy (Management Science2002) present data that, according to their claims, violate prospect theory. They suggest that prospect theory's hypothesis of an S-shaped value function, concave for gains and convex for losses, is incorrect. However, all the data of Levy and Levy are perfectly consistent with the predictions of prospect theory, as can be verified by simply applying prospect theory formulas. The mistake of Levy and Levy is that they, incorrectly, thought that probability weig...

  16. Freshman year alcohol and marijuana use prospectively predict time to college graduation and subsequent adult roles and independence.

    Science.gov (United States)

    Wilhite, Emily R; Ashenhurst, James R; Marino, Elise N; Fromme, Kim

    2017-06-15

    This study examined how freshman year substance use prospectively predicted time to college graduation, and whether delayed graduation predicted postponed adoption of adult roles and future substance use. Participants were part of a longitudinal study that began in 2004. The first analyses focused on freshman year (N = 2,050). The second analyses corresponded to a subset of participants at age 27 (N = 575). Measures included self-reported substance use, adult role adoption, and university reported graduation dates. Results indicated that frequent binge drinking and marijuana use during freshman year predicted delayed college graduation. Those who took longer to graduate were more likely to have lower incomes and were less likely to obtain a graduate degree. Taking 5-6 years to graduate was associated with greater likelihood of alcohol-related problems. Findings support the importance of interventions during freshman year of college to decrease substance use and promote timely graduation.

  17. PREDICT-PD: An online approach to prospectively identify risk indicators of Parkinson's disease.

    Science.gov (United States)

    Noyce, Alastair J; R'Bibo, Lea; Peress, Luisa; Bestwick, Jonathan P; Adams-Carr, Kerala L; Mencacci, Niccolo E; Hawkes, Christopher H; Masters, Joseph M; Wood, Nicholas; Hardy, John; Giovannoni, Gavin; Lees, Andrew J; Schrag, Anette

    2017-02-01

    A number of early features can precede the diagnosis of Parkinson's disease (PD). To test an online, evidence-based algorithm to identify risk indicators of PD in the UK population. Participants aged 60 to 80 years without PD completed an online survey and keyboard-tapping task annually over 3 years, and underwent smell tests and genotyping for glucocerebrosidase (GBA) and leucine-rich repeat kinase 2 (LRRK2) mutations. Risk scores were calculated based on the results of a systematic review of risk factors and early features of PD, and individuals were grouped into higher (above 15th centile), medium, and lower risk groups (below 85th centile). Previously defined indicators of increased risk of PD ("intermediate markers"), including smell loss, rapid eye movement-sleep behavior disorder, and finger-tapping speed, and incident PD were used as outcomes. The correlation of risk scores with intermediate markers and movement of individuals between risk groups was assessed each year and prospectively. Exploratory Cox regression analyses with incident PD as the dependent variable were performed. A total of 1323 participants were recruited at baseline and >79% completed assessments each year. Annual risk scores were correlated with intermediate markers of PD each year and baseline scores were correlated with intermediate markers during follow-up (all P values < 0.001). Incident PD diagnoses during follow-up were significantly associated with baseline risk score (hazard ratio = 4.39, P = .045). GBA variants or G2019S LRRK2 mutations were found in 47 participants, and the predictive power for incident PD was improved by the addition of genetic variants to risk scores. The online PREDICT-PD algorithm is a unique and simple method to identify indicators of PD risk. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder

  18. FDG PET during radiochemotherapy is predictive of outcome at 1 year in non-small-cell lung cancer patients: a prospective multicentre study (RTEP2)

    International Nuclear Information System (INIS)

    Vera, Pierre; Edet-Sanson, Agathe; Modzelewski, Romain; Mezzani-Saillard, Sandrine; Thureau, Sebastien; Dubray, Bernard; Menard, Jean-Francois; Meyer, Marc-Etienne; Jalali, Khadija; Bardet, Stephane; Lerouge, Delphine; Houzard, Claire; Mornex, Francoise; Olivier, Pierre; Faure, Guillaume; Rousseau, Caroline; Mahe, Marc-Andre; Gomez, Philippe; Brenot-Rossi, Isabelle; Salem, Naji

    2014-01-01

    To assess prospectively the prognostic value of FDG PET/CT during curative-intent radiotherapy (RT) with or without concomitant chemotherapy in patients with non-small-cell lung cancer (NSCLC). Patients with histological proof of invasive localized NSCLC and evaluable tumour, and who were candidates for curative-intent radiochemotherapy (RCT) or RT were preincluded after providing written informed consent. Definitive inclusion was conditional upon significant FDG uptake before RT (PET 1 ). All included patients had a FDG PET/CT scan during RT (PET 2 , mean dose 43 Gy) and were evaluated by FDG PET/CT at 3 months and 1 year after RT. The main endpoint was death (from whatever cause) or tumour progression at 1 year. Of 77 patients preincluded, 52 were evaluable. Among the evaluable patients, 77 % received RT with induction chemotherapy and 73 % RT with concomitant chemotherapy. At 1 year, 40 patients (77 %) had died or had tumour progression. No statistically significant association was found between stage (IIIB vs. other), histology (squamous cell carcinoma vs. other), induction or concomitant chemotherapy, and death/tumour progression at 1 year. The SUV max in the PET 2 scan was the single variable predictive of death or tumour progression at 1 year (odds ratio 1.97, 95 % CI 1.25 - 3.09, p = 0.003) in multivariate analysis. The area under the receiver operating characteristic curve was 0.85 (95 % CI 0.73 - 0.94, p -4 ). A SUV max value of 5.3 in the PET 2 scan yielded a sensitivity of 70 % and a specificity of 92 % for predicting tumour progression or death at 1 year. This prospective multicentre study demonstrated the prognostic value in terms of disease-free survival of SUV max assessed during the 5th week of curative-intent RT or RCT in NSCLC patients (NCT01261598; RTEP2 study). (orig.)

  19. Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study

    International Nuclear Information System (INIS)

    Jacob, Sophie; Pathak, Atul; Franck, Denis; Latorzeff, Igor; Jimenez, Gaelle; Fondard, Olivier; Lapeyre, Matthieu; Colombier, Daniel; Bruguiere, Eric; Lairez, Olivier; Fontenel, Benoit; Milliat, Fabien; Tamarat, Radia; Broggio, David; Derreumaux, Sylvie; Ducassou, Marianne; Ferrières, Jean; Laurier, Dominique; Benderitter, Marc; Bernier, Marie-Odile

    2016-01-01

    Radiotherapy (RT) for breast cancer presents a benefit in terms of reducing local recurrence and deaths resulting from breast cancer but it can lead to secondary effects due to the presence of neighboring cardiac normal tissues within the irradiation field. Breast RT has been shown to be associated with long-term increased risk of heart failure, coronary artery disease, myocardial infarction and finally cardiovascular death more than 10 years after RT. However, there is still a lack of knowledge for early cardiotoxicity induced by breast RT that can appear long before the onset of clinically significant cardiac events. Based on a 2-year follow-up prospective cohort of patients treated with breast RT, the BACCARAT (BreAst Cancer and CArdiotoxicity Induced by RAdioTherapy) study aims to enhance knowledge on detection and prediction of early subclinical cardiac dysfunction and lesions induced by breast RT and on biological mechanisms potentially involved, based on functional and anatomical cardiac imaging combined with simultaneous assessment of multiple circulating biomarkers and accurate heart dosimetry. BACCARAT study consists in a monocentric prospective cohort study that will finally include 120 women treated with adjuvant 3D CRT for breast cancer, and followed for 2 years after RT. Women aged 50 to 70 years, treated for breast cancer and for whom adjuvant 3D CRT is indicated, without chemotherapy are eligible for the study. Baseline (before RT) and follow-up data include measurements of functional myocardial dysfunction including strain and strain rate based on 2D-speckle tracking echocardiography, anatomical coronary lesions including description of plaques in segments of coronary arteries based on Coronary computed tomography angiography, and a wide panel of circulating biomarkers. The absorbed dose is evaluated for the whole heart and its substructures, in particular the coronary arteries. Analysis on occurrence and evolution of subclinical cardiac lesions

  20. Validating prediction scales of type 2 diabetes mellitus in Spain: the SPREDIA-2 population-based prospective cohort study protocol

    Science.gov (United States)

    Salinero-Fort, Miguel Ángel; de Burgos-Lunar, Carmen; Mostaza Prieto, José; Lahoz Rallo, Carlos; Abánades-Herranz, Juan Carlos; Gómez-Campelo, Paloma; Laguna Cuesta, Fernando; Estirado De Cabo, Eva; García Iglesias, Francisca; González Alegre, Teresa; Fernández Puntero, Belén; Montesano Sánchez, Luis; Vicent López, David; Cornejo Del Río, Víctor; Fernández García, Pedro J; Sabín Rodríguez, Concesa; López López, Silvia; Patrón Barandío, Pedro

    2015-01-01

    Introduction The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide. When diagnosed, many patients already have organ damage or advance subclinical atherosclerosis. An early diagnosis could allow the implementation of lifestyle changes and treatment options aimed at delaying the progression of the disease and to avoid cardiovascular complications. Different scores for identifying undiagnosed diabetes have been reported, however, their performance in populations of southern Europe has not been sufficiently evaluated. The main objectives of our study are: to evaluate the screening performance and cut-off points of the main scores that identify the risk of undiagnosed T2DM and prediabetes in a Spanish population, and to develop and validate our own predictive models of undiagnosed T2DM (screening model), and future T2DM (prediction risk model) after 5-year follow-up. As a secondary objective, we will evaluate the atherosclerotic burden of the population with undiagnosed T2DM. Methods and analysis Population-based prospective cohort study with baseline screening, to evaluate the performance of the FINDRISC, DANISH, DESIR, ARIC and QDScore, against the gold standard tests: Fasting plasma glucose, oral glucose tolerance and/or HbA1c. The sample size will include 1352 participants between the ages of 45 and 74 years. Analysis: sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio positive, likelihood ratio negative and receiver operating characteristic curves and area under curve. Binary logistic regression for the first 700 individuals (derivation) and last 652 (validation) will be performed. All analyses will be calculated with their 95% CI; statistical significance will be p<0.05. Ethics and dissemination The study protocol has been approved by the Research Ethics Committee of the Carlos III Hospital (Madrid). The score performance and predictive model will be presented in medical conferences, workshops

  1. Predictive modelling for swallowing dysfunction after primary (chemo)radiation: results of a prospective observational study.

    Science.gov (United States)

    Christianen, Miranda E M C; Schilstra, Cornelis; Beetz, Ivo; Muijs, Christina T; Chouvalova, Olga; Burlage, Fred R; Doornaert, Patricia; Koken, Phil W; Leemans, C René; Rinkel, Rico N P M; de Bruijn, Marieke J; de Bock, G H; Roodenburg, Jan L N; van der Laan, Bernard F A M; Slotman, Ben J; Verdonck-de Leeuw, Irma M; Bijl, Hendrik P; Langendijk, Johannes A

    2012-10-01

    The purpose of this large multicentre prospective cohort study was to identify which dose volume histogram parameters and pre-treatment factors are most important to predict physician-rated and patient-rated radiation-induced swallowing dysfunction (RISD) in order to develop predictive models for RISD after curative (chemo) radiotherapy ((CH) RT). The study population consisted of 354 consecutive head and neck cancer patients treated with (CH) RT. The primary endpoint was grade 2 or more swallowing dysfunction according to the RTOG/EORTC late radiation morbidity scoring criteria at 6 months after (CH) RT. The secondary endpoints were patient-rated swallowing complaints as assessed with the EORTC QLQ-H&N35 questionnaire. To select the most predictive variables a multivariate logistic regression analysis with bootstrapping was used. At 6 months after (CH) RT the bootstrapping procedure revealed that a model based on the mean dose to the superior pharyngeal constrictor muscle (PCM) and mean dose to the supraglottic larynx was most predictive. For the secondary endpoints different predictive models were found: for problems with swallowing liquids the most predictive factors were the mean dose to the supraglottic larynx and radiation technique (3D-CRT versus IMRT). For problems with swallowing soft food the mean dose to the middle PCM, age (18-65 versus >65 years), tumour site (naso/oropharynx versus other sites) and radiation technique (3D-CRT versus IMRT) were the most predictive factors. For problems with swallowing solid food the most predictive factors were the mean dose to the superior PCM, the mean dose to the supraglottic larynx and age (18-65 versus >65 years). And for choking when swallowing the V60 of the oesophageal inlet muscle and the mean dose to the supraglottic larynx were the most predictive factors. Physician-rated and patient-rated RISD in head and neck cancer patients treated with (CH) RT cannot be predicted with univariate relationships between the

  2. Accuracy of Consecutive Fecal Calprotectin Measurements to Predict Relapse in Inflammatory Bowel Disease Patients Under Maintenance With Anti-TNF Therapy: A Prospective Longitudinal Cohort Study.

    Science.gov (United States)

    Ferreiro-Iglesias, Rocio; Barreiro-de Acosta, Manuel; Lorenzo-Gonzalez, Aurelio; Dominguez-Muñoz, Juan E

    2018-03-01

    Predicting relapse in inflammatory bowel disease (IBD) patients could allow early changes in therapy. We aimed at evaluating the accuracy of consecutive fecal calprotectin (FC) measurements to predict flares in IBD patients under maintenance treatment with anti-tumor necrosis factor (TNF) drugs. A prospective longitudinal cohort study with 16-month follow-up period was designed. IBD patients in clinical remission for at least 6 months under anti-TNF therapy were included. FC was quantified at 4-month intervals for 1 year, and patients were clinically evaluated for relapse at 2-month intervals. Diagnostic accuracy of FC for predicting relapse was evaluated by receiver-operating characteristic curve analysis. In total, 95 of 106 included patients finalized the study and were analyzed (median age 44 y, 50.5% female, 75% with Crohn's disease). A total of 30 patients (31.6%) had a relapse over follow-up. FC concentration was significantly higher in patients who relapsed (477 μg/g) than in patients who maintained in remission (65 μg/g) (Ppredict remission was 130 μg/g (negative predictive value of 100%), and 300 μg/g to predict relapse (positive predictive value of 78.3%). FC is a good predictor of clinical relapse and a particularly good predictor of remission over the following 4 months in patients with IBD on maintenance therapy with anti-TNF drugs. FC levels 300 μg/g allow predicting relapse with a high probability at any time over the following 4 months.

  3. Soluble Suppression of Tumorigenicity-2 Predicts Hospital Mortality in Burn Patients: An Observational Prospective Cohort Pilot Study.

    Science.gov (United States)

    Ruiz-Castilla, Mireia; Bosacoma, Pau; Dos Santos, Bruce; Baena, Jacinto; Guilabert, Patricia; Marin-Corral, Judith; Masclans, Joan R; Roca, Oriol; Barret, Juan P

    2018-04-10

    The IL33/ST2 pathway has been implicated in the pathogenesis of different inflammatory diseases. Our aim was to analyze whether plasma levels of biomarkers involved in the IL33/ST2 axis might help to predict mortality in burn patients. Single-center prospective observational cohort pilot study performed at the Burns Unit of the Plastic and Reconstructive Surgery Department of the Vall d'Hebron University Hospital (Barcelona). All patients aged ≥18 years old with second or third-degree burns requiring admission to the Burns Unit were considered for inclusion. Blood samples were taken to measure levels of interleukins (IL)6, IL8, IL33, and soluble suppression of tumorigenicity-2 (sST2) within 24 h of admission to the Burns Unit and at day 3. Results are expressed as medians and interquartile ranges or as frequencies and percentages. Sixty-nine patients (58 [84.1%] male, mean age 52 [35-63] years, total body surface area burned 21% [13%-30%], Abbreviated Burn Severity Index 6 [4-8]) were included. Thirteen (18.8%) finally died in the Burns Unit. Plasma levels of sST2 measured at day 3 after admission demonstrated the best prediction accuracy for survival (area under the ROC curve 0.85 [0.71-0.99]; P < 0.001). The best cutoff point for the AUROC index was estimated to be 2,561. In the Cox proportional hazards model, after adjusting for potential confounding, a plasma sST2 level ≥2,561 measured at day 3 was significantly associated with mortality (HR 6.94 [1.73-27.74]; P = 0.006). Plasma sST2 at day 3 predicts hospital mortality in burn patients.

  4. A prospective investigation of predictive and modifiable risk factors for breast cancer in unaffected BRCA1 and BRCA2 gene carriers

    International Nuclear Information System (INIS)

    Guinan, Emer M; Hussey, Juliette; McGarrigle, Sarah A; Healy, Laura A; O’Sullivan, Jacintha N; Bennett, Kathleen; Connolly, Elizabeth M

    2013-01-01

    Breast cancer is the most common female cancer worldwide. The lifetime risk of a woman being diagnosed with breast cancer is approximately 12.5%. For women who carry the deleterious mutation in either of the BRCA genes, BRCA1 or BRCA2, the risk of developing breast or ovarian cancer is significantly increased. In recent years there has been increased penetrance of BRCA1 and BRCA2 associated breast cancer, prompting investigation into the role of modifiable risk factors in this group. Previous investigations into this topic have relied on participants recalling lifetime weight changes and subjective methods of recording physical activity. The influence of obesity-related biomarkers, which may explain the link between obesity, physical activity and breast cancer risk, has not been investigated prospectively in this group. This paper describes the design of a prospective cohort study investigating the role of predictive and modifiable risk factors for breast cancer in unaffected BRCA1 and BRCA2 gene mutation carriers. Participants will be recruited from breast cancer family risk clinics and genetics clinics. Lifestyle risk factors that will be investigated will include body composition, metabolic syndrome and its components, physical activity and dietary intake. PBMC telomere length will be measured as a potential predictor of breast cancer occurrence. Measurements will be completed on entry to the study and repeated at two years and five years. Participants will also be followed annually by questionnaire to track changes in risk factor status and to record cancer occurrence. Data will be analysed using multiple regression models. The study has an accrual target of 352 participants. The results from this study will provide valuable information regarding the role of modifiable lifestyle risk factors for breast cancer in women with a deleterious mutation in the BRCA gene. Additionally, the study will attempt to identify potential blood biomarkers which may be predictive

  5. Size ratio correlates with intracranial aneurysm rupture status: a prospective study.

    Science.gov (United States)

    Rahman, Maryam; Smietana, Janel; Hauck, Erik; Hoh, Brian; Hopkins, Nick; Siddiqui, Adnan; Levy, Elad I; Meng, Hui; Mocco, J

    2010-05-01

    The prediction of intracranial aneurysm (IA) rupture risk has generated significant controversy. The findings of the International Study of Unruptured Intracranial Aneurysms (ISUIA) that small anterior circulation aneurysms (IAs are small. These discrepancies have led to the search for better aneurysm parameters to predict rupture. We previously reported that size ratio (SR), IA size divided by parent vessel diameter, correlated strongly with IA rupture status (ruptured versus unruptured). These data were all collected retrospectively off 3-dimensional angiographic images. Therefore, we performed a blinded prospective collection and evaluation of SR data from 2-dimensional angiographic images for a consecutive series of patients with ruptured and unruptured IAs. We prospectively enrolled 40 consecutive patients presenting to a single institution with either ruptured IA or for first-time evaluation of an incidental IA. Blinded technologists acquired all measurements from 2-dimensional angiographic images. Aneurysm rupture status, location, IA maximum size, and parent vessel diameter were documented. The SR was calculated by dividing the aneurysm size (mm) by the average parent vessel size (mm). A 2-tailed Mann-Whitney test was performed to assess statistical significance between ruptured and unruptured groups. Fisher exact test was used to compare medical comorbidities between the ruptured and unruptured groups. Significant differences between the 2 groups were subsequently tested with logistic regression. SE and probability values are reported. Forty consecutive patients with 24 unruptured and 16 ruptured aneurysms met the inclusion criteria. No significant differences were found in age, gender, smoking status, or medical comorbidities between ruptured and unruptured groups. The average maximum size of the unruptured IAs (6.18 + or - 0.60 mm) was significantly smaller compared with the ruptured IAs (7.91 + or - 0.47 mm; P=0.03), and the unruptured group had

  6. QRS analysis using wavelet transformation for the prediction of response to cardiac resynchronization therapy: a prospective pilot study.

    Science.gov (United States)

    Vassilikos, Vassilios P; Mantziari, Lilian; Dakos, Georgios; Kamperidis, Vasileios; Chouvarda, Ioanna; Chatzizisis, Yiannis S; Kalpidis, Panagiotis; Theofilogiannakos, Efstratios; Paraskevaidis, Stelios; Karvounis, Haralambos; Mochlas, Sotirios; Maglaveras, Nikolaos; Styliadis, Ioannis H

    2014-01-01

    Wider QRS and left bundle branch block morphology are related to response to cardiac resynchronization therapy (CRT). A novel time-frequency analysis of the QRS complex may provide additional information in predicting response to CRT. Signal-averaged electrocardiograms were prospectively recorded, before CRT, in orthogonal leads and QRS decomposition in three frequency bands was performed using the Morlet wavelet transformation. Thirty eight patients (age 65±10years, 31 males) were studied. CRT responders (n=28) had wider baseline QRS compared to non-responders and lower QRS energies in all frequency bands. The combination of QRS duration and mean energy in the high frequency band had the best predicting ability (AUC 0.833, 95%CI 0.705-0.962, p=0.002) followed by the maximum energy in the high frequency band (AUC 0.811, 95%CI 0.663-0.960, p=0.004). Wavelet transformation of the QRS complex is useful in predicting response to CRT. © 2013.

  7. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight.

    Science.gov (United States)

    Chao, Ariana M; Jastreboff, Ania M; White, Marney A; Grilo, Carlos M; Sinha, Rajita

    2017-04-01

    To examine whether baseline chronic stress, morning cortisol, and other appetite-related hormones (leptin, ghrelin, and insulin) predict future weight gain and food cravings in a naturalistic, longitudinal, 6-month follow-up study. A prospective community cohort of 339 adults (age 29.1 ± 9.0 years; BMI = 26.7 ± 5.4 kg/m 2 ; 56.9% female; 70.2% white) completed assessments at baseline and 6-month follow-up. Fasting blood draws were used to assess cortisol and other appetite-related hormone levels at baseline. At baseline and follow-up, body weight was measured, and the Cumulative Adversity Interview and Food Craving Inventory were administered. Data were analyzed using linear mixed models adjusting for demographic and clinical covariates. Over the 6-month period, 49.9% of the sample gained weight. Food cravings and chronic stress decreased over 6 months (Ps < 0.05). However, after adjusting for covariates, individuals with higher baseline total ghrelin had significantly higher food cravings at 6 months (P = 0.04). Furthermore, higher cortisol, insulin, and chronic stress were each predictive of greater future weight gain (Ps < 0.05). These results suggest that ghrelin plays a role in increased food cravings and reward-driven eating behaviors. Studies are needed that examine the utility of stress reduction methods for normalizing disrupted cortisol responses and preventing future weight gain. © 2017 The Obesity Society.

  8. A Study on Pharmacokinetics of Bosentan with Systems Modeling, Part 2: Prospectively Predicting Systemic and Liver Exposure in Healthy Subjects.

    Science.gov (United States)

    Li, Rui; Kimoto, Emi; Niosi, Mark; Tess, David A; Lin, Jian; Tremaine, Larry M; Di, Li

    2018-04-01

    Predicting human pharmacokinetics of novel compounds is a critical step in drug discovery and clinical study design but continues to be a challenging task for hepatic transporter substrates, particularly in predicting their liver exposures. In this study, using bosentan as an example, we prospectively predicted systemic exposure and the (pseudo) steady-state unbound liver-to-unbound plasma ratio ( K p uu ) in healthy subjects using 1) a mechanistic approach solely based on in vitro hepatocyte assays and 2) an approach based on hepatic process rates from monkey in vivo data but Michaelis-Menten constants from in vitro data. Both methods reasonably match the observed human systemic time course data, but the second method leads to better prediction accuracy. In addition, the second method can predict a human K p uu value that is close to the value deduced using clinical data. We also generated rat and monkey liver K p uu values in terminal studies. However, these directly measured animal values are different from the deduced human value. Copyright © 2018 by The American Society for Pharmacology and Experimental Therapeutics.

  9. Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women.

    Science.gov (United States)

    Nakić Radoš, Sandra; Herman, Radoslav; Tadinac, Meri

    2016-01-01

    The researchers' aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period.

  10. Accuracy and Predictability of PANC-3 Scoring System over APACHE II in Acute Pancreatitis: A Prospective Study.

    Science.gov (United States)

    Rathnakar, Surag Kajoor; Vishnu, Vikram Hubbanageri; Muniyappa, Shridhar; Prasath, Arun

    2017-02-01

    Acute Pancreatitis (AP) is one of the common conditions encountered in the emergency room. The course of the disease ranges from mild form to severe acute form. Most of these episodes are mild and spontaneously subsiding within 3 to 5 days. In contrast, Severe Acute Pancreatitis (SAP) occurring in around 15-20% of all cases, mortality can range between 10 to 85% across various centres and countries. In such a situation we need an indicator which can predict the outcome of an attack, as severe or mild, as early as possible and such an indicator should be sensitive and specific enough to trust upon. PANC-3 scoring is such a scoring system in predicting the outcome of an attack of AP. To assess the accuracy and predictability of PANC-3 scoring system over APACHE II in predicting severity in an attack of AP. This prospective study was conducted on 82 patients admitted with the diagnosis of pancreatitis. Investigations to evaluate PANC-3 and APACHE II were done on all the patients and the PANC-3 and APACHE II score was calculated. PANC-3 score has a sensitivity of 82.6% and specificity of 77.9%, the test had a Positive Predictive Value (PPV) of 0.59 and Negative Predictive Value (NPV) of 0.92. Sensitivity of APACHE II in predicting SAP was 91.3% and specificity was 96.6% with PPV of 0.91, NPV was 0.96. Our study shows that PANC-3 can be used to predict the severity of pancreatitis as efficiently as APACHE II. The interpretation of PANC-3 does not need expertise and can be applied at the time of admission which is an advantage when compared to classical scoring systems.

  11. Information processing biases concurrently and prospectively predict depressive symptoms in adolescents: Evidence from a self-referent encoding task.

    Science.gov (United States)

    Connolly, Samantha L; Abramson, Lyn Y; Alloy, Lauren B

    2016-01-01

    Negative information processing biases have been hypothesised to serve as precursors for the development of depression. The current study examined negative self-referent information processing and depressive symptoms in a community sample of adolescents (N = 291, Mage at baseline = 12.34 ± 0.61, 53% female, 47.4% African-American, 49.5% Caucasian and 3.1% Biracial). Participants completed a computerised self-referent encoding task (SRET) and a measure of depressive symptoms at baseline and completed an additional measure of depressive symptoms nine months later. Several negative information processing biases on the SRET were associated with concurrent depressive symptoms and predicted increases in depressive symptoms at follow-up. Findings partially support the hypothesis that negative information processing biases are associated with depressive symptoms in a nonclinical sample of adolescents, and provide preliminary evidence that these biases prospectively predict increases in depressive symptoms.

  12. Esomeprazole use is independently associated with significant reduction of BMD: 1-year prospective comparative safety study of four proton pump inhibitors.

    Science.gov (United States)

    Bahtiri, Elton; Islami, Hilmi; Hoxha, Rexhep; Qorraj-Bytyqi, Hasime; Rexhepi, Sylejman; Hoti, Kreshnik; Thaçi, Kujtim; Thaçi, Shpetim; Karakulak, Çağla

    2016-09-01

    Because of the efficacy of proton pump inhibitors (PPIs), their the use is increasing dramatically. The risk of adverse effects of short-term PPI therapy is low, but there are important safety concerns for potential adverse effects of prolonged PPI therapy. Findings from studies assessing the association between PPI use and bone mineral density (BMD) and/or fracture risk are contradictory. The aim of this study was to prospectively assess potential association of PPI treatment with the 12-month change in BMD of the lumbar spine, femur neck, and total hip. The study was performed in 200 PPI users and 50 PPI nonusers. Lumbar spine (L1-L4), femur neck, and total hip BMD were measured by dual-energy X-ray absorptiometry at the baseline and at 12 months. A total of 209 subjects completed the entire 12 months of the study and were included in the final analysis. A Wilcoxon signed-rank test showed that at 12 months PPI use was associated with statistically significant reductions in femur neck and total hip T scores (Z = -2.764, p = 0.005 and Z = -3.281, p = 0.001, respectively). A multiple linear regression analysis showed that only esomeprazole added significantly to the prediction of total lumbar spine and femur neck T scores (p = 0.048 and p = 0.037, respectively). Compared with the baseline, 12 months of PPI treatment resulted in lower femur neck and total hip BMD T scores. Among the four PPIs studied, esomeprazole was independently associated with significant reduction of BMD, whereas omeprazole had no effects on BMD. Considering the widespread use of PPIs, BMD screening should be considered in the case of prolonged PPI use.

  13. Office gel sonovaginography for the prediction of posterior deep infiltrating endometriosis: a multicenter prospective observational study.

    Science.gov (United States)

    Reid, S; Lu, C; Hardy, N; Casikar, I; Reid, G; Cario, G; Chou, D; Almashat, D; Condous, G

    2014-12-01

    To use office gel sonovaginography (SVG) to predict posterior deep infiltrating endometriosis (DIE) in women undergoing laparoscopy. This was a multicenter prospective observational study carried out between January 2009 and February 2013. All women were of reproductive age, had a history of chronic pelvic pain and underwent office gel SVG assessment for the prediction of posterior compartment DIE prior to laparoscopic endometriosis surgery. Gel SVG findings were compared with laparoscopic findings to determine the diagnostic accuracy of office gel SVG for the prediction of posterior compartment DIE. In total, 189 women underwent preoperative gel SVG and laparoscopy for endometriosis. At laparoscopy, 57 (30%) women had posterior DIE and 43 (23%) had rectosigmoid/anterior rectal DIE. For the prediction of rectosigmoid/anterior rectal (i.e. bowel) DIE, gel SVG had an accuracy of 92%, sensitivity of 88%, specificity of 93%, positive predictive value (PPV) of 79%, negative predictive value (NPV) of 97%, positive likelihood ratio (LR+) of 12.9 and negative likelihood ratio (LR-) of 0.12 (P = 3.98E-25); for posterior vaginal wall and rectovaginal septum (RVS) DIE, respectively, the accuracy was 95% and 95%, sensitivity was 18% and 18%, specificity was 99% and 100%, PPV was 67% and 100%, NPV was 95% and 95%, LR+ was 32.4 and infinity and LR- was 0.82 and 0.82 (P = 0.009 and P = 0.003). Office gel SVG appears to be an effective outpatient imaging technique for the prediction of bowel DIE, with a higher accuracy for the prediction of rectosigmoid compared with anterior rectal DIE. Although the sensitivity for vaginal and RVS DIE was limited, gel SVG had a high specificity and NPV for all forms of posterior DIE, indicating that a negative gel SVG examination is highly suggestive of the absence of DIE at laparoscopy. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  14. Model training across multiple breeding cycles significantly improves genomic prediction accuracy in rye (Secale cereale L.).

    Science.gov (United States)

    Auinger, Hans-Jürgen; Schönleben, Manfred; Lehermeier, Christina; Schmidt, Malthe; Korzun, Viktor; Geiger, Hartwig H; Piepho, Hans-Peter; Gordillo, Andres; Wilde, Peer; Bauer, Eva; Schön, Chris-Carolin

    2016-11-01

    Genomic prediction accuracy can be significantly increased by model calibration across multiple breeding cycles as long as selection cycles are connected by common ancestors. In hybrid rye breeding, application of genome-based prediction is expected to increase selection gain because of long selection cycles in population improvement and development of hybrid components. Essentially two prediction scenarios arise: (1) prediction of the genetic value of lines from the same breeding cycle in which model training is performed and (2) prediction of lines from subsequent cycles. It is the latter from which a reduction in cycle length and consequently the strongest impact on selection gain is expected. We empirically investigated genome-based prediction of grain yield, plant height and thousand kernel weight within and across four selection cycles of a hybrid rye breeding program. Prediction performance was assessed using genomic and pedigree-based best linear unbiased prediction (GBLUP and PBLUP). A total of 1040 S 2 lines were genotyped with 16 k SNPs and each year testcrosses of 260 S 2 lines were phenotyped in seven or eight locations. The performance gap between GBLUP and PBLUP increased significantly for all traits when model calibration was performed on aggregated data from several cycles. Prediction accuracies obtained from cross-validation were in the order of 0.70 for all traits when data from all cycles (N CS  = 832) were used for model training and exceeded within-cycle accuracies in all cases. As long as selection cycles are connected by a sufficient number of common ancestors and prediction accuracy has not reached a plateau when increasing sample size, aggregating data from several preceding cycles is recommended for predicting genetic values in subsequent cycles despite decreasing relatedness over time.

  15. A new model using routinely available clinical parameters to predict significant liver fibrosis in chronic hepatitis B.

    Directory of Open Access Journals (Sweden)

    Wai-Kay Seto

    Full Text Available OBJECTIVE: We developed a predictive model for significant fibrosis in chronic hepatitis B (CHB based on routinely available clinical parameters. METHODS: 237 treatment-naïve CHB patients [58.4% hepatitis B e antigen (HBeAg-positive] who had undergone liver biopsy were randomly divided into two cohorts: training group (n = 108 and validation group (n = 129. Liver histology was assessed for fibrosis. All common demographics, viral serology, viral load and liver biochemistry were analyzed. RESULTS: Based on 12 available clinical parameters (age, sex, HBeAg status, HBV DNA, platelet, albumin, bilirubin, ALT, AST, ALP, GGT and AFP, a model to predict significant liver fibrosis (Ishak fibrosis score ≥3 was derived using the five best parameters (age, ALP, AST, AFP and platelet. Using the formula log(index+1 = 0.025+0.0031(age+0.1483 log(ALP+0.004 log(AST+0.0908 log(AFP+1-0.028 log(platelet, the PAPAS (Platelet/Age/Phosphatase/AFP/AST index predicts significant fibrosis with an area under the receiving operating characteristics (AUROC curve of 0.776 [0.797 for patients with ALT <2×upper limit of normal (ULN] The negative predictive value to exclude significant fibrosis was 88.4%. This predictive power is superior to other non-invasive models using common parameters, including the AST/platelet/GGT/AFP (APGA index, AST/platelet ratio index (APRI, and the FIB-4 index (AUROC of 0.757, 0.708 and 0.723 respectively. Using the PAPAS index, 67.5% of liver biopsies for patients being considered for treatment with ALT <2×ULN could be avoided. CONCLUSION: The PAPAS index can predict and exclude significant fibrosis, and may reduce the need for liver biopsy in CHB patients.

  16. Meta-Analysis of Predictive Significance of the Black Hole Sign for Hematoma Expansion in Intracerebral Hemorrhage.

    Science.gov (United States)

    Zheng, Jun; Yu, Zhiyuan; Guo, Rui; Li, Hao; You, Chao; Ma, Lu

    2018-04-27

    Hematoma expansion is related to unfavorable prognosis in intracerebral hemorrhage (ICH). The black hole sign is a novel marker on non-contrast computed tomography for predicting hematoma expansion. However, its predictive values are different in previous studies. Thus, this meta-analysis was conducted to evaluate the predictive significance of the black hole sign for hematoma expansion in ICH. A systematic literature search was performed. Original researches on the association between the black hole sign and hematoma expansion in ICH were included. Sensitivity and specificity were pooled to assess the predictive accuracy. Summary receiver operating characteristics curve (SROC) was developed. Deeks' funnel plot asymmetry test was used to assess the publication bias. Five studies with a total of 1495 patients were included in this study. The pooled sensitivity and specificity of the black hole sign for predicting hematoma expansion were 0.30 and 0.91, respectively. The area under the curve was 0.78 in SROC curve. There was no significant publication bias. This meta-analysis shows that the black hole sign is a helpful imaging marker for predicting hematoma expansion in ICH. Although the black hole sign has a relatively low sensitivity, its specificity is relatively high. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Personality Traits as Prospective Predictors of Suicide Attempts

    Science.gov (United States)

    Yen, Shirley; Shea, M. Tracie; Sanislow, Charles A.; Skodol, Andrew E.; Grilo, Carlos M.; Edelen, Maria Orlando; Stout, Robert L.; Morey, Leslie C.; Zanarini, Mary C.; Markowitz, John C.; McGlashan, Thomas H.; Daversa, Maria T.; Gunderson, John G.

    2009-01-01

    OBJECTIVE To examine higher order personality factors of negative affectivity (NA) and disinhibition (DIS), as well as lower order facets of impulsivity, as prospective predictors of suicide attempts in a predominantly personality disordered (PD) sample. METHOD Data were analyzed from 701 participants of the Collaborative Longitudinal Personality Disorders Study (CLPS) with available follow-up data for up to 7 years. Cox proportional hazards regression analyses was used to examine NA and DIS, and facets of impulsivity (e.g., urgency, lack of perseverance, lack of premeditation, and sensation seeking), as prospective predictors of suicide attempts. RESULTS NA, DIS, and all facets of impulsivity except for sensation seeking were significant in univariate analyses. In multivariate models which included sex, childhood sexual abuse (CSA), course of major depressive disorder (MDD) and substance use disorders (SUD), only NA and lack of premeditation remained significant in predicting suicide attempts. Disinhibition and the remaining impulsivity facets were not significant. CONCLUSION Negative affectivity emerged as a stronger and more robust predictor of suicide attempts than disinhibition and impulsivity, and warrants greater attention in suicide risk assessment. Distinguishing between facets of impulsivity is important for clinical risk assessment. PMID:19298413

  18. Prediction of treatment outcome in patients with obsessive-compulsive disorder with Low-Resolution Brain Electromagnetic Tomography: a prospective EEG study

    Directory of Open Access Journals (Sweden)

    Daniela eKrause

    2016-01-01

    Full Text Available The issue of predicting treatment response and identifying, in advance, which patient will profit from treating obsessive-compulsive disorder (OCD seems to be an elusive goal. This prospective study investigated brain electric activity (using Low-Resolution Brain Electromagnetic Tomography (LORETA for the purpose of predicting response to treatment. Forty-one unmedicated patients with a DSM-IV diagnosis of OCD were included. A resting 32-channel EEG was obtained from each participant before and after ten weeks of standardized treatment with sertraline and behavioral therapy. LORETA was used to localize the sources of brain electrical activity. At week ten, patients were divided into responders and non-responders (according to a reduction of symptom severity > 50% on the Y-BOCS. LORETA analysis revealed that at baseline responders showed compared to non-responders a significantly lower brain electric activity within the beta 1 (t=2.86, p<0.05, 2 (t=2.81, p<0.05 and 3 (t=2.76, p<0.05 frequency bands and ROI analysis confirmed a reduced activity in alpha 2 (t=2.06, p<0.05 in the anterior cingulate cortex (ACC. When baseline LORETA data were compared to follow-up data, the analysis showed in the responder group a significantly lower brain electrical resting activity in the beta 1 (t=3.17. p<0.05 and beta 3 (t=3.11. p<0.05 frequency bands and equally for the ROI analysis of the orbitofrontal cortex (OFC in the alpha 2 (t=2.15. p<0.05 frequency band. In the group of non-responders the opposite results were found. In addition, a positive correlation between frequency alpha 2 (rho=0.40, p=0.010, beta 3 (rho=0.42, p=0.006, delta (rho=0.33, p=0.038, theta (rho=0.34, p=0.031, alpha 1 (rho=0.38, p=0.015 and beta1 (rho=0.34, p=0.028 of the OFC and the bands delta (rho=0.33, p=0.035, alpha 1 (rho=0.36, p=0.019, alpha 2 (rho=0.34, p=0.031 and beta 3 (rho=0.38, p=0.015 of the ACC with a reduction of the Y-BOCS scores was identified.Our results suggest that

  19. Early EEG for outcome prediction of postanoxic coma: prospective cohort study with cost-minimization analysis.

    Science.gov (United States)

    Sondag, Lotte; Ruijter, Barry J; Tjepkema-Cloostermans, Marleen C; Beishuizen, Albertus; Bosch, Frank H; van Til, Janine A; van Putten, Michel J A M; Hofmeijer, Jeannette

    2017-05-15

    We recently showed that electroencephalography (EEG) patterns within the first 24 hours robustly contribute to multimodal prediction of poor or good neurological outcome of comatose patients after cardiac arrest. Here, we confirm these results and present a cost-minimization analysis. Early prognosis contributes to communication between doctors and family, and may prevent inappropriate treatment. A prospective cohort study including 430 subsequent comatose patients after cardiac arrest was conducted at intensive care units of two teaching hospitals. Continuous EEG was started within 12 hours after cardiac arrest and continued up to 3 days. EEG patterns were visually classified as unfavorable (isoelectric, low-voltage, or burst suppression with identical bursts) or favorable (continuous patterns) at 12 and 24 hours after cardiac arrest. Outcome at 6 months was classified as good (cerebral performance category (CPC) 1 or 2) or poor (CPC 3, 4, or 5). Predictive values of EEG measures and cost-consequences from a hospital perspective were investigated, assuming EEG-based decision- making about withdrawal of life-sustaining treatment in the case of a poor predicted outcome. Poor outcome occurred in 197 patients (51% of those included in the analyses). Unfavorable EEG patterns at 24 hours predicted a poor outcome with specificity of 100% (95% CI 98-100%) and sensitivity of 29% (95% CI 22-36%). Favorable patterns at 12 hours predicted good outcome with specificity of 88% (95% CI 81-93%) and sensitivity of 51% (95% CI 42-60%). Treatment withdrawal based on an unfavorable EEG pattern at 24 hours resulted in a reduced mean ICU length of stay without increased mortality in the long term. This gave small cost reductions, depending on the timing of withdrawal. Early EEG contributes to reliable prediction of good or poor outcome of postanoxic coma and may lead to reduced length of ICU stay. In turn, this may bring small cost reductions.

  20. Predicting Reading and Spelling Disorders: A 4-Year Prospective Cohort Study.

    Science.gov (United States)

    Bigozzi, Lucia; Tarchi, Christian; Caudek, Corrado; Pinto, Giuliana

    2016-01-01

    In this 4-year prospective cohort study, children with a reading and spelling disorder, children with a spelling impairment, and children without a reading and/or spelling disorder (control group) in a transparent orthography were identified in third grade, and their emergent literacy performances in kindergarten compared retrospectively. Six hundred and forty-two Italian children participated. This cohort was followed from the last year of kindergarten to third grade. In kindergarten, the children were assessed in phonological awareness, conceptual knowledge of writing systems and textual competence. In third grade, 18 children with a reading and spelling impairment and 13 children with a spelling impairment were identified. Overall, conceptual knowledge of the writing system was the only statistically significant predictor of the clinical samples. No differences were found between the two clinical samples.

  1. Cognitive Shifting as a Predictor of Progress in Social Understanding in High-Functioning Adolescents with Autism: A Prospective Study.

    Science.gov (United States)

    Berger, Hans J. C.; And Others

    1993-01-01

    This prospective study of 17 high-functioning residentially treated adolescents with autism found that cognitive shifting, as measured by card sorting tests, was the only significant factor in predicting progress in social understanding. (Author/JDD)

  2. Prospective and retrospective ECG-gating for CT coronary angiography perform similarly accurate at low heart rates

    Energy Technology Data Exchange (ETDEWEB)

    Stolzmann, Paul, E-mail: paul.stolzmann@usz.ch [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Goetti, Robert; Baumueller, Stephan [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Plass, Andre; Falk, Volkmar [Clinic for Cardiovascular Surgery, University Hospital Zurich (Switzerland); Scheffel, Hans; Feuchtner, Gudrun; Marincek, Borut [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Alkadhi, Hatem [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Leschka, Sebastian [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2011-07-15

    Objective: To compare, in patients with suspicion of coronary artery disease (CAD) and low heart rates, image quality, diagnostic performance, and radiation dose values of prospectively and retrospectively electrocardiography (ECG)-gated dual-source computed tomography coronary angiography (CTCA) for the diagnosis of significant coronary stenoses. Materials and methods: Two-hundred consecutive patients with heart rates {<=}70 bpm were retrospectively enrolled; 100 patients undergoing prospectively ECG-gated CTCA (group 1) and 100 patients undergoing retrospectively-gated CTCA (group 2). Coronary artery segments were assessed for image quality and significant luminal diameter narrowing. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and accuracy of both CTCA groups were determined using conventional catheter angiography (CCA) as reference standard. Radiation dose values were calculated. Results: Both groups were comparable regarding gender, body weight, cardiovascular risk profile, severity of CAD, mean heart rate, heart rate variability, and Agatston score (all p > 0.05). There was no significant difference in the rate of non-assessable coronary segments between group 1 (1.6%, 24/1404) and group 2 (1.4%, 19/1385; p = 0.77); non-diagnostic image quality was significantly (p < 0.001) more often attributed to stair step artifacts in group 1. Segment-based sensitivity, specificity, PPV, NPV, and accuracy were 98%, 98%, 88%, 100%, and 100% among group 1; 96%, 99%, 90%, 100%, and 98% among group 2, respectively. Parameters of diagnostic performance were similar (all p > 0.05). Mean effective radiation dose of prospectively ECG-gated CTCA (2.2 {+-} 0.4 mSv) was significantly (p < 0.0001) smaller than that of retrospectively ECG-gated CTCA (8.1 {+-} 0.6 mSv). Conclusion: Prospectively ECG-gated CTCA yields similar image quality, performs as accurately as retrospectively ECG-gated CTCA in patients having heart rates {<=}70 bpm

  3. Accurate prediction of the functional significance of single nucleotide polymorphisms and mutations in the ABCA1 gene.

    Directory of Open Access Journals (Sweden)

    Liam R Brunham

    2005-12-01

    Full Text Available The human genome contains an estimated 100,000 to 300,000 DNA variants that alter an amino acid in an encoded protein. However, our ability to predict which of these variants are functionally significant is limited. We used a bioinformatics approach to define the functional significance of genetic variation in the ABCA1 gene, a cholesterol transporter crucial for the metabolism of high density lipoprotein cholesterol. To predict the functional consequence of each coding single nucleotide polymorphism and mutation in this gene, we calculated a substitution position-specific evolutionary conservation score for each variant, which considers site-specific variation among evolutionarily related proteins. To test the bioinformatics predictions experimentally, we evaluated the biochemical consequence of these sequence variants by examining the ability of cell lines stably transfected with the ABCA1 alleles to elicit cholesterol efflux. Our bioinformatics approach correctly predicted the functional impact of greater than 94% of the naturally occurring variants we assessed. The bioinformatics predictions were significantly correlated with the degree of functional impairment of ABCA1 mutations (r2 = 0.62, p = 0.0008. These results have allowed us to define the impact of genetic variation on ABCA1 function and to suggest that the in silico evolutionary approach we used may be a useful tool in general for predicting the effects of DNA variation on gene function. In addition, our data suggest that considering patterns of positive selection, along with patterns of negative selection such as evolutionary conservation, may improve our ability to predict the functional effects of amino acid variation.

  4. Predicting students' physical activity and health-related well-being: a prospective cross-domain investigation of motivation across school physical education and exercise settings.

    Science.gov (United States)

    Standage, Martyn; Gillison, Fiona B; Ntoumanis, Nikos; Treasure, Darren C

    2012-02-01

    A three-wave prospective design was used to assess a model of motivation guided by self-determination theory (Ryan & Deci, 2008) spanning the contexts of school physical education (PE) and exercise. The outcome variables examined were health-related quality of life (HRQoL), physical self-concept (PSC), and 4 days of objectively assessed estimates of activity. Secondary school students (n = 494) completed questionnaires at three separate time points and were familiarized with how to use a sealed pedometer. Results of structural equation modeling supported a model in which perceptions of autonomy support from a PE teacher positively predicted PE-related need satisfaction (autonomy, competence, and relatedness). Competence predicted PSC, whereas relatedness predicted HRQoL. Autonomy and competence positively predicted autonomous motivation toward PE, which in turn positively predicted autonomous motivation toward exercise (i.e., 4-day pedometer step count). Autonomous motivation toward exercise positively predicted step count, HRQoL, and PSC. Results of multisample structural equation modeling supported gender invariance. Suggestions for future work are discussed.

  5. Telephone Encounters Predict Future High Financial Expenditures in Inflammatory Bowel Disease Patients: A 3-Year Prospective Observational Study.

    Science.gov (United States)

    Click, Benjamin; Anderson, Alyce M; Ramos Rivers, Claudia; Koutroubakis, Ioannis E; Hashash, Jana G; Dunn, Michael A; Schwartz, Marc; Swoger, Jason; Barrie, Arthur; Szigethy, Eva; Regueiro, Miguel; Schoen, Robert E; Binion, David G

    2018-04-01

    Telephone activity is essential in management of complex chronic diseases including inflammatory bowel disease (IBD). Telephone encounters logged in the electronic medical record have recently been proposed as a surrogate marker of disease activity and impending health care utilization; however, the association between telephone calls and financial expenditures has not been evaluated. We performed a 3-year prospective observational study of telephone encounters logged at a tertiary referral IBD center. We analyzed patient demographics, disease characteristics, comorbidities, clinical activity, and health care financial charges by telephone encounter frequency. Eight hundred one patients met inclusion criteria (52.3% female; mean age, 44.1 y), accounted for 12,669 telephone encounters, and accrued $70,513,449 in charges over 3 years. High telephone encounter frequency was associated with female gender (P=0.003), anxiety/depression (Pfinancial charges the following year after controlling for demographic, utilization, and medication covariates. Increased telephone encounters are associated with significantly higher health care utilization and financial expenditures. Increased call frequency is predictive of future health care spending. Telephone encounters are a useful tool to identify patients at risk of clinical deterioration and large financial expense.

  6. How to Mitigate Theme Park Crowding? A Prospective Coordination Approach

    Directory of Open Access Journals (Sweden)

    Yuguo Yuan

    2018-01-01

    Full Text Available Crowding is a key factor in tourists’ experience in theme parks, and mitigating crowding makes parks more competitive. This study examines how to effectively mitigate crowding in theme parks. First, a Markov-based method is developed to predict the spatial-temporal distribution of tourists in the park. Then, a prospective coordination approach based on the tourist distribution prediction is proposed. To evaluate the performance of this approach, an experiment is constructed using an agent-based simulation platform. The results indicate that the proposed method significantly outperforms existing methods. Furthermore, we conduct two experiments and, based on the results, offer several recommendations for crowd management.

  7. Does dairy food intake predict arterial stiffness and blood pressure in men?: Evidence from the Caerphilly Prospective Study.

    Science.gov (United States)

    Livingstone, Katherine M; Lovegrove, Julie A; Cockcroft, John R; Elwood, Peter C; Pickering, Janet E; Givens, D Ian

    2013-01-01

    Arterial stiffness is an independent predictor of cardiovascular disease events and mortality, and like blood pressure, may be influenced by dairy food intake. Few studies have investigated the effects of consumption of these foods on prospective measures of arterial stiffness. The present analysis aimed to investigate the prospective relationship between milk, cheese, cream, and butter consumption and aortic pulse wave velocity, augmentation index, systolic and diastolic blood pressure, as well as cross-sectional relationships between these foods and systolic and diastolic blood pressure and metabolic markers using data from the Caerphilly Prospective Study. Included in this cohort were 2512 men, aged 45 to 59 years, who were followed up at 5-year intervals for a mean of 22.8 years (number follow-up 787). Augmentation index was 1.8% lower in subjects in the highest quartiles of dairy product intake compared with the lowest (P trend=0.021), whereas in the highest group of milk consumption systolic blood pressure was 10.4 mm Hg lower (P trend=0.033) than in nonmilk consumers after a 22.8-year follow-up. Cross-sectional analyses indicated that across increasing quartiles of butter intake, insulin (P trend=0.011), triacylglycerol (P trend=0.023), total cholesterol (P trend=0.002), and diastolic blood pressure (P trend=0.027) were higher. Across increasing groups of milk intake and quartiles of dairy product intake, glucose (P trend=0.032) and triglyceride concentrations (P trend=0.031) were lower, respectively. The present results confirm that consumption of milk predicts prospective blood pressure, whereas dairy product consumption, excluding butter, is not detrimental to arterial stiffness and metabolic markers. Further research is needed to better understand the mechanisms that underpin these relationships.

  8. Preoperative prediction of inpatient recovery of function after total hip arthroplasty using performance-based tests: a prospective cohort study.

    Science.gov (United States)

    Oosting, Ellen; Hoogeboom, Thomas J; Appelman-de Vries, Suzan A; Swets, Adam; Dronkers, Jaap J; van Meeteren, Nico L U

    2016-01-01

    The aim of this study was to evaluate the value of conventional factors, the Risk Assessment and Predictor Tool (RAPT) and performance-based functional tests as predictors of delayed recovery after total hip arthroplasty (THA). A prospective cohort study in a regional hospital in the Netherlands with 315 patients was attending for THA in 2012. The dependent variable recovery of function was assessed with the Modified Iowa Levels of Assistance scale. Delayed recovery was defined as taking more than 3 days to walk independently. Independent variables were age, sex, BMI, Charnley score, RAPT score and scores for four performance-based tests [2-minute walk test, timed up and go test (TUG), 10-meter walking test (10 mW) and hand grip strength]. Regression analysis with all variables identified older age (>70 years), Charnley score C, slow walking speed (10 mW >10.0 s) and poor functional mobility (TUG >10.5 s) as the best predictors of delayed recovery of function. This model (AUC 0.85, 95% CI 0.79-0.91) performed better than a model with conventional factors and RAPT scores, and significantly better (p = 0.04) than a model with only conventional factors (AUC 0.81, 95% CI 0.74-0.87). The combination of performance-based tests and conventional factors predicted inpatient functional recovery after THA. Two simple functional performance-based tests have a significant added value to a more conventional screening with age and comorbidities to predict recovery of functioning immediately after total hip surgery. Patients over 70 years old, with comorbidities, with a TUG score >10.5 s and a walking speed >1.0 m/s are at risk for delayed recovery of functioning. Those high risk patients need an accurate discharge plan and could benefit from targeted pre- and postoperative therapeutic exercise programs.

  9. Quantitative prediction process and evaluation method for seafloor polymetallic sulfide resources

    Directory of Open Access Journals (Sweden)

    Mengyi Ren

    2016-03-01

    Full Text Available Seafloor polymetallic sulfide resources exhibit significant development potential. In 2011, China received the exploration rights for 10,000 km2 of a polymetallic sulfides area in the Southwest Indian Ocean; China will be permitted to retain only 25% of the area in 2021. However, an exploration of seafloor hydrothermal sulfide deposits in China remains in the initial stage. According to the quantitative prediction theory and the exploration status of seafloor sulfides, this paper systematically proposes a quantitative prediction evaluation process of oceanic polymetallic sulfide resources and divides it into three stages: prediction in a large area, prediction in the prospecting region, and the verification and evaluation of targets. The first two stages of the prediction process have been employed in seafloor sulfides prospecting of the Chinese contract area. The results of stage one suggest that the Chinese contract area is located in the high posterior probability area, which indicates good prospecting potential area in the Indian Ocean. In stage two, the Chinese contract area of 48°–52°E has the highest posterior probability value, which can be selected as the reserved region for additional exploration. In stage three, the method of numerical simulation is employed to reproduce the ore-forming process of sulfides to verify the accuracy of the reserved targets obtained from the three-stage prediction. By narrowing the exploration area and gradually improving the exploration accuracy, the prediction will provide a basis for the exploration and exploitation of seafloor polymetallic sulfide resources.

  10. Dim prospects for earthquake prediction

    Science.gov (United States)

    Geller, Robert J.

    I was misquoted by C. Lomnitz's [1998] Forum letter (Eos, August 4, 1998, p. 373), which said: [I wonder whether Sasha Gusev [1998] actually believes that branding earthquake prediction a ‘proven nonscience’ [Geller, 1997a] is a paradigm for others to copy.”Readers are invited to verify for themselves that neither “proven nonscience” norv any similar phrase was used by Geller [1997a].

  11. Validation of the cephalosporin intradermal skin test for predicting immediate hypersensitivity: a prospective study with drug challenge.

    Science.gov (United States)

    Yoon, S-Y; Park, S Y; Kim, S; Lee, T; Lee, Y S; Kwon, H-S; Cho, Y S; Moon, H-B; Kim, T-B

    2013-07-01

    Cephalosporin is a major offending agent in terms of drug hypersensitivity along with penicillin. Cephalosporin intradermal skin tests (IDTs) have been widely used; however, their validity for predicting immediate hypersensitivity has not been studied. This study aimed to determine the predictive value of cephalosporin intradermal skin testing before administration of the drug. We prospectively conducted IDTs with four cephalosporins, one each of selected first-, second-, third-, or fourth-generation cephalosporins: ceftezol; cefotetan or cefamandole; ceftriaxone or cefotaxime; and flomoxef, respectively, as well as with penicillin G. After the skin test, whatever the result, one of the tested cephalosporins was administered intravenously and the patient was carefully observed. We recruited 1421 patients who required preoperative cephalosporins. Seventy-four patients (74/1421, 5.2%) were positive to at least one cephalosporin. However, none of responders had immediate hypersensitivity reactions after a challenge dose of the same or different cephalosporin, which were positive in the skin test. Four patients who suffered generalized urticaria and itching after challenge gave negative skin tests for the corresponding drug. The IDT for cephalosporin had a sensitivity of 0%, a specificity of 97.5%, a negative predictive value of 99.7%, and a positive predictive value (PPV) of 0%, when challenged with the same drugs that were positive in the skin test. Routine skin testing with a cephalosporin before its administration is not useful for predicting immediate hypersensitivity because of the extremely low sensitivity and PPV of the skin test (CRIS registration no. KCT0000455). © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Transionospheric propagation predictions

    Science.gov (United States)

    Klobucher, J. A.; Basu, S.; Basu, S.; Bernhardt, P. A.; Davies, K.; Donatelli, D. E.; Fremouw, E. J.; Goodman, J. M.; Hartmann, G. K.; Leitinger, R.

    1979-01-01

    The current status and future prospects of the capability to make transionospheric propagation predictions are addressed, highlighting the effects of the ionized media, which dominate for frequencies below 1 to 3 GHz, depending upon the state of the ionosphere and the elevation angle through the Earth-space path. The primary concerns are the predictions of time delay of signal modulation (group path delay) and of radio wave scintillation. Progress in these areas is strongly tied to knowledge of variable structures in the ionosphere ranging from the large scale (thousands of kilometers in horizontal extent) to the fine scale (kilometer size). Ionospheric variability and the relative importance of various mechanisms responsible for the time histories observed in total electron content (TEC), proportional to signal group delay, and in irregularity formation are discussed in terms of capability to make both short and long term predictions. The data base upon which predictions are made is examined for its adequacy, and the prospects for prediction improvements by more theoretical studies as well as by increasing the available statistical data base are examined.

  13. Dependence regulation in newlywed couples: A prospective examination.

    Science.gov (United States)

    Derrick, Jaye L; Leonard, Kenneth E; Homish, Gregory G

    2012-12-01

    According to the Risk Regulation Model (Murray, S. L., Holmes, J. G., & Collins, N. L. (2006). Optimizing assurance: The risk regulation system in relationships. Psychological Bulletin, 132 , 641-666), people need to trust in their partner's regard before they risk interdependence. The current study prospectively examines the association between perceived regard and levels of dependence in newlywed couples over nine years of marriage. Analyses demonstrate that changes in perceived regard predict levels of dependence, changes in dependence do not predict perceived regard, and alternative explanations cannot account for these effects. Further, changes in perceived regard prospectively predict divorce, and levels of dependence mediate this association. Results are discussed in terms of the dependence regulation component of the Risk Regulation Model.

  14. A prediction rule for shoulder pain related sick leave: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    van der Heijden Geert JMG

    2006-12-01

    Full Text Available Abstract Background Shoulder pain is common in primary care, and has an unfavourable outcome in many patients. Information about predictors of shoulder pain related sick leave in workers is scarce and inconsistent. The objective was to develop a clinical prediction rule for calculating the risk of shoulder pain related sick leave for individual workers, during the 6 months following first consultation in general practice. Methods A prospective cohort study with 6 months follow-up was conducted among 350 workers with a new episode of shoulder pain. Potential predictors included the results of a physical examination, sociodemographic variables, disease characteristics (duration of symptoms, sick leave in the 2 months prior to consultation, pain intensity, disability, comorbidity, physical activity, physical work load, psychological factors, and the psychosocial work environment. The main outcome measure was sick leave during 6 months following first consultation in general practice. Results Response rate to the follow-up questionnaire at 6 months was 85%. During the 6 months after first consultation 30% (89/298 of the workers reported sick leave. 16% (47 reported 10 days sick leave or more. Sick leave during this period was predicted in a multivariable model by a longer duration of sick leave prior to consultation, more shoulder pain, a perceived cause of strain or overuse during regular activities, and co-existing psychological complaints. The discriminative ability of the prediction model was satisfactory with an area under the curve of 0.70 (95% CI 0.64–0.76. Conclusion Although 30% of all workers with shoulder pain reported sick leave during follow-up, the duration of sick leave was limited to a few days in most workers. We developed a prediction rule and a score chart that can be used by general practitioners and occupational health care providers to calculate the absolute risk of sick leave in individual workers with shoulder pain, which

  15. Metallogenetic prospecting prediction of volcanic rock type of uranium deposit in Pucheng Area

    International Nuclear Information System (INIS)

    Xiao Bin; Wang Yong

    1998-01-01

    Based on the metallogenetic geological conditions of Pucheng area, metallogenetic geological model existing and the information quality method, the logic vector length method and the logic vector length weighted method, some favorable geological variance are selected. The assessment model is set up and some favorable metallogenetic area are delineated according to the different contribution degrees of the geological variances to mineralization. By geological assessment in the favorable metallogenetic areas, it is considered that the favorable metallogenetic geological conditions exist in this areas, and there are prospecting prospective surroundings areas and glorious prospecting future were confirmed in the district

  16. Prospect theory does not describe the feedback-related negativity value function.

    Science.gov (United States)

    Sambrook, Thomas D; Roser, Matthew; Goslin, Jeremy

    2012-12-01

    Humans handle uncertainty poorly. Prospect theory accounts for this with a value function in which possible losses are overweighted compared to possible gains, and the marginal utility of rewards decreases with size. fMRI studies have explored the neural basis of this value function. A separate body of research claims that prediction errors are calculated by midbrain dopamine neurons. We investigated whether the prospect theoretic effects shown in behavioral and fMRI studies were present in midbrain prediction error coding by using the feedback-related negativity, an ERP component believed to reflect midbrain prediction errors. Participants' stated satisfaction with outcomes followed prospect theory but their feedback-related negativity did not, instead showing no effect of marginal utility and greater sensitivity to potential gains than losses. Copyright © 2012 Society for Psychophysiological Research.

  17. The interaction between self-regulation and motivation prospectively predicting problem behavior in adolescence.

    Science.gov (United States)

    Rhodes, Jessica D; Colder, Craig R; Trucco, Elisa M; Speidel, Carolyn; Hawk, Larry W; Lengua, Liliana J; Das Eiden, Rina; Wieczorek, William

    2013-01-01

    A large literature suggests associations between self-regulation and motivation and adolescent problem behavior; however, this research has mostly pitted these constructs against one another or tested them in isolation. Following recent neural-systems based theories (e.g., Ernst & Fudge, 2009 ), the present study investigated the interactions between self-regulation and approach and avoidance motivation prospectively predicting delinquency and depressive symptoms in early adolescence. The community sample included 387 adolescents aged 11 to 13 years old (55% female; 17% minority). Laboratory tasks were used to assess self-regulation and approach and avoidance motivation, and adolescent self-reports were used to measure depressive symptoms and delinquency. Analyses suggested that low levels of approach motivation were associated with high levels of depressive symptoms, but only at high levels of self-regulation (p = .01). High levels of approach were associated with high levels of rule breaking, but only at low levels of self-regulation (p theories that posit integration of motivational and self-regulatory individual differences via moderational models to understand adolescent problem behavior.

  18. Body dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys.

    Science.gov (United States)

    Paxton, Susan J; Neumark-Sztainer, Dianne; Hannan, Peter J; Eisenberg, Marla E

    2006-12-01

    This research examined whether body dissatisfaction prospectively predicted depressive mood and low self-esteem in adolescent girls and boys 5 years later. Participants were early-adolescent girls (n = 440, Time 1 M age = 12.7 years) and boys (n = 366, Time 1 M age = 12.8 years) and midadolescent girls (n = 946, Time 1 M age = 15.8 years) and boys (n = 764, Time 1 M age = 15.9 years). After controlling for Time 1 of the relevant dependent variable, ethnicity, socioeconomic status, and body mass index, Time 1 body dissatisfaction was a unique predictor of Time 2 depressive mood and low self-esteem in early-adolescent girls (depressive mood: F = 4.80, p self-esteem: F = 9.64, p p self-esteem: F = 9.38, p low self-esteem in both girls and boys but in different phases of adolescence.

  19. Predictive value of radioculography in patients with lumbago-sciatica. A prospective study (part 2)

    Energy Technology Data Exchange (ETDEWEB)

    Espersen, J.O.; Kosteljanetz, M. (University Hospital, Aarhus (Denmark). Dept. of Neurosurgery); Halaburt, H.; Miletic, T. (University Hospital, Aarhus (Denmark). Dept. of Neuroradiology)

    1984-01-01

    One hundred patients with symptoms of lumbo-sacral root compression were prospectively and consecutively assigned to operation based alone on clinical findings. A preoperative myelogram was performed in all patients and described without a knowledge of the clinical features. All patients were explored for the clinically and myelographically relevant disc. When the myelogram was normal (16 patients) both lower lumbar interspaces were exposed. In 58 patients a herniated disc was revealed at surgery. Only 'myelographic herniation' with indentation of the contrast column was accompanied by a high frequency of disc herniation at surgery (73-87%). In cases with normal myelograms only 5% had a disc herniation. The severity of the myelographic finding was clearly correlated to the frequency of positive surgical findings and good outcomes. The preoperative radiculogram gives a high degree of certainty in the preoperative evaluation whether a surgical lesion is present or not and reveals a precise prediction of the outcome of surgery.

  20. Prospective memory and aging: evidence for preserved spontaneous retrieval with exact but not related cues.

    Science.gov (United States)

    Mullet, Hillary G; Scullin, Michael K; Hess, Theodore J; Scullin, Rachel B; Arnold, Kathleen M; Einstein, Gilles O

    2013-12-01

    We examined whether normal aging spares or compromises cue-driven spontaneous retrieval processes that support prospective remembering. In Experiment 1, young and older adults performed prospective-memory tasks that required either strategic monitoring processes for retrieval (nonfocal) or for which participants relied on spontaneous retrieval processes (focal). We found age differences for nonfocal, but not focal, prospective-memory performance. Experiments 2 and 3 used an intention-interference paradigm in which participants were asked to perform a prospective-memory task (e.g., press "Q" when the word money appears) in the context of an image-rating task and were then told to suspend their prospective-memory intention until after completing an intervening lexical-decision task. During the lexical-decision task, we presented the exact prospective-memory cue (e.g., money; Experiments 2 and 3) or a semantically related lure (e.g., wallet; Experiment 3), and we inferred spontaneous retrieval from slowed lexical-decision responses to these items relative to matched control items. Young and older adults showed significant slowing when the exact prospective-memory cue was presented. Only young adults, however, showed significant slowing to the semantically related lure items. Collectively, these results partially support the multiprocess theory prediction that aging spares spontaneous retrieval processes. Spontaneous retrieval processes may become less sensitive with aging, such that older adults are less likely to respond to cues that do not exactly match their encoded targets. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  1. A Prospective Cohort Study Evaluating the Ability of Anticipated Pain, Perceived Analgesic Needs, and Psychological Traits to Predict Pain and Analgesic Usage following Cesarean Delivery

    Directory of Open Access Journals (Sweden)

    Brendan Carvalho

    2016-01-01

    Full Text Available Introduction. This study aimed to determine if preoperative psychological tests combined with simple pain prediction ratings could predict pain intensity and analgesic usage following cesarean delivery (CD. Methods. 50 healthy women undergoing scheduled CD with spinal anesthesia comprised the prospective study cohort. Preoperative predictors included 4 validated psychological questionnaires (Anxiety Sensitivity Index (ASI, Fear of Pain (FPQ, Pain Catastrophizing Scale, and Eysenck Personality Questionnaire and 3 simple ratings: expected postoperative pain (0–10, anticipated analgesic threshold (0–10, and perceived analgesic needs (0–10. Postoperative outcome measures included post-CD pain (combined rest and movement and opioid used for the 48-hour study period. Results. Bivariate correlations were significant with expected pain and opioid usage (r=0.349, anticipated analgesic threshold and post-CD pain (r=-0.349, and perceived analgesic needs and post-CD pain (r=0.313. Multiple linear regression analysis found that expected postoperative pain and anticipated analgesic needs contributed to post-CD pain prediction modeling (R2=0.443, p<0.0001; expected postoperative pain, ASI, and FPQ were associated with opioid usage (R2=0.421, p<0.0001. Conclusion. Preoperative psychological tests combined with simple pain prediction ratings accounted for 44% and 42% of pain and analgesic use variance, respectively. Preoperatively determined expected postoperative pain and perceived analgesic needs appear to be useful predictors for post-CD pain and analgesic requirements.

  2. PROGNOSTIC SIGNIFICANCE OF CLINICAL, HISTOPATHOLOGICAL, AND MOLECULAR CHARACTERISTICS OF MEDULLOBLASTOMAS IN THE PROSPECTIVE HIT2000 MULTICENTER CLINICAL TRIAL COHORT

    Science.gov (United States)

    Pietsch, Torsten; Schmidt, Rene; Remke, Marc; Korshunov, Andrey; Hovestadt, Volker; Jones, David TW; Felsberg, Jörg; Kaulich, Kerstin; Goschzik, Tobias; Kool, Marcel; Northcott, Paul A.; von Hoff, Katja; von Bueren, André O.; Friedrich, Carsten; Skladny, Heyko; Fleischhack, Gudrun; Taylor, Michael D.; Cremer, Friedrich; Lichter, Peter; Faldum, Andreas; Reifenberger, Guido; Rutkowski, Stefan; Pfister, Stefan M.

    2014-01-01

    BACKGROUND: This study aimed to prospectively evaluate clinical, histopathological and molecular variables for outcome prediction in medulloblastoma patients. METHODS: Patients from the HIT2000 cooperative clinical trial were prospectively enrolled based on the availability of sufficient tumor material and complete clinical information. This revealed a cohort of 184 patients (median age 7.6 years), which was randomly split at a 2:1 ratio into a training (n = 127), and a validation (n = 57) dataset. All samples were subjected to thorough histopathological investigation, CTNNB1 mutation analysis, quantitative PCR, MLPA and FISH analyses for cytogenetic variables, and methylome analysis. RESULTS: By univariable analysis, clinical factors (M-stage), histopathological variables (large cell component, endothelial proliferation, synaptophysin pattern), and molecular features (chromosome 6q status, MYC amplification, TOP2A copy-number, subgrouping) were found to be prognostic. Molecular consensus subgrouping (WNT, SHH, Group 3, Group 4) was validated as an independent feature to stratify patients into different risk groups. When comparing methods for the identification of WNT-driven medulloblastoma, this study identified CTNNB1 sequencing and methylation profiling to most reliably identify these patients. After removing patients with particularly favorable (CTNNB1 mutation, extensive nodularity) or unfavorable (MYC amplification) markers, a risk score for the remaining “intermediate molecular risk” population dependent on age, M-stage, pattern of synaptophysin expression, and MYCN copy-number status was identified and validated, with speckled synaptophysin expression indicating worse outcome. CONCLUSIONS: Methylation subgrouping and CTNNB1 mutation status represent robust tools for the risk-stratification of medulloblastoma. A simple clinico-pathological risk score for “intermediate molecular risk” patients was identified, which deserves further validation

  3. [Speed of ocular saccades in Huntington disease. Prospective study].

    Science.gov (United States)

    García Ruiz, P J; Cenjor, C; Ulmer, E; Hernández, J; Cantarero, S; Fanjul, S; García de Yébenes, J

    2001-02-01

    Oculomotor abnormalities, especially slow saccades, have long been recognized in Huntington's disease (HD). To study prospectively horizontal saccade velocity by videonystagmography in 21 patients with genetically confirmed HD. The study included a baseline analysis and a second evaluation after 18.8 +/- 7.1 months. We included a control group of 15 subjects. HD group exhibited decreased saccade velocity when compared with that from a control group (for predictive and unpredictive target). HD patients showed decreased saccade velocity with the passage of time (for predictive target, p < 0.01). Finally we found statistical significant correlation between saccade velocity and triplet length. The measurement of saccade velocity might be an objective method to study the natural evolution of HD, and thus evaluate the effectiveness of future therapies.

  4. Does message framing predict willingness to participate in a hypothetical HIV vaccine trial: an application of Prospect Theory.

    Science.gov (United States)

    Evangeli, Michael; Kafaar, Zuhayr; Kagee, Ashraf; Swartz, Leslie; Bullemor-Day, Philippa

    2013-01-01

    It is vital that enough participants are willing to participate in clinical trials to test HIV vaccines adequately. It is, therefore, necessary to explore what affects peoples' willingness to participate (WTP) in such trials. Studies have only examined individual factors associated with WTP and not the effect of messages about trial participation on potential participants (e.g., whether losses or gains are emphasized, or whether the outcome is certain or uncertain). This study explores whether the effects of message framing on WTP in a hypothetical HIV vaccine trial are consistent with Prospect Theory. This theory suggests that people are fundamentally risk averse and that (1) under conditions of low risk and high certainty, gain-framed messages will be influential (2) under conditions of high risk and low certainty, loss-framed messages will be influential. This cross-sectional study recruited 283 HIV-negative students from a South African university who were given a questionnaire that contained matched certain gain-framed, certain loss-framed, uncertain gain-framed, and uncertain loss-framed statements based on common barriers and facilitators of WTP. Participants were asked to rate how likely each statement was to result in their participation in a hypothetical preventative HIV vaccine trial. Consistent with Prospect Theory predictions, for certain outcomes, gain-framed messages were more likely to result in WTP than loss-framed messages. Inconsistent with predictions, loss-framed message were not more likely to be related to WTP for uncertain outcomes than gain-framed messages. Older students were less likely to express their WTP across the different message frames. Recruitment for HIV vaccine trials should pay attention to how messages about the trial are presented to potential participants.

  5. Protective Factors, Coping Appraisals, and Social Barriers Predict Mental Health Following Community Violence: A Prospective Test of Social Cognitive Theory.

    Science.gov (United States)

    Smith, Andrew J; Felix, Erika D; Benight, Charles C; Jones, Russell T

    2017-06-01

    This study tested social cognitive theory of posttraumatic adaptation in the context of mass violence, hypothesizing that pre-event protective factors (general self-efficacy and perceived social support) would reduce posttraumatic stress symptoms (PTSS) and depression severity through boosting post-event coping self-efficacy appraisals (mediator). We qualified hypotheses by predicting that post-event social support barriers would disrupt (moderate) the health-promoting indirect effects of pre-event protective factors. With a prospective longitudinal sample, we employed path models with bootstrapping resampling to test hypotheses. Participants included 70 university students (71.4% female; 40.0% White; 34.3% Asian; 14.3% Hispanic) enrolled during a mass violence event who completed surveys one year pre-event and 5-6 months post-event. Results revealed significant large effects in predicting coping self-efficacy (mastery model, R 2 = .34; enabling model, R 2 = .36), PTSS (mastery model, R 2 = .35; enabling model, R 2 = .41), and depression severity (mastery model, R 2 = .43; enabling model, R 2 = .46). Overall findings supported study hypotheses, showing that at low levels of post-event social support barriers, pre-event protective factors reduced distress severity through boosting coping self-efficacy. However, as post-event social support barriers increased, the indirect, distress-reducing effects of pre-event protective factors were reduced to nonsignificance. Study implications focus on preventative and responsive intervention. Copyright © 2017 International Society for Traumatic Stress Studies.

  6. Submucosal Plexitis as a Predictive Factor for Postoperative Endoscopic Recurrence in Patients with Crohn's Disease Undergoing a Resection with Ileocolonic Anastomosis: Results from a Prospective Single-centre Study.

    Science.gov (United States)

    Lemmens, Bart; de Buck van Overstraeten, Anthony; Arijs, Ingrid; Sagaert, Xavier; Van Assche, Gert; Vermeire, Séverine; Tertychnyy, Alexander; Geboes, Karel; Wolthuis, Albert; D'Hoore, Andre; De Hertogh, Gert; Ferrante, Marc

    2017-02-01

    Ileocolonoscopy allows early detection of recurrence after surgical resection for Crohn's disease [CD]. Plexitis, defined as presence of inflammatory cells in or around enteric ganglia or nerve bundles, in the proximal surgical margin has been associated with an increased overall recurrence risk. We investigated prospectively whether plexitis can predict endoscopic recurrence [ER] in a consecutive cohort of CD patients undergoing ileocolonic resection. All CD patients undergoing ileocolonic resection in our institution between October 2009 and December 2012 were eligible for this study. Clinical data were obtained prospectively from the patients' files, and biopsies from the proximal surgical margins were analysed immunohistochemically for inflammation at the myenteric and submucosal plexus [lymphocytes, mast cells, eosinophils]. The degree of plexitis was correlated with the presence of ER at 6 months, defined as a modified Rutgeerts' score of ≥ i2b. Multivariate models were developed and tested to predict posterior probability of ER. A total of 74 patients were included. Six months after ileocolonic resection, 50% showed ER. Known risk factors such as penetrating disease, previous resections, and active smoking, showed no relation with ER. On the other hand, submucosal lymphocytic plexitis was associated with ER [p = 0.020]. The predictive value of lymphocytic cell count increased with more extensive biopsy sampling and with application of immunohistochemistry. Submucosal lymphocytic plexitis in the proximal surgical margin was significantly related with a higher risk for ER after ileocolonic resection. These data support development of a postoperative prevention trial with vedolizumab, which may block lymphocytic trafficking in the postoperative bowel. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. The value of daily platelet counts for predicting dengue shock syndrome: Results from a prospective observational study of 2301 Vietnamese children with dengue.

    Science.gov (United States)

    Lam, Phung Khanh; Ngoc, Tran Van; Thu Thuy, Truong Thi; Hong Van, Nguyen Thi; Nhu Thuy, Tran Thi; Hoai Tam, Dong Thi; Dung, Nguyen Minh; Hanh Tien, Nguyen Thi; Thanh Kieu, Nguyen Tan; Simmons, Cameron; Wills, Bridget; Wolbers, Marcel

    2017-04-01

    Dengue is the most important mosquito-borne viral infection to affect humans. Although it usually manifests as a self-limited febrile illness, complications may occur as the fever subsides. A systemic vascular leak syndrome that sometimes progresses to life-threatening hypovolaemic shock is the most serious complication seen in children, typically accompanied by haemoconcentration and thrombocytopenia. Robust evidence on risk factors, especially features present early in the illness course, for progression to dengue shock syndrome (DSS) is lacking. Moreover, the potential value of incorporating serial haematocrit and platelet measurements in prediction models has never been assessed. We analyzed data from a prospective observational study of Vietnamese children aged 5-15 years admitted with clinically suspected dengue to the Hospital for Tropical Diseases in Ho Chi Minh City between 2001 and 2009. The analysis population comprised all children with laboratory-confirmed dengue enrolled between days 1-4 of illness. Logistic regression was the main statistical model for all univariate and multivariable analyses. The prognostic value of daily haematocrit levels and platelet counts were assessed using graphs and separate regression models fitted on each day of illness. Among the 2301 children included in the analysis, 143 (6%) progressed to DSS. Significant baseline risk factors for DSS included a history of vomiting, higher temperature, a palpable liver, and a lower platelet count. Prediction models that included serial daily platelet counts demonstrated better ability to discriminate patients who developed DSS from others, than models based on enrolment information only. However inclusion of daily haematocrit values did not improve prediction of DSS. Daily monitoring of platelet counts is important to help identify patients at high risk of DSS. Development of dynamic prediction models that incorporate signs, symptoms, and daily laboratory measurements, could improve

  8. SU-F-R-48: Early Prediction of Pathological Response of Locally Advanced Rectal Cancer Using Perfusion CT:A Prospective Clinical Study

    Energy Technology Data Exchange (ETDEWEB)

    Nie, K; Yue, N; Jabbour, S; Kim, S [Rutgers-Cancer Institute of New Jersey, Rutgers-Robert Wood Johnson Medical, New Brunswick, NJ (United States); Shi, L; Mao, T; Qian, L; Hu, X; Sun, X; Niu, T [Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang (China)

    2016-06-15

    Purpose: To prospectively evaluate the tumor vascularity assessed by perfusion CT for prediction of chemo-radiation treatment (CRT) response in locally advanced rectal cancer (LARC). Methods: Eighteen consecutive patients (61.9±8.8 years, from March–June 2015) diagnosed with LARC who underwent 6–8 weeks CRT followed by surgery were included. The pre-treatment perfusion CT was acquired after a 5s delay of contrast agent injection for 45s with 1s interval. A total of 7-cm craniocaudal range covered the tumor region with 3-mm slice thickness. The effective radiation dose is around 15mSv, which is about 1.5 the conventional abdomen/pelvis CT dose. The parametric map of blood flow (BF), blood volume (BV), mean transit time (MTT), permeability (PMB), and maximum intensity map (MIP) were obtained from commercial software (Syngo-CT 2011A, Siemens). An experienced radiation oncologist outlined the tumor based on the pre-operative MR and pathologic residual region, but was blinded with regards to pathological tumor stage. The perfusion parameters were compared to histopathological response quantified by tumor regression grade as good-responder (GR, TRG 0-1) vs. non-good responder (non-GR). Furthermore, the predictive value for pathological complete response (pCR) was also investigated. Results: Both BV (p=0.02) and MTT (P=0.02) was significantly higher and permeambility was lower (p=0.004) in the good responders. The BF was higher in GR group but not statistically significant. Regarding the discrimination of pCR vs non-pCR, the BF was higher in the pCR group (p=0.08) but none of those parameters showed statistically significant differences. Conclusion: BV and MTT can discriminate patients with a favorable response from those that fail to respond well, potentially selecting high-risk patients with resistant tumors that may benefit from an aggressive preoperative treatment approach. However, future studies with more patient data are needed to verify the prognostic value

  9. Surface tensions of multi-component mixed inorganic/organic aqueous systems of atmospheric significance: measurements, model predictions and importance for cloud activation predictions

    Directory of Open Access Journals (Sweden)

    D. O. Topping

    2007-01-01

    Full Text Available In order to predict the physical properties of aerosol particles, it is necessary to adequately capture the behaviour of the ubiquitous complex organic components. One of the key properties which may affect this behaviour is the contribution of the organic components to the surface tension of aqueous particles in the moist atmosphere. Whilst the qualitative effect of organic compounds on solution surface tensions has been widely reported, our quantitative understanding on mixed organic and mixed inorganic/organic systems is limited. Furthermore, it is unclear whether models that exist in the literature can reproduce the surface tension variability for binary and higher order multi-component organic and mixed inorganic/organic systems of atmospheric significance. The current study aims to resolve both issues to some extent. Surface tensions of single and multiple solute aqueous solutions were measured and compared with predictions from a number of model treatments. On comparison with binary organic systems, two predictive models found in the literature provided a range of values resulting from sensitivity to calculations of pure component surface tensions. Results indicate that a fitted model can capture the variability of the measured data very well, producing the lowest average percentage deviation for all compounds studied. The performance of the other models varies with compound and choice of model parameters. The behaviour of ternary mixed inorganic/organic systems was unreliably captured by using a predictive scheme and this was dependent on the composition of the solutes present. For more atmospherically representative higher order systems, entirely predictive schemes performed poorly. It was found that use of the binary data in a relatively simple mixing rule, or modification of an existing thermodynamic model with parameters derived from binary data, was able to accurately capture the surface tension variation with concentration. Thus

  10. Poor self-control and harsh punishment in childhood prospectively predict borderline personality symptoms in adolescent girls.

    Science.gov (United States)

    Hallquist, Michael N; Hipwell, Alison E; Stepp, Stephanie D

    2015-08-01

    Developmental theories of borderline personality disorder (BPD) propose that harsh, invalidating parenting of a child with poor self-control and heightened negative emotionality often leads to a coercive cycle of parent-child transactions that increase risk for BPD symptoms such as emotion dysregulation. Although parenting practices and child temperament have previously been linked with BPD, less is known about the prospective influences of caregiver and child characteristics. Using annual longitudinal data from the Pittsburgh Girls Study (n = 2,450), our study examined how reciprocal influences among harsh parenting, self-control, and negative emotionality between ages 5 and 14 predicted the development of BPD symptoms in adolescent girls ages 14 to 17. Consistent with developmental theories, we found that harsh punishment, poor self-control, and negative emotionality predicted BPD symptom severity at age 14. Only worsening self-control between ages 12 and 14, however, predicted growth in BPD symptoms from 14 to 17. Furthermore, the effects of harsh punishment and poor self-control on age 14 BPD symptoms were partially mediated by their earlier reciprocal effects on each other between ages 5 and 14. Our findings underscore the need to address both child and parental contributions to dysfunctional transactions in order to stem the development of BPD symptoms. Moreover, problems with self-regulation in early adolescence may indicate heightened risk for subsequent BPD. Altogether, these results increase our understanding of developmental trajectories associated with BPD symptoms in adolescent girls. (c) 2015 APA, all rights reserved).

  11. A test of prospect theory.

    Science.gov (United States)

    Feeny, David; Eng, Ken

    2005-01-01

    Prospect theory (PT) hypothesizes that people judge states relative to a reference point, usually assumed to be their current health. States better than the reference point are valued on a concave portion of the utility function; worse states are valued on a convex portion. Using prospectively collected utility scores, the objective is to test empirically implications of PT. Osteoarthritis (OA) patients undergoing total hip arthroplasty periodically provided standard gamble scores for three OA hypothetical states describing mild, moderate, and severe OA as well as their subjectively defined current state (SDCS). Our hypothesis was that most patients improved between the pre- and postsurgery assessments. According to PT, scores for hypothetical states previously > SDCS but now < SDCS should be lower at the postsurgery assessment. Fourteen patients met the criteria for testing the hypothesis. Predictions were confirmed for 0 patients; there was no change or mixed results for 6 patients (42.9 percent); and scores moved in the direction opposite to that predicted by PT for 8 patients (57.1 percent). In general, the direction and magnitude of the changes in hypothetical-state scores do not conform to the predictions of PT.

  12. [Intensive care medicine-survival and prospect of life].

    Science.gov (United States)

    Valentin, A

    2017-10-01

    Intensive care medicine has achieved a significant increase in survival rates from critical illness. In addition to short-term outcomes like intensive care unit or hospital mortality, long-term prognosis and prospect of life of intensive care patients have recently become increasingly important. Pure survival is no longer a sole goal of intensive care medicine. The prediction of an intensive care patient's individual course should include the period after intensive care. A relevant proportion of all intensive care patients is affected by physical, psychological, cognitive, and social limitations after discharge from the intensive care unit. The prognosis of the status of the patient after discharge from the intensive care unit is an important part of the decision-making process with respect to the implementation or discontinuation of intensive care measures. The heavy burden of intensive care treatment should not solely be argued by pure survival but an anticipated sound prospect of life.

  13. Neural Reactivity to Emotional Stimuli Prospectively Predicts the Impact of a Natural Disaster on Psychiatric Symptoms in Children.

    Science.gov (United States)

    Kujawa, Autumn; Hajcak, Greg; Danzig, Allison P; Black, Sarah R; Bromet, Evelyn J; Carlson, Gabrielle A; Kotov, Roman; Klein, Daniel N

    2016-09-01

    Natural disasters expose entire communities to stress and trauma, leading to increased risk for psychiatric symptoms. Yet, the majority of exposed individuals are resilient, highlighting the importance of identifying underlying factors that contribute to outcomes. The current study was part of a larger prospective study of children in Long Island, New York (n = 260). At age 9, children viewed unpleasant and pleasant images while the late positive potential (LPP), an event-related potential component that reflects sustained attention toward salient information, was measured. Following the event-related potential assessment, Hurricane Sandy, the second costliest hurricane in United States history, hit the region. Eight weeks after the hurricane, mothers reported on exposure to hurricane-related stress and children's internalizing and externalizing symptoms. Symptoms were reassessed 8 months after the hurricane. The LPP predicted both internalizing and externalizing symptoms after accounting for prehurricane symptomatology and interacted with stress to predict externalizing symptoms. Among children exposed to higher levels of hurricane-related stress, enhanced neural reactivity to unpleasant images predicted greater externalizing symptoms 8 weeks after the disaster, while greater neural reactivity to pleasant images predicted lower externalizing symptoms. Moreover, interactions between the LPP and stress continued to predict externalizing symptoms 8 months after the hurricane. Results indicate that heightened neural reactivity and attention toward unpleasant information, as measured by the LPP, predispose children to psychiatric symptoms when exposed to higher levels of stress related to natural disasters, while greater reactivity to and processing of pleasant information may be a protective factor. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. Specificity in autobiographical memory narratives correlates with performance on the Autobiographical Memory Test and prospectively predicts depressive symptoms

    Science.gov (United States)

    Sumner, Jennifer A.; Mineka, Susan; McAdams, Dan P.

    2012-01-01

    Reduced autobiographical memory specificity (AMS) is an important cognitive marker in depression that is typically measured with the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986). The AMT is widely used, but the overreliance on a single methodology for assessing AMS is a limitation in the field. The current study investigated memory narratives as an alternative measure of AMS in an undergraduate student sample selected for being high or low on a measure of depressive symptoms (N = 55). We employed a multi-method design to compare narrative- and AMT-based measures of AMS. Participants generated personally significant self-defining memory narratives, and also completed two versions of the AMT (with and without instructions to retrieve specific memories). Greater AMS in self-defining memory narratives correlated with greater AMS in performance on both versions of the AMT in the full sample, and the patterns of relationships between the different AMS measures were generally similar in low and high dysphoric participants. Furthermore, AMS in self-defining memory narratives was prospectively associated with depressive symptom levels. Specifically, greater AMS in self-defining memory narratives predicted fewer depressive symptoms at a 10-week follow-up over and above baseline symptom levels. Implications for future research and clinical applications are discussed. PMID:23240988

  15. Interaction effects in the theory of planned behaviour: Predicting fruit and vegetable consumption in three prospective cohorts.

    Science.gov (United States)

    Kothe, Emily J; Mullan, Barbara A

    2015-09-01

    The theory of planned behaviour (TPB) has been criticized for not including interactions between major constructs thought to underlie behaviour. This study investigated the application of the TPB to the prediction of fruit and vegetable consumption across three prospective cohorts. The primary aim of the study was to investigate whether interactions between major constructs in the theory would increase the ability of the model to predict intention to consume fruit and vegetables (i.e., attitude × perceived behavioural control [PBC], subjective norm × PBC, subjective norm × attitude) and self-reported fruit and vegetable intake (i.e., PBC × intention). Secondary data analysis from three cohorts: One predictive study (cohort 1) and two intervention studies (cohorts 2 and 3). Participants completed a TPB measure at baseline and a measure of fruit and vegetable intake at 1 week (cohort 1; n = 90) or 1 month (cohorts 2 and 3; n = 296). Attitude moderated the impact of PBC on intention. PBC moderated the impact of intention on behaviour at 1 week but not 1 month. The variance accounted for by the interactions was small. However, the presence of interactions between constructs within the TPB demonstrates a need to consider interactions between variables within the TPB in both theoretical and applied research using the model. © 2014 The British Psychological Society.

  16. Prospective Teachers Proportional Reasoning and Presumption of Student Work

    Directory of Open Access Journals (Sweden)

    Mujiyem Sapti

    2015-08-01

    Full Text Available This study aimed to describe the proportional reasoning of prospective teachers and their predictions about students' answers. Subjects were 4 prospective teacher  7th semester Department of Mathematics Education, Muhammadiyah University of Purworejo. Proportional reasoning task used to obtain research data. Subjects were asked to explain their reasoning and write predictions of student completion. Data was taken on October 15th, 2014. Interviews were conducted after the subjects completed the task and recorded with audio media. The research data were subject written work and interview transcripts. Data were analyzed using qualitative analysis techniques. In solving the proportional reasoning task, subjects using the cross product. However, they understand the meaning of the cross product. Subject also could predict students' reasoning on the matter.

  17. DADOS-Prospective: an open source application for Web-based prospective data collection

    Directory of Open Access Journals (Sweden)

    Nguyen Lam

    2006-11-01

    Full Text Available Abstract Background Randomized, prospective trials involving multi-institutional collaboration have become a central part of clinical and translational research. However, data management and coordination of multi-center studies is a complex process that involves developing systems for data collection and quality control, tracking data queries and resolutions, as well as developing communication procedures. We describe DADOS-Prospective, an open-source Web-based application for collecting and managing prospective data on human subjects for clinical and translational trials. DADOS-Prospective not only permits users to create new clinical research forms (CRF and supports electronic signatures, but also offers the advantage of containing, in a single environment, raw research data in downloadable spreadsheet format, source documentation and regulatory files stored in PDF format, and audit trails. Results Feedback from formal and field usability tests was used to guide the design and development of DADOS-Prospective. To date, DADOS-Prospective has been implemented in five prospective clinical studies at our institution. Four of these studies are still in the CRF creation phase and one study has been entirely launched. Conclusion DADOS-Prospective has significant advantages over existing Web-based data collecting programs. At our institution, it has been demonstrated to be an efficient tool for prospective clinical studies.

  18. Prediction of renovascualar hypertension by captopril-stimulated renal vein renin ratios

    International Nuclear Information System (INIS)

    Roubidoux, M.A.; Dunnick, N.R.; Svetkey, L.; Newmann, G.E.; Cohan, R.H.; Kadir, S.; Klotman, P.

    1989-01-01

    The authors have prospectively studied 114 patients with suspected renovascular hypertension to determine whether captopril-stimulated, selective, renal vein renin ratios could be used to predict renovascular hypertension. As judged by the response to correction of renal artery lesions, 14 patients had renovascular hypertension, and renal vein renin ratios were significant in eight (sensitivity 57%). Overall, the positive predictive value of renal vein renin ratios was 33%, and the negative predictive value was 89%. The authors concluded that, in patients with renal artery stenosis, renal vein renin ratios predict neither the need for conventional arteriography nor potential benefit from the correction of vascular insufficiency

  19. Bidirectional Prospective Associations Between Cardiac Autonomic Activity and Inflammatory Markers.

    Science.gov (United States)

    Hu, Mandy Xian; Lamers, Femke; Neijts, Melanie; Willemsen, Gonneke; de Geus, Eco J C; Penninx, Brenda W J H

    2018-06-01

    Autonomic nervous system (ANS) imbalance has been cross-sectionally associated with inflammatory processes. Longitudinal studies are needed to shed light on the nature of this relationship. We examined cross-sectional and bidirectional prospective associations between cardiac autonomic measures and inflammatory markers. Analyses were conducted with baseline (n = 2823), 2-year (n = 2099), and 6-year (n = 1774) data from the Netherlands Study of Depression and Anxiety. To compare the pattern of results, prospective analyses with ANS (during sleep, leisure time, and work) and inflammation were conducted in two data sets from the Netherlands Twin Register measured for 4.9 years (n = 356) and 5.4 years (n = 472). Autonomic nervous system measures were heart rate (HR) and respiratory sinus arrhythmia (RSA). Inflammatory markers were C-reactive protein (CRP) and interleukin (IL)-6. The Netherlands Study of Depression and Anxiety results showed that higher HR and lower RSA were cross-sectionally significantly associated with higher inflammatory levels. Higher HR predicted higher levels of CRP (B = .065, p < .001) and IL-6 (B = .036, p = .014) at follow-up. Higher CRP levels predicted lower RSA (B = -.024, p = .048) at follow-up. The Netherlands Twin Register results confirmed that higher HR was associated with higher CRP and IL-6 levels 4.9 years later. Higher IL-6 levels predicted higher HR and lower RSA at follow-up. Autonomic imbalance is associated with higher levels of inflammation. Independent data from two studies converge in evidence that higher HR predicts subsequent higher levels of CRP and IL-6. Inflammatory markers may also predict future ANS activity, but evidence for this was less consistent.

  20. The predictive value of treatment response using FDG PET performed on day 21 of chemoradiotherapy in patients with oesophageal squamous cell carcinoma. A prospective, multicentre study (RTEP3)

    International Nuclear Information System (INIS)

    Palie, Odre; Vera, Pierre; Michel, Pierre; Di Fiore, Frederic; Menard, Jean-Francois; Rousseau, Caroline; Bridji, Boumediene; Rio, Emmanuel; Benyoucef, Ahmed; Meyer, Marc-Etienne; Jalali, Khadija; Bardet, Stephane; M'Vondo, Che Mabubu; Olivier, Pierre; Faure, Guillaume; Itti, Emmanuel; Diana, Christian; Houzard, Claire; Mornex, Francoise

    2013-01-01

    FDG PET has been suggested to have predictive value in the prognosis of oesophageal carcinoma. However, the retrospective studies reported in the literature have shown discordant results. Additionally, only four studies have evaluated FDG PET during chemoradiotherapy (CRT) in patients with different histological lesions. The purpose of this study was to investigate the predictive value of FDG PET performed early during CRT (on day 21) in a population of patients with oesophageal squamous cell carcinoma. Included in this prospective study were 57 patients with a histological diagnosis of squamous cell carcinoma of the oesophagus. Of these 57 patients, 48 (84 %) were evaluated (aged 63 ± 11 years; 44 men, 4 women). Each patient underwent FDG PET (4.5 MBq/kg) before CRT, according to the Herskovic protocol (t0; PET 1 ) and on day 21 ± 3 from the start of CRT (d21; PET 2 ). The response assessment included a clinical examination, CT scan or FDG PET and histological analysis 3 months and 1 year after PET 1 . The patients were classified as showing a complete response (CR) or a noncomplete response. A quantitative analysis was carried out for PET 1 and PET 2 using the following parameters: SUVmax, SUVmean (with SUVmean 40 as the 3-D volume at an SUVmax threshold of 40 % and SUVmean p as that defined by a physician), tumour volume (TV, with TV 40 defined as the TV at 40 % of SUVmax, and TV p as that defined by a physician); and the total lesion glycolysis (TLG, SUVmean x TV, with TLG 40 defined as the TLG at 40 % of SUVmax, and TLG p as that defined by a physician). The differences in responses at 3 months and 1 year between PET 1 (t0) and PET 2 (d21) were assessed in terms of variations in SUV, TV and TLG using a repeated measures of variance (ANOVA). SUVmax, SUVmean and TLG decreased significantly between PET 1 (t0) and PET 2 (d21; p p (p = 0.02); TV 40 did not decrease significantly. With respect to the predictive value of PET 1 , only TV 40 1 and TV p 1 values, and

  1. Intraoperative ultrasound for prediction of hepatocellular carcinoma biological behaviour: Prospective comparison with pathology.

    Science.gov (United States)

    Santambrogio, Roberto; Cigala, Claudia; Barabino, Matteo; Maggioni, Marco; Scifo, Giovanna; Bruno, Savino; Bertolini, Emanuela; Opocher, Enrico; Bulfamante, Gaetano

    2018-02-01

    Preoperative prediction of both microinvasive hepatocellular carcinoma and histological grade of hepatocellular carcinoma is pivotal to treatment planning and prognostication. The aim of this study was to evaluate whether some intraoperative ultrasound features correlate with both the presence of same histological patterns and differentiation grade of hepatocellular carcinoma on the histological features of the primary resected tumour. All patients with single, small hepatocellular carcinoma that underwent hepatic resection were included in this prospective double-blind study: the intraoperative ultrasound patterns of nodule were registered and compared with similar histological features. A total of 179 patients were enclosed in this study: 97 (54%) patients (34% in HCC ≤2 cm) had a microinvasive hepatocellular carcinoma at ultrasound examination, while 82 (46%) patients (41% in HCC ≤2 cm) at histological evaluation. Statistical analysis showed that diameters ≤2 cm, presence of satellites and microinvasive hepatocellular carcinoma at ultrasound examination were the variables with the strongest association with the histological findings. In the multivariate analysis, the vascular microinfiltration and infiltrative hepatocellular carcinoma aspect were independent predictors for grading. In patients with cirrhosis and hepatocellular carcinoma, the prevalence of microinvasive hepatocellular carcinoma is high, even in cases of HCC ≤2 cm. Intraoperative ultrasound findings strongly correlated with histopathological criteria in detecting microinvasive patterns and are useful to predict neoplastic differentiation. The knowledge of these features prior to treatment are highly desired (this can be obtained by an intraoperative ultrasound examination), as they could help in providing optimal management of patients with hepatocellular carcinoma. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. A prospective cohort study on the clinical utility of second trimester mean arterial blood pressure in the prediction of late-onset preeclampsia among Nigerian women.

    Science.gov (United States)

    Udenze, I C; Arikawe, A P; Makwe, C C; Olowoselu, O F

    2017-06-01

    Early detection of preeclampsia will help reduce the morbidities and mortalities associated with the disorder. Late-onset preeclampsia was the predominant presentation in this cohort. The search for biomarkers for predicting preeclampsia is still ongoing. Mean arterial blood pressure (MABP), which has the advantage of presenting a single cutoff value compared with the use of systolic and diastolic blood pressure measurements, merits evaluation. The study aims to evaluate the clinical utility of second trimester MABP in the prediction of preeclampsia. This was a prospective cohort study of 155 normotensive, nonproteinuric pregnant women without prior history of gestational hypertension. The women were booked patients attending the antenatal clinic at the Lagos University Teaching Hospital and were all in their second trimesters of pregnancy. The outcome measures were systolic blood pressure, diastolic blood pressure, and MABP. The end point of the study was the development of preeclampsia. The diagnosis of preeclampsia was made by the attending obstetrician. The data were analyzed using the IBM SPSS statistical software. Statistical significance was set at P blood pressure, diastolic blood pressure, and MABP values in the group of women who later developed preeclampsia, P = 0.005, 0.001, and area under the receiver-operative characteristics curve (AUC) was 0.732 (95% confidence interval, 0.544-0.919, P = 0.011). The negative predictive value (NPV) was 88.88% and the positive predictive value (PPV) was 45.45%, P AUC of 0.732, MABP performed moderately (considering that excellent performance has an AUC of 1.0) in the prediction of late-onset preeclampsia in Nigerian women. Its high NPV suggests a strong ability to rule out preeclampsia and help to appropriate management.

  3. Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones

    DEFF Research Database (Denmark)

    Borly, L; Anderson, I B; Bardram, L

    1999-01-01

    and sonography evaluated gallbladder motility, gallstones, and gallbladder volume. Preoperative variables in patients with or without postcholecystectomy pain were compared statistically, and significant variables were combined in a logistic regression model to predict the postoperative outcome. RESULTS: Eighty...... and by the absence of 'agonizing' pain and of symptoms coinciding with pain (P model 15 of 18 predicted patients had postoperative pain (PVpos = 0.83). Of 62 patients predicted as having no pain postoperatively, 56 were pain-free (PVneg = 0.90). Overall accuracy...... was 89%. CONCLUSION: From this prospective study a model based on preoperative symptoms was developed to predict postcholecystectomy pain. Since intrastudy reclassification may give too optimistic results, the model should be validated in future studies....

  4. Predicting Circulatory Diseases from Psychosocial Safety Climate: A Prospective Cohort Study from Australia

    Directory of Open Access Journals (Sweden)

    Harry Becher

    2018-02-01

    Full Text Available Circulatory diseases (CDs (including myocardial infarction, angina, stroke or hypertension are among the leading causes of death in the world. In this paper, we explore for the first time the impact of a specific aspect of organizational climate, Psychosocial Safety Climate (PSC, on CDs. We used two waves of interview data from Australia, with an average lag of 5 years (excluding baseline CDs, final n = 1223. Logistic regression was conducted to estimate the prospective associations between PSC at baseline on incident CDs at follow-up. It was found that participants in low PSC environments were 59% more likely to develop new CD than those in high PSC environments. Logistic regression showed that high PSC at baseline predicts lower CD risk at follow-up (OR = 0.98, 95% CI 0.96–1.00 and this risk remained unchanged even after additional adjustment for known job design risk factors (effort reward imbalance and job strain. These results suggest that PSC is an independent risk factor for CDs in Australia. Beyond job design this study implicates organizational climate and prevailing management values regarding worker psychological health as the genesis of CDs.

  5. The predictive value of transthoracic echocardiographic variables for sinus rhythm maintenance after electrical cardioversion of atrial fibrillation. Results from the CAPRAF study, a prospective, randomized, placebo-controlled study.

    Science.gov (United States)

    Grundvold, Irene; Tveit, Arnljot; Smith, Pål; Seljeflot, Ingebjørg; Abdelnoor, Michael; Arnesen, Harald

    2008-01-01

    The recurrence rate of atrial fibrillation after electrical cardioversion is disappointingly high. The aim of the present study was to prospectively investigate if standard echocardiographic variables at the day of cardioversion could predict sinus rhythm maintenance. Transthoracic echocardiographic examination was performed within 4 h after cardioversion for all the patients in the CAPRAF (Candesartan in the Prevention of Relapsing Atrial Fibrillation) study. Cardioversion was successful for 137 patients not given specific antiarrhythmic therapy, and only 41 (30%) maintained sinus rhythm at 6-month follow-up. There were significant (p = 0.05) lower transmitral A wave velocities in the group with relapsing atrial fibrillation compared with the group with sinus rhythm at 6-month follow-up. All patients with the lowest A wave velocities had an early recurrence of atrial fibrillation. There were no differences between the groups regarding atrial dimensions or left ventricular function. The use of the angiotensin II receptor antagonist candesartan had no influence on the echocardiographic variables, nor on the recurrence rate of atrial fibrillation after cardioversion. Transthoracic echocardiographic examination performed a short time after electrical cardioversion of atrial fibrillation showed that only A wave peak velocities were significantly predictive of sinus rhythm maintenance 6 months after the procedure. (c) 2008 S. Karger AG, Basel.

  6. Clinical Significance of Hemostatic Parameters in the Prediction for Type 2 Diabetes Mellitus and Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Lianlian Pan

    2018-01-01

    Full Text Available It would be important to predict type 2 diabetes mellitus (T2DM and diabetic nephropathy (DN. This study was aimed at evaluating the predicting significance of hemostatic parameters for T2DM and DN. Plasma coagulation and hematologic parameters before treatment were measured in 297 T2DM patients. The risk factors and their predicting power were evaluated. T2DM patients without complications exhibited significantly different activated partial thromboplastin time (aPTT, platelet (PLT, and D-dimer (D-D levels compared with controls (P<0.01. Fibrinogen (FIB, PLT, and D-D increased in DN patients compared with those without complications (P<0.001. Both aPTT and PLT were the independent risk factors for T2DM (OR: 1.320 and 1.211, P<0.01, resp., and FIB and PLT were the independent risk factors for DN (OR: 1.611 and 1.194, P<0.01, resp.. The area under ROC curve (AUC of aPTT and PLT was 0.592 and 0.647, respectively, with low sensitivity in predicting T2DM. AUC of FIB was 0.874 with high sensitivity (85% and specificity (76% for DN, and that of PLT was 0.564, with sensitivity (60% and specificity (89% based on the cutoff values of 3.15 g/L and 245 × 109/L, respectively. This study suggests that hemostatic parameters have a low predicting value for T2DM, whereas fibrinogen is a powerful predictor for DN.

  7. Baseline social amotivation predicts 1-year functioning in UHR subjects: A validation and prospective investigation.

    Science.gov (United States)

    Lam, Max; Abdul Rashid, Nur Amirah; Lee, Sara-Ann; Lim, Jeanette; Foussias, George; Fervaha, Gagan; Ruhrman, Stephan; Remington, Gary; Lee, Jimmy

    2015-12-01

    Social amotivation and diminished expression have been reported to underlie negative symptomatology in schizophrenia. In the current study we sought to establish and validate these negative symptom domains in a large cohort of schizophrenia subjects (n=887) and individuals who are deemed to be Ultra-High Risk (UHR) for psychosis. Confirmatory factor analysis conducted on PANSS item domains demonstrate that the dual negative symptom domains exist in schizophrenia and UHR subjects. We further sought to examine if these negative symptom domains were associated with functioning in UHR subjects. Linear regression analyses confirmed that social amotivation predicted functioning in UHR subjects prospectively at 1 year follow up. Results suggest that the association between social amotivation and functioning is generalisable beyond schizophrenia populations to those who are at-risk of developing psychosis. Social amotivation may be an important dimensional clinical construct to be studied across a range of psychiatric conditions. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  8. Childhood Conscientiousness and Leukocyte Telomere Length 40 Years Later in Adult Women--Preliminary Findings of a Prospective Association.

    Directory of Open Access Journals (Sweden)

    Grant W Edmonds

    Full Text Available Leukocyte telomere length (LTL shortens with age, and is a prospective marker of mortality related to cardiovascular disease. Many health behaviors and social environmental factors have been found to be associated with LTL. Several of these are also associated with conscientiousness, a dispositional personality trait. Conscientiousness is a propensity to be planful, adhere to social norms, and inhibit pre-potent responses. Like LTL, conscientiousness is prospectively related to mortality, possibly through cumulative effects on health over the life course via multiple pathways. As a result, we hypothesized that childhood levels of conscientiousness would predict LTL prospectively in adulthood. We selected a sample of 60 women in the Hawaii Personality and Health Cohort; 30 described by their teachers as high on conscientiousness in childhood and 30 described as low on the trait. Dried blood spot samples collected in adulthood 40 years later were used as sources of DNA for the LTL assay. Conscientiousness was associated with longer LTL (p = .02. Controlling for age did not account for this association. Controlling for education and physiological dysregulation partially attenuated the association, and the effect remained significant when accounting for differences in LTL across cultural groups. These results represent the first evidence that childhood personality prospectively predicts LTL 40 years later in adulthood. Our findings would be consistent with a mediation hypothesis whereby conscientiousness predicts life paths and trajectories of health that are reflected in rates of LTL erosion across the lifespan.

  9. Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Msangi Viola

    2007-05-01

    Full Text Available Abstract Background Bloodstream infection is a common cause of hospitalization, morbidity and death in children. The impact of antimicrobial resistance and HIV infection on outcome is not firmly established. Methods We assessed the incidence of bloodstream infection and risk factors for fatal outcome in a prospective cohort study of 1828 consecutive admissions of children aged zero to seven years with signs of systemic infection. Blood was obtained for culture, malaria microscopy, HIV antibody test and, when necessary, HIV PCR. We recorded data on clinical features, underlying diseases, antimicrobial drug use and patients' outcome. Results The incidence of laboratory-confirmed bloodstream infection was 13.9% (255/1828 of admissions, despite two thirds of the study population having received antimicrobial therapy prior to blood culture. The most frequent isolates were klebsiella, salmonellae, Escherichia coli, enterococci and Staphylococcus aureus. Furthermore, 21.6% had malaria and 16.8% HIV infection. One third (34.9% of the children with laboratory-confirmed bloodstream infection died. The mortality rate from Gram-negative bloodstream infection (43.5% was more than double that of malaria (20.2% and Gram-positive bloodstream infection (16.7%. Significant risk factors for death by logistic regression modeling were inappropriate treatment due to antimicrobial resistance, HIV infection, other underlying infectious diseases, malnutrition and bloodstream infection caused by Enterobacteriaceae, other Gram-negatives and candida. Conclusion Bloodstream infection was less common than malaria, but caused more deaths. The frequent use of antimicrobials prior to blood culture may have hampered the detection of organisms susceptible to commonly used antimicrobials, including pneumococci, and thus the study probably underestimates the incidence of bloodstream infection. The finding that antimicrobial resistance, HIV-infection and malnutrition predict fatal

  10. Pelvic Lymph Node Status Assessed by 18F-Fluorodeoxyglucose Positron Emission Tomography Predicts Low-Risk Group for Distant Recurrence in Locally Advanced Cervical Cancer: A Prospective Study

    International Nuclear Information System (INIS)

    Kang, Sokbom; Park, Jung-Yeol; Lim, Myung-Chul; Song, Yong-Joong; Park, Se-Hyun; Kim, Seok-Ki; Chung, Dae-Chul; Seo, Sang-Soo; Kim, Joo-Young; Park, Sang-Yoon

    2011-01-01

    Purpose: To develop a prediction model to identify a low-risk group for distant recurrence in patients with locally advanced cervical cancer treated by concurrent chemoradiation. Methods and Materials: Prospectively, 62 patients with locally advanced cervical cancer were recruited as a training cohort. Clinical variables and parameters obtained from positron emission tomography (PET) and magnetic resonance imaging were analyzed by logistic regression. For the test set, 54 patients were recruited independently. To identify the low-risk group, negative likelihood ratio (LR) less than 0.2 was set to be a cutoff. Results: Among the training cohort, multivariate logistic analysis revealed that advanced International Federation of Gynecology and Obstetrics (FIGO) stage and a high serum squamous cancer cell (SCC) antigen level were significant risk factors (p = 0.015 and 0.025, respectively). Using the two parameters, criteria to determine a low-risk subset for distant recurrence were postulated: (1) FIGO Stage IIB or less and (2) pretreatment SCC < 2.4 (Model A). Positive pelvic node on PET completely predicted all cases with distant recurrence and thus was considered as another prediction model (Model B). In the test cohort, although Model A did not showed diagnostic performance, Model B completely predicted all cases with distant recurrence and showed a sensitivity of 100% with negative LR of 0. Across the training and test cohort (n = 116), the false negative rate was 0 (95% confidence interval 0%-7.6%). Conclusions: Positive pelvic node on PET is a useful marker in prediction of distant recurrence in patients with locally advanced cervical cancer who are treated with concurrent chemoradiation.

  11. The predictive value of ePAQ in the urodynamic diagnoses-A prospective cohort study.

    Science.gov (United States)

    McCooty, Shanteela; Nightingale, Peter; Latthe, Pallavi

    2018-01-01

    To assess whether the electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF) had accuracy in predicting the urodynamic diagnoses of Detrusor Overactivity (DO) and/or Urodynamic Stress Incontinence (USI). Tertiary urogynaecology unit linked to an academic university teaching hospital. Consecutive women who presented with lower urinary tract symptoms (LUTS) and were booked to have urodynamic studies. Women completed an ePAQ-PF prior to having urodynamics (UDS) by clinicians who were blinded to the ePAQ-PF results while conducting this procedure. Receiver Operating Characteristics (ROC) curves were constructed for predictive accuracy of overactive bladder (OAB) score in DO and of stress urinary incontinence (SUI) score in USI. Prospective cohort study designed to meet the requirements of the standards for reporting of diagnostic accuracy (STARD). 390 women with a mean age of 54.2 (range 21-92) years were recruited. The majority (n = 294; 75%) were White Caucasian and had two children (n = 157; 40.3%). Of them, 67.2% (n = 262) had DO and USI was confirmed in 21.5% (n = 84). The area under the ROC curve for DO was 0.704 (95% confidence interval 0.650-0.759) and for USI it was 0.731 (95% confidence interval 0.652-0.778). The OAB and SUI scores on the ePAQ-PF demonstrated that they are fair predictors in diagnosing DO and USI. As the OAB and SUI score on ePAQ-PF increased so did the likelihood of DO (up to a score of 75) and USI on UDS. © 2017 Wiley Periodicals, Inc.

  12. Predicting significant torso trauma.

    Science.gov (United States)

    Nirula, Ram; Talmor, Daniel; Brasel, Karen

    2005-07-01

    Identification of motor vehicle crash (MVC) characteristics associated with thoracoabdominal injury would advance the development of automatic crash notification systems (ACNS) by improving triage and response times. Our objective was to determine the relationships between MVC characteristics and thoracoabdominal trauma to develop a torso injury probability model. Drivers involved in crashes from 1993 to 2001 within the National Automotive Sampling System were reviewed. Relationships between torso injury and MVC characteristics were assessed using multivariate logistic regression. Receiver operating characteristic curves were used to compare the model to current ACNS models. There were a total of 56,466 drivers. Age, ejection, braking, avoidance, velocity, restraints, passenger-side impact, rollover, and vehicle weight and type were associated with injury (p < 0.05). The area under the receiver operating characteristic curve (83.9) was significantly greater than current ACNS models. We have developed a thoracoabdominal injury probability model that may improve patient triage when used with ACNS.

  13. A prospective examination of whether childhood sexual abuse predicts subsequent sexual offending.

    Science.gov (United States)

    Widom, Cathy Spatz; Massey, Christina

    2015-01-01

    Childhood sexual abuse has been assumed to increase the risk for sexual offending. However, despite methodological limitations of prior research, public policies and clinical practice have been based on this assumption. To empirically examine the commonly held belief that sexually abused children grow up to become sexual offenders and specialize in sex crimes. This prospective cohort study and archival records check included cases and control individuals originally from a metropolitan county in the Midwest. Children with substantiated cases of physical and sexual abuse and neglect (aged 0-11 years) were matched with children without such histories on the basis of age, sex, race/ethnicity, and approximate family social class (908 cases and 667 control individuals). Both groups were followed up into adulthood (mean age, 51 years). The court cases were from 1967 to 1971; the follow-up extended to 2013. Criminal history information was collected from federal and state law enforcement agency records at 3 points in time and from state sex offender registries. Overall, individuals with histories of childhood abuse and neglect were at increased risk for being arrested for a sex crime compared with control individuals (adjusted odds ratio [AOR], 2.17; 95% CI, 1.38-3.40), controlling for age, sex, and race/ethnicity. Specifically, individuals with histories of physical abuse (AOR, 2.06; 95% CI, 1.02-4.16) and neglect (AOR, 2.21; 95% CI, 1.39-3.51) were at significantly increased risk for arrest for sex offenses, whereas for sexual abuse, the AOR (2.13; 95% CI, 0.83-5.47) did not reach significance. Physically abused and neglected males (not females) were at increased risk and physically abused males also had a higher mean number of sex crime arrests compared with control individuals. The results did not provide support for sex crime specialization. The widespread belief that sexually abused children are uniquely at risk to become sex offenders was not supported by

  14. Sense of coherence predicts post-myocardial infarction trajectory of leisure time physical activity: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Gerber Yariv

    2011-09-01

    Full Text Available Abstract Background Physical activity confers a survival advantage after myocardial infarction (MI, yet the majority of post-MI patients are not regularly active. Since sense of coherence (SOC has been associated with health outcomes and some health behaviours, we investigated whether it plays a role in post-MI physical activity. We examined the predictive role of SOC in the long-term trajectory of leisure time physical activity (LTPA after MI using a prospective cohort design. Methods A cohort of 643 patients aged ≤ 65 years admitted to hospital in central Israel with incident MI between February 1992 and February 1993 were followed up for 13 years. Socioeconomic, clinical and psychological factors, including SOC, were assessed at baseline, and LTPA was self-reported on 5 separate occasions during follow-up. The predictive role of SOC in long-term trajectory of LTPA was assessed using generalized estimating equations. Results SOC was consistently associated with engagement in LTPA throughout follow-up. Patients in the lowest SOC tertile had almost twice the odds (odds ratio,1.99; 95% confidence interval,1.52-2.60 of decreasing their engagement in LTPA as those in the highest tertile. A strong association remained after controlling for disease severity, depression, sociodemographic and clinical factors. Conclusion Our evidence suggests that SOC predicts LTPA trajectory post-MI. Assessment of SOC can help identify high-risk MI survivors, who may require additional help in following secondary prevention recommendations which can dramatically improve prognosis.

  15. Impulsive approach tendencies towards physical activity and sedentary behaviors, but not reflective intentions, prospectively predict non-exercise activity thermogenesis.

    Science.gov (United States)

    Cheval, Boris; Sarrazin, Philippe; Pelletier, Luc

    2014-01-01

    Understanding the determinants of non-exercise activity thermogenesis (NEAT) is crucial, given its extensive health benefits. Some scholars have assumed that a proneness to react differently to environmental cues promoting sedentary versus active behaviors could be responsible for inter-individual differences in NEAT. In line with this reflection and grounded on the Reflective-Impulsive Model, we test the assumption that impulsive processes related to sedentary and physical activity behaviors can prospectively predict NEAT, operationalized as spontaneous effort exerted to maintain low intensity muscle contractions within the release phases of an intermittent maximal isometric contraction task. Participants (n = 91) completed a questionnaire assessing their intentions to adopt physical activity behaviors and a manikin task to assess impulsive approach tendencies towards physical activity behaviors (IAPA) and sedentary behaviors (IASB). Participants were then instructed to perform a maximal handgrip strength task and an intermittent maximal isometric contraction task. As hypothesized, multilevel regression analyses revealed that spontaneous effort was (a) positively predicted by IAPA, (b) negatively predicted by IASB, and (c) was not predicted by physical activity intentions, after controlling for some confounding variables such as age, sex, usual PA level and average force provided during the maximal-contraction phases of the task. These effects remained constant throughout all the phases of the task. This study demonstrated that impulsive processes may play a unique role in predicting spontaneous physical activity behaviors. Theoretically, this finding reinforces the utility of a motivational approach based on dual-process models to explain inter-individual differences in NEAT. Implications for health behavior theories and behavior change interventions are outlined.

  16. Subjective but Not Actigraphy-Defined Sleep Predicts Next-Day Fatigue in Chronic Fatigue Syndrome: A Prospective Daily Diary Study.

    Science.gov (United States)

    Russell, Charlotte; Wearden, Alison J; Fairclough, Gillian; Emsley, Richard A; Kyle, Simon D

    2016-04-01

    This study aimed to (1) examine the relationship between subjective and actigraphy-defined sleep, and next-day fatigue in chronic fatigue syndrome (CFS); and (2) investigate the potential mediating role of negative mood on this relationship. We also sought to examine the effect of presleep arousal on perceptions of sleep. Twenty-seven adults meeting the Oxford criteria for CFS and self-identifying as experiencing sleep difficulties were recruited to take part in a prospective daily diary study, enabling symptom capture in real time over a 6-day period. A paper diary was used to record nightly subjective sleep and presleep arousal. Mood and fatigue symptoms were rated four times each day. Actigraphy was employed to provide objective estimations of sleep duration and continuity. Multilevel modelling revealed that subjective sleep variables, namely sleep quality, efficiency, and perceiving sleep to be unrefreshing, predicted following-day fatigue levels, with poorer subjective sleep related to increased fatigue. Lower subjective sleep efficiency and perceiving sleep as unrefreshing predicted reduced variance in fatigue across the following day. Negative mood on waking partially mediated these relationships. Increased presleep cognitive and somatic arousal predicted self-reported poor sleep. Actigraphy-defined sleep, however, was not found to predict following-day fatigue. For the first time we show that nightly subjective sleep predicts next-day fatigue in CFS and identify important factors driving this relationship. Our data suggest that sleep specific interventions, targeting presleep arousal, perceptions of sleep and negative mood on waking, may improve fatigue in CFS. © 2016 Associated Professional Sleep Societies, LLC.

  17. Statistical significance of theoretical predictions: A new dimension in nuclear structure theories (I)

    International Nuclear Information System (INIS)

    DUDEK, J; SZPAK, B; FORNAL, B; PORQUET, M-G

    2011-01-01

    In this and the follow-up article we briefly discuss what we believe represents one of the most serious problems in contemporary nuclear structure: the question of statistical significance of parametrizations of nuclear microscopic Hamiltonians and the implied predictive power of the underlying theories. In the present Part I, we introduce the main lines of reasoning of the so-called Inverse Problem Theory, an important sub-field in the contemporary Applied Mathematics, here illustrated on the example of the Nuclear Mean-Field Approach.

  18. Basic Needs as a Predictors of Prospective Teachers' Self-Actualization

    Science.gov (United States)

    Arslan, Ali

    2017-01-01

    The purpose of this study is to compare the predictive power of prospective teachers' basic needs on self-actualization. This is a correlational research which is one of the descriptive research methods. The study was conducted on 1033 prospective teachers studying in Bulent Ecevit University Eregli Faculty of Education in the spring term of the…

  19. Can Predictive Modeling Identify Head and Neck Oncology Patients at Risk for Readmission?

    Science.gov (United States)

    Manning, Amy M; Casper, Keith A; Peter, Kay St; Wilson, Keith M; Mark, Jonathan R; Collar, Ryan M

    2018-05-01

    Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study. Setting Tertiary academic medical center. Subjects and Methods Prospectively collected data for patients undergoing surgical treatment for head and neck cancer from January 2013 to January 2015 were used to build predictive models for readmission within 30 days of discharge using logistic regression, classification and regression tree (CART) analysis, and random forests. One model (logistic regression) was then placed prospectively into the discharge workflow from March 2016 to May 2016 to determine the model's ability to predict which patients would be readmitted within 30 days. Results In total, 174 admissions had descriptive data. Thirty-two were excluded due to incomplete data. Logistic regression, CART, and random forest predictive models were constructed using the remaining 142 admissions. When applied to 106 consecutive prospective head and neck oncology patients at the time of discharge, the logistic regression model predicted readmissions with a specificity of 94%, a sensitivity of 47%, a negative predictive value of 90%, and a positive predictive value of 62% (odds ratio, 14.9; 95% confidence interval, 4.02-55.45). Conclusion Prospectively collected head and neck cancer databases can be used to develop predictive models that can accurately predict which patients will be readmitted. This offers valuable support for quality improvement initiatives and readmission-related cost reduction in head and neck cancer care.

  20. Comparison of prospective risk estimates for postoperative complications: human vs computer model.

    Science.gov (United States)

    Glasgow, Robert E; Hawn, Mary T; Hosokawa, Patrick W; Henderson, William G; Min, Sung-Joon; Richman, Joshua S; Tomeh, Majed G; Campbell, Darrell; Neumayer, Leigh A

    2014-02-01

    Surgical quality improvement tools such as NSQIP are limited in their ability to prospectively affect individual patient care by the retrospective audit and feedback nature of their design. We hypothesized that statistical models using patient preoperative characteristics could prospectively provide risk estimates of postoperative adverse events comparable to risk estimates provided by experienced surgeons, and could be useful for stratifying preoperative assessment of patient risk. This was a prospective observational cohort. Using previously developed models for 30-day postoperative mortality, overall morbidity, cardiac, thromboembolic, pulmonary, renal, and surgical site infection (SSI) complications, model and surgeon estimates of risk were compared with each other and with actual 30-day outcomes. The study cohort included 1,791 general surgery patients operated on between June 2010 and January 2012. Observed outcomes were mortality (0.2%), overall morbidity (8.2%), and pulmonary (1.3%), cardiac (0.3%), thromboembolism (0.2%), renal (0.4%), and SSI (3.8%) complications. Model and surgeon risk estimates showed significant correlation (p risk for overall morbidity to be low, the model-predicted risk and observed morbidity rates were 2.8% and 4.1%, respectively, compared with 10% and 18% in perceived high risk patients. Patients in the highest quartile of model-predicted risk accounted for 75% of observed mortality and 52% of morbidity. Across a broad range of general surgical operations, we confirmed that the model risk estimates are in fairly good agreement with risk estimates of experienced surgeons. Using these models prospectively can identify patients at high risk for morbidity and mortality, who could then be targeted for intervention to reduce postoperative complications. Published by Elsevier Inc.

  1. Hemodynamic and glucometabolic factors in the prediction of left ventricular filling pressures

    DEFF Research Database (Denmark)

    Pareek, M; Nielsen, M L; Olesen, T B

    2015-01-01

    OBJECTIVE: To explore possible hemodynamic and glucometabolic determinants of left ventricular filling pressures as assessed by the non-invasive surrogate marker, averaged E/é, in otherwise healthy, middle-aged male survivors from a random population sample. DESIGN AND METHODS: Prospective.......01). We did not find any significant interactions in the prediction of E/é. CONCLUSION: In a prospective population-based cohort study including apparently healthy, middle-aged male subjects, higher age, BMI, and creatinine, but not SBP or HR, were significantly associated with higher left ventricular...... population-based cohort study examining associations between hemodynamic factors [systolic blood pressure (SBP), heart rate (HR)), glucometabolic factors (fasting blood glucose, fasting plasma insulin, Homeostatic Model Assessment (HOMA) derived indices of beta-cell function (HOMA-2B) and insulin sensitivity...

  2. A prediction score for significant coronary artery disease in Chinese patients ≥50 years old referred for rheumatic valvular heart disease surgery.

    Science.gov (United States)

    Xu, Zhenjun; Pan, Jun; Chen, Tao; Zhou, Qing; Wang, Qiang; Cao, Hailong; Fan, Fudong; Luo, Xuan; Ge, Min; Wang, Dongjin

    2018-04-01

    Our goal was to establish a prediction score and protocol for the preoperative prediction of significant coronary artery disease (CAD) in patients with rheumatic valvular heart disease. Using multivariate logistic regression analysis, we validated the model based on 490 patients without a history of myocardial infarction and who underwent preoperative screening coronary angiography. Significant CAD was defined as ≥50% narrowing of the diameter of the lumen of the left main coronary artery or ≥70% narrowing of the diameter of the lumen of the left anterior descending coronary artery, left circumflex artery or right coronary artery. Significant CAD was present in 9.8% of patients. Age, smoking, diabetes mellitus, diastolic blood pressure, low-density lipoprotein cholesterol and ischaemia evident on an electrocardiogram were independently associated with significant CAD and were entered into the multivariate model. According to the logistic regression predictive risk score, preoperative coronary angiography is recommended in (i) postmenopausal women between 50 and 59 years of age with ≥9.1% logistic regression predictive risk score; (ii) postmenopausal women who are ≥60 years old with a logistic regression predictive risk score ≥6.6% and (iii) men ≥50 years old whose logistic regression predictive risk score was ≥2.8%. Based on this predictive model, 246 (50.2%) preoperative coronary angiograms could be safely avoided. The negative predictive value of the model was 98.8% (246 of 249). This model was accurate for the preoperative prediction of significant CAD in patients with rheumatic valvular heart disease. This model must be validated in larger cohorts and various populations.

  3. Prognosis of non-significant coronary atherosclerotic disease detected by coronary artery tomography

    Energy Technology Data Exchange (ETDEWEB)

    Barros, Marcio Vinicius Lins; Siqueira, Bruna Pinto; Guimaraes, Carolina Camargos Braichi; Cruz, David Filipe Silva; Guimaraes, Leiziane Assuncao Alves; Lima, Maicom Marcio Perigolo, E-mail: marciovlbarros@gmail.com [Faculdade de Saude e Ecologia Humana, Vespasiano, MG (Brazil); Nunes, Maria do Carmo Pereira [Universidade de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Medicina; Siqueira, Maria Helena Albernaz [Hospital Materdei, Belo Horizonte, MG (Brazil)

    2015-07-15

    Introduction: Although studies have shown high diagnostic accuracy of coronary tomography (CT) in detecting coronary artery disease (CAD), data on the prognostic value of this method in patients with no significant coronary obstruction are limited. Objective: To evaluate the value of CT in predicting adverse events in patients with suspected CAD and no significant coronary obstruction. Methods: We prospectively evaluated 440 patients between January 2008 and July 2013 by MDCT, diagnosed with no significant obstruction or no atherosclerotic coronary obstruction with an average follow-up of 33 months. The outcomes evaluated were: cardiac death, myocardial infarction, unstable angina associated with hospitalization or coronary artery bypass grafting. Results: Of the 440 patients studied, 295 (67%) were men with mean age 55.9 ± 12.0 years. Non-significant obstruction was found in 152 (35%) of the patients and there were 49 (11%) outcomes. In the multivariate analysis using the Cox regression model, the predictors of clinical outcomes were non-significant obstruction on CT (hazard ratio 3.51; 95% CI 1.73 - 7.8; p <0.01), age and hypertension. Non-significant obstruction on CT was associated with adverse clinical outcomes and survival analysis showed a significant difference (log-rank 24.6; p <0.01) in predicting these outcomes. Conclusion: The detection of non-significant atherosclerotic obstruction by CT was associated with the presence of adverse events in patients with suspected CAD, which may prove useful in the risk stratification of these patients. (author)

  4. Academic decision making and prospect theory.

    Science.gov (United States)

    Mowrer, Robert R; Davidson, William B

    2011-08-01

    Two studies are reported that investigate the applicability of prospect theory to college students' academic decision making. Exp. 1 failed to provide support for the risk-seeking portion of the fourfold pattern predicted by prospect theory but did find the greater weighting of losses over gains. Using a more sensitive dependent measure, in Exp. 2 the results of the first experiment were replicated in terms of the gain-loss effect and also found some support for the fourfold pattern in the interaction between probabilities and gain versus loss. The greatest risk-seeking was found in the high probability loss condition.

  5. Validation of the new graded prognostic assessment scale for brain metastases: a multicenter prospective study

    International Nuclear Information System (INIS)

    Villà, Salvador; Verger, Eugènia; Balañà, Carme; Graus, Francesc; Weber, Damien C; Moretones, Cristina; Mañes, Anabel; Combescure, Christophe; Jové, Josep; Puyalto, Paloma; Cuadras, Patricia; Bruna, Jordi

    2011-01-01

    Prognostic indexes are useful to guide tailored treatment strategies for cancer patients with brain metastasis (BM). We evaluated the new Graded Prognostic Assessment (GPA) scale in a prospective validation study to compare it with two published prognostic indexes. A total of 285 newly diagnosed BM (n = 85 with synchronous BM) patients, accrued prospectively between 2000 and 2009, were included in this analysis. Mean age was 62 ± 12.0 years. The median KPS and number of BM was 70 (range, 20-100) and 3 (range, 1-50), respectively. The majority of primary tumours were lung (53%), or breast (17%) cancers. Treatment was administered to 255 (89.5%) patients. Only a minority of patients could be classified prospectively in a favourable prognostic class: GPA 3.5-4: 3.9%; recursive partitioning analysis (RPA) 1, 8.4% and Basic Score for BM (BSBM) 3, 9.1%. Mean follow-up (FU) time was 5.2 ± 4.7 months. During the period of FU, 225 (78.9%) patients died. The 6 months- and 1 year-OS was 36.9% and 17.6%, respectively. On multivariate analysis, performance status (P < 0.001), BSBM (P < 0.001), Center (P = 0.007), RPA (P = 0.02) and GPA (P = 0.03) were statistically significant for OS. The survival prediction performances' of all indexes were identical. Noteworthy, the significant OS difference observed within 3 months of diagnosis between the BSBM, RPA and GPA classes/groups was not observed after this cut-off time point. Harrell's concordance indexes C were 0.58, 0.61 and 0.58 for the GPA, BSBM and RPA, respectively. Our data suggest that the new GPA index is a valid prognostic index. In this prospective study, the prediction performance was as good as the BSBM or RPA systems. These published indexes may however have limited long term prognostication capability

  6. Prospective detection of large prediction errors: a hypothesis testing approach

    International Nuclear Information System (INIS)

    Ruan, Dan

    2010-01-01

    Real-time motion management is important in radiotherapy. In addition to effective monitoring schemes, prediction is required to compensate for system latency, so that treatment can be synchronized with tumor motion. However, it is difficult to predict tumor motion at all times, and it is critical to determine when large prediction errors may occur. Such information can be used to pause the treatment beam or adjust monitoring/prediction schemes. In this study, we propose a hypothesis testing approach for detecting instants corresponding to potentially large prediction errors in real time. We treat the future tumor location as a random variable, and obtain its empirical probability distribution with the kernel density estimation-based method. Under the null hypothesis, the model probability is assumed to be a concentrated Gaussian centered at the prediction output. Under the alternative hypothesis, the model distribution is assumed to be non-informative uniform, which reflects the situation that the future position cannot be inferred reliably. We derive the likelihood ratio test (LRT) for this hypothesis testing problem and show that with the method of moments for estimating the null hypothesis Gaussian parameters, the LRT reduces to a simple test on the empirical variance of the predictive random variable. This conforms to the intuition to expect a (potentially) large prediction error when the estimate is associated with high uncertainty, and to expect an accurate prediction when the uncertainty level is low. We tested the proposed method on patient-derived respiratory traces. The 'ground-truth' prediction error was evaluated by comparing the prediction values with retrospective observations, and the large prediction regions were subsequently delineated by thresholding the prediction errors. The receiver operating characteristic curve was used to describe the performance of the proposed hypothesis testing method. Clinical implication was represented by miss

  7. The discriminatory capability of existing scores to predict advanced colorectal neoplasia: a prospective colonoscopy study of 5,899 screening participants.

    Science.gov (United States)

    Wong, Martin C S; Ching, Jessica Y L; Ng, Simpson; Lam, Thomas Y T; Luk, Arthur K C; Wong, Sunny H; Ng, Siew C; Ng, Simon S M; Wu, Justin C Y; Chan, Francis K L; Sung, Joseph J Y

    2016-02-03

    We evaluated the performance of seven existing risk scoring systems in predicting advanced colorectal neoplasia in an asymptomatic Chinese cohort. We prospectively recruited 5,899 Chinese subjects aged 50-70 years in a colonoscopy screening programme(2008-2014). Scoring systems under evaluation included two scoring tools from the US; one each from Spain, Germany, and Poland; the Korean Colorectal Screening(KCS) scores; and the modified Asia Pacific Colorectal Screening(APCS) scores. The c-statistics, sensitivity, specificity, positive predictive values(PPVs), and negative predictive values(NPVs) of these systems were evaluated. The resources required were estimated based on the Number Needed to Screen(NNS) and the Number Needed to Refer for colonoscopy(NNR). Advanced neoplasia was detected in 364 (6.2%) subjects. The German system referred the least proportion of subjects (11.2%) for colonoscopy, whilst the KCS scoring system referred the highest (27.4%). The c-statistics of all systems ranged from 0.56-0.65, with sensitivities ranging from 0.04-0.44 and specificities from 0.74-0.99. The modified APCS scoring system had the highest c-statistics (0.65, 95% C.I. 0.58-0.72). The NNS (12-19) and NNR (5-10) were similar among the scoring systems. The existing scoring systems have variable capability to predict advanced neoplasia among asymptomatic Chinese subjects, and further external validation should be performed.

  8. Physiologically-based, predictive analytics using the heart-rate-to-Systolic-Ratio significantly improves the timeliness and accuracy of sepsis prediction compared to SIRS.

    Science.gov (United States)

    Danner, Omar K; Hendren, Sandra; Santiago, Ethel; Nye, Brittany; Abraham, Prasad

    2017-04-01

    Enhancing the efficiency of diagnosis and treatment of severe sepsis by using physiologically-based, predictive analytical strategies has not been fully explored. We hypothesize assessment of heart-rate-to-systolic-ratio significantly increases the timeliness and accuracy of sepsis prediction after emergency department (ED) presentation. We evaluated the records of 53,313 ED patients from a large, urban teaching hospital between January and June 2015. The HR-to-systolic ratio was compared to SIRS criteria for sepsis prediction. There were 884 patients with discharge diagnoses of sepsis, severe sepsis, and/or septic shock. Variations in three presenting variables, heart rate, systolic BP and temperature were determined to be primary early predictors of sepsis with a 74% (654/884) accuracy compared to 34% (304/884) using SIRS criteria (p < 0.0001)in confirmed septic patients. Physiologically-based predictive analytics improved the accuracy and expediency of sepsis identification via detection of variations in HR-to-systolic ratio. This approach may lead to earlier sepsis workup and life-saving interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Multidimensional assessment of patient condition and mutational analysis in peripheral blood, as tools to improve outcome prediction in myelodysplastic syndromes: A prospective study of the Spanish MDS group.

    Science.gov (United States)

    Ramos, Fernando; Robledo, Cristina; Pereira, Arturo; Pedro, Carmen; Benito, Rocío; de Paz, Raquel; Del Rey, Mónica; Insunza, Andrés; Tormo, Mar; Díez-Campelo, María; Xicoy, Blanca; Salido, Eduardo; Sánchez-Del-Real, Javier; Arenillas, Leonor; Florensa, Lourdes; Luño, Elisa; Del Cañizo, Consuelo; Sanz, Guillermo F; María Hernández-Rivas, Jesús

    2017-09-01

    The International Prognostic Scoring System and its revised form (IPSS-R) are the most widely used indices for prognostic assessment of patients with myelodysplastic syndromes (MDS), but can only partially account for the observed variation in patient outcomes. This study aimed to evaluate the relative contribution of patient condition and mutational status in peripheral blood when added to the IPSS-R, for estimating overall survival and the risk of leukemic transformation in patients with MDS. A prospective cohort (2006-2015) of 200 consecutive patients with MDS were included in the study series and categorized according to the IPSS-R. Patients were further stratified according to patient condition (assessed using the multidimensional Lee index for older adults) and genetic mutations (peripheral blood samples screened using next-generation sequencing). The change in likelihood-ratio was tested in Cox models after adding individual covariates. The addition of the Lee index to the IPSS-R significantly improved prediction of overall survival [hazard ratio (HR) 3.02, 95% confidence interval (CI) 1.96-4.66, P < 0.001), and mutational analysis significantly improved prediction of leukemic evolution (HR 2.64, 1.56-4.46, P < 0.001). Non-leukemic death was strongly linked to patient condition (HR 2.71, 1.72-4.25, P < 0.001), but not to IPSS-R score (P = 0.35) or mutational status (P = 0.75). Adjustment for exposure to disease-modifying therapy, evaluated as a time-dependent covariate, had no effect on the proposed model's predictive ability. In conclusion, patient condition, assessed by the multidimensional Lee index and patient mutational status can improve the prediction of clinical outcomes of patients with MDS already stratified by IPSS-R. © 2017 Wiley Periodicals, Inc.

  10. Theory of mind and switching predict prospective memory performance in adolescents

    NARCIS (Netherlands)

    Altgassen, A.M.; Vetter, N.C.; Phillips, L.H.; Akgün, C.; Kliegel, M.

    2014-01-01

    Research indicates ongoing development of prospective memory as well as theory of mind and executive functions across late childhood and adolescence. However, so far the interplay of these processes has not been investigated. Therefore, the purpose of the current study was to investigate whether

  11. Prospect Theory for Online Financial Trading

    Science.gov (United States)

    Liu, Yang-Yu; Nacher, Jose C.; Ochiai, Tomoshiro; Martino, Mauro; Altshuler, Yaniv

    2014-03-01

    Prospect theory is widely viewed as the best available descriptive model of how people evaluate risk in experimental settings. According to prospect theory, people make decisions based on the potential value of losses and gains rather than the final outcome. People are risk-averse with respect to gains and risk-seeking with respect to losses, a phenomenon called ``loss aversion''. Despite of the fact that prospect theory has been well studied in behavioral economics at the theoretical level, there exist very few empirical research and most of them has been undertaken with micro-panel data. Here we analyze the trading activities of over 1.5 million members of an online financial trading community over 28 months, aiming to explore the large-scale empirical aspect of prospect theory. By analyzing and comparing the behaviour of ``winners'' and ``losers'', i.e., traders with positive or negative final net profit, we find clear evidence of the loss aversion phenomenon, an essence in prospect theory. This work demonstrates an unprecedented large-scale empirical evidence of prospect theory. It has immediate implication in financial trading, e.g., developing new trading strategies by minimizing the effect of loss aversion. It also provides opportunity to augment online social trading, where users are allowed to watch and follow the trading activity of others, by predicting potential winners based on their historical trading behaviour.

  12. The predictive value of treatment response using FDG PET performed on day 21 of chemoradiotherapy in patients with oesophageal squamous cell carcinoma. A prospective, multicentre study (RTEP3)

    Energy Technology Data Exchange (ETDEWEB)

    Palie, Odre; Vera, Pierre [Henri Becquerel Cancer Center and Rouen University Hospital, and QuantIF - LITIS (EA 4108), University of Rouen, Department of Nuclear Medicine, Faculty of Medicine, Rouen (France); Michel, Pierre; Di Fiore, Frederic [Rouen University Hospital and University of Rouen, Digestive Oncology Unit, Hepatogastroenterology Department, Rouen (France); Menard, Jean-Francois [Rouen University Hospital and University of Rouen, Department of Biostatistic, Rouen (France); Rousseau, Caroline; Bridji, Boumediene [Department of Nuclear Medicine, Renee Gauducheau Cancer Center, Nantes (France); Rio, Emmanuel [Department of Radiotherapy, Renee Gauducheau Cancer Center, Nantes (France); Benyoucef, Ahmed [Department of Radiotherapy, Henri Becquerel Cancer Center, Rouen (France); Meyer, Marc-Etienne [Amiens University Hospital, Department of Nuclear Medicine, Amiens (France); Jalali, Khadija [Amiens University Hospital, Department of Radiotherapy, Amiens (France); Bardet, Stephane [Department of Nuclear Medicine, Francois Baclesse Cancer Center, Caen (France); M' Vondo, Che Mabubu [Department of radiotherapy, Francois Baclesse Cancer Center, Caen (France); Olivier, Pierre [Brabois University Hospital, Department of Nuclear Medicine, Nancy (France); Faure, Guillaume [Department of Radiotherapy, Centre prive de Radiotherapie de Metz, Metz (France); Itti, Emmanuel [Henri Mondor University Hospital, Department of Nuclear Medicine, Creteil (France); Diana, Christian [Henri Mondor University Hospital, Department of Radiotherapy, Creteil (France); Houzard, Claire [Department of Nuclear Medicine, Hospices Civils de Lyon, Lyon (France); Mornex, Francoise [Department of Radiotherapy, Hospices Civils de Lyon, Lyon (France)

    2013-09-15

    FDG PET has been suggested to have predictive value in the prognosis of oesophageal carcinoma. However, the retrospective studies reported in the literature have shown discordant results. Additionally, only four studies have evaluated FDG PET during chemoradiotherapy (CRT) in patients with different histological lesions. The purpose of this study was to investigate the predictive value of FDG PET performed early during CRT (on day 21) in a population of patients with oesophageal squamous cell carcinoma. Included in this prospective study were 57 patients with a histological diagnosis of squamous cell carcinoma of the oesophagus. Of these 57 patients, 48 (84 %) were evaluated (aged 63 {+-} 11 years; 44 men, 4 women). Each patient underwent FDG PET (4.5 MBq/kg) before CRT, according to the Herskovic protocol (t0; PET{sub 1}) and on day 21 {+-} 3 from the start of CRT (d21; PET{sub 2}). The response assessment included a clinical examination, CT scan or FDG PET and histological analysis 3 months and 1 year after PET{sub 1}. The patients were classified as showing a complete response (CR) or a noncomplete response. A quantitative analysis was carried out for PET{sub 1} and PET{sub 2} using the following parameters: SUVmax, SUVmean (with SUVmean{sub 40} as the 3-D volume at an SUVmax threshold of 40 % and SUVmean{sub p} as that defined by a physician), tumour volume (TV, with TV{sub 40} defined as the TV at 40 % of SUVmax, and TV{sub p} as that defined by a physician); and the total lesion glycolysis (TLG, SUVmean x TV, with TLG{sub 40} defined as the TLG at 40 % of SUVmax, and TLG{sub p} as that defined by a physician). The differences in responses at 3 months and 1 year between PET{sub 1} (t0) and PET{sub 2} (d21) were assessed in terms of variations in SUV, TV and TLG using a repeated measures of variance (ANOVA). SUVmax, SUVmean and TLG decreased significantly between PET{sub 1} (t0) and PET{sub 2} (d21; p < 0.0001). The TV significantly decreased only when assessed

  13. Parametric Optimization and Prediction Tool for Excavation and Prospecting Tasks, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Honeybee Robotics therefore proposed to develop a software tool for facilitating prospecting and excavation system trades in support of selecting an optimal...

  14. Impulsive approach tendencies towards physical activity and sedentary behaviors, but not reflective intentions, prospectively predict non-exercise activity thermogenesis.

    Directory of Open Access Journals (Sweden)

    Boris Cheval

    Full Text Available Understanding the determinants of non-exercise activity thermogenesis (NEAT is crucial, given its extensive health benefits. Some scholars have assumed that a proneness to react differently to environmental cues promoting sedentary versus active behaviors could be responsible for inter-individual differences in NEAT. In line with this reflection and grounded on the Reflective-Impulsive Model, we test the assumption that impulsive processes related to sedentary and physical activity behaviors can prospectively predict NEAT, operationalized as spontaneous effort exerted to maintain low intensity muscle contractions within the release phases of an intermittent maximal isometric contraction task. Participants (n = 91 completed a questionnaire assessing their intentions to adopt physical activity behaviors and a manikin task to assess impulsive approach tendencies towards physical activity behaviors (IAPA and sedentary behaviors (IASB. Participants were then instructed to perform a maximal handgrip strength task and an intermittent maximal isometric contraction task. As hypothesized, multilevel regression analyses revealed that spontaneous effort was (a positively predicted by IAPA, (b negatively predicted by IASB, and (c was not predicted by physical activity intentions, after controlling for some confounding variables such as age, sex, usual PA level and average force provided during the maximal-contraction phases of the task. These effects remained constant throughout all the phases of the task. This study demonstrated that impulsive processes may play a unique role in predicting spontaneous physical activity behaviors. Theoretically, this finding reinforces the utility of a motivational approach based on dual-process models to explain inter-individual differences in NEAT. Implications for health behavior theories and behavior change interventions are outlined.

  15. Predictive and associated factors of psychiatric disorders after traumatic brain injury: a prospective study.

    Science.gov (United States)

    Gould, Kate Rachel; Ponsford, Jennie Louise; Johnston, Lisa; Schönberger, Michael

    2011-07-01

    Psychiatric disorders are common and often debilitating following traumatic brain injury (TBI). However, there is little consensus within the literature regarding the risk factors for post-injury psychiatric disorders. A 1-year prospective study was conducted to examine which pre-injury, injury-related, and concurrent factors were associated with experiencing a psychiatric disorder, diagnosed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders, at 1 year post-injury. Participants were 122 adults with TBI and 88 proxy informants. Psychiatric disorders were common both pre-injury (54.1%) and at 12 months post-injury (45.9%). Results of regression analyses indicated individuals without a pre-injury psychiatric disorder or psychiatric symptomatology in the acute post-injury period were less likely to have a psychiatric disorder at 12 months post-injury. These findings confirm the importance of pre-injury history for the prediction of post-injury psychiatric disorders. Limb injury also emerged as a useful early indicator of later psychiatric disorder. Post-injury psychiatric disorders were associated with concurrent unemployment, pain, poor quality of life, and use of unproductive coping skills. The clinical implications of these findings are discussed.

  16. Irregular menses predicts ovarian cancer: Prospective evidence from the Child Health and Development Studies.

    Science.gov (United States)

    Cirillo, Piera M; Wang, Erica T; Cedars, Marcelle I; Chen, Lee-May; Cohn, Barbara A

    2016-09-01

    We tested the hypothesis that irregular menstruation predicts lower risk for ovarian cancer, possibly due to less frequent ovulation. We conducted a 50-year prospective study of 15,528 mothers in the Child Health and Development Studies cohort recruited from the Kaiser Foundation Health Plan from 1959 to 1966. Irregular menstruation was classified via medical record and self-report at age 26. We identified 116 cases and 84 deaths due to ovarian cancer through 2011 via linkage to the California Cancer Registry and Vital Statistics. Contrary to expectation, women with irregular menstrual cycles had a higher risk of ovarian cancer incidence and mortality over the 50-year follow-up. Associations increased with age (p irregular menstruation and ovarian cancer-we unexpectedly found higher risk for women with irregular cycles. These women are easy to identify and many may have polycystic ovarian syndrome. Classifying high-risk phenotypes such as irregular menstruation creates opportunities to find novel early biomarkers, refine clinical screening protocols and potentially develop new risk reduction strategies. These efforts can lead to earlier detection and better survival for ovarian cancer. © 2016 UICC.

  17. Prospective, longitudinal study of tic, obsessive-compulsive, and attention-deficit/hyperactivity disorders in an epidemiological sample.

    Science.gov (United States)

    Peterson, B S; Pine, D S; Cohen, P; Brook, J S

    2001-06-01

    Understanding the interrelatedness of tics, obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD) has been complicated by studying only cross-sectional samples of clinically referred subjects. The authors report the cross-sectional and longitudinal associations of these disorders in an epidemiological sample of children followed prospectively into early adulthood. Structured diagnostic interview information was acquired on 976 children, aged 1 to 10 years, who were randomly selected from families living in upstate New York in 1975. Reassessments were acquired in 776 of these subjects 8, 10, and 15 years later. Diagnostic prevalences were estimated at each time point. The associations among tics, OCD, and ADHD were assessed within and across time points, as were their associations with comorbid illnesses and demographic risk factors. In temporal cross-section, tics and ADHD symptoms were associated with OCD symptoms in late adolescence and early adulthood after demographic features and comorbid psychiatric symptoms were controlled. In prospective analyses, tics in childhood and early adolescence predicted an increase in OCD symptoms in late adolescence and early adulthood. ADHD symptoms in adolescence predicted more OCD symptoms in early adulthood, and OCD in adolescence predicted more ADHD symptoms in adulthood. The associations of tics with ADHD were unimpressive in temporal cross-section and were not significant in prospective analyses. Tics, OCD, and ADHD shared numerous complex associations with demographic and psychopathological risk factors. ADHD was associated with lower IQ and lower social status, whereas OCD was associated with higher IQ. Tics and OCD were significantly associated in this sample, as were OCD and ADHD. These findings are in general consistent with those from family studies, and they help to define the natural history, comorbid illnesses, and interrelatedness of these conditions.

  18. PROSPECT improves cis-acting regulatory element prediction by integrating expression profile data with consensus pattern searches

    Science.gov (United States)

    Fujibuchi, Wataru; Anderson, John S. J.; Landsman, David

    2001-01-01

    Consensus pattern and matrix-based searches designed to predict cis-acting transcriptional regulatory sequences have historically been subject to large numbers of false positives. We sought to decrease false positives by incorporating expression profile data into a consensus pattern-based search method. We have systematically analyzed the expression phenotypes of over 6000 yeast genes, across 121 expression profile experiments, and correlated them with the distribution of 14 known regulatory elements over sequences upstream of the genes. Our method is based on a metric we term probabilistic element assessment (PEA), which is a ranking of potential sites based on sequence similarity in the upstream regions of genes with similar expression phenotypes. For eight of the 14 known elements that we examined, our method had a much higher selectivity than a naïve consensus pattern search. Based on our analysis, we have developed a web-based tool called PROSPECT, which allows consensus pattern-based searching of gene clusters obtained from microarray data. PMID:11574681

  19. [Non operative treatment for perforated peptic ulcer: results of a prospective study].

    Science.gov (United States)

    Songne, B; Jean, F; Foulatier, O; Khalil, H; Scotté, M

    2004-12-01

    The conservative management of perforated peptic ulcer has not gained widespread acceptance despite introduction of proton-pomp inhibitors because surgical procedures can achieve immediate closure by eventually using a laparoscopic approach. The aim of this prospective study was to evaluate the results of Taylor's method and to identify predictive factors of failure of medical treatment in patients presenting with perforated peptic ulcer. Between 1990 and 2000, 82 consecutive patients, with diagnosis of perforated peptic ulcer were prospectively included in this study. They were initially treated with non-operative procedure (nasogastric suction and intravenous administration of H2-blockers or proton-pomp inhibitors). No clinical improvement after 24 hours required a surgical treatment. Predictive factors of failure of non-operative treatment were tested in univariate or multivariate analysis. Clinical improvement was obtained with non-operative treatment in 54% of the patients (44/82). The overall mortality rate was 1%. In univariate analysis, significant predictive factors of failure of non-operative treatment were: size of pneumoperitoneum, heart beat >94 bpm, abdominal meteorism, pain at digital rectal exam, and age >59 years. In multivariate analysis, the significant factors were the size of pneumoperitoneum, heart beat, and abdominal meteorism. The association of these criteria: size of pneumoperitoneum >size of the first lumbar vertebra, heart beat >94 bpm, pain at digital rectal exam and age > 59 years , led to surgical treatment in all cases. These results suggest that more than 50% of patients with perforated peptic ulcer respond to conservative treatment without surgery and that the association of few criteria (size of pneumoperitoneum, heart beat, pain at digital rectal exam and age) require emergency surgery.

  20. Preoperative prediction of lymph node metastasis and deep stromal invasion in women with invasive cervical cancer: prospective multicenter study using 2D and 3D ultrasound.

    Science.gov (United States)

    Pálsdóttir, K; Fischerova, D; Franchi, D; Testa, A; Di Legge, A; Epstein, E

    2015-04-01

    To determine how various objective two-dimensional (2D) and three-dimensional (3D) ultrasound parameters allow prediction of deep stromal tumor invasion and lymph node involvement, in comparison to subjective ultrasound assessment, in women scheduled for surgery for cervical cancer. This was a prospective multicenter trial including 104 women with cervical cancer at FIGO Stages IA2-IIB, verified histologically. Patients scheduled for surgery underwent a preoperative ultrasound examination. The value of various 2D (size, color score) and 3D (volume, vascular indices) ultrasound parameters was compared to that of subjective assessment in the prediction of deep stromal tumor invasion and lymph node involvement. Histology obtained from radical hysterectomy or trachelectomy and pelvic lymphadenectomy was considered as the gold standard for assessment. All women underwent pelvic lymphadenectomy, with 99 (95%) undergoing subsequent radical surgery; five underwent only pelvic lymphadenectomy because of the presence of a positive sentinel lymph node. Women with deep stromal invasion or lymph node involvement had significantly larger tumors (diameter and volume) but there was no correlation with vascular indices measured on 3D ultrasound. Subjective evaluation was superior (AUC, 0.93; sensitivity, 90.5%; specificity, 97.2%) in the prediction of deep stromal invasion when compared to any objective measurement technique, with maximal tumor diameter at 20.5-mm cut-off (AUC, 0.83; sensitivity, 90.5%; specificity, 61.1%) and 3D tumor volume at 9.1-mm(3) cut-off (AUC, 0.85; sensitivity, 79.4%; specificity, 83.3%) providing the best performance among the objective parameters. Both subjective assessment and objective measurements were poorly predictive of lymph node involvement. In women with cervical cancer, subjective ultrasound evaluation allowed better prediction of deep stromal invasion than did objective measurements; however, neither subjective evaluation nor objective

  1. The clinical significance and risk factors of anti-platelet factor 4/heparin antibody on maintenance hemodialysis patients: a two-year prospective follow-up.

    Directory of Open Access Journals (Sweden)

    Delong Zhao

    Full Text Available BACKGROUND: Heparin-induced thrombocytopenia is an immune response mediated by anti-PF4/heparin antibody, which is clinically characterized by thrombocytopenia and thromboembolic events. In this study, a prospective and multi-center clinical investigation 1 determined the positive rate of anti-PF4/heparin antibody in maintenance hemodialysis patients in China, 2 identified the related risk factors, and 3 further explored the effect of the anti-PF4/heparin antibody on bleeding, thromboembolic events, and risk of death in the patients. METHODS: The serum anti-PF4/heparin antibody was measured in 661 patients from nine hemodialysis centers, detected by IgG-specific ELISA and followed by confirmation with excess heparin. Risk factors of these patients were analyzed. Based on a two-year follow-up, the association between the anti-PF4/heparin antibody and bleeding, thromboembolic events, and risk of death in the patients was investigated. RESULTS: 1 The positivity rate of the anti-PF4/heparin antibody in maintenance hemodialysis patients was 5.6%. With diabetes as an independent risk factor, the positivity rate of the anti-PF4/heparin antibody decreased in the patients undergoing weekly dialyses ≥3 times. 2 The positivity rate of the anti-PF4/heparin antibody was not related to the occurrence of clinical thromboembolic events and was not a risk factor for death within two years in maintenance hemodialysis patients. 3 Negativity for the anti-PF4/heparin antibody combined with a reduction of the platelet count or combined with the administration of antiplatelet drugs yielded a significant increase in bleeding events. However, the composite determination of the anti-PF4/heparin antibody and thrombocytopenia, as well as the administration of antiplatelet drugs, was not predictive for the risk of thromboembolic events in the maintenance hemodialysis patients. CONCLUSIONS: A single detection of the anti-PF4/heparin antibody did not predict the occurrence

  2. Feasibility and predictive performance of the Hendrich Fall Risk Model II in a rehabilitation department: a prospective study.

    Science.gov (United States)

    Campanini, Isabella; Mastrangelo, Stefano; Bargellini, Annalisa; Bassoli, Agnese; Bosi, Gabriele; Lombardi, Francesco; Tolomelli, Stefano; Lusuardi, Mirco; Merlo, Andrea

    2018-01-11

    Falls are a common adverse event in both elderly inpatients and patients admitted to rehabilitation units. The Hendrich Fall Risk Model II (HIIFRM) has been already tested in all hospital wards with high fall rates, with the exception of the rehabilitation setting. This study's aim is to address the feasibility and predictive performances of HIIFRM in a hospital rehabilitation department. A 6 months prospective study in a Italian rehabilitation department with patients from orthopaedic, pulmonary, and neurological rehabilitation wards. All admitted patients were enrolled and assessed within 24 h of admission by means of the HIIFRM. The occurrence of falls was checked and recorded daily. HIIFRM feasibility was assessed as the percentage of successful administrations at admission. HIIFRM predictive performance was determined in terms of area under the Receiver Operating Characteristic (ROC) curve (AUC), best cutoff, sensitivity, specificity, positive and negative predictive values, along with their asymptotic 95% confidence intervals (95% CI). One hundred ninety-one patents were admitted. HIIFRM was feasible in 147 cases (77%), 11 of which suffered a fall (7.5%). Failures in administration were mainly due to bedridden patients (e.g. minimally conscious state, vegetative state). AUC was 0.779(0.685-0.873). The original HIIFRM cutoff of 5 led to a sensitivity of 100% with a mere specificity of 49%(40-57%), thus suggesting using higher cutoffs. Moreover, the median score for non-fallers at rehabilitation units was higher than that reported in literature for geriatric non fallers. The best trade-off between sensitivity and specificity was obtained by using a cutoff of 8. This lead to sensitivity = 73%(46-99%), specificity = 72%(65-80%), positive predictive value = 17% and negative predictive value = 97%. These results support the use of the HIIFRM as a predictive tool. The HIIFRM showed satisfactory feasibility and predictive performances in

  3. Prospective memory, level of disability, and return to work in severe mental illness.

    Science.gov (United States)

    Burton, Cynthia Z; Vella, Lea; Twamley, Elizabeth W

    2018-02-25

    Prospective memory (the ability to remember to do things) has clear implications for everyday functioning, including employment, in people with severe mental illnesses (SMI). This study aimed to evaluate prospective memory performance and its relationship to real-world functional variables in an employment-seeking sample of people with SMI (Clinical Trial registration number NCT00895258). 153 individuals with DSM-IV diagnosis of depression (n = 58), bipolar disorder (n = 37), or schizophrenia (n = 58) who were receiving outpatient psychiatric care at a university clinic enrolled in a trial of supported employment and completed a baseline assessment. Prospective memory was measured with the Memory for Intentions Test (MIST); real-world functional status included work history variables, clinical history variables, baseline functional capacity (UCSD Performance-based Skills Assessment-Brief), and work outcomes (weeks worked and wages earned during two years of supported employment). Participants with schizophrenia performed worse on the MIST than did those with affective disorders. Independent of diagnosis, education, and estimated intellectual functioning, prospective memory significantly predicted variance in measures of disability and illness burden (disability benefits, hospitalization history, current functional capacity), and work outcomes over two years of supported employment (weeks worked). Worse prospective memory appears to be associated with greater illness burden and functional disability in SMI. Mental health clinicians and employment specialists may counsel clients to use compensatory prospective memory strategies to improve work performance and decrease functional disability associated with SMI.

  4. Novel Signs and Their Clinical Utility in Diagnosing Complex Regional Pain Syndrome (CRPS): A Prospective Observational Cohort Study.

    Science.gov (United States)

    Kuttikat, Anoop; Shaikh, Maliha; Oomatia, Amin; Parker, Richard; Shenker, Nicholas

    2017-06-01

    Delays in diagnosis occur with complex regional pain syndrome (CRPS). We define and prospectively demonstrate that novel bedside tests measuring body perception disruption can identify patients with CRPS postfracture. The objectives of our study were to define and validate 4 bedside tests, to identify the prevalence of positive tests in patients with CRPS and other chronic pain conditions, and to assess the clinical utility (sensitivity, specificity, positive predictive value, negative predictive value) for identifying CRPS within a Fracture cohort. This was a single UK teaching hospital prospective cohort study with 313 recruits from pain-free volunteers and patients with chronic pain conditions.Four novel tests were Finger Perception (FP), Hand Laterality identification (HL), Astereognosis (AS), and Body Scheme (BS) report. Five questionnaires (Brief Pain Inventory, Upper Extremity Functional Index, Lower Extremity Functional Index, Neglect-like Symptom Questionnaire, Hospital Anxiety and Depression Score) assessed the multidimensional pain experience. FP and BS were the best performing tests. Prospective monitoring of fracture patients showed that out of 7 fracture patients (total n=47) who had both finger misperception and abnormal BS report at initial testing, 3 developed persistent pain with 1 having a formal diagnosis of CRPS. Novel signs are reliable, easy to perform, and present in chronic pain patients. FP and BS have significant clinical utility in predicting persistent pain in a fracture group thereby allowing targeted early intervention.

  5. Case studies in archaeological predictive modelling

    NARCIS (Netherlands)

    Verhagen, Jacobus Wilhelmus Hermanus Philippus

    2007-01-01

    In this thesis, a collection of papers is put together dealing with various quantitative aspects of predictive modelling and archaeological prospection. Among the issues covered are the effects of survey bias on the archaeological data used for predictive modelling, and the complexities of testing

  6. IL-6 is a potential marker for radiation pneumonitis: a prospective clinical study of circulating cytokines in predicting radiation pulmonary injury

    International Nuclear Information System (INIS)

    Chen Yuhchyau; Rubin, Philip; McDonald, Sandra; Finkelstein, Jacob; Smudzin, Therese; Hernady, Eric; Williams, Jacqueline

    1997-01-01

    Purpose/Objective: The use of radiotherapy in eradicating thoracic malignancy is limited by the normal lung tissue tolerance to ionizing radiation. Subacute and late radiation pulmonary toxicity manifests as radiation pneumonitis and ultimately lung fibrosis. Recently, the addition of chemotherapy or a biologic response modifier to radiation has become the standard therapy for inoperable lung cancer. The radiosensitizing effect of these agents is associated with an increased risk of radiation pulmonary injury and treatment related mortality. The search for a serum marker for predicting radiation pulmonary injury will help us understand the mechanism leading to such events and find possible interventions to prevent the adverse outcome. Unpublished data from our laboratory suggested that following a single dose of radiation, there was a dose-related elevation in IL-6 protein levels in the lung of radiation fibrosis prone mice. Based on this information, a prospective clinical study of circulating cytokine levels and its application to predict radiation induced pulmonary injury was conducted at University of Rochester. Preliminary results revealed promising information in identifying a circulating cytokine as a predictor for radiation pneumonitis. Materials and Methods: Eighteen patients receiving thoracic irradiation for primary thoracic malignancy were registered in the study. Radiation pneumonitis was determined by subjective respiratory symptoms assessed according to RTOG morbidity scoring criteria. Pretreatment and serial post-therapy chest X-ray, chest CT scan and pulmonary function tests were obtained. Radiation fibrosis was determined by radiographic changes in irradiated normal lung using a scoring system which quantified the extent of loss of air content, degree of opacification, anatomic extent of involvement, air bronchogram, pleural thickening, or effusion. Plasma levels of interleukin-6 (IL-6), tumor necrosis factor (TNF), transforming growth factor

  7. Selective effects of acute alcohol intake on the prospective and retrospective components of a prospective-memory task with emotional targets.

    Science.gov (United States)

    Walter, Nora T; Bayen, Ute J

    2016-01-01

    Prospective memory involves remembering to do something in the future and has a prospective component (remembering that something must be done) and a retrospective component (remembering what must be done and when it must be done). Initial studies reported an impairment in prospective-memory performance due to acute alcohol consumption. Retrospective-memory studies demonstrated that alcohol effects vary depending on the emotionality of the information that needs to be learned. The aim of the present study was to investigate possible differential effects of a mild acute alcohol dose (0.4 g/kg) on the prospective and retrospective components of prospective memory depending on cue valence. Seventy-five participants were allocated to an alcohol or placebo group and performed a prospective-memory task in which prospective-memory cue valence was manipulated (negative, neutral, positive). The multinomial model of event-based prospective memory (Smith and Bayen 2004) was used to measure alcohol and valence effects on the two prospective-memory components separately. Overall, no main effect of alcohol or valence on prospective-memory performance occurred. However, model-based analyses demonstrated a significantly higher retrospective component for positive compared with negative cues in the placebo group. In the alcohol group, the prospective component was weaker for negative than for neutral cues and the retrospective component was stronger for positive than for neutral cues. Group comparisons showed that the alcohol group had a significantly lower prospective component for negative cues and a lower retrospective component for neutral cues. This is the first study to demonstrate selective alcohol effects on prospective-memory components depending on prospective-memory cue valence.

  8. Predicting sugar-sweetened behaviours with theory of planned behaviour constructs: Outcome and process results from the SIPsmartER behavioural intervention.

    Science.gov (United States)

    Zoellner, Jamie M; Porter, Kathleen J; Chen, Yvonnes; Hedrick, Valisa E; You, Wen; Hickman, Maja; Estabrooks, Paul A

    2017-05-01

    Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology. Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants. Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models. TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13-20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6-38%) and behaviour (average 30%, range 6-55%) were significant. Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases.

  9. Predicting sugar-sweetened behaviours with theory of planned behaviour constructs: Outcome and process results from the SIPsmartER behavioural intervention

    Science.gov (United States)

    Zoellner, Jamie M.; Porter, Kathleen J.; Chen, Yvonnes; Hedrick, Valisa E.; You, Wen; Hickman, Maja; Estabrooks, Paul A.

    2017-01-01

    Objective Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology. Design Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants. Main Outcome Measures Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models. Results TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13–20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6–38%) and behaviour (average 30%, range 6–55%) were significant. Conclusion Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases. PMID:28165771

  10. Transthoracic Doppler echocardiography to predict optimal tube pulsing window for coronary artery CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Gang, E-mail: cjr.sungang@vip.163.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Li, Min, E-mail: limin22000@yahoo.com.cn [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jiang, Xiang-sen, E-mail: jiangxiangsen123@126.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Li, Li, E-mail: leely1976@yahoo.com.cn [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Peng, Zhao-hui, E-mail: zhaohuipeng_R@163.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Mu, Nan-nan, E-mail: munannan22000@sohu.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China)

    2012-09-15

    Rationale and objective: To evaluate the feasibility of transthoracic Doppler echocardiography to determine the optimal pulsing windows for CT coronary angiography to narrow the pulsing windows further, especially in higher heart rate. Materials and methods: Doppler was performed on 135 patients before CT scanning. For Doppler, the intervals with minimal motion were evaluated during both systole and diastole integrating electrocardiogram (ECG) intervals. For CT scanning, the retrospective ECG-gating was applied and the optimal reconstruction intervals were determined. The accuracy of Doppler analysis to predict the optimal reconstruction intervals was tested. The predicted length of pulsing windows was compared between Doppler analysis and traditional prospective ECG-gating protocol (heart rate ≦ 65 bpm, 60–76%; 66–79 bpm, 30–77%; ≧80 bpm, 31–47%). Results: According to Doppler analysis, the mean length of intervals with minimal motion in systole was 106.4 ± 39.2 ms and 125.2 ± 92.0 ms in diastole. When the intervals with minimal motion during diastole > 90 ms, the optimal reconstruction intervals were located at diastole; otherwise, at systole (P < 0.001). The optimal reconstruction intervals in 93.8% (132/135) patients could be predicted accurately by Doppler analysis. If the optimal reconstruction intervals predicted by Doppler were applied as the exposure windows, the mean length of pulsing windows should has been 105.2 ± 69.4 ms (range: 26.9–510.3 ms), which was significantly shorter than that of traditional prospective ECG-gating protocol (232.0 ± 120.2 ms, range: 93.2–427.3 ms, P < 0.001). Conclusion: Doppler can help detecting the optimal pulsing windows accurately. Prospective ECG-gating incorporating Doppler analysis may narrow pulsing windows significantly while maintaining image quality.

  11. Transthoracic Doppler echocardiography to predict optimal tube pulsing window for coronary artery CT angiography

    International Nuclear Information System (INIS)

    Sun, Gang; Li, Min; Jiang, Xiang-sen; Li, Li; Peng, Zhao-hui; Mu, Nan-nan

    2012-01-01

    Rationale and objective: To evaluate the feasibility of transthoracic Doppler echocardiography to determine the optimal pulsing windows for CT coronary angiography to narrow the pulsing windows further, especially in higher heart rate. Materials and methods: Doppler was performed on 135 patients before CT scanning. For Doppler, the intervals with minimal motion were evaluated during both systole and diastole integrating electrocardiogram (ECG) intervals. For CT scanning, the retrospective ECG-gating was applied and the optimal reconstruction intervals were determined. The accuracy of Doppler analysis to predict the optimal reconstruction intervals was tested. The predicted length of pulsing windows was compared between Doppler analysis and traditional prospective ECG-gating protocol (heart rate ≦ 65 bpm, 60–76%; 66–79 bpm, 30–77%; ≧80 bpm, 31–47%). Results: According to Doppler analysis, the mean length of intervals with minimal motion in systole was 106.4 ± 39.2 ms and 125.2 ± 92.0 ms in diastole. When the intervals with minimal motion during diastole > 90 ms, the optimal reconstruction intervals were located at diastole; otherwise, at systole (P < 0.001). The optimal reconstruction intervals in 93.8% (132/135) patients could be predicted accurately by Doppler analysis. If the optimal reconstruction intervals predicted by Doppler were applied as the exposure windows, the mean length of pulsing windows should has been 105.2 ± 69.4 ms (range: 26.9–510.3 ms), which was significantly shorter than that of traditional prospective ECG-gating protocol (232.0 ± 120.2 ms, range: 93.2–427.3 ms, P < 0.001). Conclusion: Doppler can help detecting the optimal pulsing windows accurately. Prospective ECG-gating incorporating Doppler analysis may narrow pulsing windows significantly while maintaining image quality

  12. Cognitive Personality Characteristics Impact the Course of Depression: A Prospective Test of Sociotropy, Autonomy and Domain-Specific Life Events.

    Science.gov (United States)

    Iacoviello, Brian M; Grant, David A; Alloy, Lauren B; Abramson, Lyn Y

    2009-01-01

    Prospective tests of the impact of sociotropy and autonomy on the course of depression are lacking. In a sample of 97 cognitive high-risk and 62 cognitive low-risk undergraduates who experienced at least one prospective depressive episode, the interactions of sociotropy and interpersonal life events and autonomy and achievement-related life events were examined as predictors of four indicators of the course of depression. Initial analyses failed to support the hypothesis that global scores for sociotropy and autonomy interact with domain-congruent life events to predict the course indicators. The autonomy-achievement events interaction predicted less severe episodes, contrary to hypothesis. Then, factors hypothesized to underlie Sociotropy (Fear of Criticism and Rejection; Preference for Affiliation) and Autonomy were also analyzed. The puzzling autonomy-achievement life event interaction was explained by the underlying Independent Goal Attainment factor. Interactions between Fear of Criticism and Rejection and achievement events, and between Sensitivity to Others' Control and interpersonal events, significantly predicted chronicity, number and severity of episodes. The findings are discussed in terms of the event-congruency hypothesis.

  13. A critical review of predictive models for the onset of significant void in forced-convection subcooled boiling

    International Nuclear Information System (INIS)

    Dorra, H.; Lee, S.C.; Bankoff, S.G.

    1993-06-01

    This predictive models for the onset of significant void (OSV) in forced-convection subcooled boiling are reviewed and compared with extensive data. Three analytical models and seven empirical correlations are considered in this review. These models and correlations are put onto a common basis and are compared, again on a common basis, with a variety of data. The evaluation of their range of validity and applicability under various operating conditions are discussed. The results show that the correlations of Saha-Zuber seems to be the best model to predict OSV in vertical subcooled boiling flow

  14. Binding Mode and Induced Fit Predictions for Prospective Computational Drug Design.

    Science.gov (United States)

    Grebner, Christoph; Iegre, Jessica; Ulander, Johan; Edman, Karl; Hogner, Anders; Tyrchan, Christian

    2016-04-25

    Computer-aided drug design plays an important role in medicinal chemistry to obtain insights into molecular mechanisms and to prioritize design strategies. Although significant improvement has been made in structure based design, it still remains a key challenge to accurately model and predict induced fit mechanisms. Most of the current available techniques either do not provide sufficient protein conformational sampling or are too computationally demanding to fit an industrial setting. The current study presents a systematic and exhaustive investigation of predicting binding modes for a range of systems using PELE (Protein Energy Landscape Exploration), an efficient and fast protein-ligand sampling algorithm. The systems analyzed (cytochrome P, kinase, protease, and nuclear hormone receptor) exhibit different complexities of ligand induced fit mechanisms and protein dynamics. The results are compared with results from classical molecular dynamics simulations and (induced fit) docking. This study shows that ligand induced side chain rearrangements and smaller to medium backbone movements are captured well in PELE. Large secondary structure rearrangements, however, remain challenging for all employed techniques. Relevant binding modes (ligand heavy atom RMSD PELE method within a few hours of simulation, positioning PELE as a tool applicable for rapid drug design cycles.

  15. A prospective cohort study of deficient maternal nurturing attitudes predicting adulthood work stress independent of adulthood hostility and depressive symptoms.

    Science.gov (United States)

    Hintsanen, M; Kivimäki, M; Hintsa, T; Theorell, T; Elovainio, M; Raitakari, O T; Viikari, J S A; Keltikangas-Järvinen, L

    2010-09-01

    Stressful childhood environments arising from deficient nurturing attitudes are hypothesized to contribute to later stress vulnerability. We examined whether deficient nurturing attitudes predict adulthood work stress. Participants were 443 women and 380 men from the prospective Cardiovascular Risk in Young Finns Study. Work stress was assessed as job strain and effort-reward imbalance in 2001 when the participants were from 24 to 39 years old. Deficient maternal nurturance (intolerance and low emotional warmth) was assessed based on mothers' reports when the participants were at the age of 3-18 years and again at the age of 6-21 years. Linear regressions showed that deficient emotional warmth in childhood predicted lower adulthood job control and higher job strain. These associations were not explained by age, gender, socioeconomic circumstances, maternal mental problems or participant hostility, and depressive symptoms. Deficient nurturing attitudes in childhood might affect sensitivity to work stress and selection into stressful work conditions in adulthood. More attention should be paid to pre-employment factors in work stress research.

  16. Bidirectional associations between family factors and Internet addiction among adolescents in a prospective investigation.

    Science.gov (United States)

    Ko, Chih-Hung; Wang, Peng-Wei; Liu, Tai-Ling; Yen, Cheng-Fang; Chen, Cheng-Sheng; Yen, Ju-Yu

    2015-04-01

    This study aimed at evaluating the effect of family factors on the occurrence of Internet addiction and determining whether Internet addiction could make any difference in the family function. A total of 2293 adolescents in grade 7 participated in the study. We assessed their Internet addiction, family function, and family factors with a 1-year follow up. In the prospective investigation, inter-parental conflict predicted the incidence of Internet addiction 1 year later in forward regression analysis, followed by not living with mother and allowance to use Internet more than 2 h per day by parents or caregiver. The inter-parental conflict and allowance to use Internet more than 2 h per day also predicted the incidence in girls. Not cared for by parents and family APGAR score predicted the incidence of Internet addiction among boys. The prospective investigation demonstrated that the incidence group had more decreased scores on family APGAR than did the non-addiction group in the 1-year follow-up. This effect was significant only among girls. Inter-parental conflict and inadequate regulation of unessential Internet use predicted risk of Internet addiction, particularly among adolescent girls. Family intervention to prevent inter-parental conflict and promote family function and Internet regulation were necessary to prevent Internet addiction. Among adolescents with Internet addiction, it is necessary to pay attention to deterioration of family function, particularly among girls. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  17. Blood biomarkers are helpful in the prediction of response to chemoradiation in rectal cancer: A prospective, hypothesis driven study on patients with locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Buijsen, Jeroen; Stiphout, Ruud G. van; Menheere, Paul P.C.A.; Lammering, Guido; Lambin, Philippe

    2014-01-01

    Purpose/objective: Chemoradiation (CRT) has been shown to lead to downsizing of an important portion of rectal cancers. In order to tailor treatment at an earlier stage during treatment, predictive models are being developed. Adding blood biomarkers may be attractive for prediction, as they can be collected very easily and determined with excellent reproducibility in clinical practice. The hypothesis of this study was that blood biomarkers related to tumor load, hypoxia and inflammation can help to predict response to CRT in rectal cancer. Material/methods: 295 patients with locally advanced rectal cancer who were planned to undergo CRT were prospectively entered into a biobank protocol ( (NCT01067872)). Blood samples were drawn before start of CRT. Nine biomarkers were selected, based on a previously defined hypothesis, and measured in a standardized way by a certified lab: CEA, CA19-9, LDH, CRP, IL-6, IL-8, CA IX, osteopontin and 25-OH-vitamin D. Outcome was analyzed in two ways: pCR vs. non-pCR and responders (defined as ypT0-2N0) vs. non-responders (all other ypTN stages). Results: 276 patients could be analyzed. 20.7% developed a pCR and 47.1% were classified as responders. In univariate analysis CEA (p = 0.001) and osteopontin (p = 0.012) were significant predictors for pCR. Taking response as outcome CEA (p < 0.001), IL-8 (p < 0.001) and osteopontin (p = 0.004) were significant predictors. In multivariate analysis CEA was the strongest predictor for pCR (OR 0.92, p = 0.019) and CEA and IL-8 predicted for response (OR 0.97, p = 0.029 and OR 0.94, p = 0.036). The model based on biomarkers only had an AUC of 0.65 for pCR and 0.68 for response; the strongest model included clinical data, PET-data and biomarkers and had an AUC of 0.81 for pCR and 0.78 for response. Conclusion: CEA and IL-8 were identified as predictive biomarkers for tumor response and PCR after CRT in rectal cancer. Incorporation of these blood biomarkers leads to an additional accuracy of

  18. Pattern recognition applied to uranium prospecting

    Energy Technology Data Exchange (ETDEWEB)

    Briggs, P L; Press, F [Massachusetts Inst. of Tech., Cambridge (USA). Dept. of Earth and Planetary Sciences

    1977-07-14

    It is stated that pattern recognition techniques provide one way of combining quantitative and descriptive geological data for mineral prospecting. A quantified decision process using computer-selected patterns of geological data has the potential for selecting areas with undiscovered deposits of uranium or other minerals. When a natural resource is mined more rapidly than it is discovered, its continued production becomes increasingly difficult, and it has been noted that, although a considerable uranium reserve may remain in the U.S.A., the discovery rate for uranium is decreasing exponentially with cumulative exploration footage drilled. Pattern recognition methods of organising geological information for prospecting may provide new predictive power, as well as insight into the occurrence of uranium ore deposits. Often the task of prospecting consists of three stages of information processing: (1) collection of data on known ore deposits; (2) noting any regularities common to the known examples of an ore; (3) selection of new exploration targets based on the results of the second stage. A logical pattern recognition algorithm is here described that implements this geological procedure to demonstrate the possibility of building a quantified uranium prospecting guide from diverse geologic data.

  19. Significant change of predictions related to the future of nuclear power

    International Nuclear Information System (INIS)

    Dumitrache, Ion

    2002-01-01

    During the last two decades of the 20th century, nuclear power contribution increased slowly in the world. This trend was mainly determined by the commissioning of new nuclear power plants, NPP, in the non-developed countries, except for Japan and South Korea. Almost all the forecasts offered the image of the stagnant nuclear power business. Sweden, Germany, Holland and Belgium Governments made clear the intention to stop the production of electricity based on fission. Recently, despite the negative effects on nuclear power of the terrorism events of September 11, 2001, the predictions related to the nuclear power future become much more optimistic. USA, Japan, South Korea and Canada made clear that new NPPs will offer their significant electricity contribution several decades, even after years 2020-2030. Moreover, several old NPP from USA obtained the license for an additional 20 years period of operation. The analysis indicated that most of the existing NPP in USA may increase the level of the maximum global power defined by the initial design. In the European Union the situation is much more complicated. About 35% of the electricity is based now on fission. Several countries, like Sweden and Germany, maintain the position of phasing out the NPPs, as soon as the licensed life-time is over. Finland decided to build a new power plant. France is very favorable to nuclear power, but does not need more energy. In the UK several very old NPP will be shut down, and companies like BNFL and British Energy intend to build new NPP, based on Westinghouse or AECL-Canada advanced reactors. Switzerland and Spain are favorable to the future use of nuclear power. In the eastern part of Europe, almost all the countries intend to base their electricity production on coal, fission, hydro and gas, nuclear contribution being significant. The most impressive increases of nuclear power output are related to Asia; in China, from 2.2 Gwe in 1999, to 18.7 Gwe in 2020, reference case, or 10

  20. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight

    Science.gov (United States)

    Chao, Ariana M.; Jastreboff, Ania M.; White, Marney A.; Grilo, Carlos M.; Sinha, Rajita

    2017-01-01

    Objective To examine whether baseline chronic stress, morning cortisol, and other appetite-related hormones (leptin, ghrelin, and insulin) predict future weight gain and food cravings in a naturalistic longitudinal 6-month follow-up study. Methods A prospective community cohort of three hundred and thirty-nine adults (age=29.1± 9.0 years; BMI=26.7±5.4 kg/m2; 56.9% female; 70.2% White) completed assessments at baseline and 6-month follow-up. Fasting blood draws were used to assess cortisol and other appetite-related hormones levels at baseline. At baseline and follow-up, body weight was measured and the Cumulative Adversity Interview and Food Craving Inventory were administered. Data were analyzed using linear mixed models adjusting for demographic and clinical covariates. Results Over the 6-month period, 49.9% of the sample gained weight. Food cravings and chronic stress decreased over 6 months (psfood cravings at 6 months (p=0.04). Furthermore, higher cortisol, insulin, and chronic stress were each predictive of greater future weight gain (psfood cravings and reward-driven eating behaviors. Studies are needed that examine the utility of stress reduction methods for normalizing disrupted cortisol responses and preventing future weight gain. PMID:28349668

  1. Does prospect theory warrant a paradigm shift in the economics of risk?

    Directory of Open Access Journals (Sweden)

    PL Mohapi

    2014-07-01

    Full Text Available This paper assesses whether a paradigm shift should be made from expected utility framework to prospect theory framework – in the economics of choice under risk. A brief overview of the subject is outlined, starting with expected utility theory and noting its descriptive limitations. Proposed theories to make up for these limitations is also provided. Prospect theory emerged as the most serious challenger to expected utility theory. A review of some descriptive predictions of prospect theory, suggests that there is no scientific reason why expected utility should not be ousted from dominance by prospect theory. The shift to prospect theory however is not without costs. Conceptual complexities and non-universality of application associated with prospect theory should be embraced with the shift while not entirely abandoning expected utility theory.

  2. Ambulatory fall-risk assessment: amount and quality of daily-life gait predict falls in older adults.

    Science.gov (United States)

    van Schooten, Kimberley S; Pijnappels, Mirjam; Rispens, Sietse M; Elders, Petra J M; Lips, Paul; van Dieën, Jaap H

    2015-05-01

    Ambulatory measurements of trunk accelerations can provide valuable information on the amount and quality of daily-life activities and contribute to the identification of individuals at risk of falls. We compared associations between retrospective and prospective falls with potential risk factors as measured by daily-life accelerometry. In addition, we investigated predictive value of these parameters for 6-month prospective falls. One week of trunk accelerometry (DynaPort MoveMonitor) was obtained in 169 older adults (mean age 75). The amount of daily activity and quality of gait were determined and validated questionnaires on fall-risk factors, grip strength, and trail making test were obtained. Six-month fall incidence was obtained retrospectively by recall and prospectively by fall diaries and monthly telephone contact. Among all participants, 35.5% had a history of ≥1 falls and 34.9% experienced ≥1 falls during 6-month follow-up. Logistic regressions showed that questionnaires, grip strength, and trail making test, as well as the amount and quality of gait, were significantly associated with falls. Significant associations differed between retrospective and prospective analyses although odds ratios indicated similar patterns. Predictive ability based on questionnaires, grip strength, and trail making test (area under the curve .68) improved substantially by accelerometry-derived parameters of the amount of gait (number of strides), gait quality (complexity, intensity, and smoothness), and their interactions (area under the curve .82). Daily-life accelerometry contributes substantially to the identification of individuals at risk of falls, and can predict falls in 6 months with good accuracy. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Self-awareness of prospective memory failure in adults with traumatic brain injury.

    Science.gov (United States)

    Roche, Nadine L; Fleming, Jennifer M; Shum, David H K

    2002-11-01

    The frequency of prospective memory failure in individuals with severe traumatic brain injury (TBI) was investigated by comparison with a non-brain-injured control group. Self-awareness of prospective memory function was also assessed by comparing self-ratings with ratings by significant others. Study participants included 33 individuals with severe TBI and 29 non-brain-injured persons. Each participant nominated a close friend or relative who completed the informant's version of the questionnaire. Participants and their significant others both rated the participants' frequency of prospective memory lapses using the Comprehensive Assessment of Prospective Memory (CAPM). An independent groups design was adopted to compare the TBI and control groups. No significant difference was found between the TBI and control participants' self-ratings of frequency of prospective memory failure, but ratings by significant others were significantly different. The TBI group demonstrated less self-awareness (i.e. underestimated the frequency of prospective memory failure compared to significant others) than the control group.

  4. Predicting remembering and forgetting of autobiographical memories in children and adults: a 4-year prospective study.

    Science.gov (United States)

    Bauer, Patricia J; Larkina, Marina

    2016-11-01

    Preservation and loss to forgetting of autobiographical memories is a focus in both the adult and developmental literatures. In both, there are comparative arguments regarding rates of forgetting. Children are assumed to forget autobiographical memories more rapidly than adults, and younger children are assumed to forget more rapidly than older children. Yet few studies can directly inform these comparisons: few feature children and adults, and few prospectively track the survival of specific autobiographical memories over time. In a 4-year prospective study, we obtained autobiographical memories from children 4, 6, and 8 years, and adults. We tested recall of different subsets of the events after 1, 2, and 3 years. Accelerated rates of forgetting were apparent among all child groups relative to adults; within the child groups, 4- and 6-year-olds had accelerated forgetting relative to 8-year-olds. The differences were especially pronounced in open-ended recall. The thematic coherence of initial memory reports also was a significant predictor of the survival of specific memories. The pattern of findings is consistent with suggestions that the adult distribution of autobiographical memories is achieved as the quality of memory traces increases (here measured by thematic coherence) and the rate of forgetting decreases.

  5. Predicting remembering and forgetting of autobiographical memories in children and adults: A 4-year prospective study

    Science.gov (United States)

    Bauer, Patricia J.; Larkina, Marina

    2015-01-01

    Preservation and loss to forgetting of autobiographical memories is a focus in both the adult and developmental literatures. In both, there are comparative arguments regarding rates of forgetting. Children are assumed to forget autobiographical memories more rapidly than adults, and younger children are assumed to forget more rapidly than older children. Yet few studies can directly inform these comparisons: few feature children and adults, and few prospectively track the survival of specific autobiographical memories over time. In a 4-year prospective study, we obtained autobiographical memories from children 4, 6, and 8 years, and adults. We tested recall of different subsets of the events after 1, 2, and 3 years. Accelerated rates of forgetting were apparent among all child groups relative to adults; within the child groups, 4- and 6-year-olds had accelerated forgetting relative to 8-year-olds. The differences were especially pronounced in open-ended recall. The thematic coherence of initial memory reports also was a significant predictor of the survival of specific memories. The pattern of findings is consistent with suggestions that the adult distribution of autobiographical memories is achieved as the quality of memory traces increases (here measured by thematic coherence) and the rate of forgetting decreases. PMID:26566236

  6. Psychosocial predictors of the onset of anxiety disorders in women: Results from a prospective 3-year longitudinal study

    Science.gov (United States)

    Calkins, Amanda W.; Otto, Michael W.; Cohen, Lee S.; Soares, Claudio N.; Vitonis, Alison F.; Hearon, Bridget A.; Harlow, Bernard L.

    2009-01-01

    In a prospective, longitudinal, population-based study of 643 women participating in the Harvard Study of Moods and Cycles we examined whether psychosocial variables predicted a new or recurrent onset of an anxiety disorder. Presence of anxiety disorders was assessed every six months over three years via structured clinical interviews. Among individuals who had a new episode of anxiety, we confirmed previous findings that history of anxiety, increased anxiety sensitivity (the fear of anxiety related sensations), and increased neuroticism were significant predictors. We also found trend level support for assertiveness as a predictor of anxiety onset. However, of these variables, only history of anxiety and anxiety sensitivity provided unique prediction. We did not find evidence for negative life events as a predictor of onset of anxiety either alone or in interaction with other variables in a diathesis-stress model. These findings from a prospective longitudinal study are discussed in relation to the potential role of such predictors in primary or relapse prevention efforts. PMID:19699609

  7. Prospective versus retrospective ECG gating for dual source CT of the coronary stent: Comparison of image quality, accuracy, and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Zhao Lei, E-mail: zhaolei219@sohu.com [Beijing Anzhen Hospital of the Capital University of Medical Sciences (China); Zhang Zhaoqi; Fan Zhanming; Yang Lin; Du Jing [Beijing Anzhen Hospital of the Capital University of Medical Sciences (China)

    2011-03-15

    Objective: To compare image quality, diagnostic accuracy and radiation dose of prospective and retrospective electrocardiogram (ECG) gated dual source computed tomography (DSCT) for the evaluation of the coronary stent, using conventional coronary angiography (CA) as a standard reference. Design, setting and patients: Sixty patients (heart rates {<=}70 bpm) with previous stent implantation who were scheduled for CA were divided in two groups, receiving either prospective or retrospective ECG gated DSCT separately. Two reviewers scored coronary stent image quality and evaluated stent lumen. Results: There was no significant difference in image quality between the two groups. In the prospective group, there were 86.4% (51/59) stents with interpretable images, in the retrospective group, there were 87.5% (49/56) stents with interpretable images. Image quality was not influenced by age, body mass index or heart rate in either group, but heart rate variability had a weak impact on the image quality of the prospective group. Image noise was higher in the prospective group, but this difference reached statistical significance only by using a smooth kernel reconstruction. Per-stent based sensitivity, specificity, and positive and negative predictive value were 100%, 84.1%, 68.2%, and 100%, respectively, in the prospective CT angiography group and 94.4%, 86.8%, 77.3%, and 97.1%, respectively, in the retrospective CT angiography group. There was a significant difference in the effective radiation dose between the two groups, mean effective dose in the prospective and retrospective group was 2.2 {+-} 0.5 mSv (1.5-3.2 mSv) and 14.6 {+-} 3.3 mSv (10.0-20.4 mSv) (p < .001) respectively. Conclusions: Compared with retrospective CT angiography, prospective CT angiography has a similar performance in assessing coronary stent patency, but a lower effective dose in selected patients with regular heart rates {<=}70 bpm.

  8. Predictive factors of postpartum fatigue: a prospective cohort study among working women

    NARCIS (Netherlands)

    Bakker, M.; Beek, A.J. van der; Hendriksen, I.J.M.; Bruinvels, D.J.; Poppel, M.N. van

    2014-01-01

    Objectives The aim of this study was to investigate which prepartum determinants contribute to the development of postpartum (PP) fatigue among working women in the Netherlands. Methods A prospective cohort study in 15 Dutch companies was conducted to measure different potential predictors using

  9. Evaluation of the white finger risk prediction model in ISO 5349 suggests need for prospective studies.

    Science.gov (United States)

    Gemne, G; Lundström, R

    1996-05-01

    The risk prediction model for white fingers in Annex A of ISO 5349 is not likely to offer protection from all tools and all work processes. It is also probable that some work place changes it has initiated are either redundant or lack the intended effect. The main reasons for these shortcomings are the following. The often demonstrated disagreement between predicted and observed white fingers occurrence may be related to the fact that the model is based on latency data. This leads to an overestimation, to an unknown extent, of true group risks. A possible healthy worker effect, resulting in underestimation, has not been considered, and uncertainty because of recall bias is connected with using latency as effect variable in a slowly developing disorder like white fingers. The diagnostic criteria for white fingers have varied over the years, causing a possible inclusion of circulatory disturbances other than those induced by vibration. Among insufficiently clarified matters unrelated to vibration are variations in individual susceptibility and other host factors that modify vibration effects, uncertainty concerning daily or total effective exposure, and the fact that variation in work methods and processes as well as ergonomic factors other than vibration tend to make different groups incomparable form the viewpoint of risk of injury. Lack of sufficient data on vibration measurements and employment durations add to the uncertainty, as do variations in tool conditions (grinder wheels, etc) and inherent difficulties in measurement. Finally, the ISO 5349 frequency-weighting curve only relates to acute sensory effects rather than chronic effects on vascular functions like white fingers, and directional difference in sensitivity has not been incorporated in the curve. Data on exposure-response relationships are needed from prospective studies that monitor the dose of exposure to special vibration types and all relevant environmental agents, employ diagnostics with good

  10. Prediction of cesarean delivery in the term nulliparous woman: results from the prospective, multicenter Genesis study.

    Science.gov (United States)

    Burke, Naomi; Burke, Gerard; Breathnach, Fionnuala; McAuliffe, Fionnuala; Morrison, John J; Turner, Michael; Dornan, Samina; Higgins, John R; Cotter, Amanda; Geary, Michael; McParland, Peter; Daly, Sean; Cody, Fiona; Dicker, Pat; Tully, Elizabeth; Malone, Fergal D

    2017-06-01

    In contemporary practice many nulliparous women require intervention during childbirth such as operative vaginal delivery or cesarean delivery (CD). Despite the knowledge that the increasing rate of CD is associated with increasing maternal age, obesity and larger infant birthweight, we lack a reliable method to predict the requirement for such potentially hazardous obstetric procedures during labor and delivery. This issue is important, as there are greater rates of morbidity and mortality associated with unplanned CD performed in labor compared with scheduled CDs. A prediction algorithm to identify women at risk of an unplanned CD could help reduced labor associated morbidity. In this primary analysis of the Genesis study, our objective was to prospectively assess the use of prenatally determined, maternal and fetal, anthropomorphic, clinical, and ultrasound features to develop a predictive tool for unplanned CD in the term nulliparous woman, before the onset of labor. The Genesis study recruited 2336 nulliparous women with a vertex presentation between 39+0 and 40+6 weeks' gestation in a prospective multicenter national study to examine predictors of CD. At recruitment, a detailed clinical evaluation and ultrasound assessment were performed. To reduce bias from knowledge of these data potentially influencing mode of delivery, women, midwives, and obstetricians were blinded to the ultrasound data. All hypothetical prenatal risk factors for unplanned CD were assessed as a composite. Multiple logistic regression analysis and mathematical modeling was used to develop a risk evaluation tool for CD in nulliparous women. Continuous predictors were standardized using z scores. From a total enrolled cohort of 2336 nulliparous participants, 491 (21%) had an unplanned CD. Five parameters were determined to be the best combined predictors of CD. These were advancing maternal age (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.09 to 1.34), shorter maternal height (OR

  11. A review and prospects for Nb3Sn superconductor development

    Science.gov (United States)

    Xu, Xingchen

    2017-09-01

    Nb3Sn superconductors have significant applications in constructing high-field (>10 T) magnets. This article briefly reviews development of Nb3Sn superconductor and proposes prospects for further improvement. It is shown that significant improvement of critical current density (J c) is needed for future accelerator magnets. After a brief review of the development of Nb3Sn superconductors, the factors controlling J c are summarized and correlated with their microstructure and chemistry. The non-matrix J c of Nb3Sn conductors is mainly determined by three factors: the fraction of current-carrying Nb3Sn phase in the non-matrix area, the upper critical field B c2, and the flux line pinning capacity. Then prospects to improve the three factors are discussed respectively. An analytic model was developed to show how the ratios of precursors determine the phase fractions after heat treatment, based on which it is predicted that the limit of current-carrying Nb3Sn fraction in subelements is ∼65%. Then, since B c2 is largely determined by the Nb3Sn stoichiometry, a thermodynamic/kinetic theory is presented to show what essentially determines the Sn content of Nb3Sn conductors. This theory explains the influences of Sn sources and Ti addition on stoichiometry and growth rate of Nb3Sn layers. Next, to improve flux pinning, previous efforts in this community to introduce additional pinning centers to Nb3Sn wires are reviewed, and an internal oxidation technique is described. Finally, prospects for further improvement of non-matrix J c of Nb3Sn conductors are discussed, and it is seen that the only opportunity for further significantly improving J c lies in improving flux pinning.

  12. Prospect theory for online financial trading.

    Science.gov (United States)

    Liu, Yang-Yu; Nacher, Jose C; Ochiai, Tomoshiro; Martino, Mauro; Altshuler, Yaniv

    2014-01-01

    Prospect theory is widely viewed as the best available descriptive model of how people evaluate risk in experimental settings. According to prospect theory, people are typically risk-averse with respect to gains and risk-seeking with respect to losses, known as the "reflection effect". People are much more sensitive to losses than to gains of the same magnitude, a phenomenon called "loss aversion". Despite of the fact that prospect theory has been well developed in behavioral economics at the theoretical level, there exist very few large-scale empirical studies and most of the previous studies have been undertaken with micro-panel data. Here we analyze over 28.5 million trades made by 81.3 thousand traders of an online financial trading community over 28 months, aiming to explore the large-scale empirical aspect of prospect theory. By analyzing and comparing the behavior of winning and losing trades and traders, we find clear evidence of the reflection effect and the loss aversion phenomenon, which are essential in prospect theory. This work hence demonstrates an unprecedented large-scale empirical evidence of prospect theory, which has immediate implication in financial trading, e.g., developing new trading strategies by minimizing the impact of the reflection effect and the loss aversion phenomenon. Moreover, we introduce three novel behavioral metrics to differentiate winning and losing traders based on their historical trading behavior. This offers us potential opportunities to augment online social trading where traders are allowed to watch and follow the trading activities of others, by predicting potential winners based on their historical trading behavior.

  13. Prospect theory for online financial trading.

    Directory of Open Access Journals (Sweden)

    Yang-Yu Liu

    Full Text Available Prospect theory is widely viewed as the best available descriptive model of how people evaluate risk in experimental settings. According to prospect theory, people are typically risk-averse with respect to gains and risk-seeking with respect to losses, known as the "reflection effect". People are much more sensitive to losses than to gains of the same magnitude, a phenomenon called "loss aversion". Despite of the fact that prospect theory has been well developed in behavioral economics at the theoretical level, there exist very few large-scale empirical studies and most of the previous studies have been undertaken with micro-panel data. Here we analyze over 28.5 million trades made by 81.3 thousand traders of an online financial trading community over 28 months, aiming to explore the large-scale empirical aspect of prospect theory. By analyzing and comparing the behavior of winning and losing trades and traders, we find clear evidence of the reflection effect and the loss aversion phenomenon, which are essential in prospect theory. This work hence demonstrates an unprecedented large-scale empirical evidence of prospect theory, which has immediate implication in financial trading, e.g., developing new trading strategies by minimizing the impact of the reflection effect and the loss aversion phenomenon. Moreover, we introduce three novel behavioral metrics to differentiate winning and losing traders based on their historical trading behavior. This offers us potential opportunities to augment online social trading where traders are allowed to watch and follow the trading activities of others, by predicting potential winners based on their historical trading behavior.

  14. Muscle Strength Is a Poor Screening Test for Predicting Lower Extremity Injuries in Professional Male Soccer Players: A 2-Year Prospective Cohort Study.

    Science.gov (United States)

    Bakken, Arnhild; Targett, Stephen; Bere, Tone; Eirale, Cristiano; Farooq, Abdulaziz; Mosler, Andrea B; Tol, Johannes L; Whiteley, Rod; Khan, Karim M; Bahr, Roald

    2018-03-01

    Lower extremity muscle strength tests are commonly used to screen for injury risk in professional soccer. However, there is limited evidence on the ability of such tests in predicting future injuries. To examine the association between hip and thigh muscle strength and the risk of lower extremity injuries in professional male soccer players. Case-control study; Level of evidence, 3. Professional male soccer players from 14 teams in Qatar underwent a comprehensive strength assessment at the beginning of the 2013/2014 and 2014/2015 seasons. Testing consisted of concentric and eccentric quadriceps and hamstring isokinetic peak torques, eccentric hip adduction and abduction forces, and bilateral isometric adductor force (squeeze test at 45°). Time-loss injuries and exposure in training and matches were registered prospectively by club medical staff throughout each season. Univariate and multivariate Cox regression analyses were used to calculate hazard ratios (HRs) with 95% CIs. In total, 369 players completed all strength tests and had registered injury and exposure data. Of these, 206 players (55.8%) suffered 538 lower extremity injuries during the 2 seasons; acute muscle injuries were the most frequent. Of the 20 strength measures examined, greater quadriceps concentric peak torque at 300 deg/s (HR, 1.005 [95% CI, 1.00-1.01]; P = .037) was the only strength measure identified as significantly associated with a risk of lower extremity injuries in multivariate analysis. Greater quadriceps concentric peak torque at 60 deg/s (HR, 1.004 [95% CI, 1.00-1.01]; P = .026) was associated with the risk of overuse injuries, and greater bilateral adductor strength adjusted for body weight (HR, 0.75 [95% CI, 0.57-0.97; P = .032) was associated with a lower risk for any knee injury. Receiver operating characteristic curve analyses indicated poor predictive ability of the significant strength variables (area under the curve, 0.45-0.56). There was a weak association with the risk of

  15. Comparisons of prediction models of quality of life after laparoscopic cholecystectomy: a longitudinal prospective study.

    Directory of Open Access Journals (Sweden)

    Hon-Yi Shi

    Full Text Available BACKGROUND: Few studies of laparoscopic cholecystectomy (LC outcome have used longitudinal data for more than two years. Moreover, no studies have considered group differences in factors other than outcome such as age and nonsurgical treatment. Additionally, almost all published articles agree that the essential issue of the internal validity (reproducibility of the artificial neural network (ANN, support vector machine (SVM, Gaussian process regression (GPR and multiple linear regression (MLR models has not been adequately addressed. This study proposed to validate the use of these models for predicting quality of life (QOL after LC and to compare the predictive capability of ANNs with that of SVM, GPR and MLR. METHODOLOGY/PRINCIPAL FINDINGS: A total of 400 LC patients completed the SF-36 and the Gastrointestinal Quality of Life Index at baseline and at 2 years postoperatively. The criteria for evaluating the accuracy of the system models were mean square error (MSE and mean absolute percentage error (MAPE. A global sensitivity analysis was also performed to assess the relative significance of input parameters in the system model and to rank the variables in order of importance. Compared to SVM, GPR and MLR models, the ANN model generally had smaller MSE and MAPE values in the training data set and test data set. Most ANN models had MAPE values ranging from 4.20% to 8.60%, and most had high prediction accuracy. The global sensitivity analysis also showed that preoperative functional status was the best parameter for predicting QOL after LC. CONCLUSIONS/SIGNIFICANCE: Compared with SVM, GPR and MLR models, the ANN model in this study was more accurate in predicting patient-reported QOL and had higher overall performance indices. Further studies of this model may consider the effect of a more detailed database that includes complications and clinical examination findings as well as more detailed outcome data.

  16. Coronary CT angiography using prospective ECG triggering. High diagnostic accuracy with low radiation dose

    International Nuclear Information System (INIS)

    Arnoldi, E.; Ramos-Duran, L.; Abro, J.A.; Costello, P.; Zwerner, P.L.; Schoepf, U.J.; Nikolaou, K.; Reiser, M.F.

    2010-01-01

    The purpose of this study was to evaluate the diagnostic performance of coronary CT angiography (coronary CTA) using prospective ECG triggering (PT) for the detection of significant coronary artery stenosis compared to invasive coronary angiography (ICA). A total of 20 patients underwent coronary CTA with PT using a 128-slice CT scanner (Definition trademark AS+, Siemens) and ICA. All coronary CTA studies were evaluated for significant coronary artery stenoses (≥50% luminal narrowing) by 2 observers in consensus using the AHA-15-segment model. Findings in CTA were compared to those in ICA. Coronary CTA using PT had 88% sensitivity in comparison to 100% with ICA, 95% to 88% specificity, 80% to 92% positive predictive value and 97% to 100% negative predictive value for diagnosing significant coronary artery stenosis on per segment per patient analysis, respectively. Mean effective radiation dose-equivalent of CTA was 2.6±1 mSv. Coronary CTA using PT enables non-invasive diagnosis of significant coronary artery stenosis with high diagnostic accuracy in comparison to ICA and is associated with comparably low radiation exposure. (orig.) [de

  17. Attribution of Large-Scale Climate Patterns to Seasonal Peak-Flow and Prospects for Prediction Globally

    Science.gov (United States)

    Lee, Donghoon; Ward, Philip; Block, Paul

    2018-02-01

    Flood-related fatalities and impacts on society surpass those from all other natural disasters globally. While the inclusion of large-scale climate drivers in streamflow (or high-flow) prediction has been widely studied, an explicit link to global-scale long-lead prediction is lacking, which can lead to an improved understanding of potential flood propensity. Here we attribute seasonal peak-flow to large-scale climate patterns, including the El Niño Southern Oscillation (ENSO), Pacific Decadal Oscillation (PDO), North Atlantic Oscillation (NAO), and Atlantic Multidecadal Oscillation (AMO), using streamflow station observations and simulations from PCR-GLOBWB, a global-scale hydrologic model. Statistically significantly correlated climate patterns and streamflow autocorrelation are subsequently applied as predictors to build a global-scale season-ahead prediction model, with prediction performance evaluated by the mean squared error skill score (MSESS) and the categorical Gerrity skill score (GSS). Globally, fair-to-good prediction skill (20% ≤ MSESS and 0.2 ≤ GSS) is evident for a number of locations (28% of stations and 29% of land area), most notably in data-poor regions (e.g., West and Central Africa). The persistence of such relevant climate patterns can improve understanding of the propensity for floods at the seasonal scale. The prediction approach developed here lays the groundwork for further improving local-scale seasonal peak-flow prediction by identifying relevant global-scale climate patterns. This is especially attractive for regions with limited observations and or little capacity to develop flood early warning systems.

  18. Biomarkers of Host Response Predict Primary End-Point Radiological Pneumonia in Tanzanian Children with Clinical Pneumonia: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Laura K Erdman

    Full Text Available Diagnosing pediatric pneumonia is challenging in low-resource settings. The World Health Organization (WHO has defined primary end-point radiological pneumonia for use in epidemiological and vaccine studies. However, radiography requires expertise and is often inaccessible. We hypothesized that plasma biomarkers of inflammation and endothelial activation may be useful surrogates for end-point pneumonia, and may provide insight into its biological significance.We studied children with WHO-defined clinical pneumonia (n = 155 within a prospective cohort of 1,005 consecutive febrile children presenting to Tanzanian outpatient clinics. Based on x-ray findings, participants were categorized as primary end-point pneumonia (n = 30, other infiltrates (n = 31, or normal chest x-ray (n = 94. Plasma levels of 7 host response biomarkers at presentation were measured by ELISA. Associations between biomarker levels and radiological findings were assessed by Kruskal-Wallis test and multivariable logistic regression. Biomarker ability to predict radiological findings was evaluated using receiver operating characteristic curve analysis and Classification and Regression Tree analysis.Compared to children with normal x-ray, children with end-point pneumonia had significantly higher C-reactive protein, procalcitonin and Chitinase 3-like-1, while those with other infiltrates had elevated procalcitonin and von Willebrand Factor and decreased soluble Tie-2 and endoglin. Clinical variables were not predictive of radiological findings. Classification and Regression Tree analysis generated multi-marker models with improved performance over single markers for discriminating between groups. A model based on C-reactive protein and Chitinase 3-like-1 discriminated between end-point pneumonia and non-end-point pneumonia with 93.3% sensitivity (95% confidence interval 76.5-98.8, 80.8% specificity (72.6-87.1, positive likelihood ratio 4.9 (3.4-7.1, negative likelihood ratio 0

  19. Biomarkers of Host Response Predict Primary End-Point Radiological Pneumonia in Tanzanian Children with Clinical Pneumonia: A Prospective Cohort Study

    Science.gov (United States)

    Erdman, Laura K.; D’Acremont, Valérie; Hayford, Kyla; Kilowoko, Mary; Kyungu, Esther; Hongoa, Philipina; Alamo, Leonor; Streiner, David L.; Genton, Blaise; Kain, Kevin C.

    2015-01-01

    Background Diagnosing pediatric pneumonia is challenging in low-resource settings. The World Health Organization (WHO) has defined primary end-point radiological pneumonia for use in epidemiological and vaccine studies. However, radiography requires expertise and is often inaccessible. We hypothesized that plasma biomarkers of inflammation and endothelial activation may be useful surrogates for end-point pneumonia, and may provide insight into its biological significance. Methods We studied children with WHO-defined clinical pneumonia (n = 155) within a prospective cohort of 1,005 consecutive febrile children presenting to Tanzanian outpatient clinics. Based on x-ray findings, participants were categorized as primary end-point pneumonia (n = 30), other infiltrates (n = 31), or normal chest x-ray (n = 94). Plasma levels of 7 host response biomarkers at presentation were measured by ELISA. Associations between biomarker levels and radiological findings were assessed by Kruskal-Wallis test and multivariable logistic regression. Biomarker ability to predict radiological findings was evaluated using receiver operating characteristic curve analysis and Classification and Regression Tree analysis. Results Compared to children with normal x-ray, children with end-point pneumonia had significantly higher C-reactive protein, procalcitonin and Chitinase 3-like-1, while those with other infiltrates had elevated procalcitonin and von Willebrand Factor and decreased soluble Tie-2 and endoglin. Clinical variables were not predictive of radiological findings. Classification and Regression Tree analysis generated multi-marker models with improved performance over single markers for discriminating between groups. A model based on C-reactive protein and Chitinase 3-like-1 discriminated between end-point pneumonia and non-end-point pneumonia with 93.3% sensitivity (95% confidence interval 76.5–98.8), 80.8% specificity (72.6–87.1), positive likelihood ratio 4.9 (3.4–7

  20. Predictive models of pain following root canal treatment: a prospective clinical study.

    Science.gov (United States)

    Arias, A; de la Macorra, J C; Hidalgo, J J; Azabal, M

    2013-08-01

    To determine the probability of the incidence, intensity, duration and triggering of post-endodontic pain, considering factors related to the patient (age, gender, medical evaluation) and to the affected tooth (group, location, number of canals, pulp vitality, preoperative pain, periapical radiolucencies, previous emergency access, presence of occlusal contacts with antagonist). A total of 500 one-visit root canal treatments (RCTs) were performed on patients referred to an endodontist. Shaping of root canals was performed manually with Gates-Glidden drills and K-Flexofiles, and apical patency was maintained with a size 10 file. A 5% NaOCl solution was used for irrigation, and canals were filled with lateral compaction and AH-Plus sealer. Independent factors were recorded during the treatment, and characteristics of post-endodontic pain (incidence, intensity, type and duration) were later surveyed through questionnaires. Of the 500 questionnaires, 374 were properly returned and split in two groups for two different statistical purposes: 316 cases were used to adjust the logistic regression models to predict each characteristic of post-endodontic pain using predictive factors, and the remaining 58 cases were used to test the validity of each model. The predictive models showed that the incidence of post-endodontic pain was significantly lower when the treated tooth was not a molar (P = 0.003), demonstrated periapical radiolucencies (P = 0.003), had no history of previous pain (P = 0.006) or emergency endodontic treatment (P = 0.045) and had no occlusal contact (P endodontic pain were generated and validated taking account of the interrelation of multiple concomitant clinical factors. A predictive model for triggering post-endodontic pain could not be established. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  1. Scissor-type knife significantly improves self-completion rate of colorectal endoscopic submucosal dissection: Single-center prospective randomized trial.

    Science.gov (United States)

    Yamashina, Takeshi; Takeuchi, Yoji; Nagai, Kengo; Matsuura, Noriko; Ito, Takashi; Fujii, Mototsugu; Hanaoka, Noboru; Higashino, Koji; Uedo, Noriya; Ishihara, Ryu; Iishi, Hiroyasu

    2017-05-01

    Colorectal endoscopic submucosal dissection (C-ESD) is recognized as a difficult procedure. Recently, scissors-type knives were launched to reduce the difficulty of C-ESD. The aim of this study was to evaluate the efficacy and safety of the combined use of a scissors-type knife and a needle-type knife with a water-jet function (WJ needle-knife) for C-ESD compared with using the WJ needle-knife alone. This was a prospective randomized controlled trial in a referral center. Eighty-five patients with superficial colorectal neoplasms were enrolled and randomly assigned to undergo C-ESD using a WJ needle-knife alone (Flush group) or a scissor-type knife-supported WJ needle-knife (SB Jr group). Procedures were conducted by two supervised residents. Primary endpoint was self-completion rate by the residents. Self-completion rate was 67% in the SB Jr group, which was significantly higher than that in the Flush group (39%, P = 0.01). Even after exclusion of four patients in the SB Jr group in whom C-ESD was completed using the WJ needle-knife alone, the self-completion rate was significantly higher (63% vs 39%; P = 0.03). Median procedure time among the self-completion cases did not differ significantly between the two groups (59 vs 51 min; P = 0.14). No fatal adverse events were observed in either group. In this single-center phase II trial, scissor-type knife significantly improved residents' self-completion rate for C-ESD, with no increase in procedure time or adverse events. A multicenter trial would be warranted to confirm the validity of the present study. © 2016 Japan Gastroenterological Endoscopy Society.

  2. Low Self-Esteem during Adolescence Predicts Poor Health, Criminal Behavior, and Limited Economic Prospects during Adulthood

    Science.gov (United States)

    Trzesniewski, Kali H.; Donnellan, M. Brent; Moffitt, Terrie E.; Robins, Richard W.; Poulton, Richie; Caspi, Avshalom

    2006-01-01

    Using prospective data from the Dunedin Multidisciplinary Health and Development Study birth cohort, the authors found that adolescents with low self-esteem had poorer mental and physical health, worse economic prospects, and higher levels of criminal behavior during adulthood, compared with adolescents with high self-esteem. The long-term…

  3. Smoking behaviors and attitudes during adolescence prospectively predict support for tobacco control policies in adulthood.

    Science.gov (United States)

    Macy, Jonathan T; Chassin, Laurie; Presson, Clark C

    2012-07-01

    Several cross-sectional studies have examined factors associated with support for tobacco control policies. The current study utilized a longitudinal design to test smoking status and attitude toward smoking measured in adolescence as prospective predictors of support for tobacco control policies measured in adulthood. Participants (N = 4,834) were from a longitudinal study of a Midwestern community-based sample. Hierarchical multiple regression analyses tested adolescent smoking status and attitude toward smoking as prospective predictors (after controlling for sociodemographic factors, adult smoking status, and adult attitude toward smoking) of support for regulation of smoking in public places, discussion of the dangers of smoking in public schools, prohibiting smoking in bars, eliminating smoking on television and in movies, prohibiting smoking in restaurants, and increasing taxes on cigarettes. Participants who smoked during adolescence demonstrated more support for discussion of the dangers of smoking in public schools and less support for increasing taxes on cigarettes but only among those who smoked as adults. Those with more positive attitudes toward smoking during adolescence demonstrated less support as adults for prohibiting smoking in bars and eliminating smoking on television and in movies. Moreover, a significant interaction indicated that those with more positive attitudes toward smoking as adolescents demonstrated less support as adults for prohibiting smoking in restaurants, but only if they became parents as adults. This study's findings suggest that interventions designed to deter adolescent smoking may have future benefits in increasing support for tobacco control policies.

  4. Prospective evaluation of biomarkers for prediction of quality of life in community-acquired pneumonia.

    Science.gov (United States)

    Nickler, Manuela; Schaffner, Daniela; Christ-Crain, Mirjam; Ottiger, Manuel; Thomann, Robert; Hoess, Claus; Henzen, Christoph; Mueller, Beat; Schuetz, Philipp

    2016-11-01

    Most clinical research investigated prognostic biomarkers for their ability to predict cardiovascular events or mortality. It is unknown whether biomarkers allow prediction of quality of life (QoL) after survival of the acute event. Herein, we investigated the prognostic potential of well-established inflammatory/cardiovascular blood biomarkers including white blood cells (WBC), C-reactive protein (CRP), procalcitonin (PCT), pro-adrenomedullin (proADM) and pro-atrial natriuretic peptide (proANP) in regard to a decline in QoL in a well-defined cohort of patients with community-acquired pneumonia (CAP). Within this secondary analysis including 753 patients with a final inpatient diagnosis of CAP from a multicenter trial, we investigated associations between admission biomarker levels and decline in QoL assessed by the EQ-5D health questionnaire from admission to day 30 and after 6 years. Admission proADM and proANP levels significantly predicted decline of the weighted EQ-5D index after 30 days (n=753) with adjusted odds ratios (ORs) of 2.0 ([95% CI 1.1-3.8]; p=0.027) and 3.7 ([95% CI 2.2-6.0]; pscale (VAS). Initial WBC, PCT and CRP values did not well predict QoL at any time point. ProADM and proANP accurately predict short- and long-term decline in QoL across most dimensions in CAP patients. It will be interesting to reveal underlying physiopathology in future studies.

  5. Prognostic significance of increased bone marrow microcirculation in newly diagnosed multiple myeloma: results of a prospective DCE-MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Merz, Maximilian; Hillengass, Jens [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); University of Heidelberg, Department of Hematology, Oncology and Rheumatology, Heidelberg (Germany); Moehler, Thomas M.; Ritsch, Judith; Delorme, Stefan [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Baeuerle, Tobias [University of Erlangen-Nuremberg, Department of Radiology, Erlangen (Germany); Zechmann, Christian M. [Rinecker Proton Therapy, Muenchen (Germany); Wagner, Barbara; Hose, Dirk [University of Heidelberg, Department of Hematology, Oncology and Rheumatology, Heidelberg (Germany); Jauch, Anna [University of Heidelberg, Institute of Human Genetics, Heidelberg (Germany); Kunz, Christina; Hielscher, Thomas [German Cancer Research Center, Department of Biostatistics, Heidelberg (Germany); Laue, Hendrik [Fraunhofer MEVIS, Bremen (Germany); Goldschmidt, Hartmut [University of Heidelberg, Department of Hematology, Oncology and Rheumatology, Heidelberg (Germany); National Center for Tumor Diseases, Heidelberg (Germany)

    2016-05-15

    Aim of this prospective study was to investigate prognostic significance of increased bone marrow microcirculation as detected by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for survival and local complications in patients with multiple myeloma (MM). We performed DCE-MRI of the lumbar spine in 131 patients with newly diagnosed MM and analysed data according to the Brix model to acquire amplitude A and exchange rate constant k{sub ep}. In 61 patients a second MRI performed after therapy was evaluated to assess changes in vertebral height and identify vertebral fractures. Correlation analysis revealed significant positive association between beta2-microglobulin as well as immunoparesis with DCE-MRI parameters A and k{sub ep}. Additionally, A was negatively correlated with haemoglobin levels and k{sub ep} was positively correlated with LDH levels. Higher baseline k{sub ep} values were associated with decreased vertebral height in a second MRI (P = 0.007) and A values were associated with new vertebral fractures in the lower lumbar spine (P = 0.03 for L4). Pre-existing lytic bone lesions or remission after therapy had no impact on the occurrence of vertebral fractures. Multivariate analysis revealed that amplitude A is an independent adverse risk factor for overall survival. DCE-MRI is a non-invasive tool with significance for systemic prognosis and vertebral complications. (orig.)

  6. Technology development and application research of remote sensing in uranium geological prospecting

    International Nuclear Information System (INIS)

    Liu Dechang; Dong Xiuzhen; Wang Zitao

    2012-01-01

    From the application, the concept, the theory study and application effect, this article discusses technology development and application research of remote sensing in uranium geological prospecting. The prospecting way from 'information prospecting' to 'theoretical prospecting' to 'simulated prospecting' to 'technology prospecting' with remote sensing is provided and achieved significant prospecting effect. (authors)

  7. Significance of High Resolution GHRSST on prediction of Indian Summer Monsoon

    KAUST Repository

    Jangid, Buddhi Prakash

    2017-02-24

    In this study, the Weather Research and Forecasting (WRF) model was used to assess the importance of very high resolution sea surface temperature (SST) on seasonal rainfall prediction. Two different SST datasets available from the National Centers for Environmental Prediction (NCEP) global model analysis and merged satellite product from Group for High Resolution SST (GHRSST) are used as a lower boundary condition in the WRF model for the Indian Summer Monsoon (ISM) 2010. Before using NCEP SST and GHRSST for model simulation, an initial verification of NCEP SST and GHRSST are performed with buoy measurements. It is found that approximately 0.4 K root mean square difference (RMSD) in GHRSST and NCEP SST when compared with buoy observations available over the Indian Ocean during 01 May to 30 September 2010. Our analyses suggest that use of GHRSST as lower boundary conditions in the WRF model improve the low level temperature, moisture, wind speed and rainfall prediction over ISM region. Moreover, temporal evolution of surface parameters such as temperature, moisture and wind speed forecasts associated with monsoon is also improved with GHRSST forcing as a lower boundary condition. Interestingly, rainfall prediction is improved with the use of GHRSST over the Western Ghats, which mostly not simulated in the NCEP SST based experiment.

  8. Significance of High Resolution GHRSST on prediction of Indian Summer Monsoon

    KAUST Repository

    Jangid, Buddhi Prakash; Kumar, Prashant; Attada, Raju; Kumar, Raj

    2017-01-01

    In this study, the Weather Research and Forecasting (WRF) model was used to assess the importance of very high resolution sea surface temperature (SST) on seasonal rainfall prediction. Two different SST datasets available from the National Centers for Environmental Prediction (NCEP) global model analysis and merged satellite product from Group for High Resolution SST (GHRSST) are used as a lower boundary condition in the WRF model for the Indian Summer Monsoon (ISM) 2010. Before using NCEP SST and GHRSST for model simulation, an initial verification of NCEP SST and GHRSST are performed with buoy measurements. It is found that approximately 0.4 K root mean square difference (RMSD) in GHRSST and NCEP SST when compared with buoy observations available over the Indian Ocean during 01 May to 30 September 2010. Our analyses suggest that use of GHRSST as lower boundary conditions in the WRF model improve the low level temperature, moisture, wind speed and rainfall prediction over ISM region. Moreover, temporal evolution of surface parameters such as temperature, moisture and wind speed forecasts associated with monsoon is also improved with GHRSST forcing as a lower boundary condition. Interestingly, rainfall prediction is improved with the use of GHRSST over the Western Ghats, which mostly not simulated in the NCEP SST based experiment.

  9. Prevalence and predictive factors for regional osteopenia in women with anorexia nervosa.

    Science.gov (United States)

    Grinspoon, S; Thomas, E; Pitts, S; Gross, E; Mickley, D; Miller, K; Herzog, D; Klibanski, A

    2000-11-21

    Anorexia nervosa is highly prevalent among young women. To determine prevalence and predictive factors for regional bone loss. Prospective cohort analysis. University hospital. 130 women with anorexia nervosa. Dual-energy x-ray absorptiometry. The prevalence of osteopenia (-1.0 SD >/= T-score > -2.5 SD) and osteoporosis (T-score anorexia nervosa. Weight, but not estrogen use, is a significant predictor of BMD in this population at all skeletal sites.

  10. Prospective validation of FibroTest in comparison with liver stiffness for predicting liver fibrosis in Asian subjects with chronic hepatitis B.

    Directory of Open Access Journals (Sweden)

    Beom Kyung Kim

    Full Text Available Diagnostic values of FibroTest (FT for hepatic fibrosis have rarely been assessed in Asian chronic hepatitis B (CHB patients. We aimed to validate its diagnostic performances in comparison with liver stiffness (LS.From 2008 to 2010, 194 CHB patients who underwent liver biopsies along with FT and transient elastography were prospectively enrolled. Fibrosis stage was assessed according to the Batts and Ludwig system.To predict significant fibrosis (F≥2, advanced fibrosis (F≥3, and cirrhosis (F = 4, areas under receiver operating characteristic curves (AUROCs of FT were 0.903, 0.907, and 0.866, comparable to those of LS (0.873, 0.897, and 0.910, respectively. Optimized cutoffs of FT to maximize sum of sensitivity and specificity were 0.32, 0.52, and 0.68 for F≥2, F≥3, and F = 4, while those of LS were 8.8, 10.2, and 14.1 kPa, respectively. According to FT and LS cutoffs, 123 (63.4% and 124 (63.9% patients were correctly classified consistent with histological fibrosis (F1, F2, F3, and F4, respectively. Overall concordance between each fibrosis stage estimated by FT and LS was observed in 111 patients, where 88 were correctly classified with histological results. A combination formula adding LS to FT (LS+FT showed similar AUROC levels (0.885, 0.905, and 0.915, while another multiplying LS by FT (LS×FT showed the best AUROCs (0.941, 0.931, and 0.929 for F≥2, F≥3, and F4, respectively.FT provides good fibrosis prediction, with comparable outcomes to LS in Asian CHB patients. FT substantially reduces need for liver biopsy, especially when used in combination with LS.

  11. Fracture predictive ability of physical performance tests and history of falls in elderly women: a 10-year prospective study.

    Science.gov (United States)

    Wihlborg, A; Englund, M; Åkesson, K; Gerdhem, P

    2015-08-01

    In a large cohort of elderly women followed for 10 years, we found that balance, gait speed, and self-reported history of fall independently predicted fracture. These clinical risk factors are easily evaluated and therefore advantageous in a clinical setting. They would improve fracture risk assessment and thereby also fracture prevention. The aim of this study was to identify additional risk factors for osteoporosis-related fracture by investigating the fracture predictive ability of physical performance tests and self-reported history of falls. In the population-based Osteoporosis Prospective Risk Assessment study (OPRA), 1044 women were recruited at the age of 75 and followed for 10 years. At inclusion, knee extension force, standing balance, gait speed, and bone mineral density (BMD) were examined. Falls the year before investigation was assessed by questionnaire. Cox proportional hazards regression analysis was used to determine fracture hazard ratios (HR) with BMD, history of fracture, BMI, smoking habits, bisphosphonate, vitamin D, glucocorticoid, and alcohol use as covariates. Continuous variables were standardized and HR shown for each standard deviation change. Of all women, 427 (41%) sustained at least one fracture during the 10-year follow-up. Failing the balance test had an HR of 1.98 (1.18-3.32) for hip fracture. Each standard deviation decrease in gait speed was associated with an HR of 1.37 (1.14-1.64) for hip fracture. Previous fall had an HR of 1.30 (1.03-1.65) for any fracture; 1.39 (1.08-1.79) for any osteoporosis-related fracture; and 1.60 (1.03-2.48) for distal forearm fracture. Knee extension force did not show fracture predictability. The balance test, gait speed test, and self-reported history of fall all hold independent fracture predictability. Consideration of these clinical risk factors for fracture would improve the fracture risk assessment and subsequently also fracture prevention.

  12. CDOCKER and lambda λ -dynamics for prospective prediction in D3R Grand Challenge 2

    Science.gov (United States)

    Ding, Xinqiang; Hayes, Ryan L.; Vilseck, Jonah Z.; Charles, Murchtricia K.; Brooks, Charles L.

    2018-01-01

    The opportunity to prospectively predict ligand bound poses and free energies of binding to the Farnesoid X Receptor in the D3R Grand Challenge 2 provided a useful exercise to evaluate CHARMM based docking (CDOCKER) and λ-dynamics methodologies for use in "real-world" applications in computer aided drug design. In addition to measuring their current performance, several recent methodological developments have been analyzed retrospectively to highlight best procedural practices in future applications. For pose prediction with CDOCKER, when the protein structure used for rigid receptor docking was close to the crystallographic holo structure, reliable poses were obtained. Benzimidazoles, with a known holo receptor structure, were successfully docked with an average RMSD of 0.97 Å. Other non-benzimidazole ligands displayed less accuracy largely because the receptor structures we chose for docking were too different from the experimental holo structures. However, retrospective analysis has shown that when these ligands were re-docked into their holo structures, the average RMSD dropped to 1.18 Å for all ligands. When sulfonamides and spiros were docked with the apo structure, which agrees more with their holo structure than the structures we chose, five out of six ligands were correctly docked. These docking results emphasize the need for flexible receptor docking approaches. For λ-dynamics techniques, including multisite λ-dynamics (MSλD), reasonable agreement with experiment was observed for the 33 ligands investigated; root mean square errors of 2.08 and 1.67 kcal/mol were obtained for free energy sets 1 and 2, respectively. Retrospectively, soft-core potentials, adaptive landscape flattening, and biasing potential replica exchange (BP-REX) algorithms were critical to model large substituent perturbations with sufficient precision and within restrictive timeframes, such as was required with participation in Grand Challenge 2. These developments, their

  13. Prospective study of serum uric acid levels and incident metabolic syndrome in a Korean rural cohort.

    Science.gov (United States)

    Yadav, Dhananjay; Lee, Eun Soo; Kim, Hong Min; Choi, Eunhee; Lee, Eun Young; Lim, Jung Soo; Ahn, Song Vogue; Koh, Sang Baek; Chung, Choon Hee

    2015-07-01

    Recent studies have demonstrated an association between serum uric acid (SUA) levels and metabolic syndrome (MetS). However, paucity of available data regarding the cause and effect relationship between SUA and MetS in healthy adults is still a big challenge which remains to be studied. Therefore, we investigated whether SUA predicts new onset of MetS in a population-based cohort study. The study included 1590 adults (661 men and 929 women) aged 40-70 years without MetS at baseline (2005-2008) and subjects were prospectively followed for 2.6 years. To evaluate the relationship between SUA and MetS, we divided the aforementioned subjects into quintiles (SUA-I to SUA-V) from the lowest to the highest values of SUA. SUA was measured by the enzymatic colorimetric method. We used category-free net reclassification improvement (NRI) and integrated discrimination improvement (IDI) to characterize the performance of predicted model. During a mean of 2.6 years of follow-up, 261(16.4%) adults developed MetS. MetS variables were significantly related to the baseline SUA level. Waist circumference (WC), blood pressure (BP), and serum triglyceride (TG) were significantly higher in the highest quintile of SUA compared to the lowest SUA quintile in men and women. After adjustment for age, total cholesterol and low-density lipoprotein cholesterol (LDL-C) in men and women, subjects in the fifth quintiles of SUA showed significantly higher ORs for incident MetS. The association between hyperuricemia and new onset of MetS were consistently stronger in women than men. Additionally, among women, we found an improvement in the area under the ROC curve in the models that added SUA to core components of MetS. Our study suggests that SUA is significantly correlated with future risk of WC, BP, TG and may predicted as a risk factor for developing MetS. SUA may have a clinical role in predicting new-onset metabolic syndrome among women. Large prospective study is needed to reveal the clinical

  14. Implicit and Explicit Attitudes Predict Smoking Cessation: Moderating Effects of Experienced Failure to Control Smoking and Plans to Quit

    OpenAIRE

    Chassin, Laurie; Presson, Clark C.; Sherman, Steven J.; Seo, Dong-Chul; Macy, Jon

    2010-01-01

    The current study tested implicit and explicit attitudes as prospective predictors of smoking cessation in a Midwestern community sample of smokers. Results showed that the effects of attitudes significantly varied with levels of experienced failure to control smoking and plans to quit. Explicit attitudes significantly predicted later cessation among those with low (but not high or average) levels of experienced failure to control smoking. Conversely, however, implicit attitudes significantly...

  15. Predicting Intentions of a Familiar Significant Other Beyond the Mirror Neuron System

    Directory of Open Access Journals (Sweden)

    Stephanie Cacioppo

    2017-08-01

    Full Text Available Inferring intentions of others is one of the most intriguing issues in interpersonal interaction. Theories of embodied cognition and simulation suggest that this mechanism takes place through a direct and automatic matching process that occurs between an observed action and past actions. This process occurs via the reactivation of past self-related sensorimotor experiences within the inferior frontoparietal network (including the mirror neuron system, MNS. The working model is that the anticipatory representations of others' behaviors require internal predictive models of actions formed from pre-established, shared representations between the observer and the actor. This model suggests that observers should be better at predicting intentions performed by a familiar actor, rather than a stranger. However, little is known about the modulations of the intention brain network as a function of the familiarity between the observer and the actor. Here, we combined functional magnetic resonance imaging (fMRI with a behavioral intention inference task, in which participants were asked to predict intentions from three types of actors: A familiar actor (their significant other, themselves (another familiar actor, and a non-familiar actor (a stranger. Our results showed that the participants were better at inferring intentions performed by familiar actors than non-familiar actors and that this better performance was associated with greater activation within and beyond the inferior frontoparietal network i.e., in brain areas related to familiarity (e.g., precuneus. In addition, and in line with Hebbian principles of neural modulations, the more the participants reported being cognitively close to their partner, the less the brain areas associated with action self-other comparison (e.g., inferior parietal lobule, attention (e.g., superior parietal lobule, recollection (hippocampus, and pair bond (ventral tegmental area, VTA were recruited, suggesting that the

  16. Spouse's subjective social status predicts older adults' prospective cognitive functioning.

    Science.gov (United States)

    Zhang, Fan; Fung, Helene; Kwok, Timothy

    2017-12-06

    The current study aims to investigate the association between subjective social status (SSS) and prospective cognitive functioning of older adults and their spouses, and to explore the potential mediating roles of health habits and physical activities in this association. Using the longitudinal data of 512 pairs of community-dwelling older couples aged 65-91 years (M = 72.2 ± 4.6), we tested the effects of SSS in cognitive functioning using an Actor-Partner Interdependence Model. SSS was measured by a self-anchoring social ladder, and cognitive functioning was measured by the Mini-Mental State Examination at baseline and 4-year follow-up. Socioeconomic status (i.e. education) was tested as a moderator, and physical activity (measured by the Physical Activity Scale for the Elderly) as well as health habits (i.e. tobacco and alcohol consumption) were included as potential mediators. A partner effect of SSS was found only in the low-education group, in which the wife's higher level of SSS in the community was associated with the husband's better cognitive functioning in the follow-up. A small proportion of this effect was found to be partially mediated by participation in housework, such that the wife's higher SSS was associated with the husband's increased housework activity, which was related to higher prospective cognitive functioning. By examining the dyadic effects of SSS with a longitudinal design, our findings extended the understanding on how subjective social status influenced older couples' cognitive health, and provided evidence-based insights for future studies on cognitive health in later life.

  17. Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study.

    Science.gov (United States)

    Yang, Ming; Hu, Xiaoyi; Wang, Haozhong; Zhang, Lei; Hao, Qiukui; Dong, Birong

    2017-04-01

    The aim of this study is to assess the prevalence of sarcopenia and investigate the associations between sarcopenia and long-term mortality and readmission in a population of elderly inpatients in acute care wards. We conducted a prospective observational study in the acute care wards of a teaching hospital in western China. The muscle mass was estimated according to a previously validated anthropometric equation. Handgrip strength was measured with a handheld dynamometer, and physical performance was measured via a 4 m walking test. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia. The survival status and readmission information were obtained via telephone interviews at 12, 24, and 36 months during the 3 year follow-up period following the baseline investigation. Two hundred and eighty-eight participants (mean age: 81.1 ± 6.6 years) were included. Forty-nine participants (17.0%) were identified as having sarcopenia. This condition was similar in men and women (16.9% vs. 17.5%, respectively, P = 0.915). During the 3 year follow-up period, 49 men (22.7%) and 9 women (16.4%) died (P = 0.307). The mortality of sarcopenic participants was significantly increased compared with non-sarcopenic participants (40.8% vs. 17.1%, respectively, P sarcopenia was an independent predictor of 3 year mortality (adjusted hazard ratio: 2.49; 95% confidential interval: 1.25-4.95) and readmission (adjusted hazard ratio: 1.81; 95% confidential interval: 1.17-2.80). Sarcopenia, which is evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable to predict hospital readmission and long-term mortality in elderly patients in acute care wards. © 2016 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

  18. Prospective memory in dynamic environments: effects of load, delay, and phonological rehearsal

    Science.gov (United States)

    Stone, M.; Dismukes, K.; Remington, R.

    2001-01-01

    A new paradigm was developed to examine prospective memory performance in a visual-spatial task that resembles some aspects of the work of air traffic controllers. Two experiments examined the role of workload (number of aeroplanes that participants directed), delay (between receipt of prospective instructions and execution), and phonological rehearsal. High workload increased prospective memory errors but increasing delay from 1-3 or 5 minutes had no effect. Shadowing aurally presented text reduced prospective memory performance, presumably because it prevented verbal rehearsal of the prospective instructions. However, performance on the foreground task of directing aeroplanes to routine destinations was affected only by workload and not by opportunity for rehearsal. Our results suggest that ability to maintain performance on a routine foreground task while performing a secondary task--perhaps analogous to conversation--does not predict ability to retrieve a prospective intention to deviate from the routine.

  19. Effectiveness of an i-PTH Measurement in Predicting Post Thyroidectomy Hypocalcemia: Prospective Controlled Study

    Science.gov (United States)

    Kim, Jin Pyeong; Park, Jung Je; Son, Hee Young; Kim, Rock Bum; Kim, Ho Youp

    2013-01-01

    Purpose Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study was to determine whether measurement of intact parathyroid hormone (i-PTH) level in thyroidectomy patients could predict hypocalcemia. Materials and Methods We performed a prospective study of patients undergoing total thyroidectomy. Serum concentration of i-PTH, total calcium (Ca), ionized calcium (Ca2+), phosphate (P), magnesium (Mg), and albumin were measured preoperatively and at 0 hour, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours postoperatively. Results 108 patients were recruited to the study. A total of 50 patients (46%) experienced hypocalcemia. The serum i-PTH concentration was linearly related to the time of measurement, while concentrations of P, Mg, albumin, Ca, and Ca2+ were not. We compared odds ratios, and found that the concentration of i-PTH at 6 hours post operation was the most closely related to the occurrence of hypocalcemic symptom. On ROC analysis using i-PTH level at 6 hours, an i-PTH level of 10.6 mg/dL was found to maximize both sensitivity and specificity at the same time point. Conclusion We found that i-PTH was a predictor of hypocalcemia, and that the earliest predictor of hypocalcemic symptoms was an i-PTH concentration lower than 10.6 mg/dL obtained 6 hours after total thyroidectomy. PMID:23549808

  20. Some findings on prospect and refuge theory: II.

    Science.gov (United States)

    Stamps, Arthur E

    2008-08-01

    This article presents four new studies on the efficacy of predictions based on prospect and refuge theory and summarizes the results over eight studies. New data covered 49 participants and 36 environments. The eight studies included in the summary covered 144 participants and 80 widely diverse environments (Japanese Tatami rooms, Western rooms, porch, meadow, neighborhood commercial, shopping mall, vacation landscapes). Data were available for hypotheses about five factors: prospect, refuge, light, venue, and spatial transition. Efficacy was represented by correlations for the levels of the factors with responses of preference or comfort. Overall, venue was the most efficacious factor (r = .42, 95% CI = .14, .64). Efficacies for the other factors were very near zero. It is suggested that a considerable amount of additional formal inquiry be conducted before assuming the utility of prospect and refuge theory.

  1. Predicting meaningful outcomes to medication and self-help treatments for binge-eating disorder in primary care: The significance of early rapid response.

    Science.gov (United States)

    Grilo, Carlos M; White, Marney A; Masheb, Robin M; Gueorguieva, Ralitza

    2015-04-01

    We examined rapid response among obese patients with binge-eating disorder (BED) in a randomized clinical trial testing antiobesity medication and self-help cognitive-behavioral therapy (shCBT), alone and in combination, in primary-care settings. One hundred four obese patients with BED were randomly assigned to 1 of 4 treatments: sibutramine, placebo, shCBT + sibutramine, or shCBT + placebo. Treatments were delivered by generalist primary-care physicians and the medications were given double-blind. Independent assessments were performed by trained and monitored doctoral research clinicians monthly throughout treatment, posttreatment (4 months), and at 6- and 12-month follow-ups (i.e., 16 months after randomization). Rapid response, defined as ≥65% reduction in binge eating by the fourth treatment week, was used to predict outcomes. Rapid response characterized 47% of patients, was unrelated to demographic and baseline clinical characteristics, and was significantly associated, prospectively, with remission from binge eating at posttreatment (51% vs. 9% for nonrapid responders), 6-month (53% vs. 23.6%), and 12-month (46.9% vs. 23.6%) follow-ups. Mixed-effects model analyses revealed that rapid response was significantly associated with greater decreases in binge-eating or eating-disorder psychopathology, depression, and percent weight loss. Our findings, based on a diverse obese patient group receiving medication and shCBT for BED in primary-care settings, indicate that patients who have a rapid response achieve good clinical outcomes through 12-month follow-ups after ending treatment. Rapid response represents a strong prognostic indicator of clinically meaningful outcomes, even in low-intensity medication and self-help interventions. Rapid response has important clinical implications for stepped-care treatment models for BED. clinicaltrials.gov: NCT00537810 (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  2. Personality, organizational stress, and attitudes toward work as prospective predictors of professional burnout in hospital nurses

    Science.gov (United States)

    Hudek-Knežević, Jasna; Kalebić Maglica, Barbara; Krapić, Nada

    2011-01-01

    Aim To examine to what extent personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness), organizational stress, and attitudes toward work and interactions between personality and either organizational stress or attitudes toward work prospectively predict 3 components of burnout. Methods The study was carried out on 118 hospital nurses. Data were analyzed by a set of hierarchical regression analyses, in which personality traits, measures of organizational stress, and attitudes toward work, as well as interactions between personality and either organizational stress or attitudes toward work were included as predictors, while 3 indices of burnout were measured 4 years later as criteria variables. Results Personality traits proved to be significant but weak prospective predictors of burnout and as a group predicted only reduced professional efficacy (R2 = 0.10), with agreeableness being a single negative predictor. Organizational stress was positive, affective-normative commitment negative predictor, while continuance commitment was not related to any dimension of burnout. We found interactions between neuroticism as well as conscientiousness and organizational stress, measured as role conflict and work overload, on reduced professional efficacy (βNRCWO = -0.30; ßcRCWO = -0.26). We also found interactions between neuroticism and affective normative commitment (β = 0.24) and between openness and continuance commitment on reduced professional efficacy (β = -0.23), as well as interactions between conscientiousness and continuance commitment on exhaustion. Conclusion Although contextual variables were strong prospective predictors and personality traits weak predictors of burnout, the results suggested the importance of the interaction between personality and contextual variables in predicting burnout. PMID:21853549

  3. Pharmacogenetics-based area-under-curve model can predict efficacy and adverse events from axitinib in individual patients with advanced renal cell carcinoma.

    Science.gov (United States)

    Yamamoto, Yoshiaki; Tsunedomi, Ryouichi; Fujita, Yusuke; Otori, Toru; Ohba, Mitsuyoshi; Kawai, Yoshihisa; Hirata, Hiroshi; Matsumoto, Hiroaki; Haginaka, Jun; Suzuki, Shigeo; Dahiya, Rajvir; Hamamoto, Yoshihiko; Matsuyama, Kenji; Hazama, Shoichi; Nagano, Hiroaki; Matsuyama, Hideyasu

    2018-03-30

    We investigated the relationship between axitinib pharmacogenetics and clinical efficacy/adverse events in advanced renal cell carcinoma (RCC) and established a model to predict clinical efficacy and adverse events using pharmacokinetic and gene polymorphisms related to drug metabolism and efflux in a phase II trial. We prospectively evaluated the area under the plasma concentration-time curve (AUC) of axitinib, objective response rate, and adverse events in 44 consecutive advanced RCC patients treated with axitinib. To establish a model for predicting clinical efficacy and adverse events, polymorphisms in genes including ABC transporters ( ABCB1 and ABCG2 ), UGT1A , and OR2B11 were analyzed by whole-exome sequencing, Sanger sequencing, and DNA microarray. To validate this prediction model, calculated AUC by 6 gene polymorphisms was compared with actual AUC in 16 additional consecutive patients prospectively. Actual AUC significantly correlated with the objective response rate ( P = 0.0002) and adverse events (hand-foot syndrome, P = 0.0055; and hypothyroidism, P = 0.0381). Calculated AUC significantly correlated with actual AUC ( P treatment precisely predicted actual AUC after axitinib treatment ( P = 0.0066). Our pharmacogenetics-based AUC prediction model may determine the optimal initial dose of axitinib, and thus facilitate better treatment of patients with advanced RCC.

  4. Interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort study

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    Kronenberger Bernd

    2012-09-01

    Full Text Available Abstract Background Interleukin-22 (IL-22, recently identified as a crucial parameter of pathology in experimental liver damage, may determine survival in clinical end-stage liver disease. Systematic analysis of serum IL-22 in relation to morbidity and mortality of patients with advanced liver cirrhosis has not been performed so far. Methods This is a prospective cohort study including 120 liver cirrhosis patients and 40 healthy donors to analyze systemic levels of IL-22 in relation to survival and hepatic complications. Results A total of 71% of patients displayed liver cirrhosis-related complications at study inclusion. A total of 23% of the patients died during a mean follow-up of 196 ± 165 days. Systemic IL-22 was detectable in 74% of patients but only in 10% of healthy donors (P P = 0.006, hepatorenal syndrome (P P = 0.001. Patients with elevated IL-22 (>18 pg/ml, n = 57 showed significantly reduced survival compared to patients with regular (≤18 pg/ml levels of IL-22 (321 days versus 526 days, P = 0.003. Other factors associated with reduced overall survival were high CRP (≥2.9 mg/dl, P = 0.005, hazard ratio (HR 0.314, confidence interval (CI (0.141 to 0.702, elevated serum creatinine (P = 0.05, HR 0.453, CI (0.203 to 1.012, presence of liver-related complications (P = 0.028, HR 0.258, CI (0.077 to 0.862, model of end stage liver disease (MELD score ≥20 (P = 0.017, HR 0.364, CI (0.159 to 0.835 and age (P = 0.011, HR 0.955, CI (0.922 to 0.989. Adjusted multivariate Cox proportional-hazards analysis identified elevated systemic IL-22 levels as independent predictors of reduced survival (P = 0.007, HR 0.218, CI (0.072 to 0.662. Conclusions In patients with liver cirrhosis, elevated systemic IL-22 levels are predictive for reduced survival independently from age, liver-related complications, CRP, creatinine and the MELD score. Thus, processes that lead to a rise in systemic interleukin-22 may be relevant for prognosis of advanced liver

  5. Prediction of response to PPI therapy and factors influencing treatment outcome in patients with GORD: a prospective pragmatic trial using pantoprazole

    Directory of Open Access Journals (Sweden)

    Tholen Anne

    2011-05-01

    Full Text Available Abstract Background Management of patients with gastro-oesophageal reflux disease (GORD can be assisted by information predicting the likely response to proton pump inhibitor (PPI treatment. The aim was to undertake a study of GORD patients designed to approximate ordinary clinical practice that would identify patient characteristics predicting symptomatic response to pantoprazole treatment. Methods 1888 patients with symptoms of GORD were enrolled in a multicentre, multinational, prospective, open study of 8 weeks pantoprazole treatment, 40 mg daily. Response was assessed by using the ReQuest™ questionnaire, by the investigator making conventional clinical enquiry and by asking patients about their satisfaction with symptom control. Factors including pre-treatment oesophagitis, gender, age, body mass index (BMI, Helicobacter pylori status, anxiety and depression, and concurrent IBS symptoms were examined using logistic regression to determine if they were related to response, judged from the ReQuest™-GI score. Results Poorer treatment responses were associated with non-erosive reflux disease, female gender, lower BMI, anxiety and concurrent irritable bowel syndrome symptoms before treatment. No association was found with age, Helicobacter pylori status or oesophagitis grade. Some reflux-related symptoms were still present in 14% of patients who declared themselves 'well-satisfied' with their symptom control. Conclusions Some readily identifiable features help to predict symptomatic responses to a PPI and consequently may help in managing patient expectation. ClinicalTrial.gov identifier: NCT00312806.

  6. Can the Bruckner test be used as a rapid screening test to detect significant refractive errors in children?

    Directory of Open Access Journals (Sweden)

    Kothari Mihir

    2007-01-01

    Full Text Available Purpose: To assess the suitability of Brückner test as a screening test to detect significant refractive errors in children. Materials and Methods: A pediatric ophthalmologist prospectively observed the size and location of pupillary crescent on Brückner test as hyperopic, myopic or astigmatic. This was compared with the cycloplegic refraction. Detailed ophthalmic examination was done for all. Sensitivity, specificity, positive predictive value and negative predictive value of Brückner test were determined for the defined cutoff levels of ametropia. Results: Ninety-six subjects were examined. Mean age was 8.6 years (range 1 to 16 years. Brückner test could be completed for all; the time taken to complete this test was 10 seconds per subject. The ophthalmologist identified 131 eyes as ametropic, 61 as emmetropic. The Brückner test had sensitivity 91%, specificity 72.8%, positive predictive value 85.5% and negative predictive value 83.6%. Of 10 false negatives four had compound hypermetropic astigmatism and three had myopia. Conclusions: Brückner test can be used to rapidly screen the children for significant refractive errors. The potential benefits from such use may be maximized if programs use the test with lower crescent measurement cutoffs, a crescent measurement ruler and a distance fixation target.

  7. Leg pain and psychological variables predict outcome 2-3 years after lumbar fusion surgery.

    Science.gov (United States)

    Abbott, Allan D; Tyni-Lenné, Raija; Hedlund, Rune

    2011-10-01

    Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.

  8. Predicting the outcome of chronic kidney disease by the estimated nephron number: The rationale and design of PRONEP, a prospective, multicenter, observational cohort study

    Directory of Open Access Journals (Sweden)

    Imasawa Toshiyuki

    2012-03-01

    Full Text Available Abstract Background The nephron number is thought to be associated with the outcome of chronic kidney disease (CKD. If the nephron number can be estimated in the clinical setting, it could become a strong tool to predict renal outcome. This study was designed to estimate the nephron number in CKD patients and to establish a method to predict the outcome by using the estimated nephron number. Methods/Design The hypothesis of this study is that the estimated nephron number can predict the outcome of a CKD patient. This will be a multicenter, prospective (minimum 3 and maximum 5 years follow-up study. The subjects will comprise CKD patients aged over 14 years who have undergone a kidney biopsy. From January 2011 to March 2013, we will recruit 600 CKD patients from 10 hospitals belonging to the National Hospital Organization of Japan. The primary parameter for assessment is the composite of total mortality, renal death, cerebro-cardiovascular events, and a 50% reduction in the eGFR. The secondary parameter is the rate of eGFR decline per year. The nephron number will be estimated by the glomerular density in biopsy specimens and the renal cortex volume. This study includes one sub-cohort study to establish the equation to calculate the renal cortex volume. Enrollment will be performed at the time of the kidney biopsy, and the data will consist of a medical interview, ultrasound for measurement of the kidney size, blood or urine test, and the pathological findings of the kidney biopsy. Patients will continue to have medical consultations and receive examinations and/or treatment as usual. The data from the patients will be collected once a year after the kidney biopsy until March 2016. All data using this study are easily obtained in routine clinical practice. Discussion This study includes the first trials to estimate the renal cortex volume and nephron number in the general clinical setting. Furthermore, this is the first prospective study to

  9. Predictive validity of granulation tissue color measured by digital image analysis for deep pressure ulcer healing: a multicenter prospective cohort study.

    Science.gov (United States)

    Iizaka, Shinji; Kaitani, Toshiko; Sugama, Junko; Nakagami, Gojiro; Naito, Ayumi; Koyanagi, Hiroe; Konya, Chizuko; Sanada, Hiromi

    2013-01-01

    This multicenter prospective cohort study examined the predictive validity of granulation tissue color evaluated by digital image analysis for deep pressure ulcer healing. Ninety-one patients with deep pressure ulcers were followed for 3 weeks. From a wound photograph taken at baseline, an image representing the granulation red index (GRI) was processed in which a redder color represented higher values. We calculated the average GRI over granulation tissue and the proportion of pixels exceeding the threshold intensity of 80 for the granulation tissue surface (%GRI80) and wound surface (%wound red index 80). In the receiver operating characteristics curve analysis, most GRI parameters had adequate discriminative values for both improvement of the DESIGN-R total score and wound closure. Ulcers were categorized by the obtained cutoff points of the average GRI (≤80, >80), %GRI80 (≤55, >55-80, >80%), and %wound red index 80 (≤25, >25-50, >50%). In the linear mixed model, higher classes for all GRI parameters showed significantly greater relative improvement in overall wound severity during the 3 weeks after adjustment for patient characteristics and wound locations. Assessment of granulation tissue color by digital image analysis will be useful as an objective monitoring tool for granulation tissue quality or surrogate outcomes of pressure ulcer healing. © 2012 by the Wound Healing Society.

  10. Evaluation of recruitment and selection for specialty training in public health: interim results of a prospective cohort study to measure the predictive validity of the selection process.

    Science.gov (United States)

    Pashayan, Nora; Gray, Selena; Duff, Celia; Parkes, Julie; Williams, David; Patterson, Fiona; Koczwara, Anna; Fisher, Grant; Mason, Brendan W

    2016-06-01

    The recruitment process for public health specialty training includes an assessment centre (AC) with three components, Rust Advanced Numerical Reasoning Appraisal (RANRA), Watson-Glaser Critical Thinking Appraisal (WGCT) and a Situation Judgement Test (SJT), which determines invitation to a selection centre (SC). The scores are combined into a total recruitment (TR) score that determines the offers of appointment. A prospective cohort study using anonymous record linkage to investigate the association between applicant's scores in the recruitment process and registrar's progress through training measured by results of Membership Faculty Public Health (MFPH) examinations and outcomes of the Annual Review of Competence Progression (ARCP). Higher scores in RANRA, WGCT, AC, SC and TR were all significantly associated with higher adjusted odds of passing Part A MFPH exam at the first attempt. Higher scores in AC, SC and TR were significantly associated with passing Part B exam at the first attempt. Higher scores in SJT, AC and SC were significantly associated with satisfactory ARCP outcomes. The current UK national recruitment and selection process for public health specialty training has good predictive validity. The individual components of the process are testing different skills and abilities and together they are providing additive value. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Tests of Cumulative Prospect Theory with graphical displays of probability

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    Michael H. Birnbaum

    2008-10-01

    Full Text Available Recent research reported evidence that contradicts cumulative prospect theory and the priority heuristic. The same body of research also violates two editing principles of original prospect theory: cancellation (the principle that people delete any attribute that is the same in both alternatives before deciding between them and combination (the principle that people combine branches leading to the same consequence by adding their probabilities. This study was designed to replicate previous results and to test whether the violations of cumulative prospect theory might be eliminated or reduced by using formats for presentation of risky gambles in which cancellation and combination could be facilitated visually. Contrary to the idea that decision behavior contradicting cumulative prospect theory and the priority heuristic would be altered by use of these formats, however, data with two new graphical formats as well as fresh replication data continued to show the patterns of evidence that violate cumulative prospect theory, the priority heuristic, and the editing principles of combination and cancellation. Systematic violations of restricted branch independence also contradicted predictions of ``stripped'' prospect theory (subjectively weighted additive utility without the editing rules.

  12. Value of quantitative MRI parameters in predicting and evaluating clinical outcome in conservatively treated patients with chronic midportion Achilles tendinopathy: A prospective study.

    Science.gov (United States)

    Tsehaie, J; Poot, D H J; Oei, E H G; Verhaar, J A N; de Vos, R J

    2017-07-01

    To evaluate whether baseline MRI parameters provide prognostic value for clinical outcome, and to study correlation between MRI parameters and clinical outcome. Observational prospective cohort study. Patients with chronic midportion Achilles tendinopathy were included and performed a 16-week eccentric calf-muscle exercise program. Outcome measurements were the validated Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire and MRI parameters at baseline and after 24 weeks. The following MRI parameters were assessed: tendon volume (Volume), tendon maximum cross-sectional area (CSA), tendon maximum anterior-posterior diameter (AP), and signal intensity (SI). Intra-class correlation coefficients (ICCs) and minimum detectable changes (MDCs) for each parameter were established in a reliability analysis. Twenty-five patients were included and complete follow-up was achieved in 20 patients. The average VISA-A scores increased significantly with 12.3 points (27.6%). The reliability was fair-good for all MRI-parameters with ICCs>0.50. Average tendon volume and CSA decreased significantly with 0.28cm 3 (5.2%) and 4.52mm 2 (4.6%) respectively. Other MRI parameters did not change significantly. None of the baseline MRI parameters were univariately associated with VISA-A change after 24 weeks. MRI SI increase over 24 weeks was positively correlated with the VISA-A score improvement (B=0.7, R 2 =0.490, p=0.02). Tendon volume and CSA decreased significantly after 24 weeks of conservative treatment. As these differences were within the MDC limits, they could be a result of a measurement error. Furthermore, MRI parameters at baseline did not predict the change in symptoms, and therefore have no added value in providing a prognosis in daily clinical practice. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. Prospects for Inflationary B-Mode Detection

    Science.gov (United States)

    Kogut, Alan J.

    2011-01-01

    Measurements of the linear polarization of the cosmic microwave background provide a direct window into the physics of inflation. The experimental challenges are daunting: not only is the predicted signal faint compared to the photon noise limit, but it is hidden behind competing foregrounds from both local and cosmic sources. I will discuss the experimental response to these challenges and the prospects for eventual detection and characterization of the inflationary signal.

  14. Prediction of language and neurologic recovery after cerebral infarction with SPECT imaging using N-isopropyl-p-(I-123) iodoamphetamine

    International Nuclear Information System (INIS)

    Bushnell, D.L.; Gupta, S.; Mlcoch, A.G.; Barnes, W.E.

    1989-01-01

    Fourteen patients (10 with left-sided and 4 with right-sided cerebral infarction) were prospectively studied with single-photon emission computed tomography (SPECT) using N-isopropyl-p-(I-123) iodoamphetamine (IMP, SPECTamine) to determine its usefulness in predicting neurologic/language recovery after cerebral infarction. All neuro-SPECT imaging was performed within 30 days after infarction. Detailed assessment of neurologic and/or language recovery (after 3 months) was carried out prospectively in each patient. Patients with smaller volume IMP defects in the region of infarction demonstrated significantly better neurologic and language recovery than patients with large IMP defects. Analysis of the IMP ''redistribution'' phenomenon failed to demonstrate definitively a relationship with clinical recovery. It was concluded that the volume of the IMP defect can aid in predicting recovery potential after cerebral infarction

  15. Prospective validation of American Diabetes Association risk tool for predicting pre-diabetes and diabetes in Taiwan-Taichung community health study.

    Directory of Open Access Journals (Sweden)

    Chia-Ing Li

    Full Text Available BACKGROUND: A simple diabetes risk tool that does not require laboratory tests would be beneficial in screening individuals at higher risk. Few studies have evaluated the ability of these tools to identify new cases of pre-diabetes. This study aimed to assess the ability of the American Diabetes Association Risk Tool (ADART to predict the 3-year incidence of pre-diabetes and diabetes in Taiwanese. METHODS: This was a 3-year prospective study of 1021 residents with normoglycemia at baseline, gathered from a random sample of residents aged 40-88 years in a metropolitan city in Taiwan. The areas under the curve (AUCs of three models were compared: ADART only, ADART plus lifestyle behaviors at baseline, and ADART plus lifestyle behaviors and biomarkers at baseline. The performance of ADART was compared with that of 16 tools that had been reported in the literature. RESULTS: The AUCs and their 95% confidence intervals (CIs were 0.60 (0.54-0.66 for men and 0.72 (0.66-0.77 for women in model 1; 0.62 (0.56-0.68 for men and 0.74 (0.68-0.80 for women in model 2; and 0.64 (0.58-0.71 for men and 0.75 (0.69-0.80 for women in model 3. The AUCs of these three models were all above 0.7 in women, but not in men. No significant difference in either women or men (p = 0.268 and 0.156, respectively was observed in the AUC of these three models. Compared to 16 tools published in the literature, ADART had the second largest AUC in both men and women. CONCLUSIONS: ADART is a good screening tool for predicting the three-year incidence of pre-diabetes and diabetes in females of a Taiwanese population. The performance of ADART in men was similar to the results with other tools published in the literature. Its performance was one of the best among the tools reported in the literature.

  16. Prospects on electroweak physics from the LHC

    International Nuclear Information System (INIS)

    Vikas, Pratibha

    2001-01-01

    The abundant production of gauge bosons, gauge boson pairs and top quarks at the LHC will offer the opportunity for comprehensive and challenging tests of theoretical predictions in the electroweak sector. Some issues which influence these measurements followed by prospects on some possible measurements by the ATLAS and CMS experiments at the Large Hadron Collider (LHC), at CERN are discussed. (author)

  17. Child Maltreatment and Executive Functioning in Middle Adulthood: A Prospective Examination

    Science.gov (United States)

    Nikulina, Valentina; Widom, Cathy Spatz

    2013-01-01

    Objective There is extensive evidence of negative consequences of childhood maltreatment for IQ, academic achievement, and post-traumatic stress disorder (PTSD) and increased attention to neurobiological consequences. However, few prospective studies have assessed the long-term effects of abuse and neglect on executive functioning. The current study examines whether childhood abuse and neglect predicts components of executive functioning and nonverbal reasoning ability in middle adulthood and whether PTSD moderates this relationship. Method Using a prospective cohort design, a large sample (N = 792) of court-substantiated cases of childhood physical and sexual abuse and neglect (ages 0-11) and matched controls were followed into adulthood (mean age = 41). Executive functioning was assessed with the Trail Making B test and non-verbal reasoning with Matrix Reasoning. PTSD (DSM-III-R lifetime diagnosis) was assessed at age 29. Data were analyzed using ordinary least squares regressions, controlling for age, sex, and race and possible confounds of IQ, depression, and excessive alcohol use. Results In multivariate analyses, childhood maltreatment overall and childhood neglect predicted poorer executive functioning and non-verbal reasoning at age 41, whereas physical and sexual abuse did not. A past history of PTSD did not mediate or moderate these relations. Conclusions Childhood maltreatment and neglect specifically have a significant long-term impact on important aspects of adult neuropsychological functioning. These findings suggest the need for targeted efforts dedicated to interventions for neglected children. PMID:23876115

  18. First trimester prediction of maternal glycemic status.

    Science.gov (United States)

    Gabbay-Benziv, Rinat; Doyle, Lauren E; Blitzer, Miriam; Baschat, Ahmet A

    2015-05-01

    To predict gestational diabetes mellitus (GDM) or normoglycemic status using first trimester maternal characteristics. We used data from a prospective cohort study. First trimester maternal characteristics were compared between women with and without GDM. Association of these variables with sugar values at glucose challenge test (GCT) and subsequent GDM was tested to identify key parameters. A predictive algorithm for GDM was developed and receiver operating characteristics (ROC) statistics was used to derive the optimal risk score. We defined normoglycemic state, when GCT and all four sugar values at oral glucose tolerance test, whenever obtained, were normal. Using same statistical approach, we developed an algorithm to predict the normoglycemic state. Maternal age, race, prior GDM, first trimester BMI, and systolic blood pressure (SBP) were all significantly associated with GDM. Age, BMI, and SBP were also associated with GCT values. The logistic regression analysis constructed equation and the calculated risk score yielded sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 62%, 13.8%, and 98.3% for a cut-off value of 0.042, respectively (ROC-AUC - area under the curve 0.819, CI - confidence interval 0.769-0.868). The model constructed for normoglycemia prediction demonstrated lower performance (ROC-AUC 0.707, CI 0.668-0.746). GDM prediction can be achieved during the first trimester encounter by integration of maternal characteristics and basic measurements while normoglycemic status prediction is less effective.

  19. The Pancreatitis Activity Scoring System predicts clinical outcomes in acute pancreatitis: findings from a prospective cohort study.

    Science.gov (United States)

    Buxbaum, James; Quezada, Michael; Chong, Bradford; Gupta, Nikhil; Yu, Chung Yao; Lane, Christianne; Da, Ben; Leung, Kenneth; Shulman, Ira; Pandol, Stephen; Wu, Bechien

    2018-03-15

    The Pancreatitis Activity Scoring System (PASS) has been derived by an international group of experts via a modified Delphi process. Our aim was to perform an external validation study to assess for concordance of the PASS score with high face validity clinical outcomes and determine specific meaningful thresholds to assist in application of this scoring system in a large prospectively ascertained cohort. We analyzed data from a prospective cohort study of consecutive patients admitted to the Los Angeles County Hospital between March 2015 and March 2017. Patients were identified using an emergency department paging system and electronic alert system. Comprehensive characterization included substance use history, pancreatitis etiology, biochemical profile, and detailed clinical course. We calculated the PASS score at admission, discharge, and at 12 h increments during the hospitalization. We performed several analyses to assess the relationship between the PASS score and outcomes at various points during hospitalization as well as following discharge. Using multivariable logistic regression analysis, we assessed the relationship between admission PASS score and risk of severe pancreatitis. PASS score performance was compared to established systems used to predict severe pancreatitis. Additional inpatient outcomes assessed included local complications, length of stay, development of systemic inflammatory response syndrome (SIRS), and intensive care unit (ICU) admission. We also assessed whether the PASS score at discharge was associated with early readmission (re-hospitalization for pancreatitis symptoms and complications within 30 days of discharge). A total of 439 patients were enrolled, their mean age was 42 (±15) years, and 53% were male. Admission PASS score >140 was associated with moderately severe and severe pancreatitis (OR 3.5 [95% CI 2.0, 6.3]), ICU admission (OR 4.9 [2.5, 9.4]), local complications (3.0 [1.6, 5.7]), and development of SIRS (OR 2.9 [1

  20. Reduced memory skills and increased hair cortisol levels in recent Ecstasy/MDMA users: significant but independent neurocognitive and neurohormonal deficits.

    Science.gov (United States)

    Downey, Luke A; Sands, Helen; Jones, Lewis; Clow, Angela; Evans, Phil; Stalder, Tobias; Parrott, Andrew C

    2015-05-01

    The goals of this study were to measure the neurocognitive performance of recent users of recreational Ecstasy and investigate whether it was associated with the stress hormone cortisol. The 101 participants included 27 recent light users of Ecstasy (one to four times in the last 3 months), 23 recent heavier Ecstasy users (five or more times) and 51 non-users. Rivermead paragraph recall provided an objective measure for immediate and delayed recall. The prospective and retrospective memory questionnaire provided a subjective index of memory deficits. Cortisol levels were taken from near-scalp 3-month hair samples. Cortisol was significantly raised in recent heavy Ecstasy users compared with controls, whereas hair cortisol in light Ecstasy users was not raised. Both Ecstasy groups were significantly impaired on the Rivermead delayed word recall, and both groups reported significantly more retrospective and prospective memory problems. Stepwise regression confirmed that lifetime Ecstasy predicted the extent of these memory deficits. Recreational Ecstasy is associated with increased levels of the bio-energetic stress hormone cortisol and significant memory impairments. No significant relationship between cortisol and the cognitive deficits was observed. Ecstasy users did display evidence of a metacognitive deficit, with the strength of the correlations between objective and subjective memory performances being significantly lower in the Ecstasy users. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Family, peer, and neighborhood influences on academic achievement among African-American adolescents: one-year prospective effects.

    Science.gov (United States)

    Gonzales, N A; Cauce, A M; Friedman, R J; Mason, C A

    1996-06-01

    Using a 1-year prospective design, this study examined the influence of family status variables (family income, parental education, family structure), parenting variables (maternal support and restrictive control), peer support, and neighborhood risk on the school performance of 120 African American junior high school students. In addition to main effects of these variables, neighborhood risk was examined as a moderator of the effects of parenting and peer support. Family status variables were not predictive of adolescent school performance as indexed by self-reported grade point average. Maternal support at Time 1 was prospectively related to adolescent grades at Time 2. Neighborhood risk was related to lower grades, while peer support predicted better grades in the prospective analyses. Neighborhood risk also moderated the effects of maternal restrictive control and peer support on adolescent grades in prospective analyses. These findings highlight the importance of an ecological approach to the problem of academic underachievement within the African American Community.

  2. Novel biomarker-based model for the prediction of sorafenib response and overall survival in advanced hepatocellular carcinoma: a prospective cohort study.

    Science.gov (United States)

    Kim, Hwi Young; Lee, Dong Hyeon; Lee, Jeong-Hoon; Cho, Young Youn; Cho, Eun Ju; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung-Hwan

    2018-03-20

    Prediction of the outcome of sorafenib therapy using biomarkers is an unmet clinical need in patients with advanced hepatocellular carcinoma (HCC). The aim was to develop and validate a biomarker-based model for predicting sorafenib response and overall survival (OS). This prospective cohort study included 124 consecutive HCC patients (44 with disease control, 80 with progression) with Child-Pugh class A liver function, who received sorafenib. Potential serum biomarkers (namely, hepatocyte growth factor [HGF], fibroblast growth factor [FGF], vascular endothelial growth factor receptor-1, CD117, and angiopoietin-2) were tested. After identifying independent predictors of tumor response, a risk scoring system for predicting OS was developed and 3-fold internal validation was conducted. A risk scoring system was developed with six covariates: etiology, platelet count, Barcelona Clinic Liver Cancer stage, protein induced by vitamin K absence-II, HGF, and FGF. When patients were stratified into low-risk (score ≤ 5), intermediate-risk (score 6), and high-risk (score ≥ 7) groups, the model provided good discriminant functions on tumor response (concordance [c]-index, 0.884) and 12-month survival (area under the curve [AUC], 0.825). The median OS was 19.0, 11.2, and 6.1 months in the low-, intermediate-, and high-risk group, respectively (P functions on tumor response (c-index, 0.825) and 12-month survival (AUC, 0.803), and good calibration functions (all P > 0.05 between expected and observed values). This new model including serum FGF and HGF showed good performance in predicting the response to sorafenib and survival in patients with advanced HCC.

  3. Allergy tests do not predict food triggers in adult patients with eosinophilic oesophagitis. A comprehensive prospective study using five modalities.

    Science.gov (United States)

    Philpott, H; Nandurkar, S; Royce, S G; Thien, F; Gibson, P R

    2016-08-01

    The use of allergy tests to guide dietary treatment for eosinophilic oesophagitis (EoE) is controversial and data are limited. Aeroallergen sensitisation patterns and food triggers have been defined in Northern Hemisphere cohorts only. To determine if allergy tests that are routinely available can predict food triggers in adult patients with EoE. To define the food triggers and aeroallergen sensitisation patterns in a novel Southern Hemisphere (Australian) cohort of patients. Consecutive patients with EoE who elected to undergo dietary therapy were prospectively assessed, demographic details and atopic characteristics recorded, and allergy tests, comprising skin-prick and skin-patch tests, serum allergen-specific IgE, basophil activation test and serum food-specific IgG, were performed. Patients underwent a six-food elimination diet with a structured algorithm that included endoscopic and histological examination of the oesophagus a minimum of 2 weeks after each challenge. Response was defined as Foods defined as triggers were considered as gold standard and were compared with those identified by allergy testing. No allergy test could accurately predict actual food triggers. Concordance among skin-prick and serum allergen-specific IgE was high for aeroallergens only. Among seasonal aeroallergens, rye-grass sensitisation was predominant. Food triggers were commonly wheat, milk and egg, alone or in combination. None of the currently-available allergy tests predicts food triggers for EoE. Exclusion-rechallenge methodology with oesophageal histological assessment remains the only effective investigation. The same food triggers were identified in this southern hemisphere cohort as previously described. © 2016 John Wiley & Sons Ltd.

  4. Central venous pressure and shock index predict lack of hemodynamic response to volume expansion in septic shock: a prospective, observational study.

    Science.gov (United States)

    Lanspa, Michael J; Brown, Samuel M; Hirshberg, Eliotte L; Jones, Jason P; Grissom, Colin K

    2012-12-01

    Volume expansion is a common therapeutic intervention in septic shock, although patient response to the intervention is difficult to predict. Central venous pressure (CVP) and shock index have been used independently to guide volume expansion, although their use is questionable. We hypothesize that a combination of these measurements will be useful. In a prospective, observational study, patients with early septic shock received 10-mL/kg volume expansion at their treating physician's discretion after brief initial resuscitation in the emergency department. Central venous pressure and shock index were measured before volume expansion interventions. Cardiac index was measured immediately before and after the volume expansion using transthoracic echocardiography. Hemodynamic response was defined as an increase in a cardiac index of 15% or greater. Thirty-four volume expansions were observed in 25 patients. A CVP of 8 mm Hg or greater and a shock index of 1 beat min(-1) mm Hg(-1) or less individually had a good negative predictive value (83% and 88%, respectively). Of 34 volume expansions, the combination of both a high CVP and a low shock index was extremely unlikely to elicit hemodynamic response (negative predictive value, 93%; P = .02). Volume expansion in patients with early septic shock with a CVP of 8 mm Hg or greater and a shock index of 1 beat min(-1) mm Hg(-1) or less is unlikely to lead to an increase in cardiac index. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Adolescent Conflict as a Developmental Process in the Prospective Pathway from Exposure to Interparental Violence to Dating Violence

    Science.gov (United States)

    Narayan, Angela J.; Englund, Michelle M.; Carlson, Elizabeth A.; Egeland, Byron

    2013-01-01

    Within a developmental psychopathology framework, the current study examined adolescent conflict (age 16) with families, best friends, and dating partners as mediators in the prospective pathway from exposure to interparental violence (EIPV) in early childhood (0–64 months) to dating violence perpetration and victimization in early adulthood (age 23). Adolescent conflict was predicted to partially mediate EIPV and dating violence with significant direct paths from EIPV to dating violence, given the extant literature on the salience of early childhood EIPV for later maladjustment. Participants (N = 182; 99 males, 83 females; 67% Caucasian, 11% African-American, 18% other, 4% unreported) were drawn from a larger prospective study of high-risk mothers (aged 12–34 years) that followed their children from birth through adulthood. EIPV and adolescent conflict were rated from interviews with mothers and participants, and dating violence (physical perpetration and victimization) was assessed with the Conflict Tactics Scale. Path analyses showed that EIPV in early childhood (a) directly predicted dating violence perpetration in early adulthood and (b) predicted conflict with best friends, which in turn predicted dating violence perpetration. Although mediation of best friend conflict was not evident, indirect effects of EIPV to dating violence were found through externalizing behaviors in adolescence and life stress in early adulthood. Findings highlight that conflict with best friends is affected by EIPV and predicts dating violence, suggesting that it may be a promising target for relationship-based interventions for youth with EIPV histories. Furthermore, deleterious early experiences and contemporaneous risk factors are salient predictors of dating violence. PMID:23979004

  6. The prospective association between sleep deprivation and depression among adolescents.

    Science.gov (United States)

    Roberts, Robert E; Duong, Hao T

    2014-02-01

    To examine the prospective, reciprocal association between sleep deprivation and depression among adolescents. A community-based two-wave cohort study. A metropolitan area with a population of over 4 million. 4,175 youths 11-17 at baseline, and 3,134 of these followed up a year later. Depression is measured using both symptoms of depression and DSM-IV major depression. Sleep deprivation is defined as ≤ 6 h of sleep per night. Sleep deprivation at baseline predicted both measures of depression at follow-up, controlling for depression at baseline. Examining the reciprocal association, major depression at baseline, but not symptoms predicted sleep deprivation at follow-up. These results are the first to document reciprocal effects for major depression and sleep deprivation among adolescents using prospective data. The data suggest reduced quantity of sleep increases risk for major depression, which in turn increases risk for decreased sleep.

  7. Pilot study on microvascular anastomosis: performance and future educational prospects.

    Science.gov (United States)

    Berretti, G; Colletti, G; Parrinello, G; Iavarone, A; Vannucchi, P; Deganello, A

    2017-11-30

    The introduction of microvascular free flaps has revolutionised modern reconstructive surgery. Unfortunately, access to training opportunities at standardised training courses is limited and expensive. We designed a pilot study on microvascular anastomoses with the aim of verifying if a short course, easily reproducible, could transmit microvascular skills to participants; if the chosen pre-test was predictive of final performance; and if age could influence the outcome. A total of 30 participants (10 students, 10 residents and 10 surgeons) without any previous microvascular experience were instructed and tested during a single 3 to 5 hour course. The two microanastomoses evaluated were the first ever performed by each participant. More than the half of the cohort was able to produce both patent microanastomoses in less than 2 hours; two-thirds of the attempted microanastomoses were patent. The pretest predicted decent scores from poor performances with a sensitivity of 61.5%, specificity of 100%, positive predictive value of 100% and negative predictive value of 40%. Students and residents obtained significantly higher scores than surgeons. Since our course model is short, cost-effective and highly reproducible, it could be introduced and implemented anywhere as an educational prospect for preselecting young residents showing talent and natural predisposition and having ambitions towards microvascular reconstructive surgery. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  8. Predictors and health-related outcomes of positive body image in adolescent girls: A prospective study.

    Science.gov (United States)

    Andrew, Rachel; Tiggemann, Marika; Clark, Levina

    2016-03-01

    This study aimed to investigate prospective predictors and health-related outcomes of positive body image in adolescent girls. In so doing, the modified acceptance model of intuitive eating was also examined longitudinally. A sample of 298 girls aged 12 to 16 years completed a questionnaire containing measures of body appreciation, potential predictors, and a range of health outcomes, at 2 time points separated by 1 year. Longitudinal change regression models showed that perceived body acceptance by others (positively), self-objectification and social comparison (negatively), and body appreciation (positively) prospectively predicted intuitive eating 1 year later, consistent with the acceptance model of intuitive eating. Perceived body acceptance by others was the only proposed predictor to prospectively predict an increase in body appreciation over time. Time 1 body appreciation prospectively predicted a decrease in dieting, alcohol, and cigarette use, and an increase in physical activity 1 year later. In particular, girls with low body appreciation were more likely than girls with high body appreciation to take up alcohol and cigarette use between time points. The results highlight body appreciation as an important target for interventions designed to prevent or delay the uptake of alcohol and cigarette consumption among girls. More broadly, they suggest that a positive body image can confer considerable benefit for adolescent girls. (c) 2016 APA, all rights reserved).

  9. A taxonomy of prospection: introducing an organizational framework for future-oriented cognition.

    Science.gov (United States)

    Szpunar, Karl K; Spreng, R Nathan; Schacter, Daniel L

    2014-12-30

    Prospection--the ability to represent what might happen in the future--is a broad concept that has been used to characterize a wide variety of future-oriented cognitions, including affective forecasting, prospective memory, temporal discounting, episodic simulation, and autobiographical planning. In this article, we propose a taxonomy of prospection to initiate the important and necessary process of teasing apart the various forms of future thinking that constitute the landscape of prospective cognition. The organizational framework that we propose delineates episodic and semantic forms of four modes of future thinking: simulation, prediction, intention, and planning. We show how this framework can be used to draw attention to the ways in which various modes of future thinking interact with one another, generate new questions about prospective cognition, and illuminate our understanding of disorders of future thinking. We conclude by considering basic cognitive processes that give rise to prospective cognitions, cognitive operations and emotional/motivational states relevant to future-oriented cognition, and the possible role of procedural or motor systems in future-oriented behavior.

  10. Prognostic and predictive roles of microRNA-383 in colorectal cancer

    Directory of Open Access Journals (Sweden)

    Alavieh Fateh

    2016-08-01

    Full Text Available MicroRNAs (miRNAs are impressive regulators of gene expression that have a critical role in the pathogenesis of colorectal cancer (CRC. With respect to the aberrant expression of miRNA-383 (miR-383 in some types of human malignancy, this prospective study characterized its contribution to CRC tumorigenesis. The real-time reverse transcriptionpolymerase chain reaction was used to examine miR-383 expression levels prospectively in 40 sample pairs of CRC tissues and adjacent noncancerous tissues (>2 cm from cancer tissue. No significant relationship was found between miR-383 expression levels and clinicopathological features. The ability of miR-383 to function as a tumor marker was also examined. Showing significant changes overall, miR-383 expression levels were significantly down regulated in the group of CRC samples compared with matched noncancerous tissue samples. A receiver-operating characteristic (ROC curve also showed ROC area of 70% for miR-383 with 68 and 75% sensitivity and specificity, respectively. Therefore, miR-383 can be considered as a tumor marker in CRC and help as a potential predictive biomarker in the diagnosis of colorectal cancer.

  11. Within-person Changes in Individual Symptoms of Depression Predict Subsequent Depressive Episodes in Adolescents: A Prospective Study

    Science.gov (United States)

    Kouros, Chrystyna D.; Morris, Matthew C.; Garber, Judy

    2015-01-01

    The current longitudinal study examined which individual symptoms of depression uniquely predicted a subsequent Major Depressive Episode (MDE) in adolescents, and whether these relations differed by sex. Adolescents (N=240) were first interviewed in grade 6 (M=11.86 years old; SD = 0.56; 54% female; 81.5% Caucasian) and then annually through grade 12 regarding their individual symptoms of depression as well as the occurrence of MDEs. Individual symptoms of depression were assessed with the Children’s Depression Rating Scale-Revised (CDRS-R) and depressive episodes were assessed with the Longitudinal Interval Follow-up Evaluation (LIFE). Results showed that within-person changes in sleep problems and low self-esteem/excessive guilt positively predicted an increased likelihood of an MDE for both boys and girls. Significant sex differences also were found. Within-person changes in anhedonia predicted an increased likelihood of a subsequent MDE among boys, whereas irritability predicted a decreased likelihood of a future MDE among boys, and concentration difficulties predicted a decreased likelihood of an MDE in girls. These results identified individual depressive symptoms that predicted subsequent depressive episodes in male and female adolescents, and may be used to guide the early detection, treatment, and prevention of depressive disorders in youth. PMID:26105209

  12. A multiparametric magnetic resonance imaging-based risk model to determine the risk of significant prostate cancer prior to biopsy.

    Science.gov (United States)

    van Leeuwen, Pim J; Hayen, Andrew; Thompson, James E; Moses, Daniel; Shnier, Ron; Böhm, Maret; Abuodha, Magdaline; Haynes, Anne-Maree; Ting, Francis; Barentsz, Jelle; Roobol, Monique; Vass, Justin; Rasiah, Krishan; Delprado, Warick; Stricker, Phillip D

    2017-12-01

    To develop and externally validate a predictive model for detection of significant prostate cancer. Development of the model was based on a prospective cohort including 393 men who underwent multiparametric magnetic resonance imaging (mpMRI) before biopsy. External validity of the model was then examined retrospectively in 198 men from a separate institution whom underwent mpMRI followed by biopsy for abnormal prostate-specific antigen (PSA) level or digital rectal examination (DRE). A model was developed with age, PSA level, DRE, prostate volume, previous biopsy, and Prostate Imaging Reporting and Data System (PIRADS) score, as predictors for significant prostate cancer (Gleason 7 with >5% grade 4, ≥20% cores positive or ≥7 mm of cancer in any core). Probability was studied via logistic regression. Discriminatory performance was quantified by concordance statistics and internally validated with bootstrap resampling. In all, 393 men had complete data and 149 (37.9%) had significant prostate cancer. While the variable model had good accuracy in predicting significant prostate cancer, area under the curve (AUC) of 0.80, the advanced model (incorporating mpMRI) had a significantly higher AUC of 0.88 (P prostate cancer. Individualised risk assessment of significant prostate cancer using a predictive model that incorporates mpMRI PIRADS score and clinical data allows a considerable reduction in unnecessary biopsies and reduction of the risk of over-detection of insignificant prostate cancer at the cost of a very small increase in the number of significant cancers missed. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  13. Can Perceptuo-Motor Skills Assessment Outcomes in Young Table Tennis Players (7-11 years) Predict Future Competition Participation and Performance? An Observational Prospective Study.

    Science.gov (United States)

    Faber, Irene R; Elferink-Gemser, Marije T; Faber, Niels R; Oosterveld, Frits G J; Nijhuis-Van der Sanden, Maria W G

    2016-01-01

    Forecasting future performance in youth table tennis players based on current performance is complex due to, among other things, differences between youth players in growth, development, maturity, context and table tennis experience. Talent development programmes might benefit from an assessment of underlying perceptuo-motor skills for table tennis, which is hypothesized to determine the players' potential concerning the perceptuo-motor domain. The Dutch perceptuo-motor skills assessment intends to measure the perceptuo-motor potential for table tennis in youth players by assessing the underlying skills crucial for developing technical and tactical qualities. Untrained perceptuo-motor tasks are used as these are suggested to represent a player's future potential better than specific sport skills themselves as the latter depend on exposure to the sport itself. This study evaluated the value of the perceptuo-motor skills assessment for a talent developmental programme by evaluating its predictive validity for competition participation and performance in 48 young table tennis players (7-11 years). Players were tested on their perceptuo-motor skills once during a regional talent day, and the subsequent competition results were recorded half-yearly over a period of 2.5 years. Logistic regression analysis showed that test scores did not predict future competition participation (p >0.05). Yet, the Generalized Estimating Equations analysis, including the test items 'aiming at target', 'throwing a ball', and 'eye-hand coordination' in the best fitting model, revealed that the outcomes of the perceptuo-motor skills assessment were significant predictors for future competition results (R2 = 51%). Since the test age influences the perceptuo-motor skills assessment's outcome, another multivariable model was proposed including test age as a covariate (R2 = 53%). This evaluation demonstrates promising prospects for the perceptuo-motor skills assessment to be included in a talent

  14. Can Perceptuo-Motor Skills Assessment Outcomes in Young Table Tennis Players (7-11 years Predict Future Competition Participation and Performance? An Observational Prospective Study.

    Directory of Open Access Journals (Sweden)

    Irene R Faber

    Full Text Available Forecasting future performance in youth table tennis players based on current performance is complex due to, among other things, differences between youth players in growth, development, maturity, context and table tennis experience. Talent development programmes might benefit from an assessment of underlying perceptuo-motor skills for table tennis, which is hypothesized to determine the players' potential concerning the perceptuo-motor domain. The Dutch perceptuo-motor skills assessment intends to measure the perceptuo-motor potential for table tennis in youth players by assessing the underlying skills crucial for developing technical and tactical qualities. Untrained perceptuo-motor tasks are used as these are suggested to represent a player's future potential better than specific sport skills themselves as the latter depend on exposure to the sport itself. This study evaluated the value of the perceptuo-motor skills assessment for a talent developmental programme by evaluating its predictive validity for competition participation and performance in 48 young table tennis players (7-11 years. Players were tested on their perceptuo-motor skills once during a regional talent day, and the subsequent competition results were recorded half-yearly over a period of 2.5 years. Logistic regression analysis showed that test scores did not predict future competition participation (p >0.05. Yet, the Generalized Estimating Equations analysis, including the test items 'aiming at target', 'throwing a ball', and 'eye-hand coordination' in the best fitting model, revealed that the outcomes of the perceptuo-motor skills assessment were significant predictors for future competition results (R2 = 51%. Since the test age influences the perceptuo-motor skills assessment's outcome, another multivariable model was proposed including test age as a covariate (R2 = 53%. This evaluation demonstrates promising prospects for the perceptuo-motor skills assessment to be

  15. Predictive Maintenance (PdM) Centralization for Significant Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Dale

    2010-09-15

    Cost effective predictive maintenance (PdM) technologies and basic energy calculations can mine energy savings form processes or maintenance activities. Centralizing and packaging this information correctly empowers facility maintenance and reliability professionals to build financial justification and support for strategies and personnel to weather global economic downturns and competition. Attendees will learn how to: Systematically build a 'pilot project' for applying PdM and tracking systems; Break down a typical electrical bill to calculate energy savings; Use return on investment (ROI) calculations to identify the best and highest value options, strategies and tips for substantiating your energy reduction maintenance strategies.

  16. Evaluation of undrilled prospects. Sensitivity to economic and geological factors

    International Nuclear Information System (INIS)

    Hermanrud, C.; Abrahamsen, K.; Vollset, J.; Nordahl, S.; Jourdan, C.

    1996-01-01

    predictable to a greater accuracy than 40 % at early stages of exploration. This, and the fluctuations in oil price, adds to the uncertainty of early economic start-up. The operational and investment costs are not generally predictable to a greater accuracy than 40 % at early stages of exploration. This, and the fluctuations in oil price, adds to the uncertainty of early economic calculations. Sensitivity analysis of calculated net present values for exploration prospects shows that the investigated prospects are sensitive to many different factors, and that a separate sensitivity analysis for each prospect is needed. 15 refs

  17. Italian multicenter, prospective study to evaluate the negative predictive value of 16- and 64-slice MDCT imaging in patients scheduled for coronary angiography (NIMISCAD-non invasive multicenter Italian study for coronary artery disease)

    International Nuclear Information System (INIS)

    Marano, Riccardo; Cobelli, Francesco de; Maschio, Alessandro del; Becker, Christoph; Herzog, Christopher; Centonze, Maurizio; Morana, Giovanni; Gualdi, Gian Franco; Ligabue, Guido; Pontone, Gianluca; Catalano, Carlo; Chiappino, Dante; Midiri, Massimo; Simonetti, Giovanni; Marchisio, Filippo; Olivetti, Lucio; Fattori, Rossella; Bonomo, Lorenzo

    2009-01-01

    This was a prospective, multicenter study designed to evaluate the utility of MDCT in the diagnosis of coronary artery disease (CAD) in patients scheduled for elective coronary angiography (CA) using different MDCT systems from different manufacturers. Twenty national sites prospectively enrolled 367 patients between July 2004 and June 2006. Computed tomography (CT) was performed using a standardized/optimized scan protocol for each type of MDCT system (≥16 slices) and compared with quantitative CA performed within 2 weeks of MDCT. A total of 284 patients (81%) were studied by 16-slice MDCT systems, while 66 patients (19%) by 64-slice MDCT scanners. The primary analysis was on-site/off-site evaluation of the negative predictive value (NPV) on a per-patient basis. Secondary analyses included on-site evaluation on a per-artery and per-segment basis. On-site evaluation included 327 patients (CAD prevalence 58%). NPV, positive predictive value (PPV), sensitivity, specificity, and diagnostic accuracy (DA) were 0.91 (95% CI 0.85-0.95), 0.91 (95% CI 0.86-0.95), 0.94 (95% CI 0.89-0.97), 0.88 (95% CI 0.81-0.93), and 0.91 (95% CI 0.88-0.94), respectively. Off-site analysis included 295 patients (CAD prevalence 56%). NPV, PPV, sensitivity, specificity, and DA were 0.73 (95% CI 0.65-0.79), 0.93 (95% CI 0.87-0.97), 0.73 (95% CI 0.65-0.79), 0.93 (95% CI 0.87-0.97), and 0.82 (95% CI 0.77-0.86), respectively. The results of this study demonstrate the utility of MDCT in excluding significant CAD even when conducted by centers with varying degrees of expertise and using different MDCT machines. (orig.)

  18. Direct Costs of Very Old Persons with Subsyndromal Depression: A 5-Year Prospective Study.

    Science.gov (United States)

    Ludvigsson, Mikael; Bernfort, Lars; Marcusson, Jan; Wressle, Ewa; Milberg, Anna

    2018-03-15

    This study aimed to compare, over a 5-year period, the prospective direct healthcare costs and service utilization of persons with subsyndromal depression (SSD) and non-depressive persons (ND), in a population of very old persons. A second aim was to develop a model that predicts direct healthcare costs in very old persons with SSD. A prospective population-based study was undertaken on 85-year-old persons in Sweden. Depressiveness was screened with the Geriatric Depression Scale at baseline and at 1-year follow-up, and the results were classified into ND, SSD, and syndromal depression. Data on individual healthcare costs and service use from a 5-year period were derived from national database registers. Direct costs were compared between categories using Mann-Whitney U tests, and a prediction model was identified with linear regression. For persons with SSD, the direct healthcare costs per month of survival exceeded those of persons with ND by a ratio 1.45 (€634 versus €436), a difference that was significant even after controlling for somatic multimorbidity. The final regression model consisted of five independent variables predicting direct healthcare costs: male sex, activities of daily living functions, loneliness, presence of SSD, and somatic multimorbidity. SSD among very old persons is associated with increased direct healthcare costs independently of somatic multimorbidity. The associations between SSD, somatic multimorbidity, and healthcare costs in the very old need to be analyzed further in order to better guide allocation of resources in health policy. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. Elite level rhythmic gymnasts have significantly more and stronger pain than peers of similar age: a prospective study.

    Science.gov (United States)

    Sabeti, Manuel; Jeremian, Lusine; Graf, Alexandra; Kandelhart, Robert

    2015-01-01

    Rhythmic gymnastics (RG) unites aesthetic, ballet-like motion, and all aspects of gymnastics. To reach elite level, girls begin at early age the intensive training. To date it is unclear if such demanding training influences the incidence and intensity of painful overuse injuries. The purpose of this study is to analyze anatomical painful regions and pain intensity in elite level rhythmic gymnasts (elRG) and compare results with an age-matched control group (CG). This prospective field study was carried out at the European Championship in RG 2013 (218 participating athletes, Vienna, Austria). Volunteering athletes were interviewed according to a preformed questionnaire. As CG secondary school pupils without any competitive sports experience were analyzed accordingly. Overall, 243 young females (144 elRG/66 % of all participants and 99 CG) were observed. ElRGs were significantly (s.) smaller, lighter, and had s. stronger pain (p < 0.001). A total of 72 % of athletes reported to have at least one painful body region compared with 52 % of CG (p < 0.001). ElRG had nearly three times more serious injuries than the CG. In all 23 % off all elRG reported to have had no access to professional medical care. ElRGs were s. more frequently (25 vs 9 %) affected at the lumbar spine and the ankle joint (17.4 vs 7 %). To our knowledge, this trial analyzes the largest cohort of elRG to date. Hence, it is clearly alluded that intensive training in RG is a significant factor causing more and stronger pain than in a CG.

  20. Vigorous physical activity predicts higher heart rate variability among younger adults.

    Science.gov (United States)

    May, Richard; McBerty, Victoria; Zaky, Adam; Gianotti, Melino

    2017-06-14

    Baseline heart rate variability (HRV) is linked to prospective cardiovascular health. We tested intensity and duration of weekly physical activity as predictors of heart rate variability in young adults. Time and frequency domain indices of HRV were calculated based on 5-min resting electrocardiograms collected from 82 undergraduate students. Hours per week of both moderate and vigorous activity were estimated using the International Physical Activity Questionnaire. In regression analyses, hours of vigorous physical activity, but not moderate activity, significantly predicted greater time domain and frequency domain indices of heart rate variability. Adjusted for weekly frequency, greater daily duration of vigorous activity failed to predict HRV indices. Future studies should test direct measurements of vigorous activity patterns as predictors of autonomic function in young adulthood.

  1. Preoperative ultrasonography and prediction of technical difficulties during laparoscopic cholecystectomy.

    Science.gov (United States)

    Daradkeh, S S; Suwan, Z; Abu-Khalaf, M

    1998-01-01

    A prospective study was carried out to investigate the value of preoperative ultrasound findings for predicting difficulties encountered during laparoscopic cholecystectomy (LC). Altogether 160 consecutive patients with symptomatic gallbladder (GB) disease (130 females, 30 males) referred to the Jordan University Hospital were recruited for the purpose of this study. All patients underwent detailed ultrasound examination 24 hours prior to LC. The overall difficulty score (ODS), as a dependent variable, was based on the following operative parameters: duration of surgery, bleeding, dissection of Calot's triangle, dissection of gallbladder wall, adhesions, spillage of bile, spillage of stone, and difficulty of gallbladder extraction. Multiple regression analysis was used to assess the significance of the following preoperative ultrasound variables (independent) for predicting the variation in the ODS: size of the GB, number of GB stones, size of stones, location of GB stones, thickness of GB wall, common bile duct (CBD) diameter, and liver size. Only thickness of GB wall and CBD diameter were found to be significant predictors of the variation in the ODS (adjusted R2 = 0.25). We conclude that the preoperative ultrasound examination is of value for predicting difficulties encountered during LC, but it is not the sole predictor.

  2. The clinical utility of informants' appraisals on prospective and retrospective memory in patients with early Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Yen-Hsuan Hsu

    Full Text Available Increasing studies suggest the importance of including prospective memory measures in clinical evaluation of dementia due to its sensitivity and functional relevance. The Prospective and Retrospective Memory Questionnaire (PRQM is originally a self-rated memory inventory that offers a direct comparison between prospective and episodic memory. However, the informant's report has been recognized as a more valid source of cognitive complaints. We thus aimed to examine the validity of the informant-rated form of the PRMQ in assessing memory function of the patients and in detecting individuals with early dementia. The informants of 140 neurological outpatients with memory complaints completed the Taiwan version of the PRMQ. Tests of prospective memory, short-term memory, and general cognitive ability were also administered to non-demented participants and patients with early stages of Alzheimer's disease (AD. Results showed significant relationships between the PRMQ ratings and objective cognitive measures, and showed that higher ratings on the PRMQ were associated with increasing odds of greater dementia severity. Receiver operative characteristic (ROC curves showed an adequate ability of the PRMQ to identify patients with dementia (93% sensitivity and 84% specificity. Hierarchical regression revealed that the PRMQ has additional explanatory power for dementia status after controlling for age, education and objective memory test results, and that the prospective memory subscale owns predictive value for dementia beyond the retrospective memory subscale. The present study demonstrated the external validity and diagnostic value of informants' evaluation of their respective patients' prospective and retrospective memory functioning, and highlighted the important role of prospective memory in early dementia detection. The proxy-version of the PRMQ is a useful tool that captures prospective and episodic memory problems in patients with early AD, in

  3. Prediction of traffic fatalities and prospects for mobility becoming ...

    Indian Academy of Sciences (India)

    edge transfer from developed countries. Four prediction ...... also depends on the average vehicle speed by the dependence of crash avoidance (reaction time, braking .... and political priority of road safety actions. ..... It is a man-made problem.

  4. Role of hyaluronic acid and laminin as serum markers for predicting significant fibrosis in patients with chronic hepatitis B

    Directory of Open Access Journals (Sweden)

    Feng Li

    Full Text Available OBJECTIVES: The aim of this study was to evaluate the diagnostic performance of serum HA and LN as serum markers for predicting significant fibrosis in CHB patients. METHODS: Serum HA and LN levels of 87 patients with chronic hepatitis B and 19 blood donors were assayed by RIA. Liver fibrosis stages were determined according to the Metavir scoring-system. The diagnostic performances of all indexes were evaluated by the receiver operating characteristic (ROC curves. RESULTS: Serum HA and LN concentrations increased significantly with the stage of hepatic fibrosis, which showed positive correlation with the stages of liver fibrosis (HA: r = 0.875, p < 0.001; LN: r = 0.610, p < 0.001. There were significant differences of serum HA and LN levels between F2-4 group in comparison with those in F0-F1 group (p < 0.001 and controls (p < 0.001, respectively. From ROC curves, 185.3 ng/mL as the optimal cut-off value of serum HA for diagnosis of significant fibrosis, giving its sensitivity, specificity, PPV, NPV, LR+, LR- and AC of 84.2%, 83.3%, 90.6%, 73.5%, 5.04, 0.19 and 83.9, respectively. While 132.7 ng/mL was the optimal cut-off value of serum LN, the sensitivity, specificity, PPV, NPV, LR+, LR- and AC were 71.9%, 80.0%, 87.2%, 60.0%, 3.59%, 0.35% and 74.7, respectively. Combinations of HA and LN by serial tests showed a perfect specificity and PPV of 100%, at the same time sensitivity declined to 63.2% and LR+ increased to 18.9, while parallel tests revealed a good sensitivity of 94.7%, NPV to 86.4%, and LR- declined to 0.08. CONCLUSIONS: Serum HA and LN concentrations showed positive correlation with the stages of liver fibrosis. Detection of serum HA and LN in predicting significant fibrosis showed good diagnostic performance, which would be further optimized by combination of the two indices. HA and LN would be clinically useful serum markers for predicting significant fibrosis in patients with chronic hepatitis B, when liver biopsy is

  5. Major depressive disorder subtypes to predict long-term course

    Science.gov (United States)

    van Loo, Hanna M.; Cai, Tianxi; Gruber, Michael J.; Li, Junlong; de Jonge, Peter; Petukhova, Maria; Rose, Sherri; Sampson, Nancy A.; Schoevers, Robert A.; Wardenaar, Klaas J.; Wilcox, Marsha A.; Al-Hamzawi, Ali Obaid; Andrade, Laura Helena; Bromet, Evelyn J.; Bunting, Brendan; Fayyad, John; Florescu, Silvia E.; Gureje, Oye; Hu, Chiyi; Huang, Yueqin; Levinson, Daphna; Medina-Mora, Maria Elena; Nakane, Yoshibumi; Posada-Villa, Jose; Scott, Kate M.; Xavier, Miguel; Zarkov, Zahari; Kessler, Ronald C.

    2016-01-01

    Background Variation in course of major depressive disorder (MDD) is not strongly predicted by existing subtype distinctions. A new subtyping approach is considered here. Methods Two data mining techniques, ensemble recursive partitioning and Lasso generalized linear models (GLMs) followed by k-means cluster analysis, are used to search for subtypes based on index episode symptoms predicting subsequent MDD course in the World Mental Health (WMH) Surveys. The WMH surveys are community surveys in 16 countries. Lifetime DSM-IV MDD was reported by 8,261 respondents. Retrospectively reported outcomes included measures of persistence (number of years with an episode; number of with an episode lasting most of the year) and severity (hospitalization for MDD; disability due to MDD). Results Recursive partitioning found significant clusters defined by the conjunctions of early onset, suicidality, and anxiety (irritability, panic, nervousness-worry-anxiety) during the index episode. GLMs found additional associations involving a number of individual symptoms. Predicted values of the four outcomes were strongly correlated. Cluster analysis of these predicted values found three clusters having consistently high, intermediate, or low predicted scores across all outcomes. The high-risk cluster (30.0% of respondents) accounted for 52.9-69.7% of high persistence and severity and was most strongly predicted by index episode severe dysphoria, suicidality, anxiety, and early onset. A total symptom count, in comparison, was not a significant predictor. Conclusions Despite being based on retrospective reports, results suggest that useful MDD subtyping distinctions can be made using data mining methods. Further studies are needed to test and expand these results with prospective data. PMID:24425049

  6. Prevalence, significance and predictive value of antiphospholipid antibodies in Crohn’s disease

    Science.gov (United States)

    Sipeki, Nora; Davida, Laszlo; Palyu, Eszter; Altorjay, Istvan; Harsfalvi, Jolan; Antal Szalmas, Peter; Szabo, Zoltan; Veres, Gabor; Shums, Zakera; Norman, Gary L; Lakatos, Peter L; Papp, Maria

    2015-01-01

    AIM: To assess the prevalence and stability of different antiphospholipid antibodies (APLAs) and their association with disease phenotype and progression in inflammatory bowel diseases (IBD) patients. METHODS: About 458 consecutive patients [Crohn’s disease (CD): 271 and ulcerative colitis (UC): 187] were enrolled into a follow-up cohort study in a tertiary IBD referral center in Hungary. Detailed clinical phenotypes were determined at enrollment by reviewing the patients’ medical charts. Disease activity, medical treatment and data about evolvement of complications or surgical interventions were determined prospectively during the follow-up. Disease course (development f complicated disease phenotype and need for surgery), occurrence of thrombotic events, actual state of disease activity according to clinical, laboratory and endoscopic scores and accurate treatment regime were recorded during the follow-up, (median, 57.4 and 61.6 mo for CD and UC). Sera of IBD patients and 103 healthy controls (HC) were tested on individual anti-β2-Glycoprotein-I (anti-β2-GPI IgA/M/G), anti-cardiolipin (ACA IgA/M/G) and anti-phosphatidylserine/prothrombin (anti-PS/PT IgA/M/G) antibodies and also anti-Saccharomyces cerevisiae antibodies (ASCA IgA/G) by enzyme-linked immunosorbent assay (ELISA). In a subgroup of CD (n = 198) and UC patients (n = 103), obtaining consecutive samples over various arbitrary time-points during the disease course, we evaluated the intraindividual stability of the APLA status. Additionally, we provide an overview of studies, performed so far, in which significance of APLAs in IBD were assessed. RESULTS: Patients with CD had significantly higher prevalence of both ACA (23.4%) and anti-PS/PT (20.4%) antibodies than UC (4.8%, P < 0.0001 and 10.2%, P = 0.004) and HC (2.9%, P < 0.0001 and 15.5%, P = NS). No difference was found for the prevalence of anti-β2-GPI between different groups (7.2%-9.7%). In CD, no association was found between APLA and ASCA

  7. Assessment and prediction of wind turbine noise

    International Nuclear Information System (INIS)

    Lowson, M.V.

    1993-01-01

    The significance of basic aerodynamic noise sources for wind turbine noise are assessed, using information on the aero-acoustic mechanisms of other rotors, which have been studied in depth for many years. From the analysis, areas of potential improvement in wind turbine noise prediction are defined. Suggestions are made for approaches to wind turbine noise control which separate the noise problems at cut-in from those at rated power. Some of these offer the possibility of noise reduction without unfavourable effects on performance. Based on this analysis, a new model for prediction of wind turbine noise is presented and comparisons made between prediction and experiment. The model is based on well established aeroacoustic theory and published laboratory data for the two principal sources, inflow turbulence and boundary layer trailing edge interaction. The new method gives good agreement with experiment with the case studied so far. Parametric trends and sensitivities for the model are presented. Comparisons with previous prediction methods are also given. A consequence of the new model is to put more emphasis on boundary layer trailing edge interaction as a noise source. There are prospects for reducing noise from this source detail changes to the wind turbine design. (author)

  8. Addendum to the article: Misuse of null hypothesis significance testing: Would estimation of positive and negative predictive values improve certainty of chemical risk assessment?

    Science.gov (United States)

    Bundschuh, Mirco; Newman, Michael C; Zubrod, Jochen P; Seitz, Frank; Rosenfeldt, Ricki R; Schulz, Ralf

    2015-03-01

    We argued recently that the positive predictive value (PPV) and the negative predictive value (NPV) are valuable metrics to include during null hypothesis significance testing: They inform the researcher about the probability of statistically significant and non-significant test outcomes actually being true. Although commonly misunderstood, a reported p value estimates only the probability of obtaining the results or more extreme results if the null hypothesis of no effect was true. Calculations of the more informative PPV and NPV require a priori estimate of the probability (R). The present document discusses challenges of estimating R.

  9. Increased Cardiovascular Events and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients: 1 Year Prospective Single Centre Study.

    Directory of Open Access Journals (Sweden)

    Piero Ruscitti

    Full Text Available Several studies showed the close relationship between Rheumatoid Arthritis (RA and cerebro-cardiovascular events (CVEs and subclinical atherosclerosis. In this study, we investigated the occurrence of CVEs and subclinical atherosclerosis during the course of RA and we evaluated the possible role of both traditional cardiovascular (CV and disease related risk factors to predict the occurrence of new CVEs and the onset of subclinical atherosclerosis.We designed a single centre, bias-adjusted, prospective, observational study to investigate, in a homogeneous subset of RA patients, the occurrence of new onset of CVEs and subclinical atherosclerosis. Statistical analyses were performed to evaluate the role of traditional CV and disease-related risk factors to predict the occurrence of new CVEs and subclinical atherosclerosis.We enrolled 347 RA patients prospectively followed for 12 months. An increased percentage of patients experienced CVEs, developed subclinical atherosclerosis and was affected by systemic arterial hypertension (SAH, type 2 diabetes mellitus and metabolic syndrome (MS, at the end of follow up. Our analysis showed that the insurgence of both SAH and MS, during the follow up, the older age, the CVE familiarity and the lack of clinical response, were associated with a significantly increased risk to experience CVEs and to develop subclinical atherosclerosis.Our study quantifies the increased expected risk for CVEs in a cohort of RA patients prospectively followed for 1 year. The occurrence of both new CVEs and subclinical atherosclerosis in RA patients may be explained by inflammatory burden as well as traditional CV risk factors.

  10. Prospects for high thermoelectric figures of merit in 2D systems

    Energy Technology Data Exchange (ETDEWEB)

    Dresselhaus, M S; Sun, X; Cronin, S B; Koga, T; Dresselhaus, G; Wang, K L

    1997-07-01

    Enhanced ZT has been predicted theoretically and observed experimentally in 2D quantum wells, with good agreement between theory and experiment. Advantages of low dimensional systems for thermoelectric applications are described and prospects for further enhancement of ZT are discussed.

  11. Predicting Community College Outcomes: Does High School CTE Participation Have a Significant Effect?

    Science.gov (United States)

    Dietrich, Cecile; Lichtenberger, Eric; Kamalludeen, Rosemaliza

    2016-01-01

    This study explored the relative importance of participation in high school career and technical education (CTE) programs in predicting community college outcomes. A hierarchical generalized linear model (HGLM) was used to predict community college outcome attainment among a random sample of direct community college entrants. Results show that…

  12. Assessment of oxidative stress markers in recurrent pregnancy loss: a prospective study.

    Science.gov (United States)

    Yiyenoğlu, Özgür Bilgin; Uğur, Mete Gürol; Özcan, Hüseyin Çağlayan; Can, Günay; Öztürk, Ebru; Balat, Özcan; Erel, Özcan

    2014-06-01

    To determine the levels of oxidative stress markers in recurrent pregnancy loss using a novel automated method. 30 pregnant women in their first trimester with a history of recurrent pregnancy loss (RPL) and 30 healthy pregnant women were enrolled in this prospective controlled study. Total antioxidant capacity (TAC), total oxidant level (TOL) and oxidative stress index (OSI) in maternal serum were measured using the more recently designated Erel method. We observed statistically significant increased TOL and OSI levels in patient group (p = 0.032, p = 0.007, respectively). We also demonstrated statistically significant decreased TAC in pregnant women who had a history of RPL (p = 0.013). Our results support the concept that oxidative stress plays a central role in the etiopathogenesis of RPL. Further studies to evaluate the predictive role of TAC, TOL, OSI levels using Erel method are needed.

  13. Exploring the significance of human mobility patterns in social link prediction

    KAUST Repository

    Alharbi, Basma Mohammed; Zhang, Xiangliang

    2014-01-01

    Link prediction is a fundamental task in social networks. Recently, emphasis has been placed on forecasting new social ties using user mobility patterns, e.g., investigating physical and semantic co-locations for new proximity measure. This paper

  14. Economic, safety and environmental prospects of fusion reactors

    Energy Technology Data Exchange (ETDEWEB)

    Conn, R W; Holdren, J P; Sharafat, S [California Univ., Los Angeles, CA (USA). Inst. of Plasma and Fusion Research; and others

    1990-09-01

    Controlled fusion energy is one of the long term, non-fossil energy sources available to mankind. It has the potential of significant advantages over fission nuclear power in that the consequences of severe accidents are predicted to be less and the radioactive waste burden is calculated to be smaller. Fusion can be an important ingredient in the future world energy mix as a hedge against environmental, supply or political difficulties connected with the use of fossil fuel and present-day nuclear power. Progress in fusion reactor technology and design is described for both magnetic and inertial fusion energy systems. The projected economic prospects show that fusion will be capital intensive, and the historical trend is towards greater mass utilization efficiency and more competitive costs. Recent studies emphasizing safety and environmental advantages show that the competitive potential of fusion can be further enhanced by specific choices of materials and design. The safety and environmental prospects of fusion appear to exceed substantially those of advanced fission and coal. Clearly, a significant and directed technology effort is necessary to achieve these advantages. Typical parameters have been established for magnetic fusion energy reactors, and a tokamak at moderately high magnetic field (about 7 T on axis) in the first regime of MHD stability ({beta} {le} 3.5 I/aB) is closest to present experimental achievement. Further improvements of the economic and technological performance of the tokamak are possible. In addition, alternative, non-tokamak magnetic fusion approaches may offer substantive economic and operational benefits, although at present these concepts must be projected from a less developed physics base. (Abstract Truncated)

  15. Prediction of Balance Compensation After Vestibular Schwannoma Surgery.

    Science.gov (United States)

    Parietti-Winkler, Cécile; Lion, Alexis; Frère, Julien; Perrin, Philippe P; Beurton, Renaud; Gauchard, Gérome C

    2016-06-01

    Background Balance compensation after vestibular schwannoma (VS) surgery is under the influence of specific preoperative patient and tumor characteristics. Objective To prospectively identify potential prognostic factors for balance recovery, we compared the respective influence of these preoperative characteristics on balance compensation after VS surgery. Methods In 50 patients scheduled for VS surgical ablation, we measured postural control before surgery (BS), 8 (AS8) days after, and 90 (AS90) days after surgery. Based on factors found previously in the literature, we evaluated age, body mass index and preoperative physical activity (PA), tumor grade, vestibular status, and preference for visual cues to control balance as potential prognostic factors using stepwise multiple regression models. Results An asymmetric vestibular function was the sole significant explanatory factor for impaired balance performance BS, whereas the preoperative PA alone significantly contributed to higher performance at AS8. An evaluation of patients' balance recovery over time showed that PA and vestibular status were the 2 significant predictive factors for short-term postural compensation (BS to AS8), whereas none of these preoperative factors was significantly predictive for medium-term postoperative postural recovery (AS8 to AS90). Conclusions We identified specific preoperative patient and vestibular function characteristics that may predict postoperative balance recovery after VS surgery. Better preoperative characterization of these factors in each patient could inform more personalized presurgical and postsurgical management, leading to a better, more rapid balance recovery, earlier return to normal daily activities and work, improved quality of life, and reduced medical and societal costs. © The Author(s) 2015.

  16. Technical development of seismic imaging prospecting

    International Nuclear Information System (INIS)

    Xu Guilai

    2006-01-01

    Geophysical methods and apparatus for shallow engineering geophysical prospecting and mining related in-roadway geophysical prospecting are important research fields which has been studied for long time, unfortunately, little significant advancement has been made compared with the demand of engineering geology. The seismic imaging method and its corresponding equipment are viewed as the most hopeful choice for 0-50 m depth and are studied in this research systematically. The recording equipment CSA is made and the related in-situ data processing software is also developed. Field application experiment for shallow seismic prospecting has been finished, the results show that the CSA seismic imaging and its application technology are effective and practical for the engineering geophysical prospecting of 0-50 m depth, and can meet the demand of engineering geology investigation. Hence, the geophysical method and equipment, which can meet the demand for 0-50 m depth engineering geology investigation have been formed through this research. (authors)

  17. Does Group-Level Commitment Predict Employee Well-Being?: A Prospective Analysis.

    Science.gov (United States)

    Clausen, Thomas; Christensen, Karl Bang; Nielsen, Karina

    2015-11-01

    To investigate the links between group-level affective organizational commitment (AOC) and individual-level psychological well-being, self-reported sickness absence, and sleep disturbances. A total of 5085 care workers from 301 workgroups in the Danish eldercare services participated in both waves of the study (T1 [2005] and T2 [2006]). The three outcomes were analyzed using linear multilevel regression analysis, multilevel Poisson regression analysis, and multilevel logistic regression analysis, respectively. Group-level AOC (T1) significantly predicted individual-level psychological well-being, self-reported sickness absence, and sleep disturbances (T2). The association between group-level AOC (T1) and psychological well-being (T2) was fully mediated by individual-level AOC (T1), and the associations between group-level AOC (T1) and self-reported sickness absence and sleep disturbances (T2) were partially mediated by individual-level AOC (T1). Group-level AOC is an important predictor of employee well-being in contemporary health care organizations.

  18. Combining Spot Sign and Intracerebral Hemorrhage Score to Estimate Functional Outcome: Analysis From the PREDICT Cohort.

    Science.gov (United States)

    Schneider, Hauke; Huynh, Thien J; Demchuk, Andrew M; Dowlatshahi, Dar; Rodriguez-Luna, David; Silva, Yolanda; Aviv, Richard; Dzialowski, Imanuel

    2018-06-01

    The intracerebral hemorrhage (ICH) score is the most commonly used grading scale for stratifying functional outcome in patients with acute ICH. We sought to determine whether a combination of the ICH score and the computed tomographic angiography spot sign may improve outcome prediction in the cohort of a prospective multicenter hemorrhage trial. Prospectively collected data from 241 patients from the observational PREDICT study (Prediction of Hematoma Growth and Outcome in Patients With Intracerebral Hemorrhage Using the CT-Angiography Spot Sign) were analyzed. Functional outcome at 3 months was dichotomized using the modified Rankin Scale (0-3 versus 4-6). Performance of (1) the ICH score and (2) the spot sign ICH score-a scoring scale combining ICH score and spot sign number-was tested. Multivariable analysis demonstrated that ICH score (odds ratio, 3.2; 95% confidence interval, 2.2-4.8) and spot sign number (n=1: odds ratio, 2.7; 95% confidence interval, 1.1-7.4; n>1: odds ratio, 3.8; 95% confidence interval, 1.2-17.1) were independently predictive of functional outcome at 3 months with similar odds ratios. Prediction of functional outcome was not significantly different using the spot sign ICH score compared with the ICH score alone (spot sign ICH score area under curve versus ICH score area under curve: P =0.14). In the PREDICT cohort, a prognostic score adding the computed tomographic angiography-based spot sign to the established ICH score did not improve functional outcome prediction compared with the ICH score. © 2018 American Heart Association, Inc.

  19. Coming home: A prospective study of family reintegration following deployment to a war zone.

    Science.gov (United States)

    Balderrama-Durbin, Christina; Cigrang, Jeffrey A; Osborne, Laura J; Snyder, Douglas K; Talcott, G Wayne; Slep, Amy M Smith; Heyman, Richard E; Tatum, JoLyn; Baker, Monty; Cassidy, Daniel; Sonnek, Scott

    2015-08-01

    The consequences of deployment extend beyond the service member to impact the entire family. The current investigation evaluated the unique challenges of family reintegration for partnered service members using a prospective design. In total, 76 partnered service members who deployed on a year-long, high-risk mission to Iraq were assessed across the entirety of the deployment cycle, i.e., pre-, during, and postdeployment. At follow-up, nearly 1 in 5 partnered service members reported moderate to severe difficulties in multiple aspects of family reintegration. Prospective interpersonal indicators such as preparations for deployment as a couple, shared commitment to the military, and predeployment relationship distress predicted postdeployment family reintegration difficulties. Significant interpersonal risk factors were medium to large in their effect sizes. Airmen's willingness to disclose deployment- and combat-related experiences, and postdeployment relationship distress served as concurrent interpersonal correlates of difficulties with family reintegration. Intrapersonal factors, including posttraumatic stress symptoms and alcohol misuse were concurrently related to challenges with family reintegration; predeployment alcohol misuse also predicted subsequent family reintegration difficulties. Additional analyses indicated that pre- and postdeployment relationship distress, combat disclosure, and postdeployment alcohol misuse each contributed to family reintegration when controlling for other intra- and interpersonal risk factors. Implications for prevention and early intervention strategies as well as future research are discussed. (c) 2015 APA, all rights reserved).

  20. Implicit and explicit attitudes predict smoking cessation: moderating effects of experienced failure to control smoking and plans to quit.

    Science.gov (United States)

    Chassin, Laurie; Presson, Clark C; Sherman, Steven J; Seo, Dong-Chul; Macy, Jonathan T

    2010-12-01

    The current study tested implicit and explicit attitudes as prospective predictors of smoking cessation in a Midwestern community sample of smokers. Results showed that the effects of attitudes significantly varied with levels of experienced failure to control smoking and plans to quit. Explicit attitudes significantly predicted later cessation among those with low (but not high or average) levels of experienced failure to control smoking. Conversely, however, implicit attitudes significantly predicted later cessation among those with high levels of experienced failure to control smoking, but only if they had a plan to quit. Because smoking cessation involves both controlled and automatic processes, interventions may need to consider attitude change interventions that focus on both implicit and explicit attitudes. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  1. Improved Prediction of Falls in Community-Dwelling Older Adults Through Phase-Dependent Entropy of Daily-Life Walking

    Directory of Open Access Journals (Sweden)

    Espen A. F. Ihlen

    2018-03-01

    Full Text Available Age and age-related diseases have been suggested to decrease entropy of human gait kinematics, which is thought to make older adults more susceptible to falls. In this study we introduce a new entropy measure, called phase-dependent generalized multiscale entropy (PGME, and test whether this measure improves fall-risk prediction in community-dwelling older adults. PGME can assess phase-dependent changes in the stability of gait dynamics that result from kinematic changes in events such as heel strike and toe-off. PGME was assessed for trunk acceleration of 30 s walking epochs in a re-analysis of 1 week of daily-life activity data from the FARAO study, originally described by van Schooten et al. (2016. The re-analyzed data set contained inertial sensor data from 52 single- and 46 multiple-time prospective fallers in a 6 months follow-up period, and an equal number of non-falling controls matched by age, weight, height, gender, and the use of walking aids. The predictive ability of PGME for falls was assessed using a partial least squares regression. PGME had a superior predictive ability of falls among single-time prospective fallers when compared to the other gait features. The single-time fallers had a higher PGME (p < 0.0001 of their trunk acceleration at 60% of their step cycle when compared with non-fallers. No significant differences were found between PGME of multiple-time fallers and non-fallers, but PGME was found to improve the prediction model of multiple-time fallers when combined with other gait features. These findings suggest that taking into account phase-dependent changes in the stability of the gait dynamics has additional value for predicting falls in older people, especially for single-time prospective fallers.

  2. Earthquake prediction with electromagnetic phenomena

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Masashi, E-mail: hayakawa@hi-seismo-em.jp [Hayakawa Institute of Seismo Electomagnetics, Co. Ltd., University of Electro-Communications (UEC) Incubation Center, 1-5-1 Chofugaoka, Chofu Tokyo, 182-8585 (Japan); Advanced Wireless & Communications Research Center, UEC, Chofu Tokyo (Japan); Earthquake Analysis Laboratory, Information Systems Inc., 4-8-15, Minami-aoyama, Minato-ku, Tokyo, 107-0062 (Japan); Fuji Security Systems. Co. Ltd., Iwato-cho 1, Shinjyuku-ku, Tokyo (Japan)

    2016-02-01

    Short-term earthquake (EQ) prediction is defined as prospective prediction with the time scale of about one week, which is considered to be one of the most important and urgent topics for the human beings. If this short-term prediction is realized, casualty will be drastically reduced. Unlike the conventional seismic measurement, we proposed the use of electromagnetic phenomena as precursors to EQs in the prediction, and an extensive amount of progress has been achieved in the field of seismo-electromagnetics during the last two decades. This paper deals with the review on this short-term EQ prediction, including the impossibility myth of EQs prediction by seismometers, the reason why we are interested in electromagnetics, the history of seismo-electromagnetics, the ionospheric perturbation as the most promising candidate of EQ prediction, then the future of EQ predictology from two standpoints of a practical science and a pure science, and finally a brief summary.

  3. GIS-based rare events logistic regression for mineral prospectivity mapping

    Science.gov (United States)

    Xiong, Yihui; Zuo, Renguang

    2018-02-01

    Mineralization is a special type of singularity event, and can be considered as a rare event, because within a specific study area the number of prospective locations (1s) are considerably fewer than the number of non-prospective locations (0s). In this study, GIS-based rare events logistic regression (RELR) was used to map the mineral prospectivity in the southwestern Fujian Province, China. An odds ratio was used to measure the relative importance of the evidence variables with respect to mineralization. The results suggest that formations, granites, and skarn alterations, followed by faults and aeromagnetic anomaly are the most important indicators for the formation of Fe-related mineralization in the study area. The prediction rate and the area under the curve (AUC) values show that areas with higher probability have a strong spatial relationship with the known mineral deposits. Comparing the results with original logistic regression (OLR) demonstrates that the GIS-based RELR performs better than OLR. The prospectivity map obtained in this study benefits the search for skarn Fe-related mineralization in the study area.

  4. Comparison of Different Risk Perception Measures in Predicting Seasonal Influenza Vaccination among Healthy Chinese Adults in Hong Kong: A Prospective Longitudinal Study

    Science.gov (United States)

    Liao, Qiuyan; Wong, Wing Sze; Fielding, Richard

    2013-01-01

    Background Risk perception is a reported predictor of vaccination uptake, but which measures of risk perception best predict influenza vaccination uptake remain unclear. Methodology During the main influenza seasons (between January and March) of 2009 (Wave 1) and 2010 (Wave 2),505 Chinese students and employees from a Hong Kong university completed an online survey. Multivariate logistic regression models were conducted to assess how well different risk perceptions measures in Wave 1 predicted vaccination uptake against seasonal influenza in Wave 2. Principal Findings The results of the multivariate logistic regression models showed that feeling at risk (β = 0.25, p = 0.021) was the better predictor compared with probability judgment while probability judgment (β = 0.25, p = 0.029 ) was better than beliefs about risk in predicting subsequent influenza vaccination uptake. Beliefs about risk and feeling at risk seemed to predict the same aspect of subsequent vaccination uptake because their associations with vaccination uptake became insignificant when paired into the logistic regression model. Similarly, to compare the four scales for assessing probability judgment in predicting vaccination uptake, the 7-point verbal scale remained a significant and stronger predictor for vaccination uptake when paired with other three scales; the 6-point verbal scale was a significant and stronger predictor when paired with the percentage scale or the 2-point verbal scale; and the percentage scale was a significant and stronger predictor only when paired with the 2-point verbal scale. Conclusions/Significance Beliefs about risk and feeling at risk are not well differentiated by Hong Kong Chinese people. Feeling at risk, an affective-cognitive dimension of risk perception predicts subsequent vaccination uptake better than do probability judgments. Among the four scales for assessing risk probability judgment, the 7-point verbal scale offered the best predictive

  5. Greater hunger and less restraint predict weight loss success with phentermine treatment.

    Science.gov (United States)

    Thomas, Elizabeth A; Mcnair, Bryan; Bechtell, Jamie L; Ferland, Annie; Cornier, Marc-Andre; Eckel, Robert H

    2016-01-01

    Phentermine is thought to cause weight loss through a reduction in hunger. It was hypothesized that higher hunger ratings would predict greater weight loss with phentermine. This is an observational pilot study in which all subjects were treated with phentermine for 8 weeks and appetite and eating behaviors were measured at baseline and week 8. Outcomes were compared in subjects with ≥5% vs. hunger (P = 0.017), desire to eat (P =0.003), and prospective food consumption (0.006) and lower baseline cognitive restraint (P = 0.01). In addition, higher baseline home prospective food consumption (P = 0.002) and lower baseline cognitive restraint (P hunger and less restraint are more likely to achieve significant weight loss with phentermine. This information can be used clinically to determine who might benefit most from phentermine treatment. © 2015 The Obesity Society.

  6. Facebook and body image concern in adolescent girls: A prospective study.

    Science.gov (United States)

    Tiggemann, Marika; Slater, Amy

    2017-01-01

    The primary aim of the study was to examine the relationship across time between Facebook use and body image concern in adolescent girls. A sample of 438 girls in the first two years (Years 8 and 9) of high school (aged 13-15 years) at Time 1 completed questionnaire measures of Facebook consumption and body image concerns, and again two years later (Time 2). Facebook involvement increased substantially over the two year time period. Body image concerns also increased. Number of Facebook friends was found to prospectively predict the observed increase in drive for thinness. On the other hand, internalization and body surveillance prospectively predicted the observed increase in number of Facebook friends. It was concluded that Facebook "friendships" represent a potent sociocultural force in the body image of adolescent girls. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:80-83). © 2016 Wiley Periodicals, Inc.

  7. Motor dual-tasking deficits predict falls in Parkinson's disease: A prospective study.

    Science.gov (United States)

    Heinzel, Sebastian; Maechtel, Mirjam; Hasmann, Sandra E; Hobert, Markus A; Heger, Tanja; Berg, Daniela; Maetzler, Walter

    2016-05-01

    Falls severely affect lives of Parkinson's disease (PD) patients. Cognitive impairment including dual-tasking deficits contribute to fall risk in PD. However, types of dual-tasking deficits preceding falls in PD are still unclear. Walking velocities during box-checking and subtracting serial 7s were assessed twice a year in 40 PD patients over 2.8 ± 1.0 years. Fourteen patients reported a fall within this period (4 excluded fallers already reported falls at baseline). Their dual-task costs (DTC; mean ± standard deviation) 4.2 ± 2.2 months before the first fall were compared with 22 patients never reporting falls. ROC analyses and logistic regressions accounting for DTC, UPDRS-III and disease duration were used for faller classification and prediction. Only walking/box-checking predicted fallers. Fallers showed higher DTC for walking while box-checking, p = 0.029, but not for box-checking while walking, p = 0.178 (combined motor DTC, p = 0.022), than non-fallers. Combined motor DTC classified fallers and non-fallers (area under curve: 0.75; 95% confidence interval, CI: 0.60-0.91) with 71.4% sensitivity (95%CI: 41.9%-91.6%) and 77.3% specificity (54.6%-92.2%), and significantly predicted future fallers (p = 0.023). Here, 20.4%-points higher combined motor DTC (i.e. the mean difference between fallers and non-fallers) was associated with a 2.6 (1.1-6.0) times higher odds to be a future faller. Motor dual-tasking is a potentially valuable predictor of falls in PD, suggesting that avoiding dual task situations as well as specific motor dual-task training might help to prevent falls in PD. These findings and their therapeutic relevance need to be further validated in PD patients without fall history, in early PD stages, and with various motor-motor dual-task challenges. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Can Perceptuo-Motor Skills Assessment Outcomes in Young Table Tennis Players (7–11 years) Predict Future Competition Participation and Performance? An Observational Prospective Study

    Science.gov (United States)

    2016-01-01

    Forecasting future performance in youth table tennis players based on current performance is complex due to, among other things, differences between youth players in growth, development, maturity, context and table tennis experience. Talent development programmes might benefit from an assessment of underlying perceptuo-motor skills for table tennis, which is hypothesized to determine the players’ potential concerning the perceptuo-motor domain. The Dutch perceptuo-motor skills assessment intends to measure the perceptuo-motor potential for table tennis in youth players by assessing the underlying skills crucial for developing technical and tactical qualities. Untrained perceptuo-motor tasks are used as these are suggested to represent a player’s future potential better than specific sport skills themselves as the latter depend on exposure to the sport itself. This study evaluated the value of the perceptuo-motor skills assessment for a talent developmental programme by evaluating its predictive validity for competition participation and performance in 48 young table tennis players (7–11 years). Players were tested on their perceptuo-motor skills once during a regional talent day, and the subsequent competition results were recorded half-yearly over a period of 2.5 years. Logistic regression analysis showed that test scores did not predict future competition participation (p >0.05). Yet, the Generalized Estimating Equations analysis, including the test items ‘aiming at target’, ‘throwing a ball’, and ‘eye-hand coordination’ in the best fitting model, revealed that the outcomes of the perceptuo-motor skills assessment were significant predictors for future competition results (R2 = 51%). Since the test age influences the perceptuo-motor skills assessment’s outcome, another multivariable model was proposed including test age as a covariate (R2 = 53%). This evaluation demonstrates promising prospects for the perceptuo-motor skills assessment to be

  9. The effect of the emotive decisions in prospect theory.

    Science.gov (United States)

    Bonavia, Tomas

    2014-12-29

    The main purpose of this paper was to show that the certainty and reflection effects of prospect theory do not occur when stimuli have an affective value. To this end, 160 participants were asked to reply to a series of problems originally designed by Kahneman and Tversky (1979), but modified according to the contributions of Rottenstreich and Hsee (2001). The sample was divided into four experimental conditions, two in a gain situation and two in a loss situation. In both cases, affect-rich and affect-poor stimuli were applied in sure and probable alternatives. The findings showed that, in agreement with our hypotheses, the affective value of the stimuli altered the outcome predicted by prospect theory, showing response patterns contrary to certainty and reflection effects (p ≤ .01 and p ≤ .05 respectively). Therefore, this research supports the influence of the emotions in the decision-making process, and should be extended to other aspects of prospect theory.

  10. A Prospective Study of the Timing and Accuracy of Neutrophil Gelatinase-Associated Lipocalin Levels in Predicting Acute Kidney Injury in High-Risk Cardiac Surgery Patients.

    Science.gov (United States)

    Fanning, Niall; Galvin, Sinead; Parke, Rachael; Gilroy, James; Bellomo, Rinaldo; McGuinness, Shay

    2016-01-01

    Neutrophil gelatinase-associated lipocalin (NGAL) appears to be a promising biomarker in the effort to predict acute kidney injury (AKI) after cardiac surgery. The authors aimed to identify the specific time point in the perioperative period at which measurement of either urinary or serum concentrations of NGAL would have the highest predictive power for AKI. The authors also investigated whether change in NGAL from baseline was a better predictor of AKI than absolute NGAL values. A prospective, investigator-blinded observational study. The cardiac surgical unit of a university teaching hospital. The study consisted of 50 patients undergoing cardiac surgery who were classified preoperatively as high risk for developing postoperative AKI. No changes to standard practice were required. The authors performed serial measurements of urinary and serum NGAL concentrations at 18 time points throughout the first 48 postoperative hours and assessed the variables required to diagnose AKI with standard criteria. Statistical analysis of predictive ability was performed using the area under receiver operator curves (AUROC) calculated for each time point. It was demonstrated that urinary NGAL performed marginally better than serum NGAL in predicting AKI. Urinary sampling at 4 and 24 hours after initiation of cardiopulmonary bypass provided the greatest diagnostic ability (AUROC, 0.702 and 0.712, respectively). Absolute NGAL values performed better than changes in NGAL values in predicting AKI. Urinary NGAL performed better than serum NGAL in predicting AKI and was most accurate when measured at 24 hours after initiation of cardiopulmonary bypass; however, NGAL appeared to be at best only a fair predictor of cardiac surgery-associated AKI. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Chronology of prescribing error during the hospital stay and prediction of pharmacist's alerts overriding: a prospective analysis

    Directory of Open Access Journals (Sweden)

    Bruni Vanida

    2010-01-01

    Full Text Available Abstract Background Drug prescribing errors are frequent in the hospital setting and pharmacists play an important role in detection of these errors. The objectives of this study are (1 to describe the drug prescribing errors rate during the patient's stay, (2 to find which characteristics for a prescribing error are the most predictive of their reproduction the next day despite pharmacist's alert (i.e. override the alert. Methods We prospectively collected all medication order lines and prescribing errors during 18 days in 7 medical wards' using computerized physician order entry. We described and modelled the errors rate according to the chronology of hospital stay. We performed a classification and regression tree analysis to find which characteristics of alerts were predictive of their overriding (i.e. prescribing error repeated. Results 12 533 order lines were reviewed, 117 errors (errors rate 0.9% were observed and 51% of these errors occurred on the first day of the hospital stay. The risk of a prescribing error decreased over time. 52% of the alerts were overridden (i.e error uncorrected by prescribers on the following day. Drug omissions were the most frequently taken into account by prescribers. The classification and regression tree analysis showed that overriding pharmacist's alerts is first related to the ward of the prescriber and then to either Anatomical Therapeutic Chemical class of the drug or the type of error. Conclusions Since 51% of prescribing errors occurred on the first day of stay, pharmacist should concentrate his analysis of drug prescriptions on this day. The difference of overriding behavior between wards and according drug Anatomical Therapeutic Chemical class or type of error could also guide the validation tasks and programming of electronic alerts.

  12. Previous injuries and some training characteristics predict running-related injuries in recreational runners: a prospective cohort study.

    Science.gov (United States)

    Hespanhol Junior, Luiz Carlos; Pena Costa, Leonardo Oliveira; Lopes, Alexandre Dias

    2013-12-01

    What is the incidence of running-related injuries (RRIs) in recreational runners? Which personal and training characteristics predict RRIs in recreational runners? Prospective cohort study. A total of 200 recreational runners answered a fortnightly online survey containing questions about their running routine, races, and presence of RRI. These runners were followed-up for a period of 12 weeks. The primary outcome of this study was running-related injury. The incidence of injuries was calculated taking into account the exposure to running and was expressed by RRI/1000 hours. The association between potential predictive factors and RRIs was estimated using generalised estimating equation models. A total of 84 RRIs were registered in 60 (31%) of the 191 recreational runners who completed all follow-up surveys. Of the injured runners 30% (n=18/60) developed two or more RRIs, with 5/18 (28%) being recurrences. The incidence of RRI was 10 RRI/1000 hours of running exposure. The main type of RRI observed was muscle injuries (30%, n=25/84). The knee was the most commonly affected anatomical region (19%, n=16/84). The variables associated with RRI were: previous RRI (OR 1.88, 95% CI 1.01 to 3.51), duration of training although the effect was very small (OR 1.01, 95% CI 1.00 to 1.02), speed training (OR 1.46, 95% CI 1.02 to 2.10), and interval training (OR 0.61, 95% CI 0.43 to 0.88). Physiotherapists should be aware and advise runners that past RRI and speed training are associated with increased risk of further RRI, while interval training is associated with lower risk, although these associations may not be causative. Copyright © 2013 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  13. Estimation of the Ideal Lumbar Lordosis to Be Restored From Spinal Fusion Surgery: A Predictive Formula for Chinese Population.

    Science.gov (United States)

    Xu, Leilei; Qin, Xiaodong; Zhang, Wen; Qiao, Jun; Liu, Zhen; Zhu, Zezhang; Qiu, Yong; Qian, Bang-ping

    2015-07-01

    A prospective, cross-sectional study. To determine the independent variables associated with lumbar lordosis (LL) and to establish the predictive formula of ideal LL in Chinese population. Several formulas have been established in Caucasians to estimate the ideal LL to be restored for lumbar fusion surgery. However, there is still a lack of knowledge concerning the establishment of such predictive formula in Chinese population. A total of 296 asymptomatic Chinese adults were prospectively recruited. The relationships between LL and variables including pelvic incidence (PI), age, sex, and body mass index were investigated to determine the independent factors that could be used to establish the predictive formula. For the validation of the current formula, other 4 reported predictive formulas were included. The absolute value of the gap between the actual LL and the ideal LL yielded by these formulas was calculated and then compared between the 4 reported formulas and the current one to determine its reliability in predicting the ideal LL. The logistic regression analysis showed that there were significant associations of LL with PI and age (R = 0.508, P < 0.001 for PI; R = 0.088, P = 0.03 for age). The formula was, therefore, established as follows: LL = 0.508 × PI - 0.088 × Age + 28.6. When applying our formula to these subjects, the gap between the predicted ideal LL and the actual LL was averaged 3.9 ± 2.1°, which was significantly lower than that of the other 4 formulas. The calculation formula derived in this study can provide a more accurate prediction of the LL for the Chinese population, which could be used as a tool for decision making to restore the LL in lumbar corrective surgery. 3.

  14. Evaluating the Predictive Impact of an Emergent Literacy Model on Dyslexia in Italian Children: A Four-Year Prospective Cohort Study.

    Science.gov (United States)

    Bigozzi, Lucia; Tarchi, Christian; Pezzica, Sara; Pinto, Giuliana

    2016-01-01

    The strong differences in manifestation, prevalence, and incidence in dyslexia across languages invite studies in specific writing systems. In particular, the question of the role played by emergent literacy in opaque and transparent writing systems remains a fraught one. This research project tested, through a 4-year prospective cohort study, an emergent literacy model for the analysis of the characteristics of future dyslexic children and normally reading peers in Italian, a transparent writing system. A cohort of 450 children was followed from the last year of kindergarten to the third grade in their reading acquisition process. Dyslexic children were individuated (Grade 3), and their performances in kindergarten in textual competence, phonological awareness, and conceptual knowledge of the writing system were compared with a matched group of normally reading peers. Results showed the predictive relevance of the conceptual knowledge of the writing system. The study's implications are discussed. © Hammill Institute on Disabilities 2014.

  15. Multivariate statistical models for disruption prediction at ASDEX Upgrade

    International Nuclear Information System (INIS)

    Aledda, R.; Cannas, B.; Fanni, A.; Sias, G.; Pautasso, G.

    2013-01-01

    In this paper, a disruption prediction system for ASDEX Upgrade has been proposed that does not require disruption terminated experiments to be implemented. The system consists of a data-based model, which is built using only few input signals coming from successfully terminated pulses. A fault detection and isolation approach has been used, where the prediction is based on the analysis of the residuals of an auto regressive exogenous input model. The prediction performance of the proposed system is encouraging when it is applied to the same set of campaigns used to implement the model. However, the false alarms significantly increase when we tested the system on discharges coming from experimental campaigns temporally far from those used to train the model. This is due to the well know aging effect inherent in the data-based models. The main advantage of the proposed method, with respect to other data-based approaches in literature, is that it does not need data on experiments terminated with a disruption, as it uses a normal operating conditions model. This is a big advantage in the prospective of a prediction system for ITER, where a limited number of disruptions can be allowed

  16. Testicular hypertrophy as a predictor for contralateral monorchism: Retrospective review of prospectively recorded data.

    Science.gov (United States)

    Hodhod, A; Capolicchio, J P; Jednak, R; El-Sherbiny, M

    2016-02-01

    Testicular hypertrophy has previously been evaluated as a predictor of monorchism. However, its implication in clinical practice is not well evaluated. The aim of the present study was to examine its value in planning the operative time. Medical charts of prospectively recorded data of 76 consecutive patients with unilateral impalpable testis from 2011 to 2014 were reviewed at the present institute. Inclusion criteria included prepubertal patients with non-palpable testes by examination under anesthesia. Contralateral testes were prospectively measured using a Takihara orchidometer. Orchiectomy or orchiopexy was performed according to the viability of the undescended testis (UDT). Collected data included age of surgery, contralateral testicular size, surgical time and laparoscopic findings. A ROC curve was used to define the best cut-off volume of the contralateral testis that can predict ipsilateral testicular viability. The Student's t-test was used to examine if this cut-off volume would be useful in allocating the operative time. Of 76 patients, four palpable testes by examination under anesthesia were excluded. The remaining 72 patients were included in the study. Ipsilateral normal viable testes were found in 26 (36.1%) patients, while 46 (63.9%) had non-viable testes (testicular nubbins or vanishing testes) (Figure). A contralateral testicular volume > 2 ml was significantly predictive for monorchism with 71.7% sensitivity and 100% specificity (P 2 ml was 50 min, which was significantly shorter than that for UDT with a contralateral size ≤ 2 ml, which was 88 min (P value for testicular hypertrophy that predicts monorchism greatly varied. This is likely due to the different methods used for testicular measurements that make it impractical to make a direct comparison. The usefulness of predicting monorchism before surgery has not previously been used as a guide for allocating operative time in the management of a unilateral non-palpable testicle. This study

  17. A taxonomy of prospection: Introducing an organizational framework for future-oriented cognition

    Science.gov (United States)

    Szpunar, Karl K.; Spreng, R. Nathan; Schacter, Daniel L.

    2014-01-01

    Prospection—the ability to represent what might happen in the future—is a broad concept that has been used to characterize a wide variety of future-oriented cognitions, including affective forecasting, prospective memory, temporal discounting, episodic simulation, and autobiographical planning. In this article, we propose a taxonomy of prospection to initiate the important and necessary process of teasing apart the various forms of future thinking that constitute the landscape of prospective cognition. The organizational framework that we propose delineates episodic and semantic forms of four modes of future thinking: simulation, prediction, intention, and planning. We show how this framework can be used to draw attention to the ways in which various modes of future thinking interact with one another, generate new questions about prospective cognition, and illuminate our understanding of disorders of future thinking. We conclude by considering basic cognitive processes that give rise to prospective cognitions, cognitive operations and emotional/motivational states relevant to future-oriented cognition, and the possible role of procedural or motor systems in future-oriented behavior. PMID:25416592

  18. Predicting the development of stress urinary incontinence 3 years after hysterectomy

    NARCIS (Netherlands)

    Lakeman, M.M.E.; van der Vaart, C.H.; van der Steeg, J.W.; Roovers, J.P.W.R.

    2011-01-01

    We aimed to develop a prediction rule to predict the individual risk to develop stress urinary incontinence (SUI) after hysterectomy. Prospective observational study with 3-year follow-up among women who underwent abdominal or vaginal hysterectomy for benign conditions, excluding vaginal prolapse,

  19. Predicting the development of stress urinary incontinence 3 years after hysterectomy

    NARCIS (Netherlands)

    Lakeman, Marielle M. E.; Van Der Vaart, C. Huub; Van Der Steeg, Jan Willem; Roovers, Jan-Paul W. R.

    Introduction and hypothesis We aimed to develop a prediction rule to predict the individual risk to develop stress urinary incontinence (SUI) after hysterectomy. Methods Prospective observational study with 3-year follow-up among women who underwent abdominal or vaginal hysterectomy for benign

  20. Rumination mediates the prospective effect of low self-esteem on depression: a five-wave longitudinal study.

    Science.gov (United States)

    Kuster, Farah; Orth, Ulrich; Meier, Laurenz L

    2012-06-01

    Previous research supports the vulnerability model of low self-esteem and depression, which states that low self-esteem operates as a prospective risk factor for depression. However, it is unclear which processes mediate the effect of low self-esteem. To test for the mediating effect of rumination, the authors used longitudinal mediation models, which included exclusively prospective effects and controlled for autoregressive effects of the constructs. Data came from 663 individuals (aged 16 to 62 years), who were assessed 5 times over an 8-month period. The results indicated that low self-esteem predicted subsequent rumination, which in turn predicted subsequent depression, and that rumination partially mediated the prospective effect of low self-esteem on depression. These findings held for both men and women, and for both affective-cognitive and somatic symptoms of depression. Future studies should test for the mediating effects of additional intrapersonal and interpersonal processes.

  1. A Novel Workflow for Geothermal Prospectively Mapping Weights-of-Evidence in Liaoning Province, Northeast China

    Directory of Open Access Journals (Sweden)

    Xuejia Sang

    2017-07-01

    Full Text Available Geological faults are highly developed in the eastern Liaoning Province in China, where Mesozoic granitic intrusions and Archean and Paleoproterozoic metamorphic rocks are widely distributed. Although the heat flow value in eastern Liaoning Province is generally low, the hot springs are very developed. It is obvious that the faults have significant control over the distribution of hot springs, and traditional methods of spatial data analysis such as WofE (weight of evidence usually do not take into account the direction of the distribution of geothermal resources in the geothermal forecast process, which seriously affects the accuracy of the prediction results. To overcome the deficiency of the traditional evidence weight method, wherein it does not take the direction of evidence factor into account, this study put forward a combination of the Fry and WofE methods, Fry-WofE, based on geological observation, gravity, remote sensing, and DEM (digital elevation model multivariate data. This study takes eastern Liaoning Province in China as an example, and the geothermal prospect was predicted respectively by the Fry-WofE and WofE methods from the statistical data on the spatial distribution of the exposed space of geothermal anomalies the surface. The result shows that the Fry-WofE method can achieve better prediction results when comparing the accuracy of these two methods. Based on the results of Fry-WofE prediction and water system extraction, 13 favorable geothermal prospect areas are delineated in eastern Liaoning Province. The Fry-WofE method is effective in study areas where the geothermal distribution area is obviously controlled by the fault. We provide not only a new method for solving the similar issue of geothermal exploration, but also a new insight into the distribution of geothermal resources in Liaoning Province.

  2. Biomarker kinetics in the prediction of VAP diagnosis: results from the BioVAP study

    NARCIS (Netherlands)

    Póvoa, Pedro; Martin-Loeches, Ignacio; Ramirez, Paula; Bos, Lieuwe D.; Esperatti, Mariano; Silvestre, Joana; Gili, Gisela; Goma, Gema; Berlanga, Eugenio; Espasa, Mateu; Gonçalves, Elsa; Torres, Antoni; Artigas, Antonio

    2016-01-01

    Prediction of diagnosis of ventilator-associated pneumonia (VAP) remains difficult. Our aim was to assess the value of biomarker kinetics in VAP prediction. We performed a prospective, multicenter, observational study to evaluate predictive accuracy of biomarker kinetics, namely C-reactive protein

  3. Predictive values of psychiatric symptoms for internet addiction in adolescents: a 2-year prospective study.

    Science.gov (United States)

    Ko, Chih-Hung; Yen, Ju-Yu; Chen, Cheng-Sheng; Yeh, Yi-Chun; Yen, Cheng-Fang

    2009-10-01

    To evaluate the predictive values of psychiatric symptoms for the occurrence of Internet addiction and to determine the sex differences in the predictive value of psychiatric symptoms for the occurrence of Internet addiction in adolescents. Internet addiction, depression, attention-deficit/hyperactivity disorder, social phobia, and hostility were assessed by self-reported questionnaires. Participants were then invited to be assessed for Internet addiction 6, 12, and 24 months later (the second, third, and fourth assessments, respectively). Ten junior high schools in southern Taiwan. A total of 2293 (1179 boys and 1114 girls) adolescents participated in the initial investigation. The course of time. Internet addiction as assessed using the Chen Internet Addiction Scale. Depression, attention-deficit/hyperactivity disorder, social phobia, and hostility were found to predict the occurrence of Internet addiction in the 2-year follow-up, and hostility and attention-deficit/hyperactivity disorder were the most significant predictors of Internet addiction in male and female adolescents, respectively. These results suggest that attention-deficit/hyperactivity disorder, hostility, depression, and social phobia should be detected early on and intervention carried out to prevent Internet addiction in adolescents. Also, sex differences in psychiatric comorbidity should be taken into consideration when developing prevention and intervention strategies for Internet addiction.

  4. Poor anaerobic power/capability and static balance predicted prospective musculoskeletal injuries among Soldiers of the 101st Airborne (Air Assault) Division.

    Science.gov (United States)

    Nagai, Takashi; Lovalekar, Mita; Wohleber, Meleesa F; Perlsweig, Katherine A; Wirt, Michael D; Beals, Kim

    2017-11-01

    Musculoskeletal injuries have negatively impacted tactical readiness. The identification of prospective and modifiable risk factors of preventable musculoskeletal injuries can guide specific injury prevention strategies for Soldiers and health care providers. To analyze physiological and neuromuscular characteristics as predictors of preventable musculoskeletal injuries. Prospective-cohort study. A total of 491 Soldiers were enrolled and participated in the baseline laboratory testing, including body composition, aerobic capacity, anaerobic power/capacity, muscular strength, flexibility, static balance, and landing biomechanics. After reviewing their medical charts, 275 male Soldiers who met the criteria were divided into two groups: with injuries (INJ) and no injuries (NOI). Simple and multiple logistic regression analyses were used to calculate the odds ratio (OR) and significant predictors of musculoskeletal injuries (pmodel included the static balance with eyes-closed and peak anaerobic power as predictors of future injuries (p<0.001). The current results highlighted the importance of anaerobic power/capacity and static balance. High intensity training and balance exercise should be incorporated in their physical training as countermeasures. Copyright © 2017 Sports Medicine Australia. All rights reserved.

  5. Uranium prospecting; La prospection de l'uranium

    Energy Technology Data Exchange (ETDEWEB)

    Roubault, M [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1955-07-01

    This report is an instruction book for uranium prospecting. It appeals to private prospecting. As prospecting is now a scientific and technical research, it cannot be done without preliminary studies. First of all, general prospecting methods are given with a recall of fundamental geologic data and some general principles which are common with all type of prospecting. The peculiarities of uranium prospecting are also presented and in particular the radioactivity property of uranium as well as the special aspect of uranium ores and the aspect of neighbouring ores. In a third part, a description of the different uranium ores is given and separated in two different categories: primary and secondary ores, according to the place of transformation, deep or near the crust surface respectively. In the first category, the primary ores include pitchblende, thorianite and rare uranium oxides as euxenite and fergusonite for example. In the second category, the secondary ores contain autunite and chalcolite for example. An exhaustive presentation of the geiger-Mueller counter is given with the presentation of its different components, its functioning and utilization and its maintenance. The radioactivity interpretation method is showed as well as the elaboration of a topographic map of the measured radioactivity. A brief presentation of other detection methods than geiger-Mueller counters is given: the measurement of fluorescence and a chemical test using the fluorescence properties of uranium salts. Finally, the main characteristics of uranium deposits are discussed. (M.P.)

  6. Prospective associations between bilingualism and executive function in Latino children: sustained effects while controlling for biculturalism.

    Science.gov (United States)

    Riggs, Nathaniel R; Shin, Hee-Sung; Unger, Jennifer B; Spruijt-Metz, Donna; Pentz, Mary Ann

    2014-10-01

    The study purpose was to test 1-year prospective associations between English-Spanish bilingualism and executive function in 5th to 6th grade students while controlling for biculturalism. Participants included 182 US Latino students (50 % female). Self-report surveys assessed biculturalism, bilingualism, and executive function (i.e., working memory, organizational skills, inhibitory control, and emotional control, as well as a summary executive function score). General linear model regressions demonstrated that bilingualism significantly predicted the summary executive function score as well as working memory such that bilingual proficiency was positively related to executive function. Results are the first to demonstrate (a) prospective associations between bilingualism to executive function while controlling for the potential third variable of biculturalism, and (b) a principal role for working memory in this relationship. Since executive function is associated with a host of health outcomes, one implication of study findings is that bilingualism may have an indirect protective influence on youth development.

  7. US Intergroup Anal Carcinoma Trial: Tumor Diameter Predicts for Colostomy

    Science.gov (United States)

    Ajani, Jaffer A.; Winter, Kathryn A.; Gunderson, Leonard L.; Pedersen, John; Benson, Al B.; Thomas, Charles R.; Mayer, Robert J.; Haddock, Michael G.; Rich, Tyvin A.; Willett, Christopher G.

    2009-01-01

    Purpose The US Gastrointestinal Intergroup Radiation Therapy Oncology Group 98-11 anal carcinoma trial showed that cisplatin-based concurrent chemoradiotherapy resulted in a significantly higher rate of colostomy compared with mitomycin-based therapy. Established prognostic variables for patients with anal carcinoma include tumor diameter, clinical nodal status, and sex, but pretreatment variables that would predict the likelihood of colostomy are unknown. Methods A secondary analysis was performed by combining patients in the two treatment arms to evaluate whether new predictive and prognostic variables would emerge. Univariate and multivariate analyses were carried out to correlate overall survival (OS), disease-free survival, and time to colostomy (TTC) with pretreatment and treatment variables. Results Of 682 patients enrolled, 644 patients were assessable and analyzed. In the multivariate analysis, tumor-related prognosticators for poorer OS included node-positive cancer (P ≤ .0001), large (> 5 cm) tumor diameter (P = .01), and male sex (P = .016). In the treatment-related categories, cisplatin-based therapy was statistically significantly associated with a higher rate of colostomy (P = .03) than was mitomycin-based therapy. In the pretreatment variables category, only large tumor diameter independently predicted for TTC (P = .008). Similarly, the cumulative 5-year colostomy rate was statistically significantly higher for large tumor diameter than for small tumor diameter (Gray's test; P = .0074). Clinical nodal status and sex were not predictive of TTC. Conclusion The combined analysis of the two arms of RTOG 98-11, representing the largest prospective database, reveals that tumor diameter (irrespective of the nodal status) is the only independent pretreatment variable that predicts TTC and 5-year colostomy rate in patients with anal carcinoma. PMID:19139424

  8. Prediction of crime and early interventions

    DEFF Research Database (Denmark)

    Christoffersen, Mogens

    This paper presents a prospective longitudinal study that attempts to predict juvenile delinquency measured by first contact with the police (arrest, pre-trial detention or charges of crimes) taking a complete cohort of all children born in Denmark in 1984 (N=54,458). The children are followed from...

  9. Clinical studies of biomarkers in suicide prediction

    OpenAIRE

    Jokinen, Jussi

    2007-01-01

    Suicide is a major clinical problem in psychiatry and suicidal behaviours can be seen as a nosological entity per se. Predicting suicide is difficult due to its low base-rate and the limited specificity of clinical predictors. Prospective biological studies suggest that dysfunctions in the hypothalamo pituitary adrenal (HPA) axis and the serotonergic system have predictive power for suicide in mood disorders. Suicide attempt is the most robust clinical predictor making suici...

  10. Prospective Tests on Biological Models of Acupuncture

    Directory of Open Access Journals (Sweden)

    Charles Shang

    2009-01-01

    Full Text Available The biological effects of acupuncture include the regulation of a variety of neurohumoral factors and growth control factors. In science, models or hypotheses with confirmed predictions are considered more convincing than models solely based on retrospective explanations. Literature review showed that two biological models of acupuncture have been prospectively tested with independently confirmed predictions: The neurophysiology model on the long-term effects of acupuncture emphasizes the trophic and anti-inflammatory effects of acupuncture. Its prediction on the peripheral effect of endorphin in acupuncture has been confirmed. The growth control model encompasses the neurophysiology model and suggests that a macroscopic growth control system originates from a network of organizers in embryogenesis. The activity of the growth control system is important in the formation, maintenance and regulation of all the physiological systems. Several phenomena of acupuncture such as the distribution of auricular acupuncture points, the long-term effects of acupuncture and the effect of multimodal non-specific stimulation at acupuncture points are consistent with the growth control model. The following predictions of the growth control model have been independently confirmed by research results in both acupuncture and conventional biomedical sciences: (i Acupuncture has extensive growth control effects. (ii Singular point and separatrix exist in morphogenesis. (iii Organizers have high electric conductance, high current density and high density of gap junctions. (iv A high density of gap junctions is distributed as separatrices or boundaries at body surface after early embryogenesis. (v Many acupuncture points are located at transition points or boundaries between different body domains or muscles, coinciding with the connective tissue planes. (vi Some morphogens and organizers continue to function after embryogenesis. Current acupuncture research suggests a

  11. Predictive Accuracy of the PanCan Lung Cancer Risk Prediction Model -External Validation based on CT from the Danish Lung Cancer Screening Trial

    DEFF Research Database (Denmark)

    Winkler Wille, Mathilde M.; van Riel, Sarah J.; Saghir, Zaigham

    2015-01-01

    Objectives: Lung cancer risk models should be externally validated to test generalizability and clinical usefulness. The Danish Lung Cancer Screening Trial (DLCST) is a population-based prospective cohort study, used to assess the discriminative performances of the PanCan models. Methods: From...... the DLCST database, 1,152 nodules from 718 participants were included. Parsimonious and full PanCan risk prediction models were applied to DLCST data, and also coefficients of the model were recalculated using DLCST data. Receiver operating characteristics (ROC) curves and area under the curve (AUC) were...... used to evaluate risk discrimination. Results: AUCs of 0.826–0.870 were found for DLCST data based on PanCan risk prediction models. In the DLCST, age and family history were significant predictors (p = 0.001 and p = 0.013). Female sex was not confirmed to be associated with higher risk of lung cancer...

  12. Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: a systematic review

    Science.gov (United States)

    2013-01-01

    Background People suffering from musculoskeletal shoulder pain are frequently referred to physiotherapy. Physiotherapy generally involves a multimodal approach to management that may include; exercise, manual therapy and techniques to reduce pain. At present it is not possible to predict which patients will respond positively to physiotherapy treatment. The purpose of this systematic review was to identify which prognostic factors are associated with the outcome of physiotherapy in the management of musculoskeletal shoulder pain. Methods A comprehensive search was undertaken of Ovid Medline, EMBASE, CINAHL and AMED (from inception to January 2013). Prospective studies of participants with shoulder pain receiving physiotherapy which investigated the association between baseline prognostic factors and change in pain and function over time were included. Study selection, data extraction and appraisal of study quality were undertaken by two independent assessors. Quality criteria were selected from previously published guidelines to form a checklist of 24 items. The study protocol was prospectively registered onto the International Prospective Register of Systematic Reviews. Results A total of 5023 titles were retrieved and screened for eligibility, 154 articles were assessed as full text and 16 met the inclusion criteria: 11 cohort studies, 3 randomised controlled trials and 2 controlled trials. Results were presented for the 9 studies meeting 13 or more of the 24 quality criteria. Clinical and statistical heterogeneity resulted in qualitative synthesis rather than meta-analysis. Three studies demonstrated that high functional disability at baseline was associated with poor functional outcome (p ≤ 0.05). Four studies demonstrated a significant association (p ≤ 0.05) between longer duration of shoulder pain and poorer outcome. Three studies, demonstrated a significant association (p ≤ 0.05) between increasing age and poorer function; three studies

  13. A 5 year prospective study of patient-relevant outcomes after total knee replacement

    DEFF Research Database (Denmark)

    Nilsdotter, A-K; Toksvig-Larsen, S; Roos, E M

    2008-01-01

    men, mean age 71 (51-86) assigned for TKR at the Department of Orthopaedics at Lund University Hospital were included in the study. The self-administered questionnaires Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-36 were mailed preoperatively and 6 months, 12 months and at 5 years......OBJECTIVE: To prospectively describe self-reported outcomes up to 5 years after total knee replacement (TKR) in Osteoarthritis (OA) and to study which patient-relevant factors may predict outcomes for pain and physical function (PF). METHODS: 102 consecutive patients with knee OA, 63 women and 39...... postoperatively. RESULTS: Response rate at 5 years was 86%. At 6 months significant improvement was seen in all KOOS and SF-36 scores (P

  14. Early signs that predict later haemodynamically significant patent ductus arteriosus.

    Science.gov (United States)

    Engür, Defne; Deveci, Murat; Türkmen, Münevver K

    2016-03-01

    Our aim was to determine the optimal cut-off values, sensitivity, specificity, and diagnostic power of 12 echocardiographic parameters on the second day of life to predict subsequent ductal patency. We evaluated preterm infants, born at ⩽32 weeks of gestation, starting on their second day of life, and they were evaluated every other day until ductal closure or until there were clinical signs of re-opening. We measured transductal diameter; pulmonary arterial diastolic flow; retrograde aortic diastolic flow; pulsatility index of the left pulmonary artery and descending aorta; left atrium and ventricle/aortic root ratio; left ventricular output; left ventricular flow velocity time integral; mitral early/late diastolic flow; and superior caval vein diameter and flow as well as performed receiver operating curve analysis. Transductal diameter (>1.5 mm); pulmonary arterial diastolic flow (>25.6 cm/second); presence of retrograde aortic diastolic flow; ductal diameter by body weight (>1.07 mm/kg); left pulmonary arterial pulsatility index (⩽0.71); and left ventricle to aortic root ratio (>2.2) displayed high sensitivity and specificity (p0.9). Parameters with moderate sensitivity and specificity were as follows: left atrial to aortic root ratio; left ventricular output; left ventricular flow velocity time integral; and mitral early/late diastolic flow ratio (p0.05) had low diagnostic value. Left pulmonary arterial pulsatility index, left ventricle/aortic root ratio, and ductal diameter by body weight are useful adjuncts offering a broader outlook for predicting ductal patency.

  15. Emotion regulation difficulties as a prospective predictor of posttraumatic stress symptoms following a mass shooting.

    Science.gov (United States)

    Bardeen, Joseph R; Kumpula, Mandy J; Orcutt, Holly K

    2013-03-01

    A strong positive association between emotion regulation difficulties (ERD) and posttraumatic stress symptoms (PTSS) has been consistently evidenced in cross-sectional research. However, a lack of prospective research has limited hypotheses regarding the temporal relationship between trauma exposure, ERD, and PTSS. The present prospective study investigated the role of pre-trauma difficulties with emotion regulation in the development of PTSS following exposure to a potentially traumatic event. Between Time 1 (T1) and Time 2 (T2), a mass shooting occurred at the participants' (n=691) university campus. ERD and PTSS were assessed prior to the shooting (T1), in the acute aftermath of the shooting (T2), and approximately eight months later (T3). Using a cross-lagged panel design, ERD was found to prospectively predict PTSS from T1 to T2 and T2 to T3. Additionally, PTSS prospectively predicted ERD from T1 to T2. However, T2 PTSS failed to predict T3 PTSS. Results indicate that ERD and PTSS are reciprocally influential from pre- to post-shooting. Further, results suggest that emotion dysregulation in the aftermath of a potentially traumatic event influences one's ability to recover from PTSS over time, even after accounting for the effects of existing symptomatology. To examine the specificity of temporal relations between ERD and PTSS a second cross-lagged panel design, in which a general distress construct was substituted for PTSS, was conducted. Results of this analysis, as well as conceptual and clinical implications, will be discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. The significance of collateral vessels, as seen on chest CT, in predicting SVC obstruction

    International Nuclear Information System (INIS)

    Yeouk, Young Soo; Kim, Sung Jin; Bae, Il Hun; Kim, Jae Youn; Hwang, Seung Min; Han, Gi Seok; Park, Kil Sun; Kim, Dae Young

    1998-01-01

    To evaluate the significance of collateral veins, as seen on chest CT, in the diagnosis of superior vena cava obstruction. We retrospectively the records of 81 patients in whom collateral veins were seen on chest CT. On spiral CT(n=49), contrast material was infused via power injector, and on conventional CT(n=32), 50 ml bolus infusion was followed by 50 ml drip infusion. Obstruction of the SVC was evaluated on chest CT; if, however, evaluation of the SVC of its major tributaries was difficult, as in five cases, the patient underwent SVC phlebography. Collateral vessels were assigned to one of ten categories. On conventional CT, the jugular venous arch in the only collateral vessel to predict SVC obstruction; on spiral CT, however, collateral vessels are not helpful in the diagnosis of SVC obstruction, but are a nonspecific finding. (author). 12 refs., 2 tab., 2 figs

  17. Significance of clinical and biologic features in Stage 3 neuroblastoma: a report from the International Neuroblastoma Risk Group project.

    Science.gov (United States)

    Meany, Holly J; London, Wendy B; Ambros, Peter F; Matthay, Katherine K; Monclair, Tom; Simon, Thorsten; Garaventa, Alberto; Berthold, Frank; Nakagawara, Akira; Cohn, Susan L; Pearson, Andrew D J; Park, Julie R

    2014-11-01

    International Neuroblastoma Staging System (INSS) Stage 3 neuroblastoma is a heterogeneous disease. Data from the International Neuroblastoma Risk Group (INRG) database were analyzed to define patient and tumor characteristics predictive of outcome. Of 8,800 patients in the INRG database, 1,483 with INSS Stage 3 neuroblastoma and complete follow-up data were analyzed. Secondary analysis was performed in 1,013 patients (68%) with MYCN-non-amplified (NA) tumors. Significant prognostic factors were identified via log-rank test comparisons of survival curves. Multivariable Cox proportional hazards regression model was used to identify factors independently predictive of event-free survival (EFS). Age at diagnosis (P INSS Stage 3 neuroblastoma patients, age at diagnosis, MYCN status and histology predict outcome. Patients <547 days of age with MYCN-NA tumors that lack chromosome 11q aberrations or those with serum ferritin <96 ng/ml have excellent prognosis and should be considered for therapy reduction. Prospective clinical trials are needed to identify optimal therapy for those patients ≥ 547 days of age with undifferentiated histology or elevated serum ferritin. © 2014 Wiley Periodicals, Inc.

  18. Comparison of three scoring systems in predicting clinical outcomes in patients with acute upper gastrointestinal bleeding: a prospective observational study.

    Science.gov (United States)

    Zhong, Min; Chen, Wan Jun; Lu, Xiao Ye; Qian, Jie; Zhu, Chang Qing

    2016-12-01

    To compare the performances of the Glasgow-Blatchford score (GBS), modified GBS (mGBS) and AIMS65 in predicting clinical outcomes in patients with acute upper gastrointestinal bleeding (AUGIB). This study enrolled 320 consecutive patients with AUGIB. Patients at high and low risks of developing adverse clinical outcomes (rebleeding, the need of clinical intervention and death) were categorized according to the GBS, mGBS and AIMS65 scoring systems. The outcome of the patients were the occurrences of adverse clinical outcomes. The areas under the receiver operating characteristics curve (AUROC) of three scoring systems were compared. Irrespective of the systems used, the high-risk groups showed higher rates of rebleeding, intervention and death compared with the low-risk groups (P < 0.05). For the prediction of rebleeding, AIMS65 (AUROC 0.735, 95% CI 0.667-0.802) performed significantly better than GBS (AUROC 0.672, 95% CI 0.597-0.747; P < 0.01) and mGBS (AUROC 0.677, 95% CI 0.602-0.753; P < 0.01). For the prediction of interventions, there was no significant difference among the three systems (GBS: AUROC 0.769, 95% CI 0.668-0.870; mGBS: AUROC 0.745, 95% CI 0.643-0.847; AIMS65: AUROC 0.746, 95% CI 0.640-0.851). For the prediction of in-hospital mortality, there was no significant difference among the three systems (GBS: AUROC 0.796, 95% CI 0.694-0.898; mGBS: AUROC 0.803, 95% CI 0.703-0.904; AIMS65: AUROC 0.786, 95% CI 0.670-0.903). The three scoring systems are reliable and accurate in predicting the rates of rebleeding, surgery and mortality in AUGIB. However, AIMS65 outperforms GBS and mGBS in predicting rebleeding. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  19. Prospects for early discoveries at the LHC with dileptons, jets and no missing energy

    International Nuclear Information System (INIS)

    Ciaccio, A. di; Thompson, E.

    2009-01-01

    Final states with high p T leptons and jets, without missing energy, are predicted by several BSM models at the LHC, including LR symmetric models and Leptoquarks. The prospects for an early discovery of particles predicted by these models, using the ATLAS experiment, are discussed. These particles include in particular first and second generation leptoquarks, right-handed W and heavy neutrinos. (author)

  20. Assessment of PANC3 score in predicting severity of acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Avreen Singh Shah

    2017-01-01

    Full Text Available Introduction: Acute pancreatitis is inflammatory process of the pancreas associated with local and systemic complications. At present, there are lots of scores (such as Ransons, APACHE II, bedside index for severity in acute pancreatitis that help us in predicting severity at the time of admission but these are time consuming or require complex calculation and are costly. Material and Methods: PANC3 Scoring System is one of the better systems because the three criteria used (hematocrit, body mass index, and pleural effusion are simple, easy to assess, readily available, and economic. In this prospective study, 100 cases were evaluated to see the prospects of PANC3 scoring in predicting the severity of acute pancreatitis as decided by modified Marshals score. Results: The results showed that PANC3 score had a 96.43% specificity, 75% sensitivity, 80% positive predictive value, and 95.29% negative predictive value. Conclusion: Hence, the PANC3 score is a cost-effective, promising score that helps in predicting the severity of acute pancreatitis leading to prompt treatment and early referral to higher center.

  1. [Predicting bipolar disorder: what can we learn from prospective cohort studies?].

    Science.gov (United States)

    Geoffroy, P A; Leboyer, M; Scott, J

    2015-02-01

    Bipolar disorder (BD) is a life course illness; and there is increasing awareness of the many personal, social and economic consequences of the illness in older adults. However, it is important to emphasize that BD usually begins in late adolescence or early adulthood and 75 % cases have a first episode in this age period. This early onset and the associated level of disability mean that BD is the 4th leading cause of global disease burden in adolescents and young adults. Internationally, mental health services are increasingly striving to diagnose and treat BD as early as possible to try to prevent poor outcomes. In addition, researchers are using methods employed previously in psychosis studies as these may help us to recognise the earliest manifestations of BD. If it is possible to identify sub-threshold and 'ultra high risk' syndromes for BD, this might lead to new interventions that could target the prevention of first episodes of mania. One approach to understanding these risk syndromes is to examine prospective community cohort studies and BD offspring studies. This paper reviews prospective cohort studies that identify robust risk factors in early illness onset, which was defined as age at onset of BD between 15-25 years. We found that although > 50 % of individuals who developed BD had developed a putative BD prodrome prior to 14 years of age, this usually began with non-specific symptoms that overlap with similar presentations for those who later develop psychosis or severe depression. However, there are some features that seem to better identify groups with a BD "at-risk" syndrome. This syndrome is frequently composed of several factors such as mood lability, depressive episodes, prior anxiety, sleep and/or conduct disorders, attention and concentration impairment, altered energy patterns, and a family history of mania and/or depression. The course of these early predictors suggests the precursor syndromes are composed of mini-clusters of symptoms many

  2. Use of paleogeochemical topographic maps for prediction of epigenetic uranium deposits

    International Nuclear Information System (INIS)

    Perel'man, A.I.

    1985-01-01

    The role of paleogeochemical maps for prospecting for and predicting uranium deposits is considered. The method of paleogeochemical landscape mapping is based on the landscape geochemistry, modern notions of geochemical condition evolution during geologic history, on the general principles of geochemical mapping. The use of the above-mentioned maps for predicting epigenetic uranium deposits is based on prospecting criteria and signs, which follow from epigenetic theory of the deposit genesis. According to the above theory a number of signs, favourable for the formation of deposits of this class (aride climate, granitoids and other rocks in the area of artesian water source, depression shapes of relief, etc.), is established

  3. Predicting physical health: implicit mental health measures versus self-report scales.

    Science.gov (United States)

    Cousineau, Tara McKee; Shedler, Jonathan

    2006-06-01

    Researchers have traditionally relied on self-report questionnaires to assess psychological well-being, but such measures may be unable to differentiate individuals who are genuinely psychologically healthy from those who maintain a facade or illusion of mental health based on denial and self-deception. Prior research suggests that clinically derived assessment procedures that assess implicit psychological processes may have advantages over self-report mental health measures. This prospective study compared the Early Memory Index, an implicit measure of mental health/distress, with a range of familiar self-report scales as predictors of physical health. The Early Memory Index showed significant prospective associations with health service utilization and clinically verified illness. In contrast, self-report measures of mental health, perceived stress, life events stress, and mood states did not predict health outcomes. The findings highlight the limitations of self-report questionnaires and suggest that implicit measures have an important role to play in mental health research.

  4. Parameter definition using vibration prediction software leads to significant drilling performance improvements

    Energy Technology Data Exchange (ETDEWEB)

    Amorim, Dalmo; Hanley, Chris Hanley; Fonseca, Isaac; Santos, Juliana [National Oilwell Varco, Houston TX (United States); Leite, Daltro J.; Borella, Augusto; Gozzi, Danilo [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil)

    2012-07-01

    The understanding and mitigation of downhole vibration has been a heavily researched subject in the oil industry as it results in more expensive drilling operations, as vibrations significantly diminish the amount of effective drilling energy available to the bit and generate forces that can push the bit or the Bottom Hole Assembly (BHA) off its concentric axis of rotation, producing high magnitude impacts with the borehole wall. In order to drill ahead, a sufficient amount of energy must be supplied by the rig to overcome the resistance of the drilling system, including the reactive torque of the system, drag forces, fluid pressure losses and energy dissipated by downhole vibrations, then providing the bit with the energy required to fail the rock. If the drill string enters resonant modes of vibration, not only does it decreases the amount of available energy to drill, but increases the potential for catastrophic downhole equipment and drilling bit failures. In this sense, the mitigation of downhole vibrations will result in faster, smoother, and cheaper drilling operations. A software tool using Finite Element Analysis (FEA) has been developed to provide better understanding of downhole vibration phenomena in drilling environments. The software tool calculates the response of the drilling system at various input conditions, based on the design of the wellbore along with the geometry of the Bottom Hole Assembly (BHA) and the drill string. It identifies where undesired levels of resonant vibration will be driven by certain combinations of specific drilling parameters, and also which combinations of drilling parameters will result in lower levels of vibration, so the least shocks, the highest penetration rate and the lowest cost per foot can be achieved. With the growing performance of personal computers, complex software systems modeling the drilling vibrations using FEA has been accessible to a wider audience of field users, further complimenting with real time

  5. Predictors of self-rated health: a 12-month prospective study of IT and media workers.

    Science.gov (United States)

    Hasson, Dan; Arnetz, Bengt B; Theorell, Töres; Anderberg, Ulla Maria

    2006-07-31

    The aim of the present study was to determine health-related risk and salutogenic factors and to use these to construct prediction models for future self-rated health (SRH), i.e. find possible characteristics predicting individuals improving or worsening in SRH over time (0-12 months). A prospective study was conducted with measurements (physiological markers and self-ratings) at 0, 6 and 12 months, involving 303 employees (187 men and 116 women, age 23-64) from four information technology and two media companies. There were a multitude of statistically significant cross-sectional correlations (Spearman's Rho) between SRH and other self-ratings as well as physiological markers. Predictors of future SRH were baseline ratings of SRH, self-esteem and social support (logistic regression), and SRH, sleep quality and sense of coherence (linear regression). The results of the present study indicate that baseline SRH and other self-ratings are predictive of future SRH. It is cautiously implied that SRH, self-esteem, social support, sleep quality and sense of coherence might be predictors of future SRH and therefore possibly also of various future health outcomes.

  6. The clinical significance of isolated loss of lordosis on cervical spine computed tomography in blunt trauma patients: a prospective evaluation of 1,007 patients.

    Science.gov (United States)

    Mejaddam, Ali Y; Kaafarani, Haytham M A; Ramly, Elie P; Avery, Laura L; Yeh, Dante D; King, David R; de Moya, Marc A; Velmahos, George C

    2015-11-01

    A negative computed tomographic (CT) scan may be used to rule out cervical spine (c-spine) injury after trauma. Loss of lordosis (LOL) is frequently found as the only CT abnormality. We investigated whether LOL should preclude c-spine clearance. All adult trauma patients with isolated LOL at our Level I trauma center (February 1, 2011 to May 31, 2012) were prospectively evaluated. The primary outcome was clinically significant injury on magnetic resonance imaging (MRI), flexion-extension views, and/or repeat physical examination. Of 3,333 patients (40 ± 17 years, 60% men) with a c-spine CT, 1,007 (30%) had isolated LOL. Among 841 patients with a Glasgow Coma Scale score of 15, no abnormalities were found on MRI, flexion-extension views, and/or repeat examinations, and all collars were removed. Among 166 patients with Glasgow Coma Scale less than 15, 3 (.3%) had minor abnormal MRI findings but no clinically significant injury. Isolated LOL on c-spine CT is not associated with a clinically significant injury and should not preclude c-spine clearance. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Stable Versus Unstable Grade II High Ankle Sprains: A Prospective Study Predicting the Need for Surgical Stabilization and Time to Return to Sports.

    Science.gov (United States)

    Calder, James D; Bamford, Richard; Petrie, Aviva; McCollum, Graham A

    2016-04-01

    To investigate grade II syndesmosis injuries in athletes and identify factors important in differentiating stable from dynamically unstable ankle sprains and those associated with a longer time to return to sports. Sixty-four athletes with an isolated syndesmosis injury (without fracture) were prospectively assessed, with a mean follow-up period of 37 months (range, 24 to 66 months). Those with an associated deltoid ligament injury or osteochondral lesion were included. Those whose injuries were considered stable (grade IIa) were treated conservatively with a boot and rehabilitation. Those whose injuries were clinically unstable underwent arthroscopy, and if instability was confirmed (grade IIb), the syndesmosis was stabilized. Clinical and magnetic resonance imaging assessments of injury to individual ligaments were recorded, along with time to return to play. A power analysis estimated that each group would need 28 patients. All athletes returned to the same level of professional sport. The 28 patients with grade IIa injuries returned at a mean of 45 days (range, 23 to 63 days) compared with 64 days (range, 27 to 104 days) for those with grade IIb injuries (P < .0001). There was a highly significant relationship between clinical and magnetic resonance imaging assessments of ligament injury (anterior tibiofibular ligament [ATFL], anterior-inferior tibiofibular ligament [AITFL], and deltoid ligament, P < .0001). Instability was 9.5 times as likely with a positive squeeze test and 11 times as likely with a deltoid injury. Combined injury to the anterior-inferior tibiofibular ligament and deltoid ligament was associated with a delay in return to sports. Concomitant injury to the ATFL indicated a different mechanism of injury-the syndesmosis is less likely to be unstable and is associated with an earlier return to sports. A positive squeeze test and injury to the ATFL and deltoid ligament are important factors in differentiating stable from dynamically unstable grade

  8. Usefulness of Clinical Prediction Rules, D-dimer, and Arterial Blood Gas Analysis to Predict Pulmonary Embolism in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Shazia Awan

    2017-03-01

    Full Text Available Objectives: Pulmonary embolism (PE is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules (CPRs were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas (ABG analysis and D-dimer in predicting PE in cancer patients. Methods: Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms (CTPAs were performed. We selected 104 individuals based on completeness of laboratory and clinical data. Patients were divided into two groups, CTPA positive (patients with PE and CTPA negative (PE excluded. Wells score, Geneva score, and modified Geneva score were calculated for each patient. Primary outcomes of interest were the sensitivities, specificities, positive, and negative predictive values for all three CPRs. Results: Of the total of 104 individuals who had CTPAs, 33 (31.7% were positive for PE and 71 (68.3% were negative. There was no difference in basic demographics between the two groups. Laboratory parameters were compared and partial pressure of oxygen was significantly lower in patients with PE (68.1 mmHg vs. 71 mmHg, p = 0.030. Clinical prediction rules showed good sensitivities (88−100% and negative predictive values (93−100%. An alveolar-arterial (A-a gradient > 20 had 100% sensitivity and negative predictive values. Conclusions: CPRs and a low A-a gradient were useful in excluding PE in cancer patients. There is a need for prospective trials to validate these results.

  9. Validation of the prognostic gene portfolio, ClinicoMolecular Triad Classification, using an independent prospective breast cancer cohort and external patient populations

    Science.gov (United States)

    2014-01-01

    Introduction Using genome-wide expression profiles of a prospective training cohort of breast cancer patients, ClinicoMolecular Triad Classification (CMTC) was recently developed to classify breast cancers into three clinically relevant groups to aid treatment decisions. CMTC was found to be both prognostic and predictive in a large external breast cancer cohort in that study. This study serves to validate the reproducibility of CMTC and its prognostic value using independent patient cohorts. Methods An independent internal cohort (n = 284) and a new external cohort (n = 2,181) were used to validate the association of CMTC between clinicopathological factors, 12 known gene signatures, two molecular subtype classifiers, and 19 oncogenic signalling pathway activities, and to reproduce the abilities of CMTC to predict clinical outcomes of breast cancer. In addition, we also updated the outcome data of the original training cohort (n = 147). Results The original training cohort reached a statistically significant difference (p risk groups. Conclusions Both prospective internal cohorts and the independent external cohorts reproduced the triad classification of CMTC and its prognostic significance. CMTC is an independent prognostic predictor, and it outperformed 12 other known prognostic gene signatures, molecular subtype classifications, and all other standard prognostic clinicopathological factors. Our results support further development of CMTC portfolio into a guide for personalized breast cancer treatments. PMID:24996446

  10. Effects of child interview tactics on prospective jurors' decisions.

    Science.gov (United States)

    Johnson, Jonni L; Shelley, Alexandra E

    2014-01-01

    Although decisions in child sexual abuse (CSA) cases are influenced by many factors (e.g., child age, juror gender), case and trial characteristics (e.g., interview quality) can strongly influence legal outcomes. In the present study, 319 prospective jurors read about a CSA investigation in which the alleged victim was interviewed at a child advocacy center (CAC) or traditional police setting. The prospective jurors then provided legally relevant ratings (e.g., child credibility, interview quality, defendant guilt). Structural equation modeling techniques revealed that child credibility predicted greater confidence in guilt decisions and also mediated all associations with such decisions. Having fewer negative prior opinions and rating the interview as of better quality were associated with higher child credibility ratings. Mitigating factors (e.g., interview quality), as opposed to proxy indicators (e.g., participant gender), better predicted CSA case outcomes. Similar associations across groups (e.g., CAC interviews did not make child victims more or less credible) permit a tentative conclusion that CACs do not positively or negatively affect decisions made in hypothetical CSA cases. Ideas for future studies examining factors influencing decisions in CSA cases are discussed. Copyright © 2014 John Wiley & Sons, Ltd.

  11. Comparison of different risk perception measures in predicting seasonal influenza vaccination among healthy Chinese adults in Hong Kong: a prospective longitudinal study.

    Science.gov (United States)

    Liao, Qiuyan; Wong, Wing Sze; Fielding, Richard

    2013-01-01

    Risk perception is a reported predictor of vaccination uptake, but which measures of risk perception best predict influenza vaccination uptake remain unclear. During the main influenza seasons (between January and March) of 2009 (Wave 1) and 2010 (Wave 2),505 Chinese students and employees from a Hong Kong university completed an online survey. Multivariate logistic regression models were conducted to assess how well different risk perceptions measures in Wave 1 predicted vaccination uptake against seasonal influenza in Wave 2. The results of the multivariate logistic regression models showed that feeling at risk (β = 0.25, p = 0.021) was the better predictor compared with probability judgment while probability judgment (β = 0.25, p = 0.029 ) was better than beliefs about risk in predicting subsequent influenza vaccination uptake. Beliefs about risk and feeling at risk seemed to predict the same aspect of subsequent vaccination uptake because their associations with vaccination uptake became insignificant when paired into the logistic regression model. Similarly, to compare the four scales for assessing probability judgment in predicting vaccination uptake, the 7-point verbal scale remained a significant and stronger predictor for vaccination uptake when paired with other three scales; the 6-point verbal scale was a significant and stronger predictor when paired with the percentage scale or the 2-point verbal scale; and the percentage scale was a significant and stronger predictor only when paired with the 2-point verbal scale. Beliefs about risk and feeling at risk are not well differentiated by Hong Kong Chinese people. Feeling at risk, an affective-cognitive dimension of risk perception predicts subsequent vaccination uptake better than do probability judgments. Among the four scales for assessing risk probability judgment, the 7-point verbal scale offered the best predictive power for subsequent vaccination uptake.

  12. Teachers' assessments of children aged eight predict life satisfaction in adolescence.

    Science.gov (United States)

    Honkanen, Meri; Meri, Honkanen; Hurtig, Tuula; Tuula, Hurtig; Taanila, Anja; Anja, Taanila; Moilanen, Irma; Irma, Moilanen; Koponen, Hannu; Hannu, Koponen; Mäki, Pirjo; Pirjo, Mäki; Veijola, Juha; Juha, Veijola; Puustjärvi, Anita; Anita, Puustjärvi; Ebeling, Hanna; Hanna, Ebeling; Koivumaa-Honkanen, Heli; Heli, Koivumaa-Honkanen

    2011-09-01

    The objective was to investigate how teachers' assessments of children predict life satisfaction in adolescence. This is a prospective cohort study on the population-based Northern Finland Birth Cohort 1986 (n = 8,959). Information was gathered from parents, teachers and adolescents using questionnaires at the age of 7, 8 and 15. Response rates were 80-90%. Emotional and behavioural problems were assessed with Rutter Children's Behavioural Questionnaires for teachers (RB2) and parents (RA2) during the first grade at age 8. At adolescence, self-reported life satisfaction was measured with a question including five response alternatives. According to teachers' assessments, 13.9% of the children had high emotional or behavioural problems (RB2 ≥9). These assessments predicted life dissatisfaction in adolescence (OR(crude) = 1.77; 95% CI 1.43-2.20) in several models including also health behaviour and use of psychotropic medicine. However, introducing all the significant variables in the same model, RB2 lost its significance (OR = 1.28; 0.96-1.70), but good school achievement assessed by teachers was still a significant predictor. Life satisfaction in adolescence was associated with a variety of favourable concurrent factors. In conclusion teachers' assessments of children during the first school year predicted life satisfaction in adolescence. In mental health promotion, teachers' early assessments should be utilized for the benefit of children.

  13. A Prospective Study of the Utility of Magnetic Resonance Imaging in Determining Candidacy for Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Dorn, Paige L.; Al-Hallaq, Hania A.; Haq, Farah; Goldberg, Mira [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois (United States); Abe, Hiroyuki [Department of Radiology, University of Chicago Medical Center, Chicago, Illinois (United States); Hasan, Yasmin [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois (United States); Chmura, Steven J., E-mail: schmura@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois (United States)

    2013-03-01

    Purpose: Retrospective data have demonstrated that breast magnetic resonance imaging (MRI) may change a patient's eligibility for partial breast irradiation (PBI) by identifying multicentric, multifocal, or contralateral disease. The objective of the current study was to prospectively determine the frequency with which MRI identifies occult disease and to establish clinical factors associated with a higher likelihood of MRI prompting changes in PBI eligibility. Methods and Materials: At The University of Chicago, women with breast cancer uniformly undergo MRI in addition to mammography and ultrasonography. From June 2009 through May 2011, all patients were screened prospectively in a multidisciplinary conference for PBI eligibility based on standard imaging, and the impact of MRI on PBI eligibility according to National Surgical Adjuvant Breast and Bowel Project protocol B-39/Radiation Therapy Oncology Group protocol 0413 entry criteria was recorded. Univariable analysis was performed using clinical characteristics in both the prospective cohort and in a separate cohort of retrospectively identified patients. Pooled analysis was used to derive a scoring index predictive of the risk that MRI would identify additional disease. Results: A total of 521 patients were screened for PBI eligibility, and 124 (23.8%) patients were deemed eligible for PBI based on standard imaging. MRI findings changed PBI eligibility in 12.9% of patients. In the pooled univariable analysis, tumor size ≥2 cm on mammography or ultrasonography (P=.02), age <50 years (P=.01), invasive lobular histology (P=.01), and HER-2/neu amplification (P=.01) were associated with a higher likelihood of MRI changing PBI eligibility. A predictive score was generated by summing the number of significant risk factors. Patients with a score of 0, 1, 2, and 3 had changes to eligibility based on MRI findings in 2.8%, 13.2%, 38.1%, and 100%, respectively (P<.0001). Conclusions: MRI identified additional

  14. Prospective evaluation of radiation-induced skin toxicity in a race/ethnically diverse breast cancer population

    International Nuclear Information System (INIS)

    Wright, Jean L.; Takita, Cristiane; Reis, Isildinha M.; Zhao, Wei; Lee, Eunkyung; Nelson, Omar L.; Hu, Jennifer J.

    2016-01-01

    We evaluated predictors of radiation-induced skin toxicity in a prospective study of a tri-racial/ethnic breast cancer population. We evaluated patient demographics, tumor characteristics, and treatment variables in the first 392 patients in a prospective study assessing radiation-induced skin toxicity. Logistic regression analyses were conducted to evaluate potential predictors of skin toxicity. The study consists of 59 non-Hispanic whites (NHW; 15%), 241 Hispanic Whites (HW; 62%), 79 black or African Americans (AA; 20%), and 13 others (3%). Overall, 48% developed grade 0–1 skin toxicity, 49.8% grade 2, and 2.2% grade 3 by the National Cancer Institute's Common Toxicity Criteria for Adverse Events (CTCAE) scale. Twenty-one percent developed moist desquamation. In multivariate analysis, higher body mass index (BMI; OR = 2.09; 95%CI = 1.15, 3.82), higher disease stage (OR = 1.82; 95%CI = 1.06, 3.11), ER-positive/PR-negative status (OR = 2.74; 95%CI = 1.26, 5.98), and conventionally fractionated regimens (OR = 3.25; 95%CI = 1.76, 6.01) were significantly associated with higher skin toxicity grade after adjustment for age, race, ethnicity, ER status, and breast volume. BMI specifically predicted for moist desquamation, but not degree of erythema. In this racially and ethnically diverse cohort of breast cancer patients receiving radiation to the intact breast, risk factors including BMI, disease stage, and conventionally fractionated radiation predicted for higher skin toxicity grade, whereas age, race, ethnicity, and breast volume did not. BMI specifically predicted for moist desquamation, suggesting that preventive measures to address this particular outcome should be investigated

  15. Serum Procalcitonin and Peripheral Venous Lactate for Predicting Dengue Shock and/or Organ Failure: A Prospective Observational Study.

    Directory of Open Access Journals (Sweden)

    Vipa Thanachartwet

    2016-08-01

    Full Text Available Currently, there are no biomarkers that can predict the incidence of dengue shock and/or organ failure, although the early identification of risk factors is important in determining appropriate management to reduce mortality. Therefore, we sought to determine the factors associated with dengue shock and/or organ failure and to evaluate the prognostic value of serum procalcitonin (PCT and peripheral venous lactate (PVL levels as biomarkers of dengue shock and/or organ failure.A prospective observational study was conducted among adults hospitalized for confirmed viral dengue infection at the Hospital for Tropical Diseases in Bangkok, Thailand between October 2013 and July 2015. Data, including baseline characteristics, clinical parameters, laboratory findings, serum PCT and PVL levels, management, and outcomes, were recorded on pre-defined case report forms. Of 160 patients with dengue, 128 (80.0% patients had dengue without shock or organ failure, whereas 32 (20.0% patients developed dengue with shock and/or organ failure. Using a stepwise multivariate logistic regression analysis, PCT ≥0.7 ng/mL (odds ratio [OR]: 4.80; 95% confidence interval [CI]: 1.60-14.45; p = 0.005 and PVL ≥2.5 mmol/L (OR: 27.99, 95% CI: 8.47-92.53; p <0.001 were independently associated with dengue shock and/or organ failure. A combination of PCT ≥0.7 ng/mL and PVL ≥2.5 mmol/L provided good prognostic value for predicting dengue shock and/or organ failure, with an area under the receiver operating characteristics curve of 0.83 (95% CI: 0.74-0.92, a sensitivity of 81.2% (95% CI: 63.6-92.8%, and a specificity of 84.4% (95% CI: 76.9-90.2%. Dengue shock patients with non-clearance of PCT and PVL expired during hospitalization.PCT ≥0.7 ng/mL and PVL ≥2.5 mmol/L were independently associated with dengue shock and/or organ failure. The combination of PCT and PVL levels could be used as prognostic biomarkers for the prediction of dengue shock and/or organ failure.

  16. The role of descriptive norm within the theory of planned behavior in predicting Korean Americans' exercise behavior.

    Science.gov (United States)

    Lee, Hyo

    2011-08-01

    There are few studies investigating psychosocial mechanisms in Korean Americans' exercise behavior. The present study tested the usefulness of the theory of planned behavior in predicting Korean American's exercise behavior and whether the descriptive norm (i.e., perceptions of what others do) improved the predictive validity of the theory of planned behavior. Using a retrospective design and self-report measures, web-survey responses from 198 Korean-American adults were analyzed using hierarchical regression analyses. The theory of planned behavior constructs accounted for 31% of exercise behavior and 43% of exercise intention. Intention and perceived behavioral control were significant predictors of exercise behavior. Although the descriptive norm did not augment the theory of planned behavior, all original constructs--attitude, injunctive norm (a narrow definition of subjective norm), and perceived behavioral control--statistically significantly predicted leisure-time physical activity intention. Future studies should consider random sampling, prospective design, and objective measures of physical activity.

  17. Usefulness of Coronary Atheroma Burden to Predict Cardiovascular Events in Patients Presenting With Acute Coronary Syndromes (from the PROSPECT Study).

    Science.gov (United States)

    Shan, Peiren; Mintz, Gary S; McPherson, John A; De Bruyne, Bernard; Farhat, Naim Z; Marso, Steven P; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

    2015-12-01

    We investigated the relation between overall atheroma burden and clinical events in the Providing Regional Observations to Study Predictors of Events in the Coronary Tree (PROSPECT) study. In PROSPECT, 660 patients (3,229 nonculprit lesions with a plaque burden ≥ 40% and complete intravascular ultrasound data) were divided into tertiles according to baseline percent atheroma volume (PAV: total plaque/vessel volume). Patients were followed for 3.4 years (median); major adverse cardiac events (MACE: death from cardiac causes, cardiac arrest, myocardial infarction, or rehospitalization because of unstable or progressive angina) were adjudicated to either culprit or nonculprit lesions. Compared with patients in low or intermediate PAV tertiles, patients in the high PAV tertile had the greatest prevalence of plaque rupture and radiofrequency thin-cap fibroatheroma (VH-TCFA) and the highest percentage of necrotic core volume; they were also more likely to have high-risk lesion characteristics: ≥ 1 lesion with minimal luminal area ≤ 4 mm(2), plaque burden >70%, and/or VH-TCFA. Three-year cumulative nonculprit lesion-related MACE was greater in the intermediate and high tertiles than in the low tertile (6.3% vs 14.7% vs 15.1%, low vs intermediate vs high tertiles, p = 0.009). On Cox multivariable analysis, insulin-dependent diabetes (hazard ratio [HR] 3.98, p = 0.002), PAV (HR 1.06, p = 0.03), and the presence of ≥1 VH-TCFA (HR 1.80, p = 0.02) were independent predictors of nonculprit MACE. In conclusion, increasing baseline overall atheroma burden was associated with more advanced, complex, and vulnerable intravascular ultrasound lesion morphology and independently predicted nonculprit lesion-related MACE in patients with acute coronary syndromes after successful culprit lesion intervention. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Birth weight and later life adherence to unhealthy lifestyles in predicting type 2 diabetes: prospective cohort study.

    Science.gov (United States)

    Li, Yanping; Ley, Sylvia H; Tobias, Deirdre K; Chiuve, Stephanie E; VanderWeele, Tyler J; Rich-Edwards, Janet W; Curhan, Gary C; Willett, Walter C; Manson, JoAnn E; Hu, Frank B; Qi, Lu

    2015-07-21

    To prospectively assess the joint association of birth weight and established lifestyle risk factors in adulthood with incident type 2 diabetes and to quantitatively decompose the attributing effects to birth weight only, to adulthood lifestyle only, and to their interaction. Prospective cohort study. Health Professionals Follow-up Study (1986-2010), Nurses' Health Study (1980-2010), and Nurses' Health Study II (1991-2011). 149,794 men and women without diabetes, cardiovascular disease, or cancer at baseline. Incident cases of type 2 diabetes, identified through self report and validated by a supplementary questionnaire. Unhealthy lifestyle was defined on the basis of body mass index, smoking, physical activity, alcohol consumption, and the alternate healthy eating index. During 20-30 years of follow-up, 11,709 new cases of type 2 diabetes were documented. The multivariate adjusted relative risk of type 2 diabetes was 1.45 (95% confidence interval 1.32 to 1.59) per kg lower birth weight and 2.10 (1.71 to 2.58) per unhealthy lifestyle factor. The relative risk of type 2 diabetes associated with a combination of per kg lower birth weight and per unhealthy lifestyle factor was 2.86 (2.26 to 3.63), which was more than the addition of the risk associated with each individual factor, indicating a significant interaction on an additive scale (P for interaction unhealthy lifestyle alone, and 18% (13.9% to 21.3%) to their interaction. Most cases of type 2 diabetes could be prevented by the adoption of a healthier lifestyle, but simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases. © Li et al 2015.

  19. Mapping Soil Properties of Africa at 250 m Resolution: Random Forests Significantly Improve Current Predictions.

    Directory of Open Access Journals (Sweden)

    Tomislav Hengl

    Full Text Available 80% of arable land in Africa has low soil fertility and suffers from physical soil problems. Additionally, significant amounts of nutrients are lost every year due to unsustainable soil management practices. This is partially the result of insufficient use of soil management knowledge. To help bridge the soil information gap in Africa, the Africa Soil Information Service (AfSIS project was established in 2008. Over the period 2008-2014, the AfSIS project compiled two point data sets: the Africa Soil Profiles (legacy database and the AfSIS Sentinel Site database. These data sets contain over 28 thousand sampling locations and represent the most comprehensive soil sample data sets of the African continent to date. Utilizing these point data sets in combination with a large number of covariates, we have generated a series of spatial predictions of soil properties relevant to the agricultural management--organic carbon, pH, sand, silt and clay fractions, bulk density, cation-exchange capacity, total nitrogen, exchangeable acidity, Al content and exchangeable bases (Ca, K, Mg, Na. We specifically investigate differences between two predictive approaches: random forests and linear regression. Results of 5-fold cross-validation demonstrate that the random forests algorithm consistently outperforms the linear regression algorithm, with average decreases of 15-75% in Root Mean Squared Error (RMSE across soil properties and depths. Fitting and running random forests models takes an order of magnitude more time and the modelling success is sensitive to artifacts in the input data, but as long as quality-controlled point data are provided, an increase in soil mapping accuracy can be expected. Results also indicate that globally predicted soil classes (USDA Soil Taxonomy, especially Alfisols and Mollisols help improve continental scale soil property mapping, and are among the most important predictors. This indicates a promising potential for transferring

  20. Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia.

    Science.gov (United States)

    Menéndez, R; Martínez, R; Reyes, S; Mensa, J; Filella, X; Marcos, M A; Martínez, A; Esquinas, C; Ramirez, P; Torres, A

    2009-07-01

    Prognostic scales provide a useful tool to predict mortality in community-acquired pneumonia (CAP). However, the inflammatory response of the host, crucial in resolution and outcome, is not included in the prognostic scales. The aim of this study was to investigate whether information about the initial inflammatory cytokine profile and markers increases the accuracy of prognostic scales to predict 30-day mortality. To this aim, a prospective cohort study in two tertiary care hospitals was designed. Procalcitonin (PCT), C-reactive protein (CRP) and the systemic cytokines tumour necrosis factor alpha (TNFalpha) and interleukins IL6, IL8 and IL10 were measured at admission. Initial severity was assessed by PSI (Pneumonia Severity Index), CURB65 (Confusion, Urea nitrogen, Respiratory rate, Blood pressure, > or = 65 years of age) and CRB65 (Confusion, Respiratory rate, Blood pressure, > or = 65 years of age) scales. A total of 453 hospitalised CAP patients were included. The 36 patients who died (7.8%) had significantly increased levels of IL6, IL8, PCT and CRP. In regression logistic analyses, high levels of CRP and IL6 showed an independent predictive value for predicting 30-day mortality, after adjustment for prognostic scales. Adding CRP to PSI significantly increased the area under the receiver operating characteristic curve (AUC) from 0.80 to 0.85, that of CURB65 from 0.82 to 0.85 and that of CRB65 from 0.79 to 0.85. Adding IL6 or PCT values to CRP did not significantly increase the AUC of any scale. When using two scales (PSI and CURB65/CRB65) and CRP simultaneously the AUC was 0.88. Adding CRP levels to PSI, CURB65 and CRB65 scales improves the 30-day mortality prediction. The highest predictive value is reached with a combination of two scales and CRP. Further validation of that improvement is needed.

  1. Uranium prospecting; La prospection de l'uranium

    Energy Technology Data Exchange (ETDEWEB)

    Roubault, M. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1955-07-01

    This report is an instruction book for uranium prospecting. It appeals to private prospecting. As prospecting is now a scientific and technical research, it cannot be done without preliminary studies. First of all, general prospecting methods are given with a recall of fundamental geologic data and some general principles which are common with all type of prospecting. The peculiarities of uranium prospecting are also presented and in particular the radioactivity property of uranium as well as the special aspect of uranium ores and the aspect of neighbouring ores. In a third part, a description of the different uranium ores is given and separated in two different categories: primary and secondary ores, according to the place of transformation, deep or near the crust surface respectively. In the first category, the primary ores include pitchblende, thorianite and rare uranium oxides as euxenite and fergusonite for example. In the second category, the secondary ores contain autunite and chalcolite for example. An exhaustive presentation of the geiger-Mueller counter is given with the presentation of its different components, its functioning and utilization and its maintenance. The radioactivity interpretation method is showed as well as the elaboration of a topographic map of the measured radioactivity. A brief presentation of other detection methods than geiger-Mueller counters is given: the measurement of fluorescence and a chemical test using the fluorescence properties of uranium salts. Finally, the main characteristics of uranium deposits are discussed. (M.P.)

  2. Lung Shunt Fraction prior to Yttrium-90 Radioembolization Predicts Survival in Patients with Neuroendocrine Liver Metastases: Single-Center Prospective Analysis

    International Nuclear Information System (INIS)

    Ludwig, Johannes M.; Ambinder, Emily McIntosh; Ghodadra, Anish; Xing, Minzhi; Prajapati, Hasmukh J.; Kim, Hyun S.

    2016-01-01

    ObjectiveTo investigate survival outcomes following radioembolization with Yttrium-90 (Y90) for neuroendocrine tumor liver metastases (NETLMs). This study was designed to assess the efficacy of Y90 radioembolization and to evaluate lung shunt fraction (LSF) as a predictor for survival.MethodsA single-center, prospective study of 44 consecutive patients (median age: 58.5 years, 29.5 % male) diagnosed with pancreatic (52.3 %) or carcinoid (47.7 %) NETLMs from 2006 to 2012 who underwent Y90 radioembolization was performed. Patients’ baseline characteristics, including LSF and median overall survival (OS) from first Y90 radioembolization, were recorded and compared between patients with high (≥10 %) and low ( 1.2 mg (p = 0.016), and lack of pretreatment with octreotide (p = 0.01) as independent prognostic factors for poorer survival. Tumor type and total radiation dose did not predict survival.ConclusionsLSF ≥10 %, elevated bilirubin levels, and lack of pretreatment with octreotide were found to be independent prognostic factors for poorer survival in patients with NETLMs.

  3. Roboethics: Fundamental Concepts and Future Prospects

    Directory of Open Access Journals (Sweden)

    Spyros G. Tzafestas

    2018-06-01

    Full Text Available Many recent studies (e.g., IFR: International Federation of Robotics, 2016 predict that the number of robots (industrial, service/social, intelligent/autonomous will increase enormously in the future. Robots are directly involved in human life. Industrial robots, household robots, medical robots, assistive robots, sociable/entertainment robots, and war robots all play important roles in human life and raise crucial ethical problems for our society. The purpose of this paper is to provide an overview of the fundamental concepts of robot ethics (roboethics and some future prospects of robots and roboethics, as an introduction to the present Special Issue of the journal Information on “Roboethics”. We start with the question of what roboethics is, as well as a discussion of the methodologies of roboethics, including a brief look at the branches and theories of ethics in general. Then, we outline the major branches of roboethics, namely: medical roboethics, assistive roboethics, sociorobot ethics, war roboethics, autonomous car ethics, and cyborg ethics. Finally, we present the prospects for the future of robotics and roboethics.

  4. Behavioral Economic Purchase Tasks to Estimate Demand for Novel Nicotine/Tobacco Products and Prospectively Predict Future Use: Evidence from the Netherlands.

    Science.gov (United States)

    Heckman, Bryan W; Cummings, K Michael; Nahas, Georges J; Willemsen, Marc C; O'Connor, Richard J; Borland, Ron; Hirsch, Alexander A; Bickel, Warren K; Carpenter, Matthew J

    2018-03-14

    The demand for alternative nicotine/tobacco products is not well established. This paper uses a behavioral economic approach to test whether smokers have differential demand for conventional factory-made, electronic, and very low nicotine content cigarettes (FMCs/ECs/VLNCs) and uses the prospective cohort design to test the predictive validity of demand indices on subsequent use of commercially available FMCs and ECs. Daily smokers (>16 years) from the Netherlands completed an online survey in April 2014 (N=1215). Purchase tasks were completed for FMCs, ECs, and VLNCs. Participants indicated the number of cigarettes they would consume in 24 hours, across a range of prices (0-30 euro). The relationship between consumption and price was quantified into four indices of demand (intensity, Pmax, breakpoint, and essential value). A follow-up survey in July 2015 measured FMC and EC use. At baseline, greater demand was observed for FMCs relative to ECs and VLNCs across all demand indices, with no difference between ECs and VLNCs. At follow-up, greater baseline FMC demand (intensity, essential value) was associated with lower quit rates and higher relapse. EC demand (Pmax, breakpoint, essential value) was positively associated with any EC use between survey waves, past 30 day EC use, and EC purchase between waves. Smokers valued FMCs more than ECs or VLNCs, and FMCs were less sensitive to price increases. Demand indices predicted use of commercially available products over a 15 month period. To serve as viable substitutes for FMCs, ECs and VLNCs will need to be priced lower than FMCs. Purchase tasks can be adapted for novel nicotine/tobacco products as a means to efficiently quantify demand and predict use. Among current daily smokers, the demand for ECs and VLNCs is lower than FMCs.

  5. Predictive factors of urinary tract infections among the oldest old in the general population. a population-based prospective follow-up study

    Directory of Open Access Journals (Sweden)

    Cools Herman JM

    2011-05-01

    Full Text Available Abstract Background Urinary tract infections (UTI are common among the oldest old and may lead to a few days of illness, delirium or even to death. We studied the incidence and predictive factors of UTI among the oldest old in the general population. Methods The Leiden 85-plus Study is a population-based prospective follow-up study of 86-year-old subjects in Leiden, The Netherlands. Information on the diagnosis of UTI was obtained annually during four years of follow-up from the medical records and interviews of treating physicians. A total of 157 men and 322 women aged 86 years participated in the study. Possible predictive factors were collected at baseline, including history of UTI between the age of 85 and 86 years, aspects of functioning (cognitive impairment (Mini-Mental State Examination (MMSE 4, disability in activities of daily living (ADL, and co-morbidities. Results The incidence of UTI from age 86 through 90 years was 11.2 (95% confidence interval (CI 9.4, 13.1 per 100 person-years at risk. Multivariate analysis showed that history of UTI between the age of 85 and 86 years (hazard ratio (HR 3.4 (95% CI 2.4, 5.0, impaired cognitive function (HR 1.9 (95% CI 1.3, 2.9, disability in daily living (HR 1.7 (95% CI 1.1, 2.5 and urine incontinence (HR 1.5 (95% CI 1.0, 2.1 were independent predictors of an increased incidence of UTI from age 86 onwards. Conclusions Within the oldest old, a history of UTI between the age of 85 and 86 years, cognitive impairment, ADL disability and urine incontinence are independent predictors of developing UTI. These predictive factors could be used to target preventive measures to the oldest old at high risk of UTI.

  6. Mood instability as a precursor to depressive illness: A prospective and mediational analysis.

    Science.gov (United States)

    Marwaha, Steven; Balbuena, Lloyd; Winsper, Catherine; Bowen, Rudy

    2015-06-01

    Mood instability levels are high in depression, but temporal precedence and potential mechanisms are unknown. Hypotheses tested were as follows: (1) mood instability is associated with depression cross-sectionally, (2) mood instability predicts new onset and maintenance of depression prospectively and (3) the mood instability and depression link are mediated by sleep problems, alcohol abuse and life events. Data from the National Psychiatric Morbidity Survey 2000 at baseline (N = 8580) and 18-month follow-up (N = 2413) were used. Regression modeling controlling for socio-demographic factors, anxiety and hypomanic mood was conducted. Multiple mediational analyses were used to test our conceptual path model. Mood instability was associated with depression cross-sectionally (odds ratio: 5.28; 95% confidence interval: [3.67, 7.59]; p depression inception (odds ratio: 2.43; 95% confidence interval: [1.03-5.76]; p = 0.042) after controlling for important confounders. Mood instability did not predict maintenance of depression. Sleep difficulties and severe problems with close friends and family significantly mediated the link between mood instability and new onset depression (23.05% and 6.19% of the link, respectively). Alcohol abuse and divorce were not important mediators in the model. Mood instability is a precursor of a depressive episode, predicting its onset. Difficulties in sleep are a significant part of the pathway. Interventions targeting mood instability and sleep problems have the potential to reduce the risk of depression. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  7. Prospective memory in schizophrenia: relationship to medication management skills, neurocognition, and symptoms in individuals with schizophrenia.

    Science.gov (United States)

    Raskin, Sarah A; Maye, Jacqueline; Rogers, Alexandra; Correll, David; Zamroziewicz, Marta; Kurtz, Matthew

    2014-05-01

    Impaired adherence to medication regimens is a serious concern for individuals with schizophrenia linked to relapse and poorer outcomes. One possible reason for poor adherence to medication is poor ability to remember future intentions, labeled prospective memory skills. It has been demonstrated in several studies that individuals with schizophrenia have impairments in prospective memory that are linked to everyday life skills. However, there have been no studies, to our knowledge, examining the relationship of a clinical measure of prospective memory to medication management skills, a key element of successful adherence. In this Study 41 individuals with schizophrenia and 25 healthy adults were administered a standardized test battery that included measures of prospective memory, medication management skills, neurocognition, and symptoms. Individuals with schizophrenia demonstrated impairments in prospective memory (both time and event-based) relative to healthy controls. Performance on the test of prospective memory was correlated with the standardized measure of medication management in individuals with schizophrenia. Moreover, the test of prospective memory predicted skills in medication adherence even after measures of neurocognition were accounted for. This suggests that prospective memory may play a key role in medication management skills and thus should be a target of cognitive remediation programs.

  8. Islet Oxygen Consumption Rate (OCR) Dose Predicts Insulin Independence in Clinical Islet Autotransplantation.

    Science.gov (United States)

    Papas, Klearchos K; Bellin, Melena D; Sutherland, David E R; Suszynski, Thomas M; Kitzmann, Jennifer P; Avgoustiniatos, Efstathios S; Gruessner, Angelika C; Mueller, Kathryn R; Beilman, Gregory J; Balamurugan, Appakalai N; Loganathan, Gopalakrishnan; Colton, Clark K; Koulmanda, Maria; Weir, Gordon C; Wilhelm, Josh J; Qian, Dajun; Niland, Joyce C; Hering, Bernhard J

    2015-01-01

    Reliable in vitro islet quality assessment assays that can be performed routinely, prospectively, and are able to predict clinical transplant outcomes are needed. In this paper we present data on the utility of an assay based on cellular oxygen consumption rate (OCR) in predicting clinical islet autotransplant (IAT) insulin independence (II). IAT is an attractive model for evaluating characterization assays regarding their utility in predicting II due to an absence of confounding factors such as immune rejection and immunosuppressant toxicity. Membrane integrity staining (FDA/PI), OCR normalized to DNA (OCR/DNA), islet equivalent (IE) and OCR (viable IE) normalized to recipient body weight (IE dose and OCR dose), and OCR/DNA normalized to islet size index (ISI) were used to characterize autoislet preparations (n = 35). Correlation between pre-IAT islet product characteristics and II was determined using receiver operating characteristic analysis. Preparations that resulted in II had significantly higher OCR dose and IE dose (p<0.001). These islet characterization methods were highly correlated with II at 6-12 months post-IAT (area-under-the-curve (AUC) = 0.94 for IE dose and 0.96 for OCR dose). FDA/PI (AUC = 0.49) and OCR/DNA (AUC = 0.58) did not correlate with II. OCR/DNA/ISI may have some utility in predicting outcome (AUC = 0.72). Commonly used assays to determine whether a clinical islet preparation is of high quality prior to transplantation are greatly lacking in sensitivity and specificity. While IE dose is highly predictive, it does not take into account islet cell quality. OCR dose, which takes into consideration both islet cell quality and quantity, may enable a more accurate and prospective evaluation of clinical islet preparations.

  9. Islet Oxygen Consumption Rate (OCR Dose Predicts Insulin Independence in Clinical Islet Autotransplantation.

    Directory of Open Access Journals (Sweden)

    Klearchos K Papas

    Full Text Available Reliable in vitro islet quality assessment assays that can be performed routinely, prospectively, and are able to predict clinical transplant outcomes are needed. In this paper we present data on the utility of an assay based on cellular oxygen consumption rate (OCR in predicting clinical islet autotransplant (IAT insulin independence (II. IAT is an attractive model for evaluating characterization assays regarding their utility in predicting II due to an absence of confounding factors such as immune rejection and immunosuppressant toxicity.Membrane integrity staining (FDA/PI, OCR normalized to DNA (OCR/DNA, islet equivalent (IE and OCR (viable IE normalized to recipient body weight (IE dose and OCR dose, and OCR/DNA normalized to islet size index (ISI were used to characterize autoislet preparations (n = 35. Correlation between pre-IAT islet product characteristics and II was determined using receiver operating characteristic analysis.Preparations that resulted in II had significantly higher OCR dose and IE dose (p<0.001. These islet characterization methods were highly correlated with II at 6-12 months post-IAT (area-under-the-curve (AUC = 0.94 for IE dose and 0.96 for OCR dose. FDA/PI (AUC = 0.49 and OCR/DNA (AUC = 0.58 did not correlate with II. OCR/DNA/ISI may have some utility in predicting outcome (AUC = 0.72.Commonly used assays to determine whether a clinical islet preparation is of high quality prior to transplantation are greatly lacking in sensitivity and specificity. While IE dose is highly predictive, it does not take into account islet cell quality. OCR dose, which takes into consideration both islet cell quality and quantity, may enable a more accurate and prospective evaluation of clinical islet preparations.

  10. Phalangeal bone mineral density predicts incident fractures

    DEFF Research Database (Denmark)

    Friis-Holmberg, Teresa; Brixen, Kim; Rubin, Katrine Hass

    2012-01-01

    This prospective study investigates the use of phalangeal bone mineral density (BMD) in predicting fractures in a cohort (15,542) who underwent a BMD scan. In both women and men, a decrease in BMD was associated with an increased risk of fracture when adjusted for age and prevalent fractures...

  11. Validation of the prognostic gene portfolio, ClinicoMolecular Triad Classification, using an independent prospective breast cancer cohort and external patient populations.

    Science.gov (United States)

    Wang, Dong-Yu; Done, Susan J; Mc Cready, David R; Leong, Wey L

    2014-07-04

    Using genome-wide expression profiles of a prospective training cohort of breast cancer patients, ClinicoMolecular Triad Classification (CMTC) was recently developed to classify breast cancers into three clinically relevant groups to aid treatment decisions. CMTC was found to be both prognostic and predictive in a large external breast cancer cohort in that study. This study serves to validate the reproducibility of CMTC and its prognostic value using independent patient cohorts. An independent internal cohort (n = 284) and a new external cohort (n = 2,181) were used to validate the association of CMTC between clinicopathological factors, 12 known gene signatures, two molecular subtype classifiers, and 19 oncogenic signalling pathway activities, and to reproduce the abilities of CMTC to predict clinical outcomes of breast cancer. In addition, we also updated the outcome data of the original training cohort (n = 147). The original training cohort reached a statistically significant difference (p value of the triad classification was reproduced in the second independent internal cohort and the new external validation cohort. CMTC achieved even higher prognostic significance when all available patients were analyzed (n = 4,851). Oncogenic pathways Myc, E2F1, Ras and β-catenin were again implicated in the high-risk groups. Both prospective internal cohorts and the independent external cohorts reproduced the triad classification of CMTC and its prognostic significance. CMTC is an independent prognostic predictor, and it outperformed 12 other known prognostic gene signatures, molecular subtype classifications, and all other standard prognostic clinicopathological factors. Our results support further development of CMTC portfolio into a guide for personalized breast cancer treatments.

  12. Comparison of propofol pharmacokinetic and pharmacodynamic models for awake craniotomy: A prospective observational study.

    Science.gov (United States)

    Soehle, Martin; Wolf, Christina F; Priston, Melanie J; Neuloh, Georg; Bien, Christian G; Hoeft, Andreas; Ellerkmann, Richard K

    2015-08-01

    Anaesthesia for awake craniotomy aims for an unconscious patient at the beginning and end of surgery but a rapidly awakening and responsive patient during the awake period. Therefore, an accurate pharmacokinetic/pharmacodynamic (PK/PD) model for propofol is required to tailor depth of anaesthesia. To compare the predictive performances of the Marsh and the Schnider PK/PD models during awake craniotomy. A prospective observational study. Single university hospital from February 2009 to May 2010. Twelve patients undergoing elective awake craniotomy for resection of brain tumour or epileptogenic areas. Arterial blood samples were drawn at intervals and the propofol plasma concentration was determined. The prediction error, bias [median prediction error (MDPE)] and inaccuracy [median absolute prediction error (MDAPE)] of the Marsh and the Schnider models were calculated. The secondary endpoint was the prediction probability PK, by which changes in the propofol effect-site concentration (as derived from simultaneous PK/PD modelling) predicted changes in anaesthetic depth (measured by the bispectral index). The Marsh model was associated with a significantly (P = 0.05) higher inaccuracy (MDAPE 28.9 ± 12.0%) than the Schnider model (MDAPE 21.5 ± 7.7%) and tended to reach a higher bias (MDPE Marsh -11.7 ± 14.3%, MDPE Schnider -5.4 ± 20.7%, P = 0.09). MDAPE was outside of accepted limits in six (Marsh model) and two (Schnider model) of 12 patients. The prediction probability was comparable between the Marsh (PK 0.798 ± 0.056) and the Schnider model (PK 0.787 ± 0.055), but after adjusting the models to each individual patient, the Schnider model achieved significantly higher prediction probabilities (PK 0.807 ± 0.056, P = 0.05). When using the 'asleep-awake-asleep' anaesthetic technique during awake craniotomy, we advocate using the PK/PD model proposed by Schnider. Due to considerable interindividual variation, additional monitoring of anaesthetic depth is

  13. Higgs searches and prospects at CDF

    International Nuclear Information System (INIS)

    Pavel A Murat

    2003-01-01

    The Standard model of electroweak interactions (SM) has been extremely successful in describing interactions of elementary particles over the last decades. The Higgs scalar boson is one of the key elements of the SM: Higgs interactions with the other particles generate the particle masses and allow to keep the theory renormalizable at electroweak scale. All the particles predicted by the SM but the Higgs boson have already been observed experimentally and therefore search for the Higgs is one of the most important scientific goals for high energy physics. The current lower limit on the SM Higgs mass M H > 114.4 GeV at 95% CL has been established by LEP experiments. In this paper we review CDF Run I results on Higgs searches including the Higgs bosons predicted by the minimal supersymmetric extention of the Standard Model (MSSM) and discuss the Run II prospects

  14. Validation of a prediction model that allows direct comparison of the Oxford Knee Score and American Knee Society clinical rating system.

    Science.gov (United States)

    Maempel, J F; Clement, N D; Brenkel, I J; Walmsley, P J

    2015-04-01

    This study demonstrates a significant correlation between the American Knee Society (AKS) Clinical Rating System and the Oxford Knee Score (OKS) and provides a validated prediction tool to estimate score conversion. A total of 1022 patients were prospectively clinically assessed five years after TKR and completed AKS assessments and an OKS questionnaire. Multivariate regression analysis demonstrated significant correlations between OKS and the AKS knee and function scores but a stronger correlation (r = 0.68, p Society of Bone & Joint Surgery.

  15. Predicting worsening asthma control following the common cold

    NARCIS (Netherlands)

    Walter, M. J.; Castro, M.; Kunselman, S. J.; Chinchilli, V. M.; Reno, M.; Ramkumar, T. P.; Avila, P. C.; Boushey, H. A.; Ameredes, B. T.; Bleecker, E. R.; Calhoun, W. J.; Cherniack, R. M.; Craig, T. J.; Denlinger, L. C.; Israel, E.; Fahy, J. V.; Jarjour, N. N.; Kraft, M.; Lazarus, S. C.; Lemanske, R. F.; Martin, R. J.; Peters, S. P.; Ramsdell, J. W.; Sorkness, C. A.; Sutherland, E. R.; Szefler, S. J.; Wasserman, S. I.; Wechsler, M. E.

    2008-01-01

    The asthmatic response to the common cold is highly variable, and early characteristics that predict worsening of asthma control following a cold have not been identified. In this prospective multicentric cohort study of 413 adult subjects with asthma, the mini-Asthma Control Questionnaire

  16. Psychophysiology of prospective memory.

    Science.gov (United States)

    Rothen, Nicolas; Meier, Beat

    2014-01-01

    Prospective memory involves the self-initiated retrieval of an intention upon an appropriate retrieval cue. Cue identification can be considered as an orienting reaction and may thus trigger a psychophysiological response. Here we present two experiments in which skin conductance responses (SCRs) elicited by prospective memory cues were compared to SCRs elicited by aversive stimuli to test whether a single prospective memory cue triggers a similar SCR as an aversive stimulus. In Experiment 2 we also assessed whether cue specificity had a differential influence on prospective memory performance and on SCRs. We found that detecting a single prospective memory cue is as likely to elicit a SCR as an aversive stimulus. Missed prospective memory cues also elicited SCRs. On a behavioural level, specific intentions led to better prospective memory performance. However, on a psychophysiological level specificity had no influence. More generally, the results indicate reliable SCRs for prospective memory cues and point to psychophysiological measures as valuable approach, which offers a new way to study one-off prospective memory tasks. Moreover, the findings are consistent with a theory that posits multiple prospective memory retrieval stages.

  17. The wind power prediction research based on mind evolutionary algorithm

    Science.gov (United States)

    Zhuang, Ling; Zhao, Xinjian; Ji, Tianming; Miao, Jingwen; Cui, Haina

    2018-04-01

    When the wind power is connected to the power grid, its characteristics of fluctuation, intermittent and randomness will affect the stability of the power system. The wind power prediction can guarantee the power quality and reduce the operating cost of power system. There were some limitations in several traditional wind power prediction methods. On the basis, the wind power prediction method based on Mind Evolutionary Algorithm (MEA) is put forward and a prediction model is provided. The experimental results demonstrate that MEA performs efficiently in term of the wind power prediction. The MEA method has broad prospect of engineering application.

  18. BNP predicts chemotherapy-related cardiotoxicity and death

    DEFF Research Database (Denmark)

    Skovgaard, Dorthe; Hasbak, Philip; Kjaer, Andreas

    2014-01-01

    ventriculography (MUGA) or echocardiography. However, the plasma cardiac biomarker B-type natriuretic peptide (BNP) has been suggested for early identification of cardiac dysfunction. The aim of the study was to compare LVEF obtained by MUGA and plasma BNP as predictors of developing congestive heart failure (CHF...... death. In multivariate Cox analysis both BNP and LVEF were independent predictors of CHF while age remained the only independent predictor of overall death. CONCLUSION: In cancer patients treated with cardiotoxic chemotherapy both BNP and LVEF can significantly predict subsequent hospitalization...... with CHF. In addition, BNP and not LVEF has a prognostic value in detecting overall death. This prospective study based on the hitherto largest study population supports BNP as a clinical relevant method for monitoring chemotherapy-related cardiac failure and death....

  19. Intelligent postoperative morbidity prediction of heart disease using artificial intelligence techniques.

    Science.gov (United States)

    Hsieh, Nan-Chen; Hung, Lun-Ping; Shih, Chun-Che; Keh, Huan-Chao; Chan, Chien-Hui

    2012-06-01

    Endovascular aneurysm repair (EVAR) is an advanced minimally invasive surgical technology that is helpful for reducing patients' recovery time, postoperative morbidity and mortality. This study proposes an ensemble model to predict postoperative morbidity after EVAR. The ensemble model was developed using a training set of consecutive patients who underwent EVAR between 2000 and 2009. All data required for prediction modeling, including patient demographics, preoperative, co-morbidities, and complication as outcome variables, was collected prospectively and entered into a clinical database. A discretization approach was used to categorize numerical values into informative feature space. Then, the Bayesian network (BN), artificial neural network (ANN), and support vector machine (SVM) were adopted as base models, and stacking combined multiple models. The research outcomes consisted of an ensemble model to predict postoperative morbidity after EVAR, the occurrence of postoperative complications prospectively recorded, and the causal effect knowledge by BNs with Markov blanket concept.

  20. The Prognostic and Predictive Value of Soluble Type IV Collagen in Colorectal Cancer

    DEFF Research Database (Denmark)

    Rolff, Hans Christian; Christensen, Ib Jarle; Vainer, Ben

    2016-01-01

    PURPOSE: To investigate the prognostic and predictive biomarker value of type IV collagen in colorectal cancer. EXPERIMENTAL DESIGN: Retrospective evaluation of two independent cohorts of patients with colorectal cancer included prospectively in 2004-2005 (training set) and 2006-2008 (validation....... RESULTS: High levels of type IV collagen showed independent prognostic significance in both cohorts with hazard ratios (HRs; for a one-unit change on the log base 2 scale) of 2.25 [95% confidence intervals (CIs), 1.78-2.84; P ... and validation set, respectively. The prognostic impact was present both in patients with metastatic and nonmetastatic disease. The predictive value of the marker was investigated in stage II and III patients. In the training set, type IV collagen was prognostic both in the subsets of patients receiving...

  1. Development and validation of multivariable models to predict mortality and hospitalization in patients with heart failure

    NARCIS (Netherlands)

    Voors, Adriaan A.; Ouwerkerk, Wouter; Zannad, Faiez; van Veldhuisen, Dirk J.; Samani, Nilesh J.; Ponikowski, Piotr; Ng, Leong L.; Metra, Marco; ter Maaten, Jozine M.; Lang, Chim C.; Hillege, Hans L.; van der Harst, Pim; Filippatos, Gerasimos; Dickstein, Kenneth; Cleland, John G.; Anker, Stefan D.; Zwinderman, Aeilko H.

    Introduction From a prospective multicentre multicountry clinical trial, we developed and validated risk models to predict prospective all-cause mortality and hospitalizations because of heart failure (HF) in patients with HF. Methods and results BIOSTAT-CHF is a research programme designed to

  2. Development and validation of multivariable models to predict mortality and hospitalization in patients with heart failure

    NARCIS (Netherlands)

    Voors, Adriaan A.; Ouwerkerk, Wouter; Zannad, Faiez; van Veldhuisen, Dirk J.; Samani, Nilesh J.; Ponikowski, Piotr; Ng, Leong L.; Metra, Marco; ter Maaten, Jozine M.; Lang, Chim C.; Hillege, Hans L.; van der Harst, Pim; Filippatos, Gerasimos; Dickstein, Kenneth; Cleland, John G.; Anker, Stefan D.; Zwinderman, Aeilko H.

    2017-01-01

    Introduction From a prospective multicentre multicountry clinical trial, we developed and validated risk models to predict prospective all-cause mortality and hospitalizations because of heart failure (HF) in patients with HF. Methods and results BIOSTAT-CHF is a research programme designed to

  3. Risk adjusted surgical audit in gynaecological oncology: P-POSSUM does not predict outcome.

    Science.gov (United States)

    Das, N; Talaat, A S; Naik, R; Lopes, A D; Godfrey, K A; Hatem, M H; Edmondson, R J

    2006-12-01

    To assess the Physiological and Operative Severity Score for the enumeration of mortality and morbidity (POSSUM) and its validity for use in gynaecological oncology surgery. All patients undergoing gynaecological oncology surgery at the Northern Gynaecological Oncology Centre (NGOC) Gateshead, UK over a period of 12months (2002-2003) were assessed prospectively. Mortality and morbidity predictions using the Portsmouth modification of the POSSUM algorithm (P-POSSUM) were compared to the actual outcomes. Performance of the model was also evaluated using the Hosmer and Lemeshow Chi square statistic (testing the goodness of fit). During this period 468 patients were assessed. The P-POSSUM appeared to over predict mortality rates for our patients. It predicted a 7% mortality rate for our patients compared to an observed rate of 2% (35 predicted deaths in comparison to 10 observed deaths), a difference that was statistically significant (H&L chi(2)=542.9, d.f. 8, prisk of mortality for gynaecological oncology patients undergoing surgery. The P-POSSUM algorithm will require further adjustments prior to adoption for gynaecological cancer surgery as a risk adjusted surgical audit tool.

  4. Early-onset Conduct Problems: Predictions from daring temperament and risk taking behavior.

    Science.gov (United States)

    Bai, Sunhye; Lee, Steve S

    2017-12-01

    Given its considerable public health significance, identifying predictors of early expressions of conduct problems is a priority. We examined the predictive validity of daring, a key dimension of temperament, and the Balloon Analog Risk Task (BART), a laboratory-based measure of risk taking behavior, with respect to two-year change in parent, teacher-, and youth self-reported oppositional defiant disorder (ODD), conduct disorder (CD), and antisocial behavior. At baseline, 150 ethnically diverse 6- to 10-year old (M=7.8, SD=1.1; 69.3% male) youth with ( n =82) and without ( n =68) DSM-IV ADHD completed the BART whereas parents rated youth temperament (i.e., daring); parents and teachers also independently rated youth ODD and CD symptoms. Approximately 2 years later, multi-informant ratings of youth ODD, CD, and antisocial behavior were gathered from rating scales and interviews. Whereas risk taking on the BART was unrelated to conduct problems, individual differences in daring prospectively predicted multi-informant rated conduct problems, independent of baseline risk taking, conduct problems, and ADHD diagnostic status. Early differences in the propensity to show positive socio-emotional responses to risky or novel experiences uniquely predicted escalating conduct problems in childhood, even with control of other potent clinical correlates. We consider the role of temperament in the origins and development of significant conduct problems from childhood to adolescence, including possible explanatory mechanisms underlying these predictions.

  5. The Role of Big Five Personality Traits in Predicting Prospective EFL Teachers' Academic Achievement

    Science.gov (United States)

    Kirkagac, Senay; Öz, Hüseyin

    2017-01-01

    This study sought to find out the possible relationships between personality traits and academic achievement of prospective English as a Foreign Language (EFL) teachers. A total of 200 university students from a major state university voluntarily participated in the study. Data were collected through the International Personality Item Tool (IPIP)…

  6. Attitudes predict the use of physical punishment: a prospective study of the emergence of disciplinary practices.

    Science.gov (United States)

    Vittrup, Brigitte; Holden, George W; Buck, Jeanell

    2006-06-01

    We sought to track the emergence of discipline techniques by mothers of young children and assess the predictive validity of spanking attitudes with subsequent reports of spanking. One hundred thirty-two mothers were surveyed every 6 months (beginning when their child was 12 months old until they were 4 years old) regarding how they disciplined their children. The discipline behaviors measured included physical punishment, noncoercive methods, and the use of time-outs and withdrawal of privileges. Attitudes toward spanking also were assessed several times. When their infants were 12 months old, mothers reported using 10 of the 12 discipline techniques assessed, and by the time the children were 24 months old, most mothers reported widespread use of the techniques. The frequency of use increased with age. Although the use of some discipline methods changed as the children got older, the mothers showed significant stability in their overall discipline strategy. Attitudes toward spanking (assessed when their children were 6 months old) were significantly correlated with subsequent spanking behavior, and the mothers' attitudes showed stability over time as well. By the time infants are 12 months old, discipline is a frequent occurrence in many families. A variety of techniques are used, and attitudes toward spanking predict subsequent spanking behavior. This information is useful for pediatricians, because it provides parents with anticipatory guidance about disciplining young children.

  7. Chronic dry eye in PRK and LASIK: manifestations, incidence and predictive factors

    Science.gov (United States)

    Bower, Kraig S.; Sia, Rose K.; Ryan, Denise S.; Mines, Michael J.; Dartt, Darlene A.

    2017-01-01

    Purpose To evaluate dry eye manifestations following photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) and determine the incidence and predictive factors of chronic dry eye using a set of dry eye criteria. Setting Walter Reed Army Medical Center, Washington, DC, USA Methods This is a prospective non-randomized clinical study of 143 active duty U.S. Army personnel aged 29.9±5.2 years with myopia or myopic astigmatism (manifest spherical equivalent −3.83±1.96 diopters) undergoing either PRK or LASIK. Dry eye evaluation was performed pre- and postoperatively. Main outcome measures included dry eye manifestations, incidence, and predictive factors of chronic dry eye. Results Schirmer scores, corneal sensitivity, ocular surface staining, surface regularity index (SRI), and responses to dry eye questionnaire significantly changed over time after PRK. After LASIK, significant changes were observed in tear breakup time, corneal sensitivity, ocular surface staining, and responses to questionnaire. At twelve months postoperatively, 5.0% of PRK and 0.8% of LASIK participants developed chronic dry eye. Regression analysis showed preoperatively lower Schirmer score will significantly influence development of chronic dry eye after PRK whereas preoperatively lower Schirmer score or higher ocular surface staining score will significantly influence the occurrence of chronic dry eye after LASIK. Conclusions Chronic dry eye is uncommon after PRK and LASIK. Ocular surface and tear film characteristics during preoperative examination may help predict chronic dry eye development in PRK and LASIK. PMID:26796443

  8. A novel index for preoperative, non-invasive prediction of macro-radical primary surgery in patients with stage IIIC-IV ovarian cancer-a part of the Danish prospective pelvic mass study

    DEFF Research Database (Denmark)

    Karlsen, Mona Aarenstrup; Fagö-Olsen, Carsten Lindberg; Høgdall, Estrid Vilma Solyom

    2016-01-01

    The purpose of this study was to develop a novel index for preoperative, non-invasive prediction of complete primary cytoreduction in patients with FIGO stage IIIC-IV epithelial ovarian cancer. Prospectively collected clinical data was registered in the Danish Gynecologic Cancer Database. Blood...... samples were collected within 14 days of surgery and stored by the Danish CancerBiobank. Serum human epididymis protein 4 (HE4), serum cancer antigen 125 (CA125), age, performance status, and presence/absence of ascites at ultrasonography were evaluated individually and combined to predict complete tumor...... removal. One hundred fifty patients with advanced epithelial ovarian cancer were treated with primary debulking surgery (PDS). Complete PDS was achieved in 41 cases (27 %). The receiver operating characteristic curves demonstrated an area under the curve of 0.785 for HE4, 0.678 for CA125, and 0...

  9. Prospective validation of pathologic complete response models in rectal cancer: Transferability and reproducibility.

    Science.gov (United States)

    van Soest, Johan; Meldolesi, Elisa; van Stiphout, Ruud; Gatta, Roberto; Damiani, Andrea; Valentini, Vincenzo; Lambin, Philippe; Dekker, Andre

    2017-09-01

    Multiple models have been developed to predict pathologic complete response (pCR) in locally advanced rectal cancer patients. Unfortunately, validation of these models normally omit the implications of cohort differences on prediction model performance. In this work, we will perform a prospective validation of three pCR models, including information whether this validation will target transferability or reproducibility (cohort differences) of the given models. We applied a novel methodology, the cohort differences model, to predict whether a patient belongs to the training or to the validation cohort. If the cohort differences model performs well, it would suggest a large difference in cohort characteristics meaning we would validate the transferability of the model rather than reproducibility. We tested our method in a prospective validation of three existing models for pCR prediction in 154 patients. Our results showed a large difference between training and validation cohort for one of the three tested models [Area under the Receiver Operating Curve (AUC) cohort differences model: 0.85], signaling the validation leans towards transferability. Two out of three models had a lower AUC for validation (0.66 and 0.58), one model showed a higher AUC in the validation cohort (0.70). We have successfully applied a new methodology in the validation of three prediction models, which allows us to indicate if a validation targeted transferability (large differences between training/validation cohort) or reproducibility (small cohort differences). © 2017 American Association of Physicists in Medicine.

  10. Utilization of reward-prospect enhances preparatory attention and reduces stimulus conflict.

    Science.gov (United States)

    van den Berg, Berry; Krebs, Ruth M; Lorist, Monicque M; Woldorff, Marty G

    2014-06-01

    The prospect of gaining money is an incentive widely at play in the real world. Such monetary motivation might have particularly strong influence when the cognitive system is challenged, such as when needing to process conflicting stimulus inputs. Here, we employed manipulations of reward-prospect and attentional-preparation levels in a cued-Stroop stimulus conflict task, along with the high temporal resolution of electrical brain recordings, to provide insight into the mechanisms by which reward-prospect and attention interact and modulate cognitive task performance. In this task, the cue indicated whether or not the participant needed to prepare for an upcoming Stroop stimulus and, if so, whether there was the potential for monetary reward (dependent on performance on that trial). Both cued attention and cued reward-prospect enhanced preparatory neural activity, as reflected by increases in the hallmark attention-related negative-polarity ERP slow wave (contingent negative variation [CNV]) and reductions in oscillatory Alpha activity, which was followed by enhanced processing of the subsequent Stroop stimulus. In addition, similar modulations of preparatory neural activity (larger CNVs and reduced Alpha) predicted shorter versus longer response times (RTs) to the subsequent target stimulus, consistent with such modulations reflecting trial-to-trial variations in attention. Particularly striking were the individual differences in the utilization of reward-prospect information. In particular, the size of the reward effects on the preparatory neural activity correlated across participants with the degree to which reward-prospect both facilitated overall task performance (shorter RTs) and reduced conflict-related behavioral interference. Thus, the prospect of reward appears to recruit attentional preparation circuits to enhance processing of task-relevant target information.

  11. C-Reactive Protein, Fibrinogen, and Cardiovascular Disease Prediction

    NARCIS (Netherlands)

    Kaptoge, Stephen; Di Angelantonio, Emanuele; Pennells, Lisa; Wood, Angela M.; White, Ian R.; Gao, Pei; Walker, Matthew; Thompson, Alexander; Sarwar, Nadeem; Caslake, Muriel; Butterworth, Adam S.; Amouyel, Philippe; Assmann, Gerd; Bakker, Stephan J. L.; Barr, Elizabeth L. M.; Barrett-Connor, Elizabeth; Benjamin, Emelia J.; Bjorkelund, Cecilia; Brenner, Hermann; Brunner, Eric; Clarke, Robert; Cooper, Jackie A.; Cremer, Peter; Cushman, Mary; Dagenais, Gilles R.; D'Agostino, Ralph B.; Dankner, Rachel; Davey-Smith, George; Deeg, Dorly; Dekker, Jacqueline M.; Engstrom, Gunnar; Folsom, Aaron R.; Fowkes, F. Gerry R.; Gallacher, John; Gaziano, J. Michael; Giampaoli, Simona; Gillum, Richard F.; Hofman, Albert; Howard, Barbara V.; Ingelsson, Erik; Iso, Hiroyasu; Jorgensen, Torben; Kiechl, Stefan; Kitamura, Akihiko; Kiyohara, Yutaka; Koenig, Wolfgang; Kromhout, Daan; Kuller, Lewis H.; Lawlor, Debbie A.; Meade, Tom W.

    2012-01-01

    Background There is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events. Methods We analyzed data from 52 prospective studies that included 246,669 participants without a history of

  12. Pre-fracture nutritional status is predictive of functional status at discharge during the acute phase with hip fracture patients: A multicenter prospective cohort study.

    Science.gov (United States)

    Inoue, Tatsuro; Misu, Syogo; Tanaka, Toshiaki; Sakamoto, Hiroki; Iwata, Kentaro; Chuman, Yuki; Ono, Rei

    2017-10-01

    Malnutrition is common in patients with hip fractures, and elderly patients with hip fractures lose functional independence and often fail to recover previous functional status. The aim of this study was to determine whether pre-fracture nutritional status predicts functional status of patients with hip fracture at discharge from acute hospitals. In the present multicenter prospective cohort study, pre-fracture nutritional status was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF). At discharge from acute hospitals, functional status was evaluated using a functional independent measurement instrument (FIM). Subsequently, multiple regression analyses were performed using FIM as the dependent variable and MNA-SF as the independent variable. Among the 204 patients analyzed in the present study, the mean length of hospital stay was 26.2 ± 12.6 days, and according to MNA-SF assessments, 51 (25.0%) patients were malnourished, 98 (48.0%) were at risk of malnutrition, and 55 (27.0%) were well-nourished before fracture. At discharge, FIM scores were higher in patients who were well-nourished than in those who were malnourished or were at risk of malnutrition (p fracture nutritional status was a significant independent predictor for functional status at discharge during the acute phase, warranting early assessment of nutritional status and early intervention for successful postoperative rehabilitation. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  13. Patient-Reported Allergies Predict Worse Outcomes After Hip and Knee Arthroplasty: Results From a Prospective Cohort Study.

    Science.gov (United States)

    Otero, Jesse E; Graves, Christopher M; Gao, Yubo; Olson, Tyler S; Dickinson, Christopher C; Chalus, Rhonda J; Vittetoe, David A; Goetz, Devon D; Callaghan, John J

    2016-12-01

    Retrospective analyses have demonstrated correlation between patient-reported allergies and negative outcomes after total joint arthroplasty. We sought to validate these observations in a prospective cohort. One hundred forty-four patients undergoing total hip arthroplasty and 302 patients undergoing total knee arthroplasty were prospectively enrolled. Preoperatively, patients listed their allergies and completed the Medical Outcomes Study Short Form 36 (SF-36) and the Charlson Comorbidity Index (CCI) Questionnaire. At a mean of 17 months (range 12-25 months) postoperatively, SF-36, CCI, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were obtained by telephone survey. Regression analysis was used to determine the strength of correlation between patient age, comorbidity burden, and number of allergies and outcome measurements. In 446 patients, 273 reported at least 1 allergy. The number of allergies reported ranged from 0 to 33. Penicillin or its derivative was the most frequently reported allergy followed by sulfa, environmental allergen, and narcotic pain medication. Patients reporting at least 1 allergy had a significantly lower postoperative SF-36 Physical Component Score compared to those reporting no allergies (51.3 vs 49.4, P = .01). The SF-36 postoperative Mental Component Score was no different between groups. Multivariate regression analysis showed that age and patient reported allergies, but not comorbidities, were independently associated with worse postoperative SF-36 Physical Component Summary (PCS) and WOMAC score. Patients with allergies experienced the same improvement in SF-36 PCS as those without an allergy. Comorbidities did not correlate with patient-reported function postoperatively. Patients who report allergies have lower postoperative outcome scores but may experience the same increment in improvement after total joint arthroplasty. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Is happiness good for your personality? Concurrent and prospective relations of the big five with subjective well-being.

    Science.gov (United States)

    Soto, Christopher J

    2015-02-01

    The present research examined longitudinal relations of the Big Five personality traits with three core aspects of subjective well-being: life satisfaction, positive affect, and negative affect. Latent growth models and autoregressive models were used to analyze data from a large, nationally representative sample of 16,367 Australian residents. Concurrent and change correlations indicated that higher levels of subjective well-being were associated with higher levels of Extraversion, Agreeableness, and Conscientiousness, and with lower levels of Neuroticism. Moreover, personality traits prospectively predicted change in well-being, and well-being levels prospectively predicted personality change. Specifically, prospective trait effects indicated that individuals who were initially extraverted, agreeable, conscientious, and emotionally stable subsequently increased in well-being. Prospective well-being effects indicated that individuals with high initial levels of well-being subsequently became more agreeable, conscientious, emotionally stable, and introverted. These findings challenge the common assumption that associations of personality traits with subjective well-being are entirely, or almost entirely, due to trait influences on well-being. They support the alternative hypothesis that personality traits and well-being aspects reciprocally influence each other over time. © 2013 Wiley Periodicals, Inc.

  15. Occupational dreams, choices and aspirations: adolescents' entrepreneurial prospects and orientations.

    Science.gov (United States)

    Schmitt-Rodermund, Eva; Vondracek, Fred W

    2002-02-01

    The present study examined possible early antecedents of entrepreneurship of 14-17-year-old 10th grade students (n=320). We hypothesized that Entrepreneurial Orientation (interest and self-efficacy), together with Willingness to Expend Effort, would be an important predictor of an adolescent's Entrepreneurial Prospects, i.e. prospects of becoming self-employed in the future. Furthermore, personality and the model of self-employed family were expected to predict the level of Entrepreneurial Orientation. The same relationships were investigated separately for students who were more or less willing to expend effort. Among students more willing to expend effort, levels of Entrepreneurial Orientation were higher for those who were conscientious, self-efficient, open to new experiences, and low in agreeableness. Among students less willing to expend effort, a high need for social recognition predicted higher levels of Entrepreneurial Orientation. In addition, parents' model for them was connected with lower levels of Entrepreneurial Orientation. A moderating effect of Willingness to Expend Effort was supported by the results for parents' model and need for social recognition. Copyright 2002 Published by Elsevier Science Ltd on behalf of The Association for Professionals in Services for Adolescents.

  16. Can middle cerebral artery peak systolic velocity predict polycythemia in monochorionic-diamniotic twins? Evidence from a prospective cohort study.

    Science.gov (United States)

    Fishel-Bartal, M; Weisz, B; Mazaki-Tovi, S; Ashwal, E; Chayen, B; Lipitz, S; Yinon, Y

    2016-10-01

    The antenatal diagnosis of twin anemia-polycythemia sequence (TAPS) in monochorionic-diamniotic (MCDA) twin pregnancies is based on elevated peak systolic velocity in the middle cerebral artery (MCA-PSV) in the donor twin and decreased MCA-PSV in the recipient twin. However, the association between these parameters and polycythemia has not yet been established. The aim of this study was to determine whether MCA-PSV can predict polycythemia in MCDA pregnancies. This was a prospective cohort study of MCDA pregnancies recruited at 14-18 weeks' gestation from a single tertiary care center between January 2011 and June 2014. Fetal MCA Doppler waveforms were recorded every 2 weeks from 18 weeks' gestation until delivery. Only those with an MCA-PSV measurement within 1 week of delivery were included in the analysis. Neonatal hematocrit level was determined in all twins from venous blood obtained within 4 h of delivery. Polycythemia was defined as a hematocrit of > 65%, and anemia as a hematocrit of  8 g/dL and reticulocyte count ratio of > 1.7 were observed. Of 162 MCDA pregnancies followed during the study period, 69 had an MCA-PSV measurement within 1 week of delivery and were included in the study. Twenty-five neonates were diagnosed with polycythemia and nine twin pairs met the criteria for TAPS. In a pooled analysis, MCA-PSV was negatively correlated with neonatal hematocrit (P = 0.017, r = -0.215) and was significantly higher in anemic fetuses than in normal controls (1.15 multiples of the median (MoM) vs 1.02 MoM, respectively; P = 0.001). However, MCA-PSV was similar among polycythemic and normal fetuses (0.95 MoM vs 1.02 MoM, respectively; P = 0.47). Intertwin difference in MCA-PSV (delta MCA-PSV) was positively correlated with intertwin hematocrit difference (P = 0.002, r = 0.394). Moreover, twin pregnancies with an intertwin hematocrit difference of > 24% had a significantly greater delta MCA-PSV than did those with an intertwin hematocrit

  17. The prognostic significance of UCA1 for predicting clinical outcome in patients with digestive system malignancies.

    Science.gov (United States)

    Liu, Fang-Teng; Dong, Qing; Gao, Hui; Zhu, Zheng-Ming

    2017-06-20

    Urothelial Carcinoma Associated 1 (UCA1) was an originally identified lncRNA in bladder cancer. Previous studies have reported that UCA1 played a significant role in various types of cancer. This study aimed to clarify the prognostic value of UCA1 in digestive system cancers. The meta-analysis of 15 studies were included, comprising 1441 patients with digestive system cancers. The pooled results of 14 studies indicated that high expression of UCA1 was significantly associated with poorer OS in patients with digestive system cancers (HR: 1.89, 95 % CI: 1.52-2.26). In addition, UCA1 could be as an independent prognostic factor for predicting OS of patients (HR: 1.85, 95 % CI: 1.45-2.25). The pooled results of 3 studies indicated a significant association between UCA1 and DFS in patients with digestive system cancers (HR = 2.50; 95 % CI = 1.30-3.69). Statistical significance was also observed in subgroup meta-analysis. Furthermore, the clinicopathological values of UCA1 were discussed in esophageal cancer, colorectal cancer and pancreatic cancer. A comprehensive retrieval was performed to search studies evaluating the prognostic value of UCA1 in digestive system cancers. Many databases were involved, including PubMed, Web of Science, Embase and Chinese National Knowledge Infrastructure and Wanfang database. Quantitative meta-analysis was performed with standard statistical methods and the prognostic significance of UCA1 in digestive system cancers was qualified. Elevated level of UCA1 indicated the poor clinical outcome for patients with digestive system cancers. It may serve as a new biomarker related to prognosis in digestive system cancers.

  18. Ecstasy use and self-reported depression, impulsivity, and sensation seeking: a prospective cohort study

    NARCIS (Netherlands)

    de Win, Maartje M. L.; Schilt, Thelma; Reneman, Liesbeth; Vervaeke, Hylke; Jager, Gerry; Dijkink, Sarah; Booij, Jan; van den Brink, Wim

    2006-01-01

    Although there are indications that ecstasy users have higher levels of depression, impulsivity, and sensation seeking, it is unknown whether these are consequences of ecstasy use or predisposing factors for starting ecstasy use. We prospectively assessed the predictive value of depression,

  19. Predictive significance of standardized uptake value parameters of FDG-PET in patients with non-small cell lung carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Duan, X-Y.; Wang, W.; Li, M.; Li, Y.; Guo, Y-M. [PET-CT Center, The First Affiliated Hospital of Xi' an, Jiaotong University, Xi' an, Shaanxi (China)

    2015-02-03

    {sup 18}F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is widely used to diagnose and stage non-small cell lung cancer (NSCLC). The aim of this retrospective study was to evaluate the predictive ability of different FDG standardized uptake values (SUVs) in 74 patients with newly diagnosed NSCLC. {sup 18}F-FDG PET/CT scans were performed and different SUV parameters (SUV{sub max}, SUV{sub avg}, SUV{sub T/L}, and SUV{sub T/A}) obtained, and their relationship with clinical characteristics were investigated. Meanwhile, correlation and multiple stepwise regression analyses were performed to determine the primary predictor of SUVs for NSCLC. Age, gender, and tumor size significantly affected SUV parameters. The mean SUVs of squamous cell carcinoma were higher than those of adenocarcinoma. Poorly differentiated tumors exhibited higher SUVs than well-differentiated ones. Further analyses based on the pathologic type revealed that the SUV{sub max}, SUV{sub avg}, and SUV{sub T/L} of poorly differentiated adenocarcinoma tumors were higher than those of moderately or well-differentiated tumors. Among these four SUV parameters, SUV{sub T/L} was the primary predictor for tumor differentiation. However, in adenocarcinoma, SUV{sub max} was the determining factor for tumor differentiation. Our results showed that these four SUV parameters had predictive significance related to NSCLC tumor differentiation; SUV{sub T/L} appeared to be most useful overall, but SUV{sub max} was the best index for adenocarcinoma tumor differentiation.

  20. Predictive value of diminutive colonic adenoma trial: the PREDICT trial.

    Science.gov (United States)

    Schoenfeld, Philip; Shad, Javaid; Ormseth, Eric; Coyle, Walter; Cash, Brooks; Butler, James; Schindler, William; Kikendall, Walter J; Furlong, Christopher; Sobin, Leslie H; Hobbs, Christine M; Cruess, David; Rex, Douglas

    2003-05-01

    Diminutive adenomas (1-9 mm in diameter) are frequently found during colon cancer screening with flexible sigmoidoscopy (FS). This trial assessed the predictive value of these diminutive adenomas for advanced adenomas in the proximal colon. In a multicenter, prospective cohort trial, we matched 200 patients with normal FS and 200 patients with diminutive adenomas on FS for age and gender. All patients underwent colonoscopy. The presence of advanced adenomas (adenoma >or= 10 mm in diameter, villous adenoma, adenoma with high grade dysplasia, and colon cancer) and adenomas (any size) was recorded. Before colonoscopy, patients completed questionnaires about risk factors for adenomas. The prevalence of advanced adenomas in the proximal colon was similar in patients with diminutive adenomas and patients with normal FS (6% vs. 5.5%, respectively) (relative risk, 1.1; 95% confidence interval [CI], 0.5-2.6). Diminutive adenomas on FS did not accurately predict advanced adenomas in the proximal colon: sensitivity, 52% (95% CI, 32%-72%); specificity, 50% (95% CI, 49%-51%); positive predictive value, 6% (95% CI, 4%-8%); and negative predictive value, 95% (95% CI, 92%-97%). Male gender (odds ratio, 1.63; 95% CI, 1.01-2.61) was associated with an increased risk of proximal colon adenomas. Diminutive adenomas on sigmoidoscopy may not accurately predict advanced adenomas in the proximal colon.

  1. Sub-seasonal prediction of significant wave heights over the Western Pacific and Indian Oceans, part II: The impact of ENSO and MJO

    Science.gov (United States)

    Shukla, Ravi P.; Kinter, James L.; Shin, Chul-Su

    2018-03-01

    This study evaluates the effect of El Niño and the Southern Oscillation (ENSO) and Madden Julian Oscillation (MJO) events on 14-day mean significant wave height (SWH) at 3 weeks lead time (Wk34) over the Western Pacific and Indian Oceans using the National Centers for Environmental Prediction (NCEP) Climate Forecast System, version 2 (CFSv2). The WAVEWATCH-3 (WW3) model is forced with daily 10m-winds predicted by a modified version of CFSv2 that is initialized with multiple ocean analyses in both January and May for 1979-2008. A significant anomaly correlation of predicted and observed SWH anomalies (SWHA) at Wk34 lead-time is found over portions of the domain, including the central western Pacific, South China Sea (SCS), Bay of Bengal (BOB) and southern Indian Ocean (IO) in January cases, and over BOB, equatorial western Pacific, the Maritime Continent and southern IO in May cases. The model successfully predicts almost all the important features of the observed composite SWHA during El Niño events in January, including negative SWHA in the central IO where westerly wind anomalies act on an easterly mean state, and positive SWHA over the southern Ocean (SO) where westerly wind anomalies act on a westerly mean state. The model successfully predicts the sign and magnitude of SWHA at Wk34 lead-time in May over the BOB and SCS in composites of combined phases-2-3 and phases-6-7 of MJO. The observed leading mode of SWHA in May and the third mode of SWHA in January are influenced by the combined effects of ENSO and MJO. Based on spatial and temporal correlations, the spatial patterns of SWHA in the model at Wk34 in both January and May are in good agreement with the observations over the equatorial western Pacific, equatorial and southern IO, and SO.

  2. Falls prediction in elderly people : A 1-year prospective study

    NARCIS (Netherlands)

    Swanenburg, Jaap; de Bruin, Eling D.; Uebelhart, Daniel; Mulder, Theo

    The aim of the present study was to determine whether force plate variables in single- and dual-task situations are able to predict the risk of multiple falls in a community-dwelling elderly population. Two hundred and seventy elderly persons (225 females, 45 males; age, 73 7 years) performed

  3. Maternal feeding practices, child eating behaviour and body mass index in preschool-aged children: a prospective analysis

    Directory of Open Access Journals (Sweden)

    Paxton Susan J

    2010-06-01

    Full Text Available Abstract Background Previous research has found associations between parental feeding practices and children's eating behaviour and weight status. Prospective research is needed to elucidate these relationships. Methods One hundred and fifty-six mothers of 2- to 4-year-old children completed questionnaires including measures of maternal feeding practices (pressure to eat, restriction, monitoring and modelling of healthy eating, child eating behaviour (food responsiveness, food fussiness and interest in food, and mother reported child height and weight. The questionnaire was repeated 12 months later. Regression analyses were used to find longitudinal associations between maternal feeding practices, child eating behaviour and child body mass index (BMI. Results Modelling of healthy eating predicted lower child food fussiness and higher interest in food one year later, and pressure to eat predicted lower child interest in food. Restriction did not predict changes in child eating behaviour. Maternal feeding practices did not prospectively predict child food responsiveness or child BMI. Conclusion Maternal feeding practices appear to influence young children's eating behaviour but not weight status in the short term.

  4. Utility of formulas predicting the optimal nasal continuous positive airway pressure in a Greek population.

    Science.gov (United States)

    Schiza, Sophia E; Bouloukaki, Izolde; Mermigkis, Charalampos; Panagou, Panagiotis; Tzanakis, Nikolaos; Moniaki, Violeta; Tzortzaki, Eleni; Siafakas, Nikolaos M

    2011-09-01

    There have been reports that optimal CPAP pressure can be predicted from a previously derived formula, with the Hoffstein formula being the most accurate and accepted in the literature so far. However, the validation of this predictive model has not been applied in different clinical settings. Our aim was to compare both the Hoffstein prediction formula and a newly derived formula to the CPAP pressure setting assessed during a formal CPAP titration study. We prospectively studied 1,111 patients (871 males/240 females) with obstructive sleep apnea hypopnea syndrome (OSAHS) undergoing a CPAP titration procedure. In this large population sample, we tested the Hoffstein formula, utilizing body mass index (BMI), neck circumference and apnea/hypopnea index (AHI), and we compared it with our new formula that included not only AHI and BMI but also smoking history and gender adjustment. We found that using the Hoffstein prediction formula, successful prediction (predicted CPAP pressure within ±2 cm H(2)O compared to the finally assessed optimum CPAP pressure during titration) was accomplished in 873 patients (79%), with significant correlation between CPAP predicted pressure (CPAPpred(1)) and the optimum CPAP pressure (CPAPopt) [r = 0.364, p history and gender adjustment, successful prediction was accomplished in 1,057 patients (95%), with significant correlation between CPAP predicted pressure (CPAPpred(2)) and the CPAPopt (r = 0.392, p titration. It may also be possible to shorten CPAP titration and perhaps in selected cases to combine it with the initial diagnostic study.

  5. Novel enzymatic assay predicts minoxidil response in the treatment of androgenetic alopecia.

    Science.gov (United States)

    Goren, Andy; Castano, Juan Antonio; McCoy, John; Bermudez, Fernando; Lotti, Torello

    2014-01-01

    Topical minoxidil is the most common drug used for the treatment of androgenetic alopecia (AGA) in men and women. Although topical minoxidil exhibits a good safety profile, the efficacy in the overall population remains relatively low at 30-40%. To observe significant improvement in hair growth, minoxidil is typically used daily for a period of at least 3-4 months. Due to the significant time commitment and low response rate, a biomarker for predicting patient response prior to therapy would be advantageous. Minoxidil is converted in the scalp to its active form, minoxidil sulfate, by the sulfotransferase enzyme SULT1A1. We hypothesized that SULT1A1 enzyme activity in the hair follicle correlates with minoxidil response for the treatment of AGA. Our preliminary retrospective study of a SULT1A1 activity assay demonstrates 95% sensitivity and 73% specificity in predicting minoxidil treatment response for AGA. A larger prospective study is now under way to further validate this novel assay. © 2013 Wiley Periodicals, Inc.

  6. A prospective blood RNA signature for tuberculosis disease risk

    Science.gov (United States)

    Zak, Daniel E.; Penn-Nicholson, Adam; Scriba, Thomas J.; Thompson, Ethan; Suliman, Sara; Amon, Lynn M.; Mahomed, Hassan; Erasmus, Mzwandile; Whatney, Wendy; Hussey, Gregory D.; Abrahams, Deborah; Kafaar, Fazlin; Hawkridge, Tony; Verver, Suzanne; Hughes, E. Jane; Ota, Martin; Sutherland, Jayne; Howe, Rawleigh; Dockrell, Hazel M.; Boom, W. Henry; Thiel, Bonnie; Ottenhoff, Tom H.M.; Mayanja-Kizza, Harriet; Crampin, Amelia C; Downing, Katrina; Hatherill, Mark; Valvo, Joe; Shankar, Smitha; Parida, Shreemanta K; Kaufmann, Stefan H.E.; Walzl, Gerhard; Aderem, Alan; Hanekom, Willem A.

    2016-01-01

    Background Identification of blood biomarkers that prospectively predict progression of Mycobacterium tuberculosis infection to tuberculosis disease may lead to interventions that impact the epidemic. Methods Healthy, M. tuberculosis infected South African adolescents were followed for 2 years; blood was collected every 6 months. A prospective signature of risk was derived from whole blood RNA-Sequencing data by comparing participants who ultimately developed active tuberculosis disease (progressors) with those who remained healthy (matched controls). After adaptation to multiplex qRT-PCR, the signature was used to predict tuberculosis disease in untouched adolescent samples and in samples from independent cohorts of South African and Gambian adult progressors and controls. The latter participants were household contacts of adults with active pulmonary tuberculosis disease. Findings Of 6,363 adolescents screened, 46 progressors and 107 matched controls were identified. A 16 gene signature of risk was identified. The signature predicted tuberculosis progression with a sensitivity of 66·1% (95% confidence interval, 63·2–68·9) and a specificity of 80·6% (79·2–82·0) in the 12 months preceding tuberculosis diagnosis. The risk signature was validated in an untouched group of adolescents (p=0·018 for RNA-Seq and p=0·0095 for qRT-PCR) and in the independent South African and Gambian cohorts (p values Bill and Melinda Gates Foundation, the National Institutes of Health, Aeras, the European Union and the South African Medical Research Council (detail at end of text). PMID:27017310

  7. Predictive Models, How good are they?

    DEFF Research Database (Denmark)

    Kasch, Helge

    The WAD grading system has been used for more than 20 years by now. It has shown long-term viability, but with strengths and limitations. New bio-psychosocial assessment of the acute whiplash injured subject may provide better prediction of long-term disability and pain. Furthermore, the emerging......-up. It is important to obtain prospective identification of the relevant risk underreported disability could, if we were able to expose these hidden “risk-factors” during our consultations, provide us with better predictive models. New data from large clinical studies will present exciting new genetic risk markers...

  8. Depressive symptoms and other risk factors predicting suicide in middle-aged men: a prospective cohort study among Korean Vietnam War veterans

    Directory of Open Access Journals (Sweden)

    Sang-Wook Yi

    2015-07-01

    Full Text Available Background. Few studies have prospectively examined whether depressive symptoms and other risk factors are associated with a higher risk of suicide death in individuals other than high-risk populations such as psychiatric patients and individuals with self-harm histories. The purpose of the study is to prospectively examine whether depressive symptoms assessed by the Beck Depression Inventory (BDI are associated with greater risk of suicide death and whether depressive symptoms and other risk factors are independent predictors of suicide in general-risk populations. Another aim is to evaluate the sensitivity of the BDI for predicting suicide death.Methods. 10,238 Korean Vietnam War veterans (mean age: 56.3 years who participated in two surveys in 2001 were followed up for suicide mortality over 7.5 years.Results. 41 men died by suicide. Severely depressed participants had a higher adjusted hazard ratio (aHR = 3.4; 95% CI [1.5–7.7] of suicide than non-to-moderately depressed ones. Higher suicide risk was associated with more severe depressive symptoms (p for trend = 0.009. After adjustment for depressive symptoms and other factors, very poor health, low education, and past drinking were associated with higher suicide risk, while good health, body mass index, and marital status were not associated with suicide. The sensitivity at the cut-off score of 31 for detecting suicide was higher during the earlier 3.5 years of the follow-up (75%; 95% CI [50–90] than during the latter 4 years (60%; 95% CI [41–76].Conclusions. Depressive symptoms are a strong independent predictor and very poor health, low education, and drinking status may be independent predictors of future suicide. The BDI may have acceptable diagnostic properties as a risk assessment tool for identifying people with depression and suicidal potential among middle-aged men.

  9. Depressive symptoms and other risk factors predicting suicide in middle-aged men: a prospective cohort study among Korean Vietnam War veterans.

    Science.gov (United States)

    Yi, Sang-Wook; Hong, Jae-Seok

    2015-01-01

    Background. Few studies have prospectively examined whether depressive symptoms and other risk factors are associated with a higher risk of suicide death in individuals other than high-risk populations such as psychiatric patients and individuals with self-harm histories. The purpose of the study is to prospectively examine whether depressive symptoms assessed by the Beck Depression Inventory (BDI) are associated with greater risk of suicide death and whether depressive symptoms and other risk factors are independent predictors of suicide in general-risk populations. Another aim is to evaluate the sensitivity of the BDI for predicting suicide death. Methods. 10,238 Korean Vietnam War veterans (mean age: 56.3 years) who participated in two surveys in 2001 were followed up for suicide mortality over 7.5 years. Results. 41 men died by suicide. Severely depressed participants had a higher adjusted hazard ratio (aHR = 3.4; 95% CI [1.5-7.7]) of suicide than non-to-moderately depressed ones. Higher suicide risk was associated with more severe depressive symptoms (p for trend = 0.009). After adjustment for depressive symptoms and other factors, very poor health, low education, and past drinking were associated with higher suicide risk, while good health, body mass index, and marital status were not associated with suicide. The sensitivity at the cut-off score of 31 for detecting suicide was higher during the earlier 3.5 years of the follow-up (75%; 95% CI [50-90]) than during the latter 4 years (60%; 95% CI [41-76]). Conclusions. Depressive symptoms are a strong independent predictor and very poor health, low education, and drinking status may be independent predictors of future suicide. The BDI may have acceptable diagnostic properties as a risk assessment tool for identifying people with depression and suicidal potential among middle-aged men.

  10. Uranium project. Geochemistry prospection

    International Nuclear Information System (INIS)

    Lambert, J.

    1983-01-01

    Geochemistry studies the distribution of the chemicals elements in the terrestrial crust and its ways to migrate. The terminology used in this report is the following one: 1) Principles of the prospection geochemistry 2) Stages of the prospection geochemistry 3)utility of the prospection geochemistry 4) geochemistry of uranium 5) procedures used within the framework of uranium project 6) Average available 7) Selection of the zones of prospection geochemistry 8) Stages of the prospection, Sample preparation and analisis 9) Presentation of the results

  11. Peripheral nerve field stimulation (PNFS) in chronic low back pain: a prospective multicenter study.

    Science.gov (United States)

    Kloimstein, Herwig; Likar, Rudolf; Kern, Michael; Neuhold, Josef; Cada, Miroslav; Loinig, Nadja; Ilias, Wilfried; Freundl, Brigitta; Binder, Heinrich; Wolf, Andreas; Dorn, Christian; Mozes-Balla, Eva Maria; Stein, Rolf; Lappe, Ivo; Sator-Katzenschlager, Sabine

    2014-02-01

    The goal of this study was to evaluate the long-term efficacy and safety of peripheral nerve field stimulation (PNFS) for chronic low back pain (cLBP). In this prospective, multicenter observational study, 118 patients were admitted to 11 centers throughout Austria and Switzerland. After a screening visit, all patients underwent a trial stimulation period of at least seven days before implantation of the permanent system. Leads were placed in the subcutaneous tissues of the lower back directly in the region of greatest pain. One hundred five patients were implanted with a permanent stimulating system. Patients' evaluation of pain and functional levels were completed before implantation and one, three, and six months after implantation. Adverse events, medication usage, and coverage of the painful area and predictive value of transcutaneous electrical nerve stimulation (TENS) were monitored. All pain and quality-of-life measures showed statistically significant improvement during the treatment period. These included the average pain visual analog scale, the Oswestry Disability Questionnaire, the Becks Depression Inventory, and the Short Form-12 item Health survey. Additionally, medication usage with opioids, nonsteroidal anti-inflammatory drugs, and anti-convulsants showed a highly significant reduction. Complications requiring surgical intervention were reported in 9.6% of the patients. The degree of coverage of painful areas seems to be an important criterion for efficacy of PNFS, whereas TENS is presumably no predictor. This prospective, multicenter study confirms that PNFS is an effective therapy for the management of cLBP. Significant improvements in many aspects of the pain condition were measured, and complications were minimal. © 2013 International Neuromodulation Society.

  12. Choice of reserve capacity by hospitals: a problem for prospective payment.

    Science.gov (United States)

    Widmer, Philippe K; Trottmann, Maria; Zweifel, Peter

    2018-06-01

    This contribution analyzes the impact of prospective payment on hospital decisions with regard to reserve capacity, using Swiss hospital data covering the years 2004-2009. This data set is unique because it permits distinguishing of institutional characteristics (e.g., ownership status) from the mode of payment as determinants of hospital efficiency, due to the fact that some Swiss cantons introduced prospective payment early while others waited for federal legislation to be enacted in 2012. Since a hospital's choice of reserve capacity depends also on the risk preferences of management while affecting the cost function, heterogeneity is predicted even in the presence of identical technology and factor prices. For estimating hospitals' marginal costs, we employ the flexible representation of risk preferences by Pope and Chavas [Am J Agric Econ 76, 196-204 (1994)]. Production uncertainty is measured as the difference between actual admissions and admissions predicted by an autoregressive moving average model. Its effect on hospital cost is analyzed using a multilevel stochastic cost frontier model with random coefficients reflecting unobserved differences in technology. Public hospitals are found to opt for a higher probability of meeting unexpected demand, as predicted. Their operating cost is 1.1% higher than for private hospitals and even 1.9% higher than for teaching hospitals, creating an incentive to turn away patients or to keep them waiting for treatment.

  13. Predictive value of serum soluble corin in the risk of hyperglycemia: A population-based prospective cohort study in China.

    Science.gov (United States)

    Zhu, Zhengbao; Zhang, Qiu; Peng, Hao; Zhong, Chongke; Guo, Daoxia; Huangfu, Xinfeng; Chao, Xiangqin; Wang, Aili; Jin, Jianhua; Zhang, Yonghong

    2018-04-01

    Serum soluble corin has been suggested to be associated with hyperglycemia by cross-sectional study. However, the prospective relationship between them remains unclear, and whether lipid component influences the relationship between them has not yet been studied. A total of 1961 participants who were free from hyperglycemia were enrolled at baseline in 2010. The serum soluble corin concentrations were measured at baseline and all participants were followed up for hyperglycemia in 2014. The association between serum soluble corin and hyperglycemia incidence was appreciably modified by high density lipoprotein cholesterol (HDL-C) (P interaction  = 0.04). Elevated serum soluble corin was associated with the risk of hyperglycemia only in the HDL-C ≥1.04 mmol/l subgroup rather than all participants. In participants with HDL-C ≥1.04 mmol/l, the adjusted odds ratio (95% CU) of hyperglycemia associated with the fourth quartiles of corin was 1.78 (1.08-2.94) compared with the lowest quartile of serum soluble corin, and there was a positive linear dose-response relationship between them (P for linearity <0.01). The ordinal analysis showed an association between serum soluble corin and hyperglycemia severity (adjusted OR, 1.81; 95% CI, 1.10-2.99; P trend  = 0.02, when 2 extreme quartiles were compared). The addition of serum soluble corin to conventional risk factors improved risk prediction for hyperglycemia (net reclassification index: 0.16; integrated discrimination improvement: 0.01) in participants with HDL-C ≥1.04 mmol/l. Serum soluble corin might be a valuable biomarker in prediction of future hyperglycemia in population with HDL-C ≥1.04 mmol/l, suggesting that corin might play a potential role in glucose metabolism. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Endogenous Prospect Theory

    OpenAIRE

    Schmidt, Ulrich; Zank, Horst

    2010-01-01

    In previous models of (cumulative) prospect theory reference-dependence of preferences is imposed beforehand and the location of the reference point is exogenously determined. This paper provides an axiomatization of a new specification of cumulative prospect theory, termed endogenous prospect theory, where reference-dependence is derived from preference conditions and a unique reference point arises endogenously.

  15. Predictors of self-rated health: a 12-month prospective study of IT and media workers

    Directory of Open Access Journals (Sweden)

    Arnetz Bengt B

    2006-07-01

    Full Text Available Abstract Objective The aim of the present study was to determine health-related risk and salutogenic factors and to use these to construct prediction models for future self-rated health (SRH, i.e. find possible characteristics predicting individuals improving or worsening in SRH over time (0–12 months. Methods A prospective study was conducted with measurements (physiological markers and self-ratings at 0, 6 and 12 months, involving 303 employees (187 men and 116 women, age 23–64 from four information technology and two media companies. Results There were a multitude of statistically significant cross-sectional correlations (Spearman's Rho between SRH and other self-ratings as well as physiological markers. Predictors of future SRH were baseline ratings of SRH, self-esteem and social support (logistic regression, and SRH, sleep quality and sense of coherence (linear regression. Conclusion The results of the present study indicate that baseline SRH and other self-ratings are predictive of future SRH. It is cautiously implied that SRH, self-esteem, social support, sleep quality and sense of coherence might be predictors of future SRH and therefore possibly also of various future health outcomes.

  16. Clinical significance of neonatal menstruation.

    Science.gov (United States)

    Brosens, Ivo; Benagiano, Giuseppe

    2016-01-01

    Past studies have clearly shown the existence of a spectrum of endometrial progesterone responses in neonatal endometrium, varying from proliferation to full decidualization with menstrual-like shedding. The bleedings represent, similar to what occurs in adult menstruation, a progesterone withdrawal bleeding. Today, the bleeding is completely neglected and considered an uneventful episode of no clinical significance. Yet clinical studies have linked the risk of bleeding to a series of events indicating fetal distress. The potential link between the progesterone response and major adolescent disorders requires to be investigated by prospective studies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Decision making and response inhibition as predictors of heavy alcohol use: a prospective study

    NARCIS (Netherlands)

    Goudriaan, Anna E.; Grekin, Emily R.; Sher, Kenneth J.

    2011-01-01

    Very few studies have investigated the "real world" prospective, predictive value of behavioral instruments used in laboratory studies to test decision-making abilities or impulse control. The current study examines the degree to which 2 commonly used decision-making/impulse control measures

  18. Drug Metabolizing Enzyme and Transporter Gene Variation, Nicotine Metabolism, Prospective Abstinence, and Cigarette Consumption.

    Directory of Open Access Journals (Sweden)

    Andrew W Bergen

    Full Text Available The Nicotine Metabolite Ratio (NMR, ratio of trans-3'-hydroxycotinine and cotinine, has previously been associated with CYP2A6 activity, response to smoking cessation treatments, and cigarette consumption. We searched for drug metabolizing enzyme and transporter (DMET gene variation associated with the NMR and prospective abstinence in 2,946 participants of laboratory studies of nicotine metabolism and of clinical trials of smoking cessation therapies. Stage I was a meta-analysis of the association of 507 common single nucleotide polymorphisms (SNPs at 173 DMET genes with the NMR in 449 participants of two laboratory studies. Nominally significant associations were identified in ten genes after adjustment for intragenic SNPs; CYP2A6 and two CYP2A6 SNPs attained experiment-wide significance adjusted for correlated SNPs (CYP2A6 PACT=4.1E-7, rs4803381 PACT=4.5E-5, rs1137115, PACT=1.2E-3. Stage II was mega-regression analyses of 10 DMET SNPs with pretreatment NMR and prospective abstinence in up to 2,497 participants from eight trials. rs4803381 and rs1137115 SNPs were associated with pretreatment NMR at genome-wide significance. In post-hoc analyses of CYP2A6 SNPs, we observed nominally significant association with: abstinence in one pharmacotherapy arm; cigarette consumption among all trial participants; and lung cancer in four case:control studies. CYP2A6 minor alleles were associated with reduced NMR, CPD, and lung cancer risk. We confirmed the major role that CYP2A6 plays in nicotine metabolism, and made novel findings with respect to genome-wide significance and associations with CPD, abstinence and lung cancer risk. Additional multivariate analyses with patient variables and genetic modeling will improve prediction of nicotine metabolism, disease risk and smoking cessation treatment prognosis.

  19. Prospective prediction of resistance to neoadjuvant therapy in patients with locoregional esophageal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Rosen DG

    2015-02-01

    Full Text Available Daniel G Rosen,1 Weiwei Shan,2 Natalie Lassen,2 Clare Johnson,2 Kristen Oelschlager,2 Yaeli Bierman-Harrar,1 Kenneth A Kesler,3 Derek Maetzold,2 Sunil Badve,3 Robert W Cook,2 Romil Saxena3 1Baylor College of Medicine, Houston TX, USA; 2Castle Biosciences, Incorporated, Friendswood, TX, USA; 3Indiana University, Indianapolis, IN, USA Background: To clinically validate a multianalyte algorithmic immunohistochemistry (IHC assay that has been previously shown to accurately identify patients with locoregional esophageal adenocarcinoma (EC who will exhibit extreme resistance to neoadjuvant chemoradiotherapy. Methods: Archived biopsy specimens of EC were subject to IHC examination of compartmentalized immunoreactivity of nuclear factor kappa B (NF-κB, Sonic Hedgehog (SHH, and GLI family zinc finger 1 (Gli-1, and a labeling index score was assigned to each biomarker. Test prediction was generated by logistic regression predictive modeling, using the labeling index scores for all three analytes from each sample, referring to a validated training set of 167 EC patients. Accuracy of the test was determined by comparing the predicted outcomes with pathologically determined College of American Pathologists tumor response grade. Analytical validity of the test was measured by comparing validation set prediction results obtained in two independent Clinical Laboratory Improvement Amendment-certified laboratories, and by measuring concordance between two trained labeling index readers. Results: Specimens from 64 patients that met specific criteria were collected. No technical failure was encountered during the IHC labeling procedures. The logistic regression algorithm generated an area under the curve of 0.96 and 0.85 for the 64 sample cohort in two independent clinical laboratories, respectively, comparing predictive results with the established training set. Positive predictive values of 88% and 82% were also achieved in each laboratory, respectively. A

  20. Integrated genomic and immunophenotypic classification of pancreatic cancer reveals three distinct subtypes with prognostic/predictive significance.

    Science.gov (United States)

    Wartenberg, Martin; Cibin, Silvia; Zlobec, Inti; Vassella, Erik; Eppenberger-Castori, Serenella M M; Terracciano, Luigi; Eichmann, Micha; Worni, Mathias; Gloor, Beat; Perren, Aurel; Karamitopoulou, Eva

    2018-04-16

    Current clinical classification of pancreatic ductal adenocarcinoma (PDAC) is unable to predict prognosis or response to chemo- or immunotherapy and does not take into account the host reaction to PDAC-cells. Our aim is to classify PDAC according to host- and tumor-related factors into clinically/biologically relevant subtypes by integrating molecular and microenvironmental findings. A well-characterized PDAC-cohort (n=110) underwent next-generation sequencing with a hotspot cancer panel, while Next-generation Tissue-Microarrays were immunostained for CD3, CD4, CD8, CD20, PD-L1, p63, hyaluronan-mediated motility receptor (RHAMM) and DNA mismatch-repair proteins. Previous data on FOXP3 were integrated. Immune-cell counts and protein expression were correlated with tumor-derived driver mutations, clinicopathologic features (TNM 8. 2017), survival and epithelial-mesenchymal-transition (EMT)-like tumor budding.  Results: Three PDAC-subtypes were identified: the "immune-escape" (54%), poor in T- and B-cells and enriched in FOXP3+Tregs, with high-grade budding, frequent CDKN2A- , SMAD4- and PIK3CA-mutations and poor outcome; the "immune-rich" (35%), rich in T- and B-cells and poorer in FOXP3+Tregs, with infrequent budding, lower CDKN2A- and PIK3CA-mutation rate and better outcome and a subpopulation with tertiary lymphoid tissue (TLT), mutations in DNA damage response genes (STK11, ATM) and the best outcome; and the "immune-exhausted" (11%) with immunogenic microenvironment and two subpopulations: one with PD-L1-expression and high PIK3CA-mutation rate and a microsatellite-unstable subpopulation with high prevalence of JAK3-mutations. The combination of low budding, low stromal FOXP3-counts, presence of TLTs and absence of CDKN2A-mutations confers significant survival advantage in PDAC-patients. Immune host responses correlate with tumor characteristics leading to morphologically recognizable PDAC-subtypes with prognostic/predictive significance. Copyright ©2018

  1. Internet Addiction among Adolescents May Predict Self-Harm/Suicidal Behavior: A Prospective Study.

    Science.gov (United States)

    Pan, Pei-Yin; Yeh, Chin-Bin

    2018-06-01

    To explore the role of Internet addiction in the development of self-harm/suicidal behavior among adolescents after 1-year of follow-up. We conducted this 1-year, prospective cohort study of 1861 adolescents (mean age 15.93 years) attending a senior high school in Taiwan; 1735 respondents (93.2%) were classified as having no history of self-harm/suicidal attempts in the initial assessment and were referred to as the "noncase" cohort. The Chen Internet Addiction Scale was used to identify individuals with Internet addiction. The participants were evaluated for self-harm/suicidal behavior again 1 year later and the "noncase" cohort was selected for statistical analysis. To examine the relationship between Internet addiction and self-harm/suicidal behavior, multivariate logistic regression analysis was performed using Internet addiction at baseline as the predictor for newly developed self-harm/suicidal behavior in the next year, after adjustment for potential confounding variables. The prevalence rate of Internet addiction at baseline was 23.0%. There were 59 students (3.9%) who were identified as having developed new self-harm/suicidal behaviors on follow-up assessments. After controlling for the effects of potential confounders, the relative risk of newly emerging self-harm/suicidal behavior for participants who were classified as Internet addicted was 2.41 (95% CI 1.16-4.99, P = .018) when compared with those without Internet addiction. Our findings indicate that Internet addiction is prospectively associated with the incidence of self-harm/suicidal behavior in adolescents. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Transient elastography for predicting liver-related events in cirrhotic HIV-infected patients

    OpenAIRE

    Montes-Ramírez, M. L.; Berenguer, Juan; Miró, J. M.; Quereda, Carmen; Hernando Jeréz, María Asunción; Sanz, J.; Ortega, E.; Tural, Cristina; Wichmann, M. A.; Zamora, F. X.; González García, J. J.

    2017-01-01

    We assessed liver stiffness measurement (LSM) for the prediction of mortality and decompensation in HIVinfected patients with compensated liver cirrhosis. A prospective cohort study of HIV-infected patients with confirmed liver cirrhosis from 9 hospitals in Spain. LSM was undertaken for each patient; clinical events were collected prospectively after the baseline visit, and patients were followed until death or the censoring date. We used univariate/multivariate Cox proportional haz...

  3. The Predictive Role of Tooth Extractions, Oral Infections, and hs-C-Reactive Protein for Mortality in Individuals with and without Diabetes: A Prospective Cohort Study of a 12 1/2-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Lise Lund Håheim

    2017-01-01

    Full Text Available The predictive role of high-sensitivity C-reactive protein (hs-CRP, number of tooth extractions, and oral infections for mortality in people with and without diabetes is unclear. This prospective cohort study is a 12 1/2-year follow-up of the Oslo II study, a health survey in 2000. In all, 12,764 men were invited. Health information was retrieved from 6434 elderly men through questionnaire information, serum measurements, and anthropometric and blood pressure measurements. Diabetes was reported by 425 men. Distinct differences were observed in baseline characteristics in individuals with and without diabetes. In the diabetes group, age and hs-CRP were statistically significant whereas in the nondiabetes group, age, hs-CRP, number of tooth extractions, tooth extractions for infections and oral infections combined, nonfasting glucose, systolic blood pressure, total cholesterol, regular alcohol drinking, daily smoking, and level of education were independent risk factors. The number of tooth extractions <5 was inversely related whereas more extractions increased the risk. Multivariate analyses showed that hs-CRP was a significant predictor in persons with diabetes and tooth extractions and oral infections combined; the number of teeth extracted and hs-CRP were for persons without diabetes. Infection and inflammation were associated with mortality in individuals both with and without diabetes.

  4. Predictors of premenstrual impairment among women undergoing prospective assessment for premenstrual dysphoric disorder: a cycle-level analysis.

    Science.gov (United States)

    Schmalenberger, K M; Eisenlohr-Moul, T A; Surana, P; Rubinow, D R; Girdler, S S

    2017-07-01

    Women who experience significant premenstrual symptoms differ in the extent to which these symptoms cause cyclical impairment. This study clarifies the type and number of symptoms that best predict premenstrual impairment in a sample of women undergoing prospective assessment for premenstrual dysphoric disorder (PMDD) in a research setting. Central research goals were to determine (1) which emotional, psychological, and physical symptoms of PMDD are uniquely associated with premenstrual impairment, and (2) how many cyclical symptoms optimally predict the presence of a clinically significant premenstrual elevation of impairment. A total of 267 naturally cycling women recruited for retrospective report of premenstrual emotional symptoms completed daily symptom reports using the Daily Record of Severity of Problems (DRSP) and occupational, recreational, and relational impairment for 1-4 menstrual cycles (N = 563 cycles). Multilevel regression revealed that emotional, psychological, and physical symptoms differ in their associations with impairment. The core emotional symptoms of PMDD were predictors of impairment, but not after accounting for secondary psychological symptoms, which were the most robust predictors. The optimal number of premenstrual symptoms for predicting clinically significant premenstrual impairment was four. Results enhance our understanding of the type and number of premenstrual symptoms associated with premenstrual impairment among women being evaluated for PMDD in research contexts. Additional work is needed to determine whether cognitive symptoms should receive greater attention in the study of PMDD, and to revisit the usefulness of the five-symptom diagnostic threshold.

  5. Integrated prediction based on GIS for sandstone-type uranium deposits in the northwest of Ordos Basin

    International Nuclear Information System (INIS)

    Han Shaoyang; Ke Dan; Hu Shuiqing; Guo Qingyin; Hou Huiqun

    2005-01-01

    The integrated prediction model of sandstone-type uranium deposits and its integrated evaluation methods as well as flow of the work based on GIS are studied. A software for extracting metallogenic information is also developed. A multi-source exploring information database is established in the northwest of Ordos Basin, and an integrated digital mineral deposit prospecting model of sandstone-type uranium deposits is designed based on GIS. The authors have completed metallogenic information extraction and integrated evaluation of sandstone-type uranium deposits based on GIS in the study area. Research results prove that the integrated prediction of sandstone-type uranium deposits based on GIS may further delineate prospective target areas rapidly and improve the predictive precision. (authors)

  6. A prospective observational study of skin to subarachnoid space depth in the Indian population

    Directory of Open Access Journals (Sweden)

    Smita Prakash

    2014-01-01

    Full Text Available Background and Aims: A pre-puncture estimate of skin to subarachnoid space depth (SSD may guide spinal needle placement and reduce complications associated with lumbar puncture. Our aim was to determine (1 The SSD in Indian males, females, parturients and the overall population; (2 To derive formulae for predicting SSD and (3 To determine which previously suggested formula best suited our population. Methods: In this prospective, observational study, 800 adult Indian patients undergoing surgery under spinal anaesthesia were divided into three groups: Males (Group M, females (Group F and parturients (Group PF. SSD was measured after lumbar puncture. The relationship between SSD and patient characteristics was studied and statistical models were used to derive formula for predicting SSD. Statistical analysis included One-way ANOVA with post hoc analysis, forward stepwise multivariate regression analysis and paired t-tests. Results: Mean SSD was 4.71 ± 0.70 cm in the overall population. SSD in adult males (4.81 ± 0.68 cm was significantly longer than that observed in females (4.55 ± 0.66 cm but was comparable with SSD in parturients (4.73 ± 0.73 cm. Formula for predicting SSD in the overall population was 2.71 + 0.09 × Body Mass Index (BMI. Stocker′s formula when applied correlated best with the observed SSD. Formulae were derived for the three groups. Conclusions: We found gender-based differences in SSD, with SSD in males being significantly greater than that observed in the female population. SSD correlated with BMI in the parturient and the overall population. Amongst the previously proposed formulae, Stocker′s formula was most accurate in predicting SSD in our population.

  7. Status and prospects of (g-2)μ and ΔαQED

    International Nuclear Information System (INIS)

    Teubner, Thomas

    2008-01-01

    A brief review of the status of the anomalous magnetic moment of the muon, (g-2) μ , and the running of the electromagnetic coupling, α QED (q 2 ), is given. The discrepancy between the Standard Model prediction of g-2 and the measurement from BNL is discussed. The prospects for further improvements in the determination of the vacuum polarisation contributions are outlined.

  8. Effects of ongoing task context and target typicality on prospective memory performance: the importance of associative cueing

    Science.gov (United States)

    Nowinski, Jessica Lang; Dismukes, Key R.

    2005-01-01

    Two experiments examined whether prospective memory performance is influenced by contextual cues. In our automatic activation model, any information available at encoding and retrieval should aid recall of the prospective task. The first experiment demonstrated an effect of the ongoing task context; performance was better when information about the ongoing task present at retrieval was available at encoding. Performance was also improved by a strong association between the prospective memory target as it was presented at retrieval and the intention as it was encoded. Experiment 2 demonstrated boundary conditions of the ongoing task context effect, which implicate the association between the ongoing and prospective tasks formed at encoding as the source of the context effect. The results of this study are consistent with predictions based on automatic activation of intentions.

  9. The application actualities and prospects of geophysical methods to uranium prospecting

    International Nuclear Information System (INIS)

    Liu Qingcheng

    2010-01-01

    Basic principles of geophysical methods to uranium prospect are briefly introduced, and the effects as well as problems in using those methods are analysed respectively. Combining with the increasing demand of uranium resources for Chinese nuclear power development and the higher requirements of geophysical techniques, the developing directions and the thoughts of geophysical techniques in uranium prospecting were proposed. A new pattern with producing, teaching and researching together is brought forward to develop advancing uranium prospecting key technologies and to break through technological bottlenecks depending on independent innovation. Integrated geophysical methods for prospecting uranium deposits are suggested. The method includes geophysical techniques as follows: gravity, magnetic, seismic, radioactive, remote sensing, and geochemical method in some proving grounds. Based on the experimental research, new uranium deposits prospecting models with efficient integrated geophysical methods can be established. (authors)

  10. A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer

    International Nuclear Information System (INIS)

    Langendijk, Johannes A.; Doornaert, Patricia; Rietveld, Derek H.F.; Verdonck-de Leeuw, Irma M.; Rene Leemans, C.; Slotman, Ben J.

    2009-01-01

    Introduction: Recently, we found that swallowing dysfunction after curative (chemo) radiation (CH) RT has a strong negative impact on health-related quality of life (HRQoL), even more than xerostomia. The purpose of this study was to design a predictive model for swallowing dysfunction after curative radiotherapy or chemoradiation. Materials and methods: A prospective study was performed including 529 patients with head and neck squamous cell carcinoma (HNSCC) treated with curative (CH) RT. In all patients, acute and late radiation-induced morbidity (RTOG Acute and Late Morbidity Scoring System) was scored prospectively. To design the model univariate and multivariate logistic regression analyses were carried out with grade 2 or higher RTOG swallowing dysfunction at 6 months as the primary (SWALL 6months ) endpoint. The model was validated by comparing the predicted and observed complication rates and by testing if the model also predicted acute dysphagia and late dysphagia at later time points (12, 18 and 24 months). Results: After univariate and multivariate logistic regression analyses, the following factors turned out to be independent prognostic factors for SWALL 6months : T3-T4, bilateral neck irradiation, weight loss prior to radiation, oropharyngeal and nasopharyngeal tumours, accelerated radiotherapy and concomitant chemoradiation. By summation of the regression coefficients derived from the multivariate model, the Total Dysphagia Risk Score (TDRS) could be calculated. In the logistic regression model, the TDRS was significantly associated with SWALL 6months ((p 6months was 5%, 24% and 46% in case of low-, intermediate- and high-risk patients, respectively. These observed percentages were within the 95% confidence intervals of the predicted values. The TDRS risk group classification was also significantly associated with acute dysphagia (P < 0.001 at all time points) and with late swallowing dysfunction at 12, 18 and 24 months (p < 0.001 at all time points

  11. Predictive genetic testing for hereditary breast and ovarian cancer: psychological distress and illness representations 1 year following disclosure.

    Science.gov (United States)

    Claes, E; Evers-Kiebooms, G; Denayer, L; Decruyenaere, M; Boogaerts, A; Philippe, K; Legius, E

    2005-10-01

    This prospective study evaluates emotional functioning and illness representations in 68 unaffected women (34 carriers/34 noncarriers) 1 year after predictive testing for BRCA1/2 mutations when offered within a multidisciplinary approach. Carriers had higher subjective risk perception of breast cancer than noncarriers. Carriers who did not have prophylactic oophorectomy had the highest risk perception of ovarian cancer. No differences were found between carriers and noncarriers regarding perceived seriousness and perceived control of breast and ovarian cancer. Mean levels of distress were within normal ranges. Only few women showed an overall pattern of clinically elevated distress. Cancer-specific distress and state-anxiety significantly decreased in noncarriers from pre- to posttest while general distress remained about the same. There were no significant changes in distress in the group of carriers except for ovarian cancer distress which significantly decreased from pre- to posttest. Our study did not reveal adverse effects of predictive testing when offered in the context of a multidisciplinary approach.

  12. Hybrid Perovskites: Prospects for Concentrator Solar Cells.

    Science.gov (United States)

    Lin, Qianqian; Wang, Zhiping; Snaith, Henry J; Johnston, Michael B; Herz, Laura M

    2018-04-01

    Perovskite solar cells have shown a meteoric rise of power conversion efficiency and a steady pace of improvements in their stability of operation. Such rapid progress has triggered research into approaches that can boost efficiencies beyond the Shockley-Queisser limit stipulated for a single-junction cell under normal solar illumination conditions. The tandem solar cell architecture is one concept here that has recently been successfully implemented. However, the approach of solar concentration has not been sufficiently explored so far for perovskite photovoltaics, despite its frequent use in the area of inorganic semiconductor solar cells. Here, the prospects of hybrid perovskites are assessed for use in concentrator solar cells. Solar cell performance parameters are theoretically predicted as a function of solar concentration levels, based on representative assumptions of charge-carrier recombination and extraction rates in the device. It is demonstrated that perovskite solar cells can fundamentally exhibit appreciably higher energy-conversion efficiencies under solar concentration, where they are able to exceed the Shockley-Queisser limit and exhibit strongly elevated open-circuit voltages. It is therefore concluded that sufficient material and device stability under increased illumination levels will be the only significant challenge to perovskite concentrator solar cell applications.

  13. Ambulation in adults with myelomeningocele. Is it possible to predict the level of ambulation in early life?

    DEFF Research Database (Denmark)

    Seitzberg, A.; Lind, M.; Biering-Sørensen, Fin

    2008-01-01

    OBJECTIVE: The objective of this study was to evaluate the prediction of ambulation in adults with myelomeningocele from muscle strength testing and ambulation in early life. MATERIALS AND METHODS: Fifty-two myelomeningocele (MMC) individuals at the age 18-37 years at follow-up were studied....... Information on muscle strength and ambulatory function in early life was retrieved from medical records. The motor levels determined by the muscle strength were used to predict ambulatory function later in life. At follow-up, a clinical examination was performed. RESULTS: Of 20 MMC individuals assessed...... life than predicted. Good strength in quadriceps muscles gave significant better prospect for adult walking. Of the 52 participants, 41 retained their ambulation status from 5-8 years of age. CONCLUSION: For MMC individuals with motor levels L3-L5, adult ambulatory function cannot be determined from...

  14. Adolescents Coping with Poverty-Related Family Stress: Prospective Predictors of Coping and Psychological Symptoms

    Science.gov (United States)

    Wadsworth, Martha E.; Berger, Lauren E.

    2006-01-01

    Examined prospective associations among poverty-related family stress, coping, involuntary stress reactivity, and psychological symptoms in a sample of 79 rural, low-income adolescents. Poverty-related family stress predicted adolescents' anxious/depressed and aggressive behavior 8 months later, controlling for prior symptoms. Coping interacted…

  15. Determinants of general practitioner’s cancer related gut feelings – a prospective cohort study

    NARCIS (Netherlands)

    Donker, G.; Wiersma, E.; Heins, M.

    2016-01-01

    Background General practitioners (GPs) use gut feelings to diagnose cancer in an early stage, but little is known about the predictive value of gut feelings and how this is influenced by patient and GP characteristics. Methods Prospective cohort study of patients in 44 general practices

  16. Predicting Risk of Motor Vehicle Collisions in Patients with Glaucoma: A Longitudinal Study.

    Science.gov (United States)

    Gracitelli, Carolina P B; Tatham, Andrew J; Boer, Erwin R; Abe, Ricardo Y; Diniz-Filho, Alberto; Rosen, Peter N; Medeiros, Felipe A

    2015-01-01

    To evaluate the ability of longitudinal Useful Field of View (UFOV) and simulated driving measurements to predict future occurrence of motor vehicle collision (MVC) in drivers with glaucoma. Prospective observational cohort study. 117 drivers with glaucoma followed for an average of 2.1 ± 0.5 years. All subjects had standard automated perimetry (SAP), UFOV, driving simulator, and cognitive assessment obtained at baseline and every 6 months during follow-up. The driving simulator evaluated reaction times to high and low contrast peripheral divided attention stimuli presented while negotiating a winding country road, with central driving task performance assessed as "curve coherence". Drivers with MVC during follow-up were identified from Department of Motor Vehicle records. Survival models were used to evaluate the ability of driving simulator and UFOV to predict MVC over time, adjusting for potential confounding factors. Mean age at baseline was 64.5 ± 12.6 years. 11 of 117 (9.4%) drivers had a MVC during follow-up. In the multivariable models, low contrast reaction time was significantly predictive of MVC, with a hazard ratio (HR) of 2.19 per 1 SD slower reaction time (95% CI, 1.30 to 3.69; P = 0.003). UFOV divided attention was also significantly predictive of MVC with a HR of 1.98 per 1 SD worse (95% CI, 1.10 to 3.57; P = 0.022). Global SAP visual field indices in the better or worse eye were not predictive of MVC. The longitudinal model including driving simulator performance was a better predictor of MVC compared to UFOV (R2 = 0.41 vs R2 = 0.18). Longitudinal divided attention metrics on the UFOV test and during simulated driving were significantly predictive of risk of MVC in glaucoma patients. These findings may help improve the understanding of factors associated with driving impairment related to glaucoma.

  17. Predicting Risk of Motor Vehicle Collisions in Patients with Glaucoma: A Longitudinal Study.

    Directory of Open Access Journals (Sweden)

    Carolina P B Gracitelli

    Full Text Available To evaluate the ability of longitudinal Useful Field of View (UFOV and simulated driving measurements to predict future occurrence of motor vehicle collision (MVC in drivers with glaucoma.Prospective observational cohort study.117 drivers with glaucoma followed for an average of 2.1 ± 0.5 years.All subjects had standard automated perimetry (SAP, UFOV, driving simulator, and cognitive assessment obtained at baseline and every 6 months during follow-up. The driving simulator evaluated reaction times to high and low contrast peripheral divided attention stimuli presented while negotiating a winding country road, with central driving task performance assessed as "curve coherence". Drivers with MVC during follow-up were identified from Department of Motor Vehicle records.Survival models were used to evaluate the ability of driving simulator and UFOV to predict MVC over time, adjusting for potential confounding factors.Mean age at baseline was 64.5 ± 12.6 years. 11 of 117 (9.4% drivers had a MVC during follow-up. In the multivariable models, low contrast reaction time was significantly predictive of MVC, with a hazard ratio (HR of 2.19 per 1 SD slower reaction time (95% CI, 1.30 to 3.69; P = 0.003. UFOV divided attention was also significantly predictive of MVC with a HR of 1.98 per 1 SD worse (95% CI, 1.10 to 3.57; P = 0.022. Global SAP visual field indices in the better or worse eye were not predictive of MVC. The longitudinal model including driving simulator performance was a better predictor of MVC compared to UFOV (R2 = 0.41 vs R2 = 0.18.Longitudinal divided attention metrics on the UFOV test and during simulated driving were significantly predictive of risk of MVC in glaucoma patients. These findings may help improve the understanding of factors associated with driving impairment related to glaucoma.

  18. Economic, safety and environmental prospects of fusion reactors

    International Nuclear Information System (INIS)

    Conn, R.W.; Holdren, J.P.; Sharafat, S.

    1990-01-01

    Controlled fusion energy is one of the long term, non-fossil energy sources available to mankind. It has the potential of significant advantages over fission nuclear power in that the consequences of severe accidents are predicted to be less and the radioactive waste burden is calculated to be smaller. Fusion can be an important ingredient in the future world energy mix as a hedge against environmental, supply or political difficulties connected with the use of fossil fuel and present-day nuclear power. Progress in fusion reactor technology and design is described for both magnetic and inertial fusion energy systems. The projected economic prospects show that fusion will be capital intensive, and the historical trend is towards greater mass utilization efficiency and more competitive costs. Recent studies emphasizing safety and environmental advantages show that the competitive potential of fusion can be further enhanced by specific choices of materials and design. The safety and environmental prospects of fusion appear to exceed substantially those of advanced fission and coal. Clearly, a significant and directed technology effort is necessary to achieve these advantages. Typical parameters have been established for magnetic fusion energy reactors, and a tokamak at moderately high magnetic field (about 7 T on axis) in the first regime of MHD stability (β ≤ 3.5 I/aB) is closest to present experimental achievement. Further improvements of the economic and technological performance of the tokamak are possible. In addition, alternative, non-tokamak magnetic fusion approaches may offer substantive economic and operational benefits, although at present these concepts must be projected from a less developed physics base. For inertial fusion energy, the essential requirements are a high efficiency (≥ 10%) repetitively pulsed pellet driver capable of delivering up to 10 MJ of energy on target, targets capable of an energy gain of about 100, reactor chambers capable of

  19. Candidate OP Phyla: Importance, Ecology and Cultivation Prospects.

    Science.gov (United States)

    Rohini Kumar, M; Saravanan, V S

    2010-10-01

    OP phyla were created in the domain bacteria, based on the group of 16S rRNA gene sequences recovered from the Obsidian Pool. However, due to the lack of cultured representative it is referred to as candidate phyla. Wider ecological occurrence was predicted for the OP phyla, especially OP3, OP10 and OP11. Recently, members of phylum OP5 and OP10 were cultured, providing clues to their cultivation prospects. At last the bioprospecting potentials of the OP members are discussed herein.

  20. Can Bcl-XL expression predict the radio sensitivity of Bilharzial-related squamous bladder carcinoma? a prospective comparative study

    Directory of Open Access Journals (Sweden)

    Kamel Nermen A

    2011-01-01

    Full Text Available Abstract Background Local pelvic recurrence after radical cystectomy for muscle invasive bilharzial related squamous cell carcinoma accounts for 75% of treatment failures even in organ confined tumors. Despite the proven value of lymphadenectomy, up to 60% of patients undergoing cystectomy do not have it. These factors are in favor of adjuvant radiotherapy reevaluation. objectives: to evaluate the effect of adjuvant radiotherapy on disease free survival in muscle invasive bilharzial related squamous cell carcinoma of the urinary bladder and to test the predictability of radio-sensitivity using the anti apoptotic protein Bcl-XL. Methods The study prospectively included 71 patients, (47 males, 24 females with muscle invasive bilharzial related squamous cell carcinoma of the bladder (Stage pT2a-T3N0-N3M0 who underwent radical cystectomy in Assiut university hospitals between January 2005 and December 2006. Thirty eight patients received adjuvant radiotherapy to the pelvis in the dose of 50Gy/25 fractions/5 weeks (Group 1, while 33 patients did not receive adjuvant radiotherapy (group 2. Immunohistochemical characterization for bcl-xL expression was done. Follow up was done every 3 months for 12 to 36 months with a mean of 16 ± 10 months. All data were analyzed using SPSS version 16. Three years cumulative disease free survival was calculated and adjusted to Bcl-XL expression and side effects of the treatment were recorded. Results The disease free cumulative survival was 48% for group 1 and 29% for group 2 (log rank p value 0.03. The multivariate predictors of tumor recurrence were the positive Bcl-XL expression (odd ratio 41.1, 95% CI 8.4 - 102.3, p Conclusions Adjuvant radiotherapy for muscle invasive bilharzial related squamous cell carcinoma of the urinary bladder has potential effectiveness and minor side effects. Moreover, Bcl-XL expression is a valuable tool for predicting those who might not respond to this adjuvant treatment.

  1. Serum Cystatin C Predicts AKI and the Prognosis of Patients in Coronary Care Unit: a Prospective, Observational Study

    Directory of Open Access Journals (Sweden)

    Yugang Hu

    2017-11-01

    Full Text Available Background/Aims: Acute Kidney Injury (AKI is a serious clinical state associated with high morbidity and mortality, particularly in critical ill patients. We investigated the hypothesis that serum Cystatin C (sCysC is a good predictor for AKI and may affect the short-term prognosis of coronary care unit (CCU patients. Methods: In this prospective, observational study, we screened 412 adults admitted to the CCU from January 1, 2014 to June 1, 2015 at Zhongnan Hospital of Wuhan University. Serum samples were obtained at the time of admission, and sCysC was quantified through nephelometry. AKI was defined based on KDIGO-AKI criteria. After the patients’ hospital discharge, the survivors in this study were followed up for up to 2 years. The primary endpoint was the incidence of AKI stratified by severity stage, while the second endpoints included 2-year mortality, rehospitalization and failure in renal recovery rates, as well as the progression of AKI to CKD. Results: According to the KDIGO-AKI criteria, AKI occurred in 130 (31.6% patients. After multivariate adjustments, the highest quartile of sCysC was associated with a 9-fold increased risk of incident AKI compared with the lowest quartile. For predicting AKI, sCysC [area under the receiver operating characteristic curve (AUC=0.842] outperformed β2-micro globulin (AUC=0.813 and the clinical model (AUC=0.777, and a cutoff of 1.255 mg/L yielded good sensitivity and specificity. After a median 19.8-month follow-up, 112 (27.2% patients died within 2 years after admission. The sCysC independently predicted the risk of 2-year mortality [adjusted odds ratio (OR, 4.955; 95% confidence interval (95% CI, 2.853 to 8.603] and rehospitalization (OR, 3.128; 95% CI, 2.011 to 4.867, as well as renal recovery failure (OR, 3.618, 95% CI, 1.753 to 7.463. Conclusions: Serum CysC is a strong predictor of AKI and the short-term prognosis of CCU patients.

  2. Clinical models are inaccurate in predicting bile duct stones in situ for patients with gallbladder.

    Science.gov (United States)

    Topal, B; Fieuws, S; Tomczyk, K; Aerts, R; Van Steenbergen, W; Verslype, C; Penninckx, F

    2009-01-01

    The probability that a patient has common bile duct stones (CBDS) is a key factor in determining diagnostic and treatment strategies. This prospective cohort study evaluated the accuracy of clinical models in predicting CBDS for patients who will undergo cholecystectomy for lithiasis. From October 2005 until September 2006, 335 consecutive patients with symptoms of gallstone disease underwent cholecystectomy. Statistical analysis was performed on prospective patient data obtained at the time of first presentation to the hospital. Demonstrable CBDS at the time of endoscopic retrograde cholangiopancreatography (ERCP) or intraoperative cholangiography (IOC) was considered the gold standard for the presence of CBDS. Common bile duct stones were demonstrated in 53 patients. For 35 patients, ERCP was performed, with successful stone clearance in 24 of 30 patients who had proven CBDS. In 29 patients, IOC showed CBDS, which were managed successfully via laparoscopic common bile duct exploration, with stone extraction at the time of cholecystectomy. Prospective validation of the existing model for CBDS resulted in a predictive accuracy rate of 73%. The new model showed a predictive accuracy rate of 79%. Clinical models are inaccurate in predicting CBDS in patients with cholelithiasis. Management strategies should be based on the local availability of therapeutic expertise.

  3. Functional status and mortality prediction in community-acquired pneumonia.

    Science.gov (United States)

    Jeon, Kyeongman; Yoo, Hongseok; Jeong, Byeong-Ho; Park, Hye Yun; Koh, Won-Jung; Suh, Gee Young; Guallar, Eliseo

    2017-10-01

    Poor functional status (FS) has been suggested as a poor prognostic factor in both pneumonia and severe pneumonia in elderly patients. However, it is still unclear whether FS is associated with outcomes and improves survival prediction in community-acquired pneumonia (CAP) in the general population. Data on hospitalized patients with CAP and FS, assessed by the Eastern Cooperative Oncology Group (ECOG) scale were prospectively collected between January 2008 and December 2012. The independent association of FS with 30-day mortality in CAP patients was evaluated using multivariable logistic regression. Improvement in mortality prediction when FS was added to the CRB-65 (confusion, respiratory rate, blood pressure and age 65) score was evaluated for discrimination, reclassification and calibration. The 30-day mortality of study participants (n = 1526) was 10%. Mortality significantly increased with higher ECOG score (P for trend <0.001). In multivariable analysis, ECOG ≥3 was strongly associated with 30-day mortality (adjusted OR: 5.70; 95% CI: 3.82-8.50). Adding ECOG ≥3 significantly improved the discriminatory power of CRB-65. Reclassification indices also confirmed the improvement in discrimination ability when FS was combined with the CRB-65, with a categorized net reclassification index (NRI) of 0.561 (0.437-0.686), a continuous NRI of 0.858 (0.696-1.019) and a relative integrated discrimination improvement in the discrimination slope of 139.8 % (110.8-154.6). FS predicted 30-day mortality and improved discrimination and reclassification in consecutive CAP patients. Assessment of premorbid FS should be considered in mortality prediction in patients with CAP. © 2017 Asian Pacific Society of Respirology.

  4. Predictive accuracy of the PanCan lung cancer risk prediction model - external validation based on CT from the Danish Lung Cancer Screening Trial

    International Nuclear Information System (INIS)

    Winkler Wille, Mathilde M.; Dirksen, Asger; Riel, Sarah J. van; Jacobs, Colin; Scholten, Ernst T.; Ginneken, Bram van; Saghir, Zaigham; Pedersen, Jesper Holst; Hohwue Thomsen, Laura; Skovgaard, Lene T.

    2015-01-01

    Lung cancer risk models should be externally validated to test generalizability and clinical usefulness. The Danish Lung Cancer Screening Trial (DLCST) is a population-based prospective cohort study, used to assess the discriminative performances of the PanCan models. From the DLCST database, 1,152 nodules from 718 participants were included. Parsimonious and full PanCan risk prediction models were applied to DLCST data, and also coefficients of the model were recalculated using DLCST data. Receiver operating characteristics (ROC) curves and area under the curve (AUC) were used to evaluate risk discrimination. AUCs of 0.826-0.870 were found for DLCST data based on PanCan risk prediction models. In the DLCST, age and family history were significant predictors (p = 0.001 and p = 0.013). Female sex was not confirmed to be associated with higher risk of lung cancer; in fact opposing effects of sex were observed in the two cohorts. Thus, female sex appeared to lower the risk (p = 0.047 and p = 0.040) in the DLCST. High risk discrimination was validated in the DLCST cohort, mainly determined by nodule size. Age and family history of lung cancer were significant predictors and could be included in the parsimonious model. Sex appears to be a less useful predictor. (orig.)

  5. Predictive accuracy of the PanCan lung cancer risk prediction model - external validation based on CT from the Danish Lung Cancer Screening Trial

    Energy Technology Data Exchange (ETDEWEB)

    Winkler Wille, Mathilde M.; Dirksen, Asger [Gentofte Hospital, Department of Respiratory Medicine, Hellerup (Denmark); Riel, Sarah J. van; Jacobs, Colin; Scholten, Ernst T.; Ginneken, Bram van [Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands); Saghir, Zaigham [Herlev Hospital, Department of Respiratory Medicine, Herlev (Denmark); Pedersen, Jesper Holst [Copenhagen University Hospital, Department of Thoracic Surgery, Rigshospitalet, Koebenhavn Oe (Denmark); Hohwue Thomsen, Laura [Hvidovre Hospital, Department of Respiratory Medicine, Hvidovre (Denmark); Skovgaard, Lene T. [University of Copenhagen, Department of Biostatistics, Koebenhavn Oe (Denmark)

    2015-10-15

    Lung cancer risk models should be externally validated to test generalizability and clinical usefulness. The Danish Lung Cancer Screening Trial (DLCST) is a population-based prospective cohort study, used to assess the discriminative performances of the PanCan models. From the DLCST database, 1,152 nodules from 718 participants were included. Parsimonious and full PanCan risk prediction models were applied to DLCST data, and also coefficients of the model were recalculated using DLCST data. Receiver operating characteristics (ROC) curves and area under the curve (AUC) were used to evaluate risk discrimination. AUCs of 0.826-0.870 were found for DLCST data based on PanCan risk prediction models. In the DLCST, age and family history were significant predictors (p = 0.001 and p = 0.013). Female sex was not confirmed to be associated with higher risk of lung cancer; in fact opposing effects of sex were observed in the two cohorts. Thus, female sex appeared to lower the risk (p = 0.047 and p = 0.040) in the DLCST. High risk discrimination was validated in the DLCST cohort, mainly determined by nodule size. Age and family history of lung cancer were significant predictors and could be included in the parsimonious model. Sex appears to be a less useful predictor. (orig.)

  6. Noninvasive work of breathing improves prediction of post-extubation outcome.

    Science.gov (United States)

    Banner, Michael J; Euliano, Neil R; Martin, A Daniel; Al-Rawas, Nawar; Layon, A Joseph; Gabrielli, Andrea

    2012-02-01

    We hypothesized that non-invasively determined work of breathing per minute (WOB(N)/min) (esophageal balloon not required) may be useful for predicting extubation outcome, i.e., appropriate work of breathing values may be associated with extubation success, while inappropriately increased values may be associated with failure. Adult candidates for extubation were divided into a training set (n = 38) to determine threshold values of indices for assessing extubation and a prospective validation set (n = 59) to determine the predictive power of the threshold values for patients successfully extubated and those who failed extubation. All were evaluated for extubation during a spontaneous breathing trial (5 cmH(2)O pressure support ventilation, 5 cmH(2)O positive end expiratory pressure) using routine clinical practice standards. WOB(N)/min data were blinded to attending physicians. Area under the receiver operating characteristic curves (AUC), sensitivity, specificity, and positive and negative predictive values of all extubation indices were determined. AUC for WOB(N)/min was 0.96 and significantly greater (p indices. WOB(N)/min had a specificity of 0.83, the highest sensitivity at 0.96, positive predictive value at 0.84, and negative predictive value at 0.96 compared to all indices. For 95% of those successfully extubated, WOB(N)/min was ≤10 J/min. WOB(N)/min had the greatest overall predictive accuracy for extubation compared to traditional indices. WOB(N)/min warrants consideration for use in a complementary manner with spontaneous breathing pattern data for predicting extubation outcome.

  7. Unstable gravitino dark matter prospects for indirect and direct detection

    International Nuclear Information System (INIS)

    Grefe, Michael

    2011-11-01

    We confront the signals expected from unstable gravitino dark matter with observations of indirect dark matter detection experiments in all possible cosmic-ray channels. For this purpose we calculate in detail the gravitino decay widths in theories with bilinear violation of R parity, particularly focusing on decay channels with three particles in the final state. Based on these calculations we predict the fluxes of gamma rays, charged cosmic rays and neutrinos expected from decays of gravitino dark matter. Although the predicted spectra could in principal explain the anomalies observed in the cosmic ray positron and electron fluxes as measured by PAMELA and Fermi LAT, we find that this possibility is ruled out by strong constraints from gamma-ray and antiproton observations. Therefore, we employ current data of indirect detection experiments to place strong constraints on the gravitino lifetime and the strength of R-parity violation. In addition, we discuss the prospects of forthcoming searches for a gravitino signal in the spectrum of cosmic-ray antideuterons, finding that they are in particular sensitive to rather low gravitino masses. Finally, we discuss in detail the prospects for detecting a neutrino signal from gravitino dark matter decays, finding that the sensitivity of neutrino telescopes like IceCube is competitive to observations in other cosmic ray channels, especially for rather heavy gravitinos. Moreover, we discuss the prospects for a direct detection of gravitino dark matter via R-parity violating inelastic scatterings off nucleons. We find that, although the scattering cross section is considerably enhanced compared to the case of elastic gravitino scattering, the expected signal is many orders of magnitude too small in order to hope for a detection in underground detectors. (orig.)

  8. Unstable gravitino dark matter prospects for indirect and direct detection

    Energy Technology Data Exchange (ETDEWEB)

    Grefe, Michael

    2011-11-15

    We confront the signals expected from unstable gravitino dark matter with observations of indirect dark matter detection experiments in all possible cosmic-ray channels. For this purpose we calculate in detail the gravitino decay widths in theories with bilinear violation of R parity, particularly focusing on decay channels with three particles in the final state. Based on these calculations we predict the fluxes of gamma rays, charged cosmic rays and neutrinos expected from decays of gravitino dark matter. Although the predicted spectra could in principal explain the anomalies observed in the cosmic ray positron and electron fluxes as measured by PAMELA and Fermi LAT, we find that this possibility is ruled out by strong constraints from gamma-ray and antiproton observations. Therefore, we employ current data of indirect detection experiments to place strong constraints on the gravitino lifetime and the strength of R-parity violation. In addition, we discuss the prospects of forthcoming searches for a gravitino signal in the spectrum of cosmic-ray antideuterons, finding that they are in particular sensitive to rather low gravitino masses. Finally, we discuss in detail the prospects for detecting a neutrino signal from gravitino dark matter decays, finding that the sensitivity of neutrino telescopes like IceCube is competitive to observations in other cosmic ray channels, especially for rather heavy gravitinos. Moreover, we discuss the prospects for a direct detection of gravitino dark matter via R-parity violating inelastic scatterings off nucleons. We find that, although the scattering cross section is considerably enhanced compared to the case of elastic gravitino scattering, the expected signal is many orders of magnitude too small in order to hope for a detection in underground detectors. (orig.)

  9. Re-examining Prostate-specific Antigen (PSA) Density: Defining the Optimal PSA Range and Patients for Using PSA Density to Predict Prostate Cancer Using Extended Template Biopsy.

    Science.gov (United States)

    Jue, Joshua S; Barboza, Marcelo Panizzutti; Prakash, Nachiketh S; Venkatramani, Vivek; Sinha, Varsha R; Pavan, Nicola; Nahar, Bruno; Kanabur, Pratik; Ahdoot, Michael; Dong, Yan; Satyanarayana, Ramgopal; Parekh, Dipen J; Punnen, Sanoj

    2017-07-01

    To compare the predictive accuracy of prostate-specific antigen (PSA) density vs PSA across different PSA ranges and by prior biopsy status in a prospective cohort undergoing prostate biopsy. Men from a prospective trial underwent an extended template biopsy to evaluate for prostate cancer at 26 sites throughout the United States. The area under the receiver operating curve assessed the predictive accuracy of PSA density vs PSA across 3 PSA ranges (10 ng/mL). We also investigated the effect of varying the PSA density cutoffs on the detection of cancer and assessed the performance of PSA density vs PSA in men with or without a prior negative biopsy. Among 1290 patients, 585 (45%) and 284 (22%) men had prostate cancer and significant prostate cancer, respectively. PSA density performed better than PSA in detecting any prostate cancer within a PSA of 4-10 ng/mL (area under the receiver operating characteristic curve [AUC]: 0.70 vs 0.53, P PSA >10 mg/mL (AUC: 0.84 vs 0.65, P PSA density was significantly more predictive than PSA in detecting any prostate cancer in men without (AUC: 0.73 vs 0.67, P PSA increases, PSA density becomes a better marker for predicting prostate cancer compared with PSA alone. Additionally, PSA density performed better than PSA in men with a prior negative biopsy. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Decision analysis with cumulative prospect theory.

    Science.gov (United States)

    Bayoumi, A M; Redelmeier, D A

    2000-01-01

    Individuals sometimes express preferences that do not follow expected utility theory. Cumulative prospect theory adjusts for some phenomena by using decision weights rather than probabilities when analyzing a decision tree. The authors examined how probability transformations from cumulative prospect theory might alter a decision analysis of a prophylactic therapy in AIDS, eliciting utilities from patients with HIV infection (n = 75) and calculating expected outcomes using an established Markov model. They next focused on transformations of three sets of probabilities: 1) the probabilities used in calculating standard-gamble utility scores; 2) the probabilities of being in discrete Markov states; 3) the probabilities of transitioning between Markov states. The same prophylaxis strategy yielded the highest quality-adjusted survival under all transformations. For the average patient, prophylaxis appeared relatively less advantageous when standard-gamble utilities were transformed. Prophylaxis appeared relatively more advantageous when state probabilities were transformed and relatively less advantageous when transition probabilities were transformed. Transforming standard-gamble and transition probabilities simultaneously decreased the gain from prophylaxis by almost half. Sensitivity analysis indicated that even near-linear probability weighting transformations could substantially alter quality-adjusted survival estimates. The magnitude of benefit estimated in a decision-analytic model can change significantly after using cumulative prospect theory. Incorporating cumulative prospect theory into decision analysis can provide a form of sensitivity analysis and may help describe when people deviate from expected utility theory.

  11. Personality predicts recurrence of late-life depression.

    Science.gov (United States)

    Steunenberg, Bas; Beekman, Aartjan T F; Deeg, Dorly J H; Kerkhof, Ad J F M

    2010-06-01

    To examine the association of personality with recurrence of depression in later life. A subsample of 91 subjects from the Longitudinal Aging Study Amsterdam (LASA; baseline sample size n=3107; aged > or = 55 years) depressed at baseline, who had recovered in the course of three years (first follow-up cycle) was identified. 41 (45%) respondents experienced a recurrence during the subsequent six years. The influences of personality and late life stress (demographic factors, health and social factors) on recurrence were investigated prospectively. Recurrence of depression was associated with a high level of neuroticism and low level of mastery, residual depressive symptoms at time of recovery, female gender, pain complaints and feelings of loneliness. In multivariable analysis entering all predictors significant in single variable analysis, residual depressive symptoms and lack of mastery remained significantly associated with recurrence. In predicting the recurrence of depression in later life, the direct effects of personality remain important and comparable in strength with other late life stressors related to recurrence. Copyright 2009 Elsevier B.V. All rights reserved.

  12. Short-term stress, but not mucosal healing nor depression was predictive for the risk of relapse in patients with ulcerative colitis: a prospective 12-month follow-up study.

    Science.gov (United States)

    Langhorst, Jost; Hofstetter, Anna; Wolfe, Fred; Häuser, Winfried

    2013-10-01

    Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease. Psychological factors such as depression and stress are under debate to contribute to the risk of relapse. The impact of mucosal healing to reduce the risk of relapse had not been studied prospectively. The aim of this study was to identify whether depression and stress increase and mucosal healing reduces the risk of clinical relapse in patients with UC in clinical remission. Patients in clinical remission were followed prospectively for 1 year, or less if they relapsed. Endoscopy and histology score and long-term perceived stress (Perceived Stress Questionnaire) were measured at baseline. Mucosal healing was defined by a Mayo Endoscopy score of 0-1. Depression (Hospital Anxiety and Depression Scale) and acute perceived stress (Cohen Perceived Stress Scale) were measured at baseline and after 1, 3, 6, 9, and 12 months. A time-dependent multivariate Cox regression model determined the predictors of time to relapse. Seventy-five patients were included into final analysis, of which 28 (37.3%) relapsed. Short-term stress at the last visit before relapse (hazard ratio [HR] = 1.05, 95% confidence interval [CI] = 1.01-1.10) and male gender (HR = 2.38, 95% CI = 1.01-5.61), but not baseline mucosal healing (HR = 0.86, 95% CI = 0.35-2.11), baseline long-term stress (HR = 0.20, 95% CI = 0.01-3.31), and depression at the last visit before relapse (HR = 1.08, 95% CI = 0.95-1.22) were predictive for a relapse. Short-term stress but not depression nor mucosal healing was predictive for the risk of relapse in patients with UC in clinical remission. Larger multicentre studies are necessary to confirm our findings.

  13. Location-based prospective memory.

    Science.gov (United States)

    O'Rear, Andrea E; Radvansky, Gabriel A

    2018-02-01

    This study explores location-based prospective memory. People often have to remember to do things when in a particular location, such as buying tissues the next time they are in the supermarket. For event cognition theory, location is important for structuring events. However, because event cognition has not been used to examine prospective memory, the question remains of how multiple events will influence prospective memory performance. In our experiments, people delivered messages from store to store in a virtual shopping mall as an ongoing task. The prospective tasks were to do certain activities in certain stores. For Experiment 1, each trial involved one prospective memory task to be done in a single location at one of three delays. The virtual environment and location cues were effective for prospective memory, and performance was unaffected by delay. For Experiment 2, each trial involved two prospective memory tasks, given in either one or two instruction locations, and to be done in either one or two store locations. There was improved performance when people received instructions from two locations and did both tasks in one location relative to other combinations. This demonstrates that location-based event structure influences how well people perform on prospective memory tasks.

  14. Adolescent Eating Disorders Predict Psychiatric, High-Risk Behaviors and Weight Outcomes in Young Adulthood

    Science.gov (United States)

    Micali, Nadia; Solmi, Francesca; Horton, Nicholas J.; Crosby, Ross D.; Eddy, Kamryn T.; Calzo, Jerel P.; Sonneville, Kendrin R.; Swanson, Sonja A.; Field, Alison E.

    2015-01-01

    Objective To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm. Method Eating disorders were ascertained at 14 and 16 years of age in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years following predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome. Results All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR]=1.39 [95% CIs: 1.00-1.94]; BN: OR=3.39[1.25-9.20]; BED: OR=2.00 [1.06-3.75]; PD: OR=2.56 [1.38-4.74]). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR=5.72[2.22-14.72], PD: OR=4.88[2.78-8.57], subthreshold BN: OR=3.97[1.44-10.98], subthreshold BED: OR=2.32[1.43-3.75]). Whilst BED and BN predicted obesity (respectively OR=3.58 [1.06-12.14] and OR=6.42 [1.69-24.30]), AN was prospectively associated with underweight. Conclusions Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders among adolescents. PMID:26210334

  15. Adolescents' prospective screen time by gender and parental education, the mediation of parental influences.

    Science.gov (United States)

    Totland, Torunn H; Bjelland, Mona; Lien, Nanna; Bergh, Ingunn H; Gebremariam, Mekdes K; Grydeland, May; Ommundsen, Yngvar; Andersen, Lene F

    2013-07-06

    The present study investigated associations in gender dyads of parents' and adolescents' time spent on television and video viewing (TV/DVD), and computer and electronic game use (PC/games) at the ages of 11 and 13 years. Possible mediating effects of parental modelling and parental regulation in the relationship between parental education and adolescents' prospective TV/DVD and PC/game time were further examined. A total of 908 adolescents, participating at both ages 11 and 13 years in the Norwegian HEalth In Adolescents (HEIA) cohort study (2007-2009), were included in the analyses. Data on adolescents', mothers' and fathers' self reported time spent on TV/DVD and PC/games were measured at both time points by questionnaires. Correlation coefficients were used to examine gender dyads of parents' and adolescents' reports. Mediation analyses using linear regression investigated possible mediation effects of parental modelling and parental regulation in the prospective relationship between parental education and adolescents' time spent on TV/DVD and PC/games between the ages of 11 and 13 years. Correlations of screen time behaviours in gender dyads of parents and adolescents showed significant associations in time spent on TV/DVD at the age of 11 and 13 years. Associations between mothers and sons and between fathers and daughters were also observed in time spent on PC/games at the age of 11 years. Maternal and paternal modelling was further found to mediate the relationship between parental education and adolescents' prospective TV/DVD time between the ages of 11 and 13 years. No mediation effect was observed for parental regulation, however a decrease in both maternal and paternal regulation at the age of 11 years significantly predicted more TV/DVD time among adolescents at the age of 13 years. Cross-sectional and longitudinal relationships were observed in gender dyads of parents' and adolescents' screen time behaviours at the ages of 11 and 13 years, and further

  16. Adolescents’ prospective screen time by gender and parental education, the mediation of parental influences

    Science.gov (United States)

    2013-01-01

    Background The present study investigated associations in gender dyads of parents’ and adolescents’ time spent on television and video viewing (TV/DVD), and computer and electronic game use (PC/games) at the ages of 11 and 13 years. Possible mediating effects of parental modelling and parental regulation in the relationship between parental education and adolescents’ prospective TV/DVD and PC/game time were further examined. Methods A total of 908 adolescents, participating at both ages 11 and 13 years in the Norwegian HEalth In Adolescents (HEIA) cohort study (2007–2009), were included in the analyses. Data on adolescents’, mothers’ and fathers’ self reported time spent on TV/DVD and PC/games were measured at both time points by questionnaires. Correlation coefficients were used to examine gender dyads of parents’ and adolescents’ reports. Mediation analyses using linear regression investigated possible mediation effects of parental modelling and parental regulation in the prospective relationship between parental education and adolescents’ time spent on TV/DVD and PC/games between the ages of 11 and 13 years. Results Correlations of screen time behaviours in gender dyads of parents and adolescents showed significant associations in time spent on TV/DVD at the age of 11 and 13 years. Associations between mothers and sons and between fathers and daughters were also observed in time spent on PC/games at the age of 11 years. Maternal and paternal modelling was further found to mediate the relationship between parental education and adolescents’ prospective TV/DVD time between the ages of 11 and 13 years. No mediation effect was observed for parental regulation, however a decrease in both maternal and paternal regulation at the age of 11 years significantly predicted more TV/DVD time among adolescents at the age of 13 years. Conclusion Cross-sectional and longitudinal relationships were observed in gender dyads of parents’ and adolescents

  17. Childhood emotional maltreatment as a robust predictor of suicidal ideation: A multi-wave, prospective investigation

    Science.gov (United States)

    Miller, Adam Bryant; Jenness, Jessica L.; Oppenheimer, Caroline W.; Barrocas Gottleib, Andrea L.; Young, Jami F.; Hankin, Benjamin L.

    2016-01-01

    Despite literature suggesting a relationship between child maltreatment and suicidal ideation, few studies have examined the prospective course of this relationship. The current study examined this relationship in a sample of 682 community youth who were followed over the course of 3 years. Repeated measures of suicidal ideation, emotional maltreatment, and depressive symptom severity were examined in multi-wave path analysis models. Overall, results suggest that emotional maltreatment over time contributes uniquely to the prospective prediction of suicidal ideation, even when controlling for age, previous suicidal ideation, biological sex, and depression symptom severity. Unlike previous studies that have only measured emotional maltreatment at one-time point, the current study demonstrates that emotional maltreatment contributes unique risk to suicidal ideation prospectively among youth. Results speak to the importance of examining emotional maltreatment and suicidal ideation within prospective models of risk and suggest that emotional maltreatment is a robust predictor of suicidal ideation, over and above history of suicidal ideation and depression. PMID:27032784

  18. Percutaneous CT-guided lung biopsy: sequential versus spiral scanning. A randomized prospective study

    International Nuclear Information System (INIS)

    Ghaye, B.; Dondelinger, R.F.; Dewe, W.

    1999-01-01

    The aim of this study was to evaluate in a prospective and randomized study spiral versus sequential scanning in the guidance of percutaneous lung biopsy. Fifty thoracic lesions occurring in 48 patients were biopsied by a senior and a junior operator. Six different time segments of the procedure were measured. Scanning mode versus length of procedure, pathological results, irradiation and complications were evaluated. Total duration of the procedure and of the first sampling was significantly longer with spiral CT for the senior operator (p < 0.004). No significant time difference was observed for the junior operator. Diameter of the lesion, depth of location, position of the patient and needle entry site did not influence the results. The sensitivity was 90.9, specificity 100, positive predictive value 100 and negative predictive value 60 % for spiral CT, and 94.7, 100, 100 and 85.7 % for sequential CT, respectively. Eleven pneumothoraces and ten perinodular hemorrhages were seen with spiral CT and six and ten, respectively, with sequential CT. The mean dose of irradiation was 4027 mAs for spiral CT and 2358 mAs for conventional CT. Spiral CT does neither reduce procedure time nor the rate of complications. Pathological results do not differ compared with sequential CT, and total dose of irradiation is higher with spiral scanning. (orig.)

  19. Can Clinical and Surgical Parameters Be Combined to Predict How Long It Will Take a Tibia Fracture to Heal? A Prospective Multicentre Observational Study: The FRACTING Study

    Directory of Open Access Journals (Sweden)

    Leo Massari

    2018-01-01

    Full Text Available Background. Healing of tibia fractures occurs over a wide time range of months, with a number of risk factors contributing to prolonged healing. In this prospective, multicentre, observational study, we investigated the capability of FRACTING (tibia FRACTure prediction healING days score, calculated soon after tibia fracture treatment, to predict healing time. Methods. The study included 363 patients. Information on patient health, fracture morphology, and surgical treatment adopted were combined to calculate the FRACTING score. Fractures were considered healed when the patient was able to fully weight-bear without pain. Results. 319 fractures (88% healed within 12 months from treatment. Forty-four fractures healed after 12 months or underwent a second surgery. FRACTING score positively correlated with days to healing: r=0.63 (p<0.0001. Average score value was 7.3 ± 2.5; ROC analysis showed strong reliability of the score in separating patients healing before versus after 6 months: AUC = 0.823. Conclusions. This study shows that the FRACTING score can be employed both to predict months needed for fracture healing and to identify immediately after treatment patients at risk of prolonged healing. In patients with high score values, new pharmacological and nonpharmacological treatments to enhance osteogenesis could be tested selectively, which may finally result in reduced disability time and health cost savings.

  20. Predicting and influencing voice therapy adherence using social-cognitive factors and mobile video.

    Science.gov (United States)

    van Leer, Eva; Connor, Nadine P

    2015-05-01

    Patient adherence to voice therapy is an established challenge. The purpose of this study was (a) to examine whether adherence to treatment could be predicted from three social-cognitive factors measured at treatment onset: self-efficacy, goal commitment, and the therapeutic alliance, and (b) to test whether the provision of clinician, self-, and peer model mobile treatment videos on MP4 players would influence the same triad of social cognitive factors and the adherence behavior of patients. Forty adults with adducted hyperfunction with and without benign lesions were prospectively randomized to either 4 sessions of voice therapy enhanced by MP4 support or without MP4 support. Adherence between sessions was assessed through self-report. Social cognitive factors and voice outcomes were assessed at the beginning and end of therapy. Utility of MP4 support was assessed via interviews. Self-efficacy and the therapeutic alliance predicted a significant amount of adherence variance. MP4 support significantly increased generalization, self-efficacy for generalization, and the therapeutic alliance. An interaction effect demonstrated that MP4 support was particularly effective for patients who started therapy with poor self-efficacy for generalization. Adherence may be predicted and influenced via social-cognitive means. Mobile technology can extend therapy to extraclinical settings.